Rural Health Transformation Program

Overview

We want to hear from you!  Please see the Department of Social Services’ webpage at this link for public comment opportunities.

Federal law in Public Law (PL) 119-21, also known as H.R. 1, section 71401 (posted at this link), creates a new Rural Health Transformation Program (RHTP). All fifty states can submit a one-time grant application to the U.S. Centers for Medicare and Medicaid Services (CMS). Based on the federal law funding formula ($10 billion annually for five years, half split evenly across all states with approved applications and half allocated by CMS based on various factors), it is anticipated that Connecticut, upon federal approval of the application, will receive at least $100 million per year for five years starting in 2026.

The State of Connecticut Department of Social Services (DSS) is collaborating with several state agencies in preparing Connecticut’s RHTP grant application, including the Offices of the Governor (OTG), Policy and Management (OPM), Rural Health (ORH), Health Strategy (OHS), and the Departments of Public Health (DPH), Mental Health and Addiction Services (DMHAS), and Children and Families (DCF). Our goal is to leverage RHTP to improve the health of residents in rural areas of the state.

Federal Requirements – Rural Health Transformation Plan

The state must submit a Rural Health Transformation Plan as part of its RHTP grant application, which must include all of these specific topics detailed in federal law:

  • Improve access to hospitals, other health care providers, and health care items and services furnished to rural residents of the state;
  • Improve health care outcomes of rural residents of the state; 
  • Prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management;
  • Initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals and other health care providers in order to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery; 
  • Enhance economic opportunity for, and the supply of, health care clinicians through enhanced recruitment and training; 
  • Prioritize data and technology driven solutions that help rural hospitals and other rural health care providers furnish high-quality health care services as close to a patient’s home as is possible;
  • Outline strategies to manage long-term financial solvency and operating models of rural hospitals in the state; and
  • Identify specific causes driving the accelerating rate of stand-alone rural hospitals becoming at risk of closure, conversion, or service reduction.

Federal Requirements – Allowable Uses of Grant Funds

Federal law provides specific rules on the allowable uses of RHTP funds, which CMS grouped into five categories:

  • Make rural America healthy again
  • Sustainable access
  • Workforce development
  • Innovative care
  • Tech innovation 

Specifically, states must use RHTP funds for three or more of the approved uses of funds:

  • Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
  • Providing payments to health care providers for the provision of health care items or services, as specified by the Administrator.
  • Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.
  • Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
  • Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of five years.
  • Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
  • Assisting rural communities to right size their health care delivery systems by identifying needed preventive, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
  • Supporting access to opioid use disorder treatment services, other substance use disorder treatment services, and mental health services.
  • Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
  • Additional uses designed to promote sustainable access to high quality rural health care services, as determined by the Administrator.

For more information about federal rules for RHTP, including a link to the CMS Notice of Funding Opportunity, please see the CMS webpage at this link. 

State Priorities

In addition to federal rules, Connecticut’s initial priorities for the RHTP are activities that:

  • Benefit the health of residents living in the state’s rural areas, focused on interventions with long-term benefits;
  • Can be accomplished within the established demonstration period consistent with federal requirements for the RHTP; and
  • Demonstrate long-term scalability and financial sustainability, such as by maximizing other available resources and without necessarily requiring new state funding.