What Is the Rural Health Transformation Program?
The Rural Health Transformation Program (RHTP) is a landmark $50 billion federal initiative created under Section 71401 of the One Big Beautiful Bill Act (Public Law 119-21). Administered by CMS, the program distributes $10 billion annually from FY2026 through FY2030 to all 50 states through cooperative agreements — no state matching funds required.
RHTP is designed to transform rural healthcare by investing in infrastructure, technology, workforce, and care delivery models that create lasting, sustainable improvements for rural communities. Learn more about RHTP on our hub page.
Five Strategic Goals
California’s RHTP Program
Key Initiatives & Focus Areas
- Telehealth and broadband connectivity for rural and frontier communities
- Behavioral health integration and substance use treatment
- Health IT modernization and interoperability across rural networks
- Rural workforce pipeline and training programs
- Community health worker expansion
Unique Aspects of California’s Program
- Despite being the most populous state, California has significant rural health disparities in its northern, eastern, and central valley regions
- Existing CalAIM initiative creates synergy opportunities with RHTP
- Strong state health information exchange infrastructure to build upon
- Large agricultural workforce with unique occupational health needs
- Wildfire and climate-related health challenges in rural communities
How Technology Supports RHTP in California
The Interoperability Challenge
Rural healthcare facilities face significant technology gaps compared to their urban counterparts. Nationally, only 48% of rural hospitals have achieved basic interoperability, compared to 62% of urban hospitals. This data-sharing gap directly impacts care quality, coordination, and outcomes for rural patients.
RHTP’s Strategic Goal 5 specifically targets technology innovation, including a Technology Innovation Catalyst Fund that supports interoperability, telehealth, remote patient monitoring, AI-enabled health tools, and cybersecurity.
How Julota Addresses RHTP Technology Requirements
Julota is a cloud-based SaaS interoperability platform purpose-built for the challenges rural healthcare organizations face. Here’s how Julota supports RHTP goals in California:
- FHIR-Native Interoperability: Julota’s platform supports HL7 FHIR APIs and G10 compliance, meeting the interoperability standards required by RHTP and the 21st Century Cures Act. Learn about Julota’s platform.
- Health Information Exchange Connectivity: Connect rural providers across California to state and regional HIEs, enabling real-time data sharing that improves care coordination and reduces duplication.
- Care Coordination & Closed-Loop Referrals: Julota’s closed-loop referral management ensures patients don’t fall through the cracks — critical for rural communities where follow-up can require long-distance travel.
- MIH-CP & Community Paramedicine Support: Julota’s MIH-CP solution supports the mobile integrated health and community paramedicine models that many states are funding under RHTP.
RHTP Eligibility in California
RHTP funds flow from CMS to California through a cooperative agreement. The state then distributes funds to eligible subrecipients through competitive processes.
Eligible Organization Types
- Critical Access Hospitals (CAHs) — Rural hospitals with 25 or fewer beds
- Federally Qualified Health Centers (FQHCs) — Community health centers serving underserved populations
- Rural Health Clinics (RHCs) — Clinics in designated shortage areas
- Community Behavioral Health Providers — Including Certified Community Behavioral Health Clinics (CCBHCs)
- Emergency Medical Services (EMS) — Ambulance services and first responders
- Tribal Health Organizations — Indian Health Service and tribal facilities
- Local Health Departments — County and regional public health agencies
- Universities and Training Programs — Workforce development partners
How to Apply
Organizations in California should contact California Department of Health Care Services for subrecipient application details. Most states distribute RHTP funds through competitive RFP processes that require demonstrating alignment with the state’s approved Rural Health Transformation Plan.
Key compliance requirements include SAM.gov registration, adherence to 2 CFR 200 uniform guidance, and commitment to quarterly and annual reporting on performance metrics and milestones.
Key Questions About RHTP in California
How much RHTP funding did California receive?
California received RHTP funding as part of the $10 billion FY2026 allocation, with the amount reflecting its rural population, health outcomes, and transformation plan. Despite its urban reputation, California has millions of rural residents.
What is California's Rural Health Transformation Program?
California's RHTP addresses rural health disparities across the state's northern, eastern, and Central Valley regions, focusing on telehealth, behavioral health, workforce development, and health IT modernization.
Who is eligible for RHTP in California?
Eligible organizations include Critical Access Hospitals, FQHCs, Rural Health Clinics, community behavioral health centers, tribal health facilities, EMS agencies, and other rural healthcare providers across California.
How does California's RHTP relate to CalAIM?
California's RHTP creates synergy with the CalAIM initiative by extending whole-person care models to rural communities, supporting interoperability between rural providers and the broader state health system.
What technology does California's RHTP fund?
California's RHTP supports broadband connectivity, telehealth infrastructure, EHR modernization, health information exchange integration, remote patient monitoring, and cybersecurity improvements for rural facilities.
How does RHTP address California's agricultural workforce health?
RHTP funds can support mobile health units, community health worker programs, and telehealth services tailored to agricultural workers in California's Central Valley and other rural farming communities.
Ready to Build RHTP-Ready Infrastructure in California?
Julota helps rural healthcare organizations meet RHTP interoperability requirements with a cloud-based platform that connects providers, enables data sharing, and supports care coordination across your community.