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
North Dakota’s RHTP Program
Key Initiatives & Focus Areas
- Telehealth expansion across frontier communities
- Behavioral health and substance use treatment
- Health IT modernization and interoperability
- Rural workforce recruitment and retention
- Critical Access Hospital transformation
Unique Aspects of North Dakota’s Program
- One of the most rural states in the nation by percentage of population
- Extreme distances and harsh winters create year-round access challenges
- Oil industry workforce creates unique health needs in western ND
- Strong Critical Access Hospital network as healthcare backbone
- Tribal communities (Standing Rock, Turtle Mountain) with specific health needs
How Technology Supports RHTP in North Dakota
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 North Dakota:
- 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 North Dakota 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 North Dakota
RHTP funds flow from CMS to North Dakota 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 North Dakota should contact North Dakota Department of Health and Human 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 North Dakota
How much RHTP funding did North Dakota receive?
North Dakota received RHTP funding as part of the FY2026 allocation. As one of the most rural states in the nation, North Dakota's allocation reflects significant frontier healthcare needs.
What is North Dakota's RHTP?
North Dakota's RHTP addresses the state's frontier healthcare challenges, focusing on telehealth, behavioral health, health IT modernization, workforce development, and Critical Access Hospital transformation.
Who is eligible for RHTP in North Dakota?
Eligible organizations include Critical Access Hospitals, FQHCs, Rural Health Clinics, tribal health facilities, behavioral health providers, EMS agencies, and other rural healthcare organizations.
What technology does North Dakota's RHTP fund?
North Dakota's RHTP supports telehealth infrastructure, EHR modernization, health information exchange, remote patient monitoring, and cybersecurity for rural and frontier providers.
How does RHTP support North Dakota's tribal communities?
RHTP funds can support telehealth, behavioral health, health IT, and workforce development at tribal health facilities serving Standing Rock, Turtle Mountain, and other North Dakota tribal communities.
How can ND providers apply for RHTP?
North Dakota providers should contact DHHS for RHTP subrecipient information and monitor state announcements for application opportunities.
Ready to Build RHTP-Ready Infrastructure in North Dakota?
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.