Arizona Rural Health Transformation Program Toolkit

Overview: The 870-page H.R. 1, also known as the One Big Beautiful Bill Act (OBBBA), was signed into law 7/4/25. The 17-page Title VII, Sec. 71401 of H.R. 1, details the Rural Health Transformation Program (RHTP). It stipulates $10 billion per year for five fiscal years 2026-30. Half will be distributed to states equally, $100 million/yr X 5, with the other half based on metrics such as % of a state’s rural population compared to other states and the nation. CMS encouraged states to submit their budget for $200 M/yr. X 5 ($1B). RHTP funding is in the mandatory side of the federal budget and administered by CMS (like Medicare), so funding is not subject to continuing resolution delays.

Arizona’s AHTP Plan: the Governor’s Office submitted its $200M/yr ($1B over 5 yrs) RHTP proposal 11/5/2025 as did each of the other 49 states. CMS announced the awards on 12/29/2025. Arizona received $166,988,956 in funding for FY26, which ranked 22^nd of the states in terms of funding per rural resident, but the sixth lowest of all states overall. States will have 2 years to spend their Year 1 awards.

Next Steps: Arizona submitted its revised narrative (74-pagse) and budget on 1/30/2026. CMS has 30 days to modify and approve state proposals. State of Arizona will release notices of funding opportunity (NOFOs) or Requests for Proposals (RFPs) – likely starting in March/April.

% of $167 M Budget, Priority Area, and State Agency Responsible

I. (28%) Rural Health Education & Training – Office of Economic Opportunity (OEO)

II. (16%) Priority Health Initiative Grants

a. (6%) Behavioral Health & Substance Use Disorder Grants (AHCCCS)

b. (3%) Maternal Health Grants (ADHS)

c. (7%) Chronic Disease Prevention & Management Grants (ADHS)

III. (23%) Making Rural Health Care Accessible (AHCCCS)

a. (10%) Telehealth, Digital Transformation

b. (13%) Rural Health Innovation – Mobile Care, Satellite Sites

IV. (23%) Making Rural Health Resilient – Medical Equipment, Technology (AHCCCS)

a. (18%) Medical Diagnostic Equipment, Technology, EHR

b. (3%) Adopt Shared Services Consortiums

c. (2%) Technical Assistance for Operational & Fiscal Performance

IDC Cap Mandated at 10% or less of the total award: State Agency (3%), Successful Awardee (7%)

The Centers for Medicare & Medicaid Services (CMS) approved the State of Arizona’s Rural Health Transformation revised Plan Narrative (74-pages) and detailed budget (78 pages). Those documents, as well as a two-page summary, and 18-slide PPT webinar are published on the AHCCCS RHTP website at: https://www.azahcccs.gov/AHCCCS/Initiatives/RHTP/

The AHCCCS RHTP website will post the NOFOs, RFPs by the 3 state agencies identified by the Governor’s Office assigned to administer the priorities (AHCCCS, OEO, ADHS).

You can stay up to date on the AZ RHT implementation and register for the Center for Rural Health’s 52^nd Annual Rural Health Conference at the NAU High Country Conference Center is here:

https://crh.arizona.edu/events/52nd-annual-arizona-rural-health-conference.

We invited the 3 lead state agencies to present (OEO, AHDS, AHCCCS) at the conference June 2-3 in Flagstaff.

As the State Office of Rural Health, the Arizona Center for Rural Health can offer resources, like letters of support, to Arizona organizations who are writing rural-focused grant applications. If you are interested in a letter of support from us, please submit the request form. A link to an open funding opportunity is required.

AHCCCS - Adopt Shared Services Consortiums: Due August 28

This competitive grant opportunity is funded through the CMS RHTP and is intended to support the development and implementation of shared service models that reduce operational costs, eliminate duplication, and strengthen the collective capacity of rural healthcare organizations across rural and rural Tribal communities in Arizona. Funded projects will support:

Shared staffing models, including joint employment arrangements, traveling clinician programs, shared administrative personnel, and locum tenens
Shared training programs, including joint continuing education, simulation training centers, competency development, and cross-training
Shared data systems, including joint IT infrastructure, shared billing/coding services, centralized data analytics, and common scheduling platforms
Shared facilities, including co-located service hubs, shared specialty clinic space, joint equipment utilization, and collaborative care sites
Joint purchasing arrangements, shared supply chain management, and equipment procurement cooperatives
Shared compliance functions, including shared compliance officers, joint audit preparation, and coordinated regulatory reporting

Visit Grant Application Page

AHCCCS - Behavioral Health & SUD Expansion: Due August 31

This competitive grant opportunity is funded through the CMS RHTP and is intended to support the expansion of behavioral health access, workforce development, and community prevention programming across rural and rural Tribal communities in Arizona. This RFGA consolidates three program areas under a single funding opportunity. Funded projects will support:

Deployment of mobile and digital behavioral health services and crisis stabilization infrastructure in rural communities
Training, recruitment, and retention of behavioral health professionals in rural shortage areas
Evidence-based prevention programming addressing suicide, trauma, and substance use for youth and adults in rural and Tribal communities

View the Grant Opportunity

AHCCCS Opioid Antagonist Distribution Initiative RFGA Released: Due August 7

Provides rural counties, Tribal communities, small fire districts, and frontier clinics with expanded capacity to prevent and respond to opioid overdoses.

Funded activities include:

procurement and distribution of opioid antagonist kits such as naloxone for first responders, rural clinics, Tribal community health representatives, school nurses, and community partners;
overdose recognition and response training for volunteer EMS, rural firefighters, and county public health workers;
rural readiness support such as medication storage and emergency communications;
Tribal partnership support to equip community members and paraprofessional responders with localized overdose prevention protocols.

Visit Grant Application page

AHCCCS Rural Health Innovative Care Pilot Program RFGA released: Due August 21

Application deadline August 21

OVERVIEW

The Arizona Health Care Cost Containment System (AHCCCS) hereby issues this Request for Grant Applications (RFGA) for the support of the Rural Health Innovative Care Pilot Program, under the Arizona RHTP.

This competitive grant opportunity is funded through the CMS RHTP and is intended to increase long-term access points to rural health care for preventive, specialty, and primary care services by piloting innovative care models and technologies, and alternative payment approaches across rural and rural Tribal communities in Arizona.

Funded projects will support:

Mobile and satellite service expansion for preventive, specialty, and primary care delivery in remote areas
Innovative and alternative care models, including community health worker programs, diversion models, in-home services, and traditional healing supports
Alternative payment and value-based care adoption initiatives to incentivize quality and efficiency in rural health delivery

These investments are intended to increase long-term rural health access points, strengthen the sustainability of healthcare delivery across rural and rural Tribal communities in Arizona, and support measurable improvements in access to care, service utilization, and population health outcomes.

Visit Grant Application page

AHCCCS Technical Assistance for Operational & Fiscal Performance RFGA Released: Due August 21

Application due August 21

OVERVIEW

The Arizona Health Care Cost Containment System (AHCCCS) hereby issues this Request for Grant Applications (RFGA) for the support of Technical Assistance for Operational & Fiscal Performance, under the Arizona RHTP.

This competitive grant opportunity is funded through the CMS RHTP and is intended to support targeted technical assistance for operational improvement, financial management, and network administration across rural and rural Tribal communities in Arizona. Funded projects will support:

Operational Improvement: Workflow optimization, process redesign, quality improvement initiatives, performance benchmarking, and efficiency assessments
Financial Management: Revenue cycle optimization, billing and coding support, cost accounting, financial planning, and sustainability assessments
Network Administration: Support for forming integrated rural health networks, governance development, legal/regulatory compliance assistance, and affiliation agreements
Value-Based Care (VBC) Readiness: Training on quality metrics, risk stratification, population health management, and participation in alternative payment models
Compliance Support: Federal grant requirements, audit preparation, reporting systems, and internal controls development.

These investments are intended to build local capacity, improve fiscal sustainability, and support the formation of integrated rural health networks. Costs are critical to ensure long-term viability and compliance with federal and state performance standards.

Visit Grant Application page