Governor Gianforte, DPHHS Announce $239.7 Million Second-Year Award to Strengthen Rural Health Care

Funding builds on first-year investments in emergency services, provider partnerships, and access to care

Governor's Office

HELENA, Mont. - Governor Greg Gianforte and Department of Public Health and Human Services (DPHHS) Director Douglas Harrington, MD, today announced Montana has received $239.7 million from the Trump Administration for the second year of the Rural Health Transformation Program (RHTP).

The award will support efforts to strengthen rural health care, expand access to services closer to home, and help providers build financially sustainable operations. It is the second annual award under a five-year federal program administered by the Centers for Medicare & Medicaid Services (CMS). CMS announced the year two award figure on November 6, 2026. Montana received the third-highest second year funding award among all 50 states and the third-highest funding increase from year one to year two.

"Montanans should be able to get quality health care without leaving the communities they call home," Gov. Gianforte said. "This investment builds on the partnerships we established in the first year of the Rural Health Transformation Program to strengthen emergency services, support our rural health care workforce, and help local providers deliver care for years to come."

CMS Administrator Dr. Mehmet Oz praised Montana's continued work to make enduring advancements to rural health.

"The Trump Administration's $50 billion Rural Health Transformation Program gives states the resources and flexibility to bring care closer to home and build stronger, more sustainable health care systems for their rural communities," said CMS Administrator Dr. Mehmet Oz. "As the program enters its second year, this next round of funding will help Montana build on the progress made in year one and continue working toward lasting improvements in access, quality, and health outcomes for rural communities."

Montana's year two award builds upon the State's complete obligation of $233 million in year one funds - an initial grant that ranked Montana fourth highest among all 50 states in total federal allocation due to the strength and quality of the State's strategic plan.

"The increased award reflects our first-year performance, a clear plan for year two, and the hard work of Montana's RHTP team," Dir. Harrington said. "In the first year, we built partnerships, committed funds, and put tools in place to support long-term improvements. In year two, we will build on that foundation to help rural facilities strengthen their operations, modernize health records, and expand access to care in rural and tribal communities."

Key Year One Accomplishments and Strategic Progress

During year one, DPHHS focused on groundwork, immediate equipment deployments, and broad stakeholder engagement to guide long-term investments:

• Partnerships with implementing partners: Through competitive procurements, direct grants, and engagement with other State partners, DPHHS selected the key partners who will support the State in turning RHTP funding into meaningful improvements in health access, sustainability, and outcomes, laying the groundwork for future success.
• Immediate support to rural EMS: DPHHS issued $10.8 million in grant funding for upgraded ambulances and equipment for EMS agencies located in or serving rural Montana.
• Expanding community-based care: DPHHS awarded $3.6 million to 17 emergency medical services agencies to establish or expand Community Integrated Health programs, which provide services such as in-home care, chronic disease support, and follow-up after hospital discharge in rural and frontier communities.
• Strengthening rural provider sustainability: The State established a Rural Health Center of Excellence (CoE) framework, appointed a 25-member advisory council to guide strategies for maintaining access to rural health care, and selected the two partners who will conduct the critical work: one to carry out CoE analysis and generate recommendations for facilities, and one to lead implementation of those recommendations.
• Stakeholder-driven enhancements: Convened the RHTP Stakeholder Advisory Committee to gather feedback from State health care leaders and rural advocates. In direct response to Committee input highlighting maternal health needs, DPHHS expanded year two programming to include a targeted home-visiting pilot program for new and expecting parents.
• Tribal outreach and collaboration: Dedicated Tribal Liaisons met with tribal leadership across Montana to share program opportunities and gather feedback to guide the design and rollout of the Community Health Aide Program (CHAP).

Year Two Focus Areas and Groundwork Expansion

Year two will transition foundational planning into operational expansion across state and tribal health systems:

• RHTP Center of Excellence (CoE): The contracted analytical experts will begin their work to produce community access assessments for rural areas and corollary recommendations for facility sustainability. The application process for facilities interested in participating in CoE work will be announced by the end of the year.
• Technology and Electronic Health Record (EHR) modernization: Launching the first wave of EHR modernization grants to help rural providers upgrade systems, enhance data sharing, and streamline patient care coordination.
• Tribal health and CHAP rollout: Expanding community health strengthening efforts across tribal nations to improve emergent, acute, and chronic care access, supporting the launch of the CHAP framework, and expanding workforce training programs such as Caring for Our Own.
• Workforce development initiatives: Partnering with State education and workforce entities to expand clinical training pipelines, recruitment incentives, and retention initiatives for rural providers.

Program Framework and Five Core Initiatives

The federal Rural Health Transformation provides $50 billion nationally over five years, with $10 billion available annually from federal fiscal year 2026 through 2030. Half of the funding is divided equally among states with approved plans. The remainder is allocated based on factors including rural population and health system characteristics, State policy actions, and proposed initiatives.

Montana's transformation strategy centers on five core initiatives: workforce development, sustainable access, innovative care models, community health and prevention, and technology innovation. Per CMS rules, initiatives cannot be added or removed, though funding, goals, and timelines within them can be adjusted.

For more information about Montana's Rural Health Transformation Program, visit ruralhealth.mt.gov . Further details on national RHTP funding announcements are available on the Centers for Medicare & Medicaid Services website here .

The Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $473,250,028.01 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

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