Frequently Asked Questions
Frequently Asked Questions
- CoE - Rural Health Center of Excellence
- CMS - Centers for Medicare & Medicaid Services
- DPHHS - Department of Public Health and Human Services
- HRSA - Health Resources and Services Administration
- NOFO - Notice of Funding Opportunity
- RHTP - Rural Health Transformation Program
- SAC - Stakeholder Advisory Committee
Montana aims to provide all residents with affordable, high-quality care regardless of geography. The State’s RHTP plan tackles rural health disparities through five core initiatives: workforce development, sustainable access, innovative care models, community health and prevention, and technology innovation.
Eligibility varies by initiative, but typical applicants include tribal nations, government agencies, health care providers, educational institutions, nonprofits, and other partners capable of implementing rural health projects.
The State is currently designing its RHTP fund distribution plans, which must comply with state procurement rules. Most initiatives will involve competitive bidding via bids.mt.gov, while others may use government-to-government contracts with another state agency (for example, the Department of Labor and Industry) or grant applications. If direct funding opportunities for communities and providers become available, they will be announced at ruralhealth.mt.gov.
Each funding opportunity will specify review criteria and selection processes aligned with Centers for Medicare & Medicaid Services (CMS) requirements, such as rural impact, feasibility, sustainability, and budget effectiveness.
CMS uses Health Resources and Services Administration (HRSA) standards, classifying 51 of Montana’s 56 counties as non-metropolitan. Specific census tracts within the five metropolitan counties (Cascade, Gallatin, Lewis and Clark, Missoula, and Yellowstone) may also qualify. While initiatives must focus on rural health, they can include non-rural areas if they significantly benefit rural populations.
Yes, provided the work demonstrably benefits rural communities. Initiatives must focus on rural health but can include non-rural regions if the rural impact is clear.
Yes. The Department of Public Health and Human Services (DPHHS) initiatives submitted on Nov. 5, 2025 are final and funded as awarded. Per CMS rules, initiatives cannot be added or removed, though the state may adjust funding, goals, and timelines within them.
Part of the second initiative, the CoE is a time-bound program providing data-backed, tailored recommendations to improve rural health facility sustainability and care delivery. Facilities can opt in to receive financial incentives for implementing these transformation plans. For details, see Montana’s RHTP Project Narrative.
The RHTP receives annual funding over five budget periods. Funds must be used by the end of the following period or they will be redistributed to other states. While Montana may distribute funds via subawards or subcontracts to execute initiatives, specific decisions have not yet been made. All efforts prioritize sustainability and impact beyond the five-year grant term.
CMS prohibits using RHTP funds for construction, major building projects, cosmetic upgrades, independent research, or restricted telecommunications equipment. Additionally, funds cannot supplant existing funding streams. For a complete list of restrictions, see pages 18-22 of the NOFO and the CMS FAQ (PDF).