Key Takeaways
- The RHT Program is a $50 billion investment focused on long-term rural health system transformation, not short-term funding.
- Local health departments are essential partners in RHT success, providing community trust, operational readiness, and on-the-ground execution.
- County-level data reporting is required under RHT, making strong data infrastructure and EHR readiness critical for funding eligibility.
- RHT funding priorities closely align with local health department work in prevention, behavioral health, workforce support, and technology modernization.
- States are more competitive when local health departments can demonstrate readiness, implementation progress, and measurable outcomes.
The Rural Health Transformation (RHT) Program represents a once-in-a-generation opportunity to reshape healthcare delivery across rural America. With $50 billion distributed over five years, RHT is designed to do far more than stabilize struggling systems. Its purpose is to build durable, efficient, and technology-enabled healthcare infrastructure that continues to improve outcomes long after the funding period ends.
While state governments serve as the primary recipients of RHT funds, local health departments are the partners who determine whether this investment succeeds at the community level. Their role is not supportive or secondary. It is foundational.
How RHT Funding Reaches Local Health Departments
Under federal law, only the 50 U.S. states may apply as primary RHT recipients. However, the program explicitly allows and expects states to sub-award or contract funds to local partners, including local health departments. States are also required to consult with local stakeholders during application development, making local engagement a core requirement rather than a courtesy.
The scale of funding reinforces the importance of these partnerships. In the first budget year alone, projected state allocations include:
- California: $233.6 million
- Colorado: $200.1 million
- Kansas: $221.9 million
- Maryland: $168.2 million
- Michigan: $173.1 million
To responsibly deploy funding of this size, states must demonstrate credible, community-level execution plans. Local health departments are uniquely positioned to provide that credibility.
Why Local Health Departments Are Essential to RHT Success
Local health departments already lead much of the work RHT is designed to expand. Community-based prevention, behavioral health integration, chronic disease management, and population-level interventions are not new initiatives for LHDs. They are core responsibilities.
States that do not formally engage local health departments risk submitting applications that lack local insight and operational realism. In contrast, states that engage LHDs early gain trusted partners with established relationships, workforce readiness, and a deep understanding of community needs that cannot be replicated at the state level.
CMS has made clear that competitive RHT applications cannot be developed in isolation. Each proposal must demonstrate coordination across agencies and local stakeholders to present a unified statewide strategy. This requirement opens the door for local health departments to participate as essential subrecipients and contracted partners.
The Power of Local Data and Measurable Progress
Every RHT-funded initiative must report at least four quantifiable metrics, with at least one measured at the county or community level. This requirement makes local data a key part of the evaluation process.
Because local health departments operate where care is delivered, they are best positioned to provide the level of data granularity CMS expects. Reliable reporting on clinical outcomes, operational performance, and population health trends depends on systems that can consistently capture and share data over time.
RHT also uses an incremental funding model tied to progress. Rather than a single award, funding increases as states demonstrate advancement through six stages:
- Stages 0 to 1: Planning and workforce preparation
- Stages 2 to 3: Active implementation and midpoint progress
- Stages 4 to 5: Measurable outcomes and demonstrated sustainability
Local health departments that can show implementation already underway significantly strengthen a state’s technical score and funding potential.
RHT Goals Align with Local Health Department Missions
The RHT Program is organized around five strategic pillars that closely mirror the work local health departments already lead:
- Improving prevention and chronic disease management
- Coordinating sustainable access across regional systems
- Developing and retaining a local healthcare workforce
- Supporting innovative, value-based care models
- Modernizing technology, data sharing, and cybersecurity
RHT funding is intentionally focused on infrastructure rather than temporary subsidies. CMS is seeking investments that persist beyond FY2031 and reduce long-term reliance on grant funding.
Permissible local uses of RHT funds include:
- Information technology infrastructure, such as EHRs, interoperability tools, cloud systems, and cybersecurity
- Behavioral health programs that integrate mental health and substance use services into community-based care
- Prevention-focused initiatives addressing chronic disease, maternal health, immunizations, and population health improvement
For local health departments, the opportunity is not to start over, but to modernize, scale, and sustain the work already underway.
Data Readiness Is No Longer Optional
Under RHT, participation without strong data infrastructure is not realistic. Every funded initiative must report consistent, accurate metrics, including county-level outcomes.
An advanced EHR or public health platform is no longer a luxury; it is a necessity. It is a prerequisite for funding eligibility, technical scoring, and long-term sustainability. Local health departments that invest in interoperable, secure systems move from being consulted partners to essential contributors in statewide RHT strategies.
A Shared Moment for State and Local Leadership
RHT creates a rare alignment between state strategy and local execution. States improve their competitiveness when local health departments can demonstrate readiness, progress in implementation, and measurable outcomes. Local leaders gain influence when they can document impact with reliable data and sustainable systems.
This is not a top-down mandate or a bottom-up experiment. It is a shared opportunity to reduce risk for states while delivering lasting transformation for rural communities.
How Patagonia Health Can Help
RHT rewards readiness, data capture, and sustainability. Patagonia Health’s EHR, Practice Management, and Billing solution was built with all three in mind.
By integrating prevention programs, behavioral health initiatives, care coordination, and time and effort tracking into a single system, Patagonia Health helps local health departments streamline workflows while meeting complex reporting requirements.
Interoperability and cybersecurity are foundational, not optional. Patagonia Health facilitates secure data exchange with state agencies and regional partners, meeting modern security standards. No data is stored overseas, and the platform has never experienced a data breach.
Most importantly, the system scales. Whether a department is already implementing programs or preparing to expand, Patagonia Health supports documentation, reporting, and long-term infrastructure that extends well beyond the RHT funding period.
RHT is not about short-term funding. It is about building systems that continue to work for communities year after year. Patagonia Health helps local health departments be ready for what comes next.
If your organization is preparing for RHT participation or evaluating data readiness, now is the time to take the next step.
