How Can Critical Access Hospitals and FQHCs Prepare for RHTP Year 2?

Q: How can critical access hospitals and FQHCs prepare for RHTP Year 2?

Under the CMS funding notice, FY2027 (Year 2) state award amounts are set by Oct. 31, 2026, and another $10 billion is available, so CAHs and FQHCs should be tracking their state's next funding cycle now and showing clean Year 1 results. In practice that means: know your state's Year 2 timeline, keep Year 1 spending and documentation current, measure outcomes against baseline, and plan how the work continues after the grant.

Why Year 1 performance affects Year 2

Half of each year's $10 billion is workload funding. CMS recalculates each state's technical score every budget period from its annual reporting, focusing on progress toward the goals and commitments in its cooperative agreement (CMS Notice of Funding Opportunity CMS-RHT-26-001 (via Grants.gov); NRHA). States also must spend each year's award by the end of the following fiscal year, or the money is redistributed (CMS Notice of Funding Opportunity CMS-RHT-26-001 (via Grants.gov)). State results depend on subrecipient results.

A Year 2 checklist

Know your state's cycle. Alaska's Year 2 fall applications close Oct. 28, 2026 (Alaska Department of Health); Oklahoma posts open opportunities on its RHTP funding page (Oklahoma RHTP). Other states differ.
Close out Year 1 cleanly. Obligate and spend on your state's deadlines; Alaska and Oklahoma cite Sept. 30, 2027 as the final spending date for Year 1 funds (Alaska Department of Health; Oklahoma State Department of Health).
Show results. Report outcomes against baseline using the metrics your state committed to. FQHCs can align with measures they already report through UDS.
Get audit-ready. Run a mock grant review before monitoring or audit.
Fit the uses. Map Year 2 proposals to the permissible uses and caps (CMS).
Plan for sustainability. CMS asks states to think about sustaining initiatives after the program, for example through Medicaid or other payers (CMS).
Partner. CMS's strategic goals favor rural facilities working together or with regional systems (CMS).

Common questions

When are RHTP Year 2 awards decided?

The CMS funding notice says CMS will set award amounts for FY2027 funding by Oct. 31, 2026. States then run their own subaward cycles.

Is there new money in Year 2?

Yes. $10 billion is available each fiscal year from FY2026 through FY2030, plus any redistributed funds.

Can new organizations get RHTP funding in Year 2?

In many states, yes. States run new funding rounds each year; check your state RHTP office for eligibility and deadlines.

How HealthRoots helps

HealthRoots.ai offers one RHTP Grant Compliance, Auditing, Analytics & Reporting package for rural hospitals, critical access hospitals and FQHCs that receive RHTP dollars. We measure Year 1 results against baseline and package them to position you for Year 2. The package includes mock grant reviews. It is priced by quote, based on your scope, your state and how often you have to report.

For other funded grant initiatives, HealthRoots works on a gainsharing basis, with no upfront cost and no IT project. Lifetime patient engagement is delivered with our partner Velocity Health.

Get your free readiness check, or reach us at Curious@Velocity.Health or 940.395.5623.

Sources

More from the RHTP Guide

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HealthRoots.ai is independent and is not affiliated with or endorsed by CMS or any state agency. This page is general information, not legal advice; always confirm requirements in your own award documents and with your state RHTP office.