Rural Health Transformation Program - Overcoming Geographic Barriers to Care, EMS Enhancement Grants to Resource Hospitals

Rural Health Transformation Program - Overcoming Geographic Barriers to Care, EMS Enhancement Grants to Resource Hospitals

The Rural Health Transformation (RHT) Program was designed to empower states to strengthen rural communities by improving healthcare access, quality, and outcomes through transforming the healthcare delivery ecosystem.

Illinois’ Rural Health Transformation Program will support rural communities across the State of Illinois in improving healthcare access, quality, and outcomes by transforming healthcare delivery. By partnering with the Illinois Department of Public Health and Resource Hospitals, this program will support EMS-related expenses in expanding care in rural communities and standing up innovative models to treat people in place; training, coordination, and staffing; limited capital infrastructure; and local training, apprenticeship, and hiring of new EMTs and paramedics.

All RHT applicants must complete the Euna application. Once the completed application is received and approved, the Illinois Department of Healthcare and Family Services will collaborate with each subaward to complete the grant award process.

Note: Stevens Amendment Acknowledgment
This funding opportunity 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 $193,418,216.21 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.

In many rural regions of the state, a major barrier to care is a lack of available transportation in rural areas of the state. Without dependable transit options, rural residents face delays or forego essential preventive, primary, and specialty care, exacerbating health inequities and increasing avoidable utilization of high-cost emergency services. Stakeholders identified lack of reliable, consistent transportation as one of the largest barriers to care in the rural regions of the state which affects individuals of all ages and care needs. Mobile service offerings present an opportunity to overcome geographic and transportation-related barriers to care.

Through this Non-Discretionary Funding Information (NDFI) the state has identified the Illinois Department of Public Health (IDPH) as the direct recipient of this award. IDPH will serve as the pass-through entity for this initiative.

This funding will support sustainable access by expanding EMS and mobile healthcare services in rural areas of the state through partnerships with Resource Hospitals providing EMS support.

To ensure that EMS providers are able to expand upon services they currently offer and move towards Treat-in-Place and other mobile integrated care models, Illinois must first build the critical infrastructure to support greater use of mobile health services. Resource Hospitals are well-suited to identify infrastructure, equipment, supplies, and systems needs in their oversight role related to statewide EMS. Resource hospitals work closely with county EMS to also determine their training and staffing needs, which are also supported by the funding under this initiative.

Details

• Awarding Agency: Healthcare And Family Serv
• CSFA Number: 478-00-3982
• CSFA Popular Name: RHTP-EMS
• Funding Opportunity Number: 3982-10-26-RHTPEMS
• Assistance Listings Number: 93.798
• Announcement Type: Initial Announcement
• Award Type: Non Competitive
• Total Funding Available: $16,500,000.00
• Expected Number of Awards: 1
• Funding Sources: Federal Or Federal Pass Through
• Capital Grant: No
• Indirect Costs Allowed: Yes
• Posted Date: 2026-05-19
• Award Period: 2026-07-01 – 2027-06-30

Funding Source Description

This program utilizes federal CMS Rural Health Transformation (RHT) Program funds. Total amount of funding expected to be awarded through this NDFI is up to $16.5 million in the first federal Budget Period and up to $70.5 million in total across Budget Periods 1-5, subject to continued funding and program approval. Funding in future years is subject to CMS’s continuation, review, and award of future Rural Health Transformation Program funding. The release of this NDFI does not obligate HFS to make an award.

Funding Restrictions

See Part 2: Funding Information

Indirect Cost Description

In order to charge indirect costs to a grant, the applicant organization must have an annually negotiated indirect cost rate agreement (NICRA).

There are three types of NICRAs:
a) Federally Negotiated Rate. Organizations that receive direct federal funding, may have an indirect cost rate that was negotiated with the Federal Cognizant Agency. Illinois will accept the federally negotiated rate. The organization must provide a copy of the federally NICRA.
b) State Negotiated Rate. The organization may negotiate an indirect cost rate with the State of Illinois if they do not have a Federally Negotiated Rate. If an organization has not previously established in indirect cost rate, an indirect cost rate proposal must be submitted through the GATA Grantee Portal no later than three months after receipt of a Notice of State Award (NOSA). If an organization previously established an indirect cost rate, the organization must annually submit a new indirect cost proposal through the GATA Grantee Portal within six months after the close of the grantee’s fiscal year.
c) De Minimis Rate. An organization that has never negotiated an indirect cost rate with the Federal Government of the State of Illinois is eligible to elect a de minimis rate of 15% of modified total direct cost (MTDC). Once established, the De Minimis Rate may be used indefinitely. The State of Illinois must verify the calculation of the MTDC annually in order to accept the De Minimis Rate.

All grantees must complete an indirect cost rate negotiation or elect the De Minimis Rate to claim indirect costs. Indirect costs claimed without a negotiated rate or a De Minimis Rate election on record in the GATA Grantee Portal indirect cost rate system may be subject to disallowance.

Restrictions on Indirect Costs

Yes

Citation Governing Indirect Cost Restriction

Section 71401 of Public Law 119-21

State Award Notices

Successful applicants will receive a Notice of State Award (NOSA) to initiate the grant agreement phase. During this phase, the selected applicant(s) will be contacted by the Department of Healthcare and Family Services to develop a Uniform Grant Agreement, which can be months long process depending on complexity, cooperation and conformity with all applicable federal and state laws. The Department reserves the right to issue a reduced award, or not to issue any award if it is in the Department’s best interest to do so. The NOSA is not an authorization to begin performance or incur costs

Administrative and National Policy Requirements

In addition to implementing the funded project consistent with the approved project proposal and budget, agencies selected for funding must comply with applicable grant terms and conditions and other legal requirements, including the CMS Rural Health Transformation  Program funds, and GATA.

Additional programmatic and administrative special conditions may be required.

Reporting

Recipients must submit periodic financial reports, periodic performance reports, final financial and performance reports, and, if applicable, an annual audit report in accordance with the 2 CFR 200 Uniform Guidelines. Future awards and fund drawdowns may be withheld if reports are delinquent.

Additional Information

https://hfs.illinois.gov/info/fedresctr/ruralhealthtp.html