Rural Health Transformation Program - Transforming Rural Healthcare Delivery, Healthcare Transformation Collaboratives

Rural Health Transformation Program - Transforming Rural Healthcare Delivery, Healthcare Transformation Collaboratives

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. This program will provide funding to existing Healthcare Transformation Collaboratives to scale models that have demonstrated initial success in improving access, quality, health outcomes and/or cost effectiveness, especially in counties in central, southern and eastern Illinois.

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.

Through this opportunity the state is seeking to award a grant to scale community-based care models implemented by existing Healthcare Transformation Collaboratives that improve healthcare access, care coordination, resolution of health-related social needs (HRSN), and outcomes for rural populations. Through this opportunity HFS is seeking to award up to $8 million annually for five years, subject to program funding and continued approval.

The purpose of the Healthcare Transformation Collaboratives (HTC) initiative is to establish local, integrated networks of health and social service providers to build transformational services and programs that reduce care gaps and health disparities in socially vulnerable communities across Illinois. Transformational is defined as a thorough or dramatic change in the delivery of healthcare at a community level. HFS provided funding to enable the launch of these networks and their proposed services. HTCs services are expected to be person-centered, holistic, integrated, and driven by community input.

HFS’ overall rural healthcare transformation objectives include:
1. “Right-size” rural healthcare delivery by filling care gaps and transforming services
2. Shift treatment to lower-cost settings
3. Improve rural population health outcomes
4. Catalyze value-based care models, regional health care partnerships in the hospital and primary care practice spaces, practice transformation, and population health improvement

Details

• Awarding Agency: Healthcare And Family Serv
• CSFA Number: 478-00-3950
• CSFA Popular Name: RHTP-HTC
• Funding Opportunity Number: 3950-10-26-RHTPHTC
• Assistance Listings Number: 93.798
• Announcement Type: Initial Announcement
• Award Type: Non Competitive
• Total Funding Available: $8,000,000.00
• Expected Number of Awards: 4
• 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. Total amount of funding expected to be awarded through this opportunity is up to $8,000,000 per year subject to ongoing funding and program approval, with approximately $1,000,000 - $3,000,000 for each eligible HTC for one year. 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 the Department 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.

Limitations on indirect costs restrict the amount and/or type of indirect costs that are allowed to be charged to grant awards. Indirect cost limitations and restrictions must be clearly stated in this section. For example, the grant award may be subject to state and federal statutory requirements that limit the allowability of costs. The maximum amount allowable under a limitation cannot exceed the total amount under the NICRA. State and federal statutes may restrict the amount of salary that can be charged to a grant award, if the base salary exceeds the Federal Executive Level II Pay Scale. If additional statutory restrictions or limitations are imposed, such as parameters for direct administrative costs, facility costs, and indirect administrative cost levels, those restrictions or limitations must be stated in this section. The statutory reference or guidance imposing the indirect cost limitation or restriction must also be stated within this section.

Grantees have discretion not to claim payment for indirect costs. Grantees that elect not to claim indirect costs cannot be reimbursed for indirect costs. The organization must record an election to “Waive Indirect Costs” into the GATA Grantee Portal.

Indirect Cost election must be completed annually, for every entity’s fiscal year. More information regarding the indirect cost election process can be found on the GATA website.

Code of Federal Regulations / Title 2 - Grants and Agreements / Vol. 1 / 2014-01-01191

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.