Rural Health Transformation Program (RHTP)

Hawaiʻi’s Rural Health Transformation Program (RHTP) is a once-in-a-generation investment in rural healthcare. This page helps Hawaiʻi organizations find their lane, understand the rules, and get ready to bid. We will keep developing it as solicitations are released.

At a glance

• Total plan: about $1 billion over five years (~$200M/yr), FY2026 to FY2031.
• Year 1 award: $188.9M, from CMS on December 29, 2025.
• Structure: a CMS cooperative agreement (federal grant). No state match required.
• Where the money goes: about 98% flows out as competitively procured contracts and subawards (~$195M/yr).
• Prime recipient: the Executive Office of the State (Budget & Finance, Office of Federal Awards Management).
• Where RFPs post: hands.ehawaii.gov, plus each lead agency’s own procurement.

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Start here: official sources

• State RHTP hub (engage.hawaii.gov/rhtp): award status, Hawaiʻi’s full application (downloadable), and links to the federal program.
• Bidding opportunities (hands.ehawaii.gov): the Hawaiʻi Awards & Notices Data System, where state RFPs post. Also see the State Procurement Office.
• Federal program (CMS Rural Health Transformation Program): the program rules, goals, and allowable uses.

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The six funding tracks

Figures are planning envelopes from Hawaiʻi’s application. The Year 1 award came in at $188.9M, and future years depend on annual federal funding, so final contract values will shift.

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Decide how to bid

You bid into the State, not CMS. Each lead agency (SHPDA, Med-QUEST, DOH, UH Mānoa, UH JABSOM, DHS) runs its own solicitations, so there is no single RHTP portal. Pick a role:

• Prime: you hold the contract. Best with past performance, federal-reporting staff, and multi-year cash flow.
• Subcontractor: you work under a prime. Best for smaller organizations and specialized vendors, with a lighter compliance burden.
• Consortium partner: you join a group bidding together, especially for the RVBI fund. Good for community organizations, FQHCs, and independent practices.

Unsure? Start by exploring subcontract or partner roles, and explore teaming opportunities with GUILD Consulting.

Eligibility and compliance

• Hawaiʻi Compliance Express: current (GET, DOL, DCCA, IRS).
• SAM.gov: registration and a UEI, and not excluded or debarred.
• Tax clearance: non-state organizations winning a subaward of $25,000 or more must show current Hawaiʻi Department of Taxation and IRS clearances.
• Single Audit: if your organization spends $1M or more in federal funds per year.
• Procurement rules: the Hawaiʻi Procurement Code (HRS 103D) plus federal rules (2 CFR Part 200) apply.

Federal guardrails: what is fundable

CMS sets limits that shape what a winning proposal can include:

• Work must use evidence-based interventions and advance the program’s rural-health goals.
• No new construction. Building renovations are capped (no more than 20% of a year’s award).
• Direct provider payments are capped (no more than 15%); replacing an existing certified EHR is capped (no more than 5%).
• No supplanting or duplication: funds cannot replace existing money or pay for services already covered by Medicaid, Medicare, CHIP, or HRSA.
• Workforce scholarships and incentives require a five-year rural-service commitment.
• A sustainability plan for life after Year 5 is expected and scored. State administrative costs are capped at 10%.

Key dates

• Nov 5, 2025: Hawaiʻi submitted its application to CMS.
• Dec 29, 2025: CMS awarded Hawaiʻi $188.9M for Year 1.
• Through FY2026 (by mid-2026): first solicitations expected, including RHIN’s core contracts, RRN respite-site operators, the first RVBI funding round, and Pili Ola subrecipient agreements.
• FY2027 to FY2031: implementation, with RVBI running a competitive round each year.
• Oct 1, 2032: any unspent federal funds return to the U.S. Treasury.

Program leadership

• Jeremy Lakin · RHTP Project Director, cabinet-level
• Mark Anderson · Office of Federal Awards Management, Budget & Finance
• Lorrin Kim · DOH Office of Planning, Policy & Program Development

Your next steps

1. Pick one or two tracks that fit your organization.
2. Get your Hawaiʻi Compliance Express and SAM.gov registration current.
3. Subscribe to alerts on hands.ehawaii.gov and follow engage.hawaii.gov/rhtp.
4. Decide whether to prime, subcontract, or partner, and line up teaming partners early.
5. Move now. Year 1 is compressed, and the first contracts are expected within FY2026.

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How GUILD Consulting can help

Winning bids share three traits: they focus on one or two lanes, they are compliance-ready, and they team up early. GUILD Consulting, Hawaiʻi’s leading management consulting firm, helps organizations decide where to play, get compliance-ready, and build the right teams for RHTP.

Talk with GUILD about RHTP

Updated June 2026. Figures from Hawaiʻi’s CMS application (November 2025) and the State’s RHTP hub; Year 1 award amount per the State (December 2025). GUILD Consulting briefing, not an official State of Hawaiʻi or CMS document. Final procurements and award terms will control.