States
Rural Health Transformation, state by state
Fifty pages covering the agency landscape and how a community paramedicine program is typically positioned inside a state plan.
Why a page per state
Every state received a Rural Health Transformation award, and every state's plan is organized around the same five CMS strategic goals, but each state chose its own administering agency, its own mix of funded activities and its own subaward process. A generic national summary can describe the program; it cannot tell you which agency in your state runs the subaward, or how community paramedicine is framed in that state's specific plan. These pages exist to get you to the right starting point faster: the agency landscape for that state, and where a community paramedicine or mobile integrated healthcare program is likely to be positioned relative to the state's stated goals.
CMS announced first-year state awards on Dec 29, 2025, with per-state amounts ranging from $147 million to $281 million. That range gives you a sense of scale, not a number for any specific state; each state page links back to the award notice and the state's published plan so you can confirm the figure that applies to you.
How awards typically flow inside a state
1. State agency
CMS pays the state's designated administering agency, usually a health department or Medicaid agency, against the approved plan.
2. Subrecipients
The state executes subaward agreements with hospitals, EMS agencies, health centers and other local organizations that carry out the funded activities.
3. Vendors
Subrecipients may contract with vendors for specific deliverables such as coordination software, training or evaluation support. The vendor does not determine allowability; the subaward does.
Where community paramedicine coordination fits within that structure does not vary much state to state: it is usually budgeted by a subrecipient, most often a hospital, health system or EMS agency, as a coordination software, onboarding and evaluation line rather than a clinical services line. What varies is which agency runs the subaward, which local organizations are eligible subrecipients, and how the state's plan narrative frames the activity against its own priorities. Read the program hub for the parts that are consistent across every state, including the five CMS goals, budget and non-supplantation considerations, and reporting obligations.
All states
Pick a state to see its agencies and the CP angle.
- AlabamaAL
- AlaskaAK
- ArizonaAZ
- ArkansasAR
- CaliforniaCA
- ColoradoCO
- ConnecticutCT
- DelawareDE
- FloridaFL
- GeorgiaGA
- HawaiiHI
- IdahoID
- IllinoisIL
- IndianaIN
- IowaIA
- KansasKS
- KentuckyKY
- LouisianaLA
- MaineME
- MarylandMD
- MassachusettsMA
- MichiganMI
- MinnesotaMN
- MississippiMS
- MissouriMO
- MontanaMT
- NebraskaNE
- NevadaNV
- New HampshireNH
- New JerseyNJ
- New MexicoNM
- New YorkNY
- North CarolinaNC
- North DakotaND
- OhioOH
- OklahomaOK
- OregonOR
- PennsylvaniaPA
- Rhode IslandRI
- South CarolinaSC
- South DakotaSD
- TennesseeTN
- TexasTX
- UtahUT
- VermontVT
- VirginiaVA
- WashingtonWA
- West VirginiaWV
- WisconsinWI
- WyomingWY
Confirm award figures at the source
Questions buyers ask
CMS announced first-year awards on Dec 29, 2025, with per-state amounts ranging from $147 million to $281 million. Confirm your state's specific figure against the CMS award notice before citing it anywhere.
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