Rural Health Transformation
Rural Health Transformation Program funding for transport and EMS, state by state
This page shows which states put transport and EMS into their Rural Health Transformation Program funding plans. It also shows the next CMS report dates and the trip metrics that a state office can report. Use it as an RHTP state funding guide for transport work. All RHTP state funding figures here come from CMS, GAO or a state RHT office, and each one has a link.
For program basics, read the RHT hub. For one state, open its page from the state index.
Last reviewed:
The numbers behind this page
$50 billion
CMS announced awards to all 50 states on Dec 29, 2025, for FY2026 to FY2030.
Source: CMS press release
$147M to $281M
The FY2026 award range, from New Jersey ($147,250,806) to Texas ($281,319,361).
Source: CMS press release
Up to $40 billion
GAO reports that CMS plans to allot up to $40 billion of the remaining funds over the next 4 years, based on each state's progress.
Source: GAO-27-108853
28 states
The Baker Institute coded transportation support in 28 state applications.
Source: Baker Institute
Which states put transportation in their RHT plans?
The Baker Institute found transportation support in 28 of the 50 state applications. In our reading of the CMS state spotlights, 34 states name a transport, EMS, mobile care or patient-transfer item.
The two sources measure different things. Baker counted transport only when the application tied it to a care plan and a health barrier. Baker also coded the original applications, so its codes do not show changes made since then. The CMS spotlights summarize each approved plan. So a state can show "No" in the Baker column and still have an EMS item in its spotlight. Mississippi and Vermont are two examples.
Three states name transport coordination directly in their CMS spotlight:
- Tennessee: a rural NEMT system with technology-enabled coordination.
- West Virginia: a health mobility platform to dispatch NEMT, and equipment so EMS can do NEMT.
- Wyoming: an NEMT coordination program.
| State | FY2026 award (CMS) | Transport in application (Baker Institute) | Transport or EMS items (CMS state spotlight) | Official RHT page |
|---|---|---|---|---|
| Alabama | $203,404,327 | Yes | None found | Alabama Dept. of Economic and Community Affairs (ADECA) |
| Alaska | $272,174,856 | Yes | EMS workforce development; EMS licensure compact commitment | Alaska Department of Health (DOH) |
| Arizona | $166,988,956 | No HRSN content coded | Mobile clinics; EMS compact commitment by 2028 | Arizona State Office of Rural Health |
| Arkansas | $208,779,396 | Yes | Target: 15% reduction in EMS response times | Arkansas Department of Health |
| California | $233,639,308 | No HRSN content coded | None found | Dept. of Health Care Access and Information (HCAI) - CalRHT |
| Colorado | $200,105,604 | No | Expansion of mobile health programs | Colorado Dept. of Health Care Policy & Financing (HCPF) - RHT Division |
| Connecticut | $154,249,106 | Yes | None found | Connecticut Dept. of Social Services (DSS) - Division of Rural Health Transformation |
| Delaware | $157,394,964 | No | Mobile health units; services that remove transportation barriers | Delaware DHSS - Division of Public Health |
| Florida | $209,938,195 | No | Community paramedicine (post-discharge care, on-site care for minor illness); mobile care | Agency for Health Care Administration (AHCA) |
| Georgia | $218,862,170 | Yes | Mobile health units; EMS among Make Rural Georgia Healthy Again strategies | Georgia Dept. of Community Health (DCH) - GREAT Health |
| Hawaii | $188,892,440 | No | EMS system named as a priority challenge | Hawaii Dept. of Health - Office of Primary Care and Rural Health |
| Idaho | $185,974,368 | No | None found | Idaho Dept. of Health and Welfare (DHW) |
| Illinois | $193,418,216 | No HRSN content coded | EMS treat-not-transport SPA; mobile health services | Illinois Dept. of Healthcare and Family Services (HFS) |
| Indiana | $206,927,897 | Yes | Center to assist with patient transfer coordination and ED diversion; reduce transportation barriers | Indiana Department of Health (IDOH) - GROW |
| Iowa | $209,040,064 | Yes | Mobile integrated health; geographic and transportation barriers | Iowa HHS - Healthy Hometowns |
| KansasOpen: NEMT RFA to Nov 18 | $221,898,008 | Yes | None found | Kansas Dept. of Health and Environment (KDHE) |
| Kentucky | $212,905,591 | Yes | EMS and Trauma Systems is one of five focus areas | Kentucky Dept. for Public Health (KDPH) |
| Louisiana | $208,374,448 | No | Target: 10% decrease in EMS response time | Louisiana Dept. of Health - Office of Rural Health Transformation and Sustainability |
| Maine | $190,008,051 | Yes | Community paramedicine model (reimbursement, career pathways) | Maine DHHS (with GOPIF) |
| Maryland | $168,180,838 | No | None found | Maryland Department of Health - State Office of Rural Health |
| Massachusetts | $162,005,238 | Yes | Tech-enabled mobile health units; home visits | Executive Office of Health and Human Services (EOHHS) / DPH Office of Rural Health |
| Michigan | $173,128,201 | Yes | None found | Michigan DHHS (MDHHS) |
| Minnesota | $193,090,618 | No | Mobile care delivery | Minnesota Dept. of Health - Office of Rural Health and Primary Care |
| MississippiOpen: pilot grant to Nov 16 | $205,907,220 | No | EMS treat-in-place pilot; EMS coordination; hospital-EMS interoperability | Mississippi State Dept. of Health - Rural Health Transformation Office |
| Missouri | $216,276,818 | Yes | Strengthened and optimized EMS network | Missouri Dept. of Social Services - MO HealthNet Rural Health Transformation Office |
| Montana | $233,509,359 | No HRSN content coded | Modernizing emergency medical services; EMS compact | Montana DPHHS |
| Nebraska | $218,529,075 | No | None found | Nebraska DHHS |
| Nevada | $179,931,608 | Yes | Investments in EMS and mobile units; at least one more mobile care unit per rural region | Nevada Health Authority (NVHA) |
| New HampshireOpen: hospital RFA to Nov 12 | $204,016,550 | Yes | Mobile clinics; EMS compact commitment | GO-NORTH (Governor's Office) with NH DHHS |
| New Jersey | $147,250,806 | No HRSN content coded | EMS compact commitment | New Jersey Dept. of Health / DHS |
| New Mexico | $211,484,741 | Yes | None found | New Mexico Health Care Authority (HCA) |
| New York | $212,058,208 | No | None found | New York State Dept. of Health (NYSDOH) |
| North CarolinaIntake closed Oct 31 | $213,008,356 | No | EMS compact | NCDHHS Office of Rural Health |
| North Dakota | $198,936,970 | Yes | Mobile clinics | North Dakota HHS |
| Ohio | $202,030,262 | Yes | Mobile clinics (OH SEE); mobile health care services | Ohio Department of Health (ODH) |
| Oklahoma | $223,476,949 | Yes | None found | Oklahoma State Dept. of Health (OSDH) |
| Oregon | $197,271,578 | Yes | EMS compact commitment | Oregon Health Authority (OHA) - Health Policy & Analytics |
| Pennsylvania | $193,294,054 | Yes | EMS tech/workflow; increased adoption of paramedicine programs at EMS agencies | Pennsylvania Dept. of Human Services (DHS) |
| Rhode Island | $156,169,931 | No | Target: decreased EMS response time | RI Executive Office of Health and Human Services (EOHHS) |
| South Carolina | $200,030,252 | No | None found | SC Dept. of Health and Human Services (SCDHHS) |
| South Dakota | $189,477,607 | No | Advance emergency medical services | South Dakota Dept. of Health - Office of Rural Health and Emergency Services |
| Tennessee | $206,888,882 | Yes | Rural NEMT: integrated, technology-enabled transportation coordination system | Tennessee Department of Health (TDH) |
| Texas | $281,319,361 | Yes | None found | Texas Health and Human Services Commission (HHSC) |
| Utah | $195,743,566 | No | None found | Utah DHHS - Commissioner's Office |
| Vermont | $195,053,740 | No | Bed tracking and patient transfer systems; community paramedicine; Mobile Integrated Health | Vermont Agency of Human Services (DVHA runs procurement) |
| Virginia | $189,544,888 | Yes | Mobile units (maternal care hubs) | Virginia State Office of Rural Health |
| Washington | $181,257,515 | Yes | None found | Washington Health Care Authority (HCA) |
| West Virginia | $199,476,099 | Yes | Health mobility platform to dispatch NEMT; equipping EMS for NEMT | West Virginia Department of Health |
| Wisconsin | $203,670,005 | Yes | None found | Wisconsin Dept. of Health Services (DHS) |
| Wyoming | $205,004,743 | Yes | NEMT coordination program | Wyoming Department of Health (WDH) |
Sources for the table: FY2026 awards from the CMS press release. Transport codes from the Baker Institute. Spotlight items from the CMS 50-state spotlights. "None found" means we found no transport or EMS item in that state's spotlight.
Can EMS agencies get RHT money?
Yes, when the state's approved plan and its funding notice include them. An EMS agency usually takes part as a subrecipient of the state or of an administrator that the state chose.
Two current examples:
- The Mississippi Innovative Pilot Program grant lists EMS agencies as eligible applicants. Awards go up to $2 million for each entity.
- In New Hampshire, the Foundation for Healthy Communities ran an EMS funding round for GO-NORTH. That round is now closed.
Many spotlights name EMS work directly. Arkansas has a target to cut EMS response times by 15%. Louisiana has a target of a 10% decrease. Illinois names an EMS treat-not-transport state plan amendment. Kentucky made EMS and trauma systems one of its five focus areas.
How much RHT money did my state get?
Find your state in the table above. CMS published each state's FY2026 award on Dec 29, 2025. GAO lists the same budget period 1 amounts by state in GAO-27-108853.
Each award is a cooperative agreement with the state. The state then funds subrecipients through its own grants and contracts. Later years depend on progress. GAO reports that CMS plans to allot up to $40 billion of the remaining funds to states "based on their demonstration of satisfactory progress toward approved initiatives."
Who runs RHT in my state, and where are open RFAs?
The last column of the table shows the lead agency and links to its official RHT page. Open funding notices change every week, so we list only items that we checked on a stated date.
Open
Kansas: Year 2 Non-Emergency Transportation
Open until Nov 18, 2026.
For local transport that helps rural Kansans reach medical appointments. Projects must not duplicate services that are already eligible for reimbursement.
Checked Nov 4, 2026.
Open
Kansas: Year 2 Regional Partnership Grant Program
Open until Nov 13, 2026.
About $44 million. KDHE says the amount depends on CMS approval of the Year 2 budget.
Checked Nov 4, 2026.
Open
Mississippi: Innovative Pilot Program Grant
Deadline Nov 16, 2026, 5 pm CST.
Up to $2 million for each entity. EMS agencies are eligible.
Checked Nov 4, 2026.
Source: Mississippi RHTP funding page
Open
New Hampshire: Critical Access Hospital and Acute Care Hospital RFA
Priority deadline Nov 12, 2026, 5 pm ET.
Run by the Foundation for Healthy Communities for GO-NORTH. Applications stay open on a rolling basis while funds last.
Checked Nov 4, 2026.
Changed
North Carolina: Rural Health Innovation Fund
Changed: intake closed Oct 31, 2026.
Entities that sent the readiness intake form must complete the full application by Dec 7, 2026, at 11:59 pm.
Checked Nov 4, 2026.
What dates matter now?
The next CMS report is Quarterly Report #1, due Monday, Nov 30, 2026. Budget period 2 began Oct 31, 2026.
| Report | Covers | Due |
|---|---|---|
| Quarterly Report #1 | Aug 1 – Oct 30, 2026 | Mon, Nov 30, 2026 |
| Quarterly Report #2 | Oct 31, 2026 – Jan 30, 2027 | Mar 1, 2027 |
| Quarterly Report #3 | Jan 31 – Apr 30, 2027 | Tue, June 1, 2027 |
CMS moved Quarterly Report #1 from Sunday, Nov 29, to Monday, Nov 30. It moved Quarterly Report #3 to June 1, 2027. The full schedule, the checkpoint rules and what each report contains are on RHT reporting requirements and due dates.
What transport metrics can a state report?
CMS asks for at least four quantifiable metrics for each initiative. At least one metric must give data at county or community level. The RHT NOFO names "travel time for patients to nearest hospital" as an example access metric.
A trip record can supply county-level metrics if it has the right fields from the start. The table shows which fields produce which metric.
| Metric a state can define | Trip fields that produce it | County roll-up |
|---|---|---|
| Travel time to care | Pickup county, pickup time, arrival time | Median minutes, by patient county |
| Requests filled | Request time, final status | Filled as a share of requested, by county |
| Time to an assigned provider | Request time, accept time | Median hours, by county |
| Trips not completed, by reason | Close reason: no-show, declined, no provider | Count by reason, by county |
| Residents served | Patient ID for the period, home county | Unique residents, by county |
The state and CMS decide which metrics count. The RHT budget kit has an evaluation outline that uses fields like these.
How a trip becomes a county number
- 01
Request: a hospital, clinic or care manager sends a trip request.
- 02
Assign: a credentialed local provider accepts the trip.
- 03
Track: each status change gets a time stamp.
- 04
Close: the trip closes with an outcome or a reason.
- 05
County roll-up: trips group by the patient's home county.
- 06
State report: the subrecipient sends the county totals to the state office.
Illustrative example. Not real patient data.
| County | Requests | Filled | Not completed (reason) | Median minutes to arrival |
|---|---|---|---|---|
| County A | 42 | 38 | 4 (2 no-show, 2 no provider) | 51 |
| County B | 17 | 17 | 0 | 64 |
If you run a state RHT office
- Put trip fields into the subaward terms, so all grantees report the same way.
- Ask each grantee for county totals on a fixed date before each CMS due date.
- Tell your Project Officer early if you want to add transport to an approved initiative.
If you are a hospital, EMS agency or health center
- Find the transport or EMS item in your state's plan before you write a budget.
- Check the funding notice for who can apply. Some states fund through an administrator.
- Decide your county-level measures before the first trip.
- Ask vendors for partnership forms or support letters early.
For allowable costs, use the RHT budget kit. It also covers non-supplantation.
Where DispatchCare fits
DispatchCare is a VectorCare product. VectorCare is a vendor or subcontractor to subrecipients. It does not administer RHT funds, file reports for a state or decide what is allowable.
DispatchCare, powered by VectorCare, coordinates scheduled, non-emergency missions, including non-emergency transport, wheelchair and stretcher trips, and community paramedicine visits. Staff send a request from the web app, the mobile app or the chart. Local providers accept the mission. Every status change gets a time stamp. A mission cannot close until its required outcome fields are complete. The export is row-level CSV, so a grantee can group it by county.
DispatchCare is not a 911 CAD and not an ePCR. Emergency calls stay in 911.
- We sign RHT partnership forms and letters of support for applicants.
- VectorCare is registered in SAM.gov and is on state purchasing platforms.
- DispatchCare is hosted on AWS in the United States.
- Retention is configurable to meet your grant and state requirements.
See how state RHT offices use DispatchCare
DispatchCare, powered by VectorCare, coordinates scheduled, non-emergency missions, including non-emergency transport, wheelchair and stretcher trips, and community paramedicine visits.
Questions
It depends on your state's approved plan and its funding notice. Kansas, for example, has an open Year 2 non-emergency transportation RFA. For allowable costs and how to check them, use the RHT budget kit.
Yes, with CMS approval. The CMS FAQ says states should tell their Project Officer as soon as they expect a change. CMS must review and approve changes to milestones, metrics, baselines or targets before they are final.
They can work as a vendor or a subcontractor to a subrecipient, such as a hospital or a regional partnership. Where a funding notice allows it, they can also apply as a subrecipient. The subrecipient holds the subaward and reports to the state. The vendor delivers the service under a contract.
Budget period 1 ended Oct 30, 2026. CMS says a state cannot use unobligated funds for new commitments after its period ends. CMS classifies those funds as unexpended and gives them to other states. Funds obligated in time can, with some exceptions, be spent up to the end of the next fiscal year.
Sources: CMS award announcement, GAO-27-108853, CMS Guide to State Awardee Reporting, Oct 20, 2026, CMS RHT FAQ, Apr 2026, RHT NOFO, CMS 50-state spotlights, Baker Institute.
Not legal advice.