DHHS seeks public input as it prepares federal Rural Health Transformation application; $500 million baseline expected

Department of Health and Human Services officials briefed the Health and Human Services Committee on Utah’s application process for the federal Rural Health Transformation grant, part of a nationwide opportunity that will deliver baseline funding to every state and additional “workload” funding based on data and state policy.

Nate Checketts, DHHS deputy director, said the nationwide program will distribute $50 billion across states; Utah’s baseline allocation is expected to be $500 million over five years. “Half of the funds will be awarded in baseline funding to all the states where Utah will get $500,000,000 over 5 years,” he told the committee.

DHHS described four strategic themes guiding its solicitation and outreach: healthy rural Utahns, workforce development, innovation and access, and technology modernization. Agency staff said they issued a public call for ideas, received more than 210 proposals and held listening sessions in Cedar City, Brigham City and Moab. Work groups are reviewing the proposals and bundling them into initiatives the department may submit in the application.

Heather Borski, assistant deputy director, said the department’s survey prioritized “provider payments” and “recruitment and retention” among respondents; she said the application will include initiatives intended to be time-limited infrastructure and capacity investments. “Provider payments was ranked 1, recruitment and retention was 2,” Borski said, summarizing survey results.

Agency leaders noted that some components of federal scoring depend on existing state policy (for example, certain scope-of-practice provisions and school physical-activity programs) and that adopting policies after the application could expose Utah to risk if the state did not follow through — the federal award could require the state to meet commitments it included in its application. DHHS said it is consulting with legislators about whether to seek additional scoring points tied to state policy changes.

The department said it intends to submit a draft for internal review in October and to file the final application by Nov. 5; CMS is expected to notify states of awards by the end of the year. If Utah is awarded additional funds the legislature would have an opportunity to appropriate and set priorities for distribution; DHHS said it expects a competitive grant process for many awards and may make some direct awards to government agencies where appropriate.

Committee members emphasized the need to prioritize projects that build sustainable capacity in rural areas while avoiding ongoing state commitments that cannot be sustained after federal funding ends. DHHS officials said proposals were required to include a sustainability plan and that funding would be targeted to time-limited pilots, infrastructure and workforce strategies that could leverage other funding sources.