Rural Health Transformation Program Subrecipient Grant to Healthcare Providers to Transform, Innovate, and Regionalize Care

Requirements Checklist

• Applicants must submit: (1) an online application via the provided Microsoft Forms link; (2) Year 1 Project Costs in the Budget Workbook (Appendix A); (3) a signed W-9 form (last 12 months); (4) Federally Negotiated Indirect Cost Rate Letter (NICRA), if applicable; (5) letters of commitment from partner organizations, if applicable. Proposals must include narrative, budget, demonstrate organizational and financial capacity, and compliance with federal and Vermont AHS requirements. Active Vermont Business Registry registration, full SAM registration, and Unique Entity Identifier (UEI) are required.

Required attachments

• Completed online application form (Microsoft Forms link in NOFO)
• Appendix A: Budget Workbook (Year 1 project costs)
• Signed W-9 Tax Form (last 12 months)
• Federally Negotiated Indirect Cost Rate Letter (NICRA, if applicable)
• Letters of commitment from partner organizations (if applicable)

Submission Instructions

Online application form link (see NOFO); supporting attachments (Budget Workbook, W-9, NICRA, partner letters) submitted by email to ahs.contracts@vermont.gov with subject line: 'Care Transformation Grant Application, [Organization Name]'.

Source Documents