New York

Event schedule: - New York State Department of Health Funding Guidance Rural Community Health Integration Key Dates Release Date: , 2026 Questions Due: June 18, 2026 Questions, Answers, Updates Posted: June 25, 2026 (on or about) Applications Due: July 9, 2026 Department of Health Contact Name & Address: Karen Madden Center for Health Care Policy and Resource Development New York State Department of Health Email: rchi@health.ny.gov This project is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $212,058,207.80 in Budget Period 1 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government - June 11 - • Hospitals including safety net hospitals, general hospitals, sole community hospitals, rural emergency hospitals, and critical access hospitals; • Federally Qualified Health Centers (FQHC); • Certified Community Behavioral Health Clinics (CCBHC); • Rural Health Networks; • Primary care or multi-specialty practices; • Diagnostic and treatment centers; • Urgent care centers; • Office of Mental Health - licensed facilities • Office of Addiction Services and Supports - licensed facilities • Developmental disability service providers; • Long-term care providers; • Hospice and palliative care providers; • Ambulatory surgery centers; • Independent Practice Associations; • Emergency Medical Service (EMS) providers. The minimum geographic unit for any application is the county. County-level geography is required for all applications. Multi-county applications are permitted and encouraged where regional collaboration supports the goals of the project. Funding levels will reflect the scope of the geographic area proposed. Project Scope – Planning Each county will be allocated up to $500,000 to develop collaborative plans resulting in integrated health networks that enhance health care delivery, coordination, and outcomes in rural areas. Activities should focus on community engagement, assessing community needs using County Community Health Needs Assessments, conducting feasibility studies, developing a governance structure, building integrated partnerships, and developing an implementation ready plan. Activities may also include, but are not limited to, clinical workflow design, financial modeling, and developing plans for technology integration, care coordination, population health improvement, and workforce development. Providers are encouraged to collaborate to maximize the use of these funds for planning. Multiple applications for planning funds from the same county will either be asked to collaborate or awards will be reduced accordingly. 3 - New York State Rural Health Transformation Program Rural Community Health Integration Introduction The New York State Department of Health (herein referred to as the Department) announces the availability of Rural Health Care Transformation Program funds to support Rural Community Health Integration. This funding guidance is to allocate $76,190,022 for Budget Period 1 of the Rural Health Transformation Program. Contracts resulting from this announcement will begin on , 2026 and end on June 30, 2027. Background/Intent The Department received an award of $212 million from the Centers for Medicare and Medicaid Services (CMS) for the first Budget Period of the five-year Rural Health Transformation Program (RHTP) to provide support to rural communities to improve health care access, quality, and outcomes by transforming the health care delivery system. The RHTP focuses on promoting innovation, strategic partnerships, infrastructure development, and workforce investment in rural communities. Funding is allocated across four initiatives to build a rural health system where every resident has timely access to high-quality, coordinated care. This funding announcement focuses on Initiative 1: Rural Community Health Integration. The purpose of the Rural Community Health Integration initiative is to establish coordinated rural health partnerships that facilitate comprehensive care coordination and enhance patient access to a wide range of providers across the care continuum, effectively addressing both health and social needs. This initiative will assist rural hospitals and community providers to build or grow integrated health networks to enhance health care delivery, coordination, and outcomes in rural areas while increasing financial sustainability through collaborative partnerships. Key results for Rural Community Health Integration include: 1. Increased access to the right care at the right time • Potentially Preventable Emergency Visits 2. Decreased readmissions due to high-quality discharge planning and post-acute supports • Hospital-wide all-cause unplanned readmission 3. Increased preventive care spanning primary and specialty care 1 - September 1 - • Hospitals including safety net hospitals, general hospitals, sole community hospitals, rural emergency hospitals, and critical access hospitals; • Federally Qualified Health Centers (FQHC); • Certified Community Behavioral Health Clinics (CCBHC); • Rural Health Networks; • Primary care or multi-specialty practices; • Diagnostic and treatment centers; • Urgent care centers; • Office of Mental Health - licensed facilities • Office of Addiction Services and Supports - licensed facilities • Developmental disability service providers; • Long-term care providers; • Hospice and palliative care providers; • Ambulatory surgery centers; • Independent Practice Associations; • Emergency Medical Service (EMS) providers. The minimum geographic unit for any application is the county. County-level geography is required for all applications. Multi-county applications are permitted and encouraged where regional collaboration supports the goals of the project. Funding levels will reflect the scope of the geographic area proposed. Project Scope – Planning Each county will be allocated up to $500,000 to develop collaborative plans resulting in integrated health networks that enhance health care delivery, coordination, and outcomes in rural areas. Activities should focus on community engagement, assessing community needs using County Community Health Needs Assessments, conducting feasibility studies, developing a governance structure, building integrated partnerships, and developing an implementation ready plan. Activities may also include, but are not limited to, clinical workflow design, financial modeling, and developing plans for technology integration, care coordination, population health improvement, and workforce development. Providers are encouraged to collaborate to maximize the use of these funds for planning. Multiple applications for planning funds from the same county will either be asked to collaborate or awards will be reduced accordingly. 3 - • Colorectal screening Eligibility Applications should demonstrate a community-focused collaborative approach to rural health integration. Each application must consist of a Lead Applicant, Partner Organization(s), and at least one General Hospital or Rural Emergency Hospital. The hospital can be either the Lead Applicant or the Partner Organization. Lead Applicants should be those institutions that possess strong institutional capacity, deep community ties, and a record of demonstrable commitment to serving their constituents. Lead Applicants must meet the following minimum qualifications by completing the Attestation in Attachment 3 and submitting it with application. • Lead Applicant is a registered not-for-profit 501(c)(3) organization or municipal hospital. • Lead Applicant has a three-year or more history of regulatory compliance including adherence to Department rules and other direction. • Lead Applicant is an eligible entity located in counties defined as rural in New York’s Rural Health Transformation Program application and listed in Attachment 1. • Funded projects will be completed by , 2027. • At least one hospital located in the counties listed in Attachment 1 is included in the application. Additionally, applicants must address at least one key area specified in New York’s RHTP application: 1. Increased access to the right care at the right time • Potentially Preventable Emergency Visits 2. Decreased readmissions due to high quality discharge planning and post-acute supports • Hospital-wide all-cause unplanned readmission 3. Increased preventative care spanning primary and specialty care • Colorectal screening Eligible Lead Applicants and Partner Organization(s) include but are not limited to the following: • Local Health Departments (The Department strongly encourages the inclusion of County Public Health Departments as Partner Organizations.) 2 - June 30 - • Hospitals including safety net hospitals, general hospitals, sole community hospitals, rural emergency hospitals, and critical access hospitals; • Federally Qualified Health Centers (FQHC); • Certified Community Behavioral Health Clinics (CCBHC); • Rural Health Networks; • Primary care or multi-specialty practices; • Diagnostic and treatment centers; • Urgent care centers; • Office of Mental Health - licensed facilities • Office of Addiction Services and Supports - licensed facilities • Developmental disability service providers; • Long-term care providers; • Hospice and palliative care providers; • Ambulatory surgery centers; • Independent Practice Associations; • Emergency Medical Service (EMS) providers. The minimum geographic unit for any application is the county. County-level geography is required for all applications. Multi-county applications are permitted and encouraged where regional collaboration supports the goals of the project. Funding levels will reflect the scope of the geographic area proposed. Project Scope – Planning Each county will be allocated up to $500,000 to develop collaborative plans resulting in integrated health networks that enhance health care delivery, coordination, and outcomes in rural areas. Activities should focus on community engagement, assessing community needs using County Community Health Needs Assessments, conducting feasibility studies, developing a governance structure, building integrated partnerships, and developing an implementation ready plan. Activities may also include, but are not limited to, clinical workflow design, financial modeling, and developing plans for technology integration, care coordination, population health improvement, and workforce development. Providers are encouraged to collaborate to maximize the use of these funds for planning. Multiple applications for planning funds from the same county will either be asked to collaborate or awards will be reduced accordingly. 3 - Funding opportunities to implement activities identified during the Budget Period 1 planning period will be available in Budget Periods 2 – 5. It is anticipated that grants covering a two-year period will be available to implement activities in Budget Periods 2 – 3 and Budget Periods 4 – 5. Project Scope - Implementation In addition to planning, applicants may submit up to three implementation projects for consideration in Budget Period 1. Implementation activities that lay the groundwork for future program iterations to transform care delivery will be considered if they are slated for completion by , 2027. The total budget for all proposed implement projects should not exceed $3,000,000. These projects must be able to be completed within the Budget Period 1 contract period, which begins on September 1, 2026 and ends on June 30, 2027. Projects not able to be fully vouchered by July 31, 2027 will not be considered for Budget Period 1. Grant contracts resulting from this announcement will be cost reimbursable based on achieving deliverables that are described in the Planning Activities and Implementation Activities section of the Application. Advance payments, which the state in its sole discretion may make to not-for-profit grant recipients, shall be made and recouped in accordance with State Finance Law Section 179-u. Federally funded contract advances will be made as set forth by the Federal award requirements and applicable Federal regulations. Additionally, Budget Period 1 funding recipients should plan to provide demonstrative progress towards meeting their target(s) through reporting by June 30, 2027. Demonstrative progress means that sufficient data and information are provided to the Department by June 30, 2027 to indicate that targets have been met. Applicants should consider the following when requesting implementation funding: • How requested funding will position providers to meet RHTP goals to transform and sustain the health care system. • Activities that will be implemented to engage the community. • Achievable outcomes specific to each activity. • How the activity will be sustainable following implementation. All applications must address at least one key area specified in New York’s RHTP application: 1. Increased access to the right care at the right time 4 - June 30 - • Potentially Preventable Emergency Visits 2. Decreased readmissions due to high-quality discharge planning and post-acute supports • Hospital-wide all-cause unplanned readmission 3. Increased preventive care spanning primary and specialty care • Colorectal screening Applications addressing maternity services and maternal child health, behavioral health integration, and substance abuse disorder prevention will be given priority. Proposed activities should result in interventions that will address maternal and infant mortality, behavioral health integration, and/or substance abuse disorder prevention. These activities should be evidence based and include baseline measures and targets for improvement. Activities may include, but are not limited to, the following. • Conduct an assessment of current need including an analysis of relevant data. • Conduct an assessment of community capacity. • Identify gaps in service delivery. • Develop programs to meet need. • Identify appropriate network partners and/or providers to implement programs. • Identify resources to implement programs. Use of Funds - Allowable Costs All awarded grant-funded activities must be either entirely new or expansions of existing activities. When expanding a program or initiative, grantees may only apply RHTP funds to costs associated with the new population and/or new activities. The costs of the original program must continue to be funded by their current funding sources. RHTP funds are intended to support transformational investments and should be feasible, measurable, and sustainable. Budgets for planning and implementation projects will be deliverable-based. Expenses will be reimbursed upon the completion of deliverables and the submission of a voucher and accompanying expenditure and progress reports. Examples of allowable costs include, but are not limited to, the following. Funding Category Use of Funding Collaboration and Integration Initiating, fostering, and strengthening local and regional strategic partnerships between rural facilities, providers, and community-based organizations to 5 - • Services, equipment, or supports that are the legal responsibility of another party under federal, state, or Tribal law, such as vocational rehabilitation or education services. • Services, equipment, or supports that are the legal responsibility of another party under any civil rights law, such as modifying a workplace or providing accommodations that are obligations under law. • Ongoing operating expenses with no path to sustainability. RHTP funds are intended to support transformational investments. • Goods or services not allocable to the project. • Solicitating donations. • Taxes, except sales tax on goods and services. • Lobbyists, political contributions. • Bad debts, late payment fees, finance charges, or contingency funds. • Independent research and development. • Electronic Medical Record (EMR) systems if a previous HITECH-certified EMR system is in place as of , 2025. • Activities prohibited under 2 CFR 200.450 and the Health and Human Services Grants Policy Statement, including but not limited to:  Payments related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before the Congress or any state government, state legislature, local legislature or legislative body, including but not limited to paying the salary or expenses of any grant recipient or agency acting for such recipient for such activity  Lobbying, but recipients can lobby at their own expense if they can segregate federal funds from other financial resources used for lobbying Outcomes & Metrics Applicants should outline the specific outcomes that will be achieved and the metrics that will be used to measure progress. Examples include, but are not limited to, the following: • Integration: Collaborative plans to develop and strengthen partnerships between providers to enable delivery of expanded services in rural areas through shared learning, collaborative approaches, and advanced technology interventions 8 - September 1 - 4:00 pm - New York State Rural Health Transformation Program Attachment 1 Rural Community Health Integration Eligible Counties Allegany Oneida Broome Ontario Cattaraugus Orange Cayuga Orleans Chautauqua Oswego Chemung Otsego Chenango Putnam Clinton Rensselaer Columbia Schenectady Cortland Schoharie Delaware Schuyler Dutchess Seneca Essex St. Lawrence Franklin Steuben Fulton Sullivan Genesee Tioga Greene Tompkins Hamilton Ulster Herkimer Warren Jefferson Washington Lewis Wayne Livingston Wyoming Madison Yates Montgomery - • Access: reduced travel times, increased primary care visits, creating new access points for community-based screenings, preventive care, and chronic disease management • Quality: lower readmission rates, improved maternal-child health indicators • Financial: improved operating margins & reduced uncompensated care and increasing viability through strategic investments in technology, data infrastructure, and collaboration • Workforce: increased clinician-to-resident ratios, reduced vacancy rates • Technology: expanded telehealth utilization, improved electronic health record interoperability • Admissions and Readmission: quarterly tracking of inpatient admission and readmission rates, benchmarked against county-level baseline data. Expectations All grantees are expected to participate in statewide learning collaboratives. These learning collaboratives will provide opportunities to meet in person and virtually to share insights, best practices, and challenges related to implementing the RHTP. Learning collaboratives will convene grantees to focus on specific activities and to discuss more general issues such as strategic planning and evaluation. More information about learning communities will be shared with grantees. Contracts for funded grantees will begin on , 2026 and end on June 30, 2027. All contracts must be executed by October 30, 2026. Grantees will be expected to work directly with Department staff to prioritize contract development to ensure execution by October 30, 2026. Reporting Specific reporting guidelines and metrics will be distributed when contracts are developed. Evaluation metrics may evolve throughout the program based on grantee contributions, findings from ongoing work and evaluation, and CMS requirements. Application Process Interested and eligible organizations are requested to submit an application. Selection will be based on demonstration of eligibility, the merits of the proposed Rural Community Health Integration project(s), and the degree to which activities meet RHTP goals. All applications for this program must be jointly submitted by a Lead Applicant and a Partner 9 - September 1 - 4:00 pm - New York State Rural Health Transformation Program Attachment 1 Rural Community Health Integration Eligible Counties Allegany Oneida Broome Ontario Cattaraugus Orange Cayuga Orleans Chautauqua Oswego Chemung Otsego Chenango Putnam Clinton Rensselaer Columbia Schenectady Cortland Schoharie Delaware Schuyler Dutchess Seneca Essex St. Lawrence Franklin Steuben Fulton Sullivan Genesee Tioga Greene Tompkins Hamilton Ulster Herkimer Warren Jefferson Washington Lewis Wayne Livingston Wyoming Madison Yates Montgomery - Organization(s). A hospital must be included as either the lead applicant or the partner organization. Questions may be directed to rchi@health.ny.gov by , 2026. Answers will be posted at: www.health.ny.gov/facilities/transforming_rural_healthcare/ on or about June 25, 2026. Applicants who meet the eligibility criteria and wish to apply may access the application at www.health.ny.gov/facilities/transforming_rural_healthcare/ and submit completed materials to rchi@health.ny.gov by 4:00 pm EST on July 9, 2026. Attachments Attachment 1: Eligible Counties Attachment 2: Application Cover Sheet Attachment 3: Attestation 10 - June 18 - New York State Rural Health Transformation Program Attachment 1 Rural Community Health Integration Eligible Counties Allegany Oneida Broome Ontario Cattaraugus Orange Cayuga Orleans Chautauqua Oswego Chemung Otsego Chenango Putnam Clinton Rensselaer Columbia Schenectady Cortland Schoharie Delaware Schuyler Dutchess Seneca Essex St. Lawrence Franklin Steuben Fulton Sullivan Genesee Tioga Greene Tompkins Hamilton Ulster Herkimer Warren Jefferson Washington Lewis Wayne Livingston Wyoming Madison Yates Montgomery - New York State Rural Health Transformation Program Attachment 3 Rural Community Health Integration Eligibility Requirements Attestation Attachment 3 is required to be completed and submitted with the application to attest to all minimum requirements . Lead Applicant Name: ___________________________________ As an authorized signatory of the Lead Applicant, I hereby attest to the following minimum eligibility requirements stated in the Funding Guidance Eligibility section: Lead Applicant is a registered not-for-profit 501(c)(3) organization or municipal hospital. Lead Applicant has a three-year or more history of regulatory compliance including adherence to Department of Health rules and other direction. Lead Applicant is an eligible entity located in counties defined as rural in New York’s Rural Health Transformation Program application and listed in Attachment 1 of the Funding Guidance. Funded projects will be completed by , 2027. At least one hospital located in the counties listed in Attachment 1 is included in the application. At least one of the following key area are included in the application: 1. Increased access to the right care at the right time Potentially Preventable Emergency Visits 2. Decreased readmissions due to high quality discharge planning and post-acute supports Hospital-wide all-cause unplanned readmission 3. Increased preventative care spanning primary and specialty care Colorectal screening As an authorized signatory of the Lead Applicant, I hereby also attest that the above information is true and accurate to the best of my knowledge. _____________________________________ _____________________________________ Name of Authorized Official (printed) Title _____________________________________ _____________________________________ Signature of Authorized Official Date - June 30

New York's RHTP application identifies persistent disparities in health access and outcomes across its 2.1 million rural residents, with concerted strategies targeting workforce gaps, service closures, technology access, and financial instability. The plan proposes multi-level initiatives focused on developing collaborative health care networks, advancing primary care and behavioral health integration, modernizing rural health IT infrastructure, and growing a sustainable workforce pipeline. Strategic investments, robust partnerships, and data-driven planning anchor the state's approach to rural health system transformation.

The program includes initiatives such as Rural Community Health Integration to coordinate care and address social needs, use of Patient-Centered Medical Home models enhanced with artificial intelligence, workforce development to meet rural healthcare staffing needs, and telehealth improvements alongside cybersecurity enhancements. New York submitted its application to CMS on November 4, 2025, and continues to conduct webinars and issue guidance for funding and application deadlines. Key contacts: RHTP@health.ny.gov Event schedule: - Application submission to CMS - 11/04/2025 - NYS Rural Health Transformation Updates Webinar - 8/12/2026 - 10:00 AM - 11:00 AM ET - Webinar (webinar number: 2829 999 9223, password: NYS_RHTP1) - Application deadline for Rural Community Health Integration - 7/14/2026

This application template is for organizations seeking planning or implementation funding under New York's Rural Health Transformation Program. It emphasizes community engagement, partnership formation, needs assessment, transformative planning, and sustained impact for rural health improvement. Applications are due by July 9, 2026. Key contacts: rchi@health.ny.gov Event schedule: - Application Submission Deadline - 07/09/2026 - 4:00 PM ET - rchi@health.ny.gov