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HHS Region 4 · Alabama Dept of Economic & Community Affairs (ADECA)
Program Overview
The Alabama Rural Health Transformation Program (ARHTP), administered by ADECA as lead agency, is currently implementing eleven targeted initiatives to enhance rural healthcare access, provider sustainability, workforce development, care delivery, and technology solutions. Guided by an executive order-established Advisory Group, the program is launching phased Notices of Funding Opportunities for priorities such as EHR/IT, EMS trauma and stroke, cancer digital regionalization, maternal health, simulation training, and workforce development. The program aligns with the CMS Rural Health Transformation framework and emphasizes multi-year planning, measurable progress, and structured annual review for practical, sustainable improvements in Alabama’s rural healthcare delivery. Current structured plan tracks 12 key initiatives and 7 strategic goals.
Updated
County-level estimates averaged across Alabama — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
pp = percentage points vs US county average
County Drilldown (67)
| County | Pop | Poverty | Uninsured |
|---|---|---|---|
| Jefferson County | 667,755 | 15.7% | 11.4% |
| Mobile County | 412,590 | 16.2% | 11.9% |
| Madison County | 405,718 | 10.1% | 6.9% |
| Baldwin County | 246,989 | 10.1% | 6.8% |
| Tuscaloosa County | 237,552 | 16.8% | 10.9% |
| Shelby County | 230,211 | 7.2% | 5.0% |
| Montgomery County | 226,718 | 19.9% | 16.3% |
| Lee County | 181,134 | 18.9% | 10.0% |
| Morgan County | 124,471 | 13.5% | 9.1% |
| Calhoun County | 116,090 | 17.9% | 12.9% |
| Limestone County | 111,233 | 10.0% | 7.3% |
| Houston County | 108,140 | 17.5% | 13.1% |
AI source: AL - 2026 - Alabama RHTP Frequently Asked Questions (FAQ) Compiled from Roadshow Sessions and Application Workshops
AI auto-updated Aug 6, 2026
API refreshed May 7, 2026
Key signals are summarized here. Open the source for the supporting detail.
Centers for Medicare & Medicaid Services (CMS)
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1,119,503 rural residents
Alabama received over $203 million in federal CMS funding and established a formal advisory group. As of July-August 2026, ADECA has issued two rounds of NOFOs spanning 10 of 11 program initiatives, with first-round applications closed and five additional major initiatives open through August 7, 2026. Application workshops and FAQ sessions are ongoing, and ADECA is processing applications with awards to providers expected next. The program continues to advance subgrant competitions and stakeholder engagement across its 11 initiatives. State opportunities: 12 total (12 past/closed), $275.1M listed funding. Key opportunities: Alabama Rural Health Transformation Program (ARHTP) 2025–2030: Statewide Strategy and Project Narrative; Alabama Rural Health Transformation Program (ARHTP), Rural Health Initiative; Alabama RHTP Collaborative EHR, IT, and Cybersecurity Initiative. Strategy alignment: supports workforce, telehealth, maternal health priorities.
Alabama’s Rural Health Transformation Program (RHTP), led by ADECA through a CMS cooperative agreement, implements milestone-based statewide initiatives targeting rural health system modernization, provider sustainability, and workforce development. Utilizing phased, competitive annual NOFOs, a centralized application and monitoring portal, and regular stakeholder workshops, RHTP emphasizes regionally integrated, technology-driven projects with strict compliance, measurable rural benefit, and adaptive oversight from the state advisory group.
Model
Statewide, regionally coordinated transformation focused on specialty and emergency care regionalization, EMS modernization, technology adoption, and rural workforce development, guided by continuous state and federal review.
Key Initiatives
Timeline: Five-year program (2026–2030), with annual CMS review, milestone-based funding, phased NOFOs beginning June–August 2026, subrecipient period of performance through 07/31/2027 for Year 1, and ongoing annual strategy updates.
Targeted improvements through a dedicated Maternal and Fetal Health Initiative to enhance outcomes in rural communities.
Enhancement of EMS capabilities through Statewide EMS Trauma and Stroke and EMS Treat-In-Place Initiatives.
Focus on addressing mental health needs in rural populations via a dedicated Mental Health Initiative.
Alabama Department of Economic and Community Affairs (ADECA)
Due Aug 7, 2026
15 related documents
AL - 2025 - Alabama RHTP Simulation Training Initiative Notice of Funding Opportunity
Official NOFO PDF
AL - 2026 - Notice of Funding Opportunity: Alabama RHTP – Statewide Emergency Medical Services (EMS) Trauma and Stroke Initiative
Primary source
AL - 2025 - Alabama Department Of Economic And Community Affairs (ADECA) Notice Of Funding Opportunity Alabama RHTP Maternal And Fetal Health Initiative
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AL - 2026 - Alabama Department Of Economic And Community Affairs Notice Of Funding Opportunity Alabama RHTP Rural Workforce Initiative
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AL - 2026 - Alabama Department Of Economic And Community Affairs Notice Of Funding Opportunity Alabama RHTP Statewide Emergency Medical Services (EMS) Trauma And Stroke Initiative
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AL - 2025 - Alabama RHTP Emergency Medical Services (EMS) Treat-In-Place Initiative Notice Of Funding Opportunity
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AL - 2026 - Notice of Funding Opportunity: Alabama RHTP Cancer Digital Regionalization Initiative
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AL - 2026 - Alabama Department Of Economic And Community Affairs Notice Of Funding Opportunity Alabama RHTP Mental Health Initiative
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AL - 2026 - Alabama Department Of Economic And Community Affairs (ADECA) Notice Of Funding Opportunity (NOFO) Alabama RHTP Collaborative Ehr, It, And Cybersecurity Initiative
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AL - 2026 - Notice Of Funding Opportunity (NOFO): Alabama Rural Health Practice Initiative
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AL - 2026 - Alabama Department Of Economic And Community Affairs Notice Of Funding Opportunity Alabama RHTP Rural Health Initiative
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AL - 2026 - Alabama RHTP Frequently Asked Questions (FAQ) Compiled from Roadshow Sessions and Application Workshops June 2026
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AL - 2026 - Alabama RHTP Frequently Asked Questions (FAQ) Compiled from Roadshow Sessions and Application Workshops
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AL - 2026 - Alabama RHTP Frequently Asked Questions (FAQ) Compiled from Roadshow Sessions and Application Workshops (ada_ARHTP_FAQ_June2026_DRAFT-06.18.2026-ADECA-FINAL)
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AL - 2025 - Alabama RHTP Statewide Emergency Medical Services (EMS) Trauma and Stroke Initiative Notice of Funding Opportunity
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Alabama Department of Economic and Community Affairs (ADECA)
Due Aug 7, 2026
1 related document
AL - 2025 - Alabama Department Of Economic And Community Affairs (ADECA) Notice Of Funding Opportunity Alabama RHTP Maternal And Fetal Health Initiative
Official NOFO PDF
Alabama Department of Economic and Community Affairs (ADECA)
Due Aug 7, 2026
2 related documents
AL - 2025 - Alabama RHTP Emergency Medical Services (EMS) Treat-In-Place Initiative Notice Of Funding Opportunity
Official NOFO PDF
AL - 2026 - Alabama RHTP (ARHTP) Application Workshops (ARHTP-Application-Workshops-Round-2-Announcement)
Auto-linked process guidance fallback (11%)
ADECA is announcing a competitive funding opportunity under Alabama's Rural Health Transformation Program to address critical workforce shortages in rural communities. Approximately $33 million in federal funds will be distributed via subawards to support innovative and practical workforce development, recruitment, incentive, and training projects in rural healthcare. Projects must serve rural Alabama and align with defined strategy categories including GME expansion, EMS workforce development, workforce education, recruitment incentives, and Certified Nurse Midwife training. Key contacts: info@alabamarhtp.com Event schedule: - Application Portal Opens - 06/03/2026 - CT - ARHTP website - Application Deadline - 06/26/2026 - 5:00 PM CT - ARHTP portal - Quarter 1 Progress Report Due - 01/10/2027 - Quarter 2 Progress Report Due - 04/10/2027 - Quarter 3 Progress Report Due - 07/10/2027 - Quarter 4 Progress Report Due - 10/10/2027
Contacts
Core Initiatives
In December 2025, Alabama was awarded $203 million for the first year of the Alabama Rural Health Transformation Program through a cooperative agreement with CMS. ADECA serves as the lead agency. This is a five-year program, with budget awards and program plans subject to annual review and update.
Event Schedule
Core Initiatives
Event schedule: - , 2026 - July 8 - MEMORANDUM - , 2026 - July 21 - 10:00 AM - 401 Adams Avenue • Suite 580 • P.O. Box 5690 • Montgomery, Alabama 36103-5690 • (334) 242-5100 - , 2026 - July 8 - 10:00 AM - Sessions will be held at: - , 2026 - July 22 - 10:00 AM - Sessions will be held at:
Event Schedule
Event schedule: - , 2026 - July 8 - M E M O R A N D U M - , 2026 - July 21 - 10:00 AM - , 2026 - July 22 - 10:00 AM - Sessions will be held at:
Event Schedule
This FAQ provides detailed guidance on the Alabama Rural Health Transformation Program's structure, eligibility, application process, allowable costs, and initiative-specific considerations. It outlines $203.4 million in Year 1 federal funding to be distributed through 11 major initiatives and clarifies compliance and sustainability requirements. The document emphasizes a focus on multi-year planning, measurable progress, and the transformation of rural health delivery through technology, workforce, clinical care, and infrastructure. Event schedule: - First Round NOFO Initiatives Released - 06/03/2026 - First Round Application Deadline - 06/26/2026 - Second Round NOFO Initiatives Released - 07/17/2026 - Second Round Application Deadline - 08/07/2026 - Subrecipient Period of Performance End Date (Year 1) - 07/31/2027 - Federal Period of Performance End Date (Year 1) - 09/30/2027 - Year 2 Program Start - 10/01/2026
Event Schedule
Core Initiatives
The document lists 58 counties in Alabama that are eligible or partially eligible for funding under the Rural Health Transformation Program. It indicates the geographic scope of the sustainable rural healthcare initiatives planned.
Governor Ivey appointed ADECA as the lead agency for ARHTP, working with partners such as the Medicaid Agency and the State Health Planning Agency. The plan was submitted to CMS and awarded $203 million for its first year, with funding and planning subject to annual review and adjustment. Five focus areas for current applications include cancer digital regionalization, EMS treat-in-place, maternal and fetal health, simulation training, and statewide EMS trauma and stroke. Event schedule: - NOFO Submission Deadline - 08/07/2026 - 5:00 PM CT - Online Application Portal - Application Workshops Round 2 - Day 1 - 07/21/2026 - CT - In-person (location details in memo) - Application Workshops Round 2 - Day 2 - 07/22/2026 - CT - In-person (location details in memo)
Event Schedule
Core Initiatives
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AL RHTP site updated — 1 new doc(s)
AL RHTP site updated — 1 new doc(s)
AL RHTP site updated — 1 new doc(s)
AL RHTP site updated — 2 new doc(s)
AL RHTP site updated — 1 new doc(s)
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed. Showing the 40 most recent of 91.
AL - 2026 - The Office of Alabama Governor Kay Ivey
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AL - 2017 - The Office of Alabama Governor Kay Ivey
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AL - 1967 - Governor -
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Alabama is launching the Rural Health Practice Initiative under the Rural Health Transformation Program, with $6.935 million in federal funds available for competitive subawards. Eligible rural providers can apply for projects focused on expanding clinic capacity, workforce recruitment, telehealth implementation, and school-based health clinics. The program aims to strengthen rural healthcare access, promote innovation, and advance long-term sustainability in Alabama's rural communities. Key contacts: info@alabamarhtp.com Event schedule: - Application portal opens - 06/03/2026 - CT - ARHTP online portal - Application submission deadline - 06/26/2026 - 5:00 PM CT - ARHTP online portal - Quarter 1 progress report due - 01/10/2027 - Quarter 2 progress report due - 04/10/2027 - Quarter 3 progress report due - 07/10/2027 - Quarter 4 progress report due - 10/10/2027
Contacts
Core Initiatives
Event schedule: - , 2026 M E M O R A N D U M TO: All Interested Parties FROM: Kenneth W. Boswell Director RE: Alabama Rural Health Transformation Program (ARHTP) Application Workshops The Alabama Department of Economic and Community Affairs (ADECA) will host in-person application workshops for the first five of the approved ARHTP initiatives. The workshops will also be accessible via Microsoft Teams at the same dates/times identified below. The one-hour workshop sessions will provide participants with a comprehensive overview of the Notice of Funding Opportunity (NOFO) and application process for each of the below initiatives. Each session will begin with a review of the key components of the NOFO, including the initiative’s goals and objectives, eligibility criteria, funding levels, subaward structure, and reporting requirements. The session will then transition to the application process and will include a walkthrough of important submission details such as navigating the online application portal, understanding required documentation, and preparing a complete and competitive application. Additionally, we will outline the application review process, highlight important dates in the award timeline, and discuss what applicants can expect during the post-selection phase. Each workshop will conclude with an opportunity for participants to ask questions during a live Q&A session. June 9, 2026 • 10:00 AM – Collaborative EHR, IT and Cybersecurity Initiative • 1:00 PM – Rural Health Initiative • 3:00 PM – Rural Workforce Initiative - June 4 - 10:00 AM - M E M O R A N D U M Page 2 , 2026 June 10, 2026 • 10:00 AM – Mental Health Initiative • 1:00 PM – Rural Health Practice Initiative Sessions will be held at: Alabama Center for Commerce 401 Adams Avenue, Montgomery, AL 36104 th 7 Floor Auditorium The parking deck is located across the street at 400 Adams Avenue, and you can access the parking deck from the Decatur Street entrance by using the following code: 988648. All individuals who will be attending a workshop in-person must pre-register at https://app.smartsheet.com/b/form/019e8addd36e7023bd945ae81c6de538 . The workshops are accessible to persons with disabilities. Persons with disabilities or special needs who may require special materials, services, or assistance should include this information in their registration. Due to space constraints, live participation will be capped at approximately 100 participants, so individuals who wish to attend in-person are encouraged to register as soon as possible. Individuals joining a workshop virtually must register for each at the sites identified below. A link to the workshop will be emailed to the registrant when registration is completed. • Collaborative EHR, IT, and Cybersecurity Initiative - https://bit.ly/RHTP_EHR_9June_Workshop_2026 • Rural Health Initiative - https://bit.ly/RHTP_RHI_9June_Workshop_2026 • Rural Workforce Initiative - https://bit.ly/RHTP_RWI_9June_Workshop_2026 • Mental Health Initiative - https://bit.ly/RHTP_MHI_10JuneWorkshop_2026 • Rural Health Practice Initiative - https://bit.ly/RHTP_RHPI_10June_Workshop_2026 Please submit any questions concerning this notice to info@alabamarhtp.com. Thank you for your attention to this matter. KWB:CGT:km - June 4
This document provides comprehensive FAQ guidance for Alabama's implementation of the CMS Rural Health Transformation Program, covering eligibility, application, funding, allowable costs, and initiative-specific details. Alabama received $203.4 million in Year 1 with the program structured across eleven initiatives, including technology, workforce, EMS, maternal health, mental health, and more. The FAQ explains initiative-specific rules, cost eligibility, timelines, and scoring processes for applicants. Key contacts: Alabama Rural Health Transformation team info@alabamarhtp.com Event schedule: - First round NOFOs released - 06/03/2026 - First round submissions closed - 06/26/2026 - Second round NOFOs released - 07/17/2026 - Second round submissions close - 08/07/2026 - End of subrecipient performance period for Year 1 funds - 07/31/2027 - End of federal fiscal year for program funds - 09/30/2027
Event Schedule
Contacts
Core Initiatives
OWR Policy and Notice of Non-Discrimination
AL - 2026 - Newsroom – ADECA
2026 · HTML
AL - 2025 - ADECA – Impacting Alabama
2025-2026 · HTML
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY AND GOVERNOR’S STAFF RHTP 2021 Document
2021 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY AND GOVERNOR’S STAFF RHTP 2021 Document
2021 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY AND GOVERNOR’S STAFF RHTP 2021 Slide Deck
2021 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY AND GOVERNOR’S STAFF RHTP 2021 Document
2021 · PDF
Alabama STATE OF ALABAMA PROCLAMATION RHTP 2020-2011 Document
2020 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2020 Document
2020 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2020 Document
2020 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2020 Document
2020 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2020 Document
2020 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY AND GOVERNOR’S STAFF RHTP 2020 Document
2020 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY AND GOVERNOR’S STAFF RHTP 2020 Document
2020 · PDF
Alabama Ivey Administration Highlights Refining The Labor Force RHTP 2020 Report
2019-2020 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2019 Document
2019 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2019 Document
2019 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2019 Document
2019 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2019 Document
2019 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2019 Document
2019 · PDF
Alabama E STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY RHTP 2019 Document
2019 · PDF
Alabama E STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY RHTP 2019 Document
2019 · PDF
Alabama E STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY RHTP 2019 Document
2019 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2018 Document
2018 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2018 Document
2018 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2018 Document
2018 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2018 Document
2018 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2018 Document
2018 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY RHTP 2018 Document
2018 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY RHTP 2018 Document
2018 · PDF
Administrative Code – ADECA Domestic Violence Center Procedures
2018 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2017 Document
2017 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2017 Document
2017 · PDF
Alabama Ivey Administration Expenditures From The Governor’s Contingency Fund RHTP 2017 Document
2017 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR ROBERT BENTLEY AND RHTP 2017 Document
2017 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR ROBERT BENTLEY, GOVERNOR KAY RHTP 2017 Document
2017 · PDF
Alabama STATE AIRCRAFT USAGE BY GOVERNOR KAY IVEY RHTP 2017 Document
2017 · PDF