HHS Region 10 · WA Health Care Authority — RHTP
Program Overview
Washington is actively implementing the Rural Health Transformation Program through the Health Care Authority and state partner agencies, focusing on six strategic initiatives addressing rural hospital innovation, workforce development, technology adoption, behavioral health, community-based care, and Native family health. The program supports collaborative efforts with sub-awardees statewide to advance rural health access and infrastructure, with current activities including program design, competitive awards, and regular updates through webinars. Current structured plan tracks 21 key initiatives and 16 strategic goals.
Updated
County-level estimates averaged across Washington — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
pp = percentage points vs US county average
County Drilldown (39)
| County | Pop | Poverty | Uninsured |
|---|---|---|---|
| King County | 2,287,171 | 8.6% | 5.2% |
| Pierce County | 930,319 | 8.8% | 5.9% |
| Snohomish County | 844,430 | 8.0% | 5.5% |
| Spokane County | 549,056 | 11.7% | 7.3% |
| Clark County | 516,959 | 8.0% | 5.5% |
| Thurston County | 299,067 | 9.5% | 6.4% |
| Kitsap County | 277,881 | 8.2% | 5.4% |
| Yakima County | 257,152 | 15.5% | 11.7% |
| Whatcom County | 230,503 | 12.9% | 7.2% |
| Benton County | 212,905 | 11.0% | 8.2% |
| Skagit County | 131,328 | 11.6% | 7.4% |
| Cowlitz County | 112,360 | 12.2% | 8.0% |
AI source: WA - 2026 - Washington State RHTP Initiatives Overview
AI auto-updated Sep 23, 2026
API refreshed May 7, 2026
Key signals are summarized here. Open the source for the supporting detail.
Centers for Medicare & Medicaid Services (CMS)
Due Nov 5, 2025
6 related documents
WA - 2025 - Washington RHTP (rhtp-webinar-qa-20251027)
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780,653 rural residents
Washington has extended application periods for multiple Rural Health Transformation Program funding opportunities, including maternal health, provider technology, and workforce incentive grants. The state is actively soliciting vendor proposals for revenue cycle and materials management consultation to support rural hospitals and is preparing to award contracts. Several procurements remain open, with applications under review or pending selection for service delivery. The program continues to clarify eligibility, respond to applicant questions, and align with workforce, maternal health, and telehealth priorities. State opportunities: 1 active (1 closing soon, 8 past/closed), $12.3M listed funding. Key opportunities: Washington Rural Nursing Education Program (RNEP); Washington RHTP Activity 1.4: Sustain and strengthen maternal, emergency, and specialty services at risk in rural areas; Washington RHTP OTP Workforce Incentive Program (2026HCA9). Strategy alignment: supports workforce, care access, maternal health priorities.
Washington’s RHTP strategy remains a collaborative, statewide initiative led by HCA, DOH, and DSHS with the Governor’s Office, advancing sustainable rural health through targeted investments in hospital and digital infrastructure, technology modernization, telehealth, behavioral health expansion, and workforce development. Core priorities include community-informed planning, stakeholder and Tribal engagement, and supports for financial sustainability such as expanded revenue cycle services. Implementation continues in phased stages, with annual federal funding, subgrantee contracts, and quarterly advisory committee engagement.
Model
Multi-sector, integrated delivery system transformation driven by rural hospital and provider innovation, collaborative networks, technology and infrastructure funding, workforce development—including the Rural Nursing Education Program (RNEP)—and a minimum 10% set-aside for Tribal Nations, with formal stakeholder and Tribal advisory input.
Key Initiatives (21)
Timeline: Application submitted fall 2025; federal funding available annually through 2026–2030; implementation begins late 2025 with annual reporting and initiative phases; 10% of funds reserved for Tribal investments throughout the period. Provider Technology Fund contracts extend through September 30, 2031, including annual and quarterly reporting. RHT-AC meets quarterly from June 2026. OTP Workforce Incentive Program operates in application rounds through 2026.
Washington is investing in long-term solutions to improve rural residents' access to high-quality specialty and emergency medical services.
The program aims to expand and sustain the rural behavioral health system to reduce strain on rural hospitals and school-based services.
There is a dedicated investment focus on improving health outcomes for Native families in rural communities.
WA - 2025 - Washington RHTP (rhtp-webinar-qa-20250925)
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WA - 2026 - RHTP NOFO Overview, Washington’s Community Input Themes, and Application Planning 1
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WA - 2026 - Washington Public Engagement
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WA - 2026 - Washington RHTP An Overview Summary
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WA - 2026 - Dear Tribal Leader Letter
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Washington Health Care Authority
Due Oct 2, 2026· ⏰ 5 days left
1 related document
WA - 2026 - In a crisis? Free or low-cost health care (rural-health-transformation-program)
WA HCA RHT program page (RNEP announcement)
Washington State Health Care Authority (HCA)
Due Sep 8, 2026
10 related documents
WA - 2026 - RFA 2026HCA9 Exhibit D Budget Proposal Template
Canonical HCA9 package document
Washington State Health Care Authority
Due Sep 3, 2026
9 related documents
WA - 2026 - RFA 2026HCA14 Exhibit D Budget Proposals Template
Canonical HCA14 package document
| FY↓ | Awardee↕ | Amount↕ | Activity↕ | Source |
|---|---|---|---|---|
| 2025 | Washington State Hospital Association (WSHA) WSHA receives funding to support technology and cybersecurity infrastructure improvements in rural hospitals. | $42.0M | Health IT | |
| 2025 | All 29 Federally-Recognized Tribes in Washington 10 percent of Washington's RHT Program funds are reserved for Tribes to conduct activities supporting the health and wellbeing of Native families, including workforce development, care coordination, and health information technology investments. | $18.1M | Population Health | |
| 2025 | UW - University of Washington UW's WWAMI residency supports rural workforce development, expanding training for rural healthcare providers. | $5.5M | Workforce | |
| 2025 | TRC - The Rural Collaborative (30 member hospitals) TRC engages 30 independent rural hospitals to build capacity, improve revenue cycle management, and co-design payment models. | $5.4M | Quality Improvement | |
| 2025 | WSU - Washington State University WSU supports rural training initiatives, including 'grow-your-own' workforce programs and nursing education. | $2.6M | Workforce | |
| 2025-2030 | Washington Tribes and Indian Health Care Providers 10% of the total Rural Health Transformation award will go directly to tribes and IHCPs for strengthening rural healthcare and investments in maternal health. | $30.2M | Population Health |
This announcement highlights a discussion featuring state health leaders from Washington, Tennessee, and Florida sharing early lessons and practical experiences from the first year of implementing the Rural Health Transformation Program. The focus is on key decisions, progress, and strategies to sustain long-term rural health improvements. Key contacts: Dennis Worsham; JW Randolph; Antraneise Jackson; John Auerbach
Contacts
Core Initiatives
Washington received about $181 million in RHT funding in its first year to support rural hospitals, clinics, and providers. The program is administered by the Washington Health Care Authority in partnership with the Department of Health, Department of Social and Health Services, and the Governor’s Office. The program invests in community-based care options, Native family health, technology, specialty and emergency care access, workforce development, and behavioral health system expansion. Event schedule: - Rural Nursing Education Program Webinar - September 15, 2026 - 11 a.m.–1 p.m. PT - Webinar - ICF Webinar: Early Lessons in Rural Health Transformation - September 30, 2026 - 1–2 p.m. PT - Webinar
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Core Initiatives
This document is an internal RFQ intake form for a rural health workforce education project in Washington State under RHTP, aimed at providing in-person revenue cycle education for rural hospital staff. The initiative targets approximately 30 staff for one training in year one, with an estimated total budget of $30,000. The RFQ process is aligned with RHTP goals to reduce billing errors and enhance workforce skills. Key contacts: Rachel Price rachel@ruralcollaborative.com Event schedule: - Target RFQ/RFP issue date - 04/27/2026 - Vendor response deadline - 05/06/2026 - Target award decision date - 05/08/2026
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Core Initiatives
This guidance outlines the requirements for recipients of the Washington RHT Program funding regarding communications, including needed federal acknowledgements, disclaimer practices, and review processes for public-facing materials. It provides detail on what materials must be reviewed and approved, the distinction between public and internal materials, and the mandatory process to remain compliant. Non-compliance may jeopardize program funding. Key contacts: HCARuralHealthTransformationProgram@hca.wa.gov Event schedule: - Publication date - 07/02/2026
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Core Initiatives
Washington received $181 million for year one of the Rural Health Transformation Program, with 10% set aside exclusively for Tribal governments. Initiative 3 will fund critical activities for Native families, including workforce development, care coordination, and improvement of health information technology. Tribal consultation ensured direct involvement in shaping the state's RHT strategy. Key contacts: Ryan Hill HCA Tribal Rural Health Transformation Program Event schedule: - Year one RHT funds spending deadline - 09/30/2027 - PT - Washington - Redistribution deadline if not spent - 06/01/2027 - PT - Washington
Event Schedule
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Core Initiatives
The Rural Health Transformation Program (RHTP), authorized by the One Big Beautiful Bill Act of 2025, allocates $10 billion annually to states for rural health system transformation from 2026–2030. Washington must submit a state plan to access funds, with major priorities in rural health access, workforce, quality, partnerships, and financial stability. Large potential losses in Medicaid/ACA coverage could impact hundreds of thousands of rural WA residents along with critical access and rural hospital viability.
Event Schedule
Core Initiatives
Washington received over $181 million in federal RHTP funds for Budget Period 1. State agencies and partners are implementing six initiatives spanning hospital innovation, tribal health, workforce development, technology upgrades, behavioral health, and community-based care. Year 1 activities include competitive bid awards, program design, evaluation, and engagement with rural partners and communities. Key contacts: RHT Program Inbox Not provided Event schedule: - Budget Period 1 Award Date - 12/29/2025 - PT - Olympia, WA - Next RHT Program Webinar - December 2026 - PT - Webinar
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Core Initiatives
This 2024 report identifies critical gaps in Washington State's mobile crisis response system for older adults, emphasizing fragmentation, workforce shortages, and accessibility challenges. It recommends improved funding, cross-sector collaboration, workforce development, enhanced facility capability, and prioritizing equity across underserved communities.
This page provides an overview of Washington's Rural Health Transformation Program including final plans, budgets, governor's endorsement, and webinar resources. It supports recipients with compliance resources and offers program updates. Key contacts: HCA Rural Health Transformation Program Event schedule: - webinar recording and slide deck - 09/16/2026 - webinar recording and slide deck - 04/14/2026
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Contacts
Document provides guidance on participation and funding opportunities for Washington's Rural Health Transformation program, including competitive bidding processes currently closed and instructions to sign up for program updates. Key contacts: HCA Rural Health Transformation Program
Washington's RHT Program supports six key initiatives aimed at improving rural health access, workforce, technology, and behavioral health services. The program involves many sub-awardees working collaboratively to enhance rural healthcare infrastructure and services across the state. Key contacts: HCA Rural Health Transformation Program
This supporting document provides additional information linked to Washington's RHTP Activity 1.4 grant opportunity. The program aims to sustain and strengthen maternal, emergency, and specialty health services at risk in rural communities.
Core Initiatives
09/30/2027
Year one RHT funds spending deadline
06/01/2027
Redistribution deadline if not spent
06/2026
RHT-AC first meeting
08/27/2026
Announcement of RHT-AC launch
WA RHTP site updated — 1 new, 1 existing source(s) refreshed
WA - 2026 - Last chance to submit questions for our RHTP webinar
Sep 12, 2026 11:57
·EmailWA RHTP site updated — 11 new, 0 existing source(s) refreshed
WA - 2026 - September Foundations
Sep 5, 2026 12:59
·EmailWA - 2026 - Save the date for our RHTP webinar
Sep 4, 2026 14:56
·EmailSpreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed. Showing the 40 most recent of 778.
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WA - 2026 - RFA 2026HCA9 Exhibit D Budget Proposal Template Amendment 2
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WA - 2026 - RFA 2026HCA12 Exhibit D Amendment 3
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ASAM technical support training is coming in September — ASAM technical assistance support training faq 20260730.pdf
WA - 2026 - RFA 2026HCA9 Exhibit D Budget Proposal Template
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WA - 2026 - RFA 2026HCA14 Exhibit D Budget Proposals Template
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WA - 2026 - RFP 2025HCA15 Exhibit D Cost Proposal Third Revision
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WA - 2026 - RFP 2025HCA15 Exhibit D Cost Proposal Second Revision
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WA - 2026 - RFP 2025HCA15 Exhibit D Revised Cost Proposal
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WA - 2026 - RFP 2025HCA15 Attachment 1 Revised Average Product and Client Usage
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WA - 2026 - RFP 2025HCA15 Exhibit E Data Security Questionnaire
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Washington’s Electronic Business Solution (WEBS) RHTP Meeting Minutes
WA - 2026 - hca forecasted needs report fy27
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WA - 2026 - Rural Health Transformation Program Applications ARE Underway
WA - 2026 - NewsNation Washington Correspondent Maddie Biertempfel sits down with
WA - 2026 - RFA 2026HCA12 Exhibit D Budget Proposal Template
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Washington Authorization For Release Of Information Health Care Authority Is Authorized To Release 1 Information Or Records About Last Name, First Name, Middle Initial Client I.D.
July Foundations — 60-0077-washington-health-care-privacy-toolkit.pdf
July Peer-to-Peer newsletter — 82-0692-guide-to-post-overdose-toolkit.pdf
WA - 2026 - paying for value survey payer template 2026.xlsx
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Adult Needs and Strengths Assessment (ANSA) Manual Version 2.0
Authorization / Request for Out of State Travel - State Form 823 (R12 / 5-15)
Washington Utah Code Effective 5/9/2017 Superseded 5/14/2019 63A-5-104 Definitions -- Capital Development And Capital Improvement Process -- Approval Requirements -- Limitations On
Washington MDHHS Physician Primary Care Rate Increase Initiative Database January 2016 HCPCS Code Short Description Non-Fac Fac Comments 99201 Office/Outpatient Visit New $32.44 $1
Washington Plan Management Frequently Asked Questions-Published March 5, 2015 Q1. Will Health Care Independence Program Eligible Individuals Be Able To Enroll In Any Silver Level Q
Promoting Healthy Youth, Schools, and Communities: A Guide to Community-School Health Councils
Washington Minnesota Department Of Human Services DHS-7990-ENG 1-21 Pediatric Symptom Checklist (PSC And PSC-Y) Pediatric Symptom Checklist (PSC) Parent-completed Version FIRST NAM
Washington EXECUTIVE DEPA RTMENT STATE OF CALIFORNIA EXECUTIVE ORDER N-01-19 WHEREAS The State's Spending On Prescription Drugs Has Increased At An Unsustainable Rate, Including Hi
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Complaint: United States v. Police Department of Baltimore City and Mayor and City Council of Baltimore
Service Animals - A Broad Definition (NY State Attorney General Civil Rights Bureau Brochure)
Building Trust in and Access to a COVID-19 Vaccine Among People of Color and Tribal Nations: A Framework for Action Convening Executive Summary
Louisiana Medicaid Dental Periodicity Schedule
Investigation of the Baltimore City Police Department
Washington Dealing With A Mental Health Crisis Information And Resources For First Responders P ...................... PROFESSIONAL RHTP Reference
Washington 1114 1 SEC. 3602. NO CUTS IN GUARANTEED BENEFITS. 2 Nothing In This Act Shall Result In The Reduction Or 3 Elimination Of Any Benefits Guaranteed By Law To Partici- 4 Pa
REVIA (naltrexone hydrochloride tablets USP) Prescribing Information
Washington === Sheet: B5 MH & DD Sets === RHTP Reference
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Washington League Of Minnesota Cities, Minnesota Chiefs Of Police Association, Minnesota Sheriffs Association & The Best Practices Working Group BEST PRACTICES IN Law Enforcement R
Behavioral Activation - WA State CBT Plus 2012
WA - 2026 - RFA 2026HCA9 Exhibit D Budget Proposal Template Amendment 2
Canonical HCA9 package document
WA - 2026 - RFA #2026HCA9: Workforce Incentive Program for Rural Opioid Treatment Providers
Primary source
WA - 2026 - Professional Services Contract for OTP Workforce Incentive under RHTP (Sample Draft - RFA #2026HCA9)
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WA - 2026 - RHT OTP Workforce Incentive Program - Grant Opportunity
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WA - 2026 - EXHIBIT B: Application Questions - RHT OTP Workforce Incentive Program Grant Opportunity
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WA - 2026 - RFA No. 2026HCA9 Amendment No. 1
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WA - 2026 - RHTP – OTP Workforce Incentive Program RFA No. 2026HCA9 Amendment No. 2
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WA - 2026 - Washington RHTP OTP Workforce Incentive Program (2026HCA9) Request for Applications
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WA - 2026 - RHTP – OTP Workforce Incentive Program RFA No. 2026HCA9 Amendment No. 3
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WA - 2026 - RFA No. 2026HCA14: Incentivizing Hospitals to Sustain Essential Rural Maternal, Emergency, and Specialty Services
WA - 2024 - SUPPORTING document for Washington RHTP Activity 1.4 grant opportunity
Source listing page
WA - 2026 - HCA RFA No. 2026HCA14 RHTP Grant Application
Amendment 1 Notice
WA - 2026 - RHTP – Rural Hospitals (Maternal, Emergency and Specialty Services) RFA No. 2026HCA14 Amendment No. 1
Amendment 1
WA - 2026 - RHTP – Rural Hospitals (Maternal, Emergency and Specialty Services) RFA No. 2026HCA14 Amendment No. 2
Amendment 2 (Q&A responses)
WA - 2027 - EXHIBIT A: Applicant Forms and Certifications – RHT – Rural Hospitals (Maternal, Emergency and Specialty Services) RFA No. 2026HCA14
Exhibit A: Applicant Forms and Certifications
WA - 2026 - EXHIBIT B: Application Questions RFA 2026HCA14
Exhibit B: Application Questions
WA - 2026 - PROFESSIONAL SERVICES CONTRACT for Provider Technology Fund Resulting from Solicitation Number: 2026HCA14
Exhibit C: Sample Draft Contract
Washington State received about $181 million in its first year under the Rural Health Transformation Program to support rural hospitals, clinics, and providers. The state is implementing six major initiatives aimed at enhancing access, workforce, technology, and behavioral health in rural areas. Event schedule: - RNEP informational webinar - September 15, 2026 - 11 a.m.–1 p.m. PT - webinar - ICF rural health lessons webinar - September 30, 2026 - 1–2 p.m. PT - webinar
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Core Initiatives
This Concept of Operations provides Washington's strategic blueprint for the statewide Community Information Exchange (WA CIE), a technology and legal framework funded by the Medicaid Transformation Project 2.0. WA CIE will link health and social service systems across regions, prioritize interoperability, and support community-based care coordination. The document outlines visions, mission, guiding principles, and identifies key pain points and opportunities for improvement, centering equity, client agency, and meaningful participation. Key contacts: Dan Renfroe Event schedule: - Document Published - 07/23/2026 - WA CIE Interim Advisory Committee Final Outcomes - 08/2026 - Key Informant Interviews - 2026-03 - Washington State - Focus Groups - 2026-04 - Washington State - Human Centered-Design (HCD) Mezzo Session - 2026-05 - Washington State - Human Centered-Design (HCD) Micro Session - 2026-05 - Washington State - ACH Deep Dive Meetings - 2026-05 - Washington State
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Washington received about $181 million in CMS funding to support rural hospitals, clinics, and providers. The program is administered by the Health Care Authority, Department of Health, and Department of Social and Health Services in partnership with the Governor’s Office. Key initiatives include expanding community-based care, investing in Native family health, technology, workforce development, and behavioral health. Event schedule: - Rural Nursing Education Program informational webinar - September 15, 2026 - 11 a.m.–1 p.m. PT - webinar
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Core Initiatives
This solicitation seeks vendors to support 31 rural hospital districts in Washington by providing revenue cycle assessment, direct support, and interim workforce services. The goal is to enhance financial sustainability, address revenue leakage, and build internal staff capacity through coaching, targeted projects, and expertise tailored to rural provider types. The contract ceiling is $350,000 per vendor per year, with partial and full-service bids considered; all proposals must specify provider type experience. Key contacts: Kaley Eastman Kaley@ruralcollaborative.com; Rachel Price Rachel@ruralcollaborative.com Event schedule: - Questions Deadline - 06/26/2026 - PT - Response Due Date - 07/02/2026 - 5:00 pm PT - Valify portal
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This RFQ invites qualified vendors to provide on-demand, expert support in revenue cycle management and payer contracting to rural hospitals and clinics in Washington. Services include consultation, coaching, interim staffing, and crisis support, with a strong emphasis on addressing financial sustainability and reducing revenue leakage. The budget cap is $60,000 per vendor per year, and services support compliance, quality, and operational improvement for rural health providers. Key contacts: Kaley Eastman Kaley@ruralcollaborative.com; Emily Conner emily@ruralcollaborative.com Event schedule: - Questions Deadline - 07/01/2026 - PT - Response Due Date - 07/08/2026 - 11:59 pm PST - Valify portal
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Washington launched its Rural Health Transformation Advisory Committee (RHT-AC), a cross-sector body providing feedback on the federally funded Rural Health Transformation Program. The state received about $181 million from CMS for the program's first year, with investments to support hospitals, clinics, and rural health providers. The committee will advise on program priorities and ensure rural community needs and experiences are represented. Key contacts: Councilwoman Dayna Seymour; Sarah Sullivan; Tyson Lacy; James Wallace Event schedule: - RHT-AC first meeting - 06/2026 - Announcement of RHT-AC - 08/27/2026
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This guidance details the requirements for documenting medical necessity in order to receive Medicaid reimbursement for supportive housing and supported employment services, newly available under Washington's 1115 Medicaid Transformation Waiver. The document defines eligibility criteria, covered activities, outcomes sought, and best practices for creating individualized service plans. It emphasizes the importance of accurate documentation and outlines functional and clinical assessment principles tailored to vulnerable Medicaid populations.
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Core Initiatives
Washington was awarded over $181 million for Budget Period 1 of the Rural Health Transformation Program, launching six major initiatives to strengthen rural hospital innovation, workforce, care access, and community health. Priorities were informed by extensive stakeholder engagement with explicit attention to Tribal health, behavioral health, and technological transformation. The RHTP aims for long-term, statewide system transformation, not just short-term grants. Key contacts: RHT Program Inbox Event schedule: - Application deadline: RHT Advisory Committee - 04/24/2026 - HCA RHT Webpage - Washington RHT Program Webinar #2 - September 16, 2026 - 1:00 PM PT - Teams meeting (online) - Budget Period 1 Performance Start - 12/29/2025
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