Collaborative EHR, IT and Cybersecurity Initiative
Regional IT and cybersecurity hubs that help rural providers upgrade electronic health records and connect to the state health information exchange.
RHTP state profile · Alabama
Alabama Rural Health Transformation Program
Alabama received $203.4 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 24th of 50 states. The Alabama Department of Economic and Community Affairs (ADECA) runs the program, which funds 11 initiatives across 58 of Alabama's 67 counties that are fully or partly rural, from health IT and maternal care to EMS and rural workforce.
Year 1 awards, all 50 statesAL: $203.4M
Texas $281.3MNew Jersey $147.3M
$203.4MYear 1 award, 24th of 50
11Funded initiatives
58 / 67Alabama counties are fully or partly rural
ADECAAlabama Department of Economic and Community Affairs
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
Alabama's program at a glance
The award is fixed for the year. Spending moves every quarter, so Alabama's section of the RHTP Year One Report tracks how much was put to work, and with whom, through July 31, 2026. It updates after each CMS data release.
Year 1 award$203,404,327, 24th of 50 states
Run byAlabama Department of Economic and Community Affairs
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives11
Rural counties58 of 67
Spending data through July 31, 2026Alabama's section of the Year One Report →Initiatives
What does Alabama's RHTP fund?
Alabama's RHTP funds 11 initiatives across health IT, telehealth, maternal care, cancer screening, EMS, mental health and workforce. Ten of them had Year 1 funding rounds, and every ADECA funding opportunity maps to one of the 11.
Rural Health Initiative
Telehealth and tele-consults, minor facility upgrades, nonemergency transportation and a pilot rural health network for shared services.
Maternal and Fetal Health Initiative
Links rural hospitals to maternal-fetal care hubs through telerobotic ultrasound and emergency labor and delivery carts.
Rural Workforce Initiative
Training and recruitment pipelines for physicians, nurses, EMS staff, midwives and dental staff, plus more rural residency training.
Cancer Digital Regionalization Initiative
Expands cancer screening and treatment through regional hubs and mobile units, building on the Operation Wipe Out cervical cancer model.
Simulation Training Initiative
Simulation-based training so rural providers can offer more specialty care close to home.
Statewide EMS Trauma and Stroke Initiative
Extends the statewide system that routes trauma and stroke patients to the right hospital to all EMS agencies and hospitals.
EMS Treat-in-Place Initiative
Pilots on-site EMS treatment for low-acuity patients, backed by telehealth consults, without a trip to the hospital.
Mental Health Initiative
School-based tele-mental health, plus help for community mental health centers becoming certified community behavioral health clinics.
Community Medicine Initiative
Mobile wellness screening units, mobile grocery units and community health education.
Rural Health Practice Initiative
Opens or upgrades networked rural clinics, including school-based health and dental clinics, with shared services.
Recipients by initiative are in Alabama's section of the RHTP Year One Report.
Source documents
Alabama's full plan is public
The approved plan has more detail than any summary: goals, partners, metrics and timelines for each initiative. Read it before responding to an Alabama funding opportunity.
PDFADECAAlabama RHT Program Project NarrativeThe full plan from ADECA, including all 11 initiatives and Alabama's policy commitments.PDFADECAAlabama RHT Program ManualADECA's operating guide to governance, funding rules and reporting, revised September 2026.PDFADECAAlabama RHT Rural CountiesADECA's list of the 58 counties the program covers.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Rural or partly rural county (58)Other counties (9)
Eligibility
Which Alabama counties are eligible for RHTP funding?
Alabama's program covers 58 of the state's 67 counties, the ones the federal Office of Rural Health Policy classifies as fully or partly rural, home to about 1.6 million residents. Eligibility follows HRSA's rural census tracts, so in partly rural counties it depends on the tract. The nine counties not covered are Autauga, Colbert, Houston, Jefferson, Lee, Madison, Montgomery, Russell and Tuscaloosa, but an applicant located anywhere can apply if its project mainly serves rural Alabamians.
View ADECA's list of rural counties →How to apply
How can Alabama providers apply for RHTP funding?
Alabama providers apply through Notices of Funding Opportunity (NOFOs) from ADECA, posted on the Alabama RHTP website and submitted through its application portal. All Year 1 rounds have closed, and Year 2 dates have not been announced. Providers and vendors don't apply to CMS directly.
- Match the work to an initiative.Each initiative has its own NOFO, and funding only goes to work that fits one of the 11.
- Sign up for updates.ADECA sends email notices to people who complete the Contact Us form on the Alabama RHTP website, where Year 2 NOFOs will post.
- Register in SAM.gov.Applicants need a UEI and an active SAM.gov registration before a subaward is signed.
- Plan for federal rules.Grant recipients follow federal grant, reporting and audit rules. A Single Audit applies at $1 million or more in federal spending a year.
- Ask ADECA directly.Email info@alabamarhtp.com.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Alabama recipient.
Grants and contracts carry different obligations
A subaward makes your organization a subrecipient that carries out part of the program, with federal reporting and audit requirements. A contract pays for goods or services, with lighter requirements.
New rounds follow CMS budget approval
States can't post funding opportunities until CMS approves their budget, so windows can open months into a budget period.
Workforce incentives need a rural commitment
Recruitment and retention payments require clinicians to commit to serving rural communities for at least five years.
Recipients must disclose the federal funding
Under the Stevens Amendment, websites, social posts and other public materials about a funded project must name the federal funding.
Allowable costs
What can Alabama's RHTP funding pay for?
Alabama's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Alabama's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $40.7M
Provider payments15% of award
About $30.5M
Administrative costs10% of award
About $20.3M
Rural Tech Catalyst Fund10% or $20M, whichever is less
$20.0M
Replacing an existing EMR system5% of award
About $10.2M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Alabama's plan. They can't raise rates for services providers already bill.
Capital funds go to existing facilities: renovations, accessibility upgrades, HVAC and like-for-like equipment replacement.
Off limits
- New construction, demolition and major expansions
- Cosmetic work such as painting, carpet or decor
- Clinician salaries at facilities that use non-compete clauses
- Home broadband installation and service
- Costs already covered by other federal or state funding
Policy commitments
Alabama's policy commitments carry deadlines
Alabama committed to six policy actions in its application. Two are done. CMS can reduce or recover funding if the rest slip.
Governor's advisory group
Create an advisory group by executive order to recommend rural health policy reforms
Executive Order 741 signed December 18, 2025EMS treat-in-place payment
Pursue a law or rules so EMS can be paid for treating patients without transport
SB 269 signed April 2026SNAP sugary food restriction
Seek a USDA waiver to exclude soda and candy from SNAP purchases
SB 57 signed April 15, 2026. USDA has not yet approved a waiverTelehealth parity and credentialing
Pursue a law or rules for telehealth payment parity and cross-facility credentialing
Presidential Fitness Test
Add the Presidential Fitness Test to school physical education
Nutrition education for physicians
Add nutrition to physicians' continuing medical education requirements
Alabama already belonged to the physician, nurse, EMS and psychology licensure compacts, and joined the physician assistant compact in March 2026.
Years 2 to 5
$40B
Future awards depend on progress
Year 1 is not a guaranteed annual amount. CMS plans up to $40 billion more nationwide through 2030 and rescores every state each year on progress, data and policy actions.
Unobligated money leaves the state
Funds not obligated by the end of a budget period can't be obligated later and are redistributed to other states.
Funds can be clawed back
CMS can withhold, reduce or recover money for unallowable costs, unapproved plan changes or missed policy commitments. States get 90 days to fix a violation, and most decisions can't be appealed.
Oversight is growing
CMS's Office of Rural Health Transformation plans site visits in all 50 states in 2026. Audits start in 2027.
Method
Reading Alabama's spending data
Use the numbers in Alabama's section of the RHTP Year One Report to understand direction and pace, not as an audit.
Put to work is not paid out
Obligated money is signed to a contract or grant. Cash reaches recipients later.
Through July 31, 2026 only
The data covers December 29, 2025 to July 31, 2026, as Alabama reported it to CMS. Commitments made after July 31, 2026 are not counted yet.
Recipients sit inside line items
The CMS report has no recipient column. Search Alabama's line item descriptions by name.
Quarterly refresh
CMS updates the data after each quarterly state report, starting with the November 30, 2026 filing.
Announcements
Major Alabama announcements
Governor Ivey announces 34 more grants totaling nearly $55 million across seven initiatives, including $20.6 million to the Alabama Community College System, rounding out Year 1.
Governor Ivey announces the first 138 grants, totaling more than $144 million, for health IT and cybersecurity, rural health, workforce, rural clinics and mental health.
ADECA opens its first five funding rounds through the Alabama RHTP portal. Five more follow in July.
Governor Ivey signs health bills tied to the program, including EMS treat-in-place payment, limited antitrust immunity for rural providers and the SNAP waiver request.
CMS awards Alabama $203.4 million for Year 1.
Governor Ivey creates the Alabama Rural Health Transformation Advisory Group by executive order.
Awards announced after July 31, 2026 are not in the CMS spending data yet. They will appear after the next CMS refresh.
Timeline
Key dates
- Dec 18, 2025Advisory group created by Executive Order 741
- Dec 29, 2025Year 1 award; Budget Period 1 begins
- Jun 26, 2026First five Year 1 funding rounds close
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Aug 7, 2026Second five Year 1 funding rounds close
- Aug 24, 2026First 138 grants announced
- Oct 1, 2026Second round of Year 1 grants announced
- Oct 30, 2026Budget Period 1 ends
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Jul 31, 2027Deadline for subrecipients to spend Year 1 funds
- Sep 30, 2027Deadline to spend all Year 1 state funds
- Dec 31, 2027Telehealth policy deadline
- Dec 31, 2028Fitness test and nutrition education deadlines
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
The Rural Health Initiative drew the most Year 1 grants, covering telehealth, tele-consults and minor facility upgrades. A new state law, HB 605, gives rural providers limited antitrust immunity to share services, staff and facilities. Watch for Year 2 NOFOs and apply early, since ADECA says incomplete applications are likely to be ruled ineligible.
For partners and vendors
Alabama routed many Year 1 grants through universities, health systems and the Alabama Community College System, and consortium applications with a lead organization are allowed. Partnering with those leads is one route in. ADECA buys its own program support through state RFPs on STAARS. Health IT and cybersecurity, telehealth, EMS and cancer screening are the most active lanes.
For applicants and grantees
Build tracking for the measures Alabama reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Alabama's annual rescoring. Funding is awarded yearly, so plan for a possible gap between Year 1 and Year 2, and spend Year 1 subawards by July 31, 2027.
FAQ
Alabama RHTP FAQs
Who runs Alabama's Rural Health Transformation Program?
The Alabama Department of Economic and Community Affairs (ADECA) runs Alabama's Rural Health Transformation Program, using federal funding from the Centers for Medicare & Medicaid Services (CMS). ADECA manages the state's plan, posts funding opportunities and answers questions at info@alabamarhtp.com. An advisory group of state lawmakers, created by Governor Ivey, advises on policy and progress. The program is Alabama's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Alabama receive?
Alabama received $203,404,327 for Year 1 of the Rural Health Transformation Program, 24th of 50 states. Every state got $100 million in baseline funding, and the rest of Alabama's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Alabama's progress.
Can Alabama RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Alabama's award each year, about $40.7 million in Year 1, can go to work on existing facilities, such as renovations, accessibility upgrades, HVAC replacement and like-for-like equipment replacement.
Can Alabama providers use RHTP funding to pay for patient care?
Only for care that insurance doesn't already pay for. Provider payments can cover nonreimbursed services, quality bonuses and outcome-based payments tied to Alabama's plan, up to 15% of the award each year, about $30.5 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Alabama is spending its RHTP funding?
The RHTP Year One Report tracks how much of Alabama's award was put to work through July 31, 2026, by initiative and recipient, using state-reported data from CMS, and is updated after each CMS data release. Grants announced after July 31, including more than $144 million in August 2026 and nearly $55 million in October 2026, will appear after the next CMS refresh.
The Alliance
RHT Alliance members serving Alabama
These RHT Alliance members serve Alabama providers, with support that spans virtual nursing, virtual care, remote monitoring, health data, diagnostics, patient education and grant writing.
Azalea HealthCloud EHR and billing with AI-assisted charting for rural hospitals and clinics.
CorstrataTelehealth access to board-certified wound, ostomy and continence nurses.
Equum MedicalTelehealth-enabled physician coverage across specialties.
Health Recovery SolutionsRemote patient monitoring and care management at home.
InterSystemsHealth data platforms and interoperability.
Medical Equipment SourceDigital pathology, mobile labs and lab equipment services.
Rural Health Transformation Funding NetworkGrant writing support for RHTP funding opportunities.
Self Care DecisionsEvidence-based triage that directs patients to the right level of care.
Solid StartsInfant feeding guidance and education for families, built by pediatric feeding specialists.
Teledentistry.com24/7 virtual dental evaluations and emergency triage.
VitalChatVirtual nursing and continuous audio and video care across hospitals.
WebMD IgniteMedically reviewed patient education and outreach, including its HEART rural program.Follow Alabama's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.