Rural "Hope Center" Initiative
Two new Hope Centers in Kent and Sussex counties that combine housing, primary care and behavioral health for people experiencing homelessness.
RHTP state profile · Delaware
Delaware Rural Health Transformation Program
Delaware received $157.4 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 47th of 50 states. The Delaware Department of Health and Social Services (DHSS) runs the program, which funds 15 initiatives in rural Kent and Sussex counties, from the state's first medical school and Hope Centers to mobile health units and value-based care.
Year 1 awards, all 50 statesDE: $157.4M
Texas $281.3MNew Jersey $147.3M
$157.4MYear 1 award, 47th of 50
15Funded initiatives
2 / 3Delaware counties are fully or partly rural
DHSSDelaware Department of Health and Social Services
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
Delaware's program at a glance
The award is fixed for the year. Spending moves every quarter, so Delaware'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$157,394,963, 47th of 50 states
Run byDelaware Department of Health and Social Services
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives15
Rural counties2 of 3
Spending data through July 31, 2026Delaware's section of the Year One Report →Initiatives
What does Delaware's RHTP fund?
Delaware's RHTP funds 15 initiatives under four goals: expand access, strengthen the workforce, drive innovation and improve outcomes. Every DHSS funding opportunity maps to one of the 15.
Rural Community Health Hubs
Mobile health units and community access points offering preventive care, chronic disease management and specialty services.
School-Based Health Centers Expansion Initiative
Four new health centers in rural elementary and middle schools in Kent and Sussex counties.
Food is Medicine Infrastructure Initiative
Payment, technology and training infrastructure for nutrition-based care for rural residents with chronic disease.
Rural Libraries Health Access Initiative
Telehealth, health navigation and social services at nine rural libraries.
Rural Provider and FQHC Value-Based Care Readiness Initiative
Health IT, expanded care teams and a provider-payer framework to help rural providers and FQHCs move to value-based payment.
Catalyst Fund for Telehealth and Remote Monitoring
Grants to companies building consumer telehealth and remote monitoring tools for rural residents.
Rural Delaware Diabetes Wellness Pilot Program
Continuous glucose monitors, care management and analytics for 500 rural Sussex County patients.
Delaware Medical School
Start-up funding for the state's first four-year medical school, with a primary care and rural health track.
Medical School Rural Workforce Development Program
Financial awards for medical students who commit to five years of rural practice.
Rural Medical Residency Recruitment Program
Housing and relocation awards for medical residents who commit to five years of rural practice.
Training Programs for Clinical Support Roles in Rural Areas
Grants to expand training for nurse practitioners, physician assistants, community health workers, dental staff and other clinical roles.
Rural Health Workforce Education Program
Education awards for students in clinical training programs who commit to five years of rural service.
Healthcare Workforce Data Center Initiative
A data center that tracks health workforce supply, demand and distribution, using authority from Senate Bill 122.
Statewide Health Information Technology Infrastructure for Real-Time Insurance Verification and Prior Authorizations
A statewide network, run with the Delaware Health Information Network, for real-time insurance checks and electronic prior authorizations.
Recipients by initiative are in Delaware's section of the RHTP Year One Report.
Source documents
Delaware'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 a Delaware solicitation.
PDFDHSSDelaware RHT Program Project NarrativeThe full plan, dated January 16, 2026, including all 15 initiatives and Delaware's policy commitments.PDFDHSSDelaware RHT Executive Budget SummaryThe revised budget for each initiative, dated January 30, 2026.PDFCMSCMS 50-State SpotlightsCMS's short profile of each state's program, including Delaware's.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Rural or partly rural county (2)New Castle County (1)
Eligibility
Which Delaware counties are eligible for RHTP funding?
Delaware's plan focuses on two of its three counties: Sussex, which is fully rural, and Kent, which is partly rural, under the federal Office of Rural Health Policy definition. New Castle County is not rural. About 400,000 people, nearly 40% of Delawareans, live in the areas the plan targets, and each solicitation states its own geographic requirements.
How to apply
How can Delaware providers apply for RHTP funding?
Delaware providers and vendors apply through requests for proposals from the Department of Health and Social Services, posted on the state's Bid Solicitation Directory. Some programs run through partners, such as the Delaware Rural Health Challenge at Delaware Prosperity Partnership. No Year 1 round was open as of November 2, 2026. Providers and vendors don't apply to CMS directly.
- Match the work to an initiative.Funding only goes to work that fits one of the 15, and the Project Narrative describes each.
- Watch for new rounds.DHSS posts RHTP requests for proposals on bids.delaware.gov and releases them on a rolling basis. The state's bid notification service can send alerts.
- Register in SAM.gov.It is standard for federally funded grants and contracts.
- 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 DHSS directly.Email dhssinfo@delaware.gov, or the contract officer named on each solicitation.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Delaware 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 Delaware's RHTP funding pay for?
Delaware's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Delaware's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $31.5M
Provider payments15% of award
About $23.6M
Administrative costs10% of award
About $15.7M
Rural Tech Catalyst Fund10% or $20M, whichever is less
About $15.7M
Replacing an existing EMR system5% of award
About $7.9M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Delaware'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
Delaware's policy commitments carry deadlines
Delaware committed to five policy actions in its application. None is fully done yet, though 2026 laws made progress on two. CMS can reduce or recover funding if they slip.
Certificate of Public Review reform
Loosen or eliminate certificate of need rules that slow new rural facilities
HB 17, signed May 12, 2026, eased some equipment review rulesScope of practice
Let nurse practitioners, physician assistants, pharmacists and dental hygienists practice at the top of their training
Physician associate (HB 325), pharmacist (SB 320) and dental hygienist (SB 283) bills signed in 2026Telehealth payment parity
Require all payers to pay for telehealth at in-person rates
Nutrition education for physicians
Require nutrition continuing medical education by regulation
To apply to license renewals from January 1, 2029Presidential Fitness Test
Require schools to bring back the Presidential Fitness Test
Delaware already belongs to the physician, nurse, EMS, psychology and physician assistant licensure compacts.
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 Delaware's spending data
Use the numbers in Delaware'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 Delaware 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 Delaware'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 Delaware announcements
CMS announces more than $1 million for rural physician recruitment in Delaware, including education awards for medical students and about 61 housing and relocation awards for residents who commit to five years of rural practice.
Delaware launches the Delaware Rural Health Challenge, with up to $5 million in grants for health technology startups serving rural Delawareans.
CMS announces nearly $23 million for Westside Family Healthcare, La Red Health Center and Henrietta Johnson Medical Center, for records upgrades, remote monitoring, care teams and mobile health units.
Delaware picks Thomas Jefferson University to open the state's first four-year medical school, with clinical training mainly in Kent and Sussex counties.
Gov. Matt Meyer signs HB 17, easing Certificate of Public Review rules, and HB 325, modernizing physician associate practice.
Delaware opens its first four RHTP requests for proposals: the medical school, school-based health centers, Food is Medicine and rural community health hubs.
CMS awards Delaware $157.4 million for Year 1.
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 29, 2025Year 1 award; Budget Period 1 begins
- Feb 9, 2026First four RHTP requests for proposals open
- Jun 2, 2026Medical school partner announced
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Oct 30, 2026Budget Period 1 ends
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Jun 30, 2027Target votes on certificate of need, scope of practice and telehealth parity bills
- Sep 30, 2028Nutrition education rule approval deadline
- Dec 31, 2028Presidential Fitness Test deadline
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
Delaware's Year 1 budget puts little directly into hospitals. The largest lines are the medical school ($42.5 million), Hope Centers ($26.4 million), value-based care readiness ($24.3 million) and clinical training ($20.9 million). Hospitals in Kent and Sussex are most likely to take part through clinical training for the new medical school and the prior authorization network, which plans a five-hospital pilot.
For partners and vendors
DHSS buys through state requests for proposals on the Bid Solicitation Directory. Active technology lanes include telehealth and remote monitoring, real-time insurance verification and prior authorization, workforce data and continuous glucose monitoring. The Delaware Rural Health Challenge funds startups through Delaware Prosperity Partnership.
For applicants and grantees
Build tracking for the metrics Delaware reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Delaware's annual rescoring. Many workforce awards also carry five-year rural service commitments.
FAQ
Delaware RHTP FAQs
Who runs Delaware's Rural Health Transformation Program?
The Delaware Department of Health and Social Services (DHSS) runs Delaware's Rural Health Transformation Program with its Division of Public Health and the Governor's Office, using federal funding from the Centers for Medicare & Medicaid Services (CMS). DHSS manages the state's plan, posts funding opportunities and answers questions at dhssinfo@delaware.gov. The program is Delaware's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Delaware receive?
Delaware received $157,394,963 for Year 1 of the Rural Health Transformation Program, 47th of 50 states. Every state got $100 million in baseline funding, and the rest of Delaware's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Delaware's progress.
Can Delaware RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Delaware's award each year, about $31.5 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 Delaware 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 Delaware's plan, up to 15% of the award each year, about $23.6 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Delaware is spending its RHTP funding?
The RHTP Year One Report tracks how much of Delaware'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. Awards announced after July 31, such as nearly $23 million in September 2026 for three Delaware health centers, will appear after the next CMS refresh.
The Alliance
RHT Alliance members serving Delaware
These RHT Alliance members serve Delaware providers, with support that spans EHR and billing, 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 Delaware's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.