Rural Health Information Network (RHIN)
A statewide digital backbone, led by SHPDA, linking rural hospitals, clinics and health centers through EHR upgrades, network connectivity and shared data hubs.
RHTP state profile · Hawaii
Hawaii Rural Health Transformation Program
Hawaii received $188.9 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 39th of 50 states. The Hawaiʻi Office of the Governor leads the program, which funds six initiatives across the neighbor islands and rural Oʻahu, from a statewide health information network and telehealth to EMS, workforce and value-based care.
Year 1 awards, all 50 statesHI: $188.9M
Texas $281.3MNew Jersey $147.3M
$188.9MYear 1 award, 39th of 50
6Funded initiatives
4 / 5Hawaii counties are fully rural
Hawaii RHTPHawaiʻi Office of the Governor
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
Hawaii's program at a glance
The award is fixed for the year. Spending moves every quarter, so Hawaii'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$188,892,440, 39th of 50 states
Run byHawaiʻi Office of the Governor
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives6
Fully rural counties4 of 5
Spending data through July 31, 2026Hawaii's section of the Year One Report →Initiatives
What does Hawaii's RHTP fund?
Hawaii's RHTP funds six initiatives across health data, telehealth, emergency and community care, workforce, medical respite and value-based care. An RHTP Oversight Team in the Governor's Office coordinates them, and state agencies and the University of Hawaiʻi carry them out. Every funding opportunity maps to one of the six.
Pili Ola Telehealth Network
Virtual care access points in schools, libraries, workplaces, community centers and homes, plus telehealth training for rural staff.
Rural Infrastructure for Care Access (RICA)
Department of Health work on EMS, ambulances, emergency communications, community paramedicine, mobile care and rural behavioral health.
HOME RUN Rural Healthcare Workforce Pipeline
Tuition awards, residencies, recruitment and retention incentives through the UH John A. Burns School of Medicine, tied to five years of rural service.
Rural Respite Network
Medical respite care in rural areas for unhoused and post-acute patients, to cut preventable hospital stays.
Rural Value-Based Innovation and AHEAD Readiness Fund
A competitive SHPDA fund that helps rural hospitals, health centers and independent practices move to value-based care and prepare for the CMS AHEAD model.
Recipients by initiative are in Hawaii's section of the RHTP Year One Report.
Source documents
Hawaii'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 Hawaii solicitation.
PDFState of HawaiʻiHawaii RHT Program ApplicationThe compiled application the state submitted to CMS (redacted), including all six initiatives and Hawaii's policy commitments.PDFSHPDASHPDA RHIN and RVBI PresentationSHPDA's June 2, 2026 overview of the Rural Health Information Network and the value-based care fund, including planned uses.PDFCMSCMS 50-State SpotlightsCMS's short profile of each state's program, including Hawaii's.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Fully rural county (4)Honolulu County (rural Oʻahu qualifies) (1)
Eligibility
Which Hawaii counties are eligible for RHTP funding?
Hawaii's plan treats every county outside Oʻahu as rural (Hawaiʻi, Maui, Kauaʻi and Kalawao), plus every part of Honolulu County outside urban Honolulu, so only urban Honolulu falls outside the rural definition. That covers about 593,600 residents, 40.8% of the state, and about 95% of its land area. Individual programs set their own boundaries: HOME RUN, for example, counts all neighbor islands and Oʻahu's west and north sides from Waiʻanae to Hauʻula. Each solicitation states its own geographic requirements.
How to apply
How can Hawaii providers apply for RHTP funding?
Hawaii providers and vendors apply through state procurements posted on HANDS, the Hawaiʻi Awards & Notices Data System, and through program applications listed on the RHTP Funding Opportunities page, such as HOME RUN workforce awards. HOME RUN applications are paused from October 30, 2026 until at least January 2027. 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 six.
- Watch for new rounds.Check the RHTP Funding Opportunities page and HANDS, and use the RHTP contact form to register your interest area.
- 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 the RHTP team directly.Email rhtpinfo@hawaii.gov.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Hawaii 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 Hawaii's RHTP funding pay for?
Hawaii's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Hawaii's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $37.8M
Provider payments15% of award
About $28.3M
Administrative costs10% of award
About $18.9M
Rural Tech Catalyst Fund10% or $20M, whichever is less
About $18.9M
Replacing an existing EMR system5% of award
About $9.4M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Hawaii'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
Hawaii's policy commitments carry deadlines
Hawaii committed to six policy actions in its application. One is done. The compact, fitness test and nutrition bills introduced in 2026 did not pass, and CMS can reduce or recover funding if the rest slip.
SNAP soft drink restriction
Seek a USDA waiver to exclude soft drinks from SNAP purchases
USDA approved the waiver December 10, 2025; the restriction starts April 1, 2027Nurse Licensure Compact
Pass a law to join the Nurse Licensure Compact
HB 897 and SB 3104 did not pass in the 2026 sessionPsychology compact
Pass a law to join PSYPACT
SB 1552 did not pass in the 2026 sessionPhysician assistant compact
Pass a law to join the PA Licensure Compact
SB 3105 passed second reading in the Senate but did not pass in 2026Presidential Fitness Test
Require the Presidential Fitness Test in public schools, by law or administrative action
HB 2303 and SB 3122 did not pass in the 2026 sessionNutrition education for physicians
Pass a law adding nutrition to physician continuing medical education
HB 2305 and SB 3124 did not pass in the 2026 sessionHawaii already belongs to the Interstate Medical Licensure Compact for physicians.
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 Hawaii's spending data
Use the numbers in Hawaii'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 Hawaii 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 Hawaii'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 Hawaii announcements
UH's John A. Burns School of Medicine details HOME RUN education awards of up to $400,000 in tuition for students who commit to five years of work in rural Hawaii.
The Department of Health details plans for 34 new ambulances (16 in Maui County, 10 on Kauaʻi, 4 on Hawaiʻi Island and 4 on Oʻahu) and upgrades to the MEDICOM emergency radio system.
CMS announces $58 million for Hawaii: $45 million for HOME RUN workforce programs and $13 million for ambulances and emergency communications.
USDA approves Hawaii's request to move the start of its SNAP soft drink restriction to April 1, 2027.
CMS awards Hawaii $188.9 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 10, 2025USDA approves Hawaii's SNAP soft drink waiver
- Dec 29, 2025Year 1 award; Budget Period 1 begins
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Sep 1, 2026CMS announces $58 million for workforce, ambulances and emergency communications
- Oct 30, 2026Budget Period 1 ends
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Apr 1, 2027SNAP soft drink restriction takes effect
- Dec 31, 2027Deadline for nurse, psychology and PA compact legislation
- Dec 31, 2028Fitness test and nutrition education deadlines
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
SHPDA runs two competitive funds open to rural hospitals, community health centers and independent practices: the Rural Health Information Network, for EHR upgrades, connectivity and data sharing, and the Rural Value-Based Innovation and AHEAD Readiness Fund, for value-based care readiness. SHPDA presented them at $45 million and $25 million in June 2026. Watch HANDS and the RHTP Funding Opportunities page for those rounds.
For partners and vendors
Hawaii routes its funding through state agencies and the University of Hawaiʻi, which then contract or subgrant through state procurement. The Department of Health has already posted RICA procurements on HANDS for ambulances, community paramedicine and behavioral health evaluation. Health data, telehealth, EMS and workforce are the most active lanes.
For applicants and grantees
Build tracking for the metrics Hawaii reports to CMS before an award lands. Subrecipients can't opt out of reporting, and HOME RUN awards carry a five-year rural service commitment with repayment if it isn't met.
FAQ
Hawaii RHTP FAQs
Who runs Hawaii's Rural Health Transformation Program?
The Hawaiʻi Office of the Governor leads Hawaii's Rural Health Transformation Program, using federal funding from the Centers for Medicare & Medicaid Services (CMS). An RHTP Oversight Team coordinates the plan, and the State Health Planning and Development Agency (SHPDA), the Department of Health, the Department of Human Services and the University of Hawaiʻi carry out its six initiatives. Questions go to rhtpinfo@hawaii.gov. The program is Hawaii's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Hawaii receive?
Hawaii received $188,892,440 for Year 1 of the Rural Health Transformation Program, 39th of 50 states. Every state got $100 million in baseline funding, and the rest of Hawaii's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Hawaii's progress.
Can Hawaii RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Hawaii's award each year, about $37.8 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 Hawaii 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 Hawaii's plan, up to 15% of the award each year, about $28.3 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Hawaii is spending its RHTP funding?
The RHTP Year One Report tracks how much of Hawaii'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 the $58 million announced in September 2026 for HOME RUN workforce programs, ambulances and emergency communications, will appear after the next CMS refresh.
The Alliance
RHT Alliance members serving Hawaii
These RHT Alliance members serve Hawaii 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 Hawaii's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.