Make Rural Nebraska Healthy Again Through Food as Medicine
School kitchen upgrades, regional food pantries, farm-to-school buying, healthy menu training and a kids fitness and nutrition day.
RHTP state profile · Nebraska
Nebraska Rural Health Transformation Program
Nebraska received $218.5 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 8th of 50 states. The Nebraska Department of Health and Human Services (DHHS) runs the program, which funds seven initiatives across Nebraska's 88 rural counties, from food as medicine and community health workers to remote patient monitoring and rural workforce incentives.
Year 1 awards, all 50 statesNE: $218.5M
Texas $281.3MNew Jersey $147.3M
$218.5MYear 1 award, 8th of 50
7Funded initiatives
88 / 93Nebraska counties are rural
DHHSNebraska Department of Health and Human 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
Nebraska's program at a glance
The award is fixed for the year. Spending moves every quarter, so Nebraska'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$218,529,075, 8th of 50 states
Run byNebraska Department of Health and Human Services
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives7
Rural counties88 of 93
Spending data through July 31, 2026Nebraska's section of the Year One Report →Initiatives
What does Nebraska's RHTP fund?
Nebraska's RHTP funds seven initiatives across nutrition, regional care and navigation, workforce, mobile and remote care, behavioral health, assisted living and health technology. Each initiative has numbered projects, such as 4.4b Remote Patient Monitoring, and every DHHS request for applications carries one of those numbers.
Regionalized Rural Access and Navigation
EMS and perinatal regionalization, community paramedicine, community health worker networks, veteran care coordination and help for critical access hospitals converting to rural emergency hospitals.
Rural Workforce Acceleration
Recruitment and retention incentives for a five-year rural commitment, VR skills training, new training sites, a school-age career pipeline and short-term provider housing.
eHealth and Mobile Care
Mobile maternal care, oral health services, technology-enabled pharmacy services, and chronic disease management with remote patient monitoring.
Rural Emergency Behavioral Health
Behavioral health in primary care, telehealth crisis support for law enforcement, crisis stabilization space in existing facilities and a behavioral health nursing home pilot.
Assisted Living Facility (ALF) Special Needs Population Incentive Model
Incentive payments for memory care and complex care in assisted living, plus facility modernization grants.
Nebraska Rural Health Technology Catalyst Fund and Partnership Initiative
Grants for early-stage health technology piloted in rural Nebraska, run by Invest Nebraska as the NETECH Rural Health Catalyst Fund.
Recipients by initiative are in Nebraska's section of the RHTP Year One Report.
Source documents
Nebraska'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 Nebraska request for applications.
PDFDHHSNebraska RHT Program Project NarrativeThe full plan from DHHS, including all seven initiatives and Nebraska's policy commitments.PDFDHHSNebraska Rural Health Transformation InitiativesDHHS's list of every numbered project under the seven initiatives.PDFDHHSNebraska RHT Project SummaryDHHS's short abstract of the plan.PDFCMSCMS 50-State SpotlightsCMS's short profile of each state's program, including Nebraska's.
Rural county (88)Other counties (5)
Eligibility
Which Nebraska counties are eligible for RHTP funding?
Nebraska's plan counts 88 of the state's 93 counties as rural under the HRSA definition, including 30 frontier counties, and 37% of Nebraskans live in rural areas. Each request for applications states its own geographic rules; the Rural Health Workforce Incentive Program, for example, covers every county except Douglas, Lancaster and Sarpy.
How to apply
How can Nebraska providers apply for RHTP funding?
Nebraska providers apply through Requests for Applications (RFAs) from DHHS, posted on its Grant Opportunities page, and some rounds run through partners such as the Nebraska Department of Education and Invest Nebraska. All 12 Year 1 DHHS RFAs have closed, and the NETECH Rural Health Catalyst Fund takes applications through November 9, 2026. Providers and vendors don't apply to CMS directly.
- Match the work to a project.Funding only goes to work that fits one of the seven initiatives, and each RFA names its project number.
- Sign up for RHTP updates.DHHS announces new RFAs through its RHTP email list and the Grant Opportunities page.
- Register as a vendor.DHHS grants require state vendor registration. SAM.gov registration 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 DHHS directly.Email DHHS.RHTP@nebraska.gov.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Nebraska 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 Nebraska's RHTP funding pay for?
Nebraska's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Nebraska's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $43.7M
Provider payments15% of award
About $32.8M
Administrative costs10% of award
About $21.9M
Rural Tech Catalyst Fund10% or $20M, whichever is less
$20.0M
Replacing an existing EMR system5% of award
About $10.9M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Nebraska'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
Nebraska's policy commitments carry deadlines
Nebraska committed to five policy actions in its application. None is done yet, and the SNAP restriction the plan cited as already in place has ended after a court ruling. CMS can reduce or recover funding if commitments slip.
Presidential Fitness Test
Bring back the Presidential Fitness Test in schools
Certificate of need
Remove certificate of need review for long-term care bed expansion
LB 437, signed February 2026, extended how long a certificate stays valid insteadCommunity health worker certification
Get legislative authority for state certification of community health workers
LB 912, signed April 14, 2026, set up state endorsement of CHW training programsCommunity paramedicine coverage
Submit a Medicaid State Plan Amendment and state rules for community paramedicine
Medicaid remote care coverage
Add Medicaid coverage for remote monitoring, chronic care management and maternal transport
Plan calls for a pilot in 2027SNAP soda and energy drink restriction
Restrict soda and energy drink purchases with SNAP under a USDA waiver
In effect January 1, 2026; a federal court vacated the waiver June 22, 2026Nebraska already belongs to the physician, nurse, EMS, psychology and physician assistant licensure compacts, and LB 912 added the athletic trainer and respiratory care compacts in April 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 Nebraska's spending data
Use the numbers in Nebraska'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 Nebraska 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 Nebraska'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 Nebraska announcements
CMS announces more than $177 million in Nebraska RHTP funding, including recruitment contracts in 51 counties, remote monitoring at 45 facilities and more than 200 community health worker positions.
DHHS reports about $136 million committed through nearly 200 grant agreements, led by about $18 million for remote monitoring across the Nebraska High Value Network's 22 rural hospitals.
DHHS launches the Nebraska RHTP Dashboard, mapping awarded funds and drive times to care.
DHHS opens rounds for school kitchens, critical access and rural emergency hospital upgrades, VR training and mental health crisis facilities.
DHHS opens the Rural Health Workforce Incentive Program for providers who commit to five years in a rural county.
DHHS releases its first RFAs, after CMS approved Nebraska's revised plan and budget on February 27.
CMS awards Nebraska $218.5 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 27, 2026CMS approves Nebraska's revised plan and budget
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Oct 30, 2026Deadline to obligate Year 1 funds; Budget Period 1 ends
- Nov 9, 2026NETECH Rural Health Catalyst Fund applications due
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Sep 30, 2027Deadline to spend Year 1 funds
- Dec 31, 2028Presidential Fitness Test deadline
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
Remote patient monitoring drew Nebraska's largest award, and critical access and rural emergency hospitals have their own upgrade and conversion funding. Watch the next DHHS rounds, and take part in your Health Care Advisory Region, which gives DHHS regional input on the program.
For partners and vendors
Nebraska routes much of its money through hospitals, local health departments, networks and partners such as Invest Nebraska and the Department of Education. Partnering with those recipients is one route in, alongside direct DHHS RFAs. Remote monitoring, VR training, telehealth crisis tools and early-stage health technology are the most active lanes.
For applicants and grantees
Build tracking for the measures Nebraska reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Nebraska's annual rescoring. Year 1 funds must be spent by September 30, 2027.
FAQ
Nebraska RHTP FAQs
Who runs Nebraska's Rural Health Transformation Program?
The Nebraska Department of Health and Human Services (DHHS) runs Nebraska's Rural Health Transformation Program, using federal funding from the Centers for Medicare & Medicaid Services (CMS). DHHS manages the state's plan, posts funding opportunities and answers questions at DHHS.RHTP@nebraska.gov. The program is Nebraska's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Nebraska receive?
Nebraska received $218,529,075 for Year 1 of the Rural Health Transformation Program, 8th of 50 states. Every state got $100 million in baseline funding, and the rest of Nebraska's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Nebraska's progress.
Can Nebraska RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Nebraska's award each year, about $43.7 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 Nebraska 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 Nebraska's plan, up to 15% of the award each year, about $32.8 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Nebraska is spending its RHTP funding?
The RHTP Year One Report tracks how much of Nebraska'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. DHHS also keeps its own RHTP Dashboard of awarded funds, which includes awards made after July 31.
The Alliance
RHT Alliance members serving Nebraska
These RHT Alliance members serve Nebraska 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 Nebraska's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.