Hawaii RHTP — Pre-Solicitation Framework
Hawaii
Eligible Entity Types
Funding
Tribal Provisions
Hawaii has no federally recognized tribal nations. Native Hawaiians are recognized under specific federal legislation (Native Hawaiian Health Care Improvement Act; Native Hawaiian Health Care Systems) but are NOT organized as federally recognized tribes under the federal Indian tribal framework. No tribal set-aside or Native Hawaiian-specific funding track has been identified in Hawaii's RHTP application. Native Hawaiians are disproportionately represented in rural and underserved Hawaii communities and are likely among the primary beneficiaries of RHTP-funded services delivered through FQHC, CAH, and community health programs.
Application Guide
Hawaii received $188,892,440 in Year 1 RHTP funding — among the highest per-rural-resident figures nationally, given Hawaii's small rural population of approximately 279,500. The lead agency is the Department of Health's Office of Primary Care and Rural Health (OPCRH).
Hawaii's rural health context is unique: it is the only island-state in the program. Healthcare delivery across six inhabited islands separated by ocean creates logistical complexity that no continental state faces — providers on Molokai, Lanai, or the Big Island cannot refer patients to a neighboring county without a flight or ferry. The nine CAHs serve communities where the nearest alternative facility may be a 30-minute flight away.
The state's implementation model signals a coordinated, state-administered approach rather than purely competitive open grants — the program description references an "oversight team" across state departments and healthcare organizations. Whether sub-grants will flow through a competitive RFA or negotiated partnership model has not been published. Six named initiatives cover digital infrastructure (RHIN), telehealth (Pili Ola), EMS and mobile health (RICA), workforce (HOME RUN), medical respite (Rural Respite Network), and value-based care (Rural Value-Based Innovation and AHEAD Readiness Fund). Initiative 6 is described as a "competitive fund" — the most likely first application opportunity for independent providers.
OPCRH: health.hawaii.gov/opcrh/. Community engagement: engage.hawaii.gov/rhtp/. Award: $188,892,440 Year 1 (~$675/rural resident — among highest per-capita nationally). 9 CAHs, 35 FQHCs, 22 RHCs. No solicitation published; budget negotiations with CMS ongoing. Year 1 expenditure deadline: September 30, 2027.