Maryland
Maryland Department of Health (MDH)
Year 1 Award
$168.2M
Solicitations
01
CMS allocated RHTP funding to this state in December 2025. The state has not yet announced a lead agency, implementation timeline, or sub-grantee solicitation.
Analysis
Maryland's RHTP profile is unusual among the 50 states: the state has zero Critical Access Hospitals and zero federally recognized tribes, which removes two of the most common RHTP eligible-entity types from its sub-grant landscape. The $168.2 million award will flow through the Maryland Department of Health and is structured around three broad goals — workforce, access and care innovation, and food access — with a notable food systems angle that reflects the state's agricultural economy and rural hunger hotspot geography. This is not a typical RHTP investment mix, and it signals that Maryland is treating food security as a legitimate health intervention rather than an add-on. Implementation pace is cautious but deliberate. MDH launched a Rural Health Transformation Committee in early 2026 (first meeting February 26, 2026), which will meet at least quarterly. The state conducted an RFI (325+ responses) and 17 local listening sessions before finalizing its application, which argues for an agency comfortable with public engagement but not yet in a rush to move money. The dual-track structure — Immediate Impact Funds for shovel-ready activities and Transformation Funds issued competitively — suggests organizations need to watch for two distinct solicitation types, likely on different timelines.
Applications & Compliance
Implementation Model
Maryland has structured its distribution model as a dual-track grant program. "Immediate Impact Funds" are intended for activities that can be deployed rapidly without extended procurement timelines; these are most likely to benefit established organizations with existing infrastructure. "Transformation Funds" will be issued competitively, requiring longer-term planning and formal competitive applications to MDH. The state has not yet published a sub-grantee RFA as of March 2026, and the Rural Health Transformation Committee's quarterly meeting cadence suggests the solicitation framework will take shape in mid-2026. Smaller organizations, FQHCs, school-based health centers, and community-based organizations are explicitly named as program targets, which is meaningful given the absence of CAHs — those entity types will be the primary recipients here rather than a secondary track.
Investment Priorities
Workforce Transformation
Expand development, recruitment, and retention of the rural health workforce across medical and behavioral health fields. Activities include community health worker apprenticeships, nursing assistant programs, peer recovery training, and Area Health Education Center (AHEC) expansion. Both Immediate Impact and Transformation Fund tracks are active for this initiative.
Sustainable Access and Care Innovation
Expand access to primary and specialty care, school-based health centers, telehealth infrastructure, and behavioral health integration. Immediate Impact Funds cover primary/specialty care capacity expansion, health IT optimization including AI-powered patient risk alerts, and telehealth. Transformation Funds cover expanded physical and behavioral health services. This initiative reflects the absence of CAHs — Maryland is investing in access infrastructure through non-hospital pathways.
Food Access and Health
Post-harvest infrastructure for small farms supplying local markets, mobile markets in rural hunger hotspots, grocery store access, and aggregation systems linking farmers to large-scale institutional buyers. This initiative is specific to Maryland's RHTP application and is not a standard RHTP category name. The investment reflects western Maryland's agricultural economy and food desert geography in Garrett and Allegany counties.
What to Watch
Transformation Fund RFA release
Expected mid-2026This is the competitive solicitation that will determine which organizations can access the larger share of Maryland's RHTP funds. The dual-track structure means Immediate Impact funds may move first and on a separate timeline. Organizations should monitor mdh.transformruralhealth@maryland.gov and the MDH RHTP page for announcement.
Eligible entity scope for FQHCs and CBOs
TBD at solicitationMaryland's framing explicitly names FQHCs, school-based health centers, community-based organizations, and AHECs as program targets — but eligibility language in the actual RFA will determine whether these are the only eligible types or whether other rural providers can apply. Given 0 CAHs, the hospital track is moot; the FQHC and CBO tracks are the primary access points.
Food Access initiative solicitation mechanism
TBDThe food access and health initiative is unusual. It is unclear whether this will be a separate RFA targeting farms and food-system organizations or bundled into the general Transformation Fund solicitation. Agricultural co-ops, local health departments, and food banks should monitor closely.
Rural Health Transformation Committee composition and influence
Q2 2026The committee is accepting volunteer applications from rural Maryland organizations. Active participation will provide advance signal on implementation priorities and solicitation timing. Contact: mdh.transformruralhealth@maryland.gov.
No federally recognized tribes, no CAHs
Structural gapMaryland's 0 CAH / 0 federally recognized tribe profile means two standard RHTP eligible-entity categories are absent from the state's landscape. State-recognized tribes (Piscataway-Conoy, Piscataway Indian Nation, Accohannock) may be eligible as CBOs under the general solicitation, but this is not confirmed. Organizations serving these communities should engage MDH directly for clarity on eligibility.