Minnesota
Minnesota Department of Health (MDH)
Year 1 Award
$193.1M
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
Minnesota's $193 million award is among the larger awards in this batch, reflecting the state's substantial rural geography, 22% nonmetro population, and — notably — its high score on the competitive merit-based component of CMS's 50/50 award formula. MDH described the award as including "significant additional funds recognizing Minnesota's innovative plan," suggesting the application scored well above the base allocation. MDH is the lead agency, operating through its Office of Rural Health and Primary Care — an office with deep existing relationships with CAHs, rural clinics, and local public health agencies. Minnesota's provider landscape is dominated by CAHs: 76 CAHs make it one of the states with the largest CAH populations in the country. This is a structural strength — CAHs have existing compliance infrastructure, cost reporting systems, and governance capable of managing federal sub-awards. The 11 federally recognized tribes (Dakota and Ojibwe nations, primarily in northern and western Minnesota) are named as potential sub-grantees alongside rural hospitals, FQHCs, CCBHCs, and local rural organizations. MDH has not published a formal tribal set-aside but explicitly includes Tribal Nations as an eligible sub-grantee category — a meaningful inclusion that stops short of a dedicated allocation. The Iron Range (northeastern Minnesota) combines high CAH concentration with significant tribal population and persistent economic distress, making it a likely priority geography for competitive awards. Implementation planning is substantive: the application reflected more than 40 stakeholder meetings and nearly 350 public responses. State officials indicated that implementation would begin in early 2026, and a health IT request for proposals was published prior to award — a Phase 1 signal suggesting MDH was building procurement infrastructure in parallel with the CMS application process.
Applications & Compliance
Implementation Model
MDH will administer RHTP sub-grants through a grant program model. Based on MDH's published approach, sub-grants will flow to eligible rural providers through five initiative-based grant programs, a combination of formula-based grants for technology and infrastructure improvements and competitive grants for telehealth, EMS treatment-in-place, and clinical training expansion. MDH published a health IT Request for Proposals (RFP) in summer 2025 (prior to award), which signals the agency was already building procurement infrastructure and may move quickly to release sub-grantee programs once CMS final budget approval is received. Eligible sub-grantees explicitly named include: rural hospitals, rural clinics, Federally Qualified Health Centers, Certified Community Behavioral Health Centers/community mental health centers, rural Tribal nations, and other local rural organizations participating in patient care or health-related social needs. Technical assistance will accompany grant programs — a signal that MDH is planning for capacity support alongside funding.
Investment Priorities
Initiative 1: Technology and Infrastructure for Financial Viability
Grant support for technology and infrastructure improvements enabling rural providers to practice more efficiently and increase access to screenings and services. Combines formula-based grants to eligible rural providers with potential technology-specific competitive elements. This initiative appears linked to the pre-award HIT RFP.
Initiative 2: Community-Based Preventive Care and Chronic Disease Management
Improve health outcomes for Minnesotans with or at risk of developing cardiovascular disease, diabetes, and chronic kidney disease. Focus on screening access, preventive interventions, and care management in rural settings.
Initiative 3: Sustain Access to Services to Keep Care Closer to Home
Competitive grants to increase telehealth technology and use in rural areas and provide EMS the ability to treat in place. Addresses Minnesota's rural transportation burden and the sustainability of dispersed rural service delivery.
Initiative 4: Create Regional Care Models to Improve Whole Person Health
Expand clinical training and residencies in rural areas to build the physician and provider pipeline. Addresses the structural workforce shortage underlying all other rural health access constraints.
Initiative 5: Workforce Expansion
Support expansion of clinical training and education pathways in rural areas. Funding mechanism includes grants to support training and residency programs.
What to Watch
Sub-grantee solicitation release
Est. Q1–Q2 2026MDH stated that implementation would begin in early 2026 and that funding for rural health organizations would be released in 2026. The pre-award HIT RFP is a strong signal that solicitation release is imminent. Monitor the MDH RHTP page for announcement. Subscribe to MDH updates via govdelivery.
Tribal Nations inclusion mechanism
TBDMDH explicitly names Tribal Nations as eligible sub-grantees but has not published a dedicated tribal set-aside or tribal-specific application process. For Minnesota's 11 federally recognized tribes — many of which are in the Iron Range and northwestern rural Minnesota — this is the critical question. Will tribes apply through the same competitive process as rural hospitals, or is there a separate track or allocation?
Iron Range geographic priority
TBDNortheastern Minnesota (the Iron Range) combines high CAH density, significant tribal population, persistent economic distress, and some of the state's most acute rural health access gaps. Whether MDH will designate geographic priority areas — or whether the funding will flow on a statewide competitive basis — will determine whether Iron Range providers have a structural advantage or disadvantage.
Initiative name and scope confirmation from narrative
Needed before Phase 1The five initiative names are not fully confirmed verbatim from the MDH project narrative PDF (not text-extractable). Organizations planning applications should access the narrative directly at health.mn.gov/facilities/ruralhealth/ruraltrans/docs/rhtpnarrative.pdf to confirm exact initiative names, eligible activities, and any per-initiative funding caps before the solicitation is released.
CCBHC eligibility and behavioral health track
TBDMDH explicitly names Certified Community Behavioral Health Centers (CCBHCs) and community mental health centers as eligible sub-grantees — an important distinction from states that limit eligibility to physical health providers. Minnesota has an active CCBHC demonstration program, and those organizations should begin RHTP preparation now.