Montana’s plans for the Rural Health Transformation Program (RHTP) are starting to take shape, as $233 million is set to begin flowing into rural health in Montana. Many questions remain about what exactly that means, who is eligible to partner with the state, what types of services will be impacted, how local organizations fit in, and where, ultimately, that funding will go.
While we don’t have all the answers (we wish we did), MNA is striving to follow the conversation, advocate for nonprofits and community-based organizations in the process, and to share relevant information, timelines, and suggested actions that nonprofits can take to be a part of this work.
Here’s what we know at this point:
Montana’s year one funding will support the five initiatives included in the state’s plan. Each initiative is broad and will require work over the full five years of the RHTP. If you aren’t sure how you fit in at this stage, keep paying attention as things evolve and the work becomes clearer.
In year one (2026), the state will offer both competitive bids for contracts and opportunities for grants.
- Competitive bids for contracts will be posted on the state’s eMACS system. The state plans to release eight competitive bids between March 2026 – September 2026.
- Grants available through DPHHS will be posted on Submittable. DPHHS is planning five direct grant programs this year, including four by September 2026. Approximately $27 million – or 12% of total funding – will be awarded as grants.
- All funding opportunities will be posted on the RHTP website: ruralhealth.mt.gov.
All activities of the RHTP must benefit residents of rural communities.
- Rural communities are broadly defined as residents of the 51 counties falling within federal definitions of rurality. Counties not meeting that definition are Yellowstone, Missoula, Lewis & Clark, Cascade, and Gallatin.
- However, all counties have Census tracts that are considered rural, even if the full county does not meet the designation. In short, do not count yourself out based on your county alone.
The first round of procurements will take place between March and June 2026.
These contracts are likely intended for large entities who will oversee the implementation of broad initiatives and manage multiple subcontractors. Anticipated procurements include: Center of Excellence implementation, Center of Excellence strategy and analytics, school-based care, and workforce talent attraction and recruitment.
- Given the size (likely $1.5 million – $105.5 million annually) and scope of the contracts, smaller nonprofits are likely not the primary audience. We anticipate that large, out-of-state entities will be competing for these contracts, likely across multiple states. Note that as outlined under the Montana Procurement Act, Montana does not give preference for in-state vendors.
- If you are a smaller organization wanting to be involved without a major contract, there may be opportunities to participate after the initial vendors are established. Our hope is that these vendors will actively engage local organizations to understand local needs, resources, and context.
- For organizations not directly working in health care, the workforce initiative is worth watching. This work will include community integration strategies to help retain healthcare workers in rural areas — an opportunity for nonprofits to partner in community development activities, whether supporting access to housing, childcare, or other components of building strong, livable communities. This initiative may also offer openings for organizations providing adult education or workforce training — for example, offering space and support for workforce recruits to attend webinars, conferences, and trainings.
Details on grants have not yet been released but we’ll be watching this space closely. Grants may be more accessible to smaller nonprofits, though most of the categories are quite narrow. Anticipated grants include:
- Community paramedicine
- Blood storage equipment for EMS agencies
- Pharmacy start-up costs for point of care testing
- Electronic Health Records modernization
- Community nutrition grants (likely released in 2027): Community nutrition grants may be an opportunity for food, nutrition, local food, and other community-based organizations to participate.
The timeframe for all of this will move quickly.
Year one funding must be obligated by October 2026, and the state’s ability to meet that deadline will impact Montana’s award in year two. DPHHS is hiring 21 new staff members to oversee the project, and will continue to convene the Stakeholder Advisory Committee, and is preparing to launch the Center of Excellence Governing Board.
That is a lot. If you are a healthcare organization, you may already be far more plugged into this work than we are! If so, please tell us what we are missing or what you recommend for other nonprofits. If you don’t work directly in healthcare but believe you can support rural health systems, here’s what we suggest for now:
- Check ruralhealth.mt.gov regularly for updates and sign up for email alerts.
- Listen to DPHHS presentations to the public and to legislators. Recordings of some presentations, including this vendor webinar, are available on the RHTP website.
- Review the five initiatives of the state plan and think about how your organization’s work can support the plan’s goals and strategies.
- Confirm your state eMACS account (or set one up) and review RFPs as the initial round of contracts is released. Remember that primary vendors will likely subcontract with local partners so keep an eye on award announcements.
- Coordinate with your network. Connect with partners on the RHTP Stakeholder Advisory Committee members (found in the FAQ section of ruralhealth.mt.gov), state associations, national partners, colleagues in other states, or similar organizations in Montana. A project with statewide or regional reach will likely be more compelling to the state than a very localized one.
- Speak up and share your ideas. If you have an idea or request for how this funding can support rural health in your community, submit it to HHSRuralHealthTransformation@mt.gov, share it with the RHTP Stakeholder Advisory Committee or the Center of Excellence Governing Board, discuss it with your state legislators, and raise it with project vendors once they are established.
MNA will continue to follow the RHTP and share updates and possible opportunities for nonprofits to plug in. If you have suggestions, questions, or need support, please let us know – we’ll do our best to connect the dots.