California

Led by the California Department of Healthcare Access and Information’s State Office of Rural Health (CalSORH), the program focuses on creating a connected and resilient rural health system through stakeholder engagement, partnerships, and policy initiatives. CalSORH administers the Medicare Rural Hospital Flexibility/Critical Access Hospital Program, Small Rural Hospital Improvement Program, and J-1 Visa Waiver Programs. The program includes webinars and listening sessions to gather input and update stakeholders. Key contacts: CalSORH@hcai.ca.gov Event schedule: - CalRHT Program Spring Webinar - April 21, 2026 - Webinar - Tech Innovation Webinar - October 1, 2025 - Webinar - Workforce Development Webinar - October 1, 2025 - Webinar - Innovative Care Webinar - October 2, 2025 - Webinar - Sustainable Access Webinar - October 2, 2025 - Webinar - Make Rural America Healthy Again Webinar - October 3, 2025 - Webinar - CalRHT Kickoff Webinar - September 4, 2025 - Webinar

California RHTP spring webinar introduction/update deck; supporting announcement context for program awareness and timeline updates.

California was awarded over $233 million for Budget Period 1 (FY2026) under the CMS Rural Health Transformation Program, the third-highest state award. The CalRHT program will invest in modernizing rural health care through workforce recruitment, care model innovation, regional collaboratives, and technology expansion, aiming for improved access and sustainability. Stakeholder engagement revealed priorities around workforce, primary and maternal care, financial sustainability, and technology.

California awarded nearly $300 million in zero-percent interest loans to 17 financially distressed community hospitals under the Distressed Hospital Loan Program to support their operational stability. Loans have a 72-month repayment term with an 18-month grace period and are intended to prevent hospital closures and sustain care services.

California's CA-RHT program will implement three major initiatives targeting rural access, workforce, and technology, requesting $233.6M federal funding in 2026-2027. Extensive program leadership, stakeholder engagement, finance, and grants management teams are planned, with subrecipient and consultant budgets laid out but not yet awarded. The program structure leverages existing Department of Health leadership and partnerships for rapid launch and rural impact. Key contacts: Hovik Khosrovian; Scott Christman; Lemeneh Tefera, MD, MSc; Michael Valle Event schedule: - Budget Narrative Revised Submission Date - 03/27/2026 - Budget revision date - 2026-03-27 - California - Previous budget revision date - 2026-02-13 - California

This guidance document outlines California's approach and timeline for participation in the Rural Health Transformation Program (RHTP), a $50 billion federal initiative (2026-2030) focused on rural hospital and provider transformation. It summarizes demographic trends, describes core challenges facing rural healthcare, and details activities and goals required as part of the state's RHTP application process. No awards to sub-recipients are announced; information is at the guidance and state-allocation planning level.

The CA-RHT program will launch three major, interconnected initiatives to expand care access, modernize infrastructure, and stabilize and grow the rural health workforce. Over $233 million in federal funds are proposed for investment in California rural health, with $35 million targeted specifically to stabilize strategically important rural hospitals. A strong commitment to Tribal health equity and modernization of health IT infrastructure is central to the plan.

This FAQ provides detailed guidance for organizations interested in applying for CalRHT rural health transformation funding in California. It explains eligibility, application timelines, funding allowability, rural definitions, strategic priorities (workforce, technology, care models), and contact information for applicants. Emphasis is placed on serving rural Californians as defined by HRSA, workforce strengthening, transformative care models, and compliance with CMS allowable uses. Key contacts: CalRHT@hcai.ca.gov Event schedule: - Budget Period 1 Obligation Deadline - 10/30/2026 - Budget Period 1 Spend Deadline - 09/30/2027 - Expected RTAC Launch (estimate) - Late 2026 or Early 2027 - RHPC Member Appointments Begin - Spring or Summer 2026

California’s Small and Rural Hospital Relief Program (SRHRP) provides state grant funding and technical assistance for seismic compliance to small, rural, and Critical Access Hospitals. The program is supported by excise tax revenue on electronic cigarettes and a 2023-24 budget allocation. Applications are accepted on an ongoing basis, and eligible projects include both planning/design and construction activities related to seismic resistance.

This document provides high-level summaries of state applications to the Rural Health Transformation Program for FY26. Each state proposes multi-million dollar initiatives focused on rural hospital stabilization, workforce expansion, telehealth adoption, and chronic disease prevention. Strategic goals commonly include increasing rural provider recruitment, expanding digital care, and implementing value-based care and population health models.

California established the Distressed Hospital Loan Program in 2023 to offer $150 million in zero-interest loans to financially distressed hospitals to support turnaround efforts. The program includes monitoring hospital financial health via quarterly data reporting and is administered jointly by HCAI and CHFFA.

The California Rural Health Transformation Program proposes to create a network of regional care collaboratives focused on improving access and quality of rural health care. It emphasizes workforce development, technology modernization, and financial stability to enhance local health outcomes across primary, maternity, chronic disease, and specialty care.

California's CA-RHT program offers a statewide, integrated framework to modernize rural health through workforce development, hub-and-spoke care networks, and expanded use of telehealth and digital health tools. Financially distressed rural hospitals and Tribal health providers receive priority for transformative supports. The plan aims to reduce rural disparities in access, quality, and health outcomes, with a minimum of 5% of the budget dedicated specifically to Tribal health partners. Key contacts: HCAI Leadership; DHCS Leadership; CDPH Leadership; HCAI State Office of Rural Health Event schedule: - Listening Sessions on workforce, technology innovation, sustainable access, and community health workers - 2025-10-01 - Statewide, California - Start of Formal Tribal Consultation - 2026-01-01 - California - Monthly CMS and state coordination calls - Virtual/Statewide - Quarterly Statewide RHPC meetings - Statewide, California - Annual Statewide RHPC meetings aligned with NCC reporting cycle - Statewide, California - Center for Connected Health Policy Telehealth update - 2024-11 - California - Centers for Medicare & Medicaid Services T-MSIS data quality progress for OBA - 2025-06 - U.S.

This document sets the 2025 California regulatory standards for seismic safety in hospital buildings, with significant attention to rural, small, and financially distressed hospitals. The Small and Rural Hospital Relief Program, administered by HCAI, includes targeted seismic safety grant opportunities intended to prevent hospital closures in vulnerable rural communities. Deadlines for seismic safety compliance, financial hardship criteria, and extension provisions are newly defined for 2025 and beyond.