RHTP for Tribal Nations/California
RHTP in California for Tribal Nations
California runs RHTP as CalRHT, through the Department of Health Care Access and Information (HCAI). Here’s where Tribes stand and what’s next.
CalRHT at a Glance
$233.6M Year 1 award
California’s total Rural Health Transformation award for Year 1. The Tribal share comes out of this total.
$11.65M Tribal set-aside
5% of Year 1, reserved for federally recognized Tribes and the rural Tribal health system.
108 recommended subrecipients
$166.72M in Year 1 awards across 45 counties, announced October 21, 2026.
20 Tribal health clinic systems
Tribal health clinic systems serving rural California, as counted by HCAI.
As of October 2026.
State snapshot
The basics Tribal leaders ask about first.
| Program | California Rural Health Transformation (CalRHT) |
|---|---|
| Lead agency | Department of Health Care Access and Information (HCAI) |
| Year 1 award to the state | $233.6 million |
| Tribal set-aside | $11.65 million, 5% of Year 1. It’s part of the initiative funding and was developed in consultation with Tribal leaders. How it’s divided across initiatives hasn’t been published yet. |
| Tribal facility eligibility | Tribal clinics and Tribal entities can apply for subawards, including Tribally operated IHS facilities. Federally operated IHS facilities can’t. |
| Rural definition | HRSA's federal definition. Check your service area with the Rural Health Grants Eligibility Analyzer. |
| Initiatives | Transformative Care Model, Workforce Development, Technology & Tools |
| Advisory body | Rural Health Policy Council |
| Where most Tribes stand | Tribal set-aside announced Allocated Competing How Tribes will access it isn’t out yet. Tribal health programs can also apply in statewide rounds. |
What this means for Tribes in California
There is a dedicated Tribal share
HCAI reserved 5% of Year 1 for Tribes and the rural Tribal health system. Watch for how HCAI offers it.
Tribal health programs are already in the mix
Tribal health organizations are among the recommended Year 1 subrecipients in all three initiatives.
Regional networks are forming now
The Transformative Care Model links rural hospitals, clinics and Tribal health programs. Programs that join early have more say in their role.
Your headquarters can sit outside a rural area
CalRHT allows applicants based outside rural areas when their services reach rural communities.
CalRHT initiatives
What each part of the program funds.
Transformative Care Model
Regional care collaboratives that link rural hospitals, clinics, other health professionals and Tribal health programs.
Workforce Development
Training paths from K–12 through college, clinical rotations, and incentives to recruit and keep health workers. The focus is primary care, maternity, behavioral health and allied health.
Technology & Tools
Upgrades to health records and practice systems, telehealth and e-consults, data sharing between systems, cybersecurity and digital tools for patients.
Key dates
What’s happened in California so far, and what’s next.
California updates
CalRHT news for Tribes, with analysis from our team.
Following other states? See every state on the RHTP hub.
How we can help Tribes in California
Tribal Nations cared for their people long before RHTP, and will long after it ends. Indigenous Pact partners with Tribes and Tribal health organizations to build, sustain and expand stronger systems of care, with Government Affairs alongside you at every step. It’s how we work toward our mission: health equity for American Indians and Alaska Natives in one generation. In California, that starts with understanding CalRHT and getting ready for what opens next. Every decision stays with your Nation.
At every step
Government Affairs
Know what CalRHT means for your Tribe.
We’re with you from your first questions through Year 5. We follow CalRHT funding opportunities, the Tribal set-aside and Rural Health Policy Council decisions, and explain them in plain terms for your leadership. We also support your advocacy priorities and help bring the right people together.
Build
Tribal Health Advisory
Decide what to build, and be ready for the next CalRHT window.
We help you assess where you stand and turn your priorities into a plan your council can act on, from feasibility and facility planning to governance, budgets and financial readiness.
Sustain
Tribal Health Operations
Launch and run what you build.
We open and manage programs on your Tribe’s behalf, from staffing and billing to day-to-day administration, while your Tribe makes the decisions. That includes opioid treatment programs. We run clinics and mobile medication units with Tribes today, and RHTP can help fund new substance use treatment services.
Expand
Tribal Care
More specialty care in your community.
Tribal Care expands the care your community can access, starting with specialists your people would otherwise travel far to see. Patients stay at your own clinic, and the specialist joins live through a video exam room, with a medical assistant by their side. CalRHT’s Technology & Tools initiative includes telehealth, so it may help fund the technology and training to start. Visits are billed through your clinic, so the service can continue after RHTP ends.
Find your Tribe’s next step on CalRHT
Talk with our team about where your Tribe fits in CalRHT and what it would take to be ready.
Guided by Tribal health policy expertise
Ashley Hesse
Vice President, Tribal & State Government Affairs, Indigenous Pact
Ashley leads Indigenous Pact’s Tribal and state government affairs work, helping Tribal Nations understand what RHTP and related federal and state policy mean for their programs.
RHTP Year 2 Playbook for Tribal Nations and Tribal Health Organizations
A free guide from Indigenous Pact's Government Affairs and Tribal Health Advisory teams.
- Find your situation in three quick questions
- A 90-day plan for each situation
- A readiness checklist built to share with your council or board
- A one-page project brief and a state-by-state guide
Send me the Playbook
We’ll email it to you right away, along with a way to reach our team if you have questions.
Get California RHTP updates
We’ll email you when CalRHT opens a funding opportunity or changes its plan, plus a short monthly RHTP briefing.
Questions Tribes in California ask
Is there money set aside for Tribes in California?
Yes. HCAI reserved $11.65 million, 5% of Year 1 CalRHT funding, for federally recognized Tribes and the rural Tribal health system. How it’s divided across initiatives hasn’t been published yet.
Can our Tribal health program apply?
Tribal clinics and Tribal entities can apply for CalRHT subawards, including Tribally operated IHS facilities. Federally operated IHS facilities can’t. Your services need to reach rural communities under HRSA’s definition.
Our clinic isn't in a rural area. Can we still take part?
Possibly. CalRHT allows applicants headquartered outside rural areas if their services reach rural communities.
How do we hear about new funding opportunities?
HCAI posts them on its CalRHT funding page, and our California alerts will let you know too.
Who can we ask at the state?
Reach HCAI’s CalRHT team at CalRHT@hcai.ca.gov. For grant application questions, contact info@calruralhealth.org or 855-CAL-RHTP (855-225-7487).
Official sources
- HCAI: California Rural Health Transformation (CalRHT)
- HCAI: CalRHT Program Updates (October 21, 2026)
- HCAI: CalRHT Grant Funding Opportunities
- HCAI: CalRHT Frequently Asked Questions (July 1, 2026)
- HRSA: Rural Health Grants Eligibility Analyzer
- CMS: Rural Health Transformation Program
