RHTP for Tribal Nations/Idaho
RHTP in Idaho for Tribal Nations
Idaho runs the Rural Health Transformation Program through the Department of Health and Welfare (DHW). Here’s where Tribes stand and what’s next.
Idaho RHTP at a Glance
$186M Year 1 award
Idaho’s Rural Health Transformation award for Year 1, received December 29, 2025.
3.5% Tribal set-aside
Idaho’s plan sets aside 3.5% of its award for Tribal rural health transformation support.
July 30, 2026
DHW issued award notifications for all five Tribal proposals.
October 28, 2026
The Governor announced that Idaho had completed its Year 1 awards.
As of November 2026.
State snapshot
The basics Tribal leaders ask about first.
| Program | Idaho Rural Health Transformation Program |
|---|---|
| Lead agency | Idaho Department of Health and Welfare (DHW) |
| Year 1 award to the state | $185,974,367.81 |
| Tribal set-aside | Idaho’s plan sets aside 3.5% of its award for the five federally recognized Tribes in Idaho: the Coeur d’Alene Tribe, Kootenai Tribe of Idaho, Nez Perce Tribe, Shoshone-Bannock Tribes, and Shoshone-Paiute Tribes of the Duck Valley Reservation. |
| How Tribal funds are awarded | Through noncompetitive subgrants administered by DHW. DHW reviewed all five Tribal proposals and issued award notifications on July 30, 2026. Agreements were being finalized as of DHW’s August 2026 project plan. In April 2026, DHW told the Legislature’s oversight committee that Tribal plans would also require final CMS approval. |
| Tribal eligibility in Year 1 statewide rounds | Tribal governments and Tribal organizations were eligible for some statewide Year 1 opportunities, including Healthcare Infrastructure Support and Behavioral Health Prevention. Eligibility is set for each opportunity, and Year 2 opportunities haven’t been posted yet. |
| Rural definition | Federally defined rural areas. Check your service area on DHW’s map of qualifying areas, last updated August 27, 2026. |
| Initiatives | Technology, Innovative Care Models, Workforce, Prevention and Chronic Disease, Infrastructure and Partnerships |
| Advisory and oversight | Governor’s Rural Health Task Force; RHTP Implementation Task Force, which includes Tribal representatives; the Legislature’s Rural Health Transformation Committee |
| Where Tribes stand | Award notifications issued July 30, 2026 Notified Agreements in progress Agreements were being finalized as of August 2026. DHW’s August project plan doesn’t confirm payment or implementation dates, which may differ by Tribe. |
What this means for Tribes in Idaho
The Tribal share runs through DHW subgrants
Idaho’s Tribal set-aside is awarded through noncompetitive subgrants administered by DHW, and all five Tribal proposals received award notifications in July. Tribal health programs reach this funding through their Tribe, and the work still has to fit Idaho’s approved state plan and federal RHTP rules.
Each funding year has its own deadlines
States must obligate each year’s funds within that year’s budget period and can generally spend properly obligated funds through the end of the following federal fiscal year. For Year 1, that outer limit is September 30, 2027, though some costs, such as personnel, follow a shorter window. A Tribe’s agreement with DHW may set earlier dates.
Plan for the years beyond the grant period
For anything meant to continue past its award, the planning question is practical: which costs remain, what revenue or other support will cover them, and who will own the ongoing work. That holds whether a Tribe is still finalizing its workplan or already carrying out its award.
Statewide opportunities are separate from the Tribal share
In Year 1, Tribal governments and Tribal organizations were also eligible for some statewide opportunities, such as Healthcare Infrastructure Support. Year 2 opportunities and their eligibility rules haven’t been posted yet.
Idaho RHTP initiatives
What Idaho’s plan covers. Specific funding depends on each year’s opportunities and awards.
Technology
Telehealth for primary and specialty care, shared IT and cybersecurity support, health records and data sharing, and upgraded emergency communications.
Innovative Care Models
Diagnostic kiosks, remote patient monitoring, community health EMS programs for preventive and follow-up visits at home, and health extenders for outreach and navigation.
Workforce
Recruitment and retention incentives for health professionals who commit to at least five years of service in rural communities, local training programs, apprenticeships, and graduate medical education with priority on OB/GYN, behavioral health and geriatrics.
Prevention and Chronic Disease
Diabetes prevention and self-management, cancer and heart disease screening, behavioral health and substance use prevention, and maternal and infant care.
Infrastructure and Partnerships
Facility renovations, clinical equipment, mobile health units, safety code upgrades, and Tribal rural health transformation support.
Key dates
What’s happened in Idaho so far, and what’s next.
Idaho updates
Idaho RHTP news for Tribes, with analysis from our team.
Following other states? See every state on the RHTP hub.
How we can help Tribes in Idaho
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 Idaho, that starts wherever your Tribe is with its RHTP award, from workplan through implementation.
At every step
Government Affairs
Know what Idaho’s RHTP means for your Tribe.
We’re with you from your first questions through Year 5. We follow DHW funding opportunities, the Implementation Task Force, and the Legislature’s Rural Health Transformation Committee, 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
Plan for operating costs from the start.
We help you work out what each project will cost to run after its award ends, what revenue or other support could cover those costs, and who will carry the work. That can include billing and revenue analysis, feasibility and facility planning, 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. Idaho’s plan includes behavioral health and substance use prevention among its activity areas.
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 come to your clinic, and the specialist joins live through a video exam room, with a medical assistant by their side. Because visits run through your clinic, we can assess with you whether they qualify for Medicaid billing and what it would take to keep the service going after the grant. Idaho’s Technology initiative includes telehealth among its activity areas.
Find your Tribe’s next step on Idaho’s RHTP
Talk with our team about where your Tribe is with its RHTP award and what comes next.
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 Idaho RHTP updates
We’ll email you when DHW opens a funding opportunity or changes Idaho’s plan, plus a short monthly RHTP briefing.
Questions Tribes in Idaho ask
Is there money set aside for Tribes in Idaho?
Yes. Idaho’s plan sets aside 3.5% of its award for the five federally recognized Tribes in Idaho.
How does our Tribe receive its share?
Through a noncompetitive subgrant administered by DHW. DHW issued award notifications for all five Tribal proposals on July 30, 2026. For your Tribe’s agreement, payment and deadline terms, contact DHW’s RHTP team.
How long do we have to spend Year 1 funds?
Under CMS rules, Year 1 funds that were properly obligated by October 30, 2026, the end of the Year 1 budget period, can generally be spent through September 30, 2027. The later date doesn’t add time to commit funds. Some costs, such as personnel, follow a shorter window, and your Tribe’s agreement with DHW may set earlier dates, so check its terms.
Can our Tribal health program apply for statewide funding too?
In Year 1, Tribal governments and Tribal organizations were eligible for some statewide opportunities, including Healthcare Infrastructure Support and Behavioral Health Prevention. Eligibility is set for each opportunity, so check each Year 2 notice when DHW posts it.
Our reservation crosses into Nevada. Does Idaho’s set-aside include us?
Yes. Idaho’s five federally recognized Tribes include the Shoshone-Paiute Tribes of the Duck Valley Reservation. Nevada received its own RHTP award and sets its own rules, so check with Nevada’s program as well.
Do Medicaid work requirements apply to our patients?
DHW lists American Indians and Alaska Natives, and people eligible for Indian Health Service, among the groups excluded from Idaho’s work requirements, which begin January 1, 2027. Other patients your clinic serves may need to meet them.
How do we hear about new funding opportunities?
DHW posts them on its Rural Health Transformation funding page, and our Idaho alerts will let you know too.
Who can we ask at the state?
Reach DHW’s RHTP team at IdahoRHTP@dhw.idaho.gov. For Medicaid billing questions, contact the Idaho Medicaid Tribal Liaison.
Official sources
- DHW: About the Rural Health Transformation Program Grant
- DHW: Funding Opportunities for Rural Health Transformation
- Office of the Governor: Year 1 awardees announced (October 28, 2026)
- CMS: RHTP Post-Award FAQ (September 2026)
- Idaho Medicaid Provider Handbook: Indian Health Services (January 21, 2026)
- DHW: Medicaid Expansion
- DHW: Medicaid managed care
- CMS: Rural Health Transformation Program
