Virginia has started a stakeholder engagement process for its rural health transformation program, aiming to secure up to $1 billion in federal funding over the next five years. This initiative follows the recent passage of H.R. 1, known as the “One Big Beautiful Bill Act,” which created the Rural Health Transformation (RHT) Program. The program will distribute $50 billion nationwide between fiscal years 2026 and 2030.
Virginia is eligible for up to $500 million in direct state allocations—$100 million annually—and can compete for additional grants based on rural health needs and capacity, potentially totaling $1 billion over five years. The funds are intended to expand access to care, support healthcare workers, and improve service delivery in rural areas.
Governor Glenn Youngkin issued Executive Directive 12 instructing state agencies and partners to prepare for these investments and align them with community priorities. “The Rural Health Transformation Program, established by the One Big Beautiful Bill Act, gives Virginia a historic opportunity to expand access to care, support providers, and deliver better outcomes for rural families,” said Governor Glenn Youngkin. “We will work closely with local leaders, providers, and federal partners to ensure this investment reflects community priorities and delivers lasting improvements to Virginia’s rural health system.”
On August 27, Secretary of Health and Human Resources Janet Vestal Kelly began the engagement process by meeting with stakeholders about Virginia’s strategy for applying for new federal funding. This marks the start of efforts to shape Virginia’s approach while keeping input from rural communities central.
Virginia must submit its plan to the Centers for Medicare & Medicaid Services (CMS) by November. H.R. 1 identifies ten key activity areas eligible for funding: chronic disease prevention programs; payments to providers; consumer technology for disease management; adoption of advanced technologies like AI or robotics; workforce recruitment and retention; IT improvements; adjustments in care delivery systems; support for substance use treatment and mental health services; innovative care models; and other CMS-approved activities that promote rural healthcare.
State agencies will consult directly with stakeholders in rural communities as they develop their plan. Stakeholders are invited to share proposals on improving healthcare delivery or access—drawing on national best practices—or provide data or partnership concepts by emailing RuralTransformation@governor.virginia.gov through September 15th.
Proposals should include a summary of goals, details on target outcomes and populations served, an implementation plan outlining roles and milestones, metrics for measuring success, and plans for sustainability beyond five years.
