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1. Award types and general expectations

• RHTP funding is distributed through several award types, and requirements vary by award. This FAQ applies only to Immediate Impact Award recipients, Catalyst Award recipients, and Local Public Health Authorities receiving RHTP funds directly from OHA. Award documents, executed agreements, Program Element requirements, and written direction from OHA control when requirements differ. This FAQ does not apply to Tribal Initiative Awards, which follow separate guidance and designated OHA points of contact.
• Separate FAQs for Federally Qualified Health Centers, Rural Health Clinics, and rural hospitals receiving  Transformation Funds are forthcoming. These organizations receive RHTP funding through partner organizations, so some requirements and processes may differ from the information in this document.

Transformation Funds for Local Public Health Authorities (LPHAs)

• Transformation funding provided to LPHAs through Program Element 82.

Immediate Impact Awards

• Awards for projects selected directly by OHA.

Catalyst Awards

• Competitive awards for projects submitted through RFGP 6244.

Tribal Initiative Awards

• Direct awards to the Nine Federally Recognized Tribes of Oregon.

General Expectations for Covered Award Recipients

• Comply with applicable CMS, federal, state and OHA requirements, including allowable-use and funding limitations.
• Submit and follow an OHA-approved project plan and budget narrative.
• Meet financial and program reporting requirements.
• Begin required activities within the timeframe specified by OHA and the applicable award documents.

2. Getting started and program participation

When may I begin implementing project activities?

• An awardee may begin performing the program activities described in its approved project plan and budget upon execution of the agreement or on the date the organization accepts its Notice of Intent to Award (NOIA), even if the grant agreement has not yet been fully executed. If an organization does not initially accept the NOIA terms, it may not begin project activities until a grant agreement is executed.
• The following restrictions still apply:
• ​​Do not purchase equipment listed in Budget Section D that costs $10,000 or more per unit until OHA confirms that CMS prior approval has been received.
• Do not begin spending on a consultant, subrecipient or contractor listed in Budget Section F until a separate budget and supporting details have been submitted to OHA and approved.
• Before the grant agreement is fully executed, job postings and requests for proposals must include the following statement: “This position/contract is designed to support the Oregon Rural Health Transformation Program, for which final budget details are currently being negotiated with the Oregon Health Authority. Hiring will be contingent on funding being disbursed."
• Local public health authorities that did not receive an NOIA may begin performing the program activities described in its OHA-approved project plan and budget when OHA notifies them by email of approval. LPHA requirements for RHTP Transformation Funds are outlined in Program Element #82, 82-01, or 182 as applicable.

Who is my primary OHA contact, and will we meet regularly?

• Your Agreement Coordinator or other designated OHA contact may vary by award. Email RHTP@oha.oregon.gov with your organization name and contract number to request the correct contact. Meetings are currently scheduled as needed. OHA will communicate any future standard meeting cadence directly to awardees.
• For LPHAs specifically, please email Veronica.Herrera2@oha.oregon.gov with any questions about RHTP funding.​

How do I connect with RHTP Regional Convenings?

• Regional Convenings are coordinated by the Oregon Office of Rural Health. Visit the Oregon Office of Rural Health page for current information.

Can OHA provide descriptions and contacts for every funded project?

• OHA does not publish individual project contacts solely for networking purposes. Awardees may publish additional information, including descriptions and contacts, on their own websites. The RHTP Awards page lists funded organizations and vendors interested in working with awardees: https://www.oregon.gov/oha/HPA/HP/Pages/rhtp-awards.aspx.

If deliverables or timelines may change, whom should I contact?

• Email RHTP@oha.oregon.gov as early as possible. State in the subject line whether the proposed change concerns deliverables, the timeline, or both. Do not implement a change that requires approval until OHA provides written authorization. or both. Do not implement a change that requires approval until OHA provides written authorization.
• For LPHAs specifically, please email Veronica.Herrera2@oha.oregon.gov with any changes to your project. State in the subject line whether the proposed change concerns deliverables, the timeline, or both. Do not implement a change that requires approval until OHA provides written authorization. or both. Do not implement a change that requires approval until OHA provides written authorization.

3. Agreements, payments and spending periods

What is a Notice of Intent to Award (NOIA)?

• ​A NOIA communicates OHA's intent to make an award and generally identifies the not-to-exceed amount and next steps for agreement development. A NOIA is not the fully executed grant agreement.
• Do not assume that receiving a NOIA by itself authorizes work. Follow the start instructions provided by OHA for your award.

What is a grant agreement?

• The grant agreement is the legal document signed by the awardee and OHA. It establishes the parties' responsibilities, payment terms, approved project requirements and applicable conditions. Some requirements such as insurance documentation, may be due at execution or within a specified period afterward.

My organization was unable to accept the terms of the NOIA. How does this affect my project start date?

• Your project period can begin when your organization accepts the NOIA OR your grant agreement is fully executed. If your organization did not initially accept the NOIA terms, your organization will need to wait until your grant agreement is fully executed to begin grant activities, regardless of the start date of your grant.

How will funds be disbursed?

• ​Payments are made according to the schedule in Exhibit A, Part 2, of the executed grant agreement. For example, one standard structure described in current award materials is an initial 50% disbursement after execution, followed by two 25% disbursements, unless a different schedule is negotiated and included in the agreement.
• Later disbursements are contingent on OHA approval of required expenditure reports.

When can we expect our second disbursement?

• ​The amount and requirements for your second disbursement depend on your agreement.

One-year agreements: Immediate Impact Award Wave 1, Local Public Health Authorities (LPHAs), and Community Mental Health Programs (CMHPs)

• ​The second disbursement is 25% of your Budget Period 1 funding, following OHA's receipt and approval of your required reporting. OHA plans to review reports during the first half of November 2026 and issue payments by the end of November. Because of payment processing time, you may not receive the funds until mid to late December 2026.

Two-year agreements: Catalyst Awards and Immediate Impact Award Wave 2

• The second disbursement is the first 50% of your Budget Period 2 funding, following OHA's receipt of your Quarterly Expenditure Report. Budget Period 2 funding is also contingent on continued CMS RHTP funding to Oregon.

Oregon expects to learn whether it will receive continued funding and the amount by November 1, 2026. Once CMS announces and approves that funding, OHA plans to issue the first Budget Period 2 payment by the end of November. Because of payment processing time, you may not receive the funds until mid to late December 2026.

These are anticipated timelines. Please refer to your agreement for the requirements that apply to your award.

Do awardees need to submit invoices or receipts to receive payment?

• ​Awardees generally do not submit invoices to trigger scheduled grant payments. Payments are issued according to the executed agreement.
• Awardees must maintain complete supporting documentation for all RHTP expenditures. OHA or CMS may request records during reporting, monitoring, a desk review, or an audit. All expenditures must align with the approved budget and applicable requirements.

How long does it take to receive the initial payment?

• ​Upon full execution of the grant agreement, funds are generally disbursed within 15–20 business days. Although OHA may take up to 45 days to issue payment, the program has not observed payment timelines extending to that maximum.
• These timeframes assume that the awardee's vendor profile and direct-deposit information are fully established. If setup has been initiated but not completed, payment may be delayed. Vendor and direct-deposit setup may require 4–6 weeks.

When must Budget Period 1 funds be spent?

• Funds awarded for the first budget period must be spent by September 30, 2027, unless the awardee receives different written direction or the executed agreement states otherwise.

When will Year 2 funding be confirmed?

• ​Year 2 funding is contingent on CMS approving and releasing additional funding to Oregon and may also depend on awardee progress and expenditure reporting. CMS stated in the original notice of funding opportunity that fiscal year 2027 award amounts would be determined by October 31, 2026. OHA will notify awardees when Year 2 funding is confirmed.

4. Budgets, equipment and prior approval

When will budget negotiations be completed?

• Budget negotiations with awardees are ongoing.

How are indirect costs handled?

• Recipients and subrecipients may elect to charge a de minimis rate of up to 15 percent of modified total direct costs (MTDC) or their current Federal negotiated indirect cost rate (including provisional rate). The recipient or subrecipient is authorized to determine the appropriate rate up to this limit.

What can we expect from expenditure reporting?

• ​Expenditure reports will follow the structure of the OHA-approved budget. Awardees will report spending by budget category and line item and compare actual expenditures with approved amounts. OHA will provide the final template and submission schedule.

What is the difference between a budget period and a spending period?

• All proposed activities under a budget period must start within that budget period, which ends October 30 each year. Those activities must end by the end of the spending period, September 30 of the following year.

How should uncertain mileage be budgeted?

• Use a reasonable estimate based on expected travel and an allowable reimbursement rate. Document the assumptions and reconcile actual costs through expenditure reporting.

Which equipment purchases require prior approval?

• Items listed under the Equipment budget category - tangible personal property with a useful life of more than one year and a per-unit acquisition cost of $10,000 or more -require CMS prior approval. Tier 2 equipment only needs to be approved by OHA. Tier 1 equipment needs CMS prior approval.
• After the budget is finalized and approved, OHA will submit the items to CMS for review. Equipment in this category may not be purchased until OHA provides written confirmation that CMS has granted approval. CMS may request additional information during its review.

Note: Transformation Fund awardees budgets are tier 2 and only need OHA approval.

Can we purchase approved items costing less than $10,000 per unit?

• An item costing less than $10,000 per unit that is included in the final approved project plan and budget generally does not require a separate equipment prior-approval request. Other procurement, allowability, and agreement requirements still apply.

How do we request a budget change?

• ​All categorical or content changes to an approved budget require prior written OHA approval. Update the OHA-approved budget template, clearly highlight each change, and provide a brief explanation. Submit the request to RHTP@oha.oregon.gov, unless OHA has provided a different submission address.
• A difference between estimated and actual spending on an existing approved line item is generally reported as a spending variance and does not require additional approval. Adding an item, changing personnel FTE, or moving funds to a different category is a budget change that will require OHA approval before spending the specified funds.
• A change to the agreement's total not-to-exceed amount requires a written amendment signed by both parties.
• All categorical or content changes to an approved budget require prior written OHA approval. Update the OHA-approved budget template, clearly highlight each change, and provide a brief explanation.  For LPHAs specifically, please email Veronica.Herrera2@oha.oregon.gov with any changes to your budget. A difference between estimated and actual spending on an existing approved line item is generally reported as a spending variance and does not require additional approval. Adding an item, changing personnel FTE, or moving funds to a different category is a budget change that will require OHA approval before spending the specified funds.
• A change to the agreement's total not-to-exceed amount requires a written amendment signed by both parties.

Is there a dollar or percentage threshold below which approval is not required when making changes to a project budget?

• No general threshold is stated. Categorical and content changes to a project budget require prior written OHA approval, even when the total award amount does not change. Ordinary spending variances on already approved items are addressed through expenditure reporting.

Can funds be moved across budget line items?

• ​Moving funds between categories, adding new items, or changing personnel FTE requires prior written OHA approval. Minor spending differences on an approved item are reported through expenditure reporting.

Can funds pay for services that are billable to Medicaid?

• No. RHTP funds may not be used to pay for Medicaid-billable services. Contact OHA before using RHTP funds for services that are billable for some populations but not others.

Can unused payroll funds be moved to another budget category?

• Potentially, if the proposed costs are allowable and continue to support the approved project goals. Moving funds from payroll to another category is a budget change and requires prior written OHA approval. Do not spend the reallocated funds until approval is received.

How does the salary cap apply?

• The maximum individual salary amount chargeable to RHTP is $228,000 per budget year.

Are patient incentives allowable?

• Patient incentives require case-by-case review. The request should explain the rural need, how the incentive supports a comprehensive RHTP initiative and how the activity will be sustained after RHTP funding ends. Obtain written approval before incurring the cost.

Can the same work continue across both budget periods?

• Yes, when the work demonstrates continued progress or expansion, such as additional sites, services or people reached. Budget costs separately in the period in which they occur.

5. Contractors, subrecipients and lower-tier entities

When and how should a required Tier 2 budget be submitted?

• ​Submit Tier 2 budgets as they are completed; batching is not required. Use the OHA budget narrative template and complete the sections applicable to the work and costs. Email RHTP@oha.oregon.gov (unless OHA has provided a different submission address) with “Subrecipient Budget" in the subject line.
• Do not execute an agreement or distribute funds when the applicable award documents require OHA budget approval and that approval has not been received.

Should Tier 2 budgets be submitted individually or in batches?

• Tier 2 budgets may be submitted individually as they are completed. Batching is not required, particularly when implementation is staggered. Each budget must include the required supporting information and receive any necessary approval before related spending begins.

Which budget sections must contractors, consultants and subrecipients complete?

• Use the OHA budget narrative template. Complete every section that applies to the entity's work and costs, including the awardee contact information section at the top of the template, and leave genuinely inapplicable sections blank unless OHA instructs otherwise. A complete and sufficiently detailed narrative is required for all included costs.

How are items requiring additional approval handled in a Tier 2 budget?

• OHA will identify items requiring additional approval and will notify the primary awardee when approval is complete. Do not purchase or obligate the item until written authorization is received.

Can a Tier 2 entity have its own subrecipient?

• ​Yes, if permitted by the approved award structure and agreement. The Tier 2 entity must obtain and review the lower-tier entity's detailed budget, confirm allowability and cost limitations, approve changes, collect expenditure reports at the required cadence, and maintain supporting documentation.
• The primary awardee remains responsible for required oversight and for ensuring that records are available to OHA.

What happens if a Tier 2 budget is higher or lower than estimated?

• ​If the Tier 2 budget total is higher than the approved amount listed in Section F of the Tier 1 budget in either Budget Period 1, 2, or both—or causes a categorical or content change—the primary awardee must revise its own budget and submit to OHA for review and approval before proceeding. If this change leads to the Tier 1 budget total exceeded the NTE, the Tier 1 agreement must be amended.
• A minor Tier 2 budget reduction that does not change approved content may be reconciled through expenditure reporting, subject to OHA direction.

Can a new subrecipient be added?

• A new subrecipient may be added only when permitted by the approved project plan, budget, and grant agreement and after all required OHA approvals are obtained. Do not redistribute work or funds until OHA provides written authorization.

Do awardees need to follow federal procurement standards?

• Only contractors, subrecipients, and consultants appropriately listed under Section F of the budget narrative are subject to 2 CFR Part 200.320. OHA, as the prime recipient of RHTP funding, may provide the written approval referenced in this regulation.
• The Tier 1 awardee received approval to proceed with its stated method of selection when OHA approved its budget and Section F. Approval of the stated method of selection is not the same as approval of the Tier 2 entity's detailed budget. The required Tier 2 budget-review steps must still be completed before Tier 2 spending occurs.

How should an organization determine whether it is a subrecipient or contractor?

• ​The classification depends on the substance of the relationship, not the label used in an agreement or budget. A subrecipient carries out part of the federal program and has responsibility for programmatic decisions. A contractor provides goods or services for the awardee's use through a procurement relationship.
• The primary awardee must document the classification and apply the corresponding oversight or procurement requirements. Contact OHA at RHTP@oha.oregon.gov when the classification is unclear before executing the agreement or distributing funds.

6. Reporting and evaluation

What are the program reporting requirements?

• OHA will provide awardees with final reporting templates, metrics, periods and due dates. Awardees should retain program and financial data needed to document progress and expenditures. Contact RHTP@oha.oregon.gov (unless OHA has provided a different submission address) if a reporting survey or template appears to be missing.

Where can we find reporting templates and questions?

• OHA will notify awardees directly when final templates and timelines are available. Use only the current materials sent by OHA or posted on the RHTP website.

Do reporting due dates require forecasting?

• Reporting timelines have been updated by CMS, and OHA is working to update guidance for awardees. Awardees have received survey questions to report on progress to date and will receive notice when expenditure-report templates and timelines are finalized.

What participant or patient demographics must be reported to CMS?

• The CMS source guidance states that OHA will report the total number of people served to CMS and will not submit individual demographic data. Follow the final OHA reporting instructions because metrics may be refined.

Who received the initial Year 1 annual-report surveys?

• The initial survey distribution varied by award type and agreement status. Projects with grant agreements executed prior to July 31, 2026, were prioritized for these Year 1 annual surveys. If you believe your organization should have received a survey, contact RHTP@oha.oregon.gov. A survey labeled for one award applies only to that award unless OHA states otherwise.

Does one reporting survey cover multiple RHTP awards?

• No, unless the survey instructions expressly state otherwise. A survey labeled for an Immediate Impact Award applies only to that award and does not also satisfy reporting for a Catalyst Award. Complete or submit separate reporting for each award as directed by OHA.

Do subrecipients submit surveys directly to OHA?

• Generally, no. Subrecipients report to the primary awardee, and the primary awardee incorporates required program and expenditure information into its reports to OHA, unless OHA provides different written instructions.

7. Compliance, records and communications

What address should be used to name the State of Oregon as an additional insured?

• ​Health Policy and Analytics - Rural Health Transformation Program / Office of Health Policy 500 Summer Street NE, E-20 Salem, OR 97301-1097

Do RHTP funds count toward the Single Audit threshold?

• Organizations that receive RHTP funds and expend $1 million or more in federal awards in a year will be required to undergo a Single Audit. Maintain clear documentation of expenses for the RHTP-funded project.

Who completes required background checks?

• Background checks must be performed by the awardee when required by its grant agreement. Not covered award recipients are required to complete background checks; the requirement will be identified in the agreement.
• The grant agreement states that specified individuals are subject to a background check through OHA's Background Check Unit pursuant to the cited Oregon Administrative Rules.

Who pays for background checks required by OHA?

• ​Background checks are completed by the awardee when required by the grant agreement.

May awardees share program information with their subrecipients?

• Yes. Awardees may share information needed for project implementation, compliance, and reporting with relevant subrecipients and contractors. Do not share confidential, privileged or personally identifiable information unless authorized and necessary. Meeting information should be limited to parties who need it for the project.

Where can I find announcements and updated materials?

• Current announcements, program materials and FAQs are available on the OHA RHTP website. Awardees may also receive updates through the RHTP email list. Contact RHTP@oha.oregon.gov if you cannot locate a current document.

How can we add contacts to grant correspondence?

• Email RHTP@oha.oregon.gov with the contract number and the name, title, and email address of each person to add or remove.

When is the Oregon Rural Health Conference?

• ​The 2026 Oregon Rural Health Conference is scheduled for October 7–9 in Bend. Visit https://www.ohsu.edu/oregon-office-of-rural-health/oregon-rural-health-conference for current details and registration.

8. Catalyst Award questions

How competitive was the Catalyst Award application review process?

• OHA received 583 project proposals from 353 organizations requesting more than $830 million across both budget years. With $160 million available for award, selected projects represent less than 17% of the total funding requested. A total of 85 organizations will receive funding for 103 projects.

9. Transformation Funds for Local Public Health Authority questions

Can LPHA funds support one-time infrastructure needs?

• Yes, when the infrastructure is part of an approved project and is an allowable RHTP cost. Capital and infrastructure spending is subject to applicable statewide and award-specific limits. Submitted LPHA budgets should not allocate more than 20% to capital and infrastructure costs unless OHA provides different written direction.

Can funds expand Family Connects Oregon?

• Yes. Projects may expand to new counties or demonstrate meaningful expansion at existing sites, subject to the approved project plan and budget.
  

Must LPHA projects align with Healthy Communities and Prevention Outcome 4?​

LPHAs must use funds to make progress toward Outcome 4: increasing rural populations served by new health care and social health services. An LPHA may also select another Healthy Communities and Prevention outcome. LPHAs selected to implement Family Connects Oregon must also support Outcome 1.

• Outcome 1: Universal access to home visiting services.
• Outcome 2: Increased availability of mental health and substance use disorder treatment.
• Outcome 3: Increased engagement with preventive health or self-management programs.
• Outcome 4: Increased rural populations served by new health care and social health services.
• Outcome 5: Expanded access through increased telehealth availability.

Can LPHAs propose Healthy Communities and Prevention activities that were not specifically described in Oregon's proposal?

• Potentially. Proposed activities must minimally connect to Outcome 4 and may also support another Healthy Communities and Prevention outcome. The activity must be allowable, rural-focused and included in an OHA-approved project plan and budget. Contact OHA before relying on an activity that is materially different from the examples in Oregon's approved proposal.

Can LPHA funds support Community Health Improvement Plan work?

• Yes, when the work is tied to the approved RHTP outcomes, targets and project plan. Examples may include oral-health strategies, data infrastructure, rural coalitions or workgroups, and an appropriate share of a CHIP coordinator's program work. By the applicable reporting period, the LPHA must be able to report progress toward specific RHTP targets.

May counties pool funds or subcontract with another county?

• Potentially. Each LPHA remains responsible for its own funds, approved outcomes and reporting. A participating LPHA that contracts or subawards funds must submit any separately required detailed budget and obtain OHA approval before proceeding.

Can an LPHA hire a contractor to support sustainability planning?

• Yes, if the work is allowable, included in the approved project and budget, and procured in accordance with applicable requirements. Costs for administering the contract may be subject to administrative-cost limitations.

Can an LPHA receive other RHTP funding in addition to Transformation Funds?

• Yes. An LPHA may serve as a subrecipient of another RHTP awardee and may receive Catalyst Award funding in addition to Transformation Funds via  Program Element 82 allocation. Budget costs may not be duplicated and all applicable requirements must be met.

Can an LPHA be a subrecipient of another RHTP-funded organization?

• Yes. An LPHA may serve as a subrecipient of a CCO or another organization receiving RHTP funds in addition to receiving its direct Program Element 82 allocation. The parties must correctly classify the relationship, obtain required approvals and prevent duplication of costs.

Can staff costs span both budget periods?

• A staff member may work during both budget periods, but salary and fringe must be budgeted and charged separately to the period in which each cost is incurred.

Is there a minimum, maximum, or a fixed percentage that must be spent in each budget period?

• No general minimum or maximum is stated. Allocations should be reasonable, support timely progress and avoid implausible end-of-period spending patterns. No fixed percentage is stated, but the budget and spending pattern must be reasonable and support timely implementation. The payment schedule does not itself dictate the percentage that must be expended by a particular date.

Will LPHAs receive funding for both budget periods?

• Budget Period 1 funding is currently provided. Budget Period 2 is contingent on Oregon receiving sufficient CMS funding and, on the awardee's, satisfactory progress and expenditure reporting. The amount may increase or decrease.
• For each budget period, the standard structure described in current award materials is an initial 50% disbursement after execution, followed by two 25% disbursements, unless a different schedule is negotiated and included in the agreement.​
  

Appendix A. Subrecipient oversight summary

Primary awardee responsibilities

• Confirm the relationship is correctly classified.
• Obtain and submit any required detailed Tier 2 budget before agreement execution or distribution of funds.
• Review allowability, cost limits and required approvals.
• Approve or submit budget changes as required.
• Collect expenditure and program reports at the required cadence.
• Maintain complete documentation and make it available to OHA.

Tier 2 responsibilities for lower-tier entities

• Obtain a complete detailed budget from each lower-tier subrecipient.
• Review costs for allowability and compliance before agreement execution.
• Review and approve changes using the same level of scrutiny applied to the original budget.
• Collect expenditure reports that align with the required cadence.
• Maintain all budgets, approvals, amendments and expenditure records for review or audit.

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