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More than half of federal funds given to Nebraska this year for rural healthcare have been awarded to rural hospitals, clinics and partner organizations.
The One Big Beautiful Bill Act passed last July created the $50 billion Rural Health Transformation Program (RHTP). The funding awarded to states is meant to stabilize and expand healthcare access in rural America, as well as offset Medicaid cuts passed in the same bill.
In December, the federal government awarded $218.5 million per year to Nebraska for the next five years.
About $136 million of this year’s funds have been awarded under nearly 200 grantee agreements, according to the Nebraska Department of Health and Human Services.
The state has until the end of October to allocate the rest of the money.
One of the organizations that has received money is The Nebraska High Value Network. The organization combines the resources and expertise of 22 rural Nebraska hospitals.
The NHVN received about $18 million under the “Remote Patient Monitoring in Facilities and at Home” grant.
“They have these things called BioButtons,” said Tyler Toline, board chair of NHVN and CEO of Franciscan Healthcare. “It can help measure respiration rates, blood pressure … It gives you kind of a leading indicator to see whether they're doing well or not.”
Toline said this technology can be used in clinical settings and at a patient’s home, allowing medical professionals to check in on patients remotely or catch markers of emergencies.
“One of the biggest struggles with small facilities is data integration, and so a portion [of the grant] will be used for connecting our [remote monitors] to a centralized database,” Toline said. “Then we can work collaboratively … as we try to prove that we've reduced the ER visits or prove that we've managed the hypertensive better.”
He said the hospitals wouldn’t be able to implement the technology – and the data systems needed to prove it’s working – without the help of these federal funds.
“Anybody could buy the monitors, but to be able to actually set it up to be able to prove the value of them and prove what you're doing, I don't think we would have had the capital funds to be able to do it,” Toline said.
Ashley Newmyer directs the Division of Public Health at the Nebraska Department of Health and Human Services. Her team conducts operations of the RHTP in Nebraska.
“I believe that we're positioned really well to maximize this once-in-a-generation opportunity to help improve access to care in rural areas, help to keep rural families in rural communities, help to keep people close to care,” she said. “I'm pleased so far with our progress.”
Other initiatives with grant opportunities released by DHHS include:
- Programs to help schools and food pantries serve more fresh, whole foods by connecting with local producers
- Programs promoting health literacy and healthy behaviors
- Assistance to infrastructure and technology upgrades for Critical Access and Rural Emergency Hospitals (CAHs and REHs)
- Emergency Medical Service (EMS) training with VR
- Oral health services
- Chronic disease education and self-management
- Behavioral, substance use and mental health care crisis care expansion
Toline said a few of the NHVN member hospitals had also received individual grants.
“I think that so far, the things that have been presented are at least innovative and creative, and give [rural hospitals] a chance to do things differently,” Toline said. “We're kind of excited to see what happens. A lot of us are part of the committees, and so we're constantly giving feedback, but ultimately, we're just trying to partner with the state the best we can.”
Current awardees
Nebraska’s RHTP Dashboard shows how funding has been allocated so far. The dashboard’s data is current as of July 7, 2026.
Based on the map alone, it appears most of the funding has gone to Nebraska’s most urban counties. But Newmyer said the data actually reflects the business address or headquarters of an awardee, and the funds will show their impact in rural areas.
“We've got universities in both of those locations. We've got the Department of Education in those locations,” she said. “We've got large health systems, but the awards are going out to their satellite clinics or for training in rural areas. Major criteria of grant applications was where they are providing services.”
For example, urban universities or businesses may help kickstart the workforce incentive program – which gives money to medical professionals who work in rural areas.
“We have received huge interest in that program, which is really helping to either recruit or retain those desired healthcare providers in rural areas,” Newmyer said. “With that program, there is an obligation under our federal grant requirements that they serve in rural areas for five years.”
According to the dashboard data, about $3 million has gone to out-of-state entities partnering with Nebraska.
10 months to obligate funds
The department is working on a tight timeline set by the federal government.
Funds have to be awarded to grantees by Oct. 30, giving Nebraska 10 months total to split up the large sum.
“The current funding opportunities that we have out there – we are forecasting – will cover the full $218 million that we've been awarded,” Newmyer said.
DHHS has posted all requests for applications for this first-year budget period, many of which are closed.
“We do have a few that are still open, and so we obviously encourage folks to take a look, see if their organization or their work would be eligible, and encourage them to apply for those,” Newmyer said.
If a state fails to obligate funds by the October deadline, unexpended funds will be distributed to other states.
“Once that period ends, States can no longer use any remaining unobligated funds to make new expenditures or commitments, as no additional costs can be incurred,” a guidance document from the federal Centers for Medicare & Medicaid Services reads.
States also receive a score depending on how efficiently they run their programs, and they can incur penalties if they are not using the money wisely.
Each state is guided by state-created, federally approved applications.
With such a short timeline, Newmyer said DHHS was strategic in selecting first-year initiatives that would make the most impact.
“When we received the award, what we looked at was which of the programs were priorities to help expand access to healthcare in rural Nebraska, or help meet a specific rural health need, along with readiness to get funds obligated quickly so the work could start rapidly,” she said.
Though grants must be awarded by the end of this October, DHHS has more time to send out the funds so grantees can spend them by the end of September 2027.
DHHS will continue updating the RHTP Dashboard on the fourth Thursday of each month.