accessRural Health Transformation Program funding for maternal care, state by state
By Ouma HealthChecked Updated
States receive an average of about $200 million a year from the Rural Health Transformation Program through 2030. We read 21 state plans against the states' own documents. Eleven put a dollar figure on maternal care. Nine name it, or have funded maternal projects, without a maternal line item. One names it only as an outcome. The table below shows what each state funded, what is open, and where a hospital or clinic can still get in.
The program
The program in five facts
$50 billion over five years. $10 billion a year, fiscal years 2026 through 2030. CMS announced awards to all 50 states on December 29, 2025. Year-one awards run from $147.3 million (New Jersey) to $281.3 million (Texas), and the average is $200 million. Half of the money is split equally, about $100 million a state. The other half is allocated on rural population, facility mix, uncompensated care and the policy commitments each state made in its application.
There are two deadlines, and the first is October 30. A state has to commit its year-one money, meaning sign the contracts and subawards, by October 30, 2026, and spend it by September 30, 2027. CMS doesn't count money that is earmarked but not paid out. Money a state fails to spend goes back to CMS and is redistributed to other states.
Nobody applies to CMS except the state. Each state runs its own subawards, and the routes differ: competitive grant rounds open to rural providers, direct contracts with a university or a hospital association, or regional hubs that pass most of their award down to local projects. A hospital, clinic or birth center applies to its state, or to its regional hub. A telehealth company doesn't apply at all; it is named as a partner in someone else's application.
The law never mentions pregnancy. The statute lists what a state can fund: prevention and chronic disease, payments to providers, consumer technology, technology training, workforce, health IT, right-sizing service lines, behavioral health, care models, and other uses CMS approves. CMS's funding notice turned that last item into two more categories, capital and regional partnerships, and added the caps: provider payments at no more than 15% of a state's award, capital at no more than 20%, and no new construction. The same notice names "prenatal care" in the program's first strategic goal, and its list of example initiatives is where maternal care shows up in detail: maternity care shortage areas, access to maternal-fetal medicine providers, perinatal quality collaboratives. Whether the money reaches obstetrics depends on what each state wrote into its plan and on who applied.
Year two is being decided now. CMS has committed to determining each state's fiscal 2027 amount by October 31, 2026, the day year two's budget period begins. Oklahoma tells applicants that CMS has asked states to plan for a similar funding level. Several states have said when their next window opens, and those dates are in the table.
State by state
Where maternal care is funded, and where it isn't
Twenty-one states, read from each state's own plan, budget narrative, funding summary, notices of funding opportunity and award announcements, not from the one-page abstracts CMS publishes. The abstracts miss most of the maternal content. Georgia's mentions newborn screening, interhospital transport and nutrition services for pregnant women and nothing on obstetric care, and Texas's doesn't mention maternal care at all, yet Georgia funds two maternal initiatives and Texas names maternal health as an early focus of its telehealth program. Each state's page lists the documents its row came from. Checked September 30, 2026.
| State | Year-one award | Maternal care in the state's own plan | What is open, or coming | Status |
|---|---|---|---|---|
| Alabama | $203.4M | Maternal and Fetal Health Initiative: $7.1 million in year one and $24 million over five years in the project narrative. Regional maternal and fetal referral hubs, digital maternity care platforms, telerobotic ultrasound at rural sites, emergency labor and delivery carts. August awards in other initiatives also funded rural obstetric training and prenatal and postpartum programs. | A round of about $6.1 million closed August 7, 2026; hospitals, critical access hospitals, rural health clinics, FQHCs and health systems were eligible, and a facility didn't need existing OB services to apply. The state expected awards three to four weeks later; none had been announced by September 30. Applications reopen for year two. | Closed, awards pending |
| Arizona | $167.0M | Improving Rural Maternal-Fetal Health grant, $5 million a year: AIM safety bundles, OB simulation training for rural hospitals, perinatal mental health certification, a perinatal clinical helpline for providers and regional tele-OB consults. A separate telehealth program funds hub sites and virtual specialty consults ($17 million in the year-one round). | The telehealth, diagnostic equipment and innovative care pilot rounds closed August 21; award notices went to applicants through the state's grants portal, and no award list has been published. The maternal-fetal grant hasn't been competed. The state aims to commit all year-one money by October 30. | Closed, awards not published |
| Arkansas | $208.8M | No maternal line item, but year-one awards fund maternal work: Arkansas Pregnancy Care Connect at UAMS ($2.99 million), a maternal mobile health unit ($796,000), a technology-enabled maternal diabetes program ($872,000), two doula programs, a rural maternal health expansion, obstetric pathways in family medicine training and a family medicine OB fellowship. | All year-one funds were awarded August 27 and September 24, 2026, pending final grant agreements. No year-two window announced; organizations must reapply. | Awarded |
| California | $233.6M | Year one puts $2 million into a rural train-the-trainer program that includes maternal health and $11.5 million into a workforce line that includes family medicine OB fellowships and OB Nest; a $5 million doula and midwife line is deferred to year two. The plan's hub-and-spoke networks include birthing centers, and the $39 million Accelerator Partners round names OB Nest and tele-OB among its models. | Accelerator Partners applications closed August 14. Award notices were scheduled for August or September and haven't been published. A CalRHT-funded maternal behavioral health fellowship for rural clinicians is recruiting. | Closed, awards pending |
| Colorado | $200.1M | No maternal line item. Perinatal remote monitoring and maternal teleconsultation were eligible activities in the telehealth grant area, and obstetric emergency readiness in the workforce area. | Awards announced September 28, 2026: $169.6 million to 91 applicants for about 250 projects. The state lists "improving maternal, newborn, and pediatric care" among the funded categories, including high-risk pregnancy monitoring and rural obstetric emergency readiness. The state doesn't expect a second round. | Awarded |
| Florida | $209.9M | No maternal line item. Obstetric and gynecologic care is named as a service the rural clinics initiative supports, and prenatal visits as part of mobile health. Three year-one awards totaling $2.28 million went to a maternal-fetal medicine practice in the specialty and acute care category; the state hasn't published what they fund. | Year-one awards (about $188 million, more than 80 awards) were announced August 11. National companies take part only as subrecipients or subcontractors. No year-two dates. | Awarded |
| Georgia | $218.9M | Strengthening Perinatal Systems of Care, $12.6 million over five years ($3.6 million in year one): stocked obstetric emergency carts for delivering and non-delivering rural hospitals. PEACE for Moms perinatal telepsychiatry inside a $14.75 million telepsychiatry line. | Both maternal items were awarded directly, and all year-one money was committed by August 27. The state withdrew its $10 million year-one telehealth hub opportunity and says it will restructure it in a later year. A rural graduate medical education grant that names OB/GYN as a priority closes October 15. | Awarded; telehealth round withdrawn |
| Iowa | $209.0M | Maternal Health Hub and Spoke Program: $38.6 million in year one and $119.8 million over four years. Equipment for maternal-fetal medicine specialist care by telemedicine, teleultrasound and 24/7 after-hours consult coverage are in scope. A separate High-Risk OB and Neonatal Transport round (about $6 million in its first year) equips EMS to reach specialists in real time. | Applications closed September 1, 2026, and letters of intent were mandatory, so the applicant pool is set. Oral presentations are around October 12 and the notice of intent to award around October 16, with contracts starting October 31. | Closed, award pending |
| Kentucky | $212.9M | PoWERing Rural Maternal and Infant Health: telehealth-enabled maternal care teams coordinated by a central telehealth nurse, home monitoring kits, doulas and perinatal community health workers. The plan estimates $15 million to $53 million a year, about $158 million over five years; no approved year-one figure has been published. | No maternal request for applications yet. A community health worker certificate round that included a perinatal certificate closed August 5. The state says it will post solicitations publicly and expects to engage qualified vendors and contractors. | Not yet solicited |
| Louisiana | $208.4M | No maternal line item. A $130 million care-integration initiative, which includes telehealth infrastructure, names prenatal care and postpartum follow-up within 30 days as goals. | The Telehealth Infrastructure round ($5 million, with maternal and prenatal health an eligible use) closed July 10 with 79 applications. The state scheduled notices of intent for the end of September; none had been posted by September 30. A public webinar is set for October 1. | Closed, awards imminent |
| Maryland | $168.2M | No maternal initiative. The plan reports that rural Marylanders get early prenatal care at a higher rate than the state overall. | The August 10 award offers include three with maternal work: a University of Maryland Medical System telehealth program covering maternal health in eight counties, regional care coordination hubs with maternal-focused services in three western counties, and a county maternal care plan. No year-two date. | Awarded |
| Mississippi | $205.9M | No maternal line item; obstetrics is named among the service lines the plan wants rural markets to open. The September 14 awards include a Delta maternal and newborn access project ($834,750), a mobile maternal telehealth hub with tele-ultrasound ($134,000) and maternal remote monitoring at UMMC ($149,100). | 167 awards ($104.1 million) were made September 14. Workforce and psychiatric emergency awards were promised within 30 to 45 days; new rounds for care gaps and EHR modernization are planned for October. | Awarded, more rounds |
| Montana | $233.5M | No maternal line item. The plan names maternal and infant health among its target populations and lists perinatal telehealth and expanded prenatal care as expected outcomes. | EMS equipment awards ($8.7 million) were made September 29. The tele-specialty hub-and-spoke initiative hasn't been solicited. | Not maternal yet |
| Nebraska | $218.5M | Maternal-Fetal Medicine Rural Provider Pairing Program ($4 million a year with EMS and perinatal regionalization): rural primary care providers co-manage high-risk pregnancies with obstetricians by teleconsultation, with an on-call MFM line for EMS along the I-80 corridor. Mobile Maternal Care and Training ($6 million a year): mobile units with fetal monitoring, basic ultrasound and home monitoring devices. | Neither initiative has a request for applications. The plan pilots the pairing program at one rural clinic in year one. | Not yet solicited |
| New Mexico | $211.5M | Healthy Horizons: $5.18 million of the year-one budget for maternal and child health. The plan also commits to incentive payments for rural hospitals and clinics that establish and sustain maternal care service lines, MFM e-consults and perinatal mental health training. | Six regional hubs were awarded $74.1 million on September 18 and must spend at least 90% on local projects; their local rounds haven't been announced. A $47 million Rural Health Innovation Fund, open to vendors, is under evaluation, with contracts expected from October 1. | Hubs awarded, local rounds next |
| Oklahoma | $223.5M | Maternal-Fetal Medicine Telehealth Expansion, run by the University of Oklahoma and Oklahoma State University with telehealth and ultrasound equipment at rural sites: $5.4 million for year one in the state's August 2026 summary (March documents showed $6.6 million). A doula program ($4.3 million), maternal remote monitoring ($0.8 million) and maternal value-based payment support ($0.6 million). | The MFM program runs through agreements with the two universities, not a competitive round. The doula round has closed. Year-two opportunities begin opening in January 2027, and county collaborative meetings run from October 26 to November 13. | Contracted; year two in January |
| Oregon | $197.3M | Maternal and child health is one of four populations of focus, and every Catalyst project had to address at least one. Maternal awards include the Oregon Perinatal Collaborative ($1.08 million in year one), a mobile obstetric simulation unit, a 24/7 obstetric addiction advice line, postpartum nurse home visiting and Nurture Oregon perinatal site expansions. | Catalyst awards ($80.1 million for year one, 85 organizations) were made July 7, alongside direct funding to rural hospitals, rural health clinics and local public health authorities. A regional funding opportunity is expected at the end of year two. | Awarded |
| Pennsylvania | $193.3M | Maternal Health Initiative, $186.4 million over the plan period: two comprehensive maternal health hubs by 2028, care management from preconception to twelve months postpartum, remote monitoring that links abnormal results to tele-maternal-fetal-medicine consults, grants to reopen labor and delivery units and to birth centers, a family medicine OB fellowship. | The first stabilization round ($42 million, 66 projects) funded ultrasound machines for telehealth and in-person MFM care at two Lehigh Valley hospitals, maternal diagnostics at a birth center and an obstetric clinic renovation in Pike County. "Maternal Health: Remote Monitoring" is listed as upcoming with no date. | Maternal round not yet issued |
| South Dakota | $189.5M | Regional Maternal and Infant Health Hubs, $24 million over five years: three organizations funded to run hubs linked to spoke sites, an OB Nest-style mix of in-person, telehealth and remote monitoring care, and doula programs. | Rural Strong grants that include maternal health hubs were awarded July 23. The state's annual report says the remaining contracts for the initiative are being finalized; recipients haven't been published. | Awarded, contracts finalizing |
| Texas | $281.3M | No maternal line item, but the plan names maternal health as an early focus of its Lone Star Advanced AI and Telehealth initiative, and the year-two narrative (revised August 31, 2026) directs that initiative's telehealth services toward prevention, behavioral health, maternal care and chronic-condition monitoring. | The initiative's first round ($37.5 million in year two, about $150 million over the grant term) is for clinically integrated networks and ACOs whose membership is at least 60% rural providers. Applications are due in December 2026 and awards in March 2027. The first awards, announced September 28, were $51 million for chronic disease programs. | Maternal-relevant round in December |
| Utah | $195.7M | No maternal line item. Maternal and infant health, virtual perinatal care, lactation support, fetal monitoring and maternal health networks are named inside several initiatives, and the telehealth plan ties its sustainability to regional partnerships with MFM specialists. | The telehealth round ($23.7 million) closed August 10 and New Models of Care ($10 million, about 12 awards) closed September 1; no awards have been published. New Models of Care limits funded clinical partners to Utah and four neighboring states. | Closed, awards pending |
Table notes. Award figures are the CMS year-one awards, rounded. "Maternal care in the state's own plan" summarizes the state's documents and quotes them where the wording matters; it doesn't judge whether the state prioritizes maternal health. A state with no line item can still fund obstetric care through a general telehealth, workforce or service-line round, and several have. Download the table as a CSV: rht-maternal-funding-by-state.csv.
Download the table (CSV)All 50 states
Every state's year-one award
Figures from USAspending, rounded to the nearest dollar and reconciled against CMS's announcement. "Maternal named in CMS abstract" records whether maternal, maternity, obstetric, prenatal, postpartum or perinatal language appears in the one-page project abstract the state submitted, which CMS published in December 2025. "No" means it doesn't appear in that abstract; it doesn't mean the state's full plan is silent. Texas is the proof: "No" here, and maternal health named in its full plan. The 21 states above were read in full.
| State | Year-one award | Lead agency | Maternal named in CMS abstract |
|---|---|---|---|
| Alabama | $203,404,327 | Dept. of Economic and Community Affairs | Yes |
| Alaska | $272,174,856 | Dept. of Health | Yes |
| Arizona | $166,988,956 | AHCCCS | Yes |
| Arkansas | $208,779,396 | Dept. of Finance and Administration with the Governor's Office and DHS | No |
| California | $233,639,308 | Health Care Access and Information | Yes |
| Colorado | $200,105,604 | Health Care Policy and Financing | Yes |
| Connecticut | $154,249,106 | Dept. of Social Services | Yes |
| Delaware | $157,394,964 | Executive Office of the Governor | No |
| Florida | $209,938,195 | Agency for Health Care Administration | Yes |
| Georgia | $218,862,170 | Dept. of Community Health | No |
| Hawaii | $188,892,440 | Executive Office of the State | No |
| Idaho | $185,974,368 | Dept. of Health and Welfare | Yes |
| Illinois | $193,418,216 | Healthcare and Family Services | No |
| Indiana | $206,927,897 | Family and Social Services | Yes |
| Iowa | $209,040,064 | Dept. of Health and Human Services | Yes |
| Kansas | $221,898,008 | Dept. of Health and Environment | No |
| Kentucky | $212,905,591 | Cabinet for Health and Family Services | Yes |
| Louisiana | $208,374,448 | Dept. of Health | Yes |
| Maine | $190,008,051 | Dept. of Health and Human Services | No |
| Maryland | $168,180,838 | Dept. of Health | No |
| Massachusetts | $162,005,238 | Executive Office of Health and Human Services | Yes |
| Michigan | $173,128,201 | Dept. of Health and Human Services | No |
| Minnesota | $193,090,618 | Dept. of Health | No |
| Mississippi | $205,907,220 | RHTP Office, Office of the Governor | No |
| Missouri | $216,276,818 | Dept. of Social Services | Yes |
| Montana | $233,509,359 | Dept. of Public Health and Human Services | No |
| Nebraska | $218,529,075 | Dept. of Health and Human Services | Yes |
| Nevada | $179,931,608 | Nevada Health Authority | No |
| New Hampshire | $204,016,550 | Dept. of Health and Human Services | Yes |
| New Jersey | $147,250,806 | Dept. of Human Services | No |
| New Mexico | $211,484,741 | Health Care Authority | Yes |
| New York | $212,058,208 | Dept. of Health | No |
| North Carolina | $213,008,356 | Dept. of Health and Human Services | Yes |
| North Dakota | $198,936,970 | Dept. of Human Services | No |
| Ohio | $202,030,262 | Dept. of Health | Yes |
| Oklahoma | $223,476,949 | State Dept. of Health | No |
| Oregon | $197,271,578 | Oregon Health Authority | No |
| Pennsylvania | $193,294,054 | Dept. of Human Services | Yes |
| Rhode Island | $156,169,931 | Executive Office of Health and Human Services | Yes |
| South Carolina | $200,030,252 | Dept. of Health and Human Services | Yes |
| South Dakota | $189,477,607 | Dept. of Health | Yes |
| Tennessee | $206,888,882 | Dept. of Health | Yes |
| Texas | $281,319,361 | Health and Human Services Commission | No |
| Utah | $195,743,566 | Dept. of Health and Human Services | Yes |
| Vermont | $195,053,740 | Agency of Human Services | No |
| Virginia | $189,544,888 | Dept. of Medical Assistance Services | Yes |
| Washington | $181,257,515 | Health Care Authority | No |
| West Virginia | $199,476,099 | State Health Department | No |
| Wisconsin | $203,670,005 | Dept. of Health Services | No |
| Wyoming | $205,004,743 | Dept. of Health | No |
The gap
The coverage gap the money is meant to close
A 2012 workforce analysis found that 98.2% of maternal-fetal medicine subspecialists lived in metropolitan counties with a Level III perinatal center, leaving rural communities without access to the subspecialty care that high-risk pregnancies require.
Rayburn WF, Klagholz JC, Elwell EC, Strunk AL. Maternal-Fetal Medicine Workforce in the United States. Am J Perinatol. 2012;29(9):741-746. Based on the 2010 ACOG membership roster; the distribution may have shifted since.
Between 2011 and 2024, 331 rural hospitals stopped offering obstetric services, roughly a quarter of the country's rural obstetric units.
Chartis, 2026 Rural Health State of the State, February 2026. A separate Health Affairs analysis (Kozhimannil et al., 2025) counts 238 rural and 299 urban hospitals losing obstetric services between 2010 and 2022.
Using the money
How a rural hospital, clinic or birth center uses this money for obstetric coverage
The money pays for programs and services, not buildings. New construction is barred, capital is capped at 20% of a state's award, and payments to providers for items or services are capped at 15%. That shape suits a maternal telehealth line: consult coverage, ultrasound interpretation, remote monitoring, training and the technology to run them fit the categories for consumer technology, technology training, health IT, service-line design and regional partnerships, without touching the provider-payment cap. Two cautions. The program doesn't pay for services insurance already covers (CMS bars it in every state, and Colorado's FAQ spells it out for billable telehealth), so the budget line should cover the parts a claim doesn't: availability, the platform, training, coordination. And every state runs its own rules, so read the state's notice before you write the budget.
Without labor and delivery
A hospital doesn't need a labor and delivery unit to have an obstetric problem. A pregnant patient in distress often goes to the nearest emergency department, whatever services it offers. Alabama's maternal round didn't require existing OB services, and Georgia put stocked obstetric emergency carts in rural hospitals that don't deliver. Consult coverage for that emergency department is a legitimate line in the same budget.
Two ways in
There are two ways in. The first is to apply in your state's round with the maternal work written into your own project: name the clinical partner, put a budget line against consults and reads, and describe how the service continues after the grant (CMS asks every state to show sustainability, and a service that bills Medicaid after year one answers that). The second is to attach to someone else's award. New Mexico's and South Dakota's regional hubs must spend most of their money on local projects. Iowa's hub and network winners, due to be named around October 16, will need the coverage they promised. California's Accelerator Partners form networks that include birth centers, and Texas's December telehealth round is open only to networks of rural providers. If your state's rounds have closed, the network route is usually still open.
Timing
Timing matters more than usual. Year-one money has to be committed by October 30, 2026 and spent by September 30, 2027. A program that can start within weeks is worth more to a state agency than one that needs a building.
Partner letter
Applying with a maternal telehealth partner
Hospitals can't name a partner they haven't found, and a partner can't apply for them. We wrote a one-page starting point: a sample scope of work for tele-MFM consults and ultrasound reads, a sample budget line, and a partner support letter a hospital can adapt for its state's application. It's free and asks for nothing.
Can a telehealth company apply for Rural Health Transformation funds?
Can the money pay for tele-MFM consults or ultrasound reads?
Can a hospital without labor and delivery use this money for obstetric coverage?
My state's CMS abstract doesn't mention maternal health. Does that settle it?
When is the next round?
What happens to money a state doesn't spend?
Ouma Health
Where Ouma fits
Expanding access to subspecialty care
Ouma's teleMFM services bring board-certified MFM specialists into rural facilities. Less than 10% of patients typically require transfer to an in-person MFM provider.
Strengthening the rural workforce
Ouma supplements existing teams with nights-and-weekends coverage, reducing burnout and improving physician retention.
Modernizing technology
Ouma works within existing EHR systems and requires no additional equipment.
Supporting innovative models
From HEDIS compliance programs to gestational carrier screening, Ouma has a track record of innovative care delivery.
Ouma's maternal-fetal medicine physicians are available at any hour for consults with a hospital's own clinicians, and that coverage extends to hospitals that don't deliver babies.
Track record
A proven track record
Ouma is licensed to practice in all 50 states and is Medicaid-enrolled in 20 states as of August 2026, and it's already embedded in the communities that the RHT Program aims to serve.
Sources
Sources and method
Award figures: USAspending (Assistance Listing 93.798), reconciled to CMS's December 29, 2025 announcement. Program rules: CMS Notice of Funding Opportunity CMS-RHT-26-001, CMS's program FAQs (October 31, 2025 and April 9, 2026) and the state project abstracts CMS published in December 2025. State rows: each state's project narrative, budget narrative, funding summary, notices of funding opportunity, FAQs and award announcements, listed on each state's page. Third-party trackers were used to find documents, never as the source of a figure. Rows are checked on the date shown, and changes are logged here.
Changelog: September 30, 2026: page rebuilt around the state table; 21 states read from primary documents, checked September 30, 2026. March 15, 2026: original page.
Let’s Talk
Keep maternity care local.
Ouma provides contracted maternal-fetal medicine coverage and ultrasound interpretation to rural and critical access hospitals.
Expert maternity telehealth, extending the reach of subspecialty clinicians to every patient who needs it.