Alaska opens $75 million rural health grant round before scoring rules are final

The Alaska Department of Health opened a round of about $75 million in rural health grants Sept. 30, but the rules that will score the applications are still drafts. The department says final rules will be posted by Oct. 14, two weeks before applications are due at 11:59 pm Wednesday, Oct. 28.

Betsy Wood, director of the department's Office of Health Savings, told the advisory council Sept. 23: "We all recognize we're working on imperfect timelines and that in an ideal world, we would have been able to provide proposed changes weeks ago."

Council member Jared Kosin of the Alaska Hospital and Healthcare Association called it "an example of just how terrible these timelines are" but said the department "cannot delay this anymore." A department official said the schedule keeps a Jan. 1 start and gives a four-week window without applicants or staff "having to work over the holidays."

The money comes from the federal Rural Health Transformation Program, run by the Centers for Medicare and Medicaid Services. Alaska's first-year award was about $272.2 million, and as of Sept. 25 the department had announced about $242 million in projected first-year awards across 249 projects. The fall round is part of year two; federal review of Alaska's second-year application was underway, the department told the council.

The draft rules update the framework for launch-ready projects, add a framework for planning projects and revise a portfolio review for projects that clear the scoring threshold, which weighs geography, population served and federal funding rules. The fall round also drops last year's letter-of-interest step, and each operating entity serving a distinct community may submit up to five applications.

Applicants should hear back in December. Projects could start Jan. 1, 2027, and must spend awards by Dec. 31, 2027, unless the department approves an extension. Comments on the draft rules close at 5 pm Friday, Oct. 9.