State of Idaho Rural Health Transformation Program - The Idaho Department of Health and Welfare’s Rural Health Transformation Program grant proposal seeks $200 million per year for five years to empower Idahoans and their communities to take charge of their health by transforming today’s fragmented rural health care infrastructure into a resilient, patient-centered system that delivers accessible, sustainable, and innovative care close to home. This will be accomplished through five coordinated initiatives that build long-term system capacity, informed by public input that identified three clear priorities guiding this plan: workforce, healthcare access, and chronic disease prevention. Improving rural access to care through technology: Through investments in technology assessments, telehealth, interoperability through electronic health records software and upgrades, artificial intelligence, cybersecurity modernization, emergency communication system implementation and enrollment, health management and data analytics tools, and digital health applications, Idaho will strengthen the backbone of rural care--bridging distance, reducing duplication, and building durable infrastructure that allows communities to manage their own health more effectively in partnership with rural healthcare systems, treatment centers, and long-term care facilities. Ensuring accessible quality care through innovative models: By investing in access to innovative diagnostics, leveraging new technologies, expanding workforce by enhancing the role of health extenders (community health workers, community health EMS, pharmacy allied professionals, and other non-physician health care professionals), strengthening EMS systems, and supporting home-based and community-based care solutions, this initiative will ensure that rural Idahoans can receive care at and close to home. Sustaining rural workforce with training, recruitment, and retention: To transform rural health sustainably, this initiative focuses on a comprehensive rural workforce strategy that leverages financial incentives, training pathways, and community support to build and sustain a skilled rural health workforce--including ladder payments for recruitment, retention, and post graduate scholarships; healthcare career exploration and advancement programs; work-based learning; and graduate medical education programs including fellowship and residency. All participants in the workforce projects will commit to a minimum of five years of service in rural communities, ensuring continuity of care and strengthening local health systems. Implement population specific, evidence-based projects to Make America Healthy Again: This initiative will advance Idaho’s rural health systems by implementing community-targeted, data-driven prevention and treatment programs that address chronic disease, behavioral health, and maternal and child health; and build local capacity for implementation and ongoing sustainability. To ensure long-term impact, all interventions will be based on proven models and supported by training, monitoring, and evaluation systems to ensure viability in rural Idaho contexts. Investing in rural health infrastructure and partnerships: This initiative will invest in rural healthcare facility renovations, pharmacy solutions, clinical equipment purchases, vehicles for patient transport and rural mobile health units, and facility compliance upgrades. Additionally, it supports partnerships, including a 3.5% set-aside for Tribal rural health transformation support. Funding will be awarded through competitive solicitations under the five initiatives.