The hawai'i rural health transformation plan will build a robust, sustainable rural health care system that will improve healthcare access, quality and outcomes through six interconnected initiatives

The Centers for Medicare and Medicaid Services awarded the Executive Office of the State of Hawaii a $566.677 million Cooperative Agreement on December 29, 2025, under the Rural Health Transformation Program (CFDA 93.798) to build a sustainable rural health care system improving healthcare access, quality, and outcomes in Hawaii through six interconnected initiatives. Performance runs through October 30, 2030, with all work performed in Hawaii.

The award funds six named sub-recipient initiatives. The Hawaii Department of Health implements the Rural Infrastructure for Care Access (RICA), expanding emergency medical services, community care, and behavioral health infrastructure in rural communities, and administers and coordinates all program implementation statewide. The University of Hawaii operates the Pili Ola Telehealth Network, a statewide telehealth network connecting rural communities to providers with digital health access, virtual care, and telehealth training capabilities, and implements the Hawaii Outreach for Medical Education in Rural Under-resourced Neighborhoods (HOME RUN) program through its John A. Burns School of Medicine. The State Planning and Development Agency creates the Rural Health Information Network (RHIN), a digital backbone connecting rural hospitals, clinics, and health centers through interoperable electronic health records, wireless networks, and integrated hubs, and establishes the Rural Value-Based Innovation and AHEAD Readiness Fund. The Department of Human Services Hawaii establishes the Rural Respite Network (RRN). Sub-awards to these recipients were obligated between February 20 and March 6, 2026.