The data is already in
When CMS opened the Rural Health Transformation Program to state applications in late 2025, it gave each state considerable flexibility to design programs around their specific rural health priorities. States did not have to propose the same solutions. They could pursue workforce development, infrastructure investment, telehealth expansion, chronic disease management, long-term care modernization, or any combination of these goals.
What states actually proposed tells us a great deal about where rural health leaders believe the highest-impact opportunities are. The National Academy for State Health Policy reviewed applications from 47 states with publicly available submissions and identified the most common priority areas.
The results are striking. Thirty-three states proposed initiatives to increase the healthcare workforce serving aging populations. Thirty-two states proposed initiatives to build upon the long-term care system for older adults, including home care and related support services. And 24 states proposed technology and telehealth initiatives specifically aimed at improving access, health monitoring, and communication for older adults.
These are not abstract policy aspirations. They represent the areas where state health leaders, after consulting with providers, community partners, and rural residents, determined that RHTP funding could do the most good. And they point clearly toward a gap that passive home monitoring is built to fill.
The gap that in-home monitoring addresses
Rural communities face a distinct combination of healthcare challenges, especially among older adults: a higher burden of chronic and complex conditions, scarce long-term care services, economic hardship, social isolation, and inadequate transportation. State health leaders know this. Their RHTP applications reflect a shared understanding that meeting the needs of aging rural populations requires new approaches to how care is delivered and monitored between visits.
The problem with traditional care delivery for this population is that it operates on a schedule. A home health aide visits twice a week. A care manager checks in monthly. Between those touchpoints, there is no visibility into what is happening. A resident whose sleep has been disrupted for six consecutive nights, whose kitchen activity has dropped significantly, or whose daily routine has become markedly more limited may not report these changes to anyone. And a care team operating on a visit schedule has no way to know.
What measurable outcomes RHTP programs must produce
RHTP funding is not a block grant. It comes with accountability requirements that flow down from the state’s cooperative agreement with CMS to every subrecipient organization. Programs must demonstrate progress, document interventions, and report on outcomes at regular intervals.
This is where many technology solutions create friction rather than reducing it. A system that is difficult to deploy at scale, that generates data in formats that are hard to export, or that requires extensive manual documentation creates administrative burden for programs that are already operating with limited staff capacity.
Passive home monitoring that is designed for program accountability from the start addresses this directly. Time-stamped behavioral data, exportable reports configurable to monthly or quarterly timelines, and structured documentation of alert activity and care team responses provide exactly the evidence base that RHTP programs need to demonstrate outcomes, support audits, and justify continued investment.
For organizations writing RHTP subgrant applications or designing technology components of existing programs, this documentation architecture is not optional. It is a core requirement. Technology partners that treat reporting as an afterthought will create significant compliance risk for the organizations that work with them.
What leading state programs look like
Virginia’s RHTP application, which received $189.5 million in first-year CMS funding, includes a remote patient monitoring sub-initiative explicitly designed to extend clinical visibility beyond traditional care settings and facilitate proactive intervention. The program spans 76 rural counties with a clear mandate to move from one-off clinic visits to continuous, digitally enabled care.
Kansas, Maryland, and South Carolina are investing in expanded RPM and patient-facing health technologies in rural areas. Maine, Arizona, and Arkansas are establishing telehealth hubs to create additional community-based access points. South Dakota has released requests for proposals specifically for caregiver support programming and chronic disease self-management programming.
Across these programs, a common thread emerges: the goal is not simply to digitize existing care models but to extend care team capacity across populations that cannot be adequately served through in-person visits alone. Passive home monitoring fits naturally into this vision because it does exactly that, continuously, without placing any burden on the resident.
How to position passive monitoring in a subgrant application
For organizations preparing to apply for RHTP subaward funding through their state, or for those already operating RHTP-funded programs looking to add a monitoring component, the following framing can strengthen an application:
- Connect to state priorities: Review your state’s approved RHTP plan and identify the specific initiatives and outcomes your monitoring program will support. The closer the alignment between your proposal and the state’s approved goals, the stronger the application.
- Emphasize workforce extension: Passive monitoring is a workforce multiplication strategy. One care manager can monitor dozens of residents from a centralized dashboard. In states where workforce development is a top RHTP priority, this framing is directly relevant.
- Lead with outcomes: RHTP requires measurable results. Describe specifically what data your monitoring program will generate, how it will be reported, and what changes in care patterns or avoided events you will document.
- Address connectivity: Rural broadband access is uneven. Specifying that your monitoring solution operates on cellular connectivity and does not require broadband demonstrates an understanding of rural deployment realities that reviewers will notice.
- Highlight the privacy approach: For aging populations, surveillance concerns can be a barrier to program participation. A monitoring approach that uses no cameras, no microphones, and no wearables is significantly easier to present to residents and families as respectful of dignity and privacy.
The window is open now
States are actively distributing RHTP subaward funding through 2030, with requests for applications, letters of interest, and procurement processes opening throughout 2026 and beyond. Organizations that begin building their technology infrastructure now are better positioned to respond quickly when funding opportunities appear in their state.
FutureCare works with rural health organizations, home care agencies, and care-enabled living programs to design and deploy passive monitoring programs that align with RHTP priorities. If your organization is navigating state RHTP processes or designing a program proposal that includes home-based monitoring, we are glad to be a resource.