States are buzzing with requests for proposals or impending new ones to fulfill their goals laid out in year one of their approved Rural Health Transformation Programs funding.To name just three: Nevada is asking for applicants for more than $26 million, while Utah is set to open an RFP for a $6 million value-based care network. In New England, Vermont is ready to get artificial intelligence-driven documentation tools to its rural care providers.Not surprisingly, AI is a significant component of proposed RHTP projects nationwide, says Daniel O'Neil, principal at Civic Operator, which operates the online Rural Health Transformation Grant Tracker."On the AI front, I've counted approximately 23 states that specifically reference it in their plans," O'Neil told Healthcare IT News on Wednesday.Nevada embraces consumer digital healthNevada's $26.9 million Request for Applications under its Rural Health Innovation and Technology projects allows only providers, tribal organizations and provider-led regional groups to lead applications. Health tech vendors must establish formal partnerships with eligible healthcare entities to participate, according to the RFA. The state said it is prioritizing RHIT proposals that offer realistic and wide adoption of sustainable technology and provider flexibility "to change vendors, add components or integrate with other systems over time." There are three tracks: Core health IT infrastructure and interoperabilityProvider‑facing digital health and remote careConsumer‑facing digital tools and AI While the state is focusing on supporting providers seeking to strengthen health IT and interoperability capabilities and expand telehealth and virtual care programs, Nevada capped funding for consumer-facing health tech at 50% of total costs. That means proposals can include smartphone apps and AI-enabled chat tools that could help rural patients manage chronic diseases, but must target other goals.Fundable projects – which should prioritize operational and clinical infrastructure, such as interoperable electronic health records and integration with the U.S. Centers for Medicare & Medicaid Service's Health Technology Ecosystem – may not rely on the potential for future state legislative appropriations to cover ongoing software or technology maintenance costs. Also, the funds cannot be used for broadband infrastructure or household internet installation. But, the state indicated that it will consider funding deployable internet access equipment in certain circumstances, such as for a mobile clinic or temporary pilot. "Upgrading underlying network infrastructure strictly for cybersecurity and compliance purposes is also a heavily encouraged, allowable expense," according to O'Neil."Nevada is being extremely strict about long-term sustainability to avoid budget crises when the five-year federal grant ends," he said by email on Wednesday. "Applicants must prove they have a reliable, self-sustaining financial model to maintain the tech beyond 2031."While the federal RHTP focuses on tech upgrades, Nevada is also allowing for building renovations through a "Flex Fund" dedicated to facility infrastructure. "For example, if a rural clinic needs to retrofit a breakroom into a dedicated telehealth suite or install specialized wiring for new servers, those construction costs can be covered under the RHIT grant as long as the state has not hit its overall 20% capital expenditure cap," O'Neil explained.Round 1 applications are due by July 6.Utah to establish a network to spur VBC The Beehive State's $6 million RFP is expected to open on May 30, according to the Utah RHTP Funding Opportunities page. The opportunity, which could last five years and receive $15 million in funding, is part of the state's Financial Approaches for Sustainable Transformation (FAST) initiative aimed at addressing the core financial challenges hindering rural healthcare. The recipient, a Utah-based non-profit healthcare organization, must mobilize both payers and rural providers to move from a fee-for-service payment model to generating revenue through performance-based models by establishing a Clinically Integrated Network. The CIN is to pool resources and centralize administrative burdens – billing, credentialing and IT – and advance care coordination by establishing data systems, specialized care teams and population health analytics. It's challenging to manage VBC across a set of providers. Subsidiary Castell Health was able to help providers make gains in affordability and quality, but was absorbed by parent company Salt Lake City-based Intermountain Health in 2024. "Utah is using this one-time funding to catalyze permanent, systemic change rather than creating future financial obligations for the state," said O'Neil. "The state intends to sustain this transformation by proving that these new models will generate shared savings for the facilities."Utah's application specifies that the awardee must complete a successful VBC pilot evaluation with two different payers.There are more open and forthcoming RHTP-driven opportunities for shared cybersecurity and AI technologies, interoperability projects and programs that fall under the state's RISE, SHIFT and LIFT initiatives.Vermont seeks ambient AI to help rural providersThe New England state is looking to develop regional rural health resources under a Clinically Integrated Network of Shared Services that aims to give practices the operational scale that larger hospital networks traditionally enjoy, O'Neil said.The state's Notice of Funding Opportunity seeks to provide access to AI scribe technology through purchase or lease to rural practices and clinics. Applicants are asked to submit a plan that addresses how they will retain or create revenue in the future enough to sustain their use of the technology.While urban clinics can also apply, 20% of their patients must reside in rural ZIP codes.The "NOFO is leveling the playing field for independent providers," O'Neil said. But, "the scoring criteria heavily favor practices where 80-100% of the patient base is rural."Applications are due by June 5.Andrea Fox is senior editor of Healthcare IT News.Email: [email protected]Healthcare IT News is a HIMSS Media publication.