Let's get wonky shall we?
$930 Million Is Coming to Rural Idaho.. I Want Rural Idaho to Actually Get It
Idaho is receiving roughly $930 million over five years through the new federal Rural Health Transformation Program. Nearly a billion dollars, folks. I mean, wowzers... sometimes these numbers get so big we forget how much of our taxpayer dollars that really is.
POV... if you spent $1,000 a day, it would take you 2,738 years to spend it all. I mean, you could buy almost 2,000 homes in Idaho with a billion dollars. I think the only person who doesn’t think a billion dollars is a lot of money is Elon Musk.. and we ain’t no Elon Musk, friends.
Okay, I digress.. I have gotten wayyy off track here. Back to what I like to call Idaho’s dirty money. Why, you ask? Great question.
Well, when the One Big Beautiful Bill was moving through Congress, the swamp needed one more vote to get it passed. They bought the final vote for a cool $50 bill, which funded what is now called “Rural Health Transformation.”
Gross? Yes. Surprising? I mean, a little, but also.. no.
So here we are. $930 million is making its way to our state.
And even though I voted NO on the final appropriation bill that approved this spending and established the final oversight structure, I did volunteer to serve on the interim committee because I want to ensure the most good is done with these dollars. I mean, our U.S. Senators sold their votes for this money fair and square, after all.
If I were queen..
I probably would have swung bigger.
With nearly a billion dollars and five years, I would love to see Idaho rally around one truly transformational idea - something on the scale of building a medical education and GME system capable of training Idaho doctors from beginning through residency, particularly in rural communities, and structuring it so it can stand on its own when these federal dollars disappear.
Idaho’s approved plan does include some of these elements, but they remain fragmented, and there doesn’t seem to be enough appetite to foster the kind of collaboration something this ambitious would take.
But that doesn’t mean enormous good can’t still come from this money.
We can bolster rural providers who are already doing great work and help them grow it.
We can invest in equipment that lets a clinic offer a service locally instead of sending a patient two hours away.
We can upgrade ancient EHR systems, expand telehealth and remote monitoring, invest in mobile healthcare, train and retain providers, and give innovative Idaho organizations a chance to try ideas they could never afford to launch on their own.
Making sure the little guy has a chance
Grant writing, procurement processes, reimbursement rules.. these are the things nightmares are made of.
A large hospital system has grant writers, accountants, attorneys, government affairs staff, and lobbyists who can sit in Boise all day watching this process.
A small rural clinic may have one administrator doing payroll at 9:00, credentialing at 10:00, filling a staffing hole over lunch, and then trying to decipher a grant application before they go home.
If we make this process complicated, we already know who has the advantage.
So one of my biggest priorities on this committee has been making sure smaller rural providers have a real shot. I’ve pushed to simplify the subgrant process, remove requirements that don’t actually add value, make the scoring more transparent, and make sure the process itself doesn’t become the barrier.
And, to DHW’s credit, there has been movement.
And yes, I’m watching who wins
I’ve also started digging much deeper into how the original stakeholder ideas became actual funding opportunities.
One example is Comagine Health.
During Idaho’s stakeholder process, Comagine described the maternal-health infrastructure it already administered through the Idaho Perinatal Quality Collaborative and proposed expanding that work with RHT dollars.
Later, DHW created an IDPQC funding opportunity.
Comagine was the only applicant and received a $1.91 million award. It also won a separate $1.2 million OB Readiness award.
That doesn’t prove anything nefarious happened, buuuuut “open and competitive” needs to mean more than posting something online and technically allowing everyone to apply when, in reality, only one organization can satisfy all of the requirements.
I’ve inquired whether Comagine had any role in shaping those opportunities before bidding on them, how many organizations could realistically meet the requirements, and whether the new federal money is paying for genuinely new work or simply moving an expense taxpayers were already covering with state dollars onto this federal grant to “save a buck” on the balance sheet.
Those answers will be important, because in this next round of solicitations I’ve already noticed another example that could potentially raise the same concern.
I’ll keep pulling on this thread and hopefully help make the process going forward even better.
If you’re a rural provider, this part is for you
Please watch these funding opportunities and please apply.
DHW now has a dedicated Funding Opportunities for Rural Health Transformation page (click button below) with open opportunities, a Subgrant Quick Start Guide and a place to sign up for updates.
And if you look at one of these applications and immediately think, there is no way we have the staff to figure this out - reach out to me at cblaylock@senate.idaho.gov
I’ve already had people reach out who are willing to help smaller providers with grant writing, and I’m happy to connect you with people who can help navigate the process.
That does not mean I can get anyone a grant. Nor should I. Every applicant will go through the same published rubric and scoring process.
But I don’t want a good rural provider deciding not to apply simply because the government paperwork feels overwhelming.
And if you do apply and something doesn’t seem right, reach out then too. Our committee has statutory access to the scoring data, rubrics and award information.
I will take a look and make sure you got the same fair shot everybody else did.
Because if, five years from now, the largest health systems and state organizations figured out how to collect hundreds of millions of dollars while the little rural clinic down the road never even applied because the paperwork scared them off.. we failed.
I want to see more care available closer to home. I want rural providers who were already doing good work to be stronger than they were before. I want technology and equipment being used in communities that couldn’t otherwise afford it. I want innovative ideas that actually expanded access.
And I want small-town Idaho to be able to point to this money and say: hey, that actually did help - that did make a difference here.
That’s why I volunteered for this committee. The money is coming either way and I want to make sure rural Idaho actually gets it.
Camille Blaylock
Idaho State Senator, District 11
Is there a deadline when this money must be distributed? If so, if Idaho misses it, will the money return to the federal government for redistribution to other states?