Governor Ferguson announces Washington will receive $181 million in federal rural health care funding

OLYMPIA - Today, Governor Bob Ferguson announced that Washington has received $181 million from the federal Rural Health Transformation Program for fiscal year 2026.

The federal program invests $50 billion nationwide to support rural hospital infrastructure, with an emphasis on technology improvements and support for chronic disease management, behavioral health care, maternal health care, addressing rural workforce shortages and improving access to emergency services.

Washington submitted its proposal for a share of the funding in November. Of Washington's 39 counties, 22 are considered fully rural, while the remaining counties all have some rural portions, as well. Washington has more than 1 million rural residents.

The funding award is close to the requested amount, which was $200 million. Washington will now decide how to allocate the funding.

"Rural Washington boasts strong communities, robust agriculture and some of the most beautiful landscapes in the world," Governor Ferguson said. "In order to sustain this way of life, we need a strong rural health care system. This funding will not replace the dramatic cuts imposed by the Republican-led Congress and the White House, but these funds will help fortify rural communities against what's to come. It is a significant investment in Washington's rural heath care."

"This funding is about making sure people in rural communities get the care they need, close to home," said Health Care Authority Director Ryan Moran. "It supports the hospitals, clinics and providers that rural families rely on every day, and helps strengthen the systems that keep care accessible, safe, and sustainable. While the need remains significant, this investment will help rural communities take important steps forward."

In addition to the Governor's Office and the Health Care Authority, multiple state agencies worked collaboratively on the plan, including the Department of Health and Department of Social and Health Services. These agencies will partner with rural communities, providers, Tribes and other organizations to move quickly to direct funding where it is most needed.

Washington's plan

Washington specifically sought funding to help build a healthier, more resilient and financially sustainable rural health system. The Rural Health Transformation funding will help rural residents across all 39 counties. Of those, 22 counties are considered fully rural - Adams, Clallam, Columbia, Ferry, Garfield, Grant, Grays Harbor, Island, Jefferson, Kittitas, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Orielle, San Juan, Skamania, Stevens, Wahkiakum and Whitman. The funding will reach rural Washington residents in these counties, as well as the rural portions of the state's remaining counties.

Washington will use the funds to:

• Develop community-based health care options to help rural residents access the right level of care at the right time
• Invest in the health of Native families
• Invest in technology that increases efficiency, access and quality in Washington's rural health care system, helping rural Washingtonians get specialty care and monitor chronic conditions
• Invest in long-term solutions will give rural Washingtonians better access to high-quality specialty and emergency medical care
• Grow, train and maintain the health care workforce in rural Washington
• Expand and sustain Washington's rural behavioral health system, decreasing the strain on rural hospitals and school-based behavioral health care services

The state will collaborate with Area Agencies on Aging, the Washington Hospital Association, the Rural Collaborative and others to target funding where it is needed most. It will also work with the state's universities to expand existing programs and initiatives that benefit rural health care systems.

For example, funds will be used to expand the University of Washington School of Medicine's Project ECHO (Extension for Community Health Outcomes). ECHO offers a multidisciplinary tele-monitoring and education platform for Washington clinicians that helps providers deal with complex and specialized patient issues, infectious diseases, psychiatry and behavioral health and intellectual and developmental disabilities. Rural Heath Transformation program funds will help expand ECHO to additional health care facilities, as well as add new medical specialties.

More on the Rural Health Transformation Program

The federal Rural Health Transformation Program offers $10 billion annually from 2026-2030. This program, managed by the Centers for Medicare & Medicaid Services, aims to support rural health system transformation, including but not limited to:

• Improving access to hospitals and other health care providers.
• Improving health care outcomes for rural residents.
• Strengthening strategic partnerships between rural hospitals and other health care providers.
• Prioritizing the use of new and emerging technologies, emphasizing prevention and chronic disease management and providing high-quality services.
• Increasing the number of clinicians through recruitment and training.
• Outlining strategies to manage long-term financial security and identifying specific causes that can lead to rural hospital closure, conversion or service reduction.