Healthy Hometowns: Maternal Health Hub and Spoke Program

The Iowa Department of Health and Human Services (Iowa HHS), through its Division of Compliance and Administration, has issued a Request for Proposal (RFP) titled Healthy Hometowns: Maternal Health Hub and Spoke Program. This initiative is part of Iowa’s broader Healthy Hometowns rural health transformation strategy, funded through the federal Rural Health Transformation Program administered by the Centers for Medicare and Medicaid Services. The program is designed to address persistent disparities in rural maternal healthcare access by establishing coordinated networks of care that improve outcomes for pregnant and postpartum individuals across Iowa. The primary objective of the program is to sustain and expand access to high quality maternal healthcare services in rural communities. This includes prenatal, labor and delivery, postpartum, mental health, and behavioral health services. Iowa HHS aims to achieve this by implementing a Hub and Spoke model in which higher level hospitals (Hubs) provide expertise, consultation, and referral support to lower level hospitals (Spokes). The program emphasizes keeping care local when appropriate while ensuring that high risk patients can access specialized services when needed. The initiative also seeks to build long term sustainability in rural healthcare systems through partnerships, telehealth integration, and workforce development. Funding for this program is substantial, with approximately 38.6 million dollars anticipated for the first contract year and total projected funding exceeding 119 million dollars across multiple years. Individual applicants may apply under one of three options: serving as a statewide hub providing teleconsultation services, expanding an existing Level I hospital to Level II capacity, or forming regional networks of hospitals to sustain maternal care services. Award amounts vary by option, with approximate four year funding caps of 14 million dollars for statewide hubs, 10.6 million dollars for expansion projects, and nearly 19.9 million dollars for network based initiatives. Funds are intended for staffing, equipment, telehealth infrastructure, coordination, and system development, but may not be used for major construction or duplicative clinical billing. Eligibility is limited to organizations physically located in Iowa, including public, private, nonprofit, for profit, academic, and governmental entities that meet specific criteria tied to maternal care hospital classifications. Additional requirements vary by application option, including hospital level designation, rural location status, and participation in coordinated networks. All applicants must have been operational as of January 1, 2026 and must submit a mandatory letter of intent prior to application submission. For network based applications, additional structural requirements apply, such as network size, geographic proximity, and referral relationships. Applications must be submitted electronically through the IowaGrants system and include multiple required forms detailing project plans, budgets, staffing, and compliance assurances. The submission process includes a mandatory letter of intent, optional applicant conference, and structured Q and A periods. Applications are evaluated based on criteria outlined in the RFP, including project design, feasibility, alignment with program goals, and capacity to sustain services long term. Selected applicants may be required to participate in oral presentations as part of the evaluation process. The application timeline is clearly defined, with the RFP issued on July 14, 2026, a mandatory letter of intent due August 10, 2026, and full applications due September 1, 2026. Award notifications are expected around mid October 2026, with contract execution shortly thereafter. The contract term runs from October 31, 2026 through September 30, 2031, with continuation contingent on performance and funding availability. The program is not recurring in a traditional grant cycle sense but represents a multi year funding opportunity tied to federal program timelines. Program oversight includes detailed reporting requirements, performance metrics, and compliance with federal and state regulations. Awardees must demonstrate financial accountability, maintain data reporting systems, and collaborate with state partners. Contacts for the program include the issuing officer at Iowa HHS, and all official communications must occur through designated channels. Overall, this opportunity represents a significant investment in transforming rural maternal healthcare delivery through coordinated, technology enabled, and sustainable systems of care.

Focus on strong network design sustainability planning and clear demonstration of improving rural maternal healthcare access; align proposal with hub and spoke model requirements