Healthy Hometowns: High-Risk OB and Neonatal Transport Initiative

The Iowa Department of Health and Human Services, Division of Public Health, has issued Request for Proposal PHTHOET27002 to support the Healthy Hometowns High-Risk OB and Neonatal Transport Initiative. This program is part of a broader statewide effort funded through the federal Rural Health Transformation Program administered by the Centers for Medicare and Medicaid Services. The initiative is designed to strengthen rural healthcare delivery systems across Iowa by improving emergency maternal and neonatal transport capabilities. It aligns with the state’s long-term strategy to enhance access to care, reduce disparities in rural health outcomes, and build sustainable healthcare infrastructure in underserved communities. The primary purpose of this funding opportunity is to support Emergency Medical Services providers in developing or expanding high-risk obstetric and neonatal transport services. The program focuses on equipping EMS agencies with advanced medical equipment, telehealth-enabled transport capabilities, workforce training, and operational readiness systems. Funding may be used for equipment purchases that meet defined criteria, workforce recruitment and retention incentives, training programs such as obstetric emergency certifications, and non-reimbursable clinical services that enhance care quality. However, strict cost restrictions apply, including prohibitions on vehicle purchases, construction, and services already reimbursable through insurance. Eligible applicants include public, private, nonprofit, academic, and governmental entities that are currently authorized EMS transport services in Iowa and serve at least one rural-eligible county. The program prioritizes applicants that demonstrate the ability to provide interfacility transport services across health systems without limitation and those serving multiple rural counties. Applicants must also demonstrate operational readiness, workforce capacity, and the ability to comply with reporting and performance requirements. The initiative emphasizes coordination with statewide health systems and integration into broader maternal health hub-and-spoke networks. Applications must be submitted electronically through the IowaGrants system. The process requires completion of multiple standardized forms, including organizational details, staffing plans, operational readiness documentation, and a detailed four-year work plan. Applicants must also submit a line-item budget and certify compliance with administrative cost limits and funding rules. Submission requires registration in the IowaGrants system, and all application components must be completed before submission is allowed. The agency does not accept submissions outside this system, and incomplete or late applications are automatically rejected. The evaluation process includes a technical review, committee scoring, priority point allocation, and final agency review. Applications are scored based on clarity, completeness, alignment with program goals, staffing capacity, and implementation feasibility. Additional priority points are awarded for serving multiple rural counties and committing to unbiased interfacility transport. The agency may also consider geographic distribution and overall system coverage when making final award decisions, rather than strictly awarding based on score ranking. The funding structure includes both line-item and deliverable-based reimbursements. Approximately six million dollars is expected to be awarded in the first year across about three awards, with total program funding exceeding twenty million dollars over the contract period. Individual awards may reach up to approximately two million dollars annually in the first year. The contract period is expected to run from October 31, 2026 through September 30, 2031, with continuation dependent on performance and funding availability. Key dates include an application deadline of September 1, 2026, with anticipated award announcements in mid-October 2026. The program requires extensive reporting, including monthly, quarterly, and annual reports, as well as compliance with federal funding transparency requirements. Successful applicants must implement services within the first year and maintain ongoing participation in statewide initiatives. This funding opportunity represents a significant investment in improving maternal and neonatal health outcomes in rural Iowa through coordinated emergency transport systems and enhanced EMS capabilities.

Emphasize rural coverage, demonstrate interfacility transport neutrality, provide strong workforce recruitment and training plans, and ensure complete compliance with all required forms and budget rules