CMS Rural Health Transformation Program  |  2 C.F.R. Part 200

RHTP Grant Administration and Compliance

You won the award to change care in your community, not to become a reimbursement office. I hold the money and the milestones together so your team can run the project.

Who this is for

RHTP sub-awardees and applicants: rural facilities and networks, health technology and innovation companies, community organizations, and the partnerships between them. If your state has selected you, or you are applying and your proposal needs a named grant administration function to be credible, this service is that function.

The problem, stated honestly

RHTP funding is cost reimbursement in most states. You spend first. You claim on your state's schedule, with documentation that survives review. Budget versus actual has to reconcile by line item. Procurement has to follow your grant contract and, where your contract makes it apply, 2 C.F.R. Part 200. Reports go in on your state's templates, on your state's clock. And the rules are still moving: CMS continues to adjust guidance to states, and states cascade those changes to their sub-recipients mid-award. Clawback risk lives in how your sub-award contract is written. Most small rural organizations and early-stage companies have never had to run this function, and the ones that learn it during the award learn it expensively.

Five-step diagram of the RHTP cost-reimbursement cycle: you spend, you document, you claim, the state pays, you report, repeating monthly for the life of the award. A Grant Administration and Compliance Lead owns steps 2 through 5.

What I own

I serve as your fractional Grant Administration and Compliance Lead. The full function, end to end:

  • Reimbursement claims prepared and submitted with complete supporting documentation, on your state's schedule.
  • Grant budget monitoring: budget versus actual by line item, variance management, and financial documentation.
  • Milestone and work-plan tracking against what your application promised.
  • Quarterly and annual programmatic and financial reporting on your state's templates, plus disbursement reconciliation.
  • Procurement and contract guidance consistent with your grant contract and, where it applies, 2 C.F.R. Part 200.
  • A configured grant management hub: document repository, fund tracker, milestone tracker, procurement and contract log, and a reporting calendar with automated deadline alerts.
  • Audit-ready records and internal controls, including the retention file, from day one through closeout.

Higher tiers add standing rural health strategic advisory and coordination of your program metrics into the grant's required reports, in partnership with whoever owns your evaluation. Program delivery stays with your project leadership. Evaluation stays with your evaluator. Clinical care and patient-level data stay with your clinical team; I do not touch protected health information. Those lines are stated in writing in every engagement.

Tiers and investment

Radical transparency in pricing is a stated value of this firm, so here it is. Each engagement is a one-time mobilization fee plus a monthly retainer, based on a standard rate of $250 per hour with a 20 percent reduction applied at 20 or more hours per month. Each tier includes everything in the tier before it.

Tier 1: Grant Administration and Compliance Lead

The full function above. Mobilization $5,500; monthly retainer $4,000; up to 20 hours per month.

Tier 2: Lead plus Implementation and Advisory Support

Adds ad hoc implementation advisory, sustainability planning input, and standing rural health strategic advisory. Mobilization $5,500; monthly retainer $5,500; up to 27.5 hours per month.

Tier 3: Lead plus Advisory plus Grant Reporting Data Coordination

Adds the reporting-data workflow that consolidates your program metrics into the grant's required reports, coordinated with your evaluator. Aggregate figures only; never patient-level data. Mobilization $9,000; monthly retainer $7,500; up to 37.5 hours per month.

Retainers are invoiced monthly, Net 30. Hours beyond the monthly allowance require prior approval. Engagements are scoped to your award and priced through a written proposal before anything is signed. If your project needs something these tiers do not cover, the scoping call is where we figure that out.

Why me

I am a behavioral scientist and rural health advisor with more than ten years of direct rural health implementation experience. I ran a State Office of Rural Health, then served as technical assistance director at the national organization serving all 50 State Offices of Rural Health, where I worked inside federal grant management from both directions: administering federal awards and helping the organizations receiving them stay compliant. I currently advise multiple states on RHTP navigation and am engaged to help a state design its RHTP program and draft its solicitations. That means I know what your state expects from a sub-recipient, because helping states set those expectations is part of my working week. My track record includes more than 250 invited technical assistance engagements across rural health audiences nationwide.

From rural, for rural. If you want a straight answer on fit, timeline, and cost, book the call.

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Regulatory Clarity. Financial Durability. Rural Health Viability.