Alaska's Rural Health Transformation Program has received a significant number of high-quality grant applications, creating intense competition for limited federal funding, state health officials said Tuesday.

The high volume of quality proposals means many meritorious projects may not receive funding through the federal program. This has prompted the Department of Health to explore partnerships with philanthropic groups to support unfunded initiatives.

"Given the competitive nature, it may not rise to the top," Deputy Commissioner Bessewood said during a legislative committee hearing. "There are a significant proportion of very good ideas and very thorough letters of interest."

The program aims to transform rural healthcare delivery across Alaska by addressing critical gaps in access and services. Officials said they are still in the first half of the review process but are moving rapidly to evaluate applications. They use established criteria that assess project feasibility, community impact, and alignment with program goals.

Bessewood said the department is discussing partnerships with Alaska philanthropic groups that could fund projects not selected for federal dollars. "It's an opportunity for us to really align on projects that have merit and think about how we can effectively use funding outside of the rural health transformation program too," she said.

Applications have included diverse proposals ranging from telemedicine infrastructure projects to mobile health clinics and community health worker training programs. The variety reflects the broad scope of healthcare challenges facing Alaska's rural communities.

For applicants who do not receive awards, the department plans to provide detailed feedback explaining why projects were not selected. "We will provide them with as much information as we can," Bessewood said. Some rejections will be obvious due to poor fit or readiness issues, while others may simply reflect the competitive field.

The department emphasized that rejected applicants will have another chance soon. "This is not the only time that organizations will have a chance to submit their ideas," Bessewood said, noting that round two applications are coming up quickly.

Senator Tobin asked whether the department would recommend additional state funding for good ideas that cannot be supported with federal dollars. "I'm all about implementing good ideas from the public," Tobin said.

Bessewood said the department plans to review the entire process with its advisory council once complete. This includes identifying unfunded projects with merit that could be supported through other means.

Representative Mina has introduced a resolution directing Alaska's federal delegation to seek changes to the program's requirements, particularly around capital expenditures. "This was a program created in great haste by Congress last year," committee chair Representative Johnson said. "I would anticipate some statutory changes in the coming years."

The department is also launching new initiatives to coordinate rural health efforts statewide. An "IMPACT series" will bring providers and organizations together monthly via Zoom to share ideas and identify common themes. Regional planning meetings will start at the end of April in Kenai, bringing communities together to discuss healthcare gaps and priorities for future funding rounds.

"In many communities people already know where many of those areas or gaps are, but they do not always come together for a day to talk about that," Bessewood said.

The department has hired program staff and accountants specifically for the Rural Health Transformation Program, with program positions filled and accounting positions currently being recruited.

The advisory committee will meet again on the morning of April 22. Meeting minutes and updates on the application review process will be available through the Department of Health.