FRANKFORT, Ky. — Kentucky officials outlined their strategy for spending a $213 million federal grant aimed at transforming rural health care during a legislative committee meeting, with state leaders warning that tight federal deadlines could jeopardize the funding if deployment targets are not met.

Dr. Steven Stack, secretary of the Cabinet for Health and Family Services, and Tom Walton, director of the Rural Health Transformation Program, told the Interim Joint Committee on Health Services that the state must quickly identify partners and begin executing projects to retain the award from the Centers for Medicare and Medicaid Services.

Kentucky was awarded $212.9 million in December 2025 as part of a nationwide $50 billion rural health initiative. State officials have until the end of October 2026 to decide how to allocate the money and select implementing partners.

The five-year initiative targets five key areas: maternal and infant health, integrated emergency medical services and trauma response, behavioral health ranging from crisis care to long-term support, dental access, and community hubs for chronic disease management. Stack emphasized the importance of ambitious planning. "We may dream big and fall a little short, but if we don't dream big, we're never going to reach high," he said.

Walton said the state prioritized hiring staff with both medical expertise and rural community experience. Federal guidelines require systemic changes in how Kentucky delivers rural health care rather than simply increasing funding for existing models, he said.

Lawmakers raised questions about implementation. Rep. Emily Callaway, R-Louisville, asked whether the program would address prenatal and maternal care for incarcerated individuals. Stack said such populations could be included if health providers serving them choose to participate.

Sen. Donald Douglas, R-Nicholasville, cautioned that the program needs clear baseline expectations and urged state officials to distinguish between lack of health care access and lack of care utilization. He called the effort "an enormous task."

Stack said multiple contracts have already been awarded, and Walton noted that CMS officials have praised Kentucky's progress compared to other states. "The thing that they really like is when we say we're being locally led," Walton said.