Utah BEMS RHTP SHIFT Initiative
Official FAQ Guide & Application Portal
Technical Assistance & Support Sessions
Twice-Weekly Q&A Drop-In Sessions
(August 18 – September 10, 2026)
Join Mary Kellogg and Megan McClure for live application support:
- Tuesdays (3:00 PM – 4:00 PM MDT): meet.google.com/mgn-anrn-pxv
- Thursdays (9:00 AM – 10:00 AM MDT): meet.google.com/siw-nxbv-vah
Office Hours Meeting Minutes
Access notes and resources from previous technical assistance sessions:
View Office Hours Meeting Minutes
Key Agency Contacts
Megan McClure, RHTP Grant Manager
Email: [email protected] | Phone: 385-346-8331
1. Application Submission & Strategy
When is the application deadline, and where do I submit it?
Deadline: Sunday, September 20, 2026, at 11:59 PM MDT.
Portal: Applications and all required attachments must be submitted online via the EUNA Grants AmpliFund Application Portal.
How do I obtain a SAM.gov Unique Entity Identifier (UEI)?
All agencies must have an active Unique Entity Identifier (UEI) registered with SAM.gov to receive federal grant funds.
- Step 1: Go to SAM.gov and select "Sign In." This will direct you to Login.gov, where you must create or sign into your secure account.
- Step 2: Once logged into SAM.gov, select "Get Started" from the workspace and choose "Register Entity" to apply for federal financial assistance.
- Step 3: Enter your agency's legal business name, physical address, and Taxpayer Identification Number (TIN). Critical Note: Ensure your organization name exactly matches the taxpayer name associated with your IRS records. A mismatch will cause significant validation delays.
- Step 4: Submit your registration. The UEI and SAM.gov registration process is completely free. Do not use or pay third-party services that charge a fee.
Timeline & Upkeep: While the initial data entry only takes about 15 minutes, the validation process can take up to a month. Start this immediately. Registrations must be renewed annually to remain active.
How much funding can our agency request per year?
There is no strict dollar cap on individual requests.
Agencies are encouraged to clearly detail their essential "must-haves" in the budget narrative so the Grants Subcommittee can triage funding based on scoring. If an application is not 100% funded in Year 1, BEMS will retain the application and evaluate it for future grant years.
Should we apply year-by-year or for the full 5-year project period?
You may apply year-by-year or for all 5 years at once, depending on agency capacity.
Director Erik Bornemeier strongly prefers agencies to submit a full 5-year plan. This helps BEMS see the full picture of statewide needs, refine multi-year budgets, and determine how to possibly distribute funds evenly across the entire 5-year project period.
Future Flexibility: You are not locked into your original submission forever. If your future plans or community needs change, you will be able to make amendments to your application and adjust your project scope when we call for applications for the associated budget period.
Can multiple agencies or regional groupings submit a joint application?
Yes. Organizations representing multiple rural agencies (such as REMSDAU) can apply as a single entity.
Agencies must coordinate carefully to avoid submitting duplicate requests for the same exact equipment or operational needs.
What is the Year 1 award timeline and obligation deadline?
- Notice of Award: Estimated for October 12, 2026.
- Legal Obligation Deadline: Year 1 subgrant funds must be legally obligated (via signed contracts, binding commitments, or purchase orders) by December 31, 2026.
- Federal Spending Deadline: September 30, 2027.
2. Eligibility & Service Areas
Which organizations are eligible to apply?
Eligible organization types include Hospitals/Health Systems, FQHCs/Rural Health Clinics (RHCs), EMS Agencies, Tribal Health Organizations, and Educational Institutions.
Applicants must serve rural Utah counties or specific Tribal Nations.
Can urban dispatch centers that dispatch for rural agencies apply?
Dispatch centers are an integral part of the EMS system. BEMS encourages dispatch centers servicing rural areas to apply for what they need while formal federal guidance is finalized.
Do traveling or outreach paramedics need to reside in the rural community they serve?
No. As long as they provide services to rural communities, it does not matter if the provider or the agency is located in an urban setting.
3. Budget Rules, Spending Caps & Staffing
Does hiring traveling paramedics count toward the 10% administrative cap?
No. Personnel costs for traveling paramedics fall under Program B (Community Paramedicine/Staffing) on the 90% operational side of the budget, not administration.
Does the 10% administrative cap apply to hiring educators?
No. The administrative cap does not apply to personnel hired specifically to deliver education and training programs.
4. Reimbursements, Invoicing & Financial Logistics
How does the reimbursement model work, and do subrecipients need to have the equipment in hand before getting reimbursed?
Per the Utah Department of Health and Human Services (DHHS) Rural Health Transformation Program Subrecipient Terms and Conditions, all grant funds are disbursed strictly on a cost-reimbursement basis for allowable costs incurred.
However, no, a subrecipient does not need to have the product in hand before getting reimbursed. You simply need to submit the vendor's invoice to BEMS to receive the payment.
Is there an initial draw-down or start-up funding available to begin our project?
Yes. Once you have an executed contract, an approved project plan, and an approved budget plan, it triggers an initial 10% budget draw-down (up to a federal cap maximum of $500,000) to begin the project.
How are grant funds disbursed?
This grant operates strictly on a monthly reimbursement basis per state mandate (H.B. 335, 2024). Agencies incur expenses or receive vendor invoices, then submit claims for reimbursement.
Our agency lacks cash reserves to front large purchases. How can we manage this?
- Invoice Submission without Cash Fronting: Agencies do not need to pay vendors before asking for reimbursement. You can submit the vendor invoice directly to BEMS, receive the state reimbursement, and then pay the vendor.
- Staggered Budgeting: Spreading large expenditures across multiple months over the 12-month budget window prevents cash-flow bottlenecks.
Are bank financing fees or debt service interest allowable for reimbursement?
No. Because agencies simply need to submit the vendor invoice to BEMS to get the payment, short-term loans and financing should not be necessary, meaning debt service and finance charges are not allowable expenses.
How do we handle the obligation and spending deadlines for long-build capital equipment (e.g., ambulances)?
Obligation vs. Expenditure: A purchase order executed during the budget period is considered an obligation, even if delivery occurs after the budget period ends. However, the purchase order will not be considered expended until funds are drawn down in the Payment Management System (PMS) to pay for the equipment.
Example Timeline: If a rural EMS provider executes a purchase order for an ambulance with a manufacturer at the start of Budget Period 2, the funds are considered obligated. The state must then request payment in PMS for the ambulance no later than September 30, 2028, providing approximately 23 months for production and delivery.
No Extensions: CMS is unable to offer extensions to the liquidation period. Unexpended or unobligated funds will be redistributed. For each budget period, recipients have until the end of the following fiscal year to spend awarded funding.
Planning is Critical: Effective planning with rural EMS providers and manufacturers is strongly encouraged to ensure that funding allocated to ambulances is obligated within the applicable budget period and expended within the allotted liquidation period.
Can grant funds be stacked on top of existing local funds?
Yes. If an agency has partial funding saved for a purchase (e.g., $100,000 toward a $300,000 ambulance), you may apply for grant funds to cover the remaining $200,000 balance.
What are the standard invoicing deadlines?
- Standard Monthly Invoices: Due within 30 days following the end of each month.
- June Invoices (Fiscal Year End): Must be submitted by July 10th.
5. Equipment, Technology & Services
Do agencies need to write Starlink into their individual applications?
Yes. If you want Starlink satellite communication units installed on your ambulances or response vehicles, you must explicitly include Starlink in your application budget.
If we request an Innovation Truck & Trailer, who owns it, and how does it work with state regulations?
Ownership & Regulations: Agencies that apply for and receive an Innovation Truck and Trailer will retain full ownership of the equipment. You will not be required to abide by state vehicle regulations; you will only need to abide by your own agency's regulations and policies.
Retention Requirement: Because you are receiving full ownership, you must maintain ownership of the equipment for the entire 5-year lifecycle of the grant (through September 30, 2031).
Operational Budgeting: Since you will own the vehicle for the entirety of the grant, you must explicitly incorporate all ongoing operational expenses into your grant budget which includes gas, vehicle insurance, routine maintenance, and tires.
If we request an Innovation Truck & Trailer, are maintenance, fuel, and tires covered?
Yes, as long as you include that in your budget request.
What is the estimated cost of a truck, canopy, and trailer, and do they have to be purchased together?
We are actively working to finalize the official specifications. Currently, the estimated costs to plan for in your budget are:
- Innovation Truck Build-Out: $65,000 – $70,000
- Canopy Build-Out: $60,000 – $65,000
- Innovation Trailer Build-Out: $200,000 – $250,000
Separate vs. Combined Purchasing: No, they do not have to be purchased together. Applicants have the flexibility to request individual components (e.g., just a truck and canopy, or just a trailer) or the full combined package based on their agency's specific operational needs and existing equipment.
Are mental health support services allowable under the grant?
Yes. Mental health education, training programs, and support services for EMS personnel can be requested under Program A - Education.
6. Application Review & Scoring Rubric
Where is the evaluation rubric located, and how are points distributed?
The scoring rubric is located in the portal under Section F: Application Review Criteria and Reporting Requirements. Applications are evaluated on a 100-point scale:
| Evaluation Criteria | Maximum Points |
|---|---|
| Project Description & Alignment | 20 points |
| Performance Metrics & Evaluation Plan | 20 points |
| Work Plan & Timeline Spreadsheet | 15 points |
| Budget & Budget Justification Spreadsheet | 15 points |
| Statement of Need (B.1) | 10 points |
| Organizational History & Mission | 5 points |
| Partnerships (B.3) | 5 points |
| Baseline Data (B.4) | 5 points |
| Funding Sustainability Plan (B.5) | 5 points |
7. Outstanding Questions Under Review by BEMS
BEMS leadership is actively formalizing official policy guidance for the following items:
- Vehicle Rollout Parameters & Cost Specifications: BEMS is currently exploring how to roll out Innovation Trucks and trailers with established state parameters. This includes trying to see if we can have regional trucks and trailers to serve multiple areas, instead of having multiple individual agencies purchase their own.
Transforming Rural Utah SHIFT
Strategic Initiative & Implementation Plan
Utah's Rural Footprint & The Challenge
The operational reality of emergency response in Utah varies drastically by geography, driving critical disparities in coverage and workforce retention.
Frontier Counties (12)
- Coverage: 42,838 sq miles (52% of Utah).
- Population: < 6 people/sq mile.
- Active Physicians: 0.9 per 1000 population.
- EMS Density: 1.3 personnel per 100 sq/miles.
- Mean Distance to Hospital: 28 miles.
Rural Counties (12)
- Coverage: 34,900 sq miles (42% of Utah).
- Population: 6-100 people/sq mile.
- Active Physicians: 1.7 per 1000 population.
- EMS Density: 4.8 personnel per 100 sq/miles.
- Mean Distance to Hospital: 12 miles.
Urban Counties (5)
- Coverage: 4,858 sq miles (6% of Utah).
- Population: 100+ people/sq mile.
- Active Physicians: 2.8 per 1000 population.
- EMS Density: 80.4 personnel per 100 sq/miles.
- Mean Distance to Hospital: 7 miles.
The Paradox of Volunteerism & Systemic Burnout
While Utah consistently ranks first in the United States for general civic volunteerism, our specialized emergency responder workforce mirrors a severe national downward trajectory. The current "patchwork" funding economy relies heavily on community bake sales, variable grants, and transport revenues, which is insufficient for 24/7 readiness.
- Burnout Drivers: Extreme tourism spikes drain local rescue resources, while high-intensity call volumes drive severe responder burnout.
- Financial Strain: 63% of rural EMS agencies lack ongoing local government funding, and 59% of billed services are not reimbursed by insurance.
- Leadership Burden: 40% of rural EMS directors are part-time, and 30% are entirely volunteer.
Strategic Funding Deployment ($52.5M over 5 Years)
A $52.5 million investment is distributed over five years, front-loaded with $12.5 million in Year 1 to accelerate immediate infrastructure and operational transitions. Subsequent years (2-5) will see $10 million annual deployments moving toward optimization and system independence.
1. Administration
Providing structural leadership, policy development, and governance needed to sustain long-term systemic progress. Includes dedicated Data and Grant Champions to evaluate metrics and manage compliance.
2. Innovation
Deploying modern clinical technologies, state-of-the-art equipment, mobile outreach trailers, and advanced technical infrastructure (such as Starlink connectivity for low-latency telemedicine).
3. Education
Empowering local workforces through rigorous training cohorts, advanced paramedic programs, K-12 outreach, and a centralized rural educational learning platform.
4. Community Paramedicine / MIH
Integrating specialized Mobile Integrated Health (MIH) directly into rural workflows to stabilize regional care and prevent unnecessary ER transports.
The Shift to Mobile Integrated Healthcare (MIH)
Transitioning from traditional "you call, we haul" responses to a proactive, preventive, and sustainable model of community-centered care. Data shows that 92% of calls are treatable on scene, with only 8% representing true transport emergencies.
Clinical & Operational Benefits
- Cost Reductions: Reduces unnecessary emergency room transports by up to 50–54%.
- Treat-in-Place (TIP): Enables rural agencies to recover crucial costs for on-scene clinical stabilization without requiring patient transport.
- Preventing Readmissions: Helps up to 75% of enrolled patients avoid preventable hospital or ER admissions within 30-day post-discharge windows.
Current Utah Success Metrics
- Salt Lake City CHAT Program: Successfully avoided 49% of ER transports and 75% of heavy apparatus deployments.
- Ogden Fire Mobile Outreach Clinic: Avoided 48.2% of ER transports, a 20% reduction since 2023.
Legislative Milestones
Utah's State Legislature has enacted critical milestones to structure emergency care, including H.B. 303 (declaring EMS an essential service), H.B. 392 (creating local option sales taxes/TRT for rural EMS), and H.B. 269 (securing base rates for ground transport).
Proposed Necessary Reforms:
- Treat in Place Rule: Validates community paramedicine and MIH by establishing regulatory approval and direct reimbursement mechanisms.
- Health Benefits & Insurance: Secures robust, state-backed health benefits specifically for rural EMS personnel as a recruitment tool.
- Fund EMS as Essential: Mandates and codifies EMS as an essential public service to unlock dedicated state and county-level tax allocations for competitive living wages.
RHTP Program: CMS Compliance Mandates
Key operational and compliance standards required by the Centers for Medicare & Medicaid Services (CMS) to secure and maintain funding.
| Mandate | Requirement Description |
|---|---|
| 1. Strict Reporting Timelines | Quarterly progress reports due within 30 days of period end; Federal Financial Reports (SF-425) due within 90 days. Missing deadlines risks immediate clawback of funds. |
| 2. Measurable Outcomes | Must report on a minimum of four quantifiable performance metrics established in the approved plan, showing baselines, targets, and actuals. |
| 3. Compliance with Caps | Strict spending limits: Admin/Indirect (10%), Capital & Infrastructure (20%), Provider Payments (15%), EMR Replacement (5%). |
| 4. Non-Supplanting | Funds must add to or transform capabilities. They are strictly prohibited from replacing current state, local, or federal operational budgets. |
| 5. Allowable Expenses Only | Expenditures must map directly to federal categories. Standard overhead, construction, and certain clinician salaries (e.g., subject to non-competes) are prohibited. |