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Rural Tech Catalyst Fund Application

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ABOUT THE RURAL tech CATALYST FUND

The Rural Tech Catalyst Fund supports health technology companies that improve access, delivery, quality, or outcomes of healthcare for rural populations in Louisiana.

FUNDING STRUCTURE

Selected companies may receive milestone-based grant funding to support deployment, validation, commercialization, and scale of rural health solutions.

Funding is not disbursed upfront. Before any award is executed, selected companies will work with the program team to finalize:

+ Scope of work

+ Budget + Quarterly milestones + Reporting requirements + Payment schedule
Awards are tied to measurable progress toward rural Louisiana deployment, implementation, sustainability, and health impact.

PROGRAM GOALS

We support companies with structured funding and mentorship that can: + Deliver measurable rural health impact, and + Build toward long-term sustainability — including future customer revenue, strategic partnerships, reimbursement pathways, and/or future equity financing.

EQUITY PARTICIPATION

For certain venture-oriented companies, the program may require a future equity participation side letter, granting limited rights to participate in a later equity financing round if one occurs.

APPLICATION PROCESS

+ One application, one process. No separate applications for different award structures.
+ Final award terms are determined during diligence, milestone negotiation, and contracting.
More info is available at: https://la.io/rural
An Applicant Guide is available here.

1. Company Name

2. Primary Point of Contact

3. Primary Point of Contact Email

4. Please list two professional references with contact information

Reference 1

Reference 2

Please provide the name, title, company, phone number, and email address for each reference.

5. Describe key personnel, experience and past performance relative to the proposed solution?

6. Does the company currently operate in Louisiana?

6. Does the company currently operate in Louisiana?
A
B

7. Does the company currently have Louisiana customers?

7. Does the company currently have Louisiana customers?
A
B

8. Does the company own:

8. Does the company own:

9. How much has the company raised?

9. How much has the company raised?
A
B
C
D
E
F

10. Who directly benefits from your product?

Select all that apply.
10. Who directly benefits from your product?

11. What specific rural Louisiana health problem does your solution address?

Select all that apply
11. What specific rural Louisiana health problem does your solution address?

12. Where will deployment occur?

Select all that apply.
12. Where will deployment occur?

13. Does the company understand that the funding is milestone-based?

13. Does the company understand that the funding is milestone-based?
A
B

14. Which baseline metrics will the company target?

Select all that apply.
14. Which baseline metrics will the company target?

15. Which quality and effectiveness metrics will the company target?

Select all that apply
15. Which quality and effectiveness metrics will the company target?

16. How quickly can the company deploy a product or service in Louisiana?

16. How quickly can the company deploy a product or service in Louisiana?
A
B
C
D
E
F

17. Which award level is the company applying for?

See attached Applicant Guide for details
17. Which award level is the company applying for?
A
B
C

18. Describe the company's 12-month spending plan.

19. Submit a 12-month spending plan.

+ Click the link below to access the mandatory 12-month budget template. Download Template Here
+ Go to File > Make a copy to create your own editable version.
+ Rename the copy as COMPANY NAME_RHTCF_12MONTHPLAN
+ Complete the spreadsheet, export it as a PDF or Excel/Sheets file, and upload it using the area below
Upload up to10 supported files: PDF or spreadsheet. Max 20 MB per file.

20. Please create an impact statement summarizing the company's venture.

For example, "Company ABC is targeting XXX patients served in X Parish to decrease hospitalization by X%. The company expects to report these outcomes no later than XX/XX/XXXX."

21. Which best describes the company’s primary sustainability pathway after the grant period? 

Select all that apply
21. Which best describes the company’s primary sustainability pathway after the grant period? 

22. Has the company previously raised equity, SAFEs, convertible notes, or other investor capital?

22. Has the company previously raised equity, SAFEs, convertible notes, or other investor capital?
A
B
C
D

23. If selected as a semi-finalist, which structure would best fit the company's current stage and financing strategy?

Applicant preference is informational only and does not determine final award structure.
23. If selected as a semi-finalist, which structure would best fit the company's current stage and financing strategy?
A
B
C
D

24. Does the company understand that it will need to provide additional financial documentation if selected as a semi-finalist? This may include an income statement, balance sheet, statement of cash flow, cap table, and other required documentation.

24. Does the company understand that it will need to provide additional financial documentation if selected as a semi-finalist? This may include an income statement, balance sheet, statement of cash flow, cap table, and other required documentation.
A
B

25. The company understands that all Cohort 1 awards are expected to be milestone-based grants, but some selected companies may be required to execute a Future Equity Participation Side Letter as a condition of award. This determination will be made during diligence and award negotiation based on company stage, financing plans, sustainability pathway, and program fit.

25. The company understands that all Cohort 1 awards are expected to be milestone-based grants, but some selected companies may be required to execute a Future Equity Participation Side Letter as a condition of award. This determination will be made during diligence and award negotiation based on company stage, financing plans, sustainability pathway, and program fit.

26. Does the company understand that if selected for the next round, it will need to be available for a virtual interview with an investment committee?

26. Does the company understand that if selected for the next round, it will need to be available for a virtual interview with an investment committee?
A
B

27. Disclose any current or prior material issues such as litigation or sanctions, and any conflicts involving public officials, investors, advisors, related-party vendors, or partners.

28. Attach supporting documents - for example: pitch deck, executive summary, outcome data, or letters of support.

Upload up to 10 supported files. Max 100 MB per file.