State Designated Rural Health Centers Support Grant
RFA TITLE: State Designated Rural Health Centers Support Grant (SDRHC)
FUNDING AGENCY NAME: North Carolina Office of Rural Health (ORH)
RFA OPENS: January 13, 2025
RFA DEADLINE: February 21, 2025, 5:00 p.m.
Incomplete applications, or applications not completed in accordance with the following instructions, will not be reviewed.
Applicants must submit their application electronically through the Zengine portal. Click link to access electronic version of application: https://webportalapp.com/sp/ncdhhs_rural_health_center_operations_fy26
See additional details below on Pages 3 and 4.
RFA TECHNICAL ASSISTANCE WEBINAR: January 24, 2025, from 1 - 2:30pm
Microsoft Teams Need help?
Join the meeting now
Meeting ID: 235 121 163 761
Passcode: Cj6b2pe6
Dial in by phone
+1 984-204-1487,,165893323# United States, Raleigh
Find a local number
Phone conference ID: 165 893 323#
PURPOSE: These grant funds, supported through the North Carolina General Assembly, allow ORH to partner with local communities to provide funding to improve their ability to serve underserved populations who would otherwise be unable to access needed primary care services due to geographic, economic, or other barriers. State Designated Rural Health Centers have become an integral part of the health care safety net for North Carolina’s rural and underserved residents.
FUNDING AVAILABILITY: Requests are contingent upon availability of program funding. ORH anticipates that approximately 15 applicants will receive funding. Successful applicants will be required to attend a grant award workshop.
ELIGIBILTY: The applicant organization must first assess if it can meet certain criteria. The purpose of the SDRHC program is to increase access to primary care for rural, uninsured, and underinsured residents. The following are specific requirements that must be met to be eligible for funding:
- Rural determination – Rural Determination can be found at: https://www.ruralhealthinfo.org/am-i-rural
- Health Professional Shortage Area determination - HPSA scores can be found at: https://data.hrsa.gov/tools/shortage-area
- Demonstrated unmet need
- County Distress Ranking – Tier 1 or 2 – County Distress Rankings can be found at: https://www.commerce.nc.gov/grants-incentives/county-distress-rankings-tiers
- Proof that the organization is not owned, controlled, or operated by another entity and holds an active 501 c3 Status. (Independent Rural Health Clinics, and Provider Based Clinics operated by Rural and Critical Access Hospitals are eligible to apply)
- Provider of primary health care services to all individuals in the defined service area regardless of ability to pay.
- Ability or plan to enroll eligible providers in Medicare and Medicaid reimbursement programs
- Documentation demonstrating that at least 10% of patient volume are Medicaid beneficiaries
As a condition of receiving state funds, the SDRHC agrees to comply with the standards of the NC Office of the Controller, NC Office of Budget and Management standards, and NC ORH Operations Program. Link for detailed requirements includes (1) Compliance Standards (Completion of all NC DHHS Contract Approval Forms), (2) Contractual Agreement, and (3) Program Operations.
AWARD INFORMATION: Applicant awardees will be awarded for a 1-year period, with the option to renew for year 2 and year 3. Awardees are required to attend a grant award workshop and participate in a site visit or desk review within 3 months of the awarded start date. Any remaining balances from Year 1 funds will not carry forward into Year 2 or 3. Future funding, including for years 2 and 3, are contingent upon substantially meeting performance and financial goals as mutually agreed upon between the division and the awardee.
MAXIMUM AWARD AMOUNT: Applicants may request up to $250,500.
PROPOSED PROJECT PERIOD OR CONTRACT TERM: State Fiscal Year 2026: July 1, 2025 – June 30, 2026.
All grantees must fully expend grant funds by June 30, 2026. All invoices for completed and projected work must be submitted to ORH for reimbursement no later than June 7, 2026.
GRANT FUNDING DESCRIPTION:
A. Tier Definitions - There are two tiers for applicants to consider. Tier 1 includes Capacity-Building sites who do not currently serve Medicaid and Medicare patients, but plan to do so within the first year of funding. If awarded, Capacity-Building sites will work with ORH and NC AHEC to complete their Medicaid application by the end of SFY 2026 to reach Tier 2. Tier 1 sites are eligible for Operating/ Infrastructure funds ONLY. Tier 1 sites are eligible for awards up to $100,000. Tier 2 includes State Designated Rural Health Centers who currently serve Medicaid and Medicare patients and meet the 10% Medicaid patient population threshold. Tier 2 sites are eligible for awards up to $250,500.
B. Health service delivery site: Primary Care Access Plan (PCAP) and/or Behavioral Health Access Plan (BHAP) – Proposal to provide a comprehensive package of healthcare services to rural uninsured/underinsured residents. These visits are reimbursable at a rate of $115.00 per PCAP encounter to the health center based on medically necessary, face-to-face provider encounters, which includes, but is not limited to the following: on-site x-rays, in-house labs, minor surgical procedures, services performed by practice providers, prophylaxis, and telehealth. BHAP funds are available for behavioral health and mental health counseling services. The visits are reimbursable at a rate of $80.00 per encounter to the health center based on face-to-face or telehealth behavioral health provider encounters. Eligible providers include but are not limited to licensed clinical social workers, advanced practice registered nurses, psychologists, and psychiatrists.
C. Quality Improvement - Applicant awardees are required to complete or update an annual practice assessment, action plan and identify mutually agreed upon activities for execution with an NC AHEC Practice Support Coach. Awardees should ensure activities prioritize identified operational performance needs, quality of care gaps, HIT optimization (EHR, telehealth, HIE), clinical and administrative workflow redesign, community health worker optimization, behavioral health integration development, etc. where applicable.
Funding preferences: Preference will be given to applicants based on the criteria listed below:
• Demonstrate a need for health care services for rural and underserved residents in their community.
• Demonstrate capacity to effectively address barriers to care for rural residents and provide quality services.
• Demonstrate capacity to provide a healthcare home and link to primary, dental, and behavioral health services and to respond to additional needs if/when necessary.
• Propose a plan to incorporate rural community and patient feedback into its service delivery approach or quality improvement efforts.
• Integrate SDOH screening questions and assist patients with unmet needs using NCCARE360.
• Describe the capacity to meet the ORH requirements and expectations outlined in the application.
D. Operational/Infrastructure Funds – An organization applying for funds in this category must describe how operating funds will support access to primary care for the population in the service area. The organization must demonstrate the ability to create systems and processes that promote sustainability of the organization being funded or how the funds will supplement the primary care services provided through PCAP and/or BHAP. Tier 1 Capacity Building sites are eligible for Operating/ Infrastructure funding only.
Funding preferences: Preference will be given to applicants based on responses to the criteria below:
• Propose the creation and implementation of sustainable staff and technological infrastructure that enhances access to health care and improves quality.
• Propose innovative strategies to promote healthcare equity and inclusion.
• Demonstrate capacity to effectively carry out COVID-19, flu and other prevention and response efforts.
• Propose an efficient strategy that uses local resources and collaborates with partners to respond to health care gaps in the community, specifically leveraging the use of PCAP and BHAP funds.
• Propose a plan to blend behavioral health and/or primary care telehealth services fully or partially within the primary care practice involving the use of Community Health Workers.
HOW TO OBTAIN FURTHER INFORMATION: Questions regarding the application can be sent to Kim McNeil at kimberly.r.mcneil@dhhs.nc.gov
SCORING CRITERIA: Grant awards will be based on the criteria listed below. Failure to fully complete all sections will affect the funding amount, up to disqualification. Applications will be reviewed and scored according to all the following criteria regardless of the funding categories requested.
The highest scoring applicants will receive an award based on applicant scores. Awarded applicants will have the opportunity to receive two (2) additional years of funding, up to the amount of the SFY 2026 award, via a non-competitive grant application process.
Overview of the Organization - 5 Points
Community Need – 20 Points
Improved Access to Care – 25 Points
Community Collaboration – 15 Points
Work Plan/Performance Measures – 20 Points
Budget – 15 Points
Total Points Awarded – 100 Points
HOW TO APPLY: Applicants must submit their application electronically through the Zengine portal. You must create a profile to access the application. Profile will require creating a username and password. Use the RFA document as guidance for the electronic version of the application.
Click link to access application portal: https://webportalapp.com/sp/ncdhhs_rural_health_center_operations_fy26