State Offices of Rural Health Program

The State Offices of Rural Health Program is administered by the Health Resources and Services Administration within the U.S. Department of Health and Human Services, specifically through the Federal Office of Rural Health Policy. This long-standing federal program, authorized under the Public Health Service Act, has been in operation since 1991 as a federal-state partnership designed to strengthen rural health systems. It supports a single designated entity in each state, as determined by the governor, to serve as the central coordinating body for rural health initiatives. The program reflects a national commitment to improving access to care and health outcomes for rural populations, which include nearly 60 million individuals across the United States. The primary purpose of the program is to help states strengthen rural health care delivery systems by maintaining a focal point for rural health coordination. Award recipients are responsible for linking rural communities with state and federal resources, disseminating information on rural health issues and research, and promoting innovative approaches to care delivery. Each funded State Office of Rural Health must maintain a clearinghouse of information, coordinate statewide rural health activities to avoid duplication, and provide technical assistance to public and nonprofit entities seeking to participate in relevant programs. Additional allowable activities include workforce recruitment and retention initiatives and issuing subawards or contracts to support program objectives. Funding under this opportunity supports a structured five-year period of performance consisting of five 12-month budget periods. The program anticipates approximately 50 awards, with funding up to $243,410 per year per recipient. Total available funding for the fiscal year is approximately $12.1 million. Funds may be used for programmatic activities aligned with rural health system strengthening but are subject to strict limitations. Prohibited uses include direct payment for health care services, purchase of major equipment or real property, and duplicative technical assistance already funded by other federal programs. Indirect costs are capped at the lower of 15 percent of total direct costs or the organization’s negotiated rate. A significant requirement of the program is cost sharing. Applicants must provide a non-federal contribution equivalent to 75 percent of the federal share, which may be met through cash or in-kind contributions. Certain territories may receive waivers or reductions of this requirement. All proposed activities must comply with applicable federal laws and policies, including restrictions related to discrimination, public safety, and allowable use of funds. Recipients must also align their work with federal priorities such as preventive health, chronic disease reduction, and improving access to primary and behavioral health care. Eligibility is limited to state governments that operate a State Office of Rural Health, with only one applicant permitted per state based on gubernatorial designation. Individuals are not eligible. Applications must be submitted through Grants.gov and require active registrations in both SAM.gov and Grants.gov systems. Required application components include a project narrative, budget narrative, work plan, staffing plan, organizational chart, and various supporting attachments. The application must adhere to strict formatting and content requirements, including a maximum page limit and specified documentation structure. Applications are evaluated through a multi-step review process, beginning with an eligibility and completeness screening followed by a merit review conducted by a panel. Evaluation criteria include demonstrated need, quality of the proposed response, performance measurement strategies, anticipated impact, organizational capacity, and appropriateness of the budget. Final funding decisions consider these scores along with alignment to agency priorities, available funding, and applicant risk assessment. The application deadline is July 10, 2026, with awards expected to begin on July 1, 2026. The program operates on an annual cycle, with continued funding contingent upon performance, appropriations, and alignment with federal priorities. Successful applicants must comply with post-award requirements including annual reporting, performance tracking through federal data systems, and adherence to federal administrative and financial regulations. Program contacts are provided for both programmatic and financial inquiries, offering direct support throughout the application and award process.

Align proposal tightly with rural health needs assessment and ensure measurable objectives linked to evaluation criteria; demonstrate coordination to avoid duplication; provide clear work plan with timelines and outcomes