Shoring Up to Sustainability Initiative

The Rural Health Transformation Program: Shoring Up to Sustainability Initiative is a state-administered grant opportunity issued by the South Carolina Department of Health and Human Services (SCDHHS) as part of the broader federally funded Rural Health Transformation Program (RHTP). The initiative is funded through a cooperative agreement between the Centers for Medicare and Medicaid Services and SCDHHS and is designed to strengthen the operational and financial resilience of rural healthcare systems across South Carolina. The program aligns with federal goals to improve healthcare access, quality, and outcomes in rural communities by investing in infrastructure, workforce capacity, and system sustainability. South Carolina received a federal award under CMS Notice of Funding Opportunity CMS-RHT-26-001, which allows the state to distribute subawards to eligible organizations. The Shoring Up to Sustainability Initiative focuses on three priority project areas for the current funding cycle: Facility Enhancements, Masterclass Training Series, and Healthcare Workforce. Facility Enhancements support upgrades to critical infrastructure in rural healthcare facilities, including HVAC systems, electrical improvements, equipment replacement, and minor renovations that improve care delivery and safety. The Masterclass Training Series provides training, technical assistance, and partnerships to build operational and financial sustainability among rural healthcare providers. The Healthcare Workforce project offers targeted financial incentives, such as recruitment and retention bonuses, to address provider shortages and stabilize staffing in rural communities. Each applicant must select only one of these project categories per application submission. The total anticipated funding for this initiative is forty million dollars, which will be distributed as subawards to selected applicants. Funding ranges vary by project type, with Facility Enhancements ranging from one hundred thousand dollars to three million dollars, Masterclass Training Series ranging from five hundred thousand dollars to two million five hundred thousand dollars, and Healthcare Workforce incentives structured per practitioner with defined minimum and maximum award levels. The program does not require cost sharing or matching funds. Awardees must expend all funds by September 30, 2027, and are subject to federal funding requirements under 2 CFR Part 200 and 2 CFR Part 300, as well as specific CMS funding limitations. Allowable uses include infrastructure improvements and training activities, while unallowable costs include new construction, lobbying, and duplicative clinical service payments. Eligibility for this opportunity is broad but clearly defined. Applicants must be based in South Carolina and must serve rural communities as defined by the Health Resources and Services Administration. Eligible entities include healthcare providers such as hospitals and clinics, community-based organizations, local government entities and public health agencies, nonprofit organizations, educational institutions engaged in workforce development, professional associations, and collaborative partnerships. All proposed activities must directly benefit rural residents and demonstrate measurable impact. Some project categories impose additional eligibility constraints, such as limiting Facility Enhancements to rural healthcare providers or requiring partnerships for training initiatives. The application process requires submission of a complete proposal package via email as a single PDF to SCDHHS. Required components include a cover sheet, project summary, project narrative, budget, budget narrative, letters of support, and disclosures regarding settlement agreements or claims. The project narrative must address organizational background, assessment of need supported by data, scope of work with timeline, monitoring and evaluation plan, and sustainability strategy. Applications are reviewed through an initial screening for completeness followed by a merit review conducted by a panel with expertise in grants management and rural health. Scoring includes evaluation of the project narrative, budget, and supporting materials, with detailed scoring matrices provided in the RFA. The timeline for the current funding cycle is clearly defined. The RFA was posted on April 2, 2026, with questions due by April 16, 2026. Applications must be submitted by June 1, 2026 at 11:59 p.m. Eastern Time. Awards are anticipated to be announced by July 31, 2026. This initiative represents the first of anticipated annual grant cycles under South Carolina’s broader RHTP implementation, which is expected to continue through federal fiscal year 2030, subject to funding availability. While the program is expected to recur annually, future cycles will depend on continued federal funding and state implementation plans.

Ensure strong alignment with one selected project category and clearly tie activities to rural impact. Provide data-driven need, detailed implementation timeline, and measurable outcomes. Budget must directly align with activities and comply with CMS cost rules.