Leveling Up Initiative

The Rural Health Transformation Program: Leveling Up Initiative is a state-administered grant program issued by the South Carolina Department of Health and Human Services as part of the broader federally funded Rural Health Transformation Program. This initiative is funded through a cooperative agreement between the Centers for Medicare and Medicaid Services and SCDHHS, with the goal of improving healthcare access, quality, and outcomes in rural communities. The Leveling Up Initiative specifically focuses on expanding and integrating proven chronic disease management programs across South Carolina to ensure that rural populations have access to coordinated, comprehensive care. The initiative aligns with federal and state priorities emphasizing innovation, workforce development, and healthcare system transformation. The Leveling Up Initiative includes a single priority project for the current funding cycle: Chronic Disease Program Expansion. This project is designed to scale evidence-based chronic care programs statewide, particularly in underserved rural areas where access to specialty care is limited. The program addresses high-burden conditions such as diabetes, heart disease, hypertension, and sickle cell disease, as well as maternal health and stroke. Activities may include expanding specialty care access through telehealth, integrating regional centers of excellence with rural providers, training healthcare professionals in chronic disease management, and delivering structured patient education programs to improve self-management. The initiative emphasizes improving care coordination and reducing fragmentation across the healthcare system. The anticipated total funding for this opportunity is twenty-seven million dollars, which will be distributed through subawards to selected applicants. The funding range for the Chronic Disease Program Expansion project is from one hundred thousand dollars to five million dollars per award. There is no cost sharing or matching requirement for this grant. Awardees must expend all funds by September 30, 2027 and comply with federal funding regulations under 2 CFR Part 200 and 2 CFR Part 300. Allowable uses include activities directly supporting chronic disease program expansion, while unallowable costs include new construction, lobbying, and duplicative reimbursement for clinical services. Eligibility for the Leveling Up Initiative is limited to South Carolina-based entities serving rural communities. Eligible applicants include healthcare providers such as hospitals, clinics, federally qualified health centers, emergency medical services providers, and pharmacies. Additional eligible entities include community-based organizations with a role in health access or digital health support, local government entities and public health agencies, and nonprofit organizations focused on improving rural health outcomes. All applicants must demonstrate that their proposed activities will directly benefit rural residents and produce measurable impacts. The initiative follows the Health Resources and Services Administration definition of rural communities. The application process requires submission of a complete application package via email as a single PDF to the SCDHHS grants inbox. Required components include a cover sheet, project summary, project narrative, budget, budget narrative, letters of support, and disclosure of any relevant settlement agreements. 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 undergo an initial completeness review followed by a merit review conducted by a panel with expertise in grants management and rural health. Evaluation criteria include narrative quality, alignment with program goals, budget justification, and overall project feasibility. The timeline for this funding opportunity is clearly defined. The request for applications 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, and award notifications are anticipated by July 31, 2026. This initiative represents the first of anticipated annual funding cycles under South Carolina’s broader Rural Health Transformation Program, which is expected to continue through federal fiscal year 2030, subject to funding availability and program continuation.

Focus on scaling an evidence-based chronic disease program with strong rural impact. Use data to justify need and clearly define outcomes. Align activities with telehealth integration, provider training, and care coordination. Ensure sustainability beyond 2027 and strong budget alignment.