Notice of Funding Opportunity

Application due 07/10/2026

Federal Office of Rural Health Policy Hospital State Division

State Offices of Rural Health Program Opportunity number: HRSA-26-065

Contents Before you begin 3

Step 1: Review the Opportunity 4 Basic information 5

Eligibility 6

Program description 8

Award information 11

Step 2: Get Ready to Apply 14 Get registered 15

Find the application package 15

Application writing help 16

Step 3: Build Your Application 17 Application checklist 18

Application contents and format 20

Step 4: Understand Review, Selection, and Award 30 Application review 31

Selection process 36

Award notices 36

Step 5: Submit Your Application 37 Application submission and deadlines 38

Other submissions 38

Step 6: Learn What Happens After Award 39 Post-award requirements and administration 40

Reporting 44

Contacts and Support 45

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up-to-date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on 07/10/2026.

All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate: racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

https://sam.gov/ https://grants.gov/

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 6

Program description 8

Award information 11

Basic information Health Resources Services Administration Federal Office of Rural Health Policy

Hospital State Division

Help states strengthen rural health care delivery systems by maintaining a focal point for rural health within each state.

Summary The State Office of Rural Health (SORH) program funds organizations to provide a framework to link small rural communities with state and federal resources to develop long-term solutions to rural health programs. Only one applicant from each state is eligible for this notice of funding opportunity (NOFO), based on the designation of the governor.

Each SORH must:

• Maintain within the state a clearinghouse for collecting and sharing information on:

◦ Rural health care issues.

◦ Research findings relating to rural health care.

◦ Innovative approaches to delivering health care in rural areas.

• Coordinate rural health–related activities in the state and avoid redundancy.

• Identify federal and state rural health programs and help public and nonprofit private entities participate in these programs.

Funding details Application types: Competing continuation, New

Expected total available funding in FY 2026: $11,200,000

Expected number and type of awards: 50 grants Funding range per award: Approximately $223,410

We plan to fund awards in five 12-month budget periods for a total five-year period of performance from 07/01/2026 to 06/30/2031.

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name:

State Offices of Rural Health Program number:

HRSA-26-065

version:

Initial

93.913

Key dates

06/08/2026 webinar:

See Webinar Section deadline:

07/10/2026

07/01/2026

07/01/2026

See other submissions for other time frames that may apply to this NOFO.

Eligibility Who can apply Types of eligible organizations These types of domestic organizations may apply:

• State governments.

• Others (see additional information on eligibility).

Additional information on eligibility States with State Offices of Rural Health are eligible to apply. Only one applicant from each state is eligible, based on the designation of the governor.

Individuals are not eligible applicants under this NOFO.

Completeness and responsiveness criteria We will review your application to make sure it meets these basic requirements to move forward in the competition.

We will not consider an application that:

• Is from an organization that does not meet all eligibility criteria.

• Is submitted after the deadline.

Application limits You may not submit more than one application. If you submit more than one application, we will only accept the last on-time submission.

Cost sharing Federal share This program requires you to contribute 75% of the federal share.

You can meet your match requirement through any combination of:

• Cash contributed by your organization, partners, or other third parties.

• In-kind (non-cash) contributions from your organization, partners, or other third parties.

You can calculate this cost-sharing requirement in two ways:

Method 1: Start with the federal share.

Calculation: Multiply the federal share by 75 and divide that product by 25.

For example: ($30,000 x 75) / 25 = $90,000.

Method 2: Start with the total project cost.

Calculation: Multiply the total project cost by 75%.

For example: $120,000 x 75% = $90,000.

We may waive or reduce the non-federal contribution if we determine that requiring matching funds would limit the State Office of Rural Health’s ability to carry out the purpose described in 42 U.S.C. § 254(r)(a).

We waive cost sharing requirements up to $200,000 for any award to the U.S. Virgin Islands, Commonwealth of the Northern Mariana Islands, American Samoa, Guam, Republic of Palau, Federated States of Micronesia, and the Republic of the Marshall Islands. (48 U.S.C. 1469a(d)).

Post-award requirements

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

Program description Purpose The purpose of the SORH Program is to help states strengthen rural health care delivery systems by maintaining a focal point for rural health. This program funds an institutional framework in each state that links small rural communities with state and federal resources to help develop long-term solutions to improve access to, and the quality of, care for the nearly 60 million people living in rural communities.

Funding opportunity goals

• Maintain within the state a clearinghouse for collecting and sharing information on rural health care issues, research findings related to rural health care, and innovative approaches to rural healthcare delivery.

• Coordinate rural health related activities in the state and avoid redundancy.

• Identify federal and state rural health programs and help public and nonprofit private entities participate in these programs.

Background The SORH Program is a federal-state partnership that has been federally funded since 1991. SORH provides funding to a single organization in each of the 50 states and serves as the central convening entity for rural coordination within the state. The SORH in each state link small rural communities with state and federal resources to help develop long-term solutions to improve access to, and the quality of care for the nearly 60 million people living in rural communities.

Authorizing legislation provides that each SORH must conduct all of the following activities:

1. Establish and maintain within the state a clearinghouse for collecting and disseminating information on all of the following:

◦ (A) Rural health care issues.

◦ (B) Research findings relating to rural health care.

◦ (C) Innovative approaches to the delivery of health care in rural areas.

2. Coordinate the activities carried out in the state that relate to rural health care, including providing coordination for the purpose of avoiding redundancy in such activities.

3. Identify federal and state programs regarding rural health, and provide technical assistance to public and nonprofit private entities regarding participation in such programs.

The legislation also allows each SORH to:

• Conduct activities pertaining to the recruitment and retention of health care professionals to serve in the rural areas of their states.

• Provide sub-awards and contracts to public and non-profit organizations to carry out SORH activities.

To help SORHs build the capacity to support rural communities, the State Rural Health Coordination and Development Program (SORHCDP) was created in 2005 to support SORH in collecting and disseminating information, coordinating activities, building collaborative partnerships, convening stakeholders, and providing leadership development to improve rural health.

SORH helps advance the Making America Healthy Again (MAHA) priorities, which include:

• Preventive health.

• Reducing chronic disease.

• Mental health.

• Nutrition.

• Primary and value-based care.

• Culturally appropriate services for tribes.

• Early childhood health and autism support.

Program requirements and expectations You, as the recipient, will be required to help:

• Strengthen the rural health-care delivery system.

• Develop short- and long-term solutions to rural health challenges.

• Prioritize the rural health program’s limited resources and activities.

To do these items, you will need a clear understanding of the rural health landscape.

Each SORH must:

• Maintain within the state a clearinghouse for collecting and sharing information on:

◦ Rural health care issues.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.hhs.gov%2Fmaha%2Findex.html&data=05%7C02%7CSNdiangui%40hrsa.gov%7Cfcd09c6d0ecb408eb43708de7bd25622%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C639084340474511497%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=e40qRbgWe2m8%2BKyg9M7qEOAzujBqTH9w72NpmveIz98%3D&reserved=0

◦ Research findings relating to rural health care.

◦ Innovative approaches to delivering health care in rural areas.

• Coordinate rural health–related activities in the state and avoid redundancy.

• Identify federal and state rural health programs and provide technical assistance to public and nonprofit private entities so they can participate in these programs.

Each SORH may also work to recruit and retain health professionals to serve in rural areas of the state and provide contracts to public and nonprofit private entities to carry out SORH activities.

Proposed activities should also advance one or more of the MAHA priorities. Strategies to consider include:

• Addressing root causes of poor health.

• Improving access to primary care, behavioral health, preventive care, or developmental services.

• Expanding nutrition programs or chronic disease prevention.

• Supporting early childhood development or autism services.

• Preparing systems for value-based care.

• Partnering with tribal health systems.

Statutory authority 42 U.S.C. § 254(r) (§ 338J of the Public Health Service Act)

Award information Funding policies and limitations Changes in HHS regulations As of October 1, 2025, HHS has adopted 2 CFR Part 200, with some modifications included in 2 CFR Part 300. These regulations replace those in 45 CFR Part 75.

Policies

• To make an award, funding must be available and allocated for this program and purpose, at which point we will move forward with the review and award process.

• Have clear policies and good financial practices to avoid spending HRSA funds on unallowable activities. Like other award rules, we may audit your policies, procedures, and controls.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Your satisfactory progress in meeting the project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• If we receive more funding for this program, we may:

◦ Fund more applicants from the rank order list.

◦ Extend the period of performance.

◦ Award supplemental funding.

General limitations

• For guidance on some types of costs we do not allow or restrict, see:

◦ Project Budget Information in Section 3.1. of the Two-Tier Application Guide

[PDF].

◦ 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost.

◦ Allowable and Unallowable Costs and Activities, in the HHS Grants Policy Statement.

• All costs must be reasonable, necessary, allocable to the award, and adequately documented (2 CFR 200.403).

• You cannot earn profit from the federal award. See 2 CFR § 200.400(g).

• Current appropriations law includes a salary limit of $228,000 as of January 2026 that applies to this program. You may pay salaries at a higher rate if the rate https://www.ecfr.gov/current/title-2/part-200 https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf#page%3D17 https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf#page%3D17 https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.404 https://www.ecfr.gov/current/title-2/section-200.405 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.403 https://www.ecfr.gov/current/title-2/part-200#p-200.400(g) beyond the salary rate limit (Executive Level II) is paid with non-HHS funds. For help calculating salaries under this limit, read more at “salary rate limitation” in the Two-Tier Application Guide [PDF].

Program-specific statutory or regulatory limitations You cannot use funds for the following:

• Paying for health care services, including cash payments.

• Conducting TA activities that another federal program already funds (non-duplication of funds).

• Purchasing medical equipment, ambulances/vehicles, aircraft, or major communications systems.

• Purchasing or improving real property.

• Supporting certificate of need activities.

See Manage Your Grant for other information on costs and financial management.

Indirect costs Indirect costs are costs you charge across more than one project that cannot be easily separated by project. For example, this could include utilities for a building that supports multiple projects.

To incur indirect costs, you can select one of two methods:

Method 1 – Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency at the time of award.

Method 2 – De minimis rate. Per 2 CFR § 200.414(f), if you do not have a current negotiated indirect cost rate, you may elect to charge a de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is up to 15% of modified total direct costs (MTDC). See 2 CFR § 200.1 for the definition of MTDC. You can use this rate indefinitely for all your federal awards or until you choose to receive a negotiated rate.

Consider your indirect costs when developing your budget.

https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf https://www.hrsa.gov/grants/manage-your-grant https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC))

Program income Program income is money earned as a result of your award-supported project activities. You must use any program income you generate from awarded funds for approved project-related activities. Find more about program income at 2 CFR 200.307.

https://www.ecfr.gov/current/title-2/section-200.307

Step 2:

Get Ready to Apply

Get registered 15

Find the application package 15

Application writing help 16

Get registered SAM.gov You must have an active account with SAM.gov to apply. SAM.gov registration can take several weeks. Begin that process today.

To register:

• Go to SAM.gov Entity Registration and select Get Started. From the same page, you can also select the Entity Registration Checklist for the information you will need to register.

• You must agree to the financial assistance general certifications and representations specifically. Those for contracts are different.

When you register, you will also receive your required Unique Entity Identifier (UEI).

Once you register:

• You will have to maintain your registration throughout the life of any award.

• If your organization has multiple UEIs, use the one associated with your physical location.

If you need additional information about user roles in SAM.gov, see “Get registered:

SAM.gov user roles” in the Application Guide [PDF].

Grants.gov You must also have an active account with Grants.gov. You can see step-by-step instructions at the Grants.gov Quick Start Guide for Applicants and How to Apply for Grants.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-26-065.

After you select the opportunity, we recommend that you select the Subscribe button to get updates.

https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D4 https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/search-grants

Application writing help Visit HHS Tips for Preparing Grant Proposals.

Visit HRSA’s How to Prepare Your Application page for more guidance.

See Apply for a Grant for other help and resources.

Join the webinar Webinar information will be posted to the Related Documents tab on Grants.gov. We recommend you “Subscribe” to the NOFO on Grants.gov to receive updates when documents are posted.

Have questions? Go to Contacts and Support.

https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://www.hrsa.gov/grants/apply-for-a-grant

Step 3:

Build Your Application

Application checklist 18

Application contents and format 20

Application checklist There are two types of forms in Grants.gov.

• Some forms allow you to upload components of your application to the form.

These include components like your project narrative, budget and budget narrative, and attachments, as applicable.

• Other forms are more typical, fill-in-the-blank forms.

Make sure that you have everything you need to apply.

Narratives

Component Grants.gov form Included in page limit*?

Project narrative Project Narrative Atatchment form. Yes

Budget narrative Budget Narrative Attachment form. Yes

Attachments Insert each in the Attachments Form in this order.

Included in

1. Work plan Yes

2. Staffing plan and job descriptions Yes

3. Biographical sketches No

4. Agreements with other entities No

5. Multi-year budgets, fifth-year budget Yes

6. Project organizational chart Yes

7. SORH letter on RHT Program No

8-15. Other relevant documents Yes

Other required forms Upload using each required form in Grants.gov.

Forms Submission requirement

Application for Federal Assistance (SF-424) With application.

Project Abstract Summary form With application.

Grants.gov Lobbying form With application.

*Only what you attach in these forms counts toward the page limit. The forms themselves do not count.

Application contents and format This section includes guidance on each component found in the application checklist.

Application page limit: 40

Submit your information in English and express whole number budget figures using U.S. dollars.

Required format Required format for project summary, project narrative, budget narrative, and attachments.

Font: A readable font like Arial, Courier, CG Times, or Times New Roman

File format: We only accept the following document formats:

• .PDF — Adobe Portable Document Format

• .DOC/.DOCX — Microsoft Word

• .RTF — Rich Text Format

• .TXT — Text

• .WPD — Word Perfect Document

• .XLS/.XLSX — Microsoft Excel

• .VSD — Microsoft Visio

Size: 12-point font

Footnotes, charts, graphics, and budget tables may be 10-point or higher.

Ink color: Black

Spacing: Single-spaced, including all text and tables.

Alignment: Left

Headings: Bold all headings and align left.

Size: 8.5 x 11 (Make sure the print area is set and allows printing to 8.5 x 11.)

Margins: 1-inch on all sides

Footer: On each page as the footer, include your organization’s name and page numbers. If a competing continuation or competing supplement, also include your 10-digit award number.

Page numbering:

• Do not number the standard OMB-approved forms.

• Number each attachment page sequentially (that is, 1, 2, 3).

• Reset the numbering for each attachment.

• Treat each attachment as a separate section.

File names: You can find guidance for naming your files in the Application Guide [PDF].

Project narrative Introduction See merit review criterion 1: Need

Briefly describe the purpose of your project. Make sure it aligns with the purpose described in the program description.

Need See merit review criterion 1: Need

Describe the rural health system and infrastructure and the needs you will address though your activities to meet the purpose of the SORH program, such as information dissemination, coordinating activities, collaborating and partnering with other entities, providing technical assistance, and recruiting and retaining rural providers.

Describe the assessment techniques you will use to determine the rural needs you will address with the funds.

Use the following subheadings for this section.

Rural population Describe your state’s rural population, based on state and HRSA’s definition of “rural.”

Use and cite demographic data whenever possible to support the information you provide. Include a map of the rural landscape.

Health status Describe the general health status of your state and rural population. Note how it compares to national data. Include any relevant factors, such as age, poverty, health outcomes, substance use disorders (including opioid use), and other social problems.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D26 https://www.hrsa.gov/rural-health/about-us/what-is-rural

Health-care delivery system

• Describe the state rural health system and infrastructure. Include components such as critical access hospitals (CAH), small rural and referral hospitals, rural health clinics (RHC), community health centers, and rural emergency medical services (EMS).

• Describe key partners and stakeholders, such as hospital and rural health associations, quality networks, public health partners, and coalitions. Describe how they coordinate and interact with each other.

• Discuss challenging issues and how you will address them. These could include broadband and telehealth access, maternity and obstetrics services, behavioral health, oral health, aging, substance use disorder (including opioid use), and transportation.

• Describe the efforts of providers and partners to participate in alternative payment models and value-based payment programs.

Workforce recruitment and retention

• Describe the availability of, distribution of, and shortages within the rural health workforce.

• Describe any other state health workforce issues.

• Include information on specific shortages, such as obstetrics/gynecology, behavioral health, or oral health.

• Include not only medical doctors but other health care professionals, such as allied health professionals.

Approach See merit review criterion 2: Response

Describe how you will meet each of the SORH program requirements and expectations.

Your program objectives should be linked to the needs you identify in the need section of your project narrative. Explain the activities, programs, and initiatives you plan to conduct. These descriptions should be specific, realistic, measurable, and achievable within the project’s time frame.

As appropriate, identify meaningful support and collaborations with key partners and stakeholders in planning, designing, and implementing all activities (for example, hospital and rural health associations, quality network, coalitions).

Your approach must align with your work plan. For example, Objective 1.a. in the approach section should be labeled as 1.a. in the work plan.

You should only describe award activities funded by the SORH federal and non-federal matching funds under this award. Do not include activities performed by SORH staff that are funded by other HRSA awards or nonfederal funds. However, you must disclose whether you participate in or benefit from your state’s CMS Rural Transformation Program. If yes, you must provide a brief summary of SORH level of involvement in the CMS Rural Transformation Program activities and include a letter in Attachment 7 explaining how you plan to ensure HRSA-funded work is non-duplicative, coordinated, and complementary.

High-level work plan See merit review criteria 2: Response and 4: Impact

The work plan narrative is a snapshot of what you describe in more detail in the approach section. Here, you will describe the activities or steps that you will use to achieve the objectives. Use a timeline that includes each activity and identifies responsible staff.

The work plan must be clear, concise, and numbered to correspond with the objectives, goals, and activities described in the approach section.

Include a more detailed work plan as Attachment 1 in a chart form and include:

• Objectives.

• Activity (multiple for each objective).

• Anticipated date of completion.

• Staff or other responsible entity, contractor, or partner.

• Anticipated progress or process measures.

• Anticipated outcomes or impacts. These may be specific or broad.

Resolving challenges See merit review criterion 2: Response

Discuss any potential barriers or challenges you anticipate in designing and implementing the activities you described in the approach and work plan. Describe the strategies and approaches you will use to resolve these barriers or challenges. If applicable, include information on how you will address any unobligated balance.

Performance management See merit review criteria 3: Performance reporting and evaluation and 5: Resources and capabilities

• Describe the strategies and measures you will use to evaluate your performance during the period of performance. Describe how progress toward meeting grant-funded objectives will be tracked, measured, and evaluated.

• Describe how data collection strategy will be implemented to collect, analyze, and track data to measure performance and determine impact or outcomes. Describe how you will use the data to improve your performance.

• Discuss how you will use any automated or web-based performance reporting system (such as TruServ) and the HRSA Salesforce Data Collection Platform (DCP) data.

• Describe the capacity of your organization and staff to evaluate the program.

Include their experience, skills, and knowledge.

• Describe how you will share results, how you will assess whether you are sharing results effectively, and whether other states or organizations can replicate your program.

See the reporting section for more information.

Organizational information See merit review criterion 5: Resources and capabilities

• Briefly describe your mission, structure, and the scope of your current activities.

Explain how they will help you carry out the program requirements. You’ll include a project organizational chart as Attachment 6.

• Describe relationships that contribute to your SORH’s ability to meet program requirements and expectations.

• Describe how your organization will routinely assess and monitor the unique needs of rural communities.

• Explain how you will use nonfederal matching funds and how they will affect the rural population within the state. Discuss how you will use matching funds to fund activities related to one or more of the three program objectives, or for other rural health–related objectives.

Budget and budget narrative See merit review criterion 6: Support requested

Your budget should follow the instructions in budget narrative: detailed instructions section of the Application Guide and the instructions listed in this section. Your budget should show a well-organized plan.

HHS now uses the definitions for equipment and supply in 2 CFR 200.1. The new definitions change the threshold for equipment to the lesser of the recipient’s capitalization level or $10,000 and the threshold for supplies to below that amount.

The total project or program costs are all allowable (direct and indirect) costs used for the HRSA award activity or project. This includes costs charged to the award and non-federal funds used to satisfy a matching or cost-sharing requirement (which may include maintenance of effort, if applicable).

The budget narrative supports the information you provide in Standard Form 424-A. It includes an itemized breakdown and a clear justification of the costs you request. The merit review committee reviews both.

As you develop your budget, consider:

• If the costs are reasonable, allowable and allocable, and consistent with your project’s purpose and activities.

• The restrictions on spending funds. See funding policies and limitations.

• How much funding you will need for staff to attend the required partnership meetings:

◦ FORHP Regional SORH Meeting.

◦ National Rural Health Association meeting.

◦ National Organization of State Offices of Rural Health meeting.

◦ The FORHP SORH orientation. New SORH directors must attend within one year of beginning their role.

• Costs that do not fit into any other category. Put these costs in the Other category and explain them. Include partner organization dues (such as for the National Rural Health Association, National Organization of State Offices of Rural Health, or 3RNet) in this category.

• The total project or program costs. These are the total allowable costs (including direct and indirect costs) you incur for this program. In your total project or program costs, include costs charged to the award and your cost-sharing funds.

To create your budget narrative, see budget narrative detailed instructions in the Application Guide.

https://www.ecfr.gov/current/title-2/part-200#p-200.1(Equipment) https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#p-200.1(Supply)

Attachments Place your attachments in this order in the Attachments Form. See application checklist to determine if they count toward the page limit.

Unless the instructions below require it, do not submit organizational brochures or other promotional materials (for example, slides, films, clips).

Attachment 1: Work plan The work plan for the project must include all information detailed in the project narrative and cover all five years of the period of performance. The work plan must describe both required and additional activities that you will use to achieve the program objectives.

As appropriate, identify meaningful support and collaborations with key partners and stakeholders in planning, designing, and implementing all activities.

The work plan should be clear, coherent, and aligned with the goals and objectives described in the approach section. Include a timeline with each activity and its responsible staff.

Reminder: The work plan should use a numbering system to identify each objective/ activity that clearly aligns with the approach section.

Attachment 2: Staffing plan and job descriptions Include a staffing plan that shows the staff positions that will support the project, and key information about each. Justify your staffing choices, including their education and experience. Explain your reasons for the amount of time you request for each staff position.

Each SORH must fund a SORH director (position title may vary) to be the dedicated face of the SORH and the primary rural health contact within the state and with FORHP.

There is no minimal full-time equivalent (FTE) requirement, but the amount should be sufficient to perform and/or oversee award objectives and activities listed in the work plan.

You may fund additional staff, such as a deputy or clerical support, with federal or matching funds. However, you may not use SORH program funds for organizational positions whose primary purpose is not directly related to the completion of SORH objectives and activities. For each key staff member, attach a one-page job description.

It must include their role, responsibilities, and qualifications.

Attachment 3: Biographical sketches Include biographical sketches for people who will hold the key positions you describe in Attachment 2.

Each biographical sketch should be no more than two pages. Do not include nonpublic personally identifiable information. If you include someone you have not hired yet, provide a letter of commitment from that person along with the biographical sketch.

Attachment 4: Agreements with other entities Provide any documents that describe working relationships between your organization and others you mention in your project narrative. If you include documents that confirm actual or pending contracts or agreements, the documents should clearly describe the roles of subrecipients and contractors and any deliverables. It is not necessary to include the entire contents of lengthy agreements, so long as the portions you include describe the working relationship between you and the other organization.

Make sure letters of agreement are signed and dated.

Attachment 5: Multi-year budgets, fifth-year budget For the fifth budget year, submit a copy of Section B of the SF-424A as an attachment.

We do not count this in the page limit. However, any related budget narrative does count. See Section 3.1.4 of the Application Guide [PDF].

Attachment 6: Project organizational chart Provide a one-page diagram that shows the full project’s organizational structure.

Attachment 7: SORH letter on RHT Program Letter must be dated and specifically describe how you plan to ensure HRSA-funded work is non-duplicative, coordinated, and complementary to your state’s CMS Rural Health Transformation Program (if applicable).

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D13

Attachment 8-15: Other relevant documents Include here any other documents that are relevant to the application, including letters of support. Letters of support must be dated and specifically indicate a commitment to the project/program (in-kind services, dollars, staff, space, equipment, federally negotiated indirect cost rate, etc.).

Other required forms You will need to complete some other forms. Upload the following forms at Grants.gov.

You can find them in the NOFO application package or review them and any available instructions at Grants.gov Forms.

Forms Submission requirement

Application for Federal Assistance (SF-424) With application.

Project Abstract Summary form With application.

Grants.gov Lobbying form With application.

Form instructions The application guide has detailed instructions for:

• The Application for Federal Assistance (SF-424) [PDF].

• The Budget Information for Non-Construction Programs (SF-424A) [PDF].

Project abstract summary form instructions Complete the information in the Project Abstract Summary form. Include a short description of your proposed project. Include the needs you plan to address, the proposed services, and the population groups you plan to serve. When writing your summary:

• Use 4,000 characters or fewer.

• Make sure it’s clear, accurate, and short.

• Do not refer to other parts of the application.

• Do not include personally identifiable information (PII) in abstract form.

If you receive an award, we’ll put your project abstract on public websites and databases, including USAspending.gov.

https://grants.gov/forms/forms-repository/sf-424-family https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D8 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D13 https://grants.gov/learn-grants/grant-terminology#p http://www.usaspending.gov/

Important: Public information

When filling out your SF-424 form, pay attention to Box 15: Descriptive Title of Applicant’s Project.

We share what you put there with USAspending. This is where the public goes to learn how the federal government spends their money.

Instead of just a title, insert a short description of your project and what it will do.

See instructions and examples [PDF].

https://www.usaspending.gov/ https://www.hhs.gov/sites/default/files/hhs-writing-award-descriptions.pdf

Step 4:

Understand Review, Selection, and Award

In this step

Application review 31

Selection process 36

Award notices 36

Application review Initial review We will review your application to make sure that it meets eligibility criteria, and the requirements in this NOFO. If your application does not meet eligibility criteria, it will not be funded. If your application does not meet other criteria, we will not fund it.

Merit review A panel reviews all applications that pass the initial review. You can find more about the merit review process in the Application Guide [PDF]. The members use these criteria.

Criterion Total number of points = 100

1. Need 20 points

2. Response 35 points

3. Performance reporting and evaluation 10 points

4. Impact 10 points

5. Resources and capabilities 15 points

6. Support requested 10 points https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D32

Criterion 1: Need (20 points) See the project narrative Introduction and Need sections.

The panel will review your application for how well it does the following.

Introduction (5 points) The reviewer will assess the extent to which your introduction section responds to the purpose included in the program description.

Needs assessment (15 points) The reviewer will assess the quality and extent to which the needs assessment section:

• Describes assessment techniques to determine the rural needs you will address with the funds.

• Describes specific needs related to the purpose of the SORH, such as collecting and sharing rural health information, coordinating activities to avoid duplication, identifying federal and state programs and providing technical assistance.

• Describes the rural health landscape, including any relevant data for the following:

◦ Demographics of the rural population.

◦ Their health status.

◦ The rural healthcare delivery system.

◦ Workforce issues, including recruitment and retention.

Criterion 2: Response (35 points) See the project narrative Approach, High-level work plan, and Resolution of challenges.

The panel will review your application for the following.

Approach (20 points) The reviewer will assess your approach section for the extent to which:

• It aligns with the SORH program requirements and expectations.

• The listed activities clearly link to the needs identified in the needs assessment section.

• It addresses the objectives, activities, programs, and initiatives, which are specific, measurable, realistic, and achievable in the project’s time frame.

• The objectives and activities are clearly numbered and align with the work plan.

• It describes coordination of rural health–related activities in the state to avoid redundancy with other HRSA funded and non-federal funded activities.

High-level work plan (10 points) The reviewer will assess the extent to which your work plan:

• Is clear and concise, with numbered objectives and activities that align with the approach section.

• Includes objectives, activities, estimated completion dates, responsible entity (e.g., staff, contractor, or partner), progress or process measures, and outcome or impact of activities, including quantitative information.

Resolution of challenges (5 points) The reviewer will assess the extent to which you sufficiently discuss:

• The barriers and challenges you expect to encounter when designing and implementing the activities described in the approach and work plan.

• How you will resolve identified challenges.

• How you will address any unobligated balance (if applicable).

Criterion 3: Performance reporting and evaluation (10 points) See the project narrative Performance reporting and evaluation section.

The panel will review your overall approach and methods to evaluate project results against goals and objectives and to gain insights into program outcomes and impact.

The panel will review the evidence you provide that the evaluative measures will be able to assess whether:

• The data collection strategy includes how data will be collected, analyzed, and tracked to measure performance and determine impact or outcomes, including a discussion of SORH performance measures.

◦ The program objectives have been met.

◦ Results are shareable and can be replicated.

◦ These results can be attributed to the project.

Criterion 4: Impact (10 points) See the project narrative High-level work plan.

The panel will review your application for:

• The activities you propose in the work plan are clear and specific, contribute to accomplishing each objective, and are reasonably achievable, given the level and experience of staff, resources available, and length of the project.

• You explain any assumptions you made when developing the project work plan and discuss anticipated performance measures and desired outcomes of award-funded activities.

Criterion 5: Resources and capabilities (15 points) See the project narrative Organizational information and Performance reporting and evaluation sections.

The panel will review your application to determine the extent to which:

• Project personnel are qualified by training and/or experience to carry out the project.

• Your organization is capable of fulfilling the requirements of the proposed project, including through the quality and availability of facilities and personnel.

• You provide a detailed project organizational chart (Attachment 6) that includes a SORH director (or similar title) and any subcomponents of SORH.

• The staffing plan and job descriptions for key personnel (Attachment 2) describe how each position will support the program objectives or activities. This includes roles, responsibilities, qualifications, and rationale for the amount of time (as a percent of FTE) requested for each staff position.

• The biographical sketches of key personnel (Attachment 3) provide sufficient detail to confirm that personnel are qualified for their positions.

Criterion 6: Support requested (10 points) See the Budget and budget narrative section.

The panel will review your application to determine:

• The extent to which SF-424A (budget grid) is complete, is accurate, and includes both federal and non-federal 3:1 matching funds, and clearly indicates that indirect costs are 15% of the budget or less.

• How reasonable the proposed budget is for each year of the period of performance.

• How reasonable costs are and how well they align with the project’s scope.

• How sufficient the time is for key staff to spend on the project to achieve project objectives.

We do not consider voluntary cost sharing during merit review.

Risk review Before making an award, we review your award history to assess risk. We need to ensure all prior awards were managed well and demonstrated sound business practices. We:

• Review any applicable past performance.

• Review audit reports and findings.

• Analyze the budget.

• Assess your management systems.

• Ensure you continue to be eligible.

• Make sure you comply with any public policies.

We may ask you to submit additional information.

As part of this review, we use SAM.gov Entity Information Responsibility/Qualification to check your history for all awards likely to be more than $250,000 over the period of performance. You can comment on your organization’s information in SAM.gov. We’ll consider your comments before making a decision about your level of risk.

If we find a significant risk, we may choose not to fund your application or to place specific conditions on the award.

For more details, see 2 CFR 200.206.

https://sam.gov/content/entity-information https://www.ecfr.gov/current/title-2/section-200.206

Selection process When making funding decisions, we consider:

• The amount of available funds.

• Assessed risk.

• Alignment with HRSA Mission and Strategic Priorities.

• The results of reviewing the progress report submitted with a competing continuation application that seeks to a new period of performance.

• Merit review results. These are key in making decisions but are not the only factor.

We may:

• Fund applications in whole or in part.

• Fund applications at a lower amount than requested.

• Decide not to allow a recipient to subaward if they may not be able to monitor and manage subrecipients properly.

• Choose to fund no applications under this NOFO.

You cannot appeal a denial, or the amount of funds awarded. Additionally, we may not make an award if you are delinquent on two or more Single Audit Report.

Award notices We issue Notices of Award (NOA) on or around the start date listed in the NOFO. See “how we make awards” in the Application Guide [PDF] for more information.

By drawing down funds, you accept the terms and conditions of the award.

bookmark://_Required_alignment_with/ https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D32

Step 5:

Submit Your Application

Application submission and deadlines 38

Other submissions 38

Application submission and deadlines Your organization’s authorized official must certify your application. See the section on finding the application package to make sure you have everything you need.

Application deadline You must submit your application by 07/10/2026, at 11:59 p.m. ET.

Grants.gov creates a date and time record when it receives applications.

If you need a deadline extension, see “requesting a waiver” in the Application Guide [PDF].

Submission method Grants.gov You must submit your application through Grants.gov. You may do so using Grants.gov Workspace. This is the preferred method. For alternative online methods, see Applicant System-to-System.

For instructions on how to submit in Grants.gov, see the Quick Start Guide for Applicants. Make sure that your application passes the Grants.gov validation checks, or we may not get it. Do not encrypt, zip, or password protect any files.

If Grants.gov rejects your application due to errors, you must correct and resubmit before the deadline.

If you want to know more about correcting errors or tracking your application, you can refer to the Application Guide [PDF].

Other submissions Intergovernmental review This NOFO is not subject to Executive Order 12372, Intergovernmental Review of Federal Programs. No action is needed.

Have questions? Go to Contacts and Support.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D7 https://www.grants.gov/system-to-system/applicant-system-to-system/ https://www.grants.gov/system-to-system/applicant-system-to-system/ http://www.grants.gov/quick-start-guide/applicants http://www.grants.gov/quick-start-guide/applicants https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D42 https://www.archives.gov/federal-register/codification/executive-order/12372.html

Step 6:

Learn What Happens After Award

In this step

Post-award requirements and administration 40

Reporting 44

Post-award requirements and administration Administrative and national policy requirements There are important rules you need to know if you get an award. You must follow:

• All terms and conditions in the Notice of Award (NOA). We incorporate this NOFO by reference.

• The regulations at 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, modifications at 2 CFR Part 300, and any superseding regulations.

• The HHS Grants Policy Statement. Your NOA will reference this document. If there are any exceptions to the GPS, they’ll be listed in your NOA.

• All federal statutes and regulations relevant to federal financial assistance, including those highlighted in HHS Grants Policy Statement, Appendix D: HHS Administrative and National Policy Requirements.

• The requirements for performance management in 2 CFR 200.301.

• All anti-discrimination laws: By applying for or accepting federal funds from HHS, you certify compliance with all federal antidiscrimination laws and these requirements. Complying with those laws is a material condition of receiving federal funding streams. You are responsible for ensuring subrecipients, contractors, and partners also comply.

Required alignment with HRSA mission and strategic priorities Recipients must use funds awarded under this NOFO to implement program goals or agency priorities in accordance with the HRSA vision, mission, core values, and strategic priorities, where authorized by law.

In administering programs under this and all funding announcements, HRSA prioritizes:

• Evidence-based healthcare:…