HRSA-26-100_Final.pdf

Notice of Funding Opportunity

Application due 07/10/2026

Federal Office of Rural Health Policy

Rural Northern Border Region Network Planning Program

HRSA-26-100

Table of Contents

Before You Begin

Step 1: Review the Opportunity

Basic information

Funding details

Eligibility

Program description

Award information

Step 2: Get Ready to Apply

Get registered

Find the application package

Application writing help

Step 3: Build Your Application

Application checklist

Application contents and format

Step 4: Understand Review, Selection, and Award

Application review

Selection process

Award notices

Step 5: Submit Your Application

Application submission and deadlines

Other submissions

Step 6: Learn What Happens After Award

Post-award requirements and administration

Reporting

Contacts and Support

Agency contacts

Help with systems

Before You Begin

Health Resources and Services Administration

Federal Office of Rural Health Policy

Rural Northern Border Region Network Planning Program

HRSA-26-100

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.

Step 1: Review the Opportunity

Basic information

Funding new or strengthening existing rural health care networks in the Northern Border Region to improve health care services and associated outcomes, achieve efficiencies, and strengthen the rural health care system.

Summary

The Rural Northern Border Region Network Development Program provides one-year funding to build new or strengthen existing healthcare networks that serve rural communities within the

Northern Border Region, which will:

• Expand access to, coordinate, and improve the quality of basic health care services and associated health outcomes.

• Achieve efficiencies.

• Strengthen the rural health care system as a whole.

Have questions? Go to Contacts and Support.

Key facts

Opportunity name:

Rural Northern Border Region Network Planning Program

Opportunity number:

HRSA-26-100

Announcement version:

https://www.nbrc.gov/content/northern-border-region initial

Federal assistance listing:

93.619

Key dates

NOFO issue date:

06/08/2026

Informational webinar:

See Join the webinar

Application deadline:

07/10/2026

Expected award date:

09/30/2026

Expected start date:

09/30/2026

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

Funding details

Application Types:

Limited competition

New

Expected total available funding in FY:

2026: $1,800,000

Expected number and type of awards:

18 G (Grant)

Funding range per award:

$0 - $100,000

We plan to fund awards in one 12-month budget periods for a total one year period of performance from 09/30/2026 to 09/29/2027.

Eligibility

You can apply if you are a domestic public or private, non-profit or for-profit entity located in the Northern Border Region and serving qualifying HRSA-designated rural area within that region.

https://data.hrsa.gov/topics/rural-health/rural-health-eligibility

Types of eligible organizations

These types of domestic organizations may apply:

• State governments

• County governments

• City or township governments

• Special district governments

• Independent school districts

• Public and State controlled institutions of higher education

• Native American tribal governments (Federally recognized)

• Public housing authorities/Indian housing authorities

• Native American tribal organizations (other than Federally recognized tribal governments)

• Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education

• Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education

• Private institutions of higher education

• For profit organizations other than small businesses

• Small businesses

• Others (see Additional Information on Eligibility for clarification)

Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled “Additional Information on Eligibility”

Additional information on eligibility

Eligible applicants include domestic public or private, non-profit or for-profit entities including domestic faith-based and community-based organizations, tribes and tribal organizations located in the Northern Border Region and serving qualifying HRSA-designated rural areas within the four Northern Border Regional Commission member States: Maine, New Hampshire, New

York, and Vermont. The applicant organization must have demonstrated experience serving, or capacity to serve populations in rural areas. Eligible applicants also include Federal Qualified

Health Centers (FQHCs) and Community Health Centers, Rural Health Clinics (RHCs), Hospitals and Rural Emergency Hospitals.

For the purposes of the notice, “Domestic” means the 50 states, the District of Columbia, the

Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S.

Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the

Republic of Palau.

Individuals are not eligible applicants under this NOFO.

Other eligibility criteria

You must meet all the requirements in this eligibility section, as well as the following additional criteria. If you do not meet all of these requirements, it will impact the eligibility and scoring of your application.

You must:

• Have demonstrated experience serving, or capacity to serve, rural populations. You can demonstrate this by describing the buy-in from the rural community or communities your proposed project plans to serve in your project narrative.

• Have not previously received a grant under this program (42.U.S.C. 254c(f)) for the same or a similar project. If you have previously received an award under this program, you are eligible to apply if you:

o Expand network services or service areas.

o Engage a new population or new focus area.

o Include new or additional stakeholders.

▪ Applicant organizations representing existing networks are eligible to apply if they propose to collaborate with at least two outside organizations they have not worked with before under a formal relationship.

• Consult the State Office of Rural Health (SORH) and the Northern Border Regional

Commission (NBRC) about your intent to apply to this program. See Attachment 1 and

Attachment 2.

• Ensure all grant activities serve only counties and/or census tracts located in HRSA-designated rural areas of Northern Border Region counties.

o Counties served by the grant must clearly align with fully or partially rural counties provided in your project narrative and documentation completed in

Attachment 3.

Network Requirements

For the purposes of this program, we define:

• Health Care Network: At least three regional or local organizations that come together to develop strategies for improving health services in a community.

• Network Participants: Local organizations that come together to form a health care network.

To meet the Network Requirements of this notice, you must:

• Represent a network comprised of three or more health care provider organizations

(including the applicant organization). This includes:

https://plus.nosorh.org/Web/Membership/Directory/State_Members_List.aspx https://www.nbrc.gov/content/hrsa https://www.nbrc.gov/content/hrsa https://data.hrsa.gov/topics/rural-health/rural-health-eligibility o No less than 3 separately owned network participants with their own EIN/UEI number, unless an exception is requested. See Attachment 11 and Attachment

12.

o Provide the EIN/UEI number for the applicant organization and each network participant in Attachment 7 showing:

▪ No less than 66%, or two-thirds of the network participant organizations working directly on your proposed project, are physically located in a qualifying eligible HRSA designated rural area within the Northern

Border Region o Scanned, signed copies of letters of commitment from each network participant listed in Attachment 7 are provided under Attachment 8.

Completeness and responsiveness criteria

Application limits

You may submit more than one application under the same Unique Entity Identifier (UEI) if each proposes a distinct project. We will only review your last validated application for each distinct project before the deadline.

If you submit more than one application under the same UEI and/or EIN for distinct proposed projects, you must provide the required EIN exception request documentation in Attachment 11

(EIN/UEI exception request) or Attachment 12 (Tribal EIN/UEI exception request).

Cost sharing

This program has no cost-sharing requirement. If you choose to share in the costs of the project, we will not consider it during merit review. Recipients agree that once committed, cost sharing amounts are enforceable and subject to reporting and auditing requirements under 2 CFR 200.

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 Rural Northern Border Region Network Planning (RNBR-NP) Program provides one-year funding to build new or strengthen existing healthcare networks in the Northern Border Region.

RNBR-NP uses network development as a strategy for linking rural health care stakeholders together for greater collective capacity to overcome local challenges, expand access, and improve the quality of care in the rural communities these organizations serve. The program helps network participants work together on three legislative aims:

• Achieve efficiencies.

https://data.hrsa.gov/topics/rural-health/rural-health-eligibility https://www.nbrc.gov/content/northern-border-region

• Expand access to, coordinate, and improve the quality of basic health care services and associated health outcomes.

• Strengthen the rural health care system as a whole.

Funding Opportunity Goals

• Build new or enhance existing partnerships and strengthen health care networks that serve rural communities within the Northern Border Region.

• Identify strategies for project sustainability after grant funding ends.

Background

HRSA’s Federal Office of Rural Health Policy (FORHP) is the focal point for rural health activities within the U.S. Department of Health and Human Services. FORHP programs provide technical assistance and other activities as necessary to support improving health care in rural areas.

The RNBR-NP Program is authorized by 42 U.S.C. 254c(f) (330A(f) of the Public Health

Service Act). This program enables recipients to use federal funding for the planning and development of integrated health care networks to achieve efficiencies, improve health care services and associated health outcomes, and strengthen the rural health care system.

RNBR-NP helps advance the Making America Healthy Again (MAHA) priorities, which include:

o Preventive health.

o Reducing chronic disease.

o Mental health.

o Nutrition.

o Access to primary and value-based care.

o Appropriate services for tribes.

o Early childhood health and autism support.

Program requirements and expectations

Projects funded through this program must also meet the requirements and expectations outlined in this section.

Legislative aims

The program requires a selection of at least one of the program’s legislative aims. Applicants must select one or more of the following aims:

Aim #1: Achieve efficiencies

Achieve efficiencies through a community health and/or provider needs assessment at the regional and/or local level. Activities may include, but are not limited to:

• Identifying the most critical need of network participants to ensure they can continue operating successfully after the network planning ends.

• Identifying additional participants in the community/region needed for a more collaborative and effective network.

https://www.hrsa.gov/rural-health https://www.hhs.gov/maha/index.html

• Assessing workforce challenges and developing long-term strategies to address workforce needs.

• Identify financial resources available to support and sustain the network services.

• Identifying opportunities and developing plans to strengthen regional systems of care that better meet the unique needs of rural patients and the broader health needs of the community.

Aim #2: Expand access to, coordinate, and improve the quality of basic health care services and associated health outcomes.

Activities may include, but are not limited to:

• Integrating health and human services to improve coordination and access to care to most vulnerable individuals, including those with disabilities. Activities may include coordinated referrals and shared planning between medical providers and social service agencies and partnerships that include community health workers and other community organizations like transportation services, disability support service, etc.

• Developing a plan to expand the role of emergency medical services within the community, including loss of services as a result of hospital closure/conversion and/or readiness to support labor and delivery.

Aim #3: Strengthen the rural health care system as a whole.

Activities may include, but are not limited to:

• Identifying and implementing best practices to integrate care across organizations, including coordination between medical, behavioral, and social services.

• Developing strategies to enhance workforce capacity and retention across the network.

• Identifying ways to encourage cross-organizational collaboration and leadership commitment to improve health outcomes.

• Identifying and establishing ways to obtain regional and/or local community support/buy-in around the development of the network.

• Developing a strategy to leverage broadband connectivity to support health information technology applications and telehealth services in rural communities.

• Establishing mechanisms to monitor and evaluate the network’s impact on regional population health and healthcare access.

• Exploring opportunities to secure funding and resources that support ongoing network operations and service expansion.

Statutory authority

42 U.S.C. 254c(f) (330A(f) of the Public Health Service Act)

Award information

Funding policies and limitations

Changes in HHS regulations https://uscode.house.gov/view.xhtml?req=granuleid:USC-2012-title42-section254c&num=0&edition=2012

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:

o Appropriation of funds.

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

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

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

o Fund more applicants from the rank order list.

o Extend the period of performance.

o Award supplemental funding.

General limitations

• For guidance on some types of costs we do not allow or restrict, see o Project Budget Information in the Application Guide.

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

o 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 beyond the salary rate limit (Executive Level II) is paid with non-HHS funds.

Program-specific statutory or regulatory limitations

You cannot use funds:

• To build or acquire real property.

• For construction.

• To pay for equipment costs not directly related to the award.

• To pay for the direct provision of clinical health services.

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.

https://www.ecfr.gov/current/title-2/part-200 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 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) https://www.hrsa.gov/grants/manage-your-grant

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.

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.

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

o Fund more applicants from the rank order list.

o Extend the period of performance.

o Award supplemental funding.

Step 2: Get Ready to Apply

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.

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)) https://www.ecfr.gov/current/title-2/section-200.307 https://sam.gov/content/entity-registration 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=4

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-26-100.

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

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.

Step 3: Build Your Application

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

Use the Project Narrative Attachment form.

Project Narrative Attachment form.

Yes

◻ Budget narrative Budget Narrative Attachment form.

Yes 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/search-grants https://www.grants.gov/search-grants 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

Use the Budget Narrative Attachment form.

Attachments

Insert each in the Attachments Form in this order.

Component Included in page limit*?

◻ 1. Documentation from State Office of Rural Health No

◻ 2. Documentation from Northern Border Region Commission No

◻ 3. Rural service area Yes

◻ 4. Work plan Yes

◻ 5. Staffing plan and job descriptions Yes

◻ 6. Biographical sketches Yes

◻ 7. Network organizational chart and network participant information Yes

◻ 8. Letters of commitment Yes

◻ 9. Funding preference documentation Yes

◻ 10. Funding priority documentation Yes

◻ 11. EIN/UEI exception request No

◻ 12. Tribal EIN/UEI exception request No

◻ 13. CMS Rural Health Transformation Program details No

◻ 14. Previous grants No

◻ 15. Other relevant document 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.

Disclosure of Lobbying Activities (SF-LLL), optional With application.

Project/Performance Site Location(s) With application.

Budget Information for Non-Construction Programs (SF 424A) With application.

Key Contacts 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 o .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.

Project narrative

Introduction See merit review criterion 1: Need

• Briefly describe the purpose of your project and what you hope to achieve.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=26 o Include the legislative aim(s) you will focus on.

• Give an overview of the eligible rural or partially rural counties you will serve.

o Include a list of all rural counties (or rural census tracts, for partially rural counties) in your target rural service area in Attachment 3.

Need See merit review criterion 1: Need

• Describe the health care needs and related needs (e.g., such as employment, education, income, housing, transportation) of the population residing within your target rural service area.

• Describe the health care service environment, including strengths as well as structural challenges and gaps impacting health care delivery, in your target rural service area.

• Use and cite supporting information from appropriate data sources, such as local, tribal, state, or regional data, whenever possible. You may also use proxy measures or composite indexes of community risk or need.

Approach See merit review criterion 2: Response

• Describe how your proposed project will help meet the health care-related needs of your target rural service area. As part of your response, describe how your proposed project will achieve one or more of the following:

o Increase access to quality health care services.

o Improve access across the full continuum of care.

o Serve rural populations within the service area.

• Tell us how you’ll meet the two funding opportunity goals and all program requirements and expectations described in this NOFO.

• Explain how your project will build from, but does not duplicate, other federal, regional, state, local or tribal programs.

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

• Give an overview of the specific activities you will implement during the period of performance to successfully execute your proposed project and meet the two funding opportunity goals.

o Provide a high-level timeline that includes when each planned activity will occur.

o As needed, identify how activities will inform or build on each other.

o Identify which organization(s) or individual(s) will lead each activity.

• You will also include a more detailed work plan in Attachment 4.

Resolving challenges See merit review criterion 2: Response

• Discuss possible challenges you may face in designing and carrying out the activities in the work plan.

o Explain how you will resolve them.

o Include how you will adapt to changes and new information you gather during the project.

Performance Management See merit review criterion 3:Performance reporting and evaluation

• Describe how you will work with network participants to collect and report information to HRSA accurately and on time.

• Describe how you will ensure appropriate plans and procedures are in place to manage and securely store data, including how you will protect data against cybersecurity threats, breaches, or other loss of data integrity.

• Describe how you will monitor and analyze performance data/information to continually improve your program. This includes helping the network set shared goals and using data to guide its activities.

See the reporting section for more information and for performance measure requirements.

Sustainability See merit review criterion 4: Impact

Propose a plan for project sustainability after the period of federal funding ends.

• Describe the actions you’ll take to obtain future sources of funding.

• Discuss challenges that you’ll likely encounter in sustaining the program. Include how you will resolve these challenges.

Organizational information See merit review criterion 5: Resources and capabilities

Applicant Organization

• Provide a brief overview of your organization that includes:

o Current mission.

o Structure, leadership, size of organization, and staffing.

o Scope of relevant current and past activities.

o Connection to and ability to serve the target rural northern border region service area.

o Ability to manage the project and associated personnel.

o Financial practices and systems in place to ensure your organization can properly account for and manage federal funds.

• Explain how these details relate to your capacity to lead the proposed project.

Network Participants

• Give an overview of current or proposed network participants and your planned network structure. Include:

o Why the network participants were selected and what each will contribute to the project.

o How your network will meet the requirement that no less than 66% of network participants are physically located (either the headquarters or a satellite site) in a qualifying HRSA-designated rural area within the Northern Border Region.

o How you will ensure that network participants have demonstrated experience serving, or capacity to serve, high-need rural populations.

• Include a detailed table of your proposed project's network participants with one letter of support from each network participant (not including the applicant organization) in

Attachment 7.

o Your network MUST include no less than three network participants, including the applicant organization.

• Describe how you will ensure that network participants and other relevant community stakeholders are engaged and actively participating throughout the project.

Key Personnel and Staffing

• Describe your plan to adequately staff the project.

o Include details of each position in Attachment 5.

o For each staff member reflected in your staffing plan, provide a brief biographical sketch in Attachment 6 that clearly demonstrates each staff member has appropriate experience for their role(s) on the project.

o If staff fulfill more than one role, describe why this is needed and how you will make sure they meet all relevant expectations.

o You must identify a project director for your proposed project.

• Briefly describe how you will manage the project team and ensure work is done effectively and efficiently.

o For positions that are currently vacant, describe your interim staffing plan for these positions, including your plan to quickly fill the position(s) if awarded.

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).

https://data.hrsa.gov/topics/rural-health/rural-health-eligibility https://www.nbrc.gov/content/northern-border-region 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)

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.

• Travel: You must budget travel funds for one program staff to attend a one-and-a-half-day program meeting at a location to be determined (within one of the four Northern

Border Region states or in Washington, D.C.) and include the cost of this as a budget line item.

o To determine estimated travel costs refer to the U.S. General Services

Administration (GSA) per diem rages for FY 2026. Per diem rates can be found on the GSA’s website.

o You may also propose travel for additional meetings and conferences that are directly related to the purpose of the program and will complement your project’s objectives.

• Legal costs: Legal costs that exceed 20% of the total award amount may be considered unreasonable and unallowable. Legal costs include services and activities such as consultations, 501(c)(3) application preparation, and development of articles of incorporation and by-laws.

• Contractual: Consistent with 2 CFR 200, you must provide a clear explanation of the purpose of each contract, how the costs were estimated, and the specific contract deliverables.

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

Guide.

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: Documentation from State Office of Rural Health Include a copy of the State Offices of Rural Health (SORH)’s response to your letter or a letter/email you sent to your SORH notifying them of your intent to apply for this grant funding.

All applicants are required to notify their State Offices of Rural Health (SORH) in the application process to advise them of their intent to apply.

Attachment 2: Documentation from Northern Border Region Commission Include a copy of the Northern Border Region Commission (NBRC)’s response to your letter or a letter/email you sent to the NBRC notifying them of your intent to apply for this grant funding.

https://www.gsa.gov/travel?gsaredirect=travel-resources https://www.gsa.gov/travel?gsaredirect=travel-resources https://plus.nosorh.org/Web/Membership/Directory/State_Members_List.aspx https://www.nbrc.gov/content/hrsa

All applicants are required to notify the NBRC in the application process to advise them of their intent to apply.

Attachment 3: Rural service area You must identify a target rural service area that includes only counties and/or census tracts that are qualifying eligible HRSA-designated rural areas AND located in the Northern Border

Region. Include:

• State.

• County name.

• Census tract identifiers.

o Only include for HRSA-designated rural census tracts within urban counties.

Attachment 4: Work Plan Attach your project’s work plan. This attachment is required and is expected to align with your project narrative.

The work plan must:

• Outline the individual or organization responsible for carrying out each activity.

• Include a timeline for the period of performance. The minimum timeline increment is by quarter.

We recommend using a table format with these headings:

• Goals/objectives.

• Key action steps.

• Activities.

• Outputs, data sources, and program assessment methods. These might include the direct products or deliverables of program activities and how you will assess them.

• Outcomes and measurements. These might include the result of a program, typically describing a change in people or system.

• Person and/or organization responsible.

• Projected completion date.

Attachment 5: Staffing plan and job descriptions Key personnel are individuals who receive funds from this award or person(s) conducting activities central to this program.

Provide a staffing plan that includes information for each key personnel using a table format.

Responses are expected to align with your project narrative and include:

• Name (if not yet hired, state “TBH”)

• Job title (e.g. project director)

• Organizational affiliation.

• Full-time equivalent (FTE) devoted to the project o You cannot bill more than 1.0 FTE for the same person across federal awards.

o Explain your reasons for the amount of time you request for each staff position.

https://data.hrsa.gov/topics/rural-health/rural-health-eligibility

• List of roles and responsibilities for the project.

• Timeline and process for hiring and onboarding, if applicable.

Attachment 6: Biographical sketches Key personnel are individuals who would receive funds from this award or person(s) conducting activities central to this program.

Include biographical sketches for people who will hold the key positions, including the project director, you describe in Attachment 5.

• Biographical sketches should be no more than two pages.

• Do not include non-public, 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 7: Network organizational chart and network participant information

• Provide a one-page network organizational chart.

• Provide a list of all network participants that includes:

o The organization’s name and type (such as a community health center, hospital, or health department).

o The organization’s physical address. This will be the address used to determine qualifying eligible HRSA-designated rural status and confirm location in the

Northern Border Region.

o The name(s) of the key personnel from the organization who will be working on the program.

o Brief description of the organization’s anticipated role in the proposed project.

o Organization’s EIN/UEI, unless the applicant is a tribe or requests a multiple

EIN/UEI exception.

• Provide screenshots from the rural health grants eligibility analyzer for each organization to demonstrate that no less than 66%, or two-thirds, of network participant organizations are physically located in a qualifying eligible HRSA-designated rural area and located in the Northern Border Region.

Attachment 8: Letters of commitment You must provide a scanned, signed copy of a letter of commitment from each network participant.

• The applicant organization does not need to submit a letter of commitment.

• Each network participant should provide a separate letter.

• Letters of support must include:

o The organization’s expected role(s) and responsibilities for the project.

o The activities each organization will be included in.

o How the organization’s expertise is relevant to the project.

o A brief description of the organization’s ties to the target rural service area.

o The address, including city, state and zip code, of the organization.

o If the participant has a location in the target rural service area, also provide that address.

Attachment 9: Funding preference documentation Provide documentation based on the funding preference you are requesting to be considered to qualify for.

• Refer to funding preferences to see whether you qualify and what information you need to include.

• We recommend that you use this statement:

“[Your organization name] qualifies for the [Name which funding preference(s) you qualify for] funding preference because [insert rationale here], for example, Applicant Organization Y is located in a designated HPSA.”

If you are not requesting consideration for a funding preference, include a statement explicitly stating this.

• Applications that do not include documentation in this attachment for a qualifying funding preference will not be considered to receive a funding preference.

• Funding preferences are either met or not met. Additional credits are not given if an applicant requests and qualifies for more than one funding preference.

Attachment 10: Funding priority documentation Submit only if applicable.

If you are requesting consideration for the New HRSA Federal Office of Rural Health Policy

(FORHP) Funding Priority, you must:

• Provide an attestation statement verifying your organization has not been a direct recipient of FORHP grant or cooperative agreement funding.

• Include your organization’s full business name, address and associated EIN/UEI number in your attestation statement.

If you are not requesting consideration for this funding priority, omission of this attachment will assume you are not requesting consideration, and you will not receive any points for this funding priority.

We will review your attestation statement to assess your organization’s qualifications for receiving this funding priority. Provision of an attestation statement in this attachment does not guarantee you will qualify to receive this funding priority.

Attachment 11: EIN/UEI exception request

Submit only if applicable.

Generally, you cannot apply for multiple projects using the same UEI (previously DUNS) number and/or EIN. In response to growing trends towards consolidation within the rural health care industry, and the possibility that multiple organizations may share the same UEI and/or EIN with one parent organization, we may allow separate applications associated with a single UEI or

EIN, if you provide the following to us in this attachment:

• Names, street addresses, EINs, and/or UEI numbers of your organizations.

• Name, street address, EIN, and/or UEI number of the parent organization.

• Names, titles, email addresses, and phone numbers for points of contact at each of your organizations and the parent organization.

• Proposed HRSA-26-100 service areas for each of your organizations.

• Assurance that the organizations will each be responsible for the planning, program management, financial management, and decision-making of their respective projects, independent of each other and the parent organization.

• Signatures from the points of contact at each of your organizations and the parent organization.

A single organization or parent organization cannot submit multiple applications even if the projects are different. If the parent organization applies using the legal and/or “doing business as” name of the parent or satellite sites, it is still considered an application submitted by the parent organization and will not be allowed.

Applications associated with the same UEI number or EIN should be independently developed and written. We reserve the right to deny this request if you provide insufficient information or if we receive nearly identical application content from organizations using the same EIN or UEI.

Attachment 12: Tribal EIN/UEI exception request Submit only if applicable.

For tribal exceptions requests, include:

• Names, titles, email addresses, and phone numbers for points of contact at your organization and network participant organizations.

• Justification for multiple applications from the network participant organizations under the same EIN and/or UEI.

o For example, unique focus area or services provided, or a lack of other applicant organizations.

Attachment 13: CMS Rural Health Transformation Program details Submit this attachment only if you participate in or benefit from your state’s CMS Rural Health

Transformation Program. Reviewers will not consider this information during merit review.

• If it applies, describe the CMS-supported activities that you participate in or benefit from.

• Clearly explain how the proposed HRSA-funded work is non-duplicative, coordinated, and complementary to the CMS-supported work

Attachment 14: Previous grants Submit only if applicable.

Provide a list of the applicant organization’s previous HRSA grants within the last five years.

Include the grant number for each.

If you are requesting consideration for this NOFO’s funding priority, you are required to provide as part of this attachment:

• A verifying statement that describes why previous grant awards cited in this attachment do not disqualify you for this NOFO’s funding priority: New to HRSA Federal Office of

Rural Health Policy Funding.

Attachment 15: Other relevant documents Optional. If you need to provide more details about your proposal, you can provide other documents in this attachment.

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.

Disclosure of Lobbying Activities (SF-LLL), optional With application.

Project/Performance Site Location(s) With application.

Budget Information for Non-Construction Programs (SF 424A) With application.

Key Contacts With application.

Form instructions The application guide has detailed instructions for:

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

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

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 legislative aim(s) you will focus on.

• Include a basic description of your target rural service area and the population you plan to serve.

When writing your summary:

• Use 4,000 characters or fewer.

• Make sure it’s clear, accurate, 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.

Important: Public information https://grants.gov/forms/forms-repository/sf-424-family https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=8 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 https://grants.gov/learn-grants/grant-terminology#p http://www.usaspending.gov/

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.

Step 4: Understand Review, Selection, and Award

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. The members use these criteria.

Criterion Total number of points = 100

1. Need 45 points

2. Response 20 points

3. Performance reporting and evaluation 5 points

4. Impact 10 points

5. Resources and capabilities 15 points

6. Support requested 5 points

Criterion 1: Need (45 points) See the project narrative Introduction and Need sections.

The panel will review your application for how clearly it:

Goals

• Describes the purpose and goals of the proposed project.

• Details project goals that align with the selected legislative aim(s).

• Identifies a proposed target rural service area aligned to proposed project goals and information provided in Attachment 3.

Need https://www.usaspending.gov/ https://www.hhs.gov/sites/default/files/hhs-writing-award-descriptions.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=32

• Describes the health care needs and related needs (e.g. factors such as employment, education, income, housing and transportation) of the people living in the target rural service area.

• Describes the health care service environment, including strengths and structural challenges and service gaps impacting health care delivery, in the target rural service area.

• Accurately incorporates and cites information from appropriate data sources, such as local, tribal, state or regional data whenever possible.

Criterion 2: Response (20 points) The panel will review your application for how well it:

• Logically explains how the project will meet the two funding opportunity goals and all program requirements described in this NOFO.

• Provides a detailed, realistic and effective work plan.

• Identifies anticipated challenges carrying out work plan activities and proposes effective approaches to resolve those challenges.

• Accurately integrates relevant data into the responses.

Criterion 3: Performance reporting and evaluation (5 points) See the project narrative Performance management section.

The panel will review your application for the strength of your plan to:

• Work with network participants to collect and report information to HRSA accurately and on time.

• Monitor and analyze data/information to continually improve your program.

Criterion 4: Impact (10 points) The panel will review your application for:

• How likely the proposed project will have a positive impact on the health care-related needs of the target rural service area.

• How strongly the work plan aligns with the…