Rural Health Transformation Program Grant Opportunities

NC ROOTS Hub Lead Request for Applications

NCDHHS is seeking applications from qualified organizations to serve as designated ROOTS Hub Leads for the North Carolina Rural Health Transformation Program (NCRHTP). This opportunity is designed to support NCDHHS’ efforts to transform rural health care delivery, strengthen local systems, and improve health outcomes for nearly 3 million rural North Carolinians.

Public Notice: NCDHHS Requests Applicants for NC Rural Health Transformation ROOTS Hub Leads 

About the NC ROOTS Hubs

NC ROOTS (Rural Organizations Orchestrating Transformation for Sustainability) Hubs are regional, locally governed networks that coordinate services and lead implementation of NCRHTP initiatives. Working with community partners, each Hub will help advance efforts across primary care, behavioral health, workforce development, value-based payment, and digital health—tailoring strategies to the unique needs of their region.

Eligibility and Scope

Up to six organizations will be selected, one for each North Carolina Medicaid region. Applicants must demonstrate the infrastructure, knowledge, experience, and capacity to serve as both the programmatic and fiduciary lead for their region, guiding a partner network to successfully implement NCRHTP initiatives.

How to Apply

Interested organizations are encouraged to review all RFA materials, including:

  • The full Request for Applicants (RFA) documents below, which outline eligibility requirements, expectations and application instructions.
  • The ROOTS Hub Leads RFA webinar provides an overview and context for the NC ROOTS Hubs' core functions.

Documents

Application Deadline

Applications must be submitted by 5 p.m. EST on April 2, 2026.

Program Background

RHTP was established under H.R. 1, a federal reconciliation bill enacted in July. The program provides one-time federal funding to support states in strengthening rural health care access, quality, and outcomes. Through RHTP, NCDHHS is investing in innovation, infrastructure, partnerships, and workforce development to help transform rural health care delivery systems.

For more information about the program, visit the North Carolina Rural Health Transformation Program webpage.

Stevens Amendment Disclosure: 213,008,356.47 or 100% of the total costs of the North Carolina Rural Health Transformation Program in budget period 1 are funded with Federal funds, including awards anticipated under this RFA; $0 or 0% of the total cost of this program is funded by non-governmental sources. This disclosure is provided in accordance with the Stevens Amendment (Section 505, Division H of Consolidated Appropriations Act, 2021, Public Law 116-260).

Off