Growing Rural Opportunities for Well-being (GROW) Regional Grants Program

The Growing Rural Opportunities for Well-being (GROW) Regional Grants Program is a major initiative under Indiana’s Rural Health Transformation Program (RHTP), a federally funded effort supported by the Centers for Medicare & Medicaid Services (CMS) and administered in partnership by the Indiana Department of Health (IDOH) and Family and Social Services Administration (FSSA). This five-year program is designed to transform healthcare access, infrastructure, and outcomes in Indiana’s rural communities. With an initial allocation of $206.9 million awarded to the state, $120 million is designated for the GROW Regional Grants in Budget Period 1, distributed across eight designated rural regions. The purpose of the GROW program is to enable regional coalitions—comprising rural hospitals, federally qualified health centers, behavioral health providers, and other stakeholders—to design and implement local solutions to pressing rural health challenges. These include chronic disease management, maternal and infant health, access to care, technology gaps, and workforce shortages. Applicants must align initiatives with one or more of five core funding categories: Technology Innovation, Sustainable Access, Innovative Care, Workforce Development, and the "Make Rural Indiana Healthy Again" pillar, which emphasizes outcomes-driven interventions. The program prioritizes collaboration across regions and sectors. Each region must submit a single, unified application representing a coordinated strategy and budget across all participating organizations. These applications must include detailed templates: a needs assessment, logic models, a two-year workplan, full budget workbooks, and a narrative response. Each proposed initiative must demonstrate alignment with the state’s Key Performance Objectives (KPOs), including reducing preventable emergency department visits, expanding telehealth access, and improving maternal and chronic care outcomes. GROW funds cannot be used for construction or supplanting existing funding. However, allowable costs include minor renovations, workforce training, new access points for care, and strategic technology investments such as EMR upgrades (within caps). Administrative costs are capped at 10% of the proposed budget, and indirect costs are not allowed. Funding will be disbursed via reimbursement to Primary Subrecipients—identified entities responsible for executing the approved initiatives. Each region may designate multiple subrecipients, and each subrecipient will sign a formal grant agreement with the state. Letters of Intent must be submitted by May 1, 2026, and full applications are due by July 1, 2026. The grant agreement period will begin on September 1, 2026. Applications will be evaluated based on both base allocation metrics (population size, access to care, and health indicators) and proposal strength (clarity of strategy, measurable outcomes, and sustainability). Final funding decisions will be made by the State Executive Oversight Committee in consultation with CMS. Throughout the five-year period, the State of Indiana will maintain oversight of program implementation, supported by the Regional Grant Technical Assistance Network. Each region will work closely with these providers to submit required reports, track progress toward outcomes, and maintain compliance. Transparency and accountability are emphasized, with public dashboards and quarterly reviews informing ongoing adjustments. The overarching goal is to ensure that rural Hoosiers benefit from sustainable, high-quality, community-informed care solutions long after the grant concludes.

Must align with KPOs; demonstrate sustainability; avoid program duplication; administrative and capital costs capped; indirect not allowed.