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

The Growing Rural Opportunities for Well-being (GROW) Regional Grants Program is a five-year initiative launched by the State of Indiana through the Indiana Department of Health (IDOH) and the Family and Social Services Administration (FSSA) as part of Indiana’s Rural Health Transformation Program (RHTP). Fully funded by the Centers for Medicare & Medicaid Services (CMS), the program aims to improve health outcomes and access to care in Indiana’s rural communities by empowering regional coalitions to identify local needs and implement data-driven, community-informed initiatives. The GROW Regional Grants are rooted in the philosophy that rural communities are best equipped to design and execute effective solutions for their unique challenges. The initiative allocates $600 million over five budget periods, beginning with an anticipated funding release on September 1, 2026. Each of Indiana’s eight rural regions will receive funding, with allocations based on regional population, healthcare access needs, and health indicators. An application process led by certified Regional Coalitions will determine competitive funding beyond base allocations. These applications must include a needs assessment, logic models, implementation workplans, budget documents, and a comprehensive initiative narrative. Applications are due July 1, 2026, with Letters of Intent required by May 1, 2026. A technical assistance period from March to July 2026 will support coalition formation and proposal development. Eligible applicants include a wide range of healthcare providers and community organizations, such as rural hospitals, FQHCs, community-based organizations, and local health departments. Applicants must form unified Regional Coalitions representing their counties and submit a single collaborative application. Each coalition will designate Primary Subrecipients to receive and administer funds. The program emphasizes collaboration, coordination, and sustainability, with clear expectations for long-term impact and post-grant viability. Funding is available for activities falling within five categories: Tech Innovation, Sustainable Access, Innovative Care, Workforce Development, and the Make Rural Indiana Healthy Again initiative. Regional applications must align proposed initiatives with at least one of these categories and address three key health outcomes: pre/postnatal care, chronic disease management, and access-related needs such as transportation and food. Initiatives must demonstrate alignment with state Key Performance Objectives (KPOs), including data interoperability, system integration, telehealth expansion, and chronic disease metrics. Allowable uses of funds include programmatic costs tied to approved initiatives, moderate facility renovations, technology enhancements, and administrative costs (up to 10% of the regional budget). Unallowable expenses include new construction, duplicative provider payments, and indirect costs. All activities must be rural-serving and compliant with CMS funding guidelines. Indiana provides strict cost caps for capital and EMR expenditures per region, and grants are structured as reimbursements rather than upfront disbursements. The application review process consists of two components: base funding allocation and evaluation scoring. Regional awards are determined by a weighted formula and qualitative review of application components. Final funding determinations and subrecipient agreements are expected by September 1, 2026. Ongoing oversight will be provided by the IDOH Regional Grant Initiative Team in partnership with the State Executive Oversight Committee and the GROW State Steering Committee. Participating regions are expected to submit regular updates, track performance metrics, and coordinate with state initiatives and technical assistance providers throughout the grant term. The program’s overarching goal is to transform Indiana’s rural health systems through durable partnerships, evidence-based interventions, and strategic investments in care access and infrastructure. By engaging a broad coalition of stakeholders and emphasizing sustainability, the GROW Regional Grants aim to create measurable, lasting improvements in rural health outcomes.

Clearly demonstrate stakeholder alignment, directly link needs assessment to outcomes, and provide a strong sustainability plan.