ToRCH Care Smart Growth and Service Line Modification (Horizon 2) Invitation For Bid

Summary

the Rural Health Transformation Program (RHTP). This initiative, funded 100% by CMS/HHS, supports rural hospitals and health centers in Missouri to modernize, renovate, reconfigure, or equip existing facilities to expand or sustain capacity in priority service lines: (1) maternal health infrastructure (obstetric, perinatal, prenatal, postpartum, and women's health); (2) behavioral health infrastructure (inpatient, outpatient, crisis, tele-behavioral health, integrated behavioral health); (3) diagnostics, outpatient care, and chronic disease management infrastructure (imaging, laboratory, specialty consults, care coordination, longitudinal management). Projects must serve counties designated as rural by Missouri's RHTP, address documented service-line gaps, demonstrate readiness for implementation, and support sustained access beyond the funding period. Proposed activities must be limited to modernization projects within an existing facility footprint—no new construction or major expansions are allowed. Horizon 2 seeks to support infrastructure improvements outside routine operations, direct service delivery, or general administrative costs. All awards are contingent upon CMS approval and adherence to RHTP, DSS, and MO HealthNet Division requirements. The maximum award per proposal is $5,000,000. Total anticipated available funding is $40 million for this round, subject to CMS budget approval. A 25% cost share is required unless hardship documentation qualifies applicants for a waiver. Application requirements, eligibility criteria, submission formats, evaluation criteria, and all attachments are detailed in the official IFB and amendments.

Eligibility

Eligible applicants include: (a) hospitals licensed under Missouri law, such as general hospitals, Critical Access Hospitals, Rural Emergency Hospitals, safety-net hospitals, hospital-based outpatient departments, and county-/city-owned hospitals; (b) health centers as defined in the IFB, including Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Certified Community Behavioral Health Clinics (CCBHCs), Behavioral Health Clinics (BHCs), Certified Community Mental Health Centers (CMHCs), birthing centers, urgent care centers, primary care centers, and other qualifying access-to-care organizations; (c) hospital- or health center-affiliated entities applying on behalf of eligible facilities; and (d) public, nonprofit, and qualifying private entities meeting program requirements. Projects must serve RHTP-designated rural counties as specified in the IFB and Glossary; proposals from or serving excluded counties (Boone, Cass, Clay, Cole, Greene, Jackson, Jefferson, Platte, St. Charles, St. Louis, and St. Louis City) are not eligible.

Requirements Checklist

• Each eligible entity may submit only one application unless granted an exception.
• Projects must directly address one or more Horizon 2 priority service lines: maternal health, behavioral health, or diagnostics/outpatient/chronic disease management.
• Projects are restricted to modernization, renovation, reconfiguration, or equipment within existing physical footprints; no new construction or major expansions are allowed.
• All proposals must serve at least one RHTP-designated rural county.
• The maximum request is $5,000,000 per proposal; anticipated program total is $40 million.
• Applicants must provide a 25% cost share unless a hardship waiver is granted and evidenced.
• All required exhibits and certifications must be submitted: Technical Methodology/Work Plan (Exhibit A/A-1/A-2), Past Performance (Exhibit B), Hospital Information (Exhibit C), Budget Narrative (Exhibit D), and Exhibits 1–5 as detailed in IFB Section 6.
• Projects must be implementation-ready within one month of award and completed by September 30, 2028; funding for activities after September 30, 2027 is contingent on additional CMS approval.
• Funding may not supplant or duplicate other sources; ineligible costs include new construction, routine administrative/operating costs unrelated to the project, food, and non-healthcare equipment.
• Proposals demonstrating clear rural access gaps, regional/multi-county impact, strategic partnerships, and sustainable business plans will receive higher consideration.
• All projects must comply with applicable state and federal compliance and reporting requirements. Full requirements and definitions are provided in IFB Sections 2–6.

Required attachments

• Exhibit A: Technical Bid – Proposed Methodology, Approach, and Work Plan
• Exhibit A-1: Project Impact Narrative
• Exhibit A-2: Team Qualifications / Organizational Staffing Capacity
• Exhibit B: Technical Bid – Past Performance
• Exhibit C: Contractor Hospital Information
• Exhibit D: Contractor Budget and Budget Narrative
• Exhibit 1: Business Entity Certification, Enrollment Documentation, and Affidavit of Work Authorization
• Exhibit 2: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
• Exhibit 3: Miscellaneous Information
• Exhibit 4: Registration of Business Name with Missouri Secretary of State
• Exhibit 5: Anti-Discrimination Against Israel Act Certification

Submission Instructions

Submit a complete proposal by email to dirk.elrod@dss.mo.gov by September 1, 2026, 2:00pm Central Time, including all required exhibits and certifications per IFB Section 6. Refer to https://dss.mo.gov/bids/files/ifb-DSS26015-ToRCH-Care-Smart-Growth-and-Service-Line-Modification.pdf for full instructions.

Source Documents

Change History

1. AmendedOct 10, 2026
2. AmendedOct 10, 2026
3. AmendedOct 10, 2026
4. AmendedOct 5, 2026
5. AmendedOct 5, 2026
6. AmendedOct 5, 2026
7. AmendedSep 28, 2026
8. AmendedSep 28, 2026
9. AmendedSep 24, 2026
10. AmendedSep 24, 2026
11. AmendedSep 21, 2026
12. AmendedSep 21, 2026
13. AmendedSep 21, 2026