HHS Region 4 · NC Department of Health and Human Services (NCDHHS) Office of Rural Health
Program Overview
The NCRHTP supports rural communities by empowering regional ROOTS Hubs to coordinate care, implement innovative initiatives, and address local needs across primary care, behavioral health, workforce development, value-based payment, and digital health. Up to six ROOTS Hub Leads, one per Medicaid region, are being selected to guide partner networks and advance the program. Nearly 3 million rural North Carolinians stand to benefit from strengthened access, quality, and outcomes through federal investments in rural health. Current structured plan tracks 8 key initiatives and 6 strategic goals.
Updated
County-level estimates averaged across North Carolina — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
pp = percentage points vs US county average
County Drilldown (100)
| County | Pop | Poverty | Uninsured |
|---|---|---|---|
| Wake County | 1,178,653 | 8.1% | 5.1% |
| Mecklenburg County | 1,154,681 | 10.4% | 7.4% |
| Guilford County | 547,940 | 14.6% | 10.3% |
| Forsyth County | 389,977 | 14.5% | 10.1% |
| Cumberland County | 338,545 | 16.7% | 13.3% |
| Durham County | 332,353 | 11.5% | 7.6% |
| Buncombe County | 274,360 | 11.8% | 6.4% |
| Union County | 250,958 | 7.7% | 5.6% |
| Cabarrus County | 236,133 | 9.3% | 6.8% |
| New Hanover County | 235,229 | 12.3% | 7.5% |
| Gaston County | 234,881 | 13.5% | 10.0% |
| Johnston County | 234,263 | 10.6% | 7.6% |
AI source: NC - 2026 - Direct file link
AI auto-updated Jun 16, 2026
API refreshed May 7, 2026
Centers for Medicare & Medicaid Services (CMS)
Grouped files
2 related documents
NC - 2026 - CMS RHTP 50-State Spotlight (FY2026) — North Carolina
2,196,327 rural residents
North Carolina received over $213 million from CMS for the Rural Health Transformation Program and has selected regional Hub Lead organizations. The state issued RFA# 2026-NCROOTS for six NC ROOTS Hub Leads, with awards announced on May 1, 2026 and contracts now being finalized; regional needs assessments will begin soon. This signals active state-level procurement and transition to implementation. Core digital health and workforce initiatives are about to commence through these selected organizations. State opportunities: 1 active (1 closing soon, 2 past/closed), $7.9M listed funding. Key opportunities: North Carolina Minority Diabetes Prevention Program – Region 8: RHT Grant FY 2026; NC ROOTS Hub Leads — Rural Health Transformation Program; NC Mobile Integrated Health (MIH) and Community Paramedicine Program Grant. Strategy alignment: supports prevention, care access, workforce priorities.
North Carolina’s Rural Health Transformation Program (RHTP) establishes regionally governed NC ROOTS Hubs that integrate medical, behavioral health, and social services, expand chronic disease prevention, and leverage advanced digital health technologies. Each Hub uses a local needs assessment to tailor workforce initiatives, prevention programs, and care models, ensuring alignment with community priorities and supporting value-based payment transformation. The statewide strategy prioritizes care coordination, workforce development, digital innovation, and targeted programs for underserved rural populations.
Model
Community-Rooted Care Networks coordinated by NC ROOTS Hubs, integrating clinical, behavioral, social, workforce, and technology strategies for comprehensive rural health transformation.
Key Initiatives
Timeline: Five-year plan (2026–2031): ROOTS Hub leads awarded and contracts finalized June 2026; needs assessments, network formation, and phased initiative deployment through 2031, with ongoing monitoring and adjustment.
Chronic Disease Prevention: Programs for diabetes, hypertension control, cancer screening, and maternal health services are being expanded with nutrition support solutions such as 'food as medicine' initiatives. (Regions: Statewide, Robeson County, Madison County, Bertie County, Dare County)
Behavioral Health: Expansion includes mental health and substance use disorder services, new clinics, mobile crisis teams, and school-based programs with primary care integration. (Regions: Statewide)
Workforce Development: Focus on training, retaining healthcare professionals via rural residency programs and incentives to address provider shortages and create rural jobs. (Regions: Statewide)
NC - 2026 - North Carolina RHTP Award Announcement
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North Carolina Department of Health and Human Services, Office of Minority Health and Health Disparities
Due Jul 7, 2026
11 related documents
NC - 2026 - NC Minority Diabetes Prevention Program (Region 8) RFA
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NC - 2027 - North Carolina Rural Hospital Flexibility Grant RHTP Announcement
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NC - 2027 - NC RHTP Project Summary
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NC - 2025 - North Carolina Rural Health Transformation Application
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NC - 2026 - Public Notice: NC ROOTS Hub Leads RFA
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NC - 2026 - RFA: NC ROOTS Hub Leads
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NC - 2026 - Rural Organizations Orchestrating Transformation for Sustainability (ROOTS) Hub Leads
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NC - 2026 - NC RHTP Frequently Asked Questions
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NC - 2026 - RHTP Grant Opportunities
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NC - 2026 - NCDHHS Selects NC ROOTS Hub Leads (Press Release)
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NC - 2026 - CMS RHTP 50-State Spotlight (FY2026) — North Carolina
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NC Office of Emergency Medical Services (NC OEMS)
Due May 20, 2026
8 related documents
NC - 2026 - NC Mobile Integrated Healthcare Request for Application Competitive Grant Funding
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Due Apr 2, 2026
3 related documents
NC - 2026 - NC ROOTS Hub Lead RFA# 2026-NCROOTS
NC - 2026 - RHTP Grant Opportunities
Upcoming Oklahoma RHTP engagement opportunities with webinar and in-person events. Event schedule: - 96 Welcome to NC's Rural Health Transformation Program newsletter Campaign URL Copy Twitter 0 tweets Subscribe Past Issues RSS Translate English العربية Afrikaans беларуская мова български català 中文(简体) 中文(繁體) Hrvatski Česky Dansk eesti keel Nederlands Suomi Fran ais Deutsch ή हिन्दी Magyar Gaeilge Indonesia íslenska Italiano 日本語 ភាសាខ្មែរ 한국어 македонски јазик بهاس ملايو Malti Norsk Polski Portugu s Portugu s - Portugal Rom nă Русский Espa ol Kiswahili Svenska עברית Lietuvių latviešu slovenčina slovenščina српски தமிழ் ภาษาไทย Türkçe Filipino украї́нська Tiếng Việt June 15, 2026 update from the NC Department of Health and Human Services View this email in your browser --> Monday, June 15, 2026 Welcome to the NCRHTP Newsletter The North Carolina Rural Health Transformation Program (NCRHTP) is a statewide initiative supported by $213 million in federal funding approved by the U.S. Centers for Medicare Medicaid Services, designed to address longstanding challenges in rural health care, including workforce shortages, hospital sustainability and gaps in access to mental health and primary care services. The program will support more than 400 rural health facilities and bring hundreds of millions of dollars in federal investment to the state over the next five years. North Carolina has the second-largest rural population in the U.S., with more than 3.5 million residents living in rural areas. This program, led by the North Carolina Department of Health and Human Services, reflects the department’s commitment to ensuring that every North Carolinian, no matter where they live, has access to high-quality health care. Learn more about the NCRHTP program. --> In Case You Missed It North Carolina's Rural Health Transformation Program has been hard at work since the initial funding announcement in late December. Here's a short recap of major activities to date: Press release: North Carolina Awarded $213 Million for Rural Health Transformation Program; Strategic roadmap and federal investment to improve health in rural communities Press release: NCDHHS Selects NC ROOTS Hub Leads to Strengthen Rural Health Care Across North Carolina Learn more about the Lead organizations on the NC ROOTS Hubs webpage Press release: NCDHHS Announces $10 Million for EMS Workforce Through NC Rural Health Transformation Program --> Join Our Next Webinar Join us as we provide a virtual community and stakeholder update on North Carolina's Rural Health Transformation Program on Wednesday, June 24, 2-3 p.m. Representatives from our newly selected NC ROOTS (Rural Organizations Orchestrating Transformation for Sustainability) Hub Lead organizations will provide introductions and share next steps as we work together to improve health care for rural North Carolinians and their communities. Registration is required. Sign up via Zoom . --> Meet NC's Rural Health Transformation Program Director In April, the North Carolina Department of Health and Human Services announced Maggie Woods as the Rural Health Transformation Program Director to lead North Carolina’s effort in transforming health care and access for more than 3.5 million rural North Carolinians. Woods comes from a background of public service and formerly served as director of the NC Department of Information Technology’s Office of Digital Opportunity, where she led efforts to close the state’s digital divide. "I am honored to join NCDHHS and work with the team to build a stronger, more connected health system that meets the needs of today while preparing for the future," said Maggie Woods. "I grew up in rural America, and I understand first-hand many of the healthcare challenges facing rural communities. This program represents an opportunity to strengthen health systems, expand access to care and ensure that everyone across our state has the opportunity to achieve their best health." --> Stevens Amendment Disclosure: This newsletter is supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $213,008,356.47 with 100% funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government. You're receiving this email because you subscribed to receive updates from the NC Department of Health and Human Services Unsubscribe - Subscription Preferences Josh Stein , Governor | Dr. Devdutta Sangvai, Secretary Our mailing address is: NCDHHS, 2001 Mail Service Center, Raleigh , NC 27699 This email was sent to p2p4.ai@gmail.com why did I get this? unsubscribe from this list update subscription preferences NCDHHS 2001 Mail Service Ctr Raleigh, NC 27699 USA
NCRHTP launched with $213M to support over 400 rural health facilities, addressing workforce shortages, hospital sustainability, and access gaps. NC selected ROOTS Hub Lead organizations to guide transformation. EMS workforce funding announced. Key contacts: Maggie Woods Event schedule: - NCRHTP Webinar - 06/24/2026 - 2:00 PM ET - ZoomGov webinar link
North Carolina was awarded more than $213 million in federal funding through the Rural Health Transformation Program. The state has the second-largest rural population in the U.S., with nearly 3 million people living in rural areas.
This RFA solicits applications to deliver an evidence-based Diabetes Prevention Program in nine rural counties of North Carolina, focusing on racial/ethnic minorities and underserved groups. The goal is to screen at least 165 residents for prediabetes, enroll a minimum of 50 participants in a CDC-approved 12-month lifestyle class, and ensure at least 60% of those served are minorities. The program is 100% federal-funded through the CMS Rural Health Transformation Grant with a $195,000 budget for the initial year. Key contacts: DeNita Nash OMHHD@dhhs.nc.gov Event schedule: - Written Questions Due - 06/29/2026 - ET - Application Deadline - 07/07/2026 - 5:00 PM ET - OMHHD@dhhs.nc.gov - Period of Performance Start - 08/01/2026 - Period of Performance End - 07/31/2027
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Core Initiatives
North Carolina is soliciting applications for up to six ROOTS Hub Leads, each representing one Medicaid region, to coordinate rural health transformation activities including primary care, behavioral health, workforce, value-based payment, and digital health. The program is federally funded with over $213 million allocated for the current budget period. Event schedule: - Application Deadline - 04/02/2026 - 5:00 PM ET - North Carolina
North Carolina Office of EMS is launching a competitive Rural Health Transformation Program grant to expand mobile integrated health and community paramedicine in rural and rural-adjacent counties. The opportunity prioritizes behavioral health and substance use crisis response enhancements among EMS agencies. Application deadline is May 20, 2026, with anticipated awards starting July 2026. Key contacts: [email protected]; [email protected] Event schedule: - RFA Posted - 04/24/2026 - Applications Due - 05/20/2026 - 11:59 PM - Online submission - Award Notifications Issued - 06/01/2026 - Anticipated Contract Period Begins - 07/01/2026 - Anticipated Contract Period Ends - 10/30/2027 - Applicant Webinar - 04/27/2026 - 1:30 PM - 2:30 PM - Webinar - Office Hours - Starting 05/08/2026 - Thursday 09:00-09:45 AM, Monday 13:00-13:45 PM - Microsoft Teams
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Core Initiatives
The NCRHTP Initiative Six: Digital Health aims to improve health information sharing, deploy AI and emerging technologies, and build digital literacy for rural North Carolinians. The initiative includes partnerships to address emerging technology needs and support rural provider capacity. Multiple sub-programs are referenced, including Rural Health Innovation Fund and digital literacy efforts.
Core Initiatives
The NCRHTP plans to invest $1 billion over five years to improve health outcomes and access for nearly 3 million rural residents in 85 of North Carolina's 100 counties. Six integrated initiatives target the creation of local care hubs, enhanced chronic disease management, behavioral health expansion, workforce development, value-based payment adoption, and health technology innovation.
Core Initiatives
This summary provides CMS executive-level overviews of FY26 Rural Health Transformation Program applications from multiple states. Key trends include focus on maternal and chronic disease outcomes, rural workforce expansion, integration of telehealth and digital health tools, and investments in sustainable care delivery infrastructure. No explicit awards to sub-grantees are stated; information is high-level and intended for broad program review.
This guidance addendum for the NC MDPP-Region 8 Rural Health Transformation Grant clarifies participant eligibility in line with CDC standards, emphasizing evidence-based prevention for at-risk rural minority populations. The submission deadline is extended to July 10, 2026. An informational webinar is scheduled to help applicants incorporate updated requirements. Key contacts: OMHHD@dhhs.nc.gov Event schedule: - Submission Deadline (Extended) - 07/10/2026 - 5:00 PM EST - Questions Deadline - 06/29/2026 - Informational Webinar - July 2, 2026 - 10:00 AM – 11:00 AM - Zoom
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Core Initiatives
The NCRHTP coordinates six strategic initiatives, including community-rooted care networks, chronic disease prevention, behavioral health expansion, workforce development, financial sustainability, and technology innovation. NC ROOTS Hubs are being established as regional networks to connect medical, behavioral, and social services across all 100 counties. Over 3 million rural North Carolinians will be served, and 400+ rural health facilities supported with $200 million in federal investment over five years. Event schedule: - NC Rural Health Transformation Program Webinar: Progress Update and ROOTS Hub Introduction - June 24, 2026 - Webinar - ROOTS Hub Lead Contracts Finalization - early June 2026
Event Schedule
Core Initiatives
The program focuses on connecting medical, mental health, and social supports through the NC ROOTS Hub, expanding prevention and chronic disease management, increasing access to mental health and substance use treatment, investing in the rural healthcare workforce, supporting value-based care transitions, and enhancing health care technology. Implementation involves collaboration among state agencies, rural providers, community organizations, and academic institutions, with a planned start in early 2026 pending CMS approval.
Core Initiatives
NC strategy refreshed: transformationStrategy updated · strategicGoals: 7 -> 6 · summary updated
NC progress refreshed: implementationPhase: IMPLEMENTING · progressSummary updated
NC overview refreshed: summary updated
NC RHTP site updated — 1 new doc(s)
NC RHTP site updated — 1 new doc(s)
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Submit a Request - Meetings | NC Governor
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NC - 2026 - Download Webinar Slides
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NC - 2026 - North Carolina Mobile Integrated Health And Community Paramedicine Grant Program Under North Carolina’s RHTP Annual Report
NC - 2026 - Request for Applications (RFA)
NC - 2026 - Mobile Integrated Health RFA - NCHPP
NC - 2026 - Addendum 1
NC - 2026 - NC RHTP Frequently Asked Questions
NC - 2026 - RHTP Grant Opportunities
NC - 2026 - NCDHHS Selects NC ROOTS Hub Leads (Press Release)
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The document lists multiple rural health-related grant opportunities available through NC DHHS for the 2026-2029 period including the Rural Hospital Flexibility Grant, Telehealth Infrastructure Grant Program Wave 5, and others. It serves as an information hub for funding solicitations rather than announcing awards. Event schedule: - NC DHHS: Rural Health Grant Opportunities Skip to main content FRAUD ALERT Be aware of multiple fraudulent text scams requesting payment for NCDMV fees, fines or tolls. NCDMV will NEVER request payment by text. Please report it as spam and delete. Learn More About NCDMV Fraudulent Text Scams An official website of the State of North Carolina An official website of NC How you know State Government websites value user privacy. To learn more, view our full privacy policy . Secure websites use HTTPS certificates. A lock icon or https:// means you’ve safely connected to the official website. 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North Carolina proposes a $1B, 5-year Rural Health Transformation Program impacting nearly 3 million rural residents across 85 counties. The strategy centers on six integrated initiatives: building regionally governed networks ('ROOTS Hubs'), scaling chronic/preventive care and maternal health, behavioral health and SUD integration, workforce expansion, implementing rural value-based payment, and technological innovation. The plan targets disparities in chronic disease, maternal health, behavioral health, and rural hospital financial distress while leveraging extensive cross-sector partnerships. Key contacts: Devdutta Sangvai Event schedule: - Application Submission Date - 11/03/2025 - Establish NC ROOTS Hubs - 2027 - Hubs Launch Community-Based Initiatives - 2028 - Hub Referral Tracking for Services (PY5) - 2031 - Hazel Health partnership for school-based telehealth - 2025-03 - North Carolina - Primary Care Capitation Pilot Launch - 2028-01-01 - North Carolina - Improve Rural Provider HIE Connectivity Target Date - 2029-12-31 - North Carolina Rural Provider Practices - Digital Transformation Initiative Outcome Targets - 2031-12-31 - North Carolina Rural Communities
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Core Initiatives
Event schedule: - Anticipated Timeline • Completed applications must be submitted to https://nc.readyop.com/fs/ 4jP3/8f8d7100 no later than 23:59 on , 2026. • Applicants must demonstrate ability to initiate services within 90– 180 days of contract execution. NC OFFICE OF EMERGENCY MEDICAL SERVICES - May 20 - Required Application Components • Application Must Include: − Required form fields in ReadyOp − Project Narrative Document (10-page limit) − Line-Item Budget Summary (template) − Budget narrative − Supporting documents • Letter of project intent on agency letterhead indicating signatory involvement • Letters of support from key partners • Letter of support from medical director • Organizational Chart (optional) • Program Implementation Chart (optional) NC OFFICE OF EMERGENCY MEDICAL SERVICES
The program funds EMS organizations in rural and rural-adjacent counties to improve behavioral health and SUD services access. Applications are due May 20, 2026, with awards announced June 1, 2026, and project periods from July 1, 2026 to October 30, 2027. Weekly office hours and webinars assist applicants. Key contacts: OEMSMIH@dhhs.nc.gov Event schedule: - RFA Posted - April 24, 2026 - Applications Due - May 20, 2026 - 23:59 - Award Notifications Issued - June 1, 2026 - Contract Period Start - July 1, 2026 - Contract Period End - October 30, 2027 - Applicant Webinar - April 27, 2026 - 1:30 PM ET - webinar
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Core Initiatives
North Carolina is preparing an RHTP application leveraging its large and diverse rural population, strong safety net, and history of rural innovation. Strategic principles emphasize measurable impact, rigorous stakeholder engagement, sustainability, and maximizing federal funding potential. Priority areas include diabetes, behavioral health, maternal health, provider shortages, digital health, and sustainable regional provider networks. Event schedule: - Stakeholder inputs period closed - 10/10/2025 - NCDHHS submitted application - 11/03/2025 - CMS application deadline - 11/05/2025 - Target CMS approval of application - 12/31/2025 - More guidance to partners regarding fund application - Early 2026
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Core Initiatives
Core Initiatives
North Carolina has selected ROOTS Hub Leads for each Medicaid region to drive the implementation of the Rural Health Transformation Program. These locally governed networks coordinate care, workforce, and technology initiatives targeted to rural community needs. Over the next five years, ROOTS Hubs will lead efforts to enhance coordination, digital health usage, primary care access, and workforce development, serving as key partners in the state's rural transformation. Key contacts: Impact Health; Trillium Health Resources; Trillium Health Resources; Vaya Health
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Core Initiatives
This FAQ document explains the proposed structure of North Carolina's Rural Health Transformation Program as submitted to CMS. It describes the six core initiatives, outlines how ROOTS Hubs will be selected, details rural definitions and regional approaches, and explains funding, application, and evaluation procedures. The document clarifies program goals related to workforce, behavioral health, technology, Medicaid integration, and accountability.
Core Initiatives
North Carolina Suspension Of Funding List RHTP Reference
2025-2026 · HTML
Article 2. Verification of Work Authorization
2025 · PDF
Public Records and Meetings Access
2018 · PDF
NC - 2026 - NCDHHS Announces 10 Million EMS Workforce Through RHTP
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NC - 2026 - Rural Health Transformation Program Page
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NC - 2026 - ROOTS Hub Leads Rural Organizations Orchestrating Transformation Sustainability
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NC - 2026 - Applicant Budget Worksheet
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Submit a Request - Events | NC Governor
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Request | NC Governor
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NC DHHS: Low-Income Services
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