Grant Writing for Rural Healthcare Projects

Rural America includes vibrant communities that find innovative solutions to unique healthcare challenges. Nonprofit organizations and healthcare providers in rural areas rely on government and state funders as well as foundations to help bring new projects to life or sustain crucial, existing services.

Getting a grant is hard work, and can involve numerous, time-intensive steps.  Funders hold competitive cycles for grant programs in which rural organizations must compete alongside well-funded, well-prepared organizations with dedicated and experienced grant writing teams. Organizations in rural areas are less likely to have staff members strictly dedicated to grant writing. Community members or staff members who have the most writing or business experience may be chosen by necessity to be responsible for securing funds.

Although rural organizations rely on grant funding, they face many barriers as identified in the National Committee for Responsive Philanthropy's 2007 report Rural Philanthropy: Building Dialogue from Within, including:

  • Lack of major foundations located in rural areas, leading to fewer networking opportunities
  • The ability to show potential impact to funders when serving less densely populated areas
  • Perception that rural projects are less sustainable and organized
  • Weaker local nonprofit infrastructure

In addition to those barriers, the amount of funding being allocated to rural organizations is significantly smaller per capita when compared to urban counterparts. A 2015 USDA report, Foundation Grants to Rural Areas from 2005 to 2010: Trends and Patterns, compares the average value of grants from large foundations given from 2005 to 2010. The report states that organizations based in nonmetro counties received less than half the amount per capita compared to organizations in metro counties.

A great grant proposal isn't just about requesting funding. Successful grant applications should be thought of as the first step to building sustainable, long-term programs that will increase the health of rural communities. This guide can serve as a starting point for those who need assistance to begin the grant writing process. It will cover tips on searching for rural-specific funding, grant proposal preparation, building successful funding relationships, and planning for program sustainability.

Frequently Asked Questions


How can I learn about funding opportunities for rural healthcare organizations?

Here at the RHIhub, we offer many ways to learn about funding opportunities. The RHIhub Funding and Opportunities section includes federal, state, local, and private funding programs of interest to rural health organizations. RHIhub staff reviews funding and opportunities that are added to the database, making certain that all of the funders either expressly state they will fund in rural areas, or have been known to fund in rural areas in the past.

RHIhub can also conduct a free, customized funding search on your behalf, which will identify funders who may be interested in your project or program. Contact us at 800.270.1898 or info@ruralhealthinfo.org to request a custom search. Please include your city, state, county and the purpose of your project in your request.

To stay up-to-date on the latest funding opportunity announcements, subscribe to the RHIhub This Week newsletter or to one of our RSS feeds.

Other ways to find federal agencies and other funders who fund rural projects (please note that RHIhub staff search these sources for relevant information on a daily basis):

Grants.gov: Serves as a comprehensive website with information about finding and applying for all federal grant programs, including funding from the Federal Office of Rural Health Policy, USDA Rural Development, and other federal agencies who provide opportunities related to rural health.

Federal Register: Provides access to information about federal benefits and opportunities for funding. There will be information overlap with funding sources provided on Grants.gov.

The Foundation Center: A nonprofit organization that provides information, resources, and training related to working with philanthropic organizations.

  • Foundation Directory Online: A subscription-based service that collects and organizes information about philanthropic organizations in the United States. Has a searchable database of known funders.
  • Philanthropy News Digest: The daily news service of the Foundation Center. Publishes philanthropy-related articles and open requests for proposals.
  • Funding Information Network Locations: Free funding information centers that provide a core collection of Foundation Center publications and a variety of supplementary materials and services. Staff are available to assist you with funding searches at each location.

State Offices of Rural Health: Many SORHs administer funding programs, and most are knowledgeable about the funders operating within their state. Many have websites or electronic newsletters that include funding and opportunities. Contact your State Office of Rural Health to learn how to find funding information specific to your state.

Other sources to consider:

  • Businesses and organizations operating in your area: Corporations, banks, and other local business often fund projects that will benefit the areas in which they operate. Especially if you are looking for a small amount, these organizations can be valuable sources of funding.
  • Community foundations: Many rural areas have community foundations who look for local projects to fund. To find your nearest Community Foundation, you can use the Council on Foundations' Community Foundation Locator.
  • Civic organizations: American Legions, Chambers of Commerce, Rotary Clubs and the like may have small amounts of funding available, or may consider hosting a fundraiser on behalf of your organization.

I found a grant program that looks like it would work for my rural project. Should I call first or just send in a proposal?

Making contact with funders before submitting a proposal is usually a good idea, but it varies by funder. Carefully review the funder's giving priorities to make sure your project matches up, and then look through what funders have to say about contact. Some funders make it explicitly clear that they aren't interested in discussing applications while others expressly ask applicants to talk to a program officer prior to submission.

Unless otherwise noted, speaking with a program officer about your application before submission can only strengthen it. When you reach out to a funder, be prepared to answer basic questions about your project, such as overall concept, budgetary needs, and partners who may also be involved. Program officers know what types of projects will be competitive and may be able to help hone your request.


Does my organization need to be a nonprofit to apply for grants?

Typically, yes. Funders rarely make grants to for-profit businesses. Grant funds are almost exclusively reserved for nonprofit organizations with 501(c)(3) status, with exceptions made for tribal, governmental, and civic organizations. It is important to read through the program guidance closely to determine eligibility.


The grant guidance says we need to be rural. What does that mean?

Rural is an inexact term that can mean different things to different people, organizations, and government agencies. RHIhub offers the Am I Rural? tool to help determine whether a specific location is considered rural based on various definitions, including those used by federal grant programs. For more information on commonly used rural definitions, see RHIhub's What is Rural? topic guide.


Does our organization need to hire a grant writing or fundraising consultant?

It depends on your organization's staffing level and expertise. If there is an individual or group on staff who can complete the proposal adequately and in time for the application deadline, you may not need a consultant. If your organization lacks the expertise to develop one particular aspect of the proposal, such as the budget, you may want to hire a consultant just for that section. Or you may choose to have a professional grant writer prepare the entire proposal.

If this is the first grant proposal your organization has submitted, a grant consultant may be able to guide you through the process and lend you valuable expertise. In addition, you may be able to re-use the sections of the proposal created by a grant consultant in future proposals, furthering the value of the consultant's fee.

Before hiring a consultant, take some time to get acquainted with the ethics and standards of fundraising. The National Council of Nonprofits has several resources on ethical fundraising. The Association of Fundraising Professionals maintains a Code of Ethical Standards involving transparency, stewardship, confidentiality, and compensation; these standards can provide a framework for developing a contract with a consultant.


Which organizations provide technical assistance to rural grant writers?

There are several organizations that may provide technical assistance for rural organizations seeking grants. All states have a designated State Office of Rural Health, and many SORHs will provide grant writing training, guidance during the writing process, or review and critique of completed grant proposals. Likewise, many State Rural Health Associations provide training programs and technical assistance for grant writers working with rural health organizations.


The funder says we need to use an evidence-based model for our program. Where can I find rural evidence-based project examples?

Evidence-based can mean a variety of different things to different funders, so it is important to clarify what the funder's requirements are regarding level of evidence. Not all rural issues have an evidence-based program example appropriate for replication in the community.

The RHIhub offers the Rural Models and Innovations section, which is a valuable source of rural-specific project examples. Successful rural models are categorized based on four levels of evidence:

  • Evidence-based – Tried in numerous rural locations, a review study published in a peer-reviewed journal, overall results were generally positive.
  • Effective – Tried in single rural location, positive results published in a peer-reviewed journal.
  • Promising – A formal program evaluation showed positive results.
  • Emerging – Anecdotal account of a successful rural program.

You may also be able to find successful evidence-based programs by browsing through a funder's list of past projects. Most funders will detail their most successful programs through news articles, reports, or on their program website.


How do we show that our project addresses a real need?

Write a well-thought out narrative that focuses on how the project will help the community and includes relevant statistics and data to support your case. This is your chance to educate the funder about your community and about the people you are trying to help. The grant reviewers who are making decisions about your grant proposal may come from completely different backgrounds, and may not be familiar with the specific problems faced in your community, or rural areas in general.


How can I find supporting statistics or research for rural health grant proposals?

The RHIhub offers the Finding Statistics and Data Related to Rural Health topic guide. The guide covers frequently asked questions about locating rural health data and statistics that can be used to support grant proposals and communicate your community's needs effectively to a funder.


Are maps useful to include in our grant application?

Maps can be an effective way to illustrate arguments made in your grant application and will provide visual emphasis to written problems.

Maps may be used to show:

  • Demographics
  • Health status
  • The location of healthcare facilities
  • The distribution of healthcare workforce
  • Data related to specific population groups
  • Information about transportation and access to healthcare

Maps can be used in proposals to show grant reviewers visual locations and distances within the state. Many grant reviewers may not know your community or your location within the state. Be careful that maps don't take up too much space and that they are readable if printed in black-and-white.


When a funding opportunity requires matching funds, what are some strategies to come up with the match?

Cash Matches:

There are many different options for procuring cash matches. Community foundations, local businesses, and community-based organizations all may be good sources of funding for matching grants.  It is important to identify these stakeholders early in your process and explain clearly how their contributions could be used to leverage additional dollars for the community.

The Council on Foundations Community Foundation Locator tool can help to identify if your community has an established Community Foundation.

In-kind Matches:

If an in-kind match is acceptable to the funder, there are many ways to show the contribution your organization and community are making to the project:

  • An organization can provide a cash match.
  • Staff time and volunteer time can count as an in-kind match. Track the contribution that participants' organizations are providing by allowing them to work on the project, including their attendance at meetings.
  • Construction and donations of capital equipment or supplies may be used as an in-kind match.
  • You may also want to keep track of other types of in-kind contributions, such as space, equipment use, printing, mailing, or utility costs.

It is important to document everything and keep good records of in-kind matches.


Should we try to find a single funder or should we use multiple funding sources?

While it would be ideal to find a single source of funding for a major project, many small organizations rely on multiple funding streams to support their work. Don't discount the smaller chunks of money that are available from funders in your area. If you add up several small grants, you may find you have enough money to do what you set out to do.

Additionally, diversifying the source of your organization's funding can make your project or organization more financially secure and sustainable in the event that one source of funding is lost.


What can we do to make our rural project more sustainable?

Funders are increasingly looking to proposed plans for sustainability during their decision-making processes. Most funders want to know that the dollars they are giving will lead to lasting impact and change. Therefore, planning for sustainability from the beginning of your project is extremely important.

The Rural Health Information Hub offers tools on Planning for Sustainability. The tools were developed by the Georgia Health Policy Center for the Federal Office of Rural Health Policy's community-based grantees. They are also useful for programs funded by other sources. The tools are intended to help you consider the sustainability of programs that address community needs and engage partners and stakeholders in this planning process.


How do we create an evaluation plan to include in our grant proposal?

Funders typically place significant emphasis on your plan to evaluate your project. Tracking and reporting on processes and outcomes will help your project improve processes, be accountable to the funder, and show impact. Evaluation planning should be done as part of the initial program design to ensure that program elements can be adequately evaluated, that benchmark data is available, and that opportunities for performance improvement are included in the program design.

To learn more about evaluating rural health programs, see the Conducting Rural Health Research, Needs Assessment, and Program Evaluation topic guide and the Rural Community Health Toolkit's Module 4: Evaluating Rural Programs.


How important is networking and collaborating to getting a project funded?

It can be very helpful to network with other facilities, agencies, and organizations in your community and beyond. It is important to build your reputation so that funders are aware of the good work you do and think of you when they have extra funds to allocate. Colleagues at other nonprofits may share information on funding opportunities with you. They may also be willing to act as grant writing mentors.

Networking can:

  • Reduce the cost of grant writing
  • Increase capacity to carry out programming
  • Increase chances of getting funded, when partnerships lend their good reputation

In some grant programs, networking or collaborating with other organizations is a requirement to receive funding. Many funders want to know that a project or program has broad support across a variety of different spectrums. In other grant programs, extra points are awarded for networking with other organizations.


How do I apply for a federal grant that requires electronic submission?

Most federal agencies are now requiring that grant applications be submitted electronically through Grants.gov.

Grants.gov requires a one-time registration by the applicant organization. This is a five-step process and should be completed by any organization wishing to apply for a grant. The registration process will require some time to process (anywhere from three business days to three weeks). Therefore, applicants or those considering applying at some point in the future should register immediately. To begin the registration process, follow the steps outlined on Grants.gov: Organization Registration.

Be sure to renew your registration every year. The renewal process can take 48-72 hours to validate, and you will be unable to submit an application if your account is inactive.


Where can I find examples of successful grant proposals?

There are many ways to access copies of successful proposals.

  • Many funders provide copies of successful proposals on their program websites. If you are unable to locate this information, you can always reach out to the funder to ask if they have examples of previous proposals.
  • For federal proposals, you can make a Freedom of Information Act (FOIA) request. Plan ahead—this process will take some time, as well as money for the cost of copies. Information for making a request can be found on the FOIA website.
  • Samples of successful cover letters, letters of inquiry, proposals, and budgets can be found at the Foundation Center's Grant Space site.
  • The Foundation Center produces annual print resources that include successful proposals. They can be found at Foundation Center and Funding Information Network locations.

Our proposal was rejected. Should we give up?

No. Many grant proposals are rejected several times before being funded. Review the comments the grant reviewers made, address the project's weaknesses in future applications, and be sure to work closely with a program officer on future applications.

You may also look for other sources of funding for your proposal, but be sure to rework your proposal to closely follow the guidance of the new opportunity.


Our proposal was funded. How do we live up to our funder's expectations?

Write a thank you note to the funder (before depositing the check, if possible), and submit reports about your project on time. Follow through with the activities you outlined in your proposal, and be sure to keep the funder informed about any changes that you need to make when the project is in progress. Send event invitations and other related products to the funder throughout the course of the project.

Remember that you are building a relationship with the funder. This may be your first grant from a specific funder, but you may be approaching them again in the future for continuation funds or a different project entirely. Applicants want to establish a long-term relationship by building contacts, securing a firm relationship, and showing that your organization is a good steward of their funds.


How can I learn more about preparing grant proposals?

There are several free online tutorials you can take, such as these from the Foundation Center:

Additionally, many State Offices of Rural Health provide free or low-cost grant writing seminars for rural health organizations.

The National Organization of State Offices of Rural Health offers the Grant Writing Institute: Rural Health Grant Writing Specialist Training, an intensive 9-part online training with courses specifically geared toward novice rural health grant writers, and courses geared toward established grant writers who want to further their knowledge.

The Technical Assistance and Services Center developed the Federal Grant Writing Manual to assist organizations, particularly Critical Access Hospitals, who wish to complete federal proposals.