The HRSA Rural PACE Planning and Development Grant funding opportunity has been withdrawn on Grants.gov and is not being offered at this time. While NPA was disappointed to learn of this development, we are hopeful that this critical funding opportunity will be reissued and interested stakeholders, including organizations that were diligently working on their applications, will have an opportunity to respond to that opportunity.

NPA is pleased to share that the Health Resources and Services Administration (HRSA) announced the availability of up to $2 million in fiscal year (FY) 2025 federal grant funding to support the expansion of the Program of All-Inclusive Care for the Elderly (PACE) model into rural communities. The Notice of Funding Opportunity (NOFO), along with important pre-registration and application requirements, are available on Grants.gov. Applications are due by 11:59 p.m. ET on April 17, 2025.

Through the Rural PACE Planning and Development program, HRSA will make as many as four awards of up to $500,000 per year to provide resources to assist with the development of an initial Centers for Medicare & Medicaid Services (CMS) PACE program serving HRSA-designated rural areas or to expand an existing certified CMS PACE program into HRSA-designated rural areas through PACE service area expansion (SAE). The HRSA announcement follows the critical work of the National Advisory Committee on Rural Health and Human Services (NACRHHS) and its 2023 policy report, to which numerous NPA and PACE stakeholders contributed, outlining recommendations and considerations to expand PACE in rural America.

NPA will hold a webinar for members to discuss the opportunity in more detail. More information about the webinar will be provided at a later date.

 Key details of the funding opportunity are as follows:

• Eligibility: Eligible applicants include all domestic public and private nonprofit or for-profit entities with demonstrated experience serving or having the capacity to serve rural underserved populations. These include state, county and local governments, as well as nonprofit and for-profit health providers such as hospitals and federally qualified health centers (FQHCs). 

   

• State, CMS and Other Partner Collaboration: Awardees are required to work with their State Administering Agency (SAA) and CMS on completing and submitting their PACE application. Funding awarded under this program does not guarantee CMS approval of any PACE application. Applicants also must identify in their business plan any organization, provider or service partners involved in the project. Please note that a letter of support from SAA is required as part of the application.

   

• Anticipated Performance Period: HRSA intends to fund awards in four 12-month budget periods, for a total four-year performance period, from Sept. 20, 2025, to Sept. 29, 2029. By the end of the four-year period of performance, HRSA expects award recipients to have a plan in place for long-term financial sustainability of the new or expanded PACE organization.

   

• Funding Pathways: HRSA will provide start-up funding to new CMS applicants seeking to become a PACE organization in a rural area for the first time (Funding Pathway 1) and to existing PACE organizations seeking to expand their service area to an HRSA-designated rural area (Funding Pathway 2). The latter pathway includes an expansion of the currently approved service area and/or the addition of a new PACE center site.

   

• Cost Sharing: This program has no cost-sharing requirement. However, if an applicant chooses to share in the costs of the project, HRSA will not consider it during merit review. HRSA will hold the awardee accountable for any funds the awardee adds, including through reporting.

   

• Priority Status for Existing PACE Program Implementation: During its review of applications, HRSA reserves the right to award up to 10 priority points for applicants proposing to start a new PACE program or proposing to expand an existing PACE program in a state that has approved state benefits under the PACE program. (See Appendix B of the NOFO or the NPA PACE Finder.)

   

• Non-Duplication of Services: HRSA recognizes that more than one PACE organization may provide complementary services in a rural area. However, applicants proposing to serve an area served by other PACE organizations must detail in their application how they will avoid duplicating efforts of the other PACE organizations in any areas of overlap.

   

• Data Collection: Award recipients must report annually to HRSA through an electronic performance measurement data collection system. Following receipt of the award, HRSA will provide awardees with the final set of measures they must report.

   

• Anticipated Award Date: HRSA expects to make awards by Sept. 1, 2025.

For more information, refer to the NOFO at Grants.gov or contact Rural PACE at HRSA. If you have any questions, please contact Peter Fitzgerald, executive vice president of Policy and Strategy at NPA, or Katie Pahner, vice president of Regulatory Affairs at NPA.