RALEIGH, NC — The North Carolina Department of Health and Human Services (NCDHHS) announced Monday, Nov. 2, 2026, the official launch of a public dashboard detailing all Year 1 projects funded under the state’s Rural Health Transformation Program (NCRHTP).
The dashboard release follows an initial $100 million award to North Carolina from the U.S. Centers for Medicare & Medicaid Services (CMS) for Year 2 of the federal initiative. The initial tranche builds on the $213 million awarded to the state in Year 1 to strengthen rural healthcare delivery, support the medical workforce, and expand technology infrastructure across rural communities.
“We will continue to put these dollars to work for rural North Carolinians,” Governor Josh Stein said in a statement. “By investing in the people, services, and technology that rural communities need, we can make it easier for families to get the care they need.”
With over 3.5 million residents in rural areas, North Carolina maintains the second-largest rural population in the United States. The five-year transformation program aims to address longstanding healthcare challenges, including provider shortages, hospital financial strain, high rates of chronic illness, and regional disparities in medical access.
Key Highlights from Year 1 Implementation
State officials noted that 100% of North Carolina’s Year 1 allocation was successfully obligated. Accomplishments during the initial phase include:
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Regional Infrastructure (NC ROOTS Hubs): Established regional governing bodies across six statewide zones to assess local needs and coordinate healthcare delivery.
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EMS Paramedic & Opioid Response: Invested $10 million across 39 local Emergency Medical Services (EMS) agencies statewide, enabling paramedics to initiate medication-assisted treatment for opioid use disorder and conduct home wellness visits.
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Behavioral Health Expansion: Expanded telehealth services for early psychosis treatment and announced new grants for school-based health centers.
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Diabetes Prevention: Implemented an evidence-based diabetes prevention program tailored to high-risk residents across 18 southeastern North Carolina counties.
Local Direct Impacts: Brunswick and Columbus Counties
The deployment of Year 1 funding and the rollout of Year 2 resources directly impact local healthcare and emergency response capabilities in Brunswick and Columbus counties:
1. Brunswick County Mobile Integrated Healthcare
Through the program’s Mobile Integrated Health initiative, Brunswick County was awarded a $210,988 subaward from NCDHHS. The county is utilizing the funding for its Community Paramedic Program, including procuring a dedicated Mobile Integrated Healthcare vehicle to support at-home wellness checks, substance use interventions, and non-emergency field responses.
2. Addiction & Mental Health Services in Columbus County
Columbus County benefits from the broader $17 million statewide mental health and addiction funding tranche rolled out under NCRHTP. This initiative funds mobile crisis response teams, expands Medications for Opioid Use Disorder (MOUD), and strengthens regional rural crisis partnerships to relieve pressure on local hospital emergency rooms.
3. Southeastern Regional Health Initiatives
Both Brunswick and Columbus counties fall within the 18 southeastern NC counties receiving expanded access to the Minority Diabetes Prevention Program and regional chronic disease management support. Local health organizations will also have access to upcoming regional grant opportunities managed by the southeastern NC ROOTS Hub as Year 2 funding transitions into direct project grants.
Federal Funding Outlook & Medicaid Considerations
While North Carolina is actively deploying federal transformation dollars, state officials noted a significant long-term financial headwind. The federal law establishing the program (H.R. 1) also includes provisions that reduce federal Medicaid matching funds to states, which state fiscal analysts project could result in a net loss of tens of billions of dollars in health funding over the next decade.
Year 2 transformation projects will shift focus from preliminary infrastructure setup to full operational rollout across participating counties. Further details and grant guidelines are available through the NCDHHS Rural Health Transformation Portal.
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