# ToRCH Care Smart Growth and Service Line Modification (Horizon 2) Invitation For Bid Missouri Department of Social Services (DSS) invites competitive bids for the Transformation of Rural Community Health Care (ToRCH Care) Smart Growth and Service Line Modification (Horizon 2) initiative (IFB #DSS26015), a component of 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. ## Key facts - Status: Closed - Type: IFB - Issued by: Missouri Department of Social Services (Missouri) - Posted: 2026-08-18 - Application due: 2026-09-01 - Funding: $5.0M – $5.3M - Eligible applicants: General Hospital, Critical Access Hospital, Rural Emergency Hospital, Safety-net Hospital, Federally Qualified Health Center, Rural Health Clinic, Certified Community Behavioral Health Clinic, Behavioral Health Clinic, Certified Community Mental Health Center, Birthing Center, Urgent Care Center, Primary Care Center, Hospital-affiliated Entity, Health Center-affiliated Entity, Public Hospital, Non-profit Hospital, Private Hospital - How to apply: 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 instru… - Funding source: Rural Health Transformation Program (CMS) - Official source: https://dss.mo.gov/bids/files/ifb-DSS26015-ToRCH-Care-Smart-Growth-and-Service-Line-Modification.pdf ## 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 1. Each eligible entity may submit only one application unless granted an exception. 2. Projects must directly address one or more Horizon 2 priority service lines: maternal health, behavioral health, or diagnostics/outpatient/chronic disease management. 3. Projects are restricted to modernization, renovation, reconfiguration, or equipment within existing physical footprints; no new construction or major expansions are allowed. 4. All proposals must serve at least one RHTP-designated rural county. 5. The maximum request is $5,000,000 per proposal; anticipated program total is $40 million. 6. Applicants must provide a 25% cost share unless a hardship waiver is granted and evidenced. 7. 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. 8. 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. 9. 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. 10. Proposals demonstrating clear rural access gaps, regional/multi-county impact, strategic partnerships, and sustainable business plans will receive higher… ## 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 ## Application package and source documents - [MO - 2026 - ToRCH Care Smart Growth and Service Line Modification (Horizon 2) Invitation For Bid (IFB #DSS26015)](https://www.ruralcarejourney.com/api/documents/daf50215-449d-40c6-9129-fa728406ac41/file) (primary) — official: https://dss.mo.gov/bids/files/ifb-DSS26015-ToRCH-Care-Smart-Growth-and-Service-Line-Modification.pdf - [MO - 2026 - rural health (008fe0)](https://www.ruralcarejourney.com/api/documents/f6a2a40b-843d-4225-8e96-4175dc1920f2/file) — official: https://mydss.mo.gov/mhd/rural-health - [MO - 2026 - ToRCH Care Smart Growth and Service Line Modification (Horizon 2) Invitation For Bid](https://www.ruralcarejourney.com/api/documents/10254e01-2dea-4d1b-8245-f6981c1d2354/file) — official: https://dss.mo.gov/bids/files/ifb-DSS26015-ToRCH-Care-Smart-Growth-and-Service-Line-Modification.docx - [MO - 2026 - DSS Issues Amendment To Horizon 2 Funding Opportunity, Extends Bid Deadline (MHA news: Amendment #01 extends bid deadline to Sept 1)](https://www.ruralcarejourney.com/api/documents/9149da03-1445-4648-bed5-f276c2256a7b/file) — official: https://www.mohospitals.org/newsroom/dss-issues-amendment-to-horizon-2-funding-opportunity-extends-bid-deadline/ - [MO - 2026 - ToRCH Care Smart Growth and Service Line Modification (Horizon 2) Invitation For Bid (IFB #DSS26015) (ifb-dss26015-02-torch-care-smart-growth-and-service-line-modifications-horizon-2)](https://www.ruralcarejourney.com/api/documents/f383e466-69cc-462c-8952-7eaf270e469d/file) — official: https://dss.mo.gov/media/file/ifb-dss26015-02-torch-care-smart-growth-and-service-line-modifications-horizon-2 - [MO - 2026 - Missouri Receives More Than $45 Million In RHTP Investments](https://www.ruralcarejourney.com/api/documents/96e9d04e-73a0-42cd-8d50-fe7732afd5f5/file) — official: https://www.mohospitals.org/newsroom/?h=1&t=rural-health-transformation-program - [MO - 2026 - Understanding the RHTP](https://www.ruralcarejourney.com/api/documents/0305736a-24b5-4360-aaf2-d2d7d0f0f39c/file) — official: https://dss.mo.gov/mhd/rural-health - [MO - 2026 - Smart Growth and Service Line Modernization Contingent Awardees (Award list (contingent awardees, Oct 30, 2026))](https://www.ruralcarejourney.com/api/documents/d9f8bdf3-427a-4499-8e26-c1fea6204727/file) — official: https://dss.mo.gov/mhd/rhtp-modernize-rural-healthcare-services - [MO - 2026 - Missouri Awards $39.4 Million to Modernize Rural Healthcare Services (Award press release (Oct 30, 2026))](https://www.ruralcarejourney.com/api/documents/f37f33aa-a7a7-4a9c-8942-e65eb92b4a6b/file) — official: https://dss.mo.gov/mhd/rhtp/missouri-awards-394-million-modernize-rural-healthcare-services More Missouri RHTP activity: https://www.ruralcarejourney.com/states/mo (markdown: https://www.ruralcarejourney.com/states/mo.md) --- Source: Rural Care Journey (RCJ), https://www.ruralcarejourney.com/opportunities/torch-care-smart-growth-and-service-line-modification-horizon-2-invitation-for-b--3803d03580 — data as of 2026-10-10. Cite the RCJ page for the summary and the linked official source for authoritative terms, deadlines, and amounts.