Today Governor Stein and the North Carolina Department of Health and Human Services announced more than $17 million for investments to improve mental health services through North Carolina’s Rural Health Transformation Program.
“Every North Carolinian deserves the opportunity to live a healthy and fulfilling life,” said Governor Josh Stein. “Nearly 1.5 million North Carolinians struggle with mental health issues, and too many people in rural areas cannot access the care they need. These investments will connect more families to high-quality care in their communities.”
NCDHHS received more than $213 million in federal funding for the 2026-27 fiscal year from the U.S. Centers for Medicare & Medicaid Services (CMS) for the NCRHTP to improve health outcomes for the state’s more than 3.5 million rural residents, the second-largest rural population in the country. A key initiative of the NCRHTP is expanding behavioral health care and substance use services.
This wave of funding includes:
- $4 million for Certified Community Behavioral Health Clinics
- $3 million to expand Medications for Opioid Use Disorder Access
- $4 million to expand Mobile Outreach, Response, Engagement, and Stabilization teams
- $3 million for Coordinated Specialty Care for First-Episode Psychosis response
- $2.9 million to establish regional Rural Crisis Partnerships
- $800,000 to expand NC MATTERS
“There is no health without mental health,” said NC Health and Human Services Secretary Dev Sangvai. “Our goal is to build a comprehensive system that delivers high-quality services to residents no matter where they live. These initiatives expand access to care and support whole-person well-being, directly advancing the NCDHHS mission to provide essential services that improve the health, safety, and well-being of all North Carolinians while developing a sustainable healthcare workforce for the future.”
NCDHHS has awarded $4 million to three Local Management Entities/Managed Care Organizations (LME/MCOs) for Certified Community Behavioral Health Clinics (CCBHCs). These facilities provide comprehensive mental health and substance use care under one roof – serving anyone who requests care, regardless of ability to pay, place of residence, or age. CCBHCs served more than 21,000 people in 2024-25 and aim to increase the number of Medicaid recipients who begin mental health treatment by 5% each year and reduce the number of emergency department visits by people who need mental health services by 8% to 10% each year.
North Carolina will continue to build on its network of Opioid Treatment Providers by committing $3 million of NCRHTP funding to establish stationary medication units co-locating opioid treatment with primary care to expand Medications for Opioid Use Disorder (MOUD) access. This funding will be used to support the implementation of Zing Satellite Technology to expand OTP services in combination with primary care in Graham, Rutherford, Cumberland, Bertie, and Columbus counties. These OTP expansion units will improve the availability of OTP services in furtherance of the MOUD Saturation plan, managed by NCDHHS, which recently announced it had approved the 100th brick-and-mortar OTP location. The expansion will help meet the goal of reducing the number of opioid overdoses in emergency departments by 20% in 2031.
Two separate awards will improve services for children, including $4 million to expand Mobile Outreach, Response, Engagement and Stabilization (MORES) teams to Beaufort, Edgecombe, Greene, Polk, Transylvania and Wilkes counties while strengthening existing teams in numerous counties. MORES is a team-based crisis response intervention for children and adolescents ages 3 to 21 experiencing escalating emotional and/or behavioral needs. MORES seeks to reduce admissions to emergency departments and long-term placements in residential settings by supporting youth in their homes and communities for up to eight weeks.
In addition, NCDHHS is providing $3 million for Coordinated Specialty Care for First Episode Psychosis (CSC) response. CSC is a team-based, early intervention for young people experiencing early psychosis. The state will implement a rural adaptation of CSC that will include a Hub & Spoke Model that incorporates tele-psychiatry with community-based teams to reduce geographic barriers. These initiatives will help reduce the number of children staying overnight in emergency departments by 8% to 10% each year through 2031.
NCDHHS will put forth $2.9 million in funding to improve response to – and help prevent – mental health crises in rural areas by establishing regional Rural Crisis Partnerships between CCBHCs and their local Behavioral Health Urgent Cares and Peer Operated Respite centers. These partnerships will ensure someone in crisis receives the appropriate level of care and will help divert people from emergency departments.
NCDHHS will also use $800,000 per year (future years contingent on additional federal funds) from NCRHTP funding to expand the NC MATTERS program to provide more intensive, locally tailored support in rural communities. NC MATTERS is North Carolina’s Perinatal Psychiatry Access Program, created to support health care professionals with identifying and managing their perinatal patients’ behavioral health in communities where appropriate services are scarce. This program is a federally funded collaboration among NCDHHS, UNC, and Duke. The NCRHTP investment will allow NCDHHS to work more closely with local health care systems to understand their particular gaps and build solutions around them.
These NCRHTP investments in mental health care support NCDHHS’s strategic priorities to improve access to care, deliver high-quality services that address whole-person well-being, build a comprehensive system that modernizes how services are delivered and strengthens rural care, and builds a sustainable workforce to deliver quality care to all residents regardless of where they live.
On Sept. 14, NCDHHS announced $1.25 million in NCRHTP funding for school-based health centers to expand preventive and acute health care, provide nutrition support, and address behavioral health needs. In the spring, NCDHHS announced it will provide $10 million to 39 local EMS agencies through the NCRHTP to strengthen the EMS workforce and expand rural communities’ access to mental health and substance use disorder treatment and services.
North Carolina is eager to maximize the funding awarded by the Rural Health Transformation Program, but the state will need to overcome significant funding losses as a result of federal reconciliation law H.R. 1, including the loss of nearly $50 billion in federal funds for North Carolina’s Medicaid program over the next 10 years and critical funding for hospitals in our state. NCDHHS will take advantage of the available funding while continuing to advocate for more funding for NC’s rural health care system in the future.
To learn more about how NCDHHS is improving rural health care through this federal partnership, visit the NCRHTP website.
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Stevens Amendment Disclosure: This press release is supported by the Centers for Medicare & 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.