External funding through securing grants and contracts represents an important resource for hospitals and health systems in the initiation, development, expansion, support, and sustainability of programs and initiatives. Effective grant writing is both an art and a science that requires an understanding of the availability of funding, alignment of an institution’s mission with that of the funder, responsiveness to sponsor requests, an understanding of basic budgeting, attention to detail, and a commitment of time and resources.

Finding Funding:

Grant and contract funding is available through federal, state, regional, community, private, philanthropic, and corporate sponsors.  A comprehensive listing of federal funding is available through Grants.gov.  An excellent resource for finding rural funding is the Rural Health Information Hub (RHI Hub). RHI Hub enables grant writers to search for funding by topic or by state.  The Grantsmanship Center is also an excellent site to identify top funders by state.

The type of project or activity proposed (i.e., research, programmatic, planning, or implementation) often signals the type of funder to consider. For example, research projects tend to be funded by federal sponsors such as NIH or AHRQ.  Programmatic funding tends to be often supported by federal funders such as HRSA or private funders. Some community and private funders only fund programs in a particular catchment area. It is important to align your program request with the mission and geographic target area of the sponsoring organization.


Each sponsor issues specific and detailed guidelines for grant applications. “Responsiveness” is a key element in successful grant writing. Responsiveness refers to the extent to which your application responds to the elements required by the sponsor. Failure to respond to a particular element may result in disqualification of the application or loss of critical scoring points. It is critical to read the sponsors Request for Application (RFA) or Request for Proposal (RFP) thoroughly multiple times well in advance in order to thoroughly understand the funder requirements. If you do not understand a requirement, consider looking for posted Frequently Asked Questions or reaching out to the program contact (if allowed).


Generally, sponsors include in their instructions a detailed summary of their scoring rubric. It is important to review the scoring elements to ensure your application addresses the key scoring elements and there are no major gaps.

Proposal Key Elements:

Sponsor requirements vary greatly and therefore, it is important to read the sponsor application requirements well in advance and consult them throughout the process. Most federal funders require, at a minimum, the following sections: Significance (background/rationale), Innovation (the “it”), Approach (activities planned), Outcomes (how will you measure attainment of goals/objectives, Biographical Sketches (Resumes) and a budget.


Budgeting is a key element of grant writing. It requires an understanding and justification of cost elements including personnel (salaries and fringes), materials/supplies, travel, equipment, and overhead.  Overhead is referred to “Indirect Costs” or “Facilities and Administrative (F&A) Costs. The amount of overhead or indirect is generally capped by the sponsor. It is important not to exceed the maximum amounts allowed by the sponsor for overhead.

Depending on the sponsor, the applicant may be required to provide cost sharing or matching. In this case, the sponsor and the applicant each agree to cover a portion of the total cost.  Caution should be exercised to identify any cost sharing or matching requirements listed in the guidance as those become mandatory if funded.


Often sponsors require demonstration of commitment by the applicant. This may take of the form of monetary support, matching, or commitment in the form of letters of support. It is recommended to read the guidance carefully and provide appropriate letters of support from the institutional leadership and the community to demonstrate institutional and community buy-in and support.

Details Matter:

In addition to the required proposal content, effective grant writers pay extremely careful attention to the details such as eligibility (is your organization eligible), budget maximums (check your math), cost sharing requirements, overhead limits, geographic target area, page count, format, font type and size, and even margin requirements.  Applications that do not conform to these requirements may be disqualified and not reviewed.  Applications are often disqualified for failure to meet basic requirements such as ineligibility, page counts that exceed maximums, wrong font type or size or budget errors.  The details really do matter.

Best Practices:

It is critical that grant writers create timeline for preparing the final application with goal of submitting a week in advance if possible. Often funders have online systems that require multi-phased registration in advance. These registrations often take a number of weeks to complete and therefore, it is important to start early and also plan to submit early.

As mentioned earlier, effective grant writing requires attention to fine details.  Multiple rounds of proofing and editing are recommended to ensure a polished final product. It is also recommended that the grant writer utilize tables, figures, pictures, and charts to break up the text and make the content more visually appealing. Effective grant writers tend to use a combination of text augmented with visuals throughout.  It is also recommended that the grant writer continue to refer to the scoring rubric throughout to ensure the final product addresses each major element to ensure the highest possible score.

As you develop your grant writing and proposal development timeline, you may want to allow sufficient time for an objective third party (ex. a person in another department) to review your application. This is an effective means to determine if the content is clear or if there are areas in which further clarification is required.

Finally, effective grant writing is about marketing of ideas. If you are excited about the project, it should come through in your tone. If you are not excited or compelled by the idea, it is unlikely the funder will be either. Tone matters.

Parting Thoughts:

Successful grant writing take practice and a commitment of time. It is generally not possible to have a single person dedicated to the effort. Grant writing is often one of many roles held by an administrator or director in an organization. However, with practice and dedication, it serves as a critical source for organizations desiring to pursue expansion of programs and services to the community.