North Dakota officials celebrate being among big winners in federal rural health funding

BISMARCK (North Dakota Monitor) — North Dakota U.S. Sen. John Hoeven and Gov. Kelly Armstrong on Friday touted the success of the state’s application for federal Rural Health Transformation Program funding, which landed one of the largest per-capita awards in the nation.

North Dakota received $199 million for the first year of the five-year grant.

Congress set aside $50 billion for the program in its reconciliation bill last year as a way to offset losses rural states will incur due to Medicaid cuts.

The funding, awarded to North Dakota in late December, is almost double the minimum funding available to states this year.

The funding amounts to roughly $561 per North Dakota resident, according to an analysis by policy research organization KFF. Only six states received larger per-capita awards. The average grant amount was about $200 million per state.

States are guaranteed at least $500 million over the five-year period, but could receive more depending on the strength of their applications and other factors.

Hoeven, a Republican, said his goal is for North Dakota to receive the maximum possible award of $1 billion.

He pointed to North Dakota’s existing hospital and communications infrastructure as factors that set its application apart.

The state has a very short window to get the money out into the hands of communities. North Dakota has until the end of September 2026 to obligate the funding, and until September 2027 to spend it.

The state Department of Health and Human Services is hiring a liaison to help tribal communities apply for the federal funding. Tribes’ unique legal status means their applications for grant money may have different requirements, Armstrong said.

“We want to make sure that they have access to somebody on our staff that helps them do that and gives them the best chance of success,” the Republican said.

State lawmakers will convene for a special legislative session later this month to authorize the spending of the grant money.

A committee of lawmakers tasked with guiding the state’s application for Rural Health Transformation Program funding will meet Tuesday and Wednesday to discuss the $200 million award and to discuss bill drafts for the special session.

While Armstrong called the special session to allocate the federal funding, lawmakers could also consider legislation related to other issues.

Legislative Management will meet on Wednesday to discuss the scope of the session.

Legislators will consider four policy bills that the state pledged to adopt in its Rural Health Transformation Program application. They would require schools to participate in a federal fitness test, require ongoing nutrition education for doctors, have North Dakota join a physician assistant licensure compact and to expand the services pharmacists are authorized to provide.

The federal government indicated that states with these policies would get larger grant awards.

North Dakota Monitor reporter Mary Steurer can be reached at msteurer@northdakotamonitor.com.