ND Department of Health and Human Services details $500M–$1B rural health transformation plan; committee backs application

Sarah Aker, executive director of the Division of Medical Services at the North Dakota Department of Health and Human Services, told the Rural Health Transformation Committee that the department will submit a federal Rural Health Transformation application by the Nov. 5 deadline and outlined draft allocations and allowable uses.

The committee voted to endorse the application during the meeting. Representative Sid Nelson moved to accept the department’s report; Representative Mitscog seconded the motion, and the roll call vote carried.

Aker said the state is preparing a plan built on stakeholder listening sessions and surveys. "We are going to receive at least a $100,000,000 a year or 500,000,000 over the first... 5 year period," she said, and noted that the Centers for Medicare & Medicaid Services (CMS) asked states to submit a hypothetical $200,000,000‑per‑year budget (a $1 billion, five‑year total) for scoring purposes. She told members the department expects the final federal award will fall between the $500 million baseline and the $1 billion hypothetical and asked the committee to focus on percentage allocations rather than fixed dollar amounts because the award amount is not yet known.

Why it matters: the federal program allows states to reshape rural health delivery with multi‑year funds that could be devoted to workforce, telehealth, safety‑net services and infrastructure. North Dakota’s draft priorities and allocation percentages will guide how the department invites applications and awards funds to providers, tribes and community organizations.

Key priorities, draft allocations and examples - Strengthen and stabilize the rural health workforce (draft ~16.2% of allocations). Aker said this bucket would include expanding residency training, "train in place" opportunities, recruitment and relocation grants, and technology used as workforce extenders. - Bring high‑quality health care closer to home…