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Lawmakers press health department on sustainability and what happens when federal rural funds end
Summary
Several members said they worry multi‑year grants will create recurring obligations after federal funding sunsets; the department said applicants must demonstrate paths to sustainability and that there is no required state match.
Multiple members raised caution about the long‑term fiscal implications of programs funded by the federal rural health transformation award during the Finance committee hearing. Representative Williams and others asked whether investments that stand up new positions or services would create year‑six obligations for the state.
"So what happens when the federal funding sunsets and the funding is gone?" a member asked. Deputy Commissioner Randolph responded, "There are no state match required," and said the department will score applications for sustainability, evaluation plans and a budget that shows a pathway beyond the five‑year federal term. Randolph said projects that cannot show a viable post‑grant plan will be less competitive.
Several members pressed for specificity on the definition of "rural" used to allocate funding; Randolph said the department plans to follow precedent used by the state's health care resiliency program that covered 89 rural counties. Lawmakers warned that programs that become recurring obligations could force future appropriations decisions.
