ND awarded $199M for Rural Health Transformation Program to strengthen care in rural communities

North Dakota has been awarded $199 million in federal funding to support the first year of a new statewide Rural Health Transformation Program aimed at strengthening health care delivery in rural communities, Gov. Kelly Armstrong announced today.

The funding, awarded by the Centers for Medicare and Medicaid Services (CMS), is part of a five-year initiative designed to improve access to care, enhance quality and strengthen health outcomes for rural North Dakotans.

To access the federal funds, state lawmakers must first appropriate the money. Armstrong issued an executive order today calling the Legislature into a special session beginning Jan. 21 to consider the funding.

“With this major investment through the Rural Health Transformation Program, we have a once-in-a-generation opportunity to rethink and reshape how health care is delivered to our rural communities,” Armstrong said. “We thank President Trump, HHS Secretary Kennedy, CMS Administrator Oz and our congressional delegation for their support in securing this funding, which will benefit citizens across our state and help make North Dakota the best place to live, work and raise a family.”

North Dakota submitted its application to CMS on Nov. 3. The Rural Health Transformation Program focuses on four core initiatives: strengthening and stabilizing the rural health care workforce; improving preventive care and promoting healthy eating; bringing high-quality care closer to home; and better connecting technology, data and providers across the state.

“This funding allows North Dakota to build on existing partnerships and invest in long-term solutions to move toward making our state the healthiest in the nation,” said Pat Traynor, commissioner of the North Dakota Department of Health and Human Services (HHS). “Rural communities face unique challenges, and this program helps ensure people can get the care they need, close to home.”

As part of its application, the state also sought approval from the U.S. Department of Agriculture for a Supplemental Nutrition Assistance Program (SNAP) waiver that limits the purchase of unhealthy foods and aims to improve health outcomes for SNAP participants. The USDA approved the waiver on Dec. 10, making North Dakota eligible for additional funding beyond the $500 million minimum allocated to each state over the five-year period.

In preparation for the special legislative session, HHS is developing a framework for prioritizing and distributing grant funds, ensuring compliance with federal requirements, and engaging key stakeholders. The agency expects to release the first round of subaward grant opportunities in the first quarter of 2026.

“Being awarded this grant funding is an important milestone,” said Sarah Aker, HHS medical services executive director. “Now, our focus shifts to implementation so the resources can start making an impact in rural communities.”

The Rural Health Transformation Program was created under the federal Working Families Tax Cut Act, which appropriated $50 billion nationwide over five years. Half of the funding was distributed equally among states, with the remaining funds awarded based on state applications and metrics demonstrating the potential for significant improvements in rural health outcomes.

By DNU Staff