# North Dakota RHTP Rural Ambulance Modernization (Solicitation 210-342) North Dakota Health and Human Services (ND HHS) is offering a competitive grant opportunity under the Rural Health Transformation Program (RHTP) to modernize licensed rural ambulance services and improve the delivery of emergency medical care through equipment modernization, telehealth, and electronic medical record (EMR) integration. Approximately $22,000,000 in total federal funds are available for this year (Year 1), with an estimated 110 awards of approximately $200,000 each, supporting projects such as ambulance retrofits, telemedicine-enabled equipment, LTE routers, SIRN radios, and related upgrades to EMS communications and interoperability. Eligible projects are prioritized if they focus on new equipment not currently utilized by the applicant. All awarded funds must be expended by August 31, 2027. Eligible applicants include ND-located licensed ground ambulance districts and providers (including non-federal tribal services) serving rural or rural tribal residents outside urban centers (Bismarck, Fargo, Grand Forks, West Fargo unless at least 50% rural focus). Applications are due through Qualtrics by August 9, 2026 at 11:59 p.m. CT. Only one application is allowed per organization. ## Key facts - Status: Closed - Type: GRANT - Issued by: North Dakota Health and Human Services (ND HHS) – Rural Health Transformation Program (North Dakota) - Posted: 2026-07-23 - Application due: 2026-08-10 - Funding: $22.0M - Eligible applicants: Local government, Ambulance district, Tribal ambulance service (non-federal), Nonprofit EMS provider - How to apply: Applications must be submitted through the ND HHS Qualtrics survey as described in the official Application Guidance PDF. Required budget template must be uploaded with application responses. - Funding source: Rural Health Transformation Program (CMS) - Official source: https://www.hhs.nd.gov/sites/default/files/documents/rhtp/20260723-Rural-Ambulance-Modernization.pdf ## Eligibility Eligible applicants include licensed North Dakota-located ground ambulance service providers and ambulance districts, including non-federally operated tribal ambulance services, serving ND rural and rural tribal residents (outside urban centers: Grand Forks, Fargo, West Fargo, Bismarck unless 50% of served population or grant activities focus on rural citizens). Applicants must be licensed and in good standing, and provide services to ND Medicaid members. FAQ addendum (posted Aug. 3, 2026): This opportunity is limited to ground ambulance services — air ambulance is not eligible. Quick response units (QRUs) are not an eligible applicant type on their own, but equipment supporting a QRU that is owned/operated by an eligible licensed ground ambulance service may be eligible. When a hospital/organization contracts with an ambulance district for service, the ambulance district should submit the application on behalf of the contracted ambulance service, using the data of the entity actually providing ambulance service (not the district's own data) if that differs. ## Requirements Applicants must describe a project for the modernization of rural ambulance services through eligible purchases, installation, configuration, and implementation of medical equipment, telehealth technology, EMR connectivity, or communications infrastructure. Projects should follow the application guidance, align with RHTP Initiative 3, prioritize new equipment, and ensure no duplication of existing efforts. Complete application through Qualtrics must include organizational background, project narrative, budget using required template, and be received by the deadline. Funds may not be used to supplant existing funding. FAQ addendum (posted Aug. 3, 2026): The purchase of a NEW ambulance or other vehicle is NOT allowable under this funding opportunity — funding is only for modernizing existing ambulances via eligible equipment, technology, connectivity, and installation. A Lease-versus-Purchase comparison is required for each piece of equipment $10,000 or greater (mark N/A with a brief explanation only if leasing is genuinely unavailable). SIRN radio requests may be handheld or rig-mounted — applicants should justify the type requested. All awarded equipment must be fully DELIVERED (not merely ordered) by Aug. 31, 2027, the end of the operating period, to qualify for reimbursement. The five-year service commitment does not automatically apply to volunteer ambulance services — it applies only when training/certification costs paid on an individual's behalf are determined to const… ## Required attachments - Itemized Subrecipient Budget Template (Excel) - Letters of support (if external partner involved) - Relevant project documentation (as applicable) ## Application package and source documents - [ND - 2026 - Rural Ambulance Modernization Funding Opportunity Application Guidance](https://www.ruralcarejourney.com/api/documents/61a85261-2c7b-4dd1-a930-7c5818ce3a75/file) (primary) — official: https://www.hhs.nd.gov/sites/default/files/documents/rhtp/20260723-Rural-Ambulance-Modernization.pdf - [ND - 2026 - Rural Ambulance Modernization – Apply Now (FAQ (posted Aug 3, 2026))](https://www.ruralcarejourney.com/api/documents/7bf37623-4bc5-447d-bd7a-9a4b9f61ddcb/file) — official: https://www.hhs.nd.gov/rural-health-transformation/funding#rural-ambulance-modernization-faq-2026-08-03 More North Dakota RHTP activity: https://www.ruralcarejourney.com/states/nd (markdown: https://www.ruralcarejourney.com/states/nd.md) --- Source: Rural Care Journey (RCJ), https://www.ruralcarejourney.com/opportunities/north-dakota-rhtp-rural-ambulance-modernization-solicitation-210-342--d9eed16d32 — data as of 2026-08-11. Cite the RCJ page for the summary and the linked official source for authoritative terms, deadlines, and amounts.