HHS Region 8 · North Dakota Department of Health and Human Services
Program Overview
The North Dakota Rural Health Transformation Program is implementing phased, competitive funding rounds focused on workforce stabilization, preventive care, behavioral health, and health technology modernization in rural and tribal communities. Current priorities include workforce training and retention, safety net service delivery, telehealth and remote monitoring, and data and infrastructure upgrades designed to support measurable, sustainable improvements in health care access and outcomes. The program emphasizes collaboration and local leadership, with structured grant opportunities tracked across four major pillars and progress monitored against established goals. As of late 2026, most Year 1 funding opportunities have closed and applications are under active review, with leadership transition underway and awards expected soon. Current structured plan tracks 4 key initiatives and 13 strategic goals.
Updated
County-level estimates averaged across North Dakota — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
pp = percentage points vs US county average
County Drilldown (53)
| County | Pop | Poverty | Uninsured |
|---|---|---|---|
| Cass County | 193,400 | 11.0% | 6.0% |
| Burleigh County | 100,600 | 7.9% | 4.7% |
| Grand Forks County | 72,923 | 13.2% | 6.3% |
| Ward County | 68,973 | 8.6% | 5.6% |
| Williams County | 39,555 | 8.6% | 5.1% |
| Morton County | 33,777 | 8.0% | 3.5% |
| Stark County | 33,302 | 12.1% | 7.7% |
| Stutsman County | 21,549 | 12.6% | 7.3% |
| Richland County | 16,584 | 9.7% | 6.5% |
| McKenzie County | 14,321 | 12.0% | 8.4% |
| Rolette County | 11,924 | 24.3% | 19.5% |
| Ramsey County | 11,556 | 15.2% | 10.3% |
AI source: ND - 2026 - Rural Health Awards Biggest Winners Losers in Round 2
AI auto-updated Nov 11, 2026
API refreshed May 7, 2026
GuideGetting ready for Year 2 in North Dakota?How to prepare for RHTP Year 2 funding →
Source: CMS State Data Maps ↗ · checked Nov 11, 2026
Federal awards to date: $405,316,596.31 (Year 1 $198.9M + Year 2 $206.4M)
Initiatives (4)
CMS stages run from Stage 0 (planning) to Stage 5 (full implementation). Complete In progress Not started
Key signals are summarized here. Open the source for the supporting detail.
Centers for Medicare & Medicaid Services (CMS)
Grouped files
No related documents
No linked documents found.
Centers for Medicare & Medicaid Services (CMS)
Due Dec 31, 2025
8 related documents
310,227 rural residents
North Dakota's Rural Health Transformation Program has awarded several year one funding opportunities across workforce, technology, and care access, with hundreds of applications from rural and tribal providers. As of October 2026, all core initial solicitations are closed and awards have been granted, with technical assistance provided and further sub-opportunities expected in mid-2026. Multiple funding rounds are planned in phases to expand engagement and impact. The state continues to announce and administer new opportunities as part of ongoing implementation. State opportunities: 25 total (25 past/closed), $59.0M listed funding. Key opportunities: North Dakota RHTP Rural Ambulance Modernization (Solicitation 210-342); Ensuring Safety Net Service Delivery Initiative; North Dakota Technology as an Extender Funding Opportunity (Solicitation 210-231). Strategy alignment: supports telehealth, care access, workforce priorities.
North Dakota’s RHTP remains a five-year, phased statewide effort anchored in four pillars: rural health workforce stability, preventive care and youth wellness, access to high-quality rural and tribal care, and technology and data modernization. The strategy emphasizes phased funding and close collaboration with federal programs, incorporating competitive rounds, technical assistance, contract partnerships, and systematic program review. Integration with Medicaid value-based payment initiatives and alignment with federal guidance ensure continued improvement of rural health infrastructure and service delivery.
Model
Phased, pillar-based model emphasizing targeted investments in workforce stabilization, provider-driven implementation, systematic assessment, compliance reporting, and coordinated rural-tribal care. This includes technology modernization, EMR enhancement, planning grants for statewide Community Information Exchange, Medicaid billing and referral updates, value-based payment frameworks, and partnership with the UND Center for Rural Health for technical assistance and assessment. Strategic, multi-year planning and leadership alignment enable sustainable, data-driven rural health systems.
Key Initiatives (4)CMS official list ↗
Supporting activities (29)
• Develop and fund Train In Place workforce credentialing programs, microcredentials, and rural-committed upskilling for rural and tribal providers
• Expand rural health care rotations, establish new rural residencies, and grow-your-own workforce pipelines
Timeline: Five-year phased effort with annual and multi-year competitive funding rounds, technical assistance and assessment cycles, strategic planning and leadership alignment, and systematic program review.
Bring High-Quality Health Care Closer to Home
Connect Tech, Data and Providers for a Stronger North Dakota
Make North Dakota Healthy Again | Preventive Care, Healthy Eating
Strengthen and Stabilize Rural Health Workforce
State Policy Action commitments (5 of 19)
North Dakota is receiving significant Rural Health Transformation Program funding, notably the largest amount nation-wide for Year 2. This funding continues the state's health transformation efforts under the RHTP.
North Dakota received the nation's largest Year 2 Rural Health Transformation Program (RHTP) funding increase, securing over $206 million from CMS—an increase of $7.44 million over Year 1. The state's cumulative RHTP funding through the five-year program totals about $405.3 million. North Dakota obligated all of its Year 1 funds and has implemented an anc...
RHTP funding targets retention of rural and tribal health workforce through direct grants to critical access hospitals and clinics.
ND - 2025 - North Dakota RHT Plan Application Letter to CMS Administrator
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ND - 2025 - North Dakota RHT Plan Budget Narrative – Year 1
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ND - 2026 - North Dakota BRFSS Comparisons by Urban/Rural County of Residence and North Dakota Rural Health Workforce Transformation Strategic Plan
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ND - 2026 - Funding Opportunity Scoring Tool Attachment B: Scoring Tool
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ND - 2026 - North Dakota Federal RHTP Award (FY2026-FY2030)
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ND - 2026 - RHTP Competitive Funding Opportunity Application Guidance: Behavioral Health Promotion Community Grants
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ND - 2026 - Behavioral Health Promotion Community Grants Funding Opportunity Application Guidance
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ND - 2026 - Rural Workforce Retention Funding Opportunity Solicitation Number: 210-22102
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North Dakota Health and Human Services
Due Aug 26, 2026
1 related document
ND - 2026 - Coordinating and Connecting Care Funding Opportunity Application Guidance
Coordinating and Connecting Care Application Guidance
North Dakota Health and Human Services
Due Aug 19, 2026
1 related document
ND - 2026 - Non-Emergency Medical Transportation Acquisition Funding Opportunity Application Guidance
Funding Opportunity Application Guidance
North Dakota Health and Human Services
Due Aug 18, 2026
2 related documents
ND - 2026 - Technology as an Extender Funding Opportunity Application Guidance
Primary source
North Dakota is receiving significant Rural Health Transformation Program funding, notably the largest amount nation-wide for Year 2. This funding continues the state's health transformation efforts under the RHTP.
The document highlights North Dakota's involvement with the Rural Health Transformation Program (RHTP) and discusses a request to HHS and CMS to implement a phased approach for collaboration with Medicaid expansion related to rural health funding.
North Dakota was awarded $206 million in second-year funding under the Rural Health Transformation Program, bringing its two-year total to approximately $406 million. The funding aims to strengthen rural hospitals, expand medical service access, and create a sustainable health care delivery system across rural North Dakota. The North Dakota Center for Rural Health will oversee sub-awards to support these initiatives. Event schedule: - Second-year award announcement - November 9, 2026 - 3:49 PM CT - Bismarck, ND
Event Schedule
Core Initiatives
North Dakota HHS is launching a competitive RHTP planning grant to strengthen statewide care coordination and information exchange, with up to $1 million available. Year 1 activities focus on convening stakeholders, assessing IT and referral platforms, and producing an actionable roadmap for a statewide Community Information Exchange and closed-loop referral system. The application is open to eligible organizations serving rural and Medicaid populations, including rural tribal communities. Event schedule: - Technical Assistance Call - 08/12/2026 - 12:00 PM CT - Webinar (Registration Link) - Application Submission Deadline - 08/26/2026 - 5:00 PM CT - Qualtrics application portal - Operating Period End - 08/31/2027
Event Schedule
Core Initiatives
North Dakota's RHTP is launching multiple funding opportunities as part of a five-year statewide effort to transform rural health, including school-based PE, community gardens, walking programs, and behavioral health grants. Eligibility is restricted to North Dakota’s rural and tribal entities, excluding urban areas, and projects target key health priorities such as preventive care, behavioral health, and nutrition. Application processes, timelines, technical assistance, and eligibility requirements are prominently outlined; indirect costs are capped and some opportunities specify budget thresholds. Event schedule: - Zero-Hour PE Initiative Application Deadline - 05/22/2026 - 5:00 PM CT - Zero-Hour PE Initiative Technical Assistance Call - May 4, 2026 - 3:30 PM CT - Community Gardens Project Application Deadline - 05/22/2026 - 5:00 PM CT - Community Gardens Project Technical Assistance Call - May 5, 2026 - 3:00 PM CT - Community-Based Walking Program Application Deadline - 05/22/2026 - 5:00 PM CT - Community-Based Walking Program Technical Assistance Call - May 6, 2026 - 3:00 PM CT - Behavioral Health Promotion Community Grants Application Deadline - 05/29/2026 - 5:00 PM CT - Behavioral Health Promotion Technical Assistance Call - May 7, 2026 - 2:00 PM CT
Event Schedule
Core Initiatives
This document provides technical assistance support related to the Rural Health Transformation Program funding opportunities in North Dakota. It aims to guide rural communities through the application process by offering expert help and regional assistance.
North Dakota anticipates receiving $1 billion in federal funding under the Rural Health Transformation Program from 2026-2030. The state's five-year plan targets chronic disease, behavioral health, access, technology modernization, and stabilizing the rural healthcare workforce, including special focus on telehealth, preventive care, and engagement with tribal communities. Multiple funding opportunities are planned for rural providers and community partners, with early engagement through public surveys, listening sessions, and ongoing outreach. Key contacts: rhtp@nd.gov Event schedule: - Public survey launch - 08/13/2025 - Three statewide listening sessions - October 2025 - RHTP Application submission deadline - 11/05/2025 - Federal award announcement deadline - 12/31/2025
Event Schedule
Contacts
Core Initiatives
The program includes multiple phased funding opportunities targeting workforce retention, preventive health initiatives like the Zero-Hour Physical Education program, and community health projects such as gardening and walking programs. These solicitations are tailored to rural and tribal public and private schools, clinics, and community organizations with technical assistance provided. Funding application deadlines are generally in May 2026, with awards supporting evidence-based, locally relevant projects. Event schedule: - Zero-Hour Physical Education (PE) Application Deadline - May 22, 2026 - 5 p.m. CT - Zero-Hour PE Technical Assistance Call - May 4, 2026 - 3:30 p.m. CT - webinar - Community Gardens Project Application Deadline - May 22, 2026 - 5 p.m. CT - Community Gardens Project Technical Assistance Call - May 5, 2026 - 3 p.m. CT - webinar - Community-Based Walking Program Application Deadline - May 22, 2026 - 5 p.m. CT - Community-Based Walking Program Technical Assistance Call - May 6, 2026 - 3 p.m. CT - webinar - Behavioral Health Promotion Community Grants Application Deadline - May 29, 2026 - 5 p.m. CT - Behavioral Health Promotion Community Grants Technical Assistance Call - May 7, 2026 - 2 p.m. - 2:45 p.m. CT - webinar
Event Schedule
Core Initiatives
North Dakota received the nation's largest Year 2 Rural Health Transformation Program (RHTP) funding increase, securing over $206 million from CMS—an increase of $7.44 million over Year 1. The state's cumulative RHTP funding through the five-year program totals about $405.3 million. North Dakota obligated all of its Year 1 funds and has implemented an anchor partner model to strengthen program administration. Year 1 investments targeted workforce shortages, facility upgrades, technology, and community health.
Article reports North Dakota posted the largest gain in competitive Rural Health Transformation funding in Round 2 and notes a $10 billion total award to all 50 states, but provides no detailed award allocations or recipient information. Event schedule: - Becker's Hospital Review North Dakota posted the largest gain in competitive Rural Health Transformation ... CMS awarded $10 billion to all 50 states for fiscal ... https://www.beckershospitalreview.com/finance/rural-...
This document is a listing of news articles and press releases highlighting RHTP awards for North Dakota and West Virginia. No explicit award data or detailed program information is included inside this document.
A $200 million funding allocation for North Dakota's Rural Health Transformation Program has been submitted to CMS. This represents year 1 funding highlights for the state program.
This document is a technical assistance (TA) call related to the Electronic Medical Record Enhancement funding opportunity in North Dakota. It supports the state's efforts to strengthen rural health care through improved health information technology. Event schedule: - TA Call - 07/08/2026
Event Schedule
Sept. 30, 2027
End of Operating Period and Fund Expenditure
The operating period will end Sept. 30, 2027, and all funds must be expended by this date.
September 30, 2027
Operating period end
The operating period will end on September 30, 2027, and all funds must be expended by this date.
September 30, 2027
Year one funds expended
All year one funds must be expended by this date.
September 30, 2027
End of RHTP operating period
The operating period will end on September 30, 2027, and all funds must be expended by this date.
September 30, 2027
Operating period ends
The operating period for the funding opportunity ends Sept. 30, 2027.
September 30, 2027
Operating period ends and funds expended
All funds must be fully expended and all goods delivered by September 30, 2027.
September 30, 2027
End of operating period
All funds must be fully expended by that date.
September 30, 2027
All year one funds must be expended
All year one funds must be fully expended by this date.
September 30, 2027
Funding Period Ends
The funding period will end on September 30, 2027, and all funds must be expended by this date.
September 2027
All Year 1 funds expended
All Year 1 funds must be expended by this date.
September 2027
All year one funds must be expended
All year one funds are required to be expended by September 2027.
September 2027
All year one funds expended
All year one funds must be expended by September 2027.
ND - 2027 - W.Va. awarded $202M for 2nd year of RHT
ND - 2026 - Rural Health Awards Biggest Winners Losers in Round 2
ND - 2026 - Delegation advancing efforts to transform health care delivery in rural North Dakota
ND - 2026 - North Dakota receives nation's largest Year 2 RHTP funding increase
Nov 10, 2026 16:49
·EmailND state summary updated: transformationStrategy initiatives: 29 -> 4
North Dakota’s RHTP continues its five-year, phased statewide initiative anchored in four pillars: workforce stability, preventive care and…
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed. Showing the 40 most recent of 171.
ND - 2026 - North Dakota Receives Largest Year 2 RHTP Funding Increase
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ND - 2026 - North Dakota Awarded $206M in Second Year of Rural Health Transformation Program
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ND - 2026 - Senator Urges Phased Approach to Medicaid Changes in North Dakota
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ND - 2026 - (RHTP). program and implementation of the Rural Health Transformation Program
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ND - 2026 - Money Follows the Person Grant
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ND - 2026 - State Sources of Supply
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ND - 2023 - preference laws
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ND - 2026 - RHTP Resources - Sheps Center
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ND - 2026 - NDAC 4-12-08
ND - 2026 - NDAC 4-12-06
ND - 2026 - NDAC 4-12-04
ND - 2025 - Agreement Between North Dakota Department of Health and Human Services and Tribal Government per NDCC Section 50-24.1-40
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ND - 2026 - North Dakota Department of Human Services Tribal 638/IHS Guidance on Claim Submission Requirements
Service Limits Prior Authorization Form SFN 481
North Dakota WHODAS Assessment 2.0 RHTP Meeting Minutes
North Dakota Medicaid Other Licensed Providers (OLPs) Billing And Policy Manual RHTP 2026 Document
EXEMPTION FOR SUBMITTING ELECTRONIC CLAIMS
North Dakota Medicaid RHTP Reference
North Dakota Medicaid Eligibility Policy For Incarcerated Individuals RHTP Document
ND - 2026 - NDCC § 32-12.2-15
Rural Health Transformation Program funding opportunity updates — IfbViTvuhuwXO_8COCAAPaZe9LfcK5X1bZjKMvY-vfM=452
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ND - 2026 - NDCC § 50-09-08.2
North Dakota Century Code Chapter 54-12: Attorney General (Duties, Powers, and Related Funds)
ND - 2026 - NDCC § 14-09-08.16
North Dakota Century Code Chapter 43-07: Contractors
Chapter 13-01.1 Interest on Delinquent Accounts
Notice of Security Breach for Personal Information (Chapter 51-30)
Tribal 638 Ihs Care Coordination Cms Facility Letter
Fluoride Varnish Comparison
Codes Rates Limits
Nd Mmis Portal Template Training Exclusion
Mmis Paper Claim Instuctions Professional
Member Eligibility Instructions
State Procurement Officer Agency Assignments
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ND - 2026 - Itemized Subrecipient Budget Template with Technology - Updated 6-12-26
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ND - 2026 - Itemized Subrecipient Budget Template - Updated 5-28-26
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ND - 2025 - 2025 208 8
ND - 2023 - 2023 640 25
North Dakota Bureau of Criminal Investigation - Chapter 12-60
ND - 2003 - Senate Concurrent Resolution No. 4018
ND - 2026 - RHTP Technical Assistance for Technology as an Extender July 30, 2026
Primary source
This newsletter summarizes October 2026 updates to North Dakota Medicaid. Key topics include new changes to Medicaid, improvements to flexible eyewear for children, tips for maximizing customer support, help for dental provider access, and member engagement opportunities. The MMEC committee invites Medicaid members to participate. Key contacts: Jen Sheppard medicaidmembers@nd.gov Event schedule: - Changes to North Dakota Medicaid Effective Date - 10/01/2026
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Core Initiatives
West Virginia was awarded $202.1 million for year two of the federal Rural Health Transformation Program, bringing its total to over $400 million for the five-year period. The program funds a range of strategic initiatives including connected care, telehealth, EMS innovation, health workforce development, and technology modernization. Early milestones show progress obligating funds, advancing awards, and executing contracts across all strategic pillars. Event schedule: - Federal Year-One Funds Obligation Deadline - 10/30/2026 - Year Two Award Announcement - 11/09/2026
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Core Initiatives
North Dakota was awarded $206 million for the second year of the RHTP, building on their initial nearly $200 million award. The funding targets infrastructure upgrades including fiber optic networks, construction of new critical access hospitals, telehealth expansion, and workforce retention initiatives. Event schedule: - Award Announcement Date - 11/09/2026 - Bismarck, ND
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Core Initiatives
North Dakota Health and Human Services was awarded $198.9M in the first year of RHTP. The Technology as an Extender funding opportunity provides $5M to eligible rural and tribal health facilities for acquiring smart technology, AI and robotics, and remote patient monitoring, aiming to transform rural care delivery, enhance workforce retention, and reduce adverse events. Guidance covers eligibility, allowable and unallowable costs, application procedures, and expected outcomes. Key contacts: Bobbie Will Event schedule: - Application Deadline - 08/18/2026 - 5:00 PM CT - Review and Scoring Period - August 19 - September 8, 2026 - Funding Period End - 08/31/2027
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Core Initiatives
North Dakota was awarded $198.9M for year one of the Rural Health Transformation Program. This funding opportunity provides up to $3 million in planning grants to support embedding sustainable childcare solutions into rural health facilities, aiming to strengthen rural workforce recruitment and retention. Eligible applicants include critical access, rural emergency, general acute, and qualifying IHS/tribal hospitals outside major urban centers. Key contacts: Colette Greek Event schedule: - Applications Due - 08/11/2026 - 5:00 PM CT - Qualtrics portal - Review and scoring period - 08/12/2026 – 09/12/2026 - Year 1 funds awarded deadline - 09/30/2026 - Funds expenditure deadline - 09/30/2027
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Governor Sanders announced Arkansas’ application process for $209 million in RHTP funding, initially focusing on modernizing rural health through the THRIVE initiative. The program spans major priorities: expanding telehealth, recruiting rural health workers, creating coordinated nutrition programs, and building integrated health networks. Extensive community and stakeholder engagement—through townhalls and partnership outreach—shaped the four core state RHTP priorities. Key contacts: info@ArkansasRHTP.com Event schedule: - Announcement date - 05/04/2026 - LITTLE ROCK, Arkansas - THRIVE application round open - 05/04/2026 - www.ArkansasRHTP.com - Additional funding rounds announced by - Within 90 days - All FY26 funds expected awarded by - Fall 2026
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