The North Dakota Rural Health Transformation Program is actively implementing phased, competitive funding rounds to address workforce stabilization, preventive care, behavioral health, and modernization of health technology in rural and tribal communities. Current focus areas include workforce training, safety net service delivery, telehealth and remote monitoring, and infrastructure upgrades supporting measurable, sustainable improvements in health care access and outcomes. The program is administered by North Dakota Health and Human Services and is partnering with communities and Critical Access Hospitals, emphasizing evidence-based initiatives and operational sustainability. Multiple structured grant opportunities are currently open and track progress across strategic pillars and initiatives. Current structured plan tracks 22 key initiatives and 7 strategic goals.
North Dakota's Rural Health Transformation Program continues active implementation, with nearly $200 million in Year 1 funding underway and multiple competitive grant opportunities open to rural and tribal providers. Applications are currently being accepted for major initiatives including Electronic Medical Record Enhancement and Technology as an Extender, with technical assistance, site visits, and application deadlines through August 2026. The state maintains ongoing engagement with partners and recipients, and fully operationalized guidance for provider requirements reflects robust program activity across workforce, telehealth, and care access priorities. State opportunities: 7 active (1 open, 6 closing soon, 20 past/closed), $62.2M listed funding. Key opportunities: North Dakota Technology as an Extender Funding Opportunity (Solicitation 210-231); North Dakota RHTP Clinics without Walls: Telehealth Infrastructure (Solicitation 210-331); North Dakota RHTP: Non-Emergency Medical Transportation Acquisition. Strategy alignment: supports workforce, telehealth, care access priorities.
RHTP Strategy
North Dakota’s RHTP maintains a phased, pillar-based strategy to stabilize the rural health workforce, promote preventive care and wellness, and advance care delivery via competitive grants, technical assistance, and targeted Medicaid reforms. Recent updates reinforce emphasis on locally driven workforce, childcare, technology, care coordination initiatives, and tribal integration, aligning with phased funding cycles and assessment processes. Systematic compliance, outcome-driven reporting, and improvement of care coordination for tribal and Medicaid populations remain central.
Model
Phased, pillar-based model pairing targeted investments with provider-driven implementation, systematic assessment cycles, and strict compliance mechanisms to stabilize workforce, modernize care, expand technology, and enable sustainable, data-driven rural health systems. Formalized care coordination arrangements and updated Medicaid billing and referral policies ensure integration of tribal, FQHC, and telehealth services for eligible populations.
Key Initiatives
1Develop and fund Train In Place workforce credentialing programs, microcredentials, and rural-committed upskilling for rural and tribal providers
2Expand rural health care rotations, establish new rural residencies, and grow-your-own workforce pipelines
3Award workforce retention funding for Critical Access Hospitals (CAHs) and affiliated clinics
4Expand and embed childcare support and planning within rural health workforce facilities
5Grant funding for hospital-based wellness equipment to support physical, mental, and emotional health for rural hospital staff
6Provide grants for fitness, mental wellness, and sensory equipment for rural and tribal schools
7Provide technical assistance and comprehensive financial and operational assessments to rural CAHs and FQHCs, including implementation of health analytics tools
8Support business-practice training for rural providers covering coding, billing, sustainability, and HR
9Fund mobile mammography units, behavioral health safety net, and rural clinical equipment acquisitions
10Launch evidence-based behavioral health promotion and suicide prevention community grants
11Conduct statewide behavioral health needs assessment and develop Train-the-Trainer curriculum for rural/tribal populations (Parents Lead)
12Implement hospital-based and school-based wellness equipment grants, and community-based physical activity (e.g., Zero-Hour PE, walking programs) and healthy eating initiatives
13Expand modernization of technology infrastructure, including electronic medical record enhancement, telehealth hub expansion, remote patient monitoring, secure data sharing, competitive funding for AI-enabled innovation, and self-serve dispensing kiosks in pharmacies
14Competitive grants for Rural Ambulance Modernization, including telemedicine-enabled ambulance retrofits, EMR and ePCR integration, and equipment upgrades
15Launch Clinics without Walls: Telehealth Infrastructure initiative to establish telehealth access points in schools, pharmacies, community and tribal facilities
16Fund Clinics without Walls: Remote Patient Monitoring to expand in-home monitoring, patient portals, and dashboards for rural populations
17Competitive funding for Technology as an Extender to deploy smart technology, robotics, AI-enabled solutions, and caregiver devices in rural and tribal facilities
18Statewide enrollment of community health workers and expansion of school-based nursing services
19Enforce strict grant compliance, reporting, fiscal accountability, outcome-driven project proposals, and continuous monitoring across all RHTP activities
20Implement, monitor, and update Medicaid care coordination agreements between Tribal entities and non-Tribal providers for improved AI/AN beneficiary access
21Standardize Medicaid enrollment and encounter-based billing for IHS, Tribal Health Programs, Tribal FQHCs, and FQHCs, including telehealth parity and updated documentation requirements
22Competitive grant for Coordinating and Connecting Care planning process to build a statewide Community Information Exchange (CIE) and closed-loop referral system, engaging rural, Medicaid, and tribal partners
Timeline: Five-year phased effort with annual and multi-year competitive funding rounds, technical assistance and assessment cycles, and systematic program review.
Health Priority
Workforce retention
Funding targets retention efforts for rural Critical Access Hospitals and clinics to stabilize essential health workforce.
Rural and tribal areas statewide
Aug 12, 2026
Health Priority
Preventive Health and Healthy Living
Programs such as community-based walking and healthy eating grants support preventive care approaches to improve rural population health.
Rural North Dakota
Aug 12, 2026
Health Priority
Access and Care Delivery
Grants focus on bringing high-quality care closer to home through telehealth, mobile mammography, and ambulance modernization initiatives.
Rural North DakotaTribal communities
Aug 12, 2026
Reference
PDF
2025-2026
Award: $198.9M
ND - 2025 - North Dakota RHTP (nd-rhtp-year-one-budget-narrative-exclusion)
Auto-grouped context match (38%)
SupportingPDF2025-2029No amount extracted
ND - 2025 - RHTP - North Dakota State Transformation Plan
ND - 2026 - Technology as an Extender Funding Opportunity Application Guidance
Primary source
SupportingPDF2026
Announcement Documents (34)
🌐
AnnouncementNEWAug 11, 2026HTML2025
North Dakota will receive $1 billion over five years under the Rural Health Transformation Program to strengthen rural health care, improve health outcomes, and modernize health technology infrastructure statewide. Key initiatives include recruiting and retaining rural clinicians, launching new prevention and wellness programs, expanding telehealth and mobile clinics, and increasing evidence-based nutrition and behavioral health strategies. Federal funds will flow through the state, which must submit a detailed plan to CMS by November 2025; awards will be announced by December 2025 with activities spanning fiscal years 2026-2030. Key contacts: rhtp@nd.gov
Event schedule:
- Public Survey Launch - 08/13/2025 - CT - Online
- Listening Sessions - October 2025 - CT - Statewide, Community venues
- Application Deadline - 11/05/2025 - CT - CMS Submission Portal
- Award Announcement - 12/31/2025 - CT - CMS Announcement
Award Announcement - 12/31/2025 - CT - CMS Announcement
Contacts
<rhtp@nd.gov> - RHTP Contact Email - Statewide
Core Initiatives
Strengthen rural health care
Make North Dakota the healthiest state in the nation
Rebuild and retain rural health workforce
Show all initiatives (6)
Strengthen rural health care
Make North Dakota the healthiest state in the nation
Rebuild and retain rural health workforce
Prevent chronic disease and reduce costs
Bring high-quality care closer to home
Modernize health technology infrastructure
✉️
AnnouncementNEWAug 10, 2026TXT2026
📄
AnnouncementAug 5, 2026PDF2025
Award Announcement Documents (1)
🌐
Award AnnouncementApr 15, 2026HTML2026Federal
North Dakota has received a substantial $199 million award as the first year allocation of the Rural Health Transformation Program. This investment will allow the state to transform rural health care delivery and support care for rural and underserved populations. No specific sub-awards or program distribution details are yet available.
Event schedule:
- Award Announcement - 2026 - North Dakota
Award: $199.0MOTHER
Event Schedule
Award Announced - 2026-03-18
Application deadline - 2026-04-30
Core Initiatives
Transform rural health care delivery in North Dakota
Support rural hospitals and providers through Medicaid innovation
North Dakota is releasing a competitive Year 1 planning grant opportunity under RHTP, focused on building the foundation for a statewide Community Information Exchange (CIE) and closed-loop referral system for rural and Medicaid-serving providers. The solicitation prioritizes cross-sector partnerships, assessment of current care coordination gaps, and actions to support future statewide implementation. Up to $1 million in federal funding is available for a single planning grantee, with the aim of improving care coordination, secure information exchange, and access for rural and tribal populations.
Event schedule:
- Application Deadline - 08/26/2026 - 5:00 PM CT - Qualtrics (online submission)
- Technical Assistance Call - 08/12/2026 - 12:00 PM CT - Registration Link (virtual conference, see website for details)
- Grant Operating Period End - 08/31/2027
HEALTH_INFORMATION_TECHNOLOGY · NETWORK_DEVELOPMENT · QUALITY_IMPROVEMENT · OTHER
This guidance details the compliance steps and requirements for North Dakota Tribal governments to receive federal FMAP matching through Medicaid care coordination agreements and the Tribal Health Fund. It sets expectations for annual reporting, audits, and defines allowable uses of funds, with caps on capital spending. The agreement is foundational for directing enhanced Medicaid funds to Tribal health priorities.
Event schedule:
- Annual Report Due Date - 08/30/yyyy - Submit to ND Medicaid Tribal Liaison
- Biennial Audit Due Date - 08/30/yyyy - Submit to ND Medicaid Tribal Liaison
POPULATION_HEALTH · FINANCE · OTHER
Event Schedule
Annual Report Due Date - 08/30/yyyy - Submit to ND Medicaid Tribal Liaison
Biennial Audit Due Date - 08/30/yyyy - Submit to ND Medicaid Tribal Liaison
Core Initiatives
Enhance health equity for American Indian Medicaid beneficiaries through coordinated Tribal-state funded care
Ensure appropriate distribution of federal FMAP savings to Tribal health care projects
Support the development and enhancement of community health representative services
📄
GuidanceAug 5, 2026PDF
This guidance clarifies the process and requirements for submitting Medicaid claims involving Tribal 638/IHS coordination in North Dakota. It specifies referral number formats and billing procedures to ensure proper coordination and reimbursement for Tribal and non-Tribal providers under Medicaid.
OTHER
📄
GuidanceAug 5, 2026PDF2026
This document provides official scoring criteria and guidance for reviewers evaluating applications to the North Dakota RHTP funding opportunity. Applications must demonstrate clear goals, defined rural health needs, robust project strategies, alignment with RHTP priorities, and a justified budget. Points are awarded based on the completeness and alignment of the application with state transformation goals for rural hospitals and Medicaid.
North Dakota aims to deploy $1B over five years through the Rural Health Transformation Program to address rural workforce shortages, prevent chronic disease, expand telehealth, and modernize care systems. Public engagement and tribal outreach are included. Funding will flow via state-issued opportunities prioritizing rural impact. Key contacts: rhtp@nd.gov
Event schedule:
- Public Survey Launch - 08/13/2025 - Statewide
- Application Deadline to CMS - 11/05/2025
- Award Announcement by CMS - 12/31/2025
- Community Meetings - Listening Sessions - October 2025 - Various
Community Meetings - Listening Sessions - October 2025 - Various
Contacts
<rhtp@nd.gov> - Primary RHTP contact - Statewide
Core Initiatives
Strengthen and stabilize rural health workforce
Prevent and manage chronic disease
Expand telehealth and access to care
Show all initiatives (4)
Strengthen and stabilize rural health workforce
Prevent and manage chronic disease
Expand telehealth and access to care
Modernize health technology and data systems
Summary Documents (2)
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SummaryMay 25, 2026PDFEvent2025
North Dakota HHS expects to receive at least $100 million per year in federal funds under the Rural Health Transformation Program, pending application approval to CMS by Dec 31, 2025. The state is currently in the planning and stakeholder engagement phase, actively soliciting input to shape its transformation plan and aligning with strategic goals to support rural health outcomes, technology, workforce, and facility solvency. No sub-award or provider-level funding has yet been announced.
Event schedule:
- RHTP State Application Deadline - 12/31/2025
- CMS Guidance Expected - Fall 2025
- ND HHS Rural Health Transformation Plan Listening Sessions (anticipated) - Fall 2025
- State Survey Deadline for Plan Input - 09/12/2025
The program is structured around four key pillars: stabilizing the rural health workforce, promoting preventive care, bringing high-quality care closer to home, and improving technology and data connections. Multiple funding opportunities are released in phases to support these goals, including workforce retention, preventive programs, telehealth infrastructure, and equipment acquisition. The program engages local entities through grants and initiatives to address specific rural health challenges.
Core Initiatives
Strengthen and stabilize rural health workforce
Promote preventive care and healthy lifestyles
Increase access to high-quality health care closer to home
Show all initiatives (4)
Strengthen and stabilize rural health workforce
Promote preventive care and healthy lifestyles
Increase access to high-quality health care closer to home
Enhance connectivity through technology, data, and provider collaboration
Reference Documents (14)
✉️
ReferenceNEWAug 11, 2026TXT2026
North Dakota HHS opened a funding opportunity to help eligible rural healthcare providers acquire accessible transportation vehicles, supporting rural Medicaid and non-Medicaid residents facing access barriers. About $2 million in federal funding is available, with an anticipated four awards of around $500,000 each. This competitive opportunity is part of the state’s RHTP Initiative 3, focused on bringing high-quality healthcare closer to home. Key contacts: Jennifer L. Skjod jlskjod@nd.gov
Event schedule:
- Application Due Date - 08/19/2026 - 5:00 PM CT - Online portal
- Funding Project End Date - 08/31/2027
OTHER
Event Schedule
Application Due Date - 08/19/2026 - 5:00 PM CT - Online portal
Funding Project End Date - 08/31/2027
Contacts
Jennifer L. Skjod - <jlskjod@nd.gov> - North Dakota
Core Initiatives
Expand access to care for rural North Dakotans by overcoming transportation barriers
Improve rural residents’ access to high-quality care
📄
ReferenceAug 5, 2026PDF2026
This template formalizes written care coordination agreements between tribal health entities and external providers in North Dakota under RHTP. It establishes roles, responsibilities, and processes for care planning, documentation, and claims for Medicaid-enrolled Indian Health Service beneficiaries. It does not authorize direct funding but supports Medicaid program compliance and Tribal-State health system integration.
📄
ReferenceAug 5, 2026PDF2026
Media (5)
Rural Health Transformation Grant Opportunities
Grant opportunities highlighted (source image):
Potential non-traditional rural-health model (analytical inference):
Zero-Hour
Walking Programs
Community Gardens
Use schools, walking networks, and community gardens as distributed prevention infrastructure.
Pair activity and food-access sites with trusted local hosts, community health workers, or optional remote check-ins.
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed. Showing the 40 most recent of 111.
ND - 2026 - Technology as an Extender Funding Opportunity Solicitation Number: 210-231
Primary source
This issue highlights new open funding opportunities in workforce, telehealth, and care coordination under North Dakota's Rural Health Transformation Program. North Dakota recently hosted CMS leaders, showcasing implementation progress, community partnerships, and the early impact of nearly $200 million in Year 1 funding. Local public health units and RDC partners are spotlighted for their ongoing support and essential roles in the program.
Event schedule:
- Childcare for the Rural Health Workforce application deadline - 08/11/2026
- Clinics without Walls: Telehealth Infrastructure application deadline - 08/14/2026
- Clinics without Walls: Remote Patient Monitoring application deadline - 08/14/2026
- Technology as an Extender application deadline - 08/18/2026
- Non-Emergency Medical Transportation Acquisition application deadline - 08/19/2026
- Coordinating and Connecting Care application deadline - 08/26/2026
WORKFORCE · HEALTH_INFORMATION_TECHNOLOGY · POPULATION_HEALTH · OTHER
Event Schedule
Childcare for the Rural Health Workforce application deadline - 08/11/2026
Clinics without Walls: Telehealth Infrastructure application deadline - 08/14/2026
Clinics without Walls: Remote Patient Monitoring application deadline - 08/14/2026
Show all schedule items (6)
Childcare for the Rural Health Workforce application deadline - 08/11/2026
Clinics without Walls: Telehealth Infrastructure application deadline - 08/14/2026
Clinics without Walls: Remote Patient Monitoring application deadline - 08/14/2026
Technology as an Extender application deadline - 08/18/2026
Non-Emergency Medical Transportation Acquisition application deadline - 08/19/2026
Coordinating and Connecting Care application deadline - 08/26/2026
Core Initiatives
Strengthen and stabilize the rural health workforce
Bring high-quality healthcare closer to home
Make North Dakota healthy again
Show all initiatives (4)
Strengthen and stabilize the rural health workforce
Bring high-quality healthcare closer to home
Make North Dakota healthy again
Support healthier communities through innovative healthcare delivery
This is the October 2025 update to North Dakota Medicaid’s authoritative telehealth billing and policy manual. The policy expands guidance on audio-only and digital health services, outlines covered service types such as diabetes training and behavioral health, and sets requirements for provider enrollment, claim coding, and reimbursement. The manual provides compliance and billing definitions for providers delivering telehealth to rural Medicaid patients. Key contacts: Medical Services dhsmedicalservices@nd.gov
Event schedule:
- Policy Update - October 2025
- Previous Policy Update - May 2025
- Prior Policy Update - January 2024
HEALTH_INFORMATION_TECHNOLOGY · OTHER
Event Schedule
Policy Update - October 2025
Previous Policy Update - May 2025
Prior Policy Update - January 2024
Contacts
Medical Services - <dhsmedicalservices@nd.gov> - General Medicaid policy contact - Statewide
Core Initiatives
Expand access to physical, mental, and behavioral health care through telehealth services for Medicaid members
Ensure Medicaid reimbursement for medically necessary telehealth services delivered by enrolled providers
Align state Medicaid telehealth billing policies with federal requirements and coding standards
North Dakota was awarded $198.9M for RHTP year one; this funding opportunity specifically allocates $5M for rural and tribal health systems to adopt advanced technology solutions. The Technology as an Extender initiative aims to support acquisition of remote patient monitoring devices, electronic caregiver systems, smart technology, and robotics to reduce reliance on in-person staff and address workforce shortages. Applications are open for eligible rural providers, with awards up to $250,000 each and a clear focus on measurable impact, innovation, and sustainability. Key contacts: Bobbie Will
Event schedule:
- Application Due - 08/18/2026 - 5:00 PM CT
- Review Period - August 19 - September 8, 2026 - CT
- Award All Year 1 Funds - September 2026 - CT
- Funds Expended Deadline - 08/31/2027 - CT
Review Period - August 19 - September 8, 2026 - CT
Award All Year 1 Funds - September 2026 - CT
Show all schedule items (4)
Application Due - 08/18/2026 - 5:00 PM CT
Review Period - August 19 - September 8, 2026 - CT
Award All Year 1 Funds - September 2026 - CT
Funds Expended Deadline - 08/31/2027 - CT
Contacts
Bobbie Will - Technical Assistance Presenter - North Dakota
Core Initiatives
Expand use of robotic devices and AI-assisted care to reduce staffing needs
Improve control of chronic disease and reduce adverse events
Increase rural provider retention and recruitment
Show all initiatives (5)
Expand use of robotic devices and AI-assisted care to reduce staffing needs
Improve control of chronic disease and reduce adverse events
Increase rural provider retention and recruitment
Reduce Health Professional Shortage Areas
Bring high-quality healthcare closer to home
North Dakota was awarded $198.9M in RHTP funding for Year 1 as part of a $50 billion five-year federal initiative. This funding opportunity supports planning grants for embedding childcare into rural health facilities, targeting critical access and rural emergency hospitals while excluding urban areas. Approximately 38 awards of $78,000 each will be made for sustainable childcare models to boost rural workforce recruitment and retention.
Event schedule:
- Applications Due - 08/11/2026 - 5:00 PM CT
- Review and scoring - 08/12/2026 - 09/12/2026
- Year 1 Funds Must Be Awarded - 09/30/2026
- Year 1 Funds Must Be Expended - 09/30/2027
Support sustainable childcare solutions for recruitment and retention
Core Initiatives
Improve care coordination between Tribal 638/IHS facilities and non-Tribal providers
Ensure accurate Medicaid claim submissions for Tribal 638/IHS related services
QUALITY_IMPROVEMENT · NETWORK_DEVELOPMENT · FINANCE · OTHER
Core Initiatives
Support North Dakota's RHTP goals
Enable impactful rural health transformation
Ensure alignment with funding opportunity priorities
North Dakota is preparing for a major federal investment via the Rural Health Transformation Program, with $500 million over five years anticipated for Medicaid and rural hospital transformation. CCBHC expansion is underway, increasing comprehensive behavioral health access across multiple regions. Medicaid modernization and tribal outreach initiatives are also advancing.
Event schedule:
- CMS Application Deadline for RHTP - 12/31/2025
- Next MFP Partner Meeting - 12/09/2025 - Fargo and virtual
- 5-State Tribal Initiative Summit - October 22-24, 2025 - Washington State
Budget: $500.0MOTHER
Core Initiatives
Transform and strengthen rural hospital systems and rural Medicaid in North Dakota.
Ensure compliance with CMS program requirements.
Expand access to crisis care and behavioral health services.
Show all initiatives (4)
Transform and strengthen rural hospital systems and rural Medicaid in North Dakota.
Ensure compliance with CMS program requirements.
Expand access to crisis care and behavioral health services.
Increase the number of CCBHCs in rural and frontier regions.
OTHER
Core Initiatives
Improve care coordination between Tribal and non-Tribal providers for Medicaid-enrolled American Indian and Alaska Native beneficiaries
Ensure IHS/638 practitioners are able to manage patient care across care transitions
Comply with federal requirements for Medicaid services 'received through' IHS/638 facilities
This policy manual details North Dakota Medicaid’s coverage, billing, and provider requirements for substance use disorder (SUD) services in alignment with RHTP priorities. It outlines eligible provider types, service definitions by ASAM level, telehealth availability, and critical exclusions such as IMD service limits for certain age groups. The document also sets forth assessment, treatment planning, documentation, reimbursement, and claims guidance for rural and tribal providers. Key contacts: dhsmedicalservices@nd.gov
POPULATION_HEALTH · OTHER
Contacts
<dhsmedicalservices@nd.gov> - Medical Services Contact - Statewide
Core Initiatives
Provide evidence-based assessment, treatment, and recovery services for Medicaid members with substance use disorders.
Ensure Medicaid provider participation according to state licensure and federal guidelines.
Promote access to multidisciplinary, medically necessary SUD services in rural and underserved populations.