By: Mary Steurer
BISMARCK, N.D. (North Dakota Monitor) – North Dakota lawmakers on Wednesday advanced a budget bill to authorize the Department of Health and Human Services to spend Rural Health Transformation Program money.
Legislative Management convened an interim committee in the fall to guide the state’s grant application and prepare the proposal, House Bill 1623.
The Rural Health Transformation Program, passed by Congress last year, sets aside $50 billion through 2030 for states. Each state is guaranteed a minimum of $500 million and is eligible to receive up to $1 billion.
The federal government in late December awarded North Dakota $199 million for the first year of the grant.
The state plans to dedicate $33.4 million of the award award on technology, $116 million to expand health care access in rural areas, $32.2 million to address workforce issues and $17.1 million to promote healthy lifestyles.
The budget bill, as currently written, gives the department the authority to move money between these categories as needed.
Interim Health and Human Services Commissioner Pat Traynor said organizations can use the money for a wide variety of purposes. A community gym could apply for a grant to purchase new equipment, for instance, Traynor said.
Clinics could seek grant money to purchase automatic sweepers and moppers to free up staff to handle other tasks, too, he added.
Traynor also suggested that health care facilities apply for a grant to improve their cyber security.
Carlotta McCleary, spokesperson for the Mental Health Advocacy Network, testified in support of the bill. McCleary said she hopes the program money will be used to invest in improving children’s mental health services across the state — including for crisis intervention programs, peer support groups and temporary housing.
Tracee Capron, executive director of HIA Health, said her organization hopes to use grant money to expand its palliative care and hospice care to rural and tribal communities across the state.
“What’s held us back from expansion was having the resources,” she said in testimony before the Joint Appropriations Committee.
The state must obligate all $199 million by Oct. 30 and spend it within the following year.
“Make sure your entities know when DHHS comes out with applications, they need to apply,” Sen. Brad Bekkedahl, a Williston Republican and co-chair of the Joint Appropriations Committee told lawmakers.
All grant applications must be approved by the federal government.
Grant money will be provided on a reimbursement basis. Once the state and federal government agree to fund an expense, a local organization will spend the money and submit receipts for reimbursement afterward.
Traynor said the agency won’t be adding more full-time employees to help implement the program. Instead, it will hire contract workers.
“We’re not gonna grow state government,” he said.
Traynor said the department does not know how much it will cost the state to stand up the grant program, but cannot spend more than 10% of its award on administrative costs.
The budget bill authorizes the North Dakota Department of Health and Human Services to spend roughly $397.9 million for the 2025-2027 budget cycle — the amount the state expects to receive for the first two years of the Rural Health Transformation Program. The legislation would become effective immediately upon its passage.
Lawmakers approved an amendment brought by Rep. Don Vigesaa, R-Cooperstown, to allow the state-owned Bank of North Dakota to provide up to $40 million in short-term loans to approved grant applicants while they’re waiting for their expenses to be reimbursed by federal money.
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