North Dakota – Governor Kelly Armstrong signed legislation Thursday that positions North Dakota to launch its Rural Health Transformation Program, with nearly $200 million in federal funding appropriated for the first year of the five-year initiative.
The funding comes from a late December award of $199 million from the U.S. Centers for Medicare and Medicaid Services, part of the federal Rural Health Transformation Program. The program is designed to strengthen rural health care by improving access, quality and health outcomes for residents in rural communities over the next five years.
Armstrong praised lawmakers for quickly passing the legislation during a three-day special session that concluded Thursday morning. He said the efficient approval of the bills will allow the state to move forward with deploying the funds in ways that improve the health and well-being of North Dakotans.
“Our citizens who depend on rural health care stand to benefit greatly from this program, and the Legislature deserves a ton of credit for staying focused and quickly moving these bills across the finish line,” Armstrong said. “Now comes the challenge of deploying these dollars in ways that improve the health and well-being our citizens, and we’re excited to work with our partners across the state to make North Dakota the healthiest state in the nation.”
The legislature approved an appropriations bill authorizing total program expenditures of $398 million over the first two years, assuming funding remains constant in Year 2. That second-year amount will not be known until the award is announced in October, officials said.
The bill signing marked the end of a process that began last summer with a statewide survey and listening sessions in the fall. An interim committee drafted the legislation in October, and the state submitted its application to CMS in early November. The state was notified of the award in late December.
Armstrong thanked the Legislature’s Rural Health Transformation Committee for its work on four policy bills that align state law with federal requirements. Officials said the policy changes improved the state’s application score with CMS and contributed to the larger funding award, which nearly doubled the base funding level of $100 million per state.
The four bills included:
Requiring the Presidential Physical Fitness test in physical education courses, with criteria and exceptions set by the North Dakota Department of Public Instruction.
Adding nutrition education to physicians’ continuing education requirements.
Allowing North Dakota to join the physician assistant licensure compact.
Expanding pharmacists’ scope of practice to allow them to order certain laboratory tests and independently prescribe certain medications.
The North Dakota Department of Health and Human Services will now promote upcoming grant opportunities to support rural health priorities and encourage participation across the state. The agency said it is planning listening sessions, technical assistance calls, meetings and outreach activities in the coming weeks.
The Rural Health Transformation Program is part of the federal Working Families Tax Cut Act, which was passed by Congress and signed into law by President Donald Trump. The program focuses on four strategic initiatives: strengthening the rural health workforce, promoting preventive care and healthy eating, bringing high-quality health care closer to home, and connecting technology, data and providers for a stronger state.
