North Dakota’s Rural Health Transformation Program (RHTP) represents one of the most comprehensive, long-term investments the state has made to strengthen rural healthcare access, stability, and sustainability. Administered by the North Dakota Department of Health and Human Services, the program is designed to address workforce shortages, improve access to care, expand preventive health, and modernize technology across rural and frontier communities.
Rather than funding isolated projects, North Dakota’s approach focuses on system-level transformation, guided by four statewide initiatives and supported through a structured grant timeline.
Program Timeline and Award Process
Figure 1. North Dakota Rural Health Transformation Program award and implementation timeline.
The RHTP timeline reflects an intentional, phased approach to awarding and deploying funds. Applications were submitted in November, with awardee decisions made by the end of the calendar year. Subaward opportunities are anticipated to roll out beginning in early 2026, followed by ongoing monitoring and reporting.
Key features of the award process include:
- Rolling subaward opportunities
- Emphasis on readiness and impact
- Required agreements between awardees and HHS
- Federal reporting and compliance requirements
This structure allows the state to prioritize funding for projects that demonstrate meaningful benefit to rural, tribal, and frontier communities while limiting unnecessary administrative burden.
Four Core Initiatives Guiding Investment
North Dakota’s RHTP funding is organized around four initiatives, each aligned with priorities identified through statewide surveys, listening sessions, and provider input .
Initiative 1: Strengthen and Stabilize the Rural Health Workforce
This initiative focuses on addressing workforce shortages by expanding training pipelines, improving retention, and reducing reliance on an overstretched workforce.
Funded activities include:
- Expanding rural residency and training programs, including tribal-specific models
- Supporting “train-in-place” opportunities for existing staff
- Growing rural rotations, housing, and preceptor development
- Recruitment and retention grants for rural providers
- Embedding on-site childcare in rural healthcare facilities
- Using technology, remote monitoring, robotics, and AI to extend workforce capacity
Rather than relying solely on recruitment, this initiative invests in long-term workforce sustainability.
Initiative 2: Make North Dakota Healthy Again
This initiative emphasizes prevention, wellness, and community-level health improvement—recognizing that healthier communities place less strain on limited rural healthcare systems.
Key focus areas include:
- Nutrition education and healthy food access through Eat Well North Dakota
- Physical activity promotion through North Dakota Moves Together
- Mental health, resiliency, and substance use prevention
- Community-based wellness and family support programming
- Value-based care initiatives for Critical Access Hospitals
This initiative positions prevention as a core strategy for rural health sustainability, not an add-on.
Initiative 3: Bring High-Quality Health Care Closer to Home
Designed to reduce travel burdens and keep care local, this initiative supports models that reshape how and where care is delivered.
Fundable activities include:
- Right-sizing facilities to better match community needs
- Telehealth infrastructure and networks
- Mobile clinics and remote monitoring
- Community health worker and community paramedic programs
- Rural ambulance modernization and connectivity
- Non-emergency medical transportation solutions
- Care coordination and closed-loop referral systems
The goal is to deliver the right care, in the right place, at the right time, without unnecessary transfers or delays.
Initiative 4: Connect Technology, Data, and Providers for a Stronger North Dakota
This initiative focuses on breaking down data silos and modernizing the systems that support care delivery.
Investments include:
- Unified electronic medical record and data platforms
- Data interoperability and all-payer claims analysis
- Cooperative purchasing for technology and cybersecurity
- Artificial intelligence and predictive analytics
- Consumer-focused health technologies
- Automation and innovative logistics, including drone technology
By strengthening data and technology infrastructure, the state aims to improve care coordination, efficiency, and long-term system resilience.
How Funding Is Supported Behind the Scenes
A significant portion of RHTP funding is dedicated to administrative capacity, ensuring the program can be implemented, monitored, and evaluated responsibly over time.
Funded roles include:
- Program leadership and oversight
- Grants management and fiscal reporting
- Compliance and procurement
- Evaluation and data analysis
- Initiative coordination and technical assistance
This administrative investment supports accountability while allowing providers and partners to focus on delivering impact.
Why This Matters for Rural Providers
North Dakota’s Rural Health Transformation Program is not a short-term funding opportunity. It is a multi-year strategy designed to help rural providers adapt to workforce shortages, changing care models, and growing community needs.
For providers, this means:
- Access to funding that supports readiness and sustainability
- Opportunities to participate at different stages of capacity
- Alignment with statewide priorities and long-term planning
- Support beyond direct service delivery, including technology and infrastructure
By aligning grants with real-world rural challenges, North Dakota’s RHTP creates a framework for transformation that is both ambitious and practical.
Moving From Grants to Lasting Change
The scale and structure of North Dakota’s Rural Health Transformation Program reflect a clear understanding: rural healthcare cannot be stabilized through isolated fixes. It requires coordinated investment in people, systems, technology, and communities.
Through its four initiatives and structured grant approach, North Dakota is laying the groundwork for a rural healthcare system that is more resilient, more accessible, and better prepared for the future.
Founder of the Rural Healthcare Transformation Hub @ Nurse Recruitment X
Looking to secure Rural Health Transformation Program funds and fix your workforce shortages? Our Rural Health Transformation Hub helps rural hospitals, clinics, and home care agencies design winning proposals and build the pipelines needed to recruit and retain staff. We combine grant support with real recruitment expertise, giving you a low-risk way to compete for funds and implement workforce solutions that work.
