North Dakota Plans Special Session for $500M Federal Rural Health Funding

North Dakota is preparing for a special legislative session to manage up to $500 million in federal funds allocated through the Rural Health Transformation Program, part of the federal One Big Beautiful Bill Act aimed at improving rural healthcare over five years. The state must submit an application by November 5 detailing how it plans to use the funds, which cannot replace existing funding or cover costs already covered by insurance. Legislative leaders, including Senate Majority Leader David Hogue, have formed a committee to collaborate with the Department of Health and Human Services and stakeholders to develop a competitive proposal. Governor Kelly Armstrong is working with lawmakers to determine whether he or the legislature will call the special session, anticipated in early 2026. The funds are intended for a range of uses such as workforce development, behavioral health, disease prevention, and infrastructure improvements, with strict spending limits on administrative costs, renovations, and provider payments. The urgency and complexity of applying for these funds have prompted comparisons to the rapid deployment of COVID-19 relief funding, emphasizing the need for careful planning to maximize the benefit to rural communities.