North Dakota directs federal rural health funds and rural loans

The Department of Health and Human Services may use up to $397,873,940 in federal funds for the federal rural health transformation program. The funds support the federal rural health transformation program and may be transferred to other state agencies or institutions if they receive awards. The appropriation is limited to federal funds that are not otherwise appropriated. The amount used may be less than the authorized amount. Grant recipients must acknowledge that the funding will not continue after the federal program ends. The department may require grant recipients to report program measures and outcomes. The funding period begins when the Act takes effect and ends June 30, 2027.

The Bank of North Dakota would administer short-term loans for approved federal rural health transformation projects with demonstrated financial need. Applicants must be grant recipients with approved projects under the federal rural health transformation program and must provide requested financial and project information. The loans may charge no more than two percent annual interest. Loan terms must follow department criteria and may not exceed three years. The Bank receives $600,000 for administration and is authorized four full-time equivalent positions. The Bank may transfer up to $40 million in current earnings and undivided profits to the medical facility infrastructure loan fund for this program only. The administration funding and transfer authority begin when the Act takes effect and end June 30, 2027.

State agencies and eligible organizations may use specified contracting, purchasing, property, and equipment procedures when spending the federal rural health funds. The procedures apply to public improvements, eligible funding recipients, and purchases made with funds appropriated for the federal rural health transformation program. Consultant procedures may cover architecture, engineering, construction management, land surveying, and related work. Some standard commercial products with electronic or shrink-wrap terms may be purchased without applying a conflicting disclosure rule if they do not involve confidential information, personal information, or data-security impacts. Cooperative purchasing and transfers of equipment or supplies must follow federal program requirements. These procedures apply when the covered federal funds are used; the department must provide periodic reports during the remainder of the 2025-26 legislative interim.