North Dakota
Guest Column: Celebrating innovation and opportunity in North Dakota on National Rural Health Day
It is no secret that there are many challenges confronting rural health care right now, from workforce shortages and declining reimbursement rates to threats to programs like 340B that support safety-net hospitals. But this week, as we celebrate National Rural Health Day on Nov. 20, I am reminded of the many reasons to be hopeful about the future of rural health care.
Earlier this month, the state of North Dakota applied for a share of the $50 billion that will be distributed nationwide beginning next year as part of the newly established Rural Health Transformation Program. With $1 billion on the line for North Dakota, the program could be one of the single greatest investments in rural health that our state has ever seen.
The Rural Health Transformation Program was designed to spur innovative and sustainable approaches to better serve the farmers, ranchers and small business owners who call rural communities home. And in order to qualify for funding, North Dakota crafted an application that demonstrates a strong vision for improving the health of our neighbors and stabilizing rural health care delivery.
As a health system that’s proud to serve mostly rural areas, Essentia Health was grateful to share our ideas for how hospitals can stabilize essential services, such as behavioral health and emergency care, while advancing workforce development and value-based care for the rural and Tribal communities we are privileged to serve. As we wait for the funding to be awarded, I am confident that North Dakota’s application is strong because it reflects the real experience and perspectives of compassionate caregivers on the front lines of rural care.
Here’s why I’m excited by this opportunity:
Attracting and retaining a strong health care workforce remains one of the most significant challenges confronting rural care. North Dakota’s application dedicates over $162 million to train and retain a high-skilled workforce through new residencies, workforce pipelines and recruitment and retention grants.
At Essentia, we’ve had success with first-of-its-kind training programs that address critical gaps in our health care workforce. We just celebrated the first graduate of our surgical technologist apprenticeship program in Fargo. These are the kinds of innovations we must continue pursuing to help care teams like ours advance our mission to make a healthy difference in people’s lives.
If awarded this funding, North Dakota plans to deepen its work to bring high-quality health care closer to home – a mission that Essentia Health whole-heartedly stands behind. With fewer clinicians to staff brick-and-mortar facilities, we need to get creative to meet people where they are – through new methods and in new spaces. A person’s access to expert care shouldn’t be determined by their zip code.
Essentia’s mobile mammography program is one example of how we can enhance access to preventive care without relying on traditional settings. The program brings essential mammography services directly to our neighbors in rural areas and could be expanded across other specialties. Since we rolled out this service, we hear repeatedly from patients who acknowledge they likely wouldn’t have done a screening if it hadn’t been available locally. Rural Health Transformation funds could be used to deploy mobile medical units to rural, underserved communities, with specific services tailored to the greatest needs of the community.
Finally, this funding would allow us to expand scalable programs, like our community health workers and community paramedics. These programs provide tailored support to patients with the goal of diminishing the rate of chronic disease, improving the health of our rural neighbors and reducing emergency room visits and hospital admissions.
The work to transform the future of rural health care has already begun at Essentia Health. The Rural Health Transformation Program represents an opportunity to expand our efforts to bolster our health care workforce, strengthen a care model that prioritizes prevention and patient outcomes and make it easier for North Dakotans to access comprehensive health care close to home.
As we celebrate National Rural Health Day, I am hopeful for the future of rural health care and especially grateful for my talented colleagues, whose dedication to advancing rural health care strengthens the communities where they live and work.
Dr. Stefanie Gefroh is the Essentia Health West Market president.
North Dakota
Challengers declare victory after ND Supreme Court rules against Legislature’s attempt to alter term limits
BISMARCK — A constitutional ballot measure to amend the state’s term limits law as proposed by the Legislature will not appear on November’s ballot, the North Dakota Supreme Court ruled Thursday, siding with petitioners who argued the Legislature exceeded its authority and violated the state constitution in proposing the changes.
“The people’s voice was heard,” Grand Forks County Commissioner Terry Bjerke said in reaction to the news.
Bjerke was a member of the sponsoring committee behind the successful 2022 effort to pass a term limits initiative, which amended the state constitution by capping legislative term limits to eight years in the House and eight years in the Senate. The amendment, which became article XV of the state constitution, also included a clause barring the Legislature from making constitutional changes to term limits.
During the 2025 session, however, lawmakers narrowly approved Senate Concurrent Resolution 4008, in which the legislature proposed Constitutional Measure 1, a ballot measure to amend the term limits language to allow legislators to decide in which chamber they want to serve their 16 years, and to repeal the clause limiting the legislative assembly’s authority to propose an amendment to alter or repeal term limits.
Bjerke and former Minot legislator Oley Larsen brought the lawsuit challenging the validity of the Legislature’s action in January, and the state Supreme Court
heard oral arguments in the case
this spring.
“Those term limits may only be altered by a measure proposed by the people rather than the Legislative Assembly. And yet a few years later, the Legislative Assembly is doing what they are prohibited from doing,” attorney Zachary Wallen argued on Bjerke and Larsen’s behalf.
Tanner Ecker / The Bismarck Tribune
The Legislature’s attorneys argued the clause prohibiting legislative proposals to alter the constitutional term limits language “infringes on our republican form of government” by “limiting the people’s ability to vote on amendments proposed by their elected officials.”
Justice Jon Jensen seemed skeptical of that argument during the April 2 hearing, questioning whether a second vote was appropriate.
“The public did speak on this. The public spoke on it when it passed the original constitutional amendment and they said, ‘Legislature, you don’t even get to propose a change.’ They have already spoken on it,” Jensen said. “You want a second shot, or a second bite at the apple, not a first one, a second.”
In Thursday’s ruling, all five justices sided with Bjerke and Larsen.
“We … conclude the Legislative Assembly’s adoption of S.C.R. 4008 violated N.D. Const. art. XV … and declare S.C.R. 4008 and Constitutional Measure 1 void … We enjoin the Secretary of State from placing Constitutional Measure 1 on the November 2026 general election ballot,” the ruling said.
Bjerke thanked the legal team that worked on behalf of their lawsuit, and said he was grateful the court reached the conclusion it did.
“I’m thrilled that what the people voted on and approved has been validated,” Bjerke said.
He added that the Legislature had “multiple opportunities” to address term limits prior to 2022’s initiated measure and chose not to, and gave a nod to the country’s coming milestone and the process by which voters expressed their support for term limits.
“We’ve lasted 250 years,” Bjerke said. “I have two words for those elected leaders who think they aren’t: everyone’s replaceable.”
North Dakota
Fargo woman convicted in North Dakota fraud case now faces charges in Minnesota: A deeper dive
FARGO, N.D. (Valley News Live) – A North Dakota woman who was sentenced to 180 days in jail in Cass County for defrauding healthcare providers and Medicaid programs is now facing additional fraud charges in Minnesota.
Christine Marie Pryor, 55, pleaded guilty in November 2024 to theft by deception involving more than $50,000. She was sentenced to first serve 180 days with a 3-year sentence suspended. She received credit for 44 days already served.
Pryor was ordered to pay $82,584.78 in restitution to Southeast Human Services in Fargo, where she worked between 2018 and 2019.
How the scheme unfolded
According to court documents, Pryor worked at multiple healthcare facilities in North Dakota and Minnesota between 2018 and 2023, using the identities and credentials of three licensed professionals without their knowledge. She submitted fraudulent Capella University diplomas and transcripts to gain employment.
Investigators say Pryor admitted she searched state licensing websites for therapists who shared her first name, then used those therapists’ last names and license numbers when applying for jobs.
At Southeast Human Services, where she worked as a Licensed Addiction Counselor, Pryor earned $55,584.82 while providing therapy services to approximately 150 patients. She also opened her own counseling center, NIAM Brain Injury Center, in Fargo between 2020 and 2021, and worked at The Lotus Center in Moorhead, Minnesota, from 2021 to 2023.
Court documents say the three licensed professionals whose identities were used told investigators they had no knowledge of Pryor’s actions and did not give her permission to use their information.
Two additional charges against Pryor in North Dakota, unauthorized use of personal identifying information, were dismissed on motion of the state.
Additional charges in Minnesota
Pryor is also facing charges in Minnesota. Minnesota Attorney General Keith Ellison announced on Tuesday charges against Pryor in Clay County District Court for six theft offenses and six identity theft offenses related to defrauding Minnesota’s Medicaid program of more than $150,000.
According to the Minnesota complaint, Pryor claimed to provide psychotherapy and alcohol and drug counseling services to Medicaid recipients despite having no license or credentials to do so. Prosecutors allege she used the credentials and identities of three licensed professionals while claiming to provide Medicaid-funded services to 169 clients.
The Minnesota charges were filed as part of National Health Care Fraud Takedown Day, a joint effort involving the Department of Justice and more than 40 state Medicaid Fraud Control Units.
Copyright 2026 KVLY. All rights reserved.
North Dakota
NCAA Set to Change Unpopular Football Rule Just in Time for North Dakota State’s FBS Jump
North Dakota State playing in the FCS playoffs and College Football Playoff in back-to-back years? It’s likelier than you think.
That’s because on Wednesday, according to a report from Ross Dellenger of Yahoo! Sports, the NCAA Division I cabinet voted to repeal a rule that effectively barred teams transitioning from FCS to FBS from playing in postseason games in their first FBS seasons. The Bison are making that move along with Sacramento State in 2026.
The reported change has been a long time coming; the rule has hampered teams from immediate bowl eligibility for decades. Its good intentions of dissuading teams from rashly making the FCS-to-FBS leap have been rendered obsolete in recent years by the fact that programs generally arrive in FBS more prepared than ever before.
Consider the number of new FBS teams that have had to work within the provision in the past decade alone
That list includes: Liberty (home for the holidays at 6–6 in 2018), James Madison (8–3 in 2022 under coach Curt Cignetti, and barely able to play in a bowl at 11–1 in ’23 due to a lack of bowl-eligible teams), Jacksonville State (8–4 in ’23 before backing in like the Dukes), Missouri State (7–5 in 2025, also backed in) and Delaware (6–6 in ’25, ditto).
James Madison in particular became a cause célèbre in ’23 because it started the season 10-0, climbing as high as No. 18 in the AP Poll in mid-November. Then-Virginia attorney general Jason Miyares bandied about suing the NCAA before the Dukes lost 26–23 to Appalachian State, an event that caused the program to back off and accept a bid to play Air Force in the Armed Forces Bowl. James Madison lost that game 31–21, by which time Cignetti had left for Indiana.
There was a time when the FCS-to-FBS jump was an imposing one, and the NCAA did not want to incentivize making it lightly—not even a proud Florida A&M program could make a mid-2000s attempt at a jump stick. However, the Flames, Dukes and other teams have shown it’s not so great a climb for programs with the right resources and management.
Now the Bison and the Hornets stand to benefit.
How far can North Dakota State and Sacramento State go in the near term?
The Bison opened 12–0 last year before a shock loss to Illinois State in the FCS playoffs’ second round, so that question may answer itself. North Dakota State does not play a single Power 4 team—a potential strength-of-schedule albatross if it has designs on really surging. A potential roadblock: the fact that the Bison have to visit the Mountain West’s two favorites, UNLV (Oct. 10) and New Mexico (Oct. 24).
It’s a different story for the Hornets, a 7–5 squad a year ago whose move to the FBS is widely seen as a gamble on their growth potential. Sacramento State also does not play a major-conference team, but has a breakneck travel schedule ahead of it—the Hornets will visit Ypsilanti, Mich.; Bowling Green, Ohio; Muncie, Ind.; Mount Pleasant, Mich. and Honolulu. Combine that with a first-year coach—Oakland native and ex-MC Hammer choreographer Alonzo Carter—and it could be a long FBS debut in California’s capital.
More College Football From Sports Illustrated
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