BISMARCK, N.D. (Valley News Live) – North Dakota lawmakers will return to the Capitol next month for a special legislative session focused on spending more than $500 million in federal funding aimed at transforming rural health care across the state.

Gov. Kelly Armstrong announced Friday, Dec. 5, he’s tentatively set Jan. 21 for the 69th Legislative Assembly to convene and appropriate the anticipated federal dollars.

The session is going to focus on the Centers for Medicare & Medicaid Services approving North Dakota’s funding application by the end of the year.

“We have an incredible opportunity to strengthen and reshape rural health care in North Dakota through the Rural Health Transformation Program,” Armstrong said in a statement. “I appreciate the collaboration with legislative leadership and look forward to a special session laser-focused on the task at hand.”

The state submitted its application to CMS on Nov. 3, outlining how it would invest the money over five years.

Officials are looking to improve access, quality, and outcomes for North Dakotans in rural communities.

Federal officials are expected to announce award decisions by Dec. 31.

Once the funding award is confirmed, Armstrong will issue an executive order officially convening the Legislature.

State law requires legislative appropriation before the federal dollars can be spent.

Four-Point Strategy

North Dakota’s application is focused on four strategic initiatives: strengthening and stabilizing the rural health workforce; expanding preventive care and healthy eating programs; bringing high-quality health care closer to home; and connecting technology, data and providers across the state.

The plan was developed with extensive public input. North Dakota Health and Human Services launched a 30-day survey that received more than 1,200 responses and hosted three listening sessions attended by over 300 participants.

The Rural Health Transformation Program was created as part of the federal Working Families Tax Cut Act. The law appropriates $50 billion over five years, with half split equally among all states. The remaining $25 billion will be distributed based on state applications and metrics showing where funding can make the biggest health impact in rural communities.

North Dakota’s rural communities have faced mounting health care challenges in recent years, including workforce shortages, hospital financial pressures, and limited access to specialized care. The federal funding represents one of the largest investments in the state’s rural health infrastructure in decades.

Armstrong worked with legislative leaders to identify the tentative date for the special session, which will focus exclusively on appropriating the federal funds.

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