Rural Health Transformation Project
Building a Stronger, Healthier Rural South Dakota
South Dakota is one of the most rural states in the country, and that creates unique healthcare challenges. Many rural and frontier residents travel long distances to reach care, face limited transportation options, and experience provider shortages. These challenges can lead to higher rates of suicide, chronic disease, and preventable health conditions.
To help address these needs, the South Dakota Department of Health has launched the Rural Health Transformation Project. This five-year initiative focuses on strengthening healthcare systems in rural communities and ensuring that access to quality care is available statewide.
South Dakota's Application
Our Vision
Every South Dakotan deserves access to safe, high-quality care close to home. This project is designed to make rural healthcare more sustainable, connected, and resilient for the long term.
Four Focus Areas
We are upgrading health information systems to improve coordination, planning, and delivery of care.
- Expand certified Electronic Health Record (EHR) systems
- Integrate statewide Health Information Exchange
- Invest in telehealth equipment and cybersecurity
- Launch a Rural Data Atlas to support data-driven decision-making
We are supporting the healthcare professionals and frontline workers who keep our rural communities healthy.
- Offer incentives to recruit and retain healthcare providers
- Expand Community Health Worker training and certification
- Create a Training and Resource Hub for continuing education
We are making it easier for South Dakotans to get care without leaving their communities.
- Develop new Medicaid payment models to support rural facilities
- Award Rural Health Access and Quality Grants for facility upgrades
- Expand chronic disease and maternal health programs
We are improving care delivery by integrating behavioral and physical health and strengthening emergency care.
- Expand Certified Community Behavioral Health Clinics (CCBHCs)
- Use collaborative care models to integrate behavioral health into primary care
- Establish regional Emergency Medical Services (EMS) hubs
Community Conversations: Listening to South Dakotans
The South Dakota Department of Health held community conversations in five locations: Aberdeen, Eagle Butte, Pierre, Rapid City, and Yankton.
These meetings helped identify the key healthcare challenges and opportunities in rural areas of the state. Participants highlighted issues such as workforce shortages, limited access to dental and behavioral health services, transportation barriers, and the need for affordable, local care. Common solutions included expanding telehealth and mobile clinics, improving broadband access, supporting rural provider recruitment programs, and developing community-based transportation and wellness initiatives.
The feedback gathered from these discussions is guiding efforts to strengthen healthcare access and delivery for all South Dakotans, regardless of where they live.
-
Access to healthcare is limited in many rural communities
-
There are not enough healthcare workers across fields
-
Transportation is a major barrier to receiving care
-
Mental and behavioral health needs are growing
-
Dental care is difficult for many residents to access
-
Telehealth can help but requires better internet and tools
-
Cost and insurance challenges prevent needed care
-
Some groups such as seniors, youth, and Native communities face added barriers
About the Rural Health Transformation Program
The Rural Health Transformation (RHT) Program was established under the federal One Big Beautiful Bill Act (Public Law 119-21, Section 71401). It is a one-time, nationwide initiative by the Centers for Medicare & Medicaid Services (CMS) to strengthen rural healthcare delivery systems. The program provides $50 billion in funding over five years (FY 2026–2030) to support state-led strategies for improving access, innovation, and sustainability in rural health.
Each state can apply for funding through cooperative agreements, with funds directed toward:
-
Expanding rural healthcare access and strengthening local health systems
-
Recruiting and retaining healthcare providers
-
Increasing telehealth and technology infrastructure
-
Improving behavioral and mental health services
-
Developing innovative and sustainable care delivery models
Strategic Goals
-
Improve rural health and wellness
Promote prevention and manage chronic disease
-
Ensure sustainable healthcare access
Strengthen local provider networks
-
Develop the workforce
Recruit, retain, and expand provider capacity in rural areas
-
Encourage innovation
Support new care models and flexible payment systems
-
Leverage technology
Expand telehealth, data sharing, and cybersecurity tools
Next Steps in South Dakota
The Department of Health is working with healthcare providers, community organizations, and state partners to prepare South Dakota’s application for the Rural Health Transformation Program.
Current efforts include:
-
Conducting statewide needs assessments and gap analyses
-
Identifying rural healthcare partners and subrecipients
-
Developing sustainability and evaluation plans
-
Aligning proposed strategies with existing rural health and Medicaid programs
Funding Overview
-
Total Funding: $50 billion nationwide
-
Funding Period: FY 2026–2030
-
Application Deadline: November 5, 2025
-
Awards Announced: December 31, 2025
-
Implementation Begins: 2026
Why This Matters
Together, these goals create a more connected, capable, and resilient rural health system to
improve access, quality, and outcomes for all South Dakotans.
Stay Connected
This project is not just about immediate improvements. It is a long-term investment in the health and resilience of South Dakota’s rural communities. As the project moves forward, we will continue sharing updates, resources, and stories from the people and providers making a difference.
Have questions or want to get involved? Contact us to learn more.