Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
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State Policy·ND·September 30, 2026

North Dakota Shifts Rural Health Grant Management to Anchor Partners

North Dakota's Health and Human Services Department is shifting from directly managing all 500-700 grants under its Rural Health Transformation Program funding to using outside "anchor partners," in-state organizations that will handle grant applications and individual grant management while HHS oversees at a higher level. North Dakota had been the only state managing every grant itself; three anchor partners are being used, including the University of North Dakota Center for Rural Health, with two more still to be finalized. The change comes as more than $161 million of the state's $199 million award remains unawarded ahead of an October 30 deadline, prompting lawmaker concerns about transparency, selection criteria, and further delays. CMS is expected to announce North Dakota's second-year funding amount, estimated near $200 million, in October.

Why it matters

State Medicaid and rural health stakeholders should watch whether the administrative pivot accelerates or further delays distribution of the $199 million in federal rural health funding ahead of the October 30 obligation deadline.

LTSS · Finance

Read the full article at northdakotamonitor.com →

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