Rural Strong Grants Program

The Rural Strong Grants program is administered by the State of South Dakota through the Department of Social Services, Division of Medical Services, in coordination with the Department of Health. This funding opportunity is part of the broader Rural Health Transformation initiative, a statewide effort supported by the Centers for Medicare & Medicaid Services. The initiative is designed to strengthen rural healthcare systems, improve access to care, and promote long-term sustainability of healthcare services across South Dakota. The program emphasizes cross-agency collaboration, innovative care delivery models, and strategic investments that address systemic challenges in rural healthcare infrastructure. The primary purpose of the Rural Strong Grants is to enhance access to essential healthcare services in rural communities. The program supports multiple strategic focus areas, including improving Medicaid access and quality, advancing primary accountable care transformation, and developing regional maternal and infant health hubs. Funding is intended to support projects that expand service delivery, improve coordination of care, and strengthen healthcare systems to better serve rural populations, including Medicaid beneficiaries and the general patient population. Eligible applicants include Medicaid-enrolled healthcare providers operating as business entities within South Dakota. These include hospitals, federally qualified health centers, rural health clinics, Indian Health Services and Tribal 638 clinics, physician group clinics, behavioral health clinics, and dental clinics. Individual providers are explicitly excluded from eligibility. Applicants must demonstrate the ability to deliver measurable improvements in healthcare access and outcomes, particularly within rural communities, even if the provider is located in an urban area. Grant funds may be used for a range of allowable activities that directly support rural healthcare transformation. These include operational and strategic planning, development of strategic partnerships, expansion of clinical service lines, creation of regional healthcare hubs and shared infrastructure, and investment in care coordination systems to support value-based care models. Funding may also support minor renovations or alterations that are directly tied to program goals and approved in advance. However, funds may not be used for construction, major renovations, duplicative services, or costs that are the responsibility of other funding sources or legal obligations. The application process requires submission of a detailed proposal through a secured file transfer system. Applicants are encouraged to submit a non-binding Letter of Intent prior to applying. Proposals must include a comprehensive project narrative, impact statement, organizational profile, implementation and sustainability plans, evaluation metrics, and a detailed budget. Applications were accepted beginning April 2, 2026, and the final submission deadline is May 22, 2026 at 5:00 PM Central Time. Late submissions are not accepted. The State may request additional information and anticipates making award decisions by June 22, 2026. Applications are evaluated based on several criteria, including the potential for measurable improvements in health outcomes, the strength and clarity of the proposed solution, readiness for implementation, sustainability beyond the grant period, and the reasonableness of the proposed budget. Preference may be given to projects that address maternal healthcare access and those that enhance care coordination infrastructure. Awardees will be required to submit regular progress reports, including quarterly and annual reporting, to support state and federal oversight requirements. The grant operates on a multi-year structure, with an initial budget period followed by potential renewal periods contingent on funding availability. The first budget period begins upon award and extends through September 30, 2027, with additional periods extending through 2031. While funding is currently confirmed for the first period, future funding is subject to federal allocation decisions. This program represents a significant investment in strengthening rural healthcare delivery systems and improving long-term health outcomes for residents of South Dakota.

Focus on measurable rural health impact, clear implementation plan, and sustainability beyond funding; prioritize maternal health or care coordination if applicable