Armstrong gave his State of the State address during the special session called to appropriate the $199 million. Related bills and other legislation also are scheduled to be acted on by legislators.

“This program is a pivotal step forward in strengthening North Dakota health care across the state. The need is clear. Seventy-five percent of North Dakota’s rural counties face primary care shortages. Over the last 20 years, health care has concentrated in our largest communities, leaving our rural residents without adequate services. These challenges demand bold action. By expanding access, promoting long term wellness and driving innovation, we have the chance to be the healthiest state in the nation,” Armstrong said.

Four proposed bills were factors in the success of the state’s application for the funds. Those four bills to be addressed in the special session will require the Presidential Fitness Test in schools, require nutrition education as part of continuing education for physicians, join the state in the physician assistant licensure compact and expand the scope of practice for pharmacists.

The Rural Health Transformation Program, a $50 billion initiative established under President Trump’s Working Families Tax Cuts legislation, will distribute half the dollars equally among the states over five years through the Centers for Medicare and Medicaid Services. The other half will be awarded based on various state metrics and proposed state policy actions.

U.S. Sen. John Hoeven shakes hands with Lt. Gov. Michelle Strinden prior to Gov. Kelly Armstrong’s presentation of the State of the State address. Also on the dais with them, center, is House Speaker Robin Weisz, R-Hurdsfield. Photo from the Governor’s Office.

“Our plan is built on four pillars,” Armstrong said. “First, we want to make North Dakota healthy again by promoting wellness and healthy lifestyles in communities across the state through initiatives focused on nutrition, exercise and reducing the risk of substance abuse, just to name a few.

“Second, we want to strengthen our communities and stabilize our rural health care workforce. That means health care workers in rural North Dakota with training, support and retention grants. Third, we want to bring high quality health care closer to home by expanding local access to essential health services through telehealth, transportation, virtual medical rooms and mobile clinics for hard-to-reach populations. And finally, we want to connect technology and data to create a health care system that is smarter, faster and more responsive, one that meets our people where they are when they need the services,” he added.

Armstrong said the plan won’t stand up unsustainable programs or hire new employees that will become North Dakota taxpayer obligations when this federal funding runs out.

“And we are not propping up underperforming programs that haven’t made North Dakotans healthier. This is about transforming rural health, and that means embracing 21st century solutions, not repeating policies of the past,” he said. “We aren’t spraying federal dollars into North Dakota with fire hose. All government money comes from taxpayers in one way or another, and we owe it to them to make the most of this investment.”

The state has nine months to obligate the $199 million. The year two award begins Oct. 1. Armstrong said the second year’s amount isn’t known yet, but legislators are being asked to approve two years of appropriation authority, an estimated $398 million, to ensure the state can quickly disperse the second tranche of funding.

“This program only works if North Dakota taxpayers have confidence in how we’re spending money,” Armstrong said. “It needs to be authorized and appropriated quickly. We need to be responsible stewards and track it closely, and it needs to have tremendous impact on the well-being of our citizens.”