Train In Place Grant Program

North Dakota Health and Human Services is offering the Train In Place Funding Opportunity under North Dakota’s Rural Health Transformation Program, a five-year effort supported by the Centers for Medicare and Medicaid Services through the federal Rural Health Transformation Program. The broader program is intended to help rural and tribal communities reimagine health care delivery, improve health outcomes, create new access points, modernize care delivery, and empower local providers through sustainable investments. This opportunity is part of Initiative 2, Strengthen and Stabilize Rural Health Workforce, and focuses on expanding the rural health care workforce training pipeline by helping the existing workforce obtain higher credentials through programs available virtually, during evenings or weekends, or closer to home. The purpose of the Train In Place opportunity is to support programs that lead to degrees, certificates, or microcredentials in high-need areas and allow rural health care workers to further specialize without leaving their communities. Eligible projects may include planning for development of a train in place program for the existing workforce to be implemented in future Rural Health Transformation Program years, including possible infrastructure development. Programs may be managed directly by a health care facility or delivered through partnerships, including partnerships with higher education institutions. Examples include maternal or behavioral health specialty training, dental or imaging upskilling, leadership development, and expanded employability factors. Funding may also support business-practice training that promotes sustainable employment of staff receiving training or credentialing in place. This training must include coding and billing and may also include workforce planning, scheduling models, financial sustainability for training programs, workflow redesign, retention-focused human resources practices, or other organizational strategies that help employees remain successfully employed after training. The opportunity also allows individual employee skill-building awards for existing workforce members to obtain new credentials, enhance competencies, or complete approved training programs. Individual awards and training that lead to a certificate, license, or degree may be tied to a minimum five-year service commitment under federal guidance, and ND HHS will determine during review whether proposed strategies are subject to that requirement. Eligible applicants must be located in or provide services in the location of the rural or tribal North Dakota health care workforce. Entities within Grand Forks, Fargo, West Fargo, and Bismarck are considered urban and do not qualify unless at least 50 percent of the population served is rural North Dakota citizens or the funding will be used for rural North Dakota citizens. Eligible applicants may include hospitals, clinics, home care providers, long-term care facilities, behavioral health providers, tribes and tribal health organizations excluding Indian Health Services, emergency medical services providers, other health care providers, local public health, nonprofit organizations, and education systems. Priority consideration will be given to applicants proposing to develop a new degree-bearing, certificate-bearing, or microcredential train in place program, or to complete business-practice training including coding and billing that supports sustainable employment of staff participating in train in place programs. Approximately $2,025,000 in total federal funds is available for year one. ND HHS expects to fund an estimated 15 awards of approximately $135,000 each, although applicants may request funding at any level necessary to support the proposed project. The operating period will begin upon execution of the agreement with all required approvals and signatures and will end on September 30, 2027. All funds must be expended by that date. ND HHS may negotiate budgets based on the number of applications received, the proposed project work plan, and the total budget available. Modified total direct administrative costs are not allowable, capital expenditures are not allowed, and funds may not be used for pre-award costs, supplanting existing funding, meeting matching requirements for other federal or local funds, vehicle purchases, ineligible construction or renovation costs, contracted or locum tenens providers, lobbying, independent research and development, or other listed unallowable costs. Applications are due May 15, 2026 at 5 p.m. Central Time and must be submitted to ND HHS through Qualtrics. Applications not received in Qualtrics by the deadline will be considered non-responsive and will not be reviewed. Application components include background information, a project narrative, an action plan, and a budget using the ND HHS itemized subrecipient budget template. The project narrative must address the identified need, proposed goals, target population, whether the project is already funded or in progress, strategies and measurable outcomes, service-commitment procedures if individual financial incentives are provided, sustainability, equipment or technology maintenance if applicable, and the relationship of the project to CMS Rural Health Transformation Program elements such as improving access, improving outcomes, technology use, partnerships, workforce, data-driven solutions, financial solvency strategies, and cause identification. A technical assistance conference call was scheduled for Wednesday, May 6, 2026 from 12:00 to 12:45 p.m. Central Time, and the recording and related resources are expected to be posted on the Rural Health Transformation Program webpage. Applicants were strongly encouraged to submit questions through the RHTP FAQ Survey before seven days prior to the submission deadline; questions submitted within seven days of the deadline may not be addressed. Applications will be reviewed and scored solely on the materials submitted, using criteria in the scoring tool. ND HHS aims to notify applicants in a timely manner, may require supplemental responses or proposal changes to uphold RHTP commitments, and will send awarded applicants an agreement to sign and return. Successful applicants must submit reimbursement requests and supporting information, progress reports, and impact stories, and may be required to report for up to five years or as otherwise required by CMS.

Prioritize proposals that develop a new degree-bearing, certificate-bearing, or microcredential train in place program or complete business-practice training including coding and billing; clearly show benefit to rural or tribal North Dakota health care workforce; avoid supplanting and capital expenditures; align outcomes with RHTP Initiative 2 metrics; explain sustainability after funding ends; ensure any individual financial incentives include policies and monitoring for a five-year service commitment if applicable.