Non-Emergency Medical Transportation Acquisition Grant

The Non-Emergency Medical Transportation Acquisition funding opportunity is offered by North Dakota Health and Human Services as part of North Dakota's Rural Health Transformation Program. Congress established the $50 billion Rural Health Transformation Program under Public Law 119-21, and the program is administered by the Centers for Medicare and Medicaid Services. North Dakota's five-year Rural Health Transformation Program is intended to create new healthcare access points, modernize care delivery, and empower local providers through sustainable investments. This funding opportunity falls under Initiative 3, Bring High-Quality Healthcare Closer to Home, and is intended to improve healthcare access for rural North Dakota residents, including rural tribal residents where applicable, with required service to Medicaid members. The funding opportunity provides grants to existing community-based healthcare organizations to acquire accessible vans or other transportation vehicles for non-emergency medical transportation within or from rural areas to healthcare delivery locations, including other healthcare organizations. Eligible acquisitions include small chassis vans equipped with wheelchair lifts and passenger seating capable of transporting at least one wheelchair and two seated passengers or two wheelchairs, excluding the driver, and large chassis vans equipped to transport at least two wheelchairs and six seated passengers or three wheelchairs, excluding the driver. Vehicle tracking hardware is required. The opportunity is for acquisition of a new NEMT vehicle for the applicant organization; replacing or upgrading existing vehicles is unallowable. The guidance also states that RHTP funds may purchase a new or used vehicle to fulfill the funding opportunity objectives, subject to case-by-case CMS review and approval. All other costs outside the permitted scope are unallowable. Approximately $2,000,000 in total federal funds is available, with an estimated four awards of approximately $500,000 each. Actual awards will depend on the applications received, and North Dakota HHS reserves the right to negotiate applicant budgets based on the proposed work plan, available program funding, and number of applications. No applicant-level minimum or maximum award amount is stated. No matching or cost-share requirement is stated for applicants. Modified total direct administrative and indirect costs are not allowable. Vehicle purchases are allowable capital expenditures when clearly linked to RHTP and funding opportunity outcomes, while replacement or upgrading of existing vehicles is prohibited. The project may not function as a passthrough or issue subawards to individual facility locations. Vehicle orders must be placed by September 30, 2026, and delivery and expenditure must be completed by August 31, 2027. Eligible applicants must serve rural North Dakota residents and Medicaid members and may also serve rural tribal residents. Eligible rural organizations are hospitals, clinics, federally qualified health centers, non-federally operated Indian Health Services facilities, and tribally run 638 health facilities. Applicants must be currently enrolled Medicaid providers in good standing and must be community-based healthcare organizations. Entities located within the cities of Grand Forks, Fargo, West Fargo, and Bismarck are considered urban and do not qualify for RHTP funding opportunities. Awardees must subsequently enroll as non-emergency medical transportation providers and comply with the North Dakota Medicaid Billing and Policy Manual applicable to NEMT. One application with one strategy per organization should be submitted for this opportunity. Applications must be submitted to North Dakota HHS through Qualtrics by August 19, 2026, at 5:00 p.m. Central Time. Late applications are considered non-responsive and will not be reviewed. A complete application requires responses to all questions and a completed Itemized Subrecipient Budget Template uploaded to Qualtrics in Excel format. Application content includes organizational background and eligibility alignment; project title and overarching goal; key personnel and external partners where applicable; an identified-need narrative addressing NEMT challenges and target populations; current related work and the need for expansion or enhancement; detailed outcomes, strategy, services, tasks, and metrics; sustainability and equipment maintenance plans; applicable CMS RHTP elements and ND RHTP outcomes; a comprehensive project timeline; and an itemized budget with justification. Vendor sales quotes are encouraged for proposed equipment but are not required for application completeness. Applications will be reviewed and scored solely on the information presented in the submitted application materials using the Scoring Tool identified in the required documents section of the funding opportunity webpage. Proposed projects should align with Initiative 3 metrics, including reducing avoidable emergency department visits for Medicaid members, improving coordination of care, improving getting care quickly, and improving timely access to specialist appointments. North Dakota HHS aims to notify applicants in a timely manner but notes that substantial CMS involvement may delay funding timelines. Successful applicants must submit reimbursement requests and supporting information, progress reports, and impact stories, with specific due dates provided in the agreement, and reporting may continue for up to five years or as otherwise required by CMS. The operating period begins upon execution of the agreement and ends August 31, 2027. A technical assistance call was scheduled for August 5, 2026, and questions were strongly encouraged before the final seven days preceding the application deadline. Application support may be requested from Regional Development Councils. No individual grant contact email address or telephone number is provided in the guidance. An additional application process for this funding opportunity is expected in future years of the Rural Health Transformation Program.

Submit one application with one strategy; demonstrate the rural NEMT need with relevant local data when available; clearly prioritize rural residents and Medicaid members; show that the project is new, expanded, or improved rather than duplicative; use SMART outcomes linked to strategy, services, and tasks; align project metrics with Initiative 3 outcomes; identify every requested vehicle as a new purchase rather than a replacement; explain sustainability and continued vehicle use after funding; provide a comprehensive milestone timeline; provide clear cost justification for every budget item; consider vendor quotes to support cost accuracy; ensure the vehicle order is placed by September 30, 2026 and delivered by August 31, 2027