Rural Hospital Clinical Equipment Grant Program

The Rural Hospital Clinical Equipment funding opportunity is part of North Dakota’s broader Rural Health Transformation Program (RHTP), a federally supported initiative established under Public Law 119-21 to strengthen healthcare delivery systems in rural and tribal communities. Administered at the state level by North Dakota Health and Human Services (ND HHS), the program reflects a five-year strategic effort to improve access, modernize infrastructure, and empower local providers through sustainable investments. This specific funding opportunity aligns with Initiative 3, which focuses on bringing high-quality healthcare closer to home by upgrading clinical capabilities within rural hospitals. The primary purpose of this funding opportunity is to support the acquisition, installation, and limited renovation associated with clinical equipment in rural hospitals. The initiative emphasizes aligning physical infrastructure with community health needs while improving operational efficiency and expanding service capacity. Eligible equipment spans a wide range of clinical areas, including diagnostic imaging, surgical services, emergency care, inpatient services, critical care, cardiology, laboratory services, oncology, rehabilitation, and more. Projects are expected to directly contribute to improved patient outcomes, reduced transfers, increased service availability, and enhanced care coordination, particularly for Medicaid populations and underserved rural residents. Funding under this opportunity is competitive, with approximately $40 million in total federal funding available. ND HHS anticipates awarding around 20 grants, each averaging approximately $2 million. Applicants may propose multiple equipment priorities within a single application, provided they are ranked and aligned with program goals. Funds may be used for equipment purchases exceeding $10,000, as well as minor renovations necessary for installation. However, the program strictly prohibits major construction, supplanting existing funding, and other unallowable costs such as lobbying or duplicative services. All funded activities must be completed within the defined performance period, ending September 30, 2027. Eligibility is limited to rurally located hospitals, including Critical Access Hospitals, Rural Emergency Hospitals, and Ambulatory Care Units. Non-federally operated Indian Health Service hospitals that meet these criteria are also eligible. Certain entities are explicitly excluded, including clinics, behavioral health facilities, and federally operated Indian Health Service hospitals. Additionally, hospitals located in designated urban areas such as Fargo, Bismarck, Grand Forks, and West Fargo are not eligible under this funding opportunity. The program encourages broad participation among eligible rural hospitals, with the flexibility to apply for multiple RHTP opportunities across different initiatives. Applications must be submitted through a Qualtrics-based system by June 30, 2026, at 5:00 PM Central Time. The application process requires detailed organizational information, a comprehensive project narrative, an action plan with timelines and measurable outcomes, and a fully itemized budget using a prescribed template. Applicants must also provide documentation of governing body approval. The review process evaluates submissions based on clarity, alignment with program goals, feasibility, and potential impact. ND HHS may request additional information or negotiate budgets prior to final award decisions. Successful applicants will enter into a formal agreement with ND HHS and must comply with all reporting and performance requirements, including submission of progress reports, reimbursement documentation, and impact narratives. Reporting obligations may extend for up to five years, depending on federal requirements. Technical assistance is provided through webinars and ongoing support channels, and applicants are encouraged to submit questions in advance of deadlines. This funding opportunity represents a significant investment in strengthening rural healthcare systems by equipping providers with the tools necessary to deliver high-quality, accessible care within their communities.

Focus on measurable outcomes tied to equipment; prioritize highest impact equipment; clearly justify budget with data; align with Initiative 3 metrics; demonstrate sustainability beyond funding period