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May 22, 2026

RFP #26-09RHT-019 Question and Answers

Building a Sustainable Rural Healthcare Workforce: Education

Thank you for your interest in RFP #26-09RHT-019: Building a Sustainable Rural Healthcare Workforce: Education under the Rural Health Transformation project.

As outlined in the RFP Schedule of Events, all questions received by the Offeror Questions due date of May 13, 2026, were compiled and addressed collectively by May 22, 2026. To ensure a fair and transparent process for all potential offerors, individual responses to questions will not be provided directly.

Questions and Answers:

1. The total budget for RFP 019 is listed as $3 million, with multiple awards anticipated. Is $3 million the total available across all awards, or the amount per individual award?

Answer: The total funding available for this RFP is $3 million, which will be distributed over multiple awards.

2. Are applicants expected to address all components of the work plan, or is it acceptable to focus on specific sections (for example, 3.2)?

Answer: Applicants may choose one or multiple sections of the work plan. They are not required to address every section.

3. Would proposals integrating practical workforce stabilization methods—such as temporary placements to reduce burnout, temp-to-perm pathways, or real-time staffing data to guide educational programs—align with the goals of improving recruitment, retention, and professional development in rural settings?

Answer: Yes. Proposals that incorporate innovative workforce stabilization and retention strategies may align with the goals of this RFP if they are clearly connected to rural healthcare workforce education, training, recruitment, retention, and long-term sustainability outcomes.

4. Recognizing that RFP 007 awards have not yet been announced, would it be acceptable for RFP 019 applicants to propose alignment with the eventual 007 awardee, particularly around shared infrastructure such as the education platform and professional training?

Answer: It is recommended that applicants review applicable funding opportunities and strategically align proposals that would avoid duplication of efforts.

5. Does the RFP permit or encourage participation from organizations with specialized expertise in EMS staffing and recruitment, particularly initiatives involving innovative retention or stabilization models that support training and long-term workforce development?

Answer: Yes, the RFP is intended to support a broad range of organizations with demonstrated expertise in rural healthcare workforce development, which could include organizations focused on Emergency Medical Services (EMS), staffing, recruitment, retention, and workforce stabilization strategies.

6. Are there preferred or mandatory partnership structures with academic institutions, technical colleges, or healthcare systems? Additionally, would a staffing provider’s expertise in rural EMS enhance a potential consortium?

Answer: There are no preferred or mandatory partnership structures. Staffing providers expertise may be beneficial depending on the proposed project.

7. Is South Dakota Urban Indian Health considered eligible to apply for the Building a Sustainable Rural Healthcare Workforce: Education (RFP # 26-09RHT-019) opportunity?

Answer: South Dakota Urban Indian Health would be eligible to apply for this RFP.

8. What additional information and application requirements are available for RFP #26-09RHT-019, particularly as they relate to addressing behavioral health workforce shortages through recruitment, retention, and the development of innovative rural-focused education and training opportunities?

Answer: RFP #26-09RHT-019 focuses on workforce education as outlined in the RFP. Behavioral health education and training opportunities would be eligible under this RFP. No additional information on application requirements is available beyond what is in the RFP.

9. For recruitment related to various initiatives (such as leadership development, mentorship programs, and preceptor development), will responsibility for identifying and engaging participants fall to the selected vendors, the State, or be shared between both parties?

Answer: This RFP is focused on workforce education. Contractors interested in this RFP must submit proposals in accordance with the RFP’s Scope of Work. The DOH will assist in identifying key stakeholders once an award is made. Engaging participants will be shared.

10. For RFP #26-09RHT-019, Section 5.3.3.2 requires a “specific point by point response, in the order listed to each requirement in the RFP” and states that each requirement should be identified as enumerated in the RFP. Does this refer to a specific consolidated “requirements section,” or is it intended as a general instruction to respond to all applicable requirements throughout the RFP in the order they appear, clearly labeled and organized?

Answer: Section 5.3.3.2 is intended as a general instruction for structuring the proposal response, rather than referring to a single consolidated “requirements section” within the RFP.

Applicants should provide a point-by-point response to all applicable requirements as they appear throughout the full solicitation document. This includes requirements embedded in the scope of work, program descriptions, technical specifications, evaluation criteria (where applicable), and any other sections that contain explicit or implied deliverable expectations.

11. Does EMS have the ability to rent housing for an EMS provider while on call?

Answer: The intent of this RFP is to solicit proposals for healthcare education.

Funding for housing is outside the scope of this RFP.

12. Under the Rural Health Transformation RFP, is funding available to purchase new equipment under the category of “technology”? Additionally, is the stated $3 million award amount intended as a one-time total allocation, or is it anticipated to be available annually over the full five-year period of the program?

Answer: Under the RFP, “technology” funding may support tools and systems that directly enable training, education, workforce development, and service delivery improvements. This may include software platforms, simulation tools, telehealth or learning systems, data infrastructure, and other technology that supports program implementation.

The total award for this first fiscal year is $3 million, which will be distributed across multiple awards. Future funding is anticipated but not yet confirmed by CMS.

13. My organization is interested in submitting for three separate initiatives under this RFP. Should they be grouped together or submitted separately?

Answer: If your organization’s proposals are not closely aligned with each other, it would be recommended to submit separate proposals.

14. Must applicants provide statewide services, or may they serve a specific geographic region (e.g., eastern South Dakota)?

Answer: Applicants are not required to serve the entire state. Regional or geographically focused proposals are allowable, including those targeting specific rural, frontier, or underserved areas such as eastern South Dakota.

15. What evaluation criteria will be used, and are any components of the scope of work weighted more heavily than others?

Answer: Evaluation criteria will be based on the requirements and scoring framework outlined in the RFP.

16. Are there any planned informational sessions or webinars related to this RFP?

Answer: Not at this time, any upcoming informational sessions or webinars specific to RFP #26-09RHT-019 would be announced through the issuing agency’s official communication channels. Applicants are encouraged to monitor those updates regularly for notices.

17. What workforce roles are considered highest priority for funding?

Answer: The highest priority is often placed on roles experiencing the most acute shortages in rural settings, including EMS personnel, nursing and allied health professionals, behavioral health providers, dental workforce roles, and other clinical and support positions essential to maintaining access to care in underserved communities.

18. How are multi-component pipeline proposals evaluated compared to single-focus proposals?

Answer: All proposals will be evaluated equitably as long as they address components within the RFP’s Scope of Work, regardless of being multi-component or singular.

19. Can grant funds be used to train, incentivize, or support clinical instructors and preceptors?

Answer: Grant funds may be used to support training infrastructure and workforce development activities, which can include support for clinical instructors and preceptors when directly tied to education and training delivery.

20. How are earn-and-learn models evaluated versus traditional education pathways?

Answer: All educational models will be evaluated equitable as long as they address components within the RFP’s Scope of Work.

21. What metrics and outcomes are most important for scoring, including use of simulation equipment and training infrastructure?

Answer: For simulation equipment and training infrastructure, proposals are evaluated based on how directly the investment supports workforce education outcomes, scalability, and long-term utility beyond a single cohort or training cycle.

22. What level of partnership documentation is expected at submission (e.g., MOUs or letters of support)?

Answer: Proposals may include letters of support, memoranda of understanding (MOUs), or other documentation demonstrating committed engagement.

23. How does the State evaluate long-term sustainability beyond the grant period?

Answer: Vendor submissions should address which Scope of Work component(s) they are trying to address and submit long-term sustainable solutions for those components.

24. Is the State open to proposals that address only specific components of the scope of work (such as non-clinical training including leadership, care coordination, or population health), or is it expected that a single contractor must address all elements of the scope, including clinical training?

Answer: Applicants are not required to address every element of the scope of work.

Proposals that focus on specific components—such as non-clinical training areas including leadership development, care coordination, or population health will be considered provided they clearly align with the overall goals of strengthening the rural healthcare workforce and demonstrate meaningful, measurable impact within their defined scope. The State is expecting to award multiple proposals as part of this RFP.

25. Would a proposal focused solely on leadership development under Section 3.1.3 be considered responsive?

Answer: Yes

26. Does the State encourage collaborative or multi-organization proposals, and are there mechanisms available to help connect interested applicants with potential partners?

Answer: Collaboration and partnerships are encouraged under this RFP. Multi-organization proposals would be acceptable.

27. Is the $3 million budget allocated only to the initial contract period (August 1, 2026– September 30, 2027), or does it represent funding for the full duration of the Rural Health Transformation program extending beyond 2027?

Answer: Regarding the funding structure, the $3 million referenced in the RFP corresponds to the initial contract period (August 1, 2026–July 31, 2027).

Funding beyond this initial period is anticipated as part of the broader Rural Health Transformation initiative; however, continuation of funding is contingent upon future federal guidance, performance, and available appropriations. Applicants should therefore design proposals that are both effective within the initial period and scalable or sustainable over the longer-term program horizon.

28. What is the expected structure and range of individual award sizes given the $3 million Year 1 budget, and will awards be segmented by scope area or region?

Answer: RFP #26-09RHT-019 is designed to support a flexible but coordinated set of awards, and while the total Year 1 funding is $3 million, the solicitation does not prescribe fixed award sizes or predefined segmentation by scope area or geography.

29. Can a single offeror receive multiple awards?

Answer: Yes, a single offeror could receive more than one award if multiple proposals are submitted and selected

30. Will the State publish weighting for the seven evaluation criteria and clarify the relative weight of technical versus cost proposals?

Answer: No, the RFP outlines the factors that will be used to assess proposals. The State generally evaluates proposals holistically, with emphasis placed on demonstrated ability to meet program goals, feasibility of implementation, strength of partnerships, and cost reasonableness.

31. How does the State define “familiarity with project locale,” and what evidence is most relevant?

Answer: “Familiarity with project locale” refers to demonstrated experience and understanding of South Dakota’s rural healthcare environment, including workforce challenges, geographic barriers, and system structure. Relevant evidence may include prior work in South Dakota, established partnerships with South Dakota-based organizations or institutions, experience serving similar rural or frontier populations, or demonstrated knowledge of comparable rural health systems in similarly structured states.

32. What level of in-person travel and presence in South Dakota should applicants anticipate?

Answer: the RFP anticipates some level of engagement within South Dakota, particularly for stakeholder convenings, coordination meetings, and implementation oversight activities. However, the exact number of required trips or in-person engagements is not predefined. Applicants are expected to propose reasonable travel assumptions in their cost proposals based on the anticipated needs of their approach.

33. Does the State have existing technology platforms that must be used or integrated with, or are contractors expected to provide their own?

Answer: contractors are expected to propose and implement the technology platforms needed to deliver their scope of work, including learning management systems, virtual training tools, or simulation platforms.

34. Should proposals explicitly map to the 2024 Strategic Analysis recommendations or only generally align with them?

Answer: Applicants are encouraged to demonstrate clear and intentional alignment with the report’s recommendations.

35. Does the State expect time-and-materials billing based on hourly rates, or are deliverable-based, milestone-based, or fixed-fee structures acceptable?

Answer: Hourly rates for personnel should be included within the proposal.

Deliverable, milestone, and fixed structures may be submitted if they are transparent and clearly articulate deliverables and outcomes.

36. What are the minimum and maximum allowable budget amounts for proposals?

Answer: The RFP does not establish minimum or maximum budget proposals.

37. What indirect cost rate should applicants use?

Answer: This will be dependent on the contractor relationship. Contractor relationships (fee for service) will not have indirect rates. For a contractor, cost breakdowns should encompass all costs, plus overhead/administrative fees.

Subrecipients with federally approved indirect cost rates should use their approved rate and should include a copy of their approved rate in the application.

Subrecipients who do not have an approved rate and meet the requirements in codified federal regulation 200.414 (f) may prepare a budget using the de minimis rate of 15%.

38. And should proposals be written for Year 1 only, or should they also address subsequent years of the funding period?

Answer: Applicants should submit proposals for the first fiscal year. If awarded, contractors may be eligible for subsequent year funding through the contract process.

39. What expectations exist regarding the balance of clinical versus non-clinical training within proposed programs?

Answer: Both clinical and non-clinical training approaches are allowable and may be included within proposals. The strongest submissions typically demonstrate how these components work together to support a more comprehensive workforce development system.

40. How will in-state versus out-of-state partners be evaluated?

Answer: Both in-state and out-of-state organizations are eligible to serve as lead applicants, provided they demonstrate strong partnerships and a clear understanding of South Dakota’s rural healthcare landscape.

41. Are activities such as establishing or expanding clinical rotations, residencies, preceptor development programs, and student training pathways allowable and encouraged under this RFP?

Answer: Activities such as establishing or expanding clinical rotations, residencies, preceptor development programs, and student training pathways are generally considered allowable and are strongly aligned with the intent of the RFP when directly connected to workforce development outcomes.

42. Can the State clarify expectations regarding allowable costs and budget structure, including, participant support costs (e.g., stipends, scholarships, incentives, preceptor payments), personnel and travel cost presentation, subcontractor classification, and profit or fee allowances?

Answer: Allowable costs must be reasonable, necessary, and directly tied to the approved scope of work. Participant support costs—including stipends, scholarships, incentives, and preceptor payments—may be allowable when clearly tied to workforce development, training participation, or retention objectives and appropriately justified within the proposal.

43. What categories of technology-enabled learning investments are allowable (e.g., LMS platforms, simulation tools, tele-education systems, software licenses, hardware, and technical support), and are there specific interoperability, cybersecurity, accessibility, or data reporting standards required?

Answer: Technology-enabled learning investments may include learning management systems, virtual training platforms, simulation tools, tele-education systems, software licenses, and related technical support when directly supporting workforce education and training outcomes

44. Can the State provide clarification on evaluation criteria and scoring, including the relative importance of innovation, statewide reach, rural familiarity, cost effectiveness, scalability, and sustainability?

Answer: Proposals will be evaluated based on criteria outlined in the RFP, which generally include alignment with program goals, strength and feasibility of the proposed approach, organizational capacity, partnership structure, cost reasonableness, and anticipated outcomes.

45. What are the expectations for performance measurement, including required metrics, baseline and target setting, and long-term outcome tracking beyond the initial contract period? Additionally, will reporting templates or dashboards be provided?

Answer: Reporting requirements will include regular submission of progress and outcome data, with additional detail provided post-award. The State may provide reporting templates, dashboards, or alignment with CMS reporting requirements depending on final contract structure.

46. What are the expectations for implementation timelines, mobilization periods, State-provided data or stakeholder support, coordination with other RHT awardees, and participation in advisory or governance structures?

Answer: Implementation is expected to begin on or around the contract start date identified in the RFP, with a reasonable mobilization period anticipated prior to full program delivery.

47. Does the State have estimated participation volumes for rural healthcare professionals and trainees, including any projected breakdowns by discipline (e.g., nursing, physicians, EMS, behavioral health, community health workers, and non-clinical leadership)?

Answer: The State does not currently prescribe fixed participation volumes or discipline-specific allocation targets within RFP #26-09RHT-019. Applicants are encouraged to propose reasonable participation estimates based on their proposed model, geographic focus, and capacity.

48. Does the State anticipate participation being voluntary or required for any stakeholder groups, and are there target participation, completion, or adoption goals?

Answer: Participation is generally expected to be voluntary, though applicants may coordinate with partner organizations that encourage engagement within their networks. The State does not mandate participation for specific stakeholder groups.

49. Should proposed programs align with a specific competency framework (statewide, discipline-specific, or national), and if so, which frameworks should be prioritized?

Answer: Applicants are not required to align to a single competency framework;

however, proposals should reference recognized state, national, or discipline-specific standards where applicable and clearly identify the framework(s) used to guide curriculum and training design.

50. Can the State provide additional details regarding existing rural health education, workforce development, tele-education, simulation, and training initiatives currently operated or funded by the Department of Health, universities, healthcare systems, or other partners that selected contractors will be expected to align with or leverage?

Answer: The State anticipates that selected contractors will coordinate with existing rural health workforce and education initiatives across South Dakota, including programs operated by State agencies, academic institutions, healthcare systems, and partner organizations.

51. Can the State clarify how it anticipates structuring multiple awards under this RFP (e.g., functional area, geography, workforce segment, or complementary service offerings)?

Answer: RFP #26-09RHT-019 anticipates multiple awards but does not prescribe a fixed distribution model such as regional or functional segmentation. The final structure of awards will be determined based on proposal quality, coverage of needs, and the State’s objective of maximizing statewide rural workforce impact.

52. Does the State envision selected contractors serving primarily as direct education and training providers, or will contractors also be expected to fulfill broader statewide coordination functions such as program administration, participant management, reporting coordination, stakeholder convening, or a program management office (PMO)-type role?

Answer: Contractors may be engaged in both direct service delivery and coordination functions depending on the scope of their proposal. The State anticipates that some contractors may serve as implementation partners delivering education and training, while others may also support broader coordination activities.

53. For proposal submission requirements, are electronic signatures (e.g., DocuSign) acceptable in lieu of ink signatures?

Answer: Yes

54. Can this funding be used to pay for housing to support student rotations in rural communities?

Answer: Yes. Allowable costs must be reasonable, necessary, directly tied to the approved scope of work and appropriately justified within the proposal.

55. Can this funding be used to support apprenticeship programs that train existing or future staff as medical assistants, dental assistants and/or community health workers?

Answer: Apprenticeship or earn-and-learn models are allowable and are aligned with the intent of this RFP. Funding may be used to support structured training programs that develop current or future healthcare staff, including roles such as medical assistants, dental assistants, and community health workers provided the program includes clear training objectives, defined competencies, and measurable workforce outcomes tied to rural healthcare needs.