Rural Strong Grants: Strengthening Access to Care in Rural Communities

The South Dakota Department of Social Services, Division of Medical Services, in partnership with the Department of Health, is issuing a Request for Proposal (RFP #26-09RHT-001) to award Rural Strong Grants intended to strengthen access to care in rural communities through the Rural Health Transformation initiative. This grant-funded procurement seeks proposals from eligible applicants including Medicaid-enrolled hospitals, federally qualified health centers, rural health clinics, Indian Health Services/Tribal 638 clinics, physician groups, behavioral health clinics, and dental clinics to address three primary initiatives: Medicaid Rural Health Access and Quality Grants, Medicaid Primary Accountable Care Transformation, and Regional Maternal and Infant Health Hubs. Proposals must focus on one of five allowable use categories: Operational and Strategic Planning, Strategic Partnerships, Service Line Expansion, Regional Resources/Hub and Spoke Models, and Care Coordination Infrastructure/Readiness for Value-Based Care, with preference given to projects addressing maternal healthcare access and care coordination readiness. All proposals must include detailed budgets demonstrating sustainability beyond the grant period and address strategic healthcare system strengthening through innovative care models and cross-agency collaboration. A non-binding Letter of Intent is due by April 16, 2026, with formal proposals due by May 22, 2026, at 5:00 PM Central Time via Secured File Transfer Protocol; inquiries regarding RFP requirements must be submitted to Kirsten.Blachford@state.sd.us by the deadline specified in the Schedule of Activities. Award decisions are anticipated on or before June 22, 2026, and selected applicants may be required to participate in oral presentations at their own expense, with contracts commencing on or around May 8, 2026, and concluding on September 30, 2027, with options for up to four one-year renewals.

Grant funds are 100 percent federally funded by the Centers for Medicare & Medicaid Services/Health and Human Services and are available only for specified allowable activities, with explicit prohibitions against pre-award costs, construction, clinician salaries subject to non-compete agreements, duplicate insurance payments, and lobbying activities. The total funding pool available for awards is up to $31,750,000 for budget period one, with individual award amounts varying based on proposed projects; however, funding for subsequent budget periods has not yet been awarded by CMS and is anticipated to decrease in periods four and five. All applicants must comply with federal certifications regarding debarment, non-discrimination, prohibited foreign ownership, and restrictions on boycotts of Israel, and must maintain required insurance coverage including $1,000,000 in commercial general liability, professional liability, and business automobile liability insurance. Budget period one funds must be obligated by September 30, 2027, and all proposals require demonstration of project sustainability beyond the grant-funded period. No incumbent vendors or current contractors are identified in this solicitation, as this represents a new grant award opportunity for strengthening rural healthcare systems across South Dakota.