South Dakota

South Dakota is working against a $189,477,607.26 Year-1 CMS award (100% federally funded) — the opening tranche of an approximately $1 billion, five-year plan that runs through September 2031. Like all RHTP awards, it is structured by CMS as an annual award across a five-year performance period, and it is South Dakota's share of the federal $50 billion Rural Health Transformation Program.

The program is administered by the South Dakota Department of Health (SD DOH), chiefly through its Office of Rural Health and Emergency Services (ORHES), under Secretary of Health Melissa Magstadt. The Department of Social Services runs Medicaid-related components. Program hub and contact: SD DOH Rural Health Transformation, DOH.Info@state.sd.us.

South Dakota's plan aims to build a sustainable rural healthcare system across workforce, digital modernization, maternal health, chronic disease, and Medicaid payment reform. A distinctive pattern has emerged: rather than build capacity in-house, SD DOH is contracting out the management layer itself — buying operators and integrators first, program delivery second. The plan aligns with the state's Strategic Analysis of South Dakota's Rural Healthcare Programs (2024).

The largest visible commitment is the Digital Health Modernization and Technology Grant Program — a nearly $480 million multi-year program, with $89,343,733 available in Cycle 1 (FFY26), structured around seven funding tiers (EHR adoption/upgrade/replacement, technology and equipment, digital security, workforce technology training, and Regional Innovation Centers). Other funded lines include a Sustainable Rural Healthcare Workforce initiative, Medicaid Primary Accountable Care Transformation (PACT), Chronic Disease Management, EMS Workforce and System Modernization, maternal health (doula workforce, access assessment), and Rural Health Forward, a statewide training hub. The full breakdown is in South Dakota's budget narrative.

South Dakota has moved fast on procurement. It has run multiple RFP rounds through its ESM Solutions posting board, including a first round of seven leadership/PM roles (Feb), a second round of three (doula workforce, maternal health assessment, Rural Health Forward), the $89.3M Digital Health Modernization RFA (#26-09RHT-020), a Recruitment & Retention RFP (#26-09RHT-024) putting up to $6M on the table, and an invitation-only Grant & Project Management RFP (#27-09RHT-024). It has already awarded three program-management contracts: North Star Solutions ($1,462,802, Digital Health Modernization), Black Hills Special Services Cooperative (Chronic Disease PM), and Business Concepts & Applications ($500,000, DSS/Medicaid). The dispatch list below carries the running record.

Recent posted dates include the Digital Health Modernization RFA (#26-09RHT-020) — applications due June 30, 2026, awards anticipated by August 13, 2026 — and the invitation-only Grant & Project Management RFP (#27-09RHT-024) with proposals due August 4 and award expected August 14, 2026. Windows have been notably tight (some as short as 10 days), so live dates surface first in the dated dispatches below and on the state's RHT posting board.

The Rural Health Transformation Program was created by Section 71401 of the One Big Beautiful Bill Act (2025) and is administered federally by CMS. In South Dakota, Governor Larry Rhoden made RHT appropriations (HB 1044) the first bill he signed this session — a signal of how fast the state intends to move money — and the program operates under SD DOH's CMS-approved project and budget narratives.

Eligibility runs on two tracks. Direct-to-state contracts go out as competitive (and sometimes invitation-only) RFPs and RFAs on the state posting board, where firms bid as prime contractors — South Dakota's early buys have leaned heavily toward program-management and integrator roles. Subgrants and subawards flow to rural providers — FQHCs, Critical Access Hospitals, tribal clinics, community mental health centers, and other South Dakota healthcare providers — where technology vendors and consultants most often engage as subcontractors or implementation partners. Note that invitation-only solicitations (e.g., via the ESM Solutions / Central Bid Exchange board) restrict who can formally respond, so registering early matters. Digital Health Modernization applicants in Sioux Falls (Minnehaha) and Rapid City (Pennington) must explicitly show benefit to rural areas.

Track opportunities on the RHT posting board and the program hub, and subscribe to the state's rural health listserv.

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