Workforce Retention Funding for Critical Access Hospitals and Their Owned and Operated Clinics

Workforce Retention Funding for Critical Access Hospitals and Their Owned and Operated Clinics is sponsored by North Dakota Department of Health and Human Services. This program aims to bolster the rural healthcare workforce by providing grants to critical access hospitals and their clinics in North Dakota. The funding supports retention strategies such as employee incentives, childcare partnerships, and professional development.

Workforce Retention Funding for Critical Access Hospitals and Their Owned and Operated Clinics | Health and Human Services North Dakota Workforce Retention Funding for Critical Access Hospitals and Their Owned and Operated Clinics Thank you for your interest in North Dakota’s Rural Health Transformation Program.

We are excited you are considering applying for this once-in-a-generation opportunity to strengthen rural health care and improve the health and well-being of North Dakotans in rural communities. You play a vital role in serving your community and your commitment to local needs is essential to making this effort successful.

We look forward to reviewing your proposal and partnering with you to transform rural health and help North Dakota become the healthiest state in the nation. Funding Opportunity Solicitation Number: 210-22102 This Rural Workforce Retention funding opportunity provides retention grants to support a variety of disciplines and strategies within critical access hospitals and their owned or operated clinics.

The goal is to strengthen and stabilize rural practice environments, ultimately improving access to care in rural communities. This opportunity supports North Dakota’s rural workforce by offering retention grants designed to make rural practice more sustainable for existing practitioners. It aligns with the Strengthen and Stabilize Rural Health Care Workforce Initiative under North Dakota’s RHTP.

Administrative costs, capital expenditures and vehicle purchases are not allowed under this funding opportunity.

Eligible workforce retention projects include, but are not limited to: Employee Incentive and Support Strategies Tuition reimbursement*, education awards* (loan repayment not allowed) and support for upskilling or career pathway development (e.g., CNA→LPN→RN, MA→LPN, administrative to clinical pathways including Community Health Workers)* Preceptor or mentorship stipends (includes the five-year service commitment if this leads to a certification or licensure*) Transportation and housing supports for staff who travel long distances or face weather-related commute challenges* Employee engagement and organization culture measurement tool Child care partnerships, including reserved child care slots, subsidized child care* or on-site child care expansion (does not include establishing new on-site child care; this will be addressed in a separate funding opportunity) Wellness, Resilience and Burnout Prevention Workplace wellness programs and staff recognition programs Activities that support resilience, reduce burnout and strengthen a positive workplace culture, including confidential counseling access, critical‑incident debriefing, peer support teams, etc. Partnerships with gyms, parks departments, community centers or schools to provide affordable family access to healthy activities Structured stay interview programs or tools aimed at identifying burnout or turnover risks early Flexible Scheduling and Innovative Staffing Models Technology or workflow solutions that assist in administrative efficiency, such as improved scheduling tools or documentation support technologies Education, Training and Professional Development Leadership development and cross-training programs Continuing education (including CMEs and CEUs for nursing and other disciplines) Licensure fees and renewal costs Tuition reimbursement as described in Employee Incentive and Support Strategies* Shared Learning, Mentorship and Professional Support Networks Shared decision-making councils or staff engagement committees Mentorship programs, clinical supervision partnerships or structured on-going evaluations designed to improve job satisfaction and support a positive work environment Telementoring and virtual professional development opportunities, including teleconsults, virtual grand rounds and rural collaborative learning networks *Note: Per federal grant guidance, financial incentives are tied to a minimum five‑year service commitment.

As part of the application review, the North Dakota Health and Human Services (ND HHS) will determine whether any additional applicant‑proposed strategies are subject to the federal five‑year service commitment requirement and will notify the applicant accordingly. Staff receiving a financial incentive must be employed and on the payroll at the time this funding application was posted.

On-site child care incurs a five-year service commitment if offered at free or reduced cost to the individual. If funds are being used to expand on-site child care and the fees are charged to the individual, then no commitment applies.

Refer to the Project Narrative and Action Plan under Application Requirements for additional details on the five‑year service commitment and to the Budget section for information on allowable and unallowable costs.

Additionally, this funding opportunity aims to support improvement in metrics identified for the Strengthen and Stabilize Rural Health Care Workforce Initiative found on pages 52-53 of the project narrative and pages 10-11 of the appendices : Increase the rural provider retention rate at 3 and 5 years Expand remote monitoring and AI-assisted care to reduce staffing needs Reduce Health Professional Shortage Area (HPSA) counties Increase the rural primary care provider retention rate Critical Access Hospitals that include their owned and operated clinics.

The funding period will begin once the agreement has been fully executed, following all required approvals and signatures. It will end on September 30, 2027, and all funds must be fully expended by that date. Approximately $10,000,000 in federal funding is available in year one for Critical Access Hospitals and their owned and operated clinics to support rural health care workforce retention efforts.

An estimated 37 awards of approximately $270,000 each are expected to be made in year one. Applicants may submit a prioritized funding proposal and requested amounts may exceed $270,000. Activities not funded in the initial awards may be considered later in the year pending a review of available funds in August 2026.

Refer to Project Narrative, Action Plan and Budget Sections under Application Requirements for additional detail.

ND HHS reserves the right to negotiate the applicant’s budget based on the number of applications received, the content of the proposed project work plan and total budget requested by the Critical Access Hospitals and their owned and operated clinics for this rural health care workforce retention funding opportunity, prior to issuing the notice of award.

Refer to the Budget section under Application Requirements for details on allowable and unallowable costs. The successful applicant(s) will be required to submit reimbursement requests or supporting information, progress reports and impact stories to ND HHS. Templates will be provided for reporting requirements.

Due dates and additional information will be provided in the agreement. Successful applicants may be required to report for up to five years or as otherwise required by CMS. Additional reporting requirements may be required based upon updated federal guidance.

Applications for this funding announcement are due by April 30, 2026, 5:00 p. m. CT.

Applications must be submitted to ND HHS through Qualtrics . Applications not received by the submission date and time will be considered non-responsive and not reviewed. A technical assistance conference call was held March 30, 2026, at 3 p.

m. CT Workforce Grant Presentation (Document) Contact rhtp@nd. gov with questions.

Please identify the funding opportunity name and number in the subject line. Interested entities are required to submit an application to be considered for the Rural Workforce Retention funding opportunity for Critical Access Hospitals and their owned and operated clinics. Do not include any proprietary or confidential information in application materials as the application will become an open record.

Below is the outline and related details for the application. All application components will be submitted through Qualtrics .

Identified Need and Proposed Goals Strategies, Activities and Measurable Outcomes Attachment A - Itemized Budget Template Attachment B - Scoring Tool Learn more: North Dakota's Rural Health Transformation Program webpage This RHTP funding opportunity is supported by CMS of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $198,936,969.

55 with 100 % funded by CMS/U.S. Department of Health and Human Services. The contents are those of ND HHS and do not necessarily represent the official views of, nor an endorsement, by CMS/U.S. Department of Health and Human Services, or the U.S. Government.