South Dakota Looks to Strengthen Rural Health Care

By Scout Nelson

South Dakota is set to receive $189 million in funding to support rural health care; a move leaders say will bring gradual improvements while larger changes take time to complete. The funding supports the Rural Health Transformation Program and covers projects planned for 2026.

During his State of the State address, Governor Larry Rhoden urges Congress to prioritize approval of federal funding. “We could be the first state in the nation to authorize this funding, so I would love it if this was the first bill that reaches my desk,” Rhoden said.

The funding equals an average of $379 per rural resident. While the amount is slightly lower than requested, state officials say the funds will still support major upgrades. The program distributes funds over five years, with half shared equally among states and the rest based on rural needs and facility conditions.

The Department of Health outlines four key goals. These include improving technology and data systems, strengthening the rural workforce, keeping health care services local, and creating systems that last beyond the funding period. Technology improvements receive the largest share and may include cybersecurity tools, health data platforms, and advanced medical equipment.

Tim Rave, CEO of the South Dakota Association of Health Organizations, says technology upgrades will likely be felt first. “That's going to get ramped up pretty fast. I mean, people are already doing it. If we can just bolster what we're doing, that one I see as a real short-term with a real quick impact on people to have access,” Rave said.

Maternal health is another priority. Plans include creating regional obstetrics hubs and local support sites to address gaps caused by rural hospital closures. Behavioral health also receives attention, especially through telehealth and shared care programs.

Tribal leaders stress that funding access must reflect the real challenges in tribal communities. “This investment creates a real opportunity to expand services and address long-standing workforce shortages in rural Tribal communities,” said Leah Belgarde.

Lawmakers and health leaders agree that the biggest challenge is sustainability. “You've just got to make sure we can prove that there'll be self-sustaining going forward once those one-time dollars are gone,” Rave said.

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