South Dakota lawmakers grapple with Rural Health Transformation funding and sustainability

Monument Health in Rapid City, S.D., will receive RHTP funding.
(Photo by Seth Tupper, South Dakota Searchlight)

Legislative and practical worries about staffing and sustainability have some South Dakota lawmakers worried that the $189.5 million the state received from the Rural Health Transformation Program won't be enough to strengthen its rural hospitals in the long term, reports Makenzie Huber of South Dakota Searchlight.

Sen. Taffy Howard, R-Rapid City, has "questions and frustrations about the funding," Huber writes. Because of the way RHTP is structured, if South Dakota lawmakers don't spend the money, "another state will spend it instead."

South Dakota's RHTP application targeted 10 initiatives, including "creating a 'data atlas' for providers and facilities to share local and state agency data, improving the rural health care workforce, improving chronic disease management, establishing regional maternal and infant health care hubs, and regionalizing behavioral health care," Huber explains. 

To support its initiatives, the state's plan includes numerous incentives designed to attract and keep needed medical staffing, such as "sign-on bonuses, relocation assistance, and rural service stipends," Huber writes. Medical professionals who accept incentives must work in their assigned rural community for at least five years.

In reviewing all the initiatives, several lawmakers "asked questions about workforce needs and how those would be addressed outside of the incentives mentioned," Huber reports. "Howard told officials that she’s skeptical about the proposal and its sustainability." Howard pointed out that infant care hubs and mental health treatment may need more than "one-time funding to operate in financially strapped rural communities."

While state lawmakers are hopeful RHTP funding can sustainably improve rural health care, many remain concerned about what the loss of federal Medicaid dollars will mean for many rural patients and hospitals. 

Rep. Erik Muckey, D-Sioux Falls, told Huber, "This still doesn’t answer the question about how to sustain quality health care going forward because of massive cuts to Medicaid.”