North Dakota to use ‘anchor partners’ to manage Rural Health grants

North Dakota’s Health and Human Services Department is turning to outside “anchor partners” to manage a federal grant program for millions of dollars meant to boost rural health care initiatives.

Lawmakers wondered what an “anchor partner” actually is, how they are chosen and how the change will affect the timing to get more than $160 million of awarded funding out the door by a looming deadline.

Earlier this year, the Republican-led Legislature accepted $199 million in federal Rural Health Transformation Program funding. The money is meant to improve technology, increase health care access in rural areas, boost workforce and promote healthy lifestyles.

All 50 states received a portion of the money under the five-year, $50 billion program.

North Dakota rural health plan approved, ‘now we’ve got to implement it’

North Dakota is the only state managing every single grant included in the Rural Health Transformation Program, estimated at 500 to 700 grants, HHS Chief Financial Officer Donna Aukland told a panel of House and Senate budget writers on Wednesday. The other states have “anchor partners,” she said.

“Anchor partners” are in-state organizations that directly handle grant applications and funding opportunities and individually manage the grants, Aukland said. HHS would still manage the grants but “from a higher level to ensure that the work was getting done,” she said. 

HHS will use three anchor partners, including the University of North Dakota Center for Rural Health. The two others are not finalized.

HHS chose partners it was already working closely with, but plans to work with more in the future four years of funding and figure out whether there will be an application process for anchor partners, Aukland said. 

Rep. Eric Murphy, R-Grand Forks, said details are lacking on the department’s change, a move Aukland called a “slight pivot.”

Rep. Jon Nelson, R-Rugby, said he doesn’t see the change helping the timeline for dispersing funds and wondered about a decision-making lag. More than $161 million remains to be awarded to grantees, awaiting final reviews, Aukland said. The deadline to do so is Oct. 30.

“There’s a lot of angst out there that the awards haven’t been granted yet,” Nelson said. 

More than $50 million available in new rural health grants

In the next week, HHS will look at all of the awards going out to anchor partners and will notify grant recipients that money is coming, “but we don’t know the total amount yet” because HHS needs to verify the amount in their grant application is allowable, Aukland said.

So far, HHS has obligated about $37.3 million of the funding.

HHS still has to have staff for the program to ensure the money is used according to plan, Aukland said. The change to anchor partners allows the department to focus on strategy and more follow-up “to ensure that we are actually getting the things out of the plan that we wanted to get.”

Earlier, she told another panel of lawmakers that HHS has had to hire about 20 positions to administer the Rural Health Transformation Program. Even with anchor partners, the department will still have administrative costs as it monitors the work for compliance with federal rules, Aukland said.

Anchor partners are allowed up to 10% of grants for administrative costs, she said. HHS requires information on administrative costs, she said.

The U.S. Centers for Medicare and Medicaid Services will announce North Dakota’s second-year funding amount in October. HHS has estimated it will be around $200 million.

Evaluations for the next four years of Rural Health funding will be under HHS guidance with the anchor partners, Aukland said.

Deputy Editor Jeff Beach contributed to this report.

Reach North Dakota Monitor reporter Jack Dura at [email protected].