make an appropriation to implement the rural health transformation program, and to declare an emergency.

South Dakota gets rural health funding

The law authorizes South Dakota’s Department of Health to spend $402 million in federal funds on rural health transformation. Spending is limited to program initiatives authorized by the One Big Beautiful Bill Act, not specified household payments. Until this funding authority is exhausted, the department must report spending by initiative each quarter to Legislative Audit and the Legislative Research Council. The Health Secretary can approve payment vouchers, and the State Auditor can issue payments authorized by this law. Money not lawfully spent or committed by October 30, 2027, returns under state budget rules. An emergency clause makes the law effective upon passage and approval.