Proponents say the federal Rural Health Transformation Program could result in “generational change” in South Dakota, but some lawmakers bristled over what they perceived as a loss of control over the state’s purse strings.
The executive branch offered stern words for the Joint Appropriations Committee to keep the time-sensitive process moving during a hearing on Thursday.
The federal program offers states a baseline of $100 million a year for the next five years, with additional funds awarded based on an application process. South Dakota received $189 million for this fiscal year, with the next round of funds announced in the fall based on early results.
The Department of Health said it needs more than only this year’s spending authority to prevent contract delays, prompting a lengthy debate over budgetary timelines and how the amount of spending authority is determined.
Sen. John Carley of Piedmont was among lawmakers who resisted uncertain numbers. He said it’s a matter of responsibility.
“This is for the elected officials to decide and look at each year. Not to turn over two years worth of guesses — this is a guessed number — to turn that over with an unknown number," he said. "So do you want to cede that authority and give that up, or do you wanna have the ability to look at it next year, see what we’ve got, and then approve those funds next year. I would suggest you shouldn’t cede that authority.”
Others, like Rep. Chris Kassin of Vermillion, argued against anything that jeopardizes additional funding for rural health initiatives.
“My responsibility is to the constituents of District 17 who pay federal tax dollars, they file their income tax and they pay. I can’t go back to them and say, ‘Hey, because of today, I voted to do something that maybe could cost our state and those taxpayers receiving their money back.’ Money’s already been allocated. We can’t give it back," Kassin said.
After an hour of debate and a brief recess, Lt. Gov. Tony Venhuizen addressed the committee he once co-chaired. He said there’s nothing to fear from granting spending authority for more money than is ultimately awarded.
“You’re losing the forest for the trees," he told committee members, "And before you consider this series of amendments, I would ask you to take a step back and think about that. This is too important. We need to get this done.”
The appropriators ultimately approved spending authority for the first two years of the program. Sens. John Carley and Taffy Howard were the only dissenting votes.
The bill still needs approval from the full House before advancing to the Senate.