Alaska starts spending its $272 million in rural health money

Alaska is starting to spend the $272 million it won in the first year of a new federal rural health program, and the money is going out faster than the state has answers about the strings attached.

The state health department made its first awards Aug. 7, more than $4.5 million across 19 projects, and by mid-August had cleared dozens more, worth nearly $35 million all told. The work ranges from sanitation and facility renovations to child care.

The catch is that Alaska made specific promises to win the money, listed as milestones in its federal application, and the state is already finding it needs to adjust them. "We don't have the clarity of guidance this year that I think we need," Deputy Commissioner Emily Ricci told an advisory council when a member pressed on whether the state could still meet what it committed to. A department official said the federal government allows changing when or how a milestone is met, but generally not swapping one commitment for a different one.

Advisory member Monique Martin urged the state to flag any milestone changes before it applies for a second year of funding.

The demand for this money is enormous. Requests across the program came to $2.7 billion, roughly ten times what Alaska received. A public webinar Sept. 11 covers the second-year cycle.