This bill appropriates $402,000,000 in federal funds to the South Dakota Department of Health for the implementation of the rural health transformation program, as authorized by the One Big Beautiful Bill Act. The Department of Health is required to submit quarterly expense reports detailing expenditures by initiative until the appropriated funds are exhausted. Additionally, the secretary of the Department of Health is responsible for approving vouchers, while the state auditor will draw warrants to facilitate the authorized expenditures.

The bill also stipulates that any unspent or unobligated funds by October 30, 2027, will revert according to established procedures. An emergency is declared to ensure the immediate effect of this Act upon its passage and approval, emphasizing its necessity for the support of state government and public institutions.