BISMARCK — A committee of North Dakota lawmakers this week began sifting through an ocean of recommendations for how to spend a $500 million federal rural health care grant as the state races to meet a Nov. 5 application deadline.

The state will have a number of complex decisions to make — including how to weigh the public’s priorities against the kinds of initiatives encouraged by the federal government, a top human services official told legislators on Tuesday, Oct. 14.

Congress created the $50 billion Rural Health Transformation Program this summer as part of its 10-year budget reconciliation law. Members of Congress pitched the program as a means to offset losses rural states will suffer from federal cuts to Medicaid approved elsewhere in the bill.

The money can be used for areas in

See Full Page