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Avera is one of four recipients nationwide to receive the Rural Maternity and Obstetrics Management Strategies Program funding, otherwise known as RMOMS, awarded by the federal Health Resources and Services Administration (HRSA).

The grant provides $1 million per year over four years for a total of $4 million to help increase access to obstetrics services and improve outcomes such as pre-term labor, low birthweight, infant mortality and more in South Dakota.

“Simply put, we want to see that moms and babies are healthy — throughout pregnancy, delivery and beyond,” said Kimberlee McKay, MD, Clinical Vice President of Avera’s OB-GYN Service Line. “For that to happen, moms need access to high quality prenatal care and careful management of conditions such as high blood pressure and gestational diabetes, regardless of their zip code.”

At some remote locations, an expecting mom might need to travel an hour to see a primary care provider, and hundreds of miles to see a specialist. This means time away from work and family, and often lost income. Due to these barriers, some women simply choose to go without prenatal care.

RMOMS-SD will implement remote patient monitoring and telehealth, coordination between different aspects of OB care and existing resources, ensuring access to statewide wraparound services, and a social determinants of health screening program.

Statewide wraparound services are those services provided by governmental, health care and non-profit agencies that contribute to the well-being of individuals and families, for example, government assistance, subsidized childcare, dental care and much more. Social determinants of health screening would look into factors like access to healthy foods, decent housing, transportation and economic security.

The grant program targets rural pregnant women in eastern South Dakota and surrounding tribal communities who have significant barriers to OB services and access to care at local facilities.

Thousands of births take place across the Avera system each year, and about two-thirds of these births occur in rural or critical access hospitals.

“In the past, Avera has successfully piloted the use of telehealth to monitor and consult with patients who develop gestational diabetes, and we’ve seen improved outcomes as a result,” McKay said. Since Avera’s virtual monitoring program for gestational diabetes began in 2016, these positive outcomes have been noted:

• A decrease in vaginal delivery complications of 27%

• A decrease in cesarean delivery complications of 18%

• A reduction in the number of infants born at weights of 4000 grams (about 8.8 pounds) or more

“The RMOMS grant is a great opportunity to expand upon that foundation of work,” McKay said.

Another aspect of RMOMS-SD is developing a robust data and evaluation program that helps partners better understand and address OB needs in the region.

“As a highly integrated system, Avera is well-positioned to successfully carry out the aspects of this grant. We are excited about how the data we gather will impact the future of OB care delivery in rural areas and help provide positive outcomes,” McKay said.

Avera McKennan Hospital & University Health Center in Sioux Falls, the grant recipient, will collaborate with numerous partners, including regional centers in Aberdeen, Mitchell, Pierre and Yankton; Avera@Home; Access Health; South Dakota Urban Indian Health; the South Dakota Department of Health and Department of Social Services; and Premier Inc. Additionally, project activities will support two rural critical access hospitals, Milbank Area Hospital Avera in Milbank and Avera St. Benedict Hospital in Parkston.

Although rural eastern South Dakota is the initial target service area, expansion in the Avera footprint will be considered in the future.

This grant program pairs with a previously awarded grant, the HRSA OB Primary Care Training and Enhancement — Community Prevention and Maternal Health Grant that was funded at $2.3 million through June 2026. This grant focuses on recruiting and retaining medical providers in rural locations and supporting them with OB training.

Between these two grants, Avera has been awarded over $6.3 million to support the delivery of maternal care. Through these awards, Avera will expand access to OB services and providers in rural South Dakota. As a result, more expecting and new mothers can stay close to home while receiving quality maternal care.

“Rural America is one of the most challenging environments for providing prenatal and OB care because people are so isolated. Women cannot always afford to travel or take time off work for regular checkups,” McKay said. “We’re grateful for federal grant funding that is allowing us to develop ways to remove barriers and improve access to care in rural areas.”

These projects are supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of two awards totaling an estimated $6,368,834 million (RMOMS: $4,000,000 over four years; Primary Care Training: $2,368,834 over five years) with approximately 8% of the Primary Care Training award financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, visit HRSA.gov.

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