Since its establishment the MHCH Foundation has supported numerous activities that strengthen the lives of rural South Dakotans. These activities have ranged from educational scholarships to the hosting and sponsorship of town hall meetings, roundtable discussions, and workshops that focus on improving the quality of life and rural vitality within the Northern Plains region.

Currently the MHCH Foundation's primary area of focus is to leverage healthcare as a driver for rural economic and community development activities within central South Dakota. The foundation has committed $200,000 over a five year period to South Dakota's largest health care systems (Sanford and Avera) to support the construction of desperately needed long term care facilities and other infrastructure needs. The foundation is currently a key partner in the development and implementation of the Prairie Futures program. This program promotes rural economic development through supporting non-traditional students living in rural areas as they complete healthcare degrees. The program addresses rural healthcare workforce shortages, while promoting rural economic development and improving quality of life.