Rural Texas Strong now has several grant application avenues open, and one track in particular gives physicians an opportunity to vie for a portion of the $1.4 billion awarded to Texas under the federal program to improve rural health care.
However, Texas Medical Association staff caution those interested in applying to pay close attention to the detailed requirements and tight deadlines in the mostly competitive application process. Reviewing eligibility requirements is key. Of the program’s six funding initiatives, physicians will likely only be eligible to apply for Initiative 4 and Initiative 6.
Initiative 4, titled “The Next Generation of the Small Town Doctor and Team,” is the program track most directly applicable to physicians, and grantees can receive a maximum of $725,000. The Texas Health and Human Services Commission (HHSC) indicated it will issue at least one grant per defined rural county to help recruit, retain, and train the rural workforce. The application deadline is May 27. Other tracks for equipment and disease prevention are also open.
TMA continues to analyze the application processes as they become available, with the details below current as of this writing.
All applications must be submitted through the HHSC Grants Management System, and TMA staff advise the best way to stay up to date on Rural Texas Strong is to sign up for email alerts. Individual grant information is available on HHSC’s grants page. The state has also created a series of YouTube videos to help explain the grant application process.
Deadline: Applications opened April 27 and will close at 10:30 am CT on Wednesday, May 27.
Who’s eligible: Certain types of health care providers and practitioners who are physically located in and provide health care services to a rural Texas county, defined as those with 68,750 people or less. This includes rural hospitals, behavioral health clinics, rural health clinics, federally qualified health centers, pharmacies, emergency medical service providers, independent primary care physicians, independent specialty physicians, and allied health professionals.
According to a TMA analysis, although higher education institutions are not directly eligible, HHSC may allow for partnerships between the eligible applicants and academic institutions.
What it does: This grant seeks to help create a career development path for high school students, fund scholarships for recent high school graduates, allow for relocation or signing bonuses, and create new residency or fellowship training programs.
A total of $322 million is available for the full project period, which is anticipated to run from September 2026 to April 2031, with a maximum award of $725,000 per applicant. No matching funds are required. HHSC anticipates issuing at least one award for each of the state’s 202 rural counties, as defined above.
Deadline: Applications opened April 30 and will close at 10:30 am CT on June 1.
Who’s eligible: Rural hospitals, rural health clinics and physician clinics, behavioral health providers (including physicians) who provide mental health services, opioid and substance abuse programs, emergency medical services (EMS), pharmacies, and public health offices.
What it does: Grant awards range from $200,000 to $2 million from a total estimated pool of $70.4 million to add or replace needed equipment that improves patient care. Some basic examples include lab equipment, ultrasound or mammography equipment, stretchers, wheelchairs, and patient beds. Facility renovations, such as safety modernizations are also eligible, as are emergency preparedness items. More examples can be found on pages 11-12 of HHSC’s information packet.
Deadline: Applications opened on April 22, and those eligible will be contacted directly by HHSC to submit applications by May 22.
Who’s eligible: Only rural hospital districts with a publicly owned and operated hospital in their jurisdiction.
Deadline: Applications opened May 4 and will close at 10:30 am CT on June 4.
Who’s eligible: Rural hospitals in Texas, as defined in the grant application guidance.
What it does: Rural hospitals are expected to enhance or create community-based prevention, wellness, and nutrition programs, or otherwise address certain chronic conditions to improve the health of rural Texans. Activities must be aimed at issues surrounding diabetes, cardiovascular disease, chronic respiratory disease, or obesity.
TMA has been actively tracking the implementation of Rural Texas Strong and its potential to support rural physician practices. At TexMed in April, the House of Delegates adopted new policy stating TMA “strongly supports use of the federal grant funds to the Rural Health Transformation Grant Program for Texas to recruit and retain physicians in rural areas of Texas.” The house also called for biannual reporting from the state on how Rural Texas Strong monies are allocated, noting that distribution details remain limited.
The program is funded through the federal Centers for Medicare & Medicaid Services, which oversees the Rural Health Transformation Program created by the One Big Beautiful Bill Act of 2025. The $281.3 million first-year investment, part of a $1.4 billion commitment to the state, is designed to confront the health care access challenges facing rural communities.
More information is available on the Rural Health Transformation Program webpage.
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