Rural health clinics, hospitals, behavioral health centers, and other entities may apply for a share of $1.4 billion in federal funding awarded to Texas to expand rural health care access through the Rural Texas Strong program this spring.
However, officials as of this writing have yet to release details on the funding application process.
The money will be allocated to 202 of the state’s 254 counties, those with less than 68,750 people. The Texas Health and Human Services Commission (HHSC) has not yet shared exactly when or how physicians can apply. In Texas’ application for funding, officials confirm physicians and others may undergo a “competitive procurement” process to receive funds.
The Texas Medical Association remains in communication with HHSC about this process. Read Texas Medicine Today for updates.
The funding comes through the federal Rural Health Transformation Program, established by the One Big Beautiful Bill Act last year to support rural health care. The program, administered by the new Office of Rural Health Transformation at the Centers for Medicare & Medicaid Services (CMS), will award Texas approximately $281 million every year from state fiscal years 2026 to 2030, the largest awards given to any state.
As chief of surgery and trauma medical director at the University Medical Center of El Paso, the region’s only level one trauma center, Alan Tyroch, MD, sees hundreds of trauma patients transferred to his hospital every year from surrounding rural areas, sometimes from over 200 miles away.
“Many small, rural hospitals send patients to us because they don’t have the physician support they need to provide acute care,” the consultant to TMA’s Committee on Emergency Services and Trauma said. “Many of these small hospitals don’t even have a surgeon. El Paso’s level I trauma center admits over 3,600 trauma patients a year, and 45% of those patients come to us by transfer.”
According to the Texas Governor’s office, HHSC will begin allocating funds in coming months to initiatives that:
- Offer grants to reduce chronic disease through prevention, wellness, and nutrition services;
- Invest in consumer-facing technology to engage with patients on improving their health;
- Deploy artificial intelligence and telehealth services to bridge service gaps;
- Recruit and retain rural health care workers through career development, scholarships, relocation payments, and training programs;
- Improve cybersecurity defenses to protect patient data; and
- Upgrade equipment in rural hospitals and clinics.
Hospitals; federally qualified health clinics; behavioral health clinics; rural behavioral health professionals; rural health centers; pharmacies; emergency medical services providers; independent primary care physicians; independent specialty physicians; and other allied health professionals will be among those eligible to apply in the spring for funding for programs that meet those six program initiatives.
In particular, it is anticipated that physicians individually will be able to apply for funding under initiatives four and six within Rural Texas Strong containing strategies for supporting the next generation of medical professionals and infrastructure improvements in rural Texas, respectively.
In its plan for initiative four, HHSC proposed funding the following types of county-level activities to increase the health professions workforce: 1) career path development for high school students, 2) scholarships for recent high school graduates, 3) relocation or signing bonuses for early, mid, or late career professionals, or 4) creation of residency programs, fellowships, or combination programs, including partnerships with academic institutions or teaching hospitals.
Initiative six will provide funding for eligible recipients to replace equipment needed to improve patient care, including “lab equipment, CT, ultrasound or mammography equipment, stretchers (especially self-loading), wheelchairs, patient beds, telemetry units, nurse call systems, ambulance buses, generators, defibrillators, crash carts, medication dispensing units, sleep labs, vital sign monitors, and oxygen tanks.”
Although Dr. Tyroch is not sure yet how the funding will be used across the state, he’s hopeful some of it will support rural hospitals and clinics that are “struggling financially and struggling to stay open.”
Texas has more rural residents than any other state in the nation – 4.3 million, per the state’s funding application. In addition, Texas has 154 rural hospitals, but 105 experienced a loss of patient services in 2024-25, according to a January 2026 report from the Center for Healthcare Quality and Payment Reform. The report found that 84 of Texas’ rural hospitals are at risk of closure, and 23 face the threat of shutting down immediately.
In email correspondence with Texas Medicine Today, HHSC confirmed it will issue public notices related to the program. There are several ways to monitor these notices. HHSC will announce future procurement opportunities, via electronic communication service Gov Delivery, and physicians and others can subscribe for updates to the Rural Texas Strong program here. Interested applicants can also monitor the Electronic State Business Daily site for the program’s procurement opportunities.
Additionally, HHSC says it is working on updating the budget amount for each of Texas’ six initiatives. The CMS Office of Rural Health Transformation must approve the budget before states can receive funds. More information will be available on the HHSC Grants webpage.
Physicians can review Texas’ application for information on award eligibility for each of the state’s six funding initiatives.
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