Rural Texas Strong Budget Period 1 Approved Revisions
The Health and Human Services Commission (HHSC) has received approval from the Centers for Medicare & Medicaid Services (CMS) for the revised Budget Year One (1) allocations for the Rural Texas Strong program. The approved Notice of Award (PDF) authorizes a total of $281,319,360.67 for Budget Period 1, from Dec. 29, 2025 to Sept. 30, 2026.
Stakeholders can see a short video with the HHSC Chief Financial and Operations Officer discussing the changes made in the recent budget revisions and the next steps providers are encouraged to take for Initiatives 1, 4 and 6.
Summary of Budget Period 1 Updates
Initiative 1 – Make Rural Texans Healthy Again – funding will be distributed in two parts:
- Part 1: An estimated $60,000,000 will be allocated to support rural hospital districts with publicly owned and operated hospitals in their jurisdiction. Funding will be provided on a cost-reimbursement basis to enhance or create community-based prevention, wellness, and nutrition programs or services aimed at improving diabetes, obesity, heart disease, and maternal health outcomes. Requests for enrollment are anticipated to be released in spring 2026.
- Part 2: An estimated $56,250,000 in competitive awards for public and private rural hospitals to enhance or create community-based prevention, wellness, and nutrition programs or services aimed at improving diabetes, obesity, heart disease, and maternal health outcomes. Requests for applications are anticipated to be released in spring 2026.
Initiative 4 – The Next Generation of the Small Town Doctor and Team:
- An estimated $98,889,963.67 will be allocated to accelerate workforce investments in rural communities. Requests for applications are anticipated to be released in spring 2026.
Initiative 6 – Infrastructure and Capital Improvement for Rural Texas:
- An estimated $56,263,872.33 will be allocated to support allowable capital and infrastructure needs for rural healthcare providers. Requests for applications are anticipated to be released in spring 2026.
The remaining amount, $9,915,524.67, will support external monitoring, performance oversight for the grantees, as well as program administration.
The approved budget files are posted on the HHSC Rural Health Transformation Program website.
Questions
For questions about the Texas Rural Health Transformation program, contact HHSC Rural Texas Strong. To receive email updates from HHSC, please sign up here.
Learn more about the Rural Health Transformation Program.
Stevens Amendment
HHSC is required by CMS to include the Stevens Amendment language below which acknowledges the federal support for the Rural Texas Strong program.
Rural Texas Strong, is supported by CMS of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $281,319,360.67 with 100 percent of funding by CMS/HHS. The contents of this email are those of HHSC and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.
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