Texas

Texas received approximately $281.3 million in its first-year award from the CMS Rural Health Transformation Program — its share of the federal $50 billion program — with an estimated $1.4 billion expected to flow to Texas over the five-year performance period. Additional annual awards are expected in each funding year.

The Texas Health and Human Services Commission (HHSC) administers the program, branded Rural Texas Strong: Supporting Health and Wellness, with Governor Greg Abbott's office announcing major funding rounds. Applications run through the HHSC Grants Management System (GMS), which requires active IAMOnline accounts. Program contact: RuralTexasStrong@hhs.texas.gov.

The federally approved Rural Texas Strong plan is organized around numbered initiatives with a strong "Make Rural Texans Healthy Again" thrust — community-based prevention, wellness and nutrition programs to combat chronic disease, alongside a rural workforce pipeline ("The Next Generation of the Small Town Doctor and Team"). Named priority tags include putting patients in the driver's seat, remote patient monitoring, and health data exchange.

Money moves through initiative rounds rather than a single published percentage split. Early deployment centered on chronic disease: a $56 million competitive grant for public and private rural hospitals (community prevention, wellness and nutrition) layered on top of $60 million in direct awards to rural hospital districts — together a roughly $116 million "Make Rural Texans Healthy Again" push. Initiative 4 (rural workforce pipeline) is running in rounds. The full breakdown sits in Texas's budget narrative; named project tags are patients-in-the-driver's-seat, RPM, and health data exchange.

Currently open: Rural Texas Strong Initiative 4, Round 2 — "The Next Generation of the Small Town Doctor and Team" (RFA No. HHS0017618), which opened the competitive application process July 15, 2026 and funds mid-level practitioners and allied health professionals around rural physicians. Entities receiving funds under the companion RFA No. HHS0017212 are not eligible under this one, and prior applications will not carry over — a new application is required. Earlier, HHSC launched the $56M chronic-disease competitive grant for rural hospitals (applications due June 4). The dispatch list below carries the running record.

The key open deadline: Initiative 4, Round 2 (RFA No. HHS0017618) applications are due August 26, 2026 at 10:30 a.m. Central Time, submitted through the HHSC Grants Management System — late submissions are not considered, so organizations need active IAMOnline accounts and GMS access in place beforehand. Texas remains in a pre-procurement blackout (no vendor meetings until postings go live), so new postings themselves are the signal to watch on the ESBD portal; live dates surface in the dispatches below.

The Rural Health Transformation Program was created by Section 71401 of the One Big Beautiful Bill Act (2025) and is administered federally by CMS. Texas administers its award through HHSC under its CMS-approved Rural Texas Strong plan and budget, with Governor Greg Abbott's office announcing major funding rounds.

Eligibility runs on two tracks. Direct-to-state contracts go out as competitive RFAs through the HHSC Grants Management System, where firms bid as prime applicants — though eligibility for the current workforce RFA is limited to rural healthcare providers and rural hospitals. Subawards and direct hospital awards flow to rural providers — rural hospital districts, Critical Access and rural hospitals, clinics and EMS — where technology vendors and consultants most often engage as subcontractors or implementation partners. Note the pre-procurement blackout: no vendor meetings occur until a posting goes live.

Register for an IAMOnline account and GMS access ahead of postings, watch the ESBD funding portal and the Rural Texas Strong hub, subscribe to HHSC updates, and direct questions to RuralTexasStrong@hhs.texas.gov.