# Texas — Rural Health Transformation Program (RHTP)

The Texas Rural Health Transformation Program (RHTP), administered by Texas Health and Human Services Commission as Rural Texas Strong, is actively implementing targeted initiatives to strengthen rural healthcare capacity. Initiatives include hospital improvement grants, workforce development, telehealth expansion, infrastructure upgrades, and technology modernization, with current efforts managed under strict reporting and performance monitoring requirements to ensure sustainable, high-quality care. Current structured plan tracks 6 key initiatives and 27 strategic goals.

## At a glance

- Federal awards to date: $563,295,386.36 (Year 1 $281.3M + Year 2 $282.0M)
- Implementation phase (RCJ): IMPLEMENTING
- Funding opportunities tracked: 16 (1 open or announced, 15 closed)
- Awards recorded: $680.6M to 322 recipients
- Critical Access Hospitals: 72
- Rural population share: 15%

## Current progress

As of late October 2026, Texas has moved several Rural Texas Strong Program applications to 'Intent to Award' and begun executing subrecipient contracts, signaling active local program implementation. Multiple grant opportunities are open or recently closed, with funding pipelines confirmed and contract execution underway. Efforts include grants supporting prevention, workforce, rural hospitals, and infrastructure, but there is no evidence of program expansion or a shift to the scaling phase yet. State opportunities: 1 active (1 upcoming, 5 past/closed), $7.7M listed funding. State opportunities: 1 active (1 upcoming, 5 past/closed), $7.7M listed funding. Key opportunities: Rural Texas Strong Program – Initiative 2: Rural Texas Patients in the Driver’s Seat (HHS0017518); The Rural Texas Strong Program – Initiative 1 (Part 2): Make Rural Texans Healthy Again; The Rural Texas Strong Program – Initiative 6 (Part 1): Infrastructure and Capital Investments for Rural Texas. Strategy alignment: supports telehealth, prevention, workforce priorities.

## CMS published status (State Data Maps)

- State Policy Action commitments: 2 of 19
- Initiatives (6), current CMS stage of each:
  - Infrastructure and Capital Improvement for Rural Texas — Stage 2
  - Lone Star Advanced AI and Telehealth — Stage 1
  - Make Rural Texans Healthy Again — Stage 2
  - Rural Texas Patients in the Driver's Seat — Stage 1
  - The Next Generation of the Small Town Doctor and Team — Stage 2
  - Unified Care Infrastructure and Rural Cyber Protection — Stage 1
- CMS data captured 2026-11-11, last confirmed 2026-11-11

## Open and announced opportunities

- [Rural Texas Strong Program – Initiative 2: Rural Texas Patients in the Driver’s Seat (HHS0017518)](https://www.ruralcarejourney.com/opportunities/rural-texas-strong-program-initiative-2-rural-texas-patients-in-the-driver-s-sea--7a2794aa9d) — RFA; Announced, not yet open

## Closed opportunities (15, most recent first)

- [Texas Comprehensive Rehabilitation Services Mobile Stroke Unit (MSU) Grant (HHS0017579)](https://www.ruralcarejourney.com/opportunities/texas-comprehensive-rehabilitation-services-mobile-stroke-unit-msu-grant-hhs0017--4a4940407a) — RFA; Closed; due 2026-09-28; $1.8M; state-funded, not RHTP
- [Rural Texas Strong Program – Initiative 4 (Round 2): The Next Generation of the Small Town Doctor and Team](https://www.ruralcarejourney.com/opportunities/rural-texas-strong-program-initiative-4-round-2-the-next-generation-of-the-small--5b3c5db951) — RFA; Closed; due 2026-08-26
- [State Fiscal Year 2026 Pediatric Tele-Connectivity Resource Program for Rural Texas (HHS0017228)](https://www.ruralcarejourney.com/opportunities/state-fiscal-year-2026-pediatric-tele-connectivity-resource-program-for-rural-te--e18dae7fb5) — RFA; Closed; due 2026-07-13; $10.0M; state-funded, not RHTP
- [The Rural Texas Strong Program – Initiative 6 (Part 1): Infrastructure and Capital Investments for Rural Texas](https://www.ruralcarejourney.com/opportunities/the-rural-texas-strong-program-initiative-6-part-1-infrastructure-and-capital-in--2e3cf57ddd) — RFA; Closed; due 2026-06-10; $2.0M
- [Rural Texas Strong Program – Initiative 4: The Next Generation of the Small Town Doctor and Team](https://www.ruralcarejourney.com/opportunities/rural-texas-strong-program-initiative-4-the-next-generation-of-the-small-town-do--91945d2468) — RFA; Closed; due 2026-06-09; $725,000
- [The Rural Texas Strong Program – Initiative 1 (Part 2): Make Rural Texans Healthy Again](https://www.ruralcarejourney.com/opportunities/the-rural-texas-strong-program-initiative-1-part-2-make-rural-texans-healthy-aga--ee2e81ac4b) — RFA; Closed; due 2026-06-04; $5.0M
- [The Rural Texas Strong Program – Initiative 1 (Part 1): Make Rural Texans Healthy Again](https://www.ruralcarejourney.com/opportunities/the-rural-texas-strong-program-initiative-1-part-1-make-rural-texans-healthy-aga--fef6ee95f9) — RFA; Closed; due 2026-05-26
- [TX - 2026 - Texas Comprehensive Rehabilitation Services Mobile Stroke Unit (MSU) Grant (HHS0016736)](https://www.ruralcarejourney.com/opportunities/tx-2026-texas-comprehensive-rehabilitation-services-mobile-stroke-unit-msu-grant--637ce1eb0a) — RFA; Closed; due 2026-02-06; $1.5M – $5.0M; state-funded, not RHTP
- [TX - 2026 - HHS0016838 - RFA - Maternal Health Outcomes Program](https://www.ruralcarejourney.com/opportunities/tx-2026-hhs0016838-rfa-maternal-health-outcomes-program--5d936b4a48) — RFA; Closed; due 2026-02-05; $5.0M; state-funded, not RHTP
- [Texas Federal RHTP Award: Year 1 (FY 2026)](https://www.ruralcarejourney.com/opportunities/texas-federal-rhtp-award-year-1-fy-2026--e0b071a6ed) — AWARD; Closed; due 2025-11-05; $281.3M
- [Texas Rural Hospital Debt Reduction Grant (HHS0015180)](https://www.ruralcarejourney.com/opportunities/texas-rural-hospital-debt-reduction-grant-hhs0015180--8067b1fa99) — RFA; Closed; due 2025-04-24; $250,000; state-funded, not RHTP
- [Texas Rural Hospital Improvement Grant (HHS0015677)](https://www.ruralcarejourney.com/opportunities/texas-rural-hospital-improvement-grant-hhs0015677--7b69a6de42) — RFA; Closed; due 2025-04-09; $350,000; state-funded, not RHTP
- [Texas Rural Hospital Labor and Delivery Grant (HHS0015668)](https://www.ruralcarejourney.com/opportunities/texas-rural-hospital-labor-and-delivery-grant-hhs0015668--32d6418cfa) — RFA; Closed; due 2025-04-08; $250,000; state-funded, not RHTP
- [TX - 2024 - HHS0014211 - RFA - Rural Mental Health Initiative Grant Program](https://www.ruralcarejourney.com/opportunities/tx-2024-hhs0014211-rfa-rural-mental-health-initiative-grant-program--0c02ee5d04) — RFA; Closed; due 2024-07-03; $9.0M; state-funded, not RHTP
- [Texas Federal RHTP Award: Year 2 (FY 2027)](https://www.ruralcarejourney.com/opportunities/texas-federal-rhtp-award-year-2-fy-2027--c2a1ed2569) — AWARD; Closed; $282.0M

## Largest recorded awards

- Crane County Hospital District — $11.1M (FY2026)
- Fisher County Hospital District — $10.2M (FY2026)
- CAHRMC — $10.0M (FY2026)
- El Campo Memorial Hospital — $9.0M (FY2026)
- Hamilton County Hospital District — $8.2M (FY2026)
- Memorial Medical Center — $7.9M (FY2026)
- Seminole Hospital District of Gaines County Texas — $7.5M (FY2026)
- TYLER COUNTY HOSPITAL DISTRICT — $7.5M (FY2026)
- Preferred Hospital Leasing Coleman Inc — $7.5M (FY2026)
- Clay County Memorial Hospital — $7.5M (FY2026)
- Coryell County Memorial Hospital Authority — $7.4M (FY2026)
- Mid Coast Medical Center - Crockett — $7.4M (FY2026)
- Madison St. Joseph Health Center — $6.9M (FY2026)
- St. Joseph Health Burleson — $6.9M (FY2026)
- St. Joseph Regional Health Center — $6.9M (FY2026)

## Official sources RCJ monitors

- [TX RHTP Primary](https://pfd.hhs.texas.gov/rural-health-transformation-program)
- [HHS Grants Portal](https://hhsgrant.my.site.com/Grants)
- [TX Release / Application](https://gov.texas.gov/news/post/governor-abbott-hhsc-submit-application-for-rural-health-transformation-program)
- [TX HHS Request for Applications](https://resources.hhs.texas.gov/rfa)
- [TX HHSC RFA HHS0017223 direct document (grants.hhs.texas.gov)](https://grants.hhs.texas.gov/vforcesite/sfc/servlet.shepherd/version/download/068cr00000nzTk2AAE)

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Source: Rural Care Journey (RCJ), https://www.ruralcarejourney.com/states/tx — data as of 2026-11-11.
Cite the RCJ page for the summary and the linked official source for authoritative terms, deadlines, and amounts.