Texas is asking for $1 billion in federal funding to address rural health care needs.
The state's application for the Rural Health Transformation program requests $200 million each year of the five-year program. The "Rural Texas Strong" project is built on several initiatives ranging from addressing provider shortages and implementing artificial intelligence processes into rural health care.
Claire Stieg, with the Texas Health and Human Services Commission, said the state submitted its application ahead of the midnight deadline Tuesday, but what the program looks like in practice depends on decisions that are now in the hands of the Centers for Medicare and Medicaid Services.
"They could come back and ask for adjustments to those initiatives, and the budget obviously will change, too, depending on how much Texas is awarded," Stieg told the Rural Hospital Advisory Committee Thursday.
The project has six initiatives. Among other things, the initiatives include proposals that would invest technology for patients to engage in improving care, upgrade equipment in rural hospitals and clinics and recruit and retain rural health care workers.
"Some of the specifics on which initiatives were prioritized first, knowing that money could get out the door very quickly, and then which initiatives might take a little bit more time given the procurement process and things like that," Steig said.
The Rural Health Transformation program is a one-time investment of $50 billion over the course of five years. That means CMS will distribute $10 billion each year among all the states in the program.
Half of that money is considered "baseline funding" and is split evenly between participating states. The other half is "workload funding" awarded to states based on their applications and "rural factors," like population of rural residents and number of rural counties.
"As you can imagine, Texas will score very highly on those," Steig said.
Texas has 4.3 million rural residents, according to the funding application. Of the state's 254 counties, the Federal Office of Rural Health Policy identified 241 with at least one census area that's considered rural – and 195 are considered fully rural.
Large portions of the state's population live in care deserts, where people may not have accessible doctors, OBGYNs or emergency medical services.
The state's application will be reviewed by a panel of federal and subject matter experts before CMS let states know how much they will receive. CMS has until the end of 2025 to make that announcement. Funding is expected to be distributed starting in January.
Some rural health leaders voiced concerns about how the federal government shutdown may delay notices of awards or funding, but Steig said that isn't an issue.
"CMS has adamantly stated they are required by law to provide the notice of awards by December 31st," Steig said. "They've been very responsive throughout the entire process."
The state's application explained Texas expects to see various benefits from the implementation of the Rural Texas Strong project, including more than 1,000 additional rural health professionals, mitigation of chronic disease and reduced duplicative health care costs.
"To keep Texas thriving, we must strengthen our rural hospitals, expand access to critical mental and physical health care, and help reduce chronic disease through wellness and nutrition initiatives," Gov. Greg Abbott said in a statement.
Abbott said the state will work with federal partners to improve health care access and quality.
"The resilient Texas rural health system will be reinforced by this project," HHSC wrote to CMS.
Abigail Ruhman is KERA's health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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