HHS Region 6 · Texas Health and Human Services Commission
Program Overview
The Texas Rural Health Transformation Program (RHTP), administered by HHSC as Rural Texas Strong, is currently focused on improving rural healthcare capacity through workforce development, telehealth and technology expansion, innovative service delivery, infrastructure upgrades, and support for rural hospitals and providers. The program is actively implementing targeted initiatives and grant opportunities, including rural hospital improvement and labor and delivery support grants, guided by structured plans with ongoing stakeholder engagement. Major initiatives and strategic goals are outlined in the Rural Texas Strong plan, with implementation involving collaboration with local leaders and residents. Current structured plan tracks 23 key initiatives and 15 strategic goals.
Updated
County-level estimates averaged across Texas — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
pp = percentage points vs US county average
County Drilldown (254)
| County | Pop | Poverty | Uninsured |
|---|---|---|---|
| Harris County | 4,838,303 | 16.3% | 13.1% |
| Dallas County | 2,621,179 | 13.9% | 10.8% |
| Tarrant County | 2,167,390 | 11.1% | 8.2% |
| Bexar County | 2,067,341 | 14.6% | 11.2% |
| Travis County | 1,330,015 | 10.9% | 7.1% |
| Collin County | 1,163,337 | 6.2% | 4.7% |
| Denton County | 979,561 | 7.1% | 4.4% |
| Fort Bend County | 893,767 | 7.6% | 6.5% |
| Hidalgo County | 891,977 | 26.7% | 23.3% |
| El Paso County | 870,779 | 18.7% | 16.3% |
| Montgomery County | 684,432 | 9.4% | 7.3% |
| Williamson County | 672,688 | 6.4% | 4.4% |
AI source: TX - 2026 - Grants Portal Home
AI auto-updated Sep 16, 2026
API refreshed May 7, 2026
Key signals are summarized here. Open the source for the supporting detail.
Due Nov 5, 2025
7 related documents
TX - 2026 - Rural Texas Strong (RHTP)
Guidance / reference (not standalone opportunity)
2,895,576 rural residents
As of September 2026, Texas has issued and awarded multiple grant opportunities supporting rural health transformation, including subgrants for mobile stroke units, nutrition incentives, and rural hospital initiatives. The Health and Human Services Grants Portal lists an active pipeline of open and recently closed procurements, with applications and awards occurring throughout 2026. These activities confirm that state-level implementation is ongoing, with local funding and capacity-building underway. No evidence indicates a transition to the scaling phase yet. State opportunities: 3 active (3 closing soon, 15 past/closed), $569.4M listed funding. Key opportunities: Texas Comprehensive Rehabilitation Services Mobile Stroke Unit (MSU) Grant (HHS0017579); DFPS Community-Based Care (CBC) Single Source Continuum Contractor (SSCC) Catchment Areas 7A and 7B; Texas Binational Tuberculosis Program. Strategy alignment: supports telehealth priorities.
Texas continues the Rural Texas Strong strategy for the Rural Health Transformation Program (RHTP), leveraging federal CMS funding through targeted grants and competitive initiatives to strengthen rural health infrastructure, advance technology use, address behavioral health, and develop the rural workforce. HHSC emphasizes modernization of care delivery, efficiency, and transparency, with preference for multi-county collaborations. The program prioritizes hospital financial stability, access to maternity services, workforce development, and robust fiscal and conflict-of-interest compliance.
Model
Multi-initiative, Texas HHSC-administered model allocating RHTP funding through coordinated initiatives: chronic disease prevention and wellness, consumer-facing technology, advanced telehealth/AI deployment, rural workforce recruitment and retention, care infrastructure modernization and cybersecurity, equipment upgrades for rural facilities, maternity and labor support, and collaborative behavioral health and trauma-informed care—supported by strong fiscal, eligibility, and transparency controls.
Key Initiatives (23)
Timeline: Application submitted to CMS (November 3, 2025); CMS Notice of Award (December 29, 2025); Budget Period 1 approved (April 7, 2026); Initiative launches begin September 2026 (grant deadlines May–December 2026); initiative contracts executed between July 2026 – May 2027; funding and initiatives continue annually through FY2030.
Texas rural communities face shortages in medical staff, particularly primary care providers, prompting targeted recruitment and training efforts.
Rural hospitals require capital investment to modernize facilities and resources, addressing healthcare access gaps in underserved areas.
Focused efforts on training and recruiting rural healthcare providers to address shortages in underserved areas.
TX - 2026 - The Rural Texas Strong Program – Initiative 1 (Part 2): Make Rural Texas Healthy Again
Auto-linked process guidance fallback (1%)
TX - 2025 - Notice of Award Dec. 29, 2025
Migrated from duplicate federal row
TX - 2025 - One Big Beautiful Bill Act (OBBBA) RHTP – Rural Texas Strong
Auto-grouped context match (38%)
TX - 2026 - Budget Period 1 Notice of Award
Auto-grouped context match (37%)
TX - 2026 - Texas RHTP
Revised Budget Period 1 Budget Narrative
TX - 2026 - Rural Texas Strong Program (RHTP)
Texas award recipients
Texas Health and Human Services Commission (HHSC)
Due Sep 28, 2026· ⏰ 8 days left
19 related documents
TX - 2026 - HHS007579 Exhibits and Forms.zip
Exhibits and Forms Archive
TX - 2026 - HHS0017579 Comprehensive Rehabilitation Services Mobile Stroke Unit (MSU).pdf
Controlling RFA
Exhibit C - HHS Additional Provisions - Grant Funding, version V1.0.pdf
RFA Package File
Texas EXHIBIT E EXCEPTIONS RHTP Document
RFA Package File
Texas Exhibit D Evaluation Tool RHTP 2023 Document
RFA Package File
Texas Form B-1 Governmental Entity RHTP Document
RFA Package File
Texas Exhibit F Narrative Proposal RHTP Document
RFA Package File
TX - 2026 - Face Page Application Form for HHSC RFA
RFA Package File
Texas FORM B-2 RHTP Document
RFA Package File
Texas Exhibit A HHS Solicitation Affirmations V 2.10 RHTP Guidance
RFA Package File
Texas Form F Applicant Experience Administering RHTP 2018 Application
RFA Package File
Texas Form D Tx HHS System Indirect Costs Rate (ICR) Questionnaire RHTP Document
RFA Package File
Texas Form G Audited Financial Statements RHTP 2024 Document
RFA Package File
Texas Form E Internal Controls Questionnaire RHTP Guidance
RFA Package File
TX - 2027 - Requested Budget Template for RFA HHS0017579
RFA Package File
Texas Exhibit B HHS Uniform Terms And Conditions Grant V 3.5 RHTP 2024 Guidance
RFA Package File
Texas Exhibit G HHS Online Bid Room Information RHTP Document
RFA Package File
TX - 2005 - Conflict of Interest, Contract, and Litigation History Form for RHTP Application
RFA Package File
TX - 2026 - Here’s how you know. Resources (rfa)
Primary source
Texas Health and Human Services Commission (HHSC) — Office of Rural Hospital Finance
Due Aug 26, 2026
5 related documents
TX - 2026 - Request for Application: HHS0017618
Primary source
Texas Health and Human Services Commission
Due Aug 3, 2026
47 related documents
Texas Nutrition Incentive Program Project RHTP Application
| FY↓ | Awardee↕ | Amount↕ | Activity↕ | Source |
|---|---|---|---|---|
| 2026 | 80 Rural Hospital Districts with a publicly owned and operated hospital Estimated 80 direct awards averaging $3,125,000 each to rural hospital districts for Initiative 1: implementation for rural health improvement. | $250.0M | Flex Fund | |
| 2026 | Department of State Health Services (DSHS) AMBUS IAC Interagency agreement for mobile medical units (AMBUS) to strengthen rural emergency medical services. | $20.0M | EMS Development | |
| 2026 | DSHS AMBUS IAC Acquisition of 10 Advanced Medical Buses (AMBUS) for rural EMS emergency and disaster response; AMBUS units to be hosted and maintained by local EMS/Fire Departments. | $20.0M | EMS Development | |
| 2026 | Any Baby Can of Austin Funds awarded to Any Baby Can of Austin to support Texas Nurse-Family Partnership services improving maternal and child health outcomes in rural and urban communities. | $13.4M | Population Health | |
| 2026 | Bexar County Hospital District Funds awarded to Bexar County Hospital District to support Texas Nurse-Family Partnership services improving maternal and child health outcomes. | $13.3M | Population Health | |
| 2026 | City of Houston Funds awarded to City of Houston to support Texas Nurse-Family Partnership services improving maternal and child health outcomes. | $13.2M | Population Health | |
| 2026 | Hillcrest Baptist Medical Center Funds awarded to Hillcrest Baptist Medical Center to support Texas Nurse-Family Partnership services improving maternal and child health outcomes. | $12.5M | Population Health | |
| 2026 | The Children's Shelter Funds awarded to The Children's Shelter to support Texas Nurse-Family Partnership services improving maternal and child health outcomes. | $12.3M | Population Health | |
| 2026 | Baylor College of Medicine Funds awarded to Baylor College of Medicine to support Texas Nurse-Family Partnership services improving maternal and child health outcomes. | $11.9M | Population Health | |
| 2026 | Ascend Dallas Funds awarded to Ascend Dallas to support Texas Nurse-Family Partnership services improving maternal and child health outcomes. | $11.5M | Population Health |
Texas HHSC will host a public forum on August 19 in Big Spring to discuss the Rural Texas Strong plan, a statewide strategy for rural health transformation. The plan is funded by CMS with an initial award of over $281 million. Key initiatives include wellness and nutrition, health technology, telehealth, workforce strengthening, cybersecurity, and equipment upgrades. Key contacts: Rural Texas Strong ruraltexasstrong@hhs.texas.gov Event schedule: - Public Forum - 08/19/2024 - 3:00 PM - 7:00 PM CT - Big Spring City Hall council chambers, 307 E. Fourth St. - Formal Presentation - 08/19/2024 - 3:30 PM CT - Big Spring City Hall council chambers - Formal Presentation - 08/19/2024 - 6:30 PM CT - Big Spring City Hall council chambers
Event Schedule
Contacts
Core Initiatives
Texas awarded over $111 million in funding to multiple local hospital districts, health systems, and community organizations under the Texas Nurse-Family Partnership program. The funds aim to improve maternal and child health outcomes through evidence-based home visiting services reaching both rural and urban populations within the state.
Core Initiatives
This administrative information form is part of the application materials for the Texas RHTP. It collects identification details, contract history, and conflict of interest disclosures for the applicant entity. Applicants must provide supplemental documentation as requested for eligibility and screening. Event schedule: - Does this Application include financial participation by a person or entity that has been convicted of violating federal law, or been assessed a penalty in a federal civil administrative enforcement action, in connect...
Event Schedule
This form is used by applicants to disclose conflicts of interest, contract, and litigation history as part of the RHTP application process in Texas. Entities must document relevant relationships, contract history, financial or legal issues, and provide appropriate proof of status depending on organizational type. It is intended to ensure compliance and transparency in awarding grants for rural health transformation. Event schedule: - Assessed a penalty in a federal civil administrative enforcement action in connection with a contract awarded by the federal government for relief, recovery, or reconstruction efforts as a result of Hurricanes Rita or...
Event Schedule
Texas Health and Human Services Commission (HHSC) applied for federal funding to improve rural health care by reducing chronic disease, investing in technology, deploying AI and telehealth, recruiting and retaining healthcare workers, improving cybersecurity, and upgrading equipment in rural hospitals and clinics. HHSC engaged with communities statewide through surveys and regional meetings before submitting its application. Event schedule: - CMS Funding Notification - 12/31/2025
Event Schedule
Core Initiatives
The document provides step-by-step instructions for applicants on completing and submitting the Requested Budget Template for a cost reimbursement grant under HHSC RFA No. HHS0016568. Guidance includes budget categories, methodologies for allowable costs, and compliance with federal and state grant management standards, focusing on personnel, fringe benefits, travel, supplies, capital equipment, and contractual/subawards. While relevant for rural health transformation funding administration, it contains no specific program budget or award figures.
This document provides a required template for respondents to indicate and explain any exceptions to the terms and conditions outlined in the main TX RHTP solicitation. Completion of this form is not required if no exceptions are being taken.
TX RHTP site updated — 8 new, 1 existing source(s) refreshed
TX - 2024 - HHSC Hosting Rural Texas Strong Public Forum Aug. 19 in Big Spring
Aug 4, 2026 15:11
·EmailTX - 2024 - Timeline for Rural Texas Strong Grant Recipient Negotiations
Jul 28, 2026 20:27
·EmailTX RHTP site updated — 1 new doc(s)
TX - 2024 - Rural Texas Strong Initiative 4, Round 2 Posting
Jul 15, 2026 21:24
·EmailSpreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed. Showing the 40 most recent of 896.
Exhibit J, HHS Additional Provisions– Grant Fund V 1.0
Exhibit C HHS Additional Provisions Grant Funding, Version V1.0
Exhibit E HHS Additional Provisions Grant Funding V.1.0
TX - 2026 - Exhibit D Requested Budget Template
XLSX
Attachment A Statement Of Work
TX - 2026 - Form G, Performance Measures
XLSX
Exhibit G Evaluation Tool V1.6mr CQC7.18 09.02
Exhibit C, HHS Additional Provisions Grant Funding V1.0
TX - 2026 - Attachment A 4 Example MatchReimCertForm
XLSX
Attachment A 3, Example SBHCC Report
TX - 2026 - Form G, Tx Health and Human Services System Indirect Costs Rate (ICR) Questionnaire
Exhibit D 1, Governmental Entity Version HHS Data Use Agreement V.8.5
Exhibit D, HHS Data Use Agreement V.8.5
TX - 2026 - Exhibit C, Requested Budget Template
XLSX
TX - 2026 - Exhibit Q, ADRC Staff and Allocation Workbook
XLSX
Exhibit K, HHS Additional Provisions Grant Funding Version 1.0
TX - 2026 - Exhibit D 2, Data Use Agreement Attachment 2, Security and Privacy Inquiry (SPI)
TX - 2026 - Exhibit E, Budget Template
XLSX
TX - 2026 - Form L, Psychiatric Emergency Flowchart
DOCX
TX - 2026 - HHS0014534 Exhibit K Assurances Non Construction Programs
TX - 2026 - HHS0014534 Form F Tx HHS System Indirect Costs Rate (ICR) Questionnaire
TX - 2026 - Exhibit H, Assurances Non Construction Programs
TX - 2026 - Exhibit H FY24 Estimated Budget Workbook
XLSX
TX - 2026 - HHS0015344 EXHIBIT K Certfication Lobbying
TX - 2026 - Attachment B 1 Additional Documentation
DOCX
TX - 2026 - Attachment A 2, Project Expenditure Report
XLSX
TX - 2022 - HHS0015344 Exhibit I HHS Ffata Certification Form August 2022
HHS0016961 Exhibit C HHS Additional Provisions Grant Funding Final 6.1.26
HHS0016961 Appendix G DSHS TBHIVSTD Local Responsible Party (LRP) Handbook V.2 2019
HHS0016961 Appendix F Clinical Quality Management Policy Clarification Notice
HHS0016961 Appendix E HRSA Trafficking In Persons Award Terms And Conditions
2015 2020 Dietary Guidelines
SB00030F
TX - 2026 - HHS0014610 - Grant Awarded
XLSX
TX - 2026 - HHS0014609 - HHS Award Notice
XLSX
TX - 2026 - HHS0014956_Attachment to Addendum 8 Revised Facilities Licensed Psychiatric Beds and HRSA (excel)
XLSX
TX - 2026 - HHS0014956_Attachment 2 to Addendum 5_HRSA (excel)
XLSX
TX - 2026 - HHS0014956_Attachment 1 to Addendum 5_Facilities Licensed Psychiatric Beds (excel)
XLSX
TX - 2026 - HHS0015357 - Grant Awarded
XLSX
TX - 2026 - Attachment to ADDENDUM 6 - Exhibit H FY2026 BCCS Budget Workbook (revised)
XLSX
TX - 2026 - Exhibit G, Federal Funding Accountability and Transparency Act (FFATA) Certification (RFA No. HHS0017618)
Exhibit G, Federal Funding Accountability and Transparency Act (FFATA) Certification
TX - 2026 - Exhibit I, Grants Management System (GMS) External Portal Information (RFA No. HHS0017618)
Exhibit I, Grants Management System (GMS) External Portal Information
TX - 2026 - Exhibit J, Texas Uniform General Conditions for Construction Contracts and 2025 Supplemental General Conditions (RFA No. HHS0017618)
Exhibit J, Texas Uniform General Conditions for Construction Contracts and 2025 Supplemental General Conditions
TX - 2026 - Exhibit L, Solicitation Form - Questions and Requests for Clarification (RFA No. HHS0017618)
Exhibit L, Solicitation Form - Questions and Requests for Clarification
Texas Nutrition Incentive Program Project RHTP Meeting Minutes
Texas Health And Human Services Data Use Agreement RHTP Guidance
Texas Nutrition Incentive Program Project RHTP Guidance
Texas Nutrition Incentive Program Project RHTP Annual Report
TX - 2026 - HHS0014534 Exhibit L Certification Regarding Lobbying
Texas Attachment 2- Security And Privacy Initial Inquiry [Attach Completed SPI Here] RHTP Guidance
Texas Attachment 2- Security And Privacy Initial Inquiry [Attach Completed SPI Here] RHTP Guidance
TX - 2026 - HHS0014534 Exhibit M Evaluation Tool
HHS0014534 Exhibit J - HHS Additional Provisions Grant Funding Version 1.0.pdf
Texas FORM B-1 Authorized Officials - Governmental Entity RHTP Document
Texas Cecile Young, Executive Commissioner Request For Applications (RFA) RHTP Document
Texas Form E: Project Work Plan Legal Business Name Of Applicant: RHTP Application
Texas Form A Face Page – Applicant Information RHTP Application
Texas Form B Administrative Information RHTP Application
Texas Form C: Financial Management And Administrative Questionnaire RHTP Document
TX - 2026 - HHS0014534 Form F Tx HHS System Indirect Costs Rate (ICR) Questionnaire
TX - 2026 - HHS0014534 Exhibit O HHS FFATA Certification Form
Texas Nutrition Incentive Program Project RHTP Guidance
Texas FORM B-2 RHTP Document
Texas FORM D: NARRATIVE PROPOSAL Legal Business Name RHTP Application
TX - 2026 - HHS0014534 Exhibit K Assurances Non Construction Programs
TX - 2026 - HHS0015874 Deaf and Hard of Hearing Access Services RFA
Primary RFA document (HHS0015874)
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Attachment A -Contract Standards for Deaf and Hard of Hearing Access Services Grants .pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Attachment A-1 - Sample DHHS Direct Communication Services Confidentiality and Professional Condu.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Attachment A-2-Sample DHHS Resource Specialist Services Advocacy Referral Form.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit A - HHS Solicitation Affirmations v.2.10.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit B - HHS Uniform Terms and Conditions - Grant, version 3.5.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit C - HHS Data Use Agreement.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit C-1 - Governmental Entity Version HHS Data Use Agreement v8.5.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit D- Additional Provisions and Grant Funding version 1.0.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit E - Evaluation Tool.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit F Online Bid Room Information.pdf
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Exhibit G - Exceptions.docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form A - Face Page .docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form B - Administrative Information.docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form B-1 Governmental Entity - Authorized Officials .docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form B-2 Non-Profit or For-Profit Entity - Authorized Officials .docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form C - Executive Summary .docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form D - Narrative Proposal Form - Resource Specialist Services.docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form D-1 - Narrative Proposal Form - Senior Citizen Services.docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form D-2 - Narrative Proposal Form - Direct Communication Services .docx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form E - Requested Budget Template.xlsx
TX - 2026 - HHS0015874 Attachments
HHS0015874 package: Form F Internal Controls Questionnaire.pdf
TX - 2026 - HHS0014534 - Exhibits and Forms (ZIP)
HHS0015874 package: Exhibit C-2 Tx HHS System -Data Use Agreement ‐Attachment 2 SECURITY AND PRIVACY INQUIRY (SPI).pdf
TX - 2026 - HHS0014534 Exhibit C Expenditure Proposal (Project Budget)
Texas Nutrition Incentive Program Project (HHS0014534) RHTP 2023 Reference
Applicants are required to provide legal, contact, and financial information as part of the application for the Texas Health and Human Services Commission, covering a multi-year budget period from September 1, 2025 to August 31, 2030. Preference is given to applicants serving multiple counties for best value, and financial compliance audits may be required for larger applicants. The form is a mandatory cover sheet for all submissions to HHSC under rural health funding solicitations. Event schedule: - Budget Period Start Date - 09/01/2025 - Budget Period End Date - 08/31/2030
Event Schedule
Core Initiatives
This is an administrative form required within the Texas RHTP application package. It collects legal business information, conflict of interest disclosures, governance, and nonprofit status documentation necessary for applicant eligibility verification. Event schedule: - Does this Application include financial participation by a person or entity that has been convicted of violating federal law, or been assessed a penalty in a federal civil administrative enforcement action, in connect...
Event Schedule
This Indirect Cost Rate Questionnaire (ICRQ) is required for applicants seeking Texas RHTP funding. It allows organizations to disclose or request their relevant indirect cost rate or to opt for a de minimis rate. Completion and submission of this form is necessary for the indirect cost rate process and compliance with RHTP solicitations. Event schedule: - Revision Date - 01/17/2025
Event Schedule
Core Initiatives
This TX RHTP supporting guidance file provides applicants instructions on preparing their proposals, including fiscal year requests, targeted counties by population size, and narrative prompts for project innovativeness, scaling, evidence-based practices, and service types. It is used for submitting new, innovative, or expanded rural health projects under the Texas Medicaid RHTP transformation plan. The document is part of the state's official bundle for application preparation.
This Q&A guidance clarifies Texas HHS program responses regarding applicant eligibility, county-based applications, eligible entities (including hospitals and tribes), submission requirements, and the approved submission portal for the rural health transformation RFA. It addresses technical, administrative, and procedural questions from prospective applicants, including budget documentation and board roster requirements. Event schedule: - Systems Support Contact - 02/06/2026
Event Schedule
Core Initiatives