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, supports rural hospitals and providers with a current focus on strengthening rural healthcare capacity through workforce development, innovative service delivery, telehealth, infrastructure upgrades, and hospital viability. The program is actively implementing targeted initiatives, solicitations, and grant opportunities, including rural hospital improvement, workforce pipeline ('Next Generation of the Small Town Doctor and Team'), and debt reduction. Public forums, structured plans, and collaborations guide ongoing efforts, with current implementation centered on major initiatives and strategic goals outlined within the Rural Texas Strong plan. Current structured plan tracks 19 key initiatives and 14 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 - Here’s how you know. Resources
AI auto-updated Sep 5, 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
Texas has received its CMS award and finalized revised narratives for Budget Period 1 as of April 2026. As of September 2026, the state continues to issue new RFAs and is soliciting applications from eligible rural health entities with application materials and budget templates publicly available. The active procurements and structured application instructions confirm ongoing statewide implementation. Program implementation is underway as application processes remain open for rural providers. State opportunities: 1 active (1 open, 15 past/closed), $569.4M listed funding. Key opportunities: Texas Comprehensive Rehabilitation Services Mobile Stroke Unit (MSU) Grant (HHS0017579); Rural Texas Strong Program – Initiative 4: The Next Generation of the Small Town Doctor and Team; The Rural Texas Strong Program – Initiative 1 (Part 2): Make Rural Texans Healthy Again. Strategy alignment: supports telehealth, workforce, prevention priorities.
Texas continues the Rural Texas Strong strategy for the Rural Health Transformation Program (RHTP), leveraging federal CMS funding to drive targeted grants, technology investment, workforce development, and infrastructure upgrades for rural communities. HHSC coordinates competitive initiatives focused on chronic disease prevention, wellness, consumer health technology, telehealth/AI deployment, workforce recruitment and retention, behavioral health, and rural hospital improvement. Rigorous fiscal controls and transparent procurement processes ensure compliance, efficiency, and long-term sustainability. Preference is given to multi-county collaborations and service area-specific budgeting to maximize rural impact.
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, and collaborative behavioral health and trauma-informed care—supported by strong fiscal, eligibility, and transparency controls.
Key Initiatives (19)
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
18 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
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 | Unspecified Rural Healthcare Providers (Initiative 6 Subawards) Subawards for rural healthcare providers for infrastructure and capital investments under Initiative 6. Award amounts will vary depending on the application process. | $4.4M | Flex Fund | |
| 2026 | External Monitoring Contract (TBD Vendor) External contractor will conduct audit readiness assessment to proactively identify and address compliance issues for subrecipients. | $1.9M | Quality Improvement | |
| 2026 | Deloitte LLP (Grants Management System Support) Provides technical and operational support for GMS tracking RHTP awards/activities. | $1.8M | Health IT | |
| 2026 | Electra Memorial Hospital Grant award to support rural hospital operations and transformation initiatives in Texas. | $250K | Other | |
| 2026 | Electra Memorial Hospital Texas Rural Hospital Improvement Grant (HHS0015677) awardee list | $350K | Rural hospital improvement award | |
| 2026 | Baylor Scott & White Medical Center – Brenham Texas Rural Hospital Improvement Grant (HHS0015677) awardee list | $350K | Rural hospital improvement award | |
| 2026 | Comanche County Consolidated Hospital District dba Comanche County EMS Texas Rural Hospital Improvement Grant (HHS0015677) awardee list | $350K | Rural hospital improvement award |
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
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 document lists multiple procurement opportunities for Texas programs including Rural Hospital Improvement focusing on rural hospital financial and quality improvements. The listed dates represent solicitation release and submission deadlines for 2025-2026. Event schedule: - Submission Deadline - 04/09/2025
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
The Texas Health and Human Services Commission (HHSC) is requesting federal funding focused on grants for chronic disease prevention, consumer health technology, AI and telehealth deployment, workforce recruitment and retention, cybersecurity, and equipment upgrades in rural hospitals. Public input was gathered through surveys, regional meetings, and comment sessions, with CMS expected to announce funding approvals by December 31. Event schedule: - CMS funding approval notification - December 31, 2025
Event Schedule
Core Initiatives
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 - 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
·EmailTX RHTP site updated — 5 new doc(s)
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed. Showing the 40 most recent of 871.
HHS0016961 Appendix E HRSA Trafficking in Persons Award Terms and Conditions.pdf
HHS0016961 Exhibit C HHS_Additional_Provisions_Grant_Funding - final 6.1.26.pdf
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
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
Event Schedule
Core Initiatives
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 supporting document guides applicants in accessing and using the HHS Online Bid Room to submit responses for the Texas Rural Health Transformation Program RFA. Instructions cover creating a new user account, organizational registration steps, and important submission deadlines. Applicants are reminded to allow several days for registration and must adhere to solicitation package requirements to avoid disqualification.
This document provides detailed quarterly performance and outcome measures for behavioral health grant programs under Texas’s RHTP initiative, specifying output and outcome indicators for participants served, program completion, symptom improvement, bed utilization, training, housing, employment, and justice involvement. The guidance includes standardized tools and definitions, promoting data-driven quality improvement and accountability for rural behavioral health transformation. No sub-award or fiscal data is present; this is a technical appendix for applicant and grantee use. Event schedule: - Quarter 1 Data Due - 12/30/2025 - CT - Quarter 2 Data Due - 03/30/2026 - CT - Quarter 3 Data Due - 06/30/2026 - CT - Quarter 4 Data Due - 09/30/2026 - CT - FY26 Version 3 release - 2025-07-01
Event Schedule
Core Initiatives
Exhibit D, HHS Data Use Agreement v.8.5.pdf
SB00030F.pdf
TX - 2026 - Form G, Tx Health and Human Services System Indirect Costs Rate (ICR) Questionnaire
HHS0016961 Appendix G DSHS TBHIVSTD Local Responsible Party (LRP) Handbook V.2-2019.pdf
TX - 2026 - HHS0014609 - HHS Award Notice
XLSX
TX - 2026 - Exhibit H, Assurances Non Construction Programs
Exhibit E_HHS Additional Provisions Grant Funding v.1.0.pdf
TX - 2026 - HHS0015357 - Grant Awarded
XLSX
TX - 2026 - HHS0014610 - Grant Awarded
XLSX
TX - 2026 - HHS0014956_Attachment 1 to Addendum 5_Facilities Licensed Psychiatric Beds (excel)
XLSX
2015-2020_Dietary_Guidelines.pdf
HHS0016961 Appendix F Clinical Quality Management Policy Clarification Notice.pdf
Exhibit G Evaluation Tool V1.6mr CQC7.18 - 09.02.pdf
TX - 2026 - HHS0014534 Form F Tx HHS System Indirect Costs Rate (ICR) Questionnaire
Attachment A Statement of Work.pdf
Attachment A-3, Example SBHCC Report.pdf
TX - 2026 - Attachment to ADDENDUM 6 - Exhibit H FY2026 BCCS Budget Workbook (revised)
XLSX
TX - 2026 - Exhibit D Requested Budget Template
XLSX
TX - 2026 - HHS0014534 Exhibit K Assurances Non Construction Programs
TX - 2026 - HHS0014956_Attachment 2 to Addendum 5_HRSA (excel)
XLSX
Exhibit C, HHS Additional Provisions Grant Funding V1.0.pdf
TX - 2026 - Exhibit H FY24 Estimated Budget Workbook
XLSX
Exhibit K, HHS Additional Provisions Grant Funding Version 1.0.pdf
TX - 2026 - Exhibit E, Budget Template
XLSX
Exhibit C - HHS Additional Provisions - Grant Funding, version V1.0.pdf
TX - 2026 - HHS0015344 EXHIBIT K Certfication Lobbying
TX - 2026 - Form G, Performance Measures
XLSX
Exhibit D-1, Governmental Entity Version HHS Data Use Agreement v.8.5.pdf
TX - 2026 - Attachment A 4 Example MatchReimCertForm
XLSX
TX - 2026 - Exhibit D 2, Data Use Agreement Attachment 2, Security and Privacy Inquiry (SPI)
TX - 2026 - Exhibit C, Requested Budget Template
XLSX
TX - 2026 - HHS0014956_Attachment to Addendum 8 Revised Facilities Licensed Psychiatric Beds and HRSA (excel)
XLSX
TX - 2026 - Attachment A 2, Project Expenditure Report
XLSX
TX - 2026 - Form L, Psychiatric Emergency Flowchart
DOCX
TX - 2026 - Exhibit Q, ADRC Staff and Allocation Workbook
XLSX
TX - 2022 - HHS0015344 Exhibit I HHS Ffata Certification Form August 2022
TX - 2026 - Attachment B 1 Additional Documentation
DOCX
TX - 2026 - HHS0016961 Form I Requested Budget
XLSX