The Fisher County Hospital District, which serves a county of fewer than 4,000 residents, is in line for $7.5 million from the state’s Rural Texas Strong program. It is one of five awards near that ceiling, and like most of the 129 providers Gov. Greg Abbott announced Oct. 29, it has not signed a contract, according to a list the Texas Health and Human Services Commission (HHSC) posted with that date.
The governor’s office said HHSC plans to award $87,248,124.49 to 129 rural health care providers, but the announcement named none of them. HHSC’s spreadsheet does. The batch covers 91 counties and carries total award amounts of $201.9 million, of which $85.7 million falls in the first year. The money comes from the federal Rural Health Transformation Program, which Texas is using to fund chronic-disease care, recruitment of doctors and emergency medical workers, and equipment and facility upgrades.
The first-year figure differs from the governor’s. An earlier version of the list, dated Oct. 23, showed a first-year amount larger than the total award for three entries, including the Anson Hospital District in Jones County. The Oct. 29 version reverses those figures; Anson, for example, now shows a total of $509,937 and a first-year subset of $262,566. The governor’s $87.25 million matches the earlier version’s first-year column exactly. The corrected column sums to about $85.66 million, roughly $1.6 million less.
The larger question for the providers is the contract. HHSC’s list says each entry is only an “intent to award,” the status after the agency has negotiated terms but before a contract is signed. In the list’s words, “a grant is not considered awarded until a contract has been fully executed.” The governor’s office said funds go out after contracts are finalized.
On the Oct. 29 list, 14 of the 129 providers in the batch have signed. None of the 86 awards under the infrastructure and capital investments initiative, labeled 6.1 on the list, has. Those 86 awards total $85.2 million, $43.9 million of it in the first year. Across all four batches posted since Oct. 8, 204 of 445 providers have signed, about 46 percent, against $680.6 million in total awards.
The biggest awards fall under initiative 1.2, the “Make Rural Texans Healthy Again” program the governor’s office describes as helping rural hospital districts — local taxing units that run public hospitals — improve outcomes for chronic conditions. Nineteen awards in that group total $100.5 million. Besides Fisher, the largest are the Hamilton County Hospital District at $7.5 million, the Tyler County Hospital District at $7,499,000, Memorial Medical Center in Calhoun County at $7,497,200 and a Colorado County provider listed as CAHRMC at $7,494,340. Tyler County’s contract is among the 14 signed. The smallest awards are $200,000, including those to the Lubbock Regional MHMR Center in Hockley County, a mental health and intellectual disability center, and Special Health Resources for Texas in Lamar County.
HHSC says it is processing applications quickly but, because of the volume, cannot give a date by which all awards will be final. The four lists posted so far account for $224.6 million in first-year money, against the $281.3 million first-year federal award the governor’s office cited. The Dispatch has tracked the gap between announced and signed grants since HHSC first listed $451 million with $238 million under contract, and reported the governor’s Oct. 29 announcement.
HHSC says it updates the list weekly. The next update will show whether any of the 86 infrastructure awards has been signed.