The Crane County Hospital District in West Texas is in line for $6.84 million over several years from the state’s new rural health grant program, but it does not yet have a signed contract. Neither do the hospital districts in Muleshoe and Electra, each lined up for more than $5 million. A neither do 215 other awards on the state’s latest list.
The Texas Health and Human Services Commission, which runs the program, published the list as of Oct. 8. It names 284 grants that the agency has moved to “Intent to Award” status. They total about $451 million over the life of the grants, with $129.1 million of that in the first year. Only 68 of the grants have been fully executed, meaning contracts are signed. Those 68 are worth $238.0 million over several years, $51.0 million in the first year.
That leaves 216 grants worth $213.0 million, or $78.1 million in the first year, that are not yet money a hospital, clinic or ambulance service can count on. “A grant is not considered awarded until a contract has been fully executed,” the commission says. It adds that, because of the volume of applications, the agency “is unable to provide a date by which all awards will be final.” The commission says it will update the list weekly.
The money comes from the federal Rural Health Transformation Program. Texas received about $281 million for the first of five years, the largest award of any state, according to a March report in Texas Medicine, the Texas Medical Association’s magazine. The 68 executed grants are the ones the governor and the commission announced in late September, which the Dispatch reported at the time: $3.5 million each, with $750,000 of it in the first year, for rural hospital districts that own and run a public hospital.
Under the first initiative, called “Make Rural Texans Healthy Again,” 23 larger grants worth $91.7 million are still waiting on contracts. The biggest go to Preferred Hospital Leasing Coleman Inc. at $7.50 million, Crane County at $6.84 million, the Coryell County Memorial Hospital Authority at $6.72 million, the Electra Hospital District at $5.90 million, Preferred Hospital Leasing Shamrock Inc. at $5.50 million, Preferred Hospital Leasing Junction Inc. at $5.45 million, the Muleshoe Area Hospital District at $5.22 million and the Seminole Hospital District of Gaines County at $4.81 million.
The second batch is aimed at people rather than buildings. Under “The Next Generation of the Small Town Doctor and Team,” 136 grants worth $75.9 million have been lined up, none yet under contract. According to Texas Medicine, the initiative is open to providers in rural counties of 68,750 people or fewer, pays up to $725,000 per applicant, and can fund scholarships, relocation and signing bonuses, and new residency or fellowship programs. Forty-seven of the grants on the list are for the full $725,000. The same article says the commission expects at least one award in each of the state’s 202 rural counties; the list does not show whether that will happen.
The third batch is equipment and facilities. Fifty-seven grants worth $45.5 million are listed under the infrastructure initiative, which funds items such as lab and imaging equipment and building renovations, with awards of $200,000 to $2 million. The Fisher County Hospital District, Hendrick Medical Center Brownwood, the Rankin County Hospital District and the Val Verde Hospital Corporation are each listed at the $2 million maximum.
The program has drawn a debate over who should get the money. The initiative that sends money directly to hospital districts has the largest share, with $433.5 million over five years, according to Texas Medicine. John Hellerstedt, a physician and former commissioner of the Department of State Health Services, said in that article that physicians may be “disappointed” they will not receive a direct allocation like rural hospitals, but urged viewing the program as one piece of a larger effort to strengthen the health care system.
The next weekly update to the list will show how many of the 216 pending grants have become signed contracts.