Rural Health Transformation Program supplemental appropriations for the fiscal year ending September 30, 2026

More funding for Alabama rural health

The law provides up to $203.404327 million in federal funding for Alabama's Rural Health Transformation Program. This supplements existing funding for the fiscal year ending September 30, 2026. Alabama's Department of Economic and Community Affairs (ADECA) manages the money from the One Big Beautiful Bill Act of 2025. Each initiative has a maximum allocation. Health records, technology, and cybersecurity receive up to $31.425971 million; the Rural Health Initiative receives up to $55.936190 million. Maternal and fetal health receive up to $6.102130 million; rural workforce efforts receive up to $57.919382 million. Cancer Digital Regionalization receives up to $8.136173 million; simulation training receives up to $1.017021 million. Statewide emergency medical services for trauma and stroke receive up to $4.068085 million. Emergency medical services that treat patients in place receive up to $5.085108 million. Mental health receives up to $7.271705 million; the Rural Health Practice Initiative receives up to $6.102130 million. Within the total, up to $20.340432 million can reimburse administration, audit, and reporting costs. Unspent funds do not expire at year-end. Money remaining on September 30, 2026, stays available for the same purposes in the fiscal year beginning October 1, 2026. To change or exceed initiative allocations, ADECA's director needs written support from a majority of three state officials. Those officials are Alabama's Finance Director and the chairs of the House and Senate general fund committees. ADECA must then seek approval from the Centers for Medicare & Medicaid Services and follow its requirements, including modified or withheld approval. All spending must follow federal law and the funding's purposes, terms, and conditions. A new joint legislative committee oversees implementation and can request reports and data and hold hearings. Its members include legislative leaders, both chambers' minority leaders, general fund committee members, and additional legislative appointees. The two general fund committee chairs lead it together. Each chamber supplies three additional general fund committee members, including its ranking minority member. The law took effect immediately upon becoming law.