Rural Health Transformation Program, appropriations for the fiscal year ending September 30, 2027

Federal funding for Alabama rural health care

Beginning October 1, 2026, the law funds Alabama's Rural Health Transformation Program through September 30, 2027. It provides ADECA—the Alabama Department of Economic and Community Affairs—up to $203.404327 million in federal funds. The money comes from the One Big Beautiful Bill Act of 2025. Funding caps include $55.936190 million for rural health and $57.919382 million for the rural workforce. Health records, information technology, and cybersecurity receive up to $31.425971 million. Maternal and fetal health and rural health practice each receive up to $6.102130 million. Cancer Digital Regionalization receives up to $8.136173 million; mental health receives up to $7.271705 million. Emergency services receive up to $4.068085 million for trauma and stroke and $5.085108 million for treating patients in place. Simulation training receives up to $1.017021 million. Up to $20.340432 million covers administration, audits, and required reports. Unspent money carries forward for the same purposes, including into the fiscal year beginning October 1, 2027. Before requesting federal approval to change or exceed an allocation, ADECA's director must get written agreement from two of three officials: Alabama's Finance Director, the House Ways and Means General Fund Committee chair, and the Senate Finance and Taxation General Fund Committee chair. The director must then seek approval from the Centers for Medicare & Medicaid Services. ADECA must follow that agency's requirements if approval is changed or denied. All spending must follow federal law and the terms governing the funds.