All Roll Calls
Yes: 541 • No: 172
TexasHB 1889th Legislature Regular SessionHouseWALLET
Relating to the establishment and administration of certain programs and services providing health care services to rural counties.
Sponsored By: Trent Ashby, Ann Johnson, Ken King, Stan Lambert, Charles Perry (Republican), VanDeaver
Signed by Governor
Disaster Preparedness & ReliefEducation--Higher--Health InstitutionsHealth Care ProvidersHealth--RuralHospitalsHuman Services--Medical AssistanceMinors--Health & SafetyState Agencies, Boards & Commissions--Newly ProposedState Finances--AppropriationsState Finances--Management & ControlRURAL HEALTH STABILIZATION & INNOVATION ACTSTAFF DEVELOPMENT & TRAININGHEALTH & HUMAN SERVICES COMMISSIONSTATE OFFICE OF RURAL HOSPITAL FINANCE
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Bill Overview
Analyzed Economic Effects
9 provisions identified: 7 benefits, 1 costs, 1 mixed.
Consent limits for rural children’s mental healthcare
Children under 18 need written consent before receiving care through the rural pediatric mental health care access program. A parent or legal guardian must consent. If neither is known or available, the adult the child primarily lives with can consent. Consent is invalid if it authorizes services affirming a child’s gender identity when it differs from the child’s biological sex.
Grants connect rural children to specialists
Texas can award grants connecting rural hospitals and clinics with pediatric telemedicine specialists or participating child mental health consortium institutions. Grants can pay for equipment, privacy-compliant technology and support, provider contract fees, and other approved needs. The law removes former grant requirements for quality assurance, pediatric staffing, facilities, and education commitments. Recipients must keep records and report how well their grants work. When practicable, Texas must award grants within 180 days after receiving applications; this does not guarantee an award.
More mental health help for rural children
The Texas Child Mental Health Care Consortium must plan rural pediatric mental health telehealth programs by September 1, 2026. On or after that date, it must establish programs as funding allows, working from a plan developed with a rural hospital organization. Programs serve children at rural hospitals and clinics, with care access comparable to the consortium’s school-based services. Service hours may be limited. The consortium must also expand provider consultations to assess mental health needs and identify services for children and patients around childbirth.
Which hospitals qualify for rural programs
The law defines which hospitals qualify for programs using the term “rural hospital.” State-licensed hospitals qualify when their county has 68,750 people or fewer. Hospitals with federal critical access, rural referral center, or sole community hospital designations also qualify outside metropolitan areas. Within a metropolitan area, those federally designated hospitals must have 100 beds or fewer.
Cost-based Medicaid payments for rural hospitals
As federal law allows, Texas must set each participating rural hospital’s Medicaid rates using that hospital’s latest cost information. These cost-based rates cover inpatient and general outpatient services and must be updated every two years. The law removes the prior requirement that this payment method depend on appropriations. Rural hospitals with obstetrics and gynecology departments also receive an annual add-on rate, as federal law allows. The law sets no payment amounts or patient charges.
Financial help and training for rural hospitals
Texas must maintain a State Office of Rural Hospital Finance to help rural hospitals and health systems with financial programs. With appropriated funding, Texas must contract with two to four colleges for a hospital finance academy by December 1, 2025. The academy provides at least 100 hours of training each year for current or future rural hospital finance leaders. Colleges must accept new participants yearly, charge no participation fees, and reimburse travel and related costs. Eligible participants serve hospitals or systems in counties with 68,750 people or fewer.
Grants help rural hospitals stay open
The law requires stabilization, emergency, and support grant programs when the Legislature specifically funds them. Rural hospitals, hospital districts, and hospital authorities qualify; support grants also cover rural hospital organizations. Stabilization applicants must face moderate or high financial risk, with awards weighing risk, sole-hospital status, and other hospitals within 35 miles. Applications received before December 1, 2026, use published state financial data; that temporary method expires September 1, 2027. Emergency grants cover disaster-related asset losses or unforeseeable or unavoidable problems threatening closure or payroll within 180 days after applying. Support grants help recipients keep operating and remain financially stable; the law sets no grant amounts.
Innovation grants support better rural care
With dedicated legislative funding, Texas must offer innovation grants to rural hospitals, hospital districts, and hospital authorities. Projects must improve care access and quality, strengthen the recipient’s finances, and be sustainable without more state funding. Priority goes to services for pregnant or recently postpartum women, people under 20, older adults, and uninsured people. The law sets no grant amounts.
Local control and limits for hospital grants
Rural hospital grants cannot cover costs another source, including Medicaid, is legally or contractually required to pay. They also cannot replace money from other federal sources, including federal grants. For recipients in systems of two or more commonly governed hospitals, the system or corporate parent cannot control grant money. Instead, a person must control it locally and be present at least two days each week. That person must work at the hospital or its administrative office within five miles.
Sponsors & Cosponsors
Sponsors
Trent Ashby
House
Ann Johnson
House
Ken King
House
Stan Lambert
House
Charles Perry
Republican • Senate
VanDeaver
Affiliation unavailable
Cosponsors
César Blanco
Democratic • Senate
Greg Bonnen
House
Brad Buckley
House
Lulu Flores
House
Ryan Guillen
House
Brent Hagenbuch
Republican • Senate
Cody Harris
House
Juan "Chuy" Hinojosa
Democratic • Senate
Lois Kolkhorst
Republican • Senate
Brooks Landgraf
House
Will Metcalf
House
Kevin Sparks
Republican • Senate
David Spiller
House
Roll Call Votes
House vote • 5/28/2025
Record vote
Yes: 115 • No: 18
Senate vote • 5/25/2025
Record vote
Yes: 26 • No: 5
Senate vote • 5/25/2025
Record vote
Yes: 26 • No: 5
Senate vote • 5/25/2025
Record vote
Yes: 9 • No: 22
Senate vote • 5/25/2025
Record vote
Yes: 26 • No: 5
Senate vote • 5/25/2025
Record vote
Yes: 26 • No: 5
House vote • 4/24/2025
Record vote
Yes: 119 • No: 24
House vote • 4/23/2025
Record vote
Yes: 106 • No: 33
House vote • 4/23/2025
Record vote
Yes: 88 • No: 55
Bill Text
Engrossed
Enrolled
House Committee Report
Introduced
Senate Committee Report
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