Alabama sets aside federal money for rural health programs

The law sets aside up to $203,404,327 in federal money for the Alabama Department of Economic and Community Affairs. The money supports ten initiatives under Alabama’s Rural Health Transformation Program. The limits are $57,919,382 for rural health workers, $55,936,190 for the Rural Health Initiative, and $31,425,971 for health records, technology, and computer security. Other limits are $8,136,173 for the Cancer Digital Regionalization Initiative, $7,271,705 for mental health, and $6,102,130 each for maternal and fetal health and rural health practice. The limits for emergency medical services are $5,085,108 for treatment in place and $4,068,085 for trauma and stroke; simulation training has a $1,017,021 limit. Up to $20,340,432 may reimburse administration, auditing, and reporting costs. Spending must follow federal rules and the conditions attached to the money. Funding covers the fiscal year ending September 30, 2026. Money unspent on that date carries forward and is set aside again for the same purposes for the fiscal year beginning October 1, 2026.

The department’s director must get written state agreement before seeking federal approval to shift initiative funding. These steps apply when an initiative’s assigned amount needs to change or be exceeded to use available money. Written agreement must come from at least two of three officials: the state Finance Director, the House Ways and Means General Fund chair, and the Senate Finance and Taxation General Fund chair. The director must then seek approval from the federal Centers for Medicare and Medicaid Services. If that agency changes or withholds approval, the department must administer the money according to the agency’s requirements.

A joint House and Senate committee oversees Rural Health Transformation Program funds. Oversight covers programs supported by Rural Health Transformation Program money under this law and other funding laws. Its members include budget committee chairs and members, minority-party leaders, other legislative leaders, and appointed lawmakers. Its co-chairs may request and receive reports and data from the department or program administrators, hold hearings, and receive testimony. The law takes effect upon becoming law. The committee must hold its first meeting within 30 days of that date and later meet when its co-chairs call it.