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HB614 • 2026

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

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

Budget Healthcare
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Reynolds
Last action
2026-04-13
Official status
Enacted
Effective date
2026-10-01

Plain English Breakdown

The effectiveness of the program depends on proper implementation and adherence to federal guidelines is not supported by the official source material.

Rural Health Transformation Program Funding for Alabama

This law provides $203,404,327 in federal funds to the Rural Health Transformation Program run by ADECA for various health initiatives.

What This Bill Does

  • Provides up to $203,404,327 from federal funds for ADECA's Rural Health Transformation Program.
  • Allocates money for specific initiatives such as electronic health records, rural health services, maternal and fetal care, workforce development, cancer treatment, simulation training, emergency medical services, mental health support, and administration costs.
  • Allows any leftover funds to be used in the next fiscal year if they are not spent by September 30, 2027.
  • Requires ADECA's Director to get approval from certain finance committees before adjusting how these funds are used.

Who It Names or Affects

  • The Alabama Department of Economic and Community Affairs (ADECA).
  • People living in rural areas who will benefit from improved health services.
  • Healthcare providers working on the initiatives funded by this program.

Terms To Know

Rural Health Transformation Program
A program that aims to improve healthcare services in rural areas of Alabama.
ADECA
Alabama Department of Economic and Community Affairs, which manages the Rural Health Transformation Program.

Limits and Unknowns

  • The law does not specify how much money will be available for each initiative beyond setting maximum amounts.
  • It is unclear exactly how many people or communities will benefit from these initiatives.

Bill History

  1. 2026-04-13 House

    Enacted

  2. 2026-04-09 House

    Delivered to Governor

  3. 2026-04-09 Senate

    Signature Requested

  4. 2026-04-09 House

    Enrolled

  5. 2026-04-09 House

    Ready to Enroll

  6. 2026-04-08 Senate

    Motion to Read a Third Time and Pass - Adopted Roll Call 1283 (Yeas 30, Nays 0)

  7. 2026-04-07 Senate

    Read for the Second Time and placed on the Calendar

  8. 2026-04-07 Senate

    Reported Out of Committee Second House

  9. 2026-04-02 Senate

    Pending Committee Action in Second House

  10. 2026-04-02 Senate

    Read for the first time and referred to the Senate Committee on Finance and Taxation General Fund

  11. 2026-04-01 House

    Motion to Read a Third Time and Pass - Adopted Roll Call 1129 (Yeas 101, Nays 0)

  12. 2026-04-01 House

    Third Reading in House of Origin (Yeas 104, Nays 0)

  13. 2026-03-19 House

    Read for the Second Time and placed on the Calendar

  14. 2026-03-18 House

    Reported Out of Committee House of Origin

  15. 2026-03-12 House

    Pending Committee Action in House of Origin

  16. 2026-03-12 House

    Read for the first time and referred to the House Committee on Ways and Means General Fund

Official Summary Text

This act: (1) makes supplemental appropriations totaling $203,404,327 from the federal One Big Beautiful Bill Act of 2025 for the Rural Health Transformation Program to the Alabama Department of Economic and Community Affairs (ADECA) for various initiatives for the fiscal year ending September 30, 2027; (2) provides that any appropriated funds unexpended on September 30, 2027, are reappropriated for the same purpose for the fiscal year beginning October 1, 2027; and (3) authorizes the Director of ADECA, upon obtaining a written concurrence from a majority of the Finance Director, Chair of the House Ways and Means General Fund Committee, and the Chair of the Senate Finance and Taxation General Fund Committee, to seek approval from the Centers for Medicare and Medicaid Services to adjust reappropriated funds for that fiscal year.

Current Bill Text

Read the full stored bill text
HB614 ENROLLED
Page 0
HB614
6YTGQ3Z-2
By Representatives Reynolds, Paramore, Crawford, Warren,
Lipscomb, Oliver, Hurst, Paschal, DuBose, Shaver, Starnes,
Stubbs, Fidler, Holk-Jones, Givens, Ross, Daniels, Tillman,
Treadaway, Pettus, Whitt
RFD: Ways and Means General Fund
First Read: 12-Mar-26
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HB614 Enrolled
Page 1
First Read: 12-Mar-26
Enrolled, An Act,
To make supplemental appropriations from the Rural
Health Transformation Program to the Alabama Department of
Economic and Community Affairs for the fiscal year ending
September 30, 2027.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. In addition to all other appropriations
heretofore or hereafter made, there is hereby appropriated a
total of up to $203,404,327 in federal funds from the One Big
Beautiful Bill Act of 2025 (P.L. 119-21) for the Rural Health
Transformation Program to the Alabama Department of Economic
and Community Affairs ("ADECA") for the fiscal year ending
September 30, 2027:
(1) To the Collaborative EHR, IT, and Cybersecurity
Initiative, up to $31,425,971.
(2) To the Rural Health Initiative, up to $55,936,190.
(3) To the Maternal and Fetal Health Initiative, up to
$6,102,130.
(4) To the Rural Workforce Initiative, up to
$57,919,382.
(5) To the Cancer Digital Regionalization Initiative,
up to $8,136,173.
(6) To the Simulation Training Initiative, up to
$1,017,021.
(7) To the Statewide EMS Trauma and Stroke Initiative,
up to $4,068,085.
(8) To the EMS Treat-In-Place Initiative, up to
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HB614 Enrolled
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(8) To the EMS Treat-In-Place Initiative, up to
$5,085,108.
(9) To the Mental Health Initiative, up to $7,271,705.
(10) To the Rural Health Practice Initiative, up to
$6,102,130.
(11) Up to $20,340,432 of funds may be used to
reimburse costs for the administration, auditing, and
reporting requirements of the Rural Health Transformation
Program funds.
Section 2. All funds appropriated herein and not
expended in the current fiscal year shall not revert but be
carried forward for the purpose appropriated.
Section 3. (a) Any amount of the funds appropriated in
this act remaining unexpended on September 30, 2027, shall be
reappropriated for the same purposes for the fiscal year
beginning October 1, 2027.
(b) In the event that any of the appropriations to any
of the initiatives listed above needs to be adjusted or
exceeded for the utilization of available funds, the Director
of ADECA shall obtain written concurrence of a majority of the
Finance Director, the Chair of the House Ways and Means
General Fund Committee, and the Chair of the Senate Finance
and Taxation General Fund Committee of the Legislature for
such reallocation prior to seeking the approval referenced in
Section (c) below.
(c) Following receipt of the above concurrence, the
Director of ADECA shall seek approval from the Centers for
Medicare and Medicaid Services ("CMS") for the above
reallocation. In the event such approval is modified or
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HB614 Enrolled
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reallocation. In the event such approval is modified or
withheld by CMS, ADECA shall continue to administer the
appropriation in accordance with CMS requirements.
Section 4. Nothing in this act is intended nor shall be
construed to require any expenditure of federal funds in
violation of any federal law, regulation, rule, policy, or
procedure, or of any term or condition applicable to the
administration of federal funds by ADECA in connection with
the Rural Health Transformation Program, nor shall anything
herein be construed to prohibit the expenditure of federal
funds by ADECA in accordance with the purposes for which and
the terms and conditions upon which such funds were made
available.
Section 5. This act shall become effective October 1,
2026.
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HB614 Enrolled
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2026.
________________________________________________
Speaker of the House of Representatives
________________________________________________
President and Presiding Officer of the Senate
House of Representatives
I hereby certify that the within Act originated in and
was passed by the House 01-Apr-26.
John Treadwell
Clerk
Senate 08-Apr-26 Passed
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