access- Year-one award
- $281,319,361
- Lead agency
- Health and Human Services Commission
- Maternal care in the plan
- Names maternal care without a maternal line item
- Status
- Maternal-relevant round in December
What Texas's plan says about maternal care
The Texas Health and Human Services Commission runs the program as Rural Texas Strong, with six initiatives. The plan describes the obstetric gap in plain terms: "Ninety-six rural hospitals no longer provide obstetrical services (OB) leaving vast OB deserts across the state that are larger than the combined land mass of Connecticut, Delaware and Rhode Island." It adds that "in many counties, women may travel up to 70.5 miles to the nearest labor and delivery hospital."
Maternal care shows up in Initiative 3, Lone Star Advanced AI and Telehealth. The original plan says "Early focus areas will include maternal health, behavioral health, and preventive screening," and one of the initiative's outcome measures is access to specialty care in behavioral health, radiology and maternal care, with a target of a 15% increase over a 2027 baseline. The year-two project narrative, revised August 31, 2026, widened the telehealth scope: "All telehealth services in this initiative will be directed toward prevention, behavioral health treatment, maternal care, or remote monitoring of chronic conditions." The year-two budget narrative says projects "may include telehealth services focused on behavioral health, maternal health, radiology, specialty consultation, and chronic disease management."
What is open, and what comes next
Nothing is open today. HHSC plans $37.5 million for Initiative 3 in year two, toward about $150 million over the grant term, awarded through a competitive request for applications. The state's estimated schedule: applications due December 2026, notices of award in March 2027, contracts routed in May 2027 and programs starting in June 2027. The state notes that every figure after year one is an estimate until CMS issues later budget awards.
The governor announced the first round of Rural Texas Strong awards on September 28, 2026: $750,000 each to 68 rural hospital districts and authorities, $51 million in all, for chronic disease programs under Initiative 1. Earlier announcements of $60 million and $99 million described funding made available, not awards.
Who can apply, and where a partner fits
Initiative 3 isn't open to individual hospitals or vendors. Applicants must be a clinically integrated network, accountable care organization or similar cooperative, and "a minimum of 60 percent of each Applicant's active membership must be comprised of rural healthcare Providers operating within Texas's 202 eligible rural counties." A telehealth practice takes part as the specialty provider a network brings in. That matches how Texas measures the initiative: it counts specialty providers, maternal care included, that have affiliation agreements to deliver telehealth. HHSC says it isn't meeting with potential vendors or applicants.
Where Ouma fits
How tele-MFM fits Texas's model
Texas has written maternal care into a telehealth initiative whose success is measured by the number of specialty providers delivering care by telehealth to rural members. A network applying in December needs a maternal-fetal medicine partner that can cover consults and ultrasound reads across a large, spread-out membership. Ouma provides contracted maternal-fetal medicine coverage and ultrasound interpretation to rural and critical access hospitals. Ouma is licensed to practice in all 50 states and is Medicaid-enrolled in 20 states as of August 2026.
See every state's plan side by side or what a partner letter for an application looks like.
Frequently asked questions
Does Texas's Rural Health Transformation plan fund maternal care?
Not as a line item. Maternal health is an early focus of the Lone Star Advanced AI and Telehealth initiative, and the initiative's year-two scope names maternal care among the services it will fund.
Who can apply to the telehealth round?
Clinically integrated networks, accountable care organizations and similar cooperatives whose active membership is at least 60% rural providers in Texas's 202 eligible rural counties. Specialty providers take part through those networks.
When are applications due?
The state estimates December 2026, with awards in March 2027.