Rural healthcare bill considered by Texas House Committee

AUSTIN (Nexstar) - The Texas House Public Health Committee met Monday morning to discuss a bill that aims to make sure rural Texans have access to hospital and health care services.

House Bill 18, known as The Rural Health Stabilization and Innovation Act, provides a comprehensive plan for ensuring that rural Texans receive adequate medical care. The committee heard from the bill’s author, Rep. Gary VanDeaver, R-New Boston, as well as numerous stakeholders.

“Members, there are Texans who do not currently have access to hospitals and health care services that the majority of us take for granted,” VanDeaver said. “We have the opportunity this session to change that.”

VanDeaver said nine of the 13 members of the Public Health Committee come from urban areas with a total of 202 hospitals. The four representatives from rural areas make up 28 counties with only 30 hospitals in the entire area, nine of which have no hospitals at all. The lack of resources in these areas is what moved VanDeaver to file HB 18.

Freddy Olivarez, CEO of the Medical Arts Hospital in Lamesa, told the committee that his rural hospital struggled to make payroll in September 2024. He said an existing grant program played a large role in allowing the hospital to maintain operations.

“We were facing looking at being the next Texas hospital closed, so that was this grant funding that Chairman VanDeaver—it’s amazing for us,” Olivarez said. “This is what's kept us open right now.”

The bill’s strategic initiatives include:

• The creation of a new State Office of Rural Hospital Finance. The office will create a strategy to ensure that hospitals have the necessary resources to support their patients, create a financial vulnerability index and provide technical assistance to these areas if necessary. 
• The establishment the Texas Rural Hospital Officers Academy. The Academy will offer at least 100 hours of coursework annually related to technical training on matters that impact the financial stability of rural hospitals. 
• The construction a grant program for rural hospitals composed of four grants:
  • The Financial Stabilization Grant: to support the financial stability of hospitals at a moderate or high risk of instability based on their vulnerability index. 
  • Emergency Hardship Grant: for hospitals that have experienced a man-made or natural disaster or unforeseen circumstances that might result in facility closures or failure to meet payroll.
  • Innovation Grant: to improve rural facilities and services for pregnant women or women who have recently given birth, individuals under the age of 20, older adults or individuals who are uninsured.
  • Rural Hospital Support Grant: to improve the financial stability and support the long term viability of rural hospitals. 
• Additions to the Health and Safety Code for the new Rural Pediatric Mental Health Care Access Program to use telehealth services to identify and assess pediatric patients seeking mental and behavioral health needs. 

The bill defines a rural community of having a population of 68,750 or less, making 156 Texas counties eligible for these services.

Representatives questioned stakeholders on whether the bill’s current language is expansive enough to address all issues affecting rural hospitals.

“What is the problem? I think it's a good bill trying to address it, but I'm worried it's not gonna go far enough,” Rep. John Bucy, D-Austin, asked Victoria Grady, who testified as a resource witness from the Health and Human Services Commission.

“I think one of the things that's really important to note about rural communities is they don't want us in their business, and they would like to solve their own problems. And so part of the challenge is having those facilities feel comfortable and confident that they can access resources early on when they're having trouble,” Grady said. She added, “As much as we're glad to give emergency hardship grants, we really don't want them coming to us at that point.” 

Grady also discussed a variety of issues that affect rural hospitals such as outdated infrastructure, inability to obtain viable equipment, uncompensated care, and complexity when submitting for reimbursement on supplemental payments. 

The bill was left pending as discussions with stakeholders continue.