MONTGOMERY, Ala. — A second wave of rural health grants announced Thursday will put nearly $55 million into maternity care networks, cancer screening programs, ambulance services and health care training across Alabama, including several projects built specifically around the hospitals and clinics of the state’s southwest corner.
Gov. Kay Ivey announced 34 grants totaling nearly $55 million to health care providers and institutions as the second round of 2026 funding through the Alabama Rural Health Transformation Program. The awards close out the program’s first year of funding and follow a much larger first round in late August, when the state distributed more than $144 million through 138 grants.
Taken together, the two rounds account for 172 grants worth nearly $200 million in year one. Alabama’s first-year award from the federal government totals $203,404,326.54, funded entirely by the Centers for Medicare & Medicaid Services within the U.S. Department of Health and Human Services.
For Mobile, Baldwin and the surrounding rural counties, the most significant pieces of this round involve high-risk pregnancy care and cancer detection. The University of South Alabama, Infirmary Health and Franklin Primary Health Center all received awards aimed at linking patients in places such as Washington, Clarke, Monroe, Conecuh and Escambia counties to specialists in Mobile.
What Ivey and Federal Officials Said
Ivey framed the awards as part of a broader effort to improve access to care regardless of where Alabamians live.
“Every Alabamian deserves access to quality care, and through the Rural Health Transformation Program, we are helping many providers and institutions improve healthcare for Alabamians throughout the state,” Ivey said. “I commend all the thoughtful efforts, from the federal policymakers and state administrators to our professional healthcare leaders, who are working hard to ensure the long-term success of this program. Once again, the Trump Administration is delivering meaningful results for real Americans.”
Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, said the program lets states design their own approaches.
“The Trump Administration’s Rural Health Transformation Program is helping states like Alabama develop innovative, locally driven solutions to improve rural Americans’ access to high-quality care,” Oz said. “Today’s grant awards demonstrate how this historic investment is empowering rural communities to strengthen their health systems, put patients first, and bring better care closer to home.”
Kenneth Boswell, director of the Alabama Department of Economic and Community Affairs, which administers the program, said the agency looks forward to watching the projects develop.
“The goal of improving rural healthcare in Alabama is of utmost importance, and we are grateful to Governor Ivey and the Legislature for their confidence in ADECA to administer this program,” Boswell said. “The projects announced today as well as those announced earlier hold great potential for improving healthcare in a wide range of areas, and we look forward to seeing the progress as these projects move forward.”
Southwest Alabama: Maternity Networks and Cancer Screening
Five awards in this round name Mobile, Baldwin or the rural counties that rely on Mobile’s hospitals for specialty care.
- University of South Alabama — $1.63 million to build a connected maternity care network that links the university’s obstetric and maternal-fetal medicine hub in Mobile with rural access locations in Baldwin, Butler, Clarke, Conecuh, Covington, Escambia, Marengo, Mobile, Monroe and Washington counties.
- Infirmary Health System — $1.79 million to create a regional maternal-fetal medicine referral hub connected with Jackson Medical Center and Washington County Hospital, so high-risk pregnant patients in Choctaw, Clarke, Mobile, Monroe and Washington counties can receive specialist-supported care closer to home.
- Infirmary Health System — $1.37 million to establish the Southwest Alabama Breast Cancer Detection Network, expanding screening, early detection, diagnostic follow-up and coordinated specialty care in Baldwin, Choctaw, Clarke, Conecuh, Escambia, Monroe and Washington counties.
- Franklin Primary Health Center — $534,937 to expand the use of its existing mobile cancer screening unit in Baldwin, Choctaw, Conecuh, Escambia and Monroe counties.
- University of South Alabama — $164,450 to send mobile teams into Baldwin, Clarke, Conecuh, Escambia, Mobile, Monroe and Washington counties for cervical cancer prevention and screening.
Those awards build on first-round money that already reached the region. In August, Infirmary Health received more than $5.3 million for projects across southwest Alabama, including a women’s access-to-care initiative with a mobile, telehealth-enabled program through North Baldwin Infirmary. Franklin Primary Health Center received first-round grants for a rural behavioral health telehealth program and a rural training track in its family medicine residency.
Covington, Coffee and the Wiregrass
Several awards serve counties east of Mobile and Baldwin that are part of the broader South Alabama region.
- Andalusia Health — $305,428 to replace two outdated portable X-ray machines with modern units that produce high-resolution bedside images, serving Butler, Conecuh, Covington and Crenshaw counties.
- South Central Alabama Mental Health Board — $840,000 to set up a coordinated rural health care network linking primary care, behavioral health, hospitals, emergency medical systems, schools, public agencies and community organizations in Butler, Coffee, Covington and Crenshaw counties.
- Flowers Hospital (Triad of Alabama LLC) — $1.45 million for a regional maternal-fetal medicine telehealth hub that connects Medical Center Enterprise to specialty services through telerobotic ultrasound, serving Barbour, Coffee, Covington, Dale, Geneva, Henry, Houston and Pike counties.
- QHG of Enterprise — $70,000 to upgrade clinical training equipment for hands-on instruction in heart and lung assessments, newborn and infant resuscitation, childbirth emergencies and facility-wide emergency response, serving Coffee, Covington, Crenshaw, Dale, Geneva and Pike counties.
- Haynes Ambulance of Alabama — $1.4 million for a physician-directed treat-in-place program in Bullock, Covington, Crenshaw, Elmore, Lowndes, Macon and Pike counties.
Workforce Training Takes the Largest Share
The two biggest grants in the round are both aimed at training the health care workers rural Alabama needs, and together they account for more than half of the money.
The Alabama Community College System received $20.6 million, the largest award of the round, to build a statewide rural health care workforce pipeline. The plan is designed to let students earn health care credentials without moving away from home. It includes remote emergency medical technician and advanced EMT tracks; a centralized allied health pipeline with shared curriculum in respiratory therapy, surgical technology, radiologic technology, medical laboratory technology and medication technician programs; added nursing faculty, simulation resources and instructional sites; and a structured path toward advanced careers as nurse practitioners, physician assistants and certified nurse midwives.
The Alabama School of Healthcare Sciences received $7.27 million. The statewide residential high school in Demopolis, created under legislation Ivey signed in 2024, is designed to prepare students from rural communities for health care careers. The grant will also support transportation to clinical placements and partnerships with health care providers and educational institutions.
Paramedics Who Treat Patients Where They Are
Eight grants totaling about $5.3 million fund “treat-in-place” programs, which allow trained paramedics, often with real-time physician support by telehealth, to assess and treat qualifying patients at home or on scene rather than transporting everyone to an emergency room. The approach is intended to keep ambulances available for true emergencies in areas where a single unit may cover a large territory.
The largest, $1.76 million to the University of Alabama, will provide portable telemedicine equipment, connectivity, training, protocols and quality monitoring to agencies in 13 west Alabama counties, along with a physician-consultation demonstration in Lamar, Perry and Pickens counties. Other treat-in-place awards went to the Health Care Authority of the City of Huntsville ($450,000 for two rapid response vehicles staffed by critical care paramedics in Lawrence, Marion and Winston counties), Greene County Health System ($750,000), Advantage Emergency Medical Services in Etowah County ($285,675), Regional Paramedical Services ($153,525), Piedmont Emergency Rescue Squad ($381,220) and Oneonta Fire and Rescue Service ($128,477), in addition to the Haynes Ambulance grant.
Trauma, Stroke and Training Statewide
The University of Alabama at Birmingham received three grants. The largest, $3.44 million, will strengthen the statewide emergency care coordination system for trauma, stroke, cardiac and other time-sensitive conditions, in partnership with the Birmingham Regional Emergency Medical Services System and its Alabama Trauma Communications Center. UAB also received $452,716 for a rural stroke transfer pilot in Blount, Chilton and St. Clair counties and $1 million to help at least 20 rural hospitals prepare for obstetric and newborn emergencies with labor and delivery carts, simulation resources and training.
Greene County Health System in Eutaw received four grants worth about $3.9 million, the most of any single recipient in the round by count. Beyond its treat-in-place program, it will launch a 14-county emergency care coordination network ($308,694), a permanent regional simulation training center for west Alabama and the Black Belt ($575,000) and the Black Warrior Rural Cancer Detection, Navigation and Early Diagnosis Network ($2.28 million).
Other awards include:
- Children’s Hospital of Alabama — $288,542 to expand pediatric emergency training for rural hospitals, EMS, outpatient clinics and school health staff statewide.
- Cahaba Medical Care Foundation — three grants totaling about $553,000 for mobile simulation training, the Project LOOP cervical cancer program and a digital patient intake platform in Bibb, Chilton, Perry and Wilcox counties.
- UAB St. Vincent’s Chilton — $618,000 for a mobile prostate cancer screening program in eight Black Belt and central Alabama counties.
- Coosa Valley Medical Center — $1.89 million to replace limited mobile scanning with a permanent PET/CT scanner and hire a nurse navigator.
- North Alabama Shoals Hospital — $683,500 to expand early-stage lung cancer detection in five northwest Alabama counties.
- East Alabama Health Care Authority — $1.23 million for three community-based maternal health access points.
- Russell Hospital — $140,242 for an ultrasound system to strengthen maternal and fetal diagnostic and referral capacity.
How the Program Works
The second round funded projects under five initiatives — Cancer Digital Regionalization, Statewide EMS Trauma and Stroke, EMS Treat in Place, Maternal and Fetal Health, and Simulation Training — and also awarded remaining funds for additional projects under the Rural Health and Rural Workforce initiatives. The first round in August covered Rural Health, Rural Workforce, Mental Health, Rural Health Practice and Collaborative Electronic Health Record, IT, and Cybersecurity initiatives.
Alabama’s spending plan was developed by a team that included the Governor’s Office, ADECA, the Alabama Department of Finance, the Alabama Medicaid Agency and the Alabama State Health Planning and Development Agency. ADECA administers the grants.
The national Rural Health Transformation Program was created by Congress as a $50 billion, five-year fund inside the federal budget and tax law that President Donald Trump signed on July 4, 2025, widely known as the One Big Beautiful Bill.
The Politics Behind the Money
The law that created the fund passed Congress along party lines, and Alabama’s delegation has continued to describe it in sharply different terms.
U.S. Sens. Katie Britt and Tommy Tuberville, both Republicans, backed the Senate amendment that added the rural health fund to the bill. After the first round of grants in August, Tuberville said, “There has been no greater champion for rural America than President Trump.” U.S. Rep. Gary Palmer, R-Hoover, said at the time, “Having proposed the inclusion of the Rural Health Transformation Fund into the Working Family Tax Cuts Act, I am proud to see this investment now making a real difference for communities across Alabama.”
Alabama’s two Democrats in Congress, U.S. Reps. Terri Sewell of Birmingham and Shomari Figures of Mobile, voted against the bill. Sewell warned of “families in rural Alabama whose nearest hospital may soon be forced to shut its doors.” Figures said, “This bill is bad for Alabama, bad for America, and there is nothing beautiful about it.” Two of the largest recipients in Thursday’s round, the Demopolis health sciences school and Greene County Health System, are in Sewell’s congressional district.
The debate has also reached this fall’s U.S. Senate race. Democratic nominee Everett Wess said last month that the program’s first-year money, while worthwhile in places, cannot make up for the law’s Medicaid changes, and he called for more transparency about how much of the money reaches hospitals and clinics directly.
What Comes Next
With Thursday’s announcement, ADECA has awarded the program’s first-year allocation. Recipients will now begin carrying out their projects, and ADECA’s director said the agency looks forward to seeing their progress. Because the federal program runs for five years, additional rounds of funding are expected in future years, subject to federal awards to the state.