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Texas HHSC · CMS Grant Program
Rural Texas Strong
1115 Waiver Application — Key Milestones & Distribution Timeline
Completed milestone
Notice of Award
Anticipated / upcoming
Future distribution
Application & Award Phase
Nov 3
2025
2025
Completed
HHSC submitted the "Rural Texas Strong" application to CMS
Dec 29
2025
2025
Completed
HHSC received Notice of Award from CMS
Jan 30
2026
2026
Completed
HHSC submitted revised plan and budget to CMS
Apr 7
2026
2026
Notice of Award
CMS approved Budget Period 1 Revised Budget & Project Narrative
CMS released Budget Period 1 Notice of Award
CMS released Budget Period 1 Notice of Award
$281,319,360.67
Near-Term Actions
May
2026
2026
Anticipated
Upcoming actions in May 2026
- HHSC receives Year 1 funds from CMS
- HHSC releases Request for Application (RFA) on Initiatives 1, 4 & 6
Q4 FY 2026 — First Distributions
Q4
FY 2026
FY 2026
Planned
Initial fund distributions across three initiatives
- Initiative 1 — Distribution of Part 1 & Part 2 funds
- Initiative 4 — Distribution of Part 1 funds
- Initiative 6 — Distribution of Part 1 & Part 2 funds
FY 2027 — Expanded Distributions
Q2
FY 2027
FY 2027
Planned
New initiatives begin distribution
- Initiative 2 — Distribution of funds begins
- Initiative 3 — Distribution of funds begins
Q4
FY 2027
FY 2027
Planned
Final initiative launches
- Initiative 5 — Distribution of funds begins
Texas Health and Human Services Commission (HHSC) · Centers for Medicare & Medicaid Services (CMS) · Data current as of April 2026
