TX HB18

Establishes the State Office of Rural Hospital Finance within the Health and Human Services Commission to provide technical assistance for rural hospitals and health care systems participating in state or federal financial programs, including Medicaid

Creates four grant programs for rural hospitals, hospital districts, and hospital authorities: a financial stabilization grant program for entities at moderate or high risk of financial instability, an emergency hardship grant program for disaster or crisis situations, an innovation grant program for initiatives improving healthcare access and quality, and a rural hospital support grant program for ongoing operational viability

Requires the strategic plan for rural hospital services to include a financial needs assessment and vulnerability index measuring each rural hospital's likelihood of maintaining services, meeting financial obligations, and remaining operational over the next two years

Establishes the Texas Rural Hospital Officers Academy through contracts with 2-4 institutions of higher education, offering at least 100 hours of free annual professional development and continuing education on financial stability, regulations, and business administration for rural hospital officers

Expands pediatric tele-connectivity and mental health services by connecting rural hospitals and rural health clinics with pediatric specialists via telemedicine, and requires the Texas Child Mental Health Care Consortium to establish telemedicine programs for pediatric mental health services at rural facilities by September 1, 2026

Defines "rural county" as one with population of 68,750 or less, and "rural hospital" as facilities in such counties or those designated as critical access hospitals, rural referral centers, or sole community hospitals by CMS