President Donald Trump’s One Big Beautiful Bill delivered nearly $55 million more to rural Alabama on Thursday, when Governor Kay Ivey awarded 34 grants to hospitals, ambulance services and colleges through the Rural Health Transformation Program.
“Once again, the Trump Administration is delivering meaningful results for real Americans,” Ivey said.
Congress created the $50 billion rural health fund inside the bill Trump signed into law on July 4, 2025.
The Senate passed it 51-50 with Vice President JD Vance breaking the tie, the House passed it 218-214, and no Democrat in either chamber voted yes.
U.S. Senators Katie Britt (R-Montgomery) and Tommy Tuberville (R-Auburn), now the Republican favorite to become Governor of Alabama in 2027, backed the Senate amendment that added the fund to the bill.
“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,” U.S. Rep. Gary Palmer (R-Hoover) said in August, after the first round of grants.
“There has been no greater champion for rural America than President Trump,” Tuberville said after that round.
U.S. Reps. Terri Sewell (D-Birmingham) and Congressman Shomari Figures (D-Mobile), Alabama’s two Democrats in Congress, voted no. 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 Thursday’s biggest winners sit in Sewell’s district.
The Alabama School of Healthcare Sciences in Demopolis, the residential healthcare high school Ivey signed into law in 2024, will receive $7.27 million.
Greene County Health System in Eutaw won four grants worth $3.9 million for cancer detection, emergency care, paramedic treat-in-place service and a regional training center.
The largest grant of the round, $20.6 million, goes to the Alabama Community College System to train rural EMTs, nurses and allied health workers without making them relocate. Combined with the Demopolis school, workforce training takes more than half of the money.
Thursday’s awards close out year one at 172 grants worth nearly $200 million.
Alabama secured $203.4 million in December, and Ivey announced the first 138 grants, worth more than $144 million, in late August.
Eight grants totaling $5.3 million will launch “treat-in-place” programs that let paramedics treat patients where they are instead of making an unnecessary trip to the emergency room. One sends $450,000 to the Health Care Authority of the City of Huntsville, which operates the Huntsville Hospital Health System that received more than $6.5 million in the first round, for two rapid response vehicles serving Lawrence, Marion and Winston counties.
Alabama drew up the plan for spending the money, and the Alabama Department of Economic and Community Affairs administers it. The federal dollars come through the Centers for Medicare & Medicaid Services, which funds 100% of the program.
Its administrator, Dr. Mehmet Oz, discussed Alabama’s award with U.S. Rep. Robert Aderholt (R-Haleyville) in September.
“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.
Full list of grants
Rural Workforce Initiative
- Alabama Community College System – $20.6 million to establish an integrated, statewide rural healthcare workforce pipeline through Alabama’s community colleges, including remote EMT and advanced EMT tracks, expanded allied health training, added nursing capacity and a rural pipeline to advanced nursing careers (Statewide).
- The Alabama School of Healthcare Sciences – $7.27 million to support the statewide residential high school in Demopolis that will prepare students from rural communities for healthcare careers. Funding will also support transportation to clinical placements and partnerships with healthcare providers and educational institutions (Statewide).
Maternal and Fetal Health Initiative
- The University of Alabama at Birmingham – $1 million to improve the ability of rural hospitals, emergency departments and emergency medical service providers to recognize, stabilize and manage obstetric and neonatal emergencies. The project will equip at least 20 rural hospitals with emergency readiness labor and delivery carts and simulation resources while providing training (Statewide).
- Triad of Alabama LLC DBA Flowers Hospital – $1.45 million to establish a regional maternal-fetal medicine telehealth hub and connect Medical Center Enterprise to specialty services through telerobotic ultrasound serving eight counties (Barbour, Coffee, Covington, Dale, Geneva, Henry, Houston, Pike).
- The East Alabama Health Care Authority – $1.23 million to establish three community-based maternal health access points and connect them to East Alabama Health specialty and referral services in three counties (Barbour, Bullock, Chambers).
- The Russell Hospital Corp. – $140,242 to strengthen maternal and fetal diagnostic and referral capacity by installing an ultrasound system and integrating it with its existing imaging, consultation and transfer infrastructure serving five counties (Clay, Coosa, Elmore, Talladega, Tallapoosa).
- University of South Alabama – $1.63 million to establish a connected maternity care network linking its obstetric and maternal-fetal medicine hub in Mobile with rural access locations in southwest Alabama (Baldwin, Butler, Clarke, Conecuh, Covington, Escambia, Marengo, Mobile, Monroe, Washington).
- Infirmary Health System Inc. – $1.79 million to establish a regional maternal-fetal medicine referral hub connected with Jackson Medical Center and Washington County Hospital, allowing high-risk pregnant patients to receive specialist-supported care closer to home in five counties (Choctaw, Clarke, Mobile, Monroe, Washington).
EMS Trauma and Stroke Initiative
- The University of Alabama at Birmingham – $3.44 million to strengthen and expand Alabama’s statewide emergency care coordination system for trauma, stroke, cardiac and other time-sensitive conditions in partnership with Birmingham Regional Emergency Medical Services System and its Alabama Trauma Communications Center (Statewide).
- Greene County Health System – $308,694 to establish a rural emergency care coordination network to strengthen how patients with suspected stroke, major trauma and other time-sensitive emergencies in 14 counties are identified, stabilized, referred and transferred to the appropriate level of care (Bibb, Choctaw, Dallas, Fayette, Greene, Hale, Lamar, Marengo, Marion, Perry, Pickens, Sumter, Tuscaloosa, Wilcox).
- The University of Alabama at Birmingham – $452,716 to implement a rural stroke transfer coordination pilot to help patients with severe strokes move more quickly from participating rural hospitals to advanced stroke centers in three counties (Blount, Chilton, St. Clair).
EMS Treat-in-Place Initiative
- The University of Alabama – $1.76 million to establish rural treat-in-place infrastructure by providing participating agencies with portable telemedicine equipment, connectivity, training, clinical protocols, documentation tools, referral workflows and quality monitoring in 13 counties (Bibb, Choctaw, Dallas, Fayette, Greene, Hale, Lamar, Marengo, Marion, Perry, Pickens, Sumter, Wilcox). The project will also establish a physician-consultation demonstration in Lamar, Perry and Pickens counties.
- The Health Care Authority of the City of Huntsville – $450,000 to establish a rural treat-in-place program using two 911-dispatched rapid response vehicles staffed by six critical care paramedics in three counties (Lawrence, Marion, Winston).
- Greene County Health System – $750,000 to establish a treat-in-place program that allows trained emergency medical personnel to assess and treat eligible patients under approved protocols and medical oversight (Greene).
- Advantage Emergency Medical Services LLC – $285,675 to establish a physician-directed treat-in-place program that allows trained paramedics to assess patients and connect them with an emergency physician through real-time telehealth consultation when transport may not be necessary (Etowah).
- Haynes Ambulance of Alabama Inc. – $1.4 million to establish a physician-directed regional treat-in-place program that allows specially trained paramedics to assess and treat qualifying patients at their location in seven counties (Bullock, Covington, Crenshaw, Elmore, Lowndes, Macon, Pike).
- Regional Paramedical Services – $153,525 to implement a treat-in-place program by deploying three non-transport response vehicles that allow paramedics to respond to qualifying patients without taking a transport-capable ambulance out of service in seven counties (Chilton, Jefferson, Marion, Shelby, St. Clair, Walker, Winston).
- Piedmont Emergency Rescue Squad Inc. – $381,220 to establish a telehealth-enabled treat-in-place program that allows trained paramedics to assess and treat qualifying patients at their location with real-time physician support in three counties (Calhoun, Cherokee, Etowah).
- Oneonta Fire and Rescue Service – $128,477 to implement a treat-in-place model to help eligible patients with non-life-threatening conditions receive care on scene under medical oversight and to improve coordination when transport is needed (Blount).
Simulation Training Initiative
- Cahaba Medical Care Foundation – $125,055 to expand mobile, hands-on training programs for rural healthcare workers and emergency medical personnel in three counties, covering childbirth emergencies, newborn resuscitation, advanced Cesarean delivery skills, bone and joint emergencies, airway management and coordinated response (Bibb, Perry, Wilcox).
- QHG of Enterprise Inc. – $70,000 to upgrade clinical training equipment to provide hospital employees with hands-on instruction for heart and lung assessments, premature newborn resuscitation, childbirth emergencies, facility-wide emergency response and infant lifesaving resuscitation in six counties (Coffee, Covington, Crenshaw, Dale, Geneva, Pike).
- Greene County Health System – $575,000 to establish a permanent regional training center for healthcare workers serving west Alabama and the Black Belt by purchasing adult, maternal, newborn and pediatric patient simulators, procedure-training equipment, portable resources and technology for recording and reviewing training exercises (Greene).
- The Children’s Hospital of Alabama – $288,542 to expand its pediatric emergency training program for rural hospitals, emergency medical services, outpatient clinics and school health personnel (Statewide).
Cancer Digital Regionalization Initiative
- St. Vincent’s Chilton LLC DBA UAB St. Vincent’s Chilton – $618,000 to implement the Rural Prostate Cancer Digital Regionalization Project by deploying a mobile prostate cancer screening program in eight counties (Bibb, Chilton, Dallas, Hale, Lowndes, Marengo, Perry, Wilcox).
- Cahaba Medical Care Foundation – $266,486 to implement Project LOOP to expand cervical cancer detection, diagnostic follow-up and treatment capacity for women in four counties (Bibb, Chilton, Perry, Wilcox).
- Greene County Health System – $2.28 million to establish the Black Warrior Rural Cancer Detection, Navigation and Early Diagnosis Network to improve access to cancer screening, early diagnosis, navigation and timely follow-up in five counties (Greene, Hale, Marengo, Pickens, Sumter).
- Franklin Primary Health Center Inc. – $534,937 to expand the deployment and clinical use of its existing mobile cancer screening unit to improve access to early-detection services in five counties (Baldwin, Choctaw, Conecuh, Escambia, Monroe).
- RCHP-Florence LLC DBA North Alabama Shoals Hospital – $683,500 to expand early-stage lung cancer detection and diagnostic services in five counties (Colbert, Franklin, Lauderdale, Lawrence, Winston).
- Infirmary Health System Inc. – $1.37 million to establish the Southwest Alabama Breast Cancer Detection Network to expand access to breast cancer screening, early detection, diagnostic follow-up and coordinated specialty care in seven counties (Baldwin, Choctaw, Clarke, Conecuh, Escambia, Monroe, Washington).
- Sylacauga Healthcare Authority DBA Coosa Valley Medical Center – $1.89 million to replace limited mobile scanning services with a permanent PET/CT scanner and hire a nurse navigator to help patients schedule cancer testing, understand their results and connect with follow-up care in five counties (Clay, Coosa, Shelby, Talladega, Tallapoosa).
- University of South Alabama – $164,450 to expand cervical cancer prevention and screening by deploying mobile teams in seven counties (Baldwin, Clarke, Conecuh, Escambia, Mobile, Monroe, Washington).
Rural Health Initiative
- Cahaba Medical Care Foundation – $161,580 to implement a unified digital patient intake and engagement platform allowing patients to electronically complete intake forms, screenings, scheduling, appointment reminders and payments in four counties (Bibb, Chilton, Perry, Wilcox).
- Andalusia Health – $305,428 to replace two outdated portable X-ray machines with modern units that produce high-resolution bedside imaging to serve four counties (Butler, Conecuh, Covington, Crenshaw).
- South Central Alabama Mental Health Board Inc. – $840,000 to establish a coordinated rural healthcare network connecting primary care, behavioral health, hospitals, emergency medical systems, schools, public agencies and community organizations in four counties (Butler, Coffee, Covington, Crenshaw).
Grayson Everett is the editor in chief of Yellowhammer News. You can follow him on X @Grayson270.
