Relating to the establishment and administration of certain programs and services providing health care services to rural counties.

Contracts

• Employment Agreements: Review contracts for rural hospital administrators. To qualify for grants, the administrator with signatory authority must be physically present at the facility (or within 5 miles) at least two days per week. Remote-only leadership disqualifies the hospital from funding.
• Managed Care Agreements: Legal and Finance must review Medicaid Managed Care Organization (MCO) contracts to ensure the new OB/GYN add-on reimbursement (approx. 2% increase) is accurately passed through prospective payment calculations.
• Telemedicine Vendor Contracts: Contracts with pediatric mental health providers must be amended to align with the technical standards of the Texas Child Mental Health Care Consortium to participate in the new access program.

Hiring/Training

• Texas Rural Hospital Officers Academy: HR should identify C-Suite executives for this 100-hour specialized training program.
• *Note:* Participation is free (institutions are prohibited from charging fees), and travel/stipends are reimbursable. Completion will likely become a metric for future grant favorability.
• Local Administrator: If your facility is owned by a large system and currently managed remotely, you must hire or relocate a decision-maker to the site immediately to meet the "Control of Funds" requirement.

Reporting & Record-Keeping

• Parental Consent Forms (Critical Liability): You must deploy a specific written consent form for the Rural Pediatric Mental Health Care Access Program.
• *Warning:* The law strictly invalidates consent if it authorizes care affirming a child’s gender perception inconsistent with their biological sex. Use of standard, broad consent forms for this specific program may trigger Medicaid fraud investigations or licensure penalties.
• Grant Fund Segregation: Finance departments must establish separate ledger accounts for SORHF grants. Funds cannot be commingled with general operating accounts accessible by a corporate parent.

Fees & Costs

• Revenue Opportunity: Rural hospitals with OB/GYN departments are entitled to a cost-based Medicaid add-on.
• Grant Streams: Prepare for four distinct applications: Financial Stabilization, Emergency Hardship, Innovation, and Rural Hospital Support.