House Bill 591 Alabama 2026 Session

Updated Mar 19, 2026

Notable

Summary

Primary Sponsor: Rex ReynoldsRepresentative
Republican
Session: 2026 Regular Session
Title: Rural Health Transformation Program supplemental appropriations for the fiscal year ending September 30, 2026
Summary: HB591 would provide supplemental federal funding from the Rural Health Transformation Program to ADECA for a set of rural health initiatives in Alabama for fiscal year 2026.
What This Bill Does
It appropriates up to $203,404,327 in federal funds to ADECA for various health initiatives for the year ending September 30, 2026, with specific caps for each program and up to $20,340,432 for administration and reporting. It allows unspent funds to carry forward to the next fiscal year and reallocation of funds if needed, but only after approvals from state legislative leaders and CMS. If CMS changes or withholds approval, ADECA must follow CMS rules. The act becomes effective immediately.

Who It Affects
Alabama Department of Economic and Community Affairs (ADECA) – administers the federal funds and allocates them to the listed initiatives; handles carryforward and reallocation processes.
Rural health initiatives and rural residents of Alabama – receive funding for EHR/IT/cybersecurity, workforce development, maternal and fetal health, mental health, EMS, cancer regionalization, simulation training, and rural health practice improvements.
Centers for Medicare and Medicaid Services (CMS) – must approve reallocations; their approval or conditions govern how funds are adjusted.
Alabama legislative leadership (Finance Director, House Ways and Means General Fund Committee Chair, Senate Finance and Taxation General Fund Committee Chair) – must concur in writing before seeking CMS approval for reallocations.

Key Provisions
Section 1: appropriates up to $203,404,327 in federal funds from the One Big Beautiful Bill Act of 2025 to ADECA for FY 2026 to support ten specified initiatives with individual funding caps (e.g., Collaborative EHR/IT/Cybersecurity $31,425,971; Rural Health $55,936,190; Maternal and Fetal Health $6,102,130; Rural Workforce $57,919,382; Cancer Digital Regionalization $8,136,173; Simulation Training $1,017,021; Statewide EMS Trauma and Stroke $4,068,085; EMS Treat-In-Place $5,085,108; Mental Health $7,271,705; Rural Health Practice $6,102,130) and up to $20,340,432 for administration, auditing, and reporting costs.
Section 2: any funds not spent in the current year shall not revert but carry forward for the intended purpose.
Section 3: unexpended funds on September 30, 2026 may be reappropriated for the same purposes starting October 1, 2026; reallocations require written concurrence from the Finance Director and both committee chairs before seeking CMS approval, and ADECA must obtain CMS approval; if CMS modifies or withholds approval, ADECA must follow CMS requirements.
Section 4: nothing in the act violates federal law or CMS terms; federal funds may be expended in accordance with their purposes and conditions.
Section 5: the act takes effect immediately upon passage and approval.

AI-generated summary using openai/gpt-5-nano-2025-08-07 on Mar 10, 2026. May contain errors — refer to the official bill text for accuracy.
Subjects: Appropriations