The Alabama Flex Grant Program, facilitated by the Alabama Department of Public Health (ADPH) in partnership with the Alabama Hospital Association (AlaHA), is aimed at enhancing the healthcare services in rural areas. Established under the Balanced Budget Act (BBA) of 1997, the program supports the creation of rural hospital networks, regionalization of health services, and improved access to hospital services for rural residents. It specifically targets Critical Access Hospitals (CAHs), providing support in achieving financial viability, quality improvement, and operational efficiency. The program encourages the development of cooperative care systems, encompassing CAHs, emergency medical services (EMS), clinics, and health practitioners to boost the efficiency and quality of care. The initiatives include quality improvement through participation in the Rural Quality Network (RQN), financial and operational improvement through feasibility studies and webinars, and population health improvement by identifying and addressing areas for improvement.