SB 1377 establishes the Rural Ambulance Service Grant Program, which provides financial assistance to qualified ambulance service providers operating in rural counties. The Texas Comptroller will administer the program, awarding grants to counties with populations of 68,750 or less to ensure adequate ground ambulance services. Grant amounts are capped at $500,000 for counties with populations under 10,000 and $350,000 for counties between 10,000 and 68,750 residents. Counties awarded grants must use the funds exclusively for ambulance purchases and are required to take possession of the ambulance within five years of receiving the funds. Additionally, counties receiving a grant may not reduce their ambulance service budget in the fiscal year following the grant award. The comptroller must establish rules governing grant applications, fund disbursement, monitoring, and the return of misused funds. The first round of grant applications begins January 1, 2026.