What This Bill Does
This bill creates two grant programs to help rural communities access healthcare. The first program awards grants to rural health centers and clinics to operate walk-in urgent care and emergency services. The second program gives grants to local public health departments in rural areas to provide emergency services and primary care.
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Who It Affects
- Rural health centers and clinics
- Local public health departments in rural areas
- Hospitals that want to convert to rural health centers or clinics
- People living in rural areas seeking healthcare
- The Health Resources and Services Administration
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Key Provisions
- The government will create a Rural Health Center Innovation Awards program that gives grants to eligible entities like Federally qualified health centers (organizations receiving federal funds to provide healthcare) and rural health clinics to establish or maintain facilities that serve as walk-in urgent care centers and emergency transport staging facilities (locations where patients wait before air or ambulance transport) (Sec. 2(b))
- Grants for the Rural Health Center Innovation Awards program can last up to 5 years, with first-year awards of up to $500,000 for existing centers or $750,000 for new ones, and $500,000 per year for years two through five (Sec. 2(d))
- Grant funds can be used to expand operating hours, pay for construction and renovation costs, and support equipment and staffing (Sec. 2(b))
- The government will create a separate Rural Health Department Enhancement Program that gives annual grants to local public health departments in rural areas for up to 5 years, with each year receiving no more than $500,000 (Sec. 3(d))
- The government must report to Congress within 3 years about whether these programs saved money, improved healthcare access, and increased use of health services in rural areas (Sec. 2(e))
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What Changes
If this bill becomes law, the Health Resources and Services Administration will start administering two new competitive grant programs. Rural health centers, clinics, and public health departments in rural areas will become eligible to apply for federal funding they cannot currently access. These organizations will gain money to expand emergency services, hire staff, purchase medical equipment, and extend operating hours in underserved rural communities.
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Important Definitions
- **Federally qualified health center**: An organization defined in the Social Security Act that receives federal funding to provide healthcare services
- **Rural health clinic**: A healthcare facility defined in the Social Security Act operating in rural areas
- **Rural area**: Any area the Office of Rural Health Policy of the Health Resources and Services Administration identifies as rural for eligibility purposes, including definitions from fiscal year 2023 and future years
- **Rural health department**: A local public health department located in a rural area
- **Triage center or staging facility**: A location where urgent care patients are assessed and prepared for transport to an emergency department by air or ambulance
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Effective Date
Not specified in bill text
I
118TH CONGRESS
1ST SESSION H. R. 1712
To amend the Public Health Service Act to establish a rural health center
innovation awards program and a rural health department enhancement
program, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 22, 2023
Mr. KUSTOFF (for himself and Ms. KUSTER) introduced the following bill;
which was referred to the Committee on Energy and Commerce
A BILL
To amend the Public Health Service Act to establish a rural
health center innovation awards program and a rural
health department enhancement program, and for other
purposes.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘Rural Health Innova-
4
tion Act of 2023’’.
5
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SEC. 2. RURAL HEALTH CENTER INNOVATION AWARDS
1
PROGRAM.
2
Subpart I of part D of title III of the Public Health
3
Service Act (42 U.S.C. 254b et seq.) is amended by adding
4
at the end the following:
5
‘‘SEC. 330Q. RURAL HEALTH CENTER INNOVATION AWARDS
6
PROGRAM.
7
‘‘(a) DEFINITIONS.—In this section:
8
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
9
tity’ means an entity that—
10
‘‘(A) is a Federally qualified health center;
11
‘‘(B) is a rural health clinic; or
12
‘‘(C) agrees (as a condition of receiving a
13
grant under this section) to establish such a
14
center or clinic, including a hospital that agrees
15
(as such a condition) to convert to a Federally
16
qualified health center or rural health clinic.
17
‘‘(2) FEDERALLY
QUALIFIED
HEALTH
CEN-
18
TER.—The term ‘Federally qualified health center’
19
has the meaning given such term in section
20
1861(aa) of the Social Security Act.
21
‘‘(3) RURAL
AREA.—The term ‘rural area’
22
means any area that is rural, within the meaning of
23
such term as used by the Office of Rural Health
24
Policy of the Health Resources and Services Admin-
25
istration for purposes of determining eligibility for
26
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•HR 1712 IH
grants or services, including any area that is rural
1
within such meaning as used by such Office for fis-
2
cal year 2023 or any area that is rural within such
3
meaning as amended for a subsequent fiscal year.
4
‘‘(4) RURAL HEALTH CLINIC.—The term ‘rural
5
health clinic’ has the meaning given such term in
6
section 1861(aa) of the Social Security Act.
7
‘‘(b) ESTABLISHMENT.—
8
‘‘(1) IN
GENERAL.—The Secretary, acting
9
through the Director of the Office of Rural Health
10
Policy of the Health Resources and Services Admin-
11
istration, shall establish a grant program to be
12
known as the ‘Rural Health Center Innovation
13
Awards program’ to award grants to eligible entities
14
that submit an application in accordance with sub-
15
section (c) to enable such entities to establish or
16
maintain a Federally qualified health center or rural
17
health clinic that—
18
‘‘(A) serves individuals in a rural area as
19
a walk-in urgent care center and as a triage
20
center or staging facility for necessary air or
21
ambulance transport to an emergency depart-
22
ment; and
23
‘‘(B) includes—
24
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‘‘(i) professional clinical staff, includ-
1
ing physicians, physician interns, residents,
2
nurse practitioners, physician assistants,
3
nurse midwives, or other health care pro-
4
viders providing walk-in urgent care and
5
emergency triage; and
6
‘‘(ii) resources, including laboratories,
7
x-ray machines, and cardiac monitors.
8
‘‘(2) PERMISSIBLE
USES
OF
FUNDS.—The
9
funds of a grant awarded under this section may be
10
used to—
11
‘‘(A) expand the hours of operation of a
12
Federally qualified health center or rural health
13
clinic;
14
‘‘(B) pay for the costs of construction and
15
renovation of a Federally qualified health center
16
or rural health clinic; or
17
‘‘(C) carry out any other activity for the
18
purposes described in paragraph (1).
19
‘‘(c) APPLICATIONS AND SELECTION.—
20
‘‘(1) IN GENERAL.—An eligible entity seeking a
21
grant under this section shall submit to the Sec-
22
retary an application at such time, in such manner,
23
and containing such information as the Secretary
24
may reasonably require.
25
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‘‘(2) START
UP
CENTERS
AND
CLINICS.—An
1
application submitted under paragraph (1) by an eli-
2
gible entity that is not a Federally qualified health
3
center, or a rural health clinic, on the date on which
4
the entity submits the application under paragraph
5
(1) shall include in such application a demonstration
6
of the costs of the equipment and staffing needed to
7
establish the center or clinic.
8
‘‘(3) CONSIDERATION
OF
OVERLAP.—In the
9
case an eligible entity submits an application under
10
paragraph (1) that proposes to serve an area that is
11
served by another eligible entity through a grant
12
under this section, the Secretary may consider
13
whether an award to the eligible entity serving such
14
same area can be justified based on the unmet need
15
for additional services in such area.
16
‘‘(4) PRIORITY.—In selecting recipients of
17
grants under this section, the Secretary shall give
18
priority to an eligible entity that is operating as a
19
Federally qualified health center, or a rural health
20
clinic, on the date on which the entity submits the
21
application under paragraph (1).
22
‘‘(d) GRANT PERIOD AND AMOUNTS.—
23
‘‘(1) PERIOD.—Each grant awarded under this
24
section shall be for a period of 5 years.
25
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‘‘(2) AMOUNT.—
1
‘‘(A) IN
GENERAL.—A grant awarded
2
under this section to an eligible entity shall not
3
exceed—
4
‘‘(i) for the first year of the grant—
5
‘‘(I) $500,000 if the entity is a
6
Federally qualified health center, or a
7
rural health clinic, on the date on
8
which the award is made; and
9
‘‘(II) $750,000 if the entity is
10
using the grant to establish a Feder-
11
ally qualified health center or a rural
12
health clinic; and
13
‘‘(ii) for each of the second through
14
fifth years of the grant, $500,000.
15
‘‘(B) CONSIDERATIONS.—In determining
16
the amount of a grant under this section for an
17
eligible entity for each year after the first year
18
in which the grant is awarded, the Secretary
19
shall, subject to subparagraph (A)(ii), consider
20
the number of patients treated, and the type of
21
treatment provided, by the entity in the prior
22
year.
23
‘‘(e) REPORTING.—
24
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‘‘(1) IN
GENERAL.—Not later than 3 years
1
after the date of enactment of this section, the Sec-
2
retary shall report to the committees described in
3
paragraph (2) on the grant program under this sec-
4
tion, including—
5
‘‘(A) an assessment of the success of the
6
program, challenges with respect to the pro-
7
gram, and any action for regulatory flexibility
8
or legislative authority needed to improve the
9
program;
10
‘‘(B) any savings to Federal health care
11
programs;
12
‘‘(C) any increase in access to care; and
13
‘‘(D) any increase in utilization of health
14
services in rural areas.
15
‘‘(2) COMMITTEES.—The committees described
16
in this paragraph are—
17
‘‘(A) the Committee on Health, Education,
18
Labor, and Pensions, and the Committee on Fi-
19
nance, of the Senate; and
20
‘‘(B) the Committee on Energy and Com-
21
merce, and the Committee on Ways and Means,
22
of the House of Representatives.
23
‘‘(f) RULE OF CONSTRUCTION.—No entity receiving
24
a grant under this section shall lose status as a Federally
25
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•HR 1712 IH
qualified health center, or a rural health clinic, on account
1
of carrying out any activities under this section.
2
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There
3
is authorized to be appropriated to carry out this section
4
$25,000,000 for each of fiscal years 2024 through 2028.’’.
5
SEC. 3. RURAL HEALTH DEPARTMENT ENHANCEMENT PRO-
6
GRAM.
7
Subpart I of part D of title III of the Public Health
8
Service Act (42 U.S.C. 254b et seq.), as amended by sec-
9
tion 2, is further amended by adding at the end the fol-
10
lowing:
11
‘‘SEC. 330R. RURAL HEALTH DEPARTMENT ENHANCEMENT
12
PROGRAM.
13
‘‘(a) DEFINITIONS.—In this section:
14
‘‘(1) RURAL AREA.—The term ‘rural area’ has
15
the meaning given the term in section 330Q(a).
16
‘‘(2) RURAL HEALTH DEPARTMENT.—The term
17
‘rural health department’ means a local public health
18
department that is located in a rural area.
19
‘‘(b)
ESTABLISHMENT.—The
Secretary,
acting
20
through the Director of the Office of Rural Health Policy
21
of the Health Resources and Services Administration,
22
shall award grants, on a competitive basis, to rural health
23
departments that submit an application in accordance
24
with subsection (c) to enhance such departments and en-
25
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•HR 1712 IH
able them to provide individuals in rural areas with emer-
1
gency services, triage and transport to emergency depart-
2
ments, primary care services, and other services similar
3
to services provided by emergency departments.
4
‘‘(c) APPLICATIONS.—A rural health department
5
seeking a grant under this section shall submit an applica-
6
tion to the Secretary at such time, in such manner, and
7
containing such information as the Secretary may reason-
8
ably require, including—
9
‘‘(1) an indication of the estimated cost of the
10
equipment and staffing needed by the department
11
for the first year of the award to set up the activities
12
and services under this section;
13
‘‘(2) a demonstration that the department has,
14
on the date on which the application is submitted,
15
a facility operating that is located in a rural area;
16
and
17
‘‘(3) a demonstration that, on the date on
18
which the application is submitted, the depart-
19
ment—
20
‘‘(A) has a nursing staff and medical
21
equipment; and
22
‘‘(B) agrees to use such staff and equip-
23
ment towards providing the services and car-
24
rying out the activities under this section.
25
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‘‘(d) GRANTS.—
1
‘‘(1) ANNUAL
AWARDS.—The funds awarded
2
through a grant under this section to a rural health
3
department shall be awarded on an annual basis for
4
each of 5 years.
5
‘‘(2) MAXIMUM AMOUNTS.—The funds awarded
6
through a grant under this section to a rural health
7
department shall be in an amount that for a year
8
does not exceed $500,000.
9
‘‘(3) CONSIDERATIONS.—The Secretary shall
10
determine the amount awarded to a rural health de-
11
partment through a grant under this section for a
12
year in accordance with the following:
13
‘‘(A) For the first year of the award, the
14
amount shall be based on the amount the rural
15
health department estimates for the cost of
16
equipment and staffing needed to set up the ac-
17
tivities and services supported under this sec-
18
tion, as specified in the application under sub-
19
section (c).
20
‘‘(B) For the second through fifth years of
21
the award, the amount shall be based on the
22
number of patients treated, and the type of
23
treatment provided, by the department in the
24
prior year.
25
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‘‘(e) USE OF FUNDS.—
1
‘‘(1) IN GENERAL.—A rural health department
2
receiving a grant under this section shall use the
3
funds awarded through the grant to provide the
4
services and carry out the activities described in sub-
5
section (b) at a facility that is located in a rural
6
area, including by—
7
‘‘(A) obtaining additional medical equip-
8
ment and resources necessary for providing the
9
services and activities described in subsection
10
(b), such as laboratories, x-ray machines, and
11
cardiac monitors;
12
‘‘(B) hiring additional providers to provide
13
the services and carry out the activities de-
14
scribed in subsection (b), such as physician in-
15
terns, residents, nurse practitioners, physician
16
assistants, and nurse midwives, which hiring
17
may be through a partnership described in
18
paragraph (2)(A); and
19
‘‘(C) providing outreach to the community
20
regarding the services and activities of the rural
21
health department as supported under this sec-
22
tion.
23
‘‘(2) LIMITATIONS.—
24
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‘‘(A) PARTNERSHIPS.—Not more than 3
1
percent of the funds awarded through a grant
2
under this section for a year may be used to-
3
wards the rural health department entering into
4
a partnership with an academic medical center
5
to assist with the hiring described in paragraph
6
(1)(B).
7
‘‘(B) COMMUNITY
OUTREACH.—For each
8
of the first 2 years of a grant awarded under
9
this section, not more than 3 percent of the
10
funds may be used by the rural health depart-
11
ment receiving the grant for the outreach de-
12
scribed in paragraph (1)(C).
13
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There
14
are authorized to be appropriated to carry out this section
15
$25,000,000 for each of fiscal years 2024 through 2028.’’.
16
Æ
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