[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 3189 Introduced in Senate (IS)]

<DOC>






114th CONGRESS
  2d Session
                                S. 3189

    To improve access to health care in rural areas, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 13, 2016

  Mr. Franken (for himself and Ms. Heitkamp) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
    To improve access to health care in rural areas, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Connecting Rural Americans to Care 
Act of 2016''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
                        TITLE I--TRANSPORTATION

Sec. 101. Reimbursement for no-load travel costs incurred by volunteers 
                            providing non-emergency medical 
                            transportation to Medicaid beneficiaries.
Sec. 102. Pilot program for innovative coordinated access and mobility.
Sec. 103. Prioritization of projects that increase access to 
                            transportation for medical purposes in 
                            rural areas.
         TITLE II--HEALTH INFORMATION TECHNOLOGY IN RURAL AREAS

Sec. 201. Interagency task force on rural health information 
                            technology.
Sec. 202. Rural health care program of the FCC.

                        TITLE I--TRANSPORTATION

SEC. 101. REIMBURSEMENT FOR NO-LOAD TRAVEL COSTS INCURRED BY VOLUNTEERS 
              PROVIDING NON-EMERGENCY MEDICAL TRANSPORTATION TO 
              MEDICAID BENEFICIARIES.

    (a) In General.--Not later than 90 days after the date of enactment 
of this Act, the Secretary of Health and Human Services shall publish 
an interim final rule to revise the Medicaid transportation regulations 
at sections 431.53 and 440.170 of title 42, Code of Federal 
Regulations, as necessary, to--
            (1) allow a State plan for medical assistance under title 
        XIX of the Social Security Act to provide, at the option of the 
        State, reimbursement for costs attributable to providing no-
        load volunteer travel services to individuals eligible for 
        medical assistance under the State plan who require 
        transportation to receive non-emergency medical treatment; and
            (2) require any State plan that opts to provide 
        reimbursement for the costs described in paragraph (1) to 
        establish oversight procedures to monitor--
                    (A) access to no-load volunteer travel services for 
                individuals eligible for medical assistance under the 
                State plan;
                    (B) complaints relating to no-load volunteer travel 
                services by individuals eligible for medical assistance 
                under the State plan; and
                    (C) the timeliness of such travel services.
    (b) No-Load Volunteer Travel Service.--For purposes of subsection 
(a), the term ``no-load volunteer travel service'' means travel 
services that--
            (1) are provided by a person who, as determined by a State, 
        local, or tribal government, provides such services on a 
        volunteer basis (referred to in this subsection as a 
        ``volunteer''); and
            (2) are necessary for the volunteer to--
                    (A) travel from the originating location of the 
                volunteer to the location of an individual who is 
                eligible for medical assistance under the State 
                Medicaid plan and requires transportation to receive 
                non-emergency medical treatment (including, for 
                purposes of an individual who requested transportation 
                to receive non-emergency medical treatment and 
                subsequently refused such transportation or was not 
                present at the requested pick-up location, any travel 
                that is necessary for the volunteer to return to their 
                originating location);
                    (B) for purposes of an individual who has been 
                provided transportation by the volunteer to receive 
                non-emergency medical treatment and is required to 
                remain at the treatment location overnight or for an 
                extended period of time (as determined appropriate by a 
                State, local, or tribal government), return to the 
                originating location of the volunteer and, following 
                the completion of such treatment, travel back to the 
                treatment location; and
                    (C) following any transportation that is necessary 
                to return an individual who has received non-emergency 
                medical treatment to their pick-up location, return to 
                the originating location of the volunteer.

SEC. 102. PILOT PROGRAM FOR INNOVATIVE COORDINATED ACCESS AND MOBILITY.

    (a) Removal of Funding From Highway Trust Fund.--Section 5338 of 
title 49, United States Code, is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``sections 3006(b)'' and 
                        inserting ``, for fiscal year 2016, section 
                        3006(b)'';
                            (ii) in subparagraph (B), by striking 
                        ``$9,534,706,043'' and inserting 
                        ``$9,531,706,403'';
                            (iii) in subparagraph (C), by striking 
                        ``$9,733,353,407'' and inserting 
                        ``$9,730,103,407'';
                            (iv) in subparagraph (D), by striking 
                        ``9,939,380,030'' and inserting 
                        ``$9,935,880,030''; and
                            (v) in subparagraph (E), by striking 
                        ``10,150,348,462'' and inserting 
                        ``$10,146,848,462''; and
                    (B) in paragraph (2)(E), by striking ``, $3,000,000 
                for fiscal year 2017, $3,250,000 for fiscal year 2018, 
                $3,500,000 for fiscal year 2019 and $3,500,000 for 
                fiscal year 2020'';
            (2) by redesignating subsections (e) through (h) as 
        subsections (f) through (i), respectively; and
            (3) by inserting after subsection (d) the following:
    ``(e) Access and Mobility Grants.--There are authorized to be 
appropriated to carry out the pilot program for innovative coordinated 
access and mobility under section 3006(b) of the Federal Public 
Transportation Act of 2015--
            ``(1) $6,000,000 for fiscal year 2017;
            ``(2) $6,500,000 for fiscal year 2018;
            ``(3) $7,000,000 for fiscal year 2019; and
            ``(4) $7,000,000 for fiscal year 2020.''.
    (b) Application Priority.--Section 3006(b) of the Federal Public 
Transportation Act of 2015 (49 U.S.C. 5310 note; Public Law 112-141) is 
amended by adding at the end the following:
            ``(7) Priority for eligible projects in rural areas.--In 
        selecting eligible recipients to participate in the pilot 
        program under this subsection, the Secretary shall give 
        priority to applications submitted by eligible recipients to 
        carry out eligible projects that serve individuals living in 
        rural areas.''.

SEC. 103. PRIORITIZATION OF PROJECTS THAT INCREASE ACCESS TO 
              TRANSPORTATION FOR MEDICAL PURPOSES IN RURAL AREAS.

    Section 5311(b)(3) of title 49, United States Code, is amended by 
adding at the end the following:
                    ``(D) Projects for medical transportation.--The 
                Secretary may, when appropriate, use amounts made 
                available under subparagraph (B) to prioritize and 
                carry out projects that increase access to 
                transportation for medical purposes in rural areas.''.

         TITLE II--HEALTH INFORMATION TECHNOLOGY IN RURAL AREAS

SEC. 201. INTERAGENCY TASK FORCE ON RURAL HEALTH INFORMATION 
              TECHNOLOGY.

    Title XXX of the Public Health Service Act (42 U.S.C. 300jj et 
seq.) is amended by adding at the end the following:

``SEC. 3022. INTERAGENCY TASK FORCE ON RURAL HEALTH INFORMATION 
              TECHNOLOGY.

    ``(a) Establishment.--The President shall establish an Interagency 
Task Force on Rural Health Information Technology (referred to in this 
section as the `Task Force').
    ``(b) Membership.--
            ``(1) Composition.--The President shall appoint members of 
        the Task Force, which shall include--
                    ``(A) a representative from the Office of Rural 
                Development of the Department of Agriculture;
                    ``(B) representatives from the Department of Health 
                and Human Services, including--
                            ``(i) a representative from the Office of 
                        the National Coordinator for Health Information 
                        Technology established under section 3001(a);
                            ``(ii) a representative from the Office of 
                        Rural Health Policy of the Health Resources and 
                        Services Administration;
                            ``(iii) a representative from the Indian 
                        Health Service;
                            ``(iv) a representative from the Substance 
                        Abuse and Mental Health Services 
                        Administration;
                            ``(v) a representative from the Centers for 
                        Disease Control and Prevention;
                            ``(vi) a representative from the Centers 
                        for Medicare & Medicaid Services; and
                            ``(vii) a representative from the Agency 
                        for Healthcare Research and Quality;
                    ``(C) representatives from other Federal agencies, 
                including--
                            ``(i) a representative from the Department 
                        of Veterans Affairs;
                            ``(ii) a representative from the Department 
                        of Labor;
                            ``(iii) a representative from the 
                        Department of Education;
                            ``(iv) a representative from the Federal 
                        Communications Commission;
                            ``(v) a representative from the Department 
                        of Transportation; and
                            ``(vi) a representative from the Department 
                        of Commerce; and
                    ``(D) any other representatives from Federal, 
                State, or private sector entities as determined 
                appropriate by the President, including the Appalachian 
                Regional Commission, the Delta Regional Authority, the 
                National Rural Health Association, the National 
                Governors Association, and the National Rural Economic 
                Developers Association.
            ``(2) Chairperson.--The Secretary shall serve as the 
        chairperson of the Task Force.
            ``(3) Appointment.--
                    ``(A) Deadline.--All initial members of the Task 
                Force shall be appointed not later than 1 year after 
                the date of enactment of the Connecting Rural Americans 
                to Care Act of 2016.
                    ``(B) Period of appointment; vacancies.--Each 
                member of the Task Force shall be appointed for a term 
                of 4 years with the opportunity for reappointment. Any 
                vacancy in the Task Force shall not affect its powers, 
                but shall be filled in the same manner in which the 
                original appointment was made.
    ``(c) Activities.--
            ``(1) In general.--The Task Force shall carry out each of 
        the following activities:
                    ``(A) Measure and evaluate progress in Federal, 
                State, local, and tribal efforts to expand health 
                information technology infrastructure in rural areas.
                    ``(B) Collaborate with the Broadband Opportunity 
                Council, or any other successor, similar, or relevant 
                Federal interagency entity that addresses delivery of 
                financial and technical assistance to rural health care 
                providers for the implementation of broadband 
                technology and development of health information 
                technology infrastructure.
                    ``(C) Provide recommendations on best practices to 
                increase internet access in rural areas for the purpose 
                of improving the delivery of health care services.
                    ``(D) Align, across Federal agencies and 
                departments, evaluation metrics for measures to 
                expedite the development and implementation of health 
                information technologies in rural areas in accordance 
                with paragraph (2).
            ``(2) Aligning metrics.--In carrying out the activity 
        described in paragraph (1)(D), the Task Force shall, to the 
        extent practicable, consider how evaluation metrics for Federal 
        measures described in such paragraph align with the evaluation 
        metrics for State and local measures to reduce administrative 
        burden.
    ``(d) Reporting.--Not later than 2 years after the date of 
enactment of the Connecting Rural Americans to Care Act of 2016, and 
every 3 years thereafter, the Task Force shall publish a report (to be 
known as the `Health Care Information Technology Infrastructure Status 
Report') that--
            ``(1) describes the current state of the connectivity gap 
        in the United States, with a special emphasis on rural areas, 
        to inform the use of Federal programs providing support for the 
        implementation of broadband technology and the development and 
        adoption of health information technology infrastructure, 
        particularly in rural areas; and
            ``(2) includes recommendations on ways to increase access 
        to health information technology in rural areas, especially 
        areas that are designated as--
                    ``(A) a health professional shortage area by the 
                Secretary under section 332; and
                    ``(B) an area without access to advanced 
                telecommunications capability, as identified by the 
                Federal Communications Commission in the county-based 
                appendix to the most recent Broadband Progress Report 
                adopted by the Federal Communications Commission as 
                required under section 706 of the Telecommunications 
                Act of 1996 (47 U.S.C. 1302).
    ``(e) Meetings.--The Task Force shall meet at the call of the 
chairperson, not less than 2 times each year.
    ``(f) Powers of the Task Force.--
            ``(1) Hearings.--The Task Force may, for the purpose of 
        carrying out this section, hold hearings, sit and act at times 
        and places, take testimony, and receive evidence as the Task 
        Force considers appropriate.
            ``(2) Information from federal agencies.--The Task Force 
        may secure directly from any department or agency of the United 
        States information necessary to enable it to carry out its 
        duties under this section. Upon request of the chairperson of 
        the Task Force, the head of that department or agency shall 
        furnish that information to the Task Force.
    ``(g) Task Force Personnel Matters.--
            ``(1) Travel expenses.--A member of the Task Force shall be 
        allowed reasonable travel expenses, including per diem in lieu 
        of subsistence, at rates for employees of agencies under 
        subchapter I of chapter 57 of title 5, United States Code, 
        while away from the member's home or regular place of business 
        in the performance of services for the Task Force.
            ``(2) Staff.--
                    ``(A) In general.--The chairperson of the Task 
                Force may, without regard to the civil service laws 
                (including regulations), appoint and terminate an 
                executive director and such other additional personnel 
                as may be necessary to enable the Task Force to perform 
                the duties of the Task Force, except that the 
                employment of an executive director shall be subject to 
                confirmation by the Task Force.
                    ``(B) Compensation.--The chairperson of the Task 
                Force may fix the compensation of the executive 
                director and other personnel without regard to chapter 
                51 and subchapter III of chapter 53 of title 5, United 
                States Code, relating to classification of positions 
                and General Schedule pay rates, except that the rate of 
                pay for the executive director and other personnel may 
                not exceed the rate payable for level V of the 
                Executive Schedule under section 5316 of that title.
            ``(3) Detail of government employees.--Any Federal 
        Government employee may be detailed to the Task Force without 
        reimbursement, and such detail shall be without interruption or 
        loss of civil service status or privilege.
            ``(4) Procurement.--The chairperson of the Task Force may 
        procure temporary and intermittent services under section 
        3109(b) of title 5, United States Code, at rates for 
        individuals which do not exceed the daily equivalent of the 
        annual rate of basic pay prescribed for level V of the 
        Executive Schedule under section 5316 of that title.
    ``(h) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this 
section.''.

SEC. 202. RURAL HEALTH CARE PROGRAM OF THE FCC.

    (a) Definitions.--In this section--
            (1) the term ``Commission'' means the Federal 
        Communications Commission; and
            (2) the term ``Healthcare Connect Fund'' means the 
        Healthcare Connect Fund of the Commission under subpart G of 
        part 54 of title 47, Code of Federal Regulations.
    (b) Simplifying the Application Process of the Healthcare Connect 
Fund.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Commission shall institute and refer 
        to a Federal-State Joint Board under section 410(c) of the 
        Communications Act of 1934 (47 U.S.C. 410(c)) a proceeding to--
                    (A) review the process for submitting a request for 
                services under the Healthcare Connect Fund; and
                    (B) make recommendations to the Commission on ways 
                that the Commission can simplify the process described 
                in subparagraph (A).
            (2) Implementation of recommendations.--Not later than 1 
        year after the date on which the Federal-State Joint Board 
        makes recommendations to the Commission under paragraph (1)(B), 
        the Commission shall implement those recommendations.
    (c) Health Care Provider.--Section 254(h)(7)(B) of the 
Communications Act of 1934 (47 U.S.C. 254(h)(7)(B)) is amended--
            (1) in clause (vii), by striking ``and'' at the end;
            (2) by redesignating clause (viii) as clause (ix);
            (3) by inserting after clause (vii) the following:
                            ``(viii) any other entities that provide 
                        health care and remote patient management, as 
                        determined by the Secretary of Health and Human 
                        Services; and''; and
            (4) in clause (ix), as so redesignated, by striking 
        ``through (vii)'' and inserting ``through (viii)''.
    (d) Code of Federal Regulations.--The Commission shall amend 
section 54.633(a) of title 47, Code of Federal Regulations--
            (1) by striking ``All health care providers'' and inserting 
        the following:
            ``(1) In general.--Except as provided in paragraph (2), all 
        health care providers'';
            (2) in paragraph (1), as so designated--
                    (A) by striking ``a 65 percent'' and inserting 
                ``not less than an 85 percent''; and
                    (B) by striking ``35 percent'' and inserting ``not 
                more than 15 percent''; and
            (3) by adding at the end the following:
            ``(2) Tribal lands.--The Federal Communications Commission 
        may decrease the percentage of the total cost of eligible 
        expenses that a health care provider is required to contribute 
        under paragraph (1), including by eliminating the requirement 
        that the health care provider contribute any percentage of that 
        cost, if the health care provider is located on Tribal lands, 
        as defined in section 54.400, or any successor regulation.''.
                                 <all>