[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 953 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 953
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 SENATE OF THE UNITED STATES
March 23, 2023
Mrs. Blackburn (for herself and Mr. Hickenlooper) introduced the
following bill; which was read twice and referred to the Committee on
Health, Education, Labor, and Pensions
_______________________________________________________________________
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 Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Rural Health Innovation Act of
2023''.
SEC. 2. RURAL HEALTH CENTER INNOVATION AWARDS PROGRAM.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:
``SEC. 330Q. RURAL HEALTH CENTER INNOVATION AWARDS PROGRAM.
``(a) Definitions.--In this section:
``(1) Eligible entity.--The term `eligible entity' means an
entity that--
``(A) is a Federally qualified health center;
``(B) is a rural health clinic; or
``(C) agrees (as a condition of receiving a grant
under this section) to establish such a center or
clinic, including a hospital that agrees (as such a
condition) to convert to a Federally qualified health
center or rural health clinic.
``(2) Federally qualified health center.--The term
`Federally qualified health center' has the meaning given such
term in section 1861(aa) of the Social Security Act.
``(3) Rural area.--The term `rural area' means any area
that is rural, within the meaning of such term as used by the
Office of Rural Health Policy of the Health Resources and
Services Administration for purposes of determining eligibility
for grants or services, including any area that is rural within
such meaning as used by such Office for fiscal year 2023 or any
area that is rural within such meaning as amended for a
subsequent fiscal year.
``(4) Rural health clinic.--The term `rural health clinic'
has the meaning given such term in section 1861(aa) of the
Social Security Act.
``(b) Establishment.--
``(1) In general.--The Secretary, acting through the
Director of the Office of Rural Health Policy of the Health
Resources and Services Administration, shall establish a grant
program to be known as the `Rural Health Center Innovation
Awards program' to award grants to eligible entities that
submit an application in accordance with subsection (c) to
enable such entities to establish or maintain a Federally
qualified health center or rural health clinic that--
``(A) serves individuals in a rural area as a walk-
in urgent care center and as a triage center or staging
facility for necessary air or ambulance transport to an
emergency department; and
``(B) includes--
``(i) professional clinical staff,
including physicians, physician interns,
residents, nurse practitioners, physician
assistants, nurse midwives, or other health
care providers providing walk-in urgent care
and emergency triage; and
``(ii) resources, including laboratories,
x-ray machines, and cardiac monitors.
``(2) Permissible uses of funds.--The funds of a grant
awarded under this section may be used to--
``(A) expand the hours of operation of a Federally
qualified health center or rural health clinic;
``(B) pay for the costs of construction and
renovation of a Federally qualified health center or
rural health clinic; or
``(C) carry out any other activity for the purposes
described in paragraph (1).
``(c) Applications and Selection.--
``(1) In general.--An eligible entity seeking a grant under
this section shall submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may reasonably require.
``(2) Start up centers and clinics.--An application
submitted under paragraph (1) by an eligible entity that is not
a Federally qualified health center, or a rural health clinic,
on the date on which the entity submits the application under
paragraph (1) shall include in such application a demonstration
of the costs of the equipment and staffing needed to establish
the center or clinic.
``(3) Consideration of overlap.--In the case an eligible
entity submits an application under paragraph (1) that proposes
to serve an area that is served by another eligible entity
through a grant under this section, the Secretary may consider
whether an award to the eligible entity serving such same area
can be justified based on the unmet need for additional
services in such area.
``(4) Priority.--In selecting recipients of grants under
this section, the Secretary shall give priority to an eligible
entity that is operating as a Federally qualified health
center, or a rural health clinic, on the date on which the
entity submits the application under paragraph (1).
``(d) Grant Period and Amounts.--
``(1) Period.--Each grant awarded under this section shall
be for a period of 5 years.
``(2) Amount.--
``(A) In general.--A grant awarded under this
section to an eligible entity shall not exceed--
``(i) for the first year of the grant--
``(I) $500,000 if the entity is a
Federally qualified health center, or a
rural health clinic, on the date on
which the award is made; and
``(II) $750,000 if the entity is
using the grant to establish a
Federally qualified health center or a
rural health clinic; and
``(ii) for each of the second through fifth
years of the grant, $500,000.
``(B) Considerations.--In determining the amount of
a grant under this section for an eligible entity for
each year after the first year in which the grant is
awarded, the Secretary shall, subject to subparagraph
(A)(ii), consider the number of patients treated, and
the type of treatment provided, by the entity in the
prior year.
``(e) Reporting.--
``(1) In general.--Not later than 3 years after the date of
enactment of this section, the Secretary shall report to the
committees described in paragraph (2) on the grant program
under this section, including--
``(A) an assessment of the success of the program,
challenges with respect to the program, and any action
for regulatory flexibility or legislative authority
needed to improve the program;
``(B) any savings to Federal health care programs;
``(C) any increase in access to care; and
``(D) any increase in utilization of health
services in rural areas.
``(2) Committees.--The committees described in this
paragraph are--
``(A) the Committee on Health, Education, Labor,
and Pensions, and the Committee on Finance, of the
Senate; and
``(B) the Committee on Energy and Commerce, and the
Committee on Ways and Means, of the House of
Representatives.
``(f) Rule of Construction.--No entity receiving a grant under this
section shall lose status as a Federally qualified health center, or a
rural health clinic, on account of carrying out any activities under
this section.
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $25,000,000 for each of fiscal
years 2024 through 2028.''.
SEC. 3. RURAL HEALTH DEPARTMENT ENHANCEMENT PROGRAM.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.), as amended by section 2, is further amended
by adding at the end the following:
``SEC. 330R. RURAL HEALTH DEPARTMENT ENHANCEMENT PROGRAM.
``(a) Definitions.--In this section:
``(1) Rural area.--The term `rural area' has the meaning
given the term in section 330Q(a).
``(2) Rural health department.--The term `rural health
department' means a local public health department that is
located in a rural area.
``(b) Establishment.--The Secretary, acting through the Director of
the Office of Rural Health Policy of the Health Resources and Services
Administration, shall award grants, on a competitive basis, to rural
health departments that submit an application in accordance with
subsection (c) to enhance such departments and enable them to provide
individuals in rural areas with emergency services, triage and
transport to emergency departments, primary care services, and other
services similar to services provided by emergency departments.
``(c) Applications.--A rural health department seeking a grant
under this section shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may reasonably require, including--
``(1) an indication of the estimated cost of the equipment
and staffing needed by the department for the first year of the
award to set up the activities and services under this section;
``(2) a demonstration that the department has, on the date
on which the application is submitted, a facility operating
that is located in a rural area; and
``(3) a demonstration that, on the date on which the
application is submitted, the department--
``(A) has a nursing staff and medical equipment;
and
``(B) agrees to use such staff and equipment
towards providing the services and carrying out the
activities under this section.
``(d) Grants.--
``(1) Annual awards.--The funds awarded through a grant
under this section to a rural health department shall be
awarded on an annual basis for each of 5 years.
``(2) Maximum amounts.--The funds awarded through a grant
under this section to a rural health department shall be in an
amount that for a year does not exceed $500,000.
``(3) Considerations.--The Secretary shall determine the
amount awarded to a rural health department through a grant
under this section for a year in accordance with the following:
``(A) For the first year of the award, the amount
shall be based on the amount the rural health
department estimates for the cost of equipment and
staffing needed to set up the activities and services
supported under this section, as specified in the
application under subsection (c).
``(B) For the second through fifth years of the
award, the amount shall be based on the number of
patients treated, and the type of treatment provided,
by the department in the prior year.
``(e) Use of Funds.--
``(1) In general.--A rural health department receiving a
grant under this section shall use the funds awarded through
the grant to provide the services and carry out the activities
described in subsection (b) at a facility that is located in a
rural area, including by--
``(A) obtaining additional medical equipment and
resources necessary for providing the services and
activities described in subsection (b), such as
laboratories, x-ray machines, and cardiac monitors;
``(B) hiring additional providers to provide the
services and carry out the activities described in
subsection (b), such as physician interns, residents,
nurse practitioners, physician assistants, and nurse
midwives, which hiring may be through a partnership
described in paragraph (2)(A); and
``(C) providing outreach to the community regarding
the services and activities of the rural health
department as supported under this section.
``(2) Limitations.--
``(A) Partnerships.--Not more than 3 percent of the
funds awarded through a grant under this section for a
year may be used towards the rural health department
entering into a partnership with an academic medical
center to assist with the hiring described in paragraph
(1)(B).
``(B) Community outreach.--For each of the first 2
years of a grant awarded under this section, not more
than 3 percent of the funds may be used by the rural
health department receiving the grant for the outreach
described in paragraph (1)(C).
``(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $25,000,000 for each of fiscal
years 2024 through 2028.''.
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