Rural health care facility stabilization assistance program

Subtitle D of the Consolidated Farm and Rural Development Act (7 U.S.C. 1981–2008w) is amended by inserting after section 374 the following:

375.

Rural health care facility stabilization assistance program

(a)

In general

The Secretary shall provide loans and loan guarantees to help prevent rural health centers from closing or reducing essential services. (b)

Eligible borrowers

(1)

In general

A health center shall be eligible for a loan or loan guarantee under this section if— (A) (i)the health center— (I)is located in a rural area; or (II)serves a rural community with a hospital at least 60 percent of the patients of which have their primary residence in a rural area; or (ii)at least 30 percent of the patients of the health center reside in a rural area; and (B)the health center demonstrates financial distress through objective indicators such as operating margin of less than 5 percent, low cash reserves, risk of service loss, or such other indicators as may be determined by the Secretary. (2)

Definitions

In this section: (A)

Health center

The term health center means the following: (i)A subsection (d) hospital (as defined in paragraph (1)(B) of section 1886(d) of the Social Security Act). (ii)A critical access hospital (as defined in section 1861(mm)(1) of the Social Security Act). (iii)A sole community hospital (as defined in section 1886(d)(5)(D)(iii) of the Social Security Act). (iv)A Medicare-dependent, small rural hospital (as defined in section 1886(d)(5)(G)(iv) of the Social Security Act). (v)A low-volume hospital (as defined in section 1886(d)(12)(C) of the Social Security Act). (vi)A rural emergency hospital (as defined in section 1861(kkk)(2) of the Social Security Act). (vii)A rural health clinic (as defined in section 1861(aa)(2) of the Social Security Act). (viii)A Federally qualified health center (as defined in section 1861(aa)(4)) of the Social Security Act. (ix)A community mental health center (as defined in section 1861(ff)(3)(B) of the Social Security Act). (x)A health center that is receiving a grant under section 330 of the Public Health Service Act. (xi)An opioid treatment program (as defined in section 1861(jjj)(2) of the Social Security Act). (xii)A certified community behavioral health clinic (as defined in section 1905(jj)(2) of the Social Security Act). (B)

Rural area

The term rural area has the meaning given the term in subparagraph (A) of section 343(a)(13), including an area described in clause (ii) of such subparagraph that the Secretary determines under subparagraph (D) of such section is a rural area. (3)

Priority

(A)

In general

In carrying out this section, the Secretary may prioritize the provision of assistance to health centers that are— (i)sole community providers, as determined by the Secretary; (ii)providers in a high poverty area or an area designated by the Secretary as having a shortage of personal health services; and (iii)hospitals delivering critical emergency and safety-net services, as determined by the Secretary. (B)

High poverty area defined

In subparagraph (A), the term high poverty area means an area with an areawide poverty rate of 20 percent or more, based on the Official Poverty Measure of the Bureau of the Census. (c)

Use of funds

Notwithstanding any other provision of this subtitle, a health center to which a loan or loan guarantee is provided under this section may use the loan or loan guarantee to prevent the closure of, or the reduction of the provision of essential services by the health center, and to restore the provision of essential services by the health center, by using the loan proceeds in ways such as— (1)for projects to acquire, repair, or upgrade the systems, facilities, and equipment of the health center; (2)to cover the operational costs of the health center, including supplies and payroll expenses (except bonuses); (3)for debt payments, working capital, maintaining essential service lines, bridging reimbursement timing gaps, or refinancing high-interest debt incurred for patient care operations; or (4)any other activity as the Secretary may allow. (d)

Report to Congress

Within 18 months after the date of the enactment of this section, the Secretary shall submit to the Committee on Agriculture of the House of Representatives and the Committee on Agriculture, Nutrition, and Forestry of the Senate a report on the activities and outcomes of the program carried out under this section, including the effect of the program on stabilizing the finances of the rural health care facilities assisted by the program, and shall make available to the public a summary of the report which does not include any personal information or any financial information about a health center.