[Congressional Record Volume 143, Number 73 (Monday, June 2, 1997)]
[Senate]
[Page S5194]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   HEALTH CARE PROTECTION ACT OF 1997

 Mr. GRASSLEY. Mr. President, on May 23, I introduced 
legislation designed to maintain rural communities' access to hospital 
care.
  Today many rural Americans live in fear that they may lose access to 
local and regional hospital care. In these rural areas, where serious 
accidents, often related to farm equipment, are a constant threat. 
Access to an emergency care hospital within 35 miles can mean the 
difference between life and death. The ability to be referred to a 
major regional hospital for more specialized care can be of like 
importance. Congress must recognize the special needs of rural America 
and work to meet them. This bill is a step in the right direction.
  The Rural Health Care Protection Act of 1997 focuses on providing 
support of sole community hospitals and rural referral centers. Sole 
community hospitals [SCH's] are hospitals located at least 35 miles 
from other hospitals and are often the sole source of emergency care or 
impatient services in their areas. There are currently 728 SCH's in 46 
States. There are 11 in my home State of Iowa. Rural referral centers 
[RRC's] are relatively large and specialized rural hospitals which 
receive referrals from community hospitals throughout a region. There 
are currently 142 RRC's in 39 States, including 5 in Iowa.
  This legislation contains four proposals designed to help keep these 
care centers operating. First, the act would give SCH's the option of 
choosing an updated fiscal year 1994-95 base year for Medicare funding 
instead of the outdated based years which they must currently use. 
Second, the act would permanently grandfather as an RRC any hospital 
that has previously qualified as an RRC. Third, the act would exempt 
the RRC's from the statewide rural wage index threshold for geographic 
reclassification. Finally, the bill would allow rural hospitals that 
meet the reclassification criteria to be reclassified as urban 
hospitals for purposes of disproportionate share hospital [DSH] payment 
adjustments.
  This bill would help ensure that rural Americans maintain access to 
these essential care centers. I ask my colleagues on both sides of the 
aisle to join me in support of this measures. 

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