[Congressional Record Volume 164, Number 124 (Tuesday, July 24, 2018)]
[Senate]
[Pages S5312-S5314]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       STATE OFFICES OF RURAL HEALTH REAUTHORIZATION ACT OF 2018

  Mr. ROUNDS. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of Calendar No. 344, S. 2278.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The bill clerk read as follows:

       A bill (S. 2278) to amend the Public Health Service Act to 
     provide grants to improve health care in rural areas.

  There being no objection, the Senate proceeded to consider the bill, 
which had been reported from the Committee

[[Page S5313]]

on Health, Education, Labor, and Pensions, with an amendment, as 
follows:
  (The part of the bill intended to be stricken is shown in boldface 
brackets and the part of the bill intended to be inserted is shown in 
italic.)

                                S. 2278

       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 ``State Offices of Rural 
     Health Reauthorization Act of 2018''.

     SEC. 2. STATE OFFICES OF RURAL HEALTH.

       Section 338J of the Public Health Service Act (42 U.S.C. 
     254r) is amended to read as follows:

     ``SEC. 338J. GRANTS TO STATE OFFICES OF RURAL HEALTH.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Federal Office of Rural Health Policy 
     (established under section 711 of the Social Security Act), 
     shall make grants to each State Office of Rural Health for 
     the purpose of improving health care in rural areas.
       ``(b) Requirement of Matching Funds.--
       ``(1) In general.--Subject to paragraph (2), the Secretary 
     may not make a grant under subsection (a) unless the State 
     office of rural health involved agrees, with respect to the 
     costs to be incurred in carrying out the purpose described in 
     such subsection, to provide non-Federal contributions toward 
     such costs in an amount equal to $3 for each $1 of Federal 
     funds provided in the grant.
       ``(2) Waiver or reduction.--The Secretary may waive or 
     reduce the non-Federal contribution if the Secretary 
     determines that requiring matching funds would limit the 
     State office of rural health's ability to carry out the 
     purpose described in subsection (a).
       ``(3) Determination of amount of non-federal 
     contribution.--Non-Federal contributions required in 
     paragraph (1) may be in cash or in kind, fairly evaluated, 
     including plant, equipment, or services. Amounts provided by 
     the Federal Government, or services assisted or subsidized to 
     any significant extent by the Federal Government, may not be 
     included in determining the amount of such non-Federal 
     contributions.
       ``(c) Certain Required Activities.--Recipients of a grant 
     under subsection (a) shall use the grant funds for purposes 
     of--
       ``(1) maintaining within the State office of rural health a 
     clearinghouse for collecting and disseminating information 
     on--
       ``(A) rural health care issues;
       ``(B) research findings relating to rural health care; and
       ``(C) innovative approaches to the delivery of health care 
     in rural areas;
       ``(2) coordinating the activities carried out in the State 
     that relate to rural health care, including providing 
     coordination for the purpose of avoiding redundancy in such 
     activities; and
       ``(3) identifying Federal and State programs regarding 
     rural health, and providing technical assistance to public 
     and nonprofit private entities regarding participation in 
     such programs.
       ``(d) Requirement Regarding Annual Budget for Office.--The 
     Secretary may not make a grant under subsection (a) unless 
     the State involved agrees that, for any fiscal year for which 
     the State office of rural health receives such a grant, the 
     office operated pursuant to subsection (a) of this section 
     will be provided with an annual budget of not less than 
     $150,000.
       ``(e) Certain Uses of Funds.--
       ``(1) Restrictions.--The Secretary may not make a grant 
     under subsection (a) unless the State office of rural health 
     involved agrees that the grant will not be expended--
       ``(A) to provide health care (including providing cash 
     payments regarding such care);
       ``(B) to conduct activities for which Federal funds are 
     expended--
       ``(i) within the State to provide technical and other 
     nonfinancial assistance under section 330A(f);
       ``(ii) under a memorandum of agreement entered into with 
     the State office of rural health under section 330A(h); or
       ``(iii) under a grant under section 338I;
       ``(C) to purchase medical equipment, to purchase 
     ambulances, aircraft, or other vehicles, or to purchase major 
     communications equipment;
       ``(D) to purchase or improve real property; or
       ``(E) to carry out any activity regarding a certificate of 
     need.
       ``(2) Authorities.--Activities for which a State office of 
     rural health may expend a grant under subsection (a) 
     include--
       ``(A) paying the costs of maintaining an office of rural 
     health for purposes of subsection (a);
       ``(B) subject to paragraph (1)(B)(iii), paying the costs of 
     any activity carried out with respect to recruiting and 
     retaining health professionals to serve in rural areas of the 
     State; and
       ``(C) providing grants and contracts to public and 
     nonprofit private entities to carry out activities authorized 
     in this section.
       ``(3) Limit on indirect costs.--The Secretary may impose a 
     limit of no more than 15 percent on indirect costs claimed by 
     the recipient of the grant.
       ``(f) Reports.--The Secretary may not make a grant under 
     subsection (a) unless the State office of rural health 
     involved agrees--
       ``(1) to submit to the Secretary reports or performance 
     data containing such information as the Secretary may require 
     regarding activities carried out under this section; and
       ``(2) to submit such a report or performance data not later 
     than September 30 of each fiscal year immediately following 
     any fiscal year for which the State office of rural health 
     has received such a grant.
       ``(g) Requirement of Application.--The Secretary may not 
     make a grant under subsection (a) unless an application for 
     the grant is submitted to the Secretary and the application 
     is in such form, is made in such manner, and contains such 
     agreements, assurances, and information as the Secretary 
     determines to be necessary to carry out such subsection.
       ``(h) Noncompliance.--The Secretary may not make payments 
     under subsection (a) to a State office of rural health for 
     any fiscal year subsequent to the first fiscal year of such 
     payments unless the Secretary determines that, for the 
     immediately preceding fiscal year, the State office of rural 
     health has complied with each of the agreements made by the 
     State office of rural health under this section.
       ``(i) Authorization of Appropriations.--
       ``(1) In general.--For the purpose of making grants under 
     subsection (a), there are authorized to be appropriated [such 
     sums as may be necessary] $12,500,000 for each of fiscal 
     years 2018 through 2022.
       ``(2) Availability.--Amounts appropriated under paragraph 
     (1) shall remain available until expended.''.
  Mr. ROUNDS. I ask unanimous consent that the committee-reported 
amendment be agreed to; that the bill, as amended, be considered read a 
third time and passed; and that the motion to reconsider be considered 
made and laid upon the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The committee-reported amendment was agreed to.
  The bill (S. 2278), as amended, was ordered to be engrossed for a 
third reading, was read the third time, and passed, as follows:

                                S. 2278

       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 ``State Offices of Rural 
     Health Reauthorization Act of 2018''.

     SEC. 2. STATE OFFICES OF RURAL HEALTH.

       Section 338J of the Public Health Service Act (42 U.S.C. 
     254r) is amended to read as follows:

     ``SEC. 338J. GRANTS TO STATE OFFICES OF RURAL HEALTH.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Federal Office of Rural Health Policy 
     (established under section 711 of the Social Security Act), 
     shall make grants to each State Office of Rural Health for 
     the purpose of improving health care in rural areas.
       ``(b) Requirement of Matching Funds.--
       ``(1) In general.--Subject to paragraph (2), the Secretary 
     may not make a grant under subsection (a) unless the State 
     office of rural health involved agrees, with respect to the 
     costs to be incurred in carrying out the purpose described in 
     such subsection, to provide non-Federal contributions toward 
     such costs in an amount equal to $3 for each $1 of Federal 
     funds provided in the grant.
       ``(2) Waiver or reduction.--The Secretary may waive or 
     reduce the non-Federal contribution if the Secretary 
     determines that requiring matching funds would limit the 
     State office of rural health's ability to carry out the 
     purpose described in subsection (a).
       ``(3) Determination of amount of non-federal 
     contribution.--Non-Federal contributions required in 
     paragraph (1) may be in cash or in kind, fairly evaluated, 
     including plant, equipment, or services. Amounts provided by 
     the Federal Government, or services assisted or subsidized to 
     any significant extent by the Federal Government, may not be 
     included in determining the amount of such non-Federal 
     contributions.
       ``(c) Certain Required Activities.--Recipients of a grant 
     under subsection (a) shall use the grant funds for purposes 
     of--
       ``(1) maintaining within the State office of rural health a 
     clearinghouse for collecting and disseminating information 
     on--
       ``(A) rural health care issues;
       ``(B) research findings relating to rural health care; and
       ``(C) innovative approaches to the delivery of health care 
     in rural areas;
       ``(2) coordinating the activities carried out in the State 
     that relate to rural health care, including providing 
     coordination for the purpose of avoiding redundancy in such 
     activities; and
       ``(3) identifying Federal and State programs regarding 
     rural health, and providing technical assistance to public 
     and nonprofit private entities regarding participation in 
     such programs.
       ``(d) Requirement Regarding Annual Budget for Office.--The 
     Secretary may not make a grant under subsection (a) unless 
     the State involved agrees that, for any fiscal year for which 
     the State office of rural health receives such a grant, the 
     office operated pursuant to subsection (a) of this section 
     will be provided with an annual budget of not less than 
     $150,000.
       ``(e) Certain Uses of Funds.--
       ``(1) Restrictions.--The Secretary may not make a grant 
     under subsection (a) unless

[[Page S5314]]

     the State office of rural health involved agrees that the 
     grant will not be expended--
       ``(A) to provide health care (including providing cash 
     payments regarding such care);
       ``(B) to conduct activities for which Federal funds are 
     expended--
       ``(i) within the State to provide technical and other 
     nonfinancial assistance under section 330A(f);
       ``(ii) under a memorandum of agreement entered into with 
     the State office of rural health under section 330A(h); or
       ``(iii) under a grant under section 338I;
       ``(C) to purchase medical equipment, to purchase 
     ambulances, aircraft, or other vehicles, or to purchase major 
     communications equipment;
       ``(D) to purchase or improve real property; or
       ``(E) to carry out any activity regarding a certificate of 
     need.
       ``(2) Authorities.--Activities for which a State office of 
     rural health may expend a grant under subsection (a) 
     include--
       ``(A) paying the costs of maintaining an office of rural 
     health for purposes of subsection (a);
       ``(B) subject to paragraph (1)(B)(iii), paying the costs of 
     any activity carried out with respect to recruiting and 
     retaining health professionals to serve in rural areas of the 
     State; and
       ``(C) providing grants and contracts to public and 
     nonprofit private entities to carry out activities authorized 
     in this section.
       ``(3) Limit on indirect costs.--The Secretary may impose a 
     limit of no more than 15 percent on indirect costs claimed by 
     the recipient of the grant.
       ``(f) Reports.--The Secretary may not make a grant under 
     subsection (a) unless the State office of rural health 
     involved agrees--
       ``(1) to submit to the Secretary reports or performance 
     data containing such information as the Secretary may require 
     regarding activities carried out under this section; and
       ``(2) to submit such a report or performance data not later 
     than September 30 of each fiscal year immediately following 
     any fiscal year for which the State office of rural health 
     has received such a grant.
       ``(g) Requirement of Application.--The Secretary may not 
     make a grant under subsection (a) unless an application for 
     the grant is submitted to the Secretary and the application 
     is in such form, is made in such manner, and contains such 
     agreements, assurances, and information as the Secretary 
     determines to be necessary to carry out such subsection.
       ``(h) Noncompliance.--The Secretary may not make payments 
     under subsection (a) to a State office of rural health for 
     any fiscal year subsequent to the first fiscal year of such 
     payments unless the Secretary determines that, for the 
     immediately preceding fiscal year, the State office of rural 
     health has complied with each of the agreements made by the 
     State office of rural health under this section.
       ``(i) Authorization of Appropriations.--
       ``(1) In general.--For the purpose of making grants under 
     subsection (a), there are authorized to be appropriated 
     $12,500,000 for each of fiscal years 2018 through 2022.
       ``(2) Availability.--Amounts appropriated under paragraph 
     (1) shall remain available until expended.''.

  Mr. ROUNDS. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. DAINES. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Rounds). Without objection, it is so 
ordered.

                          ____________________