[Congressional Record Volume 164, Number 200 (Wednesday, December 19, 2018)]
[House]
[Pages H10286-H10288]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATE OFFICES OF RURAL HEALTH REAUTHORIZATION ACT OF 2018
Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the
bill (S. 2278) to amend the Public Health Service Act to provide grants
to improve health care in rural areas.
The Clerk read the title of the bill.
The text of the bill is 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 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.--
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``(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.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Oregon (Mr. Walden) and the gentleman from New York (Mr. Tonko) each
will control 20 minutes.
The Chair recognizes the gentleman from Oregon.
General Leave
Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Oregon?
There was no objection.
Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of S. 2278, the State Offices of
Rural Health Reauthorization Act led by Senator Pat Roberts and by my
Energy and Commerce Committee colleagues Representative Markwayne
Mullin of Oklahoma and my fellow Oregonian, Kurt Schrader, here in the
House.
This important legislation reauthorizes and enhances Federal grants
to States for improving healthcare in rural areas through the operation
of State Offices of Rural Health.
Now, in my home State of Oregon, the Oregon Office of Rural Health
has been the coordinating body for frontier health since the 1970s.
This office partners with the Oregon Health & Sciences University to
improve the delivery of statewide resources to rural areas, such as the
Second District.
Telehealth, rotational programs for medical students in rural
communities, and recruitment of healthcare providers are just a few
examples of the Oregon Office of Rural Health's work to help patients
in Oregon's rural areas.
I am proud of the great work that they do, and this bill will enhance
their ability and those of all State Rural Health Offices to equip
communities with the tools they need to strengthen the delivery of
healthcare in rural and underserved areas.
So, Mr. Speaker, I strongly support passage of this legislation. I
urge my colleagues to vote ``yes,'' and I reserve the balance of my
time.
Mr. TONKO. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of S. 2278, the State Offices of Rural
Health Reauthorization Act of 2018. I thank Chair Walden and incoming
Chair Pallone, along with Congressman Schrader and Congressman Mullin,
for their work on this important legislation.
This legislation would reauthorize the Federal grant program that
supports Offices of Rural Health in each State, including the Charles
D. Cook Office of Rural Health with the New York State Department of
Health for the first time.
These offices assist States in strengthening rural health delivery
systems and improving access to quality services in rural areas. This
work is particularly important because patients and providers in rural
communities can face obstacles that can: result in reduced access to
care, increase health disparities, and inhibit individuals from
experiencing optimal health.
To ensure that States can continue to meet the requirements of this
grant program, this reauthorization legislation provides new
flexibility for State offices to meet their Federal match requirements,
as well as to request a waiver that would allow the State office to
continue to receive Federal funding if an office faces an extreme
hardship in meeting that requirement.
Mr. Speaker, I urge my colleagues to support S. 2278, and I reserve
the balance of my time.
Mr. WALDEN. Mr. Speaker, I yield 3 minutes to the gentleman from
Oklahoma (Mr. Mullin), who is a cosponsor of this very important
legislation.
Mr. MULLIN. Mr. Speaker, I rise today in favor of my bill, the State
Offices of Rural Health Reauthorization Act of 2018.
There is a healthcare crisis right now going on in rural America.
Rural hospitals are closing their doors at an alarming rate. Eighty-
five rural hospitals have closed since 2010, and 673 are vulnerable to
close at any time. More closures are coming, and Congress needs to
start making changes to ensure that rural Americans have the healthcare
they need.
My bill, the State Offices of Rural Health Reauthorization Act, will
help Oklahoma's rural hospitals keep their doors open by reauthorizing
the Oklahoma Office of Rural Health. This office provides a valuable
resource to the hospitals of Oklahoma by helping hospitals explore
innovative and collaborative ideas that can lead to improvements and
savings.
Mr. Speaker, I would be remiss not to mention that awesome sweater-
vest that you are wearing. So in the spirit of Christmas, I believe you
just pull that off.
Mr. TONKO. Mr. Speaker, I yield such time as he may consume to the
gentleman from Oregon (Mr. Schrader), who represents Oregon's Fifth
Congressional District.
Mr. SCHRADER. Mr. Speaker, today I rise in support of the State
Offices of Rural Health Reauthorization Act.
Since 1979, as alluded to before, Oregon's Office of Rural Health has
provided services critical to the folks in the rural portion of my
State. Thirty-six percent of Oregonians live in rural communities, and
as we know, these communities often face challenges not experienced in
urban or suburban settings.
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People in rural areas might have long distances to travel over
mountainous terrain just to see their doctor, or they might have issues
even finding a primary care provider or specialist who can help them
where and when they need it. That is why we need the Offices of Rural
Health and why the House should pass this bill today.
Oregonians have come to rely on the services and expertise of the
Oregon Office of Rural Health to help build up the healthcare in rural
areas so folks in these communities know they will be able to see a
doctor, nurse practitioner, or other healthcare professional.
The Office of Rural Health has worked with small hospitals and EMS
providers to ensure that patients are safe, the ethics are up to code,
and they can work through the often challenging patchwork of programs
and regulation.
My State's Office of Rural Health has also been instrumental in
providing the data and policy expertise we have needed to ensure that
all Oregonians receive the care that the Affordable Care Act and
Oregon's healthcare transformation projects have promised.
Everyone, including folks in our rural areas, should have access to
quality healthcare. This bill provides the Federal support and
resources necessary to ensure that all 50 States' Offices of Rural
Health can be there for the patients who need them.
I am proud to have led on this bill in the House with my good friend,
Markwayne Mullin. I am grateful to Chairman Walden and Ranking Member
Pallone for getting this to the floor before the end of a very
interesting session. I thank them for their leadership on this issue
and urge support for this bill.
Mr. WALDEN. Mr. Speaker, I yield 3 minutes to the gentleman from
Texas (Mr. Burgess), the chairman of the Subcommittee on Health.
Mr. BURGESS. Mr. Speaker, I also want to rise in support of S. 2278,
the State Offices of Rural Health Reauthorization Act of 2018.
This bill, which was introduced by Senators Pat Roberts and Heidi
Heitkamp, reauthorizes grants to State Offices of Rural Health.
I also need to thank our House champion of this effort,
Representative Markwayne Mullin, a valuable member of the Health
Subcommittee.
This legislation already passed the Senate, and today we have the
opportunity to pass it on the floor of the House and send it down to
the President for his signature.
The majority of counties in the United States are rural. While urban
and suburban counties are growing in population, certainly in my own
community back in the 26th District of Texas, we have a significant
percentage of the population living in rural areas.
Citizens of rural America reap many benefits of their communities,
but they
[[Page H10288]]
are also faced with unique challenges, particularly when it comes to
healthcare. S. 2278 will enable States to maintain and improve upon
healthcare in rural areas by reauthorizing grants to State Offices of
Rural Health.
Grantees will be required to maintain a clearinghouse for collecting
and disseminating information on rural healthcare issues, research
related to rural healthcare, as well as innovative approaches to rural
healthcare delivery. The grantees will also be tasked with identifying
both Federal and State programs to address rural health and to provide
technical assistance to public and nonprofit private entities regarding
participation in these programs.
State Offices of Rural Health provide much value to the 57 million
Americans that live in these areas around the country. Many of us
represent towns and counties that are largely dependent upon the
strength of rural Members of Congress. For these reasons, I ask Members
to join me in supporting S. 2278.
Mr. TONKO. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I rise in support, again, of the legislation before us.
I want to commend Congressmen Schrader and Mullin for their great
work on this important legislation. It shows great sensitivity to the
healthcare needs of rural America and to the corresponding health
delivery systems. For that reason alone, this is worthy of our
unanimous support.
Mr. Speaker, I yield back the balance of my time.
Mr. WALDEN. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I, too, want to thank Members on both sides of the
aisle, my colleagues who have worked so hard on this legislation, and,
frankly, our friends in the Senate, as well, who worked with us on
this. We are glad to bring this to a conclusion and another very
important healthcare bill will make its way to the President's desk.
Mr. Speaker, I ask my colleagues to support this legislation, and I
yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Oregon (Mr. Walden) that the House suspend the rules and
pass the bill, S. 2278.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. WALDEN. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further
proceedings on this motion will be postponed.
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