[Congressional Record (Bound Edition), Volume 152 (2006), Part 6]
[House]
[Pages 7360-7361]
[From the U.S. Government Publishing Office, www.gpo.gov]




              RURAL HEALTH CARE CAPITAL ACCESS ACT OF 2006

  Mr. RENZI. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 4912) to amend section 242 of the National Housing Act to extend 
the exemption for critical access hospitals under the FHA program for 
mortgage insurance for hospitals.
  The Clerk read as follows:

                               H.R. 4912

       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 Care Capital 
     Access Act of 2006''.

     SEC. 2. EXTENSION.

       Paragraph (1) of section 242(i) of the National Housing Act 
     (12 U.S.C. 1715z-7(i)(1)) is amended by striking ``July 31, 
     2006'' and inserting ``July 31, 2011''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Arizona (Mr. Renzi) and the gentleman from California (Mr. Baca) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Arizona.
  Mr. RENZI. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 4912, the Rural Health Care 
Capital Access Act of 2006. This piece of legislation would extend the 
exemption of the current law that allows small rural hospitals to 
remain eligible for Federal Housing Administration mortgage insurance.
  Recent health care statistics show a huge backlog of capital 
improvement needs for the majority of hospitals in the United States, 
and rural hospitals face even fewer opportunities to make such needed 
repairs, achieve reasonable terms for refinancing or build replacement 
facilities. The FHA Section 242 Hospital Mortgage Insurance Program has 
been a valuable tool for many hospitals seeking to rebuild or make 
improvements.
  Recently the program became available to critical access hospitals. 
Critical access hospitals are facilities certified to receive cost-
based reimbursement for Medicare. This cost-based reimbursement is 
intended to improve their financial performance and thereby reduce 
hospital closures.
  Despite the efforts of FHA, some challenges have remained for these 
rural hospitals to gain access to the critical access program. One of 
these was a statutory requirement in section 242 that at least 50 
percent of the hospital's adjusted net patient days must be used for 
acute medical care. While this requirement may be useful in urban 
areas, rural isolated communities such as those served by critical 
access hospitals often cannot sustain separate independent hospitals 
which provide acute care and nursing facilities.

                              {time}  1500

  It is common for rural hospitals and nursing homes to operate as a 
single unit in order to take advantage of savings related to cost-
sharing of some services and staff.
  To deny critical-access hospitals access to FHA mortgage insurance on 
these grounds unfairly disadvantages these facilities that are 
desperately in need of capital improvements.
  H.R. 659, the Hospital Mortgage Insurance Act of 2003 amended section 
242 of the National Housing Act and included an exemption that 
eliminated the so-called Patient Day Test for critical-access 
hospitals, which allowed these rural hospitals to be eligible for FHA 
mortgage insurance. The exemption expires on July 31, 2006. H.R. 4912 
would simply extend this vital exemption for 5 years, which would give 
FHA and the Department of Housing and Urban Development time to review 
the exemption's impact and recommend to the Congress whether it should 
be made permanent.
  I am a proud cosponsor of this important legislation, which will 
benefit 11 critical-access hospitals in my home State of Arizona and 
three hospitals in my district: Page Memorial Hospital in Page, 
Arizona, Sage Memorial Hospital in Ganado, located on the Navajo 
Nation, and Winslow Memorial Hospital located in the town of Winslow, 
Arizona.
  I would like to thank the Housing Subcommittee chairman, Congressman 
Ney, Ranking Member Waters, full committee Chairman Oxley, Ranking 
Member Frank and all of those who worked hard to pull this together for 
their support of this legislation.
  Mr. Speaker, I urge my colleagues to support this bipartisan piece of 
legislation that would allow more opportunities for critical-access 
hospitals to improve the quality of health care in rural America.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BACA. Mr. Speaker, I yield myself such time as I might consume.
  Mr. Speaker, I rise today to express my strong support for H.R. 4912, 
the Rural Health Care Capital Access Act of 2006, along with Mr. Frank 
who is one of the cosponsors of this important legislation.
  This bill extends and exempts under the Hospital Mortgage Insurance 
Act of 2003 small, rural critical-access hospitals. This allows them to 
qualify for the Department of Housing and Urban Development section 242 
mortgage insurance program.
  This section 242 program is an important program which provides 
mortgage insurance for loans made for construction, renovation and 
equipment of acute-care hospitals. To be eligible for section 242 
requires that at least half of the hospital's net patient days qualify 
as acute care, which is referred to as a Patient's Day Test.
  Small, rural hospitals sometimes have a hard time meeting these 
requirements. This is because rural communities often have hospitals 
and nursing homes combined in order to achieve savings by sharing 
facilities and services such as pharmacy and food services.
  The Hospital Mortgage Insurance Act of 2003 eliminated the so-called 
Patient Day Test for critical-access hospital, but limited the 
exemption to 3 years. The exemption expires on July 31, 2006.
  Today only one hospital sought approval under this exemption. This is 
not surprising considering the length of time required for applying to 
the program, particularly for small hospitals with limited staff and 
resources to devote to such complicated processes.
  As we all know, there are many small hospitals throughout the Nation 
that

[[Page 7361]]

need this kind of help. It is very complicated, applying for this kind 
of a process. Nevertheless, this exemption is necessary for small 
hospitals to have access, and I state, to have access to section 242 
programs. And it is important that they do have the access.
  H.R. 4912, the Rural Health Care Capital Access Act of 2006, would 
extend the exemption for an additional 5 years. During this time, HUD 
and FHA can review the impact and recommend to Congress whether the 
exemption should be made permanent.
  Again, Mr. Speaker, I express my strong support for this bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. RENZI. Mr. Speaker, I have no additional speakers, and reserve 
the balance of my time.
  Ms. WATERS. Mr. Speaker, l rise in strong support of H.R. 4912, the 
``Rural Health Care Capital Access Act of 2006'', of which I am an 
original sponsor. The Committee on Financial Services marked-up H.R. 
4912 on March 13, 2006, so I am delighted that this important measure 
has reached the floor today. Mr. Ney, the Chairman of the Subcommittee 
on Housing and Community Affairs, is to be applauded for his efforts on 
behalf of rural communities.
  The bill would allow hospitals located in rural areas access to the 
Federal Housing Administration (FHA) mortgage insurance program for 
hospitals, under Section 242 of the National Housing Act. These 
hospitals are located in rural areas of the country, and are not always 
able to meet the bed capacity requirements for critical care 
facilities. Thus, the bill would extend the exemption for another 5 
years, enabling rural hospitals to be exempted from critical bed 
requirements.
  The bill addresses the mortgage insurance needs of Critical Access 
Hospitals. These hospitals are rural hospitals with a maximum of 25 
beds and must be 35 miles from the nearest hospital. Another 
requirement is related to the so-called ``patient day'' requirement. 
Under Section 242, not more than 50 percent of a hospital's adjusted 
net patient days could be ``assignable to the categories of chronic 
convalescent and rest, drug and alcoholic, epileptic, mentally 
deficient, mental, nervous and mental, and tuberculosis . . .'' These 
are onerous requirements for small rural hospitals to meet. When we 
passed the Hospital Insurance Mortgage Act of 2003, it eliminated the 
patient day requirement, but it expires on July 31, 2006.
  By supporting H.R. 4912 to extend the exemption for another 5 years, 
we will be addressing an issue of major concern in rural areas. 
Hospitals are far and few apart. Within many of our rural communities 
hospitals double up with nursing homes to meet these bed requirements, 
as well as to share in cost savings, to qualify for Section 242 
mortgage insurance. H.R. 4912 removes another barrier to health care in 
rural communities, and therefore, I urge support of the measure.
  Mr. BACA. Mr. Speaker, I have no additional speakers. I appreciate 
the gentleman from Arizona's leadership in taking up this legislation 
along with the cosponsor, Mr. Frank, who feels this is important for a 
lot of the hospitals in rural communities, and I yield back the balance 
of my time.
  Mr. RENZI. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Price of Georgia). The question is on 
the motion offered by the gentleman from Arizona (Mr. Renzi) that the 
House suspend the rules and pass the bill, H.R. 4912.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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