    [United States Statutes at Large, Volume 132, 115th Congress, 2nd Session]
    [From the U.S. Government Publishing Office, www.gpo.gov]

    Public Law 115-408
    115th Congress

    An Act

    To amend the Public Health Service Act to provide grants to improve
    health care in rural areas. <>

    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--

    [[Page 5385]]

    ``(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

    [[Page 5386]]

    ``(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.''.

    Approved December 31, 2018.

    LEGISLATIVE HISTORY--S. 2278:
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    CONGRESSIONAL RECORD, Vol. 164 (2018):
    July 24, considered and passed Senate.
    Dec. 19, considered and passed House.