,,iii  #aacth ,,congress  #ast ,session 
,s4 ,,res4 #bf  ,,in ,,the ,,senate ,,of
 ,,the ,,united ,,states  ,february #g1 
#bjac ,mr4 ,moran 7for himself and ,ms4 
,klobuchar7 submitted the following     
resolution2 which was referred to the   
,committee on ,health1 ,education1      
,labor1 and ,pensions  ,,resolution     
,recognizing that access to hospitals   
and other health care providers for     
patients in rural areas of the ,united  
,states is essential to the survival and
 success of communities in the ,united  
,states4  ,whereas access to quality    
health care services determines whether 
individuals in the ,united ,states can  
remain in the communities they call home
 and whether their children will return 
to those communities to raise families  
of their own2 ,whereas more than        
#fj1jjj1jjj individuals in rural areas  
of the ,united ,states rely on rural    
hospitals and other providers as        
critical access points to health care2  
,whereas rural areas of the ,united     

,states need quality health care        
services to attract and retain business 
and industry2 ,whereas1 to ensure that  
communities in the ,united ,states      
survive and flourish1 ,congress must    
address the unique health care needs of 
individuals in rural areas of the       
,united ,states2 ,whereas individuals in
 rural areas of the ,united ,states are1
 per capita1 older1 poorer1 and sicker  
than individuals in urban areas of the  
,united ,states2 ,whereas1 according to 
the ,department of ,health and ,human   
,services1 rural areas have higher rates
 of poverty1 chronic disease1 and       
uninsurance1 and millions of rural      
,americans have limited access to a     
primary care provider2 ,whereas1        
according to the ,department of         
,agriculture1 individuals in rural areas
 of the ,united ,states have higher     
rates of age-adjusted mortality1        
disability1 and chronic disease than    
individuals in urban areas of the       
,united ,states2 ,whereas the #bj       

percent of the population of the ,united
 ,states that lives in rural areas is   
scattered over #ij percent of the       
landmass of the ,united ,states2        
,whereas the geography and weather of   
rural areas of the ,united ,states can  
make accessing health care difficult1   
and cultural1 social1 and language      
barriers compound rural health          
challenges2 ,whereas individuals in     
rural areas of the ,united ,states are  
more likely to be uninsured and more    
likely to receive coverage through      
public sources than individuals in urban
 areas of the ,united ,states2 ,whereas 
the proportion of uninsured and         
underinsured individuals is rising      
faster in rural areas of the ,united    
,states than in urban areas of the      
,united ,states2 ,whereas access to     
health care continues to be a major     
challenge in rural areas of the ,united 
,states1 as--  7#a7 #gg percent of the  
#b1jej rural counties in the ,united    
,states are designated as primary care  

,health ,professional ,shortage ,areas  
7commonly referred to as ,h,p,s,as72    
7#b7 rural areas of the ,united ,states 
have fewer than half as many primary    
care physicians per #ajj1jjj people as  
urban areas of the ,united ,states2 and 
7#c7 more than #ej percent of patients  
in rural areas of the ,united ,states   
travel at least #bj miles to receive    
specialty medical care1 compared to only
 #f percent of patients in urban areas  
of the ,united ,states2  ,whereas1      
because rural hospitals and other       
providers face unique challenges in     
administering care to patients1         
,congress has traditionally supported   
those providers by implementing--  7#a7 
specific programs to address rural      
hospital closures that occurred in the  
#aihjs by providing financial support to
 hospitals that are geographically      
isolated and in which ,medicare patients
 make up a significant percentage of    
hospital inpatient days or discharges2  
and  7#b7 a program established in #aiig

 to support limited-service hospitals   
that1 being located in rural areas of   
the ,united ,states that cannot support 
a full-service hospital1 are critical   
access points to health care for rural  
patients2  ,whereas hospitals in rural  
areas of the ,united ,states achieve    
high levels of performance1 according to
 standards for quality1 patient         
satisfaction1 and operational           
efficiency1 for the types of care most  
relevant to rural communities2 ,whereas1
 in addition to the vital care that     
rural health care providers provide to  
patients1 rural health care providers   
are critical to the local economies of  
their communities and are one of the    
largest types of employers in rural     
areas of the ,united ,states where1 on  
average1 #ad percent of total employment
 is attributed to the health sector2    
,whereas a hospital in a rural area of  
the ,united ,states is typically one of 
the top #b largest employers in that    
area2 ,whereas #a primary care physician

 in a rural community annually generates
 approximately #a1ejj1jjj in total      
revenue1 and #a general surgeon in a    
rural community annually generates      
approximately #b1gjj1jjj in total       
revenue2 ,whereas the average ,critical 
,access ,hospital1 a limited-service    
rural health care facility1 creates #ajg
 jobs and generates #d1hjj1jjj in annual
 payroll1 and the wages1 salaries1 and  
benefits provided by a ,critical ,access
 ,hospital can amount to #bj percent of 
the output of a rural community's       
economy2 ,whereas hospitals in rural    
communities play a vital role in caring 
for the residents of those communities  
and preserving the special way of life  
that communities in the ,united ,states 
foster2 and ,whereas the closure of a   
hospital in a rural community often     
results in severe economic decline in   
the community and the departure of      
physicians1 nurses1 pharmacists1 and    
other health providers from the         
community1 and forces patients to travel

 long distances for care or to delay    
receiving care1 leading to decreased    
health outcomes1 higher costs1 and added
 burden to patients3 ,now1 therefore1 be
 it  ,that the ,senate--  7#a7          
recognizes that access to hospitals and 
other health care providers for patients
 in rural areas of the ,united ,states  
is essential to the survival and success
 of communities in the ,united ,states2 
7#b7 recognizes that preserving and     
strengthening access to quality health  
care in rural areas of the ,united      
,states is crucial to the success and   
prosperity of the ,united ,states2  7#c7
 recognizes that strengthening access to
 hospitals and other health care        
providers for patients in rural areas of
 the ,united ,states makes ,medicare    
more cost-effective and improves health 
outcomes for patients2  7#d7 recognizes 
that1 in addition to the vital care that
 rural health care providers provide to 
patients1 rural health care providers   
are integral to the local economies and 

are one of the largest types of         
employers in rural areas of the ,united 
,states2 and  7#e7 celebrates the many  
dedicated medical professionals across  
the ,united ,states who work hard each  
day to deliver quality care to the      
nearly #a in #e people in the ,united   
,states living in rural areas1 because  
the dedication and professionalism of   
those medical professionals preserves   
the special way of life and sense of    
community enjoyed and cherished by      
individuals in rural areas of the       
,united ,states4