,,ii  #aad? ,,congress  #b;d ,session   
,s4 #cahi  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ac1 #bjaf ,mr4  
,frank5 7= himself & ,ms4 ,heitkamp7    
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to improve access to heal?  
c>e 9 rural areas1 & = o!r purposes4    
#a4 ,%ort title  ,?is ,act may be cit$ z
 ! ,connect+ ,rural ,am]icans to ,c>e   
,act ( #bjaf4  #b4 ,table ( cont5ts ,!  
table ( cont5ts = ?is ,act is z foll[s3 
,sec4 #a4 ,%ort title4 ,sec4 #b4 ,table 
( cont5ts4 ,,title ,i--,transportation  
,sec4 #aja4 ,reimbursem5t = no-load     
travel co/s incurr$ by volunte]s provid+
 non-em]g5cy m$ical transportation to   
,m$icaid b5efici>ies4 ,sec4 #ajb4 ,pilot
 program = innovative coord9at$ access &
 mobility4 ,sec4 #ajc4 ,prioritization (
 projects t increase access to          
transportation = m$ical purposes 9 rural
 areas4 ,,title ,,ii--,heal? in=mation  
te*nology 9 rural areas ,sec4 #bja4     

,int]ag5cy task =ce on rural heal?      
in=mation te*nology4 ,sec4 #bjb4 ,rural 
heal? c>e program ( ! ,,fcc4  ,i        
,transportation  #aja4 ,reimbursem5t =  
no-load travel co/s incurr$ by volunte]s
 provid+ non-em]g5cy m$ical             
transportation to ,m$icaid b5efici>ies  
7a7 ,9 g5]al ,n lat] ?an #ij days aft] !
 date ( enactm5t ( ?is ,act1 ! ,secret>y
 ( ,heal? & ,human ,s]vices %all publi% 
an int]im f9al rule to revise ! ,m$icaid
 transportation regulations at sections 
#dca4ec & #ddj4agj ( title #db1 ,code ( 
,f$]al ,regulations1 z necess>y1 to--   
7#a7 all[ a ,/ate plan = m$ical         
assi/ance "u title ,,xix ( ! ,social    
,security ,act to provide1 at ! option (
 ! ,/ate1 reimbursem5t = co/s           
attributable to provid+ no-load volunte]
 travel s]vices to individuals eligible 
= m$ical assi/ance "u ! ,/ate plan :o   
require transportation to receive       
non-em]g5cy m$ical treatm5t2 &  7#b7    
require any ,/ate plan t opts to provide
 reimbursem5t = ! co/s describ$ 9       

p>agraph 7#a7 to e/abli% ov]sight       
proc$ures to monitor--  7,a7 access to  
no-load volunte] travel s]vices =       
individuals eligible = m$ical assi/ance 
"u ! ,/ate plan2  7,b7 compla9ts relat+ 
to no-load volunte] travel s]vices by   
individuals eligible = m$ical assi/ance 
"u ! ,/ate plan2 &  7,c7 ! timel9ess (  
su* travel s]vices4  7b7 ,no-,load      
volunte] travel s]vice ,= purposes (    
subsection 7a71 ! t]m no-load volunte]  
travel s]vice means travel s]vices t--  
7#a7 are provid$ by a p]son :o1 z       
det]m9$ by a ,/ate1 local1 or tribal    
gov]nm5t1 provides su* s]vices on a     
volunte] basis 7ref]r$ to 9 ?is         
subsection z a volunte]72 &  7#b7 are   
necess>y = ! volunte] to--  7,a7 travel 
f ! orig9at+ location ( ! volunte] to ! 
location ( an individual :o is eligible 
= m$ical assi/ance "u ! ,/ate ,m$icaid  
plan & requires transportation to       
receive non-em]g5cy m$ical treatm5t     
7includ+1 = purposes ( an individual :o 
reque/$ transportation to receive       

non-em]g5cy m$ical treatm5t &           
subsequ5tly refus$ su* transportation or
 0 n pres5t at ! reque/$ pick-up        
location1 any travel t is necess>y = !  
volunte] to return to _! orig9at+       
location72  7,b7 = purposes ( an        
individual :o has be5 provid$           
transportation by ! volunte] to receive 
non-em]g5cy m$ical treatm5t & is requir$
 to rema9 at ! treatm5t location        
ov]night or = an ext5d$ p]iod ( "t 7z   
det]m9$ appropriate by a ,/ate1 local1  
or tribal gov]nm5t71 return to !        
orig9at+ location ( ! volunte] &1 foll[+
 ! completion ( su* treatm5t1 travel    
back to ! treatm5t location2 &  7,c7    
foll[+ any transportation t is necess>y 
to return an individual :o has receiv$  
non-em]g5cy m$ical treatm5t to _!       
pick-up location1 return to ! orig9at+  
location ( ! volunte]4  #ajb4 ,pilot    
program = innovative coord9at$ access & 
mobility  7a7 ,removal ( fund+ f        
,highway ,tru/ ,fund ,section #ecch (   
title #di1 ,unit$ ,/ates ,code1 is      

am5d$-- 7#a7 9 subsection 7a7--  7,a7 9 
p>agraph 7#a7-- 7i7 9 ! matt] prec$+    
subp>agraph 7,a71 by /rik+ sections     
#cjjf7;b7 & ins]t+ 1 = fiscal ye> #bjaf1
 section #cjjf7;b72  7ii7 9 subp>agraph 
7,b71 by /rik+ #i1ecd1gjf1jdc & ins]t+  
#i1eca1gjf1djc2  7iii7 9 subp>agraph    
7,c71 by /rik+ #i1gcc1cec1djg & ins]t+  
#i1gcj1ajc1djg2  7iv7 9 subp>agraph     
7,d71 by /rik+ #i1ici1chj1jcj & ins]t+  
#i1ice1hhj1jcj2 &  7v7 9 subp>agraph    
7,e71 by /rik+ #aj1aej1cdh1dfb & ins]t+ 
#aj1adf1hdh1dfb2 &  7,b7 9 p>agraph     
7#b77;,e71 by /rik+ 1 #c1jjj1jjj =      
fiscal ye> #bjag1 #c1bej1jjj = fiscal   
ye> #bjah1 #c1ejj1jjj = fiscal ye> #bjai
 & #c1ejj1jjj = fiscal ye> #bjbj2  7#b7 
by r$esignat+ subsections 7e7 ?r\gh 7h7 
z subsections 7f7 ?r\gh 7i71            
respectively2 &  7#c7 by ins]t+ aft]    
subsection 7d7 ! foll[+3  7e7 ,access & 
mobility grants ,!re are au?oriz$ to be 
appropriat$ to c>ry out ! pilot program 
= innovative coord9at$ access & mobility
 "u section #cjjf7;b7 ( ! ,f$]al ,public

 ,transportation ,act ( #bjae--  7#a7   
#f1jjj1jjj = fiscal ye> #bjag2  7#b7    
#f1ejj1jjj = fiscal ye> #bjah2  7#c7    
#g1jjj1jjj = fiscal ye> #bjai2 &  7#d7  
#g1jjj1jjj = fiscal ye> #bjbj4  4  7b7  
,application priority ,section #cjjf7;b7
 ( ! ,f$]al ,public ,transportation ,act
 ( #bjae 7#di ,u4,s4,c4 #ecaj note2     
,public ,law #aab-ada7 is am5d$ by add+ 
at ! end ! foll[+3  7#g7 ,priority =    
eligible projects 9 rural areas ,9      
select+ eligible recipi5ts to p>ticipate
 9 ! pilot program "u ?is subsection1 ! 
,secret>y %all give priority to         
applications submitt$ by eligible       
recipi5ts to c>ry out eligible projects 
t s]ve individuals liv+ 9 rural areas4  
4  #ajc4 ,prioritization ( projects t   
increase access to transportation =     
m$ical purposes 9 rural areas ,section  
#ecaa7;b77#c7 ( title #di1 ,unit$ ,/ates
 ,code1 is am5d$ by add+ at ! end !     
foll[+3  7,d7 ,projects = m$ical        
transportation ,! ,secret>y may1 :5     
appropriate1 use am\nts made available  

"u subp>agraph 7,b7 to prioritize & c>ry
 out projects t increase access to      
transportation = m$ical purposes 9 rural
 areas4  4  ,,ii ,heal? in=mation       
te*nology 9 rural areas  #bja4          
,int]ag5cy task =ce on rural heal?      
in=mation te*nology ,title ,,xxx ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;jj et seq47 is am5d$ by  
add+ at ! end ! foll[+3  #cjbb4         
,int]ag5cy task =ce on rural heal?      
in=mation te*nology  7a7 ,e/abli%m5t ,! 
,presid5t %all e/abli% an ,int]ag5cy    
,task ,=ce on ,rural ,heal? ,in=mation  
,te*nology 7ref]r$ to 9 ?is section z ! 
,task ,=ce74  7b7 ,memb]%ip  7#a7       
,composition ,! ,presid5t %all appo9t   
memb]s ( ! ,task ,=ce1 :i* %all         
include-- 7,a7 a repres5tative f !      
,(fice ( ,rural ,developm5t ( !         
,dep>tm5t ( ,agriculture2  7,b7         
repres5tatives f ! ,dep>tm5t ( ,heal? & 
,human ,s]vices1 includ+-- 7i7 a        
repres5tative f ! ,(fice ( ! ,national  
,coord9ator = ,heal? ,in=mation         

,te*nology e/abli%$ "u section          
#cjja7;a72  7ii7 a repres5tative f !    
,(fice ( ,rural ,heal? ,policy ( !      
,heal? ,res\rces & ,s]vices             
,adm9i/ration2  7iii7 a repres5tative f 
! ,indian ,heal? ,s]vice2  7iv7 a       
repres5tative f ! ,sub/ance ,abuse &    
,m5tal ,heal? ,s]vices ,adm9i/ration2   
7v7 a repres5tative f ! ,c5t]s =        
,disease ,control & ,prev5tion2  7vi7 a 
repres5tative f ! ,c5t]s = ,m$ic>e      
,m$icaid ,s]vices2 &  7vii7 a           
repres5tative f ! ,ag5cy = ,heal?c>e    
,rese>* & ,quality2  7,c7 repres5tatives
 f o!r ,f$]al ag5cies1 includ+--  7i7 a 
repres5tative f ! ,dep>tm5t ( ,vet]ans  
,affairs2  7ii7 a repres5tative f !     
,dep>tm5t ( ,labor2  7iii7 a            
repres5tative f ! ,dep>tm5t (           
,education2  7iv7 a repres5tative f !   
,f$]al ,communications ,commission2  7v7
 a repres5tative f ! ,dep>tm5t (        
,transportation2 &  7vi7 a repres5tative
 f ! ,dep>tm5t ( ,comm]ce2 &  7,d7 any  
o!r repres5tatives f ,f$]al1 ,/ate1 or  

private sector entities z det]m9$       
appropriate by ! ,presid5t1 includ+ !   
,appala*ian ,regional ,commission1 !    
,delta ,regional ,au?ority1 ! ,national 
,rural ,heal? ,association1 ! ,national 
,gov]nors ,association1 & ! ,national   
,rural ,economic ,develop]s             
,association4  7#b7 ,*airp]son ,!       
,secret>y %all s]ve z ! *airp]son ( !   
,task ,=ce4  7#c7 ,appo9tm5t  7,a7      
,deadl9e ,all initial memb]s ( ! ,task  
,=ce %all be appo9t$ n lat] ?an #a ye>  
aft] ! date ( enactm5t ( ! ,connect+    
,rural ,am]icans to ,c>e ,act ( #bjaf4  
7,b7 ,p]iod ( appo9tm5t2 vacancies ,ea* 
memb] ( ! ,task ,=ce %all be appo9t$ = a
 t]m ( #d ye>s ) ! opportunity =        
reappo9tm5t4 ,any vacancy 9 ! ,task ,=ce
 %all n affect its p[]s1 b %all be fill$
 9 ! same mann] 9 :i* ! orig9al         
appo9tm5t 0 made4  7c7 ,activities  7#a7
 ,9 g5]al ,! ,task ,=ce %all c>ry out   
ea* ( ! foll[+ activities3 7,a7 ,measure
 & evaluate progress 9 ,f$]al1 ,/ate1   
local1 & tribal ef=ts to exp& heal?     

in=mation te*nology infra/ructure 9     
rural areas4  7,b7 ,collaborate ) !     
,broadb& ,opportunity ,c\ncil1 or any   
o!r successor1 simil>1 or relevant      
,f$]al int]ag5cy entity t addresses     
deliv]y ( f9ancial & te*nical assi/ance 
to rural heal? c>e provid]s = !         
implem5tation ( broadb& te*nology &     
developm5t ( heal? in=mation te*nology  
infra/ructure4  7,c7 ,provide           
recomm5dations on be/ practices to      
increase int]net access 9 rural areas = 
! purpose ( improv+ ! deliv]y ( heal?   
c>e s]vices4  7,d7 ,align1 across ,f$]al
 ag5cies & dep>tm5ts1 evaluation metrics
 = measures to exp$ite ! developm5t &   
implem5tation ( heal? in=mation         
te*nologies 9 rural areas 9 accordance )
 p>agraph 7#b74  7#b7 ,align+ metrics ,9
 c>ry+ out ! activity describ$ 9        
p>agraph 7#a77;,d71 ! ,task ,=ce %all1  
to ! ext5t practicable1 consid] h[      
evaluation metrics = ,f$]al measures    
describ$ 9 su* p>agraph align ) !       
evaluation metrics = ,/ate & local      

measures to r$uce adm9i/rative burd54   
7d7 ,report+ ,n lat] ?an #b ye>s aft] ! 
date ( enactm5t ( ! ,connect+ ,rural    
,am]icans to ,c>e ,act ( #bjaf1 & e #c  
ye>s !reaft]1 ! ,task ,=ce %all publi% a
 report 7to be kn[n z ! ,heal? ,c>e     
,in=mation ,te*nology ,infra/ructure    
,/atus ,report7 t-- 7#a7 describes !    
curr5t /ate ( ! connectivity gap 9 !    
,unit$ ,/ates1 ) a special emphasis on  
rural areas1 to in=m ! use ( ,f$]al     
programs provid+ support = !            
implem5tation ( broadb& te*nology & !   
developm5t & adoption ( heal? in=mation 
te*nology infra/ructure1 p>ticul>ly 9   
rural areas2 &  7#b7 includes           
recomm5dations on ways to increase      
access to heal? in=mation te*nology 9   
rural areas1 especially areas t are     
designat$ z--  7,a7 a heal? pr(essional 
%ortage area by ! ,secret>y "u section  
#ccb2 &  7,b7 an area )\t access to     
advanc$ telecommunications capability1 z
 id5tifi$ by ! ,f$]al ,communications   
,commission 9 ! c\nty-bas$ app5dix to ! 

mo/ rec5t ,broadb& ,progress ,report    
adopt$ by ! ,f$]al ,communications      
,commission z requir$ "u section #gjf ( 
! ,telecommunications ,act ( #aiif 7#dg 
,u4,s4,c4 #acjb74  7e7 ,meet+s ,! ,task 
,=ce %all meet at ! call ( ! *airp]son1 
n less ?an #b times ea* ye>4  7f7 ,p[]s 
( ! task =ce  7#a7 ,he>+s ,! ,task ,=ce 
may1 = ! purpose ( c>ry+ out ?is        
section1 hold he>+s1 sit & act at times 
& places1 take te/imony1 & receive      
evid5ce z ! ,task ,=ce consid]s         
appropriate4  7#b7 ,in=mation f ,f$]al  
ag5cies ,! ,task ,=ce may secure        
directly f any dep>tm5t or ag5cy ( !    
,unit$ ,/ates in=mation necess>y to     
enable x to c>ry out its duties "u ?is  
section4 ,^u reque/ ( ! *airp]son ( !   
,task ,=ce1 ! head ( t dep>tm5t or ag5cy
 %all furni% t in=mation to ! ,task     
,=ce4  7g7 ,task ,=ce p]sonnel matt]s   
7#a7 ,travel exp5ses ,a memb] ( ! ,task 
,=ce %all be all[$ reasonable travel    
exp5ses1 includ+ p] diem 9 lieu (       
subsi/5ce1 at rates = employees (       

ag5cies "u sub*apt] ,i ( *apt] #eg (    
title #e1 ,unit$ ,/ates ,code1 :ile away
 f ! memb]'s home or regul> place (     
bus9ess 9 ! p]=mance ( s]vices = ! ,task
 ,=ce4  7#b7 ,/aff  7,a7 ,9 g5]al ,!    
*airp]son ( ! ,task ,=ce may1 )\t reg>d 
to ! civil s]vice laws 7includ+         
regulations71 appo9t & t]m9ate an       
executive director & su* o!r additional 
p]sonnel z may be necess>y to enable !  
,task ,=ce to p]=m ! duties ( ! ,task   
,=ce1 except t ! employm5t ( an         
executive director %all be subject to   
confirmation by ! ,task ,=ce4  7,b7     
,comp5sation ,! *airp]son ( ! ,task ,=ce
 may fix ! comp5sation ( ! executive    
director & o!r p]sonnel )\t reg>d to    
*apt] #ea & sub*apt] ,,iii ( *apt] #ec (
 title #e1 ,unit$ ,/ates ,code1 relat+  
to classification ( positions & ,g5]al  
,s*$ule pay rates1 except t ! rate ( pay
 = ! executive director & o!r p]sonnel  
may n exce$ ! rate payable = level ,v ( 
! ,executive ,s*$ule "u section #ecaf ( 
t title4  7#c7 ,detail ( ,gov]nm5t      

employees ,any ,f$]al ,gov]nm5t employee
 may be detail$ to ! ,task ,=ce )\t     
reimbursem5t1 & su* detail %all be )\t  
int]ruption or loss ( civil s]vice /atus
 or privilege4  7#d7 ,procurem5t ,!     
*airp]son ( ! ,task ,=ce may procure    
tempor>y & int]mitt5t s]vices "u section
 #caji7;b7 ( title #e1 ,unit$ ,/ates    
,code1 at rates = individuals :i* d n   
exce$ ! daily equival5t ( ! annual rate 
( basic pay prescrib$ = level ,v ( !    
,executive ,s*$ule "u section #ecaf ( t 
title4  7h7 ,au?orization (             
appropriations ,!re are au?oriz$ to be  
appropriat$ su* sums z may be necess>y  
to c>ry out ?is section4  4  #bjb4      
,rural heal? c>e program ( ! ,,fcc  7a7 
,def9itions ,9 ?is section--  7#a7 ! t]m
 ,commission means ! ,f$]al             
,communications ,commission2 &  7#b7 !  
t]m ,heal?c>e ,connect ,fund means !    
,heal?c>e ,connect ,fund ( ! ,commission
 "u subp>t ,g ( "p #ed ( title #dg1     
,code ( ,f$]al ,regulations4  7b7       
,simplify+ ! application process ( !    

,heal?c>e ,connect ,fund  7#a7 ,9 g5]al 
,n lat] ?an #a ye> aft] ! date (        
enactm5t ( ?is ,act1 ! ,commission %all 
in/itute & ref] to a ,f$]al-,/ate ,jo9t 
,bo>d "u section #daj7;c7 ( !           
,communications ,act ( #aicd 7#dg       
,u4,s4,c4 #daj7;c77 a proce$+ to--  7,a7
 review ! process = submitt+ a reque/ = 
s]vices "u ! ,heal?c>e ,connect ,fund2 &
  7,b7 make recomm5dations to !         
,commission on ways t ! ,commission c   
simplify ! process describ$ 9           
subp>agraph 7,a74  7#b7 ,implem5tation (
 recomm5dations ,n lat] ?an #a ye> aft] 
! date on :i* ! ,f$]al-,/ate ,jo9t ,bo>d
 makes recomm5dations to ! ,commission  
"u p>agraph 7#a77;,b71 ! ,commission    
%all implem5t ^? recomm5dations4  7c7   
,heal? c>e provid] ,section             
#bed7;h77#g77;,b7 ( ! ,communications   
,act ( #aicd 7#dg ,u4,s4,c4             
#bed7;h77#g77;,b77 is am5d$-- 7#a7 9    
clause 7vii71 by /rik+ & at ! end2  7#b7
 by r$esignat+ clause 7viii7 z clause   
7ix72  7#c7 by ins]t+ aft] clause 7vii7 

! foll[+3  7viii7 any o!r entities t    
provide heal? c>e & remote pati5t       
managem5t1 z det]m9$ by ! ,secret>y (   
,heal? & ,human ,s]vices2 &  2 &  7#d7 9
 clause 7ix71 z s r$esignat$1 by /rik+  
?r\gh 7vii7 & ins]t+ ?r\gh 7viii74  7d7 
,code ( ,f$]al ,regulations ,!          
,commission %all am5d section           
#ed4fcc7;a7 ( title #dg1 ,code ( ,f$]al 
,regulations--  7#a7 by /rik+ ,all heal?
 c>e provid]s & ins]t+ ! foll[+3  7#a7  
,9 g5]al ,except z provid$ 9 p>agraph   
7#b71 all heal? c>e provid]s  2  7#b7 9 
p>agraph 7#a71 z s designat$-- 7,a7 by  
/rik+ a #fe p]c5t & ins]t+ n less ?an an
 #he p]c5t2 &  7,b7 by /rik+ #ce p]c5t &
 ins]t+ n m ?an #ae p]c5t2 &  7#c7 by   
add+ at ! end ! foll[+3  7#b7 ,tribal   
l&s ,! ,f$]al ,communications           
,commission may decrease ! p]c5tage ( ! 
total co/ ( eligible exp5ses t a heal?  
c>e provid] is requir$ to contribute "u 
p>agraph 7#a71 includ+ by elim9at+ !    
requirem5t t ! heal? c>e provid]        
contribute any p]c5tage ( t co/1 if !   

heal? c>e provid] is locat$ on ,tribal  
l&s1 z def9$ 9 section #ed4djj1 or any  
successor regulation4  4