,,ii  #aae? ,,congress  #b;d ,session   
,s4 #bbgh  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,janu>y #d1 #bjah,mr4  
,rob]ts 7= himself1 ,ms4 ,heitkamp1 ,mr4
 ,b>rasso1 ,mr4 ,casey1 ,mr4 ,grassley1 
& ,ms4 ,baldw97 introduc$ ! foll[+ bill2
 :i* 0 read twice & ref]r$ to !         
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions  ,a ,,bill  ,to am5d 
! ,public ,heal? ,s]vice ,act to provide
 grants to improve heal? c>e 9 rural    
areas4  #a4 ,%ort title ,?is ,act may be
 cit$ z ! ,/ate ,(fices ( ,rural ,heal? 
,reau?orization ,act ( #bjah4  #b4 ,/ate
 (fices ( rural heal? ,section #cch;,j (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #bedr7 is am5d$ to read z     
foll[s3  #cch;,j4 ,grants to ,/ate      
(fices ( rural heal?  7a7 ,9 g5]al ,!   
,secret>y1 act+ ?r\gh ! ,director ( !   
,f$]al ,(fice ( ,rural ,heal? ,policy   
7e/abli%$ "u section #gaa ( ! ,social   
,security ,act71 %all make grants to ea*
 ,/ate ,(fice ( ,rural ,heal? = !       
purpose ( improv+ heal? c>e 9 rural     

areas4  7b7 ,requirem5t ( mat*+ funds   
7#a7 ,9 g5]al ,subject to p>agraph 7#b71
 ! ,secret>y may n make a grant "u      
subsection 7a7 unless ! ,/ate (fice (   
rural heal? involv$ agrees1 ) respect to
 ! co/s to be incurr$ 9 c>ry+ out !     
purpose describ$ 9 su* subsection1 to   
provide non-,f$]al contributions t[>d   
su* co/s 9 an am\nt equal to #c = ea* #a
 ( ,f$]al funds provid$ 9 ! grant4  7#b7
 ,waiv] or ,r$uction ,! ,secret>y may   
waive or r$uce ! non-,f$]al contribution
 if ! ,secret>y det]m9es t requir+ mat*+
 funds w\ld limit ! ,/ate (fice ( rural 
heal?'s ability to c>ry out ! purpose   
describ$ 9 subsection 7a74  7#c7        
,det]m9ation ( am\nt ( non-,f$]al       
contribution ,non-,f$]al contributions  
requir$ 9 p>agraph 7#a7 may be 9 ca% or 
9 k9d1 fairly evaluat$1 includ+ plant1  
equipm5t1 or s]vices4 ,am\nts provid$ by
 ! ,f$]al ,gov]nm5t1 or s]vices assi/$  
or subsidiz$ to any significant ext5t by
 ! ,f$]al ,gov]nm5t1 may n be includ$ 9 
det]m9+ ! am\nt ( su* non-,f$]al        

contributions4  7c7 ,c]ta9 requir$      
activities ,recipi5ts ( a grant "u      
subsection 7a7 %all use ! grant funds = 
purposes (-- 7#a7 ma9ta9+ )9 ! ,/ate    
(fice ( rural heal? a cle>+h\se =       
collect+ & dissem9at+ in=mation on--    
7,a7 rural heal? c>e issues2  7,b7      
rese>* f9d+s relat+ to rural heal? c>e2 
&  7,c7 innovative approa*es to !       
deliv]y ( heal? c>e 9 rural areas2  7#b7
 coord9at+ ! activities c>ri$ out 9 !   
,/ate t relate to rural heal? c>e1      
includ+ provid+ coord9ation = ! purpose 
( avoid+ r$undancy 9 su* activities2 &  
7#c7 id5tify+ ,f$]al & ,/ate programs   
reg>d+ rural heal?1 & provid+ te*nical  
assi/ance to public & nonpr(it private  
entities reg>d+ p>ticipation 9 su*      
programs4  7d7 ,requirem5t reg>d+ annual
 budget = (fice ,! ,secret>y may n make 
a grant "u subsection 7a7 unless ! ,/ate
 involv$ agrees t1 = any fiscal ye> =   
:i* ! ,/ate (fice ( rural heal? receives
 su* a grant1 ! (fice op]at$ pursuant to
 subsection 7a7 ( ?is section w be      

provid$ ) an annual budget ( n less ?an 
#aej1jjj4  7e7 ,c]ta9 uses ( funds  7#a7
 ,re/rictions ,! ,secret>y may n make a 
grant "u subsection 7a7 unless ! ,/ate  
(fice ( rural heal? involv$ agrees t !  
grant w n be exp5d$--  7,a7 to provide  
heal? c>e 7includ+ provid+ ca% paym5ts  
reg>d+ su* c>e72  7,b7 to conduct       
activities = :i* ,f$]al funds are       
exp5d$--  7i7 )9 ! ,/ate to provide     
te*nical & o!r nonf9ancial assi/ance "u 
section #ccj;,a7f72  7ii7 "u a memor&um 
( agreem5t ent]$ into ) ! ,/ate (fice ( 
rural heal? "u section #ccj;,a7h72 or   
7iii7 "u a grant "u section #cch;,i2    
7,c7 to pur*ase m$ical equipm5t1 to     
pur*ase ambulances1 aircraft1 or o!r    
vehicles1 or to pur*ase major           
communications equipm5t2  7,d7 to       
pur*ase or improve real prop]ty2 or     
7,e7 to c>ry out any activity reg>d+ a  
c]tificate ( ne$4  7#b7 ,au?orities     
,activities = :i* a ,/ate (fice ( rural 
heal? may exp5d a grant "u subsection   
7a7 include--  7,a7 pay+ ! co/s (       

ma9ta9+ an (fice ( rural heal? =        
purposes ( subsection 7a72  7,b7 subject
 to p>agraph 7#a77;,b77iii71 pay+ ! co/s
 ( any activity c>ri$ out ) respect to  
recruit+ & reta9+ heal? pr(essionals to 
s]ve 9 rural areas ( ! ,/ate2 &  7,c7   
provid+ grants & contracts to public &  
nonpr(it private entities to c>ry out   
activities au?oriz$ 9 ?is section4  7#c7
 ,limit on ,indirect ,co/s ,! ,secret>y 
may impose a limit ( no m ?an #ae p]c5t 
on indirect co/s claim$ by ! recipi5t ( 
! grant4  7f7 ,reports ,! ,secret>y may 
n make a grant "u subsection 7a7 unless 
! ,/ate (fice ( rural heal? involv$     
agrees--  7#a7 to submit to ! ,secret>y 
reports or p]=mance data conta9+ su*    
in=mation z ! ,secret>y may require     
reg>d+ activities c>ri$ out "u ?is      
section2 &  7#b7 to submit su* a report 
or p]=mance data n lat] ?an ,septemb]   
#cj ( ea* fiscal ye> imm$iately foll[+  
any fiscal ye> = :i* ! ,/ate (fice (    
rural heal? has receiv$ su* a grant4    
7g7 ,requirem5t ( application ,!        

,secret>y may n make a grant "u         
subsection 7a7 unless an application = !
 grant is submitt$ to ! ,secret>y & !   
application is 9 su* =m1 is made 9 su*  
mann]1 & conta9s su* agreem5ts1         
assurances1 & in=mation z ! ,secret>y   
det]m9es to be necess>y to c>ry out su* 
subsection4  7h7 ,noncompliance ,!      
,secret>y may n make paym5ts "u         
subsection 7a7 to a ,/ate (fice ( rural 
heal? = any fiscal ye> subsequ5t to !   
fir/ fiscal ye> ( su* paym5ts unless !  
,secret>y det]m9es t1 = ! imm$iately    
prec$+ fiscal ye>1 ! ,/ate (fice ( rural
 heal? has compli$ ) ea* ( ! agreem5ts  
made by ! ,/ate (fice ( rural heal? "u  
?is section4  7i7 ,au?orization (       
appropriations  7#a7 ,9 g5]al ,= !      
purpose ( mak+ grants "u subsection 7a71
 !re are au?oriz$ to be appropriat$ su* 
sums z may be necess>y = ea* ( fiscal   
ye>s #bjah ?r\gh #bjbb4  7#b7           
,availability ,am\nts appropriat$ "u    
p>agraph 7#a7 %all rema9 available until
 exp5d$4  4