,i #aafth ,,congress #ast ,session ,h4 ,r4 #dhih ,,in ,,the ,,house ,,of ,,representatives ,october #bi1 #bjai,mr4 ,kustoff of ,tennessee 7for himself1 ,mr4 ,david ,p4 ,roe of ,tennessee1 and ,ms4 ,kuster of ,new ,hampshire7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to establish a rural health center innovation awards program and a rural health department enhancement program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,rural ,health ,innovation ,act of #bjai4 #b4 ,rural health center innovation awards program ,subpart ,i of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq47 is amended by adding at the end the following3 #ccj,n4 ,rural health center innovation awards program 7a7 ,definitions ,in this section3 7#a7 ,covered rural area ,the term covered rural area means a rural area-- 7,a7 that is located not less than #cj minutes by automobile from the nearest emergency department1 using the speed limit of the most direct route to such emergency department2 or 7,b7 from which an individual cannot access an emergency department by road4 7#b7 ,eligible entity ,the term eligible entity means an entity that-- 7,a7 is a ,federally qualified health center2 7,b7 is a rural health clinic2 or 7,c7 agrees 7as a condition of receiving a grant under this section7 to establish such a center or clinic1 including a hospital that agrees 7as such a condition7 to convert to a ,federally qualified health center4 7#c7 ,federally qualified health center ,the term ,federally qualified health center has the meaning given such term in section #ahfa7;aa7 of the ,social ,security ,act4 7#d7 ,rural area ,the term rural area has the meaning given such term in section #ccj;,j7e74 7#e7 ,rural health clinic ,the term rural health clinic has the meaning given such term in section #ahfa7;aa7 of the ,social ,security ,act4 7b7 ,establishment 7#a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall establish a grant program to be known as the ,rural ,health ,center ,innovation ,awards program to award grants to eligible entities that submit an application in accordance with subsection 7c7 to enable such entities to establish or maintain a ,federally qualified health center or rural health clinic that-- 7,a7 serves individuals in a covered rural area as a walk-in urgent care center and as a triage center or staging facility for necessary air or ambulance transport to an emergency department2 and 7,b7 includes-- 7i7 professional clinical staff1 including physicians1 physician interns1 residents1 nurse practitioners1 physician assistants1 nurse midwives1 or other health care providers providing walk-in urgent care and emergency triage2 and 7ii7 resources1 including laboratories1 x-ray machines1 and cardiac monitors4 7#b7 ,permissible uses of funds ,the funds of a grant awarded under this section may be used to-- 7,a7 expand the hours of operation of a ,federally qualified health center or rural health clinic2 7,b7 pay for the costs of construction and renovation of a ,federally qualified health center or rural health clinic2 or 7,c7 carry out any other activity for the purposes described in paragraph 7#a74 7c7 ,applications and selection 7#a7 ,in general ,an eligible entity seeking a grant under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may reasonably require4 7#b7 ,start up centers and clinics ,an application submitted under paragraph 7#a7 by an eligible entity that is not a ,federally qualified health center1 or a rural health clinic1 on the date on which the entity submits the application under paragraph 7#a7 shall include in such application a demonstration of the costs of the equipment and staffing needed to establish the center or clinic4 7#c7 ,expedited review ,the ,secretary shall establish a process for expediting the review of any application submitted under paragraph 7#a7 for a grant under this section from an eligible entity that plans to use the funds of the grant to serve individuals in a covered rural area in which a hospital has closed in the #g years preceding the date on which the entity submitted the application4 7d7 ,grant period and amounts 7#a7 ,period ,each grant awarded under this section shall be for a period of #e years4 7#b7 ,amount 7,a7 ,in general ,a grant awarded under this section to an eligible entity shall not exceed-- 7i7 for the first year of the grant-- 7,i7 #ejj1jjj if the entity is a ,federally qualified health center1 or a rural health clinic1 on the date on which the award is made2 and 7,,ii7 #gej1jjj if the entity is using the grant to establish a ,federally qualified health center or a rural health clinic2 and 7ii7 for each of the third through fifth years of the grant1 #ejj1jjj4 7,b7 ,considerations ,in determining the amount of a grant under this section for an eligible entity for each year after the first year in which the grant is awarded1 the ,secretary shall1 subject to subparagraph 7,a77ii71 consider the number of patients treated1 and the type of treatment provided1 by the entity in the prior year4 7e7 ,reporting 7#a7 ,in general ,not later than #c years after the date of enactment of this section1 the ,secretary shall report to the committees described in paragraph 7#b7 on the grant program under this section1 including-- 7,a7 an assessment of the success of the program1 challenges with respect to the program1 and any action for regulatory flexibility or legislative authority needed to improve the program2 7,b7 any savings to ,federal health care programs2 7,c7 any increase in access to care2 and 7,d7 any increase in utilization of health services in covered rural areas4 7#b7 ,committees ,the committees described in this paragraph are-- 7,a7 the ,committee on ,health1 ,education1 ,labor1 and ,pensions1 and the ,committee on ,finance1 of the ,senate2 and 7,b7 the ,committee on ,energy and ,commerce1 and the ,committee on ,ways and ,means1 of the ,house of ,representatives4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #be1jjj1jjj for each of fiscal years #bjbj through #bjbd4 4 #c4 ,rural health department enhancement program ,subpart ,i of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq471 as amended by section #b1 is further amended by adding at the end the following3 #ccj,o4 ,rural health department enhancement program 7a7 ,definitions ,in this section3 7#a7 ,covered rural area ,the term covered rural area has the meaning given the term in section #ccj,n7a74 7#b7 ,rural health department ,the term rural health department means a health department that is located in a covered rural area4 7b7 ,establishment ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall award grants1 on a competitive basis1 to rural health departments that submit an application in accordance with subsection 7c7 to enhance such departments and enable them to provide individuals in covered rural areas with emergency services1 triage and transport to emergency departments1 primary care services1 and other services similar to services provided by emergency departments4 7c7 ,applications ,a rural health department seeking a grant under this section shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may reasonably require1 including-- 7#a7 an indication of the estimated cost of the equipment and staffing needed by the department for the first year of the award to set up the activities and services under this section2 7#b7 a demonstration that the department has1 on the date on which the application is submitted1 a facility operating that is located in a covered rural area2 and 7#c7 a demonstration that1 on the date on which the application is submitted1 the department-- 7,a7 has a nursing staff and medical equipment2 and 7,b7 agrees to use such staff and equipment towards providing the services and carrying out the activities under this section4 7d7 ,grants 7#a7 ,annual awards ,the funds awarded through a grant under this section to a rural health department shall be awarded on an annual basis for each of #e years4 7#b7 ,maximum amounts ,the funds awarded through a grant under this section to a rural health department shall be in an amount that for a year does not exceed #ejj1jjj4 7#c7 ,considerations ,the ,secretary shall determine the amount awarded to a rural health department through a grant under this section for a year in accordance with the following3 7,a7 ,for the first year of the award1 the amount shall be based on the amount the rural health department estimates for the cost of equipment and staffing needed to set up the activities and services supported under this section1 as specified in the application under subsection 7c74 7,b7 ,for the second through fifth years of the award1 the amount shall be based on the number of patients treated1 and the type of treatment provided1 by the department in the prior year4 7e7 ,use of funds 7#a7 ,in general ,a rural health department receiving a grant under this section shall use the funds awarded through the grant to provide the services and carry out the activities described in subsection 7b7 at a facility that is located in a covered rural area1 including by-- 7,a7 obtaining additional medical equipment and resources necessary for providing the services and activities described in subsection 7b71 such as laboratories1 x-ray machines1 and cardiac monitors2 7,b7 hiring additional providers to provide the services and carry out the activities described in subsection 7b71 such as physician interns1 residents1 nurse practitioners1 physician assistants1 and nurse midwives1 which hiring may be through a partnership described in paragraph 7#b77;,a72 and 7,c7 providing outreach to the community regarding the services and activities of the rural health department as supported under this section4 7#b7 ,limitations 7,a7 ,partnerships ,not more than #c percent of the funds awarded through a grant under this section for a year may be used towards the rural health department entering into a partnership with an academic medical center to assist with the hiring described in paragraph 7#a77;,b74 7,b7 ,community outreach ,for each of the first #b years of a grant awarded under this section1 not more than #c percent of the funds may be used by the rural health department receiving the grant for the outreach described in paragraph 7#a77;,c74 7f7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #be1jjj1jjj for each of fiscal years #bjbj through #bjbd4 4