,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #bdaa  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ca1 #bjai ,mrs4 
,blackburn 7= h]self & ,ms4 ,murk[ski7  
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 e/abli% a rural heal?   
c5t] innovation aw>ds program & a rural 
heal? dep>tm5t enhancem5t program1 & =  
o!r purposes4  #a4 ,%ort title  ,?is    
,act may be cit$ z ! ,rural ,heal?      
,innovation ,act ( #bjai4  #b4 ,rural   
heal? c5t] innovation aw>ds program     
,subp>t ,i ( "p ,d ( title ,,iii ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;b et seq47 is am5d$ by   
add+ at ! end ! foll[+3  #ccj,n4 ,rural 
heal? c5t] innovation aw>ds program  7a7
 ,def9itions ,9 ?is section3 7#a7 ,cov]$
 rural area ,! t]m cov]$ rural area     
means a rural area--  7,a7 t is locat$ n
 less ?an #cj m9utes by automobile f !  
ne>e/ em]g5cy dep>tm5t1 us+ ! spe$ limit

 ( ! mo/ direct r\te to su* em]g5cy     
dep>tm5t2 or  7,b7 f :i* an individual  
_c access an em]g5cy dep>tm5t by road4  
7#b7 ,eligible entity ,! t]m eligible   
entity means an entity t--  7,a7 is a   
,f$]ally qualifi$ heal? c5t]2  7,b7 is a
 rural heal? cl9ic2 or  7,c7 agrees 7z a
 condition ( receiv+ a grant "u ?is     
section7 to e/abli% su* a c5t] or cl9ic1
 includ+ a hospital t agrees 7z su* a   
condition7 to conv]t to a ,f$]ally      
qualifi$ heal? c5t]4  7#c7 ,f$]ally     
qualifi$ heal? c5t] ,! t]m ,f$]ally     
qualifi$ heal? c5t] has ! mean+ giv5 su*
 t]m 9 section #ahfa7;aa7 ( ! ,social   
,security ,act4  7#d7 ,rural area ,! t]m
 rural area has ! mean+ giv5 su* t]m 9  
section #ccj;,j7e74  7#e7 ,rural heal?  
cl9ic ,! t]m rural heal? cl9ic has !    
mean+ giv5 su* t]m 9 section #ahfa7;aa7 
( ! ,social ,security ,act4  7b7        
,e/abli%m5t  7#a7 ,9 g5]al ,! ,secret>y1
 act+ ?r\gh ! ,adm9i/rator ( ! ,heal?   
,res\rces & ,s]vices ,adm9i/ration1 %all
 e/abli% a grant program to be kn[n z ! 

,rural ,heal? ,c5t] ,innovation ,aw>ds  
program to aw>d grants to eligible      
entities t submit an application 9      
accordance ) subsection 7c7 to enable   
su* entities to e/abli% or ma9ta9 a     
,f$]ally qualifi$ heal? c5t] or rural   
heal? cl9ic t--  7,a7 s]ves individuals 
9 a cov]$ rural area z a walk-9 urg5t   
c>e c5t] & z a triage c5t] or /ag+      
facility = necess>y air or ambulance    
transport to an em]g5cy dep>tm5t2 &     
7,b7 includes-- 7i7 pr(essional cl9ical 
/aff1 includ+ physicians1 physician     
int]ns1 resid5ts1 nurse practition]s1   
physician assi/ants1 nurse midwives1 or 
o!r heal? c>e provid]s provid+ walk-9   
urg5t c>e & em]g5cy triage2 &  7ii7     
res\rces1 includ+ laboratories1 x-ray   
ma*9es1 & c>diac monitors4  7#b7        
,p]missible uses ( funds ,! funds ( a   
grant aw>d$ "u ?is section may be us$   
to--  7,a7 exp& ! h\rs ( op]ation ( a   
,f$]ally qualifi$ heal? c5t] or rural   
heal? cl9ic2  7,b7 pay = ! co/s (       
con/ruction & r5ovation ( a ,f$]ally    

qualifi$ heal? c5t] or rural heal?      
cl9ic2 or  7,c7 c>ry out any o!r        
activity = ! purposes describ$ 9        
p>agraph 7#a74  7c7 ,applications &     
selection  7#a7 ,9 g5]al ,an eligible   
entity seek+ a grant "u ?is section %all
 submit to ! ,secret>y an application at
 su* "t1 9 su* mann]1 & conta9+ su*     
in=mation z ! ,secret>y may reasonably  
require4  7#b7 ,/>t up c5t]s & cl9ics   
,an application submitt$ "u p>agraph    
7#a7 by an eligible entity t is n a     
,f$]ally qualifi$ heal? c5t]1 or a rural
 heal? cl9ic1 on ! date on :i* ! entity 
submits ! application "u p>agraph 7#a7  
%all include 9 su* application a        
demon/ration ( ! co/s ( ! equipm5t &    
/aff+ ne$$ to e/abli% ! c5t] or cl9ic4  
7#c7 ,exp$it$ review ,! ,secret>y %all  
e/abli% a process = exp$it+ ! review (  
any application submitt$ "u p>agraph    
7#a7 = a grant "u ?is section f an      
eligible entity t plans to use ! funds (
 ! grant to s]ve individuals 9 a cov]$  
rural area 9 :i* a hospital has clos$ 9 

! #g ye>s prec$+ ! date on :i* ! entity 
submitt$ ! application4  7d7 ,grant     
p]iod & am\nts  7#a7 ,p]iod ,ea* grant  
aw>d$ "u ?is section %all be = a p]iod (
 #e ye>s4  7#b7 ,am\nt  7,a7 ,9 g5]al ,a
 grant aw>d$ "u ?is section to an       
eligible entity %all n exce$--  7i7 = ! 
fir/ ye> ( ! grant-- 7,i7 #ejj1jjj if ! 
entity is a ,f$]ally qualifi$ heal?     
c5t]1 or a rural heal? cl9ic1 on ! date 
on :i* ! aw>d is made2 &  7,,ii7        
#gej1jjj if ! entity is us+ ! grant to  
e/abli% a ,f$]ally qualifi$ heal? c5t]  
or a rural heal? cl9ic2 &  7ii7 = ea* ( 
! ?ird ?r\gh fif? ye>s ( ! grant1       
#ejj1jjj4  7,b7 ,consid]ations ,9       
det]m9+ ! am\nt ( a grant "u ?is section
 = an eligible entity = ea* ye> aft] !  
fir/ ye> 9 :i* ! grant is aw>d$1 !      
,secret>y %all1 subject to subp>agraph  
7,a77ii71 consid] ! numb] ( pati5ts     
treat$1 & ! type ( treatm5t provid$1 by 
! entity 9 ! prior ye>4  7e7 ,report+   
7#a7 ,9 g5]al ,n lat] ?an #c ye>s aft] !
 date ( enactm5t ( ?is section1 !       

,secret>y %all report to ! committees   
describ$ 9 p>agraph 7#b7 on ! grant     
program "u ?is section1 includ+--  7,a7 
an assessm5t ( ! success ( ! program1   
*all5ges ) respect to ! program1 & any  
action = regulatory flexibility or      
legislative au?ority ne$$ to improve !  
program2  7,b7 any sav+s to ,f$]al heal?
 c>e programs2  7,c7 any increase 9     
access to c>e2 &  7,d7 any increase 9   
utilization ( heal? s]vices 9 cov]$     
rural areas4  7#b7 ,committees ,!       
committees describ$ 9 ?is p>agraph are--
  7,a7 ! ,committee on ,heal?1          
,education1 ,labor1 & ,p5sions1 & !     
,committee on ,f9ance1 ( ! ,s5ate2 &    
7,b7 ! ,committee on ,en]gy & ,comm]ce1 
& ! ,committee on ,ways & ,means1 ( !   
,h\se ( ,repres5tatives4  7f7           
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section #be1jjj1jjj = ea* ( fiscal  
ye>s #bjbj ?r\gh #bjbd4  4  #c4 ,rural  
heal? dep>tm5t enhancem5t program       
,subp>t ,i ( "p ,d ( title ,,iii ( !    

,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;b et seq471 z am5d$ by   
section #b1 is fur!r am5d$ by add+ at ! 
end ! foll[+3  #ccj,o4 ,rural heal?     
dep>tm5t enhancem5t program  7a7        
,def9itions ,9 ?is section3 7#a7 ,cov]$ 
rural area ,! t]m cov]$ rural area has !
 mean+ giv5 ! t]m 9 section #ccj,n7a74  
7#b7 ,rural heal? dep>tm5t ,! t]m rural 
heal? dep>tm5t means a heal? dep>tm5t t 
is locat$ 9 a cov]$ rural area4  7b7    
,e/abli%m5t ,! ,secret>y1 act+ ?r\gh !  
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 %all aw>d       
grants1 on a competitive basis1 to rural
 heal? dep>tm5ts t submit an application
 9 accordance ) subsection 7c7 to       
enhance su* dep>tm5ts & enable !m to    
provide individuals 9 cov]$ rural areas 
) em]g5cy s]vices1 triage & transport to
 em]g5cy dep>tm5ts1 prim>y c>e s]vices1 
& o!r s]vices simil> to s]vices provid$ 
by em]g5cy dep>tm5ts4  7c7 ,applications
 ,a rural heal? dep>tm5t seek+ a grant  
"u ?is section %all submit an           

application to ! ,secret>y at su* "t1 9 
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may reasonably require1       
includ+--  7#a7 an indication ( !       
e/imat$ co/ ( ! equipm5t & /aff+ ne$$ by
 ! dep>tm5t = ! fir/ ye> ( ! aw>d to set
 up ! activities & s]vices "u ?is       
section2  7#b7 a demon/ration t !       
dep>tm5t has1 on ! date on :i* !        
application is submitt$1 a facility     
op]at+ t is locat$ 9 a cov]$ rural area2
 &  7#c7 a demon/ration t1 on ! date on 
:i* ! application is submitt$1 !        
dep>tm5t-- 7,a7 has a nurs+ /aff &      
m$ical equipm5t2 &  7,b7 agrees to use  
su* /aff & equipm5t t[>ds provid+ !     
s]vices & c>ry+ out ! activities "u ?is 
section4  7d7 ,grants  7#a7 ,annual     
aw>ds ,! funds aw>d$ ?r\gh a grant "u   
?is section to a rural heal? dep>tm5t   
%all be aw>d$ on an annual basis = ea* (
 #e ye>s4  7#b7 ,maximum am\nts ,! funds
 aw>d$ ?r\gh a grant "u ?is section to a
 rural heal? dep>tm5t %all be 9 an am\nt
 t = a ye> does n exce$ #ejj1jjj4  7#c7 

,consid]ations ,! ,secret>y %all det]m9e
 ! am\nt aw>d$ to a rural heal? dep>tm5t
 ?r\gh a grant "u ?is section = a ye> 9 
accordance ) ! foll[+3  7,a7 ,= ! fir/  
ye> ( ! aw>d1 ! am\nt %all be bas$ on ! 
am\nt ! rural heal? dep>tm5t e/imates = 
! co/ ( equipm5t & /aff+ ne$$ to set up 
! activities & s]vices support$ "u ?is  
section1 z specifi$ 9 ! application "u  
subsection 7c74  7,b7 ,= ! second ?r\gh 
fif? ye>s ( ! aw>d1 ! am\nt %all be bas$
 on ! numb] ( pati5ts treat$1 & ! type (
 treatm5t provid$1 by ! dep>tm5t 9 !    
prior ye>4  7e7 ,use ( funds  7#a7 ,9   
g5]al ,a rural heal? dep>tm5t receiv+ a 
grant "u ?is section %all use ! funds   
aw>d$ ?r\gh ! grant to provide ! s]vices
 & c>ry out ! activities describ$ 9     
subsection 7b7 at a facility t is locat$
 9 a cov]$ rural area1 includ+ by--     
7,a7 obta9+ additional m$ical equipm5t &
 res\rces necess>y = provid+ ! s]vices &
 activities describ$ 9 subsection 7b71  
su* z laboratories1 x-ray ma*9es1 &     
c>diac monitors2  7,b7 hir+ additional  

provid]s to provide ! s]vices & c>ry out
 ! activities describ$ 9 subsection 7b71
 su* z physician int]ns1 resid5ts1 nurse
 practition]s1 physician assi/ants1 &   
nurse midwives1 :i* hir+ may be ?r\gh a 
p>tn]%ip describ$ 9 p>agraph 7#b77;,a72 
&  7,c7 provid+ outrea* to ! community  
reg>d+ ! s]vices & activities ( ! rural 
heal? dep>tm5t z support$ "u ?is        
section4  7#b7 ,limitations  7,a7       
,p>tn]%ips ,n m ?an #c p]c5t ( ! funds  
aw>d$ ?r\gh a grant "u ?is section = a  
ye> may be us$ t[>ds ! rural heal?      
dep>tm5t ent]+ into a p>tn]%ip ) an     
academic m$ical c5t] to assi/ ) ! hir+  
describ$ 9 p>agraph 7#a77;,b74  7,b7    
,community outrea* ,= ea* ( ! fir/ #b   
ye>s ( a grant aw>d$ "u ?is section1 n m
 ?an #c p]c5t ( ! funds may be us$ by ! 
rural heal? dep>tm5t receiv+ ! grant = !
 outrea* describ$ 9 p>agraph 7#a77;,c74 
7f7 ,au?orization ( appropriations ,!re 
are au?oriz$ to be appropriat$ to c>ry  
out ?is section #be1jjj1jjj = ea* (     
fiscal ye>s #bjbj ?r\gh #bjbd4  4