,i  #aahth ,,congress  #ast ,session    
,h4 ,r4 #dgac  ,,in ,,the ,,house ,,of  
,,representatives  ,july #ah1 #bjbc,mr4 
,jackson of ,texas 7for himself1 ,mr4   
,kilmer1 ,mr4 ,zinke1 ,ms4 ,tokuda1     
,mrs4 ,boebert1 ,ms4 ,sewell1 ,mr4      
,arrington1 ,ms4 ,kuster1 ,mr4 ,mann1   
,ms4 ,wild1 ,mr4 ,sessions1 ,ms4        
,pettersen1 ,mr4 ,carl1 ,mr4 ,larsen of 
,washington1 ,mr4 ,la,malfa1 ,ms4       
,schrier1 ,ms4 ,perez1 ,ms4 ,hoyle of   
,oregon1 ,ms4 ,budzinski1 ,mr4 ,davis of
 ,north ,carolina1 ,mr4 ,schiff1 ,mr4   
,pfluger1 ,mr4 ,trone1 and ,mrs4 ,miller
 of ,west ,virginia7 introduced the     
following bill2 which was referred to   
the ,committee on ,agriculture  ,a      
,,bill  ,to codify the ,rural ,hospital 
,technical ,assistance ,program of the  
,department of ,agriculture4  #a4 ,short
 title ,this ,act may be cited as the   
,rural ,hospital ,technical ,assistance 
,program ,act4  #b4 ,codification of the
 ,rural ,hospital ,technical ,assistance
 ,program of the ,department of         

,agriculture  7a7 ,in general ,in lieu  
of any other authority under which the  
,secretary of ,agriculture 7in this     
section referred to as the ,secretary7  
may provide technical assistance to any 
eligible rural hospital facility1 the   
,secretary shall establish1 and         
maintain1 directly or by grant1         
contract1 or cooperative agreement1 a   
,rural ,hospital ,technical ,assistance 
,program 7in this section referred to as
 the ,program7 to provide technical     
assistance and training1 tailored to the
 capacity and needs of each eligible    
hospital facility1 to help eligible     
hospital facilities in rural areas with 
a population of not more than #ej1jjj   
inhabitants--  7#a7 identify development
 needs for maintaining essential health 
care services1 and support action plans 
for financial1 operational1 and quality 
improvement projects to meet the        
development needs2  7#b7 better manage  
their financial and business strategies2
 and  7#c7 identify1 and apply for      

assistance from1 loan and grant programs
 of the ,department of ,agriculture for 
which the facilities are eligible4  7b7 
,goals ,the goals of the ,program shall 
be to--  7#a7 improve the long-term     
financial position and operational      
efficiency of eligible rural hospital   
facilities2  7#b7 prevent the closure of
 eligible rural hospital facilities2    
7#c7 strengthen the delivery of health  
care in rural areas2 and  7#d7 help     
eligible rural hospital facilities      
better access and compete for loans and 
grants from programs administered by the
 ,department of ,agriculture4  7c7      
,definitions ,in this section3 7#a7     
,development needs ,the term development
 needs includes--  7,a7 constructing1   
expanding1 renovating or otherwise      
modernizing health care facilities2     
7,b7 increasing telehealth capabilities2
  7,c7 acquiring or upgrading health    
care information systems such as        
electronic health records2 and  7,d7    
such other needs as the ,secretary deems

 critical to maintaining health care    
services in the community in which an   
eligible rural hospital facility is     
located4  7#b7 ,eligible hospital       
facility ,the term eligible hospital    
facility means a facility that is-- 7,a7
 7i7 a hospital 7as defined in section  
#ahfa7;e7 of the ,social ,security      
,act72  7ii7 a psychiatric hospital 7as 
defined in section #ahfa7;f7 of such    
,act72  7iii7 a long-term care hospital 
7as defined in section #ahfa7;ccc7 of   
such ,act72  7iv7 a critical access     
hospital 7as defined in section         
#ahfa7mm77#a7 of such ,act72  7v7 a     
religious nonmedical health care        
institution 7as defined in section      
#ahfa7ss77#a7 of such ,act72  7vi7 a    
rural health clinic 7as defined in      
section #ahfa7;aa77#b7 of such ,act72   
7vii7 a sole community hospital 7as     
defined in section                      
#ahhf7;d77#e77;,c77iii7 of such ,act72  
7viii7 a rural emergency hospital 7as   
defined in section #ahfa7kkk77#b7 of    

such ,act72  7ix7 a community health    
center 7as defined in section #ccj of   
the ,public ,health ,service ,act72 or  
7x7 any other rural hospital as         
determined by the ,secretary of         
,agriculture in consultation with the   
,secretary of the ,department of ,health
 and ,human ,services2 and  7,b7 located
 in a rural area4  7#c7 ,rural area ,the
 term rural area has the meaning given  
the term in section #cdc7;a77#ac77;,a7  
of the ,consolidated ,farm and ,rural   
,development ,act4  7#d7 ,health        
professional shortage area ,the term    
health professional shortage area has   
the meaning given the term in section   
#ccb7;a77#a77;,a7 of the ,public ,health
 ,service ,act74  7#e7 ,medically       
underserved area ,the term medically    
underserved area has the meaning given  
the term in section #ccj;,i7a77#e7 of   
the ,public ,health ,service ,act4  7#f7
 ,medically underserved population ,the 
term medically underserved population   
has the meaning given the term in       

section #ccj7;b77#c7 of the ,public     
,health ,service ,act4  7d7 ,program    
participation  7#a7 ,in general ,the    
,secretary shall engage in outreach and 
engagement strategies to encourage      
eligible hospital facilities to         
participate in the ,program4  7#b7      
,hospital selection ,in selecting       
eligible hospital facilities to         
participate in the ,program1 the        
,secretary shall give priority to       
borrowers and grantees of the ,rural    
,housing ,service1 ,rural               
,business-,cooperative ,service1 and    
,rural ,utilities ,service4 ,the        
,secretary may also consider--  7,a7 the
 age and physical state of the hospital 
or clinic facilities involved2  7,b7 the
 financial vulnerability of the hospital
 or clinic facilities1 and the ability  
of the hospital or clinic facilities to 
meet debt obligations2  7,c7 the        
electronic health record implementation 
needs of the hospital or clinic         
facilities2  7,d7 whether the hospital  

or clinic is located in a health        
professional shortage area or a         
medically underserved area2  7,e7       
whether the hospital serves a medically 
underserved population2 and  7,f7 such  
other criteria and priorities as are    
determined by the ,secretary4  7e7      
,reporting requirements ,not later than 
#a year after the date of the enactment 
of this section1 and annually           
thereafter1 the ,secretary shall submit 
to the ,committee on ,agriculture of the
 ,house of ,representatives and the     
,committee on ,agriculture1 ,nutrition1 
and ,forestry of the ,senate a written  
report describing the progress and      
results of the program conducted under  
this section1 which should include--    
7#a7 a brief description of each project
 to provide technical assistance to an  
eligible hospital facility under this   
section1 including--  7,a7 the name and 
location of the facility2  7,b7 a       
description of the assistance provided2 
7,c7 a description of the outcomes for  

completed projects2  7,d7 the cost of   
the technical assistance2 and  7,e7 any 
other information the ,secretary deems  
appropriate2  7#b7 a summary of the     
technical assistance projects completed2
  7#c7 a summary of the outcomes of the 
technical assistance projects2  7#d7 an 
assessment of the effectiveness of the  
,program2 and  7#e7 recommendations for 
improving the ,program4  7f7            
,limitations on authorization of        
appropriations ,to carry out this       
section1 there are authorized to be     
appropriated to the ,secretary not more 
than #b1jjj1jjj for each of fiscal years
 #bjbd through #bjbh4