,i #aai? ,,congress #a/ ,session ,h4 ,r4 #fhjd ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,decemb] #ag1 #bjbe,mrs4 ,mill] ( ,we/ ,virg9ia 7= h]self & ,ms4 ,sewell7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,ways & ,means ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to /r5g!n ,m$ic>e rural hospital flexibility program grants4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,rural ,hospital ,flexibility ,act ( #bjbe4 #b4 ,m$ic>e rural hospital flexibility program grants ,section #ahbj7;g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#d7;g77 is am5d$-- 7#a7 by am5d+ p>agraph 7#a77;,d7 to read z foll[s3 7,d7 provid+ support = critical access hospitals1 c]tifi$ rural heal? cl9ics1 & rural em]g5cy hospitals 7z def9$ 9 section #ahfa7kkk77#b77 = quality improvem5t1 quality report+1 p]=mance improvem5ts1 b5*m>k+1 address+ population heal?1 trans=m+ s]vices1 & provid+ l9kages & s]vices = behavioral heal? & sub/ance use disord]s respond+ to public heal? em]g5cies4 2 7#b7 by r$esignat+ p>agraphs 7#c7 ?r\gh 7#g7 z p>agraphs 7#d7 ?r\gh 7#h71 respectively2 7#c7 aft] p>agraph 7#b71 by ins]t+ ! foll[+ new p>agraph3 7#c7 ,activities to support c>ry+ out o!r grants ,! ,secret>y may aw>d grants or coop]ative agreem5ts to entities aw>d$ grants or agreem5ts "u o!r provisions ( ?is subsection = purposes ( support+ su* entities 9 c>ry+ out activities "u su* o!r grants or agreem5ts by provid+ te*nical assi/ance1 data analysis1 & evaluation ef=ts4 ,an entity seek+ a grant "u ?is p>agraph %all submit an application to ! ,secret>y at su* "t & 9 su* mann] z specifi$ by ! ,secret>y4 2 7#d7 9 p>agraph 7#d71 z r$esignat$-- 7,a7 9 subp>agraph 7,a7-- 7i7 9 ! head]1 by /rik+ hospitals & ins]t+ ,/ate ,(fices ( ,rural ,heal?2 & 7ii7 by /rik+ grants to hospitals & ins]t+ grants to ,/ate ,(fices ( ,rural ,heal?2 7,b7 9 subp>agraph 7,b7-- 7i7 by r$esignat+ clauses 7i7 & 7ii7 z subclauses 7,i7 & 7,,ii71 respectively2 7ii7 by /rik+ means a non-,f$]al & ins]t+ ! foll[+3 means-- 7i7 a non-,f$]al 2 & 7iii7 by /rik+ ! p]iod at ! end & ins]t+ ! foll[+3 2 or 7ii7 a rural em]g5cy hospital 7z def9$ 9 section #ahfa7kkk774 2 7,c7 by am5d+ subp>agraph 7,c7 to read z foll[s3 7,c7 ,application ,! ,/ate ,(fice ( ,rural ,heal? %all submit an application to ! ,secret>y on or be=e su* date & 9 su* =m & mann] z ! ,secret>y specifies4 2 7,d7 by am5d+ subp>agraph 7,d7 to read z foll[s3 7,d7 ,am\nt ( grant ,) respect to funds made available to make grants "u ?is p>agraph 9 a fiscal ye>1 ! am\nt aw>d$ to a ,/ate ,(fice ( ,rural ,heal? %all be> ! same ratio to ! total am\nt ( su* funds s made available z ! numb] ( eligible small rural hospitals 9 su* ,/ate be>s to ! total numb] ( eligible small rural hospitals 9 all ,/ates receiv+ a grant "u ?is p>agraph = su* fiscal ye> propose4 2 7,e7 by am5d+ subp>agraph 7,e7 to read z foll[s3 7,e7 ,use ( funds ,/ate ,(fices ( ,rural ,heal? may use ! funds receiv$ ?r\gh a grant "u ?is p>agraph = ! pur*ase ( comput] s(tw>e & h>dw>e on behalf ( eligible small rural hospitals1 = ! education & tra9+ ( eligible small rural hospital /aff on bill+1 op]ational1 quality improvem5t1 & relat$ value-focus$ ef=ts1 & = o!r deliv]y sy/em re=m programs det]m9$ appropriate by ! ,secret>y4 2 & 7,f7 9 subp>agraph 7,f7-- 7i7 9 clause 7i71 by /rik+ ,a hospital receiv+ a grant "u ?is section & ins]t+ ,an entity receiv+ a grant "u ?is p>agraph2 & 7ii7 9 clause 7ii71 by /rik+ section ea* place su* t]m appe>s & ins]t+ p>agraph 9 ea* su* place2 7#e7 9 p>agraph 7#e71 z r$esignat$1 by /rik+ p>agraph 7#a7 or 7#b7 & ins]t+ p>agraph 7#a71 7#b71 or 7#d72 & 7#f7 by add+ at ! end ! foll[+ new p>agraphs3 7#i7 ,rural ,heal? ,trans=mation ,grants 7,a7 ,grants ,! ,secret>y may aw>d #e-ye> grants to ,/ate ,(fices ( ,rural ,heal? & to eligible rural heal? c>e provid]s 7z def9$ 9 subp>agraph 7,d77 on ! transition to new models1 includ+ rural em]g5cy hospitals1 ext5d$ /ay cl9ics1 free/&+ em]g5cy dep>tm5ts1 rural heal? cl9ics1 & integration ( behavioral1 oral heal? s]vices1 teleheal? & o!r trans=mational models relevant to rural provid]s z su* provid]s evolve to bett] meet community ne$s & ! *ang+ heal? c>e environm5t4 7,b7 ,application ,an eligible rural heal? c>e provid]1 9 consultation ) ! ,/ate ,(fice ( ,rural ,heal? 9 ! ,/ate 9 :i* ! rural heal? c>e provid] seek+ a grant "u ?is p>agraph is locat$1 %all submit an application to ! ,secret>y on or be=e su* date & 9 su* =m & mann] z ! ,secret>y specifies4 7,c7 ,additional requirem5ts ,! ,secret>y may n aw>d a grant "u ?is p>agraph to an eligible rural heal? c>e provid] unless-- 7i7 local organizations or ! ,/ate 9 :i* ! hospital is locat$ provides support 7ei!r direct or 9 k9d72 & !re are lett]s ( support f key ,/ate pay]s su* z ,m$icaid & private insurance2 & 7ii7 ! applicant describes 9 detail h[ ! transition ( ! heal? c>e provid] or provid]s w bett] meet local ne$s & be su/a9able4 7,d7 ,eligible rural heal? c>e provid] def9$ ,= purposes ( ?is p>agraph1 ! t]m eligible rural heal? c>e provid] includes a critical access hospital1 a c]tifi$ rural heal? cl9ic1 a rural nurs+ home1 skill$ nurs+ facility1 em]g5cy c>e provid]1 or o!r entity id5tifi$ by ! ,secret>y4 ,an eligible rural heal? c>e provid] may include o!r entities apply+ on behalf ( a gr\p ( rural heal? c>e provid]s su* z a ,/ate ,(fice ( ,rural ,heal?1 a ,/ate or local heal? c>e au?ority1 a rural heal? network1 or o!r entity id5tifi$ by ! ,secret>y4 7#aj7 ,rural em]g5cy hospital te*nical assi/ance 7,a7 ,9 g5]al ,! ,secret>y may aw>d grants or coop]ative agreem5ts to eligible entities 7z det]m9$ by ! ,secret>y7 = ! purpose ( provid+ te*nical assi/ance1 data analysis1 & o!r support to hospitals t are seek+ to be designat$1 or are curr5tly designat$1 z rural em]g5cy hospitals 7z describ$ 9 section #ahfa7kkk77#b774 7,b7 ,application ,an entity seek+ a grant "u subp>agraph 7,a7 %all submit an application to ! ,secret>y at su* "t & 9 su* =m & mann] z specifi$ by ! ,secret>y4 4