,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hejd  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #bg1 #bjbf,mr4 
,figures 7= himself1 ,ms4 ,bynum1 ,ms4  
,sewell1 ,mr4 ,?ompson ( ,mississippi1 &
 ,mrs4 ,beatty7 introduc$ ! foll[+ bill2
 :i* 0 ref]r$ to ! ,committee on        
,agriculture  ,a ,,bill  ,to au?orize   
af=dable f9anc+ assi/ance = rural heal? 
c5t]s fac+ f9ancial di/ress1 & to       
protect access to ess5tial heal? s]vices
 9 rural communities4  #a4 ,%ort title  
,?is ,act may be cit$ z ! ,rural ,heal? 
,resili5ce ,act ( #bjbf4  #b4 ,rural    
heal? c>e facility /abilization         
assi/ance program ,subtitle ,d ( !      
,consolidat$ ,f>m & ,rural ,developm5t  
,act 7#g ,u4,s4,c4 #aiha-bjjhw7 is am5d$
 by ins]t+ aft] section #cgd ! foll[+3  
#cge4 ,rural heal? c>e facility         
/abilization assi/ance program  7a7 ,9  
g5]al ,! ,secret>y %all provide loans & 
loan gu>antees to help prev5t rural     
heal? c5t]s f clos+ or r$uc+ ess5tial   
s]vices4  7b7 ,eligible borr[]s  7#a7 ,9

 g5]al ,a heal? c5t] %all be eligible = 
a loan or loan gu>antee "u ?is section  
if-- 7,a7 7i7 ! heal? c5t]--  7,i7 is   
locat$ 9 a rural area2 or  7,,ii7 s]ves 
a rural community ) a hospital at lea/  
#fj p]c5t ( ! pati5ts ( :i* h _! prim>y 
resid5ce 9 a rural area2 or  7ii7 at    
lea/ #cj p]c5t ( ! pati5ts ( ! heal?    
c5t] reside 9 a rural area2 &  7,b7 !   
heal? c5t] demon/rates f9ancial di/ress 
?r\gh objective indicators su* z op]at+ 
m>g9 ( less ?an #e p]c5t1 l[ ca%        
res]ves1 risk ( s]vice loss1 or su* o!r 
indicators z may be det]m9$ by !        
,secret>y4  7#b7 ,def9itions ,9 ?is     
section3 7,a7 ,heal? c5t] ,! t]m heal?  
c5t] means ! foll[+3  7i7 ,a subsection 
7d7 hospital 7z def9$ 9 p>agraph        
7#a77;,b7 ( section #ahhf7;d7 ( !       
,social ,security ,act74  7ii7 ,a       
critical access hospital 7z def9$ 9     
section #ahfa7mm77#a7 ( ! ,social       
,security ,act74  7iii7 ,a sole         
community hospital 7z def9$ 9 section   
#ahhf7;d77#e77;,d77iii7 ( ! ,social     

,security ,act74  7iv7 ,a               
,m$ic>e-dep5d5t1 small rural hospital 7z
 def9$ 9 section #ahhf7;d77#e77;,g77iv7 
( ! ,social ,security ,act74  7v7 ,a    
l[-volume hospital 7z def9$ 9 section   
#ahhf7;d77#ab77;,c7 ( ! ,social         
,security ,act74  7vi7 ,a rural em]g5cy 
hospital 7z def9$ 9 section             
#ahfa7kkk77#b7 ( ! ,social ,security    
,act74  7vii7 ,a rural heal? cl9ic 7z   
def9$ 9 section #ahfa7;aa77#b7 ( !      
,social ,security ,act74  7viii7 ,a     
,f$]ally qualifi$ heal? c5t] 7z def9$ 9 
section #ahfa7;aa77#d77 ( ! ,social     
,security ,act4  7ix7 ,a community m5tal
 heal? c5t] 7z def9$ 9 section          
#ahfa7;ff77#c77;,b7 ( ! ,social         
,security ,act74  7x7 ,a heal? c5t] t is
 receiv+ a grant "u section #ccj ( !    
,public ,heal? ,s]vice ,act4  7xi7 ,an  
opioid treatm5t program 7z def9$ 9      
section #ahfa7;jjj77#b7 ( ! ,social     
,security ,act74  7xii7 ,a c]tifi$      
community behavioral heal? cl9ic 7z     
def9$ 9 section #aije7;jj77#b7 ( !      

,social ,security ,act74  7,b7 ,rural   
area ,! t]m rural area has ! mean+ giv5 
! t]m 9 subp>agraph 7,a7 ( section      
#cdc7;a77#ac71 includ+ an area describ$ 
9 clause 7ii7 ( su* subp>agraph t !     
,secret>y det]m9es "u subp>agraph 7,d7 (
 su* section is a rural area4  7#c7     
,priority  7,a7 ,9 g5]al ,9 c>ry+ out   
?is section1 ! ,secret>y may prioritize 
! provision ( assi/ance to heal? c5t]s t
 are--  7i7 sole community provid]s1 z  
det]m9$ by ! ,secret>y2  7ii7 provid]s 9
 a high pov]ty area or an area designat$
 by ! ,secret>y z hav+ a %ortage (      
p]sonal heal? s]vices2 &  7iii7         
hospitals deliv]+ critical em]g5cy &    
safety-net s]vices1 z det]m9$ by !      
,secret>y4  7,b7 ,high pov]ty area def9$
 ,9 subp>agraph 7,a71 ! t]m high pov]ty 
area means an area ) an areawide pov]ty 
rate ( #bj p]c5t or m1 bas$ on !        
,(ficial ,pov]ty ,measure ( ! ,bureau ( 
! ,c5sus4  7c7 ,use ( funds ,not)/&+ any
 o!r provision ( ?is subtitle1 a heal?  
c5t] to :i* a loan or loan gu>antee is  

provid$ "u ?is section may use ! loan or
 loan gu>antee to prev5t ! closure (1 or
 ! r$uction ( ! provision ( ess5tial    
s]vices by ! heal? c5t]1 & to re/ore !  
provision ( ess5tial s]vices by ! heal? 
c5t]1 by us+ ! loan proce$s 9 ways su*  
z-- 7#a7 = projects to acquire1 repair1 
or upgrade ! sy/ems1 facilities1 &      
equipm5t ( ! heal? c5t]2  7#b7 to cov] !
 op]ational co/s ( ! heal? c5t]1 includ+
 supplies & payroll exp5ses 7except     
bonuses72  7#c7 = debt paym5ts1 work+   
capital1 ma9ta9+ ess5tial s]vice l9es1  
bridg+ reimbursem5t tim+ gaps1 or       
ref9anc+ high-int]e/ debt incurr$ =     
pati5t c>e op]ations2 or  7#d7 any o!r  
activity z ! ,secret>y may all[4  7d7   
,report to ,congress ,)9 #ah mon?s aft] 
! date ( ! enactm5t ( ?is section1 !    
,secret>y %all submit to ! ,committee on
 ,agriculture ( ! ,h\se (               
,repres5tatives & ! ,committee on       
,agriculture1 ,nutrition1 & ,=e/ry ( !  
,s5ate a report on ! activities &       
outcomes ( ! program c>ri$ out "u ?is   

section1 includ+ ! effect ( ! program on
 /abiliz+ ! f9ances ( ! rural heal? c>e 
facilities assi/$ by ! program1 & %all  
make available to ! public a summ>y ( ! 
report :i* does n include any p]sonal   
in=mation or any f9ancial in=mation ab\t
 a heal? c5t]4  4