II 

115TH CONGRESS 

2D SESSION S. 2278 

To amend the Public Health Service Act to provide grants to improve health 

care in rural areas. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 4, 2018 

Mr. ROBERTS (for himself, Ms. HEITKAMP, Mr. BARRASSO, Mr. CASEY, Mr. 

GRASSLEY, and Ms. BALDWIN) introduced the following bill; which was 

read twice and referred to the Committee on Health, Education, Labor, 

and Pensions 

A BILL 

To amend the Public Health Service Act to provide grants 

to improve health care in rural areas. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘State Offices of Rural 

5 Health Reauthorization Act of 2018’’. 

6 SEC. 2. STATE OFFICES OF RURAL HEALTH. 

7 Section 338J of the Public Health Service Act (42 

8 U.S.C. 254r) is amended to read as follows: 


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1 ‘‘SEC. 338J. GRANTS TO STATE OFFICES OF RURAL HEALTH. 

2 ‘‘(a) IN GENERAL.—The Secretary, acting through 

3 the Director of the Federal Office of Rural Health Policy 

4 (established under section 711 of the Social Security Act), 

5 shall make grants to each State Office of Rural Health 

6 for the purpose of improving health care in rural areas. 

7 ‘‘(b) REQUIREMENT OF MATCHING FUNDS.— 

8 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

9 the Secretary may not make a grant under sub10 section (a) unless the State office of rural health in11 volved agrees, with respect to the costs to be in12 curred in carrying out the purpose described in such 

13 subsection, to provide non-Federal contributions to14 ward such costs in an amount equal to $3 for each 

15 $1 of Federal funds provided in the grant. 

16 ‘‘(2) WAIVER OR REDUCTION.—The Secretary 

17 may waive or reduce the non-Federal contribution if 

18 the Secretary determines that requiring matching 

19 funds would limit the State office of rural health’s 

20 ability to carry out the purpose described in sub21 section (a). 

22 ‘‘(3) DETERMINATION OF AMOUNT OF NON23 FEDERAL CONTRIBUTION.—Non-Federal contribu24 tions required in paragraph (1) may be in cash or 

25 in kind, fairly evaluated, including plant, equipment, 

26 or services. Amounts provided by the Federal GovVerDate Sep 11 2014 23:55 Jan 04, 2018 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2278.IS S2278

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1 ernment, or services assisted or subsidized to any 

2 significant extent by the Federal Government, may 

3 not be included in determining the amount of such 

4 non-Federal contributions. 

5 ‘‘(c) CERTAIN REQUIRED ACTIVITIES.—Recipients of 

6 a grant under subsection (a) shall use the grant funds for 

7 purposes of— 

8 ‘‘(1) maintaining within the State office of 

9 rural health a clearinghouse for collecting and dis10 seminating information on— 

11 ‘‘(A) rural health care issues; 

12 ‘‘(B) research findings relating to rural 

13 health care; and 

14 ‘‘(C) innovative approaches to the delivery 

15 of health care in rural areas; 

16 ‘‘(2) coordinating the activities carried out in 

17 the State that relate to rural health care, including 

18 providing coordination for the purpose of avoiding 

19 redundancy in such activities; and 

20 ‘‘(3) identifying Federal and State programs re21 garding rural health, and providing technical assist22 ance to public and nonprofit private entities regard23 ing participation in such programs. 

24 ‘‘(d) REQUIREMENT REGARDING ANNUAL BUDGET

25 FOR OFFICE.—The Secretary may not make a grant 


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1 under subsection (a) unless the State involved agrees that, 

2 for any fiscal year for which the State office of rural 

3 health receives such a grant, the office operated pursuant 

4 to subsection (a) of this section will be provided with an 

5 annual budget of not less than $150,000. 

6 ‘‘(e) CERTAIN USES OF FUNDS.— 

7 ‘‘(1) RESTRICTIONS.—The Secretary may not 

8 make a grant under subsection (a) unless the State 

9 office of rural health involved agrees that the grant 

10 will not be expended— 

11 ‘‘(A) to provide health care (including pro12 viding cash payments regarding such care); 

13 ‘‘(B) to conduct activities for which Fed14 eral funds are expended— 

15 ‘‘(i) within the State to provide tech16 nical and other nonfinancial assistance 

17 under section 330A(f); 

18 ‘‘(ii) under a memorandum of agree19 ment entered into with the State office of 

20 rural health under section 330A(h); or 

21 ‘‘(iii) under a grant under section 

22 338I; 

23 ‘‘(C) to purchase medical equipment, to 

24 purchase ambulances, aircraft, or other vehicles, 


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1 or to purchase major communications equip2 ment; 

3 ‘‘(D) to purchase or improve real property; 

4 or 

5 ‘‘(E) to carry out any activity regarding a 

6 certificate of need. 

7 ‘‘(2) AUTHORITIES.—Activities for which a 

8 State office of rural health may expend a grant 

9 under subsection (a) include— 

10 ‘‘(A) paying the costs of maintaining an 

11 office of rural health for purposes of subsection 

12 (a); 

13 ‘‘(B) subject to paragraph (1)(B)(iii), pay14 ing the costs of any activity carried out with re15 spect to recruiting and retaining health profes16 sionals to serve in rural areas of the State; and 

17 ‘‘(C) providing grants and contracts to 

18 public and nonprofit private entities to carry 

19 out activities authorized in this section. 

20 ‘‘(3) LIMIT ON INDIRECT COSTS.—The Sec21 retary may impose a limit of no more than 15 per22 cent on indirect costs claimed by the recipient of the 

23 grant. 


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1 ‘‘(f) REPORTS.—The Secretary may not make a 

2 grant under subsection (a) unless the State office of rural 

3 health involved agrees— 

4 ‘‘(1) to submit to the Secretary reports or per5 formance data containing such information as the 

6 Secretary may require regarding activities carried 

7 out under this section; and 

8 ‘‘(2) to submit such a report or performance 

9 data not later than September 30 of each fiscal year 

10 immediately following any fiscal year for which the 

11 State office of rural health has received such a 

12 grant. 

13 ‘‘(g) REQUIREMENT OF APPLICATION.—The Sec14 retary may not make a grant under subsection (a) unless 

15 an application for the grant is submitted to the Secretary 

16 and the application is in such form, is made in such man17 ner, and contains such agreements, assurances, and infor18 mation as the Secretary determines to be necessary to 

19 carry out such subsection. 

20 ‘‘(h) NONCOMPLIANCE.—The Secretary may not 

21 make payments under subsection (a) to a State office of 

22 rural health for any fiscal year subsequent to the first fis23 cal year of such payments unless the Secretary determines 

24 that, for the immediately preceding fiscal year, the State 

25 office of rural health has complied with each of the agreeVerDate Sep 11 2014 23:55 Jan 04, 2018 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2278.IS S2278

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1 ments made by the State office of rural health under this 

2 section. 

3 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

4 ‘‘(1) IN GENERAL.—For the purpose of making 

5 grants under subsection (a), there are authorized to 

6 be appropriated such sums as may be necessary for 

7 each of fiscal years 2018 through 2022. 

8 ‘‘(2) AVAILABILITY.—Amounts appropriated 

9 under paragraph (1) shall remain available until ex10 pended.’’. 

Æ 


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