115TH CONGRESS 

2D SESSION S. 2278 

AN ACT 

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, 
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1 SECTION 1. SHORT TITLE. 

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

3 Health Reauthorization Act of 2018’’. 

4 SEC. 2. STATE OFFICES OF RURAL HEALTH. 

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

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

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

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

9 the Director of the Federal Office of Rural Health Policy 

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

11 shall make grants to each State Office of Rural Health 

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

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

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

15 the Secretary may not make a grant under sub16 section (a) unless the State office of rural health in17 volved agrees, with respect to the costs to be in18 curred in carrying out the purpose described in such 

19 subsection, to provide non-Federal contributions to20 ward such costs in an amount equal to $3 for each 

21 $1 of Federal funds provided in the grant. 

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

23 may waive or reduce the non-Federal contribution if 

24 the Secretary determines that requiring matching 

25 funds would limit the State office of rural health’s 
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1 ability to carry out the purpose described in sub2 section (a). 

3 ‘‘(3) DETERMINATION OF AMOUNT OF NON4 FEDERAL CONTRIBUTION.—Non-Federal contribu5 tions required in paragraph (1) may be in cash or 

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

7 or services. Amounts provided by the Federal Gov8 ernment, or services assisted or subsidized to any 

9 significant extent by the Federal Government, may 

10 not be included in determining the amount of such 

11 non-Federal contributions. 

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

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

14 purposes of— 

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

16 rural health a clearinghouse for collecting and dis17 seminating information on— 

18 ‘‘(A) rural health care issues; 

19 ‘‘(B) research findings relating to rural 

20 health care; and 

21 ‘‘(C) innovative approaches to the delivery 

22 of health care in rural areas; 

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

24 the State that relate to rural health care, including 
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1 providing coordination for the purpose of avoiding 

2 redundancy in such activities; and 

3 ‘‘(3) identifying Federal and State programs re4 garding rural health, and providing technical assist5 ance to public and nonprofit private entities regard6 ing participation in such programs. 

7 ‘‘(d) REQUIREMENT REGARDING ANNUAL BUDGET

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

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

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

11 health receives such a grant, the office operated pursuant 

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

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

14 ‘‘(e) CERTAIN USES OF FUNDS.— 

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

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

17 office of rural health involved agrees that the grant 

18 will not be expended— 

19 ‘‘(A) to provide health care (including pro20 viding cash payments regarding such care); 

21 ‘‘(B) to conduct activities for which Fed22 eral funds are expended— 

23 ‘‘(i) within the State to provide tech24 nical and other nonfinancial assistance 

25 under section 330A(f); 
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1 ‘‘(ii) under a memorandum of agree2 ment entered into with the State office of 

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

4 ‘‘(iii) under a grant under section 

5 338I; 

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

7 purchase ambulances, aircraft, or other vehicles, 

8 or to purchase major communications equip9 ment; 

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

11 or 

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

13 certificate of need. 

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

15 State office of rural health may expend a grant 

16 under subsection (a) include— 

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

18 office of rural health for purposes of subsection 

19 (a); 

20 ‘‘(B) subject to paragraph (1)(B)(iii), pay21 ing the costs of any activity carried out with re22 spect to recruiting and retaining health profes23 sionals to serve in rural areas of the State; and 
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1 ‘‘(C) providing grants and contracts to 

2 public and nonprofit private entities to carry 

3 out activities authorized in this section. 

4 ‘‘(3) LIMIT ON INDIRECT COSTS.—The Sec5 retary may impose a limit of no more than 15 per6 cent on indirect costs claimed by the recipient of the 

7 grant. 

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

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

10 health involved agrees— 

11 ‘‘(1) to submit to the Secretary reports or per12 formance data containing such information as the 

13 Secretary may require regarding activities carried 

14 out under this section; and 

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

16 data not later than September 30 of each fiscal year 

17 immediately following any fiscal year for which the 

18 State office of rural health has received such a 

19 grant. 

20 ‘‘(g) REQUIREMENT OF APPLICATION.—The Sec21 retary may not make a grant under subsection (a) unless 

22 an application for the grant is submitted to the Secretary 

23 and the application is in such form, is made in such man24 ner, and contains such agreements, assurances, and infor-
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1 mation as the Secretary determines to be necessary to 

2 carry out such subsection. 

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

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

5 rural health for any fiscal year subsequent to the first fis6 cal year of such payments unless the Secretary determines 

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

8 office of rural health has complied with each of the agree9 ments made by the State office of rural health under this 

10 section. 

11 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

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

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

14 be appropriated $12,500,000 for each of fiscal years 

15 2018 through 2022. 

16 ‘‘(2) AVAILABILITY.—Amounts appropriated 

17 under paragraph (1) shall remain available until ex18 pended.’’. 

Passed the Senate July 24, 2018. 

Attest: 

Secretary. 
115TH CONGRESS 

2D SESSION S. 2278 

AN ACT 

To amend the Public Health Service Act to provide 

grants to improve health care in rural areas.