S. 2278 

One Hundred Fifteenth Congress 

of the 

United States of America 

AT THE SECOND SESSION 

Begun and held at the City of Washington on Wednesday, 

the third day of January, two thousand and eighteen 

An Act 

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

in rural areas. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. SHORT TITLE. 

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

Reauthorization Act of 2018’’. 

SEC. 2. STATE OFFICES OF RURAL HEALTH. 

Section 338J of the Public Health Service Act (42 U.S.C. 254r) 

is amended to read as follows: 

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

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

of the Federal Office of Rural Health Policy (established under 

section 711 of the Social Security Act), shall make grants to each 

State Office of Rural Health for the purpose of improving health 

care in rural areas. 

‘‘(b) REQUIREMENT OF MATCHING FUNDS.— 

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

may not make a grant under subsection (a) unless the State 

office of rural health involved agrees, with respect to the costs 

to be incurred in carrying out the purpose described in such 

subsection, to provide non-Federal contributions toward such 

costs in an amount equal to $3 for each $1 of Federal funds 

provided in the grant. 

‘‘(2) WAIVER OR REDUCTION.—The Secretary may waive or 

reduce the non-Federal contribution if the Secretary determines 

that requiring matching funds would limit the State office 

of rural health’s ability to carry out the purpose described 

in subsection (a). 

‘‘(3) DETERMINATION OF AMOUNT OF NON-FEDERAL CONTRIBUTION.—Non-Federal contributions required in paragraph 

(1) may be in cash or in kind, fairly evaluated, including plant, 

equipment, or services. Amounts provided by the Federal 

Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included 

in determining the amount of such non-Federal contributions. 

‘‘(c) CERTAIN REQUIRED ACTIVITIES.—Recipients of a grant 

under subsection (a) shall use the grant funds for purposes of— 

‘‘(1) maintaining within the State office of rural health 

a clearinghouse for collecting and disseminating information 

on— 
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‘‘(A) rural health care issues; 

‘‘(B) research findings relating to rural health care; 

and 

‘‘(C) innovative approaches to the delivery of health 

care in rural areas; 

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

that relate to rural health care, including providing coordination 

for the purpose of avoiding redundancy in such activities; and 

‘‘(3) identifying Federal and State programs regarding rural 

health, and providing technical assistance to public and nonprofit private entities regarding participation in such programs. 

‘‘(d) REQUIREMENT REGARDING ANNUAL BUDGET FOR OFFICE.— The Secretary may not make a grant under subsection (a) unless 

the State involved agrees that, for any fiscal year for which the 

State office of rural health receives such a grant, the office operated 

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

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

‘‘(e) CERTAIN USES OF FUNDS.— 

‘‘(1) RESTRICTIONS.—The Secretary may not make a grant 

under subsection (a) unless the State office of rural health 

involved agrees that the grant will not be expended— 

‘‘(A) to provide health care (including providing cash 

payments regarding such care); 

‘‘(B) to conduct activities for which Federal funds are 

expended— 

‘‘(i) within the State to provide technical and other 

nonfinancial assistance under section 330A(f); 

‘‘(ii) under a memorandum of agreement entered 

into with the State office of rural health under section 

330A(h); or 

‘‘(iii) under a grant under section 338I; 

‘‘(C) to purchase medical equipment, to purchase ambulances, aircraft, or other vehicles, or to purchase major 

communications equipment; 

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

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

of need. 

‘‘(2) AUTHORITIES.—Activities for which a State office of 

rural health may expend a grant under subsection (a) include— 

‘‘(A) paying the costs of maintaining an office of rural 

health for purposes of subsection (a); 

‘‘(B) subject to paragraph (1)(B)(iii), paying the costs 

of any activity carried out with respect to recruiting and 

retaining health professionals to serve in rural areas of 

the State; and 

‘‘(C) providing grants and contracts to public and nonprofit private entities to carry out activities authorized 

in this section. 

‘‘(3) LIMIT ON INDIRECT COSTS.—The Secretary may impose 

a limit of no more than 15 percent on indirect costs claimed 

by the recipient of the grant. 

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

subsection (a) unless the State office of rural health involved 

agrees— 

‘‘(1) to submit to the Secretary reports or performance 

data containing such information as the Secretary may require 

regarding activities carried out under this section; and 
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‘‘(2) to submit such a report or performance data not later 

than September 30 of each fiscal year immediately following 

any fiscal year for which the State office of rural health has 

received such a grant. 

‘‘(g) REQUIREMENT OF APPLICATION.—The Secretary may not 

make a grant under subsection (a) unless an application for the 

grant is submitted to the Secretary and the application is in such 

form, is made in such manner, and contains such agreements, 

assurances, and information as the Secretary determines to be 

necessary to carry out such subsection. 

‘‘(h) NONCOMPLIANCE.—The Secretary may not make payments 

under subsection (a) to a State office of rural health for any fiscal 

year subsequent to the first fiscal year of such payments unless 

the Secretary determines that, for the immediately preceding fiscal 

year, the State office of rural health has complied with each of 

the agreements made by the State office of rural health under 

this section. 

‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

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

subsection (a), there are authorized to be appropriated 

$12,500,000 for each of fiscal years 2018 through 2022. 

‘‘(2) AVAILABILITY.—Amounts appropriated under paragraph (1) shall remain available until expended.’’. 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate.