II 

Calendar No. 344 

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, Ms. BALDWIN, Ms. SMITH, Mrs. SHAHEEN, Mr. JONES, Mr. 

KING, Mr. SCOTT, Ms. KLOBUCHAR, Ms. WARREN, Ms. COLLINS, Ms. 

HASSAN, and Mr. HOEVEN) introduced the following bill; which was read 

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

Pensions 

MARCH 12, 2018 

Reported by Mr. ALEXANDER, with an amendment 

[Omit the part struck through and insert the part printed in italic] 

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’’. 


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1 SEC. 2. STATE OFFICES OF RURAL HEALTH. 

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

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

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

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

6 the Director of the Federal Office of Rural Health Policy 

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

8 shall make grants to each State Office of Rural Health 

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

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

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

12 the Secretary may not make a grant under sub13 section (a) unless the State office of rural health in14 volved agrees, with respect to the costs to be in15 curred in carrying out the purpose described in such 

16 subsection, to provide non-Federal contributions to17 ward such costs in an amount equal to $3 for each 

18 $1 of Federal funds provided in the grant. 

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

20 may waive or reduce the non-Federal contribution if 

21 the Secretary determines that requiring matching 

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

23 ability to carry out the purpose described in sub24 section (a). 

25 ‘‘(3) DETERMINATION OF AMOUNT OF NON26 FEDERAL CONTRIBUTION.—Non-Federal contribuVerDate Sep 11 2014 21:38 Mar 12, 2018 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2278.RS S2278

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1 tions required in paragraph (1) may be in cash or 

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

3 or services. Amounts provided by the Federal Gov4 ernment, or services assisted or subsidized to any 

5 significant extent by the Federal Government, may 

6 not be included in determining the amount of such 

7 non-Federal contributions. 

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

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

10 purposes of— 

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

12 rural health a clearinghouse for collecting and dis13 seminating information on— 

14 ‘‘(A) rural health care issues; 

15 ‘‘(B) research findings relating to rural 

16 health care; and 

17 ‘‘(C) innovative approaches to the delivery 

18 of health care in rural areas; 

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

20 the State that relate to rural health care, including 

21 providing coordination for the purpose of avoiding 

22 redundancy in such activities; and 

23 ‘‘(3) identifying Federal and State programs re24 garding rural health, and providing technical assistVerDate Sep 11 2014 21:38 Mar 12, 2018 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2278.RS S2278

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1 ance to public and nonprofit private entities regard2 ing participation in such programs. 

3 ‘‘(d) REQUIREMENT REGARDING ANNUAL BUDGET

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

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

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

7 health receives such a grant, the office operated pursuant 

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

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

10 ‘‘(e) CERTAIN USES OF FUNDS.— 

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

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

13 office of rural health involved agrees that the grant 

14 will not be expended— 

15 ‘‘(A) to provide health care (including pro16 viding cash payments regarding such care); 

17 ‘‘(B) to conduct activities for which Fed18 eral funds are expended— 

19 ‘‘(i) within the State to provide tech20 nical and other nonfinancial assistance 

21 under section 330A(f); 

22 ‘‘(ii) under a memorandum of agree23 ment entered into with the State office of 

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


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1 ‘‘(iii) under a grant under section 

2 338I; 

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

4 purchase ambulances, aircraft, or other vehicles, 

5 or to purchase major communications equip6 ment; 

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

8 or 

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

10 certificate of need. 

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

12 State office of rural health may expend a grant 

13 under subsection (a) include— 

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

15 office of rural health for purposes of subsection 

16 (a); 

17 ‘‘(B) subject to paragraph (1)(B)(iii), pay18 ing the costs of any activity carried out with re19 spect to recruiting and retaining health profes20 sionals to serve in rural areas of the State; and 

21 ‘‘(C) providing grants and contracts to 

22 public and nonprofit private entities to carry 

23 out activities authorized in this section. 

24 ‘‘(3) LIMIT ON INDIRECT COSTS.—The Sec25 retary may impose a limit of no more than 15 perVerDate Sep 11 2014 21:38 Mar 12, 2018 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2278.RS S2278

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1 cent on indirect costs claimed by the recipient of the 

2 grant. 

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

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

5 health involved agrees— 

6 ‘‘(1) to submit to the Secretary reports or per7 formance data containing such information as the 

8 Secretary may require regarding activities carried 

9 out under this section; and 

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

11 data not later than September 30 of each fiscal year 

12 immediately following any fiscal year for which the 

13 State office of rural health has received such a 

14 grant. 

15 ‘‘(g) REQUIREMENT OF APPLICATION.—The Sec16 retary may not make a grant under subsection (a) unless 

17 an application for the grant is submitted to the Secretary 

18 and the application is in such form, is made in such man19 ner, and contains such agreements, assurances, and infor20 mation as the Secretary determines to be necessary to 

21 carry out such subsection. 

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

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

24 rural health for any fiscal year subsequent to the first fis25 cal year of such payments unless the Secretary determines 


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

2 office of rural health has complied with each of the agree3 ments made by the State office of rural health under this 

4 section. 

5 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

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

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

8 be appropriated such sums as may be necessary 

9 $12,500,000 for each of fiscal years 2018 through 

10 2022. 

11 ‘‘(2) AVAILABILITY.—Amounts appropriated 

12 under paragraph (1) shall remain available until ex13 pended.’’. 


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Calendar No. 344 

115TH CONGRESS 

2D SESSION S. 2278 

A BILL 

To amend the Public Health Service Act to provide 

grants to improve health care in rural areas. 

MARCH 12, 2018 

Reported with an amendment 


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