II 

117TH CONGRESS 

1ST SESSION S. 2450 

To amend the Public Health Service Act to establish a rural health center 

innovation awards program and a rural health department enhancement 

program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 22, 2021 

Mrs. BLACKBURN (for herself and Mr. HICKENLOOPER) 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 establish a rural 

health center innovation awards program and a rural 

health department enhancement program, and for other 

purposes. 

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 ‘‘Rural Health Innova5 tion Act of 2021’’. 


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1 SEC. 2. RURAL HEALTH CENTER INNOVATION AWARDS 

2 PROGRAM. 

3 Subpart I of part D of title III of the Public Health 

4 Service Act (42 U.S.C. 254b et seq.) is amended by adding 

5 at the end the following: 

6 ‘‘SEC. 330O. RURAL HEALTH CENTER INNOVATION AWARDS 

7 PROGRAM. 

8 ‘‘(a) DEFINITIONS.—In this section: 

9 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en10 tity’ means an entity that— 

11 ‘‘(A) is a Federally qualified health center; 

12 ‘‘(B) is a rural health clinic; or 

13 ‘‘(C) agrees (as a condition of receiving a 

14 grant under this section) to establish such a 

15 center or clinic, including a hospital that agrees 

16 (as such a condition) to convert to a Federally 

17 qualified health center or rural health clinic. 

18 ‘‘(2) FEDERALLY QUALIFIED HEALTH CEN19 TER.—The term ‘Federally qualified health center’ 

20 has the meaning given such term in section 

21 1861(aa) of the Social Security Act. 

22 ‘‘(3) RURAL AREA.—The term ‘rural area’ 

23 means any area that is rural, within the meaning of 

24 such term as used by the Office of Rural Health 

25 Policy of the Health Resources and Services Admin26 istration for purposes of determining eligibility for 


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1 grants or services, including any area that is rural 

2 within such meaning as used by such Office for fis3 cal year 2021 or any area that is rural within such 

4 meaning as amended for a subsequent fiscal year. 

5 ‘‘(4) RURAL HEALTH CLINIC.—The term ‘rural 

6 health clinic’ has the meaning given such term in 

7 section 1861(aa) of the Social Security Act. 

8 ‘‘(b) ESTABLISHMENT.— 

9 ‘‘(1) IN GENERAL.—The Secretary, acting 

10 through the Director of the Office of Rural Health 

11 Policy of the Health Resources and Services Admin12 istration, shall establish a grant program to be 

13 known as the ‘Rural Health Center Innovation 

14 Awards program’ to award grants to eligible entities 

15 that submit an application in accordance with sub16 section (c) to enable such entities to establish or 

17 maintain a Federally qualified health center or rural 

18 health clinic that— 

19 ‘‘(A) serves individuals in a rural area as 

20 a walk-in urgent care center and as a triage 

21 center or staging facility for necessary air or 

22 ambulance transport to an emergency depart23 ment; and 

24 ‘‘(B) includes— 


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1 ‘‘(i) professional clinical staff, includ2 ing physicians, physician interns, residents, 

3 nurse practitioners, physician assistants, 

4 nurse midwives, or other health care pro5 viders providing walk-in urgent care and 

6 emergency triage; and 

7 ‘‘(ii) resources, including laboratories, 

8 x-ray machines, and cardiac monitors. 

9 ‘‘(2) PERMISSIBLE USES OF FUNDS.—The 

10 funds of a grant awarded under this section may be 

11 used to— 

12 ‘‘(A) expand the hours of operation of a 

13 Federally qualified health center or rural health 

14 clinic; 

15 ‘‘(B) pay for the costs of construction and 

16 renovation of a Federally qualified health center 

17 or rural health clinic; or 

18 ‘‘(C) carry out any other activity for the 

19 purposes described in paragraph (1). 

20 ‘‘(c) APPLICATIONS AND SELECTION.— 

21 ‘‘(1) IN GENERAL.—An eligible entity seeking a 

22 grant under this section shall submit to the Sec23 retary an application at such time, in such manner, 

24 and containing such information as the Secretary 

25 may reasonably require. 


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1 ‘‘(2) START UP CENTERS AND CLINICS.—An 

2 application submitted under paragraph (1) by an eli3 gible entity that is not a Federally qualified health 

4 center, or a rural health clinic, on the date on which 

5 the entity submits the application under paragraph 

6 (1) shall include in such application a demonstration 

7 of the costs of the equipment and staffing needed to 

8 establish the center or clinic. 

9 ‘‘(3) CONSIDERATION OF OVERLAP.—In the 

10 case an eligible entity submits an application under 

11 paragraph (1) that proposes to serve an area that is 

12 served by another eligible entity through a grant 

13 under this section, the Secretary may consider 

14 whether an award to the eligible entity serving such 

15 same area can be justified based on the unmet need 

16 for additional services in such area. 

17 ‘‘(4) PRIORITY.—In selecting recipients of 

18 grants under this section, the Secretary shall give 

19 priority to an eligible entity that is operating as a 

20 Federally qualified health center, or a rural health 

21 clinic, on the date on which the entity submits the 

22 application under paragraph (1). 

23 ‘‘(d) GRANT PERIOD AND AMOUNTS.— 

24 ‘‘(1) PERIOD.—Each grant awarded under this 

25 section shall be for a period of 5 years. 


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1 ‘‘(2) AMOUNT.— 

2 ‘‘(A) IN GENERAL.—A grant awarded 

3 under this section to an eligible entity shall not 

4 exceed— 

5 ‘‘(i) for the first year of the grant— 

6 ‘‘(I) $500,000 if the entity is a 

7 Federally qualified health center, or a 

8 rural health clinic, on the date on 

9 which the award is made; and 

10 ‘‘(II) $750,000 if the entity is 

11 using the grant to establish a Feder12 ally qualified health center or a rural 

13 health clinic; and 

14 ‘‘(ii) for each of the second through 

15 fifth years of the grant, $500,000. 

16 ‘‘(B) CONSIDERATIONS.—In determining 

17 the amount of a grant under this section for an 

18 eligible entity for each year after the first year 

19 in which the grant is awarded, the Secretary 

20 shall, subject to subparagraph (A)(ii), consider 

21 the number of patients treated, and the type of 

22 treatment provided, by the entity in the prior 

23 year. 

24 ‘‘(e) REPORTING.— 


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1 ‘‘(1) IN GENERAL.—Not later than 3 years 

2 after the date of enactment of this section, the Sec3 retary shall report to the committees described in 

4 paragraph (2) on the grant program under this sec5 tion, including— 

6 ‘‘(A) an assessment of the success of the 

7 program, challenges with respect to the pro8 gram, and any action for regulatory flexibility 

9 or legislative authority needed to improve the 

10 program; 

11 ‘‘(B) any savings to Federal health care 

12 programs; 

13 ‘‘(C) any increase in access to care; and 

14 ‘‘(D) any increase in utilization of health 

15 services in rural areas. 

16 ‘‘(2) COMMITTEES.—The committees described 

17 in this paragraph are— 

18 ‘‘(A) the Committee on Health, Education, 

19 Labor, and Pensions, and the Committee on Fi20 nance, of the Senate; and 

21 ‘‘(B) the Committee on Energy and Com22 merce, and the Committee on Ways and Means, 

23 of the House of Representatives. 

24 ‘‘(f) RULE OF CONSTRUCTION.—No entity receiving 

25 a grant under this section shall lose status as a Federally 


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1 qualified health center, or a rural health clinic, on account 

2 of carrying out any activities under this section. 

3 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

4 is authorized to be appropriated to carry out this section 

5 $25,000,000 for each of fiscal years 2022 through 2026.’’. 

6 SEC. 3. RURAL HEALTH DEPARTMENT ENHANCEMENT PRO7 GRAM. 

8 Subpart I of part D of title III of the Public Health 

9 Service Act (42 U.S.C. 254b et seq.), as amended by sec10 tion 2, is further amended by adding at the end the fol11 lowing: 

12 ‘‘SEC. 330P. RURAL HEALTH DEPARTMENT ENHANCEMENT 

13 PROGRAM. 

14 ‘‘(a) DEFINITIONS.—In this section: 

15 ‘‘(1) RURAL AREA.—The term ‘rural area’ has 

16 the meaning given the term in section 330O(a). 

17 ‘‘(2) RURAL HEALTH DEPARTMENT.—The term 

18 ‘rural health department’ means a local public health 

19 department that is located in a rural area. 

20 ‘‘(b) ESTABLISHMENT.—The Secretary, acting 

21 through the Director of the Office of Rural Health Policy 

22 of the Health Resources and Services Administration, 

23 shall award grants, on a competitive basis, to rural health 

24 departments that submit an application in accordance 

25 with subsection (c) to enhance such departments and enVerDate Sep 11 2014 00:00 Jul 24, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2450.IS S2450

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1 able them to provide individuals in rural areas with emer2 gency services, triage and transport to emergency depart3 ments, primary care services, and other services similar 

4 to services provided by emergency departments. 

5 ‘‘(c) APPLICATIONS.—A rural health department 

6 seeking a grant under this section shall submit an applica7 tion to the Secretary at such time, in such manner, and 

8 containing such information as the Secretary may reason9 ably require, including— 

10 ‘‘(1) an indication of the estimated cost of the 

11 equipment and staffing needed by the department 

12 for the first year of the award to set up the activities 

13 and services under this section; 

14 ‘‘(2) a demonstration that the department has, 

15 on the date on which the application is submitted, 

16 a facility operating that is located in a rural area; 

17 and 

18 ‘‘(3) a demonstration that, on the date on 

19 which the application is submitted, the depart20 ment— 

21 ‘‘(A) has a nursing staff and medical 

22 equipment; and 

23 ‘‘(B) agrees to use such staff and equip24 ment towards providing the services and car25 rying out the activities under this section. 


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1 ‘‘(d) GRANTS.— 

2 ‘‘(1) ANNUAL AWARDS.—The funds awarded 

3 through a grant under this section to a rural health 

4 department shall be awarded on an annual basis for 

5 each of 5 years. 

6 ‘‘(2) MAXIMUM AMOUNTS.—The funds awarded 

7 through a grant under this section to a rural health 

8 department shall be in an amount that for a year 

9 does not exceed $500,000. 

10 ‘‘(3) CONSIDERATIONS.—The Secretary shall 

11 determine the amount awarded to a rural health de12 partment through a grant under this section for a 

13 year in accordance with the following: 

14 ‘‘(A) For the first year of the award, the 

15 amount shall be based on the amount the rural 

16 health department estimates for the cost of 

17 equipment and staffing needed to set up the ac18 tivities and services supported under this sec19 tion, as specified in the application under sub20 section (c). 

21 ‘‘(B) For the second through fifth years of 

22 the award, the amount shall be based on the 

23 number of patients treated, and the type of 

24 treatment provided, by the department in the 

25 prior year. 


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1 ‘‘(e) USE OF FUNDS.— 

2 ‘‘(1) IN GENERAL.—A rural health department 

3 receiving a grant under this section shall use the 

4 funds awarded through the grant to provide the 

5 services and carry out the activities described in sub6 section (b) at a facility that is located in a rural 

7 area, including by— 

8 ‘‘(A) obtaining additional medical equip9 ment and resources necessary for providing the 

10 services and activities described in subsection 

11 (b), such as laboratories, x-ray machines, and 

12 cardiac monitors; 

13 ‘‘(B) hiring additional providers to provide 

14 the services and carry out the activities de15 scribed in subsection (b), such as physician in16 terns, residents, nurse practitioners, physician 

17 assistants, and nurse midwives, which hiring 

18 may be through a partnership described in 

19 paragraph (2)(A); and 

20 ‘‘(C) providing outreach to the community 

21 regarding the services and activities of the rural 

22 health department as supported under this sec23 tion. 

24 ‘‘(2) LIMITATIONS.— 


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1 ‘‘(A) PARTNERSHIPS.—Not more than 3 

2 percent of the funds awarded through a grant 

3 under this section for a year may be used to4 wards the rural health department entering into 

5 a partnership with an academic medical center 

6 to assist with the hiring described in paragraph 

7 (1)(B). 

8 ‘‘(B) COMMUNITY OUTREACH.—For each 

9 of the first 2 years of a grant awarded under 

10 this section, not more than 3 percent of the 

11 funds may be used by the rural health depart12 ment receiving the grant for the outreach de13 scribed in paragraph (1)(C). 

14 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated to carry out this section 

16 $25,000,000 for each of fiscal years 2022 through 2026.’’. 

Æ 


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