‘‘(d) ASSISTANCE AVAILABLE.—Capital financing as-
sistance available under this title shall include loan guar-
antees, interest rate subsidies, matching loans, and direct 
grants. Health care facilities determined to be generally 
eligible for assistance under this title may apply for and 
receive more than one type of assistance under this title. 
‘‘SEC. 2902. APPLICATION FOR ASSISTANCE. 
‘‘(a) IN GENERAL.—No health care facilities may re-
ceive assistance for a qualifying project under this title 
unless the health care facility— 
‘‘(1) has filed with the Secretary, in a form and 
manner specified by the Secretary, with the advice 
and approval of the Trust Fund Board (as described 
in section 2904(d)), an application for assistance 
under this title; 
‘‘(2) establishes in its application (for its most 
recent cost reporting period) that it meets the cri-
teria for general eligibility under this title; 
‘‘(3) includes a description of the project, in-
cluding the community in which it is located, and 
describes utilization and services characteristics of 
the project and the health care facility, and the pa-
tient population that is to be served; 
‘‘(4) describes the extent to which the project 
will include the financial participation of State and 
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local governments if assistance is granted under this 
title, and all other sources of financing sought for 
the project; and 
‘‘(5) establishes, to the satisfaction of the Sec-
retary and the Trust Fund Board, that the project 
meets the additional criteria for each type of capital 
financing assistance for which it is applying. 
‘‘(b) CRITERIA FOR APPROVAL.—The Secretary, with 
the approval of the Trust Fund Board, shall determine 
for each application for assistance under this title— 
‘‘(1) whether the health care facility meets the 
general eligibility criteria under section 2901(b); 
‘‘(2) whether the health care facility meets the 
specific eligibility criteria of each type of assistance 
for which it has applied, including whether the 
health care facility meets any criteria for priority 
consideration for the type of assistance for which it 
has applied; 
‘‘(3) whether the capital project for which as-
sistance is being requested is a qualifying project 
under this title; and 
‘‘(4) whether funds are available, pursuant to 
the limitations of each program, to fully fund the re-
quest for assistance. 
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‘‘(c) PRIORITY OF APPLICATIONS.—In addition to 
meeting the criteria otherwise described in this title, at 
the discretion of the Trust Fund Board, the Secretary 
shall give preference to those applications for qualifying 
projects that— 
‘‘(1)(A) are necessary to bring existing safety 
net health care facilities into compliance with ac-
creditation standards of fire and life safety, seismic, 
or other related Federal, State or local regulatory 
standards; 
‘‘(B) improve the provision of essential services 
such as emergency medical and trauma services, 
AIDS and infectious disease, perinatal, burn, pri-
mary care, and other services which the Trust Fund 
Board may designate; or 
‘‘(C) provide access to otherwise unavailable es-
sential health services to the indigent and other 
needy persons within the health care facility’s terri-
torial area; 
‘‘(2) include specific State or local governmental 
or other non-Federal assurances of financial support 
if assistance for a qualifying project is granted 
under this title; and 
‘‘(3) are unlikely to be financed without assist-
ance granted under this title. 
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‘‘(d) SUBMISSION OF APPLICATIONS.—Applications 
under this title shall be submitted to the Secretary 
through the Trust Fund Board. If two or more health care 
facilities join in the project, the application shall be sub-
mitted by all participating health care facilities jointly. 
Such applications shall set forth all of the descriptions, 
plans, specifications, and assurances as required by this 
title and contain other such information as the Trust 
Fund Board shall require. 
‘‘(e) OPPORTUNITY FOR APPEAL.—The Trust Fund 
Board shall afford a health care facility applying for a loan 
guarantee under this section an opportunity for a hearing 
if the guarantee is denied. 
‘‘(f) APPLICATIONS
FOR
AMENDMENTS.—Amend-
ment of an approved application shall be subject to ap-
proval in the same manner as an original application. 
‘‘SEC. 2903. PUBLIC SERVICE RESPONSIBILITIES. 
‘‘(a) IN GENERAL.—Any health care facility accept-
ing capital financing assistance under this title shall 
agree— 
‘‘(1) to make the services of the facility or por-
tion thereof to be constructed, acquired, or modern-
ized available to all persons; and 
‘‘(2) to provide a significant volume of services 
to persons unable to pay therefore, consistent with 
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other provisions of this Act and the amount of as-
sistance received under this title. 
‘‘(b) ENFORCEMENT.—The Director of the Office for 
Civil Rights of the Department of Health and Human 
Services shall be given the power to enforce the public 
service responsibilities described in this section. 
‘‘SEC. 2904. HEALTH SAFETY NET INFRASTRUCTURE TRUST 
FUND. 
‘‘(a) CREATION OF TRUST FUND.—There is estab-
lished in the Treasury of the United States a trust fund 
to be known as the Health Safety Net Infrastructure 
Trust Fund, consisting of such amounts as may be trans-
ferred, appropriated, or credited to such Trust Fund as 
provided in this title. 
‘‘(b) AUTHORIZATION
OF
APPROPRIATIONS
TO 
TRUST FUND.—There are authorized to be appropriated 
to the Trust Fund such sums as may be necessary to carry 
out the purposes of this title. 
‘‘(c) EXPENDITURES FROM TRUST FUND.—Amounts 
in the Trust Fund shall be available, pursuant to appro-
priations Acts, only for making expenditures to carry out 
the purposes of this title. 
‘‘(d) BOARD OF TRUSTEES; COMPOSITION; MEET-
INGS; DUTIES.— 
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