I 
118TH CONGRESS 
1ST SESSION H. R. 1712 
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 HOUSE OF REPRESENTATIVES 
MARCH 22, 2023 
Mr. KUSTOFF (for himself and Ms. KUSTER) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Rural Health Innova-
tion Act of 2023’’. 
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SEC. 2. RURAL HEALTH CENTER INNOVATION AWARDS 
PROGRAM. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 330Q. RURAL HEALTH CENTER INNOVATION AWARDS 
PROGRAM. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means an entity that— 
‘‘(A) is a Federally qualified health center; 
‘‘(B) is a rural health clinic; or 
‘‘(C) agrees (as a condition of receiving a 
grant under this section) to establish such a 
center or clinic, including a hospital that agrees 
(as such a condition) to convert to a Federally 
qualified health center or rural health clinic. 
‘‘(2) FEDERALLY
QUALIFIED
HEALTH
CEN-
TER.—The term ‘Federally qualified health center’ 
has the meaning given such term in section 
1861(aa) of the Social Security Act. 
‘‘(3) RURAL
AREA.—The term ‘rural area’ 
means any area that is rural, within the meaning of 
such term as used by the Office of Rural Health 
Policy of the Health Resources and Services Admin-
istration for purposes of determining eligibility for 
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grants or services, including any area that is rural 
within such meaning as used by such Office for fis-
cal year 2023 or any area that is rural within such 
meaning as amended for a subsequent fiscal year. 
‘‘(4) RURAL HEALTH CLINIC.—The term ‘rural 
health clinic’ has the meaning given such term in 
section 1861(aa) of the Social Security Act. 
‘‘(b) ESTABLISHMENT.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Office of Rural Health 
Policy of the Health Resources and Services Admin-
istration, shall establish a grant program to be 
known as the ‘Rural Health Center Innovation 
Awards program’ to award grants to eligible entities 
that submit an application in accordance with sub-
section (c) to enable such entities to establish or 
maintain a Federally qualified health center or rural 
health clinic that— 
‘‘(A) serves individuals in a rural area as 
a walk-in urgent care center and as a triage 
center or staging facility for necessary air or 
ambulance transport to an emergency depart-
ment; and 
‘‘(B) includes— 
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‘‘(i) professional clinical staff, includ-
ing physicians, physician interns, residents, 
nurse practitioners, physician assistants, 
nurse midwives, or other health care pro-
viders providing walk-in urgent care and 
emergency triage; and 
‘‘(ii) resources, including laboratories, 
x-ray machines, and cardiac monitors. 
‘‘(2) PERMISSIBLE
USES
OF
FUNDS.—The 
funds of a grant awarded under this section may be 
used to— 
‘‘(A) expand the hours of operation of a 
Federally qualified health center or rural health 
clinic; 
‘‘(B) pay for the costs of construction and 
renovation of a Federally qualified health center 
or rural health clinic; or 
‘‘(C) carry out any other activity for the 
purposes described in paragraph (1). 
‘‘(c) APPLICATIONS AND SELECTION.— 
‘‘(1) IN GENERAL.—An eligible entity seeking a 
grant under this section shall submit to the Sec-
retary an application at such time, in such manner, 
and containing such information as the Secretary 
may reasonably require. 
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‘‘(2) START
UP
CENTERS
AND
CLINICS.—An 
application submitted under paragraph (1) by an eli-
gible entity that is not a Federally qualified health 
center, or a rural health clinic, on the date on which 
the entity submits the application under paragraph 
(1) shall include in such application a demonstration 
of the costs of the equipment and staffing needed to 
establish the center or clinic. 
‘‘(3) CONSIDERATION
OF
OVERLAP.—In the 
case an eligible entity submits an application under 
paragraph (1) that proposes to serve an area that is 
served by another eligible entity through a grant 
under this section, the Secretary may consider 
whether an award to the eligible entity serving such 
same area can be justified based on the unmet need 
for additional services in such area. 
‘‘(4) PRIORITY.—In selecting recipients of 
grants under this section, the Secretary shall give 
priority to an eligible entity that is operating as a 
Federally qualified health center, or a rural health 
clinic, on the date on which the entity submits the 
application under paragraph (1). 
‘‘(d) GRANT PERIOD AND AMOUNTS.— 
‘‘(1) PERIOD.—Each grant awarded under this 
section shall be for a period of 5 years. 
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‘‘(2) AMOUNT.— 
‘‘(A) IN
GENERAL.—A grant awarded 
under this section to an eligible entity shall not 
exceed— 
‘‘(i) for the first year of the grant— 
‘‘(I) $500,000 if the entity is a 
Federally qualified health center, or a 
rural health clinic, on the date on 
which the award is made; and 
‘‘(II) $750,000 if the entity is 
using the grant to establish a Feder-
ally qualified health center or a rural 
health clinic; and 
‘‘(ii) for each of the second through 
fifth years of the grant, $500,000. 
‘‘(B) CONSIDERATIONS.—In determining 
the amount of a grant under this section for an 
eligible entity for each year after the first year 
in which the grant is awarded, the Secretary 
shall, subject to subparagraph (A)(ii), consider 
the number of patients treated, and the type of 
treatment provided, by the entity in the prior 
year. 
‘‘(e) REPORTING.— 
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‘‘(1) IN
GENERAL.—Not later than 3 years 
after the date of enactment of this section, the Sec-
retary shall report to the committees described in 
paragraph (2) on the grant program under this sec-
tion, including— 
‘‘(A) an assessment of the success of the 
program, challenges with respect to the pro-
gram, and any action for regulatory flexibility 
or legislative authority needed to improve the 
program; 
‘‘(B) any savings to Federal health care 
programs; 
‘‘(C) any increase in access to care; and 
‘‘(D) any increase in utilization of health 
services in rural areas. 
‘‘(2) COMMITTEES.—The committees described 
in this paragraph are— 
‘‘(A) the Committee on Health, Education, 
Labor, and Pensions, and the Committee on Fi-
nance, of the Senate; and 
‘‘(B) the Committee on Energy and Com-
merce, and the Committee on Ways and Means, 
of the House of Representatives. 
‘‘(f) RULE OF CONSTRUCTION.—No entity receiving 
a grant under this section shall lose status as a Federally 
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qualified health center, or a rural health clinic, on account 
of carrying out any activities under this section. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$25,000,000 for each of fiscal years 2024 through 2028.’’. 
SEC. 3. RURAL HEALTH DEPARTMENT ENHANCEMENT PRO-
GRAM. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.), as amended by sec-
tion 2, is further amended by adding at the end the fol-
lowing: 
‘‘SEC. 330R. RURAL HEALTH DEPARTMENT ENHANCEMENT 
PROGRAM. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) RURAL AREA.—The term ‘rural area’ has 
the meaning given the term in section 330Q(a). 
‘‘(2) RURAL HEALTH DEPARTMENT.—The term 
‘rural health department’ means a local public health 
department that is located in a rural area. 
‘‘(b) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Director of the Office of Rural Health Policy 
of the Health Resources and Services Administration, 
shall award grants, on a competitive basis, to rural health 
departments that submit an application in accordance 
with subsection (c) to enhance such departments and en-
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‘‘(e) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—A rural health department 
receiving a grant under this section shall use the 
funds awarded through the grant to provide the 
services and carry out the activities described in sub-
section (b) at a facility that is located in a rural 
area, including by— 
‘‘(A) obtaining additional medical equip-
ment and resources necessary for providing the 
services and activities described in subsection 
(b), such as laboratories, x-ray machines, and 
cardiac monitors; 
‘‘(B) hiring additional providers to provide 
the services and carry out the activities de-
scribed in subsection (b), such as physician in-
terns, residents, nurse practitioners, physician 
assistants, and nurse midwives, which hiring 
may be through a partnership described in 
paragraph (2)(A); and 
‘‘(C) providing outreach to the community 
regarding the services and activities of the rural 
health department as supported under this sec-
tion. 
‘‘(2) LIMITATIONS.— 
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‘‘(A) PARTNERSHIPS.—Not more than 3 
percent of the funds awarded through a grant 
under this section for a year may be used to-
wards the rural health department entering into 
a partnership with an academic medical center 
to assist with the hiring described in paragraph 
(1)(B). 
‘‘(B) COMMUNITY
OUTREACH.—For each 
of the first 2 years of a grant awarded under 
this section, not more than 3 percent of the 
funds may be used by the rural health depart-
ment receiving the grant for the outreach de-
scribed in paragraph (1)(C). 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$25,000,000 for each of fiscal years 2024 through 2028.’’. 
Æ 
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