Administration, the Agency for Health Care Quality 
and Research, or the Centers for Medicare & Med-
icaid Services to the Commission to assist in car-
rying out this subsection. 
(6) REPORTS TO CONGRESS.—Not later than 1 
year after the establishment of the Commission, and 
annually thereafter, the Commission shall submit a 
report to the Congress on rural health quality. Each 
such report shall include the following: 
(A) An inventory of relevant programs and 
recommendations for improved coordination and 
integration of policy and programs. 
(B) An assessment of achievement of the 
objectives identified in the national plan devel-
oped under paragraph (2) and recommenda-
tions for realizing such objectives. 
(C) Recommendations on Federal legisla-
tion, regulations, or administrative policies to 
enhance rural health quality and outcomes. 
(b) RURAL
HEALTH
QUALITY
DEMONSTRATION 
PROJECTS.— 
(1) IN
GENERAL.—Not later than 270 days 
after the date of the enactment of this section, the 
Secretary, in consultation with the Rural Health 
Quality Advisory Commission, the Office of Rural 
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Health Policy of the Health Resources and Services 
Administration, the Agency for Healthcare Research 
and Quality, and the Centers for Medicare & Med-
icaid Services, shall make grants to eligible entities 
for 5 demonstration projects to implement and 
evaluate methods for improving the quality of health 
care in rural communities. Each such demonstration 
project shall include— 
(A) alternative community models that— 
(i) will achieve greater integration of 
personal and population health services; 
and 
(ii) 
address 
safety, 
effectiveness, 
patient- or community-centeredness, timeli-
ness, efficiency, and equity (the six aims 
identified by the Institute of Medicine of 
the National Academies in its report enti-
tled ‘‘Crossing the Quality Chasm: A New 
Health System for the 21st Century’’ re-
leased on March 1, 2001); 
(B) innovative approaches to the financing 
and delivery of health services to achieve rural 
health quality goals; and 
(C) development of quality improvement 
support structures to assist rural health sys-
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tems and professionals (such as workforce sup-
port structures, quality monitoring and report-
ing, clinical care protocols, and information 
technology applications). 
(2) ELIGIBLE
ENTITIES.—In this subsection, 
the term ‘‘eligible entity’’ means a consortium 
that— 
(A) shall include— 
(i) at least one health care provider or 
health care delivery system located in a 
rural area; and 
(ii) at least one organization rep-
resenting multiple community stakeholders; 
and 
(B) may include other partners such as 
rural research centers. 
(3) CONSULTATION.—In developing the pro-
gram for awarding grants under this subsection, the 
Secretary shall consult with the Administrator of the 
Agency for Healthcare Research and Quality, rural 
health care providers, rural health care researchers, 
and private and non-profit groups (including na-
tional associations) which are undertaking similar 
efforts. 
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(4) EXPEDITED WAIVERS.—The Secretary shall 
expedite the processing of any waiver that— 
(A) is authorized under title XVIII or XIX 
of the Social Security Act (42 U.S.C. 1395 et 
seq.); and 
(B) is necessary to carry out a demonstra-
tion project under this subsection. 
(5) DEMONSTRATION
PROJECT
SITES.—The 
Secretary shall ensure that the 5 demonstration 
projects funded under this subsection are conducted 
at a variety of sites representing the diversity of 
rural communities in the Nation. 
(6) DURATION.—Each demonstration project 
under this subsection shall be for a period of 4 
years. 
(7) INDEPENDENT
EVALUATION.—The Sec-
retary shall enter into an arrangement with an enti-
ty that has experience working directly with rural 
health systems for the conduct of an independent 
evaluation of the program carried out under this 
subsection. 
(8) REPORT.—Not later than one year after the 
conclusion of all of the demonstration projects fund-
ed under this subsection, the Secretary shall submit 
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a report to the Congress on the results of such 
projects. The report shall include— 
(A) an evaluation of patient access to care, 
patient outcomes, and an analysis of the cost 
effectiveness of each such project; and 
(B) recommendations on Federal legisla-
tion, regulations, or administrative policies to 
enhance rural health quality and outcomes. 
(c) APPROPRIATION.— 
(1) IN GENERAL.—Out of funds in the Treas-
ury not otherwise appropriated, there are appro-
priated to the Secretary to carry out this section 
$30,000,000 for the period of fiscal years 2008 
through 2012. 
(2) AVAILABILITY.— 
(A) IN
GENERAL.—Funds appropriated 
under paragraph (1) shall remain available for 
expenditure through fiscal year 2012. 
(B) REPORT.—For purposes of carrying 
out subsection (b)(8), funds appropriated under 
paragraph (1) shall remain available for ex-
penditure through fiscal year 2013. 
(3) RESERVATION.—Of the amount appro-
priated under paragraph (1), the Secretary shall re-
serve— 
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(A) $5,000,000 to carry out subsection (a); 
and 
(B) $25,000,000 to carry out subsection 
(b), of which— 
(i) 2 percent shall be for the provision 
of technical assistance to grant recipients; 
and 
(ii) 5 percent shall be for independent 
evaluation under subsection (b)(7). 
Æ 
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