SEC. 2. GREATER AVAILABILITY OF COMMUNITY FACILI-
TIES GRANTS FOR RURAL HOSPITALS. 
(a) IN GENERAL.—Section 306(a)(19) of the Consoli-
dated Farm and Rural Development Act (7 U.S.C. 
1926(a)(19)) is amended by adding at the end the fol-
lowing: 
‘‘(C) SPECIAL
RULES
APPLICABLE
TO 
GRANTS
FOR
HOSPITALS.—In the case of a 
grant under this paragraph for a hospital: 
‘‘(i) MAXIMUM
GRANT.—The max-
imum amount of such a grant shall be 
$100,000. 
‘‘(ii) NO FINANCING REQUIREMENT.— 
The Secretary may not condition the provi-
sion of such a grant on the inability of the 
applicant to finance the proposed project, 
in whole or in part, from the resources of 
the applicant, through commercial credit at 
reasonable rates and terms, or from any 
other funding source. 
‘‘(iii) FEDERAL SHARE.—The amount 
of such a grant shall not exceed 50 percent 
of the cost of developing the hospital.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on the date that is 90 days 
after the date of the enactment of this Act. 
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SEC. 3. REAUTHORIZATION OF PROGRAM OF GRANTS TO 
STATE OFFICES OF RURAL HEALTH. 
Section 338J of the Public Health Service Act (42 
U.S.C. 254r) is amended to read as follows: 
‘‘SEC. 338J. GRANTS TO STATE OFFICES OF RURAL HEALTH. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Office of Rural Health Policy (estab-
lished in section 711 of the Social Security Act), shall 
make grants to each State Office of Rural Health for the 
purpose of improving health care in rural areas. 
‘‘(b) REQUIREMENT OF MATCHING FUNDS.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
the Secretary may not make a grant under sub-
section (a) unless the State Office of Rural Health 
involved agrees, with respect to the costs to be in-
curred in carrying out the purpose described in such 
subsection, to provide non-Federal contributions to-
ward such costs in an amount equal to $3 for each 
$1 of Federal funds provided in the grant. 
‘‘(2) WAIVER OR REDUCTION.—The Secretary 
may waive or reduce the non-Federal contribution if 
the State Office of Rural Health can demonstrate 
that requiring matching funds would limit its ability 
to carry out the purpose described in subsection (a). 
‘‘(3) DETERMINATION
OF
AMOUNT
OF
NON- 
FEDERAL
CONTRIBUTION.—Non-Federal contribu-
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tions required in paragraph (1) may be in cash or 
in kind, fairly evaluated, including plant, equipment, 
or services. Amounts provided by the Federal Gov-
ernment, or services assisted or subsidized to any 
significant extent by the Federal Government, may 
not be included in determining the amount of such 
non-Federal contributions. 
‘‘(c) CERTAIN REQUIRED ACTIVITIES.—Activities for 
which grant dollars shall be awarded under subsection (a) 
include— 
‘‘(1) maintaining within the State Office of 
Rural Health a clearinghouse for collecting and dis-
seminating information on— 
‘‘(A) rural health care issues; 
‘‘(B) research findings relating to rural 
health care; and 
‘‘(C) innovative approaches to the delivery 
of health care in rural areas; 
‘‘(2) coordinating the activities carried out in 
the State that relate to rural health care, including 
providing coordination for the purpose of avoiding 
redundancy in such activities; and 
‘‘(3) identifying Federal and State programs re-
garding rural health, and providing technical assist-
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ance to public and nonprofit private entities regard-
ing participation in such programs. 
‘‘(d) REQUIREMENT REGARDING ANNUAL BUDGET 
FOR OFFICE.—The Secretary may not make a grant 
under subsection (a) unless the State Office of Rural 
Health involved agrees that, for any fiscal year for which 
the State Office of Rural Health receives such a grant, 
the office operated pursuant to subsection (a) will be pro-
vided with an annual budget of not less than $50,000. 
‘‘(e) CERTAIN USES OF FUNDS.— 
‘‘(1) RESTRICTIONS.—The Secretary may not 
make a grant under subsection (a) unless the State 
Office of Rural Health involved agrees that the 
grant will not be expended— 
‘‘(A) to provide health care (including pro-
viding cash payments regarding such care); 
‘‘(B) to conduct activities for which Fed-
eral funds are expended— 
‘‘(i) within the State to provide tech-
nical and other nonfinancial assistance 
under subsection (f) of section 330; 
‘‘(ii) under a memorandum of agree-
ment entered into with the State Office of 
Rural Health under subsection (h) of such 
section; or 
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‘‘(iii) under a grant under section 
338I; 
‘‘(C) to purchase medical equipment, to 
purchase ambulances, aircraft, or other vehicles, 
or to purchase major communications equip-
ment; 
‘‘(D) to purchase or improve real property; 
or 
‘‘(E) to carry out any activity regarding a 
certificate of need. 
‘‘(2) AUTHORITIES.—Activities for which a 
State Office of Rural Health may expend a grant 
under subsection (a) include— 
‘‘(A) paying the costs of maintaining such 
Office for the purpose described in subsection 
(a); 
‘‘(B) subject to paragraph (1)(B)(iii), pay-
ing the costs of any activity carried out with re-
spect to recruiting and retaining health profes-
sionals to serve in rural areas of the State; and 
‘‘(C) providing grants and contracts to 
public and nonprofit private entities to carry 
out activities authorized in this section. 
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‘‘(f) REPORTS.—The Secretary may not make a 
grant under subsection (a) unless the State Office of 
Rural Health involved agrees— 
‘‘(1) to submit to the Secretary reports or per-
formance data containing such information as the 
Secretary may require regarding activities carried 
out under this section; and 
‘‘(2) to submit such a report or performance 
data not later than the close of the fiscal year imme-
diately following any fiscal year for which the State 
Office of Rural Health has received such a grant. 
‘‘(g) REQUIREMENT
OF APPLICATION.—The Sec-
retary may not make a grant under subsection (a) unless 
an application for the grant is submitted to the Secretary 
and the application is in such form, is made in such man-
ner, and contains such agreements, assurances, and infor-
mation as the Secretary determines to be necessary to 
carry out such subsection. 
‘‘(h) NONCOMPLIANCE.—The Secretary may not 
make payments under subsection (a) to a State Office of 
Rural Health for any fiscal year subsequent to the first 
fiscal year of such payments unless the Secretary deter-
mines that, for the immediately preceding fiscal year, the 
State Office of Rural Health has complied with each of 
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the agreements made by the State Office of Rural Health 
under this section. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) The term ‘State’ means each of the several 
States. 
‘‘(2) The term ‘State Office of Rural Health’ 
means, with respect to a State, the agency or office 
that is primarily responsible for improving health 
care in rural areas. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—For the purpose of making 
grants under subsection (a), there are authorized to 
be appropriated, $15,000,000 for fiscal year 2017 
and such sums as may be necessary for fiscal years 
2018 through 2021. 
‘‘(2) 
AVAILABILITY.—Amounts 
appropriated 
under paragraph (1) shall remain available until ex-
pended.’’. 
SEC. 4. ANNUAL STUDY AND REPORT ON RURAL HOS-
PITALS. 
(a) STUDY.—The Secretary of Health and Human 
Services shall, with respect to the first fiscal year begin-
ning after the date of the enactment of this Act and each 
fiscal year thereafter, conduct an annual study on the fol-
lowing: 
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(1) The number of rural hospitals that closed in 
such fiscal year. 
(2) With respect to the rural hospitals that so 
closed in such fiscal year, the reasons for such clo-
sures. 
(3) With respect to the rural hospitals that so 
closed in such fiscal year, the effect such closure had 
on patient access to care for the given area. 
(4) With respect to each category of rural hos-
pitals described in subsection (b), the financial well- 
being of the rural hospitals in such category during 
such fiscal year. 
(b) CATEGORIES DESCRIBED.—The categories of 
rural hospitals described in this subsection are the fol-
lowing: 
(1) Rural hospitals that are critical access hos-
pitals (as defined in section 1861(mm)(1) of the So-
cial Security Act (42 U.S.C. 1395x(mm)(1))). 
(2) Rural hospitals that are sole community 
hospitals (as defined in section 1886(d)(5)(D)(iii) of 
such Act (42 U.S.C. 1395ww(d)(5)(D)(iii))). 
(3) Rural hospitals that are a medicare-depend-
ent, small rural hospital (as defined in section 
1886(d)(5)(G) 
of 
such 
Act 
(42 
U.S.C. 
1395ww(d)(5)(G))). 
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(4) Any other such category of rural hospitals 
that the Secretary of Health and Human Services 
determines appropriate. 
(c) DEFINITION OF RURAL HOSPITAL.—For pur-
poses of this section, the term ‘‘rural hospital’’ means a 
hospital located in a rural area (as defined in section 
1886(d)(2)(D) of the Social Security Act (42 U.S.C. 
1395ww(d)(2)(D))). 
(d) REPORT.—With respect to each study conducted 
pursuant to subsection (a) with respect to a fiscal year, 
the Secretary of Health and Human Services shall, not 
later than December 31 of the following fiscal year, submit 
to Congress and to each State office of rural health (as 
described in section 338J(a) of the Public Health Service 
Act (42 U.S.C. 254r(a))) a report on such study. 
Æ 
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