(1) improve the long-term financial position and 
operational efficiency of eligible rural hospital facili-
ties; 
(2) prevent the closure of eligible rural hospital 
facilities; 
(3) strengthen the delivery of health care in 
rural areas; and 
(4) help eligible rural hospital facilities better 
access and compete for loans and grants from pro-
grams administered by the Department of Agri-
culture. 
(c) DEFINITIONS.—In this section: 
(1) DEVELOPMENT NEEDS.—The term ‘‘devel-
opment needs’’ includes— 
(A) constructing, expanding, renovating or 
otherwise modernizing health care facilities; 
(B) increasing telehealth capabilities; 
(C) acquiring or upgrading health care in-
formation systems such as electronic health 
records; and 
(D) such other needs as the Secretary 
deems critical to maintaining health care serv-
ices in the community in which an eligible rural 
hospital facility is located. 
VerDate Sep 11 2014 
22:39 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4713.IH
H4713
kjohnson on DSK79L0C42PROD with BILLS
(2) ELIGIBLE HOSPITAL FACILITY.—The term 
‘‘eligible hospital facility’’ means a facility that is— 
(A)(i) a hospital (as defined in section 
1861(e) of the Social Security Act); 
(ii) a psychiatric hospital (as defined in 
section 1861(f) of such Act); 
(iii) a long-term care hospital (as defined 
in section 1861(ccc) of such Act); 
(iv) a critical access hospital (as defined in 
section 1861(mm)(1) of such Act); 
(v) a religious nonmedical health care in-
stitution (as defined in section 1861(ss)(1) of 
such Act); 
(vi) a rural health clinic (as defined in sec-
tion 1861(aa)(2) of such Act); 
(vii) a sole community hospital (as defined 
in section 1886(d)(5)(C)(iii) of such Act); 
(viii) a rural emergency hospital (as de-
fined in section 1861(kkk)(2) of such Act); 
(ix) a community health center (as defined 
in section 330 of the Public Health Service 
Act); or 
(x) any other rural hospital as determined 
by the Secretary of Agriculture in consultation 
VerDate Sep 11 2014 
22:39 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4713.IH
H4713
kjohnson on DSK79L0C42PROD with BILLS
with the Secretary of the Department of Health 
and Human Services; and 
(B) located in a rural area. 
(3) RURAL AREA.—The term ‘‘rural area’’ has 
the meaning given the term in section 343(a)(13)(A) 
of the Consolidated Farm and Rural Development 
Act. 
(4) 
HEALTH
PROFESSIONAL
SHORTAGE 
AREA.—The term ‘‘health professional shortage 
area’’ has the meaning given the term in section 
332(a)(1)(A) of the Public Health Service Act). 
(5) MEDICALLY
UNDERSERVED
AREA.—The 
term ‘‘medically underserved area’’ has the meaning 
given the term in section 330I(a)(5) of the Public 
Health Service Act. 
(6) MEDICALLY UNDERSERVED POPULATION.— 
The term ‘‘medically underserved population’’ has 
the meaning given the term in section 330(b)(3) of 
the Public Health Service Act. 
(d) PROGRAM PARTICIPATION.— 
(1) IN GENERAL.—The Secretary shall engage 
in outreach and engagement strategies to encourage 
eligible hospital facilities to participate in the Pro-
gram. 
VerDate Sep 11 2014 
22:39 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4713.IH
H4713
kjohnson on DSK79L0C42PROD with BILLS
(2) HOSPITAL SELECTION.—In selecting eligible 
hospital facilities to participate in the Program, the 
Secretary shall give priority to borrowers and grant-
ees of the Rural Housing Service, Rural Business- 
Cooperative Service, and Rural Utilities Service. The 
Secretary may also consider— 
(A) the age and physical state of the hos-
pital or clinic facilities involved; 
(B) the financial vulnerability of the hos-
pital or clinic facilities, and the ability of the 
hospital or clinic facilities to meet debt obliga-
tions; 
(C) the electronic health record implemen-
tation needs of the hospital or clinic facilities; 
(D) whether the hospital or clinic is lo-
cated in a health professional shortage area or 
a medically underserved area; 
(E) whether the hospital serves a medically 
underserved population; and 
(F) such other criteria and priorities as 
are determined by the Secretary. 
(e) REPORTING REQUIREMENTS.—Not later than 1 
year after the date of the enactment of this section, and 
annually thereafter, the Secretary shall submit to the 
Committee on Agriculture of the House of Representatives 
VerDate Sep 11 2014 
22:39 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H4713.IH
H4713
kjohnson on DSK79L0C42PROD with BILLS
and the Committee on Agriculture, Nutrition, and For-
estry of the Senate a written report describing the 
progress and results of the program conducted under this 
section, which should include— 
(1) a brief description of each project to provide 
technical assistance to an eligible hospital facility 
under this section, including— 
(A) the name and location of the facility; 
(B) a description of the assistance pro-
vided; 
(C) a description of the outcomes for com-
pleted projects; 
(D) the cost of the technical assistance; 
and 
(E) any other information the Secretary 
deems appropriate; 
(2) a summary of the technical assistance 
projects completed; 
(3) a summary of the outcomes of the technical 
assistance projects; 
(4) an assessment of the effectiveness of the 
Program; and 
(5) recommendations for improving the Pro-
gram. 
VerDate Sep 11 2014 
22:39 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H4713.IH
H4713
kjohnson on DSK79L0C42PROD with BILLS
(f) LIMITATIONS ON AUTHORIZATION OF APPROPRIA-
TIONS.—To carry out this section, there are authorized 
to be appropriated to the Secretary not more than 
$2,000,000 for each of fiscal years 2024 through 2028. 
Æ 
VerDate Sep 11 2014 
22:39 Aug 07, 2023
Jkt 039200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6301
E:\BILLS\H4713.IH
H4713
kjohnson on DSK79L0C42PROD with BILLS