Rural Hospital Enhancement and Long Term Health Act of 2016

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Hospital Enhancement and Long 
Term Health Act of 2016''.

SEC. 2. GREATER AVAILABILITY OF COMMUNITY FACILITIES GRANTS FOR RURAL 
              HOSPITALS.

    (a) In General.--Section 306(a)(19) of the Consolidated Farm and 
Rural Development Act (7 U.S.C. 1926(a)(19)) is amended by adding at 
the end the following:
                    ``(C) Special rules applicable to grants for 
                hospitals.--In the case of a grant under this paragraph 
                for a hospital:
                            ``(i) Maximum grant.--The maximum amount of 
                        such a grant shall be $100,000.
                            ``(ii) No financing requirement.--The 
                        Secretary may not condition the provision 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.

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 (established 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 subsection (a) unless the State 
        Office of Rural Health involved agrees, with respect to the 
        costs to be incurred in carrying out the purpose described in 
        such subsection, to provide non-Federal contributions toward 
        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 contributions required in paragraph 
        (1) may be in cash or in kind, fairly evaluated, including 
        plant, equipment, or services. Amounts provided by the Federal 
        Government, 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 disseminating 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 regarding 
        rural health, and providing technical assistance to public and 
        nonprofit private entities regarding 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 provided 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 providing 
                cash payments regarding such care);
                    ``(B) to conduct activities for which Federal funds 
                are expended--
                            ``(i) within the State to provide technical 
                        and other nonfinancial assistance under 
                        subsection (f) of section 330;
                            ``(ii) under a memorandum of agreement 
                        entered into with the State Office of Rural 
                        Health under subsection (h) of such section; or
                            ``(iii) under a grant under section 338I;
                    ``(C) to purchase medical equipment, to purchase 
                ambulances, aircraft, or other vehicles, or to purchase 
                major communications equipment;
                    ``(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), paying the 
                costs of any activity carried out with respect to 
                recruiting and retaining health professionals 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.
    ``(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 performance 
        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 immediately following any 
        fiscal year for which the State Office of Rural Health has 
        received such a grant.
    ``(g) Requirement of Application.--The Secretary 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 manner, and contains such agreements, assurances, and 
information 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 determines that, for the immediately preceding fiscal year, 
the State Office of Rural Health has complied with each of 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 expended.''.

SEC. 4. ANNUAL STUDY AND REPORT ON RURAL HOSPITALS.

    (a) Study.--The Secretary of Health and Human Services shall, with 
respect to the first fiscal year beginning after the date of the 
enactment of this Act and each fiscal year thereafter, conduct an 
annual study on the following:
            (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 closures.
            (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 hospitals 
        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 following:
            (1) Rural hospitals that are critical access hospitals (as 
        defined in section 1861(mm)(1) of the Social 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-dependent, small 
        rural hospital (as defined in section 1886(d)(5)(G) of such Act 
        (42 U.S.C. 1395ww(d)(5)(G))).
            (4) Any other such category of rural hospitals that the 
        Secretary of Health and Human Services determines appropriate.
    (c) Definition of Rural Hospital.--For purposes 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.

Summary: Rural Hospital Enhancement and Long Term Health Act of 2016 This bill revises the Consolidated Farm and Rural Development Act by increasing the maximum grant amount for hospitals under the community facilities grant program. The Department of Health and Human Services (HHS) may not condition grants on the inability of applicants to finance their projects. The bill amends the Public Health Service Act by reauthorizing through FY2021 and revising the grant program for state offices of rural health, including by requiring HHS to make the grants, thus removing HHS' discretion to make them. HHS must report annually to Congress and each state office of rural health on rural hospitals' closures.