I 118th CONGRESS 1st Session H. R. 4713 IN THE HOUSE OF REPRESENTATIVES July 18, 2023 Mr. Jackson of Texas (for himself, Mr. Kilmer , Mr. Zinke , Ms. Tokuda , Mrs. Boebert , Ms. Sewell , Mr. Arrington , Ms. Kuster , Mr. Mann , Ms. Wild , Mr. Sessions , Ms. Pettersen , Mr. Carl , Mr. Larsen of Washington , Mr. LaMalfa , Ms. Schrier , Ms. Perez , Ms. Hoyle of Oregon , Ms. Budzinski , Mr. Davis of North Carolina , Mr. Schiff , Mr. Pfluger , Mr. Trone , and Mrs. Miller of West Virginia ) introduced the following bill; which was referred to the Committee on Agriculture A BILL To codify the Rural Hospital Technical Assistance Program of the Department of Agriculture.

1. Short title This Act may be cited as the Rural Hospital Technical Assistance Program Act . 2. Codification of the Rural Hospital Technical Assistance Program of the Department of Agriculture (a) In general In lieu of any other authority under which the Secretary of Agriculture (in this section referred to as the Secretary ) may provide technical assistance to any eligible rural hospital facility, the Secretary shall establish, and maintain, directly or by grant, contract, or cooperative agreement, a Rural Hospital Technical Assistance Program (in this section referred to as the Program ) to provide technical assistance and training, tailored to the capacity and needs of each eligible hospital facility, to help eligible hospital facilities in rural areas with a population of not more than 50,000 inhabitants— (1) identify development needs for maintaining essential health care services, and support action plans for financial, operational, and quality improvement projects to meet the development needs; (2) better manage their financial and business strategies; and (3) identify, and apply for assistance from, loan and grant programs of the Department of Agriculture for which the facilities are eligible. (b) Goals The goals of the Program shall be to— (1) improve the long-term financial position and operational efficiency of eligible rural hospital facilities; (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 programs administered by the Department of Agriculture. (c) Definitions In this section: (1) Development needs The term development needs includes— (A) constructing, expanding, renovating or otherwise modernizing health care facilities; (B) increasing telehealth capabilities; (C) acquiring or upgrading health care information systems such as electronic health records; and (D) such other needs as the Secretary deems critical to maintaining health care services in the community in which an eligible rural hospital facility is located. (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 institution (as defined in section 1861(ss)(1) of such Act); (vi) a rural health clinic (as defined in section 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 defined 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 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 Program. (2) Hospital selection In selecting eligible hospital facilities to participate in the Program, the Secretary shall give priority to borrowers and grantees 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 hospital or clinic facilities involved; (B) the financial vulnerability of the hospital or clinic facilities, and the ability of the hospital or clinic facilities to meet debt obligations; (C) the electronic health record implementation needs of the hospital or clinic facilities; (D) whether the hospital or clinic is located 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 and the Committee on Agriculture, Nutrition, and Forestry 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 provided; (C) a description of the outcomes for completed 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 Program. (f) Limitations on authorization of appropriations 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.