II 119th CONGRESS 1st Session S. 1282 IN THE SENATE OF THE UNITED STATES April 3, 2025 Mr. Rounds (for himself and Mr. Welch ) introduced the following bill; which was read twice and referred to the Committee on Agriculture, Nutrition, and Forestry 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 Development Hospital Technical Assistance Program Act of 2025 . 2. Codification of the Rural Hospital Technical Assistance Program of the Department of Agriculture (a) Definitions In this section: (1) Development needs The term development needs means— (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 determines to be critical to maintaining health care services in the community in which an eligible 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 ( 42 U.S.C. 1395x(e) )); (ii) a psychiatric hospital (as defined in section 1861(f) of that Act ( 42 U.S.C. 1395x(f) )); (iii) a long-term care hospital (as defined in section 1861(ccc) of that Act ( 42 U.S.C. 1395x(ccc) )); (iv) a critical access hospital (as defined in section 1861(mm)(1) of that Act ( 42 U.S.C. 1395x(mm)(1) )); (v) a religious nonmedical health care institution (as defined in section 1861(ss)(1) of that Act ( 42 U.S.C. 1395x(ss)(1) )); (vi) a rural health clinic (as defined in section 1861(aa)(2) of that Act ( 42 U.S.C. 1395x(aa)(2) )); (vii) a sole community hospital (as defined in section 1886(d)(5)(D)(iii) of that Act ( 42 U.S.C. 1395ww(d)(5)(D)(iii) )); (viii) a rural emergency hospital (as defined in section 1861(kkk)(2) of that Act ( 42 U.S.C. 1395x(kkk)(2) )); (ix) a community health center receiving funding under section 330 of the Public Health Service Act ( 42 U.S.C. 254b ); or (x) any other rural hospital, as determined by the Secretary, in consultation with the Secretary of Health and Human Services; and (B) located in a rural area. (3) 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 ( 42 U.S.C. 254e(a)(1)(A) ). (4) Medically underserved area The term medically underserved area has the meaning given the term in section 330I(a)(4) of the Public Health Service Act ( 42 U.S.C. 254c–14(a)(4) ). (5) 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 ( 42 U.S.C. 254b(b)(3) ). (6) Program The term Program means the Rural Hospital Technical Assistance Program established under subsection (b). (7) Secretary The term Secretary means the Secretary of Agriculture. (8) 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 ( 7 U.S.C. 1991(a)(13)(A) ). (b) Establishment In lieu of any other authority under which the Secretary may provide technical assistance to any eligible hospital facility, the Secretary shall establish, and maintain, directly or by grant, contract, or cooperative agreement, a Rural Hospital Technical Assistance Program to provide technical assistance and training, tailored to the capacity and needs of each eligible hospital facility, to help eligible hospital facilities— (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 the financial and business strategies of the eligible hospital facilities; and (3) identify, and apply for assistance from, loan and grant programs of the Department of Agriculture for which the eligible hospital facilities are eligible. (c) Goals The goals of the Program shall be— (1) to improve the long-term financial position and operational efficiency of eligible hospital facilities; (2) to prevent the closure of eligible hospital facilities; (3) to strengthen the delivery of health care in rural areas; and (4) to help eligible hospital facilities better access and compete for loans and grants from programs administered by the Department of Agriculture. (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— (A) shall give priority to borrowers of loans and recipients of grants from the Rural Housing Service, the Rural Business-Cooperative Service, and the Rural Utilities Service; and (B) may consider— (i) the age and physical state of the hospital or clinic facilities involved; (ii) the financial vulnerability of the hospital or clinic facilities, and the ability of the hospital or clinic facilities to meet debt obligations; (iii) the electronic health record implementation needs of the hospital or clinic facilities; (iv) whether the hospital or clinic is located in a health professional shortage area or a medically underserved area; (v) whether the hospital serves a medically underserved population; and (vi) such other criteria and priorities as are determined by the Secretary. (e) Reporting requirements Not later than 1 year after the date of enactment of this Act, 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, including— (1) a brief description of each project to provide technical assistance to an eligible hospital facility, 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 determines to be 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) Authorization of appropriations There is authorized to be appropriated to the Secretary to carry out this section not more than $2,000,000 for each of fiscal years 2025 through 2029.