Rural Health Care Capital Access Act of 2006

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 4912) to amend section 242 of the National Housing Act to extend the exemption for critical access hospitals under the FHA program for mortgage insurance for hospitals.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in support of H.R. 4912, the Rural Health Care Capital Access Act of 2006. This piece of legislation would extend the exemption of the current law that allows small rural hospitals to remain eligible for Federal Housing Administration mortgage insurance.

Recent health care statistics show a huge backlog of capital improvement needs for the majority of hospitals in the United States, and rural hospitals face even fewer opportunities to make

such needed repairs, achieve reasonable terms for refinancing or build replacement facilities. The FHA Section 242 Hospital Mortgage Insurance Program has been a valuable tool for many hospitals seeking to rebuild or make improvements.

Recently the program became available to critical access hospitals. Critical access hospitals are facilities certified to receive cost- based reimbursement for Medicare. This cost-based reimbursement is intended to improve their financial performance and thereby reduce hospital closures.

Despite the efforts of FHA, some challenges have remained for these rural hospitals to gain access to the critical access program. One of these was a statutory requirement in section 242 that at least 50 percent of the hospital's adjusted net patient days must be used for acute medical care. While this requirement may be useful in urban areas, rural isolated communities such as those served by critical access hospitals often cannot sustain separate independent hospitals which provide acute care and nursing facilities.

It is common for rural hospitals and nursing homes to operate as a single unit in order to take advantage of savings related to cost- sharing of some services and staff.

To deny critical-access hospitals access to FHA mortgage insurance on these grounds unfairly disadvantages these facilities that are desperately in need of capital improvements.

H.R. 659, the Hospital Mortgage Insurance Act of 2003 amended section 242 of the National Housing Act and included an exemption that eliminated the so-called Patient Day Test for critical-access hospitals, which allowed these rural hospitals to be eligible for FHA mortgage insurance. The exemption expires on July 31, 2006. H.R. 4912 would simply extend this vital exemption for 5 years, which would give FHA and the Department of Housing and Urban Development time to review the exemption's impact and recommend to the Congress whether it should be made permanent.

I am a proud cosponsor of this important legislation, which will benefit 11 critical-access hospitals in my home State of Arizona and three hospitals in my district: Page Memorial Hospital in Page, Arizona, Sage Memorial Hospital in Ganado, located on the Navajo Nation, and Winslow Memorial Hospital located in the town of Winslow, Arizona.

I would like to thank the Housing Subcommittee chairman, Congressman Ney, Ranking Member Waters, full committee Chairman Oxley, Ranking Member Frank and all of those who worked hard to pull this together for their support of this legislation.

Mr. Speaker, I urge my colleagues to support this bipartisan piece of legislation that would allow more opportunities for critical-access hospitals to improve the quality of health care in rural America.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I have no additional speakers, and reserve the balance of my time.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I yield myself such time as I might consume.

Mr. Speaker, I rise today to express my strong support for H.R. 4912, the Rural Health Care Capital Access Act of 2006, along with Mr. Frank who is one of the cosponsors of this important legislation.

This bill extends and exempts under the Hospital Mortgage Insurance Act of 2003 small, rural critical-access hospitals. This allows them to qualify for the Department of Housing and Urban Development section 242 mortgage insurance program.

This section 242 program is an important program which provides mortgage insurance for loans made for construction, renovation and equipment of acute-care hospitals. To be eligible for section 242 requires that at least half of the hospital's net patient days qualify as acute care, which is referred to as a Patient's Day Test.

Small, rural hospitals sometimes have a hard time meeting these requirements. This is because rural communities often have hospitals and nursing homes combined in order to achieve savings by sharing facilities and services such as pharmacy and food services.

The Hospital Mortgage Insurance Act of 2003 eliminated the so-called Patient Day Test for critical-access hospital, but limited the exemption to 3 years. The exemption expires on July 31, 2006.

Today only one hospital sought approval under this exemption. This is not surprising considering the length of time required for applying to the program, particularly for small hospitals with limited staff and resources to devote to such complicated processes.

As we all know, there are many small hospitals throughout the Nation that need this kind of help. It is very complicated, applying for this kind of a process. Nevertheless, this exemption is necessary for small hospitals to have access, and I state, to have access to section 242 programs. And it is important that they do have the access.

H.R. 4912, the Rural Health Care Capital Access Act of 2006, would extend the exemption for an additional 5 years. During this time, HUD and FHA can review the impact and recommend to Congress whether the exemption should be made permanent.

Again, Mr. Speaker, I express my strong support for this bill.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I have no additional speakers. I appreciate the gentleman from Arizona's leadership in taking up this legislation along with the cosponsor, Mr. Frank, who feels this is important for a lot of the hospitals in rural communities, and I yield back the balance of my time.

Mr. Speaker, l rise in strong support of H.R. 4912, the ``Rural Health Care Capital Access Act of 2006'', of which I am an original sponsor. The Committee on Financial Services marked-up H.R. 4912 on March 13, 2006, so I am delighted that this important measure has reached the floor today. Mr. Ney, the Chairman of the Subcommittee on Housing and Community Affairs, is to be applauded for his efforts on behalf of rural communities.

The bill would allow hospitals located in rural areas access to the Federal Housing Administration (FHA) mortgage insurance program for hospitals, under Section 242 of the National Housing Act. These hospitals are located in rural areas of the country, and are not always able to meet the bed capacity requirements for critical care facilities. Thus, the bill would extend the exemption for another 5 years, enabling rural hospitals to be exempted from critical bed requirements.

The bill addresses the mortgage insurance needs of Critical Access Hospitals. These hospitals are rural hospitals with a maximum of 25 beds and must be 35 miles from the nearest hospital. Another requirement is related to the so-called ``patient day'' requirement. Under Section 242, not more than 50 percent of a hospital's adjusted net patient days could be ``assignable to the categories of chronic convalescent and rest, drug and alcoholic, epileptic, mentally deficient, mental, nervous and mental, and tuberculosis . . .'' These are onerous requirements for small rural hospitals to meet. When we passed the Hospital Insurance Mortgage Act of 2003, it eliminated the patient day requirement, but it expires on July 31, 2006.

By supporting H.R. 4912 to extend the exemption for another 5 years, we will be addressing an issue of major concern in rural areas. Hospitals are far and few apart. Within many of our rural communities hospitals double up with nursing homes to meet these bed requirements, as well as to share in cost savings, to qualify for Section 242 mortgage insurance. H.R. 4912 removes another barrier to health care in rural communities, and therefore, I urge support of the measure.

I ask unanimous consent the Committee on Banking, Housing and Urban Affairs be discharged from further consideration of H.R. 4912, and the Senate proceed to its immediate consideration.

I ask unanimous consent the bill be read a third time and passed, the motion to reconsider be laid upon the table, and any statements be printed in the Record.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks on H.R. 4902 and H.R. 4912 and to insert extraneous material thereon.