H.R. 5641House115th Congress (2017-2019)In Committee

State Offices of Rural Health Reauthorization Act of 2018

AI-Generated Summary

Updated April 15, 2026 at 9:31 PM UTC

The State Offices of Rural Health Reauthorization Act of 2018 updates the Public Health Service Act to continue federal grant funding for state rural health offices. The grants are meant to help these offices improve health care delivery, information sharing, and coordination in rural areas. The law sets conditions on how the money can be used, how much matching funding states must provide, and reporting requirements. It primarily affects state rural health offices and the federal agencies that administer the grants.

Key Provisions

The Secretary, through the Federal Office of Rural Health Policy, may award grants to each State Office of Rural Health to improve rural health care.
States must provide non‑federal contributions equal to $3 for every $1 of federal grant money, unless the Secretary waives or reduces the match.
Each state office must have an annual budget of at least $150,000 to receive a grant.
Grant funds cannot be used for direct health‑care services, major equipment purchases, real‑property acquisition, or certificate‑of‑need activities; they are limited to maintaining the office, coordinating rural health activities, and supporting recruitment/retention of health professionals.
Indirect costs claimed by grant recipients are capped at 15 percent.
Recipients must submit performance reports by September 30 each year and must apply using a form approved by the Secretary.
Appropriations of $12.5 million are authorized for each fiscal year from 2018 through 2022.

Legislative Activity

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1 earlier action

HouseIntro Referral Latest Action

Referred to the House Committee on Energy and Commerce.

Energy and Commerce Committee

April 26, 2018

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HouseIntro Referral

Introduced in House

April 26, 2018

HouseIntro Referral

Referred to the House Committee on Energy and Commerce.

Energy and Commerce Committee

April 26, 2018

Floor Debate

1 member

What members said about H.R. 5641 on the floor

1 Republican

Rep. Glenn ThompsonR-PA-5 · Nov 15, 2018

Mr. Speaker, this week is Rural Health Week in the Commonwealth of Pennsylvania, and today is National Rural Health Day. It is a time to promote awareness of the full range of issues that impact…

Mr. Speaker, this week is Rural Health Week in the Commonwealth of Pennsylvania, and today is National Rural Health Day.

It is a time to promote awareness of the full range of issues that impact approximately 60 million rural Americans. Pennsylvania ranks as one of the States with the highest number of rural residents, with 23 percent of Pennsylvanians residing in rural areas.

Rural communities face unique healthcare concerns, such as a lack of providers; accessibility issues, particularly in terms of transportation and technology; affordability issues as a result of larger percentages of uninsured and underinsured citizens; and greater out-of-pocket health costs.

Mr. Speaker, before I was elected to the House of Representatives, I spent nearly 30 years in the nonprofit healthcare field assisting those facing life-changing diseases and disabilities. I am acutely aware of the challenges many face when it comes to obtaining reasonably priced healthcare. It is especially critical for rural America, like much of my congressional district.

We are facing a healthcare crisis in our Nation's rural areas. These often disadvantaged populations are still struggling to access affordable quality care. Many remain uninsured; most are underinsured. However, access to quality care remains the largest challenge.

Even when people gain access to health insurance, it does not equal access to care. Rural hospitals across the country are closing, leaving patients without access to their emergency rooms and their long-term care facilities.

Mr. Speaker, 90 rural hospitals have closed since 2010, and nearly 700 are at risk. One in three rural hospitals is financially vulnerable. At the current closure rate, more than 25 percent of rural hospitals will close in less than a decade.

Continued cuts in hospital payments have taken their toll, forcing hospitals to operate in the red until they finally make the painful decision to stop providing care. Between 2017 and 2018, the number of rural hospitals operating at a loss rose from 40 to 44 percent.

In addition to hospital closures, a workforce shortage plagues rural America. Mr. Speaker, 77 percent of

more than 2,000 rural communities in the United States are designated as having a shortage of healthcare professionals. Recruitment and retention of experienced professionals, including primary care physicians, is an ongoing challenge.

That is why I am a proud sponsor of H.R. 5641, the State Offices of Rural Health Reauthorization Bill of 2018. This legislation benefits States by increasing annual funding and reauthorizing vital programs for rural Americans for the first time since the 1990s. I urge my colleagues to cosponsor this piece of legislation today.

Another issue that has ravaged our rural communities is the opioid epidemic. It continues to leave even more rural Americans in need of crucial health services.

Adolescents and young adults living in rural areas are more vulnerable to opioid abuse than their urban counterparts. The prevalence of fatal drug overdoses has skyrocketed in rural areas. High unemployment and a greater rate of the types of injuries that result in prescriptions for opioid medications have contributed to this.

There are ways to increase treatment options. As a part of the VA MISSION Act, which was signed into law in June, I included a provision that expands healthcare access for our veterans through telemedicine. We now allow VA-credentialed healthcare providers to practice telemedicine across State lines.

Mr. Speaker, our veterans should receive the best care possible no matter where they are located and where they live. With advances in technology, we see new opportunities for veterans to obtain coverage through telemedicine, especially in some of our most rural areas.

For those in rural regions, the need is great and services are scarce. Let us all recognize and celebrate the power of our vibrant rural communities in the face of these grave challenges.

As we celebrate National Rural Health Day today, it is my hope that we continue to strive for a 21st century healthcare system that works for everyone in America. Thanks to technology, we have the opportunity to expand services, regardless of where one resides, and all Americans deserve no less.

Bill Text

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Introduced in HouseIssued April 26, 2018

115th CONGRESS

2d Session

H. R. 5641

IN THE HOUSE OF REPRESENTATIVES

April 26, 2018

Mr. Mullin (for himself and Mr. Schrader) introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL

To amend the Public Health Service Act to provide grants to improve health care in rural areas.

Short title

This Act may be cited as the State Offices of Rural Health Reauthorization Act of 2018.

State offices of rural health

Section 338J of the Public Health Service Act (42 U.S.C. 254r) is amended to read as follows:

338J.

Grants to State offices of rural health

(a)

In general

The Secretary, acting through the Director of the Federal Office of Rural Health Policy (established under 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 Secretary determines that requiring matching funds would limit the State office of rural health’s 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

Recipients of a grant under subsection (a) shall use the grant funds for purposes of—

(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 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) of this section will be provided with an annual budget of not less than $150,000.

(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 section 330A(f);

(ii)

under a memorandum of agreement entered into with the State office of rural health under section 330A(h); 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 an office of rural health for purposes of 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.

(3)

Limit on indirect costs

The Secretary may impose a limit of no more than 15 percent on indirect costs claimed by the recipient of the grant.

(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 September 30 of each 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)

Authorization of appropriations

(1)

In general

For the purpose of making grants under subsection (a), there are authorized to be appropriated $12,500,000 for each of fiscal years 2018 through 2022.

(2)

Availability

Amounts appropriated under paragraph (1) shall remain available until expended.