S. 4204

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4204 Introduced in Senate (IS)]

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119th CONGRESS
2d Session
S. 4204

To amend the Public Health Service Act to establish a rural health 
center innovation awards program and a rural health department 
enhancement program, and for other purposes.

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

March 25, 2026

Mrs. Blackburn (for herself, Mr. Hickenlooper, and Mrs. Hyde-Smith) 
introduced the following bill; which was read twice and referred to the 
Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

A BILL

To amend the Public Health Service Act to establish a rural health 
center innovation awards program and a rural health department 
enhancement program, and for other purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Rural Health Innovation Act of 
2026''.

SEC. 2. RURAL HEALTH CENTER INNOVATION AWARDS PROGRAM.

Subpart I of part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:

``SEC. 330Q. RURAL HEALTH CENTER INNOVATION AWARDS PROGRAM.

``(a) Definitions.--In this section:
``(1) Eligible entity.--The term `eligible entity' means an 
entity that--
``(A) is a Federally qualified health center;
``(B) is a rural health clinic; or
``(C) agrees (as a condition of receiving a grant 
under this section) to establish such a center or 
clinic, including a hospital that agrees (as such a 
condition) to convert to a Federally qualified health 
center or rural health clinic.
``(2) Federally qualified health center.--The term 
`Federally qualified health center' has the meaning given such 
term in section 1861(aa) of the Social Security Act.
``(3) Rural health clinic.--The term `rural health clinic' 
has the meaning given such term in section 1861(aa) of the 
Social Security Act.
``(b) Establishment.--
``(1) In general.--The Secretary, acting through the 
Director of the Office of Rural Health Policy of the Health 
Resources and Services Administration, shall establish a grant 
program to be known as the `Rural Health Center Innovation 
Awards program' to award grants to eligible entities that 
submit an application in accordance with subsection (c) to 
enable such entities to establish or maintain a Federally 
qualified health center or rural health clinic that--
``(A) serves individuals in a rural area as a walk-
in urgent care center and as a triage center or staging 
facility for necessary air or ambulance transport to an 
emergency department; and
``(B) includes--
``(i) professional clinical staff, 
including physicians, physician interns, 
residents, nurse practitioners, physician 
assistants, nurse midwives, or other health 
care providers providing walk-in urgent care 
and emergency triage; and
``(ii) resources, including laboratories, 
x-ray machines, and cardiac monitors.
``(2) Permissible uses of funds.--The funds of a grant 
awarded under this section may be used to--
``(A) expand the hours of operation of a Federally 
qualified health center or rural health clinic;
``(B) pay for the costs of construction and 
renovation of a Federally qualified health center or 
rural health clinic; or
``(C) carry out any other activity for the purposes 
described in paragraph (1).
``(c) Applications and Selection.--
``(1) In general.--An eligible entity seeking a grant under 
this section shall submit to the Secretary an application at 
such time, in such manner, and containing such information as 
the Secretary may reasonably require.
``(2) Start up centers and clinics.--An application 
submitted under paragraph (1) by an eligible entity that is not 
a Federally qualified health center, or a rural health clinic, 
on the date on which the entity submits the application under 
paragraph (1) shall include in such application a demonstration 
of the costs of the equipment and staffing needed to establish 
the center or clinic.
``(3) Consideration of overlap.--In the case an eligible 
entity submits an application under paragraph (1) that proposes 
to serve an area that is served by another eligible entity 
through a grant under this section, the Secretary may consider 
whether an award to the eligible entity serving such same area 
can be justified based on the unmet need for additional 
services in such area.
``(4) Priority.--In selecting recipients of grants under 
this section, the Secretary shall give priority to an eligible 
entity that is operating as a Federally qualified health 
center, or a rural health clinic, on the date on which the 
entity submits the application under paragraph (1).
``(d) Grant Period and Amounts.--
``(1) Period.--Each grant awarded under this section shall 
be for a period of 5 years.
``(2) Amount.--
``(A) In general.--A grant awarded under this 
section to an eligible entity shall not exceed--
``(i) for the first year of the grant--
``(I) $500,000 if the entity is a 
Federally qualified health center, or a 
rural health clinic, on the date on 
which the award is made; and
``(II) $750,000 if the entity is 
using the grant to establish a 
Federally qualified health center or a 
rural health clinic; and
``(ii) for each of the second through fifth 
years of the grant, $500,000.
``(B) Considerations.--In determining the amount of 
a grant under this section for an eligible entity for 
each year after the first year in which the grant is 
awarded, the Secretary shall, subject to subparagraph 
(A)(ii), consider the number of patients treated, and 
the type of treatment provided, by the entity in the 
prior year.
``(e) Reporting.--
``(1) In general.--Not later than 3 years after the date of 
enactment of this section, the Secretary shall report to the 
committees described in paragraph (2) on the grant program 
under this section, including--
``(A) an assessment of the success of the program, 
challenges with respect to the program, and any action 
for regulatory flexibility or legislative authority 
needed to improve the program;
``(B) any savings to Federal health care programs;
``(C) any increase in access to care; and
``(D) any increase in utilization of health 
services in rural areas.
``(2) Committees.--The committees described in this 
paragraph are--
``(A) the Committee on Health, Education, Labor, 
and Pensions, and the Committee on Finance, of the 
Senate; and
``(B) the Committee on Energy and Commerce, and the 
Committee on Ways and Means, of the House of 
Representatives.
``(f) Rule of Construction.--No entity receiving a grant under this 
section shall lose status as a Federally qualified health center, or a 
rural health clinic, on account of carrying out any activities under 
this section.
``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $25,000,000 for each of fiscal 
years 2027 through 2031.''.

SEC. 3. RURAL HEALTH DEPARTMENT ENHANCEMENT PROGRAM.

Subpart I of part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.), as amended by section 2, is further amended 
by adding at the end the following:

``SEC. 330R. RURAL HEALTH DEPARTMENT ENHANCEMENT PROGRAM.

``(a) Definition of Rural Health Department.--In this section, the 
term `rural health department' means a local public health department 
that is located in a rural area.
``(b) Establishment.--The Secretary, acting through the Director of 
the Office of Rural Health Policy of the Health Resources and Services 
Administration, shall award grants, on a competitive basis, to rural 
health departments that submit an application in accordance with 
subsection (c) to enhance such departments and enable them to provide 
individuals in rural areas with emergency services, triage and 
transport to emergency departments, primary care services, and other 
services similar to services provided by emergency departments.
``(c) Applications.--A rural health department seeking a grant 
under this section shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may reasonably require, including--
``(1) an indication of the estimated cost of the equipment 
and staffing needed by the department for the first year of the 
award to set up the activities and services under this section;
``(2) a demonstration that the department has, on the date 
on which the application is submitted, a facility operating 
that is located in a rural area; and
``(3) a demonstration that, on the date on which the 
application is submitted, the department--
``(A) has a nursing staff and medical equipment; 
and
``(B) agrees to use such staff and equipment 
towards providing the services and carrying out the 
activities under this section.
``(d) Grants.--
``(1) Annual awards.--The funds awarded through a grant 
under this section to a rural health department shall be 
awarded on an annual basis for each of 5 years.
``(2) Maximum amounts.--The funds awarded through a grant 
under this section to a rural health department shall be in an 
amount that for a year does not exceed $500,000.
``(3) Considerations.--The Secretary shall determine the 
amount awarded to a rural health department through a grant 
under this section for a year in accordance with the following:
``(A) For the first year of the award, the amount 
shall be based on the amount the rural health 
department estimates for the cost of equipment and 
staffing needed to set up the activities and services 
supported under this section, as specified in the 
application under subsection (c).
``(B) For the second through fifth years of the 
award, the amount shall be based on the number of 
patients treated, and the type of treatment provided, 
by the department in the prior year.
``(e) Use of Funds.--
``(1) In general.--A rural health department receiving a 
grant under this section shall use the funds awarded through 
the grant to provide the services and carry out the activities 
described in subsection (b) at a facility that is located in a 
rural area, including by--
``(A) obtaining additional medical equipment and 
resources necessary for providing the services and 
activities described in subsection (b), such as 
laboratories, x-ray machines, and cardiac monitors;
``(B) hiring additional providers to provide the 
services and carry out the activities described in 
subsection (b), such as physician interns, residents, 
nurse practitioners, physician assistants, and nurse 
midwives, which hiring may be through a partnership 
described in paragraph (2)(A); and
``(C) providing outreach to the community regarding 
the services and activities of the rural health 
department as supported under this section.
``(2) Limitations.--
``(A) Partnerships.--Not more than 3 percent of the 
funds awarded through a grant under this section for a 
year may be used towards the rural health department 
entering into a partnership with an academic medical 
center to assist with the hiring described in paragraph 
(1)(B).
``(B) Community outreach.--For each of the first 2 
years of a grant awarded under this section, not more 
than 3 percent of the funds may be used by the rural 
health department receiving the grant for the outreach 
described in paragraph (1)(C).
``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $25,000,000 for each of fiscal 
years 2027 through 2031.''.
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