If interested in viewing NOSORH Policy Committee meeting notes, please contact Ashley Muninger.

Appropriations Committee Advances Labor-HHS Funding Bill

On July 14, the House Appropriations Committee advanced the Fiscal Year (FY) 2017 Labor-HHS appropriations bill along party lines (19-12). The committee bill includes a $1 million increase for the State Offices of Rural Health (SORH) to $10,511,000 annually.

In June, the Senate Appropriations Committee passed its own FY 2017 Labor-HHS-Ed appropriations bill for the first time in seven years. However, the Senate bill funds the SORH program at $9,511,000, which was the same amount as FY 2016. With Congress now on recess until after Labor Day, it is highly unlikely lawmakers will reconcile the two bills prior to the fiscal year ending on September 30, 2016. The most likely course of action is Congress passing a continuing resolution to fund the government at the current FY 16 level through at least the November 2016 elections. Congress would then attempt to fund the federal government for FY 17 through an omnibus measure at the end of 2016 or beginning of 2017. It is through this legislation that future SORH funding will be determined.

Overall, the House bill provides a total of $73.2 billion for HHS, an increase of $2.6 billion above last year’s enacted level.  The bill includes over $6.1 billion for the Health Resources and Services Administration (HRSA), a cut of $218 million from FY 16. Within the HRSA account, $300 million is for the Children’s Hospital Graduate Medical Education program which is $5 million more than FY 2016. The bill also provides an increase for Rural Outreach Grants, Rural Hospital Flexibility Grants, Telehealth and the Rural Opioid Overdose Reversal Grant programs.

SORH Legislation Adds Cosponsors in the House, R-HOPE Bill Delayed

In the House, Rep. Crescent Hardy’s (R-NV) bill to reauthorize the State Offices of Rural Health (H.R. 5133) now includes 10 other House members who have endorsed his bill that would reauthorize the SORH program for five years at $15 million annually. In the Senate, Senator Pat Roberts (R-KS) and Senator Al Franken (D-MN) are still looking to introduce the Rural Hospital and Provider Equity (R-HoPE) bill that would most likely include a reauthorization of the SORH program. With Congress on recess until after Labor Day, a September introduction date is probable.

Trio of Rural Health Bills Introduced in the Senate

On July 13, Senator Al Franken (D-MN) introduced a series of rural health focused bills (S. 3189, S.3190, and S. 3191). Specifically, S. 3191 would create a Rural Health Council and suggests that external stakeholders with objective rural health expertise like the State Offices of Rural Health be included on the council.

The Strengthening Our Rural Health Workforce Act of 2016 (S. 3190) would require the HHS Secretary to clarify the definition of rural track training programs across federal programs so that more rural health care facilities are able to participate and reauthorize the Primary Care Residency Expansion Program, which supports residency programs in family medicine, general internal medicine, and general pediatrics, in rural and other medically underserved areas.

The Rural Health Care Quality Improvement Act of 2016 (S. 3191) would establish core quality measures that are tailored to rural communities and focused on improving patient outcomes and safety, reducing costs and increasing care coordination. The legislation would reauthorize the Medicare Rural Hospital Flexibility Grant Program to fund initiatives that support quality improvement efforts for rural health and would create a new grant program to support critical access hospitals in rural communities.

The Connecting Rural Americans to Care Act of 2016 (S. 3189) would increase funding for transportation programs that serve patients living in rural areas and would allow states to reimburse volunteer drivers who transport Medicaid patients to medical appointments for the entire trip, not just for the portion of the trip during which the patient is in the vehicle. The bill would also require the Federal Communications Commission (FCC) to simplify and strengthen its Healthcare Connect Fund to expand access to internet services for rural health providers and increases the discount the program provides on broadband services, equipment, and connections from 65 percent to 85 percent.

Ways and Means Advances Bill Delaying Physician-Supervision Rule

On July 7, the House Ways and Means Committee voted to advance the Continuing Access to Hospitals Act by Rep. Lynn Jenkins (R-KS).  The bill (H.R. 5613) would provide relief to rural hospitals by delaying through 2016 CMS’ enforcement of the physician supervision requirement for outpatient therapy services critical access hospitals in rural areas.  The legislation would provide allow physicians and other qualified clinicians to provide general, rather than direct supervision, over most outpatient therapeutic services. Senator John Thune (R-SD) introduced a companion bill in the Senate (S. 3129).  Floor action on the Jenkins bill is expect to occur when members return after Labor Day.

House Passes Mental Health Reform Bill

On July 6, the House overwhelmingly voted to pass a mental health reform bill (H.R. 2646). Despite the strong House vote (422-2), the full Senate did not take up their version (S. 2680) that passed the health committee in March.  With Congress adjourned until after Labor Day, that leaves little time for Senate passage before the end of the legislative year.

The House legislation would establish a new leadership position within HHS to direct federal mental health and substance abuse programs. The bill would reauthorize existing treatment and suicide prevention programs and create new ones, including a minority fellowship program for mental health providers and a training program that teaches clinicians how to better comply with HIPAA. The legislation would also require HHS to clarify conditions under which covered entities may release protected mental health information and would codify a Medicaid managed care regulation allowing optional state coverage of Institutions for Mental Disease (IMD) care for adults.

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