Appropriations: On October 18, the Senate released their Fiscal year 2022 (FY 22) omnibus spending package. Included in the Labor-HHS package was $12.5 million for the State Office of Rural Health grant program for FY 22.  In July, the House included $13 million for the SORH grant program, an increase of $500,000 over FY 2021. The House and Senate appropriations committee will work out the differences and settle on a final number.

The Senate bill included $57,509,000 for the Medicare Rural Hospital Flexibility Program (Flex). The Senate number was significantly lower than what was advanced by the House. The House had included $79,009,000 for Rural Hospital Flexibility (FLEX) Grants, $23,400,000 above the FY 2021 enacted level and $23,242,000 for SHIP, an increase of $2,300,000 over FY 21. The Committee included $10,000,000 within the total for Flex Grants to establish the Rural Emergency Hospital Technical Assistance Program. This program will provide technical assistance from existing State Flex Programs to assist facilities in implementing the new Rural Emergency Hospital model. Finally, the Committee included $4,000,000 within the total for Flex Grants to establish the Rural Provider Modernization Grants program. This program will make grants to support hospitals, public health departments, clinics, and community-based organizations to plan and implement emerging, sustainable models of care.

Congress is currently operating under FY 21 funding until December 3, as Congress passed a continuing resolution (CR) on September 30 that extends funding for all federal programs through December 3, 2021. In between now and December, NOSORH will continue outreach to Senate offices on adopting the bulk of the House Labor-HHS rural provisions. This would include the slight increase in SORH funding and $10 million to establish the Rural Emergency Hospital Technical Assistance Program. NOSORH urges State Offices to email their senate contacts and ask them to request the House rural health language under HRSA be approved by Congress. 

Reconciliation Package Rolled Out:  On October 28, the long-anticipated Social Spending package (Build Back Better) was released by Congress. Democratic leadership hopes to expedite a vote on the $1.75 trillion package. Whether support exists to pass this bill through the House and Senate remains a major question mark. Two of the major health policy pieces, prescription drug reform and Medicare expansion for dental care, were not included in the framework. Repeal of the drug rebate rule was included.