WASHINGTON, D.C. – Senator Marsha Blackburn (R-Tenn.) introduced her Rural Health Agenda, aimed at addressing health care delivery challenges in rural America to maintain quality care close to home. The Rural Health Agenda includes three bills: the bipartisan Rural America Health Corps Act, cosponsored by Senators Dick Durbin (D-Ill.), Kevin Cramer (R-N.D.), Doug Jones (D-Ala.) and Lisa Murkowski (R-Alaska); the Rural Health Innovation Act, cosponsored by Senator Murkowski; and the Telemedicine Across State Lines Act, cosponsored by Senator Cramer.
 
“Tennesseans worry that as rural hospitals close, they will be left without access to health care,” said Senator Blackburn. “It is imperative that we find an appropriate substitute for maintaining care in these communities. If the old models of care delivery no longer work in our rural communities, we need new models. These three pieces of legislation, which come directly at the request of small town mayors and community leaders, will fill gaps left by hospital closures. We need to make quality care accessible closer to home for rural America. The Rural Health Agenda targets areas that need improvement in order to meet that goal.”

Background on the three pieces of Senator Blackburn’s Rural Health Agenda may be found below.
 
RURAL AMERICA HEALTH CORPS ACT
This bipartisan bill, led by Senators Blackburn and Durbin, and cosponsored by Cramer, Jones and Murkowski, would enhance the National Health Service Corps (NHSC) to include a Rural America Healthcare Corps to incentivize academic medical centers and health care graduates to rotate through underserved communities, and a range of sites would qualify for the program. 
 
The Rural America Health Corps Act:

• Creates a new loan repayment program titled “NHSC Rural Provider Loan Repayment Program.”
• Includes a range of providers such as nurse practitioners and physician assistants.
• Ensures practitioners would be eligible for loan repayment on a sliding scale, based on the severity of the shortage in that area.
• Waives any associated income tax liability for the loan repayment program.
• Other than these provisions, the program would follow the same rules as the current NHSC program.

 
RURAL HEALTH INNOVATION ACT
This bill, cosponsored by Senator Murkowski, incentivizes communities to leverage their existing resources to provide for the community’s urgent care needs. It would incentivize the establishment of robust Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) staffed with physician interns and residents, physician assistants, nurse practitioners, nurse midwives, and other advance-practice nurses. These facilities would have the equipment needed to triage and stabilize patients in an emergency, including a lab, X-ray machine, cardiac monitors, and more. These centers would serve the walk-in urgent care needs for a rural community and serve as a triage center and staging facility for necessary air or ambulance transports to area emergency departments.
 
This bill would also create a collaborative federal, state and local pilot program to expand rural health departments to meet urgent care needs, including a full range of necessary equipment, so these robust health departments can serve the walk-in urgent care needs of rural communities and serve as a triage center and staging facility for air or ambulance transports to area emergency departments.
 
The Rural Health Innovation Act:

• Creates two 5-year grant programs, administered by the Health Resources and Services Administration’s Community-Based Division.
• One grant program would help establish FQHCs and RHCs capable of meeting the community’s urgent care and triage needs; Grants will be limited to $500,000 for existing facilities and $750,000 for startup facilities.
• The other grant program would expand rural health departments to meet urgent care and triage needs; Grants will be limited to $500,000. Communities must have an existing health department with a government-funded building, some nursing staff, and medical equipment.
• Communities must be rural and be located at least thirty minutes from the nearest emergency department, using the speed limit on the most direct route from the proposed site to the nearest emergency department or be inaccessible by road.
• Communities that have lost a hospital in the last seven years will have priority.

 
TELEMEDICINE ACROSS STATE LINES ACT
This bill, cosponsored by Senator Cramer, would create uniform, national best practices for the provision of telemedicine across state lines. It also includes a five-year grant program to incentivize the expansion of effective telemedicine programs to reach rural communities. Lastly, it would authorize the creation of a new payment system to incentivize the adoption of telemedicine.
 
The Telemedicine Across State Lines Act:

• Instructs the Secretary of Health and Human Services (HHS) to initiate a rulemaking to create federal telemedicine program best practices: the Secretary should consult with range of stakeholders, including technology experts, primary care providers, specialists, academic medical centers, emergency medicine providers, federal agencies with expertise in this area, and more. The Secretary must report on the progress of the rulemaking to the Congressional committees of jurisdiction.
• Creates a grant program to incentivize the expansion of effective telemedicine programs to reach rural communities. To qualify, applications should: Be an existing telemedicine program; Meet criteria established by the Secretary; Have a planned expansion to a rural community as defined by the Federal Office of Rural Health Policy.
• Instructs the Center for Medicare and Medicaid Innovation (CMMI) to create a model to incentivize the adoption of telemedicine in order to increase access to care in rural areas.

The National Rural Health Association supports the Rural America Health Corps Act and the Telemedicine Across State Lines Act.