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Sec. 254r. Grants to States for operation of offices of rural health

[ a ) In general
The Secretary, a c t i n g through the Director of the Office of Rural
Health Policy [established in section 912 of t h i s title), may make
grants to States for the purpose of improving health care in rural
areas through the operation of State offices o f r u r a l health,
(b) Requirement of matching funds
(1) In general The Secretary may not make a grant under subsection (a) of this
section unless t h e State involved agrees, w i t h respect to the
costs to be incurred by t h e State in carrying out the purpose
described in such subsection, to provide non-Federal
contributions in cash toward such costs i n an amount equal to -
(A] for t h e first fiscal year of payments under the grant,
not less than $1 for each $3 of Federal funds provided in the
grant;
{Bj for any second fiscal year of such payments, not less
than $1 for each $1 of Federal funds provided i n the grant; and
( C ) for any third fiscal year of such payments, not less than
$3 for each $1 of Federal funds provided in the grant.
( 2 ) Determination of amount of non-Federal contribution
(A) Subject to subparagraph [B), nowFederal 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.
(B) The Secretary may not make a grant under subsection {a) of
t h i s section unless the State involved agrees that -
(i) fox the first fiscal year of payments under the grant,
100 percent or less of the non-Federal contributions required
in paragraph (11 w i l l be provided i n the farm of in-kind
contributions;
( i i l for any second fiscal year of such payments, not more
than 50 percent of such non-federal contributions w i l l be
provided in the form of in-kind contributions; and
liii) for any third fiscal year of such payments, such
non-Federal contributions will be provided solely in the form
of cash.
(c) Certain required activities
The Secretary may not make a grant under subsection (a) of this
section unless the State involved agrees that activities carried
out by an office operated pursuant to such subsection w i l l include -
111 establishing and maintaining within the State a
clearinghouse for collecting and disseminating information an -
(A] rural health care issues;

'(B) research findings relating to rural health care; and
( C ) innovative approaches to the delivery of health care in
r u r a l areas;
(2) coordinating the activities carried out in the State that
relate to r u r a l health care, including providing coordination for
the purpose of avoiding redundancy i n sueh activities; and
( 3 ) identifying Federal and State programs regarding rural
health, and providing technical assistance to public and
nonprofit private entities regarding participation in sueh
programs.
(d) Requirement regarding annual budget for office
The Secretary may not make a grant under subsection {a) of this
section unless the State involved agrees t h a t , for any fiscal year
for which the State receives such a g r a n t , the o f f i c e operated
pursuant to subsection (a) of this section will be provided with an
annual budget of not less than $50,000.
(e) Certain uses of funds
(1) R e s t r i c t i o n s
The Secretary may not make a grant under subsection (a] of t h i s
section unless the State involved agrees t h a t -
(A) if research with respect to rural health is conducted
pursuant to the grant, not more than 10 percent of the grant
will be expended for such research; and
(B) the grant will not be expended -
(i) to provide health caxe (including providing cash
payments regarding such care);
{ii) to conduct activities for which Federal funds are
expended -
{I) within the State t o provide technical and other
nonfinancial assistance under subsection (f) of section
254c (FOOTNOTE 1) of this t i t l e ;
(FOOTNOTE 1) See References i n Text note below.
(TI) under a memorandum of agreement entered into with
the S t a t e under subsection Ih) of such section; or
(111) under a grant under section 254q-1 of this title;
( i i i l to purchase medical equipment, to purchase
ambulances, a i r c r a f t , or other vehicles, or to purchase major
communications equipment;
(iv) to purchase or improve real property; or
lv) to carry out any activity regarding a certificate of
need.
(2) Authorities
Activities for which a State may expend a grant under
subsection (a) of this section include -
(A) paying the coats of establishing an office of r u r a l
health for purposes of subsection (a) of t h i s section;
(B) subject t o paragraph (1) (B) (ii) (TII), 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.
( f ) Reports
The Secretary may not make a grant under subsection (a) of t h i s
section unless the State involved agrees -
(1) to submit to the Secretary repoxts containing sueh
information as the Secretary may require regarding activities
carried out under this section by the State; and
(2) t o submit such a xeport not later than January 10 of each
fisial year immediately following any fiscal year for which the
State has received such a grant.
( g ) Requirement of application
The Secretary may not make a grant under subsection [a) of this
section 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) of this
section to a State 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 has complied
w i t h each of the agreements made by the State under this section.
(i) * (Stateq defined
For purposes of this section, the term "State" means each of
the several States.
(j) Authorization of appropriations
(1) In general
For the purpose of making grants under subsection (a) of this
section, there are authorized to be appropriated $3,000,000 for
fiscal year 1991, $4,000,000 f o r f i s c a l year 1992, and $3,000,000
for fiscal year 1993.
(2) Availability
Amounts appropriated under paragraph (1) shall remain available
until expended.
(k) Termination of program
No grant may be made under t h i s section after the aggregate
amounts appropriated under subsection {j) (1) o f this section are
equal to $10,000,000.

Source
(July 1, 1944, ch. 373, title 111, Sec. 3385, as added Nov. 16,
1990, Pub. L. 101-597, t i t l e 111, Sec. 302, 104 Stat. 3032.)

REFERENCES IN TEXT
Section 2Sdc of t h i s title, referred to in subsec.
(el (1) ( B ) ( i i l (I), was i n the original a reference to section 330,
meaning section 330 of act July 1, 1944, which was omitted in the
general emendment of subpart I (Sec. 254b et seq.) of this part by
Pub. L. 104-299, Sec. 2 , O c t . 11, 1996, 110 Stat. 3626. Sections 2
and 3(a) of Pub. L. 104-299 enacted new sections 330 and 330A of
act July I, 1944, which are classified, respectively, to sections
-254b and 254c of this title.

PRIOR PROVISIONS
A prior section 254r, act July 1, 1944, eh. 373, title 111, Sec.
3381, formerly title VII, Sac. 757, as added Aug. I, 1977, Pub. L.
95-83, title 111, Sec. 307 (n) (11, 91 Stat. 392; amended Dec. 17,
1980, Pub. L. 96-537, 5ec. 3(d), 94 Stat. 3174; renumbered Sec.
33BG, Aug. 13, 1981, Pub. L. 97-35, t i t l e XXVII, Sec. 27091a), 95
Stat. 908: O c t . 30, 1984, Pub. L. 90-551, Sec. 3, 90 Stat. 2817;
renumbered Sec. 3381, Dec. 1, 1987, Pub. L. 100-177, title 11, See
201(11, 101 Stat. 992; Nov. 4, 1988, Pub. L. 100-607, title VI,
S.ec. 629(a) ( 3 ) , 102 Stat. 3146, which related to Indian Health
,Schol~rships and was classified to section 294y-1 of this title
prior to renumbering by Pub. L. 97-35, was repealed by Pub. L.
100-713, t i t l e I, Sec. 104 (b) (1) , Nov. 23, 1988, 102 Stat, 4787.
For provisions continuing scholarships provided on or before Mov.
23, 1988, see section 104 (b) (2) of Pub. L. 100-713.
A p r i o r section 3385 of act J u l y 1, 1944, was renumbered section
338K by Pub. L. 101-597 and is classified to section 254s of this
title,

COMMUNICATIONS FOR RURAL HEALTH PROVIDERS
Pub. L. 102-538, t i t l e I, Sec. 154, formerly Sec. 134, Oct. 27,
1992, 106 Stat. 3541, renumbered Sec. 154 by Pub. L. 103-66, title
VI, Sec. 6001(a) (21, Aug. 10, 1993, 107 Stat, 379, directed
Secretary of Commerce, i n conjunction with Secretary of Health and
Human Services, to establish an advisory panel to develop
recommendations for the improvement of rural health care through
t h e collection of information needed by providers and t h e
improvement in the use of communications to disseminate such
information and, not later than I year after establishment o f Panel
to prepare and submit to Congress a report summarizing the
recommendations made by the Panel.
Similar provisions were contained in Pub. L, 102-555, Sec. 3,
Nov. 15, 1990, 104 Stat. 2760.

SECTION REFERRED TO IN OTHER SECTIONS
This section is referred t o in section 254q-1 of this title.