§254c. Rural health outreach, network development, and telemedicine grant program

(a) Administration

The rural health services outreach demonstration grant program established under section 241 of this title shall be administered by the Office of Rural Health Policy (of the Health Resources and Services Administration), in consultation with State rural health offices or other appropriate State governmental entities.

(b) Grants

Under the program referred to in subsection (a) of this section, the Secretary, acting through the Director of the Office of Rural Health Policy, may award grants to expand access to, coordinate, restrain the cost of, and improve the quality of essential health care services, including preventive and emergency services, through the development of integrated health care delivery systems or networks in rural areas and regions.

(c) Eligible networks

(1) Outreach networks

To be eligible to receive a grant under this section, an entity shall-

(A) be a rural public or nonprofit private entity that is or represents a network or potential network that includes three or more health care providers or other entities that provide or support the delivery of health care services; and

(B) in consultation with the State office of rural health or other appropriate State entity, prepare and submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require, including-

(i) a description of the activities which the applicant intends to carry out using amounts provided under the grant;

(ii) a plan for continuing the project after Federal support is ended;

(iii) a description of the manner in which the activities funded under the grant will meet health care needs of underserved rural populations within the State; and

(iv) a description of how the local community or region to be served by the network or proposed network will be involved in the development and ongoing operations of the network.

(2) For-profit entities

An eligible network may include for-profit entities so long as the network grantee is a nonprofit entity.

(3) Telemedicine networks

(A) In general

An entity that is a health care provider and a member of an existing or proposed telemedicine network, or an entity that is a consortium of health care providers that are members of an existing or proposed telemedicine network shall be eligible for a grant under this section.

(B) Requirement

A telemedicine network referred to in subparagraph (A) shall, at a minimum, be composed of-

(i) a multispecialty entity that is located in an urban or rural area, which can provide 24-hour a day access to a range of specialty care; and

(ii) at least two rural health care facilities, which may include rural hospitals, rural physician offices, rural health clinics, rural community health clinics, and rural nursing homes.

(d) Preference

In awarding grants under this section, the Secretary shall give preference to applicant networks that include-

(1) a majority of the health care providers serving in the area or region to be served by the network;

(2) any federally qualified health centers, rural health clinics, and local public health departments serving in the area or region;

(3) outpatient mental health providers serving in the area or region; or

(4) appropriate social service providers, such as agencies on aging, school systems, and providers under the women, infants, and children program, to improve access to and coordination of health care services.

(e) Use of funds

(1) In general

Amounts provided under grants awarded under this section shall be used-

(A) for the planning and development of integrated self-sustaining health care networks; and

(B) for the initial provision of services.

(2) Expenditures in rural areas

(A) In general

In awarding a grant under this section, the Secretary shall ensure that not less than 50 percent of the grant award is expended in a rural area or to provide services to residents of rural areas.

(B) Telemedicine networks

An entity described in subsection (c)(3) of this section may not use in excess of-

(i) 40 percent of the amounts provided under a grant under this section to carry out activities under paragraph (3)(A)(iii); and

(ii) 20 percent of the amounts provided under a grant under this section to pay for the indirect costs associated with carrying out the purposes of such grant.

(3) Telemedicine networks

(A) In general

An entity described in subsection (c)(3) of this section, may use amounts provided under a grant under this section to-

(i) demonstrate the use of telemedicine in facilitating the development of rural health care networks and for improving access to health care services for rural citizens;

(ii) provide a baseline of information for a systematic evaluation of telemedicine systems serving rural areas;

(iii) purchase or lease and install equipment; and

(iv) operate the telemedicine system and evaluate the telemedicine system.

(B) Limitations

An entity described in subsection (c)(3) of this section, may not use amounts provided under a grant under this section-

(i) to build or acquire real property;

(ii) purchase or install transmission equipment (such as laying cable or telephone lines, microwave towers, satellite dishes, amplifiers, and digital switching equipment); or

(iii) for construction, except that such funds may be expended for minor renovations relating to the installation of equipment; ¹

(f) Term of grants

Funding may not be provided to a network under this section for in excess of a 3-year period.

(g) Authorization of appropriations

For the purpose of carrying out this section there are authorized to be appropriated $36,000,000 for fiscal year 1997, and such sums as may be necessary for each of the fiscal years 1998 through 2001.

(July 1, 1944, ch. 373, title III, §330A, as added Pub. L. 104–299, §3(a), Oct. 11, 1996, 110 Stat. 3642 .)

Prior Provisions

A prior section 254c, act July 1, 1944, ch. 373, title III, §330, as added July 29, 1975, Pub. L. 94–63, title V, §501(a), 89 Stat. 342 ; amended Apr. 22, 1976, Pub. L. 94–278, title VIII, §801(b), 90 Stat. 415 ; Aug. 1, 1977, Pub. L. 95–83, title III, §304, 91 Stat. 388 ; Nov. 10, 1978, Pub. L. 95–626, title I, §104(a)–(d)(3)(B), (4), (5), (e), (f), 92 Stat. 3556–3559 ; July 10, 1979, Pub. L. 96–32, §§6(b)–(d), 7(c), 93 Stat. 83 , 84; Oct. 17, 1979, Pub. L. 96–88, title V, §509(b), 93 Stat. 695 ; Oct. 19, 1980, Pub. L. 96–470, title I, §106(e), 94 Stat. 2238 ; Aug. 13, 1981, Pub. L. 97–35, title IX, §§903(a), 905, 906, 95 Stat. 561 , 562; Jan. 4, 1983, Pub. L. 97–414, §8(e), 96 Stat. 2060 ; Apr. 24, 1986, Pub. L. 99–280, §§2–4, 100 Stat. 399 , 400; Aug. 10, 1988, Pub. L. 100–386, §§3, 4, 102 Stat. 921 , 923; Nov. 4, 1988, Pub. L. 100–607, title I, §163(3), 102 Stat. 3062 ; Dec. 19, 1989, Pub. L. 101–239, title VI, §6103(e)(5), 103 Stat. 2207 ; Nov. 6, 1990, Pub. L. 101–527, §9(a), 104 Stat. 2332 ; Oct. 27, 1992, Pub. L. 102–531, title III, §309(b), 106 Stat. 3500 , related to community health centers, prior to the general amendment of this subpart by Pub. L. 104–299, §2.

Effective Date

Section effective Oct. 1, 1996, see section 5 of Pub. L. 104–299, as amended, set out as an Effective Date of 1996 Amendment note under section 233 of this title.

Report on Telemedicine

Pub. L. 106–129, §6, Dec. 6, 1999, 113 Stat. 1675 , provided that: "Not later than January 10, 2001, the Secretary of Health and Human Services shall submit to the Congress a report that-

"(1) identifies any factors that inhibit the expansion and accessibility of telemedicine services, including factors relating to telemedicine networks;

"(2) identifies any factors that, in addition to geographical isolation, should be used to determine which patients need or require access to telemedicine care;

"(3) determines the extent to which-

"(A) patients receiving telemedicine service have benefited from the services, and are satisfied with the treatment received pursuant to the services; and

"(B) the medical outcomes for such patients would have differed if telemedicine services had not been available to the patients;

"(4) determines the extent to which physicians involved with telemedicine services have been satisfied with the medical aspects of the services;

"(5) determines the extent to which primary care physicians are enhancing their medical knowledge and experience through the interaction with specialists provided by telemedicine consultations; and

"(6) identifies legal and medical issues relating to State licensing of health professionals that are presented by telemedicine services, and provides any recommendations of the Secretary for responding to such issues."

¹ So in original. The semicolon probably should be a period.