Farm bill includes new rural health programs

Rural health care

The House and Senate earlier this week passed a $867 billion farm bill. The Congressional Budget Office (CBO) states that even though the farm bill approaches almost $1 trillion in spending per year  for 10 years, it won’t increase the budget deficit due to the baseline set under the existing spending levels. The bill is 807 pages and is the federal government’s primary agricultural and food policy which was first created in 1933. The current bill includes 12 titles: Commodities, conservation, trade, nutrition, credit, rural development, research and extension, forestry, energy, horticulture, crop insurance and a miscellaneous section.

Title VI: Rural Development Title supports the rural business community programs including the rural electric and telecommunications services, rural water, sewer infrastructure and, most importantly for South Dakota Association of Healthcare Organization members, the rural hospitals and health care programs.

For the first time in the farm bill’s history there is a new section under the rural development title for rural health and it includes three new sections:

  • Sec. 6101. Combating substance use disorder in rural America; prioritizations.
  • Sec. 6102. Distance learning and telemedicine.
  • Sec. 6103. Refining of certain rural hospital debt.

Sec. 6101. Combating substance use disorder (SUD): For fiscal years 2019- 2025, the Secretary of Agriculture will set aside no less than 20 percent of funding for distance learning and telemedicine grants for addressing SUD in rural areas. Under the Community Facilities Direct Loans and Grants Program, the secretary will give preference to those applicants focusing on developing facilities that will focus on SUD treatment, prevention and recovery services. Rural health and safety education applicants will also receive prioritization if they are applying for a loan supporting services that will address SUD.

Sec. 6102. Distance learning and telemedicine: This section simply increases the amount of money provided for this program from $75,000,000 for each fiscal year 2014 through 2018 to $82,000,000 for each fiscal year 2019 through 2023.

Sec. 6103. Refinancing of certain rural hospital debt: The bill authorized assistance for a community facility to include the refinancing of a debt obligation of a rural hospital as an eligible loan or loan guarantee purpose if the assistance would help preserve access to health service in a rural community and meaningfully improve the financial position of the hospital. This provision requires rural hospitals seeking refinancing to meet the U.S. Department of Agriculture’s (USDA) financial feasibility and adequacy of security requirements.

Finally, Title XII – Miscellaneous – Subtitle D – Department of Agriculture Reorganization Act of 1994 Amendments, includes Sec. 12409. Rural Health Liaison. This section creates a rural health liaison to promote the awareness and availability of USDA resources and provide guidance and technical assistance to the field offices and staff on how to best serve the communities. The position is also tasked with coordinating with the Department of Health & Human Services to improve rural health care delivery.

One of the hot topics and part of the major national debate on the farm bill over the summer and fall was the Supplemental Nutrition Assistance Program (SNAP) where the House increased the age for work requirements. The hotly contested provision that was included in the House version did not pass in the Senate and was ultimately pulled out of the Conference report.

More specifics will be provided at a later date.