“This subtitle may be cited as the ‘Rural Access to Emergency Devices Act’ or the ‘Rural AED Act’.
A prior section 254c, act July 1, 1944, ch. 373, title III, § 330, as added
2020—Subsec. (d)(2)(A). Pub. L. 116–136, § 3213(1)(A), substituted “basic” for “essential”.
Subsec. (d)(2)(B). Pub. L. 116–136, § 3213(1)(B), inserted “to” after “grants” in introductory provisions and struck out “to” at beginning of cls. (i) to (iii).
Subsec. (e)(1). Pub. L. 116–136, § 3213(2)(A), inserted “improving and” after “outreach by” and “, through community engagement and evidence-based or innovative, evidence-informed models” after “rural areas” and substituted “5 years” for “3 years”.
Subsec. (e)(2). Pub. L. 116–136, § 3213(2)(B)(i), inserted “shall” after “entity” in introductory provisions.
Subsec. (e)(2)(A). Pub. L. 116–136, § 3213(2)(B)(ii), substituted “be an entity with demonstrated experience serving, or the capacity to serve, rural underserved populations” for “shall be a rural public or rural nonprofit private entity”.
Subsec. (e)(2)(B). Pub. L. 116–136, § 3213(2)(B)(iii), (iv), struck out “shall” before “represent” and inserted “that” after “members” in introductory provisions and struck out “that” at beginning of cls. (i) and (ii).
Subsec. (e)(2)(C). Pub. L. 116–136, § 3213(2)(B)(iii), struck out “shall” before “not previously”.
Subsec. (e)(3)(C). Pub. L. 116–136, § 3213(2)(C), substituted “the rural underserved populations in the local community or region” for “the local community or region”.
Subsec. (f)(1)(A). Pub. L. 116–136, § 3213(3)(A)(i)(I), substituted “plan, develop, and implement integrated health care networks that collaborate” for “promote, through planning and implementation, the development of integrated health care networks that have combined the functions of the entities participating in the networks” in introductory provisions.
Subsec. (f)(1)(A)(ii). Pub. L. 116–136, § 3213(3)(A)(i)(II), substituted “basic health care services and associated health outcomes” for “essential health care services”.
Subsec. (f)(1)(B). Pub. L. 116–136, § 3213(3)(A)(ii), amended subpar. (B) generally. Prior to amendment, text read as follows: “The Director may award such a rural health network development grant for implementation activities for a period of 3 years. The Director may also award such a rural health network development grant for planning activities for a period of 1 year, to assist in the development of an integrated health care network, if the proposed participants in the network do not have a history of collaborative efforts and a 3-year grant would be inappropriate.”
Subsec. (f)(2). Pub. L. 116–136, § 3213(3)(B)(i), inserted “shall” after “entity” in introductory provisions.
Subsec. (f)(2)(A). Pub. L. 116–136, § (3)(B)(ii), substituted “be an entity with demonstrated experience serving, or the capacity to serve, rural underserved populations” for “shall be a rural public or rural nonprofit private entity”.
Subsec. (f)(2)(B). Pub. L. 116–136, § 3213(3)(B)(iii), struck out “shall” before “represent” and inserted “that” after “participants” in introductory provisions and struck out “that” at beginning of cls. (i) and (ii).
Subsec. (f)(2)(C). Pub. L. 116–136, § 3213(3)(B)(iv), struck out “shall” before “not previously”.
Subsec. (f)(3)(C)(iii). Pub. L. 116–136, § 3213(3)(C)(i), amended cl. (iii) generally. Prior to amendment, cl. (iii) read as follows: “how the local community or region to be served will benefit from and be involved in the activities carried out by the network;”.
Subsec. (f)(3)(D). Pub. L. 116–136, § 3213(3)(C)(ii), substituted “the rural underserved populations in the local community or region” for “the local community or region”.
Subsec. (g)(1). Pub. L. 116–136, § 3213(4)(A), inserted “, including activities related to increasing care coordination, enhancing chronic disease management, and improving patient health outcomes” after “quality improvement activities” and substituted “5 years” for “3 years”.
Subsec. (g)(2). Pub. L. 116–136, § 3213(4)(B)(i), inserted “shall” after “entity” in introductory provisions.
Subsec. (g)(2)(A). Pub. L. 116–136, § 3213(4)(B)(ii), (iii), struck out “shall” at beginning of cls. (i) and (ii), and inserted “or regional” after “local” in cl. (ii).
Subsec. (g)(2)(B). Pub. L. 116–136, § 3213(4)(B)(ii), struck out “shall” before “not previously”.
Subsec. (g)(3)(D). Pub. L. 116–136, § 3213(4)(C), substituted “the rural underserved populations in the local community or region” for “the local community or region”.
Subsec. (h)(3). Pub. L. 116–136, § 3213(5), inserted “, as appropriate,” after “the Secretary” in introductory provisions.
Subsec. (i). Pub. L. 116–136, § 3213(6), amended subsec. (i) generally. Prior to amendment, text read as follows: “Not later than
Subsec. (j). Pub. L. 116–136, § 3213(7), substituted “$79,500,000 for each of fiscal years 2021 through 2025” for “$45,000,000 for each of fiscal years 2008 through 2012”.
2008—Subsec. (j). Pub. L. 110–355 substituted “$45,000,000 for each of fiscal years 2008 through 2012.” for “$40,000,000 for fiscal year 2002, and such sums as may be necessary for each of fiscal years 2003 through 2006.”
2003—Subsec. (b)(4). Pub. L. 108–163 substituted “section 295p(6)” for “section 295p”.
2002—Pub. L. 107–251 amended section generally. Prior to amendment, section related to a rural health outreach, network development, and telemedicine grant program, and in subsec. (a), provided for administration by the Office of Rural Health Policy; in subsec. (b), set out the objectives of grants; in subsec. (c), set out eligibility requirements; in subsec. (d), described preferred characteristics of applicant networks; in subsec. (e), specified permitted uses of grant funds; in subsec. (f), limited the duration of grants; and in subsec. (g), authorized appropriations.
Amendment by Pub. L. 108–163 deemed to have taken effect immediately after the enactment of Pub. L. 107–251, see section 3 of Pub. L. 108–163, set out as a note under section 233 of this title.
Section effective
Pub. L. 106–505, title IV, subtitle B, “This subtitle may be cited as the ‘Rural Access to Emergency Devices Act’ or the ‘Rural AED Act’.“SEC. 411. SHORT TITLE.“SEC. 412. FINDINGS.“Congress makes the following findings:“(1) Heart disease is the leading cause of death in the United States.“(2) The American Heart Association estimates that 250,000 Americans die from sudden cardiac arrest each year.“(3) A cardiac arrest victim’s chance of survival drops 10 percent for every minute that passes before his or her heart is returned to normal rhythm.“(4) Because most cardiac arrest victims are initially in ventricular fibrillation, and the only treatment for ventricular fibrillation is defibrillation, prompt access to defibrillation to return the heart to normal rhythm is essential.“(5) Lifesaving technology, the automated external defibrillator, has been developed to allow trained lay rescuers to respond to cardiac arrest by using this simple device to shock the heart into normal rhythm.“(6) Those people who are likely to be first on the scene of a cardiac arrest situation in many communities, particularly smaller and rural communities, lack sufficient numbers of automated external defibrillators to respond to cardiac arrest in a timely manner.“(7) The American Heart Association estimates that more than 50,000 deaths could be prevented each year if defibrillators were more widely available to designated responders.“(8) Legislation should be enacted to encourage greater public access to automated external defibrillators in communities across the United States.“SEC. 413. GRANTS.“(a) The Secretary of Health and Human Services, acting through the Rural Health Outreach Office of the Health Resources and Services Administration, shall award grants to community partnerships that meet the requirements of subsection (b) to enable such partnerships to purchase equipment and provide training as provided for in subsection (c).“(b) A community partnership meets the requirements of this subsection if such partnership—“(1) is composed of local emergency response entities such as community training facilities, local emergency responders, fire and rescue departments, police, community hospitals, and local non-profit entities and for-profit entities concerned about cardiac arrest survival rates;“(2) evaluates the local community emergency response times to assess whether they meet the standards established by national public health organizations such as the American Heart Association and the American Red Cross; and“(3) submits to the Secretary of Health and Human Services an application at such time, in such manner, and containing such information as the Secretary may require.“(c) Amounts provided under a grant under this section shall be used—“(1) to purchase automated external defibrillators that have been approved, or cleared for marketing, by the Food and Drug Administration; and“(2) to provide defibrillator and basic life support training in automated external defibrillator usage through the American Heart Association, the American Red Cross, or other nationally recognized training courses.“(d) Not later than 4 years after the date of the enactment of this Act [“(e) There is authorized to be appropriated $25,000,000 for fiscal years 2001 through 2003 to carry out this section.”
Pub. L. 106–129, § 6, “(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.”
Ex. Ord. No. 13941,
By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:
Since 2010, the year the [Patient Protection and] Affordable Care Act [Pub. L. 111–148] was passed, 129 rural hospitals in the United States have closed. Predictably, financial distress is the strongest driver for risk of closure, and many rural hospitals lack sufficient patient volume to be sustainable under traditional healthcare-reimbursement mechanisms. From 2015 to 2017, the average occupancy rate of a hospital that closed was only 22 percent. When hospitals close, the patient population around them carries an increased risk of mortality due to increased travel time and decreased access.
During the COVID–19 public health emergency (PHE), hospitals curtailed elective medical procedures and access to in-person clinical care was limited. To help patients better access healthcare providers, my Administration implemented new flexibility regarding what services may be provided via telehealth, who may provide them, and in what circumstances, and the use of telehealth increased dramatically across the Nation. Internal analysis by the Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services (HHS) showed a weekly jump in virtual visits for CMS beneficiaries, from approximately 14,000 pre-PHE to almost 1.7 million in the last week of April. Additionally, a recent report by HHS shows that nearly half (43.5 percent) of Medicare fee-for-service primary care visits were provided through telehealth in April, compared with far less than one percent (0.1 percent) in February before the PHE. Importantly, the report finds that telehealth visits continued to be frequent even after in-person primary care visits resumed in May, indicating that the expansion of telehealth services is likely to be a more permanent feature of the healthcare delivery system.
Rural healthcare providers, in particular, need these types of flexibilities to provide continuous care to patients in their communities. It is the purpose of this order to increase access to, improve the quality of, and improve the financial economics of rural healthcare, including by increasing access to high-quality care through telehealth.
(a) increase rural access to healthcare by eliminating regulatory burdens that limit the availability of clinical professionals;
(b) prevent disease and mortality by developing rural-specific efforts to drive improved health outcomes;
(c) reduce maternal mortality and morbidity; and
(d) improve mental health in rural communities.
(a) the additional telehealth services offered to Medicare beneficiaries; and
(b) the services, reporting, staffing, and supervision flexibilities offered to Medicare providers in rural areas.
(i) the authority granted by law to an executive department or agency, or the head thereof; or
(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.