S. 5526
Agricultural Act of 2026
Sponsor: John Boozman · 0 cosponsors
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Text of the bill
I Commodities
A Commodity Policy
B Dairy
C Supplemental Agricultural Disaster Assistance
D Administration
II Conservation
A Conservation Reserve Program
B Environmental Quality Incentives Program
C Conservation Stewardship Program
D Funding and administration
E Agricultural Conservation Easement Program
F Regional Conservation Partnership Program
G Forest Conservation Easement Program
H Other Conservation programs
III Trade
A Food for Peace Act
B Agricultural Trade Act of 1978
C Other agricultural trade laws
D Reports
IV Nutrition
A Supplemental nutrition assistance program
B Commodity distribution programs
C Miscellaneous
V Credit
A Farm Credit System
B Farm ownership and operating loans
C Administrative provisions
VI Rural Development
A Rural Electrification Act of 1936
I Rural broadband access
II Additional amendments
B Consolidated Farm and Rural Development Act
C Miscellaneous
I Rural care economy
(a) In general. Section 342 of the Consolidated Farm and Rural Development Act (7 U.S.C. 1990a) is amended—
(1) by striking a rural hospital and inserting an eligible health care facility;
(2) by striking rural community and inserting rural area;
(3) by striking hospital, and inserting eligible health care facility,;
(4) by striking Assistance and inserting the following:
(a) Refinancing of certain rural health care facility debt
(1) In general. Assistance
; and
(5) by adding at the end the following:
(2) Requirements. To promote the long-term sustainability and financial viability of an eligible health care facility, the Secretary shall—
(A) provide assistance described in paragraph (1) to an eligible health care facility for the purpose of—
(i) ensuring the facility has necessary resources to maintain public health, safety, or order;
(ii) addressing financial hardships of the facility, the patients of the facility, and the area served by the facility; and
(iii) identifying the financial stability of the facility, including—
(I) operational practices;
(II) revenue enhancements;
(III) policy revisions;
(IV) partnerships, regionalization, or consolidation of rural health systems; and
(V) contract services; and
(B) require an applicant for assistance described in paragraph (1)—
(i) to receive financial planning assistance; and
(ii) to prepare a long-term financial plan.
(3) Waiver. In the case of an application for refinancing pursuant to this subsection, the Secretary may waive the requirement of section 302(a)(1)(D) if the eligible health care facility is insolvent.
(b) Rural health care facility technical assistance program
(1) In general. In lieu of any other authority under which the Secretary may provide technical assistance to any eligible health care facility, the Secretary shall establish, and maintain, directly or by grant, contract, or cooperative agreement, a Rural Health Care Facility Technical Assistance Program (referred to in this subsection as the Program) to provide technical assistance and training, tailored to the capacity and needs of each eligible health care facility, to help eligible health care facilities—
(A) identify development needs for maintaining essential health care services and support action plans for operational and quality improvement projects to meet the development needs;
(B) better manage the financial and business strategies of the eligible heath care facilities, including providing financial planning assistance and preparing long-term financial plans; and
(C) identify, and apply for assistance from, loan and grant programs of the Department of Agriculture for which the eligible health care facilities are eligible.
(2) Goals. The goals of the Program shall be—
(A) to improve the long-term financial position and operational efficiency of eligible health care facilities;
(B) to prevent the closure of eligible health care facilities;
(C) to strengthen the delivery of health care in rural areas;
(D) to help eligible health care facilities better access and compete for loans and grants from programs administered by the Department of Agriculture; and
(E) to continue the activities of the Rural Hospital Technical Assistance Program (as in effect on the day before the date of enactment of this subsection).
(3) Program participation
(A) In general. The Secretary shall engage in outreach and engagement strategies to encourage eligible health care facilities to participate in the Program.
(B) Eligible health care facility selection. In selecting eligible health care facilities to participate in the Program, the Secretary—
(i) shall give priority to borrowers of loans and recipients of grants from the Rural Housing Service, the Rural Business-Cooperative Service, and the Rural Utilities Service; and
(ii) may consider—
(I) the age and physical state of the eligible health care facility involved;
(II) the financial vulnerability of the eligible health care facility and the ability of the eligible health care facility to meet debt obligations;
(III) the electronic health record implementation needs of the eligible health care facility;
(IV) whether the eligible health care facility is located in a health professional shortage area or a medically underserved area;
(V) whether the eligible health care facility serves a medically underserved population; and
(VI) such other criteria and priorities as are determined by the Secretary.
(4) Reporting requirements. Not later than 1 year after the date of enactment of this subsection, and annually thereafter, the Secretary shall submit to the Committee on Agriculture of the House of Representatives and the Committee on Agriculture, Nutrition, and Forestry of the Senate a written report describing the progress and results of the Program, including—
(A) a brief description of each project to provide technical assistance to an eligible health care facility under this subsection, including—
(i) the name and location of the facility;
(ii) a description of the assistance provided;
(iii) a description of the outcomes for completed projects;
(iv) the cost of the technical assistance; and
(v) any other information the Secretary determines to be appropriate;
(B) a summary of the technical assistance projects completed;
(C) a summary of the outcomes of the technical assistance projects;
(D) an assessment of the effectiveness of the Program; and
(E) recommendations for improving the Program.
(5) Authorization of appropriations. There is authorized to be appropriated to the Secretary to carry out this subsection not more than $2,000,000 for each of fiscal years 2027 through 2031.
(c) Definitions. In this section:
(1) Rural area. The term rural area has the meaning given the term in section 343(a)(13)(A).
(2) Development needs. The term development needs means—
(A) constructing, expanding, renovating, or otherwise modernizing health care facilities;
(B) increasing telehealth capabilities;
(C) acquiring or upgrading health care information systems, such as electronic health records;
(D) providing financial planning assistance and preparing a long-term financial plan; and
(E) such other needs as the Secretary determines to be critical to maintaining health care services in the community in which an eligible health care facility is located.
(3) Eligible health care facility. The term eligible health care facility means a facility that is located in a rural area and is—
(A) a hospital (as defined in section 1861(e) of the Social Security Act (42 U.S.C. 1395x(e)));
(B) a psychiatric hospital (as defined in section 1861(f) of that Act (42 U.S.C. 1395x(f)));
(C) a home health agency (as defined in section 1861(o) of that Act (42 U.S.C. 1395x(o)));
(D) a rural health clinic (as defined in section 1861(aa)(2) of that Act (42 U.S.C. 1395x(aa)(2)));
(E) a critical access hospital (as defined in section 1861(mm)(1) of that Act (42 U.S.C. 1395x(mm)(1)));
(F) a religious nonmedical health care institution (as defined in section 1861(ss)(1) of that Act (42 U.S.C. 1395x(ss)(1)));
(G) a long-term care hospital (as defined in section 1861(ccc) of that Act (42 U.S.C. 1395x(ccc)));
(H) a rural emergency hospital (as defined in section 1861(kkk)(2) of that Act (42 U.S.C. 1395x(kkk)(2)));
(I) a sole community hospital (as defined in section 1886(d)(5)(D)(iii) of that Act (42 U.S.C. 1395ww(d)(5)(D)(iii))); and
(J) a community health center receiving funding under section 330 of the Public Health Service Act (42 U.S.C. 254b).
(4) Health professional shortage area. The term health professional shortage area has the meaning given the term in section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)).
(5) Medically underserved area. The term medically underserved area has the meaning given the term in section 330I(a) of the Public Health Service Act (42 U.S.C. 254c–14(a)).
(6) Medically underserved population. The term medically underserved population has the meaning given the term in section 330(b)(3) of the Public Health Service Act (42 U.S.C. 254b(b)(3)).
(b) Regulations. The Secretary shall issue regulations to carry out the amendments made by subsection (a).
(c) Effective date. Except for purposes of issuing regulations under subsection (b), the amendments made by subsection (a) shall take effect on the effective date of those regulations.
II Other miscellaneous provisions
VII Research, Extension, and Related Matters
A National Agricultural Research, Extension, and Teaching Policy Act of 1977
B Food, Agriculture, Conservation, and Trade Act of 1990
C Agricultural Research, Extension, and Education Reform Act of 1998
D Food, Conservation, and Energy Act of 2008
I Agricultural security
II Miscellaneous provisions
E Other Matters
VIII Forestry
A Forest data modernization
B Forest health and management
I Forest Service management
II State and private partnerships
III Timber innovation
C Forest conservation
D Land designations
E White oak resilience
F Other matters
IX Energy
X Horticulture
A Horticulture marketing and information
B Regulatory reform
XI Crop insurance
XII Miscellaneous
A Livestock
B National security
C Fertilizer
D United States grain standards reauthorization
E Year-Round E15 and RFS reform
F Other miscellaneous provisions