Page:United States Statutes at Large Volume 111 Part 1.djvu/394

 Ill STAT. 370 PUBLIC LAW 105-33—AUG. 5, 1997 "(i) provides for the creation of 1 or more rural health networks (as defined in subsection (d)) in the State; "(ii) promotes regionalization of rural health services in the State; and "(iii) improves access to hospital and other health services for rural residents of the State; and "(B) has developed the rural health care plan described in subparagraph (A) in consultation with the hospital association of the State, rural hospitals located in the State, and the State Office of Rural Health (or, in the case of a State in the process of developing such plan, that assures the Secretary that the State will consult with its State hospital association, rural hospitals located in the State, and the State Office of Rural Health in developing such plan); "(2) assurances that the State has designated (consistent with the rural health care plan described in paragraph (1)(A)), or is in the process of so designating, rural nonprofit or public hospitals or facilities located in the State as critical access hospitals; and "(3) such other information and assurances as the Secretary may require. " (c) MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM DESCRIBED.— "(1) IN GENERAL. — A State that has submitted an application in accordance with subsection (b), may establish a medicare rural hospital flexibility program that provides that— "(A) the State shall develop at least 1 rural health network (as defined in subsection (d)) in the State; and "(B) at least 1 facility in the State shall be designated as a critical access hospital in accordance with paragraph (2). " (2) STATE DESIGNATION OF FACILITIES.— "(A) IN GENERAL.—^A State may designate 1 or more facilities as a critical access hospital in accordance with subparagraph (B). "(B) CRITERIA FOR DESIGNATION AS CRITICAL ACCESS HOSPITAL. — A State may designate a facility as a critical access hospital if the facility— "(i) is a nonprofit or public hospital and is located in a county (or equivalent unit of local government) in a rural area (as defined in section 1886(d)(2)(D)) that— "(I) is located more than a 35-mile drive (or, in the case of mountainous terrain or in areas with only secondary roads available, a 15-mile drive) from a hospital, or another facility described in this subsection; or "(II) is certified by the State as being a necessary provider of health care services to residents in the area; "(ii) makes available 24-hour emergency care services that a State determines are necessary for ensuring access to emergency care services in each area served by a critical access hospital;

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