PRINTER'S NO. 215 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL No.271 Session of 2025 INTRODUCED BY CAUSER, CIRESI, CUTLER, JAMES, PICKETT AND VITALI, JANUARY 22, 2025 REFERRED TO COMMITTEE ON HEALTH, JANUARY 22, 2025 AN ACT Establishing the Distressed Hospital Grant Program to award grants to distressed hospitals to prevent the reduction of services or cessation of operations; and making an appropriation. The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows: Section 1. Short title. This act shall be known and may be cited as the Distressed Hospital Grant Program Act. Section 2. Definitions. The following words and phrases when used in this act shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Applicant." A distressed hospital that submits an application under section 5(a) to the department for a grant under the program. "Department." The Department of Health of the Commonwealth. "Designated medically underserved area." As defined in section 1301 of the act of December 2, 1992 (P.L.741, No.113), 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 known as the Children's Health Care Act. "Distressed hospital." A hospital that meets all of the following criteria: (1) The hospital had a negative profit margin for at least the previous three consecutive calendar years or fiscal years. (2) The hospital is located more than 25 miles of travel distance on a roadway to another hospital located within this Commonwealth. "Grant." An amount of money awarded by the department under the program. "Hospital." Any of the following: (1) A hospital licensed by the department under section 808 of the act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act, that provides inpatient medical care and other related services for surgery, acute medical conditions or injuries. (2) A hospital licensed by the department under section 808 of the Health Care Facilities Act that specializes in services exclusively to infants, children, adolescents and young adults from birth up to 21 years of age. "Program." The Distressed Hospital Grant Program established under section 3. "Rural county." A county of this Commonwealth where the number of people per square mile within the county is less than 291. Section 3. Establishment of program. The Distressed Hospital Grant Program is established within the department for the purposes specified under this act. Section 4. Awards of grants. 20250HB0271PN0215 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 The department shall award grants in accordance with this act from money appropriated by the General Assembly for grants. Section 5. Applications for grants. (a) Applications.--A distressed hospital may apply for a grant. The department shall develop the application in a form determined by the department and make the application available electronically on the department's publicly accessible Internet website. To be eligible for a grant, a distressed hospital shall include any information required by the department in the application, including the certification under section 6. (b) Consideration.--No later than 45 days after the effective date of this subsection, the department shall receive and consider applications on a rolling basis until funding for grants has been completely expended, or until December 31, 2029, whichever occurs first. Section 6. Certification requirements. (a) Certification.--An applicant shall, in good faith, certify all of the following to the department: (1) The applicant is a distressed hospital and, if applicable, meets one of the criteria specified under section 9 for a priority to receive a grant. (2) The distressed hospital will remain in operation and does not intend to reduce services or cease operations within two years of the date of receipt of a grant. (3) The grant will be used to prevent the distressed hospital from reducing services or ceasing operations. (4) The grant will not be used to pay a remuneration to the distressed hospital's executives, administrators or administrative support staff. (5) The distressed hospital has not been awarded more 20250HB0271PN0215 - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 than one grant during a calendar year or fiscal year. (6) The distressed hospital has taken measures to affiliate or enter into a business arrangement with another person to prevent the distressed hospital from reducing services or ceasing operations. The distressed hospital shall provide supporting documentation to the department for the measures required under this paragraph. (7) The information provided in the application under section 5 and this section and all supporting documentation is true and accurate in all material aspects. (b) False statements.--An applicant or an authorized representative of the applicant that knowingly makes a false statement to obtain a grant shall be subject to 18 Pa.C.S. § 4904 (relating to unsworn falsification to authorities). Section 7. Review of applications. (a) Approval or disapproval.--No later than 60 days after the department has received a completed application under section 5(a), the department shall approve or deny the application for a grant. The department shall provide a notice to the applicant of any of the following: (1) The application for a grant is approved. (2) The application for a grant is denied and the reasons for denying the application. (3) The application for a grant is approved for an amount less than requested by the applicant and the reasons for approving an amount less than requested by the applicant. (b) Grant agreements.--Upon approving an application under subsection (a), the department shall enter into a grant agreement with the distressed hospital to award the grant. The grant agreement shall explain the terms and conditions of the 20250HB0271PN0215 - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 grant, including the applicable laws of this Commonwealth and reporting requirements. The department, the distressed hospital and any other applicable party may enter the grant agreement via electronic signature. Section 8. Distribution of grant money. No later than 60 days after approving an application under section 7(a), the department shall distribute grant money to a distressed hospital in accordance with this act as follows: (1) The distressed hospital may receive an amount equal to no more than 20% of the amount of money available for the program. (2) The department may award grants to the distressed hospital in increments of $1,000, subject to the limitation under paragraph (1). (3) The department may not distribute grant money to the distressed hospital unless the department, the distressed hospital and any other applicable party have fully executed a grant agreement under section 7(b). Section 9. Priority of grant awards. In awarding grants, the department shall prioritize all of the following: (1) A distressed hospital that has provided notice to the department that the distressed hospital will reduce services or cease operations under 28 Pa. Code § 51.3 (relating to notification). (2) A distressed hospital located in a designated medically underserved area. (3) A distressed hospital located in a rural county. Section 10. Reports. (a) Publication.--No later than December 31 of each year, 20250HB0271PN0215 - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 the department shall publish a report on the department's publicly accessible Internet website that contains the following information: (1) A list of each grant. (2) The name and address of each grant recipient. (3) The amount of the grant and a description of the financial impact to the grant recipient. (b) Submission.--The department shall submit the report under subsection (a) to the following: (1) The chair and minority chair of the Appropriations Committee of the Senate. (2) The chair and minority chair of the Appropriations Committee of the House of Representatives. (3) The chair and minority chair of the Health and Human Services Committee of the Senate. (4) The chair and minority chair of the Health Committee of the House of Representatives. (c) Final report.--Upon disbursement of all money appropriated for grants, or December 31, 2029, whichever is earlier, the department shall publish a final report under subsection (a). Section 11. Appropriation. The sum of $100,000,000 is appropriated from the General Fund to the department for the award of grants. The appropriation shall not lapse and shall be available for u se until the disbursement of all money appropriated for the program, or December 31, 2029, whichever is earlier. Section 12. Effective date. This act shall take effect immediately. 20250HB0271PN0215 - 6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29