Rural Health Modernization Act

Community Engagement Committee Report 6/8

  1. Rural Health Care Action 

Community Engagement reviewed the proposed legislation, HR 2788 and         S 1037 “Rural Health Clinics Modernization Act,” and decided to get opinions from various health professional organizations.  If these are positive, we will proceed to present the project to the Meeting for Business.  If there are negative positions, we will call another meeting of this committee.  There is a statement by Dr. Barrasso, co-sponsor of the Senate bill that we will add to our informational links. We seek to network with Peace & Social Action to co-sponsor an action Minute for Meeting For Business.

Following our meeting, Gretchen reviewed the professional organizations and found:

  1. Texas Nurses Association:  summaries only, no opinion [referred to]
  2. American Nurses Association:  same results
  3. American Association of Nurse Practioners:  Lists both bills with no comments.
  4. American Academy of Physicians Assistants:  need to log in for further search on bills.
  5. American Medical Association:  No results found on either bill number.

Proposed Minute:  Friends Meeting of San Antonio calls for passage of HR 2788 and S1037 “Rural Health Modernization Act” to address the lack of health care facilities caused by the closing of rural hospitals throughout the country.  We will network with other Friends Meetings, faith based, and health care organizations to lobby our congressional delegations.

  1. Sending Announcements

There are two ways to communicate with F/friends:  the Newsletter list of 239 names around the country and the Announcement list for local names. Further, committee clerks and conveners keep lists of their members and communicate directly.  We reaffirm the original policy of keeping the first two list for their specific purposes.  We seek to minimize communication so as not to overburden F/friends.

  1. Telephone Messages

Jim Spickard and Bill Sweet receive the messages from the Meeting telephone and have responsibility for answering.  Usually they identify which will respond.  This system works well.                         Gretchen Haynes, c

Rural Health Care Bill

The Wednesday Meet Up group suggested individual and Meeting actions to support public health policy changes to come out of the wreckage of the pandemic.  CBS program 60 Minutes aired an analysis of the plight of rural hospitals and clinics nationwide.  We decided to focus on those in Texas and to network with others concerned with this problem.  Here is one response from Elizabeth Ellis  <>

“If you would like to truly support Rural Health, contact your Senators/Congressmen in Washington to support S.1037 Rural Health Modernization Act sponsored by Sen. Barrasso and Sen. Smith. This bill will provide long term support and modernization of rural health clinics across America. Additionally, speak to your State Senators/ Representatives to ensure rural America receives high speed/fiber internet to help ensure health access for all! “

That would be Senator John Cornyn at and Senator Ted Cruz at  To find your state senator and representation, go to Texas – TLO find the box “Who represents Me?” and fill in your address, city and zip.

The legislation is S.[enate] 1037, “Rural Health Clinic Modernization Act of 2019” co-sponsored by John Barrasso (R – WY) and Tina Smith (D – MN).  It has been referred to the Committee on Finance where it would amend title XVIII of the Social Security Act provisions relating to these clinics under Medicare after 30 years.

S.1037 concerns facilities not directed by a physician by “modernizing” and specifying the requirements for physicians, physician assistants and nurse practioners. It would allow flexibility in contracting with physician assistants and nurse practioners.  Further, it would allow rural clinics to be distant sites for telehealth visits and increase the reimbursement scale which was set in 1988.

This is one of 12,285 currently pending bills of which about 7% will ever become law. If Meeting approves, we can mobilize support, join with Yearly Meeting, and other organizations to bring pressure on our congressional representatives to get the bill in line for passage. If this project is approved, we can register our support on Govtrack website.  The second issue is within Texas, to bring high speed/fiber internet to these areas.  Let’s tackle that later and laser-bean our attention on S.1037.

It is a small step for our congressional delegation but a giant step for health care in rural areas.

Community Engagement Committee reviewed the information and recommends that F/friends inform themselves on these issues.  In lieu of our usual forum. please read  the material in the links and direct questions and comments to before June 19.   These will be reviewed, collated and presented to Meeting for Business for discernment.   


Background Information

Rural Health Care, which has been inadequate for many years, has been deeply affected by the excellerated closing of rural hospitals.  S.1037 would bring smaller clinics with professional staff and equipment to these blighted areas.

A report of NETWORK, Advocates for Justice, Inspired by Catholic Sisters.

“The NETWROK rural roundtable discussions brought to light key challenges and identified policy solutions, which are critical to the future of our rural communities.  For example, I have worked on health care at the state and federal level, and know that the challenges all Americas face with rising costs and dwindling access are amplified in less populated areas.  It’s hard to attract doctors. It’s hard to keep rural hospitals open, and it’s hard to deal with complicated disease management in communities where transportation is difficult.  I learned from experience that if a hospital closes in a rural area the town itself “closes” because many people can’t or won’t live in a community without access to health care.”            Kathleen Sebelius, former Kansas Governor and Secretary of Health and Human Services.

The University of North Carolina found that at least 160 rural hospitals have closed since 2005 (121 of those since 2010) and that the rate of closure has been accelerating, from just three in 2010 to at least 17 in 2019. …One of the most commonly discussed problems was the shortage of local health care providers.  … People told us how often medical staff will rotate through for a time to help pay off student loans but then move on.  Physician shortages mean that the few doctors are constantly “on call” and over stretched.  Participants felt that economic conditions made it difficult for medical schools to recruit students to return to their communities.  They felt student debt made it difficult for doctors to live and work in their localities.  Raising Rural Voices: Listening to the Hopes and Hardships of Rural Communities.

The message is clear: rural residents share the same desire for a just, equitable, and prosperous future as those living in metropolitan areas.  To realize that future, rural community need their elected officials to find and support solutions that recognize the unique charact4ristics of rural life.  We hope that the voices we’ve raises in this report will be heard, their needs will guide policy decisions, and their lived experiences in rural communities will be considered to achieve these goals.

In a time of pandemic, another rural hospital shuts its doors   



It’s a pattern that is likely to play out across the nation as COVID-19 unsettles the precarious finances of hundreds of small rural hospitals. Already, more than 170 have closed in the last 15 years, according to the University of North Carolina’s Rural Health Research Program. Last year, 18 shut their doors — the most since 2000 — and 12 have shuttered in the first four months of this year.

“It’s hard to envision a scenario in which we do not see a lot more hospitals closing,” said Alan Morgan, chief executive of the National Rural Health Assn., noting that in February, the nonprofit group identified more than 400 hospitals at risk for closure.  “Things have only gotten significantly worse.”


According to a recent report by the American Hospital Assn., hospitals and health systems across the nation face unprecedented financial challenges in the coming months, with an estimated loss of more than $200 billion from COVID-19 expenses from March to June.

After cancelling all outpatient and elective procedures, which account for 70% to 80% of revenue, Morgan said, many hospitals are furloughing and laying off staff. In April, the healthcare sector lost 1.4 million jobs, according to the U.S. Bureau of Labor Statistics, with nearly 135,000 hospital workers laid off across the country.

[Commenting on the news that Williamson Memorial Hospital, W VA., was shutting down]  :                                   “I’ve always said if you lose your community hospital, tumbleweeds are next,” said Mayor Charles Hatfield, who served as the hospital CEO until it declared bankruptcy.  Closing the hospital not only puts stress on local restaurants and stores, but also makes it harder for Williamson to attract tourism and diversify its economy.

With 100 full-time staff, the hospital served as an economic engine for the city. It was the main employer, Hatfield said, contributing more than $100,000 a year in property taxes and about a third of the city’s business and occupation tax revenue.

While big hospitals in places such as New York City, Detroit and New Orleans have been overwhelmed with a massive surge of COVID-19 cases, Williamson Memorial is one of hundreds of rural hospitals across the nation that have suffered from an altogether different crisis: a massive drop in patients.

The struggling 76-bed hospital in this rugged Appalachian coal country town of 2,800 residents was forced to close down last month after the global coronavirus pandemic hit just as administrators were trying to climb out of bankruptcy and work out a deal for another hospital to take over.