PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2147 used for engaging in activities relating to planning and im- plementing a rural health care plan and rural health networks, designating hospitals or facilities in the State as essential access community hospitals or rural primary care hospitals, and devel- oping and supporting communication and emergency transpor- tation systems. "(2) GRANTS TO HOSPITALS, FACILITIES, AND CONSORTIA.—A hos-
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pital or facility shall use a grant received under subsection (a)(2) to finance the costs it incurs in converting itself to a rural primary care hospital or an essential access community hospital or in becoming part of a rural health network in the State in which it is located, including capital costs, costs incurred in the development of necessary communications systems, and costs incurred in the development of an emergency transportation system. A consortium shall use a grant received under subsec- tion (a)(2) to finance the costs it incurs in converting hospitals or facilities that are part of the consortium into rural primary care hospitals or in developing and implementing a rural health network consisting of its members in the State in which it is located, including capital costs, costs incurred in the develop- ment of necessary communications systems, and costs incurred in the development of an emergency transportation system. "(e) DESIGNATION BY STATE OF ESSENTIAL ACCESS COMMUNITY HOS- PITALS.—A State may designate a hospital as an essential access community hospital only if the hospital— "(1) is located in a rural area (as defined in section 1886(d)(2)(D)); "(2)(A) is located more than 35 miles from any hospital that either (i) has been designated as an essential access community hospital, (ii) is classified by the Secretary as a rural referral center under section 1886(d)(5)(C), or (iii) is located in an urban area that meets the criteria for classification as a regional referral center under such section, or (B) meets such other criteria relating to geographic location as the State may impose with the approval of the Secretary; "(3) has at least 75 inpatient beds or is located more than 35 miles from any other hospital; "(4) has in effect an agreement to provide emergency and Contracts, medical backup services to rural primary care hospitals partici- pating in the rural health network of which it is a member and throughout its service area; "(5) has in effect an agreement, with each rural primary care hospital participating in the rural health network of which it is a member, to accept patients transferred from such primary care hospital, to receive data from and transmit data to such primary care hospital, and to provide staff privileges to physi- cians providing care at such primary care hospital; and "(6) meets any other requirements imposed by the State with the approval of the Secretary. "(f) DESIGNATION BY STATE OF RURAL PRIMARY CARE HosprrAis.— "(1) CRITERIA FOR DESIGNATION.—A State may designate a facility as a rural primary care hospital only if the facility— "(A) is located in a rural area (as defined in section 1886(d)(2)(D)); .4, "(B) at the time such facility applies to the State for «.. designation as a rural primary care hospital, is a hospital with a participation agreement in effect under section
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