ADVANCEMENT OF HEALTH CARE SERVICES.

SEC. 638. ADVANCEMENT OF HEALTH CARE SERVICES. (a) In General.—Of the amounts appropriated in each of the fiscal years 1989 through 1991 to carry out title VII of the Public Health Service Act, the Secretary of Health and Human Services 102 STAT. 3152shall, for each such fiscal year, make available $500,000 for the purpose of advancing the health care services furnished by qualified hospitals. For purposes of this subsection, the term “qualified hospital” means a hospital located in a rural county that— (1) is adjacent to three counties, one of which is a central county of a Metropolitan Statistical Area, and all of which are classified as urban; (2) has a workforce of which at least 12.2 percent of such workers commute from the rural county to the central counties of the two immediately adjacent Metropolitan Statistical Areas (out-commuting), and the total in-commuting rate from the two immediately adjacent Metropolitan Statistical Areas to the rural county is at least 6.1 percent, so that when added to the out-commuting rate from the rural county the total in/out-commuting rate is at least 18 percent; (3) is also impacted by a third Metropolitan Statistical Area with an out-commuting rate from the rural county to that Metropolitan Statistical Area that is at least .15 percent and the in-commuting rate from the Metropolitan Statistical Area to such rural county is at least .15 percent; (4) has more than 73,500 residents but less than 74,000 residents according to the 1980 census; and (5) that has a health-related labor pool that is competitively impacted by, in addition to the normal competitive pressures of an urban labor market, the location in one of the adjacent Metropolitan Statistical Areas of at least three large health-related facilities, each with more than 375 beds, including a State-owned medical school/hospital complex with more than 4,000 employees, and a large Veterans’ Administration hospital with more than 400 beds. (b) Pro Rata Determination.—In making available amounts for a fiscal year for purposes of subsection (a), the Secretary of Health and Human Services may not reduce the amounts available for each program authorized under title VII of the Public Health Service Act by more than the amount equal to the product of— (1) the amounts appropriated, after the date of the enactment of this Act, for carrying out the program involved for the fiscal year; and (2) a percentage equal to the quotient of— (A) $500,000; divided by (B) the amounts appropriated, after the date of the enactment of this Act, for carrying out such title VII.