SB 681 – Rural Health Care Stabilization Act

Primary Sponsors: Sen. Jerry Tillman (R-Randolph), Sen. Phil Berger (R-Rockingham)

Bill Summary

This bill would establish the Rural Health Care Stabilization Program to provide loans to eligible applicants for the support of eligible hospitals located in rural areas that are in financial crisis.

The financial crisis must be due to one of the following:

  • operation of oversized and outdated facilities
  • recent changes in the viability of health care delivery in their communities
  • demand for patient services
  • composition of payer mixes and patient populations

This program would provide loans at below market interest rates with structured repayment terms to transition to more efficient health care service models.

Loan funds could be used to finance new facilities or provide operational costs.

UNC Health Care shall collaborate with the Local Government Commission to administer this program. UNC Health Care shall be responsible for assessing Plans, negotiating terms of loan agreements, implementing approved loan agreements.

UNC Health Care would also evaluate the applicant’s ability to repay the loan.

The interest rate for the loan shall be below the market rate.

The maximum maturity of the loan is 7 years.

Bill Movement


This bill was filed on June 20, 2019.

This bill was heard for discussion only in Senate Finance on June 26, 2019.

This bill passed Senate Finance on June 28, 2019.

This bill passed Senate Rules on July 1, 2019

This bill passed the Senate floor on July 2, 2019.


This bill was referred to the following House Committees:

  • Finance – calendared to be heard on July 11, 2019.
    • The committee ran out of time on this bill. It will remain in this committee.
    • A proposed committee substitute was introduced on July 24, 2019. This bill includes local sales tax provision and expanded eligibility for utility accounts.
    • The proposed Committee Subsitute passed in House Finance and will now move to the House Rules Committee.
  • Rules
    • There was a technical amendment passed that was requested by staff.
    • There was an additional amendment passed to extend the loan timeline for 20 years.
    • The bill passed on July 31, 2019 and will now go to the House floor.

This bill passed the House on August 7, 2019 and will be sent back to the Senate for concurrence.

On August 13, 2019, the Senate voted not to concur with the House changes. A conference committee of House and Senate members will be appointed to further discuss the bill and implement changes.