From a returned study draft to a workable plan.

The returned draft. LC 1969, a draft dated November 5, 2026, would direct OHA to study a defined class of rural hospitals:

• The class. Hospitals outside a metropolitan area, classified by the federal government as both sole community hospitals and rural referral centers, and licensed for more than 50 beds.
• The study. Compare their reimbursement with their actual costs, and estimate the state fiscal effect if one of them reduced capacity or closed.
• The report. Due by September 15, 2028, with recommendations allowed but not required. The study is repealed on January 2, 2029.

The draft contains no designation, payment or appropriation. A returned draft is not a filed or introduced bill.

Five levels in the working drafts. Each level adds the proposed Systemically Important Rural Hospital designation and OHA certification. These are choices for review, not an adopted sequence or a promise of funding.

1. Designation alone. Define and certify the hospital class; create no payment obligation.
2. Designation and study. Add an OHA study reporting in 2028.
3. Publicly funded payment pilot. Add a pilot supported by a willing public entity, subject to lawful funds and required approvals.
4. Targeted payment protection. Add payment support limited to money appropriated for that purpose.
5. Allowable-cost payment target. Add a payment target and a General Fund formula for the first biennium, subject to legislative funding and applicable federal limits.

Each level has two eligibility versions: federal hospital classifications alone, or those classifications with an additional service-based route. The ten working drafts show those choices. They are separate project drafts; they do not change what Legislative Counsel returned in LC 1969.

Legislative Counsel would advise on procedure and timing. The ordinary presession draft-delivery deadline is 5 p.m. on December 1, 2026, and submission for introduction is due by 5 p.m. on December 11, 2026. The initial request deadline has passed. These dates do not automatically authorize expanding a returned request; the member’s office and Legislative Counsel must confirm the permitted scope and timing of revisions. SCR 209 (2026), paragraph 3(b)–(c) and § 4 exceptions.

One drafting issue to resolve first. The draft's class uses federal classifications, while Oregon's existing rural hospital categories use their own definitions. Legislative Counsel should reconcile the two before anything is built on either.

The requests run in three stages: inventory first, then the member's selection, then targeted follow-up. All three offices work from one baseline, seen three ways:

• government cost;
• financing receipts and who bears them;
• hospital retained net cash.

The decision measure is additional hospital resources retained, not gross funds moved. Preserve actual versus forecast, gross versus net, cash versus accrual, award versus disbursement, and calendar versus state or hospital fiscal-year distinctions. Use consistent baseline periods where existing records permit: hospital information from 2019 through the latest available 2026 period; state records from 2019–21 through 2025–27; and existing forecasts through 2030–31. An initial response need not await a complete historical dataset.

The twelve variants below are payment tools for levels 3 through 5: a pilot, targeted support or an allowable-cost target. They are not twelve funding sources or twelve new entitlements. Levels 1 and 2 do not themselves authorize payments. After the inventory, select two or three tools for initial modeling.

Keep a service carve-out and actual critical-access conversion as separate structural tests. Each selected design needs covered patients and services, allowable costs, credited payments, a funding source, a risk bearer, approvals and a first feasible cash date.