1. Short title This Act may be cited as the State Offices of Rural Health Reauthorization Act of 2018 . 2. State offices of rural health Section 338J of the Public Health Service Act ( 42 U.S.C. 254r ) is amended to read as follows: 338J. Grants to State offices of rural health (a) In general The Secretary, acting through the Director of the Federal Office of Rural Health Policy (established under section 711 of the Social Security Act), shall make grants to each State Office of Rural Health for the purpose of improving health care in rural areas. (b) Requirement of matching funds (1) In general Subject to paragraph (2), the Secretary may not make a grant under subsection (a) unless the State office of rural health involved agrees, with respect to the costs to be incurred in carrying out the purpose described in such subsection, to provide non-Federal contributions toward such costs in an amount equal to $3 for each $1 of Federal funds provided in the grant. (2) Waiver or reduction The Secretary may waive or reduce the non-Federal contribution if the Secretary determines that requiring matching funds would limit the State office of rural health’s ability to carry out the purpose described in subsection (a). (3) Determination of amount of non-Federal contribution Non-Federal contributions required in paragraph (1) may be in cash or in-kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions. (c) Certain required activities Recipients of a grant under subsection (a) shall use the grant funds for purposes of— (1) maintaining within the State office of rural health a clearinghouse for collecting and disseminating information on— (A) rural health care issues; (B) research findings relating to rural health care; and (C) innovative approaches to the delivery of health care in rural areas