Provides new federal authority for the Secretary to give extra financial help to rural water, wastewater, and waste disposal systems. Help can take the form of grants, very low‑interest loans, loan forgiveness or modification, or refinancing to protect public health and assist systems serving disadvantaged or economically distressed areas.

Requires the Secretary to adopt a local affordability measure to identify communities and systems that qualify for hardship assistance and to guide how the additional assistance is targeted and awarded.