I 

118TH CONGRESS 

2D SESSION H. R. 9631 

To provide for the establishment or expansion of Food as Medicine programs, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 17, 2024 

Ms. LEE of California introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committee 

on Agriculture, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To provide for the establishment or expansion of Food as 

Medicine programs, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘National Food as Med5 icine Program Act of 2024’’. 

6 SEC. 2. FOOD AS MEDICINE MEDICAID WAIVER GRANT PRO7 GRAM. 

8 (a) IN GENERAL.—The Secretary of Health and 

9 Human Services (in this section referred to as the ‘‘SecVerDate Sep 11 2014 01:36 Sep 27, 2024 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H9631.IH H9631

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1 retary’’) shall establish a program under which the Sec2 retary shall award grants to States to plan, implement, 

3 expand, or evaluate Food as Medicine programs. 

4 (b) APPLICATION.—A State seeking a grant under 

5 this section shall submit an application to the Secretary 

6 at such time, in such manner, and containing such infor7 mation as the Secretary may require. 

8 (c) PRIORITY.—In awarding grants under this sec9 tion, the Secretary shall give priority to States that have, 

10 as of the date of submission of the application for a grant 

11 under this section, a partnership with— 

12 (1) a network of health care providers that in13 cludes public, nonprofit, and community-based orga14 nizations or entities, and community health clinics, 

15 including Federally qualified health centers (as de16 fined in section 1861 of the Social Security Act (42 

17 U.S.C. 1395x)); or 

18 (2) public, nonprofit, socially disadvantaged, 

19 and community-based organizations or entities that 

20 provide locally-sourced (or regionally-sourced, if lo21 cally-sourced produce is not available) agricultural 

22 products (as defined in section 207 of the Agricul23 tural Marketing Act of 1946 (7 U.S.C. 1626)) 

24 grown, or working to transition to, a covered method 

25 of production. 


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1 (d) USE OF FUNDS.—A State that receives a grant 

2 under this section shall use funds received through the 

3 grant to establish, implement, and expand Food as Medi4 cine interventions to reduce nutrition-related chronic con5 ditions, address food and nutrition insecurity, and improve 

6 health through providing locally-sourced (or regionally7 sourced, if locally-sourced produce is not available) agri8 cultural products grown, or working to transition to, a cov9 ered method of production. 

10 (e) REPORT TO THE SECRETARY.—Not less than 3 

11 years after the date on which a State receives a grant 

12 under this section, such State shall provide to the Sec13 retary a report that contains— 

14 (1) an evaluation of the impact of the Food as 

15 Medicine program established or expanded in such 

16 State, including relevant data collected under the 

17 Medicaid program under title XIX of the Social Se18 curity Act (42 U.S.C. 1396 et seq.); 

19 (2) the impact of the Food as Medicine pro20 gram on, with respect to individuals participating in 

21 such program, the appropriate health, nutrition, and 

22 associated behavioral outcome baseline information 

23 for such individuals that is relevant to the stated 

24 goals and desired outcomes of the pilot project; 


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1 (3) to the extent possible, the Food as Medicine 

2 Program’s impact on hospital admissions and re3 admissions, admissions into long-term care facilities, 

4 medication utilization, emergency room utilization 

5 rates, primary care, specialty care, primary care 

6 medical home engagement, patient experience, and 

7 health care team engagement; 

8 (4) other relevant findings, including rec9 ommendations on strengthening the administration 

10 of the program and resources needed to support and 

11 strengthen the Food as Medicine program. 

12 (f) DEFINITIONS.—In this section: 

13 (1) The term ‘‘covered method of production’’ 

14 means, with respect to an agricultural product, that 

15 the product is— 

16 (A) regeneratively produced; 

17 (B) organically produced; or 

18 (C) regeneratively and organically pro19 duced. 

20 (2) The term ‘‘Food as Medicine program’’ 

21 means a program under which a State pursuant to 

22 a waiver under section 1115 of the Social Security 

23 Act (42 U.S.C. 1315) provides to individuals eligible 

24 to receive medical assistance under such waiver 


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1 medically supportive food and nutrition interven2 tions. 

3 (3) The term ‘‘food hub’’ means a business or 

4 organization that actively manages the aggregation, 

5 distribution, and marketing of source-identified food 

6 products primarily from local and regional producers 

7 to strengthen their ability to satisfy wholesale, retail, 

8 and institutional demand. 

9 (4)(A) The term ‘‘medically supportive food and 

10 nutrition interventions’’ means interventions that 

11 provide culturally-appropriate, nutrient-rich whole 

12 food (including any fresh vegetables and fruit, leg13 ume, nut, seed, whole grain, low-mercury and high14 omega-3 fatty acid seafood, or lean animal protein) 

15 prescribed by a health care professional for the pre16 vention, reversal, or treatment of certain health con17 ditions. 

18 (B) Such term includes the following interven19 tions: 

20 (i) Meals that are— 

21 (I) tailored to a recipient’s health con22 ditions by a registered dietitian nutritionist 

23 and adhere to standards informed by avail24 able dietary recommendations for specific 

25 health conditions or dietary therapies. 


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1 based on evidence-based nutritional prac2 tice guidelines; and 

3 (II) consistent with the Dietary 

4 Guidelines for Americans established under 

5 section 301 of the National Nutrition Mon6 itoring and Related Research Act of 1990 

7 (7 U.S.C. 5341). 

8 (ii) Produce (vegetables and fruit) pre9 scriptions, delivered or procured from in a gro10 cery store, farm, farmers’ market, or food hub, 

11 that are consistent with the Dietary Guidelines 

12 for Americans established under section 301 of 

13 the National Nutrition Monitoring and Related 

14 Research Act of 1990 (7 U.S.C. 5341). 

15 (iii) Nutrition coaching or counseling, 

16 group medical visits, cooking education and 

17 tools, health coaching, and other behavioral 

18 supports based on a recipient’s medical condi19 tions, when paired with the interventions de20 scribed in subparagraphs (A) and (B). 

21 (5) The term ‘‘organically produced’’ means, 

22 with respect to an agricultural product, that the 

23 product is— 


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1 (A) certified under the Organic Foods Pro2 duction Act of 1990 (7 U.S.C. 6501 et seq.) as 

3 organically produced; or 

4 (B) verified through a community-based, 

5 culturally-appropriate verification program 

6 under the Organic Foods Production Act of 

7 1990 as organically produced. 

8 (6) The term ‘‘regeneratively produced’’ means, 

9 with respect to an agricultural product, that the 

10 product is produced— 

11 (A) using an integrated approach to farm12 ing and ranching rooted in the principles of soil 

13 health leading to improved target outcomes, in14 cluding— 

15 (i) building soil health; 

16 (ii) restoring and maintaining water 

17 resources; 

18 (iii) protecting air quality; 

19 (iv) sequestering greenhouse gas emis20 sions; 

21 (v) using sustainable and integrated 

22 pest management to eliminate reliance on 

23 pesticides; 

24 (vi) improving nutrient cycling to re25 duce use of external fertilizers; 


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1 (vii) supporting Native-led steward2 ship practices (as described in Order No. 

3 3403 entitled ‘‘Joint Secretarial Order on 

4 Fulfilling the Trust Responsibility to In5 dian Tribes in the Stewardship of Federal 

6 Lands and Waters’’ published jointly by 

7 the Secretary of Agriculture and the Sec8 retary of the Interior on November 15, 

9 2021); and 

10 (viii) fostering wildlife and animal 

11 welfare; and 

12 (B) in a manner that fosters community 

13 and social wellness, including— 

14 (i) improving human health in rural 

15 and urban communities; 

16 (ii) creating supportive livelihoods 

17 (worker conditions, safety) and durable so18 lutions for a healthy food and agriculture 

19 workforce; 

20 (iii) creating economic vitality for 

21 farmers, ranchers, and a healthy food and 

22 agriculture workforce; and 

23 (iv) optimizing the above target out24 comes to ensure that there is minimal neg25 ative impact on other target outcomes. 


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1 (7) The term ‘‘regeneratively-organically pro2 duced’’ means, with respect to an agricultural prod3 uct, that the product is produced— 

4 (A) using some organic methods, as de5 scribed in the Organic Foods Production Act of 

6 1990 (7 U.S.C. 6501 et seq.); and 

7 (B) using some methods included in the in8 tegrated approach described in paragraph (5). 

9 (8) The term ‘‘State’’ each of the several States 

10 and each territory and possession of the United 

11 States. 

12 SEC. 3. DEPARTMENT OF AGRICULTURE FOOD AS MEDI13 CINE TECHNICAL ASSISTANCE PROGRAM. 

14 (a) IN GENERAL.—The Secretary of Agriculture (re15 ferred to in this section as the ‘‘Secretary’’) shall enter 

16 into cooperative agreements with eligible entities to pro17 vide technical assistance and infrastructure support to 

18 producers to enable such producers to connect with local 

19 health care providers for purposes of providing nutritious 

20 food under a Food is Medicine program established or ex21 panded pursuant to section 2. An eligible entity may work 

22 in collaboration with a Regional Food Business Center of 

23 the Department of Agriculture to provide such technical 

24 assistance under a cooperative agreement. 


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1 (b) APPLICATION.—An eligible entity seeking to enter 

2 into a cooperative agreement under this section shall sub3 mit to the Secretary an application at such time, in such 

4 manner, and containing such information as the Secretary 

5 may require. 

6 (c) PRIORITY.—In selecting eligible entities with 

7 which to enter into cooperative agreements under this sec8 tion, the Secretary shall give priority to applications con9 taining proposals— 

10 (1) to provide technical assistance and infra11 structure support to beginning farmers and ranchers 

12 (as defined in section 343(a) of the Consolidated 

13 Farm and Rural Development Act (7 U.S.C. 

14 1991(a))) and socially disadvantaged farmers and 

15 ranchers (as defined in section 355(e) of the Con16 solidated Farm and Rural Development Act (7 

17 U.S.C. 2003(e))); and 

18 (2) to provide technical assistance and infra19 structure support to producers that produce agricul20 tural products (as defined in section 207 of the Ag21 ricultural Marketing Act of 1946 (7 U.S.C. 1626)) 

22 that are produced using a covered method of produc23 tion (as defined in section 2) or verified through 

24 community-based, culturally appropriate verification 

25 programs. 


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1 (d) DEFINITIONS.—In this section: 

2 (1) The term ‘‘Food is Medicine program’’ has 

3 the meaning given such term in section 2. 

4 (2) The term ‘‘eligible entity’’ means— 

5 (A) a land-grant college or university; 

6 (B) a food hub (as defined in section 2); 

7 or 

8 (C) a Regional Food Business Center sup9 ported by the Department of Agriculture. 

10 (3) The term ‘‘land-grant college or university’’ 

11 has the meaning given the term ‘‘land-grant colleges 

12 and universities’’ in section 1404 of the National 

13 Agricultural Research, Extension, and Teaching Pol14 icy Act of 1977 (7 U.S.C. 3103). 

15 SEC. 4. REPORT TO CONGRESS. 

16 Not later than one year after the date on which the 

17 first grant is awarded under section 2, the Secretary of 

18 Health and Human Services, in consultation with the Sec19 retary of Agriculture, shall submit to Congress a report 

20 that includes the information received from the States 

21 under section 2 and the Secretary’s recommendations with 

22 respect to best practices for carrying out a Food is Medi23 cine program. 


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1 SEC. 5. FOOD AS MEDICINE GUIDANCE. 

2 (a) IN GENERAL.—Not later than one year after the 

3 date of the enactment of this Act, the Secretary of Health 

4 and Human Services, in consultation with the officials and 

5 stakeholders described in subsection (c), shall develop and 

6 issue— 

7 (1) recommendations for States and counties to 

8 implement or expand a Food as Medicine program 

9 (as defined in section 2), clinical nutrition training 

10 for health care providers, and nutritional and behav11 ioral support for patients to integrate food interven12 tions into daily habits; and 

13 (2) guidance related to— 

14 (A) how a State may include food insecu15 rity and or nutrition insecurity as conditions 

16 making an individual eligible to participate in 

17 Food as Medicine programs, in addition to eligi18 ble populations with chronic conditions; 

19 (B) eligible populations that address food 

20 insecurity, nutrition insecurity, and chronic con21 ditions; 

22 (C) the duration and dosage of medically 

23 supportive food and nutrition intervention 

24 plans; 

25 (D) the value-based procurement of food 

26 through a managed care rate setting process 


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1 that includes minimum percentages and tier2 based incentives to increase the procurement of 

3 products grown using covered methods of pro4 duction (as defined in section 2) by socially dis5 advantaged farmers and ranchers (as defined in 

6 section 2501 of the Food, Agriculture, Con7 servation, and Trade Act of 1990 (7 U.S.C. 

8 2279)); 

9 (E) determination of providers permitted 

10 to provide medically supportive food and nutri11 tion interventions (as defined in section 2); and 

12 (F) continuing education for health care 

13 providers prescribing medically supportive food 

14 and nutrition interventions. 

15 (b) PUBLIC COMMENT PERIOD.—The Secretary shall 

16 provide for 30-day public comment period with respect to 

17 any proposed guidance issued under this section. Such 

18 guidance shall not be finalized until the date that is 60 

19 days after the close of such public comment period. 

20 (c) OFFICIALS AND STAKEHOLDERS DESCRIBED.— 

21 The officials and stakeholders described in this subsection 

22 include the following: 

23 (1) The heads of appropriate Federal agencies 

24 within the Department of Health and Human Serv25 ices. 


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1 (2) The Secretary of Agriculture. 

2 (3) Diverse stakeholders from community-based 

3 organizations, small- to medium-sized farms oper4 ated by socially disadvantaged farmers and ranchers, 

5 food hubs, health care providers, and Medicaid man6 aged care organizations who have helped to imple7 ment Food as Medicine programs. 

Æ 


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