II 

109TH CONGRESS 

1ST SESSION S. 1049

To amend title XXI of the Social Security Act to provide grants to promote 

innovative outreach and enrollment under the medicaid and State children’s health insurance programs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 17, 2005

Mr. FRIST (for himself, Mr. BINGAMAN, Mr. LUGAR, Ms. CANTWELL, Mr. 

SANTORUM, Ms. COLLINS, Mr. COCHRAN, Mrs. MURRAY, and Mrs. FEINSTEIN) introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL

To amend title XXI of the Social Security Act to provide 

grants to promote innovative outreach and enrollment 

under the medicaid and State children’s health insurance 

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 ‘‘Covering Kids Act of 

5 2005’’. 
2

•S 1049 IS 

1 SEC. 2. GRANTS TO PROMOTE INNOVATIVE OUTREACH AND 

2 ENROLLMENT UNDER MEDICAID AND SCHIP. 

3 (a) GRANTS FOR EXPANDED OUTREACH ACTIVI4 TIES.—Title XXI of the Social Security Act (42 U.S.C. 

5 1397aa et seq.) is amended by adding at the end the fol6 lowing: 

7 ‘‘SEC. 2111. EXPANDED OUTREACH ACTIVITIES. 

8 ‘‘(a) GRANTS TO CONDUCT INNOVATIVE OUTREACH

9 AND ENROLLMENT EFFORTS.—

10 ‘‘(1) IN GENERAL.—The Secretary shall award 

11 grants to eligible entities to—

12 ‘‘(A) conduct innovative outreach and en13 rollment efforts that are designed to increase 

14 the enrollment and participation of eligible chil15 dren under this title and title XIX; and 

16 ‘‘(B) promote understanding of the impor17 tance of health insurance coverage for prenatal 

18 care and children. 

19 ‘‘(2) PERFORMANCE BONUSES.—The Secretary 

20 may reserve a portion of the funds appropriated 

21 under subsection (g) for a fiscal year for the purpose 

22 of awarding performance bonuses during the suc23 ceeding fiscal year to eligible entities that meet en24 rollment goals or other criteria established by the 

25 Secretary. 

26 ‘‘(b) PRIORITY FOR AWARD OF GRANTS.—
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•S 1049 IS 

1 ‘‘(1) IN GENERAL.—In making grants under 

2 subsection (a)(1), the Secretary shall give priority 

3 to—

4 ‘‘(A) eligible entities that propose to target 

5 geographic areas with high rates of—

6 ‘‘(i) eligible but unenrolled children, 

7 including such children who reside in rural 

8 areas; or 

9 ‘‘(ii) racial and ethnic minorities and 

10 health disparity populations, including 

11 those proposals that address cultural and 

12 linguistic barriers to enrollment; and 

13 ‘‘(B) eligible entities that plan to engage in 

14 outreach efforts with respect to individuals de15 scribed in subparagraph (A) and that are—

16 ‘‘(i) Federal health safety net organi17 zations; or 

18 ‘‘(ii) faith-based organizations or con19 sortia. 

20 ‘‘(2) 10 PERCENT SET ASIDE FOR OUTREACH

21 TO INDIAN CHILDREN.—An amount equal to 10 per22 cent of the funds appropriated under subsection (g) 

23 for a fiscal year shall be used by the Secretary to 

24 award grants to Indian Health Service providers and 

25 urban Indian organizations receiving funds under 
4

•S 1049 IS 

1 title V of the Indian Health Care Improvement Act 

2 (25 U.S.C. 1651 et seq.) for outreach to, and enroll3 ment of, children who are Indians. 

4 ‘‘(c) APPLICATION.—An eligible entity that desires to 

5 receive a grant under subsection (a)(1) shall submit an 

6 application to the Secretary in such form and manner, and 

7 containing such information, as the Secretary may decide. 

8 Such application shall include—

9 ‘‘(1) quality and outcomes performance meas10 ures to evaluate the effectiveness of activities funded 

11 by a grant awarded under this section to ensure that 

12 the activities are meeting their goals; and 

13 ‘‘(2) an assurance that the entity shall—

14 ‘‘(A) conduct an assessment of the effec15 tiveness of such activities against such perform16 ance measures; and 

17 ‘‘(B) cooperate with the collection and re18 porting of enrollment data and other informa19 tion determined as a result of conducting such 

20 assessments to the Secretary, in such form and 

21 manner as the Secretary shall require. 

22 ‘‘(d) DISSEMINATION OF ENROLLMENT DATA AND

23 INFORMATION DETERMINED FROM EFFECTIVENESS AS24 SESSMENTS; ANNUAL REPORT.—The Secretary shall—
5

•S 1049 IS 

1 ‘‘(1) disseminate to eligible entities and make 

2 publicly available the enrollment data and informa3 tion collected and reported in accordance with sub4 section (c)(2)(B); and 

5 ‘‘(2) submit an annual report to Congress on 

6 the outreach activities funded by grants awarded 

7 under this section. 

8 ‘‘(e) SUPPLEMENT, NOT SUPPLANT.—Federal funds 

9 awarded under this section shall be used to supplement, 

10 not supplant, non-Federal funds that are otherwise avail11 able for activities funded under this section. 

12 ‘‘(f) DEFINITIONS.—In this section: 

13 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en14 tity’ means any of the following: 

15 ‘‘(A) A State or local government. 

16 ‘‘(B) A Federal health safety net organiza17 tion. 

18 ‘‘(C) A national, local, or community-based 

19 public or nonprofit private organization. 

20 ‘‘(D) A faith-based organization or con21 sortia, to the extent that a grant awarded to 

22 such an entity is consistent with the require23 ments of section 1955 of the Public Health 

24 Service Act (42 U.S.C. 300x–65) relating to a 

25 grant award to non-governmental entities. 
6

•S 1049 IS 

1 ‘‘(E) An elementary or secondary school. 

2 ‘‘(2) FEDERAL HEALTH SAFETY NET ORGANI3 ZATION.—The term ‘Federal health safety net orga4 nization’ means—

5 ‘‘(A) an Indian tribe, tribal organization, 

6 or an urban Indian organization receiving funds 

7 under title V of the Indian Health Care Im8 provement Act (25 U.S.C. 1651 et seq.), or an 

9 Indian Health Service provider; 

10 ‘‘(B) a Federally-qualified health center 

11 (as defined in section 1905(l)(2)(B)); 

12 ‘‘(C) a hospital defined as a dispropor13 tionate share hospital for purposes of section 

14 1923; 

15 ‘‘(D) a covered entity described in section 

16 340B(a)(4) of the Public Health Service Act 

17 (42 U.S.C. 256b(a)(4)); and 

18 ‘‘(E) any other entity or a consortium that 

19 serves children under a federally-funded pro20 gram, including the special supplemental nutri21 tion program for women, infants, and children 

22 (WIC) established under section 17 of the Child 

23 Nutrition Act of 1966 (42 U.S.C. 1786), the 

24 head start and early head start programs under 

25 the Head Start Act (42 U.S.C. 9801 et seq.), 
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•S 1049 IS 

1 the school lunch program established under the 

2 Richard B. Russell National School Lunch Act, 

3 and an elementary or secondary school. 

4 ‘‘(3) INDIANS; INDIAN TRIBE; TRIBAL ORGANI5 ZATION; URBAN INDIAN ORGANIZATION.—The terms 

6 ‘Indian’, ‘Indian tribe’, ‘tribal organization’, and 

7 ‘urban Indian organization’ have the meanings given 

8 such terms in section 4 of the Indian Health Care 

9 Improvement Act (25 U.S.C. 1603). 

10 ‘‘(g) APPROPRIATION.—There is appropriated, out of 

11 any money in the Treasury not otherwise appropriated, 

12 $50,000,000 for each of fiscal years 2006 and 2007 for 

13 the purpose of awarding grants under this section. 

14 Amounts appropriated and paid under the authority of 

15 this section shall be in addition to amounts appropriated 

16 under section 2104 and paid to States in accordance with 

17 section 2105, including with respect to expenditures for 

18 outreach activities in accordance with subsection 

19 (a)(1)(D)(iii) of that section.’’. 

20 (b) EXTENDING USE OF OUTSTATIONED WORKERS

21 TO ACCEPT TITLE XXI APPLICATIONS.—Section 

22 1902(a)(55) of the Social Security Act (42 U.S.C. 

23 1396a(a)(55)) is amended by striking ‘‘or 

24 (a)(10)(A)(ii)(IX)’’ and inserting ‘‘(a)(10)(A)(ii)(IX), or 
8

•S 1049 IS 

1 (a)(10)(A)(ii)(XIV), and applications for child health as2 sistance under title XXI’’. 

3 SEC. 3. STATE OPTION TO PROVIDE FOR SIMPLIFIED DE4 TERMINATIONS OF A CHILD’S FINANCIAL ELI5 GIBILITY FOR MEDICAL ASSISTANCE UNDER 

6 MEDICAID OR CHILD HEALTH ASSISTANCE 

7 UNDER SCHIP. 

8 (a) MEDICAID.—Section 1902(e) of the Social Secu9 rity Act (42 U.S.C. 1396a(e)) is amended by adding at 

10 the end the following: 

11 ‘‘(13)(A) At the option of the State, the plan 

12 may provide that financial eligibility requirements 

13 for medical assistance are met for a child who is 

14 under an age specified by the State (not to exceed 

15 21 years of age) by using a determination made 

16 within a reasonable period (as determined by the 

17 State) before its use for this purpose, of the child’s 

18 family or household income, or if applicable for pur19 poses of determining eligibility under this title or 

20 title XXI, assets or resources, by a Federal or State 

21 agency, or a public or private entity making such de22 termination on behalf of such agency, specified by 

23 the plan, including (but not limited to) an agency 

24 administering the State program funded under part 

25 A of title IV, the Food Stamp Act of 1977, the 
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•S 1049 IS 

1 Richard B. Russell National School Lunch Act, or 

2 the Child Nutrition Act of 1966, notwithstanding 

3 any differences in budget unit, disregard, deeming, 

4 or other methodology, but only if— 

5 ‘‘(i) the agency has fiscal liabilities or re6 sponsibilities affected or potentially affected by 

7 such determination; and 

8 ‘‘(ii) any information furnished by the 

9 agency pursuant to this subparagraph is used 

10 solely for purposes of determining financial eli11 gibility for medical assistance under this title or 

12 for child health assistance under title XXI. 

13 ‘‘(B) Nothing in subparagraph (A) shall be con14 strued— 

15 ‘‘(i) to authorize the denial of medical as16 sistance under this title or of child health as17 sistance under title XXI to a child who, without 

18 the application of this paragraph, would qualify 

19 for such assistance; 

20 ‘‘(ii) to relieve a State of the obligation 

21 under subsection (a)(8) to furnish medical as22 sistance with reasonable promptness after the 

23 submission of an initial application that is eval24 uated or for which evaluation is requested pur25 suant to this paragraph; 
10

•S 1049 IS 

1 ‘‘(iii) to relieve a State of the obligation to 

2 determine eligibility for medical assistance 

3 under this title or for child health assistance 

4 under title XXI on a basis other than family or 

5 household income (or, if applicable, assets or re6 sources) if a child is determined ineligible for 

7 such assistance on the basis of information fur8 nished pursuant to this paragraph; or 

9 ‘‘(iv) as affecting the applicability of any 

10 non-financial requirements for eligibility for 

11 medical assistance under this title or child 

12 health assistance under title XXI.’’. 

13 (b) SCHIP.—Section 2107(e)(1) of the Social Secu14 rity Act (42 U.S.C. 1397gg(e)(1)) is amended by adding 

15 at the end the following: 

16 ‘‘(E) Section 1902(e)(13) (relating to the 

17 State option to base a determination of child’s 

18 financial eligibility for assistance on financial 

19 determinations made by a program providing 

20 nutrition or other public assistance).’’. 

21 (c) EFFECTIVE DATE.—The amendments made by 

22 this section take effect on October 1, 2005.

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