In the Senate of the United States, 

February 9 (legislative day, February 8), 2018. 

Resolved, That the bill from the House of Representatives (H.R. 1892) entitled ‘‘An Act to amend title 4, United 

States Code, to provide for the flying of the flag at half-staff 

in the event of the death of a first responder in the line of 

duty.’’, do pass with the following 

SENATE AMENDMENT TO HOUSE AMENDMENT TO 

SENATE AMENDMENT: 

In lieu of the matter proposed to be inserted, insert 

the following: 

1 SECTION 1. SHORT TITLE. 

2 (a) SHORT TITLE.—This Act may be cited as the ‘‘Bi3 partisan Budget Act of 2018’’. 
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† HR 1892 EAS2 

1 DIVISION B—SUPPLEMENTAL APPROPRIA2 TIONS, TAX RELIEF, AND MEDICAID 

3 CHANGES RELATING TO CERTAIN DIS4 ASTERS AND FURTHER EXTENSION OF 

5 CONTINUING APPROPRIATIONS 

6 Subdivision 1—Further Additional Supple7 mental Appropriations for Disaster Relief 

8 Requirements Act, 2018 

9 The following sums in this subdivision are appro10 priated, out of any money in the Treasury not otherwise 

11 appropriated, for the fiscal year ending September 30, 2018 

12 and for other purposes, namely: 

13 TITLE I 

14 DEPARTMENT OF AGRICULTURE 

15 AGRICULTURAL PROGRAMS 

16 PROCESSING, RESEARCH AND MARKETING

17 OFFICE OF THE SECRETARY

18 For an additional amount for the ‘‘Office of the Sec19 retary’’, $2,360,000,000, which shall remain available until 

20 December 31, 2019, for necessary expenses related to crops, 

21 trees, bushes, and vine losses related to the consequences of 

22 Hurricanes Harvey, Irma, Maria, and other hurricanes 

23 and wildfires occurring in calendar year 2017 under such 

24 terms and conditions as determined by the Secretary: Pro25 vided, That the Secretary may provide assistance for such 
3 

† HR 1892 EAS2 

1 losses in the form of block grants to eligible states and terri2 tories: Provided further, That the total amount of payments 

3 received under this heading and applicable policies of crop 

4 insurance under the Federal Crop Insurance Act (7 U.S.C. 

5 1501 et seq.) or the Noninsured Crop Disaster Assistance 

6 Program (NAP) under section 196 of the Federal Agri7 culture Improvement and Reform Act of 1996 (7 U.S.C. 

8 7333) shall not exceed 85 percent of the loss as determined 

9 by the Secretary: Provided further, That the total amount 

10 of payments received under this heading for producers who 

11 did not obtain a policy or plan of insurance for an insur12 able commodity for the 2017 crop year, or 2018 crop year 

13 as applicable, under the Federal Crop Insurance Act (7 

14 U.S.C. 1501 et seq.) for the crop incurring the losses or did 

15 not file the required paperwork and pay the service fee by 

16 the applicable State filing deadline for a noninsurable com17 modity for the 2017 crop year, or 2018 crop year as appli18 cable, under NAP for the crop incurring the losses shall not 

19 exceed 65 percent of the loss as determined by the Secretary: 

20 Provided further, That producers receiving payments under 

21 this heading, as determined by the Secretary, shall be re22 quired to purchase crop insurance where crop insurance is 

23 available for the next two available crop years, and pro24 ducers receiving payments under this heading shall be re25 quired to purchase coverage under NAP where crop insur-
4 

† HR 1892 EAS2 

1 ance is not available in the next two available crop years, 

2 as determined by the Secretary: Provided further, That, not 

3 later than 90 days after the end of fiscal year 2018, the 

4 Secretary shall submit a report to the Congress specifying 

5 the type, amount, and method of such assistance by state 

6 and territory and the status of the amounts obligated and 

7 plans for further expenditure and include improvements 

8 that can be made to Federal Crop Insurance policies, either 

9 administratively or legislatively, to increase participation, 

10 particularly among underserved producers, in higher levels 

11 of coverage in future years for crops qualifying for assist12 ance under this heading: Provided further, That such 

13 amount is designated by the Congress as being for an emer14 gency requirement pursuant to section 251(b)(2)(A)(i) of 

15 the Balanced Budget and Emergency Deficit Control Act 

16 of 1985. 

17 OFFICE OF INSPECTOR GENERAL

18 For an additional amount for ‘‘Office of Inspector 

19 General’’, $2,500,000, to remain available until expended, 

20 for oversight and audit of programs, grants, and activities 

21 funded by this subdivision and administered by the Depart22 ment of Agriculture: Provided, That such amount is des23 ignated by the Congress as being for an emergency require24 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

25 Budget and Emergency Deficit Control Act of 1985. 
5 

† HR 1892 EAS2 

1 AGRICULTURAL RESEARCH SERVICE

2 BUILDINGS AND FACILITIES

3 For an additional amount for ‘‘Buildings and Facili4 ties’’, $22,000,000, to remain available until expended, for 

5 necessary expenses related to the consequences of Hurricanes 

6 Harvey, Irma, and Maria: Provided, That such amount is 

7 designated by the Congress as being for an emergency re8 quirement pursuant to section 251(b)(2)(A)(i) of the Bal9 anced Budget and Emergency Deficit Control Act of 1985. 

10 FARM SERVICE AGENCY

11 EMERGENCY CONSERVATION PROGRAM

12 For an additional amount for the ‘‘Emergency Con13 servation Program’’, for necessary expenses related to the 

14 consequences of Hurricanes Harvey, Irma, and Maria and 

15 of wildfires occurring in calendar year 2017, and other nat16 ural disasters, $400,000,000, to remain available until ex17 pended: Provided, That such amount is designated by the 

18 Congress as being for an emergency requirement pursuant 

19 to section 251(b)(2)(A)(i) of the Balanced Budget and 

20 Emergency Deficit Control Act of 1985. 

21 NATURAL RESOURCES CONSERVATION SERVICE

22 WATERSHED AND FLOOD PREVENTION OPERATIONS

23 For an additional amount for ‘‘Watershed and Flood 

24 Prevention Operations’’, for necessary expenses for the 

25 Emergency Watershed Protection Program related to the 
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† HR 1892 EAS2 

1 consequences of Hurricanes Harvey, Irma, and Maria and 

2 of wildfires occurring in calendar year 2017, and other nat3 ural disasters, $541,000,000, to remain available until ex4 pended: Provided, That such amount is designated by the 

5 Congress as being for an emergency requirement pursuant 

6 to section 251(b)(2)(A)(i) of the Balanced Budget and 

7 Emergency Deficit Control Act of 1985. 

8 RURAL DEVELOPMENT PROGRAMS 

9 RURAL HOUSING SERVICE

10 RURAL HOUSING INSURANCE FUND PROGRAM ACCOUNT

11 For an additional amount for ‘‘Rural Housing Insur12 ance Fund Program Account’’, $18,672,000, to remain 

13 available until September 30, 2019, for the cost of direct 

14 loans, including the cost of modifying loans as defined in 

15 section 502 of the Congressional Budget Act of 1974, for 

16 the rehabilitation of section 515 rental housing (42 U.S.C. 

17 1485) in areas impacted by Hurricanes Harvey, Irma, and 

18 Maria where owners were not required to carry national 

19 flood insurance: Provided, That such amount is designated 

20 by the Congress as being for an emergency requirement pur21 suant to section 251(b)(2)(A)(i) of the Balanced Budget and 

22 Emergency Deficit Control Act of 1985. 
7 

† HR 1892 EAS2 

1 RURAL UTILITIES SERVICE

2 RURAL WATER AND WASTE DISPOSAL PROGRAM ACCOUNT

3 For an additional amount for the ‘‘Rural Water and 

4 Waste Disposal Program Account’’, $165,475,000, to re5 main available until expended, for grants to repair drink6 ing water systems and sewer and solid waste disposal sys7 tems impacted by Hurricanes Harvey, Irma, and Maria: 

8 Provided, That not to exceed $2,000,000 of the amount ap9 propriated under this heading shall be for technical assist10 ance grants for rural water and waste systems pursuant 

11 to section 306(a)(22) of the Consolidated Farm and Rural 

12 Development Act: Provided further, That such amount is 

13 designated by the Congress as being for an emergency re14 quirement pursuant to section 251(b)(2)(A)(i) of the Bal15 anced Budget and Emergency Deficit Control Act of 1985. 

16 DOMESTIC FOOD PROGRAMS 

17 FOOD AND NUTRITION SERVICE

18 SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR

19 WOMEN, INFANTS, AND CHILDREN (WIC)

20 For an additional amount for the ‘‘Special Supple21 mental Nutrition Program for Women, Infants, and Chil22 dren’’, $14,000,000, to remain available until September 

23 30, 2019, for infrastructure grants to the Commonwealth 

24 of Puerto Rico and the U.S. Virgin Islands to assist in the 

25 repair and restoration of buildings, equipment, technology, 
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† HR 1892 EAS2 

1 and other infrastructure damaged as a consequence of Hur2 ricanes Irma and Maria: Provided, That such amount is 

3 designated by the Congress as being for an emergency re4 quirement pursuant to section 251(b)(2)(A)(i) of the Bal5 anced Budget and Emergency Deficit Control Act of 1985. 

6 COMMODITY ASSISTANCE PROGRAM

7 For an additional amount for ‘‘Commodity Assistance 

8 Program’’ for the emergency food assistance program as au9 thorized by section 27(a) of the Food and Nutrition Act of 

10 2008 (7 U.S.C. 2036(a)) and section 204(a)(1) of the Emer11 gency Food Assistance Act of 1983 (7 U.S.C. 7508(a)(1)), 

12 $24,000,000, to remain available until September 30, 2019, 

13 for necessary expenses of those jurisdictions that received 

14 a major disaster or emergency declaration pursuant to sec15 tion 401 or 501, respectively, of the Robert T. Stafford Dis16 aster Relief and Emergency Assistance Act (42 U.S.C. 5170, 

17 5191) related to the consequences of Hurricanes Harvey, 

18 Irma, and Maria or due to wildfires in 2017: Provided, 

19 That notwithstanding any other provisions of the Emer20 gency Food Assistance Act of 1983, the Secretary of Agri21 culture may provide resources to Puerto Rico, the Virgin 

22 Islands of the United States, and affected States, as deter23 mined by the Secretary, to assist affected families and indi24 viduals without regard to sections 204 and 214 of such Act 

25 (7 U.S.C. 7508, 7515) by allocating additional foods and 
9 

† HR 1892 EAS2 

1 funds for administrative expenses from resources specifi2 cally appropriated, transferred, or reprogrammed: Provided 

3 further, That such amount is designated by the Congress 

4 as being for an emergency requirement pursuant to section 

5 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

6 Deficit Control Act of 1985. 

7 RELATED AGENCIES AND FOOD AND DRUG 

8 ADMINISTRATION 

9 DEPARTMENT OF HEALTH AND HUMAN SERVICES

10 FOOD AND DRUG ADMINISTRATION

11 BUILDINGS AND FACILITIES

12 (INCLUDING TRANSFER OF FUNDS)

13 For an additional amount for ‘‘Buildings and Facili14 ties’’, $7,600,000, to remain available until expended, for 

15 necessary expenses related to the consequences of Hurricanes 

16 Harvey, Irma, and Maria: Provided, That such amount 

17 may be transferred to ‘‘Department of Health and Human 

18 Services—Food and Drug Administration—Salaries and 

19 Expenses’’ for costs related to repair of facilities, for re20 placement of equipment, and for other increases in facility21 related costs: Provided further, That obligations incurred 

22 for the purposes provided herein prior to the date of enact23 ment of this subdivision may be charged to funds appro24 priated by this paragraph: Provided further, That such 

25 amount is designated by the Congress as being for an emer-
10 

† HR 1892 EAS2 

1 gency requirement pursuant to section 251(b)(2)(A)(i) of 

2 the Balanced Budget and Emergency Deficit Control Act 

3 of 1985. 

4 GENERAL PROVISION—THIS TITLE 

5 SEC. 20101. (a) Section 1501(b) of the Agricultural 

6 Act of 2014 (7 U.S.C. 9081(b)) is amended— 

7 (1) in paragraph (1), in the matter before sub8 paragraph (A), by inserting ‘‘sold livestock for a re9 duced sale price, or both’’ after ‘‘normal mortality,’’; 

10 (2) in paragraph (2), by striking ‘‘applicable 

11 livestock on the day before the date of death of the 

12 livestock, as determined by the Secretary.’’ and insert13 ing the following: 

14 ‘‘affected livestock, as determined by the Secretary, on, 

15 as applicable— 

16 ‘‘(A) the day before the date of death of the 

17 livestock; or 

18 ‘‘(B) the day before the date of the event 

19 that caused the harm to the livestock that re20 sulted in a reduced sale price.’’; and 

21 (3) by adding at the end the following new para22 graph: 

23 ‘‘(4) A payment made under paragraph (1) to 

24 an eligible producer on a farm that sold livestock for 

25 a reduced sale price shall— 
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† HR 1892 EAS2 

1 ‘‘(A) be made if the sale occurs within a 

2 reasonable period following the event, as deter3 mined by the Secretary; and 

4 ‘‘(B) be reduced by the amount that the pro5 ducer received for the sale.’’. 

6 (b) Section 1501(d)(1) of the Agricultural Act of 2014 

7 (7 U.S.C. 9081(d)(1)) is amended by striking ‘‘not more 

8 than $20,000,000 of’’. 

9 (c) Section 1501(e)(4)(C) of the Agricultural Act of 

10 2014 (7 U.S.C. 9081(e)(4)(C)) is amended by striking ‘‘500 

11 acres’’ and inserting ‘‘1,000 acres’’. 

12 (d) Section 1501 of the Agricultural Act of 2014 (7 

13 U.S.C. 9081) is amended— 

14 (1) in subsection (e)(4)— 

15 (A) by striking subparagraph (B); and 

16 (B) by redesignating subparagraph (C), as 

17 amended by subsection (c), as subparagraph (B); 

18 and 

19 (2) in subsection (f)(2), by striking ‘‘subsection 

20 (e)’’ and inserting ‘‘subsections (b) and (e)’’. 

21 (e) Section 1501 of the Agricultural Act of 2014 (7 

22 U.S.C. 9081), as amended by this section, shall apply with 

23 respect to losses described in such section 1501 incurred on 

24 or after January 1, 2017. 
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† HR 1892 EAS2 

1 (f) The amounts provided by subsections (a) through 

2 (e) for fiscal year 2018 are designated by the Congress as 

3 being for an emergency requirement pursuant to section 

4 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

5 Deficit Control Act of 1985. 

6 TITLE II 

7 DEPARTMENT OF COMMERCE 

8 ECONOMIC DEVELOPMENT ADMINISTRATION

9 ECONOMIC DEVELOPMENT ASSISTANCE PROGRAMS

10 (INCLUDING TRANSFERS OF FUNDS)

11 Pursuant to section 703 of the Public Works and Eco12 nomic Development Act (42 U.S.C. 3233), for an additional 

13 amount for ‘‘Economic Development Assistance Programs’’ 

14 for necessary expenses related to flood mitigation, disaster 

15 relief, long-term recovery, and restoration of infrastructure 

16 in areas that received a major disaster designation as a 

17 result of Hurricanes Harvey, Irma, and Maria, and of 

18 wildfires and other natural disasters occurring in calendar 

19 year 2017 under the Robert T. Stafford Disaster Relief and 

20 Emergency Assistance Act (42 U.S.C. 5121 et seq.), 

21 $600,000,000, to remain available until expended: Pro22 vided, That the amount provided under this heading is des23 ignated by the Congress as being for an emergency require24 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

25 Budget and Emergency Deficit Control Act of 1985: Pro-
13 

† HR 1892 EAS2 

1 vided further, That within the amount appropriated, up to 

2 2 percent of funds may be transferred to the ‘‘Salaries and 

3 Expenses’’ account for administration and oversight activi4 ties: Provided further, That within the amount appro5 priated, $1,000,000 shall be transferred to the ‘‘Office of In6 spector General’’ account for carrying out investigations 

7 and audits related to the funding provided under this head8 ing. 

9 NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION

10 OPERATIONS, RESEARCH, AND FACILITIES

11 For an additional amount for ‘‘Operations, Research, 

12 and Facilities’’ for necessary expenses related to the con13 sequences of Hurricanes Harvey, Irma, and Maria, 

14 $120,904,000, to remain available until September 30, 

15 2019, as follows: 

16 (1) $12,904,000 for repair and replacement of 

17 observing assets, Federal real property, and equip18 ment; 

19 (2) $18,000,000 for marine debris assessment 

20 and removal; 

21 (3) $40,000,000 for mapping, charting, and ge22 odesy services; and 

23 (4) $50,000,000 to improve weather forecasting, 

24 hurricane intensity forecasting and flood forecasting 
14 

† HR 1892 EAS2 

1 and mitigation capabilities, including data assimila2 tion from ocean observing platforms and satellites: 

3 Provided, That the amount provided under this heading is 

4 designated by the Congress as being for an emergency re5 quirement pursuant to section 251(b)(2)(A)(i) of the Bal6 anced Budget and Emergency Deficit Control Act of 1985: 

7 Provided further, That the National Oceanic and Atmos8 pheric Administration shall submit a spending plan to the 

9 Committees on Appropriations of the House of Representa10 tives and the Senate within 45 days after the date of enact11 ment of this subdivision. 

12 PROCUREMENT, ACQUISITION AND CONSTRUCTION

13 For an additional amount for ‘‘Procurement, Acquisi14 tion and Construction’’ for necessary expenses related to the 

15 consequences of Hurricanes Harvey, Irma, and Maria, 

16 $79,232,000, to remain available until September 30, 2020, 

17 as follows: 

18 (1) $29,232,000 for repair and replacement of 

19 Federal real property and observing assets; and 

20 (2) $50,000,000 for improvements to operational 

21 and research weather supercomputing infrastructure 

22 and for improvement of satellite ground services used 

23 in hurricane intensity and track prediction: 

24 Provided, That the amount provided under this heading is 

25 designated by the Congress as being for an emergency re-
15 

† HR 1892 EAS2 

1 quirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985: 

3 Provided further, That the National Oceanic and Atmos4 pheric Administration shall submit a spending plan to the 

5 Committees on Appropriations of the House of Representa6 tives and the Senate within 45 days after the date of enact7 ment of this subdivision. 

8 FISHERIES DISASTER ASSISTANCE

9 For an additional amount for ‘‘Fisheries Disaster As10 sistance’’ for necessary expenses associated with the mitiga11 tion of fishery disasters, $200,000,000, to remain available 

12 until expended: Provided, That funds shall be used for miti13 gating the effects of commercial fishery failures and fishery 

14 resource disasters declared by the Secretary of Commerce 

15 in calendar year 2017, as well those declared by the Sec16 retary to be a direct result of Hurricanes Harvey, Irma, 

17 or Maria: Provided further, That the amount provided 

18 under this heading is designated by the Congress as being 

19 for an emergency requirement pursuant to section 

20 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

21 Deficit Control Act of 1985. 
16 

† HR 1892 EAS2 

1 DEPARTMENT OF JUSTICE 

2 UNITED STATES MARSHALS SERVICE

3 SALARIES AND EXPENSES

4 For an additional amount for ‘‘Salaries and Ex5 penses’’ for necessary expenses related to the consequences 

6 of Hurricanes Harvey, Irma, and Maria, $2,500,000: Pro7 vided, That the amount provided under this heading is des8 ignated by the Congress as being for an emergency require9 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

10 Budget and Emergency Deficit Control Act of 1985. 

11 FEDERAL BUREAU OF INVESTIGATION

12 SALARIES AND EXPENSES

13 For an additional amount for ‘‘Salaries and Ex14 penses’’ for necessary expenses related to the consequences 

15 of Hurricanes Harvey, Irma, and Maria, $21,200,000: Pro16 vided, That the amount provided under this heading is des17 ignated by the Congress as being for an emergency require18 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

19 Budget and Emergency Deficit Control Act of 1985. 

20 DRUG ENFORCEMENT ADMINISTRATION

21 SALARIES AND EXPENSES

22 For an additional amount for ‘‘Salaries and Ex23 penses’’ for necessary expenses related to the consequences 

24 of Hurricanes Harvey, Irma, and Maria, $11,500,000: Pro25 vided, That the amount provided under this heading is des-
17 

† HR 1892 EAS2 

1 ignated by the Congress as being for an emergency require2 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

3 Budget and Emergency Deficit Control Act of 1985. 

4 FEDERAL PRISON SYSTEM

5 SALARIES AND EXPENSES

6 For an additional amount for ‘‘Salaries and Ex7 penses’’ for necessary expenses related to the consequences 

8 of Hurricanes Harvey, Irma, and Maria, $16,000,000: Pro9 vided, That the amount provided under this heading is des10 ignated by the Congress as being for an emergency require11 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

12 Budget and Emergency Deficit Control Act of 1985. 

13 BUILDINGS AND FACILITIES

14 For an additional amount for ‘‘Buildings and Facili15 ties’’ for necessary expenses related to the consequences of 

16 Hurricanes Harvey, Irma, and Maria, $34,000,000, to re17 main available until expended: Provided, That the amount 

18 provided under this heading is designated by the Congress 

19 as being for an emergency requirement pursuant to section 

20 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

21 Deficit Control Act of 1985. 
18 

† HR 1892 EAS2 

1 SCIENCE 

2 NATIONAL AERONAUTICS AND SPACE ADMINISTRATION

3 CONSTRUCTION AND ENVIRONMENTAL COMPLIANCE AND

4 RESTORATION

5 For an additional amount for ‘‘Construction and En6 vironmental Compliance and Restoration’’ for repairs at 

7 National Aeronautics and Space Administration facilities 

8 damaged by hurricanes during 2017, $81,300,000, to re9 main available until expended: Provided, That the amount 

10 provided under this heading is designated by the Congress 

11 as being for an emergency requirement pursuant to section 

12 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

13 Deficit Control Act of 1985. 

14 NATIONAL SCIENCE FOUNDATION

15 RESEARCH AND RELATED ACTIVITIES

16 For an additional amount for ‘‘Research and Related 

17 Activities’’ for necessary expenses to repair National 

18 Science Foundation radio observatory facilities damaged by 

19 hurricanes that occurred during 2017, $16,300,000, to re20 main available until expended: Provided, That the amount 

21 provided under this heading is designated by the Congress 

22 as being for an emergency requirement pursuant to section 

23 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

24 Deficit Control Act of 1985: Provided further, That the Na25 tional Science Foundation shall submit a spending plan to 
19 

† HR 1892 EAS2 

1 the Committees on Appropriations of the House of Rep2 resentatives and the Senate within 45 days after the date 

3 of enactment of this subdivision. 

4 RELATED AGENCIES 

5 LEGAL SERVICES CORPORATION

6 PAYMENT TO THE LEGAL SERVICES CORPORATION

7 For an additional amount for ‘‘Payment to the Legal 

8 Services Corporation’’ to carry out the purposes of the Legal 

9 Services Corporation Act by providing for necessary ex10 penses related to the consequences of Hurricanes Harvey, 

11 Irma, and Maria and of the calendar year 2017 wildfires, 

12 $15,000,000: Provided, That the amount made available 

13 under this heading shall be used only to provide the mobile 

14 resources, technology, and disaster coordinators necessary to 

15 provide storm-related services to the Legal Services Cor16 poration client population and only in the areas signifi17 cantly affected by Hurricanes Harvey, Irma, and Maria 

18 and by the calendar year 2017 wildfires: Provided further, 

19 That such amount is designated by the Congress as being 

20 for an emergency requirement pursuant to section 

21 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

22 Deficit Control Act of 1985: Provided further, That none 

23 of the funds appropriated in this subdivision to the Legal 

24 Services Corporation shall be expended for any purpose pro25 hibited or limited by, or contrary to any of the provisions 
20 

† HR 1892 EAS2 

1 of, sections 501, 502, 503, 504, 505, and 506 of Public Law 

2 105–119, and all funds appropriated in this subdivision to 

3 the Legal Services Corporation shall be subject to the same 

4 terms and conditions set forth in such sections, except that 

5 all references in sections 502 and 503 to 1997 and 1998 

6 shall be deemed to refer instead to 2017 and 2018, respec7 tively, and except that sections 501 and 503 of Public Law 

8 104–134 (referenced by Public Law 105–119) shall not 

9 apply to the amount made available under this heading: 

10 Provided further, That, for the purposes of this subdivision, 

11 the Legal Services Corporation shall be considered an agen12 cy of the United States Government. 

13 GENERAL PROVISION—THIS TITLE 

14 SEC. 20201. (a) In recognition of the consistency of 

15 the Mid-Barataria Sediment Diversion, Mid-Breton Sound 

16 Sediment Diversion, and Calcasieu Ship Channel Salinity 

17 Control Measures projects, as selected by the 2017 Louisiana 

18 Comprehensive Master Plan for a Sustainable Coast, with 

19 the findings and policy declarations in section 2(6) of the 

20 Marine Mammal Protection Act (16 U.S.C. 1361 et seq., 

21 as amended) regarding maintaining the health and sta22 bility of the marine ecosystem, within 120 days of the enact23 ment of this section, the Secretary of Commerce shall issue 

24 a waiver pursuant to section 101(a)(3)(A) and this section 

25 to section 101(a) and section 102(a) of the Act, for such 
21 

† HR 1892 EAS2 

1 projects that will remain in effect for the duration of the 

2 construction, operations and maintenance of the projects. 

3 No rulemaking, permit, determination, or other condition 

4 or limitation shall be required when issuing a waiver pur5 suant to this section. 

6 (b) Upon issuance of a waiver pursuant to this section, 

7 the State of Louisiana shall, in consultation with the Sec8 retary of Commerce: 

9 (1) To the extent practicable and consistent with 

10 the purposes of the projects, minimize impacts on ma11 rine mammal species and population stocks; and 

12 (2) Monitor and evaluate the impacts of the 

13 projects on such species and population stocks. 

14 TITLE III 

15 DEPARTMENT OF DEFENSE 

16 DEPARTMENT OF DEFENSE—MILITARY 

17 OPERATION AND MAINTENANCE 

18 OPERATION AND MAINTENANCE, ARMY

19 For an additional amount for ‘‘Operation and Mainte20 nance, Army’’, $20,110,000, for necessary expenses related 

21 to the consequences of Hurricanes Harvey, Irma, and 

22 Maria: Provided, That such amount is designated by the 

23 Congress as being for an emergency requirement pursuant 

24 to section 251(b)(2)(A)(i) of the Balanced Budget and 

25 Emergency Deficit Control Act of 1985. 
22 

† HR 1892 EAS2 

1 OPERATION AND MAINTENANCE, NAVY

2 For an additional amount for ‘‘Operation and Mainte3 nance, Navy’’, $267,796,000, for necessary expenses related 

4 to the consequences of Hurricanes Harvey, Irma, and 

5 Maria: Provided, That such amount is designated by the 

6 Congress as being for an emergency requirement pursuant 

7 to section 251(b)(2)(A)(i) of the Balanced Budget and 

8 Emergency Deficit Control Act of 1985. 

9 OPERATION AND MAINTENANCE, MARINE CORPS

10 For an additional amount for ‘‘Operation and Mainte11 nance, Marine Corps’’, $17,920,000, for necessary expenses 

12 related to the consequences of Hurricanes Harvey, Irma, 

13 and Maria: Provided, That such amount is designated by 

14 the Congress as being for an emergency requirement pursu15 ant to section 251(b)(2)(A)(i) of the Balanced Budget and 

16 Emergency Deficit Control Act of 1985. 

17 OPERATION AND MAINTENANCE, AIR FORCE

18 For an additional amount for ‘‘Operation and Mainte19 nance, Air Force’’, $20,916,000, for necessary expenses re20 lated to the consequences of Hurricanes Harvey, Irma, and 

21 Maria: Provided, That such amount is designated by the 

22 Congress as being for an emergency requirement pursuant 

23 to section 251(b)(2)(A)(i) of the Balanced Budget and 

24 Emergency Deficit Control Act of 1985. 
23 

† HR 1892 EAS2 

1 OPERATION AND MAINTENANCE, DEFENSE-WIDE

2 For an additional amount for ‘‘Operation and Mainte3 nance, Defense-Wide’’, $2,650,000, for necessary expenses 

4 related to the consequences of Hurricanes Harvey, Irma, 

5 and Maria: Provided, That such amount is designated by 

6 the Congress as being for an emergency requirement pursu7 ant to section 251(b)(2)(A)(i) of the Balanced Budget and 

8 Emergency Deficit Control Act of 1985. 

9 OPERATION AND MAINTENANCE, ARMY RESERVE

10 For an additional amount for ‘‘Operation and Mainte11 nance, Army Reserve’’, $12,500,000, for necessary expenses 

12 related to the consequences of Hurricanes Harvey, Irma, 

13 and Maria: Provided, That such amount is designated by 

14 the Congress as being for an emergency requirement pursu15 ant to section 251(b)(2)(A)(i) of the Balanced Budget and 

16 Emergency Deficit Control Act of 1985. 

17 OPERATION AND MAINTENANCE, NAVY RESERVE

18 For an additional amount for ‘‘Operation and Mainte19 nance, Navy Reserve’’, $2,922,000, for necessary expenses 

20 related to the consequences of Hurricanes Harvey, Irma, 

21 and Maria: Provided, That such amount is designated by 

22 the Congress as being for an emergency requirement pursu23 ant to section 251(b)(2)(A)(i) of the Balanced Budget and 

24 Emergency Deficit Control Act of 1985. 
24 

† HR 1892 EAS2 

1 OPERATION AND MAINTENANCE, AIR FORCE RESERVE

2 For an additional amount for ‘‘Operation and Mainte3 nance, Air Force Reserve’’, $5,770,000, for necessary ex4 penses related to the consequences of Hurricanes Harvey, 

5 Irma, and Maria: Provided, That such amount is des6 ignated by the Congress as being for an emergency require7 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

8 Budget and Emergency Deficit Control Act of 1985. 

9 OPERATION AND MAINTENANCE, ARMY NATIONAL GUARD

10 For an additional amount for ‘‘Operation and Mainte11 nance, Army National Guard’’, $55,471,000, for necessary 

12 expenses related to the consequences of Hurricanes Harvey, 

13 Irma, and Maria: Provided, That such amount is des14 ignated by the Congress as being for an emergency require15 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

16 Budget and Emergency Deficit Control Act of 1985. 

17 PROCUREMENT 

18 OTHER PROCUREMENT, NAVY

19 For an additional amount for ‘‘Other Procurement, 

20 Navy’’ $18,000,000, to remain available until September 

21 30, 2020, for necessary expenses related to the consequences 

22 of Hurricanes Harvey, Irma, and Maria: Provided, That 

23 such amount is designated by the Congress as being for an 

24 emergency requirement pursuant to section 251(b)(2)(A)(i) 
25 

† HR 1892 EAS2 

1 of the Balanced Budget and Emergency Deficit Control Act 

2 of 1985. 

3 REVOLVING AND MANAGEMENT FUNDS 

4 DEFENSE WORKING CAPITAL FUNDS

5 For an additional amount for ‘‘Defense Working Cap6 ital Funds’’ for the Navy Working Capital Fund, 

7 $9,486,000, for necessary expenses related to the con8 sequences of Hurricanes Harvey, Irma, and Maria: Pro9 vided, That such amount is designated by the Congress as 

10 being for an emergency requirement pursuant to section 

11 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

12 Deficit Control Act of 1985. 

13 OTHER DEPARTMENT OF DEFENSE PROGRAMS 

14 DEFENSE HEALTH PROGRAM

15 For an additional amount for operation and mainte16 nance for ‘‘Defense Health Program’’, $704,000, for nec17 essary expenses related to the consequences of Hurricanes 

18 Harvey, Irma, and Maria: Provided, That such amount is 

19 designated by the Congress as being for an emergency re20 quirement pursuant to section 251(b)(2)(A)(i) of the Bal21 anced Budget and Emergency Deficit Control Act of 1985. 
26 

† HR 1892 EAS2 

1 TITLE IV 

2 CORPS OF ENGINEERS—CIVIL 

3 DEPARTMENT OF THE ARMY 

4 INVESTIGATIONS

5 For an additional amount for ‘‘Investigations’’ for 

6 necessary expenses related to the completion, or initiation 

7 and completion, of flood and storm damage reduction, in8 cluding shore protection, studies which are currently au9 thorized or which are authorized after the date of enactment 

10 of this subdivision, to reduce risk from future floods and 

11 hurricanes, at full Federal expense, $135,000,000, to remain 

12 available until expended: Provided, That of such amount, 

13 not less than $75,000,000 is available for such studies in 

14 States and insular areas that were impacted by Hurricanes 

15 Harvey, Irma, and Maria: Provided further, That funds 

16 made available under this heading shall be for high-priority 

17 studies of projects in States and insular areas with more 

18 than one flood-related major disaster declared pursuant to 

19 the Robert T. Stafford Disaster Relief and Emergency As20 sistance Act (42 U.S.C. 5121 et seq.) in calendar years 

21 2014, 2015, 2016, or 2017: Provided further, That such 

22 amount is designated by the Congress as being for an emer23 gency requirement pursuant to section 251(b)(2)(A)(i) of 

24 the Balanced Budget and Emergency Deficit Control Act 

25 of 1985: Provided further, That the Assistant Secretary of 
27 

† HR 1892 EAS2 

1 the Army for Civil Works shall provide a monthly report 

2 to the Committees on Appropriations of the House of Rep3 resentatives and the Senate detailing the allocation and ob4 ligation of these funds, including new studies selected to be 

5 initiated using funds provided under this heading, begin6 ning not later than 60 days after the enactment of this sub7 division. 

8 CONSTRUCTION

9 For an additional amount for ‘‘Construction’’ for nec10 essary expenses to address emergency situations at Corps 

11 of Engineers projects, and to construct, and rehabilitate and 

12 repair damages caused by natural disasters, to Corps of En13 gineers projects, $15,055,000,000, to remain available until 

14 expended: Provided, That of such amount, $15,000,000,000 

15 is available to construct flood and storm damage reduction, 

16 including shore protection, projects which are currently au17 thorized or which are authorized after the date of enactment 

18 of this subdivision, and flood and storm damage reduction, 

19 including shore protection, projects which have signed 

20 Chief’s Reports as of the date of enactment of this subdivi21 sion or which are studied using funds provided under the 

22 heading ‘‘Investigations’’ if the Secretary determines such 

23 projects to be technically feasible, economically justified, 

24 and environmentally acceptable, in States and insular 

25 areas with more than one flood-related major disaster de-
28 

† HR 1892 EAS2 

1 clared pursuant to the Robert T. Stafford Disaster Relief 

2 and Emergency Assistance Act (42 U.S.C. 5121 et seq.) in 

3 calendar years 2014, 2015, 2016, or 2017: Provided further, 

4 That of the amounts in the preceding proviso, not less than 

5 $10,425,000,000 shall be available for such projects within 

6 States and insular areas that were impacted by Hurricanes 

7 Harvey, Irma, and Maria: Provided further, That all re8 pair, rehabilitation, study, design, and construction of 

9 Corps of Engineers projects in Puerto Rico and the United 

10 States Virgin Islands, using funds provided under this 

11 heading, shall be conducted at full Federal expense: Pro12 vided further, That for projects receiving funding under this 

13 heading, the provisions of section 902 of the Water Re14 sources Development Act of 1986 shall not apply to these 

15 funds: Provided further, That the completion of ongoing 

16 construction projects receiving funds provided under this 

17 heading shall be at full Federal expense with respect to such 

18 funds: Provided further, That using funds provided under 

19 this heading, the non-Federal cash contribution for projects 

20 eligible for funding pursuant to the first proviso shall be 

21 financed in accordance with the provisions of section 103(k) 

22 of Public Law 99–662 over a period of 30 years from the 

23 date of completion of the project or separable element: Pro24 vided further, That up to $50,000,000 of the funds made 

25 available under this heading shall be used for continuing 
29 

† HR 1892 EAS2 

1 authorities projects to reduce the risk of flooding and storm 

2 damage: Provided further, That any projects using funds 

3 appropriated under this heading shall be initiated only 

4 after non-Federal interests have entered into binding agree5 ments with the Secretary requiring, where applicable, the 

6 non-Federal interests to pay 100 percent of the operation, 

7 maintenance, repair, replacement, and rehabilitation costs 

8 of the project and to hold and save the United States free 

9 from damages due to the construction or operation and 

10 maintenance of the project, except for damages due to the 

11 fault or negligence of the United States or its contractors: 

12 Provided further, That such amount is designated by the 

13 Congress as being for an emergency requirement pursuant 

14 to section 251(b)(2)(A)(i) of the Balanced Budget and 

15 Emergency Deficit Control Act of 1985: Provided further, 

16 That the Assistant Secretary of the Army for Civil Works 

17 shall provide a monthly report to the Committees on Appro18 priations of the House of Representatives and the Senate 

19 detailing the allocation and obligation of these funds, begin20 ning not later than 60 days after the enactment of this sub21 division. 

22 MISSISSIPPI RIVER AND TRIBUTARIES

23 For an additional amount for ‘‘Mississippi River and 

24 Tributaries’’ for necessary expenses to address emergency 

25 situations at Corps of Engineers projects, and to construct, 
30 

† HR 1892 EAS2 

1 and rehabilitate and repair damages to Corps of Engineers 

2 projects, caused by natural disasters, $770,000,000, to re3 main available until expended: Provided, That of such 

4 amount, $400,000,000 is available to construct flood and 

5 storm damage reduction projects which are currently au6 thorized or which are authorized after the date of enactment 

7 of this subdivision: Provided further, That such amount is 

8 designated by the Congress as being for an emergency re9 quirement pursuant to section 251(b)(2)(A)(i) of the Bal10 anced Budget and Emergency Deficit Control Act of 1985: 

11 Provided further, That the Assistant Secretary of the Army 

12 for Civil Works shall provide a monthly report to the Com13 mittees on Appropriations of the House of Representatives 

14 and the Senate detailing the allocation and obligation of 

15 these funds, beginning not later than 60 days after the en16 actment of this subdivision. 

17 OPERATION AND MAINTENANCE

18 For an additional amount for ‘‘Operation and Mainte19 nance’’ for necessary expenses to dredge Federal navigation 

20 projects in response to, and repair damages to Corps of En21 gineers Federal projects caused by, natural disasters, 

22 $608,000,000, to remain available until expended, of which 

23 such sums as are necessary to cover the Federal share of 

24 eligible operation and maintenance costs for coastal harbors 

25 and channels, and for inland harbors shall be derived from 
31 

† HR 1892 EAS2 

1 the Harbor Maintenance Trust Fund: Provided, That such 

2 amount is designated by the Congress as being for an emer3 gency requirement pursuant to section 251(b)(2)(A)(i) of 

4 the Balanced Budget and Emergency Deficit Control Act 

5 of 1985: Provided further, That the Assistant Secretary of 

6 the Army for Civil Works shall provide a monthly report 

7 to the Committees on Appropriations of the House of Rep8 resentatives and the Senate detailing the allocation and ob9 ligation of these funds, beginning not later than 60 days 

10 after the enactment of this subdivision. 

11 FLOOD CONTROL AND COASTAL EMERGENCIES

12 For an additional amount for ‘‘Flood Control and 

13 Coastal Emergencies’’, as authorized by section 5 of the Act 

14 of August 18, 1941 (33 U.S.C. 701n), for necessary expenses 

15 to prepare for flood, hurricane and other natural disasters 

16 and support emergency operations, repairs, and other ac17 tivities in response to such disasters, as authorized by law, 

18 $810,000,000, to remain available until expended: Pro19 vided, That funding utilized for authorized shore protection 

20 projects shall restore such projects to the full project profile 

21 at full Federal expense: Provided further, That such amount 

22 is designated by the Congress as being for an emergency 

23 requirement pursuant to section 251(b)(2)(A)(i) of the Bal24 anced Budget and Emergency Deficit Control Act of 1985: 

25 Provided further, That the Assistant Secretary of the Army 
32 

† HR 1892 EAS2 

1 for Civil Works shall provide a monthly report to the Com2 mittees on Appropriations of the House of Representatives 

3 and the Senate detailing the allocation and obligation of 

4 these funds, beginning not later than 60 days after the en5 actment of this subdivision. 

6 EXPENSES

7 For an additional amount for ‘‘Expenses’’ for nec8 essary expenses to administer and oversee the obligation 

9 and expenditure of amounts provided in this title for the 

10 Corps of Engineers, $20,000,000, to remain available until 

11 expended: Provided, That such amount is designated by the 

12 Congress as being for an emergency requirement pursuant 

13 to section 251(b)(2)(A)(i) of the Balanced Budget and 

14 Emergency Deficit Control Act of 1985: Provided further, 

15 That the Assistant Secretary of the Army for Civil Works 

16 shall provide a monthly report to the Committees on Appro17 priations of the House of Representatives and the Senate 

18 detailing the allocation and obligation of these funds, begin19 ning not later than 60 days after enactment of this subdivi20 sion. 

21 DEPARTMENT OF ENERGY 

22 ENERGY PROGRAMS 

23 ELECTRICITY DELIVERY AND ENERGY RELIABILITY

24 For an additional amount for ‘‘Electricity Delivery 

25 and Energy Reliability’’, $13,000,000, to remain available 
33 

† HR 1892 EAS2 

1 until expended, for necessary expenses related to the con2 sequences of Hurricanes Harvey, Irma, and Maria, includ3 ing technical assistance related to electric grids: Provided, 

4 That such amount is designated by the Congress as being 

5 for an emergency requirement pursuant to section 

6 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

7 Deficit Control Act of 1985. 

8 STRATEGIC PETROLEUM RESERVE

9 For an additional amount for ‘‘Strategic Petroleum 

10 Reserve’’, $8,716,000, to remain available until expended, 

11 for necessary expenses related to damages caused by Hurri12 canes Harvey, Irma, and Maria: Provided, That such 

13 amount is designated by the Congress as being for an emer14 gency requirement pursuant to section 251(b)(2)(A)(i) of 

15 the Balanced Budget and Emergency Deficit Control Act 

16 of 1985. 

17 GENERAL PROVISIONS—THIS TITLE 

18 SEC. 20401. In fiscal year 2018, and each fiscal year 

19 thereafter, the Chief of Engineers of the U.S. Army Corps 

20 of Engineers shall transmit to the Congress, after reasonable 

21 opportunity for comment, but without change, by the Assist22 ant Secretary of the Army for Civil Works, a monthly re23 port, the first of which shall be transmitted to Congress not 

24 later than 2 days after the date of enactment of this subdivi25 sion and monthly thereafter, which includes detailed esti-
34 

† HR 1892 EAS2 

1 mates of damages to each Corps of Engineers project, caused 

2 by natural disasters or otherwise. 

3 SEC. 20402. From the unobligated balances of amounts 

4 made available to the U.S. Army Corps of Engineers, 

5 $518,900,000 under the heading ‘‘Corps of Engineers— 

6 Civil, Flood Control and Coastal Emergencies’’ and 

7 $210,000,000 under the heading ‘‘Corps of Engineers— 

8 Civil, Operations and Maintenance’’ in title X of the Dis9 aster Relief Appropriations Act, 2013 (Public Law 113– 

10 2; 127 Stat. 25) shall be transferred to ‘‘Corps of Engi11 neers—Civil, Construction’’, to remain available until ex12 pended, to rehabilitate, repair and construct Corps of Engi13 neers projects: Provided, That those projects may only in14 clude construction expenses, including cost sharing, as de15 scribed under the heading ‘‘Corps of Engineers—Civil, Con16 struction’’ in title X of that Act or other construction ex17 penses related to the consequences of Hurricane Sandy: Pro18 vided further, That amounts transferred pursuant to this 

19 section that were previously designated by the Congress as 

20 an emergency requirement pursuant to the Balanced Budg21 et and Emergency Deficit Control Act are designated by 

22 the Congress as an emergency requirement pursuant to sec23 tion 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

24 Deficit Control Act of 1985: Provided further, That the As25 sistant Secretary of the Army for Civil Works shall provide 
35 

† HR 1892 EAS2 

1 a monthly report to the Committees on Appropriations of 

2 the House of Representatives and the Senate detailing the 

3 allocation and obligation of these funds, beginning not later 

4 than 60 days after the enactment of this subdivision. 

5 TITLE V 

6 INDEPENDENT AGENCIES 

7 GENERAL SERVICES ADMINISTRATION

8 REAL PROPERTY ACTIVITIES

9 FEDERAL BUILDINGS FUND

10 For an additional amount to be deposited in the ‘‘Fed11 eral Buildings Fund’’, $126,951,000, to remain available 

12 until expended, for necessary expenses related to the con13 sequences of Hurricanes Harvey, Maria, and Irma for re14 pair and alteration of buildings under the custody and con15 trol of the Administrator of General Services, and real 

16 property management and related activities not otherwise 

17 provided for: Provided, That funds may be used to reim18 burse the ‘‘Federal Buildings Fund’’ for obligations in19 curred for this purpose prior to enactment of this subdivi20 sion: Provided further, That not more than $15,000,000 

21 shall be available for tenant improvements in damaged U.S. 

22 courthouses: Provided further, That such amount is des23 ignated by the Congress as being for an emergency require24 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

25 Budget and Emergency Deficit Control Act of 1985. 
36 

† HR 1892 EAS2 

1 SMALL BUSINESS ADMINISTRATION

2 OFFICE OF INSPECTOR GENERAL

3 For an additional amount for the ‘‘Office of Inspector 

4 General’’, $7,000,000, to remain available until expended: 

5 Provided, That such amount is designated by the Congress 

6 as being for an emergency requirement pursuant to section 

7 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

8 Deficit Control Act of 1985. 

9 DISASTER LOANS PROGRAM ACCOUNT

10 (INCLUDING TRANSFER OF FUNDS)

11 For an additional amount for the ‘‘Disaster Loans 

12 Program Account’’ for the cost of direct loans authorized 

13 by section 7(b) of the Small Business Act, $1,652,000,000, 

14 to remain available until expended: Provided, That up to 

15 $618,000,000 may be transferred to and merged with ‘‘Sala16 ries and Expenses’’ for administrative expenses to carry out 

17 the disaster loan program authorized by section 7(b) of the 

18 Small Business Act: Provided further, That none of the 

19 funds provided under this heading may be used for indirect 

20 administrative expenses: Provided further, That the amount 

21 provided under this heading is designated by the Congress 

22 as being for an emergency requirement pursuant to section 

23 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

24 Deficit Control Act of 1985. 
37 

† HR 1892 EAS2 

1 TITLE VI 

2 DEPARTMENT OF HOMELAND SECURITY 

3 DEPARTMENTAL MANAGEMENT, OPERATIONS, 

4 INTELLIGENCE, AND OVERSIGHT 

5 OFFICE OF INSPECTOR GENERAL

6 OPERATIONS AND SUPPORT

7 For an additional amount for ‘‘Operations and Sup8 port’’ for necessary expenses related to the consequences of 

9 Hurricanes Harvey, Irma, and Maria, $25,000,000, to re10 main available until September 30, 2020, for audits and 

11 investigations of activities funded by this title: Provided, 

12 That such amount is designated by the Congress as being 

13 for an emergency requirement pursuant to section 

14 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

15 Deficit Control Act of 1985. 

16 SECURITY, ENFORCEMENT, AND INVESTIGATIONS 

17 U.S. CUSTOMS AND BORDER PROTECTION

18 OPERATIONS AND SUPPORT

19 For an additional amount for ‘‘Operations and Sup20 port’’ for necessary expenses related to the consequences of 

21 Hurricanes Harvey, Irma, and Maria, $104,494,000, to re22 main available until September 30, 2019: Provided, That 

23 such amount is designated by the Congress as being for an 

24 emergency requirement pursuant to section 251(b)(2)(A)(i) 

25 of the Balanced Budget and Emergency Deficit Control Act 
38 

† HR 1892 EAS2 

1 of 1985: Provided further, That not more than $39,400,000 

2 may be used to carry out U.S. Customs and Border Protec3 tion activities in fiscal year 2018 in Puerto Rico and the 

4 United States Virgin Islands, in addition to any other 

5 amounts available for such purposes. 

6 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

7 For an additional amount for ‘‘Procurement, Con8 struction, and Improvements’’ for necessary expenses re9 lated to the consequences of Hurricanes Harvey, Irma, and 

10 Maria, including for the reconstruction of facilities affected, 

11 $45,000,000, to remain available until September 30, 2022: 

12 Provided, That such amount is designated by the Congress 

13 as being for an emergency requirement pursuant to section 

14 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

15 Deficit Control Act of 1985: Provided further, That funds 

16 are provided to carry out U.S. Customs and Border Protec17 tion activities in Puerto Rico and the United States Virgin 

18 Islands, in addition to any other amounts available for such 

19 purposes. 

20 U.S. IMMIGRATION AND CUSTOMS ENFORCEMENT

21 OPERATIONS AND SUPPORT

22 For an additional amount for ‘‘Operations and Sup23 port’’ for necessary expenses related to the consequences of 

24 Hurricanes Harvey, Irma, and Maria, $30,905,000, to re25 main available until September 30, 2019: Provided, That 
39 

† HR 1892 EAS2 

1 such amount is designated by the Congress as being for an 

2 emergency requirement pursuant to section 251(b)(2)(A)(i) 

3 of the Balanced Budget and Emergency Deficit Control Act 

4 of 1985. 

5 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

6 For an additional amount for ‘‘Procurement, Con7 struction, and Improvements’’ for necessary expenses re8 lated to the consequences of Hurricanes Harvey, Irma, and 

9 Maria, $33,052,000, to remain available until September 

10 30, 2022: Provided, That such amount is designated by the 

11 Congress as being for an emergency requirement pursuant 

12 to section 251(b)(2)(A)(i) of the Balanced Budget and 

13 Emergency Deficit Control Act of 1985. 

14 TRANSPORTATION SECURITY ADMINISTRATION

15 OPERATIONS AND SUPPORT

16 For an additional amount for ‘‘Operations and Sup17 port’’ for necessary expenses related to the consequences of 

18 Hurricanes Harvey, Irma, and Maria, $10,322,000, to re19 main available until September 30, 2019: Provided, That 

20 such amount is designated by the Congress as being for an 

21 emergency requirement pursuant to section 251(b)(2)(A)(i) 

22 of the Balanced Budget and Emergency Deficit Control Act 

23 of 1985. 
40 

† HR 1892 EAS2 

1 COAST GUARD

2 OPERATING EXPENSES

3 For an additional amount for ‘‘Operating Expenses’’ 

4 for necessary expenses related to the consequences of Hurri5 canes Harvey, Irma, and Maria, $112,136,000, to remain 

6 available until September 30, 2019: Provided, That such 

7 amount is designated by the Congress as being for an emer8 gency requirement pursuant to section 251(b)(2)(A)(i) of 

9 the Balanced Budget and Emergency Deficit Control Act 

10 of 1985. 

11 ENVIRONMENTAL COMPLIANCE AND RESTORATION

12 For an additional amount for ‘‘Environmental Com13 pliance and Restoration’’ for necessary expenses related to 

14 the consequences of Hurricanes Harvey, Irma, and Maria, 

15 $4,038,000, to remain available until September 30, 2022: 

16 Provided, That such amount is designated by the Congress 

17 as being for an emergency requirement pursuant to section 

18 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

19 Deficit Control Act of 1985. 

20 ACQUISITION, CONSTRUCTION, AND IMPROVEMENTS

21 For an additional amount for Acquisition, Construc22 tion, and Improvements’’ for necessary expenses related to 

23 the consequences of Hurricanes Harvey, Irma, Maria, and 

24 Matthew, $718,919,000, to remain available until Sep25 tember 30, 2022: Provided, That, not later than 60 days 
41 

† HR 1892 EAS2 

1 after enactment of this subdivision, the Secretary of Home2 land Security, or her designee, shall submit to the Commit3 tees on Appropriations of the House of Representatives and 

4 the Senate a detailed expenditure plan for funds appro5 priated under this heading: Provided further, That such 

6 amount is designated by the Congress as being for an emer7 gency requirement pursuant to section 251(b)(2)(A)(i) of 

8 the Balanced Budget and Emergency Deficit Control Act 

9 of 1985. 

10 PROTECTION, PREPAREDNESS, RESPONSE, AND 

11 RECOVERY 

12 FEDERAL EMERGENCY MANAGEMENT AGENCY

13 OPERATIONS AND SUPPORT

14 For an additional amount for ‘‘Operations and Sup15 port’’ for necessary expenses related to the consequences of 

16 Hurricanes Harvey, Irma, and Maria, $58,800,000, to re17 main available until September 30, 2019: Provided, That 

18 such amount is designated by the Congress as being for an 

19 emergency requirement pursuant to section 251(b)(2)(A)(i) 

20 of the Balanced Budget and Emergency Deficit Control Act 

21 of 1985. 

22 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

23 For an additional amount for ‘‘Procurement, Con24 struction, and Improvements’’ for necessary expenses re25 lated to the consequences of Hurricanes Harvey, Irma, and 
42 

† HR 1892 EAS2 

1 Maria, $1,200,000, to remain available until September 30, 

2 2020: Provided, That such amount is designated by the 

3 Congress as being for an emergency requirement pursuant 

4 to section 251(b)(2)(A)(i) of the Balanced Budget and 

5 Emergency Deficit Control Act of 1985. 

6 DISASTER RELIEF FUND

7 For an additional amount for ‘‘Disaster Relief Fund’’ 

8 for major disasters declared pursuant to the Robert T. Staf9 ford Disaster Relief and Emergency Assistance Act (42 

10 U.S.C. 5121 et seq.), $23,500,000,000, to remain available 

11 until expended: Provided, That the Administrator of the 

12 Federal Emergency Management Agency shall publish on 

13 the Agency’s website not later than 5 days after an award 

14 of a public assistance grant under section 406 or 428 of 

15 the Robert T. Stafford Disaster Relief and Emergency As16 sistance Act (42 U.S.C. 5172 or 5189f) that is in excess 

17 of $1,000,000, the specifics of each such grant award: Pro18 vided further, That for any mission assignment or mission 

19 assignment task order to another Federal department or 

20 agency regarding a major disaster in excess of $1,000,000, 

21 not later than 5 days after the issuance of such mission 

22 assignment or mission assignment task order, the Adminis23 trator shall publish on the Agency’s website the following: 

24 the name of the impacted State, the disaster declaration for 

25 such State, the assigned agency, the assistance requested, 
43 

† HR 1892 EAS2 

1 a description of the disaster, the total cost estimate, and 

2 the amount obligated: Provided further, That not later than 

3 10 days after the last day of each month until a mission 

4 assignment or mission assignment task order described in 

5 the preceding proviso is completed and closed out, the Ad6 ministrator shall update any changes to the total cost esti7 mate and the amount obligated: Provided further, That for 

8 a disaster declaration related to Hurricanes Harvey, Irma, 

9 or Maria, the Administrator shall submit to the Committees 

10 on Appropriations of the House of Representatives and the 

11 Senate, not later than 5 days after the first day of each 

12 month beginning after the date of enactment of this subdivi13 sion, and shall publish on the Agency’s website, not later 

14 than 10 days after the first day of each such month, an 

15 estimate or actual amount, if available, for the current fis16 cal year of the cost of the following categories of spending: 

17 public assistance, individual assistance, operations, mitiga18 tion, administrative, and any other relevant category (in19 cluding emergency measures and disaster resources): Pro20 vided, further, That not later than 10 days after the first 

21 day of each month, the Administrator shall publish on the 

22 Agency’s website the report (referred to as the Disaster Re23 lief Monthly Report) as required by Public Law 114–4: Pro24 vided further, That of the amounts provided under this 

25 heading for the Disaster Relief Fund, up to $150,000,000 
44 

† HR 1892 EAS2 

1 shall be transferred to the Disaster Assistance Direct Loan 

2 Program Account for the cost to lend a territory or posses3 sion of the United States that portion of assistance for 

4 which the territory or possession is responsible under the 

5 cost-sharing provisions of the major disaster declaration for 

6 Hurricanes Irma or Maria, as authorized under section 319 

7 of the Robert T. Stafford Disaster Relief and Emergency 

8 Assistance Act (42 U.S.C. 5162): Provided further, That of 

9 the amount provided under this paragraph for transfer, up 

10 to $1,000,000 may be transferred to the Disaster Assistance 

11 Direct Loan Program Account for administrative expenses 

12 to carry out the Advance of Non-Federal Share program, 

13 as authorized by section 319 of the Robert T. Stafford Dis14 aster Relief and Emergency Assistance Act (42 U.S.C. 

15 5162): Provided further, That such amount is designated 

16 by the Congress as being for an emergency requirement pur17 suant to section 251(b)(2)(A)(i) of the Balanced Budget and 

18 Emergency Deficit Control Act of 1985. 

19 RESEARCH, DEVELOPMENT, TRAINING, AND 

20 SERVICES 

21 FEDERAL LAW ENFORCEMENT TRAINING CENTERS

22 OPERATIONS AND SUPPORT

23 For an additional amount for ‘‘Operations and Sup24 port’’ for necessary expenses related to the consequences of 

25 Hurricanes Harvey, Irma, and Maria, $5,374,000, to re-
45 

† HR 1892 EAS2 

1 main available until September 30, 2019: Provided, That 

2 such amount is designated by the Congress as being for an 

3 emergency requirement pursuant to section 251(b)(2)(A)(i) 

4 of the Balanced Budget and Emergency Deficit Control Act 

5 of 1985. 

6 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

7 For an additional amount for ‘‘Procurement, Con8 struction, and Improvements’’ for necessary expenses re9 lated to the consequences of Hurricanes Harvey, Irma, and 

10 Maria, $5,000,000, to remain available until September 30, 

11 2022: Provided, That such amount is designated by the 

12 Congress as being for an emergency requirement pursuant 

13 to section 251(b)(2)(A)(i) of the Balanced Budget and 

14 Emergency Deficit Control Act of 1985. 

15 GENERAL PROVISIONS—THIS TITLE 

16 SEC. 20601. The Administrator of the Federal Emer17 gency Management Agency may provide assistance, pursu18 ant to section 428 of the Robert T. Stafford Disaster Relief 

19 and Emergency Assistance Act (42 U.S.C. 5121 et seq.), for 

20 critical services as defined in section 406 of the Robert T. 

21 Stafford Disaster Relief and Emergency Assistance Act for 

22 the duration of the recovery for incidents DR–4336–PR, 

23 DR–4339–PR, DR–4340–USVI, and DR–4335–USVI to— 
46 

† HR 1892 EAS2 

1 (1) replace or restore the function of a facility or 

2 system to industry standards without regard to the 

3 pre-disaster condition of the facility or system; and 

4 (2) replace or restore components of the facility 

5 or system not damaged by the disaster where nec6 essary to fully effectuate the replacement or restora7 tion of disaster-damaged components to restore the 

8 function of the facility or system to industry stand9 ards. 

10 SEC. 20602. Notwithstanding section 404 or 420 of the 

11 Robert T. Stafford Disaster Relief and Emergency Assist12 ance Act (42 U.S.C. 5170c and 8187), for fiscal years 2017 

13 and 2018, the President shall provide hazard mitigation as14 sistance in accordance with such section 404 in any area 

15 in which assistance was provided under such section 420. 

16 SEC. 20603. The third proviso of the second paragraph 

17 in title I of Public Law 115–72 under the heading ‘‘Federal 

18 Emergency Management Agency—Disaster Relief Fund’’ 

19 shall be amended by striking ‘‘180 days’’ and inserting 

20 ‘‘365 days’’: Provided, That amounts repurposed pursuant 

21 to this section that were previously designated by the Con22 gress as an emergency requirement pursuant to the Bal23 anced Budget and Emergency Deficit Control Act are des24 ignated by the Congress as an emergency requirement pur-
47 

† HR 1892 EAS2 

1 suant to section 251(b)(2)(A)(i) of the Balanced Budget and 

2 Emergency Deficit Control Act of 1985. 

3 SEC. 20604. (a) DEFINITION OF PRIVATE NONPROFIT

4 FACILITY.—Section 102(11)(B) of the Robert T. Stafford 

5 Disaster Relief and Emergency Assistance Act (42 U.S.C. 

6 5122(11)(B)) is amended to read as follows: 

7 ‘‘(A) IN GENERAL.—The term ‘private non8 profit facility’ means private nonprofit edu9 cational (without regard to the religious char10 acter of the facility), utility, irrigation, emer11 gency, medical, rehabilitational, and temporary 

12 or permanent custodial care facilities (including 

13 those for the aged and disabled) and facilities on 

14 Indian reservations, as defined by the President. 

15 ‘‘(B) ADDITIONAL FACILITIES.—In addition 

16 to the facilities described in subparagraph (A), 

17 the term ‘private nonprofit facility’ includes any 

18 private nonprofit facility that provides essential 

19 social services to the general public (including 

20 museums, zoos, performing arts facilities, com21 munity arts centers, community centers, librar22 ies, homeless shelters, senior citizen centers, reha23 bilitation facilities, shelter workshops, broad24 casting facilities, houses of worship, and facili25 ties that provide health and safety services of a 
48 

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1 governmental nature), as defined by the Presi2 dent. No house of worship may be excluded from 

3 this definition because leadership or membership 

4 in the organization operating the house of wor5 ship is limited to persons who share a religious 

6 faith or practice.’’. 

7 (b) REPAIR, RESTORATION, AND REPLACEMENT OF

8 DAMAGED FACILITIES.—Section 406(a)(3) of the Robert T. 

9 Stafford Disaster Relief and Emergency Assistance Act (42 

10 U.S.C. 5172(a)(3)) is amended by adding at the end the 

11 following: 

12 ‘‘(C) RELIGIOUS FACILITIES.—A church, 

13 synagogue, mosque, temple, or other house of 

14 worship, educational facility, or any other pri15 vate nonprofit facility, shall be eligible for con16 tributions under paragraph (1)(B), without re17 gard to the religious character of the facility or 

18 the primary religious use of the facility. No 

19 house of worship, educational facility, or any 

20 other private nonprofit facility may be excluded 

21 from receiving contributions under paragraph 

22 (1)(B) because leadership or membership in the 

23 organization operating the house of worship is 

24 limited to persons who share a religious faith or 

25 practice.’’. 
49 

† HR 1892 EAS2 

1 (c) APPLICABILITY.—This section and the amendments 

2 made by this section shall apply— 

3 (1) to the provision of assistance in response to 

4 a major disaster or emergency declared on or after 

5 August 23, 2017; or 

6 (2) with respect to— 

7 (A) any application for assistance that, as 

8 of the date of enactment of this Act, is pending 

9 before Federal Emergency Management Agency; 

10 and 

11 (B) any application for assistance that has 

12 been denied, where a challenge to that denial is 

13 not yet finally resolved as of the date of enact14 ment of this Act. 

15 SEC. 20605. (a) The Federal share of assistance, in16 cluding direct Federal assistance, provided under section 

17 407 of the Robert T. Stafford Disaster Relief and Emer18 gency Assistance Act (42 U.S.C. 5173), with respect to a 

19 major disaster declared pursuant to such Act for damages 

20 resulting from a wildfire in calendar year 2017, shall be 

21 90 percent of the eligible costs under such section. 

22 (b) The Federal share provided by subsection (a) shall 

23 apply to assistance provided before, on, or after the date 

24 of enactment of this Act. 
50 

† HR 1892 EAS2 

1 FEDERAL COST-SHARE ADJUSTMENTS FOR REPAIR, RES2 TORATION, AND REPLACEMENT OF DAMAGED FACILI3 TIES

4 SEC. 20606. Section 406(b) of the Robert T. Stafford 

5 Disaster Relief and Emergency Assistance Act (42 U.S.C. 

6 5172(b)) is amended by inserting after paragraph (2) the 

7 following: 

8 ‘‘(3) INCREASED FEDERAL SHARE.— 

9 ‘‘(A) INCENTIVE MEASURES.—The President 

10 may provide incentives to a State or Tribal gov11 ernment to invest in measures that increase 

12 readiness for, and resilience from, a major dis13 aster by recognizing such investments through a 

14 sliding scale that increases the minimum Federal 

15 share to 85 percent. Such measures may in16 clude— 

17 ‘‘(i) the adoption of a mitigation plan 

18 approved under section 322; 

19 ‘‘(ii) investments in disaster relief, in20 surance, and emergency management pro21 grams; 

22 ‘‘(iii) encouraging the adoption and 

23 enforcement of the latest published editions 

24 of relevant consensus-based codes, specifica25 tions, and standards that incorporate the 
51 

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1 latest hazard-resistant designs and establish 

2 minimum acceptable criteria for the design, 

3 construction, and maintenance of residen4 tial structures and facilities that may be el5 igible for assistance under this Act for the 

6 purpose of protecting the health, safety, and 

7 general welfare of the buildings’ users 

8 against disasters; 

9 ‘‘(iv) facilitating participation in the 

10 community rating system; and 

11 ‘‘(v) funding mitigation projects or 

12 granting tax incentives for projects that re13 duce risk. 

14 ‘‘(B) COMPREHENSIVE GUIDANCE.—Not 

15 later than 1 year after the date of enactment of 

16 this paragraph, the President, acting through the 

17 Administrator, shall issue comprehensive guid18 ance to State and Tribal governments regarding 

19 the measures and investments, weighted appro20 priately based on actuarial assessments of eligi21 ble actions, that will be recognized for the pur22 pose of increasing the Federal share under this 

23 section. Guidance shall ensure that the agency’s 

24 review of eligible measures and investments does 
52 

† HR 1892 EAS2 

1 not unduly delay determining the appropriate 

2 Federal cost share. 

3 ‘‘(C) REPORT.—One year after the issuance 

4 of the guidance required by subparagraph (B), 

5 the Administrator shall submit to the Committee 

6 on Transportation and Infrastructure of the 

7 House of Representatives and the Committee on 

8 Homeland Security and Governmental Affairs of 

9 the Senate a report regarding the analysis of the 

10 Federal cost shares paid under this section. 

11 ‘‘(D) SAVINGS CLAUSE.—Nothing in this 

12 paragraph prevents the President from increas13 ing the Federal cost share above 85 percent.’’. 

14 SEC. 20607. Division F of the Consolidated Appro15 priations Act, 2017, is amended by inserting the following 

16 at the end of Title V: 

17 ‘‘SEC. 545. (a) PREMIUM PAY AUTHORITY.—During 

18 calendar year 2017, any premium pay that is funded, ei19 ther directly or through reimbursement, by the ‘Federal 

20 Emergency Management Agency—Disaster Relief Fund’ 

21 shall be exempted from the aggregate of basic pay and pre22 mium pay calculated under section 5547(a) of title 5, 

23 United States Code, and any other provision of law lim24 iting the aggregate amount of premium pay payable on a 

25 biweekly or calendar year basis. 
53 

† HR 1892 EAS2 

1 ‘‘(b) OVERTIME AUTHORITY.—During calendar year 

2 2017, any overtime that is funded, either directly or through 

3 reimbursement, by the ‘Federal Emergency Management 

4 Agency—Disaster Relief Fund’ shall be exempted from any 

5 annual limit on the amount of overtime payable in a cal6 endar or fiscal year. 

7 ‘‘(c) APPLICABILITY OF AGGREGATE LIMITATION ON

8 PAY.—In determining whether an employee’s pay exceeds 

9 the applicable annual rate of basic pay payable under sec10 tion 5307 of title 5, United States Code, the head of an 

11 Executive agency shall not include pay exempted under this 

12 section. 

13 ‘‘(d) LIMITATION OF PAY AUTHORITY.—Pay exempted 

14 from otherwise applicable limits under subsection (a) shall 

15 not cause the aggregate pay earned for the calendar year 

16 in which the exempted pay is earned to exceed the rate of 

17 basic pay payable for a position at level II of the Executive 

18 Schedule under section 5313 of title 5, United States Code. 

19 ‘‘(e) EFFECTIVE DATE.—This section shall take effect 

20 as if enacted on December 31, 2016.’’. 
54 

† HR 1892 EAS2 

1 TITLE VII 

2 DEPARTMENT OF THE INTERIOR 

3 UNITED STATES FISH AND WILDLIFE SERVICE

4 CONSTRUCTION

5 For an additional amount for ‘‘Construction’’ for nec6 essary expenses related to the consequences of Hurricanes 

7 Harvey, Irma, and Maria, $210,629,000, to remain avail8 able until expended: Provided, That such amount is des9 ignated by the Congress as being for an emergency require10 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

11 Budget and Emergency Deficit Control Act of 1985. 

12 NATIONAL PARK SERVICE

13 HISTORIC PRESERVATION FUND

14 For an additional amount for the ‘‘Historic Preserva15 tion Fund’’ for necessary expenses related to the con16 sequences of Hurricanes Harvey, Irma, and Maria, 

17 $50,000,000, to remain available until September 30, 2019, 

18 including costs to States and territories necessary to com19 plete compliance activities required by section 306108 of 

20 title 54, United States Code (formerly section 106 of the 

21 National Historic Preservation Act) and costs needed to ad22 minister the program: Provided, That grants shall only be 

23 available for areas that have received a major disaster dec24 laration pursuant to the Robert T. Stafford Disaster Relief 

25 and Emergency Assistance Act (42 U.S.C. 5121 et seq.): 
55 

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1 Provided further, That individual grants shall not be sub2 ject to a non-Federal matching requirement: Provided fur3 ther, That such amount is designated by the Congress as 

4 being for an emergency requirement pursuant to section 

5 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

6 Deficit Control Act of 1985. 

7 CONSTRUCTION

8 For an additional amount for ‘‘Construction’’ for nec9 essary expenses related to the consequences of Hurricanes 

10 Harvey, Irma, and Maria, $207,600,000, to remain avail11 able until expended: Provided, That such amount is des12 ignated by the Congress as being for an emergency require13 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

14 Budget and Emergency Deficit Control Act of 1985. 

15 UNITED STATES GEOLOGICAL SURVEY

16 SURVEYS, INVESTIGATIONS, AND RESEARCH

17 For an additional amount for ‘‘Surveys, Investiga18 tions, and Research’’ for necessary expenses related to the 

19 consequences of Hurricanes Harvey, Irma, and Maria, and 

20 in those areas impacted by a major disaster declared pursu21 ant to the Robert T. Stafford Disaster Relief and Emer22 gency Assistance Act (42 U.S.C. 5121 et seq.) with respect 

23 to wildfires in 2017, $42,246,000, to remain available until 

24 expended: Provided, That such amount is designated by the 

25 Congress as being for an emergency requirement pursuant 
56 

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1 to section 251(b)(2)(A)(i) of the Balanced Budget and 

2 Emergency Deficit Control Act of 1985. 

3 DEPARTMENTAL OFFICES

4 INSULAR AFFAIRS

5 ASSISTANCE TO TERRITORIES

6 For an additional amount for ‘‘Technical Assistance’’ 

7 for financial management expenses related to the con8 sequences of Hurricanes Irma and Maria, $3,000,000, to 

9 remain available until expended: Provided, That such 

10 amount is designated by the Congress as being for an emer11 gency requirement pursuant to section 251(b)(2)(A)(i) of 

12 the Balanced Budget and Emergency Deficit Control Act 

13 of 1985. 

14 OFFICE OF INSPECTOR GENERAL

15 SALARIES AND EXPENSES

16 For an additional amount for ‘‘Salaries and Ex17 penses’’ for necessary expenses related to the consequences 

18 of Hurricanes Harvey, Irma, and Maria, $2,500,000, to re19 main available until expended: Provided, That such amount 

20 is designated by the Congress as being for an emergency 

21 requirement pursuant to section 251(b)(2)(A)(i) of the Bal22 anced Budget and Emergency Deficit Control Act of 1985. 
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1 ENVIRONMENTAL PROTECTION AGENCY

2 HAZARDOUS SUBSTANCE SUPERFUND

3 For an additional amount for ‘‘Hazardous Substance 

4 Superfund’’ for necessary expenses related to the con5 sequences of Hurricanes Harvey, Irma, and Maria, 

6 $6,200,000, to remain available until expended: Provided, 

7 That such amount is designated by the Congress as being 

8 for an emergency requirement pursuant to section 

9 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

10 Deficit Control Act of 1985. 

11 LEAKING UNDERGROUND STORAGE TANK TRUST FUND

12 PROGRAM

13 For an additional amount for ‘‘Leaking Underground 

14 Storage Tank Fund’’ for necessary expenses related to the 

15 consequences of Hurricanes Harvey, Irma, and Maria, 

16 $7,000,000, to remain available until expended: Provided, 

17 That such amount is designated by the Congress as being 

18 for an emergency requirement pursuant to section 

19 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

20 Deficit Control Act of 1985. 

21 STATE AND TRIBAL ASSISTANCE GRANTS

22 For an additional amount for ‘‘State and Tribal As23 sistance Grants’’ for necessary expenses related to the con24 sequences of Hurricanes Harvey, Irma, and Maria for the 

25 hazardous waste financial assistance grants program and 
58 

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1 for other solid waste management activities, $50,000,000, 

2 to remain available until expended: Provided, That none 

3 of these funds allocated within Region 2 shall be subject to 

4 cost share requirements under section 3011(b) of the Solid 

5 Waste Disposal Act: Provided further, That such amount 

6 is designated by the Congress as being for an emergency 

7 requirement pursuant to section 251(b)(2)(A)(i) of the Bal8 anced Budget and Emergency Deficit Control Act of 1985. 

9 ADMINISTRATIVE PROVISION—ENVIRONMENTAL

10 PROTECTION AGENCY

11 Of amounts previously appropriated for capitalization 

12 grants for the State Revolving Funds under title VI of the 

13 Federal Water Pollution Control Act or under section 1452 

14 of the Safe Drinking Water Act to a State or territory in15 cluded as part of a disaster declaration related to Hurri16 canes Irma and Maria, all existing grant funds that are 

17 available but not drawn down shall not be subject to the 

18 matching or cost share requirements of sections 602(b)(2), 

19 602(b)(3) of the Federal Water Pollution Control Act nor 

20 the matching requirements of section 1452(e) of the Safe 

21 Drinking Water Act and shall be awarded to such state or 

22 territory: Provided, That, notwithstanding the requirements 

23 of section 603(d) of the Federal Water Pollution Control Act 

24 or section 1452(f) of the Safe Drinking Water Act, the state 

25 or territory shall utilize the full amount of such funds, ex-
59 

† HR 1892 EAS2 

1 cluding existing loans, to provide additional subsidization 

2 to eligible recipients in the form of forgiveness of principal, 

3 negative interest loans or grants or any combination of 

4 these: Provided further, That such funds may be used for 

5 eligible projects whose purpose is to repair damage incurred 

6 as a result of Hurricanes Irma and Maria, reduce flood 

7 damage risk and vulnerability or to enhance resiliency to 

8 rapid hydrologic change or a natural disaster at treatment 

9 works as defined by section 212 of the Federal Water Pollu10 tion Control Act or a public drinking water system under 

11 section 1452 of the Safe Drinking Water Act: Provided fur12 ther, That any project involving the repair or replacement 

13 of a lead service line shall replace the entire lead service 

14 line, not just a portion. 

15 RELATED AGENCIES 

16 DEPARTMENT OF AGRICULTURE 

17 FOREST SERVICE

18 STATE AND PRIVATE FORESTRY

19 For an additional amount for ‘‘State and Private For20 estry’’ for necessary expenses related to the consequences of 

21 Hurricanes Harvey, Irma, and Maria, $7,500,000, to re22 main available until expended: Provided, That such amount 

23 is designated by the Congress as being for an emergency 

24 requirement pursuant to section 251(b)(2)(A)(i) of the Bal25 anced Budget and Emergency Deficit Control Act of 1985. 
60 

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1 NATIONAL FOREST SYSTEM

2 For an additional amount for ‘‘National Forest Sys3 tem’’ for necessary expenses related to the consequences of 

4 Hurricanes Harvey, Irma, and Maria, $20,652,000, to re5 main available until expended: Provided, That such amount 

6 is designated by the Congress as being for an emergency 

7 requirement pursuant to section 251(b)(2)(A)(i) of the Bal8 anced Budget and Emergency Deficit Control Act of 1985. 

9 CAPITAL IMPROVEMENT AND MAINTENANCE

10 For an additional amount for ‘‘Capital Improvement 

11 and Maintenance’’ for necessary expenses related to the con12 sequences of Hurricanes Harvey, Irma, and Maria, and the 

13 2017 fire season, $91,600,000, to remain available until ex14 pended: Provided, That such amount is designated by the 

15 Congress as being for an emergency requirement pursuant 

16 to section 251(b)(2)(A)(i) of the Balanced Budget and 

17 Emergency Deficit Control Act of 1985. 

18 GENERAL PROVISION—THIS TITLE 

19 SEC. 20701. Agencies receiving funds appropriated by 

20 this title shall each provide a monthly report to the Com21 mittees on Appropriations of the House of Representatives 

22 and the Senate detailing the allocation and obligation of 

23 these funds by account, beginning not later than 90 days 

24 after enactment of this Act. 
61 

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1 TITLE VIII 

2 DEPARTMENT OF LABOR 

3 EMPLOYMENT AND TRAINING ADMINISTRATION

4 TRAINING AND EMPLOYMENT SERVICES

5 (INCLUDING TRANSFERS OF FUNDS)

6 For an additional amount for ‘‘Training and Employ7 ment Services’’, $100,000,000, for the dislocated workers as8 sistance national reserve for necessary expenses directly re9 lated to the consequences of Hurricanes Harvey, Maria, and 

10 Irma and those jurisdictions that received a major disaster 

11 declaration pursuant to the Robert T. Stafford Disaster Re12 lief and Emergency Assistance Act (42 U.S.C. 5121 et seq.) 

13 due to wildfires in 2017, which shall be available from the 

14 date of enactment of this subdivision through September 30, 

15 2019: Provided, That the Secretary of Labor may transfer 

16 up to $2,500,000 of such funds to any other Department 

17 of Labor account for reconstruction and recovery needs, in18 cluding worker protection activities: Provided further, That 

19 these sums may be used to replace grant funds previously 

20 obligated to the impacted areas: Provided further, That of 

21 the amount provided, up to $500,000, to remain available 

22 until expended, shall be transferred to ‘‘Office of Inspector 

23 General’’for oversight of activities responding to such hurri24 canes and wildfires: Provided further, That such amount 

25 is designated by the Congress as being for an emergency 
62 

† HR 1892 EAS2 

1 requirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985. 

3 JOB CORPS

4 For an additional amount for ‘‘Job Corps’’ for con5 struction, rehabilitation and acquisition for Job Corps Cen6 ters in Puerto Rico, $30,900,000, which shall be available 

7 upon the date of enactment of this subdivision and remain 

8 available for obligation through June 30, 2021: Provided, 

9 That such amount is designated by the Congress as being 

10 for an emergency requirement pursuant to section 

11 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

12 Deficit Control Act of 1985. 

13 GENERAL PROVISIONS—DEPARTMENT OF LABOR

14 DEFERRAL OF INTEREST PAYMENTS FOR VIRGIN ISLANDS

15 SEC. 20801. Notwithstanding any other provision of 

16 law, the interest payment of the Virgin Islands that was 

17 due under section 1202(b)(1) of the Social Security Act on 

18 September 29, 2017, shall not be due until September 28, 

19 2018, and no interest shall accrue on such amount through 

20 September 28, 2018: Provided, That such amount is des21 ignated by the Congress as being for an emergency require22 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

23 Budget and Emergency Deficit Control Act of 1985. 
63 

† HR 1892 EAS2 

1 FLEXIBILITY IN USE OF FUNDS UNDER WIOA

2 SEC. 20802. (a) IN GENERAL.—Notwithstanding sec3 tion 133(b)(4) of the Workforce Innovation and Oppor4 tunity Act, in States, as defined by section 3(56) of such 

5 Act, affected by Hurricanes Harvey, Irma, and Maria, a 

6 local board, as defined by section 3(33) of such Act, in a 

7 local area, as defined by section 3(32) of such Act, affected 

8 by such Hurricanes may transfer, if such transfer is ap9 proved by the Governor, up to 100 percent of the funds allo10 cated to the local area for Program Years 2016 and 2017 

11 for Youth Workforce Investment activities under paragraphs 

12 (2) or (3) of section 128(b) of such Act, for Adult employ13 ment and training activities under paragraphs (2)(A) or 

14 (3) of section 133(b) of such Act, or for Dislocated Worker 

15 employment and training activities under paragraph 

16 (2)(B) of section 133(b) of such Act among— 

17 (1) adult employment and training activities; 

18 (2) dislocated worker employment and training 

19 activities; and 

20 (3) youth workforce investment activities. 

21 (b) THE VIRGIN ISLANDS.—Except for the funds re22 served to carry out required statewide activities under sec23 tions 127(b) and 134(a)(2) of the Workforce Innovation and 

24 Opportunity Act, the Governor of the Virgin Islands may 

25 authorize the transfer of up to 100 percent of the remaining 
64 

† HR 1892 EAS2 

1 funds provided to the Virgin Islands for Program Years 

2 2016 and 2017 for Youth Workforce Investment activities 

3 under section 127(b)(1)(B) of such Act, for Adult employ4 ment and training activities under section 132(b)(1)(A) of 

5 such Act, or for Dislocated Worker employment and train6 ing activities under section 133(b)(2)(A) of such Act 

7 among— 

8 (1) adult employment and training activities; 

9 (2) dislocated worker employment and training 

10 activities; and 

11 (3) youth workforce investment activities. 

12 DEPARTMENT OF HEALTH AND HUMAN 

13 SERVICES 

14 CENTERS FOR DISEASE CONTROL AND PREVENTION

15 CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT

16 (INCLUDING TRANSFER OF FUNDS)

17 For an additional amount for ‘‘CDC-Wide Activities 

18 and Program Support’’, $200,000,000, to remain available 

19 until September 30, 2020, for response, recovery, prepara20 tion, mitigation, and other expenses directly related to the 

21 consequences of Hurricanes Harvey, Irma, and Maria: Pro22 vided, That obligations incurred for the purposes provided 

23 herein prior to the date of enactment of this subdivision 

24 may be charged to funds appropriated by this paragraph: 

25 Provided further, That of the amount provided, not less 
65 

† HR 1892 EAS2 

1 than $6,000,000 shall be transferred to the ‘‘Buildings and 

2 Facilities’’ account for the purposes provided herein: Pro3 vided further, That such amount is designated by the Con4 gress as being for an emergency requirement pursuant to 

5 section 251(b)(2)(A)(i) of the Balanced Budget and Emer6 gency Deficit Control Act of 1985. 

7 NATIONAL INSTITUTES OF HEALTH

8 OFFICE OF THE DIRECTOR

9 For an additional amount for fiscal year 2018 for ‘‘Of10 fice of the Director’’, $50,000,000, to remain available until 

11 September 30, 2020, for response, recovery, and other ex12 penses directly related to the consequences of Hurricanes 

13 Harvey, Irma, and Maria: Provided, That obligations in14 curred for these purposes prior to the date of enactment of 

15 this subdivision may be charged to funds appropriated by 

16 this paragraph: Provided further, That funds appropriated 

17 by this paragraph may be used for construction grants or 

18 contracts under section 404I of the Public Health Service 

19 Act without regard to section 404I(c)(2): Provided further, 

20 That such amount is designated by the Congress as being 

21 for an emergency requirement pursuant to section 

22 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

23 Deficit Control Act of 1985. 
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1 ADMINISTRATION FOR CHILDREN AND FAMILIES

2 CHILDREN AND FAMILIES SERVICES PROGRAMS

3 For an additional amount for ‘‘Children and Families 

4 Services Programs’’, $650,000,000, to remain available 

5 until September 30, 2021, for Head Start programs, for 

6 necessary expenses directly related to the consequences of 

7 Hurricanes Harvey, Irma, and Maria, including making 

8 payments under the Head Start Act: Provided, That none 

9 of the funds appropriated in this paragraph shall be in10 cluded in the calculation of the ‘‘base grant’’ in subsequent 

11 fiscal years, as such term is defined in sections 

12 640(a)(7)(A), 641A(h)(1)(B), or 645(d)(3) of the Head 

13 Start Act: Provided further, That funds appropriated in 

14 this paragraph are not subject to the allocation require15 ments of section 640(a) of the Head Start Act: Provided 

16 further, That funds appropriated in this paragraph shall 

17 not be available for costs that are reimbursed by the Federal 

18 Emergency Management Agency, under a contract for in19 surance, or by self-insurance: Provided further, That up to 

20 $12,500,000 shall be available for Federal administrative 

21 expenses: Provided further, That obligations incurred for the 

22 purposes provided herein prior to the date of enactment of 

23 this subdivision may be charged to funds appropriated 

24 under this heading: Provided further, That such amount is 

25 designated by the Congress as being for an emergency re-
67 

† HR 1892 EAS2 

1 quirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985. 

3 OFFICE OF THE SECRETARY

4 PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

5 (INCLUDING TRANSFERS OF FUNDS)

6 For an additional amount for the ‘‘Public Health and 

7 Social Services Emergency Fund’’, $162,000,000, to remain 

8 available until September 30, 2020, for response, recovery, 

9 preparation, mitigation and other expenses directly related 

10 to the consequences of Hurricanes Harvey, Irma, and 

11 Maria, including activities authorized under section 319(a) 

12 of the Public Health Service Act (referred to in this subdivi13 sion as the ‘‘PHS Act’’): Provided, That of the amount pro14 vided, $60,000,000 shall be transferred to ‘‘Health Resources 

15 and Services Administration—Primary Health Care’’, for 

16 expenses related to the consequences of Hurricanes Harvey, 

17 Irma, and Maria for disaster response and recovery, for the 

18 Health Centers Program under section 330 of the PHS Act: 

19 Provided further, That not less than $50,000,000, of 

20 amounts transferred under the preceding proviso, shall be 

21 available for alteration, renovation, construction, equip22 ment, and other capital improvement costs as necessary to 

23 meet the needs of areas affected by Hurricanes Harvey, 

24 Irma, and Maria: Provided further, That the time limita25 tion in section 330(e)(3) of the PHS Act shall not apply 
68 

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1 to funds made available under the preceding proviso: Pro2 vided further, That of the amount provided, not less than 

3 $20,000,000 shall be transferred to ‘‘Substance Abuse and 

4 Mental Health Services Administration—Health Surveil5 lance and Program Support’’ for grants, contracts, and co6 operative agreements for behavioral health treatment, crisis 

7 counseling, and other related helplines, and for other simi8 lar programs to provide support to individuals impacted 

9 by Hurricanes Harvey, Irma, and Maria: Provided further, 

10 That of the amount provided, up to $2,000,000, to remain 

11 available until expended, shall be transferred to ‘‘Office of 

12 the Secretary—Office of Inspector General’’ for oversight of 

13 activities responding to such hurricanes: Provided further, 

14 That obligations incurred for the purposes provided herein 

15 prior to the date of enactment of this subdivision may be 

16 charged to funds appropriated under this heading: Provided 

17 further, That funds appropriated in this paragraph shall 

18 not be available for costs that are reimbursed by the Federal 

19 Emergency Management Agency, under a contract for in20 surance, or by self-insurance: Provided further, That such 

21 amount is designated by the Congress as being for an emer22 gency requirement pursuant to section 251(b)(2)(A)(i) of 

23 the Balanced Budget and Emergency Deficit Control Act 

24 of 1985. 
69 

† HR 1892 EAS2 

1 GENERAL PROVISION—DEPARTMENT OF HEALTH AND

2 HUMAN SERVICES

3 DIRECT HIRE AUTHORITY FOR CERTAIN EMERGENCY

4 RESPONSE POSITIONS

5 SEC. 20803. (a) IN GENERAL.—As the Secretary of 

6 Health and Human Services determines necessary to re7 spond to a critical hiring need for emergency response posi8 tions, after providing public notice and without regard to 

9 the provisions of sections 3309 through 3319 of title 5, 

10 United States Code, the Secretary may appoint candidates 

11 directly to the following positions, consistent with sub12 section (b), to perform critical work directly relating to the 

13 consequences of Hurricanes Harvey, Irma, and Maria: 

14 (1) Intermittent disaster-response personnel in 

15 the National Disaster Medical System, under section 

16 2812 of the Public Health Service Act (42 U.S.C. 

17 300hh–11). 

18 (2) Term or temporary related positions in the 

19 Centers for Disease Control and Prevention and the 

20 Office of the Assistant Secretary for Preparedness and 

21 Response. 

22 (b) EXPIRATION.—The authority under subsection (a) 

23 shall expire 270 days after the date of enactment of this 

24 section. 
70 

† HR 1892 EAS2 

1 DEPARTMENT OF EDUCATION 

2 HURRICANE EDUCATION RECOVERY

3 (INCLUDING TRANSFER OF FUNDS)

4 For an additional amount for ‘‘Hurricane Education 

5 Recovery’’ for necessary expenses related to the consequences 

6 of Hurricanes Harvey, Irma, and Maria, or wildfires in 

7 2017 for which a major disaster or emergency has been de8 clared under sections 401 or 501 of the Robert T. Stafford 

9 Disaster Relief and Emergency Assistance Act (42 U.S.C. 

10 5170 and 5190) (referred to under this heading as ‘‘covered 

11 disaster or emergency’’), $2,700,000,000, to remain avail12 able through September 30, 2022, for assisting in meeting 

13 the educational needs of individuals affected by a covered 

14 disaster or emergency: Provided, That such amount is des15 ignated by the Congress as being for an emergency require16 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

17 Budget and Emergency Deficit Control Act of 1985: Pro18 vided further, That— 

19 (1) such funds shall be used— 

20 (A) to make awards to eligible entities for 

21 immediate aid to restart school operations, in 

22 accordance with paragraph (2); 

23 (B) for temporary emergency impact aid for 

24 displaced students, in accordance with para25 graph (2); 
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1 (C) for emergency assistance to institutions 

2 of higher education and students attending insti3 tutions of higher education in an area directly 

4 affected by a covered disaster or emergency in 

5 accordance with paragraph (3); 

6 (D) for payments to institutions of higher 

7 education to help defray the unexpected expenses 

8 associated with enrolling displaced students from 

9 institutions of higher education directly affected 

10 by a covered disaster or emergency, in accord11 ance with paragraph (4); and 

12 (E) to provide assistance to local edu13 cational agencies serving homeless children and 

14 youth in accordance with paragraph (5); 

15 (2) immediate aid to restart school operations 

16 and temporary emergency impact aid for displaced 

17 students described in subparagraphs (A) and (B) of 

18 paragraph (1) shall be provided under the statutory 

19 terms and conditions that applied to assistance under 

20 sections 102 and 107 of title IV of division B of Pub21 lic Law 109–148, respectively, except that such sec22 tions shall be applied so that— 

23 (A) each reference to a major disaster de24 clared in accordance with section 401 of the Rob25 ert T. Stafford Disaster Relief and Emergency 
72 

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1 Assistance Act (42 U.S.C. 5170) shall be to a 

2 major disaster or emergency declared by the 

3 President in accordance with section 401 or 501, 

4 respectively, of such Act; 

5 (B) each reference to Hurricane Katrina or 

6 Hurricane Rita shall be a reference to a covered 

7 disaster or emergency; 

8 (C) each reference to August 22, 2005 shall 

9 be to the date that is one week prior to the date 

10 that the major disaster or emergency was de11 clared for the area; 

12 (D) each reference to the States of Lou13 isiana, Mississippi, Alabama, and Texas shall be 

14 to the States or territories affected by a covered 

15 disaster or emergency, and each reference to the 

16 State educational agencies of Louisiana, Mis17 sissippi, Alabama, or Texas shall be a reference 

18 to the State educational agencies that serve the 

19 states or territories affected by a covered disaster 

20 or emergency; 

21 (E) each reference to the 2005–2006 school 

22 year shall be to the 2017–2018 school year; 

23 (F) the references in section 102(h)(1) of 

24 title IV of division B of Public Law 109–148 to 

25 the number of non-public and public elementary 
73 

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1 schools and secondary schools in the State shall 

2 be to the number of students in non-public and 

3 public elementary schools and secondary schools 

4 in the State, and the reference in such section to 

5 the National Center for Data Statistics Common 

6 Core of Data for the 2003–2004 school year shall 

7 be to the most recent and appropriate data set 

8 for the 2016–2017 school year; 

9 (G) in determining the amount of imme10 diate aid provided to restart school operations as 

11 described in section 102(b) of title IV of division 

12 B of Public Law 109–148, the Secretary shall 

13 consider the number of students enrolled, during 

14 the 2016–2017 school year, in elementary schools 

15 and secondary schools that were closed as a re16 sult of a covered disaster or emergency; 

17 (H) in determining the amount of emer18 gency impact aid that a State educational agen19 cy is eligible to receive under paragraph (1)(B), 

20 the Secretary shall, subject to section 

21 107(d)(1)(B) of such title, provide— 

22 (i) $9,000 for each displaced student 

23 who is an English learner, as that term is 

24 defined in section 8101 of the Elementary 
74 

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1 and Secondary Education Act of 1965 (20 

2 U.S.C. 7801); 

3 (ii) $10,000 for each displaced student 

4 who is a child with a disability (regardless 

5 of whether the child is an English learner); 

6 and 

7 (iii) $8,500 for each displaced student 

8 who is not a child with a disability or an 

9 English learner; 

10 (I) with respect to the emergency impact 

11 aid provided under paragraph (1)(B), the Sec12 retary may modify the State educational agency 

13 and local educational agency application 

14 timelines in section 107(c) of such title; and 

15 (J) each reference to a public elementary 

16 school may include, as determined by the local 

17 educational agency, a publicly-funded preschool 

18 program that enrolls children below the age of 

19 kindergarten entry and is part of an elementary 

20 school; 

21 (3) $100,000,000 of the funds made available 

22 under this heading shall be for programs authorized 

23 under subpart 3 of Part A, part C of title IV and 

24 part B of title VII of the Higher Education Act of 

25 1965 (20 U.S.C. 1087–51 et seq., 1138 et seq.) for in-
75 

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1 stitutions located in an area affected by a covered dis2 aster or emergency, and students enrolled in such in3 stitutions, except that— 

4 (A) any requirements relating to matching, 

5 Federal share, reservation of funds, or mainte6 nance of effort under such parts that would oth7 erwise be applicable to that assistance shall not 

8 apply; 

9 (B) such assistance may be used for student 

10 financial assistance; 

11 (C) such assistance may also be used for 

12 faculty and staff salaries, equipment, student 

13 supplies and instruments, or any purpose au14 thorized under the Higher Education Act of 

15 1965, by institutions of higher education that are 

16 located in areas affected by a covered disaster or 

17 emergency; and 

18 (D) the Secretary shall prioritize, to the ex19 tent possible, students who are homeless or at 

20 risk of becoming homeless as a result of displace21 ment, and institutions that have sustained exten22 sive damage, by a covered disaster or emergency; 

23 (4) up to $75,000,000 of the funds made avail24 able under this heading shall be for payments to in25 stitutions of higher education to help defray the unex-
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1 pected expenses associated with enrolling displaced 

2 students from institutions of higher education at 

3 which operations have been disrupted by a covered 

4 disaster or emergency, in accordance with criteria es5 tablished by the Secretary and made publicly avail6 able; 

7 (5) $25,000,000 of the funds made available 

8 under this heading shall be available to provide as9 sistance to local educational agencies serving homeless 

10 children and youths displaced by a covered disaster or 

11 emergency, consistent with section 723 of the McKin12 ney-Vento Homeless Assistance Act (42 U.S.C. 11431– 

13 11435) and with section 106 of title IV of division B 

14 of Public Law 109–148, except that funds shall be 

15 disbursed based on demonstrated need and the number 

16 of homeless children and youth enrolled as a result of 

17 displacement by a covered disaster or emergency; 

18 (6) section 437 of the General Education Provi19 sions Act (20 U.S.C. 1232) and section 553 of title 5, 

20 United States Code, shall not apply to activities 

21 under this heading; 

22 (7) $4,000,000 of the funds made available under 

23 this heading, to remain available until expended, 

24 shall be transferred to the Office of the Inspector Gen25 eral of the Department of Education for oversight of 
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1 activities supported with funds appropriated under 

2 this heading, and up to $3,000,000 of the funds made 

3 available under this heading shall be for program ad4 ministration; 

5 (8) up to $35,000,000 of the funds made avail6 able under this heading shall be to carry out activities 

7 authorized under section 4631(b) of the Elementary 

8 and Secondary Education Act of 1965 (20 U.S.C. 

9 7281(b)): Provided, That obligations incurred for the 

10 purposes provided herein prior to the date of enact11 ment of this subdivision may be charged to funds ap12 propriated under this paragraph; 

13 (9) the Secretary may waive, modify, or provide 

14 extensions for certain requirements of the Higher 

15 Education Act of 1965 (20 U.S.C. 1001 et seq.) for af16 fected individuals, affected students, and affected in17 stitutions in covered disaster or emergency areas in 

18 the same manner as the Secretary was authorized to 

19 waive, modify, or provide extensions for certain re20 quirements of such Act under provisions of subtitle B 

21 of title IV of division B of Public Law 109–148 for 

22 affected individuals, affected students, and affected in23 stitutions in areas affected by Hurricane Katrina and 

24 Hurricane Rita, except that the cost associated with 

25 any action taken by the Secretary under this para-
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1 graph is designated by the Congress as being for an 

2 emergency requirement pursuant to section 

3 251(b)(2)(A)(i) of the Balanced Budget and Emer4 gency Deficit Control Act of 1985; and 

5 (10) if any provision under this heading or ap6 plication of such provision to any person or cir7 cumstance is held to be unconstitutional, the remain8 der of the provisions under this heading and the ap9 plication of such provisions to any person or cir10 cumstance shall not be affected thereby. 

11 GENERAL PROVISION—DEPARTMENT OF EDUCATION

12 SEC. 20804. (a) Notwithstanding any other provision 

13 of law, the Secretary of Education is hereby authorized to 

14 forgive any outstanding balance owed to the Department 

15 of Education under the HBCU Hurricane Supplemental 

16 Loan program established pursuant to section 2601 of Pub17 lic Law 109–234, as modified by section 307 of title III 

18 of division F of the Consolidated Appropriations Act, 2012 

19 (Public Law 112–74), as carried forward by the Continuing 

20 Appropriations Resolution, 2013 (Public Law 112–175). 

21 (b) There are authorized to be appropriated, and there 

22 are hereby appropriated, such sums as may be necessary 

23 to carry out subsection (a): Provided, That such amount 

24 is designated by the Congress as an emergency requirement 
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1 pursuant to section 251(b)(2)(A)(i) of the Balance Budget 

2 and Emergency Deficit Control Act of 1985. 

3 GENERAL PROVISIONS—THIS TITLE 

4 (INCLUDING TRANSFER OF FUNDS)

5 SEC. 20805. Funds appropriated to the Department 

6 of Health and Human Services by this title may be trans7 ferred to, and merged with, other appropriation accounts 

8 under the headings ‘‘Centers for Disease Control and Pre9 vention’’ and ‘‘Public Health and Social Services Emer10 gency Fund’’ for the purposes specified in this title fol11 lowing consultation with the Office of Management and 

12 Budget: Provided, That the Committees on Appropriations 

13 in the House of Representatives and the Senate shall be no14 tified 10 days in advance of any such transfer: Provided 

15 further, That, upon a determination that all or part of the 

16 funds transferred from an appropriation are not necessary, 

17 such amounts may be transferred back to that appropria18 tion: Provided further, That none of the funds made avail19 able by this title may be transferred pursuant to the author20 ity in section 205 of division H of Public Law 115–31 or 

21 section 241(a) of the PHS Act. 

22 SEC. 20806. Not later than 30 days after enactment 

23 of this subdivision, the Secretary of Health and Human 

24 Services shall provide a detailed spend plan of anticipated 

25 uses of funds made available in this title, including esti-
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1 mated personnel and administrative costs, to the Commit2 tees on Appropriations: Provided, That such plans shall be 

3 updated and submitted to the Committees on Appropria4 tions every 60 days until all funds are expended or expire. 

5 SEC. 20807. Unless otherwise provided for by this title, 

6 the additional amounts appropriated by this title to appro7 priations accounts shall be available under the authorities 

8 and conditions applicable to such appropriations accounts 

9 for fiscal year 2018. 

10 TITLE IX 

11 LEGISLATIVE BRANCH 

12 GOVERNMENT ACCOUNTABILITY OFFICE 

13 SALARIES AND EXPENSES

14 For an additional amount for ‘‘Salaries and Ex15 penses’’, $14,000,000, to remain available until expended, 

16 for audits and investigations relating to Hurricanes Har17 vey, Irma, and Maria and the 2017 wildfires: Provided, 

18 That such amount is designated by the Congress as being 

19 for an emergency requirement pursuant to section 

20 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

21 Deficit Control Act of 1985. 
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1 TITLE X 

2 DEPARTMENT OF DEFENSE 

3 MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

4 For an additional amount for ‘‘Military Construction, 

5 Navy and Marine Corps’’, $201,636,000, to remain avail6 able until September 30, 2022, for necessary expenses re7 lated to the consequences of Hurricanes Harvey, Irma, and 

8 Maria: Provided, That none of the funds made available 

9 to the Navy and Marine Corps for recovery efforts related 

10 to Hurricanes Harvey, Irma, and Maria in this subdivision 

11 shall be available for obligation until the Committees on 

12 Appropriations of the House of Representatives and the 

13 Senate receive form 1391 for each specific request: Provided 

14 further, That, not later than 60 days after enactment of 

15 this subdivision, the Secretary of the Navy, or his designee, 

16 shall submit to the Committees on Appropriations of House 

17 of Representatives and the Senate a detailed expenditure 

18 plan for funds provided under this heading: Provided fur19 ther, That such funds may be obligated or expended for 

20 planning and design and military construction projects not 

21 otherwise authorized by law: Provided further, That such 

22 amount is designated by the Congress as being for an emer23 gency requirement pursuant to section 251(b)(2)(A)(i) of 

24 the Balanced Budget and Emergency Deficit Control Act 

25 of 1985. 
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1 MILITARY CONSTRUCTION, ARMY NATIONAL GUARD

2 For an additional amount for ‘‘Military Construction, 

3 Army National Guard’’, $519,345,000, to remain available 

4 until September 30, 2022, for necessary expenses related to 

5 the consequences of Hurricanes Harvey, Irma, and Maria: 

6 Provided, That none of the funds made available to the 

7 Army National Guard for recovery efforts related to Hurri8 canes Harvey, Irma, and Maria in this subdivision shall 

9 be available for obligation until the Committees on Appro10 priations of the House of Representatives and the Senate 

11 receive form 1391 for each specific request: Provided further, 

12 That, not later than 60 days after enactment of this subdivi13 sion, the Director of the Army National Guard, or his des14 ignee, shall submit to the Committees on Appropriations 

15 of the House of Representatives and the Senate a detailed 

16 expenditure plan for funds provided under this heading: 

17 Provided further, That such funds may be obligated or ex18 pended for planning and design and military construction 

19 projects not otherwise authorized by law: Provided further, 

20 That such amount is designated by the Congress as being 

21 for an emergency requirement pursuant to section 

22 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

23 Deficit Control Act of 1985. 
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1 DEPARTMENT OF VETERANS AFFAIRS 

2 VETERANS HEALTH ADMINISTRATION

3 MEDICAL SERVICES

4 For an additional amount for ‘‘Medical Services’’, 

5 $11,075,000, to remain available until September 30, 2019, 

6 for necessary expenses related to the consequences of Hurri7 canes Harvey, Irma, and Maria: Provided, That such 

8 amount is designated by the Congress as being for an emer9 gency requirement pursuant to section 251(b)(2)(A)(i) of 

10 the Balanced Budget and Emergency Deficit Control Act 

11 of 1985. 

12 MEDICAL SUPPORT AND COMPLIANCE

13 For an additional amount for ‘‘Medical Support and 

14 Compliance’’, $3,209,000, to remain available until Sep15 tember 30, 2019, for necessary expenses related to the con16 sequences of Hurricanes Harvey, Irma, and Maria: Pro17 vided, That such amount is designated by the Congress as 

18 being for an emergency requirement pursuant to section 

19 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

20 Deficit Control Act of 1985. 

21 MEDICAL FACILITIES

22 For an additional amount for ‘‘Medical Facilities’’, 

23 $75,108,000, to remain available until September 30, 2022, 

24 for necessary expenses related to the consequences of Hurri25 canes Harvey, Irma, and Maria: Provided, That none of 
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1 these funds shall be available for obligation until the Sec2 retary of Veterans Affairs submits to the Committees on Ap3 propriations of the House of Representatives and the Senate 

4 a detailed expenditure plan for funds provided under this 

5 heading: Provided further, That such amount is designated 

6 by the Congress as being for an emergency requirement pur7 suant to section 251(b)(2)(A)(i) of the Balanced Budget and 

8 Emergency Deficit Control Act of 1985. 

9 DEPARTMENTAL ADMINISTRATION

10 CONSTRUCTION, MINOR PROJECTS

11 For an additional amount for ‘‘Construction, Minor 

12 Projects’’, $4,088,000, to remain available until September 

13 30, 2022, for necessary expenses related to the consequences 

14 of Hurricanes Harvey, Irma, and Maria: Provided, That 

15 such amount is designated by the Congress as being for an 

16 emergency requirement pursuant to section 251(b)(2)(A)(i) 

17 of the Balanced Budget and Emergency Deficit Control Act 

18 of 1985. 

19 GENERAL PROVISION—THIS TITLE 

20 SEC. 21001. Notwithstanding section 18236(b) of title 

21 10, United States Code, the Secretary of Defense shall con22 tribute to Puerto Rico, 100 percent of the total cost of con23 struction (including the cost of architectural, engineering 

24 and design services) for the acquisition, construction, ex25 pansion, rehabilitation, or conversion of the Arroyo readi-
85 

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1 ness center under paragraph (5) of section 18233(a) of title 

2 10, United States Code. 

3 TITLE XI 

4 DEPARTMENT OF TRANSPORTATION 

5 FEDERAL AVIATION ADMINISTRATION

6 OPERATIONS

7 (AIRPORT AND AIRWAY TRUST FUND)

8 For an additional amount for ‘‘Operations’’, 

9 $35,000,000, to be derived from the Airport and Airway 

10 Trust Fund and to remain available until expended, for 

11 necessary expenses related to the consequences of Hurricanes 

12 Harvey, Irma, and Maria, and other hurricanes occurring 

13 in calendar year 2017: Provided, That such amount is des14 ignated by the Congress as being for an emergency require15 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

16 Budget and Emergency Deficit Control Act of 1985. 

17 FACILITIES AND EQUIPMENT

18 (AIRPORT AND AIRWAY TRUST FUND)

19 For an additional amount for ‘‘Facilities and Equip20 ment’’, $79,589,000, to be derived from the Airport and Air21 way Trust Fund and to remain available until expended, 

22 for necessary expenses related to the consequences of Hurri23 canes Harvey, Irma, and Maria, and other hurricanes oc24 curring in calendar year 2017: Provided, That such amount 

25 is designated by the Congress as being for an emergency 
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1 requirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985. 

3 FEDERAL HIGHWAY ADMINISTRATION

4 FEDERAL-AID HIGHWAYS

5 EMERGENCY RELIEF PROGRAM

6 For an additional amount for the ‘‘Emergency Relief 

7 Program’’ as authorized under section 125 of title 23, 

8 United States Code, $1,374,000,000, to remain available 

9 until expended: Provided, That notwithstanding section 

10 125(d)(4) of title 23, United States Code, no limitation on 

11 the total obligations for projects under section 125 of such 

12 title shall apply to the Virgin Islands, Guam, American 

13 Samoa, and the Commonwealth of the Northern Mariana 

14 Islands for fiscal year 2018 and fiscal year 2019: Provided 

15 further, That notwithstanding subsection (e) of section 120 

16 of title 23, United States Code, for this fiscal year and here17 after, the Federal share for Emergency Relief funds made 

18 available under section 125 of such title to respond to dam19 age caused by Hurricanes Irma and Maria, shall be 100 

20 percent for Puerto Rico: Provided further, That such 

21 amount is designated by the Congress as being for an emer22 gency requirement pursuant to section 251(b)(2)(A)(i) of 

23 the Balanced Budget and Emergency Deficit Control Act 

24 of 1985. 
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1 FEDERAL TRANSIT ADMINISTRATION

2 PUBLIC TRANSPORTATION EMERGENCY RELIEF PROGRAM

3 For an additional amount for the ‘‘Public Transpor4 tation Emergency Relief Program’’ as authorized under sec5 tion 5324 of title 49, United States Code, $330,000,000 to 

6 remain available until expended, for transit systems af7 fected by Hurricanes Harvey, Irma, and Maria with major 

8 disaster declarations in 2017: Provided, That not more than 

9 three-quarters of one percent of the funds for public trans10 portation emergency relief shall be available for adminis11 trative expenses and ongoing program management over12 sight as authorized under sections 5334 and 5338(f)(2) of 

13 such title and shall be in addition to any other appropria14 tions for such purpose: Provided further, That such amount 

15 is designated by the Congress as being for an emergency 

16 requirement pursuant to section 251(b)(2)(A)(i) of the Bal17 anced Budget and Emergency Deficit Control Act of 1985. 

18 MARITIME ADMINISTRATION

19 OPERATIONS AND TRAINING

20 For an additional amount for ‘‘Operations and Train21 ing’’, $10,000,000, to remain available until expended, for 

22 necessary expenses, including for dredging, related to dam23 age to Maritime Administration facilities resulting from 

24 Hurricane Harvey: Provided, That such amount is des25 ignated by the Congress as being for an emergency require-
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1 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 

2 Budget and Emergency Deficit Control Act of 1985. 

3 GENERAL PROVISION—DEPARTMENT OF TRANSPORTATION

4 SEC. 21101. Notwithstanding 49 U.S.C. 5302, for fis5 cal years 2018, 2019, and 2020 the Secretary of Transpor6 tation shall treat an area as an ‘‘urbanized area’’ for pur7 poses of 49 U.S.C. 5307 and 5336(a) until the next decen8 nial census following the enactment of this Act if the area 

9 was defined and designated as an ‘‘urbanized’’ area by the 

10 Secretary of Commerce in the 2000 decennial census and 

11 the population of such area fell below 50,000 after the 2000 

12 decennial census as a result of a major disaster: Provided, 

13 That an area treated as an ‘‘urbanized area’’ for purposes 

14 of this section shall be assigned the population and square 

15 miles of the urbanized area designated by the Secretary of 

16 Commerce in the 2000 decennial census: Provided further, 

17 That the term ‘‘major disaster’’ has the meaning given such 

18 term in section 102(2) of the Disaster Relief Act of 1974 

19 (42 U.S.C. 5122(2)). 
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1 DEPARTMENT OF HOUSING AND URBAN 

2 DEVELOPMENT 

3 COMMUNITY PLANNING AND DEVELOPMENT

4 COMMUNITY DEVELOPMENT FUND

5 (INCLUDING TRANSFERS OF FUNDS)

6 For an additional amount for ‘‘Community Develop7 ment Fund’’, $28,000,000,000, to remain available until ex8 pended, for necessary expenses for activities authorized 

9 under title I of the Housing and Community Development 

10 Act of 1974 (42 U.S.C. 5301 et seq.) related to disaster re11 lief, long-term recovery, restoration of infrastructure and 

12 housing, economic revitalization, and mitigation in the 

13 most impacted and distressed areas resulting from a major 

14 declared disaster that occurred in 2017 (except as otherwise 

15 provided under this heading) pursuant to the Robert T. 

16 Stafford Disaster Relief and Emergency Assistance Act (42 

17 U.S.C. 5121 et seq.): Provided, That funds shall be awarded 

18 directly to the State, unit of general local government, or 

19 Indian tribe (as such term is defined in section 102 of the 

20 Housing and Community Development Act of 1974) at the 

21 discretion of the Secretary: Provided further, That of the 

22 amounts made available under this heading, up to 

23 $16,000,000,000 shall be allocated to meet unmet needs for 

24 grantees that have received or will receive allocations under 

25 this heading for major declared disasters that occurred in 
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1 2017 or under the same heading of Division B of Public 

2 Law 115–56, except that, of the amounts made available 

3 under this proviso, no less than $11,000,000,000 shall be 

4 allocated to the States and units of local government af5 fected by Hurricane Maria, and of such amounts allocated 

6 to such grantees affected by Hurricane Maria, 

7 $2,000,000,000 shall be used to provide enhanced or im8 proved electrical power systems: Provided further, That to 

9 the extent amounts under the previous proviso are insuffi10 cient to meet all unmet needs, the allocation amounts re11 lated to infrastructure shall be reduced proportionally based 

12 on the total infrastructure needs of all grantees: Provided 

13 further, That of the amounts made available under this 

14 heading, no less than $12,000,000,000 shall be allocated for 

15 mitigation activities to all grantees of funding provided 

16 under this heading, section 420 of division L of Public Law 

17 114–113, section 145 of division C of Public Law 114–223, 

18 section 192 of division C of Public Law 114–223 (as added 

19 by section 101(3) of division A of Public Law 114–254), 

20 section 421 of division K of Public Law 115–31, and the 

21 same heading in division B of Public Law 115–56, and 

22 that such mitigation activities shall be subject to the same 

23 terms and conditions under this subdivision, as determined 

24 by the Secretary: Provided further, That all such grantees 

25 shall receive an allocation of funds under the preceding pro-
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1 viso in the same proportion that the amount of funds each 

2 grantee received or will receive under the second proviso of 

3 this heading or the headings and sections specified in the 

4 previous proviso bears to the amount of all funds provided 

5 to all grantees specified in the previous proviso: Provided 

6 further, That of the amounts made available under the sec7 ond and fourth provisos of this heading, the Secretary shall 

8 allocate to all such grantees an aggregate amount not less 

9 than 33 percent of each such amounts of funds provided 

10 under this heading within 60 days after the enactment of 

11 this subdivision based on the best available data (especially 

12 with respect to data for all such grantees affected by Hurri13 canes Harvey, Irma, and Maria), and shall allocate no less 

14 than 100 percent of the funds provided under this heading 

15 by no later than December 1, 2018: Provided further, That 

16 the Secretary shall not prohibit the use of funds made avail17 able under this heading and the same heading in division 

18 B of Public Law 115–56 for non-federal share as authorized 

19 by section 105(a)(9) of the Housing and Community Devel20 opment Act of 1974 (42 U.S.C. 5305(a)(9)): Provided fur21 ther, That of the amounts made available under this head22 ing, grantees may establish grant programs to assist small 

23 businesses for working capital purposes to aid in recovery: 

24 Provided further, That as a condition of making any grant, 

25 the Secretary shall certify in advance that such grantee has 
92 

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1 in place proficient financial controls and procurement 

2 processes and has established adequate procedures to prevent 

3 any duplication of benefits as defined by section 312 of the 

4 Robert T. Stafford Disaster Relief and Emergency Assist5 ance Act (42 U.S.C. 5155), to ensure timely expenditure 

6 of funds, to maintain comprehensive websites regarding all 

7 disaster recovery activities assisted with these funds, and 

8 to detect and prevent waste, fraud, and abuse of funds: Pro9 vided further, That with respect to any such duplication 

10 of benefits, the Secretary and any grantee under this section 

11 shall not take into consideration or reduce the amount pro12 vided to any applicant for assistance from the grantee 

13 where such applicant applied for and was approved, but 

14 declined assistance related to such major declared disasters 

15 that occurred in 2014, 2015, 2016, and 2017 from the Small 

16 Business Administration under section 7(b) of the Small 

17 Business Act (15 U.S.C. 636(b)): Provided further, That the 

18 Secretary shall require grantees to maintain on a public 

19 website information containing common reporting criteria 

20 established by the Department that permits individuals and 

21 entities awaiting assistance and the general public to see 

22 how all grant funds are used, including copies of all rel23 evant procurement documents, grantee administrative con24 tracts and details of ongoing procurement processes, as de25 termined by the Secretary: Provided further, That prior to 
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1 the obligation of funds a grantee shall submit a plan to 

2 the Secretary for approval detailing the proposed use of all 

3 funds, including criteria for eligibility and how the use of 

4 these funds will address long-term recovery and restoration 

5 of infrastructure and housing, economic revitalization, and 

6 mitigation in the most impacted and distressed areas: Pro7 vided further, That such funds may not be used for activi8 ties reimbursable by, or for which funds are made available 

9 by, the Federal Emergency Management Agency or the 

10 Army Corps of Engineers: Provided further, That funds al11 located under this heading shall not be considered relevant 

12 to the non-disaster formula allocations made pursuant to 

13 section 106 of the Housing and Community Development 

14 Act of 1974 (42 U.S.C. 5306): Provided further, That a 

15 State, unit of general local government, or Indian tribe may 

16 use up to 5 percent of its allocation for administrative costs: 

17 Provided further, That the sixth proviso under this heading 

18 in the Supplemental Appropriations for Disaster Relief Re19 quirements Act, 2017 (division B of Public Law 115–56) 

20 is amended by striking ‘‘State or subdivision thereof’’ and 

21 inserting ‘‘State, unit of general local government, or In22 dian tribe (as such term is defined in section 102 of the 

23 Housing and Community Development Act of 1974 (42 

24 U.S.C. 5302))’’: Provided further, That in administering 

25 the funds under this heading, the Secretary of Housing and 
94 

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1 Urban Development may waive, or specify alternative re2 quirements for, any provision of any statute or regulation 

3 that the Secretary administers in connection with the obli4 gation by the Secretary or the use by the recipient of these 

5 funds (except for requirements related to fair housing, non6 discrimination, labor standards, and the environment), if 

7 the Secretary finds that good cause exists for the waiver 

8 or alternative requirement and such waiver or alternative 

9 requirement would not be inconsistent with the overall pur10 pose of title I of the Housing and Community Development 

11 Act of 1974: Provided further, That, notwithstanding the 

12 preceding proviso, recipients of funds provided under this 

13 heading that use such funds to supplement Federal assist14 ance provided under section 402, 403, 404, 406, 407, 

15 408(c)(4), or 502 of the Robert T. Stafford Disaster Relief 

16 and Emergency Assistance Act (42 U.S.C. 5121 et seq.) may 

17 adopt, without review or public comment, any environ18 mental review, approval, or permit performed by a Federal 

19 agency, and such adoption shall satisfy the responsibilities 

20 of the recipient with respect to such environmental review, 

21 approval or permit: Provided further, That, notwith22 standing section 104(g)(2) of the Housing and Community 

23 Development Act of 1974 (42 U.S.C. 5304(g)(2)), the Sec24 retary may, upon receipt of a request for release of funds 

25 and certification, immediately approve the release of funds 
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1 for an activity or project assisted under this heading if the 

2 recipient has adopted an environmental review, approval 

3 or permit under the preceding proviso or the activity or 

4 project is categorically excluded from review under the Na5 tional Environmental Policy Act of 1969 (42 U.S.C. 4321 

6 et seq.): Provided further, That the Secretary shall publish 

7 via notice in the Federal Register any waiver, or alternative 

8 requirement, to any statute or regulation that the Secretary 

9 administers pursuant to title I of the Housing and Commu10 nity Development Act of 1974 no later than 5 days before 

11 the effective date of such waiver or alternative requirement: 

12 Provided further, That the eighth proviso under this head13 ing in the Supplemental Appropriations for Disaster Relief 

14 Requirements Act, 2017 (division B of Public Law 115– 

15 56) is amended by inserting ‘‘408(c)(4),’’ after ‘‘407,’’: Pro16 vided further, That of the amounts made available under 

17 this heading, up to $15,000,000 shall be made available for 

18 capacity building and technical assistance, including as19 sistance on contracting and procurement processes, to sup20 port States, units of general local government, or Indian 

21 tribes (and their subrecipients) that receive allocations pur22 suant to this heading, received disaster recovery allocations 

23 under the same heading in Public Law 115–56, or may re24 ceive similar allocations for disaster recovery in future ap25 propriations Acts: Provided further, That of the amounts 
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1 made available under this heading, up to $10,000,000 shall 

2 be transferred, in aggregate, to ‘‘Department of Housing 

3 and Urban Development—Program Office Salaries and Ex4 penses—Community Planning and Development’’ for nec5 essary costs, including information technology costs, of ad6 ministering and overseeing the obligation and expenditure 

7 of amounts under this heading: Provided further, That the 

8 amount specified in the preceding proviso shall be combined 

9 with funds appropriated under the same heading and for 

10 the same purpose in Public Law 115–56 and the aggregate 

11 of such amounts shall be available for any of the purposes 

12 specified under this heading or the same heading in Public 

13 Law 115–56 without limitation: Provided further, That, of 

14 the funds made available under this heading, $10,000,000 

15 shall be transferred to the Office of the Inspector General 

16 for necessary costs of overseeing and auditing funds made 

17 available under this heading: Provided further, That such 

18 amount is designated by the Congress as being for an emer19 gency requirement pursuant to section 251(b)(2)(A)(i) of 

20 the Balanced Budget and Emergency Deficit Control Act 

21 of 1985: Provided further, That amounts repurposed pursu22 ant to this section that were previously designated by the 

23 Congress as an emergency requirement pursuant to the Bal24 anced Budget and Emergency Deficit Control Act are des25 ignated by the Congress as an emergency requirement pur-
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1 suant to section 251(b)(2)(A)(i) of the Balanced Budget and 

2 Emergency Deficit Control Act of 1985. 

3 GENERAL PROVISIONS—DEPARTMENT OF HOUSING AND

4 URBAN DEVELOPMENT

5 SEC. 21102. Any funds made available under the head6 ing ‘‘Community Development Fund’’ under this subdivi7 sion that remain available, after the other funds under such 

8 heading have been allocated for necessary expenses for ac9 tivities authorized under such heading, shall be used for ad10 ditional mitigation activities in the most impacted and dis11 tressed areas resulting from a major declared disaster that 

12 occurred in 2014, 2015, 2016 or 2017: Provided, That such 

13 remaining funds shall be awarded to grantees of funding 

14 provided for disaster relief under the heading ‘‘Community 

15 Development Fund’’ in this subdivision, section 420 of divi16 sion L of Public Law 114–113, section 145 of division C 

17 of Public Law 114–223, section 192 of division C of Public 

18 Law 114–223 (as added by section 101(3) of division A of 

19 Public Law 114–254), section 421 of division K of Public 

20 Law 115–31, and the same heading in division B of Public 

21 Law 115–56 subject to the same terms and conditions under 

22 this subdivision and such Acts respectively: Provided fur23 ther, That each such grantee shall receive an allocation from 

24 such remaining funds in the same proportion that the 

25 amount of funds such grantee received under this subdivi-
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1 sion and under the Acts specified in the previous proviso 

2 bears to the amount of all funds provided to all grantees 

3 specified in the previous proviso. 

4 SEC. 21103. For 2018, the Secretary of Housing and 

5 Urban Development may make temporary adjustments to 

6 the section 8 housing choice voucher annual renewal fund7 ing allocations and administrative fee eligibility deter8 minations for public housing agencies located in the most 

9 impacted and distressed areas in which a major Presi10 dentially declared disaster occurred during 2017 under title 

11 IV of the Robert T. Stafford Disaster Relief and Emergency 

12 Assistance Act (42 U.S.C. 5170 et seq.), to avoid significant 

13 adverse funding impacts that would otherwise result from 

14 the disaster, or to facilitate leasing up to a public housing 

15 agency’s authorized level of units under contract (but not 

16 to exceed such level), upon request by and in consultation 

17 with a public housing agency and supported by documenta18 tion as required by the Secretary that demonstrates the need 

19 for the adjustment. 

20 TITLE XII 

21 GENERAL PROVISIONS—THIS SUBDIVISION 

22 SEC. 21201. Each amount appropriated or made 

23 available by this subdivision is in addition to amounts oth24 erwise appropriated for the fiscal year involved. 
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1 SEC. 21202. No part of any appropriation contained 

2 in this subdivision shall remain available for obligation be3 yond the current fiscal year unless expressly so provided 

4 herein. 

5 SEC. 21203. Unless otherwise provided for by this sub6 division, the additional amounts appropriated by this sub7 division to appropriations accounts shall be available under 

8 the authorities and conditions applicable to such appro9 priations accounts for fiscal year 2018. 

10 SEC. 21204. Each amount designated in this subdivi11 sion by the Congress as being for an emergency requirement 

12 pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

13 and Emergency Deficit Control Act of 1985 shall be avail14 able (or rescinded or transferred, if applicable) only if the 

15 President subsequently so designates all such amounts and 

16 transmits such designations to the Congress. 

17 SEC. 21205. For purposes of this subdivision, the con18 sequences or impacts of any hurricane shall include dam19 ages caused by the storm at any time during the entirety 

20 of its duration as a cyclone, as defined by the National 

21 Hurricane Center. 

22 SEC. 21206. Any amount appropriated by this sub23 division, designated by the Congress as an emergency re24 quirement pursuant to section 251(b)(2)(A)(i) of the Bal25 anced Budget and Emergency Deficit Control Act of 1985 
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1 and subsequently so designated by the President, and trans2 ferred pursuant to transfer authorities provided by this sub3 division shall retain such designation. 

4 SEC. 21207. The terms and conditions applicable to 

5 the funds provided in this subdivision, including those pro6 vided by this title, shall also apply to the funds made avail7 able in division B of Public Law 115–56 and in division 

8 A of Public Law 115–72. 

9 SEC. 21208. (a) Section 305 of division A of the Addi10 tional Supplemental Appropriations for Disaster Relief Re11 quirements Act, 2017 (Public Law 115–72) is amended— 

12 (1) in subsection (a)— 

13 (A) by striking ‘‘(1) Not later than Decem14 ber 31, 2017,’’ and inserting ‘‘Not later than 

15 March 31, 2018,’’; and 

16 (B) by striking paragraph (2); and 

17 (2) in subsection (b), by striking ‘‘receiving 

18 funds under this division’’ and inserting ‘‘expending 

19 more than $10,000,000 of funds provided by this divi20 sion and division B of Public Law 115–56 in any 

21 one fiscal year’’. 

22 (b) Section 305 of division A of the Additional Supple23 mental Appropriations for Disaster Relief Requirements 

24 Act, 2017 (Public Law 115–72), as amended by this section, 
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1 shall apply to funds appropriated by this division as if they 

2 had been appropriated by that division. 

3 (c) In order to proactively prepare for oversight of fu4 ture disaster relief funding, not later than one year after 

5 the date of enactment of this Act, the Director of the Office 

6 of Management and Budget shall issue standard guidance 

7 for Federal agencies to use in designing internal control 

8 plans for disaster relief funding. This guidance shall lever9 age existing internal control review processes and shall in10 clude, at a minimum, the following elements: 

11 (1) Robust criteria for identifying and docu12 menting incremental risks and mitigating controls re13 lated to the funding. 

14 (2) Guidance for documenting the linkage be15 tween the incremental risks related to disaster fund16 ing and efforts to address known internal control 

17 risks. 

18 SEC. 21209. Any agency or department provided fund19 ing in excess of $3,000,000,000 by this subdivision, includ20 ing the Federal Emergency Management Agency, the De21 partment of Housing and Urban Development, and the 

22 Corps of Engineers, is directed to provide a report to the 

23 Committees on Appropriations of the House of Representa24 tives and the Senate regarding its efforts to provide ade-
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1 quate resources and technical assistance for small, low-in2 come communities affected by natural disasters. 

3 SEC. 21210. (a) Not later than 180 days after the date 

4 of enactment of this subdivision and in coordination with 

5 the Administrator of the Federal Emergency Management 

6 Agency, with support and contributions from the Secretary 

7 of the Treasury, the Secretary of Energy, and other Federal 

8 agencies having responsibilities defined under the National 

9 Disaster Recovery Framework, the Governor of the Com10 monwealth of Puerto Rico shall submit to Congress a report 

11 describing the Commonwealth’s 12- and 24-month economic 

12 and disaster recovery plan that— 

13 (1) defines the priorities, goals, and expected out14 comes of the recovery effort for the Commonwealth, 

15 based on damage assessments prepared pursuant to 

16 Federal law, if applicable, including— 

17 (A) housing; 

18 (B) economic issues, including workforce de19 velopment and industry expansion and cultiva20 tion; 

21 (C) health and social services; 

22 (D) natural and cultural resources; 

23 (E) governance and civic institutions; 

24 (F) electric power systems and grid restora25 tion; 
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1 (G) environmental issues, including solid 

2 waste facilities; and 

3 (H) other infrastructure systems, including 

4 repair, restoration, replacement, and improve5 ment of public infrastructure such water and 

6 wastewater treatment facilities, communications 

7 networks, and transportation infrastructure; 

8 (2) is consistent with— 

9 (A) the Commonwealth’s fiscal capacity to 

10 provide long-term operation and maintenance of 

11 rebuilt or replaced assets; 

12 (B) alternative procedures and associated 

13 programmatic guidance adopted by the Adminis14 trator of the Federal Emergency Management 

15 Agency pursuant to section 428 of the Robert T. 

16 Stafford Disaster Relief and Emergency Assist17 ance Act (42 U.S.C. 5189f); and 

18 (C) actions as may be necessary to mitigate 

19 vulnerabilities to future extreme weather events 

20 and natural disasters and increase community 

21 resilience, including encouraging the adoption 

22 and enforcement of the latest published editions 

23 of relevant consensus-based codes, specifications, 

24 and standards that incorporate the latest hazard25 resistant designs and establish minimum accept-
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1 able criteria for the design, construction, and 

2 maintenance of residential structures and facili3 ties for the purpose of protecting the health, safe4 ty, and general welfare of the buildings’ users 

5 against disasters; 

6 (3) promotes transparency and accountability 

7 through appropriate public notification, outreach, 

8 and hearings; 

9 (4) identifies performance metrics for assessing 

10 and reporting on the progress toward achieving the 

11 Commonwealth’s recovery goals, as identified under 

12 paragraph (1); 

13 (5) is developed in coordination with the Over14 sight Board established under PROMESA; and 

15 (6) is certified by that Oversight Board to be 

16 consistent with the purpose set forth in section 101(a) 

17 of PROMESA (48 U.S.C. 2121(a)). 

18 (b) At the end of every 30-day period before the submis19 sion of the report described in subsection (a), the Governor 

20 of the Commonwealth of Puerto Rico, in coordination with 

21 the Administrator of the Federal Emergency Management 

22 Agency, shall provide to Congress interim status updates 

23 on progress developing such report. 

24 (c) At the end of every 180-day period after the submis25 sion of the report described in subsection (a), the Governor 
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1 of the Commonwealth of Puerto Rico, in coordination with 

2 the Administrator of the Federal Emergency Management 

3 Agency, shall make public a report on progress achieving 

4 the goals set forth in such report. 

5 (d) During the development, and after the submission, 

6 of the report required in subsection (a), the Oversight Board 

7 may provide to Congress reports on the status of coordina8 tion with the Governor of Puerto Rico. 

9 (e) Amounts made available by this subdivision to a 

10 covered territory for response to or recovery from Hurricane 

11 Irma or Hurricane Maria in an aggregate amount greater 

12 than $10,000,000 may be reviewed by the Oversight Board 

13 under the Oversight Board’s authority under 204(b)(2) of 

14 PROMESA (48 U.S.C. 2144(b)(2)). 

15 (f) When developing a Fiscal Plan while the recovery 

16 plan required under subsection (a) is in development and 

17 in effect, the Oversight Board shall use and incorporate, to 

18 the greatest extent feasible, damage assessments prepared 

19 pursuant to Federal law. 

20 (g) For purposes of this section, the terms ‘‘covered ter21 ritory’’ and ‘‘Oversight Board’’ have the meaning given 

22 those term in section 5 of PROMESA (48 U.S.C. 2104). 

23 This subdivision may be cited as the ‘‘Further Addi24 tional Supplemental Appropriations for Disaster Relief Re25 quirements Act, 2018’’. 
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1 SUBDIVISION 2—TAX RELIEF 

2 AND MEDICAID CHANGES RE3 LATING TO CERTAIN DISAS4 TERS 

5 TITLE I—CALIFORNIA FIRES 

6 SEC. 20101. DEFINITIONS. 

7 For purposes of this title— 

8 (1) CALIFORNIA WILDFIRE DISASTER ZONE.— 

9 The term ‘‘California wildfire disaster zone’’ means 

10 that portion of the California wildfire disaster area 

11 determined by the President to warrant individual or 

12 individual and public assistance from the Federal 

13 Government under the Robert T. Stafford Disaster 

14 Relief and Emergency Assistance Act by reason of 

15 wildfires in California. 

16 (2) CALIFORNIA WILDFIRE DISASTER AREA.— 

17 The term ‘‘California wildfire disaster area’’ means 

18 an area with respect to which between January 1, 

19 2017 through January 18, 2018 a major disaster has 

20 been declared by the President under section 401 of 

21 such Act by reason of wildfires in California. 

22 SEC. 20102. SPECIAL DISASTER-RELATED RULES FOR USE 

23 OF RETIREMENT FUNDS. 

24 (a) TAX-FAVORED WITHDRAWALS FROM RETIREMENT

25 PLANS.— 
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1 (1) IN GENERAL.—Section 72(t) of the Internal 

2 Revenue Code of 1986 shall not apply to any quali3 fied wildfire distribution. 

4 (2) AGGREGATE DOLLAR LIMITATION.— 

5 (A) IN GENERAL.—For purposes of this sub6 section, the aggregate amount of distributions re7 ceived by an individual which may be treated as 

8 qualified wildfire distributions for any taxable 

9 year shall not exceed the excess (if any) of— 

10 (i) $100,000, over 

11 (ii) the aggregate amounts treated as 

12 qualified wildfire distributions received by 

13 such individual for all prior taxable years. 

14 (B) TREATMENT OF PLAN DISTRIBU15 TIONS.—If a distribution to an individual would 

16 (without regard to subparagraph (A)) be a quali17 fied wildfire distribution, a plan shall not be 

18 treated as violating any requirement of the In19 ternal Revenue Code of 1986 merely because the 

20 plan treats such distribution as a qualified wild21 fire distribution, unless the aggregate amount of 

22 such distributions from all plans maintained by 

23 the employer (and any member of any controlled 

24 group which includes the employer) to such indi25 vidual exceeds $100,000. 
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1 (C) CONTROLLED GROUP.—For purposes of 

2 subparagraph (B), the term ‘‘controlled group’’ 

3 means any group treated as a single employer 

4 under subsection (b), (c), (m), or (o) of section 

5 414 of the Internal Revenue Code of 1986. 

6 (3) AMOUNT DISTRIBUTED MAY BE REPAID.— 

7 (A) IN GENERAL.—Any individual who re8 ceives a qualified wildfire distribution may, at 

9 any time during the 3-year period beginning on 

10 the day after the date on which such distribution 

11 was received, make one or more contributions in 

12 an aggregate amount not to exceed the amount 

13 of such distribution to an eligible retirement 

14 plan of which such individual is a beneficiary 

15 and to which a rollover contribution of such dis16 tribution could be made under section 402(c), 

17 403(a)(4), 403(b)(8), 408(d)(3), or 457(e)(16), of 

18 the Internal Revenue Code of 1986, as the case 

19 may be. 

20 (B) TREATMENT OF REPAYMENTS OF DIS21 TRIBUTIONS FROM ELIGIBLE RETIREMENT PLANS

22 OTHER THAN IRAS.—For purposes of the Inter23 nal Revenue Code of 1986, if a contribution is 

24 made pursuant to subparagraph (A) with respect 

25 to a qualified wildfire distribution from an eligi-
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1 ble retirement plan other than an individual re2 tirement plan, then the taxpayer shall, to the ex3 tent of the amount of the contribution, be treated 

4 as having received the qualified wildfire distribu5 tion in an eligible rollover distribution (as de6 fined in section 402(c)(4) of such Code) and as 

7 having transferred the amount to the eligible re8 tirement plan in a direct trustee to trustee trans9 fer within 60 days of the distribution. 

10 (C) TREATMENT OF REPAYMENTS FOR DIS11 TRIBUTIONS FROM IRAS.—For purposes of the 

12 Internal Revenue Code of 1986, if a contribution 

13 is made pursuant to subparagraph (A) with re14 spect to a qualified wildfire distribution from an 

15 individual retirement plan (as defined by section 

16 7701(a)(37) of such Code), then, to the extent of 

17 the amount of the contribution, the qualified 

18 wildfire distribution shall be treated as a dis19 tribution described in section 408(d)(3) of such 

20 Code and as having been transferred to the eligi21 ble retirement plan in a direct trustee to trustee 

22 transfer within 60 days of the distribution. 

23 (4) DEFINITIONS.—For purposes of this sub24 section— 
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1 (A) QUALIFIED WILDFIRE DISTRIBUTION.— 

2 Except as provided in paragraph (2), the term 

3 ‘‘qualified wildfire distribution’’ means any dis4 tribution from an eligible retirement plan made 

5 on or after October 8, 2017, and before January 

6 1, 2019, to an individual whose principal place 

7 of abode during any portion of the period from 

8 October 8, 2017, to December 31, 2017, is located 

9 in the California wildfire disaster area and who 

10 has sustained an economic loss by reason of the 

11 wildfires to which the declaration of such area 

12 relates. 

13 (B) ELIGIBLE RETIREMENT PLAN.—The 

14 term ‘‘eligible retirement plan’’ shall have the 

15 meaning given such term by section 402(c)(8)(B) 

16 of the Internal Revenue Code of 1986. 

17 (5) INCOME INCLUSION SPREAD OVER 3-YEAR PE18 RIOD.— 

19 (A) IN GENERAL.—In the case of any quali20 fied wildfire distribution, unless the taxpayer 

21 elects not to have this paragraph apply for any 

22 taxable year, any amount required to be in23 cluded in gross income for such taxable year 

24 shall be so included ratably over the 3-taxable25 year period beginning with such taxable year. 
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1 (B) SPECIAL RULE.—For purposes of sub2 paragraph (A), rules similar to the rules of sub3 paragraph (E) of section 408A(d)(3) of the Inter4 nal Revenue Code of 1986 shall apply. 

5 (6) SPECIAL RULES.— 

6 (A) EXEMPTION OF DISTRIBUTIONS FROM

7 TRUSTEE TO TRUSTEE TRANSFER AND WITH8 HOLDING RULES.—For purposes of sections 

9 401(a)(31), 402(f), and 3405 of the Internal Rev10 enue Code of 1986, qualified wildfire distribu11 tions shall not be treated as eligible rollover dis12 tributions. 

13 (B) QUALIFIED WILDFIRE DISTRIBUTIONS

14 TREATED AS MEETING PLAN DISTRIBUTION RE15 QUIREMENTS.—For purposes the Internal Rev16 enue Code of 1986, a qualified wildfire distribu17 tion shall be treated as meeting the requirements 

18 of sections 401(k)(2)(B)(i), 403(b)(7)(A)(ii), 

19 403(b)(11), and 457(d)(1)(A) of such Code. 

20 (b) RECONTRIBUTIONS OF WITHDRAWALS FOR HOME

21 PURCHASES.— 

22 (1) RECONTRIBUTIONS.— 

23 (A) IN GENERAL.—Any individual who re24 ceived a qualified distribution may, during the 

25 period beginning on October 8, 2017, and ending 
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1 on June 30, 2018, make one or more contribu2 tions in an aggregate amount not to exceed the 

3 amount of such qualified distribution to an eligi4 ble retirement plan (as defined in section 

5 402(c)(8)(B) of the Internal Revenue Code of 

6 1986) of which such individual is a beneficiary 

7 and to which a rollover contribution of such dis8 tribution could be made under section 402(c), 

9 403(a)(4), 403(b)(8), or 408(d)(3), of such Code, 

10 as the case may be. 

11 (B) TREATMENT OF REPAYMENTS.—Rules 

12 similar to the rules of subparagraphs (B) and 

13 (C) of subsection (a)(3) shall apply for purposes 

14 of this subsection. 

15 (2) QUALIFIED DISTRIBUTION.—For purposes of 

16 this subsection, the term ‘‘qualified distribution’’ 

17 means any distribution— 

18 (A) described in section 401(k)(2)(B)(i)(IV), 

19 403(b)(7)(A)(ii) (but only to the extent such dis20 tribution relates to financial hardship), 

21 403(b)(11)(B), or 72(t)(2)(F), of the Internal 

22 Revenue Code of 1986, 

23 (B) received after March 31, 2017, and be24 fore January 15, 2018, and 
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1 (C) which was to be used to purchase or 

2 construct a principal residence in the California 

3 wildfire disaster area but which was not so pur4 chased or constructed on account of the wildfires 

5 to which the declaration of such area relates. 

6 (c) LOANS FROM QUALIFIED PLANS.— 

7 (1) INCREASE IN LIMIT ON LOANS NOT TREATED

8 AS DISTRIBUTIONS.—In the case of any loan from a 

9 qualified employer plan (as defined under section 

10 72(p)(4) of the Internal Revenue Code of 1986) to a 

11 qualified individual made during the period begin12 ning on the date of the enactment of this Act and end13 ing on December 31, 2018— 

14 (A) clause (i) of section 72(p)(2)(A) of such 

15 Code shall be applied by substituting ‘‘$100,000’’ 

16 for ‘‘$50,000’’, and 

17 (B) clause (ii) of such section shall be ap18 plied by substituting ‘‘the present value of the 

19 nonforfeitable accrued benefit of the employee 

20 under the plan’’ for ‘‘one-half of the present 

21 value of the nonforfeitable accrued benefit of the 

22 employee under the plan’’. 

23 (2) DELAY OF REPAYMENT.—In the case of a 

24 qualified individual with an outstanding loan on or 

25 after October 8, 2017, from a qualified employer plan 
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1 (as defined in section 72(p)(4) of the Internal Rev2 enue Code of 1986)— 

3 (A) if the due date pursuant to subpara4 graph (B) or (C) of section 72(p)(2) of such Code 

5 for any repayment with respect to such loan oc6 curs during the period beginning on October 8, 

7 2017, and ending on December 31, 2018, such 

8 due date shall be delayed for 1 year, 

9 (B) any subsequent repayments with respect 

10 to any such loan shall be appropriately adjusted 

11 to reflect the delay in the due date under para12 graph (1) and any interest accruing during such 

13 delay, and 

14 (C) in determining the 5-year period and 

15 the term of a loan under subparagraph (B) or 

16 (C) of section 72(p)(2) of such Code, the period 

17 described in subparagraph (A) shall be dis18 regarded. 

19 (3) QUALIFIED INDIVIDUAL.—For purposes of 

20 this subsection, the term ‘‘qualified individual’’ means 

21 any individual whose principal place of abode during 

22 any portion of the period from October 8, 2017, to 

23 December 31, 2017, is located in the California wild24 fire disaster area and who has sustained an economic 
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1 loss by reason of wildfires to which the declaration of 

2 such area relates. 

3 (d) PROVISIONS RELATING TO PLAN AMENDMENTS.— 

4 (1) IN GENERAL.—If this subsection applies to 

5 any amendment to any plan or annuity contract, 

6 such plan or contract shall be treated as being oper7 ated in accordance with the terms of the plan during 

8 the period described in paragraph (2)(B)(i). 

9 (2) AMENDMENTS TO WHICH SUBSECTION AP10 PLIES.— 

11 (A) IN GENERAL.—This subsection shall 

12 apply to any amendment to any plan or annu13 ity contract which is made— 

14 (i) pursuant to any provision of this 

15 section, or pursuant to any regulation 

16 issued by the Secretary or the Secretary of 

17 Labor under any provision of this section, 

18 and 

19 (ii) on or before the last day of the first 

20 plan year beginning on or after January 1, 

21 2019, or such later date as the Secretary 

22 may prescribe. 

23 In the case of a governmental plan (as defined 

24 in section 414(d) of the Internal Revenue Code 

25 of 1986), clause (ii) shall be applied by sub-
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1 stituting the date which is 2 years after the date 

2 otherwise applied under clause (ii). 

3 (B) CONDITIONS.—This subsection shall not 

4 apply to any amendment unless— 

5 (i) during the period— 

6 (I) beginning on the date that this 

7 section or the regulation described in 

8 subparagraph (A)(i) takes effect (or in 

9 the case of a plan or contract amend10 ment not required by this section or 

11 such regulation, the effective date speci12 fied by the plan), and 

13 (II) ending on the date described 

14 in subparagraph (A)(ii) (or, if earlier, 

15 the date the plan or contract amend16 ment is adopted), 

17 the plan or contract is operated as if such plan 

18 or contract amendment were in effect, and 

19 (ii) such plan or contract amendment 

20 applies retroactively for such period. 

21 SEC. 20103. EMPLOYEE RETENTION CREDIT FOR EMPLOY22 ERS AFFECTED BY CALIFORNIA WILDFIRES. 

23 (a) IN GENERAL.—For purposes of section 38 of the 

24 Internal Revenue Code of 1986, in the case of an eligible 

25 employer, the California wildfire employee retention credit 
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1 shall be treated as a credit listed in subsection (b) of such 

2 section. For purposes of this subsection, the California wild3 fire employee retention credit for any taxable year is an 

4 amount equal to 40 percent of the qualified wages with re5 spect to each eligible employee of such employer for such 

6 taxable year. For purposes of the preceding sentence, the 

7 amount of qualified wages which may be taken into account 

8 with respect to any individual shall not exceed $6,000. 

9 (b) DEFINITIONS.—For purposes of this section— 

10 (1) ELIGIBLE EMPLOYER.—The term ‘‘eligible 

11 employer’’ means any employer— 

12 (A) which conducted an active trade or 

13 business on October 8, 2017, in the California 

14 wildfire disaster zone, and 

15 (B) with respect to whom the trade or busi16 ness described in subparagraph (A) is inoperable 

17 on any day after October 8, 2017, and before 

18 January 1, 2018, as a result of damage sus19 tained by reason of the wildfires to which such 

20 declaration of such area relates. 

21 (2) ELIGIBLE EMPLOYEE.—The term ‘‘eligible 

22 employee’’ means with respect to an eligible employer 

23 an employee whose principal place of employment on 

24 October 8, 2017, with such eligible employer was in 

25 the California wildfire disaster zone. 
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1 (3) QUALIFIED WAGES.—The term ‘‘qualified 

2 wages’’ means wages (as defined in section 51(c)(1) of 

3 the Internal Revenue Code of 1986, but without re4 gard to section 3306(b)(2)(B) of such Code) paid or 

5 incurred by an eligible employer with respect to an 

6 eligible employee on any day after October 8, 2017, 

7 and before January 1, 2018, which occurs during the 

8 period— 

9 (A) beginning on the date on which the 

10 trade or business described in paragraph (1) 

11 first became inoperable at the principal place of 

12 employment of the employee immediately before 

13 the wildfires to which the declaration of the Cali14 fornia wildfire disaster area relates, and 

15 (B) ending on the date on which such trade 

16 or business has resumed significant operations at 

17 such principal place of employment. 

18 Such term shall include wages paid without regard to 

19 whether the employee performs no services, performs 

20 services at a different place of employment than such 

21 principal place of employment, or performs services 

22 at such principal place of employment before signifi23 cant operations have resumed. 

24 (c) CERTAIN RULES TO APPLY.—For purposes of this 

25 section, rules similar to the rules of sections 51(i)(1), 52, 
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1 and 280C(a) of the Internal Revenue Code of 1986, shall 

2 apply. 

3 (d) EMPLOYEE NOT TAKEN INTO ACCOUNT MORE

4 THAN ONCE.—An employee shall not be treated as an eligi5 ble employee for purposes of this section for any period with 

6 respect to any employer if such employer is allowed a credit 

7 under section 51 of the Internal Revenue Code of 1986 with 

8 respect to such employee for such period. 

9 SEC. 20104. ADDITIONAL DISASTER-RELATED TAX RELIEF 

10 PROVISIONS. 

11 (a) TEMPORARY SUSPENSION OF LIMITATIONS ON

12 CHARITABLE CONTRIBUTIONS.— 

13 (1) IN GENERAL.—Except as otherwise provided 

14 in paragraph (2), subsection (b) of section 170 of the 

15 Internal Revenue Code of 1986 shall not apply to 

16 qualified contributions and such contributions shall 

17 not be taken into account for purposes of applying 

18 subsections (b) and (d) of such section to other con19 tributions. 

20 (2) TREATMENT OF EXCESS CONTRIBUTIONS.— 

21 For purposes of section 170 of the Internal Revenue 

22 Code of 1986— 

23 (A) INDIVIDUALS.—In the case of an indi24 vidual— 
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1 (i) LIMITATION.—Any qualified con2 tribution shall be allowed only to the extent 

3 that the aggregate of such contributions does 

4 not exceed the excess of the taxpayer’s con5 tribution base (as defined in subparagraph 

6 (H) of section 170(b)(1) of such Code) over 

7 the amount of all other charitable contribu8 tions allowed under section 170(b)(1) of 

9 such Code. 

10 (ii) CARRYOVER.—If the aggregate 

11 amount of qualified contributions made in 

12 the contribution year (within the meaning 

13 of section 170(d)(1) of such Code) exceeds 

14 the limitation of clause (i), such excess shall 

15 be added to the excess described in the por16 tion of subparagraph (A) of such section 

17 which precedes clause (i) thereof for pur18 poses of applying such section. 

19 (B) CORPORATIONS.—In the case of a cor20 poration— 

21 (i) LIMITATION.—Any qualified con22 tribution shall be allowed only to the extent 

23 that the aggregate of such contributions does 

24 not exceed the excess of the taxpayer’s tax25 able income (as determined under para-
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1 graph (2) of section 170(b) of such Code) 

2 over the amount of all other charitable con3 tributions allowed under such paragraph. 

4 (ii) CARRYOVER.—Rules similar to the 

5 rules of subparagraph (A)(ii) shall apply 

6 for purposes of this subparagraph. 

7 (3) EXCEPTION TO OVERALL LIMITATION ON

8 ITEMIZED DEDUCTIONS.—So much of any deduction 

9 allowed under section 170 of the Internal Revenue 

10 Code of 1986 as does not exceed the qualified con11 tributions paid during the taxable year shall not be 

12 treated as an itemized deduction for purposes of sec13 tion 68 of such Code. 

14 (4) QUALIFIED CONTRIBUTIONS.— 

15 (A) IN GENERAL.—For purposes of this sub16 section, the term ‘‘qualified contribution’’ means 

17 any charitable contribution (as defined in sec18 tion 170(c) of the Internal Revenue Code of 

19 1986) if— 

20 (i) such contribution— 

21 (I) is paid during the period be22 ginning on October 8, 2017, and end23 ing on December 31, 2018, in cash to 

24 an organization described in section 

25 170(b)(1)(A) of such Code, and 
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1 (II) is made for relief efforts in 

2 the California wildfire disaster area, 

3 (ii) the taxpayer obtains from such or4 ganization contemporaneous written ac5 knowledgment (within the meaning of sec6 tion 170(f)(8) of such Code) that such con7 tribution was used (or is to be used) for re8 lief efforts described in clause (i)(II), and 

9 (iii) the taxpayer has elected the appli10 cation of this subsection with respect to such 

11 contribution. 

12 (B) EXCEPTION.—Such term shall not in13 clude a contribution by a donor if the contribu14 tion is— 

15 (i) to an organization described in sec16 tion 509(a)(3) of the Internal Revenue Code 

17 of 1986, or 

18 (ii) for the establishment of a new, or 

19 maintenance of an existing, donor advised 

20 fund (as defined in section 4966(d)(2) of 

21 such Code). 

22 (C) APPLICATION OF ELECTION TO PART23 NERSHIPS AND S CORPORATIONS.—In the case of 

24 a partnership or S corporation, the election 
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1 under subparagraph (A)(iii) shall be made sepa2 rately by each partner or shareholder. 

3 (b) SPECIAL RULES FOR QUALIFIED DISASTER-RE4 LATED PERSONAL CASUALTY LOSSES.— 

5 (1) IN GENERAL.—If an individual has a net 

6 disaster loss for any taxable year— 

7 (A) the amount determined under section 

8 165(h)(2)(A)(ii) of the Internal Revenue Code of 

9 1986 shall be equal to the sum of— 

10 (i) such net disaster loss, and 

11 (ii) so much of the excess referred to in 

12 the matter preceding clause (i) of section 

13 165(h)(2)(A) of such Code (reduced by the 

14 amount in clause (i) of this subparagraph) 

15 as exceeds 10 percent of the adjusted gross 

16 income of the individual, 

17 (B) section 165(h)(1) of such Code shall be 

18 applied by substituting ‘‘$500’’ for ‘‘$500 ($100 

19 for taxable years beginning after December 31, 

20 2009)’’, 

21 (C) the standard deduction determined 

22 under section 63(c) of such Code shall be in23 creased by the net disaster loss, and 

24 (D) section 56(b)(1)(E) of such Code shall 

25 not apply to so much of the standard deduction 
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1 as is attributable to the increase under subpara2 graph (C) of this paragraph. 

3 (2) NET DISASTER LOSS.—For purposes of this 

4 subsection, the term ‘‘net disaster loss’’ means the ex5 cess of qualified disaster-related personal casualty 

6 losses over personal casualty gains (as defined in sec7 tion 165(h)(3)(A) of the Internal Revenue Code of 

8 1986). 

9 (3) QUALIFIED DISASTER-RELATED PERSONAL

10 CASUALTY LOSSES.—For purposes of this subsection, 

11 the term ‘‘qualified disaster-related personal casualty 

12 losses’’ means losses described in section 165(c)(3) of 

13 the Internal Revenue Code of 1986 which arise in the 

14 California wildfire disaster area on or after October 

15 8, 2017, and which are attributable to the wildfires 

16 to which the declaration of such area relates. 

17 (c) SPECIAL RULE FOR DETERMINING EARNED IN18 COME.— 

19 (1) IN GENERAL.—In the case of a qualified in20 dividual, if the earned income of the taxpayer for the 

21 taxable year which includes any portion of the period 

22 from October 8, 2017, to December 31, 2017, is less 

23 than the earned income of the taxpayer for the pre24 ceding taxable year, the credits allowed under sections 

25 24(d) and 32 of the Internal Revenue Code of 1986 
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1 may, at the election of the taxpayer, be determined by 

2 substituting— 

3 (A) such earned income for the preceding 

4 taxable year, for 

5 (B) such earned income for the taxable year 

6 which includes any portion of the period from 

7 October 8, 2017, to December 31, 2017. 

8 (2) QUALIFIED INDIVIDUAL.—For purposes of 

9 this subsection, the term ‘‘qualified individual’’ means 

10 any individual whose principal place of abode during 

11 any portion of the period from October 8, 2017, to 

12 December 31, 2017, was located— 

13 (A) in the California wildfire disaster zone, 

14 or 

15 (B) in the California wildfire disaster area 

16 (but outside the California wildfire disaster 

17 zone) and such individual was displaced from 

18 such principal place of abode by reason of the 

19 wildfires to which the declaration of such area 

20 relates. 

21 (3) EARNED INCOME.—For purposes of this sub22 section, the term ‘‘earned income’’ has the meaning 

23 given such term under section 32(c) of the Internal 

24 Revenue Code of 1986. 

25 (4) SPECIAL RULES.— 
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1 (A) APPLICATION TO JOINT RETURNS.—For 

2 purposes of paragraph (1), in the case of a joint 

3 return for a taxable year which includes any 

4 portion of the period from October 8, 2017, to 

5 December 31, 2017— 

6 (i) such paragraph shall apply if ei7 ther spouse is a qualified individual, and 

8 (ii) the earned income of the taxpayer 

9 for the preceding taxable year shall be the 

10 sum of the earned income of each spouse for 

11 such preceding taxable year. 

12 (B) UNIFORM APPLICATION OF ELECTION.— 

13 Any election made under paragraph (1) shall 

14 apply with respect to both sections 24(d) and 32, 

15 of the Internal Revenue Code of 1986. 

16 (C) ERRORS TREATED AS MATHEMATICAL

17 ERROR.—For purposes of section 6213 of the In18 ternal Revenue Code of 1986, an incorrect use on 

19 a return of earned income pursuant to para20 graph (1) shall be treated as a mathematical or 

21 clerical error. 

22 (D) NO EFFECT ON DETERMINATION OF

23 GROSS INCOME, ETC.—Except as otherwise pro24 vided in this subsection, the Internal Revenue 
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1 Code of 1986 shall be applied without regard to 

2 any substitution under paragraph (1). 

3 TITLE II—TAX RELIEF FOR HUR4 RICANES HARVEY, IRMA, AND 

5 MARIA 

6 SEC. 20201. TAX RELIEF FOR HURRICANES HARVEY, IRMA, 

7 AND MARIA. 

8 (a) MODIFICATION OF HURRICANES HARVEY AND

9 IRMA DISASTER AREAS.—Subsections (a)(2) and (b)(2) of 

10 section 501 of the Disaster Tax Relief and Airport and Air11 way Extension Act of 2017 (Public Law 115–63; 131 Stat. 

12 1173) are both amended by striking ‘‘September 21, 2017’’ 

13 and inserting ‘‘October 17, 2017’’. 

14 (b) EMPLOYEE RETENTION CREDIT.—Subsections 

15 (a)(3), (b)(3), and (c)(3) of section 503 of the Disaster Tax 

16 Relief and Airport and Airway Extension Act of 2017 

17 (Public Law 115–63; 131 Stat. 1181) are each amended by 

18 striking ‘‘sections 51(i)(1) and 52’’ and inserting ‘‘sections 

19 51(i)(1), 52, and 280C(a)’’. 

20 (c) EFFECTIVE DATE.—The amendments made by this 

21 section shall take effect as if included in the provisions of 

22 title V of the Disaster Tax Relief and Airport and Airway 

23 Extension Act of 2017 to which such amendments relate. 
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1 TITLE III—HURRICANE MARIA 

2 RELIEF FOR PUERTO RICO 

3 AND THE VIRGIN ISLANDS 

4 MEDICAID PROGRAMS 

5 SEC. 20301. HURRICANE MARIA RELIEF FOR PUERTO RICO 

6 AND THE VIRGIN ISLANDS MEDICAID PRO7 GRAMS. 

8 (a) INCREASED CAPS.—Section 1108(g)(5) of the So9 cial Security Act (42 U.S.C. 1308(g)(5)) is amended— 

10 (1) in subparagraph (A), by striking ‘‘subpara11 graph (B)’’ and inserting ‘‘subparagraphs (B), (C), 

12 (D), and (E)’’; and 

13 (2) by adding at the end the following new sub14 paragraphs: 

15 ‘‘(C) Subject to subparagraphs (D) and (E), for 

16 the period beginning January 1, 2018, and ending 

17 September 30, 2019— 

18 ‘‘(i) the amount of the increase otherwise 

19 provided under subparagraphs (A) and (B) for 

20 Puerto Rico shall be further increased by 

21 $3,600,000,000; and 

22 ‘‘(ii) the amount of the increase otherwise 

23 provided under subparagraph (A) for the Virgin 

24 Islands shall be further increased by 

25 $106,931,000. 
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1 ‘‘(D) For the period described in subparagraph 

2 (C), the amount of the increase otherwise provided 

3 under subparagraph (A)— 

4 ‘‘(i) for Puerto Rico shall be further in5 creased by $1,200,000,000 if the Secretary cer6 tifies that Puerto Rico has taken reasonable and 

7 appropriate steps during such period, in accord8 ance with a timeline established by the Sec9 retary, to— 

10 ‘‘(I) implement methods, satisfactory to 

11 the Secretary, for the collection and report12 ing of reliable data to the Transformed 

13 Medicaid Statistical Information System 

14 (T–MSIS) (or a successor system); and 

15 ‘‘(II) demonstrate progress in estab16 lishing a State medicaid fraud control unit 

17 described in section 1903(q); and 

18 ‘‘(ii) for the Virgin Islands shall be further 

19 increased by $35,644,000 if the Secretary cer20 tifies that the Virgin Islands has taken reason21 able and appropriate steps during such period, 

22 in accordance with a timeline established by the 

23 Secretary, to meet the conditions for certification 

24 specified in subclauses (I) and (II) of clause (i). 
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1 ‘‘(E) Notwithstanding any other provision of 

2 title XIX, during the period in which the additional 

3 funds provided under subparagraphs (C) and (D) are 

4 available for Puerto Rico and the Virgin Islands, re5 spectively, with respect to payments from such addi6 tional funds for amounts expended by Puerto Rico 

7 and the Virgin Islands under such title, the Secretary 

8 shall increase the Federal medical assistance percent9 age or other rate that would otherwise apply to such 

10 payments to 100 percent.’’. 

11 (b) DISREGARD OF CERTAIN EXPENDITURES FROM

12 SPENDING CAP.—Section 1108(g)(4) of the Social Security 

13 Act (42 U.S.C. 1308(g)(4)) is amended— 

14 (1) by inserting ‘‘for a calendar quarter of such 

15 fiscal year,’’ after ‘‘section 1903(a)(3)’’; and 

16 (2) by striking ‘‘of such fiscal year for a cal17 endar quarter of such fiscal year,’’ and inserting ‘‘of 

18 such fiscal year, and with respect to fiscal years be19 ginning with fiscal year 2018, if the Virgin Islands 

20 qualifies for a payment under section 1903(a)(6) for 

21 a calendar quarter (beginning on or after January 1, 

22 2018) of such fiscal year,’’. 

23 (c) REPORT TO CONGRESS.—Not later than July 1, 

24 2018, the Secretary of Health and Human Services shall 

25 submit a report to the Committee on Energy and Commerce 
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1 of the House of Representatives and the Committee on Fi2 nance of the Senate that— 

3 (1) describes the steps taken by Puerto Rico and 

4 the Virgin Islands to meet the conditions for certifi5 cation specified in clauses (i) and (ii ), respectively, 

6 of section 1108(g)(5)(D) of the Social Security Act 

7 (42 U.S.C. 1308(g)(5)(D)) (as amended by subsection 

8 (a) of this section); and 

9 (2) specifies timelines for each such territory to, 

10 as a condition of eligibility for any additional in11 creases in the amounts determined for Puerto Rico or 

12 the Virgin Islands, respectively, under subsection (g) 

13 of section 1108 of such Act (42 U.S.C. 1308) for pur14 poses of payments under title XIX of such Act for fis15 cal year 2019, complete— 

16 (A) implementation of methods, satisfactory 

17 to the Secretary, for the collection and reporting 

18 of reliable data to the Transformed Medicaid 

19 Statistical Information System (T–MSIS) (or a 

20 successor system); and 

21 (B) the establishment of a State medicaid 

22 fraud control unit described in section 1903(q) of 

23 the Social Security Act (42 U.S.C. 1396d(q)). 
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1 TITLE IV—BUDGETARY EFFECTS 

2 SEC. 20401. EMERGENCY DESIGNATION. 

3 This subdivision is designated as an emergency re4 quirement pursuant to section 4(g) of the Statutory Pay5 As-You-Go Act of 2010 (2 U.S.C. 933(g)). 

6 SEC. 20402. DESIGNATION IN SENATE. 

7 In the Senate, this subdivision is designated as an 

8 emergency requirement pursuant to section 4112(a) of H. 

9 Con. Res. 71 (115th Congress), the concurrent resolution on 

10 the budget for fiscal year 2018. 

11 Subdivision 3—Further Extension of 

12 Continuing Appropriations Act, 2018 

13 SEC. 20101. The Continuing Appropriations Act, 2018 

14 (division D of Public Law 115–56) is further amended by— 

15 (1) striking the date specified in section 106(3) 

16 and inserting ‘‘March 23, 2018’’; and 

17 (2) inserting after section 155 the following new 

18 sections: 

19 ‘‘SEC. 156. In addition to amounts provided by section 

20 101, amounts are provided for ‘Department of Commerce— 

21 Bureau of the Census—Periodic Census and Programs’ at 

22 a rate for operations of $182,000,000 for an additional 

23 amount for the 2020 Decennial Census Program; and such 

24 amounts may be apportioned up to the rate for operations 

25 necessary to maintain the schedule and deliver the required 
133 

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1 data according to statutory deadlines in the 2020 Decennial 

2 Census Program. 

3 ‘‘SEC. 157. Notwithstanding section 101, the matter 

4 preceding the first proviso and the first proviso under the 

5 heading ‘Power Marketing Administrations—Operation 

6 and Maintenance, Southeastern Power Administration’ in 

7 division D of Public Law 115–31 shall be applied by sub8 stituting ‘$6,379,000’ for ‘$1,000,000’ each place it appears. 

9 ‘‘SEC. 158. As authorized by section 404 of the Bipar10 tisan Budget Act of 2015 (Public Law 114–74; 42 U.S.C. 

11 6239 note), the Secretary of Energy shall draw down and 

12 sell not to exceed $350,000,000 of crude oil from the Stra13 tegic Petroleum Reserve in fiscal year 2018: Provided, That 

14 the proceeds from such drawdown and sale shall be depos15 ited into the ‘Energy Security and Infrastructure Mod16 ernization Fund’ (in this section referred to as the ‘Fund’) 

17 during fiscal year 2018: Provided further, That in addition 

18 to amounts otherwise made available by section 101, any 

19 amounts deposited in the Fund shall be made available and 

20 shall remain available until expended at a rate for oper21 ations of $350,000,000, for necessary expenses in carrying 

22 out the Life Extension II project for the Strategic Petroleum 

23 Reserve. 

24 ‘‘SEC. 159. Amounts made available by section 101 for 

25 ‘The Judiciary—Courts of Appeals, District Courts, and 
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1 Other Judicial Services—Fees of Jurors and Commis2 sioners’ may be apportioned up to the rate for operations 

3 necessary to accommodate increased juror usage. 

4 ‘‘SEC. 160. Section 144 of the Continuing Appropria5 tions Act, 2018 (division D of Public Law 115–56), as 

6 amended by the Further Additional Continuing Appropria7 tions Act, 2018 (division A of Public Law 115–96), is 

8 amended by (1) striking ‘$11,761,000’ and inserting 

9 ‘$22,247,000’, and (2) striking ‘$1,104,000’ and inserting 

10 ‘$1,987,000’. 

11 ‘‘SEC. 161. Section 458(a)(4) of the Higher Education 

12 Act of 1965 (20 U.S.C. 1087h(a)(4)) shall be applied by 

13 substituting ‘2018’ for ‘2017’. 

14 ‘‘SEC. 162. For the purpose of carrying out section 

15 435(a)(2) of the Higher Education Act of 1965 (HEA) (20 

16 U.S.C. 1085(a)(2)), during the period covered by this Act 

17 the Secretary of Education may waive the requirement 

18 under section 435(a)(5)(A)(ii) of the HEA (20 U.S.C. 

19 1085(a)(5)(A)(ii)) for an institution of higher education 

20 that offers an associate degree, is a public institution, and 

21 is located in an economically distressed county, defined as 

22 a county that ranks in the lowest 5 percent of all counties 

23 in the United States based on a national index of county 

24 economic status: Provided, That this section shall apply to 

25 an institution of higher education that otherwise would be 
135 

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1 ineligible to participate in a program under part A of title 

2 IV of the HEA on or after the date of enactment of this 

3 Act due to the application of section 435(a)(2) of the HEA. 

4 ‘‘SEC. 163. Notwithstanding any other provision of 

5 law, funds made available by this Act for military construc6 tion, land acquisition, and family housing projects and ac7 tivities may be obligated and expended to carry out plan8 ning and design and military construction projects author9 ized by law: Provided, That funds and authority provided 

10 by this section may be used notwithstanding sections 102 

11 and 104: Provided further, That such funds may be used 

12 only for projects identified by the Department of the Air 

13 Force in its January 29, 2018, letter sent to the Committees 

14 on Appropriations of both Houses of Congress detailing ur15 gently needed fiscal year 2018 construction requirements. 

16 ‘‘SEC. 164. (a) Section 116(h)(3)(D) of title 49, United 

17 States Code, is amended— 

18 ‘‘(1) in clause (i), by striking ‘During the 2-year 

19 period beginning on the date of enactment of this sec20 tion, the’; inserting ‘The’; and inserting the following 

21 after the first sentence: ‘Any such funds or limitation 

22 of obligations or portions thereof transferred to the 

23 Bureau may be transferred back to and merged with 

24 the original account.’; and 
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1 ‘‘(2) in clause (ii) by striking ‘During the 2-year 

2 period beginning on the date of enactment of this sec3 tion, the’; inserting ‘The’; and inserting the following 

4 after the first sentence: ‘Any such funds or limitation 

5 of obligations or portions thereof transferred to the 

6 Bureau may be transferred back to and merged with 

7 the original account.’. 

8 ‘‘(b) Section 503(l)(4) of the Railroad Revitalization 

9 and Regulatory Reform Act of 1976 (45 U.S.C. 823(l)(4)) 

10 is amended— 

11 ‘‘(1) in the heading by striking ‘Safety and oper12 ations account’ and inserting ‘National Surface 

13 Transportation and Innovative Finance Bureau ac14 count’; and 

15 ‘‘(2) in subparagraph (A) by striking ‘Safety 

16 and Operations account of the Federal Railroad Ad17 ministration’ and inserting ‘National Surface Trans18 portation and Innovative Finance Bureau account’. 

19 ‘‘SEC. 165. Section 24(o) of the United States Housing 

20 Act of 1937 (42 U.S.C. 1437v) shall be applied by sub21 stituting the date specified in section 106(3) for ‘September 

22 30, 2017’.’’. 

23 This subdivision may be cited as the ‘‘Further Exten24 sion of Continuing Appropriations Act, 2018’’. 
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1 DIVISION C—BUDGETARY AND 

2 OTHER MATTERS 

3 SEC. 30001. TABLE OF CONTENTS. 

4 The table of contents for this division is as follows: 

DIVISION C—BUDGETARY AND OTHER MATTERS 

Sec. 30001. Table of contents. 

TITLE I—BUDGET ENFORCEMENT 

Sec. 30101. Amendments to the Balanced Budget and Emergency Deficit Control 

Act of 1985. 

Sec. 30102. Balances on the PAYGO Scorecards. 

Sec. 30103. Authority for fiscal year 2019 budget resolution in the Senate. 

Sec. 30104. Authority for fiscal year 2019 budget resolution in the House of Representatives. 

Sec. 30105. Exercise of rulemaking powers. 

TITLE II—OFFSETS 

Sec. 30201. Customs user fees. 

Sec. 30202. Aviation security service fees. 

Sec. 30203. Extension of certain immigration fees. 

Sec. 30204. Strategic Petroleum Reserve drawdown. 

Sec. 30205. Elimination of surplus funds of Federal reserve banks. 

Sec. 30206. Reemployment services and eligibility assessments. 

TITLE III—TEMPORARY EXTENSION OF PUBLIC DEBT LIMIT 

Sec. 30301. Temporary extension of public debt limit. 

TITLE IV—JOINT SELECT COMMITTEES 

Subtitle A—Joint Select Committee on Solvency of Multiemployer Pension 

Plans 

Sec. 30421. Definitions. 

Sec. 30422. Establishment of Joint Select Committee. 

Sec. 30423. Funding. 

Sec. 30424. Consideration of joint committee bill in the Senate. 

Subtitle B—Joint Select Committee on Budget and Appropriations Process 

Reform 

Sec. 30441. Definitions. 

Sec. 30442. Establishment of Joint Select Committee. 

Sec. 30443. Funding. 

Sec. 30444. Consideration of joint committee bill in the Senate. 
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1 TITLE I—BUDGET 

2 ENFORCEMENT 

3 SEC. 30101. AMENDMENTS TO THE BALANCED BUDGET AND 

4 EMERGENCY DEFICIT CONTROL ACT OF 1985. 

5 (a) REVISED DISCRETIONARY SPENDING LIMITS.— 

6 Section 251(c) of the Balanced Budget and Emergency Def7 icit Control Act of 1985 (2 U.S.C. 901(c)) is amended by 

8 striking paragraphs (5) and (6) and inserting the following: 

9 ‘‘(5) for fiscal year 2018— 

10 ‘‘(A) for the revised security category, 

11 $629,000,000,000 in new budget authority; and 

12 ‘‘(B) for the revised nonsecurity category 

13 $579,000,000,000 in new budget authority; 

14 ‘‘(6) for fiscal year 2019— 

15 ‘‘(A) for the revised security category, 

16 $647,000,000,000 in new budget authority; and 

17 ‘‘(B) for the revised nonsecurity category, 

18 $597,000,000,000 in new budget authority;’’. 

19 (b) DIRECT SPENDING ADJUSTMENTS FOR FISCAL

20 YEARS 2018 AND 2019.—Section 251A of the Balanced 

21 Budget and Emergency Deficit Control Act of 1985 (2 

22 U.S.C. 901a), is amended— 

23 (1) in paragraph (5)(B), in the matter preceding 

24 clause (i), by striking ‘‘and (11)’’ and inserting ‘‘, 

25 (11), and (12)’’; and 
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1 (2) by adding at the end the following: 

2 ‘‘(12) IMPLEMENTING DIRECT SPENDING REDUC3 TIONS FOR FISCAL YEARS 2018 AND 2019.—(A) OMB 

4 shall make the calculations necessary to implement 

5 the direct spending reductions calculated pursuant to 

6 paragraphs (3) and (4) without regard to the amend7 ment made to section 251(c) revising the discre8 tionary spending limits for fiscal years 2018 and 

9 2019 by the Bipartisan Budget Act of 2018. 

10 ‘‘(B) Paragraph (5)(B) shall not be implemented 

11 for fiscal years 2018 and 2019.’’. 

12 (c) EXTENSION OF DIRECT SPENDING REDUCTIONS

13 THROUGH FISCAL YEAR 2027.—Section 251A(6) of the 

14 Balanced Budget and Emergency Deficit Control Act of 

15 1985 (2 U.S.C. 901a(6)) is amended— 

16 (1) in subparagraph (B), in the matter pre17 ceding clause (i), by striking ‘‘for fiscal year 2022, for 

18 fiscal year 2023, for fiscal year 2024, and for fiscal 

19 year 2025’’ and inserting ‘‘for each of fiscal years 

20 2022 through 2027’’; and 

21 (2) in subparagraph (C), in the matter preceding 

22 clause (i), by striking ‘‘fiscal year 2025’’ and insert23 ing ‘‘fiscal year 2027’’. 
140 

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1 SEC. 30102. BALANCES ON THE PAYGO SCORECARDS. 

2 Effective on the date of enactment of this Act, the bal3 ances on the PAYGO scorecards established pursuant to 

4 paragraphs (4) and (5) of section 4(d) of the Statutory Pay5 As-You-Go Act of 2010 (2 U.S.C. 933(d)) shall be zero. 

6 SEC. 30103. AUTHORITY FOR FISCAL YEAR 2019 BUDGET 

7 RESOLUTION IN THE SENATE. 

8 (a) FISCAL YEAR 2019.—For purposes of enforcing the 

9 Congressional Budget Act of 1974 (2 U.S.C. 621 et seq.) 

10 after April 15, 2018, and enforcing budgetary points of 

11 order in prior concurrent resolutions on the budget, the allo12 cations, aggregates, and levels provided for in subsection (b) 

13 shall apply in the Senate in the same manner as for a con14 current resolution on the budget for fiscal year 2019 with 

15 appropriate budgetary levels for fiscal years 2020 through 

16 2028. 

17 (b) COMMITTEE ALLOCATIONS, AGGREGATES, AND

18 LEVELS.—After April 15, 2018, but not later than May 15, 

19 2018, the Chairman of the Committee on the Budget of the 

20 Senate shall file— 

21 (1) for the Committee on Appropriations, com22 mittee allocations for fiscal year 2019 consistent with 

23 discretionary spending limits set forth in section 

24 251(c)(6) of the Balanced Budget and Emergency 

25 Deficit Control Act of 1985, as amended by this Act, 
141 

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1 for the purposes of enforcing section 302 of the Con2 gressional Budget Act of 1974 (2 U.S.C. 633); 

3 (2) for all committees other than the Committee 

4 on Appropriations, committee allocations for fiscal 

5 years 2019, 2019 through 2023, and 2019 through 

6 2028 consistent with the most recent baseline of the 

7 Congressional Budget Office, as adjusted for the budg8 etary effects of any provision of law enacted during 

9 the period beginning on the date such baseline is 

10 issued and ending on the date of submission of such 

11 statement, for the purposes of enforcing section 302 of 

12 the Congressional Budget Act of 1974 (2 U.S.C. 633); 

13 (3) aggregate spending levels for fiscal year 2019 

14 in accordance with the allocations established under 

15 paragraphs (1) and (2), for the purpose of enforcing 

16 section 311 of the Congressional Budget Act of 1974 

17 (2 U.S.C. 642); 

18 (4) aggregate revenue levels for fiscal years 2019, 

19 2019 through 2023, and 2019 through 2028 consistent 

20 with the most recent baseline of the Congressional 

21 Budget Office, as adjusted for the budgetary effects of 

22 any provision of law enacted during the period begin23 ning on the date such baseline is issued and ending 

24 on the date of submission of such statement, for the 
142 

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1 purpose of enforcing section 311 of the Congressional 

2 Budget Act of 1974 (2 U.S.C. 642); and 

3 (5) levels of Social Security revenues and outlays 

4 for fiscal years 2019, 2019 through 2023, and 2019 

5 through 2028 consistent with the most recent baseline 

6 of the Congressional Budget Office, as adjusted for the 

7 budgetary effects of any provision of law enacted dur8 ing the period beginning on the date such baseline is 

9 issued and ending on the date of submission of such 

10 statement, for the purpose of enforcing sections 302 

11 and 311 of the Congressional Budget Act of 1974 (2 

12 U.S.C. 633 and 642). 

13 (c) ADDITIONAL MATTER.—The filing referred to in 

14 subsection (b) may also include for fiscal year 2019 the def15 icit-neutral reserve funds contained in title III of H. Con. 

16 Res. 71 (115th Congress) updated by one fiscal year. 

17 (d) EXPIRATION.—This section shall expire if a con18 current resolution on the budget for fiscal year 2019 is 

19 agreed to by the Senate and the House of Representatives 

20 pursuant to section 301 of the Congressional Budget Act 

21 of 1974 (2 U.S.C. 632). 
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1 SEC. 30104. AUTHORITY FOR FISCAL YEAR 2019 BUDGET 

2 RESOLUTION IN THE HOUSE OF REPRESENT3 ATIVES. 

4 (a) FISCAL YEAR 2019.—If a concurrent resolution on 

5 the budget for fiscal year 2019 has not been adopted by 

6 April 15, 2018, for the purpose of enforcing the Congres7 sional Budget Act of 1974, the allocations, aggregates, and 

8 levels provided for in subsection (b) shall apply in the 

9 House of Representatives after April 15, 2018, in the same 

10 manner as for a concurrent resolution on the budget for 

11 fiscal year 2019 with appropriate budgetary levels for fiscal 

12 year 2019 and for fiscal years 2020 through 2028. 

13 (b) COMMITTEE ALLOCATIONS, AGGREGATES, AND

14 LEVELS.—In the House of Representatives, the Chair of the 

15 Committee on the Budget shall submit a statement for pub16 lication in the Congressional Record after April 15, 2018, 

17 but not later than May 15, 2018, containing— 

18 (1) for the Committee on Appropriations, com19 mittee allocations for fiscal year 2019 for discre20 tionary budget authority at the total level set forth in 

21 section 251(c)(6) of the Balanced Budget and Emer22 gency Deficit Control Act of 1985, as amended by this 

23 Act, and the outlays flowing therefrom, and committee 

24 allocations for fiscal year 2019 for current law man25 datory budget authority and outlays, for the purpose 
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1 of enforcing section 302 of the Congressional Budget 

2 Act of 1974; 

3 (2) for all committees other than the Committee 

4 on Appropriations, committee allocations for fiscal 

5 year 2019 and for the period of fiscal years 2019 

6 through 2028 at the levels included in the most recent 

7 baseline of the Congressional Budget Office, as ad8 justed for the budgetary effects of any provision of law 

9 enacted during the period beginning on the date such 

10 baseline is issued and ending on the date of submis11 sion of such statement, for the purpose of enforcing 

12 section 302 of the Congressional Budget Act of 1974; 

13 and 

14 (3) aggregate spending levels for fiscal year 2019 

15 and aggregate revenue levels for fiscal year 2019 and 

16 for the period of fiscal years 2019 through 2028, at 

17 the levels included in the most recent baseline of the 

18 Congressional Budget Office, as adjusted for the budg19 etary effects of any provision of law enacted during 

20 the period beginning on the date such baseline is 

21 issued and ending on the date of submission of such 

22 statement, for the purpose of enforcing section 311 of 

23 the Congressional Budget Act of 1974. 

24 (c) ADDITIONAL MATTER.—The statement referred to 

25 in subsection (b) may also include for fiscal year 2019, the 
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1 matter contained in the provisions referred to in subsection 

2 (f)(1). 

3 (d) FISCAL YEAR 2019 ALLOCATION TO THE COM4 MITTEE ON APPROPRIATIONS.—If the statement referred to 

5 in subsection (b) is not filed by May 15, 2018, then the 

6 matter referred to in subsection (b)(1) shall be submitted 

7 by the Chair of the Committee on the Budget for publication 

8 in the Congressional Record on the next day that the House 

9 of Representatives is in session. 

10 (e) ADJUSTMENTS.—The chair of the Committee on the 

11 Budget of the House of Representatives may adjust the levels 

12 included in the statement referred to in subsection (b) to 

13 reflect the budgetary effects of any legislation enacted dur14 ing the 115th Congress that reduces the deficit or as other15 wise necessary. 

16 (f) APPLICATION.—Upon submission of the statement 

17 referred to in subsection (b)— 

18 (1) all references in sections 5101 through 5112, 

19 sections 5201 through 5205, section 5301, and section 

20 5401 of House Concurrent Resolution 71 (115th Con21 gress) to a fiscal year shall be considered for all pur22 poses in the House to be references to the succeeding 

23 fiscal year; and 

24 (2) all references in the provisions referred to in 

25 paragraph (1) to allocations, aggregates, or other ap-
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1 propriate levels in ‘‘this concurrent resolution’’, ‘‘the 

2 most recently agreed to concurrent resolution on the 

3 budget’’, or ‘‘this resolution’’ shall be considered for 

4 all purposes in the House to be references to the allo5 cations, aggregates, or other appropriate levels con6 tained in the statement referred to in subsection (b), 

7 as adjusted. 

8 (g) EXPIRATION.—Subsections (a) through (f) shall no 

9 longer apply if a concurrent resolution on the budget for 

10 fiscal year 2019 is agreed to by the Senate and House of 

11 Representatives. 

12 SEC. 30105. EXERCISE OF RULEMAKING POWERS. 

13 Sections 30103 and 30104 are enacted by the Con14 gress— 

15 (1) as an exercise of the rulemaking power of the 

16 Senate and the House of Representatives, respectively, 

17 and as such they shall be considered as part of the 

18 rules of each House, respectively, or of that House to 

19 which they specifically apply, and such rules shall su20 persede other rules only to the extent that they are in21 consistent therewith; and 

22 (2) with full recognition of the constitutional 

23 right of either House to change such rules (so far as 

24 relating to such House) at any time, in the same 
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1 manner, and to the same extent as in the case of any 

2 other rule of such House. 

3 TITLE II—OFFSETS 

4 SEC. 30201. CUSTOMS USER FEES. 

5 (a) IN GENERAL.—Section 13031(j)(3) of the Consoli6 dated Omnibus Budget Reconciliation Act of 1985 (19 

7 U.S.C. 58c(j)(3)) is amended— 

8 (1) in subparagraph (A), by striking ‘‘January 

9 14, 2026’’ and inserting ‘‘February 24, 2027’’; and 

10 (2) in subparagraph (B)(i), by striking ‘‘Sep11 tember 30, 2025’’ and inserting ‘‘September 30, 

12 2027’’. 

13 (b) RATE FOR MERCHANDISE PROCESSING FEES.— 

14 Section 503 of the United States–Korea Free Trade Agree15 ment Implementation Act (Public Law 112–41; 19 U.S.C. 

16 3805 note) is amended by striking ‘‘January 14, 2026’’ and 

17 inserting ‘‘February 24, 2027’’. 

18 SEC. 30202. AVIATION SECURITY SERVICE FEES. 

19 Paragraph (4) of section 44940(i) of title 49, United 

20 States Code, is amended by adding at the end the following 

21 new subparagraphs: 

22 ‘‘(M) $1,640,000,000 for fiscal year 2026. 

23 ‘‘(N) $1,680,000,000 for fiscal year 2027.’’. 
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1 SEC. 30203. EXTENSION OF CERTAIN IMMIGRATION FEES. 

2 (a) VISA WAIVER PROGRAM.—Section 

3 217(h)(3)(B)(iii) of the Immigration and Nationality Act 

4 (8 U.S.C. 1187(h)(3)(B)(iii)) is amended by striking ‘‘Sep5 tember 30, 2020’’ and inserting ‘‘September 30, 2027’’. 

6 (b) L–1 AND H–1B VISAS.—Section 411 of the Air 

7 Transportation Safety and System Stabilization Act (49 

8 U.S.C. 40101 note) is amended by striking ‘‘September 30, 

9 2025’’ each place it appears and inserting ‘‘September 30, 

10 2027’’. 

11 SEC. 30204. STRATEGIC PETROLEUM RESERVE DRAWDOWN. 

12 (a) DRAWDOWN AND SALE.— 

13 (1) IN GENERAL.—Notwithstanding section 161 

14 of the Energy Policy and Conservation Act (42 U.S.C. 

15 6241), except as provided in subsection (b), the Sec16 retary of Energy shall draw down and sell from the 

17 Strategic Petroleum Reserve— 

18 (A) 30,000,000 barrels of crude oil during 

19 the period of fiscal years 2022 through 2025; 

20 (B) 35,000,000 barrels of crude oil during 

21 fiscal year 2026; and 

22 (C) 35,000,000 barrels of crude oil during 

23 fiscal year 2027. 

24 (2) DEPOSIT OF AMOUNTS RECEIVED FROM

25 SALE.—Amounts received from a sale under para26 graph (1) shall be deposited in the general fund of the 
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1 Treasury during the fiscal year in which the sale oc2 curs. 

3 (b) EMERGENCY PROTECTION.—The Secretary of En4 ergy may not draw down and sell crude oil under this sec5 tion in quantities that would limit the authority to sell pe6 troleum products under subsection (h) of section 161 of the 

7 Energy Policy and Conservation Act (42 U.S.C. 6241) in 

8 the full quantity authorized by that subsection. 

9 (c) STRATEGIC PETROLEUM DRAWDOWN CONDITIONS

10 AND LIMITATIONS.— 

11 (1) CONDITIONS.—Section 161(h)(1) of the En12 ergy Policy and Conservation Act (42 U.S.C. 

13 6241(h)(1)) is amended in subparagraph (B) by strik14 ing ‘‘shortage; and’’ and all that follows through ‘‘Sec15 retary of’’ in subparagraph (C) and inserting the fol16 lowing: ‘‘shortage; 

17 ‘‘(C) the Secretary has found that action 

18 taken under this subsection will not impair the 

19 ability of the United States to carry out obliga20 tions of the United States under the inter21 national energy program; and 

22 ‘‘(D) the Secretary of’’. 

23 (2) LIMITATIONS.—Section 161(h)(2) of the En24 ergy Policy and Conservation Act (42 U.S.C. 
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1 6241(h)(2)) is amended by striking ‘‘450,000,000’’ 

2 each place it appears and inserting ‘‘350,000,000’’. 

3 SEC. 30205. ELIMINATION OF SURPLUS FUNDS OF FEDERAL 

4 RESERVE BANKS. 

5 Section 7(a)(3)(A) of the Federal Reserve Act (12 

6 U.S.C. 289(a)(3)(A)) is amended by striking 

7 ‘‘$10,000,000,000’’ and inserting ‘‘$7,500,000,000’’. 

8 SEC. 30206. REEMPLOYMENT SERVICES AND ELIGIBILITY 

9 ASSESSMENTS. 

10 (a) IN GENERAL.—Title III of the Social Security Act 

11 (42 U.S.C. 501 et seq.) is amended by adding at the end 

12 the following: 

13 ‘‘SEC. 306. GRANTS TO STATES FOR REEMPLOYMENT SERV14 ICES AND ELIGIBILITY ASSESSMENTS. 

15 ‘‘(a) IN GENERAL.—The Secretary of Labor (in this 

16 section referred to as the ‘Secretary’) shall award grants 

17 under this section for a fiscal year to eligible States to con18 duct a program of reemployment services and eligibility as19 sessments for individuals referred to reemployment services 

20 as described in section 303(j) for weeks in such fiscal year 

21 for which such individuals receive unemployment com22 pensation. 

23 ‘‘(b) PURPOSES.—The purposes of this section are to 

24 accomplish the following goals: 
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1 ‘‘(1) To improve employment outcomes of indi2 viduals that receive unemployment compensation and 

3 to reduce the average duration of receipt of such com4 pensation through employment. 

5 ‘‘(2) To strengthen program integrity and reduce 

6 improper payments of unemployment compensation 

7 by States through the detection and prevention of such 

8 payments to individuals who are not eligible for such 

9 compensation. 

10 ‘‘(3) To promote alignment with the broader vi11 sion of the Workforce Innovation and Opportunity 

12 Act (29 U.S.C. 3101 et seq.) of increased program in13 tegration and service delivery for job seekers, includ14 ing claimants for unemployment compensation. 

15 ‘‘(4) To establish reemployment services and eli16 gibility assessments as an entry point for individuals 

17 receiving unemployment compensation into other 

18 workforce system partner programs. 

19 ‘‘(c) EVIDENCE-BASED STANDARDS.— 

20 ‘‘(1) IN GENERAL.—In carrying out a State pro21 gram of reemployment services and eligibility assess22 ments using grant funds awarded to the State under 

23 this section, a State shall use such funds only for 

24 interventions demonstrated to reduce the number of 

25 weeks for which program participants receive unem-
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1 ployment compensation by improving employment 

2 outcomes for program participants. 

3 ‘‘(2) EXPANDING EVIDENCE-BASED INTERVEN4 TIONS.—In addition to the requirement imposed by 

5 paragraph (1), a State shall— 

6 ‘‘(A) for fiscal years 2023 and 2024, use no 

7 less than 25 percent of the grant funds awarded 

8 to the State under this section for interventions 

9 with a high or moderate causal evidence rating 

10 that show a demonstrated capacity to improve 

11 employment and earnings outcomes for program 

12 participants; 

13 ‘‘(B) for fiscal years 2025 and 2026, use no 

14 less than 40 percent of such grant funds for 

15 interventions described in subparagraph (A); 

16 and 

17 ‘‘(C) for fiscal years beginning after fiscal 

18 year 2026, use no less than 50 percent of such 

19 grant funds for interventions described in sub20 paragraph (A). 

21 ‘‘(d) EVALUATIONS.— 

22 ‘‘(1) REQUIRED EVALUATIONS.—Any interven23 tion without a high or moderate causal evidence rat24 ing used by a State in carrying out a State program 

25 of reemployment services and eligibility assessments 
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1 under this section shall be under evaluation at the 

2 time of use. 

3 ‘‘(2) FUNDING LIMITATION.—A State shall use 

4 not more than 10 percent of grant funds awarded to 

5 the State under this section to conduct or cause to be 

6 conducted evaluations of interventions used in car7 rying out a program under this section (including 

8 evaluations conducted pursuant to paragraph (1)). 

9 ‘‘(e) STATE PLAN.— 

10 ‘‘(1) IN GENERAL.—As a condition of eligibility 

11 to receive a grant under this section for a fiscal year, 

12 a State shall submit to the Secretary, at such time 

13 and in such manner as the Secretary may require, a 

14 State plan that outlines how the State intends to con15 duct a program of reemployment services and eligi16 bility assessments under this section, including— 

17 ‘‘(A) assurances that, and a description of 

18 how, the program will provide— 

19 ‘‘(i) proper notification to partici20 pating individuals of the program’s eligi21 bility conditions, requirements, and bene22 fits, including the issuance of warnings and 

23 simple, clear notifications to ensure that 

24 participating individuals are fully aware of 

25 the consequences of failing to adhere to such 
154 

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1 requirements, including policies related to 

2 non-attendance or non-fulfillment of work 

3 search requirements; and 

4 ‘‘(ii) reasonable scheduling accom5 modations to maximize participation for el6 igible individuals; 

7 ‘‘(B) assurances that, and a description of 

8 how, the program will conform with the purposes 

9 outlined in subsection (b) and satisfy the re10 quirement to use evidence-based standards under 

11 subsection (c), including— 

12 ‘‘(i) a description of the evidence-based 

13 interventions the State plans to use to speed 

14 reemployment; 

15 ‘‘(ii) an explanation of how such inter16 ventions are appropriate to the population 

17 served; and 

18 ‘‘(iii) if applicable, a description of the 

19 evaluation structure the State plans to use 

20 for interventions without at least a mod21 erate or high causal evidence rating, which 

22 may include national evaluations conducted 

23 by the Department of Labor or by other en24 tities; and 
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1 ‘‘(C) a description of any reemployment ac2 tivities and evaluations conducted in the prior 

3 fiscal year, and any data collected on— 

4 ‘‘(i) characteristics of program partici5 pants; 

6 ‘‘(ii) the number of weeks for which 

7 program participants receive unemployment 

8 compensation; and 

9 ‘‘(iii) employment and other outcomes 

10 for program participants consistent with 

11 State performance accountability measures 

12 provided by the State unemployment com13 pensation program and in section 116(b) of 

14 the Workforce Innovation and Opportunity 

15 Act (29 U.S.C. 3141(b)). 

16 ‘‘(2) APPROVAL.—The Secretary shall approve 

17 any State plan, that is timely submitted to the Sec18 retary, in such manner as the Secretary may require, 

19 that satisfies the conditions described in paragraph 

20 (1). 

21 ‘‘(3) DISAPPROVAL AND REVISION.—If the Sec22 retary determines that a State plan submitted pursu23 ant to this subsection fails to satisfy the conditions 

24 described in paragraph (1), the Secretary shall— 

25 ‘‘(A) disapprove such plan; 
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1 ‘‘(B) provide to the State, not later than 30 

2 days after the date of receipt of the State plan, 

3 a written notice of such disapproval that in4 cludes a description of any portion of the plan 

5 that was not approved and the reason for the 

6 disapproval of each such portion; and 

7 ‘‘(C) provide the State with an opportunity 

8 to correct any such failure and submit a revised 

9 State plan. 

10 ‘‘(f) ALLOCATION OF FUNDS.— 

11 ‘‘(1) BASE FUNDING.— 

12 ‘‘(A) IN GENERAL.—For each fiscal year 

13 after fiscal year 2020, the Secretary shall allo14 cate a percentage equal to the base funding per15 centage for such fiscal year of the funds made 

16 available for grants under this section among the 

17 States awarded such a grant for such fiscal year 

18 using a formula prescribed by the Secretary 

19 based on the rate of insured unemployment (as 

20 defined in section 203(e)(1) of the Federal-State 

21 Extended Unemployment Compensation Act of 

22 1970 (26 U.S.C. 3304 note)) in the State for a 

23 period to be determined by the Secretary. In de24 veloping such formula with respect to a State, 

25 the Secretary shall consider the importance of 
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1 avoiding sharp reductions in grant funding to a 

2 State over time. 

3 ‘‘(B) BASE FUNDING PERCENTAGE.—For 

4 purposes of subparagraph (A), the term ‘base 

5 funding percentage’ means— 

6 ‘‘(i) for fiscal years 2021 through 2026, 

7 89 percent; and 

8 ‘‘(ii) for fiscal years after 2026, 84 

9 percent. 

10 ‘‘(2) RESERVATION FOR OUTCOME PAYMENTS.— 

11 ‘‘(A) IN GENERAL.—Of the amounts made 

12 available for grants under this section for each 

13 fiscal year after 2020, the Secretary shall reserve 

14 a percentage equal to the outcome reservation 

15 percentage for such fiscal year for outcome pay16 ments to increase the amount otherwise awarded 

17 to a State under paragraph (1). Such outcome 

18 payments shall be paid to States conducting re19 employment services and eligibility assessments 

20 under this section that, during the previous fiscal 

21 year, met or exceeded the outcome goals provided 

22 in subsection (b)(1) related to reducing the aver23 age duration of receipt of unemployment com24 pensation by improving employment outcomes. 
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1 ‘‘(B) OUTCOME RESERVATION PERCENT2 AGE.—For purposes of subparagraph (A), the 

3 term ‘outcome reservation percentage’ means— 

4 ‘‘(i) for fiscal years 2021 through 2026, 

5 10 percent; and 

6 ‘‘(ii) for fiscal years after 2026, 15 

7 percent. 

8 ‘‘(3) RESERVATION FOR RESEARCH AND TECH9 NICAL ASSISTANCE.—Of the amounts made available 

10 for grants under this section for each fiscal year after 

11 2020, the Secretary may reserve not more than 1 per12 cent to conduct research and provide technical assist13 ance to States. 

14 ‘‘(4) CONSULTATION AND PUBLIC COMMENT.— 

15 Not later than September 30, 2019, the Secretary 

16 shall— 

17 ‘‘(A) consult with the States and seek public 

18 comment in developing the allocation formula 

19 under paragraph (1) and the criteria for car20 rying out the reservations under paragraph (2); 

21 and 

22 ‘‘(B) make publicly available the allocation 

23 formula and criteria developed pursuant to sub24 clause (A). 
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1 ‘‘(g) NOTIFICATION TO CONGRESS.—Not later than 90 

2 days prior to making any changes to the allocation formula 

3 or the criteria developed pursuant to subsection (f)(5)(A), 

4 the Secretary shall submit to Congress, including to the 

5 Committee on Ways and Means and the Committee on Ap6 propriations of the House of Representatives and the Com7 mittee on Finance and the Committee on Appropriations 

8 of the Senate, a notification of any such change. 

9 ‘‘(h) SUPPLEMENT NOT SUPPLANT.—Funds made 

10 available to carry out this section shall be used to supple11 ment the level of Federal, State, and local public funds that, 

12 in the absence of such availability, would be expended to 

13 provide reemployment services and eligibility assessments 

14 to individuals receiving unemployment compensation, and 

15 in no case to supplant such Federal, State, or local public 

16 funds. 

17 ‘‘(i) DEFINITIONS.—In this section: 

18 ‘‘(1) CAUSAL EVIDENCE RATING.—The terms 

19 ‘high causal evidence rating’ and ‘moderate causal 

20 evidence rating’ shall have the meaning given such 

21 terms by the Secretary of Labor. 

22 ‘‘(2) ELIGIBLE STATE.—The term ‘eligible State’ 

23 means a State that has in effect a State plan ap24 proved by the Secretary in accordance with subsection 

25 (e). 
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1 ‘‘(3) INTERVENTION.—The term ‘intervention’ 

2 means a service delivery strategy for the provision of 

3 State reemployment services and eligibility assess4 ment activities under this section. 

5 ‘‘(4) STATE.—The term ‘State’ has the meaning 

6 given the term in section 205 of the Federal-State Ex7 tended Unemployment Compensation Act of 1970 (26 

8 U.S.C. 3304 note). 

9 ‘‘(5) UNEMPLOYMENT COMPENSATION.—The term 

10 unemployment compensation means ‘regular com11 pensation’, ‘extended compensation’, and ‘additional 

12 compensation’ (as such terms are defined by section 

13 205 of the Federal-State Extended Unemployment 

14 Compensation Act of 1970 (26 U.S.C. 3304 note)).’’. 

15 (b) REPORT.—Not later than 3 years after the date 

16 of enactment of this Act, the Secretary of Labor shall submit 

17 to Congress a report to describe promising interventions 

18 used by States to provide reemployment assistance. 

19 (c) ADJUSTMENT TO DISCRETIONARY SPENDING LIM20 ITS.—Section 251(b)(2) of the Balanced Budget and Emer21 gency Deficit Control Act of 1985 (2 U.S.C. 901(b)(2)) is 

22 amended by adding at the end the following: 

23 ‘‘(E) REEMPLOYMENT SERVICES AND ELIGI24 BILITY ASSESSMENTS.— 
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1 ‘‘(i) IN GENERAL.—If a bill or joint 

2 resolution making appropriations for a fis3 cal year is enacted that specifies an amount 

4 for grants to States under section 306 of the 

5 Social Security Act, then the adjustment for 

6 that fiscal year shall be the additional new 

7 budget authority provided in that Act for 

8 such grants for that fiscal year, but shall 

9 not exceed— 

10 ‘‘(I) for fiscal year 2018, $0; 

11 ‘‘(II) for fiscal year 2019, 

12 $33,000,000; 

13 ‘‘(III) for fiscal year 2020, 

14 $58,000,000; and 

15 ‘‘(IV) for fiscal year 2021, 

16 $83,000,000. 

17 ‘‘(ii) DEFINITION.—As used in this 

18 subparagraph, the term ‘additional new 

19 budget authority’ means the amount pro20 vided for a fiscal year, in excess of 

21 $117,000,000, in an appropriation Act and 

22 specified to pay for grants to States under 

23 section 306 of the Social Security Act.’’. 
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1 (d) OTHER BUDGETARY ADJUSTMENTS.—Section 314 

2 of the Congressional Budget Act of 1974 (2 U.S.C. 645) is 

3 amended by adding at the end the following: 

4 ‘‘(g) ADJUSTMENT FOR REEMPLOYMENT SERVICES

5 AND ELIGIBILITY ASSESSMENTS.— 

6 ‘‘(1) IN GENERAL.— 

7 ‘‘(A) ADJUSTMENTS.—If the Committee on 

8 Appropriations of either House reports an ap9 propriation measure for any of fiscal years 2022 

10 through 2027 that provides budget authority for 

11 grants under section 306 of the Social Security 

12 Act, or if a conference committee submits a con13 ference report thereon, the chairman of the Com14 mittee on the Budget of the House of Representa15 tives or the Senate shall make the adjustments 

16 referred to in subparagraph (B) to reflect the ad17 ditional new budget authority provided for such 

18 grants in that measure or conference report and 

19 the outlays resulting therefrom, consistent with 

20 subparagraph (D). 

21 ‘‘(B) TYPES OF ADJUSTMENTS.—The adjust22 ments referred to in this subparagraph consist of 

23 adjustments to— 

24 ‘‘(i) the discretionary spending limits 

25 for that fiscal year as set forth in the most 
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1 recently adopted concurrent resolution on 

2 the budget; 

3 ‘‘(ii) the allocations to the Committees 

4 on Appropriations of the Senate and the 

5 House of Representatives for that fiscal year 

6 under section 302(a); and 

7 ‘‘(iii) the appropriate budget aggre8 gates for that fiscal year in the most re9 cently adopted concurrent resolution on the 

10 budget. 

11 ‘‘(C) ENFORCEMENT.—The adjusted discre12 tionary spending limits, allocations, and aggre13 gates under this paragraph shall be considered 

14 the appropriate limits, allocations, and aggre15 gates for purposes of congressional enforcement of 

16 this Act and concurrent budget resolutions under 

17 this Act. 

18 ‘‘(D) LIMITATION.—No adjustment may be 

19 made under this subsection in excess of— 

20 ‘‘(i) for fiscal year 2022, $133,000,000; 

21 ‘‘(ii) for fiscal year 2023, 

22 $258,000,000; 

23 ‘‘(iii) for fiscal year 2024, 

24 $433,000,000; 
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1 ‘‘(iv) for fiscal year 2025, 

2 $533,000,000; 

3 ‘‘(v) for fiscal year 2026, $608,000,000; 

4 and 

5 ‘‘(vi) for fiscal year 2027, 

6 $633,000,000. 

7 ‘‘(E) DEFINITION.—As used in this subsection, 

8 the term ‘additional new budget authority’ means the 

9 amount provided for a fiscal year, in excess of 

10 $117,000,000, in an appropriation measure or con11 ference report (as the case may be) and specified to 

12 pay for grants to States under section 306 of the So13 cial Security Act. 

14 ‘‘(2) REPORT ON 302(B) LEVEL.—Following any 

15 adjustment made under paragraph (1), the Commit16 tees on Appropriations of the Senate and the House 

17 of Representatives may report appropriately revised 

18 suballocations pursuant to section 302(b) to carry out 

19 this subsection.’’. 

20 TITLE III—TEMPORARY EXTEN21 SION OF PUBLIC DEBT LIMIT 

22 SEC. 30301. TEMPORARY EXTENSION OF PUBLIC DEBT 

23 LIMIT. 

24 (a) IN GENERAL.—Section 3101(b) of title 31, United 

25 States Code, shall not apply for the period beginning on 
165 

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1 the date of the enactment of this Act and ending on March 

2 1, 2019. 

3 (b) SPECIAL RULE RELATING TO OBLIGATIONS

4 ISSUED DURING EXTENSION PERIOD.—Effective on March 

5 2, 2019, the limitation in effect under section 3101(b) of 

6 title 31, United States Code, shall be increased to the extent 

7 that— 

8 (1) the face amount of obligations issued under 

9 chapter 31 of such title and the face amount of obliga10 tions whose principal and interest are guaranteed by 

11 the United States Government (except guaranteed ob12 ligations held by the Secretary of the Treasury) out13 standing on March 2, 2019, exceeds 

14 (2) the face amount of such obligations out15 standing on the date of the enactment of this Act. 

16 (c) RESTORING CONGRESSIONAL AUTHORITY OVER

17 THE NATIONAL DEBT.— 

18 (1) EXTENSION LIMITED TO NECESSARY OBLIGA19 TIONS.—An obligation shall not be taken into account 

20 under subsection (b)(1) unless the issuance of such ob21 ligation was necessary to fund a commitment in22 curred pursuant to law by the Federal Government 

23 that required payment before March 2, 2019. 

24 (2) PROHIBITION ON CREATION OF CASH RE25 SERVE DURING EXTENSION PERIOD.—The Secretary 
166 

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1 of the Treasury shall not issue obligations during the 

2 period specified in subsection (a) for the purpose of 

3 increasing the cash balance above normal operating 

4 balances in anticipation of the expiration of such pe5 riod. 

6 TITLE IV—JOINT SELECT 

7 COMMITTEES 

8 Subtitle A—Joint Select Committee 

9 on Solvency of Multiemployer 

10 Pension Plans 

11 SEC. 30421. DEFINITIONS. 

12 In this subtitle— 

13 (1) the term ‘‘joint committee’’ means the Joint 

14 Select Committee on Solvency of Multiemployer Pen15 sion Plans established under section 30422(a); and 

16 (2) the term ‘‘joint committee bill’’ means a bill 

17 consisting of the proposed legislative language of the 

18 joint committee recommended in accordance with sec19 tion 30422(b)(2)(B)(ii) and introduced under section 

20 30424(a). 

21 SEC. 30422. ESTABLISHMENT OF JOINT SELECT COM22 MITTEE. 

23 (a) ESTABLISHMENT OF JOINT SELECT COM24 MITTEE.—There is established a joint select committee of 
167 

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1 Congress to be known as the ‘‘Joint Select Committee on 

2 Solvency of Multiemployer Pension Plans’’. 

3 (b) IMPLEMENTATION.— 

4 (1) GOAL.—The goal of the joint committee is to 

5 improve the solvency of multiemployer pension plans 

6 and the Pension Benefit Guaranty Corporation. 

7 (2) DUTIES.— 

8 (A) IN GENERAL.—The joint committee 

9 shall provide recommendations and legislative 

10 language that will significantly improve the sol11 vency of multiemployer pension plans and the 

12 Pension Benefit Guaranty Corporation. 

13 (B) REPORT, RECOMMENDATIONS, AND LEG14 ISLATIVE LANGUAGE.— 

15 (i) IN GENERAL.—Not later than No16 vember 30, 2018, the joint committee shall 

17 vote on— 

18 (I) a report that contains a de19 tailed statement of the findings, conclu20 sions, and recommendations of the 

21 joint committee; and 

22 (II) proposed legislative language 

23 to carry out the recommendations de24 scribed in subclause (I). 
168 

† HR 1892 EAS2 

1 (ii) APPROVAL OF REPORT AND LEGIS2 LATIVE LANGUAGE.— 

3 (I) IN GENERAL.—The report of 

4 the joint committee and the proposed 

5 legislative language described in clause 

6 (i) shall only be approved upon receiv7 ing the votes of— 

8 (aa) a majority of joint com9 mittee members appointed by the 

10 Speaker of the House of Rep11 resentatives and the Majority 

12 Leader of the Senate; and 

13 (bb) a majority of joint com14 mittee members appointed by the 

15 Minority Leader of the House of 

16 Representatives and the Minority 

17 Leader of the Senate. 

18 (II) AVAILABILITY.—The text of 

19 any report and proposed legislative 

20 language shall be publicly available in 

21 electronic form at least 24 hours prior 

22 to its consideration. 

23 (iii) ADDITIONAL VIEWS.—A member 

24 of the joint committee who gives notice of an 

25 intention to file supplemental, minority, or 
169 

† HR 1892 EAS2 

1 additional views at the time of the final 

2 joint committee vote on the approval of the 

3 report and legislative language under clause 

4 (ii) shall be entitled to 2 calendar days 

5 after the day of such notice in which to file 

6 such views in writing with the co-chairs. 

7 Such views shall then be included in the 

8 joint committee report and printed in the 

9 same volume, or part thereof, and their in10 clusion shall be noted on the cover of the re11 port. In the absence of timely notice, the 

12 joint committee report may be printed and 

13 transmitted immediately without such 

14 views. 

15 (iv) TRANSMISSION OF REPORT AND

16 LEGISLATIVE LANGUAGE.—If the report and 

17 legislative language are approved by the 

18 joint committee pursuant to clause (ii), the 

19 joint committee shall submit the joint com20 mittee report and legislative language de21 scribed in clause (i) to the President, the 

22 Vice President, the Speaker of the House of 

23 Representatives, and the majority and mi24 nority leaders of each House of Congress not 
170 

† HR 1892 EAS2 

1 later than 15 calendar days after such ap2 proval. 

3 (v) REPORT AND LEGISLATIVE LAN4 GUAGE TO BE MADE PUBLIC.—Upon the ap5 proval of the joint committee report and leg6 islative language pursuant to clause (ii), the 

7 joint committee shall promptly make the 

8 full report and legislative language, and a 

9 record of any vote, available to the public. 

10 (3) MEMBERSHIP.— 

11 (A) IN GENERAL.—The joint committee 

12 shall be composed of 16 members appointed pur13 suant to subparagraph (B). 

14 (B) APPOINTMENT.—Members of the joint 

15 committee shall be appointed as follows: 

16 (i) The Speaker of the House of Rep17 resentatives shall appoint 4 members from 

18 among Members of the House of Representa19 tives. 

20 (ii) The Minority Leader of the House 

21 of Representatives shall appoint 4 members 

22 from among Members of the House of Rep23 resentatives. 
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† HR 1892 EAS2 

1 (iii) The Majority Leader of the Senate 

2 shall appoint 4 members from among Mem3 bers of the Senate. 

4 (iv) The Minority Leader of the Senate 

5 shall appoint 4 members from among Mem6 bers of the Senate. 

7 (C) CO-CHAIRS.—Two of the appointed 

8 members of the joint committee will serve as co9 chairs. The Speaker of the House of Representa10 tives and the Majority Leader of the Senate shall 

11 jointly appoint one co-chair, and the Minority 

12 Leader of the House of Representatives and the 

13 Minority Leader of the Senate shall jointly ap14 point the second co-chair. The co-chairs shall be 

15 appointed not later than 14 calendar days after 

16 the date of enactment of this Act. 

17 (D) DATE.—Members of the joint committee 

18 shall be appointed not later than 14 calendar 

19 days after the date of enactment of this Act. 

20 (E) PERIOD OF APPOINTMENT.—Members 

21 shall be appointed for the life of the joint com22 mittee. Any vacancy in the joint committee shall 

23 not affect its powers, but shall be filled not later 

24 than 14 calendar days after the date on which 

25 the vacancy occurs, in the same manner as the 
172 

† HR 1892 EAS2 

1 original appointment was made. If a member of 

2 the joint committee ceases to be a Member of the 

3 House of Representatives or the Senate, as the 

4 case may be, the member is no longer a member 

5 of the joint committee and a vacancy shall exist. 

6 (4) ADMINISTRATION.— 

7 (A) IN GENERAL.—To enable the joint com8 mittee to exercise its powers, functions, and du9 ties under this subtitle, there are authorized to be 

10 disbursed by the Senate the actual and necessary 

11 expenses of the joint committee approved by the 

12 co-chairs, subject to the rules and regulations of 

13 the Senate. 

14 (B) EXPENSES.—To enable the joint com15 mittee to exercise its powers, functions, and du16 ties under this subtitle, there are authorized to be 

17 appropriated for each fiscal year such sums as 

18 may be necessary, to be disbursed by the Sec19 retary of the Senate on vouchers signed by the 

20 co-chairs. 

21 (C) QUORUM.—Nine members of the joint 

22 committee shall constitute a quorum for purposes 

23 of voting and meeting, and 5 members of the 

24 joint committee shall constitute a quorum for 

25 holding hearings. 
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1 (D) VOTING.—No proxy voting shall be al2 lowed on behalf of the members of the joint com3 mittee. 

4 (E) MEETINGS.— 

5 (i) INITIAL MEETING.—Not later than 

6 30 calendar days after the date of enact7 ment of this Act, the joint committee shall 

8 hold its first meeting. 

9 (ii) AGENDA.—The co-chairs of the 

10 joint committee shall provide an agenda to 

11 the joint committee members not less than 

12 48 hours in advance of any meeting. 

13 (F) HEARINGS.— 

14 (i) IN GENERAL.—The joint committee 

15 may, for the purpose of carrying out this 

16 section, hold such hearings, sit and act at 

17 such times and places, require attendance of 

18 witnesses and production of books, papers, 

19 and documents, take such testimony, receive 

20 such evidence, and administer such oaths as 

21 the joint committee considers advisable. 

22 (ii) HEARING PROCEDURES AND RE23 SPONSIBILITIES OF CO-CHAIRS.— 

24 (I) ANNOUNCEMENT.—The co25 chairs of the joint committee shall 
174 

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1 make a public announcement of the 

2 date, place, time, and subject matter of 

3 any hearing to be conducted, not less 

4 than 7 days in advance of such hear5 ing, unless the co-chairs determine that 

6 there is good cause to begin such hear7 ing at an earlier date. 

8 (II) EQUAL REPRESENTATION OF

9 WITNESSES.—Each co-chair shall be 

10 entitled to select an equal number of 

11 witnesses for each hearing held by the 

12 joint committee. 

13 (III) WRITTEN STATEMENT.—A 

14 witness appearing before the joint com15 mittee shall file a written statement of 

16 proposed testimony at least 2 calendar 

17 days before the appearance of the wit18 ness, unless the requirement is waived 

19 by the co-chairs, following their deter20 mination that there is good cause for 

21 failure to comply with such require22 ment. 

23 (G) MINIMUM NUMBER OF PUBLIC MEET24 INGS AND HEARINGS.—The joint committee shall 

25 hold— 
175 

† HR 1892 EAS2 

1 (i) not less than a total of 5 public 

2 meetings or public hearings; and 

3 (ii) not less than 3 public hearings, 

4 which may include field hearings. 

5 (H) TECHNICAL ASSISTANCE.—Upon writ6 ten request of the co-chairs, a Federal agency, in7 cluding legislative branch agencies, shall provide 

8 technical assistance to the joint committee in 

9 order for the joint committee to carry out its du10 ties. 

11 (I) STAFFING.— 

12 (i) DETAILS.—Employees of the legis13 lative branch may be detailed to the joint 

14 committee on a nonreimbursable basis. 

15 (ii) STAFF DIRECTOR.—The co-chairs, 

16 acting jointly, may designate one such em17 ployee as staff director of the joint com18 mittee. 

19 (c) ETHICAL STANDARDS.—Members on the joint com20 mittee who serve in the House of Representatives shall be 

21 governed by the ethics rules and requirements of the House. 

22 Members of the Senate who serve on the joint committee 

23 shall comply with the ethics rules of the Senate. 

24 (d) TERMINATION.—The joint committee shall termi25 nate on December 31, 2018 or 30 days after submission of 
176 

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1 its report and legislative recommendations pursuant to this 

2 section whichever occurs first. 

3 SEC. 30423. FUNDING. 

4 To enable the joint committee to exercise its powers, 

5 functions, and duties under this subtitle, there are author6 ized to be paid not more than $500,000 from the appropria7 tions account for ‘‘Expenses of Inquiries and Investiga8 tions’’ of the Senate, such sums to be disbursed by the Sec9 retary of the Senate, in accordance with Senate rules and 

10 procedures, upon vouchers signed by the co-chairs. The 

11 funds authorized under this section shall be available dur12 ing the period beginning on the date of enactment of this 

13 Act and ending on January 2, 2019. 

14 SEC. 30424. CONSIDERATION OF JOINT COMMITTEE BILL IN 

15 THE SENATE. 

16 (a) INTRODUCTION.—Upon receipt of proposed legisla17 tive language approved in accordance with section 

18 30422(b)(2)(B)(ii), the language shall be introduced in the 

19 Senate (by request) on the next day on which the Senate 

20 is in session by the Majority Leader of the Senate or by 

21 a Member of the Senate designated by the Majority Leader 

22 of the Senate. 

23 (b) COMMITTEE CONSIDERATION.—A joint committee 

24 bill introduced in the Senate under subsection (a) shall be 

25 jointly referred to the Committee on Finance and the Com-
177 

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1 mittee on Health, Education, Labor, and Pensions, which 

2 committees shall report the bill without any revision and 

3 with a favorable recommendation, an unfavorable rec4 ommendation, or without recommendation, no later than 

5 7 session days after introduction of the bill. If either com6 mittee fails to report the bill within that period, that com7 mittee shall be automatically discharged from consideration 

8 of the bill, and the bill shall be placed on the appropriate 

9 calendar. 

10 (c) MOTION TO PROCEED TO CONSIDERATION.— 

11 (1) IN GENERAL.—Notwithstanding rule XXII of 

12 the Standing Rules of the Senate, it is in order, not 

13 later than 2 days of session after the date on which 

14 a joint committee bill is reported or discharged from 

15 the Committee on Finance and the Committee on 

16 Health, Education, Labor, and Pensions, for the Ma17 jority Leader of the Senate or the Majority Leader’s 

18 designee to move to proceed to the consideration of the 

19 joint committee bill. It shall also be in order for any 

20 Member of the Senate to move to proceed to the con21 sideration of the joint committee bill at any time 

22 after the conclusion of such 2-day period. 

23 (2) CONSIDERATION OF MOTION.—Consideration 

24 of the motion to proceed to the consideration of the 

25 joint committee bill and all debatable motions and 
178 

† HR 1892 EAS2 

1 appeals in connection therewith shall not exceed 10 

2 hours, which shall be divided equally between the Ma3 jority and Minority Leaders or their designees. A mo4 tion to further limit debate is in order, shall require 

5 an affirmative vote of three-fifths of Members duly 

6 chosen and sworn, and is not debatable. 

7 (3) VOTE THRESHOLD.—The motion to proceed 

8 to the consideration of the joint committee bill shall 

9 only be agreed to upon an affirmative vote of three10 fifths of Members duly chosen and sworn. 

11 (4) LIMITATIONS.—The motion is not subject to 

12 a motion to postpone. All points of order against the 

13 motion to proceed to the joint committee bill are 

14 waived. A motion to reconsider the vote by which the 

15 motion is agreed to or disagreed to shall not be in 

16 order. 

17 (5) DEADLINE.—Not later than the last day of 

18 the 115th Congress, the Senate shall vote on a motion 

19 to proceed to the joint committee bill. 

20 (6) COMPANION MEASURES.—For purposes of 

21 this subsection, the term ‘‘joint committee bill’’ in22 cludes a bill of the House of Representatives that is 

23 a companion measure to the joint committee bill in24 troduced in the Senate. 
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† HR 1892 EAS2 

1 (d) RULES OF SENATE.—This section is enacted by 

2 Congress— 

3 (1) as an exercise of the rulemaking power of the 

4 Senate, and as such is deemed a part of the rules of 

5 the Senate, but applicable only with respect to the 

6 procedure to be followed in the Senate in the case of 

7 a joint committee bill, and supersede other rules only 

8 to the extent that they are inconsistent with such 

9 rules; and 

10 (2) with full recognition of the constitutional 

11 right of the Senate to change the rules (so far as relat12 ing to the procedure of the Senate) at any time, in 

13 the same manner, and to the same extent as in the 

14 case of any other rule of the Senate. 

15 Subtitle B—Joint Select Committee 

16 on Budget and Appropriations 

17 Process Reform 

18 SEC. 30441. DEFINITIONS. 

19 In this subtitle— 

20 (1) the term ‘‘joint committee’’ means the Joint 

21 Select Committee on Budget and Appropriations 

22 Process Reform established under section 30442(a); 

23 and 

24 (2) the term ‘‘joint committee bill’’ means a bill 

25 consisting of the proposed legislative language of the 
180 

† HR 1892 EAS2 

1 joint committee recommended in accordance with sec2 tion 30442(b)(2)(B)(ii) and introduced under section 

3 30444(a). 

4 SEC. 30442. ESTABLISHMENT OF JOINT SELECT COM5 MITTEE. 

6 (a) ESTABLISHMENT OF JOINT SELECT COM7 MITTEE.—There is established a joint select committee of 

8 Congress to be known as the ‘‘Joint Select Committee on 

9 Budget and Appropriations Process Reform’’. 

10 (b) IMPLEMENTATION.— 

11 (1) GOAL.—The goal of the joint committee is to 

12 reform the budget and appropriations process. 

13 (2) DUTIES.— 

14 (A) IN GENERAL.—The joint committee 

15 shall provide recommendations and legislative 

16 language that will significantly reform the budg17 et and appropriations process. 

18 (B) REPORT, RECOMMENDATIONS, AND LEG19 ISLATIVE LANGUAGE.— 

20 (i) IN GENERAL.—Not later than No21 vember 30, 2018, the joint committee shall 

22 vote on— 

23 (I) a report that contains a de24 tailed statement of the findings, conclu-
181 

† HR 1892 EAS2 

1 sions, and recommendations of the 

2 joint committee; and 

3 (II) proposed legislative language 

4 to carry out the recommendations de5 scribed in subclause (I). 

6 (ii) APPROVAL OF REPORT AND LEGIS7 LATIVE LANGUAGE.— 

8 (I) IN GENERAL.—The report of 

9 the joint committee and the proposed 

10 legislative language described in clause 

11 (i) shall only be approved upon receiv12 ing the votes of— 

13 (aa) a majority of joint com14 mittee members appointed by the 

15 Speaker of the House of Rep16 resentatives and the Majority 

17 Leader of the Senate; and 

18 (bb) a majority of joint com19 mittee members appointed by the 

20 Minority Leader of the House of 

21 Representatives and the Minority 

22 Leader of the Senate. 

23 (II) AVAILABILITY.—The text of 

24 any report and proposed legislative 

25 language shall be publicly available in 
182 

† HR 1892 EAS2 

1 electronic form at least 24 hours prior 

2 to its consideration. 

3 (iii) ADDITIONAL VIEWS.—A member 

4 of the joint committee who gives notice of an 

5 intention to file supplemental, minority, or 

6 additional views at the time of the final 

7 joint committee vote on the approval of the 

8 report and legislative language under clause 

9 (ii) shall be entitled to 2 calendar days 

10 after the day of such notice in which to file 

11 such views in writing with the co-chairs. 

12 Such views shall then be included in the 

13 joint committee report and printed in the 

14 same volume, or part thereof, and their in15 clusion shall be noted on the cover of the re16 port. In the absence of timely notice, the 

17 joint committee report may be printed and 

18 transmitted immediately without such 

19 views. 

20 (iv) TRANSMISSION OF REPORT AND

21 LEGISLATIVE LANGUAGE.—If the report and 

22 legislative language are approved by the 

23 joint committee pursuant to clause (ii), the 

24 joint committee shall submit the joint com25 mittee report and legislative language de-
183 

† HR 1892 EAS2 

1 scribed in clause (i) to the President, the 

2 Vice President, the Speaker of the House of 

3 Representatives, and the majority and mi4 nority leaders of each House of Congress not 

5 later than 15 calendar days after such ap6 proval. 

7 (v) REPORT AND LEGISLATIVE LAN8 GUAGE TO BE MADE PUBLIC.—Upon the ap9 proval of the joint committee report and leg10 islative language pursuant to clause (ii), the 

11 joint committee shall promptly make the 

12 full report and legislative language, and a 

13 record of any vote, available to the public. 

14 (3) MEMBERSHIP.— 

15 (A) IN GENERAL.—The joint committee 

16 shall be composed of 16 members appointed pur17 suant to subparagraph (B). 

18 (B) APPOINTMENT.—Members of the joint 

19 committee shall be appointed as follows: 

20 (i) The Speaker of the House of Rep21 resentatives shall appoint 4 members from 

22 among Members of the House of Representa23 tives. 

24 (ii) The Minority Leader of the House 

25 of Representatives shall appoint 4 members 
184 

† HR 1892 EAS2 

1 from among Members of the House of Rep2 resentatives. 

3 (iii) The Majority Leader of the Senate 

4 shall appoint 4 members from among Mem5 bers of the Senate. 

6 (iv) The Minority Leader of the Senate 

7 shall appoint 4 members from among Mem8 bers of the Senate. 

9 (C) CO-CHAIRS.—Two of the appointed 

10 members of the joint committee will serve as co11 chairs. The Speaker of the House of Representa12 tives and the Majority Leader of the Senate shall 

13 jointly appoint one co-chair, and the Minority 

14 Leader of the House of Representatives and the 

15 Minority Leader of the Senate shall jointly ap16 point the second co-chair. The co-chairs shall be 

17 appointed not later than 14 calendar days after 

18 the date of enactment of this Act. 

19 (D) DATE.—Members of the joint committee 

20 shall be appointed not later than 14 calendar 

21 days after the date of enactment of this Act. 

22 (E) PERIOD OF APPOINTMENT.—Members 

23 shall be appointed for the life of the joint com24 mittee. Any vacancy in the joint committee shall 

25 not affect its powers, but shall be filled not later 
185 

† HR 1892 EAS2 

1 than 14 calendar days after the date on which 

2 the vacancy occurs, in the same manner as the 

3 original appointment was made. If a member of 

4 the joint committee ceases to be a Member of the 

5 House of Representatives or the Senate, as the 

6 case may be, the member is no longer a member 

7 of the joint committee and a vacancy shall exist. 

8 (4) ADMINISTRATION.— 

9 (A) IN GENERAL.—To enable the joint com10 mittee to exercise its powers, functions, and du11 ties under this subtitle, there are authorized to be 

12 disbursed by the Senate the actual and necessary 

13 expenses of the joint committee approved by the 

14 co-chairs, subject to the rules and regulations of 

15 the Senate. 

16 (B) EXPENSES.—To enable the joint com17 mittee to exercise its powers, functions, and du18 ties under this subtitle, there are authorized to be 

19 appropriated for each fiscal year such sums as 

20 may be necessary, to be disbursed by the Sec21 retary of the Senate on vouchers signed by the 

22 co-chairs. 

23 (C) QUORUM.—Nine members of the joint 

24 committee shall constitute a quorum for purposes 

25 of voting and meeting, and 5 members of the 
186 

† HR 1892 EAS2 

1 joint committee shall constitute a quorum for 

2 holding hearings. 

3 (D) VOTING.—No proxy voting shall be al4 lowed on behalf of the members of the joint com5 mittee. 

6 (E) MEETINGS.— 

7 (i) INITIAL MEETING.—Not later than 

8 30 calendar days after the date of enact9 ment of this Act, the joint committee shall 

10 hold its first meeting. 

11 (ii) AGENDA.—The co-chairs of the 

12 joint committee shall provide an agenda to 

13 the joint committee members not less than 

14 48 hours in advance of any meeting. 

15 (F) HEARINGS.— 

16 (i) IN GENERAL.—The joint committee 

17 may, for the purpose of carrying out this 

18 section, hold such hearings, sit and act at 

19 such times and places, require attendance of 

20 witnesses and production of books, papers, 

21 and documents, take such testimony, receive 

22 such evidence, and administer such oaths as 

23 the joint committee considers advisable. 

24 (ii) HEARING PROCEDURES AND RE25 SPONSIBILITIES OF CO-CHAIRS.— 
187 

† HR 1892 EAS2 

1 (I) ANNOUNCEMENT.—The co2 chairs of the joint committee shall 

3 make a public announcement of the 

4 date, place, time, and subject matter of 

5 any hearing to be conducted, not less 

6 than 7 days in advance of such hear7 ing, unless the co-chairs determine that 

8 there is good cause to begin such hear9 ing at an earlier date. 

10 (II) EQUAL REPRESENTATION OF

11 WITNESSES.—Each co-chair shall be 

12 entitled to select an equal number of 

13 witnesses for each hearing held by the 

14 joint committee. 

15 (III) WRITTEN STATEMENT.—A 

16 witness appearing before the joint com17 mittee shall file a written statement of 

18 proposed testimony at least 2 calendar 

19 days before the appearance of the wit20 ness, unless the requirement is waived 

21 by the co-chairs, following their deter22 mination that there is good cause for 

23 failure to comply with such require24 ment. 
188 

† HR 1892 EAS2 

1 (G) MINIMUM NUMBER OF PUBLIC MEET2 INGS AND HEARINGS.—The joint committee shall 

3 hold— 

4 (i) not less than a total of 5 public 

5 meetings or public hearings; and 

6 (ii) not less than 3 public hearings, 

7 which may include field hearings. 

8 (H) TECHNICAL ASSISTANCE.—Upon writ9 ten request of the co-chairs, a Federal agency, in10 cluding legislative branch agencies, shall provide 

11 technical assistance to the joint committee in 

12 order for the joint committee to carry out its du13 ties. 

14 (I) STAFFING.— 

15 (i) DETAILS.—Employees of the legis16 lative branch may be detailed to the joint 

17 committee on a nonreimbursable basis. 

18 (ii) STAFF DIRECTOR.—The co-chairs, 

19 acting jointly, may designate one such em20 ployee as staff director of the joint com21 mittee. 

22 (c) ETHICAL STANDARDS.—Members on the joint com23 mittee who serve in the House of Representatives shall be 

24 governed by the ethics rules and requirements of the House. 
189 

† HR 1892 EAS2 

1 Members of the Senate who serve on the joint committee 

2 shall comply with the ethics rules of the Senate. 

3 (d) TERMINATION.—The joint committee shall termi4 nate on December 31, 2018 or 30 days after submission of 

5 its report and legislative recommendations pursuant to this 

6 section whichever occurs first. 

7 SEC. 30443. FUNDING. 

8 To enable the joint committee to exercise its powers, 

9 functions, and duties under this subtitle, there are author10 ized to be paid not more than $500,000 from the appropria11 tions account for ‘‘Expenses of Inquiries and Investiga12 tions’’ of the Senate, such sums to be disbursed by the Sec13 retary of the Senate, in accordance with Senate rules and 

14 procedures, upon vouchers signed by the co-chairs. The 

15 funds authorized under this section shall be available dur16 ing the period beginning on the date of enactment of this 

17 Act and ending on January 2, 2019. 

18 SEC. 30444. CONSIDERATION OF JOINT COMMITTEE BILL IN 

19 THE SENATE. 

20 (a) INTRODUCTION.—Upon receipt of proposed legisla21 tive language approved in accordance with section 

22 30442(b)(2)(B)(ii), the language shall be introduced in the 

23 Senate (by request) on the next day on which the Senate 

24 is in session by the Majority Leader of the Senate or by 
190 

† HR 1892 EAS2 

1 a Member of the Senate designated by the Majority Leader 

2 of the Senate. 

3 (b) COMMITTEE CONSIDERATION.—A joint committee 

4 bill introduced in the Senate under subsection (a) shall be 

5 referred to the Committee on the Budget, which shall report 

6 the bill without any revision and with a favorable rec7 ommendation, an unfavorable recommendation, or without 

8 recommendation, no later than 7 session days after intro9 duction of the bill. If the Committee on the Budget fails 

10 to report the bill within that period, the committee shall 

11 be automatically discharged from consideration of the bill, 

12 and the bill shall be placed on the appropriate calendar. 

13 (c) MOTION TO PROCEED TO CONSIDERATION.— 

14 (1) IN GENERAL.—Notwithstanding rule XXII of 

15 the Standing Rules of the Senate, it is in order, not 

16 later than 2 days of session after the date on which 

17 a joint committee bill is reported or discharged from 

18 the Committee on the Budget, for the Majority Leader 

19 of the Senate or the Majority Leader’s designee to 

20 move to proceed to the consideration of the joint com21 mittee bill. It shall also be in order for any Member 

22 of the Senate to move to proceed to the consideration 

23 of the joint committee bill at any time after the con24 clusion of such 2-day period. 
191 

† HR 1892 EAS2 

1 (2) CONSIDERATION OF MOTION.—Consideration 

2 of the motion to proceed to the consideration of the 

3 joint committee bill and all debatable motions and 

4 appeals in connection therewith shall not exceed 10 

5 hours, which shall be divided equally between the Ma6 jority and Minority Leaders or their designees. A mo7 tion to further limit debate is in order, shall require 

8 an affirmative vote of three-fifths of Members duly 

9 chosen and sworn, and is not debatable. 

10 (3) VOTE THRESHOLD.—The motion to proceed 

11 to the consideration of the joint committee bill shall 

12 only be agreed to upon an affirmative vote of three13 fifths of Members duly chosen and sworn. 

14 (4) LIMITATIONS.—The motion is not subject to 

15 a motion to postpone. All points of order against the 

16 motion to proceed to the joint committee bill are 

17 waived. A motion to reconsider the vote by which the 

18 motion is agreed to or disagreed to shall not be in 

19 order. 

20 (5) DEADLINE.—Not later than the last day of 

21 the 115th Congress, the Senate shall vote on a motion 

22 to proceed to the joint committee bill. 

23 (d) RULES OF SENATE.—This section is enacted by 

24 Congress— 
192 

† HR 1892 EAS2 

1 (1) as an exercise of the rulemaking power of the 

2 Senate, and as such is deemed a part of the rules of 

3 the Senate, but applicable only with respect to the 

4 procedure to be followed in the Senate in the case of 

5 a joint committee bill, and supersede other rules only 

6 to the extent that they are inconsistent with such 

7 rules; and 

8 (2) with full recognition of the constitutional 

9 right of the Senate to change the rules (so far as relat10 ing to the procedure of the Senate) at any time, in 

11 the same manner, and to the same extent as in the 

12 case of any other rule of the Senate. 

13 DIVISION D—REVENUE 

14 MEASURES 

15 SEC. 40001. TABLE OF CONTENTS. 

16 The table of contents for this division is as follows: 

DIVISION D—REVENUE MEASURES 

Sec. 40001. Table of contents. 

TITLE I—EXTENSION OF EXPIRING PROVISIONS 

Sec. 40101. Amendment of Internal Revenue Code of 1986. 

Subtitle A—Tax Relief for Families and Individuals 

Sec. 40201. Extension of exclusion from gross income of discharge of qualified 

principal residence indebtedness. 

Sec. 40202. Extension of mortgage insurance premiums treated as qualified residence interest. 

Sec. 40203. Extension of above-the-line deduction for qualified tuition and related 

expenses. 

Subtitle B—Incentives for Growth, Jobs, Investment, and Innovation 

Sec. 40301. Extension of Indian employment tax credit. 

Sec. 40302. Extension of railroad track maintenance credit. 

Sec. 40303. Extension of mine rescue team training credit. 
193 

† HR 1892 EAS2 

Sec. 40304. Extension of classification of certain race horses as 3-year property. 

Sec. 40305. Extension of 7-year recovery period for motorsports entertainment 

complexes. 

Sec. 40306. Extension of accelerated depreciation for business property on an Indian reservation. 

Sec. 40307. Extension of election to expense mine safety equipment. 

Sec. 40308. Extension of special expensing rules for certain productions. 

Sec. 40309. Extension of deduction allowable with respect to income attributable 

to domestic production activities in Puerto Rico. 

Sec. 40310. Extension of special rule relating to qualified timber gain. 

Sec. 40311. Extension of empowerment zone tax incentives. 

Sec. 40312. Extension of American Samoa economic development credit. 

Subtitle C—Incentives for Energy Production and Conservation 

Sec. 40401. Extension of credit for nonbusiness energy property. 

Sec. 40402. Extension and modification of credit for residential energy property. 

Sec. 40403. Extension of credit for new qualified fuel cell motor vehicles. 

Sec. 40404. Extension of credit for alternative fuel vehicle refueling property. 

Sec. 40405. Extension of credit for 2-wheeled plug-in electric vehicles. 

Sec. 40406. Extension of second generation biofuel producer credit. 

Sec. 40407. Extension of biodiesel and renewable diesel incentives. 

Sec. 40408. Extension of production credit for Indian coal facilities. 

Sec. 40409. Extension of credits with respect to facilities producing energy from 

certain renewable resources. 

Sec. 40410. Extension of credit for energy-efficient new homes. 

Sec. 40411. Extension and phaseout of energy credit. 

Sec. 40412. Extension of special allowance for second generation biofuel plant 

property. 

Sec. 40413. Extension of energy efficient commercial buildings deduction. 

Sec. 40414. Extension of special rule for sales or dispositions to implement FERC 

or State electric restructuring policy for qualified electric utilities. 

Sec. 40415. Extension of excise tax credits relating to alternative fuels. 

Sec. 40416. Extension of Oil Spill Liability Trust Fund financing rate. 

Subtitle D—Modifications of Energy Incentives 

Sec. 40501. Modifications of credit for production from advanced nuclear power 

facilities. 

TITLE II—MISCELLANEOUS PROVISIONS 

Sec. 41101. Amendment of Internal Revenue Code of 1986. 

Sec. 41102. Modifications to rum cover over. 

Sec. 41103. Extension of waiver of limitations with respect to excluding from 

gross income amounts received by wrongfully incarcerated individuals. 

Sec. 41104. Individuals held harmless on improper levy on retirement plans. 

Sec. 41105. Modification of user fee requirements for installment agreements. 

Sec. 41106. Form 1040SR for seniors. 

Sec. 41107. Attorneys fees relating to awards to whistleblowers. 

Sec. 41108. Clarification of whistleblower awards. 

Sec. 41109. Clarification regarding excise tax based on investment income of private colleges and universities. 
194 

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Sec. 41110. Exception from private foundation excess business holding tax for 

independently-operated philanthropic business holdings. 

Sec. 41111. Rule of construction for Craft Beverage Modernization and Tax Reform. 

Sec. 41112. Simplification of rules regarding records, statements, and returns. 

Sec. 41113. Modification of rules governing hardship distributions. 

Sec. 41114. Modification of rules relating to hardship withdrawals from cash or 

deferred arrangements. 

Sec. 41115. Opportunity Zones rule for Puerto Rico. 

Sec. 41116. Tax home of certain citizens or residents of the United States living 

abroad. 

Sec. 41117. Treatment of foreign persons for returns relating to payments made 

in settlement of payment card and third party network transactions. 

Sec. 41118. Repeal of shift in time of payment of corporate estimated taxes. 

Sec. 41119. Enhancement of carbon dioxide sequestration credit. 

1 TITLE I—EXTENSION OF 

2 EXPIRING PROVISIONS 

3 SEC. 40101. AMENDMENT OF INTERNAL REVENUE CODE OF 

4 1986. 

5 Except as otherwise expressly provided, whenever in 

6 this title an amendment or repeal is expressed in terms of 

7 an amendment to, or repeal of, a section or other provision, 

8 the reference shall be considered to be made to a section or 

9 other provision of the Internal Revenue Code of 1986. 

10 Subtitle A—Tax Relief for Families 

11 and Individuals 

12 SEC. 40201. EXTENSION OF EXCLUSION FROM GROSS IN13 COME OF DISCHARGE OF QUALIFIED PRIN14 CIPAL RESIDENCE INDEBTEDNESS. 

15 (a) IN GENERAL.—Section 108(a)(1)(E) is amended 

16 by striking ‘‘January 1, 2017’’ each place it appears and 

17 inserting ‘‘January 1, 2018’’. 
195 

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1 (b) EFFECTIVE DATE.—The amendments made by this 

2 section shall apply to discharges of indebtedness after De3 cember 31, 2016. 

4 SEC. 40202. EXTENSION OF MORTGAGE INSURANCE PRE5 MIUMS TREATED AS QUALIFIED RESIDENCE 

6 INTEREST. 

7 (a) IN GENERAL.—Subclause (I) of section 

8 163(h)(3)(E)(iv) is amended by striking ‘‘December 31, 

9 2016’’ and inserting ‘‘December 31, 2017’’. 

10 (b) EFFECTIVE DATE.—The amendment made by this 

11 section shall apply to amounts paid or accrued after Decem12 ber 31, 2016. 

13 SEC. 40203. EXTENSION OF ABOVE-THE-LINE DEDUCTION 

14 FOR QUALIFIED TUITION AND RELATED EX15 PENSES. 

16 (a) IN GENERAL.—Section 222(e) is amended by strik17 ing ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

18 2017’’. 

19 (b) EFFECTIVE DATE.—The amendment made by this 

20 section shall apply to taxable years beginning after Decem21 ber 31, 2016. 
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1 Subtitle B—Incentives for Growth, 

2 Jobs, Investment, and Innovation 

3 SEC. 40301. EXTENSION OF INDIAN EMPLOYMENT TAX 

4 CREDIT. 

5 (a) IN GENERAL.—Section 45A(f) is amended by strik6 ing ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

7 2017’’. 

8 (b) EFFECTIVE DATE.—The amendment made by this 

9 section shall apply to taxable years beginning after Decem10 ber 31, 2016. 

11 SEC. 40302. EXTENSION OF RAILROAD TRACK MAINTE12 NANCE CREDIT. 

13 (a) IN GENERAL.—Section 45G(f) is amended by strik14 ing ‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 

15 (b) EFFECTIVE DATE.— 

16 (1) IN GENERAL.—The amendment made by this 

17 section shall apply to expenditures paid or incurred 

18 in taxable years beginning after December 31, 2016. 

19 (2) SAFE HARBOR ASSIGNMENTS.—Assignments, 

20 including related expenditures paid or incurred, 

21 under paragraph (2) of section 45G(b) of the Internal 

22 Revenue Code of 1986 for taxable years ending after 

23 January 1, 2017, and before January 1, 2018, shall 

24 be treated as effective as of the close of such taxable 

25 year if made pursuant to a written agreement entered 
197 

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1 into no later than 90 days following the date of the 

2 enactment of this Act. 

3 SEC. 40303. EXTENSION OF MINE RESCUE TEAM TRAINING 

4 CREDIT. 

5 (a) IN GENERAL.—Section 45N(e) is amended by 

6 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

7 2017’’. 

8 (b) EFFECTIVE DATE.—The amendment made by this 

9 section shall apply to taxable years beginning after Decem10 ber 31, 2016. 

11 SEC. 40304. EXTENSION OF CLASSIFICATION OF CERTAIN 

12 RACE HORSES AS 3-YEAR PROPERTY. 

13 (a) IN GENERAL.—Section 168(e)(3)(A)(i) is amend14 ed— 

15 (1) by striking ‘‘January 1, 2017’’ in subclause 

16 (I) and inserting ‘‘January 1, 2018’’, and 

17 (2) by striking ‘‘December 31, 2016’’ in sub18 clause (II) and inserting ‘‘December 31, 2017’’. 

19 (b) EFFECTIVE DATE.—The amendments made by this 

20 section shall apply to property placed in service after De21 cember 31, 2016. 
198 

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1 SEC. 40305. EXTENSION OF 7-YEAR RECOVERY PERIOD FOR 

2 MOTORSPORTS ENTERTAINMENT COM3 PLEXES. 

4 (a) IN GENERAL.—Section 168(i)(15)(D) is amended 

5 by striking ‘‘December 31, 2016’’ and inserting ‘‘December 

6 31, 2017’’. 

7 (b) EFFECTIVE DATE.—The amendment made by this 

8 section shall apply to property placed in service after De9 cember 31, 2016. 

10 SEC. 40306. EXTENSION OF ACCELERATED DEPRECIATION 

11 FOR BUSINESS PROPERTY ON AN INDIAN 

12 RESERVATION. 

13 (a) IN GENERAL.—Section 168(j)(9) is amended by 

14 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

15 2017’’. 

16 (b) EFFECTIVE DATE.—The amendment made by this 

17 section shall apply to property placed in service after De18 cember 31, 2016. 

19 SEC. 40307. EXTENSION OF ELECTION TO EXPENSE MINE 

20 SAFETY EQUIPMENT. 

21 (a) IN GENERAL.—Section 179E(g) is amended by 

22 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

23 2017’’. 

24 (b) EFFECTIVE DATE.—The amendment made by this 

25 section shall apply to property placed in service after De26 cember 31, 2016. 
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1 SEC. 40308. EXTENSION OF SPECIAL EXPENSING RULES FOR 

2 CERTAIN PRODUCTIONS. 

3 (a) IN GENERAL.—Section 181(g) is amended by strik4 ing ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

5 2017’’. 

6 (b) EFFECTIVE DATE.—The amendment made by this 

7 section shall apply to productions commencing after Decem8 ber 31, 2016. 

9 SEC. 40309. EXTENSION OF DEDUCTION ALLOWABLE WITH 

10 RESPECT TO INCOME ATTRIBUTABLE TO DO11 MESTIC PRODUCTION ACTIVITIES IN PUERTO 

12 RICO. 

13 For purposes of applying section 199(d)(8)(C) of the 

14 Internal Revenue Code of 1986 with respect to taxable years 

15 beginning during 2017, such section shall be applied— 

16 (1) by substituting ‘‘first 12 taxable years’’ for 

17 ‘‘first 11 taxable years’’, and 

18 (2) by substituting ‘‘January 1, 2018’’ for ‘‘Jan19 uary 1, 2017’’. 

20 SEC. 40310. EXTENSION OF SPECIAL RULE RELATING TO 

21 QUALIFIED TIMBER GAIN. 

22 For purposes of applying section 1201(b) of the Inter23 nal Revenue Code of 1986 with respect to taxable years be24 ginning during 2017, such section shall be applied by sub25 stituting ‘‘2016 or 2017’’ for ‘‘2016’’. 
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1 SEC. 40311. EXTENSION OF EMPOWERMENT ZONE TAX IN2 CENTIVES. 

3 (a) IN GENERAL.— 

4 (1) EXTENSION.—Section 1391(d)(1)(A)(i) is 

5 amended by striking ‘‘December 31, 2016’’ and insert6 ing ‘‘December 31, 2017’’. 

7 (2) TREATMENT OF CERTAIN TERMINATION

8 DATES SPECIFIED IN NOMINATIONS.—In the case of a 

9 designation of an empowerment zone the nomination 

10 for which included a termination date which is con11 temporaneous with the date specified in subparagraph 

12 (A)(i) of section 1391(d)(1) of the Internal Revenue 

13 Code of 1986 (as in effect before the enactment of this 

14 Act), subparagraph (B) of such section shall not 

15 apply with respect to such designation if, after the 

16 date of the enactment of this section, the entity which 

17 made such nomination amends the nomination to 

18 provide for a new termination date in such manner 

19 as the Secretary of the Treasury (or the Secretary’s 

20 designee) may provide. 

21 (b) EFFECTIVE DATE.—The amendment made by sub22 section (a)(1) shall apply to taxable years beginning after 

23 December 31, 2016. 
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1 SEC. 40312. EXTENSION OF AMERICAN SAMOA ECONOMIC 

2 DEVELOPMENT CREDIT. 

3 (a) IN GENERAL.—Section 119 of division A of the 

4 Tax Relief and Health Care Act of 2006 is amended— 

5 (1) in subsection (d)— 

6 (A) by striking ‘‘January 1, 2017’’ each 

7 place it appears and inserting ‘‘January 1, 

8 2018’’, 

9 (B) by striking ‘‘first 11 taxable years’’ in 

10 paragraph (1) and inserting ‘‘first 12 taxable 

11 years’’, and 

12 (C) by striking ‘‘first 5 taxable years’’ in 

13 paragraph (2) and inserting ‘‘first 6 taxable 

14 years’’, and 

15 (2) in subsection (e), by adding at the end the 

16 following: ‘‘References in this subsection to section 199 

17 of the Internal Revenue Code of 1986 shall be treated 

18 as references to such section as in effect before its re19 peal.’’. 

20 (b) EFFECTIVE DATE.—The amendments made by this 

21 section shall apply to taxable years beginning after Decem22 ber 31, 2016. 
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1 Subtitle C—Incentives for Energy 

2 Production and Conservation 

3 SEC. 40401. EXTENSION OF CREDIT FOR NONBUSINESS EN4 ERGY PROPERTY. 

5 (a) IN GENERAL.—Section 25C(g)(2) is amended by 

6 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

7 2017’’. 

8 (b) EFFECTIVE DATE.—The amendment made by this 

9 section shall apply to property placed in service after De10 cember 31, 2016. 

11 SEC. 40402. EXTENSION AND MODIFICATION OF CREDIT 

12 FOR RESIDENTIAL ENERGY PROPERTY. 

13 (a) IN GENERAL.—Section 25D(h) is amended by 

14 striking ‘‘December 31, 2016’’ and all that follows and in15 serting ‘‘December 31, 2021.’’. 

16 (b) PHASEOUT.— 

17 (1) IN GENERAL.—Section 25D(a) is amended by 

18 striking ‘‘the sum of—’’ and all that follows and in19 serting ‘‘the sum of the applicable percentages of— 

20 ‘‘(1) the qualified solar electric property expendi21 tures, 

22 ‘‘(2) the qualified solar water heating property 

23 expenditures, 

24 ‘‘(3) the qualified fuel cell property expenditures, 
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1 ‘‘(4) the qualified small wind energy property 

2 expenditures, and 

3 ‘‘(5) the qualified geothermal heat pump prop4 erty expenditures, 

5 made by the taxpayer during such year.’’. 

6 (2) CONFORMING AMENDMENT.—Section 25D(g) 

7 is amended by striking ‘‘paragraphs (1) and (2) of’’. 

8 (c) EFFECTIVE DATE.—The amendment made by this 

9 section shall apply to property placed in service after De10 cember 31, 2016. 

11 SEC. 40403. EXTENSION OF CREDIT FOR NEW QUALIFIED 

12 FUEL CELL MOTOR VEHICLES. 

13 (a) IN GENERAL.—Section 30B(k)(1) is amended by 

14 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

15 2017’’. 

16 (b) EFFECTIVE DATE.—The amendment made by this 

17 section shall apply to property purchased after December 

18 31, 2016. 

19 SEC. 40404. EXTENSION OF CREDIT FOR ALTERNATIVE 

20 FUEL VEHICLE REFUELING PROPERTY. 

21 (a) IN GENERAL.—Section 30C(g) is amended by 

22 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

23 2017’’. 
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1 (b) EFFECTIVE DATE.—The amendment made by this 

2 section shall apply to property placed in service after De3 cember 31, 2016. 

4 SEC. 40405. EXTENSION OF CREDIT FOR 2-WHEELED PLUG5 IN ELECTRIC VEHICLES. 

6 (a) IN GENERAL.—Section 30D(g)(3)(E)(ii) is amend7 ed by striking ‘‘January 1, 2017’’ and inserting ‘‘January 

8 1, 2018’’. 

9 (b) EFFECTIVE DATE.—The amendment made by this 

10 section shall apply to vehicles acquired after December 31, 

11 2016. 

12 SEC. 40406. EXTENSION OF SECOND GENERATION BIOFUEL 

13 PRODUCER CREDIT. 

14 (a) IN GENERAL.—Section 40(b)(6)(J)(i) is amended 

15 by striking ‘‘January 1, 2017’’ and inserting ‘‘January 1, 

16 2018’’. 

17 (b) EFFECTIVE DATE.—The amendment made by this 

18 section shall apply to qualified second generation biofuel 

19 production after December 31, 2016. 

20 SEC. 40407. EXTENSION OF BIODIESEL AND RENEWABLE 

21 DIESEL INCENTIVES. 

22 (a) INCOME TAX CREDIT.— 

23 (1) IN GENERAL.—Subsection (g) of section 40A 

24 is amended by striking ‘‘December 31, 2016’’ and in25 serting ‘‘December 31, 2017’’. 
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† HR 1892 EAS2 

1 (2) EFFECTIVE DATE.—The amendment made by 

2 this subsection shall apply to fuel sold or used after 

3 December 31, 2016. 

4 (b) EXCISE TAX INCENTIVES.— 

5 (1) IN GENERAL.—Section 6426(c)(6) is amend6 ed by striking ‘‘December 31, 2016’’ and inserting 

7 ‘‘December 31, 2017’’. 

8 (2) PAYMENTS.—Section 6427(e)(6)(B) is 

9 amended by striking ‘‘December 31, 2016’’ and insert10 ing ‘‘December 31, 2017’’. 

11 (3) EFFECTIVE DATE.—The amendments made 

12 by this subsection shall apply to fuel sold or used 

13 after December 31, 2016. 

14 (4) SPECIAL RULE FOR 2017.—Notwithstanding 

15 any other provision of law, in the case of any bio16 diesel mixture credit properly determined under sec17 tion 6426(c) of the Internal Revenue Code of 1986 for 

18 the period beginning on January 1, 2017, and ending 

19 on December 31, 2017, such credit shall be allowed, 

20 and any refund or payment attributable to such cred21 it (including any payment under section 6427(e) of 

22 such Code) shall be made, only in such manner as the 

23 Secretary of the Treasury (or the Secretary’s delegate) 

24 shall provide. Such Secretary shall issue guidance 

25 within 30 days after the date of the enactment of this 
206 

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1 Act providing for a one-time submission of claims 

2 covering periods described in the preceding sentence. 

3 Such guidance shall provide for a 180-day period for 

4 the submission of such claims (in such manner as 

5 prescribed by such Secretary) to begin not later than 

6 30 days after such guidance is issued. Such claims 

7 shall be paid by such Secretary not later than 60 

8 days after receipt. If such Secretary has not paid 

9 pursuant to a claim filed under this subsection within 

10 60 days after the date of the filing of such claim, the 

11 claim shall be paid with interest from such date de12 termined by using the overpayment rate and method 

13 under section 6621 of such Code. 

14 SEC. 40408. EXTENSION OF PRODUCTION CREDIT FOR IN15 DIAN COAL FACILITIES. 

16 (a) IN GENERAL.—Section 45(e)(10)(A) is amended by 

17 striking ‘‘11-year period’’ each place it appears and insert18 ing ‘‘12-year period’’. 

19 (b) EFFECTIVE DATE.—The amendment made by this 

20 section shall apply to coal produced after December 31, 

21 2016. 
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1 SEC. 40409. EXTENSION OF CREDITS WITH RESPECT TO FA2 CILITIES PRODUCING ENERGY FROM CER3 TAIN RENEWABLE RESOURCES. 

4 (a) IN GENERAL.—The following provisions of section 

5 45(d) are each amended by striking ‘‘January 1, 2017’’ 

6 each place it appears and inserting ‘‘January 1, 2018’’: 

7 (1) Paragraph (2)(A). 

8 (2) Paragraph (3)(A). 

9 (3) Paragraph (4)(B). 

10 (4) Paragraph (6). 

11 (5) Paragraph (7). 

12 (6) Paragraph (9). 

13 (7) Paragraph (11)(B). 

14 (b) EXTENSION OF ELECTION TO TREAT QUALIFIED

15 FACILITIES AS ENERGY PROPERTY.—Section 

16 48(a)(5)(C)(ii) is amended by striking ‘‘January 1, 2017’’ 

17 and inserting ‘‘January 1, 2018’’. 

18 (c) EFFECTIVE DATE.—The amendments made by this 

19 section shall take effect on January 1, 2017. 

20 SEC. 40410. EXTENSION OF CREDIT FOR ENERGY-EFFICIENT 

21 NEW HOMES. 

22 (a) IN GENERAL.—Section 45L(g) is amended by 

23 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

24 2017’’. 
208 

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1 (b) EFFECTIVE DATE.—The amendment made by this 

2 section shall apply to homes acquired after December 31, 

3 2016. 

4 SEC. 40411. EXTENSION AND PHASEOUT OF ENERGY CRED5 IT. 

6 (a) EXTENSION OF SOLAR AND THERMAL ENERGY

7 PROPERTY.—Section 48(a)(3)(A) is amended— 

8 (1) by striking ‘‘periods ending before January 

9 1, 2017’’ in clause (ii) and inserting ‘‘property the 

10 construction of which begins before January 1, 2022’’, 

11 and 

12 (2) by striking ‘‘periods ending before January 

13 1, 2017’’ in clause (vii) and inserting ‘‘property the 

14 construction of which begins before January 1, 2022’’. 

15 (b) PHASEOUT OF 30-PERCENT CREDIT RATE FOR

16 FIBER-OPTIC SOLAR, QUALIFIED FUEL CELL, AND QUALI17 FIED SMALL WIND ENERGY PROPERTY.— 

18 (1) IN GENERAL.—Section 48(a) is amended by 

19 adding at the end the following new paragraph: 

20 ‘‘(7) PHASEOUT FOR FIBER-OPTIC SOLAR, QUALI21 FIED FUEL CELL, AND QUALIFIED SMALL WIND EN22 ERGY PROPERTY.— 

23 ‘‘(A) IN GENERAL.—Subject to subpara24 graph (B), in the case of any qualified fuel cell 

25 property, qualified small wind property, or en-
209 

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1 ergy property described in paragraph (3)(A)(ii), 

2 the energy percentage determined under para3 graph (2) shall be equal to— 

4 ‘‘(i) in the case of any property the 

5 construction of which begins after December 

6 31, 2019, and before January 1, 2021, 26 

7 percent, and 

8 ‘‘(ii) in the case of any property the 

9 construction of which begins after December 

10 31, 2020, and before January 1, 2022, 22 

11 percent. 

12 ‘‘(B) PLACED IN SERVICE DEADLINE.—In 

13 the case of any energy property described in sub14 paragraph (A) which is not placed in service be15 fore January 1, 2024, the energy percentage de16 termined under paragraph (2) shall be equal to 

17 0 percent.’’. 

18 (2) CONFORMING AMENDMENT.—Section 

19 48(a)(2)(A) is amended by striking ‘‘paragraph (6)’’ 

20 and inserting ‘‘paragraphs (6) and (7)’’. 

21 (3) CLARIFICATION RELATING TO PHASEOUT FOR

22 WIND FACILITIES.—Section 48(a)(5)(E) is amended 

23 by inserting ‘‘which is treated as energy property by 

24 reason of this paragraph’’ after ‘‘using wind to 

25 produce electricity’’. 
210 

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1 (c) EXTENSION OF QUALIFIED FUEL CELL PROP2 ERTY.—Section 48(c)(1)(D) is amended by striking ‘‘for 

3 any period after December 31, 2016’’ and inserting ‘‘the 

4 construction of which does not begin before January 1, 

5 2022’’. 

6 (d) EXTENSION OF QUALIFIED MICROTURBINE PROP7 ERTY.—Section 48(c)(2)(D) is amended by striking ‘‘for 

8 any period after December 31, 2016’’ and inserting ‘‘the 

9 construction of which does not begin before January 1, 

10 2022’’. 

11 (e) EXTENSION OF COMBINED HEAT AND POWER SYS12 TEM PROPERTY.—Section 48(c)(3)(A)(iv) is amended by 

13 striking ‘‘which is placed in service before January 1, 2017’’ 

14 and inserting ‘‘the construction of which begins before Jan15 uary 1, 2022’’. 

16 (f) EXTENSION OF QUALIFIED SMALL WIND ENERGY

17 PROPERTY.—Section 48(c)(4)(C) is amended by striking 

18 ‘‘for any period after December 31, 2016’’ and inserting 

19 ‘‘the construction of which does not begin before January 

20 1, 2022’’. 

21 (g) EFFECTIVE DATE.— 

22 (1) IN GENERAL.—Except as otherwise provided 

23 in this subsection, the amendments made by this sec24 tion shall apply to periods after December 31, 2016, 

25 under rules similar to the rules of section 48(m) of the 
211 

† HR 1892 EAS2 

1 Internal Revenue Code of 1986 (as in effect on the 

2 day before the date of the enactment of the Revenue 

3 Reconciliation Act of 1990). 

4 (2) EXTENSION OF COMBINED HEAT AND POWER

5 SYSTEM PROPERTY.—The amendment made by sub6 section (e) shall apply to property placed in service 

7 after December 31, 2016. 

8 (3) PHASEOUTS AND TERMINATIONS.—The 

9 amendments made by subsection (b) shall take effect 

10 on the date of the enactment of this Act. 

11 SEC. 40412. EXTENSION OF SPECIAL ALLOWANCE FOR SEC12 OND GENERATION BIOFUEL PLANT PROP13 ERTY. 

14 (a) IN GENERAL.—Section 168(l)(2)(D) is amended by 

15 striking ‘‘January 1, 2017’’ and inserting ‘‘January 1, 

16 2018’’. 

17 (b) EFFECTIVE DATE.—The amendment made by this 

18 section shall apply to property placed in service after De19 cember 31, 2016. 

20 SEC. 40413. EXTENSION OF ENERGY EFFICIENT COMMER21 CIAL BUILDINGS DEDUCTION. 

22 (a) IN GENERAL.—Section 179D(h) is amended by 

23 striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

24 2017’’. 
212 

† HR 1892 EAS2 

1 (b) EFFECTIVE DATE.—The amendment made by this 

2 section shall apply to property placed in service after De3 cember 31, 2016. 

4 SEC. 40414. EXTENSION OF SPECIAL RULE FOR SALES OR 

5 DISPOSITIONS TO IMPLEMENT FERC OR 

6 STATE ELECTRIC RESTRUCTURING POLICY 

7 FOR QUALIFIED ELECTRIC UTILITIES. 

8 (a) IN GENERAL.—Section 451(k)(3), as amended by 

9 section 13221 of Public Law 115–97, is amended by strik10 ing ‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 

11 (b) EFFECTIVE DATE.—The amendment made by this 

12 section shall apply to dispositions after December 31, 2016. 

13 SEC. 40415. EXTENSION OF EXCISE TAX CREDITS RELATING 

14 TO ALTERNATIVE FUELS. 

15 (a) EXTENSION OF ALTERNATIVE FUELS EXCISE TAX

16 CREDITS.— 

17 (1) IN GENERAL.—Sections 6426(d)(5) and 

18 6426(e)(3) are each amended by striking ‘‘December 

19 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

20 (2) OUTLAY PAYMENTS FOR ALTERNATIVE

21 FUELS.—Section 6427(e)(6)(C) is amended by strik22 ing ‘‘December 31, 2016’’ and inserting ‘‘December 

23 31, 2017’’. 
213 

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1 (3) EFFECTIVE DATE.—The amendments made 

2 by this subsection shall apply to fuel sold or used 

3 after December 31, 2016. 

4 (b) SPECIAL RULE FOR 2017.—Notwithstanding any 

5 other provision of law, in the case of any alternative fuel 

6 credit properly determined under section 6426(d) of the In7 ternal Revenue Code of 1986 for the period beginning on 

8 January 1, 2017, and ending on December 31, 2017, such 

9 credit shall be allowed, and any refund or payment attrib10 utable to such credit (including any payment under section 

11 6427(e) of such Code) shall be made, only in such manner 

12 as the Secretary of the Treasury (or the Secretary’s dele13 gate) shall provide. Such Secretary shall issue guidance 

14 within 30 days after the date of the enactment of this Act 

15 providing for a one-time submission of claims covering pe16 riods described in the preceding sentence. Such guidance 

17 shall provide for a 180-day period for the submission of 

18 such claims (in such manner as prescribed by such Sec19 retary) to begin not later than 30 days after such guidance 

20 is issued. Such claims shall be paid by such Secretary not 

21 later than 60 days after receipt. If such Secretary has not 

22 paid pursuant to a claim filed under this subsection within 

23 60 days after the date of the filing of such claim, the claim 

24 shall be paid with interest from such date determined by 
214 

† HR 1892 EAS2 

1 using the overpayment rate and method under section 6621 

2 of such Code. 

3 SEC. 40416. EXTENSION OF OIL SPILL LIABILITY TRUST 

4 FUND FINANCING RATE. 

5 (a) IN GENERAL.—Section 4611(f)(2) is amended by 

6 striking ‘‘December 31, 2017’’ and inserting ‘‘December 31, 

7 2018’’. 

8 (b) EFFECTIVE DATE.—The amendment made by this 

9 section shall apply on and after the first day of the first 

10 calendar month beginning after the date of the enactment 

11 of this Act. 

12 Subtitle D—Modifications of Energy 

13 Incentives 

14 SEC. 40501. MODIFICATIONS OF CREDIT FOR PRODUCTION 

15 FROM ADVANCED NUCLEAR POWER FACILI16 TIES. 

17 (a) TREATMENT OF UNUTILIZED LIMITATION

18 AMOUNTS.—Section 45J(b) is amended— 

19 (1) by inserting ‘‘or any amendment to’’ after 

20 ‘‘enactment of’’ in paragraph (4), and 

21 (2) by adding at the end the following new para22 graph: 

23 ‘‘(5) ALLOCATION OF UNUTILIZED LIMITATION.— 

24 ‘‘(A) IN GENERAL.—Any unutilized na25 tional megawatt capacity limitation shall be al-
215 

† HR 1892 EAS2 

1 located by the Secretary under paragraph (3) as 

2 rapidly as is practicable after December 31, 

3 2020— 

4 ‘‘(i) first to facilities placed in service 

5 on or before such date to the extent that 

6 such facilities did not receive an allocation 

7 equal to their full nameplate capacity, and 

8 ‘‘(ii) then to facilities placed in service 

9 after such date in the order in which such 

10 facilities are placed in service. 

11 ‘‘(B) UNUTILIZED NATIONAL MEGAWATT CA12 PACITY LIMITATION.—The term ‘unutilized na13 tional megawatt capacity limitation’ means the 

14 excess (if any) of— 

15 ‘‘(i) 6,000 megawatts, over 

16 ‘‘(ii) the aggregate amount of national 

17 megawatt capacity limitation allocated by 

18 the Secretary before January 1, 2021, re19 duced by any amount of such limitation 

20 which was allocated to a facility which was 

21 not placed in service before such date. 

22 ‘‘(C) COORDINATION WITH OTHER PROVI23 SIONS.—In the case of any unutilized national 

24 megawatt capacity limitation allocated by the 

25 Secretary pursuant to this paragraph— 
216 

† HR 1892 EAS2 

1 ‘‘(i) such allocation shall be treated for 

2 purposes of this section in the same manner 

3 as an allocation of national megawatt ca4 pacity limitation, and 

5 ‘‘(ii) subsection (d)(1)(B) shall not 

6 apply to any facility which receives such al7 location.’’. 

8 (b) TRANSFER OF CREDIT BY CERTAIN PUBLIC ENTI9 TIES.— 

10 (1) IN GENERAL.—Section 45J is amended— 

11 (A) by redesignating subsection (e) as sub12 section (f), and 

13 (B) by inserting after subsection (d) the fol14 lowing new subsection: 

15 ‘‘(e) TRANSFER OF CREDIT BY CERTAIN PUBLIC ENTI16 TIES.— 

17 ‘‘(1) IN GENERAL.—If, with respect to a credit 

18 under subsection (a) for any taxable year— 

19 ‘‘(A) a qualified public entity would be the 

20 taxpayer (but for this paragraph), and 

21 ‘‘(B) such entity elects the application of 

22 this paragraph for such taxable year with respect 

23 to all (or any portion specified in such election) 

24 of such credit, 
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1 the eligible project partner specified in such election, 

2 and not the qualified public entity, shall be treated as 

3 the taxpayer for purposes of this title with respect to 

4 such credit (or such portion thereof). 

5 ‘‘(2) DEFINITIONS.—For purposes of this sub6 section— 

7 ‘‘(A) QUALIFIED PUBLIC ENTITY.—The term 

8 ‘qualified public entity’ means— 

9 ‘‘(i) a Federal, State, or local govern10 ment entity, or any political subdivision, 

11 agency, or instrumentality thereof, 

12 ‘‘(ii) a mutual or cooperative electric 

13 company described in section 501(c)(12) or 

14 1381(a)(2), or 

15 ‘‘(iii) a not-for-profit electric utility 

16 which had or has received a loan or loan 

17 guarantee under the Rural Electrification 

18 Act of 1936. 

19 ‘‘(B) ELIGIBLE PROJECT PARTNER.—The 

20 term ‘eligible project partner’ means any person 

21 who— 

22 ‘‘(i) is responsible for, or participates 

23 in, the design or construction of the ad24 vanced nuclear power facility to which the 

25 credit under subsection (a) relates, 
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† HR 1892 EAS2 

1 ‘‘(ii) participates in the provision of 

2 the nuclear steam supply system to such fa3 cility, 

4 ‘‘(iii) participates in the provision of 

5 nuclear fuel to such facility, 

6 ‘‘(iv) is a financial institution pro7 viding financing for the construction or op8 eration of such facility, or 

9 ‘‘(v) has an ownership interest in such 

10 facility. 

11 ‘‘(3) SPECIAL RULES.— 

12 ‘‘(A) APPLICATION TO PARTNERSHIPS.—In 

13 the case of a credit under subsection (a) which 

14 is determined at the partnership level— 

15 ‘‘(i) for purposes of paragraph (1)(A), 

16 a qualified public entity shall be treated as 

17 the taxpayer with respect to such entity’s 

18 distributive share of such credit, and 

19 ‘‘(ii) the term ‘eligible project partner’ 

20 shall include any partner of the partner21 ship. 

22 ‘‘(B) TAXABLE YEAR IN WHICH CREDIT

23 TAKEN INTO ACCOUNT.—In the case of any credit 

24 (or portion thereof) with respect to which an 

25 election is made under paragraph (1), such cred-
219 

† HR 1892 EAS2 

1 it shall be taken into account in the first taxable 

2 year of the eligible project partner ending with, 

3 or after, the qualified public entity’s taxable year 

4 with respect to which the credit was determined. 

5 ‘‘(C) TREATMENT OF TRANSFER UNDER PRI6 VATE USE RULES.—For purposes of section 

7 141(b)(1), any benefit derived by an eligible 

8 project partner in connection with an election 

9 under this subsection shall not be taken into ac10 count as a private business use.’’. 

11 (2) SPECIAL RULE FOR PROCEEDS OF TRANS12 FERS FOR MUTUAL OR COOPERATIVE ELECTRIC COM13 PANIES.—Section 501(c)(12) is amended by adding at 

14 the end the following new subparagraph: 

15 ‘‘(I) In the case of a mutual or cooperative 

16 electric company described in this paragraph or 

17 an organization described in section 1381(a)(2), 

18 income received or accrued in connection with 

19 an election under section 45J(e)(1) shall be treat20 ed as an amount collected from members for the 

21 sole purpose of meeting losses and expenses.’’. 

22 (c) EFFECTIVE DATES.— 

23 (1) TREATMENT OF UNUTILIZED LIMITATION

24 AMOUNTS.—The amendment made by subsection (a) 
220 

† HR 1892 EAS2 

1 shall take effect on the date of the enactment of this 

2 Act. 

3 (2) TRANSFER OF CREDIT BY CERTAIN PUBLIC

4 ENTITIES.—The amendments made by subsection (b) 

5 shall apply to taxable years beginning after the date 

6 of the enactment of this Act. 

7 TITLE II—MISCELLANEOUS 

8 PROVISIONS 

9 SEC. 41101. AMENDMENT OF INTERNAL REVENUE CODE OF 

10 1986. 

11 Except as otherwise expressly provided, whenever in 

12 this title an amendment or repeal is expressed in terms of 

13 an amendment to, or repeal of, a section or other provision, 

14 the reference shall be considered to be made to a section or 

15 other provision of the Internal Revenue Code of 1986. 

16 SEC. 41102. MODIFICATIONS TO RUM COVER OVER. 

17 (a) EXTENSION.— 

18 (1) IN GENERAL.—Section 7652(f)(1) is amended 

19 by striking ‘‘January 1, 2017’’ and inserting ‘‘Janu20 ary 1, 2022’’. 

21 (2) EFFECTIVE DATE.—The amendment made by 

22 this subsection shall apply to distilled spirits brought 

23 into the United States after December 31, 2016. 

24 (b) DETERMINATION OF TAXES ON RUM.— 
221 

† HR 1892 EAS2 

1 (1) IN GENERAL.—Section 7652(e) is amended 

2 by adding at the end the following new paragraph: 

3 ‘‘(5) DETERMINATION OF AMOUNT OF TAXES

4 COLLECTED.—For purposes of this subsection, the 

5 amount of taxes collected under section 5001(a)(1) 

6 shall be determined without regard to section 

7 5001(c).’’. 

8 (2) EFFECTIVE DATE.—The amendment made by 

9 this subsection shall apply to distilled spirits brought 

10 into the United States after December 31, 2017. 

11 SEC. 41103. EXTENSION OF WAIVER OF LIMITATIONS WITH 

12 RESPECT TO EXCLUDING FROM GROSS IN13 COME AMOUNTS RECEIVED BY WRONGFULLY 

14 INCARCERATED INDIVIDUALS. 

15 (a) IN GENERAL.—Section 304(d) of the Protecting 

16 Americans from Tax Hikes Act of 2015 (26 U.S.C. 139F 

17 note) is amended by striking ‘‘1-year’’ and inserting ‘‘3- 

18 year’’. 

19 (b) EFFECTIVE DATE.—The amendment made by this 

20 section shall take effect on the date of the enactment of this 

21 Act. 

22 SEC. 41104. INDIVIDUALS HELD HARMLESS ON IMPROPER 

23 LEVY ON RETIREMENT PLANS. 

24 (a) IN GENERAL.—Section 6343 is amended by adding 

25 at the end the following new subsection: 
222 

† HR 1892 EAS2 

1 ‘‘(f) INDIVIDUALS HELD HARMLESS ON WRONGFUL

2 LEVY, ETC. ON RETIREMENT PLAN.— 

3 ‘‘(1) IN GENERAL.—If the Secretary determines 

4 that an individual’s account or benefit under an eli5 gible retirement plan (as defined in section 

6 402(c)(8)(B)) has been levied upon in a case to which 

7 subsection (b) or (d)(2)(A) applies and property or an 

8 amount of money is returned to the individual— 

9 ‘‘(A) the individual may contribute such 

10 property or an amount equal to the sum of— 

11 ‘‘(i) the amount of money so returned 

12 by the Secretary, and 

13 ‘‘(ii) interest paid under subsection (c) 

14 on such amount of money, 

15 into such eligible retirement plan if such con16 tribution is permitted by the plan, or into an in17 dividual retirement plan (other than an endow18 ment contract) to which a rollover contribution 

19 of a distribution from such eligible retirement 

20 plan is permitted, but only if such contribution 

21 is made not later than the due date (not includ22 ing extensions) for filing the return of tax for the 

23 taxable year in which such property or amount 

24 of money is returned, and 
223 

† HR 1892 EAS2 

1 ‘‘(B) the Secretary shall, at the time such 

2 property or amount of money is returned, notify 

3 such individual that a contribution described in 

4 subparagraph (A) may be made. 

5 ‘‘(2) TREATMENT AS ROLLOVER.—The distribu6 tion on account of the levy and any contribution 

7 under paragraph (1) with respect to the return of 

8 such distribution shall be treated for purposes of this 

9 title as if such distribution and contribution were de10 scribed in section 402(c), 402A(c)(3), 403(a)(4), 

11 403(b)(8), 408(d)(3), 408A(d)(3), or 457(e)(16), 

12 whichever is applicable; except that— 

13 ‘‘(A) the contribution shall be treated as 

14 having been made for the taxable year in which 

15 the distribution on account of the levy occurred, 

16 and the interest paid under subsection (c) shall 

17 be treated as earnings within the plan after the 

18 contribution and shall not be included in gross 

19 income, and 

20 ‘‘(B) such contribution shall not be taken 

21 into account under section 408(d)(3)(B). 

22 ‘‘(3) REFUND, ETC., OF INCOME TAX ON LEVY.— 

23 ‘‘(A) IN GENERAL.—If any amount is in24 cludible in gross income for a taxable year by 

25 reason of a distribution on account of a levy re-
224 

† HR 1892 EAS2 

1 ferred to in paragraph (1) and any portion of 

2 such amount is treated as a rollover contribution 

3 under paragraph (2), any tax imposed by chap4 ter 1 on such portion shall not be assessed, and 

5 if assessed shall be abated, and if collected shall 

6 be credited or refunded as an overpayment made 

7 on the due date for filing the return of tax for 

8 such taxable year. 

9 ‘‘(B) EXCEPTION.—Subparagraph (A) shall 

10 not apply to a rollover contribution under this 

11 subsection which is made from an eligible retire12 ment plan which is not a Roth IRA or a des13 ignated Roth account (within the meaning of 

14 section 402A) to a Roth IRA or a designated 

15 Roth account under an eligible retirement plan. 

16 ‘‘(4) INTEREST.—Notwithstanding subsection 

17 (d), interest shall be allowed under subsection (c) in 

18 a case in which the Secretary makes a determination 

19 described in subsection (d)(2)(A) with respect to a 

20 levy upon an individual retirement plan. 

21 ‘‘(5) TREATMENT OF INHERITED ACCOUNTS.— 

22 For purposes of paragraph (1)(A), section 

23 408(d)(3)(C) shall be disregarded in determining 

24 whether an individual retirement plan is a plan to 
225 

† HR 1892 EAS2 

1 which a rollover contribution of a distribution from 

2 the plan levied upon is permitted.’’. 

3 (b) EFFECTIVE DATE.—The amendment made by this 

4 section shall apply to amounts paid under subsections (b), 

5 (c), and (d)(2)(A) of section 6343 of the Internal Revenue 

6 Code of 1986 in taxable years beginning after December 31, 

7 2017. 

8 SEC. 41105. MODIFICATION OF USER FEE REQUIREMENTS 

9 FOR INSTALLMENT AGREEMENTS. 

10 (a) IN GENERAL.—Section 6159 is amended by redes11 ignating subsection (f) as subsection (g) and by inserting 

12 after subsection (e) the following new subsection: 

13 ‘‘(f) INSTALLMENT AGREEMENT FEES.— 

14 ‘‘(1) LIMITATION ON FEE AMOUNT.—The amount 

15 of any fee imposed on an installment agreement 

16 under this section may not exceed the amount of such 

17 fee as in effect on the date of the enactment of this 

18 subsection. 

19 ‘‘(2) WAIVER OR REIMBURSEMENT.—In the case 

20 of any taxpayer with an adjusted gross income, as de21 termined for the most recent year for which such in22 formation is available, which does not exceed 250 per23 cent of the applicable poverty level (as determined by 

24 the Secretary)— 
226 

† HR 1892 EAS2 

1 ‘‘(A) if the taxpayer has agreed to make 

2 payments under the installment agreement by 

3 electronic payment through a debit instrument, 

4 no fee shall be imposed on an installment agree5 ment under this section, and 

6 ‘‘(B) if the taxpayer is unable to make pay7 ments under the installment agreement by elec8 tronic payment through a debit instrument, the 

9 Secretary shall, upon completion of the install10 ment agreement, pay the taxpayer an amount 

11 equal to any such fees imposed.’’. 

12 (b) EFFECTIVE DATE.—The amendments made by this 

13 section shall apply to agreements entered into on or after 

14 the date which is 60 days after the date of the enactment 

15 of this Act. 

16 SEC. 41106. FORM 1040SR FOR SENIORS. 

17 (a) IN GENERAL.—The Secretary of the Treasury (or 

18 the Secretary’s delegate) shall make available a form, to be 

19 known as ‘‘Form 1040SR’’, for use by individuals to file 

20 the return of tax imposed by chapter 1 of the Internal Rev21 enue Code of 1986. Such form shall be as similar as prac22 ticable to Form 1040EZ, except that— 

23 (1) the form shall be available only to individ24 uals who have attained age 65 as of the close of the 

25 taxable year, 
227 

† HR 1892 EAS2 

1 (2) the form may be used even if income for the 

2 taxable year includes— 

3 (A) social security benefits (as defined in 

4 section 86(d) of the Internal Revenue Code of 

5 1986), 

6 (B) distributions from qualified retirement 

7 plans (as defined in section 4974(c) of such 

8 Code), annuities or other such deferred payment 

9 arrangements, 

10 (C) interest and dividends, or 

11 (D) capital gains and losses taken into ac12 count in determining adjusted net capital gain 

13 (as defined in section 1(h)(3) of such Code), and 

14 (3) the form shall be available without regard to 

15 the amount of any item of taxable income or the total 

16 amount of taxable income for the taxable year. 

17 (b) EFFECTIVE DATE.—The form required by sub18 section (a) shall be made available for taxable years begin19 ning after the date of the enactment of this Act. 

20 SEC. 41107. ATTORNEYS FEES RELATING TO AWARDS TO 

21 WHISTLEBLOWERS. 

22 (a) IN GENERAL.—Paragraph (21) of section 62(a) is 

23 amended to read as follows: 

24 ‘‘(21) ATTORNEYS’ FEES RELATING TO AWARDS

25 TO WHISTLEBLOWERS.— 
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† HR 1892 EAS2 

1 ‘‘(A) IN GENERAL.—Any deduction allow2 able under this chapter for attorney fees and 

3 court costs paid by, or on behalf of, the taxpayer 

4 in connection with any award under— 

5 ‘‘(i) section 7623(b), or 

6 ‘‘(ii) in the case of taxable years begin7 ning after December 31, 2017, any action 

8 brought under— 

9 ‘‘(I) section 21F of the Securities 

10 Exchange Act of 1934 (15 U.S.C. 78u– 

11 6), 

12 ‘‘(II) a State law relating to false 

13 or fraudulent claims that meets the re14 quirements described in section 1909(b) 

15 of the Social Security Act (42 U.S.C. 

16 1396h(b)), or 

17 ‘‘(III) section 23 of the Com18 modity Exchange Act (7 U.S.C. 26). 

19 ‘‘(B) MAY NOT EXCEED AWARD.—Subpara20 graph (A) shall not apply to any deduction in 

21 excess of the amount includible in the taxpayer’s 

22 gross income for the taxable year on account of 

23 such award.’’. 
229 

† HR 1892 EAS2 

1 (b) EFFECTIVE DATE.—The amendment made by this 

2 section shall apply to taxable years beginning after Decem3 ber 31, 2017. 

4 SEC. 41108. CLARIFICATION OF WHISTLEBLOWER AWARDS. 

5 (a) DEFINITION OF PROCEEDS.— 

6 (1) IN GENERAL.—Section 7623 is amended by 

7 adding at the end the following new subsection: 

8 ‘‘(c) PROCEEDS.—For purposes of this section, the 

9 term ‘proceeds’ includes— 

10 ‘‘(1) penalties, interest, additions to tax, and ad11 ditional amounts provided under the internal revenue 

12 laws, and 

13 ‘‘(2) any proceeds arising from laws for which 

14 the Internal Revenue Service is authorized to admin15 ister, enforce, or investigate, including— 

16 ‘‘(A) criminal fines and civil forfeitures, 

17 and 

18 ‘‘(B) violations of reporting requirements.’’. 

19 (2) CONFORMING AMENDMENTS.—Paragraphs 

20 (1) and (2)(A) of section 7623(b) are each amended 

21 by striking ‘‘collected proceeds (including penalties, 

22 interest, additions to tax, and additional amounts) 

23 resulting from the action’’ and inserting ‘‘proceeds 

24 collected as a result of the action’’. 
230 

† HR 1892 EAS2 

1 (b) AMOUNT OF PROCEEDS DETERMINED WITHOUT

2 REGARD TO AVAILABILITY.—Paragraphs (1) and (2)(A) of 

3 section 7623(b) are each amended by inserting ‘‘(determined 

4 without regard to whether such proceeds are available to 

5 the Secretary)’’ after ‘‘in response to such action’’. 

6 (c) DISPUTED AMOUNT THRESHOLD.—Section 

7 7623(b)(5)(B) is amended by striking ‘‘tax, penalties, inter8 est, additions to tax, and additional amounts’’ and insert9 ing ‘‘proceeds’’. 

10 (d) EFFECTIVE DATE.—The amendments made by this 

11 section shall apply to information provided before, on, or 

12 after the date of the enactment of this Act with respect to 

13 which a final determination for an award has not been 

14 made before such date of enactment. 

15 SEC. 41109. CLARIFICATION REGARDING EXCISE TAX BASED 

16 ON INVESTMENT INCOME OF PRIVATE COL17 LEGES AND UNIVERSITIES. 

18 (a) IN GENERAL.—Subsection (b)(1) of section 4968, 

19 as added by section 13701(a) of Public Law 115–97, is 

20 amended— 

21 (1) by inserting ‘‘tuition-paying’’ after ‘‘500’’ in 

22 subparagraph (A), and 

23 (2) by inserting ‘‘tuition-paying’’ after ‘‘50 per24 cent of the’’ in subparagraph (B). 
231 

† HR 1892 EAS2 

1 (b) EFFECTIVE DATE.—The amendments made by this 

2 section shall apply to taxable years beginning after Decem3 ber 31, 2017. 

4 SEC. 41110. EXCEPTION FROM PRIVATE FOUNDATION EX5 CESS BUSINESS HOLDING TAX FOR INDE6 PENDENTLY-OPERATED PHILANTHROPIC 

7 BUSINESS HOLDINGS. 

8 (a) IN GENERAL.—Section 4943 is amended by adding 

9 at the end the following new subsection: 

10 ‘‘(g) EXCEPTION FOR CERTAIN HOLDINGS LIMITED TO

11 INDEPENDENTLY-OPERATED PHILANTHROPIC BUSINESS.— 

12 ‘‘(1) IN GENERAL.—Subsection (a) shall not 

13 apply with respect to the holdings of a private foun14 dation in any business enterprise which meets the re15 quirements of paragraphs (2), (3), and (4) for the 

16 taxable year. 

17 ‘‘(2) OWNERSHIP.—The requirements of this 

18 paragraph are met if— 

19 ‘‘(A) 100 percent of the voting stock in the 

20 business enterprise is held by the private founda21 tion at all times during the taxable year, and 

22 ‘‘(B) all the private foundation’s ownership 

23 interests in the business enterprise were acquired 

24 by means other than by purchase. 

25 ‘‘(3) ALL PROFITS TO CHARITY.— 
232 

† HR 1892 EAS2 

1 ‘‘(A) IN GENERAL.—The requirements of 

2 this paragraph are met if the business enterprise, 

3 not later than 120 days after the close of the tax4 able year, distributes an amount equal to its net 

5 operating income for such taxable year to the 

6 private foundation. 

7 ‘‘(B) NET OPERATING INCOME.—For pur8 poses of this paragraph, the net operating in9 come of any business enterprise for any taxable 

10 year is an amount equal to the gross income of 

11 the business enterprise for the taxable year, re12 duced by the sum of— 

13 ‘‘(i) the deductions allowed by chapter 

14 1 for the taxable year which are directly 

15 connected with the production of such in16 come, 

17 ‘‘(ii) the tax imposed by chapter 1 on 

18 the business enterprise for the taxable year, 

19 and 

20 ‘‘(iii) an amount for a reasonable re21 serve for working capital and other business 

22 needs of the business enterprise. 

23 ‘‘(4) INDEPENDENT OPERATION.—The require24 ments of this paragraph are met if, at all times dur25 ing the taxable year— 
233 

† HR 1892 EAS2 

1 ‘‘(A) no substantial contributor (as defined 

2 in section 4958(c)(3)(C)) to the private founda3 tion or family member (as determined under sec4 tion 4958(f)(4)) of such a contributor is a direc5 tor, officer, trustee, manager, employee, or con6 tractor of the business enterprise (or an indi7 vidual having powers or responsibilities similar 

8 to any of the foregoing), 

9 ‘‘(B) at least a majority of the board of di10 rectors of the private foundation are persons who 

11 are not— 

12 ‘‘(i) directors or officers of the business 

13 enterprise, or 

14 ‘‘(ii) family members (as so deter15 mined) of a substantial contributor (as so 

16 defined) to the private foundation, and 

17 ‘‘(C) there is no loan outstanding from the 

18 business enterprise to a substantial contributor 

19 (as so defined) to the private foundation or to 

20 any family member of such a contributor (as so 

21 determined). 

22 ‘‘(5) CERTAIN DEEMED PRIVATE FOUNDATIONS

23 EXCLUDED.—This subsection shall not apply to— 
234 

† HR 1892 EAS2 

1 ‘‘(A) any fund or organization treated as a 

2 private foundation for purposes of this section by 

3 reason of subsection (e) or (f), 

4 ‘‘(B) any trust described in section 

5 4947(a)(1) (relating to charitable trusts), and 

6 ‘‘(C) any trust described in section 

7 4947(a)(2) (relating to split-interest trusts).’’. 

8 (b) EFFECTIVE DATE.—The amendment made by this 

9 section shall apply to taxable years beginning after Decem10 ber 31, 2017. 

11 SEC. 41111. RULE OF CONSTRUCTION FOR CRAFT BEV12 ERAGE MODERNIZATION AND TAX REFORM. 

13 (a) IN GENERAL.—Subpart A of part IX of subtitle 

14 C of title I of Public Law 115–97 is amended by adding 

15 at the end the following new section: 

16 ‘‘SEC. 13809. RULE OF CONSTRUCTION. 

17 ‘‘Nothing in this subpart, the amendments made by 

18 this subpart, or any regulation promulgated under this sub19 part or the amendments made by this subpart, shall be con20 strued to preempt, supersede, or otherwise limit or restrict 

21 any State, local, or tribal law that prohibits or regulates 

22 the production or sale of distilled spirits, wine, or malt bev23 erages.’’. 
235 

† HR 1892 EAS2 

1 (b) EFFECTIVE DATE.—The amendment made by this 

2 section shall take effect as if included in Public Law 115– 

3 97. 

4 SEC. 41112. SIMPLIFICATION OF RULES REGARDING 

5 RECORDS, STATEMENTS, AND RETURNS. 

6 (a) IN GENERAL.—Subsection (a) of section 5555 is 

7 amended by adding at the end the following: ‘‘For calendar 

8 quarters beginning after the date of the enactment of this 

9 sentence, and before January 1, 2020, the Secretary shall 

10 permit a person to employ a unified system for any records, 

11 statements, and returns required to be kept, rendered, or 

12 made under this section for any beer produced in the brew13 ery for which the tax imposed by section 5051 has been de14 termined, including any beer which has been removed for 

15 consumption on the premises of the brewery.’’. 

16 (b) EFFECTIVE DATE.—The amendment made by this 

17 section shall apply to calendar quarters beginning after the 

18 date of the enactment of this Act. 

19 SEC. 41113. MODIFICATION OF RULES GOVERNING HARD20 SHIP DISTRIBUTIONS. 

21 (a) IN GENERAL.—Not later than 1 year after the date 

22 of the enactment of this Act, the Secretary of the Treasury 

23 shall modify Treasury Regulation section 1.401(k)– 

24 1(d)(3)(iv)(E) to— 
236 

† HR 1892 EAS2 

1 (1) delete the 6-month prohibition on contribu2 tions imposed by paragraph (2) thereof, and 

3 (2) make any other modifications necessary to 

4 carry out the purposes of section 401(k)(2)(B)(i)(IV) 

5 of the Internal Revenue Code of 1986. 

6 (b) EFFECTIVE DATE.—The revised regulations under 

7 this section shall apply to plan years beginning after De8 cember 31, 2018. 

9 SEC. 41114. MODIFICATION OF RULES RELATING TO HARD10 SHIP WITHDRAWALS FROM CASH OR DE11 FERRED ARRANGEMENTS. 

12 (a) IN GENERAL.—Section 401(k) is amended by add13 ing at the end the following: 

14 ‘‘(14) SPECIAL RULES RELATING TO HARDSHIP

15 WITHDRAWALS.—For purposes of paragraph 

16 (2)(B)(i)(IV)— 

17 ‘‘(A) AMOUNTS WHICH MAY BE WITH18 DRAWN.—The following amounts may be distrib19 uted upon hardship of the employee: 

20 ‘‘(i) Contributions to a profit-sharing 

21 or stock bonus plan to which section 

22 402(e)(3) applies. 

23 ‘‘(ii) Qualified nonelective contribu24 tions (as defined in subsection (m)(4)(C)). 
237 

† HR 1892 EAS2 

1 ‘‘(iii) Qualified matching contributions 

2 described in paragraph (3)(D)(ii)(I). 

3 ‘‘(iv) Earnings on any contributions 

4 described in clause (i), (ii), or (iii). 

5 ‘‘(B) NO REQUIREMENT TO TAKE AVAIL6 ABLE LOAN.—A distribution shall not be treated 

7 as failing to be made upon the hardship of an 

8 employee solely because the employee does not 

9 take any available loan under the plan.’’. 

10 (b) CONFORMING AMENDMENT.—Section 

11 401(k)(2)(B)(i)(IV) is amended to read as follows: 

12 ‘‘(IV) subject to the provisions of 

13 paragraph (14), upon hardship of the 

14 employee, or’’. 

15 (c) EFFECTIVE DATE.—The amendments made by this 

16 section shall apply to plan years beginning after December 

17 31, 2018. 

18 SEC. 41115. OPPORTUNITY ZONES RULE FOR PUERTO RICO. 

19 (a) IN GENERAL.—Subsection (b) of section 1400Z– 

20 1 is amended by adding at the end the following new para21 graph: 

22 ‘‘(3) SPECIAL RULE FOR PUERTO RICO.—Each 

23 population census tract in Puerto Rico that is a low24 income community shall be deemed to be certified and 
238 

† HR 1892 EAS2 

1 designated as a qualified opportunity zone, effective 

2 on the date of the enactment of Public Law 115–97.’’. 

3 (b) CONFORMING AMENDMENT.—Section 1400Z– 

4 1(d)(1) is amended by inserting ‘‘and subsection (b)(3)’’ 

5 after ‘‘paragraph (2)’’. 

6 SEC. 41116. TAX HOME OF CERTAIN CITIZENS OR RESI7 DENTS OF THE UNITED STATES LIVING 

8 ABROAD. 

9 (a) IN GENERAL.—Paragraph (3) of section 911(d) is 

10 amended by inserting before the period at the end of the 

11 second sentence the following: ‘‘, unless such individual is 

12 serving in an area designated by the President of the United 

13 States by Executive order as a combat zone for purposes 

14 of section 112 in support of the Armed Forces of the United 

15 States’’. 

16 (b) EFFECTIVE DATE.—The amendment made by this 

17 section shall apply to taxable years beginning after Decem18 ber 31, 2017. 

19 SEC. 41117. TREATMENT OF FOREIGN PERSONS FOR RE20 TURNS RELATING TO PAYMENTS MADE IN 

21 SETTLEMENT OF PAYMENT CARD AND THIRD 

22 PARTY NETWORK TRANSACTIONS. 

23 (a) IN GENERAL.—Section 6050W(d)(1)(B) is amend24 ed by adding at the end the following: ‘‘Notwithstanding 

25 the preceding sentence, a person with only a foreign address 
239 

† HR 1892 EAS2 

1 shall not be treated as a participating payee with respect 

2 to any payment settlement entity solely because such person 

3 receives payments from such payment settlement entity in 

4 dollars.’’. 

5 (b) EFFECTIVE DATE.—The amendment made by this 

6 section shall apply to returns for calendar years beginning 

7 after December 31, 2017. 

8 SEC. 41118. REPEAL OF SHIFT IN TIME OF PAYMENT OF 

9 CORPORATE ESTIMATED TAXES. 

10 The Trade Preferences Extension Act of 2015 is 

11 amended by striking section 803 (relating to time for pay12 ment of corporate estimated taxes). 

13 SEC. 41119. ENHANCEMENT OF CARBON DIOXIDE SEQUES14 TRATION CREDIT. 

15 (a) IN GENERAL.—Section 45Q is amended to read as 

16 follows: 

17 ‘‘SEC. 45Q. CREDIT FOR CARBON OXIDE SEQUESTRATION. 

18 ‘‘(a) GENERAL RULE.—For purposes of section 38, the 

19 carbon oxide sequestration credit for any taxable year is 

20 an amount equal to the sum of— 

21 ‘‘(1) $20 per metric ton of qualified carbon oxide 

22 which is— 

23 ‘‘(A) captured by the taxpayer using carbon 

24 capture equipment which is originally placed in 

25 service at a qualified facility before the date of 
240 

† HR 1892 EAS2 

1 the enactment of the Bipartisan Budget Act of 

2 2018, and 

3 ‘‘(B) disposed of by the taxpayer in secure 

4 geological storage and not used by the taxpayer 

5 as described in paragraph (2)(B), 

6 ‘‘(2) $10 per metric ton of qualified carbon oxide 

7 which is— 

8 ‘‘(A) captured by the taxpayer using carbon 

9 capture equipment which is originally placed in 

10 service at a qualified facility before the date of 

11 the enactment of the Bipartisan Budget Act of 

12 2018, and 

13 ‘‘(B)(i) used by the taxpayer as a tertiary 

14 injectant in a qualified enhanced oil or natural 

15 gas recovery project and disposed of by the tax16 payer in secure geological storage, or 

17 ‘‘(ii) utilized by the taxpayer in a manner 

18 described in subsection (f)(5), 

19 ‘‘(3) the applicable dollar amount (as determined 

20 under subsection (b)(1)) per metric ton of qualified 

21 carbon oxide which is— 

22 ‘‘(A) captured by the taxpayer using carbon 

23 capture equipment which is originally placed in 

24 service at a qualified facility on or after the date 

25 of the enactment of the Bipartisan Budget Act of 
241 

† HR 1892 EAS2 

1 2018, during the 12-year period beginning on the 

2 date the equipment was originally placed in 

3 service, and 

4 ‘‘(B) disposed of by the taxpayer in secure 

5 geological storage and not used by the taxpayer 

6 as described in paragraph (4)(B), and 

7 ‘‘(4) the applicable dollar amount (as determined 

8 under subsection (b)(1)) per metric ton of qualified 

9 carbon oxide which is— 

10 ‘‘(A) captured by the taxpayer using carbon 

11 capture equipment which is originally placed in 

12 service at a qualified facility on or after the date 

13 of the enactment of the Bipartisan Budget Act of 

14 2018, during the 12-year period beginning on the 

15 date the equipment was originally placed in 

16 service, and 

17 ‘‘(B)(i) used by the taxpayer as a tertiary 

18 injectant in a qualified enhanced oil or natural 

19 gas recovery project and disposed of by the tax20 payer in secure geological storage, or 

21 ‘‘(ii) utilized by the taxpayer in a manner 

22 described in subsection (f)(5). 

23 ‘‘(b) APPLICABLE DOLLAR AMOUNT; ADDITIONAL

24 EQUIPMENT; ELECTION.— 

25 ‘‘(1) APPLICABLE DOLLAR AMOUNT.— 
242 

† HR 1892 EAS2 

1 ‘‘(A) IN GENERAL.—The applicable dollar 

2 amount shall be an amount equal to— 

3 ‘‘(i) for any taxable year beginning in 

4 a calendar year after 2016 and before 

5 2027— 

6 ‘‘(I) for purposes of paragraph (3) 

7 of subsection (a), the dollar amount es8 tablished by linear interpolation be9 tween $22.66 and $50 for each cal10 endar year during such period, and 

11 ‘‘(II) for purposes of paragraph 

12 (4) of such subsection, the dollar 

13 amount established by linear interpola14 tion between $12.83 and $35 for each 

15 calendar year during such period, and 

16 ‘‘(ii) for any taxable year beginning in 

17 a calendar year after 2026— 

18 ‘‘(I) for purposes of paragraph (3) 

19 of subsection (a), an amount equal to 

20 the product of $50 and the inflation 

21 adjustment factor for such calendar 

22 year determined under section 

23 43(b)(3)(B) for such calendar year, de24 termined by substituting ‘2025’ for 

25 ‘1990’, and 
243 

† HR 1892 EAS2 

1 ‘‘(II) for purposes of paragraph 

2 (4) of such subsection, an amount 

3 equal to the product of $35 and the in4 flation adjustment factor for such cal5 endar year determined under section 

6 43(b)(3)(B) for such calendar year, de7 termined by substituting ‘2025’ for 

8 ‘1990’. 

9 ‘‘(B) ROUNDING.—The applicable dollar 

10 amount determined under subparagraph (A) 

11 shall be rounded to the nearest cent. 

12 ‘‘(2) INSTALLATION OF ADDITIONAL CARBON CAP13 TURE EQUIPMENT ON EXISTING QUALIFIED FACIL14 ITY.—In the case of a qualified facility placed in 

15 service before the date of the enactment of the Bipar16 tisan Budget Act of 2018, for which additional carbon 

17 capture equipment is placed in service on or after the 

18 date of the enactment of such Act, the amount of 

19 qualified carbon oxide which is captured by the tax20 payer shall be equal to— 

21 ‘‘(A) for purposes of paragraphs (1)(A) and 

22 (2)(A) of subsection (a), the lesser of— 

23 ‘‘(i) the total amount of qualified car24 bon oxide captured at such facility for the 

25 taxable year, or 
244 

† HR 1892 EAS2 

1 ‘‘(ii) the total amount of the carbon di2 oxide capture capacity of the carbon cap3 ture equipment in service at such facility on 

4 the day before the date of the enactment of 

5 the Bipartisan Budget Act of 2018, and 

6 ‘‘(B) for purposes of paragraphs (3)(A) and 

7 (4)(A) of such subsection, an amount (not less 

8 than zero) equal to the excess of— 

9 ‘‘(i) the amount described in clause (i) 

10 of subparagraph (A), over 

11 ‘‘(ii) the amount described in clause 

12 (ii) of such subparagraph. 

13 ‘‘(3) ELECTION.—For purposes of determining 

14 the carbon oxide sequestration credit under this sec15 tion, a taxpayer may elect to have the dollar amounts 

16 applicable under paragraph (1) or (2) of subsection 

17 (a) apply in lieu of the dollar amounts applicable 

18 under paragraph (3) or (4) of such subsection for each 

19 metric ton of qualified carbon oxide which is captured 

20 by the taxpayer using carbon capture equipment 

21 which is originally placed in service at a qualified fa22 cility on or after the date of the enactment of the Bi23 partisan Budget Act of 2018. 

24 ‘‘(c) QUALIFIED CARBON OXIDE.—For purposes of this 

25 section— 
245 

† HR 1892 EAS2 

1 ‘‘(1) IN GENERAL.—The term ‘qualified carbon 

2 oxide’ means— 

3 ‘‘(A) any carbon dioxide which— 

4 ‘‘(i) is captured from an industrial 

5 source by carbon capture equipment which 

6 is originally placed in service before the 

7 date of the enactment of the Bipartisan 

8 Budget Act of 2018, 

9 ‘‘(ii) would otherwise be released into 

10 the atmosphere as industrial emission of 

11 greenhouse gas or lead to such release, and 

12 ‘‘(iii) is measured at the source of cap13 ture and verified at the point of disposal, 

14 injection, or utilization, 

15 ‘‘(B) any carbon dioxide or other carbon 

16 oxide which— 

17 ‘‘(i) is captured from an industrial 

18 source by carbon capture equipment which 

19 is originally placed in service on or after 

20 the date of the enactment of the Bipartisan 

21 Budget Act of 2018, 

22 ‘‘(ii) would otherwise be released into 

23 the atmosphere as industrial emission of 

24 greenhouse gas or lead to such release, and 
246 

† HR 1892 EAS2 

1 ‘‘(iii) is measured at the source of cap2 ture and verified at the point of disposal, 

3 injection, or utilization, or 

4 ‘‘(C) in the case of a direct air capture fa5 cility, any carbon dioxide which— 

6 ‘‘(i) is captured directly from the am7 bient air, and 

8 ‘‘(ii) is measured at the source of cap9 ture and verified at the point of disposal, 

10 injection, or utilization. 

11 ‘‘(2) RECYCLED CARBON OXIDE.—The term 

12 ‘qualified carbon oxide’ includes the initial deposit of 

13 captured carbon oxide used as a tertiary injectant. 

14 Such term does not include carbon oxide that is re15 captured, recycled, and re-injected as part of the en16 hanced oil and natural gas recovery process. 

17 ‘‘(d) QUALIFIED FACILITY.—For purposes of this sec18 tion, the term ‘qualified facility’ means any industrial fa19 cility or direct air capture facility— 

20 ‘‘(1) the construction of which begins before Jan21 uary 1, 2024, and— 

22 ‘‘(A) construction of carbon capture equip23 ment begins before such date, or 
247 

† HR 1892 EAS2 

1 ‘‘(B) the original planning and design for 

2 such facility includes installation of carbon cap3 ture equipment, and 

4 ‘‘(2) which captures— 

5 ‘‘(A) in the case of a facility which emits 

6 not more than 500,000 metric tons of carbon 

7 oxide into the atmosphere during the taxable 

8 year, not less than 25,000 metric tons of quali9 fied carbon oxide during the taxable year which 

10 is utilized in a manner described in subsection 

11 (f)(5), 

12 ‘‘(B) in the case of an electricity generating 

13 facility which is not described in subparagraph 

14 (A), not less than 500,000 metric tons of quali15 fied carbon oxide during the taxable year, or 

16 ‘‘(C) in the case of a direct air capture fa17 cility or any facility not described in subpara18 graph (A) or (B), not less than 100,000 metric 

19 tons of qualified carbon oxide during the taxable 

20 year. 

21 ‘‘(e) DEFINITIONS.—For purposes of this section— 

22 ‘‘(1) DIRECT AIR CAPTURE FACILITY.— 

23 ‘‘(A) IN GENERAL.—Subject to subpara24 graph (B), the term ‘direct air capture facility’ 

25 means any facility which uses carbon capture 
248 

† HR 1892 EAS2 

1 equipment to capture carbon dioxide directly 

2 from the ambient air. 

3 ‘‘(B) EXCEPTION.—The term ‘direct air 

4 capture facility’ shall not include any facility 

5 which captures carbon dioxide— 

6 ‘‘(i) which is deliberately released from 

7 naturally occurring subsurface springs, or 

8 ‘‘(ii) using natural photosynthesis. 

9 ‘‘(2) QUALIFIED ENHANCED OIL OR NATURAL

10 GAS RECOVERY PROJECT.—The term ‘qualified en11 hanced oil or natural gas recovery project’ has the 

12 meaning given the term ‘qualified enhanced oil recov13 ery project’ by section 43(c)(2), by substituting ‘crude 

14 oil or natural gas’ for ‘crude oil’ in subparagraph 

15 (A)(i) thereof. 

16 ‘‘(3) TERTIARY INJECTANT.—The term ‘tertiary 

17 injectant’ has the same meaning as when used within 

18 section 193(b)(1). 

19 ‘‘(f) SPECIAL RULES.— 

20 ‘‘(1) ONLY QUALIFIED CARBON OXIDE CAPTURED

21 AND DISPOSED OF OR USED WITHIN THE UNITED

22 STATES TAKEN INTO ACCOUNT.—The credit under this 

23 section shall apply only with respect to qualified car24 bon oxide the capture and disposal, use, or utilization 

25 of which is within— 
249 

† HR 1892 EAS2 

1 ‘‘(A) the United States (within the meaning 

2 of section 638(1)), or 

3 ‘‘(B) a possession of the United States 

4 (within the meaning of section 638(2)). 

5 ‘‘(2) SECURE GEOLOGICAL STORAGE.—The Sec6 retary, in consultation with the Administrator of the 

7 Environmental Protection Agency, the Secretary of 

8 Energy, and the Secretary of the Interior, shall estab9 lish regulations for determining adequate security 

10 measures for the geological storage of qualified carbon 

11 oxide under subsection (a) such that the qualified car12 bon oxide does not escape into the atmosphere. Such 

13 term shall include storage at deep saline formations, 

14 oil and gas reservoirs, and unminable coal seams 

15 under such conditions as the Secretary may deter16 mine under such regulations. 

17 ‘‘(3) CREDIT ATTRIBUTABLE TO TAXPAYER.— 

18 ‘‘(A) IN GENERAL.—Except as provided in 

19 subparagraph (B) or in any regulations pre20 scribed by the Secretary, any credit under this 

21 section shall be attributable to— 

22 ‘‘(i) in the case of qualified carbon 

23 oxide captured using carbon capture equip24 ment which is originally placed in service 

25 at a qualified facility before the date of the 
250 

† HR 1892 EAS2 

1 enactment of the Bipartisan Budget Act of 

2 2018, the person that captures and phys3 ically or contractually ensures the disposal, 

4 utilization, or use as a tertiary injectant of 

5 such qualified carbon oxide, and 

6 ‘‘(ii) in the case of qualified carbon 

7 oxide captured using carbon capture equip8 ment which is originally placed in service 

9 at a qualified facility on or after the date 

10 of the enactment of the Bipartisan Budget 

11 Act of 2018, the person that owns the car12 bon capture equipment and physically or 

13 contractually ensures the capture and dis14 posal, utilization, or use as a tertiary 

15 injectant of such qualified carbon oxide. 

16 ‘‘(B) ELECTION.—If the person described in 

17 subparagraph (A) makes an election under this 

18 subparagraph in such time and manner as the 

19 Secretary may prescribe by regulations, the cred20 it under this section— 

21 ‘‘(i) shall be allowable to the person 

22 that disposes of the qualified carbon oxide, 

23 utilizes the qualified carbon oxide, or uses 

24 the qualified carbon oxide as a tertiary 

25 injectant, and 
251 

† HR 1892 EAS2 

1 ‘‘(ii) shall not be allowable to the per2 son described in subparagraph (A). 

3 ‘‘(4) RECAPTURE.—The Secretary shall, by regu4 lations, provide for recapturing the benefit of any 

5 credit allowable under subsection (a) with respect to 

6 any qualified carbon oxide which ceases to be cap7 tured, disposed of, or used as a tertiary injectant in 

8 a manner consistent with the requirements of this sec9 tion. 

10 ‘‘(5) UTILIZATION OF QUALIFIED CARBON

11 OXIDE.— 

12 ‘‘(A) IN GENERAL.—For purposes of this 

13 section, utilization of qualified carbon oxide 

14 means— 

15 ‘‘(i) the fixation of such qualified car16 bon oxide through photosynthesis or 

17 chemosynthesis, such as through the growing 

18 of algae or bacteria, 

19 ‘‘(ii) the chemical conversion of such 

20 qualified carbon oxide to a material or 

21 chemical compound in which such qualified 

22 carbon oxide is securely stored, or 

23 ‘‘(iii) the use of such qualified carbon 

24 oxide for any other purpose for which a 

25 commercial market exists (with the excep-
252 

† HR 1892 EAS2 

1 tion of use as a tertiary injectant in a 

2 qualified enhanced oil or natural gas recov3 ery project), as determined by the Secretary. 

4 ‘‘(B) MEASUREMENT.— 

5 ‘‘(i) IN GENERAL.—For purposes of de6 termining the amount of qualified carbon 

7 oxide utilized by the taxpayer under para8 graph (2)(B)(ii) or (4)(B)(ii) of subsection 

9 (a), such amount shall be equal to the met10 ric tons of qualified carbon oxide which the 

11 taxpayer demonstrates, based upon an anal12 ysis of lifecycle greenhouse gas emissions 

13 and subject to such requirements as the Sec14 retary, in consultation with the Secretary of 

15 Energy and the Administrator of the Envi16 ronmental Protection Agency, determines 

17 appropriate, were— 

18 ‘‘(I) captured and permanently 

19 isolated from the atmosphere, or 

20 ‘‘(II) displaced from being emitted 

21 into the atmosphere, 

22 through use of a process described in sub23 paragraph (A). 

24 ‘‘(ii) LIFECYCLE GREENHOUSE GAS

25 EMISSIONS.—For purposes of clause (i), the 
253 

† HR 1892 EAS2 

1 term ‘lifecycle greenhouse gas emissions’ has 

2 the same meaning given such term under 

3 subparagraph (H) of section 211(o)(1) of 

4 the Clean Air Act (42 U.S.C. 7545(o)(1)), 

5 as in effect on the date of the enactment of 

6 the Bipartisan Budget Act of 2018, except 

7 that ‘product’ shall be substituted for ‘fuel’ 

8 each place it appears in such subparagraph. 

9 ‘‘(6) ELECTION FOR APPLICABLE FACILITIES.— 

10 ‘‘(A) IN GENERAL.—For purposes of this 

11 section, in the case of an applicable facility, for 

12 any taxable year in which such facility captures 

13 not less than 500,000 metric tons of qualified 

14 carbon oxide during the taxable year, the person 

15 described in paragraph (3)(A)(ii) may elect to 

16 have such facility, and any carbon capture 

17 equipment placed in service at such facility, 

18 deemed as having been placed in service on the 

19 date of the enactment of the Bipartisan Budget 

20 Act of 2018. 

21 ‘‘(B) APPLICABLE FACILITY.—For purposes 

22 of this paragraph, the term ‘applicable facility’ 

23 means a qualified facility— 
254 

† HR 1892 EAS2 

1 ‘‘(i) which was placed in service before 

2 the date of the enactment of the Bipartisan 

3 Budget Act of 2018, and 

4 ‘‘(ii) for which no taxpayer claimed a 

5 credit under this section in regards to such 

6 facility for any taxable year ending before 

7 the date of the enactment of such Act. 

8 ‘‘(7) INFLATION ADJUSTMENT.—In the case of 

9 any taxable year beginning in a calendar year after 

10 2009, there shall be substituted for each dollar amount 

11 contained in paragraphs (1) and (2) of subsection (a) 

12 an amount equal to the product of— 

13 ‘‘(A) such dollar amount, multiplied by 

14 ‘‘(B) the inflation adjustment factor for 

15 such calendar year determined under section 

16 43(b)(3)(B) for such calendar year, determined 

17 by substituting ‘2008’ for ‘1990’. 

18 ‘‘(g) APPLICATION OF SECTION FOR CERTAIN CARBON

19 CAPTURE EQUIPMENT.—In the case of any carbon capture 

20 equipment placed in service before the date of the enactment 

21 of the Bipartisan Budget Act of 2018, the credit under this 

22 section shall apply with respect to qualified carbon oxide 

23 captured using such equipment before the end of the cal24 endar year in which the Secretary, in consultation with the 

25 Administrator of the Environmental Protection Agency, 
255 

† HR 1892 EAS2 

1 certifies that, during the period beginning after October 3, 

2 2008, a total of 75,000,000 metric tons of qualified carbon 

3 oxide have been taken into account in accordance with— 

4 ‘‘(1) subsection (a) of this section, as in effect on 

5 the day before the date of the enactment of the Bipar6 tisan Budget Act of 2018, and 

7 ‘‘(2) paragraphs (1) and (2) of subsection (a) of 

8 this section. 

9 ‘‘(h) REGULATIONS.—The Secretary may prescribe 

10 such regulations and other guidance as may be necessary 

11 or appropriate to carry out this section, including regula12 tions or other guidance to— 

13 ‘‘(1) ensure proper allocation under subsection 

14 (a) for qualified carbon oxide captured by a taxpayer 

15 during the taxable year ending after the date of the 

16 enactment of the Bipartisan Budget Act of 2018, and 

17 ‘‘(2) determine whether a facility satisfies the re18 quirements under subsection (d)(1) during such tax19 able year.’’. 

20 (b) EFFECTIVE DATE.—The amendment made by this 

21 section shall apply to taxable years beginning after Decem22 ber 31, 2017. 
256 

† HR 1892 EAS2 

1 DIVISION E—HEALTH AND 

2 HUMAN SERVICES EXTENDERS 

3 SEC. 50100. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This division may be cited as the 

5 ‘‘Advancing Chronic Care, Extenders, and Social Services 

6 (ACCESS) Act’’ 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this division is as follows: 

DIVISION E—HEALTH AND HUMAN SERVICES EXTENDERS 

Sec. 50100. Short title; table of contents. 

TITLE I—CHIP 

Sec. 50101. Funding extension of the Children’s Health Insurance Program 

through fiscal year 2027. 

Sec. 50102. Extension of pediatric quality measures program. 

Sec. 50103. Extension of outreach and enrollment program. 

TITLE II—MEDICARE EXTENDERS 

Sec. 50201. Extension of work GPCI floor. 

Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to 

ensure appropriate therapy. 

Sec. 50203. Medicare ambulance services. 

Sec. 50204. Extension of increased inpatient hospital payment adjustment for 

certain low-volume hospitals. 

Sec. 50205. Extension of the Medicare-dependent hospital (MDH) program. 

Sec. 50206. Extension of funding for quality measure endorsement, input, and selection; reporting requirements. 

Sec. 50207. Extension of funding outreach and assistance for low-income programs; State health insurance assistance program reporting requirements. 

Sec. 50208. Extension of home health rural add-on. 

TITLE III—CREATING HIGH-QUALITY RESULTS AND OUTCOMES 

NECESSARY TO IMPROVE CHRONIC (CHRONIC) CARE 

Subtitle A—Receiving High Quality Care in the Home 

Sec. 50301. Extending the Independence at Home Demonstration Program. 

Sec. 50302. Expanding access to home dialysis therapy. 

Subtitle B—Advancing Team-Based Care 

Sec. 50311. Providing continued access to Medicare Advantage special needs 

plans for vulnerable populations. 
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† HR 1892 EAS2 

Subtitle C—Expanding Innovation and Technology 

Sec. 50321. Adapting benefits to meet the needs of chronically ill Medicare Advantage enrollees. 

Sec. 50322. Expanding supplemental benefits to meet the needs of chronically ill 

Medicare Advantage enrollees. 

Sec. 50323. Increasing convenience for Medicare Advantage enrollees through telehealth. 

Sec. 50324. Providing accountable care organizations the ability to expand the 

use of telehealth. 

Sec. 50325. Expanding the use of telehealth for individuals with stroke. 

Subtitle D—Identifying the Chronically Ill Population 

Sec. 50331. Providing flexibility for beneficiaries to be part of an accountable 

care organization. 

Subtitle E—Empowering Individuals and Caregivers in Care Delivery 

Sec. 50341. Eliminating barriers to care coordination under accountable care organizations. 

Sec. 50342. GAO study and report on longitudinal comprehensive care planning 

services under Medicare part B. 

Subtitle F—Other Policies to Improve Care for the Chronically Ill 

Sec. 50351. GAO study and report on improving medication synchronization. 

Sec. 50352. GAO study and report on impact of obesity drugs on patient health 

and spending. 

Sec. 50353. HHS study and report on long-term risk factors for chronic conditions among Medicare beneficiaries. 

Sec. 50354. Providing prescription drug plans with parts A and B claims data 

to promote the appropriate use of medications and improve 

health outcomes. 

TITLE IV—PART B IMPROVEMENT ACT AND OTHER PART B 

ENHANCEMENTS 

Subtitle A—Medicare Part B Improvement Act 

Sec. 50401. Home infusion therapy services temporary transitional payment. 

Sec. 50402. Orthotist’s and prosthetist’s clinical notes as part of the patient’s 

medical record. 

Sec. 50403. Independent accreditation for dialysis facilities and assurance of high 

quality surveys. 

Sec. 50404. Modernizing the application of the Stark rule under Medicare. 

Subtitle B—Additional Medicare Provisions 

Sec. 50411. Making permanent the removal of the rental cap for durable medical 

equipment under Medicare with respect to speech generating devices. 

Sec. 50412. Increased civil and criminal penalties and increased sentences for 

Federal health care program fraud and abuse. 

Sec. 50413. Reducing the volume of future EHR-related significant hardship requests. 

Sec. 50414. Strengthening rules in case of competition for diabetic testing strips. 
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† HR 1892 EAS2 

TITLE V—OTHER HEALTH EXTENDERS 

Sec. 50501. Extension for family-to-family health information centers. 

Sec. 50502. Extension for sexual risk avoidance education. 

Sec. 50503. Extension for personal responsibility education. 

TITLE VI—CHILD AND FAMILY SERVICES AND SUPPORTS 

EXTENDERS 

Subtitle A—Continuing the Maternal, Infant, and Early Childhood Home 

Visiting Program 

Sec. 50601. Continuing evidence-based home visiting program. 

Sec. 50602. Continuing to demonstrate results to help families. 

Sec. 50603. Reviewing statewide needs to target resources. 

Sec. 50604. Improving the likelihood of success in high-risk communities. 

Sec. 50605. Option to fund evidence-based home visiting on a pay for outcome 

basis. 

Sec. 50606. Data exchange standards for improved interoperability. 

Sec. 50607. Allocation of funds. 

Subtitle B—Extension of Health Professions Workforce Demonstration Projects 

Sec. 50611. Extension of health workforce demonstration projects for low-income 

individuals. 

TITLE VII—FAMILY FIRST PREVENTION SERVICES ACT 

Subtitle A—Investing in Prevention and Supporting Families 

Sec. 50701. Short title. 

Sec. 50702. Purpose. 

PART I—PREVENTION ACTIVITIES UNDER TITLE IV–E 

Sec. 50711. Foster care prevention services and programs. 

Sec. 50712. Foster care maintenance payments for children with parents in a licensed residential family-based treatment facility for substance 

abuse. 

Sec. 50713. Title IV–E payments for evidence-based kinship navigator programs. 

PART II—ENHANCED SUPPORT UNDER TITLE IV–B 

Sec. 50721. Elimination of time limit for family reunification services while in 

foster care and permitting time-limited family reunification 

services when a child returns home from foster care. 

Sec. 50722. Reducing bureaucracy and unnecessary delays when placing children 

in homes across State lines. 

Sec. 50723. Enhancements to grants to improve well-being of families affected by 

substance abuse. 

PART III—MISCELLANEOUS

Sec. 50731. Reviewing and improving licensing standards for placement in a relative foster family home. 

Sec. 50732. Development of a statewide plan to prevent child abuse and neglect 

fatalities. 

Sec. 50733. Modernizing the title and purpose of title IV–E. 

Sec. 50734. Effective dates. 
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† HR 1892 EAS2 

PART IV—ENSURING THE NECESSITY OF A PLACEMENT THAT IS NOT IN A

FOSTER FAMILY HOME

Sec. 50741. Limitation on Federal financial participation for placements that 

are not in foster family homes. 

Sec. 50742. Assessment and documentation of the need for placement in a qualified residential treatment program. 

Sec. 50743. Protocols to prevent inappropriate diagnoses. 

Sec. 50744. Additional data and reports regarding children placed in a setting 

that is not a foster family home. 

Sec. 50745. Criminal records checks and checks of child abuse and neglect registries for adults working in child-care institutions and other 

group care settings. 

Sec. 50746. Effective dates; application to waivers. 

PART V—CONTINUING SUPPORT FOR CHILD AND FAMILY SERVICES

Sec. 50751. Supporting and retaining foster families for children. 

Sec. 50752. Extension of child and family services programs. 

Sec. 50753. Improvements to the John H. Chafee foster care independence program and related provisions. 

PART VI—CONTINUING INCENTIVES TO STATES TO PROMOTE ADOPTION AND

LEGAL GUARDIANSHIP

Sec. 50761. Reauthorizing adoption and legal guardianship incentive programs. 

PART VII—TECHNICAL CORRECTIONS

Sec. 50771. Technical corrections to data exchange standards to improve program 

coordination. 

Sec. 50772. Technical corrections to State requirement to address the developmental needs of young children. 

PART VIII—ENSURING STATES REINVEST SAVINGS RESULTING FROM

INCREASE IN ADOPTION ASSISTANCE

Sec. 50781. Delay of adoption assistance phase-in. 

Sec. 50782. GAO study and report on State reinvestment of savings resulting 

from increase in adoption assistance. 

TITLE VIII—SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY 

FOR RESULTS 

Sec. 50801. Short title. 

Sec. 50802. Social impact partnerships to pay for results. 

TITLE IX—PUBLIC HEALTH PROGRAMS 

Sec. 50901. Extension for community health centers, the National Health Service 

Corps, and teaching health centers that operate GME programs. 

Sec. 50902. Extension for special diabetes programs. 

TITLE X—MISCELLANEOUS HEALTH CARE POLICIES 

Sec. 51001. Home health payment reform. 

Sec. 51002. Information to satisfy documentation of Medicare eligibility for home 

health services. 

Sec. 51003. Technical amendments to Public Law 114–10. 
260 

† HR 1892 EAS2 

Sec. 51004. Expanded access to Medicare intensive cardiac rehabilitation programs. 

Sec. 51005. Extension of blended site neutral payment rate for certain long-term 

care hospital discharges; temporary adjustment to site neutral 

payment rates. 

Sec. 51006. Recognition of attending physician assistants as attending physicians 

to serve hospice patients. 

Sec. 51007. Extension of enforcement instruction on supervision requirements for 

outpatient therapeutic services in critical access and small rural 

hospitals through 2017. 

Sec. 51008. Allowing physician assistants, nurse practitioners, and clinical nurse 

specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. 

Sec. 51009. Transitional payment rules for certain radiation therapy services 

under the physician fee schedule. 

TITLE XI—PROTECTING SENIORS’ ACCESS TO MEDICARE ACT 

Sec. 52001. Repeal of the Independent Payment Advisory Board. 

TITLE XII—OFFSETS 

Sec. 53101. Modifying reductions in Medicaid DSH allotments. 

Sec. 53102. Third party liability in Medicaid and CHIP. 

Sec. 53103. Treatment of lottery winnings and other lump-sum income for purposes of income eligibility under Medicaid. 

Sec. 53104. Rebate obligation with respect to line extension drugs. 

Sec. 53105. Medicaid Improvement Fund. 

Sec. 53106. Physician fee schedule update. 

Sec. 53107. Payment for outpatient physical therapy services and outpatient occupational therapy services furnished by a therapy assistant. 

Sec. 53108. Reduction for non-emergency ESRD ambulance transports. 

Sec. 53109. Hospital transfer policy for early discharges to hospice care. 

Sec. 53110. Medicare payment update for home health services. 

Sec. 53111. Medicare payment update for skilled nursing facilities. 

Sec. 53112. Preventing the artificial inflation of star ratings after the consolidation of Medicare Advantage plans offered by the same organization. 

Sec. 53113. Sunsetting exclusion of biosimilars from Medicare part D coverage 

gap discount program. 

Sec. 53114. Adjustments to Medicare part B and part D premium subsidies for 

higher income individuals. 

Sec. 53115. Medicare Improvement Fund. 

Sec. 53116. Closing the Donut Hole for Seniors. 

Sec. 53117. Modernizing child support enforcement fees. 

Sec. 53118. Increasing efficiency of prison data reporting. 

Sec. 53119. Prevention and Public Health Fund. 
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† HR 1892 EAS2 

1 TITLE I—CHIP 

2 SEC. 50101. FUNDING EXTENSION OF THE CHILDREN’S 

3 HEALTH INSURANCE PROGRAM THROUGH 

4 FISCAL YEAR 2027. 

5 (a) IN GENERAL.—Section 2104(a) of the Social Secu6 rity Act (42 U.S.C. 1397dd(a)), as amended by section 

7 3002(a) of the HEALTHY KIDS Act (division C of Public 

8 Law 115–120), is amended— 

9 (1) in paragraph (25), by striking ‘‘; and’’ and 

10 inserting a semicolon; 

11 (2) in paragraph (26), by striking the period at 

12 the end and inserting a semicolon; and 

13 (3) by adding at the end the following new para14 graphs: 

15 ‘‘(27) for each of fiscal years 2024 through 2026, 

16 such sums as are necessary to fund allotments to 

17 States under subsections (c) and (m); and 

18 ‘‘(28) for fiscal year 2027, for purposes of mak19 ing two semi-annual allotments— 

20 ‘‘(A) $7,650,000,000 for the period begin21 ning on October 1, 2026, and ending on March 

22 31, 2027; and 

23 ‘‘(B) $7,650,000,000 for the period begin24 ning on April 1, 2027, and ending on September 

25 30, 2027.’’. 
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† HR 1892 EAS2 

1 (b) ALLOTMENTS.— 

2 (1) IN GENERAL.—Section 2104(m) of the Social 

3 Security Act (42 U.S.C. 1397dd(m)), as amended by 

4 section 3002(b) of the HEALTHY KIDS Act (division 

5 C of Public Law 115–120), is amended— 

6 (A) in paragraph (2)(B)— 

7 (i) in the matter preceding clause (i), 

8 by striking ‘‘(25)’’ and inserting ‘‘(27)’’; 

9 (ii) in clause (i), by striking ‘‘and 

10 2023’’ and inserting ‘‘, 2023, and 2027’’; 

11 and 

12 (iii) in clause (ii)(I), by striking ‘‘(or, 

13 in the case of fiscal year 2018, under para14 graph (4))’’ and inserting ‘‘(or, in the case 

15 of fiscal year 2018 or 2024, under para16 graph (4) or (10), respectively)’’; 

17 (B) in paragraph (5)— 

18 (i) by striking ‘‘or (10)’’ and inserting 

19 ‘‘(10), or (11)’’; and 

20 (ii) by striking ‘‘or 2023,’’ and insert21 ing ‘‘2023, or 2027,’’; 

22 (C) in paragraph (7)— 

23 (i) in subparagraph (A), by striking 

24 ‘‘2023’’ and inserting ‘‘2027,’’; and 
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1 (ii) in the matter following subpara2 graph (B), by striking ‘‘or fiscal year 2022’’ 

3 and inserting ‘‘fiscal year 2022, fiscal year 

4 2024, or fiscal year 2026’’; 

5 (D) in paragraph (9)— 

6 (i) by striking ‘‘or (10)’’ and inserting 

7 ‘‘(10), or (11)’’; and 

8 (ii) by striking ‘‘or 2023,’’ and insert9 ing ‘‘2023, or 2027,’’; and 

10 (E) by adding at the end the following: 

11 ‘‘(11) FOR FISCAL YEAR 2027.— 

12 ‘‘(A) FIRST HALF.—Subject to paragraphs 

13 (5) and (7), from the amount made available 

14 under subparagraph (A) of paragraph (28) of 

15 subsection (a) for the semi-annual period de16 scribed in such subparagraph, increased by the 

17 amount of the appropriation for such period 

18 under section 50101(b)(2) of the Advancing 

19 Chronic Care, Extenders, and Social Services 

20 Act, the Secretary shall compute a State allot21 ment for each State (including the District of 

22 Columbia and each commonwealth and territory) 

23 for such semi-annual period in an amount equal 

24 to the first half ratio (described in subparagraph 
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1 (D)) of the amount described in subparagraph 

2 (C). 

3 ‘‘(B) SECOND HALF.—Subject to para4 graphs (5) and (7), from the amount made 

5 available under subparagraph (B) of paragraph 

6 (28) of subsection (a) for the semi-annual period 

7 described in such subparagraph, the Secretary 

8 shall compute a State allotment for each State 

9 (including the District of Columbia and each 

10 commonwealth and territory) for such semi-an11 nual period in an amount equal to the amount 

12 made available under such subparagraph, multi13 plied by the ratio of— 

14 ‘‘(i) the amount of the allotment to 

15 such State under subparagraph (A); to 

16 ‘‘(ii) the total of the amount of all of 

17 the allotments made available under such 

18 subparagraph. 

19 ‘‘(C) FULL YEAR AMOUNT BASED ON

20 REBASED AMOUNT.—The amount described in 

21 this subparagraph for a State is equal to the 

22 Federal payments to the State that are attrib23 utable to (and countable towards) the total 

24 amount of allotments available under this section 

25 to the State in fiscal year 2026 (including pay-
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1 ments made to the State under subsection (n) for 

2 fiscal year 2026 as well as amounts redistributed 

3 to the State in fiscal year 2026), multiplied by 

4 the allotment increase factor under paragraph 

5 (6) for fiscal year 2027. 

6 ‘‘(D) FIRST HALF RATIO.—The first half 

7 ratio described in this subparagraph is the ratio 

8 of— 

9 ‘‘(i) the sum of— 

10 ‘‘(I) the amount made available 

11 under subsection (a)(28)(A); and 

12 ‘‘(II) the amount of the appro13 priation for such period under section 

14 50101(b)(2) of the Advancing Chronic 

15 Care, Extenders, and Social Services 

16 Act; to 

17 ‘‘(ii) the sum of— 

18 ‘‘(I) the amount described in 

19 clause (i); and 

20 ‘‘(II) the amount made available 

21 under subsection (a)(28)(B).’’. 

22 (2) ONE-TIME APPROPRIATION FOR FISCAL YEAR

23 2027.—There is appropriated to the Secretary of 

24 Health and Human Services, out of any money in the 

25 Treasury not otherwise appropriated, such sums as 
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1 are necessary to fund allotments to States under sub2 sections (c) and (m) of section 2104 of the Social Se3 curity Act (42 U.S.C. 1397dd) for fiscal year 2027, 

4 taking into account the full year amounts calculated 

5 for States under paragraph (11)(C) of subsection (m) 

6 of such section (as added by paragraph (1)) and the 

7 amounts appropriated under subparagraphs (A) and 

8 (B) of subsection (a)(28) of such section (as added by 

9 subsection (a)). Such amount shall accompany the al10 lotment made for the period beginning on October 1, 

11 2026, and ending on March 31, 2027, under para12 graph (28)(A) of section 2104(a) of such Act (42 

13 U.S.C. 1397dd(a)), to remain available until ex14 pended. Such amount shall be used to provide allot15 ments to States under paragraph (11) of section 

16 2104(m) of such Act for the first 6 months of fiscal 

17 year 2027 in the same manner as allotments are pro18 vided under subsection (a)(28)(A) of such section 

19 2104 and subject to the same terms and conditions as 

20 apply to the allotments provided from such subsection 

21 (a)(28)(A). 

22 (c) EXTENSION OF THE CHILD ENROLLMENT CONTIN23 GENCY FUND.—Section 2104(n) of the Social Security Act 

24 (42 U.S.C. 1397dd(n)), as amended by section 3002(c) of 
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1 the HEALTHY KIDS Act (division C of Public Law 115– 

2 120), is amended— 

3 (1) in paragraph (2)— 

4 (A) in subparagraph (A)(ii)— 

5 (i) by striking ‘‘and 2018 through 

6 2022’’ and inserting ‘‘2018 through 2022, 

7 and 2024 through 2026’’; and 

8 (ii) by striking ‘‘and 2023’’ and insert9 ing ‘‘2023, and 2027’’; and 

10 (B) in subparagraph (B)— 

11 (i) by striking ‘‘and 2018 through 

12 2022’’ and inserting ‘‘2018 through 2022, 

13 and 2024 through 2026’’; and 

14 (ii) by striking ‘‘and 2023’’ and insert15 ing ‘‘2023, and 2027’’; and 

16 (2) in paragraph (3)(A), in the matter preceding 

17 clause (i)— 

18 (A) by striking ‘‘or in any of fiscal years 

19 2018 through 2022’’ and inserting ‘‘fiscal years 

20 2018 through 2022, or fiscal years 2024 through 

21 2026’’; and 

22 (B) by striking ‘‘or 2023’’ and inserting 

23 ‘‘2023, or 2027’’. 

24 (d) EXTENSION OF QUALIFYING STATES OPTION.— 

25 Section 2105(g)(4) of the Social Security Act (42 U.S.C. 
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1 1397ee(g)(4)), as amended by section 3002(d) of the 

2 HEALTHY KIDS Act (division C of Public Law 115–120), 

3 is amended— 

4 (1) in the paragraph heading, by striking 

5 ‘‘THROUGH 2023’’ and inserting ‘‘THROUGH 2027’’; 

6 and 

7 (2) in subparagraph (A), by striking ‘‘2023’’ and 

8 inserting ‘‘2027’’. 

9 (e) EXTENSION OF EXPRESS LANE ELIGIBILITY OP10 TION.—Section 1902(e)(13)(I) of the Social Security Act 

11 (42 U.S.C. 1396a(e)(13)(I)), as amended by section 3002(e) 

12 of the HEALTHY KIDS Act (division C of Public Law 

13 115–120), is amended by striking ‘‘2023’’ and inserting 

14 ‘‘2027’’. 

15 (f) ASSURANCE OF ELIGIBILITY STANDARD FOR CHIL16 DREN AND FAMILIES.— 

17 (1) IN GENERAL.—Section 2105(d)(3) of the So18 cial Security Act (42 U.S.C. 1397ee(d)(3)), as amend19 ed by section 3002(f)(1) of the HEALTHY KIDS Act 

20 (division C of Public Law 115–120), is amended— 

21 (A) in the paragraph heading, by striking 

22 ‘‘THROUGH SEPTEMBER 30, 2023’’ and inserting 

23 ‘‘THROUGH SEPTEMBER 30, 2027’’; and 
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1 (B) in subparagraph (A), in the matter pre2 ceding clause (i), by striking ‘‘2023’’ each place 

3 it appears and inserting ‘‘2027’’. 

4 (2) CONFORMING AMENDMENTS.—Section 

5 1902(gg)(2) of the Social Security Act (42 U.S.C. 

6 1396a(gg)(2)), as amended by section 3002(f)(2) of 

7 the HEALTHY KIDS Act (division C of Public Law 

8 115–120), is amended— 

9 (A) in the paragraph heading, by striking 

10 ‘‘THROUGH SEPTEMBER 30, 2023’’ and inserting 

11 ‘‘THROUGH SEPTEMBER 30, 2027’’; and 

12 (B) by striking ‘‘2023,’’ each place it ap13 pears and inserting ‘‘2027’’. 

14 SEC. 50102. EXTENSION OF PEDIATRIC QUALITY MEASURES 

15 PROGRAM. 

16 (a) IN GENERAL.—Section 1139A(i)(1) of the Social 

17 Security Act (42 U.S.C. 1320b–9a(i)(1)), as amended by 

18 section 3003(b) of the HEALTHY KIDS Act (division C 

19 of Public Law 115–120), is amended— 

20 (1) in subparagraph (B), by striking ‘‘; and’’ 

21 and inserting a semicolon; 

22 (2) in subparagraph (C), by striking the period 

23 at the end and inserting ‘‘; and’’; and 

24 (3) by adding at the end the following new sub25 paragraph: 
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1 ‘‘(D) for the period of fiscal years 2024 

2 through 2027, $60,000,000 for the purpose of 

3 carrying out this section (other than subsections 

4 (e), (f), and (g)).’’. 

5 (b) MAKING REPORTING MANDATORY.—Section 1139A 

6 of the Social Security Act (42 U.S.C. 1320b–9a) is amend7 ed— 

8 (1) in subsection (a)— 

9 (A) in the heading for paragraph (4), by 

10 inserting ‘‘AND MANDATORY REPORTING’’ after 

11 ‘‘REPORTING’’; 

12 (B) in paragraph (4)— 

13 (i) by striking ‘‘Not later than’’ and 

14 inserting the following: 

15 ‘‘(A) VOLUNTARY REPORTING.—Not later 

16 than’’; and 

17 (ii) by adding at the end the following: 

18 ‘‘(B) MANDATORY REPORTING.—Beginning 

19 with the annual State report on fiscal year 2024 

20 required under subsection (c)(1), the Secretary 

21 shall require States to use the initial core meas22 urement set and any updates or changes to that 

23 set to report information regarding the quality of 

24 pediatric health care under titles XIX and XXI 

25 using the standardized format for reporting in-
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1 formation and procedures developed under sub2 paragraph (A).’’; and 

3 (C) in paragraph (6)(B), by inserting ‘‘and, 

4 beginning with the report required on January 

5 1, 2025, and for each annual report thereafter, 

6 the status of mandatory reporting by States 

7 under titles XIX and XXI, utilizing the initial 

8 core quality measurement set and any updates 

9 or changes to that set’’ before the semicolon; and 

10 (2) in subsection (c)(1)(A), by inserting ‘‘and, 

11 beginning with the annual report on fiscal year 2024, 

12 all of the core measures described in subsection (a) 

13 and any updates or changes to those measures’’ before 

14 the semicolon. 

15 SEC. 50103. EXTENSION OF OUTREACH AND ENROLLMENT 

16 PROGRAM. 

17 (a) IN GENERAL.—Section 2113 of the Social Security 

18 Act (42 U.S.C. 1397mm), as amended by section 3004(a) 

19 of the HEALTHY KIDS Act (division C of Public Law 

20 115–120), is amended— 

21 (1) in subsection (a)(1), by striking ‘‘2023’’ and 

22 inserting ‘‘2027’’; and 

23 (2) in subsection (g)— 

24 (A) by striking ‘‘and $120,000,000’’ and in25 serting ‘‘, $120,000,000’’; and 
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1 (B) by inserting ‘‘, and $48,000,000 for the 

2 period of fiscal years 2024 through 2027’’ after 

3 ‘‘2023’’. 

4 (b) ADDITIONAL RESERVED FUNDS.—Section 2113(a) 

5 of the Social Security Act (42 U.S.C. 1397mm(a)) is 

6 amended— 

7 (1) in paragraph (1), by striking ‘‘paragraph 

8 (2)’’ and inserting ‘‘paragraphs (2) and (3)’’; and 

9 (2) by adding at the end the following new para10 graph: 

11 ‘‘(3) TEN PERCENT SET ASIDE FOR EVALUATING

12 AND PROVIDING TECHNICAL ASSISTANCE TO GRANT13 EES.—For the period of fiscal years 2024 through 

14 2027, an amount equal to 10 percent of such amounts 

15 shall be used by the Secretary for the purpose of eval16 uating and providing technical assistance to eligible 

17 entities awarded grants under this section.’’. 

18 (c) USE OF RESERVED FUNDS FOR NATIONAL EN19 ROLLMENT AND RETENTION STRATEGIES.—Section 2113(h) 

20 of the Social Security Act (42 U.S.C. 1397mm(h)) is 

21 amended— 

22 (1) in paragraph (5), by striking ‘‘; and’’ and 

23 inserting a semicolon; 

24 (2) by redesignating paragraph (6) as para25 graph (7); and 
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1 (3) by inserting after paragraph (5) the fol2 lowing new paragraph: 

3 ‘‘(6) the development of materials and toolkits 

4 and the provision of technical assistance to States re5 garding enrollment and retention strategies for eligi6 ble children under this title and title XIX; and’’. 

7 TITLE II—MEDICARE 

8 EXTENDERS 

9 SEC. 50201. EXTENSION OF WORK GPCI FLOOR. 

10 Section 1848(e)(1)(E) of the Social Security Act (42 

11 U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘Janu12 ary 1, 2018’’ and inserting ‘‘January 1, 2020’’. 

13 SEC. 50202. REPEAL OF MEDICARE PAYMENT CAP FOR 

14 THERAPY SERVICES; LIMITATION TO ENSURE 

15 APPROPRIATE THERAPY. 

16 Section 1833(g) of the Social Security Act (42 U.S.C. 

17 1395l(g)) is amended— 

18 (1) in paragraph (1)— 

19 (A) by striking ‘‘Subject to paragraphs (4) 

20 and (5)’’ and inserting ‘‘(A) Subject to para21 graphs (4) and (5)’’; 

22 (B) in the subparagraph (A), as inserted 

23 and designated by subparagraph (A) of this 

24 paragraph, by adding at the end the following 

25 new sentence: ‘‘The preceding sentence shall not 
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1 apply to expenses incurred with respect to serv2 ices furnished after December 31, 2017.’’; and 

3 (C) by adding at the end the following new 

4 subparagraph: 

5 ‘‘(B) With respect to services furnished during 2018 

6 or a subsequent year, in the case of physical therapy serv7 ices of the type described in section 1861(p), speech-lan8 guage pathology services of the type described in such sec9 tion through the application of section 1861(ll)(2), and 

10 physical therapy services and speech-language pathology 

11 services of such type which are furnished by a physician 

12 or as incident to physicians’ services, with respect to ex13 penses incurred in any calendar year, any amount that is 

14 more than the amount specified in paragraph (2) for the 

15 year shall not be considered as incurred expenses for pur16 poses of subsections (a) and (b) unless the applicable re17 quirements of paragraph (7) are met.’’; 

18 (2) in paragraph (3)— 

19 (A) by striking ‘‘Subject to paragraphs (4) 

20 and (5)’’ and inserting ‘‘(A) Subject to para21 graphs (4) and (5)’’; 

22 (B) in the subparagraph (A), as inserted 

23 and designated by subparagraph (A) of this 

24 paragraph, by adding at the end the following 

25 new sentence: ‘‘The preceding sentence shall not 
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1 apply to expenses incurred with respect to serv2 ices furnished after December 31, 2017.’’; and 

3 (C) by adding at the end the following new 

4 subparagraph:. 

5 ‘‘(B) With respect to services furnished during 2018 

6 or a subsequent year, in the case of occupational therapy 

7 services (of the type that are described in section 1861(p) 

8 through the operation of section 1861(g) and of such type 

9 which are furnished by a physician or as incident to physi10 cians’ services), with respect to expenses incurred in any 

11 calendar year, any amount that is more than the amount 

12 specified in paragraph (2) for the year shall not be consid13 ered as incurred expenses for purposes of subsections (a) 

14 and (b) unless the applicable requirements of paragraph (7) 

15 are met.’’; 

16 (3) in paragraph (5)— 

17 (A) by redesignating subparagraph (D) as 

18 paragraph (8) and moving such paragraph to 

19 immediately follow paragraph (7), as added by 

20 paragraph (4) of this section; and 

21 (B) in subparagraph (E)(iv), by inserting 

22 ‘‘, except as such process is applied under para23 graph (7)(B)’’ before the period at the end; and 

24 (4) by adding at the end the following new para25 graph: 
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1 ‘‘(7) For purposes of paragraphs (1)(B) and (3)(B), 

2 with respect to services described in such paragraphs, the 

3 requirements described in this paragraph are as follows: 

4 ‘‘(A) INCLUSION OF APPROPRIATE MODIFIER.— 

5 The claim for such services contains an appropriate 

6 modifier (such as the KX modifier described in para7 graph (5)(B)) indicating that such services are medi8 cally necessary as justified by appropriate docu9 mentation in the medical record involved. 

10 ‘‘(B) TARGETED MEDICAL REVIEW FOR CERTAIN

11 SERVICES ABOVE THRESHOLD.— 

12 ‘‘(i) IN GENERAL.—In the case where ex13 penses that would be incurred for such services 

14 would exceed the threshold described in clause 

15 (ii) for the year, such services shall be subject to 

16 the process for medical review implemented 

17 under paragraph (5)(E). 

18 ‘‘(ii) THRESHOLD.—The threshold under 

19 this clause for— 

20 ‘‘(I) a year before 2028, is $3,000; 

21 ‘‘(II) 2028, is the amount specified in 

22 subclause (I) increased by the percentage in23 crease in the MEI (as defined in section 

24 1842(i)(3)) for 2028; and 
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1 ‘‘(III) a subsequent year, is the amount 

2 specified in this clause for the preceding 

3 year increased by the percentage increase in 

4 the MEI (as defined in section 1842(i)(3)) 

5 for such subsequent year; 

6 except that if an increase under subclause (II) or 

7 (III) for a year is not a multiple of $10, it shall 

8 be rounded to the nearest multiple of $10. 

9 ‘‘(iii) APPLICATION.—The threshold under 

10 clause (ii) shall be applied separately— 

11 ‘‘(I) for physical therapy services and 

12 speech-language pathology services; and 

13 ‘‘(II) for occupational therapy services. 

14 ‘‘(iv) FUNDING.—For purposes of carrying 

15 out this subparagraph, the Secretary shall pro16 vide for the transfer, from the Federal Supple17 mentary Medical Insurance Trust Fund under 

18 section 1841 to the Centers for Medicare & Med19 icaid Services Program Management Account, of 

20 $5,000,000 for each fiscal year beginning with 

21 fiscal year 2018, to remain available until ex22 pended. Such funds may not be used by a con23 tractor under section 1893(h) for medical reviews 

24 under this subparagraph.’’. 
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1 SEC. 50203. MEDICARE AMBULANCE SERVICES. 

2 (a) EXTENSION OF CERTAIN GROUND AMBULANCE

3 ADD-ON PAYMENTS.— 

4 (1) GROUND AMBULANCE.—Section 

5 1834(l)(13)(A) of the Social Security Act (42 U.S.C. 

6 1395m(l)(13)(A)) is amended by striking ‘‘2018’’ and 

7 inserting ‘‘2023’’ each place it appears. 

8 (2) SUPER RURAL AMBULANCE.—Section 

9 1834(l)(12)(A) of the Social Security Act (42 U.S.C. 

10 1395m(l)(12)(A)) is amended, in the first sentence, by 

11 striking ‘‘2018’’ and inserting ‘‘2023’’. 

12 (b) REQUIRING GROUND AMBULANCE PROVIDERS OF

13 SERVICES AND SUPPLIERS TO SUBMIT COST AND OTHER

14 INFORMATION.—Section 1834(l) of the Social Security Act 

15 (42 U.S.C. 1395m(l)) is amended by adding at the end the 

16 following new paragraph: 

17 ‘‘(17) SUBMISSION OF COST AND OTHER INFOR18 MATION.— 

19 ‘‘(A) DEVELOPMENT OF DATA COLLECTION

20 SYSTEM.—The Secretary shall develop a data 

21 collection system (which may include use of a 

22 cost survey) to collect cost, revenue, utilization, 

23 and other information determined appropriate 

24 by the Secretary with respect to providers of 

25 services (in this paragraph referred to as ‘pro26 viders’) and suppliers of ground ambulance serv-
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1 ices. Such system shall be designed to collect in2 formation— 

3 ‘‘(i) needed to evaluate the extent to 

4 which reported costs relate to payment rates 

5 under this subsection; 

6 ‘‘(ii) on the utilization of capital 

7 equipment and ambulance capacity, includ8 ing information consistent with the type of 

9 information described in section 1121(a); 

10 and 

11 ‘‘(iii) on different types of ground am12 bulance services furnished in different geo13 graphic locations, including rural areas 

14 and low population density areas described 

15 in paragraph (12). 

16 ‘‘(B) SPECIFICATION OF DATA COLLECTION

17 SYSTEM.— 

18 ‘‘(i) IN GENERAL.—The Secretary 

19 shall— 

20 ‘‘(I) not later than December 31, 

21 2019, specify the data collection system 

22 under subparagraph (A); and 

23 ‘‘(II) identify the providers and 

24 suppliers of ground ambulance services 

25 that would be required to submit infor-
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1 mation under such data collection sys2 tem, including the representative sam3 ple described in clause (ii). 

4 ‘‘(ii) DETERMINATION OF REPRESENT5 ATIVE SAMPLE.— 

6 ‘‘(I) IN GENERAL.—Not later than 

7 December 31, 2019, with respect to the 

8 data collection for the first year under 

9 such system, and for each subsequent 

10 year through 2024, the Secretary shall 

11 determine a representative sample to 

12 submit information under the data col13 lection system. 

14 ‘‘(II) REQUIREMENTS.—The sam15 ple under subclause (I) shall be rep16 resentative of the different types of pro17 viders and suppliers of ground ambu18 lance services (such as those providers 

19 and suppliers that are part of an 

20 emergency service or part of a govern21 ment organization) and the geographic 

22 locations in which ground ambulance 

23 services are furnished (such as urban, 

24 rural, and low population density 

25 areas). 
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1 ‘‘(III) LIMITATION.—The Sec2 retary shall not include an individual 

3 provider or supplier of ground ambu4 lance services in the sample under sub5 clause (I) in 2 consecutive years, to the 

6 extent practicable. 

7 ‘‘(C) REPORTING OF COST INFORMATION.— 

8 For each year, a provider or supplier of ground 

9 ambulance services identified by the Secretary 

10 under subparagraph (B)(i)(II) as being required 

11 to submit information under the data collection 

12 system with respect to a period for the year shall 

13 submit to the Secretary information specified 

14 under the system. Such information shall be sub15 mitted in a form and manner, and at a time, 

16 specified by the Secretary for purposes of this 

17 subparagraph. 

18 ‘‘(D) PAYMENT REDUCTION FOR FAILURE

19 TO REPORT.— 

20 ‘‘(i) IN GENERAL.—Beginning Janu21 ary 1, 2022, subject to clause (ii), a 10 per22 cent reduction to payments under this sub23 section shall be made for the applicable pe24 riod (as defined in clause (ii)) to a provider 
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1 or supplier of ground ambulance services 

2 that— 

3 ‘‘(I) is required to submit infor4 mation under the data collection sys5 tem with respect to a period under sub6 paragraph (C); and 

7 ‘‘(II) does not sufficiently submit 

8 such information, as determined by the 

9 Secretary. 

10 ‘‘(ii) APPLICABLE PERIOD DEFINED.— 

11 For purposes of clause (i), the term ‘appli12 cable period’ means, with respect to a pro13 vider or supplier of ground ambulance serv14 ices, a year specified by the Secretary not 

15 more than 2 years after the end of the pe16 riod with respect to which the Secretary has 

17 made a determination under clause (i)(II) 

18 that the provider or supplier of ground am19 bulance services failed to sufficiently submit 

20 information under the data collection sys21 tem. 

22 ‘‘(iii) HARDSHIP EXEMPTION.—The 

23 Secretary may exempt a provider or sup24 plier from the payment reduction under 

25 clause (i) with respect to an applicable pe-
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1 riod in the event of significant hardship, 

2 such as a natural disaster, bankruptcy, or 

3 other similar situation that the Secretary 

4 determines interfered with the ability of the 

5 provider or supplier of ground ambulance 

6 services to submit such information in a 

7 timely manner for the specified period. 

8 ‘‘(iv) INFORMAL REVIEW.—The Sec9 retary shall establish a process under which 

10 a provider or supplier of ground ambulance 

11 services may seek an informal review of a 

12 determination that the provider or supplier 

13 is subject to the payment reduction under 

14 clause (i). 

15 ‘‘(E) ONGOING DATA COLLECTION.— 

16 ‘‘(i) REVISION OF DATA COLLECTION

17 SYSTEM.—The Secretary may, as the Sec18 retary determines appropriate and, if avail19 able, taking into consideration the report 

20 (or reports) under subparagraph (F), revise 

21 the data collection system under subpara22 graph (A). 

23 ‘‘(ii) SUBSEQUENT DATA COLLEC24 TION.—In order to continue to evaluate the 

25 extent to which reported costs relate to pay-
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1 ment rates under this subsection and for 

2 other purposes the Secretary deems appro3 priate, the Secretary shall require providers 

4 and suppliers of ground ambulance services 

5 to submit information for years after 2024 

6 as the Secretary determines appropriate, 

7 but in no case less often than once every 3 

8 years. 

9 ‘‘(F) GROUND AMBULANCE DATA COLLEC10 TION SYSTEM STUDY.— 

11 ‘‘(i) IN GENERAL.—Not later than 

12 March 15, 2023, and as determined nec13 essary by the Medicare Payment Advisory 

14 Commission thereafter, such Commission 

15 shall assess, and submit to Congress a re16 port on, information submitted by providers 

17 and suppliers of ground ambulance services 

18 through the data collection system under 

19 subparagraph (A), the adequacy of pay20 ments for ground ambulance services under 

21 this subsection, and geographic variations 

22 in the cost of furnishing such services. 

23 ‘‘(ii) CONTENTS.—A report under 

24 clause (i) shall contain the following: 
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1 ‘‘(I) An analysis of information 

2 submitted through the data collection 

3 system. 

4 ‘‘(II) An analysis of any burden 

5 on providers and suppliers of ground 

6 ambulance services associated with the 

7 data collection system. 

8 ‘‘(III) A recommendation as to 

9 whether information should continue to 

10 be submitted through such data collec11 tion system or if such system should be 

12 revised under subparagraph (E)(i). 

13 ‘‘(IV) Other information deter14 mined appropriate by the Commission. 

15 ‘‘(G) PUBLIC AVAILABILITY.—The Secretary 

16 shall post information on the results of the data 

17 collection under this paragraph on the Internet 

18 website of the Centers for Medicare & Medicaid 

19 Services, as determined appropriate by the Sec20 retary. 

21 ‘‘(H) IMPLEMENTATION.—The Secretary 

22 shall implement this paragraph through notice 

23 and comment rulemaking. 

24 ‘‘(I) ADMINISTRATION.—Chapter 35 of title 

25 44, United States Code, shall not apply to the 
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1 collection of information required under this sub2 section. 

3 ‘‘(J) LIMITATIONS ON REVIEW.—There shall 

4 be no administrative or judicial review under 

5 section 1869, section 1878, or otherwise of the 

6 data collection system or identification of re7 spondents under this paragraph. 

8 ‘‘(K) FUNDING FOR IMPLEMENTATION.—For 

9 purposes of carrying out subparagraph (A), the 

10 Secretary shall provide for the transfer, from the 

11 Federal Supplementary Medical Insurance Trust 

12 Fund under section 1841, of $15,000,000 to the 

13 Centers for Medicare & Medicaid Services Pro14 gram Management Account for fiscal year 2018. 

15 Amounts transferred under this subparagraph 

16 shall remain available until expended.’’. 

17 SEC. 50204. EXTENSION OF INCREASED INPATIENT HOS18 PITAL PAYMENT ADJUSTMENT FOR CERTAIN 

19 LOW-VOLUME HOSPITALS. 

20 (a) IN GENERAL.—Section 1886(d)(12) of the Social 

21 Security Act (42 U.S.C. 1395ww(d)(12)) is amended— 

22 (1) in subparagraph (B), in the matter pre23 ceding clause (i), by striking ‘‘fiscal year 2018’’ and 

24 inserting ‘‘fiscal year 2023’’; 

25 (2) in subparagraph (C)— 
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1 (A) in clause (i)— 

2 (i) by striking ‘‘through 2017’’ the first 

3 place it appears and inserting ‘‘through 

4 2022’’; and 

5 (ii) by striking ‘‘ and has less than 800 

6 discharges’’ and all that follows through the 

7 period at the end and inserting the fol8 lowing ‘‘and has— 

9 ‘‘(I) with respect to each of fiscal 

10 years 2005 through 2010, less than 800 

11 discharges during the fiscal year; 

12 ‘‘(II) with respect to each of fiscal 

13 years 2011 through 2018, less than 

14 1,600 discharges of individuals entitled 

15 to, or enrolled for, benefits under part 

16 A during the fiscal year or portion of 

17 fiscal year; 

18 ‘‘(III) with respect to each of fis19 cal years 2019 through 2022, less than 

20 3,800 discharges during the fiscal year; 

21 and 

22 ‘‘(IV) with respect to fiscal year 

23 2023 and each subsequent fiscal year, 

24 less than 800 discharges during the fis25 cal year.’’; and 
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1 (B) in clause (ii)— 

2 (i) by striking ‘‘subparagraph (B)’’ 

3 and inserting ‘‘subparagraphs (B) and 

4 (D)’’; and 

5 (ii) by inserting ‘‘(except as provided 

6 in clause (i)(II) and subparagraph (D)(i))’’ 

7 after ‘‘regardless’’; and 

8 (3) in subparagraph (D)— 

9 (A) by striking ‘‘through 2017’’ and insert10 ing ‘‘through 2022’’; 

11 (B) by striking ‘‘hospitals with 200 or 

12 fewer’’ and inserting the following: ‘‘hospitals— 

13 ‘‘(i) with respect to each of fiscal years 

14 2011 through 2018, with 200 or fewer’’; 

15 (C) by striking the period at the end and 

16 inserting ‘‘or portion of fiscal year; and’’; and 

17 (D) by adding at the end the following new 

18 clause: 

19 ‘‘(ii) with respect to each of fiscal 

20 years 2019 through 2022, with 500 or fewer 

21 discharges in the fiscal year to 0 percent for 

22 low-volume hospitals with greater than 

23 3,800 discharges in the fiscal year.’’. 
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1 (b) MEDPAC REPORT ON EXTENSION OF INCREASED

2 INPATIENT HOSPITAL PAYMENT ADJUSTMENT FOR CER3 TAIN LOW-VOLUME HOSPITALS.— 

4 (1) IN GENERAL.—Not later than March 15, 

5 2022, the Medicare Payment Advisory Commission 

6 shall submit to Congress a report on the extension of 

7 the increased inpatient hospital payment adjustment 

8 for certain low-volume hospitals under section 

9 1886(d)(12) of the Social Security Act (42 U.S.C. 

10 1395ww(d)(12)) under the provisions of, and amend11 ments made by, this section. 

12 (2) CONTENTS.—The report under paragraph (1) 

13 shall include an evaluation of the effects of such exten14 sion on the following: 

15 (A) Beneficiary utilization of inpatient hos16 pital services under title XVIII of the Social Se17 curity Act (42 U.S.C. 1395 et seq.). 

18 (B) The financial status of hospitals with a 

19 low volume of Medicare or total inpatient admis20 sions. 

21 (C) Program spending under such title 

22 XVIII. 

23 (D) Other matters relevant to evaluating the 

24 effects of such extension. 
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1 SEC. 50205. EXTENSION OF THE MEDICARE-DEPENDENT 

2 HOSPITAL (MDH) PROGRAM. 

3 (a) IN GENERAL.—Section 1886(d)(5)(G) of the Social 

4 Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amended— 

5 (1) in clause (i), by striking ‘‘October 1, 2017’’ 

6 and inserting ‘‘October 1, 2022’’; 

7 (2) in clause (ii)(II), by striking ‘‘October 1, 

8 2017’’ and inserting ‘‘October 1, 2022’’; and 

9 (3) in clause (iv), by striking subclause (I) and 

10 inserting the following new subclause: 

11 ‘‘(I) that is located in— 

12 ‘‘(aa) a rural area; or 

13 ‘‘(bb) a State with no rural area (as defined 

14 in paragraph (2)(D)) and satisfies any of the 

15 criteria in subclause (I), (II), or (III) of para16 graph (8)(E)(ii),’’; and 

17 (4) by inserting after subclause (IV) the fol18 lowing new flush sentences: 

19 ‘‘Subclause (I)(bb) shall apply for purposes of payment 

20 under clause (ii) only for discharges of a hospital occurring 

21 on or after the effective date of a determination of medicare22 dependent small rural hospital status made by the Sec23 retary with respect to the hospital after the date of the en24 actment of this sentence. For purposes of applying subclause 

25 (II) of paragraph (8)(E)(ii) under subclause (I)(bb), such 
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1 subclause (II) shall be applied by inserting ‘as of January 

2 1, 2018,’ after ‘such State’ each place it appears.’’. 

3 (b) CONFORMING AMENDMENTS.— 

4 (1) EXTENSION OF TARGET AMOUNT.—Section 

5 1886(b)(3)(D) of the Social Security Act (42 U.S.C. 

6 1395ww(b)(3)(D)) is amended— 

7 (A) in the matter preceding clause (i), by 

8 striking ‘‘October 1, 2017’’ and inserting ‘‘Octo9 ber 1, 2022’’; and 

10 (B) in clause (iv), by striking ‘‘through fis11 cal year 2017’’ and inserting ‘‘through fiscal 

12 year 2022’’. 

13 (2) PERMITTING HOSPITALS TO DECLINE RE14 CLASSIFICATION.—Section 13501(e)(2) of the Omni15 bus Budget Reconciliation Act of 1993 (42 U.S.C. 

16 1395ww note) is amended by striking ‘‘through fiscal 

17 year 2017’’ and inserting ‘‘through fiscal year 2022’’. 

18 (c) GAO STUDY AND REPORT.— 

19 (1) STUDY.—The Comptroller General of the 

20 United States (in this subsection referred to as the 

21 ‘‘Comptroller General’’) shall conduct a study on the 

22 medicare-dependent, small rural hospital program 

23 under section 1886(d) of the Social Security Act (42 

24 U.S.C. 1395x(d)). Such study shall include an anal25 ysis of the following: 
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1 (A) The payor mix of medicare-dependent, 

2 small rural hospitals (as defined in paragraph 

3 (5)(G)(iv) of such section 1886(d)), how such 

4 mix will trend in future years (based on current 

5 trends and projections), and whether or not the 

6 requirement under subclause (IV) of such para7 graph should be revised. 

8 (B) The characteristics of medicare-depend9 ent, small rural hospitals that meet the require10 ment of such subclause (IV) through the applica11 tion of paragraph (a)(iii)(A) or (a)(iii)(B) of 

12 section 412.108 of title 42, Code of Federal Regu13 lations, including Medicare inpatient and out14 patient utilization, payor mix, and financial 

15 status (including Medicare and total margins), 

16 and whether or not Medicare payments for such 

17 hospitals should be revised. 

18 (C) Such other items related to medicare-de19 pendent, small rural hospitals as the Comptroller 

20 General determines appropriate. 

21 (2) REPORT.—Not later than 2 years after the 

22 date of the enactment of this Act, the Comptroller 

23 General shall submit to Congress a report containing 

24 the results of the study conducted under paragraph 

25 (1), together with recommendations for such legisla-
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1 tion and administrative action as the Comptroller 

2 General determines appropriate. 

3 SEC. 50206. EXTENSION OF FUNDING FOR QUALITY MEAS4 URE ENDORSEMENT, INPUT, AND SELECTION; 

5 REPORTING REQUIREMENTS. 

6 (a) EXTENSION OF FUNDING.—Section 1890(d)(2) of 

7 the Social Security Act (42 U.S.C. 1395aaa(d)(2)) is 

8 amended— 

9 (1) in the first sentence— 

10 (A) by striking ‘‘2014 and’’ and inserting 

11 ‘‘2014,’’; and 

12 (B) by inserting the following before the pe13 riod: ‘‘, and $7,500,000 for each of fiscal years 

14 2018 and 2019’’; and 

15 (2) by adding at the end the following new sen16 tence: ‘‘Amounts transferred for each of fiscal years 

17 2018 and 2019 shall be in addition to any unobli18 gated funds transferred for a preceding fiscal year 

19 that are available under the preceding sentence.’’ 

20 (b) ANNUAL REPORT BY SECRETARY TO CONGRESS.— 

21 Section 1890 of the Social Security Act (42 U.S.C. 

22 1395aaa) is amended by adding at the end the following 

23 new subsection: 

24 ‘‘(e) ANNUAL REPORT BY SECRETARY TO CON25 GRESS.—By not later than March 1 of each year (beginning 
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1 with 2019), the Secretary shall submit to Congress a report 

2 containing the following: 

3 ‘‘(1) A comprehensive plan that identifies the 

4 quality measurement needs of programs and initia5 tives of the Secretary and provides a strategy for 

6 using the entity with a contract under subsection (a) 

7 and any other entity the Secretary has contracted 

8 with or may contract with to perform work associated 

9 with section 1890A to help meet those needs, specifi10 cally with respect to the programs under this title 

11 and title XIX. In years after the first plan under this 

12 paragraph is submitted, the requirements of this 

13 paragraph may be met by providing an update to the 

14 plan. 

15 ‘‘(2) The amount of funding provided under sub16 section (d) for purposes of carrying out this section 

17 and section 1890A that has been obligated by the Sec18 retary, the amount of funding provided that has been 

19 expended, and the amount of funding provided that 

20 remains unobligated. 

21 ‘‘(3) With respect to the activities described 

22 under this section or section 1890A, a description of 

23 how the funds described in paragraph (2) have been 

24 obligated or expended, including how much of that 

25 funding has been obligated or expended for work per-
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1 formed by the Secretary, the entity with a contract 

2 under subsection (a), and any other entity the Sec3 retary has contracted with to perform work. 

4 ‘‘(4) A description of the activities for which the 

5 funds described in paragraph (2) were used, includ6 ing task orders and activities assigned to the entity 

7 with a contract under subsection (a), activities per8 formed by the Secretary, and task orders and activi9 ties assigned to any other entity the Secretary has 

10 contracted with to perform work related to carrying 

11 out section 1890A. 

12 ‘‘(5) The amount of funding described in para13 graph (2) that has been obligated or expended for each 

14 of the activities described in paragraph (4). 

15 ‘‘(6) Estimates for, and descriptions of, obliga16 tions and expenditures that the Secretary anticipates 

17 will be needed in the succeeding two year period to 

18 carry out each of the quality measurement activities 

19 required under this section and section 1890A, includ20 ing any obligations that will require funds to be ex21 pended in a future year.’’. 

22 (c) REVISIONS TO ANNUAL REPORT FROM CON23 SENSUS-BASED ENTITY TO CONGRESS AND THE SEC24 RETARY.— 
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1 (1) IN GENERAL.—Section 1890(b)(5)(A) of the 

2 Social Security Act (42 U.S.C. 1395aaa(b)(5)(A)) is 

3 amended— 

4 (A) by redesignating clauses (i) through (vi) 

5 as subclauses (I) through (VI), respectively, and 

6 moving the margins accordingly; 

7 (B) in the matter preceding subclause (I), 

8 as redesignated by subparagraph (A), by striking 

9 ‘‘containing a description of—’’ and inserting 

10 ‘‘containing the following: 

11 ‘‘(i) A description of—’’; and 

12 (C) by adding at the end the following new 

13 clauses: 

14 ‘‘(ii) An itemization of financial infor15 mation for the fiscal year ending September 

16 30 of the preceding year, including— 

17 ‘‘(I) annual revenues of the entity 

18 (including any government funding, 

19 private sector contributions, grants, 

20 membership revenues, and investment 

21 revenue); 

22 ‘‘(II) annual expenses of the enti23 ty (including grants paid, benefits 

24 paid, salaries or other compensation, 
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1 fundraising expenses, and overhead 

2 costs); and 

3 ‘‘(III) a breakdown of the amount 

4 awarded per contracted task order and 

5 the specific projects funded in each task 

6 order assigned to the entity. 

7 ‘‘(iii) Any updates or modifications of 

8 internal policies and procedures of the enti9 ty as they relate to the duties of the entity 

10 under this section, including— 

11 ‘‘(I) specifically identifying any 

12 modifications to the disclosure of inter13 ests and conflicts of interests for com14 mittees, work groups, task forces, and 

15 advisory panels of the entity; and 

16 ‘‘(II) information on external 

17 stakeholder participation in the duties 

18 of the entity under this section (includ19 ing complete rosters for all committees, 

20 work groups, task forces, and advisory 

21 panels funded through government con22 tracts, descriptions of relevant interests 

23 and any conflicts of interest for mem24 bers of all committees, work groups, 

25 task forces, and advisory panels, and 
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1 the total percentage by health care sec2 tor of all convened committees, work 

3 groups, task forces, and advisory pan4 els.’’. 

5 (2) EFFECTIVE DATE.—The amendments made 

6 by this subsection shall apply to reports submitted for 

7 years beginning with 2019. 

8 (d) GAO STUDY AND REPORT.— 

9 (1) STUDY.—The Comptroller General of the 

10 United States shall conduct a study on health care 

11 quality measurement efforts funded under sections 

12 1890 and 1890A of the Social Security Act (42 

13 U.S.C. 1395aaa; 1395aaa–1). Such study shall in14 clude an examination of the following: 

15 (A) The extent to which the Secretary of 

16 Health and Human Services (in this subsection 

17 referred to as the ‘‘Secretary’’) has set and 

18 prioritized objectives to be achieved for each of 

19 the quality measurement activities required 

20 under such sections 1890 and 1890A. 

21 (B) The efforts that the Secretary has un22 dertaken to meet quality measurement objectives 

23 associated with such sections 1890 and 1890A, 

24 including division of responsibilities for those ef25 forts within the Department of Health and 
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1 Human Services and through contracts with a 

2 consensus-based entity under subsection (a) of 

3 such section 1890 (in this subsection referred to 

4 as the ‘‘consensus-based entity’’) and other enti5 ties, and the extent of any overlap among the 

6 work performed by the Secretary, the consensus7 based entity, the Measure Applications Partner8 ship (MAP) convened by such entity to provide 

9 input to the Secretary on the selection of quality 

10 and efficiency measures, and any other entities 

11 the Secretary has contracted with to perform 

12 work related to carrying out such sections 1890 

13 and 1890A. 

14 (C) The total amount of funding provided 

15 to the Secretary for purposes of carrying out 

16 such sections 1890 and 1890A, the amount of 

17 such funding that has been obligated or expended 

18 by the Secretary, and the amount of such fund19 ing that remains unobligated. 

20 (D) How the funds described in subpara21 graph (C) have been allocated, including how 

22 much of the funding has been allocated for work 

23 performed by the Secretary, the consensus-based 

24 entity, and any other entity the Secretary has 

25 contracted with to perform work related to car-
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1 rying out such sections 1890 and 1890A, respec2 tively, and descriptions of such work. 

3 (E) The extent to which the Secretary has 

4 developed a comprehensive and long-term plan to 

5 ensure that it can achieve quality measurement 

6 objectives related to carrying out such sections 

7 1890 and 1890A in a timely manner and with 

8 efficient use of available resources, including the 

9 roles of the consensus-based entity, the Measure 

10 Applications Partnership (MAP), and any other 

11 entity the Secretary has contracted with to per12 form work related to such sections 1890 and 

13 1890A in helping the Secretary achieve those ob14 jectives. 

15 (2) REPORT.—Not later than 18 months after the 

16 date of enactment of this Act, the Comptroller General 

17 of the United States shall submit to Congress a report 

18 containing the results of the study conducted under 

19 paragraph (1), together with recommendations for 

20 such legislation and administrative action as the 

21 Comptroller General determines appropriate. 
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1 SEC. 50207. EXTENSION OF FUNDING OUTREACH AND AS2 SISTANCE FOR LOW-INCOME PROGRAMS; 

3 STATE HEALTH INSURANCE ASSISTANCE 

4 PROGRAM REPORTING REQUIREMENTS. 

5 (a) FUNDING EXTENSIONS.— 

6 (1) ADDITIONAL FUNDING FOR STATE HEALTH

7 INSURANCE PROGRAMS.—Subsection (a)(1)(B) of sec8 tion 119 of the Medicare Improvements for Patients 

9 and Providers Act of 2008 (42 U.S.C. 1395b–3 note), 

10 as amended by section 3306 of the Patient Protection 

11 and Affordable Care Act (Public Law 111–148), sec12 tion 610 of the American Taxpayer Relief Act of 2012 

13 (Public Law 112–240), section 1110 of the Pathway 

14 for SGR Reform Act of 2013 (Public Law 113–67), 

15 section 110 of the Protecting Access to Medicare Act 

16 of 2014 (Public Law 113–93), and section 208 of the 

17 Medicare Access and CHIP Reauthorization Act of 

18 2015 (Public Law 114–10) is amended— 

19 (A) in clause (vi), by striking ‘‘and’’ at the 

20 end; 

21 (B) in clause (vii), by striking the period at 

22 the end and inserting ‘‘; and’’; and 

23 (C) by adding at the end the following new 

24 clauses: 

25 ‘‘(viii) for fiscal year 2018, of 

26 $13,000,000; and 
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1 ‘‘(ix) for fiscal year 2019, of 

2 $13,000,000.’’. 

3 (2) ADDITIONAL FUNDING FOR AREA AGENCIES

4 ON AGING.—Subsection (b)(1)(B) of such section 119, 

5 as so amended, is amended— 

6 (A) in clause (vi), by striking ‘‘and’’ at the 

7 end; 

8 (B) in clause (vii), by striking the period at 

9 the end and inserting ‘‘; and’’; and 

10 (C) by inserting after clause (vii) the fol11 lowing new clauses: 

12 ‘‘(viii) for fiscal year 2018, of 

13 $7,500,000; and 

14 ‘‘(ix) for fiscal year 2019, of 

15 $7,500,000.’’. 

16 (3) ADDITIONAL FUNDING FOR AGING AND DIS17 ABILITY RESOURCE CENTERS.—Subsection (c)(1)(B) 

18 of such section 119, as so amended, is amended— 

19 (A) in clause (vi), by striking ‘‘and’’ at the 

20 end; 

21 (B) in clause (vii), by striking the period at 

22 the end and inserting ‘‘; and’’; and 

23 (C) by inserting after clause (vii) the fol24 lowing new clauses: 
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1 ‘‘(viii) for fiscal year 2018, of 

2 $5,000,000; and 

3 ‘‘(ix) for fiscal year 2019, of 

4 $5,000,000.’’. 

5 (4) ADDITIONAL FUNDING FOR CONTRACT WITH

6 THE NATIONAL CENTER FOR BENEFITS AND OUT7 REACH ENROLLMENT.—Subsection (d)(2) of such sec8 tion 119, as so amended, is amended— 

9 (A) in clause (vi), by striking ‘‘and’’ at the 

10 end; 

11 (B) in clause (vii), by striking the period at 

12 the end and inserting ‘‘; and’’; and 

13 (C) by inserting after clause (vii) the fol14 lowing new clauses: 

15 ‘‘(viii) for fiscal year 2018, of 

16 $12,000,000; and 

17 ‘‘(ix) for fiscal year 2019, of 

18 $12,000,000.’’. 

19 (b) STATE HEALTH INSURANCE ASSISTANCE PRO20 GRAM REPORTING REQUIREMENTS.—Beginning not later 

21 than April 1, 2019, and biennially thereafter, the Agency 

22 for Community Living shall electronically post on its 

23 website the following information, with respect to grants to 

24 States for State health insurance assistance programs, (such 

25 information to be presented by State and by entity receiv-
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1 ing funds from the State to carry out such a program fund2 ed by such grant): 

3 (1) The amount of Federal funding provided to 

4 each such State for such program for the period in5 volved and the amount of Federal funding provided 

6 by each such State for such program to each such en7 tity for the period involved. 

8 (2) Information as the Secretary may specify, 

9 with respect to such programs carried out through 

10 such grants, consistent with the terms and conditions 

11 for receipt of such grants. 

12 SEC. 50208. EXTENSION OF HOME HEALTH RURAL ADD-ON. 

13 (a) EXTENSION.— 

14 (1) IN GENERAL.—Section 421 of the Medicare 

15 Prescription Drug, Improvement, and Modernization 

16 Act of 2003 (Public Law 108–173; 117 Stat. 2283; 42 

17 U.S.C. 1395fff note), as amended by section 5201(b) 

18 of the Deficit Reduction Act of 2005 (Public Law 

19 109–171; 120 Stat. 46), section 3131(c) of the Patient 

20 Protection and Affordable Care Act (Public Law 111– 

21 148; 124 Stat. 428), and section 210 of the Medicare 

22 Access and CHIP Reauthorization Act of 2015 (Pub23 lic Law 114–10; 129 Stat. 151) is amended— 
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1 (A) in subsection (a), by striking ‘‘January 

2 1, 2018’’ and inserting ‘‘January 1, 2019’’ each 

3 place it appears; 

4 (B) by redesignating subsections (b) and (c) 

5 as subsections (c) and (d), respectively; 

6 (C) in each of subsections (c) and (d), as so 

7 redesignated, by striking ‘‘subsection (a)’’ and 

8 inserting ‘‘subsection (a) or (b)’’; and 

9 (D) by inserting after subsection (a) the fol10 lowing new subsection: 

11 ‘‘(b) SUBSEQUENT TEMPORARY INCREASE.— 

12 ‘‘(1) IN GENERAL.—The Secretary shall increase 

13 the payment amount otherwise made under such sec14 tion 1895 for home health services furnished in a 

15 county (or equivalent area) in a rural area (as de16 fined in such section 1886(d)(2)(D)) that, as deter17 mined by the Secretary— 

18 ‘‘(A) is in the highest quartile of all coun19 ties (or equivalent areas) based on the number of 

20 Medicare home health episodes furnished per 100 

21 individuals who are entitled to, or enrolled for, 

22 benefits under part A of title XVIII of the Social 

23 Security Act or enrolled for benefits under part 

24 B of such title (but not enrolled in a plan under 

25 part C of such title)— 
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1 ‘‘(i) in the case of episodes and visits 

2 ending during 2019, by 1.5 percent; and 

3 ‘‘(ii) in the case of episodes and visits 

4 ending during 2020, by 0.5 percent; 

5 ‘‘(B) has a population density of 6 individ6 uals or fewer per square mile of land area and 

7 is not described in subparagraph (A)— 

8 ‘‘(i) in the case of episodes and visits 

9 ending during 2019, by 4 percent; 

10 ‘‘(ii) in the case of episodes and visits 

11 ending during 2020, by 3 percent; 

12 ‘‘(iii) in the case of episodes and visits 

13 ending during 2021, by 2 percent; and 

14 ‘‘(iv) in the case of episodes and visits 

15 ending during 2022, by 1 percent; and 

16 ‘‘(C) is not described in either subpara17 graph (A) or (B)— 

18 ‘‘(i) in the case of episodes and visits 

19 ending during 2019, by 3 percent; 

20 ‘‘(ii) in the case of episodes and visits 

21 ending during 2020, by 2 percent; and 

22 ‘‘(iii) in the case of episodes and visits 

23 ending during 2021, by 1 percent. 

24 ‘‘(2) RULES FOR DETERMINATIONS.— 
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1 ‘‘(A) NO SWITCHING.—For purposes of this 

2 subsection, the determination by the Secretary as 

3 to which subparagraph of paragraph (1) applies 

4 to a county (or equivalent area) shall be made 

5 a single time and shall apply for the duration 

6 of the period to which this subsection applies. 

7 ‘‘(B) UTILIZATION.—In determining which 

8 counties (or equivalent areas) are in the highest 

9 quartile under paragraph (1)(A), the following 

10 rules shall apply: 

11 ‘‘(i) The Secretary shall use data from 

12 2015. 

13 ‘‘(ii) The Secretary shall exclude data 

14 from the territories (and the territories shall 

15 not be described in such paragraph). 

16 ‘‘(iii) The Secretary may exclude data 

17 from counties (or equivalent areas) in rural 

18 areas with a low volume of home health epi19 sodes (and if data is so excluded with re20 spect to a county (or equivalent area), such 

21 county (or equivalent area) shall not be de22 scribed in such paragraph). 

23 ‘‘(C) POPULATION DENSITY.—In deter24 mining population density under paragraph 
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1 (1)(B), the Secretary shall use data from the 

2 2010 decennial Census. 

3 ‘‘(3) LIMITATIONS ON REVIEW.—There shall be 

4 no administrative or judicial review under section 

5 1869, section 1878, or otherwise of determinations 

6 under paragraph (1).’’. 

7 (2) REQUIREMENT TO SUBMIT COUNTY DATA ON

8 CLAIM FORM.—Section 1895(c) of the Social Security 

9 Act (42 U.S.C. 1395fff(c)) is amended— 

10 (A) in paragraph (1), by striking ‘‘and’’ at 

11 the end; 

12 (B) in paragraph (2), by striking the period 

13 at the end and inserting ‘‘; and’’; and 

14 (C) by adding at the end the following new 

15 paragraph: 

16 ‘‘(3) in the case of home health services furnished 

17 on or after January 1, 2019, the claim contains the 

18 code for the county (or equivalent area) in which the 

19 home health service was furnished.’’. 

20 (b) HHS OIG ANALYSIS.—Not later than January 1, 

21 2023, the Inspector General of the Department of Health 

22 and Human Services shall submit to Congress— 

23 (1) an analysis of the home health claims and 

24 utilization of home health services by county (or 

25 equivalent area) under the Medicare program; and 
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1 (2) recommendations the Inspector General de2 termines appropriate based on such analysis. 

3 TITLE III—CREATING HIGH4 QUALITY RESULTS AND OUT5 COMES NECESSARY TO IM6 PROVE CHRONIC (CHRONIC) 

7 CARE 

8 Subtitle A—Receiving High Quality 

9 Care in the Home 

10 SEC. 50301. EXTENDING THE INDEPENDENCE AT HOME 

11 DEMONSTRATION PROGRAM. 

12 (a) IN GENERAL.—Section 1866E of the Social Secu13 rity Act (42 U.S.C. 1395cc–5) is amended— 

14 (1) in subsection (e)— 

15 (A) in paragraph (1)— 

16 (i) by striking ‘‘An agreement’’ and in17 serting ‘‘Agreements’’; and 

18 (ii) by striking ‘‘5-year’’ and inserting 

19 ‘‘7-year’’; and 

20 (B) in paragraph (5)— 

21 (i) by striking ‘‘10,000’’ and inserting 

22 ‘‘15,000’’; and 

23 (ii) by adding at the end the following 

24 new sentence: ‘‘An applicable beneficiary 

25 that participates in the demonstration pro-
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1 gram by reason of the increase from 10,000 

2 to 15,000 in the preceding sentence pursu3 ant to the amendment made by section 

4 50301(a)(1)(B)(i) of the Advancing Chronic 

5 Care, Extenders, and Social Services Act 

6 shall be considered in the spending target 

7 estimates under paragraph (1) of subsection 

8 (c) and the incentive payment calculations 

9 under paragraph (2) of such subsection for 

10 the sixth and seventh years of such pro11 gram.’’; 

12 (2) in subsection (g), in the first sentence, by in13 serting ‘‘, including, to the extent practicable, with re14 spect to the use of electronic health information sys15 tems, as described in subsection (b)(1)(A)(vi)’’ after 

16 ‘‘under the demonstration program’’; and 

17 (3) in subsection (i)(1)(A), by striking ‘‘will not 

18 receive an incentive payment for the second of 2’’ and 

19 inserting ‘‘did not achieve savings for the third of 3’’. 

20 (b) EFFECTIVE DATE.—The amendment made by sub21 section (a)(3) shall take effect as if included in the enact22 ment of Public Law 111–148. 
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† HR 1892 EAS2 

1 SEC. 50302. EXPANDING ACCESS TO HOME DIALYSIS THER2 APY. 

3 (a) IN GENERAL.—Section 1881(b)(3) of the Social Se4 curity Act (42 U.S.C. 1395rr(b)(3)) is amended— 

5 (1) by redesignating subparagraphs (A) and (B) 

6 as clauses (i) and (ii), respectively; 

7 (2) in clause (ii), as redesignated by paragraph 

8 (1), by striking ‘‘on a comprehensive’’ and insert 

9 ‘‘subject to subparagraph (B), on a comprehensive’’; 

10 (3) by striking ‘‘With respect to’’ and inserting 

11 ‘‘(A) With respect to’’; and 

12 (4) by adding at the end the following new sub13 paragraph: 

14 ‘‘(B)(i) For purposes of subparagraph (A)(ii), subject 

15 to clause (ii), an individual determined to have end stage 

16 renal disease receiving home dialysis may choose to receive 

17 monthly end stage renal disease-related clinical assessments 

18 furnished on or after January 1, 2019, via telehealth. 

19 ‘‘(ii) Clause (i) shall apply to an individual only if 

20 the individual receives a face-to-face clinical assessment, 

21 without the use of telehealth— 

22 ‘‘(I) in the case of the initial 3 months of home 

23 dialysis of such individual, at least monthly; and 

24 ‘‘(II) after such initial 3 months, at least once 

25 every 3 consecutive months.’’. 

26 (b) ORIGINATING SITE REQUIREMENTS.— 
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1 (1) IN GENERAL.—Section 1834(m) of the Social 

2 Security Act (42 U.S.C. 1395m(m)) is amended— 

3 (A) in paragraph (4)(C)(ii), by adding at 

4 the end the following new subclauses: 

5 ‘‘(IX) A renal dialysis facility, 

6 but only for purposes of section 

7 1881(b)(3)(B). 

8 ‘‘(X) The home of an individual, 

9 but only for purposes of section 

10 1881(b)(3)(B).’’; and 

11 (B) by adding at the end the following new 

12 paragraph: 

13 ‘‘(5) TREATMENT OF HOME DIALYSIS MONTHLY

14 ESRD-RELATED VISIT.—The geographic requirements 

15 described in paragraph (4)(C)(i) shall not apply with 

16 respect to telehealth services furnished on or after 

17 January 1, 2019, for purposes of section 

18 1881(b)(3)(B), at an originating site described in 

19 subclause (VI), (IX), or (X) of paragraph (4)(C)(ii).’’. 

20 (2) NO FACILITY FEE IF ORIGINATING SITE FOR

21 HOME DIALYSIS THERAPY IS THE HOME.—Section 

22 1834(m)(2)(B) of the Social Security (42 U.S.C. 

23 1395m(m)(2)(B)) is amended— 
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† HR 1892 EAS2 

1 (A) by redesignating clauses (i) and (ii) as 

2 subclauses (I) and (II), and indenting appro3 priately; 

4 (B) in subclause (II), as redesignated by 

5 subparagraph (A), by striking ‘‘clause (i) or this 

6 clause’’ and inserting ‘‘subclause (I) or this sub7 clause’’; 

8 (C) by striking ‘‘SITE.—With respect to’’ 

9 and inserting ‘‘SITE.— 

10 ‘‘(i) IN GENERAL.—Subject to clause 

11 (ii), with respect to’’; and 

12 (D) by adding at the end the following new 

13 clause: 

14 ‘‘(ii) NO FACILITY FEE IF ORIGINATING

15 SITE FOR HOME DIALYSIS THERAPY IS THE

16 HOME.—No facility fee shall be paid under 

17 this subparagraph to an originating site de18 scribed in paragraph (4)(C)(ii)(X).’’. 

19 (c) CLARIFICATION REGARDING TELEHEALTH PRO20 VIDED TO BENEFICIARIES.—Section 1128A(i)(6) of the So21 cial Security Act (42 U.S.C. 1320a–7a(i)(6)) is amended— 

22 (1) in subparagraph (H), by striking ‘‘or’’ at the 

23 end; 

24 (2) in subparagraph (I), by striking the period 

25 at the end and inserting ‘‘; or’’; and 
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1 (3) by adding at the end the following new sub2 paragraph: 

3 ‘‘(J) the provision of telehealth technologies 

4 (as defined by the Secretary) on or after Janu5 ary 1, 2019, by a provider of services or a renal 

6 dialysis facility (as such terms are defined for 

7 purposes of title XVIII) to an individual with 

8 end stage renal disease who is receiving home di9 alysis for which payment is being made under 

10 part B of such title, if— 

11 ‘‘(i) the telehealth technologies are not 

12 offered as part of any advertisement or so13 licitation; 

14 ‘‘(ii) the telehealth technologies are pro15 vided for the purpose of furnishing tele16 health services related to the individual’s 

17 end stage renal disease; and 

18 ‘‘(iii) the provision of the telehealth 

19 technologies meets any other requirements 

20 set forth in regulations promulgated by the 

21 Secretary.’’. 

22 (d) CONFORMING AMENDMENT.—Section 1881(b)(1) of 

23 the Social Security Act (42 U.S.C. 1395rr(b)(1)) is amend24 ed by striking ‘‘paragraph (3)(A)’’ and inserting ‘‘para25 graph (3)(A)(i)’’. 
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1 Subtitle B—Advancing Team-Based 

2 Care 

3 SEC. 50311. PROVIDING CONTINUED ACCESS TO MEDICARE 

4 ADVANTAGE SPECIAL NEEDS PLANS FOR VUL5 NERABLE POPULATIONS. 

6 (a) EXTENSION.—Section 1859(f)(1) of the Social Se7 curity Act (42 U.S.C. 1395w–28(f)(1)) is amended by strik8 ing ‘‘and for periods before January 1, 2019’’. 

9 (b) INCREASED INTEGRATION OF DUAL SNPS.— 

10 (1) IN GENERAL.—Section 1859(f) of the Social 

11 Security Act (42 U.S.C. 1395w–28(f)) is amended— 

12 (A) in paragraph (3), by adding at the end 

13 the following new subparagraph: 

14 ‘‘(F) The plan meets the requirements ap15 plicable under paragraph (8).’’; and 

16 (B) by adding at the end the following new 

17 paragraph: 

18 ‘‘(8) INCREASED INTEGRATION OF DUAL SNPS.— 

19 ‘‘(A) DESIGNATED CONTACT.—The Sec20 retary, acting through the Federal Coordinated 

21 Health Care Office established under section 

22 2602 of Public Law 111–148, shall serve as a 

23 dedicated point of contact for States to address 

24 misalignments that arise with the integration of 

25 specialized MA plans for special needs individ-
316 

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1 uals described in subsection (b)(6)(B)(ii) under 

2 this paragraph and, consistent with such role, 

3 shall establish— 

4 ‘‘(i) a uniform process for dissemi5 nating to State Medicaid agencies informa6 tion under this title impacting contracts be7 tween such agencies and such plans under 

8 this subsection; and 

9 ‘‘(ii) basic resources for States inter10 ested in exploring such plans as a platform 

11 for integration, such as a model contract or 

12 other tools to achieve those goals. 

13 ‘‘(B) UNIFIED GRIEVANCES AND APPEALS

14 PROCESS.— 

15 ‘‘(i) IN GENERAL.—Not later than 

16 April 1, 2020, the Secretary shall establish 

17 procedures, to the extent feasible as deter18 mined by the Secretary, unifying grievances 

19 and appeals procedures under sections 

20 1852(f), 1852(g), 1902(a)(3), 1902(a)(5), 

21 and 1932(b)(4) for items and services pro22 vided by specialized MA plans for special 

23 needs individuals described in subsection 

24 (b)(6)(B)(ii) under this title and title XIX. 

25 With respect to items and services described 
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1 in the preceding sentence, procedures estab2 lished under this clause shall apply in place 

3 of otherwise applicable grievances and ap4 peals procedures. The Secretary shall solicit 

5 comment in developing such procedures 

6 from States, plans, beneficiaries and their 

7 representatives, and other relevant stake8 holders. 

9 ‘‘(ii) PROCEDURES.—The procedures 

10 established under clause (i) shall be in11 cluded in the plan contract under para12 graph (3)(D) and shall— 

13 ‘‘(I) adopt the provisions for the 

14 enrollee that are most protective for the 

15 enrollee and, to the extent feasible as 

16 determined by the Secretary, are com17 patible with unified timeframes and 

18 consolidated access to external review 

19 under an integrated process; 

20 ‘‘(II) take into account differences 

21 in State plans under title XIX to the 

22 extent necessary; 

23 ‘‘(III) be easily navigable by an 

24 enrollee; and 
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1 ‘‘(IV) include the elements de2 scribed in clause (iii), as applicable. 

3 ‘‘(iii) ELEMENTS DESCRIBED.—Both 

4 unified appeals and unified grievance pro5 cedures shall include, as applicable, the fol6 lowing elements described in this clause: 

7 ‘‘(I) Single written notification of 

8 all applicable grievances and appeal 

9 rights under this title and title XIX. 

10 For purposes of this subparagraph, the 

11 Secretary may waive the requirements 

12 under section 1852(g)(1)(B) when the 

13 specialized MA plan covers items or 

14 services under this part or under title 

15 XIX. 

16 ‘‘(II) Single pathways for resolu17 tion of any grievance or appeal related 

18 to a particular item or service pro19 vided by specialized MA plans for spe20 cial needs individuals described in sub21 section (b)(6)(B)(ii) under this title 

22 and title XIX. 

23 ‘‘(III) Notices written in plain 

24 language and available in a language 

25 and format that is accessible to the en-
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1 rollee, including in non-English lan2 guages that are prevalent in the service 

3 area of the specialized MA plan. 

4 ‘‘(IV) Unified timeframes for 

5 grievances and appeals processes, such 

6 as an individual’s filing of a grievance 

7 or appeal, a plan’s acknowledgment 

8 and resolution of a grievance or ap9 peal, and notification of decisions with 

10 respect to a grievance or appeal. 

11 ‘‘(V) Requirements for how the 

12 plan must process, track, and resolve 

13 grievances and appeals, to ensure bene14 ficiaries are notified on a timely basis 

15 of decisions that are made throughout 

16 the grievance or appeals process and 

17 are able to easily determine the status 

18 of a grievance or appeal. 

19 ‘‘(iv) CONTINUATION OF BENEFITS

20 PENDING APPEAL.—The unified procedures 

21 under clause (i) shall, with respect to all 

22 benefits under parts A and B and title XIX 

23 subject to appeal under such procedures, in24 corporate provisions under current law and 

25 implementing regulations that provide con-
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1 tinuation of benefits pending appeal under 

2 this title and title XIX. 

3 ‘‘(C) REQUIREMENT FOR UNIFIED GRIEV4 ANCES AND APPEALS.—For 2021 and subsequent 

5 years, the contract of a specialized MA plan for 

6 special needs individuals described in subsection 

7 (b)(6)(B)(ii) with a State Medicaid agency 

8 under paragraph (3)(D) shall require the use of 

9 unified grievances and appeals procedures as de10 scribed in subparagraph (B). 

11 ‘‘(D) REQUIREMENTS FOR INTEGRATION.— 

12 ‘‘(i) IN GENERAL.—For 2021 and sub13 sequent years, a specialized MA plan for 

14 special needs individuals described in sub15 section (b)(6)(B)(ii) shall meet one or more 

16 of the following requirements, to the extent 

17 permitted under State law, for integration 

18 of benefits under this title and title XIX: 

19 ‘‘(I) The specialized MA plan 

20 must meet the requirements of con21 tracting with the State Medicaid agen22 cy described in paragraph (3)(D) in 

23 addition to coordinating long-term 

24 services and supports or behavioral 

25 health services, or both, by meeting an 
321 

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1 additional minimum set of require2 ments determined by the Secretary 

3 through the Federal Coordinated 

4 Health Care Office established under 

5 section 2602 of the Patient Protection 

6 and Affordable Care Act based on 

7 input from stakeholders, such as noti8 fying the State in a timely manner of 

9 hospitalizations, emergency room vis10 its, and hospital or nursing home dis11 charges of enrollees, assigning one pri12 mary care provider for each enrollee, 

13 or sharing data that would benefit the 

14 coordination of items and services 

15 under this title and the State plan 

16 under title XIX. Such minimum set of 

17 requirements must be included in the 

18 contract of the specialized MA plan 

19 with the State Medicaid agency under 

20 such paragraph. 

21 ‘‘(II) The specialized MA plan 

22 must meet the requirements of a fully 

23 integrated plan described in section 

24 1853(a)(1)(B)(iv)(II) (other than the 

25 requirement that the plan have similar 
322 

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1 average levels of frailty, as determined 

2 by the Secretary, as the PACE pro3 gram), or enter into a capitated con4 tract with the State Medicaid agency 

5 to provide long-term services and sup6 ports or behavioral health services, or 

7 both. 

8 ‘‘(III) In the case of a specialized 

9 MA plan that is offered by a parent or10 ganization that is also the parent orga11 nization of a Medicaid managed care 

12 organization providing long term serv13 ices and supports or behavioral services 

14 under a contract under section 

15 1903(m), the parent organization must 

16 assume clinical and financial responsi17 bility for benefits provided under this 

18 title and title XIX with respect to any 

19 individual who is enrolled in both the 

20 specialized MA plan and the Medicaid 

21 managed care organization. 

22 ‘‘(ii) SUSPENSION OF ENROLLMENT

23 FOR FAILURE TO MEET REQUIREMENTS

24 DURING INITIAL PERIOD.—During the pe25 riod of plan years 2021 through 2025, if the 
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1 Secretary determines that a specialized MA 

2 plan for special needs individuals described 

3 in subsection (b)(6)(B)(ii) has failed to 

4 comply with clause (i), the Secretary may 

5 provide for the application against the 

6 Medicare Advantage organization offering 

7 the plan of the remedy described in section 

8 1857(g)(2)(B) in the same manner as the 

9 Secretary may apply such remedy, and in 

10 accordance with the same procedures as 

11 would apply, in the case of an MA organi12 zation determined by the Secretary to have 

13 engaged in conduct described in section 

14 1857(g)(1). If the Secretary applies such 

15 remedy to a Medicare Advantage organiza16 tion under the preceding sentence, the orga17 nization shall submit to the Secretary (at a 

18 time, and in a form and manner, specified 

19 by the Secretary) information describing 

20 how the plan will come into compliance 

21 with clause (i). 

22 ‘‘(E) STUDY AND REPORT TO CONGRESS.— 

23 ‘‘(i) IN GENERAL.—Not later than 

24 March 15, 2022, and, subject to clause (iii), 

25 biennially thereafter through 2032, the 
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1 Medicare Payment Advisory Commission 

2 established under section 1805, in consulta3 tion with the Medicaid and CHIP Payment 

4 and Access Commission established under 

5 section 1900, shall conduct (and submit to 

6 the Secretary and the Committees on Ways 

7 and Means and Energy and Commerce of 

8 the House of Representatives and the Com9 mittee on Finance of the Senate a report 

10 on) a study to determine how specialized 

11 MA plans for special needs individuals de12 scribed in subsection (b)(6)(B)(ii) perform 

13 among each other based on data from 

14 Healthcare Effectiveness Data and Informa15 tion Set (HEDIS) quality measures, re16 ported on the plan level, as required under 

17 section 1852(e)(3) (or such other measures 

18 or data sources that are available and ap19 propriate, such as encounter data and Con20 sumer Assessment of Healthcare Providers 

21 and Systems data, as specified by such 

22 Commissions as enabling an accurate eval23 uation under this subparagraph). Such 

24 study shall include, as feasible, the following 

25 comparison groups of specialized MA plans 
325 

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1 for special needs individuals described in 

2 subsection (b)(6)(B)(ii): 

3 ‘‘(I) A comparison group of such 

4 plans that are described in subpara5 graph (D)(i)(I). 

6 ‘‘(II) A comparison group of such 

7 plans that are described in subpara8 graph (D)(i)(II). 

9 ‘‘(III) A comparison group of 

10 such plans operating within the Fi11 nancial Alignment Initiative dem12 onstration for the period for which 

13 such plan is so operating and the dem14 onstration is in effect, and, in the case 

15 that an integration option that is not 

16 with respect to specialized MA plans 

17 for special needs individuals is estab18 lished after the conclusion of the dem19 onstration involved. 

20 ‘‘(IV) A comparison group of such 

21 plans that are described in subpara22 graph (D)(i)(III). 

23 ‘‘(V) A comparison group of MA 

24 plans, as feasible, not described in a 

25 previous subclause of this clause, with 
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1 respect to the performance of such 

2 plans for enrollees who are special 

3 needs individuals described in sub4 section (b)(6)(B)(ii). 

5 ‘‘(ii) ADDITIONAL REPORTS.—Begin6 ning with 2033 and every five years there7 after, the Medicare Payment Advisory Com8 mission, in consultation with the Medicaid 

9 and CHIP Payment and Access Commis10 sion, shall conduct a study described in 

11 clause (i).’’. 

12 (2) CONFORMING AMENDMENT TO RESPONSIBIL13 ITIES OF FEDERAL COORDINATED HEALTH CARE OF14 FICE.—Section 2602(d) of Public Law 111–148 (42 

15 U.S.C. 1315b(d)) is amended by adding at the end the 

16 following new paragraphs: 

17 ‘‘(6) To act as a designated contact for States 

18 under subsection (f)(8)(A) of section 1859 of the So19 cial Security Act (42 U.S.C. 1395w–28) with respect 

20 to the integration of specialized MA plans for special 

21 needs individuals described in subsection (b)(6)(B)(ii) 

22 of such section. 

23 ‘‘(7) To be responsible, subject to the final ap24 proval of the Secretary, for developing regulations 

25 and guidance related to the implementation of a uni-
327 

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1 fied grievance and appeals process as described in 

2 subparagraphs (B) and (C) of section 1859(f)(8) of 

3 the Social Security Act (42 U.S.C. 1395w–28(f)(8)). 

4 ‘‘(8) To be responsible, subject to the final ap5 proval of the Secretary, for developing regulations 

6 and guidance related to the integration or alignment 

7 of policy and oversight under the Medicare program 

8 under title XVIII of such Act and the Medicaid pro9 gram under title XIX of such Act regarding special10 ized MA plans for special needs individuals described 

11 in subsection (b)(6)(B)(ii) of such section 1859.’’. 

12 (c) IMPROVEMENTS TO SEVERE OR DISABLING CHRON13 IC CONDITION SNPS.— 

14 (1) CARE MANAGEMENT REQUIREMENTS.—Sec15 tion 1859(f)(5) of the Social Security Act (42 U.S.C. 

16 1395w–28(f)(5)) is amended— 

17 (A) by striking ‘‘ALL SNPS.—The require18 ments’’ and inserting ‘‘ALL SNPS.— 

19 ‘‘(A) IN GENERAL.—Subject to subpara20 graph (B), the requirements’’; 

21 (B) by redesignating subparagraphs (A) 

22 and (B) as clauses (i) and (ii), respectively, and 

23 indenting appropriately; and 

24 (C) in clause (ii), as redesignated by sub25 paragraph (B), by redesignating clauses (i) 
328 

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1 through (iii) as subclauses (I) through (III), re2 spectively, and indenting appropriately; and 

3 (D) by adding at the end the following new 

4 subparagraph: 

5 ‘‘(B) IMPROVEMENTS TO CARE MANAGE6 MENT REQUIREMENTS FOR SEVERE OR DIS7 ABLING CHRONIC CONDITION SNPS.—For 2020 

8 and subsequent years, in the case of a specialized 

9 MA plan for special needs individuals described 

10 in subsection (b)(6)(B)(iii), the requirements de11 scribed in this paragraph include the following: 

12 ‘‘(i) The interdisciplinary team under 

13 subparagraph (A)(ii)(III) includes a team 

14 of providers with demonstrated expertise, 

15 including training in an applicable spe16 cialty, in treating individuals similar to the 

17 targeted population of the plan. 

18 ‘‘(ii) Requirements developed by the 

19 Secretary to provide face-to-face encounters 

20 with individuals enrolled in the plan not 

21 less frequently than on an annual basis. 

22 ‘‘(iii) As part of the model of care 

23 under clause (i) of subparagraph (A), the 

24 results of the initial assessment and annual 

25 reassessment under clause (ii)(I) of such 
329 

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1 subparagraph of each individual enrolled in 

2 the plan are addressed in the individual’s 

3 individualized care plan under clause 

4 (ii)(II) of such subparagraph. 

5 ‘‘(iv) As part of the annual evaluation 

6 and approval of such model of care, the Sec7 retary shall take into account whether the 

8 plan fulfilled the previous year’s goals (as 

9 required under the model of care). 

10 ‘‘(v) The Secretary shall establish a 

11 minimum benchmark for each element of the 

12 model of care of a plan. The Secretary shall 

13 only approve a plan’s model of care under 

14 this paragraph if each element of the model 

15 of care meets the minimum benchmark ap16 plicable under the preceding sentence.’’. 

17 (2) REVISIONS TO THE DEFINITION OF A SEVERE

18 OR DISABLING CHRONIC CONDITIONS SPECIALIZED

19 NEEDS INDIVIDUAL.— 

20 (A) IN GENERAL.—Section 

21 1859(b)(6)(B)(iii) of the Social Security Act (42 

22 U.S.C. 1395w–28(b)(6)(B)(iii)) is amended— 

23 (i) by striking ‘‘who have’’ and insert24 ing ‘‘who— 
330 

† HR 1892 EAS2 

1 ‘‘(I) before January 1, 2022, 

2 have’’; 

3 (ii) in subclause (I), as added by 

4 clause (i), by striking the period at the end 

5 and inserting ‘‘; and’’; and 

6 (iii) by adding at the end the following 

7 new subclause: 

8 ‘‘(II) on or after January 1, 2022, 

9 have one or more comorbid and medi10 cally complex chronic conditions that 

11 is life threatening or significantly lim12 its overall health or function, have a 

13 high risk of hospitalization or other 

14 adverse health outcomes, and require 

15 intensive care coordination and that is 

16 listed under subsection (f)(9)(A).’’. 

17 (B) PANEL OF CLINICAL ADVISORS.—Sec18 tion 1859(f) of the Social Security Act (42 

19 U.S.C. 1395w–28(f)), as amended by subsection 

20 (b), is amended by adding at the end the fol21 lowing new paragraph: 

22 ‘‘(9) LIST OF CONDITIONS FOR CLARIFICATION OF

23 THE DEFINITION OF A SEVERE OR DISABLING CHRON24 IC CONDITIONS SPECIALIZED NEEDS INDIVIDUAL.— 
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1 ‘‘(A) IN GENERAL.—Not later than Decem2 ber 31, 2020, and every 5 years thereafter, sub3 ject to subparagraphs (B) and (C), the Secretary 

4 shall convene a panel of clinical advisors to es5 tablish and update a list of conditions that meet 

6 each of the following criteria: 

7 ‘‘(i) Conditions that meet the defini8 tion of a severe or disabling chronic condi9 tion under subsection (b)(6)(B)(iii) on or 

10 after January 1, 2022. 

11 ‘‘(ii) Conditions that require prescrip12 tion drugs, providers, and models of care 

13 that are unique to the specific population of 

14 enrollees in a specialized MA plan for spe15 cial needs individuals described in such sub16 section on or after such date and— 

17 ‘‘(I) as a result of access to, and 

18 enrollment in, such a specialized MA 

19 plan for special needs individuals, in20 dividuals with such condition would 

21 have a reasonable expectation of slow22 ing or halting the progression of the 

23 disease, improving health outcomes and 

24 decreasing overall costs for individuals 

25 diagnosed with such condition com-
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1 pared to available options of care other 

2 than through such a specialized MA 

3 plan for special needs individuals; or 

4 ‘‘(II) have a low prevalence in the 

5 general population of beneficiaries 

6 under this title or a disproportionally 

7 high per-beneficiary cost under this 

8 title. 

9 ‘‘(B) INCLUSION OF CERTAIN CONDITIONS.— 

10 The conditions listed under subparagraph (A) 

11 shall include HIV/AIDS, end stage renal disease, 

12 and chronic and disabling mental illness. 

13 ‘‘(C) REQUIREMENT.—In establishing and 

14 updating the list under subparagraph (A), the 

15 panel shall take into account the availability of 

16 varied benefits, cost-sharing, and supplemental 

17 benefits under the model described in paragraph 

18 (2) of section 1859(h), including the expansion 

19 under paragraph (1) of such section.’’. 

20 (d) QUALITY MEASUREMENT AT THE PLAN LEVEL FOR

21 SNPS AND DETERMINATION OF FEASABILITY OF QUALITY

22 MEASUREMENT AT THE PLAN LEVEL FOR ALL MA 

23 PLANS.—Section 1853(o) of the Social Security Act (42 

24 U.S.C. 1395w–23(o)) is amended by adding at the end the 

25 following new paragraphs: 
333 

† HR 1892 EAS2 

1 ‘‘(6) QUALITY MEASUREMENT AT THE PLAN

2 LEVEL FOR SNPS.— 

3 ‘‘(A) IN GENERAL.—Subject to subpara4 graph (B), the Secretary may require reporting 

5 of data under section 1852(e) for, and apply 

6 under this subsection, quality measures at the 

7 plan level for specialized MA plans for special 

8 needs individuals instead of at the contract level. 

9 ‘‘(B) CONSIDERATIONS.—Prior to applying 

10 quality measurement at the plan level under this 

11 paragraph, the Secretary shall— 

12 ‘‘(i) take into consideration the min13 imum number of enrollees in a specialized 

14 MA plan for special needs individuals in 

15 order to determine if a statistically signifi16 cant or valid measurement of quality at the 

17 plan level is possible under this paragraph; 

18 ‘‘(ii) take into consideration the im19 pact of such application on plans that serve 

20 a disproportionate number of individuals 

21 dually eligible for benefits under this title 

22 and under title XIX; 

23 ‘‘(iii) if quality measures are reported 

24 at the plan level, ensure that MA plans are 
334 

† HR 1892 EAS2 

1 not required to provide duplicative informa2 tion; and 

3 ‘‘(iv) ensure that such reporting does 

4 not interfere with the collection of encounter 

5 data submitted by MA organizations or the 

6 administration of any changes to the pro7 gram under this part as a result of the col8 lection of such data. 

9 ‘‘(C) APPLICATION.—If the Secretary ap10 plies quality measurement at the plan level 

11 under this paragraph— 

12 ‘‘(i) such quality measurement may in13 clude Medicare Health Outcomes Survey 

14 (HOS), Healthcare Effectiveness Data and 

15 Information Set (HEDIS), Consumer As16 sessment of Healthcare Providers and Sys17 tems (CAHPS) measures and quality meas18 ures under part D; and 

19 ‘‘(ii) the Secretary shall consider ap20 plying administrative actions, such as rem21 edies described in section 1857(g)(2), at the 

22 plan level. 

23 ‘‘(7) DETERMINATION OF FEASIBILITY OF QUAL24 ITY MEASUREMENT AT THE PLAN LEVEL FOR ALL MA

25 PLANS.— 
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1 ‘‘(A) DETERMINATION OF FEASIBILITY.— 

2 The Secretary shall determine the feasibility of 

3 requiring reporting of data under section 1852(e) 

4 for, and applying under this subsection, quality 

5 measures at the plan level for all MA plans 

6 under this part. 

7 ‘‘(B) CONSIDERATION OF CHANGE.—After 

8 making a determination under subparagraph 

9 (A), the Secretary shall consider requiring such 

10 reporting and applying such quality measures at 

11 the plan level as described in such subpara12 graph’’. 

13 (e) GAO STUDY AND REPORT ON STATE-LEVEL INTE14 GRATION BETWEEN DUAL SNPS AND MEDICAID.— 

15 (1) STUDY.—The Comptroller General of the 

16 United States (in this subsection referred to as the 

17 ‘‘Comptroller General’’) shall conduct a study on 

18 State-level integration between specialized MA plans 

19 for special needs individuals described in subsection 

20 (b)(6) (B)(ii) of section 1859 of the Social Security 

21 Act (42 U.S.C. 1395w–28) and the Medicaid program 

22 under title XIX of such Act (42 U.S.C. 1396 et seq.). 

23 Such study shall include an analysis of the following: 

24 (A) The characteristics of States in which 

25 the State agency responsible for administering 
336 

† HR 1892 EAS2 

1 the State plan under such title XIX has a con2 tract with such a specialized MA plan and that 

3 delivers long-term services and supports under 

4 the State plan under such title XIX through a 

5 managed care program, including the require6 ments under such State plan with respect to 

7 long-term services and supports. 

8 (B) The types of such specialized MA plans, 

9 which may include the following: 

10 (i) A plan described in section 

11 1853(a)(1)(B)(iv)(II) of such Act (42 U.S.C. 

12 1395w–23(a)(1)(B)(iv)(II)). 

13 (ii) A plan that meets the requirements 

14 described in subsection (f)(3)(D) of such sec15 tion 1859. 

16 (iii) A plan described in clause (ii) 

17 that also meets additional requirements es18 tablished by the State. 

19 (C) The characteristics of individuals en20 rolled in such specialized MA plans. 

21 (D) As practicable, the following with re22 spect to State programs for the delivery of long23 term services and supports under such title XIX 

24 through a managed care program: 
337 

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1 (i) Which populations of individuals 

2 are eligible to receive such services and sup3 ports. 

4 (ii) Whether all such services and sup5 ports are provided on a capitated basis or 

6 if any of such services and supports are 

7 carved out and provided through fee-for 

8 service. 

9 (E) As practicable, how the availability and 

10 variation of integration arrangements of such 

11 specialized MA plans offered in States affects 

12 spending, service delivery options, access to com13 munity-based care, and utilization of care. 

14 (F) The efforts of State Medicaid programs 

15 to transition dually-eligible beneficiaries receiv16 ing long-term services and supports (LTSS) 

17 from institutional settings to home and commu18 nity-based settings and related financial impacts 

19 of such transitions. 

20 (G) Barriers and opportunities for making 

21 further progress on dual integration, as well as 

22 recommendations for legislation or administra23 tive action to expedite or refine pathways toward 

24 fully integrated care. 
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1 (2) REPORT.—Not later than 2 years after the 

2 date of the enactment of this Act, the Comptroller 

3 General shall submit to Congress a report containing 

4 the results of the study conducted under paragraph 

5 (1), together with recommendations for such legisla6 tion and administrative action as the Comptroller 

7 General determines appropriate. 

8 Subtitle C—Expanding Innovation 

9 and Technology 

10 SEC. 50321. ADAPTING BENEFITS TO MEET THE NEEDS OF 

11 CHRONICALLY ILL MEDICARE ADVANTAGE 

12 ENROLLEES. 

13 Section 1859 of the Social Security Act (42 U.S.C. 

14 1395w–28) is amended by adding at the end the following 

15 new subsection: 

16 ‘‘(h) NATIONAL TESTING OF MEDICARE ADVANTAGE

17 VALUE-BASED INSURANCE DESIGN MODEL.— 

18 ‘‘(1) IN GENERAL.—In implementing the Medi19 care Advantage Value-Based Insurance Design model 

20 that is being tested under section 1115A(b), the Sec21 retary shall revise the testing of the model under such 

22 section to cover, effective not later than January 1, 

23 2020, all States. 

24 ‘‘(2) TERMINATION AND MODIFICATION PROVI25 SION NOT APPLICABLE UNTIL JANUARY 1, 2022.—The 
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1 provisions of section 1115A(b)(3)(B) shall apply to 

2 the Medicare Advantage Value-Based Insurance De3 sign model, including such model as revised under 

4 paragraph (1), beginning January 1, 2022, but shall 

5 not apply to such model, as so revised, prior to such 

6 date. 

7 ‘‘(3) FUNDING.—The Secretary shall allocate 

8 funds made available under section 1115A(f)(1) to de9 sign, implement, and evaluate the Medicare Advan10 tage Value-Based Insurance Design model, as revised 

11 under paragraph (1).’’. 

12 SEC. 50322. EXPANDING SUPPLEMENTAL BENEFITS TO 

13 MEET THE NEEDS OF CHRONICALLY ILL 

14 MEDICARE ADVANTAGE ENROLLEES. 

15 (a) IN GENERAL.—Section 1852(a)(3) of the Social Se16 curity Act (42 U.S.C. 1395w–22(a)(3)) is amended— 

17 (1) in subparagraph (A), by striking ‘‘Each’’ 

18 and inserting ‘‘Subject to subparagraph (D), each’’; 

19 and 

20 (2) by adding at the end the following new sub21 paragraph: 

22 ‘‘(D) EXPANDING SUPPLEMENTAL BENEFITS

23 TO MEET THE NEEDS OF CHRONICALLY ILL EN24 ROLLEES.— 
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1 ‘‘(i) IN GENERAL.—For plan year 2020 

2 and subsequent plan years, in addition to 

3 any supplemental health care benefits other4 wise provided under this paragraph, an MA 

5 plan, including a specialized MA plan for 

6 special needs individuals (as defined in sec7 tion 1859(b)(6)), may provide supplemental 

8 benefits described in clause (ii) to a chron9 ically ill enrollee (as defined in clause (iii)). 

10 ‘‘(ii) SUPPLEMENTAL BENEFITS DE11 SCRIBED.— 

12 ‘‘(I) IN GENERAL.—Supplemental 

13 benefits described in this clause are 

14 supplemental benefits that, with respect 

15 to a chronically ill enrollee, have a rea16 sonable expectation of improving or 

17 maintaining the health or overall func18 tion of the chronically ill enrollee and 

19 may not be limited to being primarily 

20 health related benefits. 

21 ‘‘(II) AUTHORITY TO WAIVE UNI22 FORMITY REQUIREMENTS.—The Sec23 retary may, only with respect to sup24 plemental benefits provided to a chron25 ically ill enrollee under this subpara-
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† HR 1892 EAS2 

1 graph, waive the uniformity require2 ments under this part, as determined 

3 appropriate by the Secretary. 

4 ‘‘(iii) CHRONICALLY ILL ENROLLEE

5 DEFINED.—In this subparagraph, the term 

6 ‘chronically ill enrollee’ means an enrollee 

7 in an MA plan that the Secretary deter8 mines— 

9 ‘‘(I) has one or more comorbid 

10 and medically complex chronic condi11 tions that is life threatening or signifi12 cantly limits the overall health or func13 tion of the enrollee; 

14 ‘‘(II) has a high risk of hos15 pitalization or other adverse health 

16 outcomes; and 

17 ‘‘(III) requires intensive care co18 ordination.’’. 

19 (b) GAO STUDY AND REPORT.— 

20 (1) STUDY.—The Comptroller General of the 

21 United States (in this subsection referred to as the 

22 ‘‘Comptroller General’’) shall conduct a study on sup23 plemental benefits provided to enrollees in Medicare 

24 Advantage plans under part C of title XVIII of the 

25 Social Security Act, including specialized MA plans 
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1 for special needs individuals (as defined in section 

2 1859(b)(6) of such Act (42 U.S.C. 1395w–28(b)(6))). 

3 To the extend data are available, such study shall in4 clude an analysis of the following: 

5 (A) The type of supplemental benefits pro6 vided to such enrollees, the total number of en7 rollees receiving each supplemental benefit, and 

8 whether the supplemental benefit is covered by 

9 the standard benchmark cost of the benefit or 

10 with an additional premium. 

11 (B) The frequency in which supplemental 

12 benefits are utilized by such enrollees. 

13 (C) The impact supplemental benefits have 

14 on— 

15 (i) indicators of the quality of care re16 ceived by such enrollees, including overall 

17 health and function of the enrollees; 

18 (ii) the utilization of items and serv19 ices for which benefits are available under 

20 the original Medicare fee-for-service pro21 gram option under parts A and B of such 

22 title XVIII by such enrollees; and 

23 (iii) the amount of the bids submitted 

24 by Medicare Advantage Organizations for 
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1 Medicare Advantage plans under such part 

2 C. 

3 (2) CONSULTATION.—In conducting the study 

4 under paragraph (1), the Comptroller General shall, 

5 as necessary, consult with the Centers for Medicare & 

6 Medicaid Services and Medicare Advantage organiza7 tions offering Medicare Advantage plans. 

8 (3) REPORT.—Not later than 5 years after the 

9 date of the enactment of this Act, the Comptroller 

10 General shall submit to Congress a report containing 

11 the results of the study conducted under paragraph 

12 (1), together with recommendations for such legisla13 tion and administrative action as the Comptroller 

14 General determines appropriate. 

15 SEC. 50323. INCREASING CONVENIENCE FOR MEDICARE AD16 VANTAGE ENROLLEES THROUGH TELE17 HEALTH. 

18 (a) IN GENERAL.—Section 1852 of the Social Security 

19 Act (42 U.S.C. 1395w–22) is amended— 

20 (1) in subsection (a)(1)(B)(i), by inserting ‘‘, 

21 subject to subsection (m),’’ after ‘‘means’’; and 

22 (2) by adding at the end the following new sub23 section: 

24 ‘‘(m) PROVISION OF ADDITIONAL TELEHEALTH BENE25 FITS.— 
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1 ‘‘(1) MA PLAN OPTION.—For plan year 2020 

2 and subsequent plan years, subject to the requirements 

3 of paragraph (3), an MA plan may provide addi4 tional telehealth benefits (as defined in paragraph 

5 (2)) to individuals enrolled under this part. 

6 ‘‘(2) ADDITIONAL TELEHEALTH BENEFITS DE7 FINED.— 

8 ‘‘(A) IN GENERAL.—For purposes of this 

9 subsection and section 1854: 

10 ‘‘(i) DEFINITION.—The term ‘addi11 tional telehealth benefits’ means services— 

12 ‘‘(I) for which benefits are avail13 able under part B, including services 

14 for which payment is not made under 

15 section 1834(m) due to the conditions 

16 for payment under such section; and 

17 ‘‘(II) that are identified for such 

18 year as clinically appropriate to fur19 nish using electronic information and 

20 telecommunications technology when a 

21 physician (as defined in section 

22 1861(r)) or practitioner (described in 

23 section 1842(b)(18)(C)) providing the 

24 service is not at the same location as 

25 the plan enrollee. 
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† HR 1892 EAS2 

1 ‘‘(ii) EXCLUSION OF CAPITAL AND IN2 FRASTRUCTURE COSTS AND INVEST3 MENTS.—The term ‘additional telehealth 

4 benefits’ does not include capital and infra5 structure costs and investments relating to 

6 such benefits. 

7 ‘‘(B) PUBLIC COMMENT.—Not later than 

8 November 30, 2018, the Secretary shall solicit 

9 comments on— 

10 ‘‘(i) what types of items and services 

11 (including those provided through supple12 mental health care benefits, such as remote 

13 patient monitoring, secure messaging, store 

14 and forward technologies, and other non15 face-to-face communication) should be con16 sidered to be additional telehealth benefits; 

17 and 

18 ‘‘(ii) the requirements for the provision 

19 or furnishing of such benefits (such as 

20 training and coordination requirements). 

21 ‘‘(3) REQUIREMENTS FOR ADDITIONAL TELE22 HEALTH BENEFITS.—The Secretary shall specify re23 quirements for the provision or furnishing of addi24 tional telehealth benefits, including with respect to the 

25 following: 
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1 ‘‘(A) Physician or practitioner qualifica2 tions (other than licensure) and other require3 ments such as specific training. 

4 ‘‘(B) Factors necessary for the coordination 

5 of such benefits with other items and services in6 cluding those furnished in-person. 

7 ‘‘(C) Such other areas as determined by the 

8 Secretary. 

9 ‘‘(4) ENROLLEE CHOICE.—If an MA plan pro10 vides a service as an additional telehealth benefit (as 

11 defined in paragraph (2))— 

12 ‘‘(A) the MA plan shall also provide access 

13 to such benefit through an in-person visit (and 

14 not only as an additional telehealth benefit); and 

15 ‘‘(B) an individual enrollee shall have dis16 cretion as to whether to receive such service 

17 through the in-person visit or as an additional 

18 telehealth benefit. 

19 ‘‘(5) TREATMENT UNDER MA.—For purposes of 

20 this subsection and section 1854, if a plan provides 

21 additional telehealth benefits, such additional tele22 health benefits shall be treated as if they were benefits 

23 under the original Medicare fee-for-service program 

24 option. 
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1 ‘‘(6) CONSTRUCTION.—Nothing in this subsection 

2 shall be construed as affecting the requirement under 

3 subsection (a)(1) that MA plans provide enrollees 

4 with items and services (other than hospice care) for 

5 which benefits are available under parts A and B, in6 cluding benefits available under section 1834(m).’’. 

7 (b) CLARIFICATION REGARDING INCLUSION IN BID

8 AMOUNT.—Section 1854(a)(6)(A)(ii)(I) of the Social Secu9 rity Act (42 U.S.C. 1395w–24(a)(6)(A)(ii)(I)) is amended 

10 by inserting ‘‘, including, for plan year 2020 and subse11 quent plan years, the provision of additional telehealth ben12 efits as described in section 1852(m)’’ before the semicolon 

13 at the end. 

14 SEC. 50324. PROVIDING ACCOUNTABLE CARE ORGANIZA15 TIONS THE ABILITY TO EXPAND THE USE OF 

16 TELEHEALTH. 

17 (a) IN GENERAL.—Section 1899 of the Social Security 

18 Act (42 U.S.C. 1395jjj) is amended by adding at the end 

19 the following new subsection: 

20 ‘‘(l) PROVIDING ACOS THE ABILITY TO EXPAND THE

21 USE OF TELEHEALTH SERVICES.— 

22 ‘‘(1) IN GENERAL.—In the case of telehealth serv23 ices for which payment would otherwise be made 

24 under this title furnished on or after January 1, 

25 2020, for purposes of this subsection only, the fol-
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1 lowing shall apply with respect to such services fur2 nished by a physician or practitioner participating 

3 in an applicable ACO (as defined in paragraph (2)) 

4 to a Medicare fee-for-service beneficiary assigned to 

5 the applicable ACO: 

6 ‘‘(A) INCLUSION OF HOME AS ORIGINATING

7 SITE.—Subject to paragraph (3), the home of a 

8 beneficiary shall be treated as an originating site 

9 described in section 1834(m)(4)(C)(ii). 

10 ‘‘(B) NO APPLICATION OF GEOGRAPHIC LIM11 ITATION.—The geographic limitation under sec12 tion 1834(m)(4)(C)(i) shall not apply with re13 spect to an originating site described in section 

14 1834(m)(4)(C)(ii) (including the home of a bene15 ficiary under subparagraph (A)), subject to State 

16 licensing requirements. 

17 ‘‘(2) DEFINITIONS.—In this subsection: 

18 ‘‘(A) APPLICABLE ACO.—The term ‘applica19 ble ACO’ means an ACO participating in a 

20 model tested or expanded under section 1115A or 

21 under this section— 

22 ‘‘(i) that operates under a two-sided 

23 model— 
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1 ‘‘(I) described in section 

2 425.600(a) of title 42, Code of Federal 

3 Regulations; or 

4 ‘‘(II) tested or expanded under 

5 section 1115A; and 

6 ‘‘(ii) for which Medicare fee-for-service 

7 beneficiaries are assigned to the ACO using 

8 a prospective assignment method, as deter9 mined appropriate by the Secretary. 

10 ‘‘(B) HOME.—The term ‘home’ means, with 

11 respect to a Medicare fee-for-service beneficiary, 

12 the place of residence used as the home of the 

13 beneficiary. 

14 ‘‘(3) TELEHEALTH SERVICES RECEIVED IN THE

15 HOME.—In the case of telehealth services described in 

16 paragraph (1) where the home of a Medicare fee-for17 service beneficiary is the originating site, the fol18 lowing shall apply: 

19 ‘‘(A) NO FACILITY FEE.—There shall be no 

20 facility fee paid to the originating site under sec21 tion 1834(m)(2)(B). 

22 ‘‘(B) EXCLUSION OF CERTAIN SERVICES.— 

23 No payment may be made for such services that 

24 are inappropriate to furnish in the home setting 
350 

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1 such as services that are typically furnished in 

2 inpatient settings such as a hospital.’’. 

3 (b) STUDY AND REPORT.— 

4 (1) STUDY.— 

5 (A) IN GENERAL.—The Secretary of Health 

6 and Human Services (in this subsection referred 

7 to as the ‘‘Secretary’’) shall conduct a study on 

8 the implementation of section 1899(l) of the So9 cial Security Act, as added by subsection (a). 

10 Such study shall include an analysis of the utili11 zation of, and expenditures for, telehealth serv12 ices under such section. 

13 (B) COLLECTION OF DATA.—The Secretary 

14 may collect such data as the Secretary deter15 mines necessary to carry out the study under 

16 this paragraph. 

17 (2) REPORT.—Not later than January 1, 2026, 

18 the Secretary shall submit to Congress a report con19 taining the results of the study conducted under para20 graph (1), together with recommendations for such 

21 legislation and administrative action as the Secretary 

22 determines appropriate. 
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1 SEC. 50325. EXPANDING THE USE OF TELEHEALTH FOR IN2 DIVIDUALS WITH STROKE. 

3 Section 1834(m) of the Social Security Act (42 U.S.C. 

4 1395m(m)), as amended by section 50302(b)(1), is amend5 ed— 

6 (1) in paragraph (4)(C)(i), in the matter pre7 ceding subclause (I), by striking ‘‘The term’’ and in8 serting ‘‘Except as provided in paragraph (6), the 

9 term’’; and 

10 (2) by adding at the end the following new para11 graph: 

12 ‘‘(6) TREATMENT OF STROKE TELEHEALTH

13 SERVICES.— 

14 ‘‘(A) NON-APPLICATION OF ORIGINATING

15 SITE REQUIREMENTS.—The requirements de16 scribed in paragraph (4)(C) shall not apply with 

17 respect to telehealth services furnished on or after 

18 January 1, 2019, for purposes of diagnosis, eval19 uation, or treatment of symptoms of an acute 

20 stroke, as determined by the Secretary. 

21 ‘‘(B) INCLUSION OF CERTAIN SITES.—With 

22 respect to telehealth services described in sub23 paragraph (A), the term ‘originating site’ shall 

24 include any hospital (as defined in section 

25 1861(e)) or critical access hospital (as defined in 

26 section 1861(mm)(1)), any mobile stroke unit (as 
352 

† HR 1892 EAS2 

1 defined by the Secretary), or any other site deter2 mined appropriate by the Secretary, at which 

3 the eligible telehealth individual is located at the 

4 time the service is furnished via a telecommuni5 cations system. 

6 ‘‘(C) NO ORIGINATING SITE FACILITY FEE

7 FOR NEW SITES.—No facility fee shall be paid 

8 under paragraph (2)(B) to an originating site 

9 with respect to a telehealth service described in 

10 subparagraph (A) if the originating site does not 

11 otherwise meet the requirements for an origi12 nating site under paragraph (4)(C).’’. 

13 Subtitle D—Identifying the 

14 Chronically Ill Population 

15 SEC. 50331. PROVIDING FLEXIBILITY FOR BENEFICIARIES 

16 TO BE PART OF AN ACCOUNTABLE CARE OR17 GANIZATION. 

18 Section 1899(c) of the Social Security Act (42 U.S.C. 

19 1395jjj(c)) is amended— 

20 (1) by redesignating paragraphs (1) and (2) as 

21 subparagraphs (A) and (B), respectively, and indent22 ing appropriately; 

23 (2) by striking ‘‘ACOS.—The Secretary’’ and in24 serting ‘‘ACOS.— 
353 

† HR 1892 EAS2 

1 ‘‘(1) IN GENERAL.—Subject to paragraph (2), the 

2 Secretary’’; and 

3 (3) by adding at the end the following new para4 graph: 

5 ‘‘(2) PROVIDING FLEXIBILITY.— 

6 ‘‘(A) CHOICE OF PROSPECTIVE ASSIGN7 MENT.—For each agreement period (effective for 

8 agreements entered into or renewed on or after 

9 January 1, 2020), in the case where an ACO es10 tablished under the program is in a Track that 

11 provides for the retrospective assignment of 

12 Medicare fee-for-service beneficiaries to the ACO, 

13 the Secretary shall permit the ACO to choose to 

14 have Medicare fee-for-service beneficiaries as15 signed prospectively, rather than retrospectively, 

16 to the ACO for an agreement period. 

17 ‘‘(B) ASSIGNMENT BASED ON VOLUNTARY

18 IDENTIFICATION BY MEDICARE FEE-FOR-SERVICE

19 BENEFICIARIES.— 

20 ‘‘(i) IN GENERAL.—For performance 

21 year 2018 and each subsequent performance 

22 year, if a system is available for electronic 

23 designation, the Secretary shall permit a 

24 Medicare fee-for-service beneficiary to volun25 tarily identify an ACO professional as the 
354 

† HR 1892 EAS2 

1 primary care provider of the beneficiary for 

2 purposes of assigning such beneficiary to an 

3 ACO, as determined by the Secretary. 

4 ‘‘(ii) NOTIFICATION PROCESS.—The 

5 Secretary shall establish a process under 

6 which a Medicare fee-for-service beneficiary 

7 is— 

8 ‘‘(I) notified of their ability to 

9 make an identification described in 

10 clause (i); and 

11 ‘‘(II) informed of the process by 

12 which they may make and change such 

13 identification. 

14 ‘‘(iii) SUPERSEDING CLAIMS-BASED AS15 SIGNMENT.—A voluntary identification by 

16 a Medicare fee-for-service beneficiary under 

17 this subparagraph shall supersede any 

18 claims-based assignment otherwise deter19 mined by the Secretary.’’. 
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1 Subtitle E—Empowering Individ2 uals and Caregivers in Care De3 livery 

4 SEC. 50341. ELIMINATING BARRIERS TO CARE COORDINA5 TION UNDER ACCOUNTABLE CARE ORGANIZA6 TIONS. 

7 (a) IN GENERAL.—Section 1899 of the Social Security 

8 Act (42 U.S.C. 1395jjj), as amended by section 50324(a), 

9 is amended— 

10 (1) in subsection (b)(2), by adding at the end the 

11 following new subparagraph: 

12 ‘‘(I) An ACO that seeks to operate an ACO 

13 Beneficiary Incentive Program pursuant to sub14 section (m) shall apply to the Secretary at such 

15 time, in such manner, and with such informa16 tion as the Secretary may require.’’; 

17 (2) by adding at the end the following new sub18 section: 

19 ‘‘(m) AUTHORITY TO PROVIDE INCENTIVE PAYMENTS

20 TO BENEFICIARIES WITH RESPECT TO QUALIFYING PRI21 MARY CARE SERVICES.— 

22 ‘‘(1) PROGRAM.— 

23 ‘‘(A) IN GENERAL.—In order to encourage 

24 Medicare fee-for-service beneficiaries to obtain 

25 medically necessary primary care services, an 
356 

† HR 1892 EAS2 

1 ACO participating under this section under a 

2 payment model described in clause (i) or (ii) of 

3 paragraph (2)(B) may apply to establish an 

4 ACO Beneficiary Incentive Program to provide 

5 incentive payments to such beneficiaries who are 

6 furnished qualifying services in accordance with 

7 this subsection. The Secretary shall permit such 

8 an ACO to establish such a program at the Sec9 retary’s discretion and subject to such require10 ments, including program integrity require11 ments, as the Secretary determines necessary. 

12 ‘‘(B) IMPLEMENTATION.—The Secretary 

13 shall implement this subsection on a date deter14 mined appropriate by the Secretary. Such date 

15 shall be no earlier than January 1, 2019, and no 

16 later than January 1, 2020. 

17 ‘‘(2) CONDUCT OF PROGRAM.— 

18 ‘‘(A) DURATION.—Subject to subparagraph 

19 (H), an ACO Beneficiary Incentive Program es20 tablished under this subsection shall be conducted 

21 for such period (of not less than 1 year) as the 

22 Secretary may approve. 

23 ‘‘(B) SCOPE.—An ACO Beneficiary Incen24 tive Program established under this subsection 

25 shall provide incentive payments to all of the fol-
357 

† HR 1892 EAS2 

1 lowing Medicare fee-for-service beneficiaries who 

2 are furnished qualifying services by the ACO: 

3 ‘‘(i) With respect to the Track 2 and 

4 Track 3 payment models described in sec5 tion 425.600(a) of title 42, Code of Federal 

6 Regulations (or in any successor regula7 tion), Medicare fee-for-service beneficiaries 

8 who are preliminarily prospectively or pro9 spectively assigned (or otherwise assigned, 

10 as determined by the Secretary) to the ACO. 

11 ‘‘(ii) With respect to any future pay12 ment models involving two-sided risk, Medi13 care fee-for-service beneficiaries who are as14 signed to the ACO, as determined by the 

15 Secretary. 

16 ‘‘(C) QUALIFYING SERVICE.—For purposes 

17 of this subsection, a qualifying service is a pri18 mary care service, as defined in section 425.20 

19 of title 42, Code of Federal Regulations (or in 

20 any successor regulation), with respect to which 

21 coinsurance applies under part B, furnished 

22 through an ACO by— 

23 ‘‘(i) an ACO professional described in 

24 subsection (h)(1)(A) who has a primary 

25 care specialty designation included in the 
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† HR 1892 EAS2 

1 definition of primary care physician under 

2 section 425.20 of title 42, Code of Federal 

3 Regulations (or any successor regulation); 

4 ‘‘(ii) an ACO professional described in 

5 subsection (h)(1)(B); or 

6 ‘‘(iii) a Federally qualified health cen7 ter or rural health clinic (as such terms are 

8 defined in section 1861(aa)). 

9 ‘‘(D) INCENTIVE PAYMENTS.—An incentive 

10 payment made by an ACO pursuant to an ACO 

11 Beneficiary Incentive Program established under 

12 this subsection shall be— 

13 ‘‘(i) in an amount up to $20, with 

14 such maximum amount updated annually 

15 by the percentage increase in the consumer 

16 price index for all urban consumers (United 

17 States city average) for the 12-month period 

18 ending with June of the previous year; 

19 ‘‘(ii) in the same amount for each 

20 Medicare fee-for-service beneficiary described 

21 in clause (i) or (ii) of subparagraph (B) 

22 without regard to enrollment of such a bene23 ficiary in a medicare supplemental policy 

24 (described in section 1882(g)(1)), in a State 

25 Medicaid plan under title XIX or a waiver 
359 

† HR 1892 EAS2 

1 of such a plan, or in any other health in2 surance policy or health benefit plan; 

3 ‘‘(iii) made for each qualifying service 

4 furnished to such a beneficiary described in 

5 clause (i) or (ii) of subparagraph (B) dur6 ing a period specified by the Secretary; and 

7 ‘‘(iv) made no later than 30 days after 

8 a qualifying service is furnished to such a 

9 beneficiary described in clause (i) or (ii) of 

10 subparagraph (B). 

11 ‘‘(E) NO SEPARATE PAYMENTS FROM THE

12 SECRETARY.—The Secretary shall not make any 

13 separate payment to an ACO for the costs, in14 cluding incentive payments, of carrying out an 

15 ACO Beneficiary Incentive Program established 

16 under this subsection. Nothing in this subpara17 graph shall be construed as prohibiting an ACO 

18 from using shared savings received under this 

19 section to carry out an ACO Beneficiary Incen20 tive Program. 

21 ‘‘(F) NO APPLICATION TO SHARED SAVINGS

22 CALCULATION.—Incentive payments made by an 

23 ACO under this subsection shall be disregarded 

24 for purposes of calculating benchmarks, esti-
360 

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1 mated average per capita Medicare expenditures, 

2 and shared savings under this section. 

3 ‘‘(G) REPORTING REQUIREMENTS.—An 

4 ACO conducting an ACO Beneficiary Incentive 

5 Program under this subsection shall, at such 

6 times and in such format as the Secretary may 

7 require, report to the Secretary such information 

8 and retain such documentation as the Secretary 

9 may require, including the amount and fre10 quency of incentive payments made and the 

11 number of Medicare fee-for-service beneficiaries 

12 receiving such payments. 

13 ‘‘(H) TERMINATION.—The Secretary may 

14 terminate an ACO Beneficiary Incentive Pro15 gram established under this subsection at any 

16 time for reasons determined appropriate by the 

17 Secretary. 

18 ‘‘(3) EXCLUSION OF INCENTIVE PAYMENTS.—Any 

19 payment made under an ACO Beneficiary Incentive 

20 Program established under this subsection shall not be 

21 considered income or resources or otherwise taken into 

22 account for purposes of— 

23 ‘‘(A) determining eligibility for benefits or 

24 assistance (or the amount or extent of benefits or 

25 assistance) under any Federal program or under 
361 

† HR 1892 EAS2 

1 any State or local program financed in whole or 

2 in part with Federal funds; or 

3 ‘‘(B) any Federal or State laws relating to 

4 taxation.’’; 

5 (3) in subsection (e), by inserting ‘‘, including 

6 an ACO Beneficiary Incentive Program under sub7 sections (b)(2)(I) and (m)’’ after ‘‘the program’’; and 

8 (4) in subsection (g)(6), by inserting ‘‘or of an 

9 ACO Beneficiary Incentive Program under sub10 sections (b)(2)(I) and (m)’’ after ‘‘under subsection 

11 (d)(4)’’. 

12 (b) AMENDMENT TO SECTION 1128B.—Section 

13 1128B(b)(3) of the Social Security Act (42 U.S.C. 1320a– 

14 7b(b)(3)) is amended— 

15 (1) by striking ‘‘and’’ at the end of subpara16 graph (I); 

17 (2) by striking the period at the end of subpara18 graph (J) and inserting ‘‘; and’’; and 

19 (3) by adding at the end the following new sub20 paragraph: 

21 ‘‘(K) an incentive payment made to a Medi22 care fee-for-service beneficiary by an ACO under 

23 an ACO Beneficiary Incentive Program estab24 lished under subsection (m) of section 1899, if 

25 the payment is made in accordance with the re-
362 

† HR 1892 EAS2 

1 quirements of such subsection and meets such 

2 other conditions as the Secretary may estab3 lish.’’. 

4 (c) EVALUATION AND REPORT.— 

5 (1) EVALUATION.—The Secretary of Health and 

6 Human Services (in this subsection referred to as the 

7 ‘‘Secretary’’) shall conduct an evaluation of the ACO 

8 Beneficiary Incentive Program established under sub9 sections (b)(2)(I) and (m) of section 1899 of the So10 cial Security Act (42 U.S.C. 1395jjj), as added by 

11 subsection (a). The evaluation shall include an anal12 ysis of the impact of the implementation of the Pro13 gram on expenditures and beneficiary health outcomes 

14 under title XVIII of the Social Security Act (42 

15 U.S.C. 1395 et seq.). 

16 (2) REPORT.—Not later than October 1, 2023, 

17 the Secretary shall submit to Congress a report con18 taining the results of the evaluation under paragraph 

19 (1), together with recommendations for such legisla20 tion and administrative action as the Secretary deter21 mines appropriate. 
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1 SEC. 50342. GAO STUDY AND REPORT ON LONGITUDINAL 

2 COMPREHENSIVE CARE PLANNING SERVICES 

3 UNDER MEDICARE PART B. 

4 (a) STUDY.—The Comptroller General shall conduct a 

5 study on the establishment under part B of the Medicare 

6 program under title XVIII of the Social Security Act of 

7 a payment code for a visit for longitudinal comprehensive 

8 care planning services. Such study shall include an anal9 ysis of the following to the extent such information is avail10 able: 

11 (1) The frequency with which services similar to 

12 longitudinal comprehensive care planning services are 

13 furnished to Medicare beneficiaries, which providers 

14 of services and suppliers are furnishing those services, 

15 whether Medicare reimbursement is being received for 

16 those services, and, if so, through which codes those 

17 services are being reimbursed. 

18 (2) Whether, and the extent to which, longitu19 dinal comprehensive care planning services would 

20 overlap, and could therefore result in duplicative pay21 ment, with services covered under the hospice benefit 

22 as well as the chronic care management code, evalua23 tion and management codes, or other codes that al24 ready exist under part B of the Medicare program. 

25 (3) Any barriers to hospitals, skilled nursing fa26 cilities, hospice programs, home health agencies, and 
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1 other applicable providers working with a Medicare 

2 beneficiary to engage in the care planning process 

3 and complete the necessary documentation to support 

4 the treatment and care plan of the beneficiary and 

5 provide such documentation to other providers and 

6 the beneficiary or the beneficiary’s representative. 

7 (4) Any barriers to providers, other than the pro8 vider furnishing longitudinal comprehensive care 

9 planning services, accessing the care plan and associ10 ated documentation for use related to the care of the 

11 Medicare beneficiary. 

12 (5) Potential options for ensuring that applica13 ble providers are notified of a patient’s existing longi14 tudinal care plan and that applicable providers con15 sider that plan in making their treatment decisions, 

16 and what the challenges might be in implementing 

17 such options. 

18 (6) Stakeholder’s views on the need for the devel19 opment of quality metrics with respect to longitudinal 

20 comprehensive care planning services, such as meas21 ures related to— 

22 (A) the process of eliciting input from the 

23 Medicare beneficiary or from a legally author24 ized representative and documenting in the med25 ical record the patient-directed care plan; 
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1 (B) the effectiveness and patient2 centeredness of the care plan in organizing deliv3 ery of services consistent with the plan; 

4 (C) the availability of the care plan and as5 sociated documentation to other providers that 

6 care for the beneficiary; and 

7 (D) the extent to which the beneficiary re8 ceived services and support that is free from dis9 crimination based on advanced age, disability 

10 status, or advanced illness. 

11 (7) Stakeholder’s views on how such quality 

12 metrics would provide information on— 

13 (A) the goals, values, and preferences of the 

14 beneficiary; 

15 (B) the documentation of the care plan; 

16 (C) services furnished to the beneficiary; 

17 and 

18 (D) outcomes of treatment. 

19 (8) Stakeholder’s views on— 

20 (A) the type of training and education 

21 needed for applicable providers, individuals, and 

22 caregivers in order to facilitate longitudinal 

23 comprehensive care planning services; 
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1 (B) the types of providers of services and 

2 suppliers that should be included in the inter3 disciplinary team of an applicable provider; and 

4 (C) the characteristics of Medicare bene5 ficiaries that would be most appropriate to re6 ceive longitudinal comprehensive care planning 

7 services, such as individuals with advanced dis8 ease and individuals who need assistance with 

9 multiple activities of daily living. 

10 (9) Stakeholder’s views on the frequency with 

11 which longitudinal comprehensive care planning serv12 ices should be furnished. 

13 (b) REPORT.—Not later than 18 months after the date 

14 of the enactment of this Act, the Comptroller General shall 

15 submit to Congress a report containing the results of the 

16 study conducted under subsection (a), together with rec17 ommendations for such legislation and administrative ac18 tion as the Comptroller General determines appropriate. 

19 (c) DEFINITIONS.—In this section: 

20 (1) APPLICABLE PROVIDER.—The term ‘‘applica21 ble provider’’ means a hospice program (as defined in 

22 subsection (dd)(2) of section 1861 of the Social Secu23 rity Act (42 U.S.C. 1395ww)) or other provider of 

24 services (as defined in subsection (u) of such section) 
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1 or supplier (as defined in subsection (d) of such sec2 tion) that— 

3 (A) furnishes longitudinal comprehensive 

4 care planning services through an interdiscipli5 nary team; and 

6 (B) meets such other requirements as the 

7 Secretary may determine to be appropriate. 

8 (2) COMPTROLLER GENERAL.—The term ‘‘Comp9 troller General’’ means the Comptroller General of the 

10 United States. 

11 (3) INTERDISCIPLINARY TEAM.—The term 

12 ‘‘interdisciplinary team’’ means a group that— 

13 (A) includes the personnel described in sub14 section (dd)(2)(B)(i) of such section 1861; 

15 (B) may include a chaplain, minister, or 

16 other clergy; and 

17 (C) may include other direct care personnel. 

18 (4) LONGITUDINAL COMPREHENSIVE CARE PLAN19 NING SERVICES.—The term ‘‘longitudinal comprehen20 sive care planning services’’ means a voluntary 

21 shared decisionmaking process that is furnished by an 

22 applicable provider through an interdisciplinary 

23 team and includes a conversation with Medicare bene24 ficiaries who have received a diagnosis of a serious or 

25 life-threatening illness. The purpose of such services is 
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1 to discuss a longitudinal care plan that addresses the 

2 progression of the disease, treatment options, the 

3 goals, values, and preferences of the beneficiary, and 

4 the availability of other resources and social supports 

5 that may reduce the beneficiary’s health risks and 

6 promote self-management and shared decisionmaking. 

7 (5) SECRETARY.—The term ‘‘Secretary’’ means 

8 the Secretary of Health and Human Services. 

9 Subtitle F—Other Policies to Im10 prove Care for the Chronically 

11 Ill 

12 SEC. 50351. GAO STUDY AND REPORT ON IMPROVING MEDI13 CATION SYNCHRONIZATION. 

14 (a) STUDY.—The Comptroller General of the United 

15 States (in this section referred to as the ‘‘Comptroller Gen16 eral’’) shall conduct a study on the extent to which Medicare 

17 prescription drug plans (MA–PD plans and stand alone 

18 prescription drug plans) under part D of title XVIII of the 

19 Social Security Act and private payors use programs that 

20 synchronize pharmacy dispensing so that individuals may 

21 receive multiple prescriptions on the same day to facilitate 

22 comprehensive counseling and promote medication adher23 ence. The study shall include a analysis of the following: 

24 (1) The extent to which pharmacies have adopted 

25 such programs. 
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1 (2) The common characteristics of such pro2 grams, including how pharmacies structure coun3 seling sessions under such programs and the types of 

4 payment and other arrangements that Medicare pre5 scription drug plans and private payors employ 

6 under such programs to support the efforts of phar7 macies. 

8 (3) How such programs compare for Medicare 

9 prescription drug plans and private payors. 

10 (4) What is known about how such programs af11 fect patient medication adherence and overall patient 

12 health outcomes, including if adherence and outcomes 

13 vary by patient subpopulations, such as disease state 

14 and socioeconomic status. 

15 (5) What is known about overall patient satisfac16 tion with such programs and satisfaction with such 

17 programs, including within patient subpopulations, 

18 such as disease state and socioeconomic status. 

19 (6) The extent to which laws and regulations of 

20 the Medicare program support such programs. 

21 (7) Barriers to the use of medication synchroni22 zation programs by Medicare prescription drug plans. 

23 (b) REPORT.—Not later than 18 months after the date 

24 of the enactment of this Act, the Comptroller General shall 

25 submit to Congress a report containing the results of the 
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1 study under subsection (a), together with recommendations 

2 for such legislation and administrative action as the Comp3 troller General determines appropriate. 

4 SEC. 50352. GAO STUDY AND REPORT ON IMPACT OF OBE5 SITY DRUGS ON PATIENT HEALTH AND 

6 SPENDING. 

7 (a) STUDY.—The Comptroller General of the United 

8 States (in this section referred to as the ‘‘Comptroller Gen9 eral’’) shall, to the extent data are available, conduct a 

10 study on the use of prescription drugs to manage the weight 

11 of obese patients and the impact of coverage of such drugs 

12 on patient health and on health care spending. Such study 

13 shall examine the use and impact of these obesity drugs in 

14 the non-Medicare population and for Medicare beneficiaries 

15 who have such drugs covered through an MA–PD plan (as 

16 defined in section 1860D–1(a)(3)(C) of the Social Security 

17 Act (42 U.S.C. 1395w–101(a)(3)(C))) as a supplemental 

18 health care benefit. The study shall include an analysis of 

19 the following: 

20 (1) The prevalence of obesity in the Medicare 

21 and non-Medicare population. 

22 (2) The utilization of obesity drugs. 

23 (3) The distribution of Body Mass Index by in24 dividuals taking obesity drugs, to the extent prac25 ticable. 
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1 (4) What is known about the use of obesity drugs 

2 in conjunction with the receipt of other items or serv3 ices, such as behavioral counseling, and how these 

4 compare to items and services received by obese indi5 viduals who do not take obesity drugs. 

6 (5) Physician considerations and attitudes re7 lated to prescribing obesity drugs. 

8 (6) The extent to which coverage policies cease or 

9 limit coverage for individuals who fail to receive clin10 ical benefit. 

11 (7) What is known about the extent to which in12 dividuals who take obesity drugs adhere to the pre13 scribed regimen. 

14 (8) What is known about the extent to which in15 dividuals who take obesity drugs maintain weight loss 

16 over time. 

17 (9) What is known about the subsequent impact 

18 such drugs have on medical services that are directly 

19 related to obesity, including with respect to sub20 populations determined based on the extent of obesity. 

21 (10) What is known about the spending associ22 ated with the care of individuals who take obesity 

23 drugs, compared to the spending associated with the 

24 care of individuals who do not take such drugs. 
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1 (b) REPORT.—Not later than 18 months after the date 

2 of the enactment of this Act, the Comptroller General shall 

3 submit to Congress a report containing the results of the 

4 study under subsection (a), together with recommendations 

5 for such legislation and administrative action as the Comp6 troller General determines appropriate. 

7 SEC. 50353. HHS STUDY AND REPORT ON LONG-TERM RISK 

8 FACTORS FOR CHRONIC CONDITIONS AMONG 

9 MEDICARE BENEFICIARIES. 

10 (a) STUDY.—The Secretary of Health and Human 

11 Services (in this section referred to as the ‘‘Secretary’’) shall 

12 conduct a study on long-term cost drivers to the Medicare 

13 program, including obesity, tobacco use, mental health con14 ditions, and other factors that may contribute to the deterio15 ration of health conditions among individuals with chronic 

16 conditions in the Medicare population. The study shall in17 clude an analysis of any barriers to collecting and ana18 lyzing such information and how to remove any such bar19 riers (including through legislation and administrative ac20 tions). 

21 (b) REPORT.—Not later than 18 months after the date 

22 of the enactment of this Act, the Secretary shall submit to 

23 Congress a report containing the results of the study under 

24 subsection (a), together with recommendations for such leg25 islation and administrative action as the Secretary deter-
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1 mines appropriate. The Secretary shall also post such re2 port on the Internet website of the Department of Health 

3 and Human Services. 

4 SEC. 50354. PROVIDING PRESCRIPTION DRUG PLANS WITH 

5 PARTS A AND B CLAIMS DATA TO PROMOTE 

6 THE APPROPRIATE USE OF MEDICATIONS 

7 AND IMPROVE HEALTH OUTCOMES. 

8 Section 1860D–4(c) of the Social Security Act (42 

9 U.S.C. 1395w–104(c)) is amended by adding at the end the 

10 following new paragraph: 

11 ‘‘(6) PROVIDING PRESCRIPTION DRUG PLANS

12 WITH PARTS A AND B CLAIMS DATA TO PROMOTE THE

13 APPROPRIATE USE OF MEDICATIONS AND IMPROVE

14 HEALTH OUTCOMES.— 

15 ‘‘(A) PROCESS.—Subject to subparagraph 

16 (B), the Secretary shall establish a process under 

17 which a PDP sponsor of a prescription drug 

18 plan may submit a request for the Secretary to 

19 provide the sponsor, on a periodic basis and in 

20 an electronic format, beginning in plan year 

21 2020, data described in subparagraph (D) with 

22 respect to enrollees in such plan. Such data shall 

23 be provided without regard to whether such en24 rollees are described in clause (ii) of paragraph 

25 (2)(A). 
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1 ‘‘(B) PURPOSES.—A PDP sponsor may use 

2 the data provided to the sponsor pursuant to 

3 subparagraph (A) for any of the following pur4 poses: 

5 ‘‘(i) To optimize therapeutic outcomes 

6 through improved medication use, as such 

7 phrase is used in clause (i) of paragraph 

8 (2)(A). 

9 ‘‘(ii) To improving care coordination 

10 so as to prevent adverse health outcomes, 

11 such as preventable emergency department 

12 visits and hospital readmissions. 

13 ‘‘(iii) For any other purpose deter14 mined appropriate by the Secretary. 

15 ‘‘(C) LIMITATIONS ON DATA USE.—A PDP 

16 sponsor shall not use data provided to the spon17 sor pursuant to subparagraph (A) for any of the 

18 following purposes: 

19 ‘‘(i) To inform coverage determinations 

20 under this part. 

21 ‘‘(ii) To conduct retroactive reviews of 

22 medically accepted indications determina23 tions. 

24 ‘‘(iii) To facilitate enrollment changes 

25 to a different prescription drug plan or an 
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1 MA–PD plan offered by the same parent or2 ganization. 

3 ‘‘(iv) To inform marketing of benefits. 

4 ‘‘(v) For any other purpose that the 

5 Secretary determines is necessary to include 

6 in order to protect the identity of individ7 uals entitled to, or enrolled for, benefits 

8 under this title and to protect the security 

9 of personal health information. 

10 ‘‘(D) DATA DESCRIBED.—The data de11 scribed in this clause are standardized extracts 

12 (as determined by the Secretary) of claims data 

13 under parts A and B for items and services fur14 nished under such parts for time periods speci15 fied by the Secretary. Such data shall include 

16 data as current as practicable.’’. 
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1 TITLE IV—PART B IMPROVE2 MENT ACT AND OTHER PART 

3 B ENHANCEMENTS 

4 Subtitle A—Medicare Part B 

5 Improvement Act 

6 SEC. 50401. HOME INFUSION THERAPY SERVICES TEM7 PORARY TRANSITIONAL PAYMENT. 

8 (a) IN GENERAL.—Section 1834(u) of the Social Secu9 rity Act (42 U.S.C. 1395m(u)) is amended, by adding at 

10 the end the following new paragraph: 

11 ‘‘(7) HOME INFUSION THERAPY SERVICES TEM12 PORARY TRANSITIONAL PAYMENT.— 

13 ‘‘(A) TEMPORARY TRANSITIONAL PAY14 MENT.— 

15 ‘‘(i) IN GENERAL.—The Secretary 

16 shall, in accordance with the payment 

17 methodology described in subparagraph (B) 

18 and subject to the provisions of this para19 graph, provide a home infusion therapy 

20 services temporary transitional payment 

21 under this part to an eligible home infusion 

22 supplier (as defined in subparagraph (F)) 

23 for items and services described in subpara24 graphs (A) and (B) of section 1861(iii)(2)) 

25 furnished during the period specified in 
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1 clause (ii) by such supplier in coordination 

2 with the furnishing of transitional home in3 fusion drugs (as defined in clause (iii)). 

4 ‘‘(ii) PERIOD SPECIFIED.—For pur5 poses of clause (i), the period specified in 

6 this clause is the period beginning on Janu7 ary 1, 2019, and ending on the day before 

8 the date of the implementation of the pay9 ment system under paragraph (1)(A). 

10 ‘‘(iii) TRANSITIONAL HOME INFUSION

11 DRUG DEFINED.—For purposes of this para12 graph, the term ‘transitional home infusion 

13 drug’ has the meaning given to the term 

14 ‘home infusion drug’ under section 

15 1861(iii)(3)(C)), except that clause (ii) of 

16 such section shall not apply if a drug de17 scribed in such clause is identified in 

18 clauses (i), (ii), (iii) or (iv) of subpara19 graph (C) as of the date of the enactment of 

20 this paragraph. 

21 ‘‘(B) PAYMENT METHODOLOGY.—For pur22 poses of this paragraph, the Secretary shall es23 tablish a payment methodology, with respect to 

24 items and services described in subparagraph 
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1 (A)(i). Under such payment methodology the 

2 Secretary shall— 

3 ‘‘(i) create the three payment categories 

4 described in clauses (i), (ii), and (iii) of 

5 subparagraph (C); 

6 ‘‘(ii) assign drugs to such categories, in 

7 accordance with such clauses; 

8 ‘‘(iii) assign appropriate Healthcare 

9 Common Procedure Coding System 

10 (HCPCS) codes to each payment category; 

11 and 

12 ‘‘(iv) establish a single payment 

13 amount for each such payment category, in 

14 accordance with subparagraph (D), for each 

15 infusion drug administration calendar day 

16 in the individual’s home for drugs assigned 

17 to such category. 

18 ‘‘(C) PAYMENT CATEGORIES.— 

19 ‘‘(i) PAYMENT CATEGORY 1.—The Sec20 retary shall create a payment category 1 

21 and assign to such category drugs which are 

22 covered under the Local Coverage Deter23 mination on External Infusion Pumps 

24 (LCD number L33794) and billed with the 

25 following HCPCS codes (as identified as of 
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1 January 1, 2018, and as subsequently 

2 modified by the Secretary): J0133, J0285, 

3 J0287, J0288, J0289, J0895, J1170, J1250, 

4 J1265, J1325, J1455, J1457, J1570, J2175, 

5 J2260, J2270, J2274, J2278, J3010, or 

6 J3285. 

7 ‘‘(ii) PAYMENT CATEGORY 2.—The Sec8 retary shall create a payment category 2 

9 and assign to such category drugs which are 

10 covered under such local coverage deter11 mination and billed with the following 

12 HCPCS codes (as identified as of January 

13 1, 2018, and as subsequently modified by 

14 the Secretary): J1555 JB, J1559 JB, J1561 

15 JB, J1562 JB, J1569 JB, or J1575 JB. 

16 ‘‘(iii) PAYMENT CATEGORY 3.—The 

17 Secretary shall create a payment category 3 

18 and assign to such category drugs which are 

19 covered under such local coverage deter20 mination and billed with the following 

21 HCPCS codes (as identified as of January 

22 1, 2018, and as subsequently modified by 

23 the Secretary): J9000, J9039, J9040, 

24 J9065, J9100, J9190, J9200, J9360, or 

25 J9370. 
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1 ‘‘(iv) INFUSION DRUGS NOT OTHER2 WISE INCLUDED.—With respect to drugs 

3 that are not included in payment category 

4 1, 2, or 3 under clause (i), (ii), or (iii), re5 spectively, the Secretary shall assign to the 

6 most appropriate of such categories, as de7 termined by the Secretary, drugs which 

8 are— 

9 ‘‘(I) covered under such local cov10 erage determination and billed under 

11 HCPCS codes J7799 or J7999 (as 

12 identified as of July 1, 2017, and as 

13 subsequently modified by the Sec14 retary); or 

15 ‘‘(II) billed under any code that is 

16 implemented after the date of the en17 actment of this paragraph and in18 cluded in such local coverage deter19 mination or included in subregulatory 

20 guidance as a home infusion drug de21 scribed in subparagraph (A)(i). 

22 ‘‘(D) PAYMENT AMOUNTS.— 

23 ‘‘(i) IN GENERAL.—Under the payment 

24 methodology, the Secretary shall pay eligible 

25 home infusion suppliers, with respect to 
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1 items and services described in subpara2 graph (A)(i) furnished during the period 

3 described in subparagraph (A)(ii) by such 

4 supplier to an individual, at amounts equal 

5 to the amounts determined under the physi6 cian fee schedule established under section 

7 1848 for services furnished during the year 

8 for codes and units of such codes described 

9 in clauses (ii), (iii), and (iv) with respect 

10 to drugs included in the payment category 

11 under subparagraph (C) specified in the re12 spective clause, determined without applica13 tion of the geographic adjustment under 

14 subsection (e) of such section. 

15 ‘‘(ii) PAYMENT AMOUNT FOR CATEGORY

16 1.—For purposes of clause (i), the codes and 

17 units described in this clause, with respect 

18 to drugs included in payment category 1 

19 described in subparagraph (C)(i), are one 

20 unit of HCPCS code 96365 plus three units 

21 of HCPCS code 96366 (as identified as of 

22 January 1, 2018, and as subsequently 

23 modified by the Secretary). 

24 ‘‘(iii) PAYMENT AMOUNT FOR CAT25 EGORY 2.—For purposes of clause (i), the 
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1 codes and units described in this clause, 

2 with respect to drugs included in payment 

3 category 2 described in subparagraph 

4 (C)(i), are one unit of HCPCS code 96369 

5 plus three units of HCPCS code 96370 (as 

6 identified as of January 1, 2018, and as 

7 subsequently modified by the Secretary). 

8 ‘‘(iv) PAYMENT AMOUNT FOR CAT9 EGORY 3.—For purposes of clause (i), the 

10 codes and units described in this clause, 

11 with respect to drugs included in payment 

12 category 3 described in subparagraph 

13 (C)(i), are one unit of HCPCS code 96413 

14 plus three units of HCPCS code 96415 (as 

15 identified as of January 1, 2018, and as 

16 subsequently modified by the Secretary). 

17 ‘‘(E) CLARIFICATIONS.— 

18 ‘‘(i) INFUSION DRUG ADMINISTRATION

19 DAY.—For purposes of this subsection, with 

20 respect to the furnishing of transitional 

21 home infusion drugs or home infusion drugs 

22 to an individual by an eligible home infu23 sion supplier or a qualified home infusion 

24 therapy supplier, a reference to payment to 

25 such supplier for an infusion drug adminis-
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1 tration calendar day in the individual’s 

2 home shall refer to payment only for the 

3 date on which professional services (as de4 scribed in section 1861(iii)(2)(A)) were fur5 nished to administer such drugs to such in6 dividual. For purposes of the previous sen7 tence, an infusion drug administration cal8 endar day shall include all such drugs ad9 ministered to such individual on such day. 

10 ‘‘(ii) TREATMENT OF MULTIPLE DRUGS

11 ADMINISTERED ON SAME INFUSION DRUG

12 ADMINISTRATION DAY.—In the case that an 

13 eligible home infusion supplier, with respect 

14 to an infusion drug administration cal15 endar day in an individual’s home, fur16 nishes to such individual transitional home 

17 infusion drugs which are not all assigned to 

18 the same payment category under subpara19 graph (C), payment to such supplier for 

20 such infusion drug administration calendar 

21 day in the individual’s home shall be a sin22 gle payment equal to the amount of pay23 ment under this paragraph for the drug, 

24 among all such drugs so furnished to such 

25 individual during such calendar day, for 
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1 which the highest payment would be made 

2 under this paragraph. 

3 ‘‘(F) ELIGIBLE HOME INFUSION SUP4 PLIERS.—In this paragraph, the term ‘eligible 

5 home infusion supplier’ means a supplier that is 

6 enrolled under this part as a pharmacy that pro7 vides external infusion pumps and external infu8 sion pump supplies and that maintains all 

9 pharmacy licensure requirements in the State in 

10 which the applicable infusion drugs are adminis11 tered. 

12 ‘‘(G) IMPLEMENTATION.—Notwithstanding 

13 any other provision of law, the Secretary may 

14 implement this paragraph by program instruc15 tion or otherwise.’’. 

16 (b) CONFORMING AMENDMENTS.—(1) Section 

17 1842(b)(6)(I) of the Social Security Act (42 U.S.C. 

18 1395u(b)(6)(I)) is amended by inserting ‘‘or, in the case 

19 of items and services described in clause (i) of section 

20 1834(u)(7)(A) furnished to an individual during the period 

21 described in clause (ii) of such section, payment shall be 

22 made to the eligible home infusion therapy supplier’’ after 

23 ‘‘payment shall be made to the qualified home infusion ther24 apy supplier’’. 
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1 (2) Section 5012(d) of the 21st Century Cures Act is 

2 amended by inserting the following before the period at the 

3 end: ‘‘, except that the amendments made by paragraphs 

4 (1) and (2) of subsection (c) shall apply to items and serv5 ices furnished on or after January 1, 2019’’. 

6 SEC. 50402. ORTHOTIST’S AND PROSTHETIST’S CLINICAL 

7 NOTES AS PART OF THE PATIENT’S MEDICAL 

8 RECORD. 

9 Section 1834(h) of the Social Security Act (42 U.S.C. 

10 1395m(h)) is amended by adding at the end the following 

11 new paragraph: 

12 ‘‘(5) DOCUMENTATION CREATED BY ORTHOTISTS

13 AND PROSTHETISTS.—For purposes of determining 

14 the reasonableness and medical necessity of orthotics 

15 and prosthetics, documentation created by an 

16 orthotist or prosthetist shall be considered part of the 

17 individual’s medical record to support documentation 

18 created by eligible professionals described in section 

19 1848(k)(3)(B).’’. 

20 SEC. 50403. INDEPENDENT ACCREDITATION FOR DIALYSIS 

21 FACILITIES AND ASSURANCE OF HIGH QUAL22 ITY SURVEYS. 

23 (a) ACCREDITATION AND SURVEYS.— 

24 (1) IN GENERAL.—Section 1865 of the Social Se25 curity Act (42 U.S.C. 1395bb) is amended— 
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† HR 1892 EAS2 

1 (A) in subsection (a)— 

2 (i) in paragraph (1), in the matter 

3 preceding subparagraph (A), by striking ‘‘or 

4 the conditions and requirements under sec5 tion 1881(b)’’; and 

6 (ii) in paragraph (4), by inserting 

7 ‘‘(including a renal dialysis facility)’’ after 

8 ‘‘facility’’; and 

9 (B) by adding at the end the following new 

10 subsection: 

11 ‘‘(e) With respect to an accreditation body that has re12 ceived approval from the Secretary under subsection 

13 (a)(3)(A) for accreditation of provider entities that are re14 quired to meet the conditions and requirements under sec15 tion 1881(b), in addition to review and oversight authori16 ties otherwise applicable under this title, the Secretary shall 

17 (as the Secretary determines appropriate) conduct, with re18 spect to such accreditation body and provider entities, any 

19 or all of the following as frequently as is otherwise required 

20 to be conducted under this title with respect to other accredi21 tation bodies or other provider entities: 

22 ‘‘(1) Validation surveys referred to in subsection 

23 (d). 
387 

† HR 1892 EAS2 

1 ‘‘(2) Accreditation program reviews (as defined 

2 in section 488.8(c) of title 42 of the Code of Federal 

3 Regulations, or a successor regulation). 

4 ‘‘(3) Performance reviews (as defined in section 

5 488.8(a) of title 42 of the Code of Federal Regula6 tions, or a successor regulation).’’. 

7 (2) TIMING FOR ACCEPTANCE OF REQUESTS

8 FROM ACCREDITATION ORGANIZATIONS.—Not later 

9 than 90 days after the date of enactment of this Act, 

10 the Secretary of Health and Human Services shall 

11 begin accepting requests from national accreditation 

12 bodies for a finding described in section 

13 1865(a)(3)(A) of the Social Security Act (42 U.S.C. 

14 1395bb(a)(3)(A)) for purposes of accrediting provider 

15 entities that are required to meet the conditions and 

16 requirements under section 1881(b) of such Act (42 

17 U.S.C. 1395rr(b)). 

18 (b) REQUIREMENT FOR TIMING OF SURVEYS OF NEW

19 DIALYSIS FACILITIES.—Section 1881(b)(1) of the Social Se20 curity Act (42 U.S.C. 1395rr(b)(1)) is amended by adding 

21 at the end the following new sentence: ‘‘Beginning 180 days 

22 after the date of the enactment of this sentence, an initial 

23 survey of a provider of services or a renal dialysis facility 

24 to determine if the conditions and requirements under this 

25 paragraph are met shall be initiated not later than 90 days 
388 

† HR 1892 EAS2 

1 after such date on which both the provider enrollment form 

2 (without regard to whether such form is submitted prior 

3 to or after such date of enactment) has been determined by 

4 the Secretary to be complete and the provider’s enrollment 

5 status indicates approval is pending the results of such sur6 vey.’’. 

7 SEC. 50404. MODERNIZING THE APPLICATION OF THE 

8 STARK RULE UNDER MEDICARE. 

9 (a) CLARIFICATION OF THE WRITING REQUIREMENT

10 AND SIGNATURE REQUIREMENT FOR ARRANGEMENTS PUR11 SUANT TO THE STARK RULE.— 

12 (1) WRITING REQUIREMENT.—Section 

13 1877(h)(1) of the Social Security Act (42 U.S.C. 

14 1395nn(h)(1)) is amended by adding at the end the 

15 following new subparagraph: 

16 ‘‘(D) WRITTEN REQUIREMENT CLARIFIED.—In 

17 the case of any requirement pursuant to this section 

18 for a compensation arrangement to be in writing, 

19 such requirement shall be satisfied by such means as 

20 determined by the Secretary, including by a collection 

21 of documents, including contemporaneous documents 

22 evidencing the course of conduct between the parties 

23 involved.’’. 

24 (2) SIGNATURE REQUIREMENT.—Section 

25 1877(h)(1) of the Social Security Act (42 U.S.C. 
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1 1395nn(h)(1)), as amended by paragraph (1), is fur2 ther amended by adding at the end the following new 

3 subparagraph: 

4 ‘‘(E) SPECIAL RULE FOR SIGNATURE RE5 QUIREMENTS.—In the case of any requirement 

6 pursuant to this section for a compensation ar7 rangement to be in writing and signed by the 

8 parties, such signature requirement shall be met 

9 if— 

10 ‘‘(i) not later than 90 consecutive cal11 endar days immediately following the date 

12 on which the compensation arrangement be13 came noncompliant, the parties obtain the 

14 required signatures; and 

15 ‘‘(ii) the compensation arrangement 

16 otherwise complies with all criteria of the 

17 applicable exception.’’. 

18 (b) INDEFINITE HOLDOVER FOR LEASE ARRANGE19 MENTS AND PERSONAL SERVICES ARRANGEMENTS PURSU20 ANT TO THE STARK RULE.—Section 1877(e) of the Social 

21 Security Act (42 U.S.C. 1395nn(e)) is amended— 

22 (1) in paragraph (1), by adding at the end the 

23 following new subparagraph: 

24 ‘‘(C) HOLDOVER LEASE ARRANGEMENTS.— 

25 In the case of a holdover lease arrangement for 
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1 the lease of office space or equipment, which im2 mediately follows a lease arrangement described 

3 in subparagraph (A) for the use of such office 

4 space or subparagraph (B) for the use of such 

5 equipment and that expired after a term of at 

6 least 1 year, payments made by the lessee to the 

7 lessor pursuant to such holdover lease arrange8 ment, if— 

9 ‘‘(i) the lease arrangement met the con10 ditions of subparagraph (A) for the lease of 

11 office space or subparagraph (B) for the use 

12 of equipment when the arrangement ex13 pired; 

14 ‘‘(ii) the holdover lease arrangement is 

15 on the same terms and conditions as the 

16 immediately preceding arrangement; and 

17 ‘‘(iii) the holdover arrangement con18 tinues to satisfy the conditions of subpara19 graph (A) for the lease of office space or 

20 subparagraph (B) for the use of equip21 ment.’’; and 

22 (2) in paragraph (3), by adding at the end the 

23 following new subparagraph: 

24 ‘‘(C) HOLDOVER PERSONAL SERVICE AR25 RANGEMENT.—In the case of a holdover personal 
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1 service arrangement, which immediately follows 

2 an arrangement described in subparagraph (A) 

3 that expired after a term of at least 1 year, re4 muneration from an entity pursuant to such 

5 holdover personal service arrangement, if— 

6 ‘‘(i) the personal service arrangement 

7 met the conditions of subparagraph (A) 

8 when the arrangement expired; 

9 ‘‘(ii) the holdover personal service ar10 rangement is on the same terms and condi11 tions as the immediately preceding arrange12 ment; and 

13 ‘‘(iii) the holdover arrangement con14 tinues to satisfy the conditions of subpara15 graph (A).’’. 

16 Subtitle B—Additional Medicare 

17 Provisions 

18 SEC. 50411. MAKING PERMANENT THE REMOVAL OF THE 

19 RENTAL CAP FOR DURABLE MEDICAL EQUIP20 MENT UNDER MEDICARE WITH RESPECT TO 

21 SPEECH GENERATING DEVICES. 

22 Section 1834(a)(2)(A)(iv) of the Social Security Act 

23 (42 U.S.C. 1395m(a)(2)(A)(iv)) is amended by striking 

24 ‘‘and before October 1, 2018,’’. 
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1 SEC. 50412. INCREASED CIVIL AND CRIMINAL PENALTIES 

2 AND INCREASED SENTENCES FOR FEDERAL 

3 HEALTH CARE PROGRAM FRAUD AND ABUSE. 

4 (a) INCREASED CIVIL MONEY PENALTIES AND CRIMI5 NAL FINES.— 

6 (1) INCREASED CIVIL MONEY PENALTIES.—Sec7 tion 1128A of the Social Security Act (42 U.S.C. 

8 1320a–7a) is amended— 

9 (A) in subsection (a), in the matter fol10 lowing paragraph (10)— 

11 (i) by striking ‘‘$10,000’’ and inserting 

12 ‘‘$20,000’’ each place it appears; 

13 (ii) by striking ‘‘$15,000’’ and insert14 ing ‘‘$30,000’’; and 

15 (iii) by striking ‘‘$50,000’’ and insert16 ing ‘‘$100,000’’ each place it appears; and 

17 (B) in subsection (b)— 

18 (i) in paragraph (1), in the flush text 

19 following subparagraph (B), by striking 

20 ‘‘$2,000’’ and inserting ‘‘$5,000’’; 

21 (ii) in paragraph (2), by striking 

22 ‘‘$2,000’’ and inserting ‘‘$5,000’’; and 

23 (iii) in paragraph (3)(A)(i), by strik24 ing ‘‘$5,000’’ and inserting ‘‘$10,000’’. 
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1 (2) INCREASED CRIMINAL FINES.—Section 

2 1128B of such Act (42 U.S.C. 1320a–7b) is amend3 ed— 

4 (A) in subsection (a), in the matter fol5 lowing paragraph (6)— 

6 (i) by striking ‘‘$25,000’’ and inserting 

7 ‘‘$100,000’’; and 

8 (ii) by striking ‘‘$10,000’’ and insert9 ing ‘‘$20,000’’; 

10 (B) in subsection (b)— 

11 (i) in paragraph (1), in the flush text 

12 following subparagraph (B), by striking 

13 ‘‘$25,000’’ and inserting ‘‘$100,000’’; and 

14 (ii) in paragraph (2), in the flush text 

15 following subparagraph (B), by striking 

16 ‘‘$25,000’’ and inserting ‘‘$100,000’’; 

17 (C) in subsection (c), by striking ‘‘$25,000’’ 

18 and inserting ‘‘$100,000’’; 

19 (D) in subsection (d), in the flush text fol20 lowing paragraph (2), by striking ‘‘$25,000’’ and 

21 inserting ‘‘$100,000’’; and 

22 (E) in subsection (e), by striking ‘‘$2,000’’ 

23 and inserting ‘‘$4,000’’. 

24 (b) INCREASED SENTENCES FOR FELONIES INVOLVING

25 FEDERAL HEALTH CARE PROGRAM FRAUD AND ABUSE.— 
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1 (1) FALSE STATEMENTS AND REPRESENTA2 TIONS.—Section 1128B(a) of the Social Security Act 

3 (42 U.S.C. 1320a–7b(a)) is amended, in the matter 

4 following paragraph (6), by striking ‘‘not more than 

5 five years or both, or (ii)’’ and inserting ‘‘not more 

6 than 10 years or both, or (ii)’’. 

7 (2) ANTIKICKBACK.—Section 1128B(b) of such 

8 Act (42 U.S.C. 1320a–7b(b)) is amended— 

9 (A) in paragraph (1), in the flush text fol10 lowing subparagraph (B), by striking ‘‘not more 

11 than five years’’ and inserting ‘‘not more than 

12 10 years’’; and 

13 (B) in paragraph (2), in the flush text fol14 lowing subparagraph (B), by striking ‘‘not more 

15 than five years’’ and inserting ‘‘not more than 

16 10 years’’. 

17 (3) FALSE STATEMENT OR REPRESENTATION

18 WITH RESPECT TO CONDITIONS OR OPERATIONS OF

19 FACILITIES.—Section 1128B(c) of such Act (42 U.S.C. 

20 1320a–7b(c)) is amended by striking ‘‘not more than 

21 five years’’ and inserting ‘‘not more than 10 years’’. 

22 (4) EXCESS CHARGES.—Section 1128B(d) of 

23 such Act (42 U.S.C. 1320a–7b(d)) is amended, in the 

24 flush text following paragraph (2), by striking ‘‘not 
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1 more than five years’’ and inserting ‘‘not more than 

2 10 years’’. 

3 (c) EFFECTIVE DATE.—The amendments made by this 

4 section shall apply to acts committed after the date of the 

5 enactment of this Act. 

6 SEC. 50413. REDUCING THE VOLUME OF FUTURE EHR-RE7 LATED SIGNIFICANT HARDSHIP REQUESTS. 

8 Section 1848(o)(2)(A) of the Social Security Act (42 

9 U.S.C. 1395w–4(o)(2)(A)) and section 1886(n)(3)(A) of 

10 such Act (42 U.S.C. 1395ww(n)(3)(A)) are each amended 

11 in the last sentence by striking ‘‘by requiring’’ and all that 

12 follows through ‘‘this paragraph’’. 

13 SEC. 50414. STRENGTHENING RULES IN CASE OF COMPETI14 TION FOR DIABETIC TESTING STRIPS. 

15 (a) SPECIAL RULE IN CASE OF COMPETITION FOR DI16 ABETIC TESTING STRIPS.— 

17 (1) IN GENERAL.—Paragraph (10) of section 

18 1847(b) of the Social Security Act (42 U.S.C. 1395w– 

19 3(b)) is amended— 

20 (A) in subparagraph (A), by striking the 

21 second sentence and inserting the following new 

22 sentence: ‘‘With respect to bids to furnish such 

23 types of products on or after January 1, 2019, 

24 the volume for such types of products shall be de25 termined by the Secretary through the use of 
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1 multiple sources of data (from mail order and 

2 non-mail order Medicare markets), including 

3 market-based data measuring sales of diabetic 

4 testing strip products that are not exclusively 

5 sold by a single retailer from such markets.’’; 

6 and 

7 (B) by adding at the end the following new 

8 subparagraphs: 

9 ‘‘(C) DEMONSTRATION OF ABILITY TO FUR10 NISH TYPES OF DIABETIC TESTING STRIP PROD11 UCTS.—With respect to bids to furnish diabetic 

12 testing strip products on or after January 1, 

13 2019, an entity shall attest to the Secretary that 

14 the entity has the ability to obtain an inventory 

15 of the types and quantities of diabetic testing 

16 strip products that will allow the entity to fur17 nish such products in a manner consistent with 

18 its bid and— 

19 ‘‘(i) demonstrate to the Secretary, 

20 through letters of intent with manufactur21 ers, wholesalers, or other suppliers, or other 

22 evidence as the Secretary may specify, such 

23 ability; or 
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† HR 1892 EAS2 

1 ‘‘(ii) demonstrate to the Secretary that 

2 it made a good faith attempt to obtain such 

3 a letter of intent or such other evidence. 

4 ‘‘(D) USE OF UNLISTED TYPES IN CALCULA5 TION OF PERCENTAGE.—With respect to bids to 

6 furnish diabetic testing strip products on or after 

7 January 1, 2019, in determining under subpara8 graph (A) whether a bid submitted by an entity 

9 under such subparagraph covers 50 percent (or 

10 such higher percentage as the Secretary may 

11 specify) of all types of diabetic testing strip 

12 products, the Secretary may not attribute a per13 centage to types of diabetic testing strip products 

14 that the Secretary does not identify by brand, 

15 model, and market share volume. 

16 ‘‘(E) ADHERENCE TO DEMONSTRATION.— 

17 ‘‘(i) IN GENERAL.—In the case of an 

18 entity that is furnishing diabetic testing 

19 strip products on or after January 1, 2019, 

20 under a contract entered into under the 

21 competition conducted pursuant to para22 graph (1), the Secretary shall establish a 

23 process to monitor, on an ongoing basis, the 

24 extent to which such entity continues to 
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1 cover the product types included in the enti2 ty’s bid. 

3 ‘‘(ii) TERMINATION.—If the Secretary 

4 determines that an entity described in 

5 clause (i) fails to maintain in inventory, or 

6 otherwise maintain ready access to (through 

7 requirements, contracts, or otherwise) a type 

8 of product included in the entity’s bid, the 

9 Secretary may terminate such contract un10 less the Secretary finds that the failure of 

11 the entity to maintain inventory of, or 

12 ready access to, the product is the result of 

13 the discontinuation of the product by the 

14 product manufacturer, a market-wide short15 age of the product, or the introduction of a 

16 newer model or version of the product in the 

17 market involved.’’. 

18 (b) CODIFYING AND EXPANDING ANTI-SWITCHING

19 RULE.—Section 1847(b) of the Social Security Act (42 

20 U.S.C. 1395w–3(b)), as amended by subsection (a)(1), is 

21 further amended— 

22 (1) by redesignating paragraph (11) as para23 graph (12); and 

24 (2) by inserting after paragraph (10) the fol25 lowing new paragraph: 
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1 ‘‘(11) ADDITIONAL SPECIAL RULES IN CASE OF

2 COMPETITION FOR DIABETIC TESTING STRIPS.— 

3 ‘‘(A) IN GENERAL.—With respect to an enti4 ty that is furnishing diabetic testing strip prod5 ucts to individuals under a contract entered into 

6 under the competitive acquisition program estab7 lished under this section, the entity shall furnish 

8 to each individual a brand of such products that 

9 is compatible with the home blood glucose mon10 itor selected by the individual. 

11 ‘‘(B) PROHIBITION ON INFLUENCING AND

12 INCENTIVIZING.—An entity described in sub13 paragraph (A) may not attempt to influence or 

14 incentivize an individual to switch the brand of 

15 glucose monitor or diabetic testing strip product 

16 selected by the individual, including by— 

17 ‘‘(i) persuading, pressuring, or advis18 ing the individual to switch; or 

19 ‘‘(ii) furnishing information about al20 ternative brands to the individual where the 

21 individual has not requested such informa22 tion. 

23 ‘‘(C) PROVISION OF INFORMATION.— 

24 ‘‘(i) STANDARDIZED INFORMATION.— 

25 Not later than January 1, 2019, the Sec-
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1 retary shall develop and make available to 

2 entities described in subparagraph (A) 

3 standardized information that describes the 

4 rights of an individual with respect to such 

5 an entity. The information described in the 

6 preceding sentence shall include information 

7 regarding— 

8 ‘‘(I) the requirements established 

9 under subparagraphs (A) and (B); 

10 ‘‘(II) the right of the individual to 

11 purchase diabetic testing strip products 

12 from another mail order supplier of 

13 such products or a retail pharmacy if 

14 the entity is not able to furnish the 

15 brand of such product that is compat16 ible with the home blood glucose mon17 itor selected by the individual; and 

18 ‘‘(III) the right of the individual 

19 to return diabetic testing strip prod20 ucts furnished to the individual by the 

21 entity. 

22 ‘‘(ii) REQUIREMENT.—With respect to 

23 diabetic testing strip products furnished on 

24 or after the date on which the Secretary de25 velops the standardized information under 
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1 clause (i), an entity described in subpara2 graph (A) may not communicate directly to 

3 an individual until the entity has verbally 

4 provided the individual with such standard5 ized information. 

6 ‘‘(D) ORDER REFILLS.—With respect to di7 abetic testing strip products furnished on or 

8 after January 1, 2019, the Secretary shall re9 quire an entity furnishing diabetic testing strip 

10 products to an individual to contact and receive 

11 a request from the individual for such products 

12 not more than 14 days prior to dispensing a re13 fill of such products to the individual.’’. 

14 (c) IMPLEMENTATION; NON-APPLICATION OF THE PA15 PERWORK REDUCTION ACT.— 

16 (1) IMPLEMENTATION.—Notwithstanding any 

17 other provision of law, the Secretary of Health and 

18 Human Services may implement the provisions of, 

19 and amendments made by, this section by program 

20 instruction or otherwise. 

21 (2) NON-APPLICATION OF THE PAPERWORK RE22 DUCTION ACT.—Chapter 35 of title 44, United States 

23 Code (commonly referred to as the ‘‘Paperwork Re24 duction Act of 1995’’), shall not apply to this section 

25 or the amendments made by this section. 
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1 TITLE V—OTHER HEALTH 

2 EXTENDERS 

3 SEC. 50501. EXTENSION FOR FAMILY-TO-FAMILY HEALTH IN4 FORMATION CENTERS. 

5 Section 501(c) of the Social Security Act (42 U.S.C. 

6 701(c)) is amended— 

7 (1) in paragraph (1)(A)— 

8 (A) in clause (v), by striking ‘‘and’’ at the 

9 end; 

10 (B) in clause (vi), by striking the period at 

11 the end and inserting ‘‘; and’’; and 

12 (C) by adding at the end the following new 

13 clause: 

14 ‘‘(vii) $6,000,000 for each of fiscal years 2018 

15 and 2019.’’; 

16 (2) in paragraph (3)(C), by inserting before the 

17 period the following: ‘‘, and with respect to fiscal 

18 years 2018 and 2019, such centers shall also be devel19 oped in all territories and at least one such center 

20 shall be developed for Indian tribes’’; and 

21 (3) by amending paragraph (5) to read as fol22 lows: 

23 ‘‘(5) For purposes of this subsection— 
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1 ‘‘(A) the term ‘Indian tribe’ has the meaning 

2 given such term in section 4 of the Indian Health 

3 Care Improvement Act (25 U.S.C. 1603); 

4 ‘‘(B) the term ‘State’ means each of the 50 States 

5 and the District of Columbia; and 

6 ‘‘(C) the term ‘territory’ means Puerto Rico, 

7 Guam, American Samoa, the Virgin Islands, and the 

8 Northern Mariana Islands.’’. 

9 SEC. 50502. EXTENSION FOR SEXUAL RISK AVOIDANCE EDU10 CATION. 

11 (a) IN GENERAL.—Section 510 of the Social Security 

12 Act (42 U.S.C. 710) is amended to read as follows: 

13 ‘‘SEC. 510. SEXUAL RISK AVOIDANCE EDUCATION. 

14 ‘‘(a) IN GENERAL.— 

15 ‘‘(1) ALLOTMENTS TO STATES.—For the purpose 

16 described in subsection (b), the Secretary shall, for 

17 each of fiscal years 2018 and 2019, allot to each State 

18 which has transmitted an application for the fiscal 

19 year under section 505(a) an amount equal to the 

20 product of— 

21 ‘‘(A) the amount appropriated pursuant to 

22 subsection (e)(1) for the fiscal year, minus the 

23 amount reserved under subsection (e)(2) for the 

24 fiscal year; and 
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1 ‘‘(B) the proportion that the number of low2 income children in the State bears to the total of 

3 such numbers of children for all the States. 

4 ‘‘(2) OTHER ALLOTMENTS.— 

5 ‘‘(A) OTHER ENTITIES.—For the purpose 

6 described in subsection (b), the Secretary shall, 

7 for each of fiscal years 2018 and 2019, for any 

8 State which has not transmitted an application 

9 for the fiscal year under section 505(a), allot to 

10 one or more entities in the State the amount that 

11 would have been allotted to the State under 

12 paragraph (1) if the State had submitted such 

13 an application. 

14 ‘‘(B) PROCESS.—The Secretary shall select 

15 the recipients of allotments under subparagraph 

16 (A) by means of a competitive grant process 

17 under which— 

18 ‘‘(i) not later than 30 days after the 

19 deadline for the State involved to submit an 

20 application for the fiscal year under section 

21 505(a), the Secretary publishes a notice so22 liciting grant applications; and 

23 ‘‘(ii) not later than 120 days after such 

24 deadline, all such applications must be sub25 mitted. 
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1 ‘‘(b) PURPOSE.— 

2 ‘‘(1) IN GENERAL.—Except for research under 

3 paragraph (5) and information collection and report4 ing under paragraph (6), the purpose of an allotment 

5 under subsection (a) to a State (or to another entity 

6 in the State pursuant to subsection (a)(2)) is to en7 able the State or other entity to implement education 

8 exclusively on sexual risk avoidance (meaning volun9 tarily refraining from sexual activity). 

10 ‘‘(2) REQUIRED COMPONENTS.—Education on 

11 sexual risk avoidance pursuant to an allotment under 

12 this section shall— 

13 ‘‘(A) ensure that the unambiguous and pri14 mary emphasis and context for each topic de15 scribed in paragraph (3) is a message to youth 

16 that normalizes the optimal health behavior of 

17 avoiding nonmarital sexual activity; 

18 ‘‘(B) be medically accurate and complete; 

19 ‘‘(C) be age-appropriate; 

20 ‘‘(D) be based on adolescent learning and 

21 developmental theories for the age group receiv22 ing the education; and 

23 ‘‘(E) be culturally appropriate, recognizing 

24 the experiences of youth from diverse commu25 nities, backgrounds, and experiences. 
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1 ‘‘(3) TOPICS.—Education on sexual risk avoid2 ance pursuant to an allotment under this section 

3 shall address each of the following topics: 

4 ‘‘(A) The holistic individual and societal 

5 benefits associated with personal responsibility, 

6 self-regulation, goal setting, healthy decision7 making, and a focus on the future. 

8 ‘‘(B) The advantage of refraining from non9 marital sexual activity in order to improve the 

10 future prospects and physical and emotional 

11 health of youth. 

12 ‘‘(C) The increased likelihood of avoiding 

13 poverty when youth attain self-sufficiency and 

14 emotional maturity before engaging in sexual ac15 tivity. 

16 ‘‘(D) The foundational components of 

17 healthy relationships and their impact on the 

18 formation of healthy marriages and safe and sta19 ble families. 

20 ‘‘(E) How other youth risk behaviors, such 

21 as drug and alcohol usage, increase the risk for 

22 teen sex. 

23 ‘‘(F) How to resist and avoid, and receive 

24 help regarding, sexual coercion and dating vio-
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1 lence, recognizing that even with consent teen sex 

2 remains a youth risk behavior. 

3 ‘‘(4) CONTRACEPTION.—Education on sexual risk 

4 avoidance pursuant to an allotment under this section 

5 shall ensure that— 

6 ‘‘(A) any information provided on contra7 ception is medically accurate and complete and 

8 ensures that students understand that contracep9 tion offers physical risk reduction, but not risk 

10 elimination; and 

11 ‘‘(B) the education does not include dem12 onstrations, simulations, or distribution of con13 traceptive devices. 

14 ‘‘(5) RESEARCH.— 

15 ‘‘(A) IN GENERAL.—A State or other entity 

16 receiving an allotment pursuant to subsection (a) 

17 may use up to 20 percent of such allotment to 

18 build the evidence base for sexual risk avoidance 

19 education by conducting or supporting research. 

20 ‘‘(B) REQUIREMENTS.—Any research con21 ducted or supported pursuant to subparagraph 

22 (A) shall be— 

23 ‘‘(i) rigorous; 

24 ‘‘(ii) evidence-based; and 
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1 ‘‘(iii) designed and conducted by inde2 pendent researchers who have experience in 

3 conducting and publishing research in peer4 reviewed outlets. 

5 ‘‘(6) INFORMATION COLLECTION AND REPORT6 ING.—A State or other entity receiving an allotment 

7 pursuant to subsection (a) shall, as specified by the 

8 Secretary— 

9 ‘‘(A) collect information on the programs 

10 and activities funded through the allotment; and 

11 ‘‘(B) submit reports to the Secretary on the 

12 data from such programs and activities. 

13 ‘‘(c) NATIONAL EVALUATION.— 

14 ‘‘(1) IN GENERAL.—The Secretary shall— 

15 ‘‘(A) in consultation with appropriate State 

16 and local agencies, conduct one or more rigorous 

17 evaluations of the education funded through this 

18 section and associated data; and 

19 ‘‘(B) submit a report to the Congress on the 

20 results of such evaluations, together with a sum21 mary of the information collected pursuant to 

22 subsection (b)(6). 

23 ‘‘(2) CONSULTATION.—In conducting the evalua24 tions required by paragraph (1), including the estab25 lishment of rigorous evaluation methodologies, the 
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1 Secretary shall consult with relevant stakeholders and 

2 evaluation experts. 

3 ‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.— 

4 ‘‘(1) Sections 503, 507, and 508 apply to allot5 ments under subsection (a) to the same extent and in 

6 the same manner as such sections apply to allotments 

7 under section 502(c). 

8 ‘‘(2) Sections 505 and 506 apply to allotments 

9 under subsection (a) to the extent determined by the 

10 Secretary to be appropriate. 

11 ‘‘(e) DEFINITIONS.—In this section: 

12 ‘‘(1) The term ‘age-appropriate’ means suitable 

13 (in terms of topics, messages, and teaching methods) 

14 to the developmental and social maturity of the par15 ticular age or age group of children or adolescents, 

16 based on developing cognitive, emotional, and behav17 ioral capacity typical for the age or age group. 

18 ‘‘(2) The term ‘medically accurate and complete’ 

19 means verified or supported by the weight of research 

20 conducted in compliance with accepted scientific 

21 methods and— 

22 ‘‘(A) published in peer-reviewed journals, 

23 where applicable; or 

24 ‘‘(B) comprising information that leading 

25 professional organizations and agencies with rel-
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1 evant expertise in the field recognize as accurate, 

2 objective, and complete. 

3 ‘‘(3) The term ‘rigorous’, with respect to research 

4 or evaluation, means using— 

5 ‘‘(A) established scientific methods for meas6 uring the impact of an intervention or program 

7 model in changing behavior (specifically sexual 

8 activity or other sexual risk behaviors), or reduc9 ing pregnancy, among youth; or 

10 ‘‘(B) other evidence-based methodologies es11 tablished by the Secretary for purposes of this 

12 section. 

13 ‘‘(4) The term ‘youth’ refers to one or more indi14 viduals who have attained age 10 but not age 20. 

15 ‘‘(f) FUNDING.— 

16 ‘‘(1) IN GENERAL.—To carry out this section, 

17 there is appropriated, out of any money in the Treas18 ury not otherwise appropriated, $75,000,000 for each 

19 of fiscal years 2018 and 2019. 

20 ‘‘(2) RESERVATION.—The Secretary shall reserve, 

21 for each of fiscal years 2018 and 2019, not more than 

22 20 percent of the amount appropriated pursuant to 

23 paragraph (1) for administering the program under 

24 this section, including the conducting of national 
411 

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1 evaluations and the provision of technical assistance 

2 to the recipients of allotments.’’. 

3 (b) EFFECTIVE DATE.—The amendment made by this 

4 section shall take effect as if enacted on October 1, 2017. 

5 SEC. 50503. EXTENSION FOR PERSONAL RESPONSIBILITY 

6 EDUCATION. 

7 (a) IN GENERAL.—Section 513 of the Social Security 

8 Act (42 U.S.C. 713) is amended— 

9 (1) in subsection (a)(1)(A), by striking ‘‘2017’’ 

10 and inserting ‘‘2019’’; and 

11 (2) in subsection (a)(4)— 

12 (A) in subparagraph (A), by striking 

13 ‘‘2017’’ each place it appears and inserting 

14 ‘‘2019’’; and 

15 (B) in subparagraph (B)— 

16 (i) in the subparagraph heading, by 

17 striking ‘‘3-YEAR GRANTS’’ and inserting 

18 ‘‘COMPETITIVE PREP GRANTS’’; and 

19 (ii) in clause (i), by striking ‘‘solicit 

20 applications to award 3-year grants in each 

21 of fiscal years 2012 through 2017’’ and in22 serting ‘‘continue through fiscal year 2019 

23 grants awarded for any of fiscal years 2015 

24 through 2017’’; 
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1 (3) in subsection (c)(1), by inserting after ‘‘youth 

2 with HIV/AIDS,’’ the following: ‘‘victims of human 

3 trafficking,’’; and 

4 (4) in subsection (f), by striking ‘‘2017’’ and in5 serting ‘‘2019’’. 

6 (b) EFFECTIVE DATE.—The amendments made by this 

7 section shall take effect as if enacted on October 1, 2017. 

8 TITLE VI—CHILD AND FAMILY 

9 SERVICES AND SUPPORTS EX10 TENDERS 

11 Subtitle A—Continuing the Mater12 nal, Infant, and Early Child13 hood Home Visiting Program 

14 SEC. 50601. CONTINUING EVIDENCE-BASED HOME VISITING 

15 PROGRAM. 

16 Section 511(j)(1)(H) of the Social Security Act (42 

17 U.S.C. 711(j)(1)(H)) is amended by striking ‘‘fiscal year 

18 2017’’ and inserting ‘‘each of fiscal years 2017 through 

19 2022’’. 

20 SEC. 50602. CONTINUING TO DEMONSTRATE RESULTS TO 

21 HELP FAMILIES. 

22 (a) REQUIRE SERVICE DELIVERY MODELS TO DEM23 ONSTRATE IMPROVEMENT IN APPLICABLE BENCHMARK

24 AREAS.—Section 511 of the Social Security Act (42 U.S.C. 
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1 711) is amended in each of subsections (d)(1)(A) and 

2 (h)(4)(A) by striking ‘‘each of’’. 

3 (b) DEMONSTRATION OF IMPROVEMENTS IN SUBSE4 QUENT YEARS.—Section 511(d)(1) of such Act (42 U.S.C. 

5 711(d)(1)) is amended by adding at the end the following: 

6 ‘‘(D) DEMONSTRATION OF IMPROVEMENTS

7 IN SUBSEQUENT YEARS.— 

8 ‘‘(i) CONTINUED MEASUREMENT OF IM9 PROVEMENT IN APPLICABLE BENCHMARK

10 AREAS.—The eligible entity, after dem11 onstrating improvements for eligible fami12 lies as specified in subparagraphs (A) and 

13 (B), shall continue to track and report, not 

14 later than 30 days after the end of fiscal 

15 year 2020 and every 3 years thereafter, in16 formation demonstrating that the program 

17 results in improvements for the eligible fam18 ilies participating in the program in at 

19 least 4 of the areas specified in subpara20 graph (A) that the service delivery model or 

21 models selected by the entity are intended to 

22 improve. 

23 ‘‘(ii) CORRECTIVE ACTION PLAN.—If 

24 the eligible entity fails to demonstrate im25 provement in at least 4 of the areas speci-
414 

† HR 1892 EAS2 

1 fied in subparagraph (A), as compared to 

2 eligible families who do not receive services 

3 under an early childhood home visitation 

4 program, the entity shall develop and im5 plement a plan to improve outcomes in each 

6 of the areas specified in subparagraph (A) 

7 that the service delivery model or models se8 lected by the entity are intended to improve, 

9 subject to approval by the Secretary. The 

10 plan shall include provisions for the Sec11 retary to monitor implementation of the 

12 plan and conduct continued oversight of the 

13 program, including through submission by 

14 the entity of regular reports to the Sec15 retary. 

16 ‘‘(iii) TECHNICAL ASSISTANCE.—The 

17 Secretary shall provide an eligible entity re18 quired to develop and implement an im19 provement plan under clause (ii) with tech20 nical assistance to develop and implement 

21 the plan. The Secretary may provide the 

22 technical assistance directly or through 

23 grants, contracts, or cooperative agreements. 

24 ‘‘(iv) NO IMPROVEMENT OR FAILURE

25 TO SUBMIT REPORT.—If the Secretary de-
415 

† HR 1892 EAS2 

1 termines after a period of time specified by 

2 the Secretary that an eligible entity imple3 menting an improvement plan under clause 

4 (ii) has failed to demonstrate any improve5 ment in at least 4 of the areas specified in 

6 subparagraph (A), or if the Secretary deter7 mines that an eligible entity has failed to 

8 submit the report required by clause (i), the 

9 Secretary shall terminate the grant made to 

10 the entity under this section and may in11 clude any unexpended grant funds in grants 

12 made to nonprofit organizations under sub13 section (h)(2)(B).’’. 

14 (c) INCLUDING INFORMATION ON APPLICABLE BENCH15 MARKS IN APPLICATION.—Section 511(e)(5) of such Act (42 

16 U.S.C. 711(e)(5)) is amended by inserting ‘‘that the service 

17 delivery model or models selected by the entity are intended 

18 to improve’’ before the period at the end. 

19 SEC. 50603. REVIEWING STATEWIDE NEEDS TO TARGET RE20 SOURCES. 

21 Section 511(b)(1) of the Social Security Act (42 U.S.C. 

22 711(b)(1)) is amended by striking ‘‘Not later than’’ and all 

23 that follows through ‘‘section 505(a))’’ and inserting ‘‘Each 

24 State shall, as a condition of receiving payments from an 

25 allotment for the State under section 502, conduct a state-
416 

† HR 1892 EAS2 

1 wide needs assessment (which may be separate from but in 

2 coordination with the statewide needs assessment required 

3 under section 505(a) and which shall be reviewed and up4 dated by the State not later than October 1, 2020)’’. 

5 SEC. 50604. IMPROVING THE LIKELIHOOD OF SUCCESS IN 

6 HIGH-RISK COMMUNITIES. 

7 Section 511(d)(4)(A) of the Social Security Act (42 

8 U.S.C. 711(d)(4)(A)) is amended by inserting ‘‘, taking into 

9 account the staffing, community resource, and other re10 quirements to operate at least one approved model of home 

11 visiting and demonstrate improvements for eligible fami12 lies’’ before the period. 

13 SEC. 50605. OPTION TO FUND EVIDENCE-BASED HOME VIS14 ITING ON A PAY FOR OUTCOME BASIS. 

15 (a) IN GENERAL.—Section 511(c) of the Social Secu16 rity Act (42 U.S.C. 711(c)) is amended by redesignating 

17 paragraphs (3) and (4) as paragraphs (4) and (5), respec18 tively, and by inserting after paragraph (2) the following: 

19 ‘‘(3) AUTHORITY TO USE GRANT FOR A PAY FOR

20 OUTCOMES INITIATIVE.—An eligible entity to which a 

21 grant is made under paragraph (1) may use up to 25 

22 percent of the grant for outcomes or success payments 

23 related to a pay for outcomes initiative that will not 

24 result in a reduction of funding for services delivered 

25 by the entity under a childhood home visitation pro-
417 

† HR 1892 EAS2 

1 gram under this section while the eligible entity devel2 ops or operates such an initiative.’’. 

3 (b) DEFINITION OF PAY FOR OUTCOMES INITIATIVE.— 

4 Section 511(k) of such Act (42 U.S.C. 711(k)) is amended 

5 by adding at the end the following: 

6 ‘‘(4) PAY FOR OUTCOMES INITIATIVE.—The term 

7 ‘pay for outcomes initiative’ means a performance8 based grant, contract, cooperative agreement, or other 

9 agreement awarded by a public entity in which a 

10 commitment is made to pay for improved outcomes 

11 achieved as a result of the intervention that result in 

12 social benefit and direct cost savings or cost avoidance 

13 to the public sector. Such an initiative shall in14 clude— 

15 ‘‘(A) a feasibility study that describes how 

16 the proposed intervention is based on evidence of 

17 effectiveness; 

18 ‘‘(B) a rigorous, third-party evaluation that 

19 uses experimental or quasi-experimental design 

20 or other research methodologies that allow for the 

21 strongest possible causal inferences to determine 

22 whether the initiative has met its proposed out23 comes as a result of the intervention; 

24 ‘‘(C) an annual, publicly available report 

25 on the progress of the initiative; and 
418 

† HR 1892 EAS2 

1 ‘‘(D) a requirement that payments are 

2 made to the recipient of a grant, contract, or co3 operative agreement only when agreed upon out4 comes are achieved, except that this requirement 

5 shall not apply with respect to payments to a 

6 third party conducting the evaluation described 

7 in subparagraph (B).’’. 

8 (c) EXTENDED AVAILABILITY OF FUNDS.—Section 

9 511(j)(3) of such Act (42 U.S.C. 711(j)(3)) is amended— 

10 (1) by striking ‘‘(3) AVAILABILITY.—Funds’’ and 

11 inserting the following: 

12 ‘‘(3) AVAILABILITY.— 

13 ‘‘(A) IN GENERAL.—Except as provided in 

14 subparagraph (B), funds’’; and 

15 (2) by adding at the end the following: 

16 ‘‘(B) FUNDS FOR PAY FOR OUTCOMES INI17 TIATIVES.—Funds made available to an eligible 

18 entity under this section for a fiscal year (or 

19 portion of a fiscal year) for a pay for outcomes 

20 initiative shall remain available for expenditure 

21 by the eligible entity for not more than 10 years 

22 after the funds are so made available.’’. 
419 

† HR 1892 EAS2 

1 SEC. 50606. DATA EXCHANGE STANDARDS FOR IMPROVED 

2 INTEROPERABILITY. 

3 (a) IN GENERAL.—Section 511(h) of the Social Secu4 rity Act (42 U.S.C. 711(h)) is amended by adding at the 

5 end the following: 

6 ‘‘(5) DATA EXCHANGE STANDARDS FOR IM7 PROVED INTEROPERABILITY.— 

8 ‘‘(A) DESIGNATION AND USE OF DATA EX9 CHANGE STANDARDS.— 

10 ‘‘(i) DESIGNATION.—The head of the 

11 department or agency responsible for ad12 ministering a program funded under this 

13 section shall, in consultation with an inter14 agency work group established by the Office 

15 of Management and Budget and considering 

16 State government perspectives, designate 

17 data exchange standards for necessary cat18 egories of information that a State agency 

19 operating the program is required to elec20 tronically exchange with another State 

21 agency under applicable Federal law. 

22 ‘‘(ii) DATA EXCHANGE STANDARDS

23 MUST BE NONPROPRIETARY AND INTER24 OPERABLE.—The data exchange standards 

25 designated under clause (i) shall, to the ex-
420 

† HR 1892 EAS2 

1 tent practicable, be nonproprietary and 

2 interoperable. 

3 ‘‘(iii) OTHER REQUIREMENTS.—In 

4 designating data exchange standards under 

5 this paragraph, the Secretary shall, to the 

6 extent practicable, incorporate— 

7 ‘‘(I) interoperable standards devel8 oped and maintained by an inter9 national voluntary consensus stand10 ards body, as defined by the Office of 

11 Management and Budget; 

12 ‘‘(II) interoperable standards de13 veloped and maintained by intergov14 ernmental partnerships, such as the 

15 National Information Exchange Model; 

16 and 

17 ‘‘(III) interoperable standards de18 veloped and maintained by Federal en19 tities with authority over contracting 

20 and financial assistance. 

21 ‘‘(B) DATA EXCHANGE STANDARDS FOR

22 FEDERAL REPORTING.— 

23 ‘‘(i) DESIGNATION.—The head of the 

24 department or agency responsible for ad25 ministering a program referred to in this 
421 

† HR 1892 EAS2 

1 section shall, in consultation with an inter2 agency work group established by the Office 

3 of Management and Budget, and consid4 ering State government perspectives, des5 ignate data exchange standards to govern 

6 Federal reporting and exchange require7 ments under applicable Federal law. 

8 ‘‘(ii) REQUIREMENTS.—The data ex9 change reporting standards required by 

10 clause (i) shall, to the extent practicable— 

11 ‘‘(I) incorporate a widely accept12 ed, nonproprietary, searchable, com13 puter-readable format; 

14 ‘‘(II) be consistent with and im15 plement applicable accounting prin16 ciples; 

17 ‘‘(III) be implemented in a man18 ner that is cost-effective and improves 

19 program efficiency and effectiveness; 

20 and 

21 ‘‘(IV) be capable of being contin22 ually upgraded as necessary. 

23 ‘‘(iii) INCORPORATION OF NONPROPRI24 ETARY STANDARDS.—In designating data 

25 exchange standards under this paragraph, 
422 

† HR 1892 EAS2 

1 the Secretary shall, to the extent practicable, 

2 incorporate existing nonproprietary stand3 ards, such as the eXtensible Mark up Lan4 guage. 

5 ‘‘(iv) RULE OF CONSTRUCTION.—Noth6 ing in this paragraph shall be construed to 

7 require a change to existing data exchange 

8 standards for Federal reporting about a 

9 program referred to in this section, if the 

10 head of the department or agency respon11 sible for administering the program finds 

12 the standards to be effective and efficient.’’. 

13 (b) EFFECTIVE DATE.—The amendment made by sub14 section (a) shall take effect on the date that is 2 years after 

15 the date of enactment of this Act. 

16 SEC. 50607. ALLOCATION OF FUNDS. 

17 Section 511(j) of the Social Security Act (42 U.S.C. 

18 711(j)) is amended by adding at the end the following: 

19 ‘‘(4) ALLOCATION OF FUNDS.—To the extent that 

20 the grant amount awarded under this section to an 

21 eligible entity is determined on the basis of relative 

22 population or poverty considerations, the Secretary 

23 shall make the determination using the most accurate 

24 Federal data available for the eligible entity.’’. 
423 

† HR 1892 EAS2 

1 Subtitle B—Extension of Health 

2 Professions Workforce Dem3 onstration Projects 

4 SEC. 50611. EXTENSION OF HEALTH WORKFORCE DEM5 ONSTRATION PROJECTS FOR LOW-INCOME 

6 INDIVIDUALS. 

7 Section 2008(c)(1) of the Social Security Act (42 

8 U.S.C. 1397g(c)(1)) is amended by striking ‘‘2017’’ and in9 serting ‘‘2019’’. 

10 TITLE VII—FAMILY FIRST 

11 PREVENTION SERVICES ACT 

12 Subtitle A—Investing in Prevention 

13 and Supporting Families 

14 SEC. 50701. SHORT TITLE. 

15 This subtitle may be cited as the ‘‘Bipartisan Budget 

16 Act of 2018’’. 

17 SEC. 50702. PURPOSE. 

18 The purpose of this subtitle is to enable States to use 

19 Federal funds available under parts B and E of title IV 

20 of the Social Security Act to provide enhanced support to 

21 children and families and prevent foster care placements 

22 through the provision of mental health and substance abuse 

23 prevention and treatment services, in-home parent skill24 based programs, and kinship navigator services. 
424 

† HR 1892 EAS2 

1 PART I—PREVENTION ACTIVITIES UNDER TITLE 

2 IV–E 

3 SEC. 50711. FOSTER CARE PREVENTION SERVICES AND 

4 PROGRAMS. 

5 (a) STATE OPTION.—Section 471 of the Social Secu6 rity Act (42 U.S.C. 671) is amended— 

7 (1) in subsection (a)(1), by striking ‘‘and’’ and 

8 all that follows through the semicolon and inserting ‘‘, 

9 adoption assistance in accordance with section 473, 

10 and, at the option of the State, services or programs 

11 specified in subsection (e)(1) of this section for chil12 dren who are candidates for foster care or who are 

13 pregnant or parenting foster youth and the parents or 

14 kin caregivers of the children, in accordance with the 

15 requirements of that subsection;’’; and 

16 (2) by adding at the end the following: 

17 ‘‘(e) PREVENTION AND FAMILY SERVICES AND PRO18 GRAMS.— 

19 ‘‘(1) IN GENERAL.—Subject to the succeeding 

20 provisions of this subsection, the Secretary may make 

21 a payment to a State for providing the following serv22 ices or programs for a child described in paragraph 

23 (2) and the parents or kin caregivers of the child 

24 when the need of the child, such a parent, or such a 

25 caregiver for the services or programs are directly re26 lated to the safety, permanence, or well-being of the 
425 

† HR 1892 EAS2 

1 child or to preventing the child from entering foster 

2 care: 

3 ‘‘(A) MENTAL HEALTH AND SUBSTANCE

4 ABUSE PREVENTION AND TREATMENT SERV5 ICES.—Mental health and substance abuse pre6 vention and treatment services provided by a 

7 qualified clinician for not more than a 12-month 

8 period that begins on any date described in 

9 paragraph (3) with respect to the child. 

10 ‘‘(B) IN-HOME PARENT SKILL-BASED PRO11 GRAMS.—In-home parent skill-based programs 

12 for not more than a 12-month period that begins 

13 on any date described in paragraph (3) with re14 spect to the child and that include parenting 

15 skills training, parent education, and individual 

16 and family counseling. 

17 ‘‘(2) CHILD DESCRIBED.—For purposes of para18 graph (1), a child described in this paragraph is the 

19 following: 

20 ‘‘(A) A child who is a candidate for foster 

21 care (as defined in section 475(13)) but can re22 main safely at home or in a kinship placement 

23 with receipt of services or programs specified in 

24 paragraph (1). 
426 

† HR 1892 EAS2 

1 ‘‘(B) A child in foster care who is a preg2 nant or parenting foster youth. 

3 ‘‘(3) DATE DESCRIBED.—For purposes of para4 graph (1), the dates described in this paragraph are 

5 the following: 

6 ‘‘(A) The date on which a child is identified 

7 in a prevention plan maintained under para8 graph (4) as a child who is a candidate for foster 

9 care (as defined in section 475(13)). 

10 ‘‘(B) The date on which a child is identified 

11 in a prevention plan maintained under para12 graph (4) as a pregnant or parenting foster 

13 youth in need of services or programs specified 

14 in paragraph (1). 

15 ‘‘(4) REQUIREMENTS RELATED TO PROVIDING

16 SERVICES AND PROGRAMS.—Services and programs 

17 specified in paragraph (1) may be provided under 

18 this subsection only if specified in advance in the 

19 child’s prevention plan described in subparagraph (A) 

20 and the requirements in subparagraphs (B) through 

21 (E) are met: 

22 ‘‘(A) PREVENTION PLAN.—The State main23 tains a written prevention plan for the child that 

24 meets the following requirements (as applicable): 
427 

† HR 1892 EAS2 

1 ‘‘(i) CANDIDATES.—In the case of a 

2 child who is a candidate for foster care de3 scribed in paragraph (2)(A), the prevention 

4 plan shall— 

5 ‘‘(I) identify the foster care pre6 vention strategy for the child so that 

7 the child may remain safely at home, 

8 live temporarily with a kin caregiver 

9 until reunification can be safely 

10 achieved, or live permanently with a 

11 kin caregiver; 

12 ‘‘(II) list the services or programs 

13 to be provided to or on behalf of the 

14 child to ensure the success of that pre15 vention strategy; and 

16 ‘‘(III) comply with such other re17 quirements as the Secretary shall es18 tablish. 

19 ‘‘(ii) PREGNANT OR PARENTING FOS20 TER YOUTH.—In the case of a child who is 

21 a pregnant or parenting foster youth de22 scribed in paragraph (2)(B), the prevention 

23 plan shall— 

24 ‘‘(I) be included in the child’s case 

25 plan required under section 475(1); 
428 

† HR 1892 EAS2 

1 ‘‘(II) list the services or programs 

2 to be provided to or on behalf of the 

3 youth to ensure that the youth is pre4 pared (in the case of a pregnant foster 

5 youth) or able (in the case of a par6 enting foster youth) to be a parent; 

7 ‘‘(III) describe the foster care pre8 vention strategy for any child born to 

9 the youth; and 

10 ‘‘(IV) comply with such other re11 quirements as the Secretary shall es12 tablish. 

13 ‘‘(B) TRAUMA-INFORMED.—The services or 

14 programs to be provided to or on behalf of a 

15 child are provided under an organizational 

16 structure and treatment framework that involves 

17 understanding, recognizing, and responding to 

18 the effects of all types of trauma and in accord19 ance with recognized principles of a trauma-in20 formed approach and trauma-specific interven21 tions to address trauma’s consequences and fa22 cilitate healing. 

23 ‘‘(C) ONLY SERVICES AND PROGRAMS PRO24 VIDED IN ACCORDANCE WITH PROMISING, SUP-
429 

† HR 1892 EAS2 

1 PORTED, OR WELL-SUPPORTED PRACTICES PER2 MITTED.— 

3 ‘‘(i) IN GENERAL.—Only State expend4 itures for services or programs specified in 

5 subparagraph (A) or (B) of paragraph (1) 

6 that are provided in accordance with prac7 tices that meet the requirements specified in 

8 clause (ii) of this subparagraph and that 

9 meet the requirements specified in clause 

10 (iii), (iv), or (v), respectively, for being a 

11 promising, supported, or well-supported 

12 practice, shall be eligible for a Federal 

13 matching payment under section 

14 474(a)(6)(A). 

15 ‘‘(ii) GENERAL PRACTICE REQUIRE16 MENTS.—The general practice requirements 

17 specified in this clause are the following: 

18 ‘‘(I) The practice has a book, 

19 manual, or other available writings 

20 that specify the components of the 

21 practice protocol and describe how to 

22 administer the practice. 

23 ‘‘(II) There is no empirical basis 

24 suggesting that, compared to its likely 
430 

† HR 1892 EAS2 

1 benefits, the practice constitutes a risk 

2 of harm to those receiving it. 

3 ‘‘(III) If multiple outcome studies 

4 have been conducted, the overall weight 

5 of evidence supports the benefits of the 

6 practice. 

7 ‘‘(IV) Outcome measures are reli8 able and valid, and are administrated 

9 consistently and accurately across all 

10 those receiving the practice. 

11 ‘‘(V) There is no case data sug12 gesting a risk of harm that was prob13 ably caused by the treatment and that 

14 was severe or frequent. 

15 ‘‘(iii) PROMISING PRACTICE.—A prac16 tice shall be considered to be a ‘promising 

17 practice’ if the practice is superior to an 

18 appropriate comparison practice using con19 ventional standards of statistical signifi20 cance (in terms of demonstrated meaningful 

21 improvements in validated measures of im22 portant child and parent outcomes, such as 

23 mental health, substance abuse, and child 

24 safety and well-being), as established by the 
431 

† HR 1892 EAS2 

1 results or outcomes of at least one study 

2 that— 

3 ‘‘(I) was rated by an independent 

4 systematic review for the quality of the 

5 study design and execution and deter6 mined to be well-designed and well-exe7 cuted; and 

8 ‘‘(II) utilized some form of control 

9 (such as an untreated group, a placebo 

10 group, or a wait list study). 

11 ‘‘(iv) SUPPORTED PRACTICE.—A prac12 tice shall be considered to be a ‘supported 

13 practice’ if— 

14 ‘‘(I) the practice is superior to an 

15 appropriate comparison practice using 

16 conventional standards of statistical 

17 significance (in terms of demonstrated 

18 meaningful improvements in validated 

19 measures of important child and par20 ent outcomes, such as mental health, 

21 substance abuse, and child safety and 

22 well-being), as established by the re23 sults or outcomes of at least one study 

24 that— 
432 

† HR 1892 EAS2 

1 ‘‘(aa) was rated by an inde2 pendent systematic review for the 

3 quality of the study design and 

4 execution and determined to be 

5 well-designed and well-executed; 

6 ‘‘(bb) was a rigorous ran7 dom-controlled trial (or, if not 

8 available, a study using a rig9 orous quasi-experimental research 

10 design); and 

11 ‘‘(cc) was carried out in a 

12 usual care or practice setting; and 

13 ‘‘(II) the study described in sub14 clause (I) established that the practice 

15 has a sustained effect (when compared 

16 to a control group) for at least 6 

17 months beyond the end of the treat18 ment. 

19 ‘‘(v) WELL-SUPPORTED PRACTICE.—A 

20 practice shall be considered to be a ‘well21 supported practice’ if— 

22 ‘‘(I) the practice is superior to an 

23 appropriate comparison practice using 

24 conventional standards of statistical 

25 significance (in terms of demonstrated 
433 

† HR 1892 EAS2 

1 meaningful improvements in validated 

2 measures of important child and par3 ent outcomes, such as mental health, 

4 substance abuse, and child safety and 

5 well-being), as established by the re6 sults or outcomes of at least two studies 

7 that— 

8 ‘‘(aa) were rated by an inde9 pendent systematic review for the 

10 quality of the study design and 

11 execution and determined to be 

12 well-designed and well-executed; 

13 ‘‘(bb) were rigorous random14 controlled trials (or, if not avail15 able, studies using a rigorous 

16 quasi-experimental research de17 sign); and 

18 ‘‘(cc) were carried out in a 

19 usual care or practice setting; and 

20 ‘‘(II) at least one of the studies de21 scribed in subclause (I) established that 

22 the practice has a sustained effect 

23 (when compared to a control group) for 

24 at least 1 year beyond the end of treat25 ment. 
434 

† HR 1892 EAS2 

1 ‘‘(D) GUIDANCE ON PRACTICES CRITERIA

2 AND PRE-APPROVED SERVICES AND PROGRAMS.— 

3 ‘‘(i) IN GENERAL.—Not later than Oc4 tober 1, 2018, the Secretary shall issue guid5 ance to States regarding the practices cri6 teria required for services or programs to 

7 satisfy the requirements of subparagraph 

8 (C). The guidance shall include a pre-ap9 proved list of services and programs that 

10 satisfy the requirements. 

11 ‘‘(ii) UPDATES.—The Secretary shall 

12 issue updates to the guidance required by 

13 clause (i) as often as the Secretary deter14 mines necessary. 

15 ‘‘(E) OUTCOME ASSESSMENT AND REPORT16 ING.—The State shall collect and report to the 

17 Secretary the following information with respect 

18 to each child for whom, or on whose behalf men19 tal health and substance abuse prevention and 

20 treatment services or in-home parent skill-based 

21 programs are provided during a 12-month pe22 riod beginning on the date the child is deter23 mined by the State to be a child described in 

24 paragraph (2): 
435 

† HR 1892 EAS2 

1 ‘‘(i) The specific services or programs 

2 provided and the total expenditures for each 

3 of the services or programs. 

4 ‘‘(ii) The duration of the services or 

5 programs provided. 

6 ‘‘(iii) In the case of a child described 

7 in paragraph (2)(A), the child’s placement 

8 status at the beginning, and at the end, of 

9 the 1-year period, respectively, and whether 

10 the child entered foster care within 2 years 

11 after being determined a candidate for fos12 ter care. 

13 ‘‘(5) STATE PLAN COMPONENT.— 

14 ‘‘(A) IN GENERAL.—A State electing to pro15 vide services or programs specified in paragraph 

16 (1) shall submit as part of the State plan re17 quired by subsection (a) a prevention services 

18 and programs plan component that meets the re19 quirements of subparagraph (B). 

20 ‘‘(B) PREVENTION SERVICES AND PRO21 GRAMS PLAN COMPONENT.—In order to meet the 

22 requirements of this subparagraph, a prevention 

23 services and programs plan component, with re24 spect to each 5-year period for which the plan 
436 

† HR 1892 EAS2 

1 component is in operation in the State, shall in2 clude the following: 

3 ‘‘(i) How providing services and pro4 grams specified in paragraph (1) is ex5 pected to improve specific outcomes for chil6 dren and families. 

7 ‘‘(ii) How the State will monitor and 

8 oversee the safety of children who receive 

9 services and programs specified in para10 graph (1), including through periodic risk 

11 assessments throughout the period in which 

12 the services and programs are provided on 

13 behalf of a child and reexamination of the 

14 prevention plan maintained for the child 

15 under paragraph (4) for the provision of the 

16 services or programs if the State determines 

17 the risk of the child entering foster care re18 mains high despite the provision of the serv19 ices or programs. 

20 ‘‘(iii) With respect to the services and 

21 programs specified in subparagraphs (A) 

22 and (B) of paragraph (1), information on 

23 the specific promising, supported, or well24 supported practices the State plans to use to 
437 

† HR 1892 EAS2 

1 provide the services or programs, including 

2 a description of— 

3 ‘‘(I) the services or programs and 

4 whether the practices used are prom5 ising, supported, or well-supported; 

6 ‘‘(II) how the State plans to im7 plement the services or programs, in8 cluding how implementation of the 

9 services or programs will be continu10 ously monitored to ensure fidelity to 

11 the practice model and to determine 

12 outcomes achieved and how informa13 tion learned from the monitoring will 

14 be used to refine and improve prac15 tices; 

16 ‘‘(III) how the State selected the 

17 services or programs; 

18 ‘‘(IV) the target population for the 

19 services or programs; and 

20 ‘‘(V) how each service or program 

21 provided will be evaluated through a 

22 well-designed and rigorous process, 

23 which may consist of an ongoing, 

24 cross-site evaluation approved by the 

25 Secretary. 
438 

† HR 1892 EAS2 

1 ‘‘(iv) A description of the consultation 

2 that the State agencies responsible for ad3 ministering the State plans under this part 

4 and part B engage in with other State 

5 agencies responsible for administering 

6 health programs, including mental health 

7 and substance abuse prevention and treat8 ment services, and with other public and 

9 private agencies with experience in admin10 istering child and family services, including 

11 community-based organizations, in order to 

12 foster a continuum of care for children de13 scribed in paragraph (2) and their parents 

14 or kin caregivers. 

15 ‘‘(v) A description of how the State 

16 shall assess children and their parents or 

17 kin caregivers to determine eligibility for 

18 services or programs specified in paragraph 

19 (1). 

20 ‘‘(vi) A description of how the services 

21 or programs specified in paragraph (1) that 

22 are provided for or on behalf of a child and 

23 the parents or kin caregivers of the child 

24 will be coordinated with other child and 

25 family services provided to the child and the 
439 

† HR 1892 EAS2 

1 parents or kin caregivers of the child under 

2 the State plans in effect under subparts 1 

3 and 2 of part B. 

4 ‘‘(vii) Descriptions of steps the State is 

5 taking to support and enhance a competent, 

6 skilled, and professional child welfare work7 force to deliver trauma-informed and evi8 dence-based services, including— 

9 ‘‘(I) ensuring that staff is quali10 fied to provide services or programs 

11 that are consistent with the promising, 

12 supported, or well-supported practice 

13 models selected; and 

14 ‘‘(II) developing appropriate pre15 vention plans, and conducting the risk 

16 assessments required under clause (iii). 

17 ‘‘(viii) A description of how the State 

18 will provide training and support for case19 workers in assessing what children and 

20 their families need, connecting to the fami21 lies served, knowing how to access and de22 liver the needed trauma-informed and evi23 dence-based services, and overseeing and 

24 evaluating the continuing appropriateness 

25 of the services. 
440 

† HR 1892 EAS2 

1 ‘‘(ix) A description of how caseload size 

2 and type for prevention caseworkers will be 

3 determined, managed, and overseen. 

4 ‘‘(x) An assurance that the State will 

5 report to the Secretary such information 

6 and data as the Secretary may require with 

7 respect to the provision of services and pro8 grams specified in paragraph (1), including 

9 information and data necessary to deter10 mine the performance measures for the 

11 State under paragraph (6) and compliance 

12 with paragraph (7). 

13 ‘‘(C) REIMBURSEMENT FOR SERVICES

14 UNDER THE PREVENTION PLAN COMPONENT.— 

15 ‘‘(i) LIMITATION.—Except as provided 

16 in subclause (ii), a State may not receive a 

17 Federal payment under this part for a 

18 given promising, supported, or well-sup19 ported practice unless (in accordance with 

20 subparagraph (B)(iii)(V)) the plan includes 

21 a well-designed and rigorous evaluation 

22 strategy for that practice. 

23 ‘‘(ii) WAIVER OF LIMITATION.—The 

24 Secretary may waive the requirement for a 

25 well-designed and rigorous evaluation of 
441 

† HR 1892 EAS2 

1 any well-supported practice if the Secretary 

2 deems the evidence of the effectiveness of the 

3 practice to be compelling and the State 

4 meets the continuous quality improvement 

5 requirements included in subparagraph 

6 (B)(iii)(II) with regard to the practice. 

7 ‘‘(6) PREVENTION SERVICES MEASURES.— 

8 ‘‘(A) ESTABLISHMENT; ANNUAL UPDATES.— 

9 Beginning with fiscal year 2021, and annually 

10 thereafter, the Secretary shall establish the fol11 lowing prevention services measures based on in12 formation and data reported by States that elect 

13 to provide services and programs specified in 

14 paragraph (1): 

15 ‘‘(i) PERCENTAGE OF CANDIDATES FOR

16 FOSTER CARE WHO DO NOT ENTER FOSTER

17 CARE.—The percentage of candidates for 

18 foster care for whom, or on whose behalf, the 

19 services or programs are provided who do 

20 not enter foster care, including those placed 

21 with a kin caregiver outside of foster care, 

22 during the 12-month period in which the 

23 services or programs are provided and 

24 through the end of the succeeding 12-month 

25 period. 
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1 ‘‘(ii) PER-CHILD SPENDING.—The total 

2 amount of expenditures made for mental 

3 health and substance abuse prevention and 

4 treatment services or in-home parent skill5 based programs, respectively, for, or on be6 half of, each child described in paragraph 

7 (2). 

8 ‘‘(B) DATA.—The Secretary shall establish 

9 and annually update the prevention services 

10 measures— 

11 ‘‘(i) based on the median State values 

12 of the information reported under each 

13 clause of subparagraph (A) for the 3 then 

14 most recent years; and 

15 ‘‘(ii) taking into account State dif16 ferences in the price levels of consumption 

17 goods and services using the most recent re18 gional price parities published by the Bu19 reau of Economic Analysis of the Depart20 ment of Commerce or such other data as the 

21 Secretary determines appropriate. 

22 ‘‘(C) PUBLICATION OF STATE PREVENTION

23 SERVICES MEASURES.—The Secretary shall an24 nually make available to the public the preven25 tion services measures of each State. 
443 

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1 ‘‘(7) MAINTENANCE OF EFFORT FOR STATE FOS2 TER CARE PREVENTION EXPENDITURES.— 

3 ‘‘(A) IN GENERAL.—If a State elects to pro4 vide services and programs specified in para5 graph (1) for a fiscal year, the State foster care 

6 prevention expenditures for the fiscal year shall 

7 not be less than the amount of the expenditures 

8 for fiscal year 2014 (or, at the option of a State 

9 described in subparagraph (E), fiscal year 2015 

10 or fiscal year 2016 (whichever the State elects)). 

11 ‘‘(B) STATE FOSTER CARE PREVENTION EX12 PENDITURES.—The term ‘State foster care pre13 vention expenditures’ means the following: 

14 ‘‘(i) TANF; IV–B; SSBG.—State ex15 penditures for foster care prevention services 

16 and activities under the State program 

17 funded under part A (including from 

18 amounts made available by the Federal 

19 Government), under the State plan devel20 oped under part B (including any such 

21 amounts), or under the Social Services 

22 Block Grant Programs under subtitle A of 

23 title XX (including any such amounts). 

24 ‘‘(ii) OTHER STATE PROGRAMS.—State 

25 expenditures for foster care prevention serv-
444 

† HR 1892 EAS2 

1 ices and activities under any State program 

2 that is not described in clause (i) (other 

3 than any State expenditures for foster care 

4 prevention services and activities under the 

5 State program under this part (including 

6 under a waiver of the program)). 

7 ‘‘(C) STATE EXPENDITURES.—The term 

8 ‘State expenditures’ means all State or local 

9 funds that are expended by the State or a local 

10 agency including State or local funds that are 

11 matched or reimbursed by the Federal Govern12 ment and State or local funds that are not 

13 matched or reimbursed by the Federal Govern14 ment. 

15 ‘‘(D) DETERMINATION OF PREVENTION

16 SERVICES AND ACTIVITIES.—The Secretary shall 

17 require each State that elects to provide services 

18 and programs specified in paragraph (1) to re19 port the expenditures specified in subparagraph 

20 (B) for fiscal year 2014 and for such fiscal years 

21 thereafter as are necessary to determine whether 

22 the State is complying with the maintenance of 

23 effort requirement in subparagraph (A). The Sec24 retary shall specify the specific services and ac25 tivities under each program referred to in sub-
445 

† HR 1892 EAS2 

1 paragraph (B) that are ‘prevention services and 

2 activities’ for purposes of the reports. 

3 ‘‘(E) STATE DESCRIBED.—For purposes of 

4 subparagraph (A), a State is described in this 

5 subparagraph if the population of children in the 

6 State in 2014 was less than 200,000 (as deter7 mined by the United States Census Bureau). 

8 ‘‘(8) PROHIBITION AGAINST USE OF STATE FOS9 TER CARE PREVENTION EXPENDITURES AND FEDERAL

10 IV–E PREVENTION FUNDS FOR MATCHING OR EXPEND11 ITURE REQUIREMENT.—A State that elects to provide 

12 services and programs specified in paragraph (1) 

13 shall not use any State foster care prevention expend14 itures for a fiscal year for the State share of expendi15 tures under section 474(a)(6) for a fiscal year. 

16 ‘‘(9) ADMINISTRATIVE COSTS.—Expenditures de17 scribed in section 474(a)(6)(B)— 

18 ‘‘(A) shall not be eligible for payment under 

19 subparagraph (A), (B), or (E) of section 

20 474(a)(3); and 

21 ‘‘(B) shall be eligible for payment under sec22 tion 474(a)(6)(B) without regard to whether the 

23 expenditures are incurred on behalf of a child 

24 who is, or is potentially, eligible for foster care 

25 maintenance payments under this part. 
446 

† HR 1892 EAS2 

1 ‘‘(10) APPLICATION.— 

2 ‘‘(A) IN GENERAL.—The provision of serv3 ices or programs under this subsection to or on 

4 behalf of a child described in paragraph (2) shall 

5 not be considered to be receipt of aid or assist6 ance under the State plan under this part for 

7 purposes of eligibility for any other program es8 tablished under this Act. 

9 ‘‘(B) CANDIDATES IN KINSHIP CARE.—A 

10 child described in paragraph (2) for whom such 

11 services or programs under this subsection are 

12 provided for more than 6 months while in the 

13 home of a kin caregiver, and who would satisfy 

14 the AFDC eligibility requirement of section 

15 472(a)(3)(A)(ii)(II) but for residing in the home 

16 of the caregiver for more than 6 months, is 

17 deemed to satisfy that requirement for purposes 

18 of determining whether the child is eligible for 

19 foster care maintenance payments under section 

20 472.’’. 

21 (b) DEFINITION.—Section 475 of such Act (42 U.S.C. 

22 675) is amended by adding at the end the following: 

23 ‘‘(13) The term ‘child who is a candidate for fos24 ter care’ means, a child who is identified in a preven25 tion plan under section 471(e)(4)(A) as being at im-
447 

† HR 1892 EAS2 

1 minent risk of entering foster care (without regard to 

2 whether the child would be eligible for foster care 

3 maintenance payments under section 472 or is or 

4 would be eligible for adoption assistance or kinship 

5 guardianship assistance payments under section 473) 

6 but who can remain safely in the child’s home or in 

7 a kinship placement as long as services or programs 

8 specified in section 471(e)(1) that are necessary to 

9 prevent the entry of the child into foster care are pro10 vided. The term includes a child whose adoption or 

11 guardianship arrangement is at risk of a disruption 

12 or dissolution that would result in a foster care place13 ment.’’. 

14 (c) PAYMENTS UNDER TITLE IV–E.—Section 474(a) 

15 of such Act (42 U.S.C. 674(a)) is amended— 

16 (1) in paragraph (5), by striking the period at 

17 the end and inserting ‘‘; plus’’; and 

18 (2) by adding at the end the following: 

19 ‘‘(6) subject to section 471(e)— 

20 ‘‘(A) for each quarter— 

21 ‘‘(i) subject to clause (ii)— 

22 ‘‘(I) beginning after September 

23 30, 2019, and before October 1, 2026, 

24 an amount equal to 50 percent of the 

25 total amount expended during the 
448 

† HR 1892 EAS2 

1 quarter for the provision of services or 

2 programs specified in subparagraph 

3 (A) or (B) of section 471(e)(1) that are 

4 provided in accordance with prom5 ising, supported, or well-supported 

6 practices that meet the applicable cri7 teria specified for the practices in sec8 tion 471(e)(4)(C); and 

9 ‘‘(II) beginning after September 

10 30, 2026, an amount equal to the Fed11 eral medical assistance percentage 

12 (which shall be as defined in section 

13 1905(b), in the case of a State other 

14 than the District of Columbia, or 70 

15 percent, in the case of the District of 

16 Columbia) of the total amount ex17 pended during the quarter for the pro18 vision of services or programs specified 

19 in subparagraph (A) or (B) of section 

20 471(e)(1) that are provided in accord21 ance with promising, supported, or 

22 well-supported practices that meet the 

23 applicable criteria specified for the 

24 practices in section 471(e)(4)(C) (or, 

25 with respect to the payments made 
449 

† HR 1892 EAS2 

1 during the quarter under a cooperative 

2 agreement or contract entered into by 

3 the State and an Indian tribe, tribal 

4 organization, or tribal consortium for 

5 the administration or payment of 

6 funds under this part, an amount 

7 equal to the Federal medical assistance 

8 percentage that would apply under sec9 tion 479B(d) (in this paragraph re10 ferred to as the ‘tribal FMAP’) if the 

11 Indian tribe, tribal organization, or 

12 tribal consortium made the payments 

13 under a program operated under that 

14 section, unless the tribal FMAP is less 

15 than the Federal medical assistance 

16 percentage that applies to the State); 

17 except that 

18 ‘‘(ii) not less than 50 percent of the 

19 total amount expended by a State under 

20 clause (i) for a fiscal year shall be for the 

21 provision of services or programs specified 

22 in subparagraph (A) or (B) of section 

23 471(e)(1) that are provided in accordance 

24 with well-supported practices; plus 
450 

† HR 1892 EAS2 

1 ‘‘(B) for each quarter specified in subpara2 graph (A), an amount equal to the sum of the 

3 following proportions of the total amount ex4 pended during the quarter— 

5 ‘‘(i) 50 percent of so much of the ex6 penditures as are found necessary by the 

7 Secretary for the proper and efficient ad8 ministration of the State plan for the provi9 sion of services or programs specified in sec10 tion 471(e)(1), including expenditures for 

11 activities approved by the Secretary that 

12 promote the development of necessary proc13 esses and procedures to establish and imple14 ment the provision of the services and pro15 grams for individuals who are eligible for 

16 the services and programs and expenditures 

17 attributable to data collection and report18 ing; and 

19 ‘‘(ii) 50 percent of so much of the ex20 penditures with respect to the provision of 

21 services and programs specified in section 

22 471(e)(1) as are for training of personnel 

23 employed or preparing for employment by 

24 the State agency or by the local agency ad25 ministering the plan in the political sub-
451 

† HR 1892 EAS2 

1 division and of the members of the staff of 

2 State-licensed or State-approved child wel3 fare agencies providing services to children 

4 described in section 471(e)(2) and their par5 ents or kin caregivers, including on how to 

6 determine who are individuals eligible for 

7 the services or programs, how to identify 

8 and provide appropriate services and pro9 grams, and how to oversee and evaluate the 

10 ongoing appropriateness of the services and 

11 programs.’’. 

12 (d) TECHNICAL ASSISTANCE AND BEST PRACTICES, 

13 CLEARINGHOUSE, AND DATA COLLECTION AND EVALUA14 TIONS.—Section 476 of such Act (42 U.S.C. 676) is amend15 ed by adding at the end the following: 

16 ‘‘(d) TECHNICAL ASSISTANCE AND BEST PRACTICES, 

17 CLEARINGHOUSE, DATA COLLECTION, AND EVALUATIONS

18 RELATING TO PREVENTION SERVICES AND PROGRAMS.— 

19 ‘‘(1) TECHNICAL ASSISTANCE AND BEST PRAC20 TICES.—The Secretary shall provide to States and, as 

21 applicable, to Indian tribes, tribal organizations, and 

22 tribal consortia, technical assistance regarding the 

23 provision of services and programs described in sec24 tion 471(e)(1) and shall disseminate best practices 

25 with respect to the provision of the services and pro-
452 

† HR 1892 EAS2 

1 grams, including how to plan and implement a well2 designed and rigorous evaluation of a promising, sup3 ported, or well-supported practice. 

4 ‘‘(2) CLEARINGHOUSE OF PROMISING, SUP5 PORTED, AND WELL-SUPPORTED PRACTICES.—The 

6 Secretary shall, directly or through grants, contracts, 

7 or interagency agreements, evaluate research on the 

8 practices specified in clauses (iii), (iv), and (v), re9 spectively, of section 471(e)(4)(C), and programs that 

10 meet the requirements described in section 427(a)(1), 

11 including culturally specific, or location- or popu12 lation-based adaptations of the practices, to identify 

13 and establish a public clearinghouse of the practices 

14 that satisfy each category described by such clauses. 

15 In addition, the clearinghouse shall include informa16 tion on the specific outcomes associated with each 

17 practice, including whether the practice has been 

18 shown to prevent child abuse and neglect and reduce 

19 the likelihood of foster care placement by supporting 

20 birth families and kinship families and improving 

21 targeted supports for pregnant and parenting youth 

22 and their children. 

23 ‘‘(3) DATA COLLECTION AND EVALUATIONS.—The 

24 Secretary, directly or through grants, contracts, or 

25 interagency agreements, may collect data and conduct 
453 

† HR 1892 EAS2 

1 evaluations with respect to the provision of services 

2 and programs described in section 471(e)(1) for pur3 poses of assessing the extent to which the provision of 

4 the services and programs— 

5 ‘‘(A) reduces the likelihood of foster care 

6 placement; 

7 ‘‘(B) increases use of kinship care arrange8 ments; or 

9 ‘‘(C) improves child well-being. 

10 ‘‘(4) REPORTS TO CONGRESS.— 

11 ‘‘(A) IN GENERAL.—The Secretary shall 

12 submit to the Committee on Finance of the Sen13 ate and the Committee on Ways and Means of 

14 the House of Representatives periodic reports 

15 based on the provision of services and programs 

16 described in section 471(e)(1) and the activities 

17 carried out under this subsection. 

18 ‘‘(B) PUBLIC AVAILABILITY.—The Secretary 

19 shall make the reports to Congress submitted 

20 under this paragraph publicly available. 

21 ‘‘(5) APPROPRIATION.—Out of any money in the 

22 Treasury of the United States not otherwise appro23 priated, there are appropriated to the Secretary 

24 $1,000,000 for fiscal year 2018 and each fiscal year 

25 thereafter to carry out this subsection.’’. 
454 

† HR 1892 EAS2 

1 (e) APPLICATION TO PROGRAMS OPERATED BY INDIAN

2 TRIBAL ORGANIZATIONS.— 

3 (1) IN GENERAL.—Section 479B of such Act (42 

4 U.S.C. 679c) is amended— 

5 (A) in subsection (c)(1)— 

6 (i) in subparagraph (C)(i)— 

7 (I) in subclause (II), by striking 

8 ‘‘and’’ after the semicolon; 

9 (II) in subclause (III), by striking 

10 the period at the end and inserting ‘‘; 

11 and’’; and 

12 (III) by adding at the end the fol13 lowing: 

14 ‘‘(IV) at the option of the tribe, 

15 organization, or consortium, services 

16 and programs specified in section 

17 471(e)(1) to children described in sec18 tion 471(e)(2) and their parents or kin 

19 caregivers, in accordance with section 

20 471(e) and subparagraph (E).’’; and 

21 (ii) by adding at the end the following: 

22 ‘‘(E) PREVENTION SERVICES AND PRO23 GRAMS FOR CHILDREN AND THEIR PARENTS AND

24 KIN CAREGIVERS.— 
455 

† HR 1892 EAS2 

1 ‘‘(i) IN GENERAL.—In the case of a 

2 tribe, organization, or consortium that 

3 elects to provide services and programs spec4 ified in section 471(e)(1) to children de5 scribed in section 471(e)(2) and their par6 ents or kin caregivers under the plan, the 

7 Secretary shall specify the requirements ap8 plicable to the provision of the services and 

9 programs. The requirements shall, to the 

10 greatest extent practicable, be consistent 

11 with the requirements applicable to States 

12 under section 471(e) and shall permit the 

13 provision of the services and programs in 

14 the form of services and programs that are 

15 adapted to the culture and context of the 

16 tribal communities served. 

17 ‘‘(ii) PERFORMANCE MEASURES.—The 

18 Secretary shall establish specific perform19 ance measures for each tribe, organization, 

20 or consortium that elects to provide services 

21 and programs specified in section 471(e)(1). 

22 The performance measures shall, to the 

23 greatest extent practicable, be consistent 

24 with the prevention services measures re25 quired for States under section 471(e)(6) 
456 

† HR 1892 EAS2 

1 but shall allow for consideration of factors 

2 unique to the provision of the services by 

3 tribes, organizations, or consortia.’’; and 

4 (B) in subsection (d)(1), by striking ‘‘and 

5 (5)’’ and inserting ‘‘(5), and (6)(A)’’. 

6 (2) CONFORMING AMENDMENT.—The heading for 

7 subsection (d) of section 479B of such Act (42 U.S.C. 

8 679c) is amended by striking ‘‘FOR FOSTER CARE

9 MAINTENANCE AND ADOPTION ASSISTANCE PAY10 MENTS’’. 

11 (f) APPLICATION TO PROGRAMS OPERATED BY TERRI12 TORIES.—Section 1108(a)(2) of the Social Security Act (42 

13 U.S.C. 1308(a)(2)) is amended by striking ‘‘or 413(f)’’ and 

14 inserting ‘‘413(f), or 474(a)(6)’’. 

15 SEC. 50712. FOSTER CARE MAINTENANCE PAYMENTS FOR 

16 CHILDREN WITH PARENTS IN A LICENSED 

17 RESIDENTIAL FAMILY-BASED TREATMENT FA18 CILITY FOR SUBSTANCE ABUSE. 

19 (a) IN GENERAL.—Section 472 of the Social Security 

20 Act (42 U.S.C. 672) is amended— 

21 (1) in subsection (a)(2)(C), by striking ‘‘or’’ and 

22 inserting ‘‘, with a parent residing in a licensed resi23 dential family-based treatment facility, but only to 

24 the extent permitted under subsection (j), or in a’’; 

25 and 
457 

† HR 1892 EAS2 

1 (2) by adding at the end the following: 

2 ‘‘(j) CHILDREN PLACED WITH A PARENT RESIDING IN

3 A LICENSED RESIDENTIAL FAMILY-BASED TREATMENT FA4 CILITY FOR SUBSTANCE ABUSE.— 

5 ‘‘(1) IN GENERAL.—Notwithstanding the pre6 ceding provisions of this section, a child who is eligi7 ble for foster care maintenance payments under this 

8 section, or who would be eligible for the payments if 

9 the eligibility were determined without regard to 

10 paragraphs (1)(B) and (3) of subsection (a), shall be 

11 eligible for the payments for a period of not more 

12 than 12 months during which the child is placed with 

13 a parent who is in a licensed residential family-based 

14 treatment facility for substance abuse, but only if— 

15 ‘‘(A) the recommendation for the placement 

16 is specified in the child’s case plan before the 

17 placement; 

18 ‘‘(B) the treatment facility provides, as part 

19 of the treatment for substance abuse, parenting 

20 skills training, parent education, and individual 

21 and family counseling; and 

22 ‘‘(C) the substance abuse treatment, par23 enting skills training, parent education, and in24 dividual and family counseling is provided 

25 under an organizational structure and treatment 
458 

† HR 1892 EAS2 

1 framework that involves understanding, recog2 nizing, and responding to the effects of all types 

3 of trauma and in accordance with recognized 

4 principles of a trauma-informed approach and 

5 trauma-specific interventions to address the con6 sequences of trauma and facilitate healing. 

7 ‘‘(2) APPLICATION.—With respect to children for 

8 whom foster care maintenance payments are made 

9 under paragraph (1), only the children who satisfy 

10 the requirements of paragraphs (1)(B) and (3) of sub11 section (a) shall be considered to be children with re12 spect to whom foster care maintenance payments are 

13 made under this section for purposes of subsection (h) 

14 or section 473(b)(3)(B).’’. 

15 (b) CONFORMING AMENDMENT.—Section 474(a)(1) of 

16 such Act (42 U.S.C. 674(a)(1)) is amended by inserting 

17 ‘‘subject to section 472(j),’’ before ‘‘an amount equal to the 

18 Federal’’ the first place it appears. 

19 SEC. 50713. TITLE IV–E PAYMENTS FOR EVIDENCE-BASED 

20 KINSHIP NAVIGATOR PROGRAMS. 

21 Section 474(a) of the Social Security Act (42 U.S.C. 

22 674(a)), as amended by section 50711(c), is amended— 

23 (1) in paragraph (6), by striking the period at 

24 the end and inserting ‘‘; plus’’; and 

25 (2) by adding at the end the following: 
459 

† HR 1892 EAS2 

1 ‘‘(7) an amount equal to 50 percent of the 

2 amounts expended by the State during the quarter as 

3 the Secretary determines are for kinship navigator 

4 programs that meet the requirements described in sec5 tion 427(a)(1) and that the Secretary determines are 

6 operated in accordance with promising, supported, or 

7 well-supported practices that meet the applicable cri8 teria specified for the practices in section 

9 471(e)(4)(C), without regard to whether the expendi10 tures are incurred on behalf of children who are, or 

11 are potentially, eligible for foster care maintenance 

12 payments under this part.’’. 

13 PART II—ENHANCED SUPPORT UNDER TITLE IV– 

14 B 

15 SEC. 50721. ELIMINATION OF TIME LIMIT FOR FAMILY RE16 UNIFICATION SERVICES WHILE IN FOSTER 

17 CARE AND PERMITTING TIME-LIMITED FAM18 ILY REUNIFICATION SERVICES WHEN A 

19 CHILD RETURNS HOME FROM FOSTER CARE. 

20 (a) IN GENERAL.—Section 431(a)(7) of the Social Se21 curity Act (42 U.S.C. 629a(a)(7)) is amended— 

22 (1) in the paragraph heading, by striking 

23 ‘‘TIME-LIMITED FAMILY’’ and inserting ‘‘FAMILY’’; 

24 and 

25 (2) in subparagraph (A)— 
460 

† HR 1892 EAS2 

1 (A) by striking ‘‘time-limited family’’ and 

2 inserting ‘‘family’’; 

3 (B) by inserting ‘‘or a child who has been 

4 returned home’’ after ‘‘child care institution’’; 

5 and 

6 (C) by striking ‘‘, but only during the 15- 

7 month period that begins on the date that the 

8 child, pursuant to section 475(5)(F), is consid9 ered to have entered foster care’’ and inserting 

10 ‘‘and to ensure the strength and stability of the 

11 reunification. In the case of a child who has been 

12 returned home, the services and activities shall 

13 only be provided during the 15-month period 

14 that begins on the date that the child returns 

15 home’’. 

16 (b) CONFORMING AMENDMENTS.— 

17 (1) Section 430 of such Act (42 U.S.C. 629) is 

18 amended in the matter preceding paragraph (1), by 

19 striking ‘‘time-limited’’. 

20 (2) Subsections (a)(4), (a)(5)(A), and (b)(1) of 

21 section 432 of such Act (42 U.S.C. 629b) are amended 

22 by striking ‘‘time-limited’’ each place it appears. 
461 

† HR 1892 EAS2 

1 SEC. 50722. REDUCING BUREAUCRACY AND UNNECESSARY 

2 DELAYS WHEN PLACING CHILDREN IN HOMES 

3 ACROSS STATE LINES. 

4 (a) STATE PLAN REQUIREMENT.—Section 471(a)(25) 

5 of the Social Security Act (42 U.S.C. 671(a)(25)) is amend6 ed— 

7 (1) by striking ‘‘provide’’ and inserting ‘‘pro8 vides’’; and 

9 (2) by inserting ‘‘, which, in the case of a State 

10 other than the Commonwealth of Puerto Rico, the 

11 United States Virgin Islands, Guam, or American 

12 Samoa, not later than October 1, 2027, shall include 

13 the use of an electronic interstate case-processing sys14 tem’’ before the first semicolon. 

15 (b) EXEMPTION OF INDIAN TRIBES.—Section 479B(c) 

16 of such Act (42 U.S.C. 679c(c)) is amended by adding at 

17 the end the following: 

18 ‘‘(4) INAPPLICABILITY OF STATE PLAN REQUIRE19 MENT TO HAVE IN EFFECT PROCEDURES PROVIDING

20 FOR THE USE OF AN ELECTRONIC INTERSTATE CASE21 PROCESSING SYSTEM.—.The requirement in section 

22 471(a)(25) that a State plan provide that the State 

23 shall have in effect procedures providing for the use 

24 of an electronic interstate case-processing system shall 

25 not apply to an Indian tribe, tribal organization, or 
462 

† HR 1892 EAS2 

1 tribal consortium that elects to operate a program 

2 under this part.’’. 

3 (c) FUNDING FOR THE DEVELOPMENT OF AN ELEC4 TRONIC INTERSTATE CASE-PROCESSING SYSTEM TO EXPE5 DITE THE INTERSTATE PLACEMENT OF CHILDREN IN FOS6 TER CARE OR GUARDIANSHIP, OR FOR ADOPTION.—Section 

7 437 of such Act (42 U.S.C. 629g) is amended by adding 

8 at the end the following: 

9 ‘‘(g) FUNDING FOR THE DEVELOPMENT OF AN ELEC10 TRONIC INTERSTATE CASE-PROCESSING SYSTEM TO EXPE11 DITE THE INTERSTATE PLACEMENT OF CHILDREN IN FOS12 TER CARE OR GUARDIANSHIP, OR FOR ADOPTION.— 

13 ‘‘(1) PURPOSE.—The purpose of this subsection 

14 is to facilitate the development of an electronic inter15 state case-processing system for the exchange of data 

16 and documents to expedite the placements of children 

17 in foster, guardianship, or adoptive homes across 

18 State lines. 

19 ‘‘(2) REQUIREMENTS.—A State that seeks fund20 ing under this subsection shall submit to the Sec21 retary the following: 

22 ‘‘(A) A description of the goals and out23 comes to be achieved, which goals and outcomes 

24 must result in— 
463 

† HR 1892 EAS2 

1 ‘‘(i) reducing the time it takes for a 

2 child to be provided with a safe and appro3 priate permanent living arrangement across 

4 State lines; 

5 ‘‘(ii) improving administrative proc6 esses and reducing costs in the foster care 

7 system; and 

8 ‘‘(iii) the secure exchange of relevant 

9 case files and other necessary materials in 

10 real time, and timely communications and 

11 placement decisions regarding interstate 

12 placements of children. 

13 ‘‘(B) A description of the activities to be 

14 funded in whole or in part with the funds, in15 cluding the sequencing of the activities. 

16 ‘‘(C) A description of the strategies for inte17 grating programs and services for children who 

18 are placed across State lines. 

19 ‘‘(D) Such other information as the Sec20 retary may require. 

21 ‘‘(3) FUNDING AUTHORITY.—The Secretary may 

22 provide funds to a State that complies with para23 graph (2). In providing funds under this subsection, 

24 the Secretary shall prioritize States that are not yet 
464 

† HR 1892 EAS2 

1 connected with the electronic interstate case-processing 

2 system referred to in paragraph (1). 

3 ‘‘(4) USE OF FUNDS.—A State to which funding 

4 is provided under this subsection shall use the fund5 ing to support the State in connecting with, or en6 hancing or expediting services provided under, the 

7 electronic interstate case-processing system referred to 

8 in paragraph (1). 

9 ‘‘(5) EVALUATIONS.—Not later than 1 year after 

10 the final year in which funds are awarded under this 

11 subsection, the Secretary shall submit to the Congress, 

12 and make available to the general public by posting 

13 on a website, a report that contains the following in14 formation: 

15 ‘‘(A) How using the electronic interstate 

16 case-processing system developed pursuant to 

17 paragraph (4) has changed the time it takes for 

18 children to be placed across State lines. 

19 ‘‘(B) The number of cases subject to the 

20 Interstate Compact on the Placement of Children 

21 that were processed through the electronic inter22 state case-processing system, and the number of 

23 interstate child placement cases that were proc24 essed outside the electronic interstate case-proc25 essing system, by each State in each year. 
465 

† HR 1892 EAS2 

1 ‘‘(C) The progress made by States in imple2 menting the electronic interstate case-processing 

3 system. 

4 ‘‘(D) How using the electronic interstate 

5 case-processing system has affected various 

6 metrics related to child safety and well-being, in7 cluding the time it takes for children to be placed 

8 across State lines. 

9 ‘‘(E) How using the electronic interstate 

10 case-processing system has affected administra11 tive costs and caseworker time spent on placing 

12 children across State lines. 

13 ‘‘(6) DATA INTEGRATION.—The Secretary, in 

14 consultation with the Secretariat for the Interstate 

15 Compact on the Placement of Children and the States, 

16 shall assess how the electronic interstate case-proc17 essing system developed pursuant to paragraph (4) 

18 could be used to better serve and protect children that 

19 come to the attention of the child welfare system, by— 

20 ‘‘(A) connecting the system with other data 

21 systems (such as systems operated by State law 

22 enforcement and judicial agencies, systems oper23 ated by the Federal Bureau of Investigation for 

24 the purposes of the Innocence Lost National Ini25 tiative, and other systems); 
466 

† HR 1892 EAS2 

1 ‘‘(B) simplifying and improving reporting 

2 related to paragraphs (34) and (35) of section 

3 471(a) regarding children or youth who have 

4 been identified as being a sex trafficking victim 

5 or children missing from foster care; and 

6 ‘‘(C) improving the ability of States to 

7 quickly comply with background check require8 ments of section 471(a)(20), including checks of 

9 child abuse and neglect registries as required by 

10 section 471(a)(20)(B).’’. 

11 (d) RESERVATION OF FUNDS TO IMPROVE THE INTER12 STATE PLACEMENT OF CHILDREN.—Section 437(b) of such 

13 Act (42 U.S.C. 629g(b)) is amended by adding at the end 

14 the following: 

15 ‘‘(4) IMPROVING THE INTERSTATE PLACEMENT

16 OF CHILDREN.—The Secretary shall reserve 

17 $5,000,000 of the amount made available for fiscal 

18 year 2018 for grants under subsection (g), and the 

19 amount so reserved shall remain available through 

20 fiscal year 2022.’’. 

21 SEC. 50723. ENHANCEMENTS TO GRANTS TO IMPROVE 

22 WELL-BEING OF FAMILIES AFFECTED BY SUB23 STANCE ABUSE. 

24 Section 437(f) of the Social Security Act (42 U.S.C. 

25 629g(f)) is amended— 
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1 (1) in the subsection heading, by striking ‘‘IN2 CREASE THE WELL-BEING OF, AND TO IMPROVE THE

3 PERMANENCY OUTCOMES FOR, CHILDREN AFFECTED

4 BY’’ and inserting ‘‘IMPLEMENT IV–E PREVENTION

5 SERVICES, AND IMPROVE THE WELL-BEING OF, AND

6 IMPROVE PERMANENCY OUTCOMES FOR, CHILDREN

7 AND FAMILIES AFFECTED BY HEROIN, OPIOIDS, AND

8 OTHER’’; 

9 (2) by striking paragraph (2) and inserting the 

10 following: 

11 ‘‘(2) REGIONAL PARTNERSHIP DEFINED.—In this 

12 subsection, the term ‘regional partnership’ means a 

13 collaborative agreement (which may be established on 

14 an interstate, State, or intrastate basis) entered into 

15 by the following: 

16 ‘‘(A) MANDATORY PARTNERS FOR ALL PART17 NERSHIP GRANTS.— 

18 ‘‘(i) The State child welfare agency 

19 that is responsible for the administration of 

20 the State plan under this part and part E. 

21 ‘‘(ii) The State agency responsible for 

22 administering the substance abuse preven23 tion and treatment block grant provided 

24 under subpart II of part B of title XIX of 

25 the Public Health Service Act. 
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1 ‘‘(B) MANDATORY PARTNERS FOR PARTNER2 SHIP GRANTS PROPOSING TO SERVE CHILDREN

3 IN OUT-OF-HOME PLACEMENTS.—If the partner4 ship proposes to serve children in out-of-home 

5 placements, the Juvenile Court or Administrative 

6 Office of the Court that is most appropriate to 

7 oversee the administration of court programs in 

8 the region to address the population of families 

9 who come to the attention of the court due to 

10 child abuse or neglect. 

11 ‘‘(C) OPTIONAL PARTNERS.—At the option 

12 of the partnership, any of the following: 

13 ‘‘(i) An Indian tribe or tribal consor14 tium. 

15 ‘‘(ii) Nonprofit child welfare service 

16 providers. 

17 ‘‘(iii) For-profit child welfare service 

18 providers. 

19 ‘‘(iv) Community health service pro20 viders, including substance abuse treatment 

21 providers. 

22 ‘‘(v) Community mental health pro23 viders. 

24 ‘‘(vi) Local law enforcement agencies. 

25 ‘‘(vii) School personnel. 
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1 ‘‘(viii) Tribal child welfare agencies 

2 (or a consortia of the agencies). 

3 ‘‘(ix) Any other providers, agencies, 

4 personnel, officials, or entities that are re5 lated to the provision of child and family 

6 services under a State plan approved under 

7 this subpart. 

8 ‘‘(D) EXCEPTION FOR REGIONAL PARTNER9 SHIPS WHERE THE LEAD APPLICANT IS AN IN10 DIAN TRIBE OR TRIBAL CONSORTIA.—If an In11 dian tribe or tribal consortium enters into a re12 gional partnership for purposes of this sub13 section, the Indian tribe or tribal consortium— 

14 ‘‘(i) may (but is not required to) in15 clude the State child welfare agency as a 

16 partner in the collaborative agreement; 

17 ‘‘(ii) may not enter into a collaborative 

18 agreement only with tribal child welfare 

19 agencies (or a consortium of the agencies); 

20 and 

21 ‘‘(iii) if the condition described in 

22 paragraph (2)(B) applies, may include trib23 al court organizations in lieu of other judi24 cial partners.’’; 

25 (3) in paragraph (3)— 
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1 (A) in subparagraph (A)— 

2 (i) by striking ‘‘2012 through 2016’’ 

3 and inserting ‘‘2017 through 2021’’; and 

4 (ii) by striking ‘‘$500,000 and not 

5 more than $1,000,000’’ and inserting 

6 ‘‘$250,000 and not more than $1,000,000’’; 

7 (B) in subparagraph (B)— 

8 (i) in the subparagraph heading, by 

9 inserting ‘‘; PLANNING’’ after ‘‘APPROVAL’’; 

10 (ii) in clause (i), by striking ‘‘clause 

11 (ii)’’ and inserting ‘‘clauses (ii) and (iii)’’; 

12 and 

13 (iii) by adding at the end the fol14 lowing: 

15 ‘‘(iii) SUFFICIENT PLANNING.—A grant 

16 awarded under this subsection shall be dis17 bursed in two phases: a planning phase (not 

18 to exceed 2 years) and an implementation 

19 phase. The total disbursement to a grantee 

20 for the planning phase may not exceed 

21 $250,000, and may not exceed the total an22 ticipated funding for the implementation 

23 phase.’’; and 

24 (C) by adding at the end the following: 
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1 ‘‘(D) LIMITATION ON PAYMENT FOR A FIS2 CAL YEAR.—No payment shall be made under 

3 subparagraph (A) or (C) for a fiscal year until 

4 the Secretary determines that the eligible part5 nership has made sufficient progress in meeting 

6 the goals of the grant and that the members of 

7 the eligible partnership are coordinating to a 

8 reasonable degree with the other members of the 

9 eligible partnership.’’; 

10 (4) in paragraph (4)— 

11 (A) in subparagraph (B)— 

12 (i) in clause (i), by inserting ‘‘, par13 ents, and families’’ after ‘‘children’’; 

14 (ii) in clause (ii), by striking ‘‘safety 

15 and permanence for such children; and’’ 

16 and inserting ‘‘safe, permanent caregiving 

17 relationships for the children;’’; 

18 (iii) in clause (iii), by striking ‘‘or’’ 

19 and inserting ‘‘increase reunification rates 

20 for children who have been placed in out-of21 home care, or decrease’’; and 

22 (iv) by redesignating clause (iii) as 

23 clause (v) and inserting after clause (ii) the 

24 following: 
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1 ‘‘(iii) improve the substance abuse 

2 treatment outcomes for parents including 

3 retention in treatment and successful com4 pletion of treatment; 

5 ‘‘(iv) facilitate the implementation, de6 livery, and effectiveness of prevention serv7 ices and programs under section 471(e); 

8 and’’; 

9 (B) in subparagraph (D), by striking 

10 ‘‘where appropriate,’’; and 

11 (C) by striking subparagraphs (E) and (F) 

12 and inserting the following: 

13 ‘‘(E) A description of a plan for sustaining 

14 the services provided by or activities funded 

15 under the grant after the conclusion of the grant 

16 period, including through the use of prevention 

17 services and programs under section 471(e) and 

18 other funds provided to the State for child wel19 fare and substance abuse prevention and treat20 ment services. 

21 ‘‘(F) Additional information needed by the 

22 Secretary to determine that the proposed activi23 ties and implementation will be consistent with 

24 research or evaluations showing which practices 

25 and approaches are most effective.’’; 
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1 (5) in paragraph (5)(A), by striking ‘‘abuse 

2 treatment’’ and inserting ‘‘use disorder treatment in3 cluding medication assisted treatment and in-home 

4 substance abuse disorder treatment and recovery’’; 

5 (6) in paragraph (7)— 

6 (A) by striking ‘‘and’’ at the end of sub7 paragraph (C); and 

8 (B) by redesignating subparagraph (D) as 

9 subparagraph (E) and inserting after subpara10 graph (C) the following: 

11 ‘‘(D) demonstrate a track record of success12 ful collaboration among child welfare, substance 

13 abuse disorder treatment and mental health 

14 agencies; and’’; 

15 (7) in paragraph (8)— 

16 (A) in subparagraph (A)— 

17 (i) by striking ‘‘establish indicators 

18 that will be’’ and inserting ‘‘review indica19 tors that are’’; and 

20 (ii) by striking ‘‘in using funds made 

21 available under such grants to achieve the 

22 purpose of this subsection’’ and inserting 

23 ‘‘and establish a set of core indicators re24 lated to child safety, parental recovery, par25 enting capacity, and family well-being. In 
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1 developing the core indicators, to the extent 

2 possible, indicators shall be made consistent 

3 with the outcome measures described in sec4 tion 471(e)(6)’’; and 

5 (B) in subparagraph (B)— 

6 (i) in the matter preceding clause (i), 

7 by inserting ‘‘base the performance meas8 ures on lessons learned from prior rounds of 

9 regional partnership grants under this sub10 section, and’’ before ‘‘consult’’; and 

11 (ii) by striking clauses (iii) and (iv) 

12 and inserting the following: 

13 ‘‘(iii) Other stakeholders or constitu14 encies as determined by the Secretary.’’; 

15 (8) in paragraph (9)(A), by striking clause (i) 

16 and inserting the following: 

17 ‘‘(i) SEMIANNUAL REPORTS.—Not later 

18 than September 30 of each fiscal year in 

19 which a recipient of a grant under this sub20 section is paid funds under the grant, and 

21 every 6 months thereafter, the grant recipi22 ent shall submit to the Secretary a report 

23 on the services provided and activities car24 ried out during the reporting period, 

25 progress made in achieving the goals of the 
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1 program, the number of children, adults, 

2 and families receiving services, and such 

3 additional information as the Secretary de4 termines is necessary. The report due not 

5 later than September 30 of the last such fis6 cal year shall include, at a minimum, data 

7 on each of the performance indicators in8 cluded in the evaluation of the regional 

9 partnership.’’; and 

10 (9) in paragraph (10), by striking ‘‘2012 

11 through 2016’’ and inserting ‘‘2017 through 2021’’. 

12 PART III—MISCELLANEOUS 

13 SEC. 50731. REVIEWING AND IMPROVING LICENSING 

14 STANDARDS FOR PLACEMENT IN A RELATIVE 

15 FOSTER FAMILY HOME. 

16 (a) IDENTIFICATION OF REPUTABLE MODEL LICENS17 ING STANDARDS.—Not later than October 1, 2018, the Sec18 retary of Health and Human Services shall identify rep19 utable model licensing standards with respect to the licens20 ing of foster family homes (as defined in section 472(c)(1) 

21 of the Social Security Act). 

22 (b) STATE PLAN REQUIREMENT.—Section 471(a) of 

23 the Social Security Act (42 U.S.C. 671(a)) is amended— 

24 (1) in paragraph (34)(B), by striking ‘‘and’’ 

25 after the semicolon; 
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1 (2) in paragraph (35)(B), by striking the period 

2 at the end and inserting a semicolon; and 

3 (3) by adding at the end the following: 

4 ‘‘(36) provides that, not later than April 1, 2019, 

5 the State shall submit to the Secretary information 

6 addressing— 

7 ‘‘(A) whether the State licensing standards 

8 are in accord with model standards identified by 

9 the Secretary, and if not, the reason for the spe10 cific deviation and a description as to why hav11 ing a standard that is reasonably in accord with 

12 the corresponding national model standards is 

13 not appropriate for the State; 

14 ‘‘(B) whether the State has elected to waive 

15 standards established in 471(a)(10)(A) for rel16 ative foster family homes (pursuant to waiver 

17 authority provided by 471(a)(10)(D)), a descrip18 tion of which standards the State most com19 monly waives, and if the State has not elected to 

20 waive the standards, the reason for not waiving 

21 these standards; 

22 ‘‘(C) if the State has elected to waive stand23 ards specified in subparagraph (B), how case24 workers are trained to use the waiver authority 

25 and whether the State has developed a process or 
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1 provided tools to assist caseworkers in waiving 

2 nonsafety standards per the authority provided 

3 in 471(a)(10)(D) to quickly place children with 

4 relatives; and 

5 ‘‘(D) a description of the steps the State is 

6 taking to improve caseworker training or the 

7 process, if any; and’’. 

8 SEC. 50732. DEVELOPMENT OF A STATEWIDE PLAN TO PRE9 VENT CHILD ABUSE AND NEGLECT FATALI10 TIES. 

11 Section 422(b)(19) of the Social Security Act (42 

12 U.S.C. 622(b)(19)) is amended to read as follows: 

13 ‘‘(19) document steps taken to track and prevent 

14 child maltreatment deaths by including— 

15 ‘‘(A) a description of the steps the State is 

16 taking to compile complete and accurate infor17 mation on the deaths required by Federal law to 

18 be reported by the State agency referred to in 

19 paragraph (1), including gathering relevant in20 formation on the deaths from the relevant orga21 nizations in the State including entities such as 

22 State vital statistics department, child death re23 view teams, law enforcement agencies, offices of 

24 medical examiners, or coroners; and 
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1 ‘‘(B) a description of the steps the State is 

2 taking to develop and implement a comprehen3 sive, statewide plan to prevent the fatalities that 

4 involves and engages relevant public and private 

5 agency partners, including those in public 

6 health, law enforcement, and the courts.’’. 

7 SEC. 50733. MODERNIZING THE TITLE AND PURPOSE OF 

8 TITLE IV–E. 

9 (a) PART HEADING.—The heading for part E of title 

10 IV of the Social Security Act (42 U.S.C. 670 et seq.) is 

11 amended to read as follows: 

12 ‘‘PART E—FEDERAL PAYMENTS FOR FOSTER 

13 CARE, PREVENTION, AND PERMANENCY’’. 

14 (b) PURPOSE.—The first sentence of section 470 of 

15 such Act (42 U.S.C. 670) is amended— 

16 (1) by striking ‘‘1995) and’’ and inserting 

17 ‘‘1995),’’; 

18 (2) by inserting ‘‘kinship guardianship assist19 ance, and prevention services or programs specified in 

20 section 471(e)(1),’’ after ‘‘needs,’’; and 

21 (3) by striking ‘‘(commencing with the fiscal 

22 year which begins October 1, 1980)’’. 

23 SEC. 50734. EFFECTIVE DATES. 

24 (a) EFFECTIVE DATES.— 
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1 (1) IN GENERAL.—Except as provided in para2 graph (2), subject to subsection (b), the amendments 

3 made by parts I through III of this subtitle shall take 

4 effect on October 1, 2018. 

5 (2) EXCEPTIONS.—The amendments made by 

6 sections 50711(d), 50731, and 50733 shall take effect 

7 on the date of enactment of this Act. 

8 (b) TRANSITION RULE.— 

9 (1) IN GENERAL.—In the case of a State plan 

10 under part B or E of title IV of the Social Security 

11 Act which the Secretary of Health and Human Serv12 ices determines requires State legislation (other than 

13 legislation appropriating funds) in order for the plan 

14 to meet the additional requirements imposed by the 

15 amendments made by parts I through III of this sub16 title, the State plan shall not be regarded as failing 

17 to comply with the requirements of such part solely 

18 on the basis of the failure of the plan to meet such 

19 additional requirements before the first day of the 

20 first calendar quarter beginning after the close of the 

21 first regular session of the State legislature that be22 gins after the date of enactment of this Act. For pur23 poses of the previous sentence, in the case of a State 

24 that has a 2-year legislative session, each year of the 
480 

† HR 1892 EAS2 

1 session shall be deemed to be a separate regular ses2 sion of the State legislature. 

3 (2) APPLICATION TO PROGRAMS OPERATED BY

4 INDIAN TRIBAL ORGANIZATIONS.—In the case of an 

5 Indian tribe, tribal organization, or tribal consortium 

6 which the Secretary of Health and Human Services 

7 determines requires time to take action necessary to 

8 comply with the additional requirements imposed by 

9 the amendments made by parts I through III of this 

10 subtitle (whether the tribe, organization, or tribal con11 sortium has a plan under section 479B of the Social 

12 Security Act or a cooperative agreement or contract 

13 entered into with a State), the Secretary shall provide 

14 the tribe, organization, or tribal consortium with such 

15 additional time as the Secretary determines is nec16 essary for the tribe, organization, or tribal consortium 

17 to take the action to comply with the additional re18 quirements before being regarded as failing to comply 

19 with the requirements. 
481 

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1 PART IV—ENSURING THE NECESSITY OF A 

2 PLACEMENT THAT IS NOT IN A FOSTER FAM3 ILY HOME 

4 SEC. 50741. LIMITATION ON FEDERAL FINANCIAL PARTICI5 PATION FOR PLACEMENTS THAT ARE NOT IN 

6 FOSTER FAMILY HOMES. 

7 (a) LIMITATION ON FEDERAL FINANCIAL PARTICIPA8 TION.— 

9 (1) IN GENERAL.—Section 472 of the Social Se10 curity Act (42 U.S.C. 672), as amended by section 

11 50712(a), is amended— 

12 (A) in subsection (a)(2)(C), by inserting ‘‘, 

13 but only to the extent permitted under subsection 

14 (k)’’ after ‘‘institution’’; and 

15 (B) by adding at the end the following: 

16 ‘‘(k) LIMITATION ON FEDERAL FINANCIAL PARTICIPA17 TION.— 

18 ‘‘(1) IN GENERAL.—Beginning with the third 

19 week for which foster care maintenance payments are 

20 made under this section on behalf of a child placed 

21 in a child-care institution, no Federal payment shall 

22 be made to the State under section 474(a)(1) for 

23 amounts expended for foster care maintenance pay24 ments on behalf of the child unless— 

25 ‘‘(A) the child is placed in a child-care in26 stitution that is a setting specified in paragraph 
482 

† HR 1892 EAS2 

1 (2) (or is placed in a licensed residential family2 based treatment facility consistent with sub3 section (j)); and 

4 ‘‘(B) in the case of a child placed in a 

5 qualified residential treatment program (as de6 fined in paragraph (4)), the requirements speci7 fied in paragraph (3) and section 475A(c) are 

8 met. 

9 ‘‘(2) SPECIFIED SETTINGS FOR PLACEMENT.— 

10 The settings for placement specified in this paragraph 

11 are the following: 

12 ‘‘(A) A qualified residential treatment pro13 gram (as defined in paragraph (4)). 

14 ‘‘(B) A setting specializing in providing 

15 prenatal, post-partum, or parenting supports for 

16 youth. 

17 ‘‘(C) In the case of a child who has attained 

18 18 years of age, a supervised setting in which the 

19 child is living independently. 

20 ‘‘(D) A setting providing high-quality resi21 dential care and supportive services to children 

22 and youth who have been found to be, or are at 

23 risk of becoming, sex trafficking victims, in ac24 cordance with section 471(a)(9)(C). 
483 

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1 ‘‘(3) ASSESSMENT TO DETERMINE APPROPRIATE2 NESS OF PLACEMENT IN A QUALIFIED RESIDENTIAL

3 TREATMENT PROGRAM.— 

4 ‘‘(A) DEADLINE FOR ASSESSMENT.—In the 

5 case of a child who is placed in a qualified resi6 dential treatment program, if the assessment re7 quired under section 475A(c)(1) is not completed 

8 within 30 days after the placement is made, no 

9 Federal payment shall be made to the State 

10 under section 474(a)(1) for any amounts ex11 pended for foster care maintenance payments on 

12 behalf of the child during the placement. 

13 ‘‘(B) DEADLINE FOR TRANSITION OUT OF

14 PLACEMENT.—If the assessment required under 

15 section 475A(c)(1) determines that the placement 

16 of a child in a qualified residential treatment 

17 program is not appropriate, a court disapproves 

18 such a placement under section 475A(c)(2), or a 

19 child who has been in an approved placement in 

20 a qualified residential treatment program is 

21 going to return home or be placed with a fit and 

22 willing relative, a legal guardian, or an adoptive 

23 parent, or in a foster family home, Federal pay24 ments shall be made to the State under section 

25 474(a)(1) for amounts expended for foster care 
484 

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1 maintenance payments on behalf of the child 

2 while the child remains in the qualified residen3 tial treatment program only during the period 

4 necessary for the child to transition home or to 

5 such a placement. In no event shall a State re6 ceive Federal payments under section 474(a)(1) 

7 for amounts expended for foster care mainte8 nance payments on behalf of a child who re9 mains placed in a qualified residential treat10 ment program after the end of the 30-day period 

11 that begins on the date a determination is made 

12 that the placement is no longer the recommended 

13 or approved placement for the child. 

14 ‘‘(4) QUALIFIED RESIDENTIAL TREATMENT PRO15 GRAM.—For purposes of this part, the term ‘qualified 

16 residential treatment program’ means a program 

17 that— 

18 ‘‘(A) has a trauma-informed treatment 

19 model that is designed to address the needs, in20 cluding clinical needs as appropriate, of children 

21 with serious emotional or behavioral disorders or 

22 disturbances and, with respect to a child, is able 

23 to implement the treatment identified for the 

24 child by the assessment of the child required 

25 under section 475A(c); 
485 

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1 ‘‘(B) subject to paragraphs (5) and (6), has 

2 registered or licensed nursing staff and other li3 censed clinical staff who— 

4 ‘‘(i) provide care within the scope of 

5 their practice as defined by State law; 

6 ‘‘(ii) are on-site according to the treat7 ment model referred to in subparagraph 

8 (A); and 

9 ‘‘(iii) are available 24 hours a day and 

10 7 days a week; 

11 ‘‘(C) to extent appropriate, and in accord12 ance with the child’s best interests, facilitates 

13 participation of family members in the child’s 

14 treatment program; 

15 ‘‘(D) facilitates outreach to the family mem16 bers of the child, including siblings, documents 

17 how the outreach is made (including contact in18 formation), and maintains contact information 

19 for any known biological family and fictive kin 

20 of the child; 

21 ‘‘(E) documents how family members are 

22 integrated into the treatment process for the 

23 child, including post-discharge, and how sibling 

24 connections are maintained; 
486 

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1 ‘‘(F) provides discharge planning and fam2 ily-based aftercare support for at least 6 months 

3 post-discharge; and 

4 ‘‘(G) is licensed in accordance with section 

5 471(a)(10) and is accredited by any of the fol6 lowing independent, not-for-profit organizations: 

7 ‘‘(i) The Commission on Accreditation 

8 of Rehabilitation Facilities (CARF). 

9 ‘‘(ii) The Joint Commission on Accred10 itation of Healthcare Organizations 

11 (JCAHO). 

12 ‘‘(iii) The Council on Accreditation 

13 (COA). 

14 ‘‘(iv) Any other independent, not-for15 profit accrediting organization approved by 

16 the Secretary. 

17 ‘‘(5) ADMINISTRATIVE COSTS.—The prohibition 

18 in paragraph (1) on Federal payments under section 

19 474(a)(1) shall not be construed as prohibiting Fed20 eral payments for administrative expenditures in21 curred on behalf of a child placed in a child-care in22 stitution and for which payment is available under 

23 section 474(a)(3). 

24 ‘‘(6) RULE OF CONSTRUCTION.—The require25 ments in paragraph (4)(B) shall not be construed as 
487 

† HR 1892 EAS2 

1 requiring a qualified residential treatment program 

2 to acquire nursing and behavioral health staff solely 

3 through means of a direct employer to employee rela4 tionship.’’. 

5 (2) CONFORMING AMENDMENT.—Section 

6 474(a)(1) of the Social Security Act (42 U.S.C. 

7 674(a)(1)), as amended by section 50712(b), is 

8 amended by striking ‘‘section 472(j)’’ and inserting 

9 ‘‘subsections (j) and (k) of section 472’’. 

10 (b) DEFINITION OF FOSTER FAMILY HOME, CHILD11 CARE INSTITUTION.—Section 472(c) of such Act (42 U.S.C. 

12 672(c)(1)) is amended to read as follows: 

13 ‘‘(c) DEFINITIONS.—For purposes of this part: 

14 ‘‘(1) FOSTER FAMILY HOME.— 

15 ‘‘(A) IN GENERAL.—The term ‘foster family 

16 home’ means the home of an individual or fam17 ily— 

18 ‘‘(i) that is licensed or approved by the 

19 State in which it is situated as a foster 

20 family home that meets the standards estab21 lished for the licensing or approval; and 

22 ‘‘(ii) in which a child in foster care 

23 has been placed in the care of an indi24 vidual, who resides with the child and who 
488 

† HR 1892 EAS2 

1 has been licensed or approved by the State 

2 to be a foster parent— 

3 ‘‘(I) that the State deems capable 

4 of adhering to the reasonable and pru5 dent parent standard; 

6 ‘‘(II) that provides 24-hour sub7 stitute care for children placed away 

8 from their parents or other caretakers; 

9 and 

10 ‘‘(III) that provides the care for 

11 not more than six children in foster 

12 care. 

13 ‘‘(B) STATE FLEXIBILITY.—The number of 

14 foster children that may be cared for in a home 

15 under subparagraph (A) may exceed the numer16 ical limitation in subparagraph (A)(ii)(III), at 

17 the option of the State, for any of the following 

18 reasons: 

19 ‘‘(i) To allow a parenting youth in fos20 ter care to remain with the child of the par21 enting youth. 

22 ‘‘(ii) To allow siblings to remain to23 gether. 
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† HR 1892 EAS2 

1 ‘‘(iii) To allow a child with an estab2 lished meaningful relationship with the 

3 family to remain with the family. 

4 ‘‘(iv) To allow a family with special 

5 training or skills to provide care to a child 

6 who has a severe disability. 

7 ‘‘(C) RULE OF CONSTRUCTION.—Subpara8 graph (A) shall not be construed as prohibiting 

9 a foster parent from renting the home in which 

10 the parent cares for a foster child placed in the 

11 parent’s care. 

12 ‘‘(2) CHILD-CARE INSTITUTION.— 

13 ‘‘(A) IN GENERAL.—The term ‘child-care in14 stitution’ means a private child-care institution, 

15 or a public child-care institution which accom16 modates no more than 25 children, which is li17 censed by the State in which it is situated or has 

18 been approved by the agency of the State respon19 sible for licensing or approval of institutions of 

20 this type as meeting the standards established for 

21 the licensing. 

22 ‘‘(B) SUPERVISED SETTINGS.—In the case 

23 of a child who has attained 18 years of age, the 

24 term shall include a supervised setting in which 

25 the individual is living independently, in ac-
490 

† HR 1892 EAS2 

1 cordance with such conditions as the Secretary 

2 shall establish in regulations. 

3 ‘‘(C) EXCLUSIONS.—The term shall not in4 clude detention facilities, forestry camps, train5 ing schools, or any other facility operated pri6 marily for the detention of children who are de7 termined to be delinquent.’’. 

8 (c) TRAINING FOR STATE JUDGES, ATTORNEYS, AND

9 OTHER LEGAL PERSONNEL IN CHILD WELFARE CASES.— 

10 Section 438(b)(1) of such Act (42 U.S.C. 629h(b)(1)) is 

11 amended in the matter preceding subparagraph (A) by in12 serting ‘‘shall provide for the training of judges, attorneys, 

13 and other legal personnel in child welfare cases on Federal 

14 child welfare policies and payment limitations with respect 

15 to children in foster care who are placed in settings that 

16 are not a foster family home,’’ after ‘‘with respect to the 

17 child,’’. 

18 (d) ASSURANCE OF NONIMPACT ON JUVENILE JUSTICE

19 SYSTEM.— 

20 (1) STATE PLAN REQUIREMENT.—Section 471(a) 

21 of such Act (42 U.S.C. 671(a)), as amended by section 

22 50731, is further amended by adding at the end the 

23 following: 

24 ‘‘(37) includes a certification that, in response to 

25 the limitation imposed under section 472(k) with re-
491 

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1 spect to foster care maintenance payments made on 

2 behalf of any child who is placed in a setting that is 

3 not a foster family home, the State will not enact or 

4 advance policies or practices that would result in a 

5 significant increase in the population of youth in the 

6 State’s juvenile justice system.’’. 

7 (2) GAO STUDY AND REPORT.—The Comptroller 

8 General of the United States shall evaluate the im9 pact, if any, on State juvenile justice systems of the 

10 limitation imposed under section 472(k) of the Social 

11 Security Act (as added by section 50741(a)(1)) on fos12 ter care maintenance payments made on behalf of 

13 any child who is placed in a setting that is not a fos14 ter family home, in accordance with the amendments 

15 made by subsections (a) and (b) of this section. In 

16 particular, the Comptroller General shall evaluate the 

17 extent to which children in foster care who also are 

18 subject to the juvenile justice system of the State are 

19 placed in a facility under the jurisdiction of the juve20 nile justice system and whether the lack of available 

21 congregate care placements under the jurisdiction of 

22 the child welfare systems is a contributing factor to 

23 that result. Not later than December 31, 2025, the 

24 Comptroller General shall submit to Congress a report 

25 on the results of the evaluation. 
492 

† HR 1892 EAS2 

1 SEC. 50742. ASSESSMENT AND DOCUMENTATION OF THE 

2 NEED FOR PLACEMENT IN A QUALIFIED RESI3 DENTIAL TREATMENT PROGRAM. 

4 Section 475A of the Social Security Act (42 U.S.C. 

5 675a) is amended by adding at the end the following: 

6 ‘‘(c) ASSESSMENT, DOCUMENTATION, AND JUDICIAL

7 DETERMINATION REQUIREMENTS FOR PLACEMENT IN A

8 QUALIFIED RESIDENTIAL TREATMENT PROGRAM.—In the 

9 case of any child who is placed in a qualified residential 

10 treatment program (as defined in section 472(k)(4)), the fol11 lowing requirements shall apply for purposes of approving 

12 the case plan for the child and the case system review proce13 dure for the child: 

14 ‘‘(1)(A) Within 30 days of the start of each 

15 placement in such a setting, a qualified individual 

16 (as defined in subparagraph (D)) shall— 

17 ‘‘(i) assess the strengths and needs of the 

18 child using an age-appropriate, evidence-based, 

19 validated, functional assessment tool approved by 

20 the Secretary; 

21 ‘‘(ii) determine whether the needs of the 

22 child can be met with family members or 

23 through placement in a foster family home or, if 

24 not, which setting from among the settings speci25 fied in section 472(k)(2) would provide the most 

26 effective and appropriate level of care for the 
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1 child in the least restrictive environment and be 

2 consistent with the short- and long-term goals for 

3 the child, as specified in the permanency plan 

4 for the child; and 

5 ‘‘(iii) develop a list of child-specific short6 and long-term mental and behavioral health 

7 goals. 

8 ‘‘(B)(i) The State shall assemble a family and 

9 permanency team for the child in accordance with the 

10 requirements of clauses (ii) and (iii). The qualified 

11 individual conducting the assessment required under 

12 subparagraph (A) shall work in conjunction with the 

13 family of, and permanency team for, the child while 

14 conducting and making the assessment. 

15 ‘‘(ii) The family and permanency team shall 

16 consist of all appropriate biological family members, 

17 relative, and fictive kin of the child, as well as, as ap18 propriate, professionals who are a resource to the 

19 family of the child, such as teachers, medical or men20 tal health providers who have treated the child, or 

21 clergy. In the case of a child who has attained age 14, 

22 the family and permanency team shall include the 

23 members of the permanency planning team for the 

24 child that are selected by the child in accordance with 

25 section 475(5)(C)(iv). 
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1 ‘‘(iii) The State shall document in the child’s 

2 case plan— 

3 ‘‘(I) the reasonable and good faith effort of 

4 the State to identify and include all the individ5 uals described in clause (ii) on the child’s family 

6 and permanency team; 

7 ‘‘(II) all contact information for members of 

8 the family and permanency team, as well as con9 tact information for other family members and 

10 fictive kin who are not part of the family and 

11 permanency team; 

12 ‘‘(III) evidence that meetings of the family 

13 and permanency team, including meetings relat14 ing to the assessment required under subpara15 graph (A), are held at a time and place conven16 ient for family; 

17 ‘‘(IV) if reunification is the goal, evidence 

18 demonstrating that the parent from whom the 

19 child was removed provided input on the mem20 bers of the family and permanency team; 

21 ‘‘(V) evidence that the assessment required 

22 under subparagraph (A) is determined in con23 junction with the family and permanency team; 

24 ‘‘(VI) the placement preferences of the fam25 ily and permanency team relative to the assess-
495 

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1 ment that recognizes children should be placed 

2 with their siblings unless there is a finding by 

3 the court that such placement is contrary to their 

4 best interest; and 

5 ‘‘(VII) if the placement preferences of the 

6 family and permanency team and child are not 

7 the placement setting recommended by the quali8 fied individual conducting the assessment under 

9 subparagraph (A), the reasons why the pref10 erences of the team and of the child were not rec11 ommended. 

12 ‘‘(C) In the case of a child who the qualified in13 dividual conducting the assessment under subpara14 graph (A) determines should not be placed in a foster 

15 family home, the qualified individual shall specify in 

16 writing the reasons why the needs of the child cannot 

17 be met by the family of the child or in a foster family 

18 home. A shortage or lack of foster family homes shall 

19 not be an acceptable reason for determining that the 

20 needs of the child cannot be met in a foster family 

21 home. The qualified individual also shall specify in 

22 writing why the recommended placement in a quali23 fied residential treatment program is the setting that 

24 will provide the child with the most effective and ap25 propriate level of care in the least restrictive environ-
496 

† HR 1892 EAS2 

1 ment and how that placement is consistent with the 

2 short- and long-term goals for the child, as specified 

3 in the permanency plan for the child. 

4 ‘‘(D)(i) Subject to clause (ii), in this subsection, 

5 the term ‘qualified individual’ means a trained pro6 fessional or licensed clinician who is not an employee 

7 of the State agency and who is not connected to, or 

8 affiliated with, any placement setting in which chil9 dren are placed by the State. 

10 ‘‘(ii) The Secretary may approve a request of a 

11 State to waive any requirement in clause (i) upon a 

12 submission by the State, in accordance with criteria 

13 established by the Secretary, that certifies that the 

14 trained professionals or licensed clinicians with re15 sponsibility for performing the assessments described 

16 in subparagraph (A) shall maintain objectivity with 

17 respect to determining the most effective and appro18 priate placement for a child. 

19 ‘‘(2) Within 60 days of the start of each place20 ment in a qualified residential treatment program, a 

21 family or juvenile court or another court (including 

22 a tribal court) of competent jurisdiction, or an ad23 ministrative body appointed or approved by the 

24 court, independently, shall— 
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1 ‘‘(A) consider the assessment, determination, 

2 and documentation made by the qualified indi3 vidual conducting the assessment under para4 graph (1); 

5 ‘‘(B) determine whether the needs of the 

6 child can be met through placement in a foster 

7 family home or, if not, whether placement of the 

8 child in a qualified residential treatment pro9 gram provides the most effective and appropriate 

10 level of care for the child in the least restrictive 

11 environment and whether that placement is con12 sistent with the short- and long-term goals for 

13 the child, as specified in the permanency plan 

14 for the child; and 

15 ‘‘(C) approve or disapprove the placement. 

16 ‘‘(3) The written documentation made under 

17 paragraph (1)(C) and documentation of the deter18 mination and approval or disapproval of the place19 ment in a qualified residential treatment program by 

20 a court or administrative body under paragraph (2) 

21 shall be included in and made part of the case plan 

22 for the child. 

23 ‘‘(4) As long as a child remains placed in a 

24 qualified residential treatment program, the State 

25 agency shall submit evidence at each status review 
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† HR 1892 EAS2 

1 and each permanency hearing held with respect to the 

2 child— 

3 ‘‘(A) demonstrating that ongoing assessment 

4 of the strengths and needs of the child continues 

5 to support the determination that the needs of 

6 the child cannot be met through placement in a 

7 foster family home, that the placement in a 

8 qualified residential treatment program provides 

9 the most effective and appropriate level of care 

10 for the child in the least restrictive environment, 

11 and that the placement is consistent with the 

12 short- and long-term goals for the child, as speci13 fied in the permanency plan for the child; 

14 ‘‘(B) documenting the specific treatment or 

15 service needs that will be met for the child in the 

16 placement and the length of time the child is ex17 pected to need the treatment or services; and 

18 ‘‘(C) documenting the efforts made by the 

19 State agency to prepare the child to return home 

20 or to be placed with a fit and willing relative, 

21 a legal guardian, or an adoptive parent, or in 

22 a foster family home. 

23 ‘‘(5) In the case of any child who is placed in 

24 a qualified residential treatment program for more 

25 than 12 consecutive months or 18 nonconsecutive 
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† HR 1892 EAS2 

1 months (or, in the case of a child who has not at2 tained age 13, for more than 6 consecutive or non3 consecutive months), the State agency shall submit to 

4 the Secretary— 

5 ‘‘(A) the most recent versions of the evidence 

6 and documentation specified in paragraph (4); 

7 and 

8 ‘‘(B) the signed approval of the head of the 

9 State agency for the continued placement of the 

10 child in that setting.’’. 

11 SEC. 50743. PROTOCOLS TO PREVENT INAPPROPRIATE DI12 AGNOSES. 

13 (a) STATE PLAN REQUIREMENT.—Section 

14 422(b)(15)(A) of the Social Security Act (42 U.S.C. 

15 622(b)(15)(A)) is amended— 

16 (1) in clause (vi), by striking ‘‘and’’ after the 

17 semicolon; 

18 (2) by redesignating clause (vii) as clause (viii); 

19 and 

20 (3) by inserting after clause (vi) the following: 

21 ‘‘(vii) the procedures and protocols the 

22 State has established to ensure that children 

23 in foster care placements are not inappro24 priately diagnosed with mental illness, 

25 other emotional or behavioral disorders, 
500 

† HR 1892 EAS2 

1 medically fragile conditions, or develop2 mental disabilities, and placed in settings 

3 that are not foster family homes as a result 

4 of the inappropriate diagnoses; and’’. 

5 (b) EVALUATION.—Section 476 of such Act (42 U.S.C. 

6 676), as amended by section 50711(d), is further amended 

7 by adding at the end the following: 

8 ‘‘(e) EVALUATION OF STATE PROCEDURES AND PRO9 TOCOLS TO PREVENT INAPPROPRIATE DIAGNOSES OF MEN10 TAL ILLNESS OR OTHER CONDITIONS.—The Secretary shall 

11 conduct an evaluation of the procedures and protocols estab12 lished by States in accordance with the requirements of sec13 tion 422(b)(15)(A)(vii). The evaluation shall analyze the ex14 tent to which States comply with and enforce the procedures 

15 and protocols and the effectiveness of various State proce16 dures and protocols and shall identify best practices. Not 

17 later than January 1, 2020, the Secretary shall submit a 

18 report on the results of the evaluation to Congress.’’. 

19 SEC. 50744. ADDITIONAL DATA AND REPORTS REGARDING 

20 CHILDREN PLACED IN A SETTING THAT IS 

21 NOT A FOSTER FAMILY HOME. 

22 Section 479A(a)(7)(A) of the Social Security Act (42 

23 U.S.C. 679b(a)(7)(A)) is amended by striking clauses (i) 

24 through (vi) and inserting the following: 
501 

† HR 1892 EAS2 

1 ‘‘(i) with respect to each such place2 ment— 

3 ‘‘(I) the type of the placement set4 ting, including whether the placement 

5 is shelter care, a group home and if so, 

6 the range of the child population in the 

7 home, a residential treatment facility, 

8 a hospital or institution providing 

9 medical, rehabilitative, or psychiatric 

10 care, a setting specializing in pro11 viding prenatal, post-partum, or par12 enting supports, or some other kind of 

13 child-care institution and if so, what 

14 kind; 

15 ‘‘(II) the number of children in 

16 the placement setting and the age, race, 

17 ethnicity, and gender of each of the 

18 children; 

19 ‘‘(III) for each child in the place20 ment setting, the length of the place21 ment of the child in the setting, wheth22 er the placement of the child in the set23 ting is the first placement of the child 

24 and if not, the number and type of 

25 previous placements of the child, and 
502 

† HR 1892 EAS2 

1 whether the child has special needs or 

2 another diagnosed mental or physical 

3 illness or condition; and 

4 ‘‘(IV) the extent of any specialized 

5 education, treatment, counseling, or 

6 other services provided in the setting; 

7 and 

8 ‘‘(ii) separately, the number and ages 

9 of children in the placements who have a 

10 permanency plan of another planned per11 manent living arrangement; and’’. 

12 SEC. 50745. CRIMINAL RECORDS CHECKS AND CHECKS OF 

13 CHILD ABUSE AND NEGLECT REGISTRIES FOR 

14 ADULTS WORKING IN CHILD-CARE INSTITU15 TIONS AND OTHER GROUP CARE SETTINGS. 

16 (a) STATE PLAN REQUIREMENT.—Section 471(a)(20) 

17 of the Social Security Act (42 U.S.C. 671(a)(20)) is amend18 ed— 

19 (1) in subparagraph (A)(ii), by striking ‘‘and’’ 

20 after the semicolon; 

21 (2) in subparagraph (B)(iii), by striking 

22 ‘‘and’’after the semicolon; 

23 (3) in subparagraph (C), by adding ‘‘and’’ after 

24 the semicolon; and 
503 

† HR 1892 EAS2 

1 (4) by inserting after subparagraph (C), the fol2 lowing new subparagraph: 

3 ‘‘(D) provides procedures for any child-care 

4 institution, including a group home, residential 

5 treatment center, shelter, or other congregate care 

6 setting, to conduct criminal records checks, in7 cluding fingerprint-based checks of national 

8 crime information databases (as defined in sec9 tion 534(f)(3)(A) of title 28, United States 

10 Code), and checks described in subparagraph (B) 

11 of this paragraph, on any adult working in a 

12 child-care institution, including a group home, 

13 residential treatment center, shelter, or other con14 gregate care setting, unless the State reports to 

15 the Secretary the alternative criminal records 

16 checks and child abuse registry checks the State 

17 conducts on any adult working in a child-care 

18 institution, including a group home, residential 

19 treatment center, shelter, or other congregate care 

20 setting, and why the checks specified in this sub21 paragraph are not appropriate for the State;’’. 

22 (b) TECHNICAL AMENDMENTS.—Subparagraphs (A) 

23 and (C) of section 471(a)(20) of the Social Security Act 

24 (42 U.S.C. 671(a)(20)) are each amended by striking ‘‘sec25 tion 534(e)(3)(A)’’ and inserting ‘‘section 534(f)(3)(A)’’. 
504 

† HR 1892 EAS2 

1 SEC. 50746. EFFECTIVE DATES; APPLICATION TO WAIVERS. 

2 (a) EFFECTIVE DATES.— 

3 (1) IN GENERAL.—Subject to paragraph (2) and 

4 subsections (b), (c), and (d), the amendments made by 

5 this part shall take effect as if enacted on January 1, 

6 2018. 

7 (2) TRANSITION RULE.—In the case of a State 

8 plan under part B or E of title IV of the Social Secu9 rity Act which the Secretary of Health and Human 

10 Services determines requires State legislation (other 

11 than legislation appropriating funds) in order for the 

12 plan to meet the additional requirements imposed by 

13 the amendments made by this part, the State plan 

14 shall not be regarded as failing to comply with the re15 quirements of part B or E of title IV of such Act sole16 ly on the basis of the failure of the plan to meet the 

17 additional requirements before the first day of the 

18 first calendar quarter beginning after the close of the 

19 first regular session of the State legislature that be20 gins after the date of enactment of this Act. For pur21 poses of the previous sentence, in the case of a State 

22 that has a 2-year legislative session, each year of the 

23 session shall be deemed to be a separate regular ses24 sion of the State legislature. 
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1 (b) LIMITATION ON FEDERAL FINANCIAL PARTICIPA2 TION FOR PLACEMENTS THAT ARE NOT IN FOSTER FAMILY

3 HOMES AND RELATED PROVISIONS.— 

4 (1) IN GENERAL.—The amendments made by sec5 tions 50741(a), 50741(b), 50741(d), and 50742 shall 

6 take effect on October 1, 2019. 

7 (2) STATE OPTION TO DELAY EFFECTIVE DATE

8 FOR NOT MORE THAN 2 YEARS.—If a State requests 

9 a delay in the effective date, the Secretary of Health 

10 and Human Services shall delay the effective date 

11 provided for in paragraph (1) with respect to the 

12 State for the amount of time requested by the State, 

13 not to exceed 2 years. If the effective date is so delayed 

14 for a period with respect to a State under the pre15 ceding sentence, then— 

16 (A) notwithstanding section 50734, the date 

17 that the amendments made by section 50711(c) 

18 take effect with respect to the State shall be de19 layed for the period; and 

20 (B) in applying section 474(a)(6) of the So21 cial Security Act with respect to the State, ‘‘on 

22 or after the date this paragraph takes effect with 

23 respect to the State’’ is deemed to be substituted 

24 for ‘‘after September 30, 2019’’ in subparagraph 

25 (A)(i)(I) of such section. 
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1 (c) CRIMINAL RECORDS CHECKS AND CHECKS OF

2 CHILD ABUSE AND NEGLECT REGISTRIES FOR ADULTS

3 WORKING IN CHILD-CARE INSTITUTIONS AND OTHER

4 GROUP CARE SETTINGS.—Subject to subsection (a)(2), the 

5 amendments made by section 50745 shall take effect on Oc6 tober 1, 2018. 

7 (d) APPLICATION TO STATES WITH WAIVERS.—In the 

8 case of a State that, on the date of enactment of this Act, 

9 has in effect a waiver approved under section 1130 of the 

10 Social Security Act (42 U.S.C. 1320a–9), the amendments 

11 made by this part shall not apply with respect to the State 

12 before the expiration (determined without regard to any ex13 tensions) of the waiver to the extent the amendments are 

14 inconsistent with the terms of the waiver. 

15 PART V—CONTINUING SUPPORT FOR CHILD AND 

16 FAMILY SERVICES 

17 SEC. 50751. SUPPORTING AND RETAINING FOSTER FAMI18 LIES FOR CHILDREN. 

19 (a) SUPPORTING AND RETAINING FOSTER PARENTS AS

20 A FAMILY SUPPORT SERVICE.—Section 431(a)(2)(B) of the 

21 Social Security Act (42 U.S.C. 631(a)(2)(B)) is amended 

22 by redesignating clauses (iii) through (vi) as clauses (iv) 

23 through (vii), respectively, and inserting after clause (ii) 

24 the following: 
507 

† HR 1892 EAS2 

1 ‘‘(iii) To support and retain foster 

2 families so they can provide quality family3 based settings for children in foster care.’’. 

4 (b) SUPPORT FOR FOSTER FAMILY HOMES.—Section 

5 436 of such Act (42 U.S.C. 629f) is amended by adding 

6 at the end the following: 

7 ‘‘(c) SUPPORT FOR FOSTER FAMILY HOMES.—Out of 

8 any money in the Treasury of the United States not other9 wise appropriated, there are appropriated to the Secretary 

10 for fiscal year 2018, $8,000,000 for the Secretary to make 

11 competitive grants to States, Indian tribes, or tribal con12 sortia to support the recruitment and retention of high13 quality foster families to increase their capacity to place 

14 more children in family settings, focused on States, Indian 

15 tribes, or tribal consortia with the highest percentage of 

16 children in non-family settings. The amount appropriated 

17 under this subparagraph shall remain available through fis18 cal year 2022.’’. 

19 SEC. 50752. EXTENSION OF CHILD AND FAMILY SERVICES 

20 PROGRAMS. 

21 (a) EXTENSION OF STEPHANIE TUBBS JONES CHILD

22 WELFARE SERVICES PROGRAM.—Section 425 of the Social 

23 Security Act (42 U.S.C. 625) is amended by striking ‘‘2012 

24 through 2016’’ and inserting ‘‘2017 through 2021’’. 
508 

† HR 1892 EAS2 

1 (b) EXTENSION OF PROMOTING SAFE AND STABLE

2 FAMILIES PROGRAM AUTHORIZATIONS.— 

3 (1) IN GENERAL.—Section 436(a) of such Act 

4 (42 U.S.C. 629f(a)) is amended by striking all that 

5 follows ‘‘$345,000,000’’ and inserting ‘‘for each of fis6 cal years 2017 through 2021.’’. 

7 (2) DISCRETIONARY GRANTS.—Section 437(a) of 

8 such Act (42 U.S.C. 629g(a)) is amended by striking 

9 ‘‘2012 through 2016’’ and inserting ‘‘2017 through 

10 2021’’. 

11 (c) EXTENSION OF FUNDING RESERVATIONS FOR

12 MONTHLY CASEWORKER VISITS AND REGIONAL PARTNER13 SHIP GRANTS.—Section 436(b) of such Act (42 U.S.C. 

14 629f(b)) is amended— 

15 (1) in paragraph (4)(A), by striking ‘‘2012 

16 through 2016’’ and inserting ‘‘2017 through 2021’’; 

17 and 

18 (2) in paragraph (5), by striking ‘‘2012 through 

19 2016’’ and inserting ‘‘2017 through 2021’’. 

20 (d) REAUTHORIZATION OF FUNDING FOR STATE

21 COURTS.— 

22 (1) EXTENSION OF PROGRAM.—Section 438(c)(1) 

23 of such Act (42 U.S.C. 629h(c)(1)) is amended by 

24 striking ‘‘2012 through 2016’’ and inserting ‘‘2017 

25 through 2021’’. 
509 

† HR 1892 EAS2 

1 (2) EXTENSION OF FEDERAL SHARE.—Section 

2 438(d) of such Act (42 U.S.C. 629h(d)) is amended by 

3 striking ‘‘2012 through 2016’’ and inserting ‘‘2017 

4 through 2021’’. 

5 (e) REPEAL OF EXPIRED PROVISIONS.—Section 438(e) 

6 of such Act (42 U.S.C. 629h(e)) is repealed. 

7 SEC. 50753. IMPROVEMENTS TO THE JOHN H. CHAFEE FOS8 TER CARE INDEPENDENCE PROGRAM AND 

9 RELATED PROVISIONS. 

10 (a) AUTHORITY TO SERVE FORMER FOSTER YOUTH

11 UP TO AGE 23.—Section 477 of the Social Security Act 

12 (42 U.S.C. 677) is amended— 

13 (1) in subsection (a)(5), by inserting ‘‘(or 23 

14 years of age, in the case of a State with a certifi15 cation under subsection (b)(3)(A)(ii) to provide assist16 ance and services to youths who have aged out of fos17 ter care and have not attained such age, in accord18 ance with such subsection)’’ after ‘‘21 years of age’’; 

19 (2) in subsection (b)(3)(A)— 

20 (A) by inserting ‘‘(i)’’ before ‘‘A certifi21 cation’’; 

22 (B) by striking ‘‘children who have left fos23 ter care’’ and all that follows through the period 

24 and inserting ‘‘youths who have aged out of fos-
510 

† HR 1892 EAS2 

1 ter care and have not attained 21 years of age.’’; 

2 and 

3 (C) by adding at the end the following: 

4 ‘‘(ii) If the State has elected under section 

5 475(8)(B) to extend eligibility for foster care to 

6 all children who have not attained 21 years of 

7 age, or if the Secretary determines that the State 

8 agency responsible for administering the State 

9 plans under this part and part B uses State 

10 funds or any other funds not provided under this 

11 part to provide services and assistance for youths 

12 who have aged out of foster care that are com13 parable to the services and assistance the youths 

14 would receive if the State had made such an elec15 tion, the certification required under clause (i) 

16 may provide that the State will provide assist17 ance and services to youths who have aged out 

18 of foster care and have not attained 23 years of 

19 age.’’; and 

20 (3) in subsection (b)(3)(B), by striking ‘‘children 

21 who have left foster care’’ and all that follows through 

22 the period and inserting ‘‘youths who have aged out 

23 of foster care and have not attained 21 years of age 

24 (or 23 years of age, in the case of a State with a cer25 tification under subparagraph (A)(i) to provide as-
511 

† HR 1892 EAS2 

1 sistance and services to youths who have aged out of 

2 foster care and have not attained such age, in accord3 ance with subparagraph (A)(ii)).’’. 

4 (b) AUTHORITY TO REDISTRIBUTE UNSPENT

5 FUNDS.—Section 477(d) of such Act (42 U.S.C. 677(d)) is 

6 amended— 

7 (1) in paragraph (4), by inserting ‘‘or does not 

8 expend allocated funds within the time period speci9 fied under section 477(d)(3)’’ after ‘‘provided by the 

10 Secretary’’; and 

11 (2) by adding at the end the following: 

12 ‘‘(5) REDISTRIBUTION OF UNEXPENDED

13 AMOUNTS.— 

14 ‘‘(A) AVAILABILITY OF AMOUNTS.—To the 

15 extent that amounts paid to States under this 

16 section in a fiscal year remain unexpended by 

17 the States at the end of the succeeding fiscal 

18 year, the Secretary may make the amounts 

19 available for redistribution in the second suc20 ceeding fiscal year among the States that apply 

21 for additional funds under this section for that 

22 second succeeding fiscal year. 

23 ‘‘(B) REDISTRIBUTION.— 

24 ‘‘(i) IN GENERAL.—The Secretary shall 

25 redistribute the amounts made available 
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† HR 1892 EAS2 

1 under subparagraph (A) for a fiscal year 

2 among eligible applicant States. In this 

3 subparagraph, the term ‘eligible applicant 

4 State’ means a State that has applied for 

5 additional funds for the fiscal year under 

6 subparagraph (A) if the Secretary deter7 mines that the State will use the funds for 

8 the purpose for which originally allotted 

9 under this section. 

10 ‘‘(ii) AMOUNT TO BE REDISTRIB11 UTED.—The amount to be redistributed to 

12 each eligible applicant State shall be the 

13 amount so made available multiplied by the 

14 State foster care ratio, (as defined in sub15 section (c)(4), except that, in such sub16 section, ‘all eligible applicant States (as de17 fined in subsection (d)(5)(B)(i))’ shall be 

18 substituted for ‘all States’). 

19 ‘‘(iii) TREATMENT OF REDISTRIBUTED

20 AMOUNT.—Any amount made available to a 

21 State under this paragraph shall be re22 garded as part of the allotment of the State 

23 under this section for the fiscal year in 

24 which the redistribution is made. 
513 

† HR 1892 EAS2 

1 ‘‘(C) TRIBES.—For purposes of this para2 graph, the term ‘State’ includes an Indian tribe, 

3 tribal organization, or tribal consortium that re4 ceives an allotment under this section.’’. 

5 (c) EXPANDING AND CLARIFYING THE USE OF EDU6 CATION AND TRAINING VOUCHERS.— 

7 (1) IN GENERAL.—Section 477(i)(3) of such Act 

8 (42 U.S.C. 677(i)(3)) is amended— 

9 (A) by striking ‘‘on the date’’ and all that 

10 follows through ‘‘23’’ and inserting ‘‘to remain 

11 eligible until they attain 26’’; and 

12 (B) by inserting ‘‘, but in no event may a 

13 youth participate in the program for more than 

14 5 years (whether or not consecutive)’’ before the 

15 period. 

16 (2) CONFORMING AMENDMENT.—Section 

17 477(i)(1) of such Act (42 U.S.C. 677(i)(1)) is amend18 ed by inserting ‘‘who have attained 14 years of age’’ 

19 before the period. 

20 (d) OTHER IMPROVEMENTS.—Section 477 of such Act 

21 (42 U.S.C. 677), as amended by subsections (a), (b), and 

22 (c), is amended— 

23 (1) in the section heading, by striking ‘‘INDE24 PENDENCE PROGRAM’’ and inserting ‘‘PROGRAM
514 

† HR 1892 EAS2 

1 FOR SUCCESSFUL TRANSITION TO ADULT2 HOOD’’; 

3 (2) in subsection (a)— 

4 (A) in paragraph (1)— 

5 (i) by striking ‘‘identify children who 

6 are likely to remain in foster care until 18 

7 years of age and to help these children make 

8 the transition to self-sufficiency by pro9 viding services’’ and inserting ‘‘support all 

10 youth who have experienced foster care at 

11 age 14 or older in their transition to adult12 hood through transitional services’’; 

13 (ii) by inserting ‘‘and post-secondary 

14 education’’ after ‘‘high school diploma’’; and 

15 (iii) by striking ‘‘training in daily liv16 ing skills, training in budgeting and finan17 cial management skills’’ and inserting 

18 ‘‘training and opportunities to practice 

19 daily living skills (such as financial lit20 eracy training and driving instruction)’’; 

21 (B) in paragraph (2), by striking ‘‘who are 

22 likely to remain in foster care until 18 years of 

23 age receive the education, training, and services 

24 necessary to obtain employment’’ and inserting 

25 ‘‘who have experienced foster care at age 14 or 
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† HR 1892 EAS2 

1 older achieve meaningful, permanent connections 

2 with a caring adult’’; 

3 (C) in paragraph (3), by striking ‘‘who are 

4 likely to remain in foster care until 18 years of 

5 age prepare for and enter postsecondary training 

6 and education institutions’’ and inserting ‘‘who 

7 have experienced foster care at age 14 or older 

8 engage in age or developmentally appropriate 

9 activities, positive youth development, and expe10 riential learning that reflects what their peers in 

11 intact families experience’’; and 

12 (D) by striking paragraph (4) and redesig13 nating paragraphs (5) through (8) as para14 graphs (4) through (7); 

15 (3) in subsection (b)— 

16 (A) in paragraph (2)(D), by striking ‘‘ado17 lescents’’ and inserting ‘‘youth’’; and 

18 (B) in paragraph (3)— 

19 (i) in subparagraph (D)— 

20 (I) by inserting ‘‘including train21 ing on youth development’’ after ‘‘to 

22 provide training’’; and 

23 (II) by striking ‘‘adolescents pre24 paring for independent living’’ and all 

25 that follows through the period and in-
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† HR 1892 EAS2 

1 serting ‘‘youth preparing for a success2 ful transition to adulthood and making 

3 a permanent connection with a caring 

4 adult.’’; 

5 (ii) in subparagraph (H), by striking 

6 ‘‘adolescents’’ each place it appears and in7 serting ‘‘youth’’; and 

8 (iii) in subparagraph (K)— 

9 (I) by striking ‘‘an adolescent’’ 

10 and inserting ‘‘a youth’’; and 

11 (II) by striking ‘‘the adolescent’’ 

12 each place it appears and inserting 

13 ‘‘the youth’’; and 

14 (4) in subsection (f), by striking paragraph (2) 

15 and inserting the following: 

16 ‘‘(2) REPORT TO CONGRESS.—Not later than Oc17 tober 1, 2019, the Secretary shall submit to the Com18 mittee on Ways and Means of the House of Represent19 atives and the Committee on Finance of the Senate a 

20 report on the National Youth in Transition Database 

21 and any other databases in which States report out22 come measures relating to children in foster care and 

23 children who have aged out of foster care or left foster 

24 care for kinship guardianship or adoption. The report 

25 shall include the following: 
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1 ‘‘(A) A description of the reasons for entry 

2 into foster care and of the foster care experiences, 

3 such as length of stay, number of placement set4 tings, case goal, and discharge reason of 17-year5 olds who are surveyed by the National Youth in 

6 Transition Database and an analysis of the com7 parison of that description with the reasons for 

8 entry and foster care experiences of children of 

9 other ages who exit from foster care before at10 taining age 17. 

11 ‘‘(B) A description of the characteristics of 

12 the individuals who report poor outcomes at ages 

13 19 and 21 to the National Youth in Transition 

14 Database. 

15 ‘‘(C) Benchmarks for determining what con16 stitutes a poor outcome for youth who remain in 

17 or have exited from foster care and plans the ex18 ecutive branch will take to incorporate these 

19 benchmarks in efforts to evaluate child welfare 

20 agency performance in providing services to chil21 dren transitioning from foster care. 

22 ‘‘(D) An analysis of the association between 

23 types of placement, number of overall place24 ments, time spent in foster care, and other fac25 tors, and outcomes at ages 19 and 21. 
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1 ‘‘(E) An analysis of the differences in out2 comes for children in and formerly in foster care 

3 at age 19 and 21 among States.’’. 

4 (e) CLARIFYING DOCUMENTATION PROVIDED TO FOS5 TER YOUTH LEAVING FOSTER CARE.—Section 475(5)(I) of 

6 such Act (42 U.S.C. 675(5)(I)) is amended by inserting 

7 after ‘‘REAL ID Act of 2005’’ the following: ‘‘, and any 

8 official documentation necessary to prove that the child was 

9 previously in foster care’’. 

10 PART VI—CONTINUING INCENTIVES TO STATES 

11 TO PROMOTE ADOPTION AND LEGAL GUARD12 IANSHIP 

13 SEC. 50761. REAUTHORIZING ADOPTION AND LEGAL 

14 GUARDIANSHIP INCENTIVE PROGRAMS. 

15 (a) IN GENERAL.—Section 473A of the Social Security 

16 Act (42 U.S.C. 673b) is amended— 

17 (1) in subsection (b)(4), by striking ‘‘2013 

18 through 2015’’ and inserting ‘‘2016 through 2020’’; 

19 (2) in subsection (h)(1)(D), by striking ‘‘2016’’ 

20 and inserting ‘‘2021’’; and 

21 (3) in subsection (h)(2), by striking ‘‘2016’’ and 

22 inserting ‘‘2021’’. 

23 (b) EFFECTIVE DATE.—The amendments made by sub24 section (a) shall take effect as if enacted on October 1, 2017. 
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1 PART VII—TECHNICAL CORRECTIONS 

2 SEC. 50771. TECHNICAL CORRECTIONS TO DATA EXCHANGE 

3 STANDARDS TO IMPROVE PROGRAM COORDI4 NATION. 

5 (a) IN GENERAL.—Section 440 of the Social Security 

6 Act (42 U.S.C. 629m) is amended to read as follows: 

7 ‘‘SEC. 440. DATA EXCHANGE STANDARDS FOR IMPROVED 

8 INTEROPERABILITY. 

9 ‘‘(a) DESIGNATION.—The Secretary shall, in consulta10 tion with an interagency work group established by the Of11 fice of Management and Budget and considering State gov12 ernment perspectives, by rule, designate data exchange 

13 standards to govern, under this part and part E— 

14 ‘‘(1) necessary categories of information that 

15 State agencies operating programs under State plans 

16 approved under this part are required under applica17 ble Federal law to electronically exchange with an18 other State agency; and 

19 ‘‘(2) Federal reporting and data exchange re20 quired under applicable Federal law. 

21 ‘‘(b) REQUIREMENTS.—The data exchange standards 

22 required by paragraph (1) shall, to the extent practicable— 

23 ‘‘(1) incorporate a widely accepted, non-propri24 etary, searchable, computer-readable format, such as 

25 the Extensible Markup Language; 
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1 ‘‘(2) contain interoperable standards developed 

2 and maintained by intergovernmental partnerships, 

3 such as the National Information Exchange Model; 

4 ‘‘(3) incorporate interoperable standards devel5 oped and maintained by Federal entities with author6 ity over contracting and financial assistance; 

7 ‘‘(4) be consistent with and implement applica8 ble accounting principles; 

9 ‘‘(5) be implemented in a manner that is cost10 effective and improves program efficiency and effec11 tiveness; and 

12 ‘‘(6) be capable of being continually upgraded as 

13 necessary. 

14 ‘‘(c) RULE OF CONSTRUCTION.—Nothing in this sub15 section shall be construed to require a change to existing 

16 data exchange standards found to be effective and effi17 cient.’’. 

18 (b) EFFECTIVE DATE.—Not later than the date that 

19 is 24 months after the date of the enactment of this section, 

20 the Secretary of Health and Human Services shall issue 

21 a proposed rule that— 

22 (1) identifies federally required data exchanges, 

23 include specification and timing of exchanges to be 

24 standardized, and address the factors used in deter-
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1 mining whether and when to standardize data ex2 changes; and 

3 (2) specifies State implementation options and 

4 describes future milestones. 

5 SEC. 50772. TECHNICAL CORRECTIONS TO STATE REQUIRE6 MENT TO ADDRESS THE DEVELOPMENTAL 

7 NEEDS OF YOUNG CHILDREN. 

8 Section 422(b)(18) of the Social Security Act (42 

9 U.S.C. 622(b)(18)) is amended by striking ‘‘such children’’ 

10 and inserting ‘‘all vulnerable children under 5 years of 

11 age’’. 

12 PART VIII—ENSURING STATES REINVEST SAV13 INGS RESULTING FROM INCREASE IN ADOP14 TION ASSISTANCE 

15 SEC. 50781. DELAY OF ADOPTION ASSISTANCE PHASE-IN. 

16 (a) IN GENERAL.—The table in section 473(e)(1)(B) 

17 of the Social Security Act (42 U.S.C. 673(e)(1)(B)) is 

18 amended by striking the last 2 rows and inserting the fol19 lowing: 

‘‘2017 through 2023 ................................. 2 

2024 .......................................................... 2 (or, in the case of a child for whom 

an adoption assistance agreement is 

entered into under this section on or 

after July 1, 2024, any age) 

2025 or thereafter .................................... any age.’’. 

20 (b) EFFECTIVE DATE.—The amendment made by this 

21 section shall take effect as if enacted on January 1, 2018. 
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1 SEC. 50782. GAO STUDY AND REPORT ON STATE REINVEST2 MENT OF SAVINGS RESULTING FROM IN3 CREASE IN ADOPTION ASSISTANCE. 

4 (a) STUDY.—The Comptroller General of the United 

5 States shall study the extent to which States are complying 

6 with the requirements of section 473(a)(8) of the Social Se7 curity Act (42 U.S.C. 673(a)(8)) relating to the effects of 

8 phasing out the AFDC income eligibility requirements for 

9 adoption assistance payments under section 473 of the So10 cial Security Act, as enacted by section 402 of the Fostering 

11 Connections to Success and Increasing Adoptions Act of 

12 2008 (Public Law 110–351; 122 Stat. 3975) and amended 

13 by section 206 of the Preventing Sex Trafficking and 

14 Strengthening Families Act (Public Law 113–183; 128 

15 Stat. 1919). In particular, the Comptroller General shall 

16 analyze the extent to which States are complying with the 

17 following requirements under section 473(a)(8)(D) of the 

18 Social Security Act: 

19 (1) The requirement to spend an amount equal 

20 to the amount of the savings (if any) in State expend21 itures under part E of title IV of the Social Security 

22 Act resulting from phasing out the AFDC income eli23 gibility requirements for adoption assistance pay24 ments under section 473 of such Act to provide to 

25 children of families any service that may be provided 

26 under part B or E of title IV of such Act. 
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1 (2) The requirement that a State shall spend not 

2 less than 30 percent of the amount of any savings de3 scribed in paragraph (1) on post-adoption services, 

4 post-guardianship services, and services to support 

5 and sustain positive permanent outcomes for children 

6 who otherwise might enter into foster care under the 

responsibility of the State, with at least 2 7 ⁄3 of the 

8 spending by the State to comply with the 30 percent 

9 requirement being spent on post-adoption and post10 guardianship services. 

11 (b) REPORT.—The Comptroller General of the United 

12 States shall submit to the Committee on Finance of the Sen13 ate, the Committee on Ways and Means of the House of 

14 Representatives, and the Secretary of Health and Human 

15 Services a report that contains the results of the study re16 quired by subsection (a), including recommendations to en17 sure compliance with laws referred to in subsection (a). 

18 TITLE VIII—SUPPORTING SO19 CIAL IMPACT PARTNERSHIPS 

20 TO PAY FOR RESULTS 

21 SEC. 50801. SHORT TITLE. 

22 This subtitle may be cited as the ‘‘Social Impact Part23 nerships to Pay for Results Act’’. 
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1 SEC. 50802. SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RE2 SULTS. 

3 Title XX of the Social Security Act (42 U.S.C. 1397 

4 et seq.) is amended— 

5 (1) in the title heading, by striking ‘‘TO 

6 STATES’’ and inserting ‘‘AND PROGRAMS’’; and 

7 (2) by adding at the end the following: 

8 ‘‘Subtitle C—Social Impact Demonstration Projects 

9 ‘‘PURPOSES

10 ‘‘SEC. 2051. The purposes of this subtitle are the fol11 lowing: 

12 ‘‘(1) To improve the lives of families and indi13 viduals in need in the United States by funding so14 cial programs that achieve real results. 

15 ‘‘(2) To redirect funds away from programs that, 

16 based on objective data, are ineffective, and into pro17 grams that achieve demonstrable, measurable results. 

18 ‘‘(3) To ensure Federal funds are used effectively 

19 on social services to produce positive outcomes for 

20 both service recipients and taxpayers. 

21 ‘‘(4) To establish the use of social impact part22 nerships to address some of our Nation’s most press23 ing problems. 

24 ‘‘(5) To facilitate the creation of public-private 

25 partnerships that bundle philanthropic or other pri26 vate resources with existing public spending to scale 
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1 up effective social interventions already being imple2 mented by private organizations, nonprofits, chari3 table organizations, and State and local governments 

4 across the country. 

5 ‘‘(6) To bring pay-for-performance to the social 

6 sector, allowing the United States to improve the im7 pact and effectiveness of vital social services programs 

8 while redirecting inefficient or duplicative spending. 

9 ‘‘(7) To incorporate outcomes measurement and 

10 randomized controlled trials or other rigorous meth11 odologies for assessing program impact. 

12 ‘‘SOCIAL IMPACT PARTNERSHIP APPLICATION

13 ‘‘SEC. 2052. (a) NOTICE.—Not later than 1 year after 

14 the date of the enactment of this subtitle, the Secretary of 

15 the Treasury, in consultation with the Federal Interagency 

16 Council on Social Impact Partnerships, shall publish in the 

17 Federal Register a request for proposals from States or local 

18 governments for social impact partnership projects in ac19 cordance with this section. 

20 ‘‘(b) REQUIRED OUTCOMES FOR SOCIAL IMPACT PART21 NERSHIP PROJECT.—To qualify as a social impact partner22 ship project under this subtitle, a project must produce one 

23 or more measurable, clearly defined outcomes that result in 

24 social benefit and Federal, State, or local savings through 

25 any of the following: 
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1 ‘‘(1) Increasing work and earnings by individ2 uals in the United States who are unemployed for 

3 more than 6 consecutive months. 

4 ‘‘(2) Increasing employment and earnings of in5 dividuals who have attained 16 years of age but not 

6 25 years of age. 

7 ‘‘(3) Increasing employment among individuals 

8 receiving Federal disability benefits. 

9 ‘‘(4) Reducing the dependence of low-income 

10 families on Federal means-tested benefits. 

11 ‘‘(5) Improving rates of high school graduation. 

12 ‘‘(6) Reducing teen and unplanned pregnancies. 

13 ‘‘(7) Improving birth outcomes and early child14 hood health and development among low-income fami15 lies and individuals. 

16 ‘‘(8) Reducing rates of asthma, diabetes, or other 

17 preventable diseases among low-income families and 

18 individuals to reduce the utilization of emergency and 

19 other high-cost care. 

20 ‘‘(9) Increasing the proportion of children living 

21 in two-parent families. 

22 ‘‘(10) Reducing incidences and adverse con23 sequences of child abuse and neglect. 

24 ‘‘(11) Reducing the number of youth in foster 

25 care by increasing adoptions, permanent guardian-
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† HR 1892 EAS2 

1 ship arrangements, reunifications, or placements with 

2 a fit and willing relative, or by avoiding placing chil3 dren in foster care by ensuring they can be cared for 

4 safely in their own homes. 

5 ‘‘(12) Reducing the number of children and 

6 youth in foster care residing in group homes, child 

7 care institutions, agency-operated foster homes, or 

8 other non-family foster homes, unless it is determined 

9 that it is in the interest of the child’s long-term 

10 health, safety, or psychological well-being to not be 

11 placed in a family foster home. 

12 ‘‘(13) Reducing the number of children returning 

13 to foster care. 

14 ‘‘(14) Reducing recidivism among juvenile of15 fenders, individuals released from prison, or other 

16 high-risk populations. 

17 ‘‘(15) Reducing the rate of homelessness among 

18 our most vulnerable populations. 

19 ‘‘(16) Improving the health and well-being of 

20 those with mental, emotional, and behavioral health 

21 needs. 

22 ‘‘(17) Improving the educational outcomes of spe23 cial-needs or low-income children. 

24 ‘‘(18) Improving the employment and well-being 

25 of returning United States military members. 
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1 ‘‘(19) Increasing the financial stability of low2 income families. 

3 ‘‘(20) Increasing the independence and employ4 ability of individuals who are physically or mentally 

5 disabled. 

6 ‘‘(21) Other measurable outcomes defined by the 

7 State or local government that result in positive so8 cial outcomes and Federal savings. 

9 ‘‘(c) APPLICATION REQUIRED.—The notice described 

10 in subsection (a) shall require a State or local government 

11 to submit an application for the social impact partnership 

12 project that addresses the following: 

13 ‘‘(1) The outcome goals of the project. 

14 ‘‘(2) A description of each intervention in the 

15 project and anticipated outcomes of the intervention. 

16 ‘‘(3) Rigorous evidence demonstrating that the 

17 intervention can be expected to produce the desired 

18 outcomes. 

19 ‘‘(4) The target population that will be served by 

20 the project. 

21 ‘‘(5) The expected social benefits to participants 

22 who receive the intervention and others who may be 

23 impacted. 

24 ‘‘(6) Projected Federal, State, and local govern25 ment costs and other costs to conduct the project. 
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1 ‘‘(7) Projected Federal, State, and local govern2 ment savings and other savings, including an esti3 mate of the savings to the Federal Government, on a 

4 program-by-program basis and in the aggregate, if 

5 the project is implemented and the outcomes are 

6 achieved as a result of the intervention. 

7 ‘‘(8) If savings resulting from the successful com8 pletion of the project are estimated to accrue to the 

9 State or local government, the likelihood of the State 

10 or local government to realize those savings. 

11 ‘‘(9) A plan for delivering the intervention 

12 through a social impact partnership model. 

13 ‘‘(10) A description of the expertise of each serv14 ice provider that will administer the intervention, in15 cluding a summary of the experience of the service 

16 provider in delivering the proposed intervention or a 

17 similar intervention, or demonstrating that the serv18 ice provider has the expertise necessary to deliver the 

19 proposed intervention. 

20 ‘‘(11) An explanation of the experience of the 

21 State or local government, the intermediary, or the 

22 service provider in raising private and philanthropic 

23 capital to fund social service investments. 

24 ‘‘(12) The detailed roles and responsibilities of 

25 each entity involved in the project, including any 
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† HR 1892 EAS2 

1 State or local government entity, intermediary, serv2 ice provider, independent evaluator, investor, or other 

3 stakeholder. 

4 ‘‘(13) A summary of the experience of the service 

5 provider in delivering the proposed intervention or a 

6 similar intervention, or a summary demonstrating 

7 the service provider has the expertise necessary to de8 liver the proposed intervention. 

9 ‘‘(14) A summary of the unmet need in the area 

10 where the intervention will be delivered or among the 

11 target population who will receive the intervention. 

12 ‘‘(15) The proposed payment terms, the method13 ology used to calculate outcome payments, the pay14 ment schedule, and performance thresholds. 

15 ‘‘(16) The project budget. 

16 ‘‘(17) The project timeline. 

17 ‘‘(18) The criteria used to determine the eligi18 bility of an individual for the project, including how 

19 selected populations will be identified, how they will 

20 be referred to the project, and how they will be en21 rolled in the project. 

22 ‘‘(19) The evaluation design. 

23 ‘‘(20) The metrics that will be used in the eval24 uation to determine whether the outcomes have been 
531 

† HR 1892 EAS2 

1 achieved as a result of the intervention and how the 

2 metrics will be measured. 

3 ‘‘(21) An explanation of how the metrics used in 

4 the evaluation to determine whether the outcomes 

5 achieved as a result of the intervention are inde6 pendent, objective indicators of impact and are not 

7 subject to manipulation by the service provider, inter8 mediary, or investor. 

9 ‘‘(22) A summary explaining the independence of 

10 the evaluator from the other entities involved in the 

11 project and the evaluator’s experience in conducting 

12 rigorous evaluations of program effectiveness includ13 ing, where available, well-implemented randomized 

14 controlled trials on the intervention or similar inter15 ventions. 

16 ‘‘(23) The capacity of the service provider to de17 liver the intervention to the number of participants 

18 the State or local government proposes to serve in the 

19 project. 

20 ‘‘(24) A description of whether and how the State 

21 or local government and service providers plan to sus22 tain the intervention, if it is timely and appropriate 

23 to do so, to ensure that successful interventions con24 tinue to operate after the period of the social impact 

25 partnership. 
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1 ‘‘(d) PROJECT INTERMEDIARY INFORMATION RE2 QUIRED.—The application described in subsection (c) shall 

3 also contain the following information about any inter4 mediary for the social impact partnership project (whether 

5 an intermediary is a service provider or other entity): 

6 ‘‘(1) Experience and capacity for providing or 

7 facilitating the provision of the type of intervention 

8 proposed. 

9 ‘‘(2) The mission and goals. 

10 ‘‘(3) Information on whether the intermediary is 

11 already working with service providers that provide 

12 this intervention or an explanation of the capacity of 

13 the intermediary to begin working with service pro14 viders to provide the intervention. 

15 ‘‘(4) Experience working in a collaborative envi16 ronment across government and nongovernmental en17 tities. 

18 ‘‘(5) Previous experience collaborating with pub19 lic or private entities to implement evidence-based 

20 programs. 

21 ‘‘(6) Ability to raise or provide funding to cover 

22 operating costs (if applicable to the project). 

23 ‘‘(7) Capacity and infrastructure to track out24 comes and measure results, including— 
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1 ‘‘(A) capacity to track and analyze program 

2 performance and assess program impact; and 

3 ‘‘(B) experience with performance-based 

4 awards or performance-based contracting and 

5 achieving project milestones and targets. 

6 ‘‘(8) Role in delivering the intervention. 

7 ‘‘(9) How the intermediary would monitor pro8 gram success, including a description of the interim 

9 benchmarks and outcome measures. 

10 ‘‘(e) FEASIBILITY STUDIES FUNDED THROUGH OTHER

11 SOURCES.—The notice described in subsection (a) shall per12 mit a State or local government to submit an application 

13 for social impact partnership funding that contains infor14 mation from a feasibility study developed for purposes other 

15 than applying for funding under this subtitle. 

16 ‘‘AWARDING SOCIAL IMPACT PARTNERSHIP AGREEMENTS

17 ‘‘SEC. 2053. (a) TIMELINE IN AWARDING AGREE18 MENT.—Not later than 6 months after receiving an applica19 tion in accordance with section 2052, the Secretary, in con20 sultation with the Federal Interagency Council on Social 

21 Impact Partnerships, shall determine whether to enter into 

22 an agreement for a social impact partnership project with 

23 a State or local government. 

24 ‘‘(b) CONSIDERATIONS IN AWARDING AGREEMENT.— 

25 In determining whether to enter into an agreement for a 

26 social impact partnership project (the application for which 
534 

† HR 1892 EAS2 

1 was submitted under section 2052) the Secretary, in con2 sultation with the Federal Interagency Council on Social 

3 Impact Partnerships and the head of any Federal agency 

4 administering a similar intervention or serving a popu5 lation similar to that served by the project, shall consider 

6 each of the following: 

7 ‘‘(1) The recommendations made by the Commis8 sion on Social Impact Partnerships. 

9 ‘‘(2) The value to the Federal Government of the 

10 outcomes expected to be achieved if the outcomes speci11 fied in the agreement are achieved as a result of the 

12 intervention. 

13 ‘‘(3) The likelihood, based on evidence provided 

14 in the application and other evidence, that the State 

15 or local government in collaboration with the inter16 mediary and the service providers will achieve the 

17 outcomes. 

18 ‘‘(4) The savings to the Federal Government if 

19 the outcomes specified in the agreement are achieved 

20 as a result of the intervention. 

21 ‘‘(5) The savings to the State and local govern22 ments if the outcomes specified in the agreement are 

23 achieved as a result of the intervention. 

24 ‘‘(6) The expected quality of the evaluation that 

25 would be conducted with respect to the agreement. 
535 

† HR 1892 EAS2 

1 ‘‘(7) The capacity and commitment of the State 

2 or local government to sustain the intervention, if ap3 propriate and timely and if the intervention is suc4 cessful, beyond the period of the social impact part5 nership. 

6 ‘‘(c) AGREEMENT AUTHORITY.— 

7 ‘‘(1) AGREEMENT REQUIREMENTS.—In accord8 ance with this section, the Secretary, in consultation 

9 with the Federal Interagency Council on Social Im10 pact Partnerships and the head of any Federal agen11 cy administering a similar intervention or serving a 

12 population similar to that served by the project, may 

13 enter into an agreement for a social impact partner14 ship project with a State or local government if the 

15 Secretary, in consultation with the Federal Inter16 agency Council on Social Impact Partnerships, deter17 mines that each of the following requirements are met: 

18 ‘‘(A) The State or local government agrees 

19 to achieve one or more outcomes as a result of 

20 the intervention, as specified in the agreement 

21 and validated by independent evaluation, in 

22 order to receive payment. 

23 ‘‘(B) The Federal payment to the State or 

24 local government for each specified outcome 

25 achieved as a result of the intervention is less 
536 

† HR 1892 EAS2 

1 than or equal to the value of the outcome to the 

2 Federal Government over a period not to exceed 

3 10 years, as determined by the Secretary, in con4 sultation with the State or local government. 

5 ‘‘(C) The duration of the project does not 

6 exceed 10 years. 

7 ‘‘(D) The State or local government has 

8 demonstrated, through the application submitted 

9 under section 2052, that, based on prior rigorous 

10 experimental evaluations or rigorous quasi-ex11 perimental studies, the intervention can be ex12 pected to achieve each outcome specified in the 

13 agreement. 

14 ‘‘(E) The State, local government, inter15 mediary, or service provider has experience rais16 ing private or philanthropic capital to fund so17 cial service investments (if applicable to the 

18 project). 

19 ‘‘(F) The State or local government has 

20 shown that each service provider has experience 

21 delivering the intervention, a similar interven22 tion, or has otherwise demonstrated the expertise 

23 necessary to deliver the intervention. 

24 ‘‘(2) PAYMENT.—The Secretary shall pay the 

25 State or local government only if the independent 
537 

† HR 1892 EAS2 

1 evaluator described in section 2055 determines that 

2 the social impact partnership project has met the re3 quirements specified in the agreement and achieved 

4 an outcome as a result of the intervention, as speci5 fied in the agreement and validated by independent 

6 evaluation. 

7 ‘‘(d) NOTICE OF AGREEMENT AWARD.—Not later than 

8 30 days after entering into an agreement under this section 

9 the Secretary shall publish a notice in the Federal Register 

10 that includes, with regard to the agreement, the following: 

11 ‘‘(1) The outcome goals of the social impact part12 nership project. 

13 ‘‘(2) A description of each intervention in the 

14 project. 

15 ‘‘(3) The target population that will be served by 

16 the project. 

17 ‘‘(4) The expected social benefits to participants 

18 who receive the intervention and others who may be 

19 impacted. 

20 ‘‘(5) The detailed roles, responsibilities, and pur21 poses of each Federal, State, or local government enti22 ty, intermediary, service provider, independent eval23 uator, investor, or other stakeholder. 
538 

† HR 1892 EAS2 

1 ‘‘(6) The payment terms, the methodology used to 

2 calculate outcome payments, the payment schedule, 

3 and performance thresholds. 

4 ‘‘(7) The project budget. 

5 ‘‘(8) The project timeline. 

6 ‘‘(9) The project eligibility criteria. 

7 ‘‘(10) The evaluation design. 

8 ‘‘(11) The metrics that will be used in the eval9 uation to determine whether the outcomes have been 

10 achieved as a result of each intervention and how 

11 these metrics will be measured. 

12 ‘‘(12) The estimate of the savings to the Federal, 

13 State, and local government, on a program-by-pro14 gram basis and in the aggregate, if the agreement is 

15 entered into and implemented and the outcomes are 

16 achieved as a result of each intervention. 

17 ‘‘(e) AUTHORITY TO TRANSFER ADMINISTRATION OF

18 AGREEMENT.—The Secretary may transfer to the head of 

19 another Federal agency the authority to administer (includ20 ing making payments under) an agreement entered into 

21 under subsection (c), and any funds necessary to do so. 

22 ‘‘(f) REQUIREMENT ON FUNDING USED TO BENEFIT

23 CHILDREN.—Not less than 50 percent of all Federal pay24 ments made to carry out agreements under this section shall 

25 be used for initiatives that directly benefit children. 
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1 ‘‘FEASIBILITY STUDY FUNDING

2 ‘‘SEC. 2054. (a) REQUESTS FOR FUNDING FOR FEASI3 BILITY STUDIES.—The Secretary shall reserve a portion of 

4 the amount made available to carry out this subtitle to as5 sist States or local governments in developing feasibility 

6 studies to apply for social impact partnership funding 

7 under section 2052. To be eligible to receive funding to as8 sist with completing a feasibility study, a State or local 

9 government shall submit an application for feasibility 

10 study funding addressing the following: 

11 ‘‘(1) A description of the outcome goals of the so12 cial impact partnership project. 

13 ‘‘(2) A description of the intervention, including 

14 anticipated program design, target population, an es15 timate regarding the number of individuals to be 

16 served, and setting for the intervention. 

17 ‘‘(3) Evidence to support the likelihood that the 

18 intervention will produce the desired outcomes. 

19 ‘‘(4) A description of the potential metrics to be 

20 used. 

21 ‘‘(5) The expected social benefits to participants 

22 who receive the intervention and others who may be 

23 impacted. 

24 ‘‘(6) Estimated costs to conduct the project. 
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† HR 1892 EAS2 

1 ‘‘(7) Estimates of Federal, State, and local gov2 ernment savings and other savings if the project is 

3 implemented and the outcomes are achieved as a re4 sult of each intervention. 

5 ‘‘(8) An estimated timeline for implementation 

6 and completion of the project, which shall not exceed 

7 10 years. 

8 ‘‘(9) With respect to a project for which the State 

9 or local government selects an intermediary to operate 

10 the project, any partnerships needed to successfully 

11 execute the project and the ability of the intermediary 

12 to foster the partnerships. 

13 ‘‘(10) The expected resources needed to complete 

14 the feasibility study for the State or local government 

15 to apply for social impact partnership funding under 

16 section 2052. 

17 ‘‘(b) FEDERAL SELECTION OF APPLICATIONS FOR FEA18 SIBILITY STUDY.—Not later than 6 months after receiving 

19 an application for feasibility study funding under sub20 section (a), the Secretary, in consultation with the Federal 

21 Interagency Council on Social Impact Partnerships and the 

22 head of any Federal agency administering a similar inter23 vention or serving a population similar to that served by 

24 the project, shall select State or local government feasibility 

25 study proposals for funding based on the following: 
541 

† HR 1892 EAS2 

1 ‘‘(1) The recommendations made by the Commis2 sion on Social Impact Partnerships. 

3 ‘‘(2) The likelihood that the proposal will achieve 

4 the desired outcomes. 

5 ‘‘(3) The value of the outcomes expected to be 

6 achieved as a result of each intervention. 

7 ‘‘(4) The potential savings to the Federal Gov8 ernment if the social impact partnership project is 

9 successful. 

10 ‘‘(5) The potential savings to the State and local 

11 governments if the project is successful. 

12 ‘‘(c) PUBLIC DISCLOSURE.—Not later than 30 days 

13 after selecting a State or local government for feasibility 

14 study funding under this section, the Secretary shall cause 

15 to be published on the website of the Federal Interagency 

16 Council on Social Impact Partnerships information ex17 plaining why a State or local government was granted fea18 sibility study funding. 

19 ‘‘(d) FUNDING RESTRICTION.— 

20 ‘‘(1) FEASIBILITY STUDY RESTRICTION.—The 

21 Secretary may not provide feasibility study funding 

22 under this section for more than 50 percent of the es23 timated total cost of the feasibility study reported in 

24 the State or local government application submitted 

25 under subsection (a). 
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1 ‘‘(2) AGGREGATE RESTRICTION.—Of the total 

2 amount made available to carry out this subtitle, the 

3 Secretary may not use more than $10,000,000 to pro4 vide feasibility study funding to States or local gov5 ernments under this section. 

6 ‘‘(3) NO GUARANTEE OF FUNDING.—The Sec7 retary shall have the option to award no funding 

8 under this section. 

9 ‘‘(e) SUBMISSION OF FEASIBILITY STUDY RE10 QUIRED.—Not later than 9 months after the receipt of feasi11 bility study funding under this section, a State or local gov12 ernment receiving the funding shall complete the feasibility 

13 study and submit the study to the Federal Interagency 

14 Council on Social Impact Partnerships. 

15 ‘‘(f) DELEGATION OF AUTHORITY.—The Secretary 

16 may transfer to the head of another Federal agency the au17 thorities provided in this section and any funds necessary 

18 to exercise the authorities. 

19 ‘‘EVALUATIONS

20 ‘‘SEC. 2055. (a) AUTHORITY TO ENTER INTO AGREE21 MENTS.—For each State or local government awarded a so22 cial impact partnership project approved by the Secretary 

23 under this subtitle, the head of the relevant agency, as rec24 ommended by the Federal Interagency Council on Social 

25 Impact Partnerships and determined by the Secretary, shall 

26 enter into an agreement with the State or local government 
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1 to pay for all or part of the independent evaluation to deter2 mine whether the State or local government project has 

3 achieved a specific outcome as a result of the intervention 

4 in order for the State or local government to receive outcome 

5 payments under this subtitle. 

6 ‘‘(b) EVALUATOR QUALIFICATIONS.—The head of the 

7 relevant agency may not enter into an agreement with a 

8 State or local government unless the head determines that 

9 the evaluator is independent of the other parties to the 

10 agreement and has demonstrated substantial experience in 

11 conducting rigorous evaluations of program effectiveness in12 cluding, where available and appropriate, well-imple13 mented randomized controlled trials on the intervention or 

14 similar interventions. 

15 ‘‘(c) METHODOLOGIES TO BE USED.—The evaluation 

16 used to determine whether a State or local government will 

17 receive outcome payments under this subtitle shall use ex18 perimental designs using random assignment or other reli19 able, evidence-based research methodologies, as certified by 

20 the Federal Interagency Council on Social Impact Partner21 ships, that allow for the strongest possible causal inferences 

22 when random assignment is not feasible. 

23 ‘‘(d) PROGRESS REPORT.— 

24 ‘‘(1) SUBMISSION OF REPORT.—The independent 

25 evaluator shall— 
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1 ‘‘(A) not later than 2 years after a project 

2 has been approved by the Secretary and bian3 nually thereafter until the project is concluded, 

4 submit to the head of the relevant agency and the 

5 Federal Interagency Council on Social Impact 

6 Partnerships a written report summarizing the 

7 progress that has been made in achieving each 

8 outcome specified in the agreement; and 

9 ‘‘(B) before the scheduled time of the first 

10 outcome payment and before the scheduled time 

11 of each subsequent payment, submit to the head 

12 of the relevant agency and the Federal Inter13 agency Council on Social Impact Partnerships a 

14 written report that includes the results of the 

15 evaluation conducted to determine whether an 

16 outcome payment should be made along with in17 formation on the unique factors that contributed 

18 to achieving or failing to achieve the outcome, 

19 the challenges faced in attempting to achieve the 

20 outcome, and information on the improved fu21 ture delivery of this or similar interventions. 

22 ‘‘(2) SUBMISSION TO THE SECRETARY AND CON23 GRESS.—Not later than 30 days after receipt of the 

24 written report pursuant to paragraph (1)(B), the 

25 Federal Interagency Council on Social Impact Part-
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1 nerships shall submit the report to the Secretary and 

2 each committee of jurisdiction in the House of Rep3 resentatives and the Senate. 

4 ‘‘(e) FINAL REPORT.— 

5 ‘‘(1) SUBMISSION OF REPORT.—Within 6 months 

6 after the social impact partnership project is com7 pleted, the independent evaluator shall— 

8 ‘‘(A) evaluate the effects of the activities un9 dertaken pursuant to the agreement with regard 

10 to each outcome specified in the agreement; and 

11 ‘‘(B) submit to the head of the relevant 

12 agency and the Federal Interagency Council on 

13 Social Impact Partnerships a written report that 

14 includes the results of the evaluation and the 

15 conclusion of the evaluator as to whether the 

16 State or local government has fulfilled each obli17 gation of the agreement, along with information 

18 on the unique factors that contributed to the suc19 cess or failure of the project, the challenges faced 

20 in attempting to achieve the outcome, and infor21 mation on the improved future delivery of this or 

22 similar interventions. 

23 ‘‘(2) SUBMISSION TO THE SECRETARY AND CON24 GRESS.—Not later than 30 days after receipt of the 

25 written report pursuant to paragraph (1)(B), the 
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1 Federal Interagency Council on Social Impact Part2 nerships shall submit the report to the Secretary and 

3 each committee of jurisdiction in the House of Rep4 resentatives and the Senate. 

5 ‘‘(f) LIMITATION ON COST OF EVALUATIONS.—Of the 

6 amount made available under this subtitle for social impact 

7 partnership projects, the Secretary may not obligate more 

8 than 15 percent to evaluate the implementation and out9 comes of the projects. 

10 ‘‘(g) DELEGATION OF AUTHORITY.—The Secretary 

11 may transfer to the head of another Federal agency the au12 thorities provided in this section and any funds necessary 

13 to exercise the authorities. 

14 ‘‘FEDERAL INTERAGENCY COUNCIL ON SOCIAL IMPACT

15 PARTNERSHIPS

16 ‘‘SEC. 2056. (a) ESTABLISHMENT.—There is estab17 lished the Federal Interagency Council on Social Impact 

18 Partnerships (in this section referred to as the ‘Council’) 

19 to— 

20 ‘‘(1) coordinate with the Secretary on the efforts 

21 of social impact partnership projects funded under 

22 this subtitle; 

23 ‘‘(2) advise and assist the Secretary in the devel24 opment and implementation of the projects; 

25 ‘‘(3) advise the Secretary on specific pro26 grammatic and policy matter related to the projects; 
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1 ‘‘(4) provide subject-matter expertise to the Sec2 retary with regard to the projects; 

3 ‘‘(5) certify to the Secretary that each State or 

4 local government that has entered into an agreement 

5 with the Secretary for a social impact partnership 

6 project under this subtitle and each evaluator selected 

7 by the head of the relevant agency under section 2055 

8 has access to Federal administrative data to assist the 

9 State or local government and the evaluator in evalu10 ating the performance and outcomes of the project; 

11 ‘‘(6) address issues that will influence the future 

12 of social impact partnership projects in the United 

13 States; 

14 ‘‘(7) provide guidance to the executive branch on 

15 the future of social impact partnership projects in the 

16 United States; 

17 ‘‘(8) prior to approval by the Secretary, certify 

18 that each State and local government application for 

19 a social impact partnership contains rigorous, inde20 pendent data and reliable, evidence-based research 

21 methodologies to support the conclusion that the 

22 project will yield savings to the State or local govern23 ment or the Federal Government if the project out24 comes are achieved; 
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1 ‘‘(9) certify to the Secretary, in the case of each 

2 approved social impact partnership that is expected 

3 to yield savings to the Federal Government, that the 

4 project will yield a projected savings to the Federal 

5 Government if the project outcomes are achieved, and 

6 coordinate with the relevant Federal agency to 

7 produce an after-action accounting once the project is 

8 complete to determine the actual Federal savings real9 ized, and the extent to which actual savings aligned 

10 with projected savings; and 

11 ‘‘(10) provide periodic reports to the Secretary 

12 and make available reports periodically to Congress 

13 and the public on the implementation of this subtitle. 

14 ‘‘(b) COMPOSITION OF COUNCIL.—The Council shall 

15 have 11 members, as follows: 

16 ‘‘(1) CHAIR.—The Chair of the Council shall be 

17 the Director of the Office of Management and Budget. 

18 ‘‘(2) OTHER MEMBERS.—The head of each of the 

19 following entities shall designate one officer or em20 ployee of the entity to be a Council member: 

21 ‘‘(A) The Department of Labor. 

22 ‘‘(B) The Department of Health and 

23 Human Services. 

24 ‘‘(C) The Social Security Administration. 

25 ‘‘(D) The Department of Agriculture. 
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1 ‘‘(E) The Department of Justice. 

2 ‘‘(F) The Department of Housing and 

3 Urban Development. 

4 ‘‘(G) The Department of Education. 

5 ‘‘(H) The Department of Veterans Affairs. 

6 ‘‘(I) The Department of the Treasury. 

7 ‘‘(J) The Corporation for National and 

8 Community Service. 

9 ‘‘COMMISSION ON SOCIAL IMPACT PARTNERSHIPS

10 ‘‘SEC. 2057. (a) ESTABLISHMENT.—There is estab11 lished the Commission on Social Impact Partnerships (in 

12 this section referred to as the ‘Commission’). 

13 ‘‘(b) DUTIES.—The duties of the Commission shall be 

14 to— 

15 ‘‘(1) assist the Secretary and the Federal Inter16 agency Council on Social Impact Partnerships in re17 viewing applications for funding under this subtitle; 

18 ‘‘(2) make recommendations to the Secretary and 

19 the Federal Interagency Council on Social Impact 

20 Partnerships regarding the funding of social impact 

21 partnership agreements and feasibility studies; and 

22 ‘‘(3) provide other assistance and information as 

23 requested by the Secretary or the Federal Interagency 

24 Council on Social Impact Partnerships. 

25 ‘‘(c) COMPOSITION.—The Commission shall be com26 posed of nine members, of whom— 
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1 ‘‘(1) one shall be appointed by the President, 

2 who will serve as the Chair of the Commission; 

3 ‘‘(2) one shall be appointed by the Majority 

4 Leader of the Senate; 

5 ‘‘(3) one shall be appointed by the Minority 

6 Leader of the Senate; 

7 ‘‘(4) one shall be appointed by the Speaker of the 

8 House of Representatives; 

9 ‘‘(5) one shall be appointed by the Minority 

10 Leader of the House of Representatives; 

11 ‘‘(6) one shall be appointed by the Chairman of 

12 the Committee on Finance of the Senate; 

13 ‘‘(7) one shall be appointed by the ranking mem14 ber of the Committee on Finance of the Senate; 

15 ‘‘(8) one member shall be appointed by the 

16 Chairman of the Committee on Ways and Means of 

17 the House of Representatives; and 

18 ‘‘(9) one shall be appointed by the ranking mem19 ber of the Committee on Ways and Means of the 

20 House of Representatives. 

21 ‘‘(d) QUALIFICATIONS OF COMMISSION MEMBERS.— 

22 The members of the Commission shall— 

23 ‘‘(1) be experienced in finance, economics, pay 

24 for performance, or program evaluation; 
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1 ‘‘(2) have relevant professional or personal expe2 rience in a field related to one or more of the out3 comes listed in this subtitle; or 

4 ‘‘(3) be qualified to review applications for social 

5 impact partnership projects to determine whether the 

6 proposed metrics and evaluation methodologies are 

7 appropriately rigorous and reliant upon independent 

8 data and evidence-based research. 

9 ‘‘(e) TIMING OF APPOINTMENTS.—The appointments of 

10 the members of the Commission shall be made not later than 

11 120 days after the date of the enactment of this subtitle, 

12 or, in the event of a vacancy, not later than 90 days after 

13 the date the vacancy arises. If a member of Congress fails 

14 to appoint a member by that date, the President may select 

15 a member of the President’s choice on behalf of the member 

16 of Congress. Notwithstanding the preceding sentence, if not 

17 all appointments have been made to the Commission as of 

18 that date, the Commission may operate with no fewer than 

19 five members until all appointments have been made. 

20 ‘‘(f) TERM OF APPOINTMENTS.— 

21 ‘‘(1) IN GENERAL.—The members appointed 

22 under subsection (c) shall serve as follows: 

23 ‘‘(A) Three members shall serve for 2 years. 

24 ‘‘(B) Three members shall serve for 3 years. 
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1 ‘‘(C) Three members (one of which shall be 

2 Chair of the Commission appointed by the Presi3 dent) shall serve for 4 years. 

4 ‘‘(2) ASSIGNMENT OF TERMS.—The Commission 

5 shall designate the term length that each member ap6 pointed under subsection (c) shall serve by unanimous 

7 agreement. In the event that unanimous agreement 

8 cannot be reached, term lengths shall be assigned to 

9 the members by a random process. 

10 ‘‘(g) VACANCIES.—Subject to subsection (e), in the 

11 event of a vacancy in the Commission, whether due to the 

12 resignation of a member, the expiration of a member’s term, 

13 or any other reason, the vacancy shall be filled in the man14 ner in which the original appointment was made and shall 

15 not affect the powers of the Commission. 

16 ‘‘(h) APPOINTMENT POWER.—Members of the Commis17 sion appointed under subsection (c) shall not be subject to 

18 confirmation by the Senate. 

19 ‘‘LIMITATION ON USE OF FUNDS

20 ‘‘SEC. 2058. Of the amounts made available to carry 

21 out this subtitle, the Secretary may not use more than 

22 $2,000,000 in any fiscal year to support the review, ap23 proval, and oversight of social impact partnership projects, 

24 including activities conducted by— 

25 ‘‘(1) the Federal Interagency Council on Social 

26 Impact Partnerships; and 
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1 ‘‘(2) any other agency consulted by the Secretary 

2 before approving a social impact partnership project 

3 or a feasibility study under section 2054. 

4 ‘‘NO FEDERAL FUNDING FOR CREDIT ENHANCEMENTS

5 ‘‘SEC. 2059. No amount made available to carry out 

6 this subtitle may be used to provide any insurance, guar7 antee, or other credit enhancement to a State or local gov8 ernment under which a Federal payment would be made 

9 to a State or local government as the result of a State or 

10 local government failing to achieve an outcome specified in 

11 an agreement. 

12 ‘‘AVAILABILITY OF FUNDS

13 ‘‘SEC. 2060. Amounts made available to carry out this 

14 subtitle shall remain available until 10 years after the date 

15 of the enactment of this subtitle. 

16 ‘‘WEBSITE

17 ‘‘SEC. 2061. The Federal Interagency Council on So18 cial Impact Partnerships shall establish and maintain a 

19 public website that shall display the following: 

20 ‘‘(1) A copy of, or method of accessing, each no21 tice published regarding a social impact partnership 

22 project pursuant to this subtitle. 

23 ‘‘(2) A copy of each feasibility study funded 

24 under this subtitle. 

25 ‘‘(3) For each State or local government that has 

26 entered into an agreement with the Secretary for a so-
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1 cial impact partnership project, the website shall con2 tain the following information: 

3 ‘‘(A) The outcome goals of the project. 

4 ‘‘(B) A description of each intervention in 

5 the project. 

6 ‘‘(C) The target population that will be 

7 served by the project. 

8 ‘‘(D) The expected social benefits to partici9 pants who receive the intervention and others 

10 who may be impacted. 

11 ‘‘(E) The detailed roles, responsibilities, and 

12 purposes of each Federal, State, or local govern13 ment entity, intermediary, service provider, 

14 independent evaluator, investor, or other stake15 holder. 

16 ‘‘(F) The payment terms, methodology used 

17 to calculate outcome payments, the payment 

18 schedule, and performance thresholds. 

19 ‘‘(G) The project budget. 

20 ‘‘(H) The project timeline. 

21 ‘‘(I) The project eligibility criteria. 

22 ‘‘(J) The evaluation design. 

23 ‘‘(K) The metrics used to determine whether 

24 the proposed outcomes have been achieved and 

25 how these metrics are measured. 
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1 ‘‘(4) A copy of the progress reports and the final 

2 reports relating to each social impact partnership 

3 project. 

4 ‘‘(5) An estimate of the savings to the Federal, 

5 State, and local government, on a program-by-pro6 gram basis and in the aggregate, resulting from the 

7 successful completion of the social impact partnership 

8 project. 

9 ‘‘REGULATIONS

10 ‘‘SEC. 2062. The Secretary, in consultation with the 

11 Federal Interagency Council on Social Impact Partner12 ships, may issue regulations as necessary to carry out this 

13 subtitle. 

14 ‘‘DEFINITIONS

15 ‘‘SEC. 2063. In this subtitle: 

16 ‘‘(1) AGENCY.—The term ‘agency’ has the mean17 ing given that term in section 551 of title 5, United 

18 States Code. 

19 ‘‘(2) INTERVENTION.—The term ‘intervention’ 

20 means a specific service delivered to achieve an im21 pact through a social impact partnership project. 

22 ‘‘(3) SECRETARY.—The term ‘Secretary’ means 

23 the Secretary of the Treasury. 

24 ‘‘(4) SOCIAL IMPACT PARTNERSHIP PROJECT.— 

25 The term ‘social impact partnership project’ means a 
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† HR 1892 EAS2 

1 project that finances social services using a social im2 pact partnership model. 

3 ‘‘(5) SOCIAL IMPACT PARTNERSHIP MODEL.—The 

4 term ‘social impact partnership model’ means a 

5 method of financing social services in which— 

6 ‘‘(A) Federal funds are awarded to a State 

7 or local government only if a State or local gov8 ernment achieves certain outcomes agreed on by 

9 the State or local government and the Secretary; 

10 and 

11 ‘‘(B) the State or local government coordi12 nates with service providers, investors (if appli13 cable to the project), and (if necessary) an inter14 mediary to identify— 

15 ‘‘(i) an intervention expected to 

16 produce the outcome; 

17 ‘‘(ii) a service provider to deliver the 

18 intervention to the target population; and 

19 ‘‘(iii) investors to fund the delivery of 

20 the intervention. 

21 ‘‘(6) STATE.—The term ‘State’ means each State 

22 of the United States, the District of Columbia, each 

23 commonwealth, territory or possession of the United 

24 States, and each federally recognized Indian tribe. 
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1 ‘‘FUNDING

2 ‘‘SEC. 2064. Out of any money in the Treasury of the 

3 United States not otherwise appropriated, there is hereby 

4 appropriated $100,000,000 for fiscal year 2018 to carry out 

5 this subtitle.’’. 

6 TITLE IX—PUBLIC HEALTH 

7 PROGRAMS 

8 SEC. 50901. EXTENSION FOR COMMUNITY HEALTH CEN9 TERS, THE NATIONAL HEALTH SERVICE 

10 CORPS, AND TEACHING HEALTH CENTERS 

11 THAT OPERATE GME PROGRAMS. 

12 (a) COMMUNITY HEALTH CENTERS FUNDING.—Sec13 tion 10503(b)(1)(F) of the Patient Protection and Afford14 able Care Act (42 U.S.C. 254b–2(b)(1)(F)), as amended by 

15 section 3101 of Public Law 115–96, is amended to read as 

16 follows: 

17 ‘‘(F) $3,800,000,000 for fiscal year 2018 

18 and $4,000,000,000 for fiscal year 2019.’’. 

19 (b) OTHER COMMUNITY HEALTH CENTERS PROVI20 SIONS.—Section 330 of the Public Health Service Act (42 

21 U.S.C. 254b) is amended— 

22 (1) in subsection (b)(1)(A)(ii), by striking 

23 ‘‘abuse’’ and inserting ‘‘use disorder’’; 

24 (2) in subsection (b)(2)(A), by striking ‘‘abuse’’ 

25 and inserting ‘‘use disorder’’; 
558 

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1 (3) in subsection (c)— 

2 (A) in paragraph (1), by striking subpara3 graphs (B) through (D); 

4 (B) by striking ‘‘(1) IN GENERAL’’ and all 

5 that follows through ‘‘The Secretary’’ and insert6 ing the following: 

7 ‘‘(1) CENTERS.—The Secretary’’; and 

8 (C) in paragraph (1), as amended, by redes9 ignating clauses (i) through (v) as subpara10 graphs (A) through (E) and moving the margin 

11 of each of such redesignated subparagraph 2 ems 

12 to the left; 

13 (4) by striking subsection (d) and inserting the 

14 following: 

15 ‘‘(d) IMPROVING QUALITY OF CARE.— 

16 ‘‘(1) SUPPLEMENTAL AWARDS.—The Secretary 

17 may award supplemental grant funds to health cen18 ters funded under this section to implement evidence19 based models for increasing access to high-quality pri20 mary care services, which may include models related 

21 to— 

22 ‘‘(A) improving the delivery of care for in23 dividuals with multiple chronic conditions; 

24 ‘‘(B) workforce configuration; 

25 ‘‘(C) reducing the cost of care; 
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1 ‘‘(D) enhancing care coordination; 

2 ‘‘(E) expanding the use of telehealth and 

3 technology-enabled collaborative learning and ca4 pacity building models; 

5 ‘‘(F) care integration, including integration 

6 of behavioral health, mental health, or substance 

7 use disorder services; and 

8 ‘‘(G) addressing emerging public health or 

9 substance use disorder issues to meet the health 

10 needs of the population served by the health cen11 ter. 

12 ‘‘(2) SUSTAINABILITY.—In making supplemental 

13 awards under this subsection, the Secretary may con14 sider whether the health center involved has submitted 

15 a plan for continuing the activities funded under this 

16 subsection after supplemental funding is expended. 

17 ‘‘(3) SPECIAL CONSIDERATION.—The Secretary 

18 may give special consideration to applications for 

19 supplemental funding under this subsection that seek 

20 to address significant barriers to access to care in 

21 areas with a greater shortage of health care providers 

22 and health services relative to the national average.’’; 

23 (5) in subsection (e)(1)— 

24 (A) in subparagraph (B)— 
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1 (i) by striking ‘‘2 years’’ and inserting 

2 ‘‘1 year’’; and 

3 (ii) by adding at the end the following: 

4 ‘‘The Secretary shall not make a grant 

5 under this paragraph unless the applicant 

6 provides assurances to the Secretary that 

7 within 120 days of receiving grant funding 

8 for the operation of the health center, the 

9 applicant will submit, for approval by the 

10 Secretary, an implementation plan to meet 

11 the requirements of subsection (k)(3). The 

12 Secretary may extend such 120-day period 

13 for achieving compliance upon a demonstra14 tion of good cause by the health center.’’; 

15 and 

16 (B) in subparagraph (C)— 

17 (i) in the subparagraph heading, by 

18 striking ‘‘AND PLANS’’; 

19 (ii) by striking ‘‘or plan (as described 

20 in subparagraphs (B) and (C) of subsection 

21 (c)(1))’’; 

22 (iii) by striking ‘‘or plan, including 

23 the purchase’’ and inserting the following: 

24 ‘‘including— 

25 ‘‘(i) the purchase’’; 
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1 (iv) by inserting ‘‘, which may include 

2 data and information systems’’ after ‘‘of 

3 equipment’’; 

4 (v) by striking the period at the end 

5 and inserting a semicolon; and 

6 (vi) by adding at the end the following: 

7 ‘‘(ii) the provision of training and 

8 technical assistance; and 

9 ‘‘(iii) other activities that— 

10 ‘‘(I) reduce costs associated with 

11 the provision of health services; 

12 ‘‘(II) improve access to, and 

13 availability of, health services provided 

14 to individuals served by the centers; 

15 ‘‘(III) enhance the quality and co16 ordination of health services; or 

17 ‘‘(IV) improve the health status of 

18 communities.’’; 

19 (6) in subsection (e)(5)(B)— 

20 (A) in the heading of subparagraph (B), by 

21 striking ‘‘AND PLANS’’; and 

22 (B) by striking ‘‘and subparagraphs (B) 

23 and (C) of subsection (c)(1) to a health center or 

24 to a network or plan’’ and inserting ‘‘to a health 

25 center or to a network’’; 
562 

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1 (7) in subsection (e), by adding at the end the 

2 following: 

3 ‘‘(6) NEW ACCESS POINTS AND EXPANDED SERV4 ICES.— 

5 ‘‘(A) APPROVAL OF NEW ACCESS POINTS.— 

6 ‘‘(i) IN GENERAL.—The Secretary may 

7 approve applications for grants under sub8 paragraph (A) or (B) of paragraph (1) to 

9 establish new delivery sites. 

10 ‘‘(ii) SPECIAL CONSIDERATION.—In 

11 carrying out clause (i), the Secretary may 

12 give special consideration to applicants that 

13 have demonstrated the new delivery site will 

14 be located within a sparsely populated area, 

15 or an area which has a level of unmet need 

16 that is higher relative to other applicants. 

17 ‘‘(iii) CONSIDERATION OF APPLICA18 TIONS.—In carrying out clause (i), the Sec19 retary shall approve applications for grants 

20 in such a manner that the ratio of the 

21 medically underserved populations in rural 

22 areas which may be expected to use the serv23 ices provided by the applicants involved to 

24 the medically underserved populations in 

25 urban areas which may be expected to use 
563 

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1 the services provided by the applicants is 

2 not less than two to three or greater than 

3 three to two. 

4 ‘‘(iv) SERVICE AREA OVERLAP.—If in 

5 carrying out clause (i) the applicant pro6 poses to serve an area that is currently 

7 served by another health center funded 

8 under this section, the Secretary may con9 sider whether the award of funding to an 

10 additional health center in the area can be 

11 justified based on the unmet need for addi12 tional services within the catchment area. 

13 ‘‘(B) APPROVAL OF EXPANDED SERVICE AP14 PLICATIONS.— 

15 ‘‘(i) IN GENERAL.—The Secretary may 

16 approve applications for grants under sub17 paragraph (A) or (B) of paragraph (1) to 

18 expand the capacity of the applicant to pro19 vide required primary health services de20 scribed in subsection (b)(1) or additional 

21 health services described in subsection 

22 (b)(2). 

23 ‘‘(ii) PRIORITY EXPANSION

24 PROJECTS.—In carrying out clause (i), the 

25 Secretary may give special consideration to 
564 

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1 expanded service applications that seek to 

2 address emerging public health or behav3 ioral health, mental health, or substance 

4 abuse issues through increasing the avail5 ability of additional health services de6 scribed in subsection (b)(2) in an area in 

7 which there are significant barriers to ac8 cessing care. 

9 ‘‘(iii) CONSIDERATION OF APPLICA10 TIONS.—In carrying out clause (i), the Sec11 retary shall approve applications for grants 

12 in such a manner that the ratio of the 

13 medically underserved populations in rural 

14 areas which may be expected to use the serv15 ices provided by the applicants involved to 

16 the medically underserved populations in 

17 urban areas which may be expected to use 

18 the services provided by such applicants is 

19 not less than two to three or greater than 

20 three to two.’’; 

21 (8) in subsection (h)— 

22 (A) in paragraph (1), by striking ‘‘and 

23 children and youth at risk of homelessness’’ and 

24 inserting ‘‘, children and youth at risk of home-
565 

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1 lessness, homeless veterans, and veterans at risk 

2 of homelessness’’; and 

3 (B) in paragraph (5)— 

4 (i) by striking subparagraph (B); 

5 (ii) by redesignating subparagraph (C) 

6 as subparagraph (B); and 

7 (iii) in subparagraph (B) (as so redes8 ignated)— 

9 (I) in the subparagraph heading, 

10 by striking ‘‘ABUSE’’ and inserting 

11 ‘‘USE DISORDER’’; and 

12 (II) by striking ‘‘abuse’’ and in13 serting ‘‘use disorder’’; 

14 (9) in subsection (k)— 

15 (A) in paragraph (2)— 

16 (i) in the paragraph heading, by in17 serting ‘‘UNMET’’ before ‘‘NEED’’; 

18 (ii) in the matter preceding subpara19 graph (A), by inserting ‘‘or subsection 

20 (e)(6)’’ after ‘‘subsection (e)(1)’’; 

21 (iii) in subparagraph (A), by inserting 

22 ‘‘unmet’’ before ‘‘need for health services’’; 

23 (iv) in subparagraph (B), by striking 

24 ‘‘and’’ at the end; 
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1 (v) in subparagraph (C), by striking 

2 the period at the end and inserting ‘‘; and’’; 

3 and 

4 (vi) by adding after subparagraph (C) 

5 the following: 

6 ‘‘(D) in the case of an application for a 

7 grant pursuant to subsection (e)(6), a dem8 onstration that the applicant has consulted with 

9 appropriate State and local government agen10 cies, and health care providers regarding the 

11 need for the health services to be provided at the 

12 proposed delivery site.’’; 

13 (B) in paragraph (3)— 

14 (i) in the matter preceding subpara15 graph (A), by inserting ‘‘or subsection 

16 (e)(6)’’ after ‘‘subsection (e)(1)(B)’’; 

17 (ii) in subparagraph (B), by striking 

18 ‘‘in the catchment area of the center’’ and 

19 inserting ‘‘, including other health care pro20 viders that provide care within the 

21 catchment area, local hospitals, and spe22 cialty providers in the catchment area of 

23 the center, to provide access to services not 

24 available through the health center and to 
567 

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1 reduce the non-urgent use of hospital emer2 gency departments’’; 

3 (iii) in subparagraph (H)(ii), by in4 serting ‘‘who shall be directly employed by 

5 the center’’ after ‘‘approves the selection of 

6 a director for the center’’; 

7 (iv) in subparagraph (L), by striking 

8 ‘‘and’’ at the end; 

9 (v) in subparagraph (M), by striking 

10 the period and inserting ‘‘; and’’; and 

11 (vi) by inserting after subparagraph 

12 (M), the following: 

13 ‘‘(N) the center has written policies and 

14 procedures in place to ensure the appropriate use 

15 of Federal funds in compliance with applicable 

16 Federal statutes, regulations, and the terms and 

17 conditions of the Federal award.’’; and 

18 (C) by striking paragraph (4); 

19 (10) in subsection (l), by adding at the end the 

20 following: ‘‘Funds expended to carry out activities 

21 under this subsection and operational support activi22 ties under subsection (m) shall not exceed 3 percent 

23 of the amount appropriated for this section for the fis24 cal year involved.’’; 
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1 (11) in subsection (q)(4), by adding at the end 

2 the following: ‘‘A waiver provided by the Secretary 

3 under this paragraph may not remain in effect for 

4 more than 1 year and may not be extended after such 

5 period. An entity may not receive more than one 

6 waiver under this paragraph in consecutive years.’’; 

7 (12) in subsection (r)(3)— 

8 (A) by striking ‘‘appropriate committees of 

9 Congress a report concerning the distribution of 

10 funds under this section’’ and inserting the fol11 lowing: ‘‘Committee on Health, Education, 

12 Labor, and Pensions of the Senate, and the Com13 mittee on Energy and Commerce of the House of 

14 Representatives, a report including, at a min15 imum— 

16 ‘‘(A) the distribution of funds for carrying 

17 out this section’’; 

18 (B) by striking ‘‘populations. Such report 

19 shall include an assessment’’ and inserting the 

20 following: ‘‘populations; 

21 ‘‘(B) an assessment’’; 

22 (C) by striking ‘‘and the rationale for any 

23 substantial changes in the distribution of funds.’’ 

24 and inserting a semicolon; and 

25 (D) by adding at the end the following: 
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1 ‘‘(C) the distribution of awards and funding 

2 for new or expanded services in each of rural 

3 areas and urban areas; 

4 ‘‘(D) the distribution of awards and fund5 ing for establishing new access points, and the 

6 number of new access points created; 

7 ‘‘(E) the amount of unexpended funding for 

8 loan guarantees and loan guarantee authority 

9 under title XVI; 

10 ‘‘(F) the rationale for any substantial 

11 changes in the distribution of funds; 

12 ‘‘(G) the rate of closures for health centers 

13 and access points; 

14 ‘‘(H) the number and reason for any grants 

15 awarded pursuant to subsection (e)(1)(B); and 

16 ‘‘(I) the number and reason for any waivers 

17 provided pursuant to subsection (q)(4).’’; 

18 (13) in subsection (r), by adding at the end the 

19 following new paragraph: 

20 ‘‘(5) FUNDING FOR PARTICIPATION OF HEALTH

21 CENTERS IN ALL OF US RESEARCH PROGRAM.—In ad22 dition to any amounts made available pursuant to 

23 paragraph (1) of this subsection, section 402A of this 

24 Act, or section 10503 of the Patient Protection and 

25 Affordable Care Act, there is authorized to be appro-
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1 priated, and there is appropriated, out of any monies 

2 in the Treasury not otherwise appropriated, to the 

3 Secretary $25,000,000 for fiscal year 2018 to support 

4 the participation of health centers in the All of Us 

5 Research Program under the Precision Medicine Ini6 tiative under section 498E of this Act.’’; and 

7 (14) by striking subsection (s). 

8 (c) NATIONAL HEALTH SERVICE CORPS.—Section 

9 10503(b)(2)(F) of the Patient Protection and Affordable 

10 Care Act (42 U.S.C. 254b–2(b)(2)(F)), as amended by sec11 tion 3101 of Public Law 115–96, is amended to read as 

12 follows: 

13 ‘‘(F) $310,000,000 for each of fiscal years 

14 2018 and 2019.’’. 

15 (d) TEACHING HEALTH CENTERS THAT OPERATE

16 GRADUATE MEDICAL EDUCATION PROGRAMS.— 

17 (1) PAYMENTS.—Subsection (a) of section 340H 

18 of the Public Health Service Act (42 U.S.C. 256h) is 

19 amended to read as follows: 

20 ‘‘(a) PAYMENTS.— 

21 ‘‘(1) IN GENERAL.—Subject to subsection (h)(2), 

22 the Secretary shall make payments under this section 

23 for direct expenses and indirect expenses to qualified 

24 teaching health centers that are listed as sponsoring 
571 

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1 institutions by the relevant accrediting body for, as 

2 appropriate— 

3 ‘‘(A) maintenance of filled positions at ex4 isting approved graduate medical residency 

5 training programs; 

6 ‘‘(B) expansion of existing approved grad7 uate medical residency training programs; and 

8 ‘‘(C) establishment of new approved grad9 uate medical residency training programs. 

10 ‘‘(2) PER RESIDENT AMOUNT.—In making pay11 ments under paragraph (1), the Secretary shall con12 sider the cost of training residents at teaching health 

13 centers and the implications of the per resident 

14 amount on approved graduate medical residency 

15 training programs at teaching health centers. 

16 ‘‘(3) PRIORITY.—In making payments under 

17 paragraph (1)(C), the Secretary shall give priority to 

18 qualified teaching health centers that— 

19 ‘‘(A) serve a health professional shortage 

20 area with a designation in effect under section 

21 332 or a medically underserved community (as 

22 defined in section 799B); or 

23 ‘‘(B) are located in a rural area (as defined 

24 in section 1886(d)(2)(D) of the Social Security 

25 Act).’’. 
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1 (2) FUNDING.—Paragraph (1) of section 

2 340H(g) of the Public Health Service Act (42 U.S.C. 

3 256h(g)), as amended by section 3101 of Public Law 

4 115–96, is amended by striking ‘‘and $30,000,000 for 

5 the period of the first and second quarters of fiscal 

6 year 2018,’’ and inserting ‘‘and $126,500,000 for each 

7 of fiscal years 2018 and 2019,’’. 

8 (3) ANNUAL REPORTING.—Subsection (h)(1) of 

9 section 340H of the Public Health Service Act (42 

10 U.S.C. 256h) is amended— 

11 (A) by redesignating subparagraph (D) as 

12 subparagraph (H); and 

13 (B) by inserting after subparagraph (C) the 

14 following: 

15 ‘‘(D) The number of patients treated by 

16 residents described in paragraph (4). 

17 ‘‘(E) The number of visits by patients treat18 ed by residents described in paragraph (4). 

19 ‘‘(F) Of the number of residents described in 

20 paragraph (4) who completed their residency 

21 training at the end of such residency academic 

22 year, the number and percentage of such resi23 dents entering primary care practice (meaning 

24 any of the areas of practice listed in the defini-
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1 tion of a primary care residency program in sec2 tion 749A). 

3 ‘‘(G) Of the number of residents described in 

4 paragraph (4) who completed their residency 

5 training at the end of such residency academic 

6 year, the number and percentage of such resi7 dents who entered practice at a health care facil8 ity— 

9 ‘‘(i) primarily serving a health profes10 sional shortage area with a designation in 

11 effect under section 332 or a medically un12 derserved community (as defined in section 

13 799B); or 

14 ‘‘(ii) located in a rural area (as de15 fined in section 1886(d)(2)(D) of the Social 

16 Security Act).’’. 

17 (4) REPORT ON TRAINING COSTS.—Not later 

18 than March 31, 2019, the Secretary of Health and 

19 Human Services shall submit to the Congress a report 

20 on the direct graduate expenses of approved graduate 

21 medical residency training programs, and the indi22 rect expenses associated with the additional costs of 

23 teaching residents, of qualified teaching health centers 

24 (as such terms are used or defined in section 340H 

25 of the Public Health Service Act (42 U.S.C. 256h)). 
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1 (5) DEFINITION.—Subsection (j) of section 340H 

2 of the Public Health Service Act (42 U.S.C. 256h) is 

3 amended— 

4 (A) by redesignating paragraphs (2) and 

5 (3) as paragraphs (3) and (4), respectively; and 

6 (B) by inserting after paragraph (1) the fol7 lowing: 

8 ‘‘(2) NEW APPROVED GRADUATE MEDICAL RESI9 DENCY TRAINING PROGRAM.—The term ‘new approved 

10 graduate medical residency training program’ means 

11 an approved graduate medical residency training 

12 program for which the sponsoring qualified teaching 

13 health center has not received a payment under this 

14 section for a previous fiscal year (other than pursuant 

15 to subsection (a)(1)(C)).’’. 

16 (6) TECHNICAL CORRECTION.—Subsection (f) of 

17 section 340H (42 U.S.C. 256h) is amended by strik18 ing ‘‘hospital’’ each place it appears and inserting 

19 ‘‘teaching health center’’. 

20 (7) PAYMENTS FOR PREVIOUS FISCAL YEARS.— 

21 The provisions of section 340H of the Public Health 

22 Service Act (42 U.S.C. 256h), as in effect on the day 

23 before the date of enactment of Public Law 115–96, 

24 shall continue to apply with respect to payments 
575 

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1 under such section for fiscal years before fiscal year 

2 2018. 

3 (e) APPLICATION.—Amounts appropriated pursuant to 

4 this section for fiscal year 2018 or 2019 are subject to the 

5 requirements contained in Public Law 115–31 for funds for 

6 programs authorized under sections 330 through 340 of the 

7 Public Health Service Act (42 U.S.C. 254b–256). 

8 (f) CONFORMING AMENDMENTS.—Paragraph (4) of 

9 section 3014(h) of title 18, United States Code, as amended 

10 by section 3101 of Public Law 115–96, is amended by strik11 ing ‘‘and section 3101(d) of the CHIP and Public Health 

12 Funding Extension Act’’ and inserting ‘‘and section 

13 50901(e) of the Advancing Chronic Care, Extenders, and 

14 Social Services Act’’. 

15 SEC. 50902. EXTENSION FOR SPECIAL DIABETES PRO16 GRAMS. 

17 (a) SPECIAL DIABETES PROGRAM FOR TYPE I DIABE18 TES.—Section 330B(b)(2)(D) of the Public Health Service 

19 Act (42 U.S.C. 254c–2(b)(2)(D)), as amended by section 

20 3102 of Public Law 115–96, is amended to read as follows: 

21 ‘‘(D) $150,000,000 for each of fiscal years 

22 2018 and 2019, to remain available until ex23 pended.’’. 

24 (b) SPECIAL DIABETES PROGRAM FOR INDIANS.—Sub25 paragraph (D) of section 330C(c)(2) of the Public Health 
576 

† HR 1892 EAS2 

1 Service Act (42 U.S.C. 254c–3(c)(2)), as amended by sec2 tion 3102 of Public Law 115–96, is amended to read as 

3 follows: 

4 ‘‘(D) $150,000,000 for each of fiscal years 

5 2018 and 2019, to remain available until ex6 pended.’’. 

7 TITLE X—MISCELLANEOUS 

8 HEALTH CARE POLICIES 

9 SEC. 51001. HOME HEALTH PAYMENT REFORM. 

10 (a) BUDGET NEUTRAL TRANSITION TO A 30-DAY UNIT

11 OF PAYMENT FOR HOME HEALTH SERVICES.—Section 

12 1895(b) of the Social Security Act (42 U.S.C. 1395fff(b)) 

13 is amended— 

14 (1) in paragraph (2)— 

15 (A) by striking ‘‘PAYMENT.—In defining’’ 

16 and inserting ‘‘PAYMENT.— 

17 ‘‘(A) IN GENERAL.—In defining’’; and 

18 (B) by adding at the end the following new 

19 subparagraph: 

20 ‘‘(B) 30-DAY UNIT OF SERVICE.—For pur21 poses of implementing the prospective payment 

22 system with respect to home health units of serv23 ice furnished during a year beginning with 

24 2020, the Secretary shall apply a 30-day unit of 
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1 service as the unit of service applied under this 

2 paragraph.’’; 

3 (2) in paragraph (3)— 

4 (A) in subparagraph (A), by adding at the 

5 end the following new clause: 

6 ‘‘(iv) BUDGET NEUTRALITY FOR 2020.— 

7 With respect to payments for home health 

8 units of service furnished that end during 

9 the 12-month period beginning January 1, 

10 2020, the Secretary shall calculate a stand11 ard prospective payment amount (or 

12 amounts) for 30-day units of service (as de13 scribed in paragraph (2)(B)) for the pro14 spective payment system under this sub15 section. Such standard prospective payment 

16 amount (or amounts) shall be calculated in 

17 a manner such that the estimated aggregate 

18 amount of expenditures under the system 

19 during such period with application of 

20 paragraph (2)(B) is equal to the estimated 

21 aggregate amount of expenditures that oth22 erwise would have been made under the sys23 tem during such period if paragraph (2)(B) 

24 had not been enacted. The previous sentence 

25 shall be applied before (and not affect the 
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1 application of) paragraph (3)(B). In calcu2 lating such amount (or amounts), the Sec3 retary shall make assumptions about behav4 ior changes that could occur as a result of 

5 the implementation of paragraph (2)(B) 

6 and the case-mix adjustment factors estab7 lished under paragraph (4)(B) and shall 

8 provide a description of such assumptions 

9 in the notice and comment rulemaking used 

10 to implement this clause.’’; and 

11 (B) by adding at the end the following new 

12 subparagraph: 

13 ‘‘(D) BEHAVIOR ASSUMPTIONS AND ADJUST14 MENTS.— 

15 ‘‘(i) IN GENERAL.—The Secretary shall 

16 annually determine the impact of dif17 ferences between assumed behavior changes 

18 (as described in paragraph (3)(A)(iv)) and 

19 actual behavior changes on estimated aggre20 gate expenditures under this subsection with 

21 respect to years beginning with 2020 and 

22 ending with 2026. 

23 ‘‘(ii) PERMANENT ADJUSTMENTS.—The 

24 Secretary shall, at a time and in a manner 

25 determined appropriate, through notice and 
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1 comment rulemaking, provide for one or 

2 more permanent increases or decreases to 

3 the standard prospective payment amount 

4 (or amounts) for applicable years, on a pro5 spective basis, to offset for such increases or 

6 decreases in estimated aggregate expendi7 tures (as determined under clause (i)). 

8 ‘‘(iii) TEMPORARY ADJUSTMENTS FOR

9 RETROSPECTIVE BEHAVIOR.—The Secretary 

10 shall, at a time and in a manner deter11 mined appropriate, through notice and 

12 comment rulemaking, provide for one or 

13 more temporary increases or decreases to 

14 the payment amount for a unit of home 

15 health services (as determined under para16 graph (4)) for applicable years, on a pro17 spective basis, to offset for such increases or 

18 decreases in estimated aggregate expendi19 tures (as determined under clause (i)). Such 

20 a temporary increase or decrease shall 

21 apply only with respect to the year for 

22 which such temporary increase or decrease 

23 is made, and the Secretary shall not take 

24 into account such a temporary increase or 
580 

† HR 1892 EAS2 

1 decrease in computing such amount under 

2 this subsection for a subsequent year.’’; and 

3 (3) in paragraph (4)(B)— 

4 (A) by striking ‘‘FACTORS.—The Secretary’’ 

5 and inserting ‘‘FACTORS.— 

6 ‘‘(i) IN GENERAL.—The Secretary’’; 

7 and 

8 (B) by adding at the end the following new 

9 clause: 

10 ‘‘(ii) TREATMENT OF THERAPY

11 THRESHOLDS.—For 2020 and subsequent 

12 years, the Secretary shall eliminate the use 

13 of therapy thresholds (established by the 

14 Secretary) in case mix adjustment factors 

15 established under clause (i) for calculating 

16 payments under the prospective payment 

17 system under this subsection.’’. 

18 (b) TECHNICAL EXPERT PANEL.— 

19 (1) IN GENERAL.—During the period beginning 

20 on January 1, 2018, and ending on December 31, 

21 2018, the Secretary of Health and Human Services 

22 shall hold at least one session of a technical expert 

23 panel, the participants of which shall include home 

24 health providers, patient representatives, and other 

25 relevant stakeholders. The technical expert panel shall 
581 

† HR 1892 EAS2 

1 identify and prioritize recommendations with respect 

2 to the prospective payment system for home health 

3 services under section 1895(b) of the Social Security 

4 Act (42 U.S.C. 1395fff(b)), on the following: 

5 (A) The Home Health Groupings Model, as 

6 described in the proposed rule ‘‘Medicare and 

7 Medicaid Programs; CY 2018 Home Health Pro8 spective Payment System Rate Update and Pro9 posed CY 2019 Case-Mix Adjustment Method10 ology Refinements; Home Health Value-Based 

11 Purchasing Model; and Home Health Quality 

12 Reporting Requirements’’ (82 Fed. Reg. 35294 

13 through 35332 (July 28, 2017)). 

14 (B) Alternative case-mix models to the 

15 Home Health Groupings Model that were sub16 mitted during 2017 as comments in response to 

17 proposed rule making, including patient-focused 

18 factors that consider the risks of hospitalization 

19 and readmission to a hospital, improvement or 

20 maintenance of functionality of individuals to 

21 increase the capacity for self-care, quality of 

22 care, and resource utilization. 

23 (2) INAPPLICABILITY OF FACA.—The provisions 

24 of the Federal Advisory Committee Act (5 U.S.C. 
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† HR 1892 EAS2 

1 App.) shall not apply to the technical expert panel 

2 under paragraph (1). 

3 (3) REPORT.—Not later than April 1, 2019, the 

4 Secretary of Health and Human Services shall sub5 mit to the Committee on Ways and Means and the 

6 Committee on Energy and Commerce of the House of 

7 Representatives and the Committee on Finance of the 

8 Senate a report on the recommendations of such panel 

9 described in such paragraph. 

10 (4) NOTICE AND COMMENT RULEMAKING.—Not 

11 later than December 31, 2019, the Secretary of Health 

12 and Human Services shall pursue notice and com13 ment rulemaking on a case-mix system with respect 

14 to the prospective payment system for home health 

15 services under section 1895(b) of the Social Security 

16 Act (42 U.S.C. 1395fff(b)). 

17 (c) REPORTS.— 

18 (1) INTERIM REPORT.—Not later than March 15, 

19 2022, the Medicare Payment Advisory Commission 

20 shall submit to Congress an interim report on the ap21 plication of a 30-day unit of service as the unit of 

22 service applied under section 1895(b)(2) of the Social 

23 Security Act (42 U.S.C. 1395fff(b)(2)), as amended by 

24 subsection (a), including an analysis of the level of 

25 payments provided to home health agencies as com-
583 

† HR 1892 EAS2 

1 pared to the cost of delivering home health services, 

2 and any unintended consequences, including with re3 spect to behavioral changes and quality. 

4 (2) FINAL REPORT.—Not later than March 15, 

5 2026, such Commission shall submit to Congress a 

6 final report on such application and any such con7 sequences. 

8 SEC. 51002. INFORMATION TO SATISFY DOCUMENTATION 

9 OF MEDICARE ELIGIBILITY FOR HOME 

10 HEALTH SERVICES. 

11 (a) PART A.—Section 1814(a) of the Social Security 

12 Act (42 U.S.C. 1395f(a)) is amended by inserting before 

13 ‘‘For purposes of paragraph (2)(C),’’ the following new sen14 tence: ‘‘For purposes of documentation for physician certifi15 cation and recertification made under paragraph (2) on or 

16 after January 1, 2019, and made with respect to home 

17 health services furnished by a home health agency, in addi18 tion to using documentation in the medical record of the 

19 physician who so certifies or the medical record of the acute 

20 or post-acute care facility (in the case that home health 

21 services were furnished to an individual who was directly 

22 admitted to the home health agency from such a facility), 

23 the Secretary may use documentation in the medical record 

24 of the home health agency as supporting material, as appro25 priate to the case involved.’’. 
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1 (b) PART B.—Section 1835(a) of the Social Security 

2 Act (42 U.S.C. 1395n(a)) is amended by inserting before 

3 ‘‘For purposes of paragraph (2)(A),’’ the following new sen4 tence: ‘‘For purposes of documentation for physician certifi5 cation and recertification made under paragraph (2) on or 

6 after January 1, 2019, and made with respect to home 

7 health services furnished by a home health agency, in addi8 tion to using documentation in the medical record of the 

9 physician who so certifies or the medical record of the acute 

10 or post-acute care facility (in the case that home health 

11 services were furnished to an individual who was directly 

12 admitted to the home health agency from such a facility), 

13 the Secretary may use documentation in the medical record 

14 of the home health agency as supporting material, as appro15 priate to the case involved.’’. 

16 SEC. 51003. TECHNICAL AMENDMENTS TO PUBLIC LAW 114– 

17 10. 

18 (a) MIPS TRANSITION.—Section 1848 of the Social 

19 Security Act (42 U.S.C. 1395w–4) is amended— 

20 (1) in subsection (q)— 

21 (A) in paragraph (1)— 

22 (i) in subparagraph (B), by striking 

23 ‘‘items and services’’ and inserting ‘‘covered 

24 professional services (as defined in sub25 section (k)(3)(A))’’; and 
585 

† HR 1892 EAS2 

1 (ii) in subparagraph (C)(iv)— 

2 (I) by amending subclause (I) to 

3 read as follows: 

4 ‘‘(I) The minimum number (as 

5 determined by the Secretary) of— 

6 ‘‘(aa) for performance peri7 ods beginning before January 1, 

8 2018, individuals enrolled under 

9 this part who are treated by the 

10 eligible professional for the per11 formance period involved; and 

12 ‘‘(bb) for performance periods 

13 beginning on or after January 1, 

14 2018, individuals enrolled under 

15 this part who are furnished cov16 ered professional services (as de17 fined in subsection (k)(3)(A)) by 

18 the eligible professional for the 

19 performance period involved.’’; 

20 (II) in subclause (II), by striking 

21 ‘‘items and services’’ and inserting 

22 ‘‘covered professional services (as de23 fined in subsection (k)(3)(A))’’; and 

24 (III) by amending subclause (III) 

25 to read as follows: 
586 

† HR 1892 EAS2 

1 ‘‘(III) The minimum amount (as 

2 determined by the Secretary) of— 

3 ‘‘(aa) for performance peri4 ods beginning before January 1, 

5 2018, allowed charges billed by 

6 such professional under this part 

7 for such performance period; and 

8 ‘‘(bb) for performance periods 

9 beginning on or after January 1, 

10 2018, allowed charges for covered 

11 professional services (as defined in 

12 subsection (k)(3)(A)) billed by 

13 such professional for such per14 formance period.’’; 

15 (B) in paragraph (5)(D)— 

16 (i) in clause (i)(I), by inserting ‘‘sub17 ject to clause (iii),’’ after ‘‘clauses (i) and 

18 (ii) of paragraph (2)(A),’’; and 

19 (ii) by adding at the end the following 

20 new clause: 

21 ‘‘(iii) TRANSITION YEARS.—For each of 

22 the second, third, fourth, and fifth years for 

23 which the MIPS applies to payments, the 

24 performance score for the performance cat25 egory described in paragraph (2)(A)(ii) 
587 

† HR 1892 EAS2 

1 shall not take into account the improvement 

2 of the professional involved.’’; 

3 (C) in paragraph (5)(E)— 

4 (i) in clause (i)(I)(bb)— 

5 (I) in the heading by striking 

6 ‘‘FIRST 2 YEARS’’ and inserting 

7 ‘‘FIRST 5 YEARS’’; and 

8 (II) by striking ‘‘the first and sec9 ond years’’ and inserting ‘‘each of the 

10 first through fifth years’’; 

11 (ii) in clause (i)(II)(bb)— 

12 (I) in the heading, by striking ‘‘2

13 YEARS’’ and inserting ‘‘5 YEARS’’; and 

14 (II) by striking the second sen15 tence and inserting the following new 

16 sentences: ‘‘For each of the second, 

17 third, fourth, and fifth years for which 

18 the MIPS applies to payments, not less 

19 than 10 percent and not more than 30 

20 percent of such score shall be based on 

21 performance with respect to the cat22 egory described in clause (ii) of para23 graph (2)(A). Nothing in the previous 

24 sentence shall be construed, with re25 spect to a performance period for a 
588 

† HR 1892 EAS2 

1 year described in the previous sentence, 

2 as preventing the Secretary from bas3 ing 30 percent of such score for such 

4 year with respect to the category de5 scribed in such clause (ii), if the Sec6 retary determines, based on informa7 tion posted under subsection (r)(2)(I) 

8 that sufficient resource use measures 

9 are ready for adoption for use under 

10 the performance category under para11 graph (2)(A)(ii) for such performance 

12 period.’’; 

13 (D) in paragraph (6)(D)— 

14 (i) in clause (i), in the second sentence, 

15 by striking ‘‘Such performance threshold’’ 

16 and inserting ‘‘Subject to clauses (iii) and 

17 (iv), such performance threshold’’; 

18 (ii) in clause (ii)— 

19 (I) in the first sentence, by insert20 ing ‘‘(beginning with 2019 and ending 

21 with 2024)’’ after ‘‘for each year of the 

22 MIPS’’; and 

23 (II) in the second sentence, by in24 serting ‘‘subject to clause (iii),’’ after 

25 ‘‘For each such year,’’; 
589 

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1 (iii) in clause (iii)— 

2 (I) in the heading, by striking ‘‘2’’ 

3 and inserting ‘‘5’’; and 

4 (II) in the first sentence, by strik5 ing ‘‘two years’’ and inserting ‘‘five 

6 years’’; and 

7 (iv) by adding at the end the following 

8 new clause: 

9 ‘‘(iv) ADDITIONAL SPECIAL RULE FOR

10 THIRD, FOURTH AND FIFTH YEARS OF

11 MIPS.—For purposes of determining MIPS 

12 adjustment factors under subparagraph (A), 

13 in addition to the requirements specified in 

14 clause (iii), the Secretary shall increase the 

15 performance threshold with respect to each 

16 of the third, fourth, and fifth years to which 

17 the MIPS applies to ensure a gradual and 

18 incremental transition to the performance 

19 threshold described in clause (i) (as esti20 mated by the Secretary) with respect to the 

21 sixth year to which the MIPS applies.’’; 

22 (E) in paragraph (6)(E)— 

23 (i) by striking ‘‘In the case of items 

24 and services’’ and inserting ‘‘In the case of 
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1 covered professional services (as defined in 

2 subsection (k)(3)(A))’’; and 

3 (ii) by striking ‘‘under this part with 

4 respect to such items and services’’ and in5 serting ‘‘under this part with respect to 

6 such covered professional services’’; and 

7 (F) in paragraph (7), in the first sentence, 

8 by striking ‘‘items and services’’ and inserting 

9 ‘‘covered professional services (as defined in sub10 section (k)(3)(A))’’; 

11 (2) in subsection (r)(2), by adding at the end the 

12 following new subparagraph: 

13 ‘‘(I) INFORMATION.—The Secretary shall, 

14 not later than December 31st of each year (begin15 ning with 2018), post on the Internet website of 

16 the Centers for Medicare & Medicaid Services in17 formation on resource use measures in use under 

18 subsection (q), resource use measures under de19 velopment and the time-frame for such develop20 ment, potential future resource use measure top21 ics, a description of stakeholder engagement, and 

22 the percent of expenditures under part A and 

23 this part that are covered by resource use meas24 ures.’’; and 
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1 (3) in subsection (s)(5)(B), by striking ‘‘section 

2 1833(z)(2)(C)’’ and inserting ‘‘section 1833(z)(3)(D)’’. 

3 (b) PHYSICIAN-FOCUSED PAYMENT MODEL TECHNICAL

4 ADVISORY COMMITTEE PROVISION OF INITIAL PROPOSAL

5 FEEDBACK.—Section 1868(c)(2)(C) of the Social Security 

6 Act (42 U.S.C. 1395ee(c)(2)(C)) is amended to read as fol7 lows: 

8 ‘‘(C) COMMITTEE REVIEW OF MODELS SUB9 MITTED.—The Committee, on a periodic basis— 

10 ‘‘(i) shall review models submitted 

11 under subparagraph (B); 

12 ‘‘(ii) may provide individuals and 

13 stakeholder entities who submitted such 

14 models with— 

15 ‘‘(I) initial feedback on such mod16 els regarding the extent to which such 

17 models meet the criteria described in 

18 subparagraph (A); and 

19 ‘‘(II) an explanation of the basis 

20 for the feedback provided under sub21 clause (I); and 

22 ‘‘(iii) shall prepare comments and rec23 ommendations regarding whether such mod24 els meet the criteria described in subpara-
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1 graph (A) and submit such comments and 

2 recommendations to the Secretary.’’. 

3 SEC. 51004. EXPANDED ACCESS TO MEDICARE INTENSIVE 

4 CARDIAC REHABILITATION PROGRAMS. 

5 Section 1861(eee)(4)(B) of the Social Security Act (42 

6 U.S.C. 1395x(eee)(4)(B)) is amended— 

7 (1) in clause (v), by striking ‘‘or’’ at the end; 

8 (2) in clause (vi), by striking the period at the 

9 end and inserting a semicolon; and 

10 (3) by adding at the end the following new 

11 clauses: 

12 ‘‘(vii) stable, chronic heart failure (defined 

13 as patients with left ventricular ejection fraction 

14 of 35 percent or less and New York Heart Asso15 ciation (NYHA) class II to IV symptoms despite 

16 being on optimal heart failure therapy for at 

17 least 6 weeks); or 

18 ‘‘(viii) any additional condition for which 

19 the Secretary has determined that a cardiac re20 habilitation program shall be covered, unless the 

21 Secretary determines, using the same process 

22 used to determine that the condition is covered 

23 for a cardiac rehabilitation program, that such 

24 coverage is not supported by the clinical evi25 dence.’’. 
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1 SEC. 51005. EXTENSION OF BLENDED SITE NEUTRAL PAY2 MENT RATE FOR CERTAIN LONG-TERM CARE 

3 HOSPITAL DISCHARGES; TEMPORARY AD4 JUSTMENT TO SITE NEUTRAL PAYMENT 

5 RATES. 

6 (a) EXTENSION.—Section 1886(m)(6)(B)(i) of the So7 cial Security Act (42 U.S.C. 1395ww(m)(6)(B)(i)) is 

8 amended— 

9 (1) in subclause (I), by striking ‘‘fiscal year 

10 2016 or fiscal year 2017’’ and inserting ‘‘fiscal years 

11 2016 through 2019’’; and 

12 (2) in subclause (II), by striking ‘‘2018’’ and in13 serting ‘‘2020’’. 

14 (b) TEMPORARY ADJUSTMENT TO SITE NEUTRAL PAY15 MENT RATES.—Section 1886(m)(6)(B) of the Social Secu16 rity Act (42 U.S.C. 1395ww(m)(6)(B)) is amended— 

17 (1) in clause (ii), in the matter preceding sub18 clause (I), by striking ‘‘In this paragraph’’ and in19 serting ‘‘Subject to clause (iv), in this paragraph’’; 

20 and 

21 (2) by adding at the end the following new 

22 clause: 

23 ‘‘(iv) ADJUSTMENT.—For each of fiscal 

24 years 2018 through 2026, the amount that 

25 would otherwise apply under clause (ii)(I) 

26 for the year (determined without regard to 
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1 this clause) shall be reduced by 4.6 per2 cent.’’. 

3 SEC. 51006. RECOGNITION OF ATTENDING PHYSICIAN AS4 SISTANTS AS ATTENDING PHYSICIANS TO 

5 SERVE HOSPICE PATIENTS. 

6 (a) RECOGNITION OF ATTENDING PHYSICIAN ASSIST7 ANTS AS ATTENDING PHYSICIANS TO SERVE HOSPICE PA8 TIENTS.— 

9 (1) IN GENERAL.—Section 1861(dd)(3)(B) of the 

10 Social Security Act (42 U.S.C. 1395x(dd)(3)(B)) is 

11 amended— 

12 (A) by striking ‘‘or nurse’’ and inserting ‘‘, 

13 the nurse’’; and 

14 (B) by inserting ‘‘, or the physician assist15 ant (as defined in such subsection)’’ after ‘‘sub16 section (aa)(5))’’. 

17 (2) CLARIFICATION OF HOSPICE ROLE OF PHYSI18 CIAN ASSISTANTS.—Section 1814(a)(7)(A)(i)(I) of the 

19 Social Security Act (42 U.S.C. 1395f(a)(7)(A)(i)(I)) 

20 is amended by inserting ‘‘or a physician assistant’’ 

21 after ‘‘a nurse practitioner’’. 

22 (b) EFFECTIVE DATE.—The amendments made by this 

23 section shall apply to items and services furnished on or 

24 after January 1, 2019. 
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1 SEC. 51007. EXTENSION OF ENFORCEMENT INSTRUCTION 

2 ON SUPERVISION REQUIREMENTS FOR OUT3 PATIENT THERAPEUTIC SERVICES IN CRIT4 ICAL ACCESS AND SMALL RURAL HOSPITALS 

5 THROUGH 2017. 

6 Section 1 of Public Law 113–198, as amended by sec7 tion 1 of Public Law 114–112 and section 16004(a) of the 

8 21st Century Cures Act (Public Law 114–255), is amend9 ed— 

10 (1) in the section heading, by striking ‘‘2016’’ 

11 and inserting ‘‘2017’’; and 

12 (2) by striking ‘‘and 2016’’ and inserting ‘‘2016, 

13 and 2017’’. 

14 SEC. 51008. ALLOWING PHYSICIAN ASSISTANTS, NURSE 

15 PRACTITIONERS, AND CLINICAL NURSE SPE16 CIALISTS TO SUPERVISE CARDIAC, INTEN17 SIVE CARDIAC, AND PULMONARY REHABILI18 TATION PROGRAMS. 

19 (a) CARDIAC AND INTENSIVE CARDIAC REHABILITA20 TION PROGRAMS.—Section 1861(eee) of the Social Security 

21 Act (42 U.S.C. 1395x(eee)) is amended— 

22 (1) in paragraph (1)— 

23 (A) by striking ‘‘physician-supervised’’; and 

24 (B) by inserting ‘‘under the supervision of 

25 a physician (as defined in subsection (r)(1)) or 

26 a physician assistant, nurse practitioner, or 
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1 clinical nurse specialist (as those terms are de2 fined in subsection (aa)(5))’’ before the period at 

3 the end; 

4 (2) in paragraph (2)— 

5 (A) in subparagraph (A)(iii), by striking 

6 the period at the end and inserting a semicolon; 

7 and 

8 (B) in subparagraph (B), by striking ‘‘a 

9 physician’’ and inserting ‘‘a physician (as de10 fined in subsection (r)(1)) or a physician assist11 ant, nurse practitioner, or clinical nurse spe12 cialist (as those terms are defined in subsection 

13 (aa)(5))’’; and 

14 (3) in paragraph (4)(A), in the matter preceding 

15 clause (i)— 

16 (A) by striking ‘‘physician-supervised’’; and 

17 (B) by inserting ‘‘under the supervision of 

18 a physician (as defined in subsection (r)(1)) or 

19 a physician assistant, nurse practitioner, or 

20 clinical nurse specialist (as those terms are de21 fined in subsection (aa)(5))’’ after ‘‘paragraph 

22 (3)’’. 

23 (b) PULMONARY REHABILITATION PROGRAMS.—Sec24 tion 1861(fff)(1) of the Social Security Act (42 U.S.C. 

25 1395x(fff)(1)) is amended— 
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1 (1) by striking ‘‘physician-supervised’’; and 

2 (2) by inserting ‘‘under the supervision of a phy3 sician (as defined in subsection (r)(1)) or a physician 

4 assistant, nurse practitioner, or clinical nurse spe5 cialist (as those terms are defined in subsection 

6 (aa)(5))’’ before the period at the end. 

7 (c) EFFECTIVE DATE.—The amendments made by this 

8 section shall apply to items and services furnished on or 

9 after January 1, 2024. 

10 SEC. 51009. TRANSITIONAL PAYMENT RULES FOR CERTAIN 

11 RADIATION THERAPY SERVICES UNDER THE 

12 PHYSICIAN FEE SCHEDULE. 

13 Section 1848 of the Social Security Act (42 U.S.C. 

14 1395w–4) is amended— 

15 (1) in subsection (b)(11), by striking ‘‘2017 and 

16 2018’’ and inserting ‘‘2017, 2018, and 2019’’; and 

17 (2) in subsection (c)(2)(K)(iv), by striking ‘‘2017 

18 and 2018’’ and inserting ‘‘2017, 2018, and 2019’’. 

19 TITLE XI—PROTECTING SEN20 IORS’ ACCESS TO MEDICARE 

21 ACT 

22 SEC. 52001. REPEAL OF THE INDEPENDENT PAYMENT ADVI23 SORY BOARD. 

24 (a) REPEAL.—Section 1899A of the Social Security 

25 Act (42 U.S.C. 1395kkk) is repealed. 
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1 (b) CONFORMING AMENDMENTS.— 

2 (1) LOBBYING COOLING-OFF PERIOD.—Para3 graph (3) of section 207(c) of title 18, United States 

4 Code, is repealed. 

5 (2) GAO STUDY AND REPORT.—Section 3403(b) 

6 of the Patient Protection and Affordable Care Act (42 

7 U.S.C. 1395kkk–1) is repealed. 

8 (3) MEDPAC REVIEW AND COMMENT.—Section 

9 1805(b) of the Social Security Act (42 U.S.C. 1395b– 

10 6(b)) is amended— 

11 (A) by striking paragraph (4); 

12 (B) by redesignating paragraphs (5) 

13 through (8) as paragraphs (4) through (7), re14 spectively; and 

15 (C) by redesignating the paragraph (9) that 

16 was redesignated by section 3403(c)(1) of the Pa17 tient Protection and Affordable Care Act (Public 

18 Law 111–148) as paragraph (8). 

19 (4) NAME CHANGE.—Section 10320(b) of the Pa20 tient Protection and Affordable Care Act (Public Law 

21 111–148) is repealed. 

22 (5) RULE OF CONSTRUCTION.—Section 10320(c) 

23 of the Patient Protection and Affordable Care Act 

24 (Public Law 111–148) is repealed. 
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1 TITLE XII—OFFSETS 

2 SEC. 53101. MODIFYING REDUCTIONS IN MEDICAID DSH AL3 LOTMENTS. 

4 Section 1923(f)(7)(A) of the Social Security Act (42 

5 U.S.C. 1396r–4(f)(7)(A)) is amended— 

6 (1) in clause (i), in the matter preceding sub7 clause (I), by striking ‘‘2018’’ and inserting ‘‘2020’’; 

8 and 

9 (2) in clause (ii), by striking subclauses (I) 

10 through (VIII) and inserting the following: 

11 ‘‘(I) $4,000,000,000 for fiscal year 

12 2020; and 

13 ‘‘(II) $8,000,000,000 for each of 

14 fiscal years 2021 through 2025.’’. 

15 SEC. 53102. THIRD PARTY LIABILITY IN MEDICAID AND 

16 CHIP. 

17 (a) MODIFICATION OF THIRD PARTY LIABILITY RULES

18 RELATED TO SPECIAL TREATMENT OF CERTAIN TYPES OF

19 CARE AND PAYMENTS.— 

20 (1) IN GENERAL.—Section 1902(a)(25)(E) of the 

21 Social Security Act (42 U.S.C. 1396a(a)(25)(E)) is 

22 amended, in the matter preceding clause (i), by strik23 ing ‘‘prenatal or’’. 
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1 (2) EFFECTIVE DATE.—The amendment made by 

2 paragraph (1) shall take effect on the date of enact3 ment of this Act. 

4 (b) DELAY IN EFFECTIVE DATE AND REPEAL OF CER5 TAIN BIPARTISAN BUDGET ACT OF 2013 AMENDMENTS.— 

6 (1) REPEAL.—Effective as of September 30, 

7 2017, subsection (b) of section 202 of the Bipartisan 

8 Budget Act of 2013 (Public Law 113–67; 127 Stat. 

9 1177; 42 U.S.C. 1396a note) (including any amend10 ments made by such subsection) is repealed and the 

11 provisions amended by such subsection shall be ap12 plied and administered as if such amendments had 

13 never been enacted. 

14 (2) DELAY IN EFFECTIVE DATE.—Subsection (c) 

15 of section 202 of the Bipartisan Budget Act of 2013 

16 (Public Law 113–67; 127 Stat. 1177; 42 U.S.C. 

17 1396a note) is amended to read as follows: 

18 ‘‘(c) EFFECTIVE DATE.—The amendments made by 

19 subsection (a) shall take effect on October 1, 2019.’’. 

20 (3) EFFECTIVE DATE; TREATMENT.—The repeal 

21 and amendment made by this subsection shall take ef22 fect as if enacted on September 30, 2017, and shall 

23 apply with respect to any open claims, including 

24 claims pending, generated, or filed, after such date. 

25 The amendments made by subsections (a) and (b) of 
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1 section 202 of the Bipartisan Budget Act of 2013 

2 (Public Law 113–67; 127 Stat. 1177; 42 U.S.C. 

3 1396a note) that took effect on October 1, 2017, are 

4 null and void and section 1902(a)(25) of the Social 

5 Security Act (42 U.S.C. 1396a(a)(25)) shall be ap6 plied and administered as if such amendments had 

7 not taken effect on such date. 

8 (c) GAO STUDY AND REPORT.—Not later than 18 

9 months after the date of enactment of this Act, the Comp10 troller General of the United States shall submit a report 

11 to the Committee on Energy and Commerce of the House 

12 of Representatives and the Committee on Finance of the 

13 Senate on the impacts of the amendments made by sub14 sections (a)(1) and (b)(2), including— 

15 (1) the impact, or potential effect, of such 

16 amendments on access to prenatal and preventive pe17 diatric care (including early and periodic screening, 

18 diagnostic, and treatment services) covered under 

19 State plans under such title (or waivers of such 

20 plans); 

21 (2) the impact, or potential effect, of such 

22 amendments on access to services covered under such 

23 plans or waivers for individuals on whose behalf child 

24 support enforcement is being carried out by a State 

25 agency under part D of title IV of such Act; and 
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1 (3) the impact, or potential effect, on providers 

2 of services under such plans or waivers of delays in 

3 payment or related issues that result from such 

4 amendments. 

5 (d) APPLICATION TO CHIP.— 

6 (1) IN GENERAL.—Section 2107(e)(1) of the So7 cial Security Act (42 U.S.C. 1397gg(e)(1)) is amend8 ed— 

9 (A) by redesignating subparagraphs (B) 

10 through (R) as subparagraphs (C) through (S), 

11 respectively; and 

12 (B) by inserting after subparagraph (A) the 

13 following new subparagraph: 

14 ‘‘(B) Section 1902(a)(25) (relating to third 

15 party liability).’’. 

16 (2) MANDATORY REPORTING.—Section 

17 1902(a)(25)(I)(i) of the Social Security Act (42 

18 U.S.C. 1396a(a)(25)(I)(i)) is amended— 

19 (A) by striking ‘‘medical assistance under 

20 the State plan’’ and inserting ‘‘medical assist21 ance under a State plan (or under a waiver of 

22 the plan)’’; 

23 (B) by striking ‘‘(and, at State option, 

24 child’’ and inserting ‘‘and child’’; and 
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1 (C) by striking ‘‘title XXI)’’ and inserting 

2 ‘‘title XXI’’. 

3 SEC. 53103. TREATMENT OF LOTTERY WINNINGS AND 

4 OTHER LUMP-SUM INCOME FOR PURPOSES 

5 OF INCOME ELIGIBILITY UNDER MEDICAID. 

6 (a) IN GENERAL.—Section 1902 of the Social Security 

7 Act (42 U.S.C. 1396a) is amended— 

8 (1) in subsection (a)(17), by striking ‘‘(e)(14), 

9 (e)(14)’’ and inserting ‘‘(e)(14), (e)(15)’’; and 

10 (2) in subsection (e)(14), by adding at the end 

11 the following new subparagraph: 

12 ‘‘(K) TREATMENT OF CERTAIN LOTTERY

13 WINNINGS AND INCOME RECEIVED AS A LUMP

14 SUM.— 

15 ‘‘(i) IN GENERAL.—In the case of an 

16 individual who is the recipient of qualified 

17 lottery winnings (pursuant to lotteries oc18 curring on or after January 1, 2018) or 

19 qualified lump sum income (received on or 

20 after such date) and whose eligibility for 

21 medical assistance is determined based on 

22 the application of modified adjusted gross 

23 income under subparagraph (A), a State 

24 shall, in determining such eligibility, in-
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1 clude such winnings or income (as applica2 ble) as income received— 

3 ‘‘(I) in the month in which such 

4 winnings or income (as applicable) is 

5 received if the amount of such 

6 winnings or income is less than 

7 $80,000; 

8 ‘‘(II) over a period of 2 months if 

9 the amount of such winnings or income 

10 (as applicable) is greater than or equal 

11 to $80,000 but less than $90,000; 

12 ‘‘(III) over a period of 3 months 

13 if the amount of such winnings or in14 come (as applicable) is greater than or 

15 equal to $90,000 but less than 

16 $100,000; and 

17 ‘‘(IV) over a period of 3 months 

18 plus 1 additional month for each incre19 ment of $10,000 of such winnings or 

20 income (as applicable) received, not to 

21 exceed a period of 120 months (for 

22 winnings or income of $1,260,000 or 

23 more), if the amount of such winnings 

24 or income is greater than or equal to 

25 $100,000. 
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1 ‘‘(ii) COUNTING IN EQUAL INSTALL2 MENTS.—For purposes of subclauses (II), 

3 (III), and (IV) of clause (i), winnings or 

4 income to which such subclause applies 

5 shall be counted in equal monthly install6 ments over the period of months specified 

7 under such subclause. 

8 ‘‘(iii) HARDSHIP EXEMPTION.—An in9 dividual whose income, by application of 

10 clause (i), exceeds the applicable eligibility 

11 threshold established by the State, shall con12 tinue to be eligible for medical assistance to 

13 the extent that the State determines, under 

14 procedures established by the State (in ac15 cordance with standards specified by the 

16 Secretary), that the denial of eligibility of 

17 the individual would cause an undue med18 ical or financial hardship as determined on 

19 the basis of criteria established by the Sec20 retary. 

21 ‘‘(iv) NOTIFICATIONS AND ASSISTANCE

22 REQUIRED IN CASE OF LOSS OF ELIGI23 BILITY.—A State shall, with respect to an 

24 individual who loses eligibility for medical 
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1 assistance under the State plan (or a waiv2 er of such plan) by reason of clause (i)— 

3 ‘‘(I) before the date on which the 

4 individual loses such eligibility, inform 

5 the individual— 

6 ‘‘(aa) of the individual’s op7 portunity to enroll in a qualified 

8 health plan offered through an 

9 Exchange established under title I 

10 of the Patient Protection and Af11 fordable Care Act during the spe12 cial enrollment period specified in 

13 section 9801(f)(3) of the Internal 

14 Revenue Code of 1986 (relating to 

15 loss of Medicaid or CHIP cov16 erage); and 

17 ‘‘(bb) of the date on which 

18 the individual would no longer be 

19 considered ineligible by reason of 

20 clause (i) to receive medical as21 sistance under the State plan or 

22 under any waiver of such plan 

23 and be eligible to reapply to re24 ceive such medical assistance; and 
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1 ‘‘(II) provide technical assistance 

2 to the individual seeking to enroll in 

3 such a qualified health plan. 

4 ‘‘(v) QUALIFIED LOTTERY WINNINGS

5 DEFINED.—In this subparagraph, the term 

6 ‘qualified lottery winnings’ means winnings 

7 from a sweepstakes, lottery, or pool de8 scribed in paragraph (3) of section 4402 of 

9 the Internal Revenue Code of 1986 or a lot10 tery operated by a multistate or multijuris11 dictional lottery association, including 

12 amounts awarded as a lump sum payment. 

13 ‘‘(vi) QUALIFIED LUMP SUM INCOME

14 DEFINED.—In this subparagraph, the term 

15 ‘qualified lump sum income’ means income 

16 that is received as a lump sum from mone17 tary winnings from gambling (as defined by 

18 the Secretary and including gambling ac19 tivities described in section 1955(b)(4) of 

20 title 18, United States Code).’’. 

21 (b) RULES OF CONSTRUCTION.— 

22 (1) INTERCEPTION OF LOTTERY WINNINGS AL23 LOWED.—Nothing in the amendment made by sub24 section (a)(2) shall be construed as preventing a State 

25 from intercepting the State lottery winnings awarded 
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1 to an individual in the State to recover amounts paid 

2 by the State under the State Medicaid plan under 

3 title XIX of the Social Security Act (42 U.S.C. 1396 

4 et seq.) for medical assistance furnished to the indi5 vidual. 

6 (2) APPLICABILITY LIMITED TO ELIGIBILITY OF

7 RECIPIENT OF LOTTERY WINNINGS OR LUMP SUM IN8 COME.—Nothing in the amendment made by sub9 section (a)(2) shall be construed, with respect to a de10 termination of household income for purposes of a de11 termination of eligibility for medical assistance under 

12 the State plan under title XIX of the Social Security 

13 Act (42 U.S.C. 1396 et seq.) (or a waiver of such 

14 plan) made by applying modified adjusted gross in15 come under subparagraph (A) of section 1902(e)(14) 

16 of such Act (42 U.S.C. 1396a(e)(14)), as limiting the 

17 eligibility for such medical assistance of any indi18 vidual that is a member of the household other than 

19 the individual who received qualified lottery winnings 

20 or qualified lump-sum income (as defined in subpara21 graph (K) of such section 1902(e)(14), as added by 

22 subsection (a)(2) of this section). 
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1 SEC. 53104. REBATE OBLIGATION WITH RESPECT TO LINE 

2 EXTENSION DRUGS. 

3 (a) IN GENERAL.—Section 1927(c)(2)(C) of the Social 

4 Security Act (42 U.S.C. 1396r–8(c)(2)(C)) is amended by 

5 striking ‘‘(C) TREATMENT OF NEW FORMULATIONS.—In the 

6 case’’ and all that follows through the period at the end 

7 of the first sentence and inserting the following: 

8 ‘‘(C) TREATMENT OF NEW FORMULA9 TIONS.— 

10 ‘‘(i) IN GENERAL.—In the case of a 

11 drug that is a line extension of a single 

12 source drug or an innovator multiple source 

13 drug that is an oral solid dosage form, the 

14 rebate obligation for a rebate period with 

15 respect to such drug under this subsection 

16 shall be the greater of the amount described 

17 in clause (ii) for such drug or the amount 

18 described in clause (iii) for such drug. 

19 ‘‘(ii) AMOUNT 1.—For purposes of 

20 clause (i), the amount described in this 

21 clause with respect to a drug described in 

22 clause (i) and rebate period is the amount 

23 computed under paragraph (1) for such 

24 drug, increased by the amount computed 

25 under subparagraph (A) and, as applicable, 
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1 subparagraph (B) for such drug and rebate 

2 period. 

3 ‘‘(iii) AMOUNT 2.—For purposes of 

4 clause (i), the amount described in this 

5 clause with respect to a drug described in 

6 clause (i) and rebate period is the amount 

7 computed under paragraph (1) for such 

8 drug, increased by the product of— 

9 ‘‘(I) the average manufacturer 

10 price for the rebate period of the line 

11 extension of a single source drug or an 

12 innovator multiple source drug that is 

13 an oral solid dosage form; 

14 ‘‘(II) the highest additional rebate 

15 (calculated as a percentage of average 

16 manufacturer price) under this para17 graph for the rebate period for any 

18 strength of the original single source 

19 drug or innovator multiple source 

20 drug; and 

21 ‘‘(III) the total number of units of 

22 each dosage form and strength of the 

23 line extension product paid for under 

24 the State plan in the rebate period (as 

25 reported by the State).’’. 
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1 (b) EFFECTIVE DATE.—The amendments made sub2 section (a) shall apply with respect to rebate periods begin3 ning on or after October 1, 2018. 

4 SEC. 53105. MEDICAID IMPROVEMENT FUND. 

5 Section 1941(b) of the Social Security Act (42 U.S.C. 

6 1396w–1(b)) is amended— 

7 (1) in paragraph (1), by striking ‘‘$5,000,000’’ 

8 and inserting ‘‘$0’’; and 

9 (2) in paragraph (3)(A), by striking 

10 ‘‘$980,000,000’’ and inserting ‘‘$0’’. 

11 SEC. 53106. PHYSICIAN FEE SCHEDULE UPDATE. 

12 Section 1848(d)(18) of the Social Security Act (42 

13 U.S.C. 1395w–4(d)(18)) is amended by striking ‘‘para14 graph (1)(C)’’ and all that follows and inserting the fol15 lowing: ‘‘paragraph (1)(C)— 

16 ‘‘(A) for 2016 and each subsequent year 

17 through 2018 shall be 0.5 percent; and 

18 ‘‘(B) for 2019 shall be 0.25 percent.’’. 

19 SEC. 53107. PAYMENT FOR OUTPATIENT PHYSICAL THER20 APY SERVICES AND OUTPATIENT OCCUPA21 TIONAL THERAPY SERVICES FURNISHED BY A 

22 THERAPY ASSISTANT. 

23 Section 1834 of the Social Security Act (42 U.S.C. 

24 1395m) is amended by adding at the end the following new 

25 subsection: 
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1 ‘‘(v) PAYMENT FOR OUTPATIENT PHYSICAL THERAPY

2 SERVICES AND OUTPATIENT OCCUPATIONAL THERAPY

3 SERVICES FURNISHED BY A THERAPY ASSISTANT.— 

4 ‘‘(1) IN GENERAL.—In the case of an outpatient 

5 physical therapy service or outpatient occupational 

6 therapy service furnished on or after January 1, 

7 2022, for which payment is made under section 1848 

8 or subsection (k), that is furnished in whole or in 

9 part by a therapy assistant (as defined by the Sec10 retary), the amount of payment for such service shall 

11 be an amount equal to 85 percent of the amount of 

12 payment otherwise applicable for the service under 

13 this part. Nothing in the preceding sentence shall be 

14 construed to change applicable requirements with re15 spect to such services. 

16 ‘‘(2) USE OF MODIFIER.— 

17 ‘‘(A) ESTABLISHMENT.—Not later than 

18 January 1, 2019, the Secretary shall establish a 

19 modifier to indicate (in a form and manner 

20 specified by the Secretary), in the case of an out21 patient physical therapy service or outpatient 

22 occupational therapy service furnished in whole 

23 or in part by a therapy assistant (as so defined), 

24 that the service was furnished by a therapy as25 sistant. 
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1 ‘‘(B) REQUIRED USE.—Each request for 

2 payment, or bill submitted, for an outpatient 

3 physical therapy service or outpatient occupa4 tional therapy service furnished in whole or in 

5 part by a therapy assistant (as so defined) on or 

6 after January 1, 2020, shall include the modifier 

7 established under subparagraph (A) for each 

8 such service. 

9 ‘‘(3) IMPLEMENTATION.—The Secretary shall im10 plement this subsection through notice and comment 

11 rulemaking.’’. 

12 SEC. 53108. REDUCTION FOR NON-EMERGENCY ESRD AMBU13 LANCE TRANSPORTS. 

14 Section 1834(l)(15) of the Social Security Act (42. 

15 U.S.C. 1395m(l)(15)) is amended by striking ‘‘on or after 

16 October 1, 2013’’ and inserting ‘‘during the period begin17 ning on October 1, 2013, and ending on September 30, 

18 2018, and by 23 percent for such services furnished on or 

19 after October 1, 2018’’. 

20 SEC. 53109. HOSPITAL TRANSFER POLICY FOR EARLY DIS21 CHARGES TO HOSPICE CARE. 

22 (a) IN GENERAL.—Section 1886(d)(5)(J) of the Social 

23 Security Act (42 U.S.C. 1395ww(d)(5)(J)) is amended— 

24 (1) in clause (ii)— 
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1 (A) in subclause (III), by striking ‘‘or’’ at 

2 the end; 

3 (B) by redesignating subclause (IV) as sub4 clause (V); and 

5 (C) by inserting after subclause (III) the 

6 following new subclause: 

7 ‘‘(IV) for discharges occurring on or after Octo8 ber 1, 2018, is provided hospice care by a hospice pro9 gram; or’’; and 

10 (2) in clause (iv)— 

11 (A) by inserting after the first sentence the 

12 following new sentence: ‘‘The Secretary shall in13 clude in the proposed rule published for fiscal 

14 year 2019, a description of the effect of clause 

15 (ii)(IV).’’; and 

16 (B) in subclause (I), by striking ‘‘and 

17 (III)’’ and inserting ‘‘(III), and, in the case of 

18 proposed and final rules for fiscal year 2019 and 

19 subsequent fiscal years, (IV)’’. 

20 (b) MEDPAC EVALUATION AND REPORT.— 

21 (1) EVALUATION.—The Medicare Payment Advi22 sory Commission (in this subsection referred to as the 

23 ‘‘Commission’’) shall conduct an evaluation of the ef24 fects of the amendments made by subsection (a), in25 cluding the effects on— 
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1 (A) the numbers of discharges of patients 

2 from an inpatient hospital setting to a hospice 

3 program; 

4 (B) the lengths of stays of patients in an in5 patient hospital setting who are discharged to a 

6 hospice program; 

7 (C) spending under the Medicare program 

8 under title XVIII of the Social Security Act; and 

9 (D) other areas determined appropriate by 

10 the Commission. 

11 (2) CONSIDERATION.—In conducting the evalua12 tion under paragraph (1), the Commission shall con13 sider factors such as whether the timely access to hos14 pice care by patients admitted to a hospital has been 

15 affected through changes to hospital policies or behav16 iors made as a result of such amendments. 

17 (3) PRELIMINARY RESULTS.—Not later than 

18 March 15, 2020, the Commission shall provide Con19 gress with preliminary results on the evaluation being 

20 conducted under paragraph (1). 

21 (4) REPORT.—Not later than March 15, 2021, 

22 the Commission shall submit to Congress a report on 

23 the evaluation conducted under paragraph (1). 
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1 SEC. 53110. MEDICARE PAYMENT UPDATE FOR HOME 

2 HEALTH SERVICES. 

3 Section 1895(b)(3)(B) of the Social Security Act (42 

4 U.S.C. 1395fff(b)(3)(B)) is amended— 

5 (1) in clause (iii), in the last sentence, by insert6 ing before the period at the end the following: ‘‘and 

7 for 2020 shall be 1.5 percent’’; and 

8 (2) in clause (vi), by inserting ‘‘and 2020’’ after 

9 ‘‘except 2018’’. 

10 SEC. 53111. MEDICARE PAYMENT UPDATE FOR SKILLED 

11 NURSING FACILITIES. 

12 Section 1888(e)(5)(B) of the Social Security Act (42 

13 U.S.C. 1395yy(e)(5)(B)) is amended— 

14 (1) in clause (i), by striking ‘‘and (iii)’’ and in15 serting ‘‘, (iii), and (iv)’’; 

16 (2) in clause (ii), by striking ‘‘clause (iii)’’ and 

17 inserting ‘‘clauses (iii) and (iv)’’; and 

18 (3) by adding at the end the following new 

19 clause: 

20 ‘‘(iv) SPECIAL RULE FOR FISCAL YEAR

21 2019.—For fiscal year 2019 (or other simi22 lar annual period specified in clause (i)), 

23 the skilled nursing facility market basket 

24 percentage, after application of clause (ii), 

25 is equal to 2.4 percent.’’. 
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1 SEC. 53112. PREVENTING THE ARTIFICIAL INFLATION OF 

2 STAR RATINGS AFTER THE CONSOLIDATION 

3 OF MEDICARE ADVANTAGE PLANS OFFERED 

4 BY THE SAME ORGANIZATION. 

5 Section 1853(o)(4) of the Social Security Act (42 

6 U.S.C. 1395w–23(o)(4)) is amended by adding at the end 

7 the following new subparagraph: 

8 ‘‘(D) SPECIAL RULE TO PREVENT THE ARTI9 FICIAL INFLATION OF STAR RATINGS AFTER THE

10 CONSOLIDATION OF MEDICARE ADVANTAGE PLANS

11 OFFERED BY A SINGLE ORGANIZATION.— 

12 ‘‘(i) IN GENERAL.—If— 

13 ‘‘(I) a Medicare Advantage orga14 nization has entered into more than 

15 one contract with the Secretary with 

16 respect to the offering of Medicare Ad17 vantage plans; and 

18 ‘‘(II) on or after January 1, 2019, 

19 the Secretary approves a request from 

20 the organization to consolidate the 

21 plans under one or more contract (in 

22 this subparagraph referred to as a 

23 ‘closed contract’) with the plans offered 

24 under a separate contract (in this sub25 paragraph referred to as the ‘con26 tinuing contract’); 
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† HR 1892 EAS2 

1 with respect to the continuing contract, the 

2 Secretary shall adjust the quality rating 

3 under the 5-star rating system and any 

4 quality increase under this subsection and 

5 rebate amounts under section 1854 to reflect 

6 an enrollment-weighted average of scores or 

7 ratings for the continuing and closed con8 tracts, as determined appropriate by the 

9 Secretary. 

10 ‘‘(ii) APPLICATION.—An adjustment 

11 under clause (i) shall apply for any year 

12 for which the quality rating of the con13 tinuing contract is based primarily on a 

14 measurement period that is prior to the 

15 first year in which a closed contract is no 

16 longer offered.’’. 

17 SEC. 53113. SUNSETTING EXCLUSION OF BIOSIMILARS 

18 FROM MEDICARE PART D COVERAGE GAP DIS19 COUNT PROGRAM. 

20 Section 1860D–14A(g)(2)(A) of the Social Security 

21 Act (42 U.S.C. 1395w–114a(g)(2)(A)) is amended by insert22 ing ‘‘, with respect to a plan year before 2019,’’ after ‘‘other 

23 than’’. 
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† HR 1892 EAS2 

1 SEC. 53114. ADJUSTMENTS TO MEDICARE PART B AND PART 

2 D PREMIUM SUBSIDIES FOR HIGHER INCOME 

3 INDIVIDUALS. 

4 (a) IN GENERAL.—Section 1839(i)(3)(C)(i) of the So5 cial Security Act (42 U.S.C. 1395r(i)(3)(C)(i)) is amend6 ed— 

7 (1) in subclause (II), in the matter preceding the 

8 table, by striking ‘‘years beginning with’’; and 

9 (2) by adding at the end the following new sub10 clause: 

11 ‘‘(III) Subject to paragraph (5), 

12 for years beginning with 2019: 

‘‘If the modified adjusted gross income is: ........ The applicable 

percentage is:

More than $85,000 but not more than $107,000 ................. 35 percent

More than $107,000 but not more than $133,500 ............... 50 percent

More than $133,500 but not more than $160,000 ............... 65 percent

More than $160,000 but less than $500,000 ......................... 80 percent

At least $500,000 .................................................................... 85 percent.’’. 

13 (b) JOINT RETURNS.—Section 1839(i)(3)(C)(ii) of the 

14 Social Security Act (42 U.S.C. 1395r(i)(3)(C)(ii)) is 

15 amended by inserting before the period the following: ‘‘ex16 cept, with respect to the dollar amounts applied in the last 

17 row of the table under subclause (III) of such clause (and 

18 the second dollar amount specified in the second to last row 

19 of such table), clause (i) shall be applied by substituting 

20 dollar amounts which are 150 percent of such dollar 

21 amounts for the calendar year’’. 
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1 (c) INFLATION ADJUSTMENT.—Section 1839(i)(5) of 

2 the Social Security Act (42 U.S.C. 1395r(i)(5)) is amend3 ed— 

4 (1) in subparagraph (A), by striking ‘‘In the 

5 case’’ and inserting ‘‘Subject to subparagraph (C), in 

6 the case’’; 

7 (2) in subparagraph (B), by striking ‘‘subpara8 graph (A)’’ and inserting ‘‘subparagraph (A) or (C)’’; 

9 and 

10 (3) by adding at the end the following new sub11 paragraph: 

12 ‘‘(C) TREATMENT OF ADJUSTMENTS FOR

13 CERTAIN HIGHER INCOME INDIVIDUALS.— 

14 ‘‘(i) IN GENERAL.—Subparagraph (A) 

15 shall not apply with respect to each dollar 

16 amount in paragraph (3) of $500,000. 

17 ‘‘(ii) ADJUSTMENT BEGINNING 2028.— 

18 In the case of any calendar year beginning 

19 after 2027, each dollar amount in para20 graph (3) of $500,000 shall be increased by 

21 an amount equal to— 

22 ‘‘(I) such dollar amount, multi23 plied by 

24 ‘‘(II) the percentage (if any) by 

25 which the average of the Consumer 
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† HR 1892 EAS2 

1 Price Index for all urban consumers 

2 (United States city average) for the 12- 

3 month period ending with August of 

4 the preceding calendar year exceeds 

5 such average for the 12-month period 

6 ending with August 2026.’’. 

7 SEC. 53115. MEDICARE IMPROVEMENT FUND. 

8 Section 1898(b)(1) of the Social Security Act (42 

9 U.S.C. 1395iii(b)(1)) is amended by striking 

10 ‘‘$220,000,000’’ and inserting ‘‘$0’’. 

11 SEC. 53116. CLOSING THE DONUT HOLE FOR SENIORS. 

12 (a) CLOSING DONUT HOLE SOONER.—Section 1860D– 

13 2(b)(2)(D) of the Social Security Act (42 U.S.C. 1395w– 

14 102(b)(2)(D))— 

15 (1) in clause (i), by amending subclause (I) to 

16 read as follows: 

17 ‘‘(I) equal to the difference be18 tween— 

19 ‘‘(aa) the applicable gap per20 centage (specified in clause (ii) 

21 for the year); and 

22 ‘‘(bb) the discount percentage 

23 specified in section 1860D– 

24 14A(g)(4)(A) for such applicable 
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† HR 1892 EAS2 

1 drugs (or, in the case of a year 

2 after 2018, 50 percent); or’’; and 

3 (2) in clause (ii)— 

4 (A) in subclause (IV), by adding ‘‘and’’ at 

5 the end; 

6 (B) by striking subclause (V); and 

7 (C) in subclause (VI)— 

8 (i) by striking ‘‘2020’’ and inserting 

9 ‘‘2019’’; and 

10 (ii) by redesignating such subclause as 

11 subclause (V). 

12 (b) LOWERING DISCOUNTED PRICE.—Section 1860D– 

13 14A(g)(4)(A) of the Social Security Act (42 U.S.C. 1395w– 

14 114a(g)(4)(A)) is amended by inserting ‘‘(or, with respect 

15 to a plan year after plan year 2018, 30 percent)’’ after ‘‘50 

16 percent’’. 

17 SEC. 53117. MODERNIZING CHILD SUPPORT ENFORCEMENT 

18 FEES. 

19 (a) IN GENERAL.—Section 454(6)(B)(ii) of the Social 

20 Security Act (42 U.S.C. 654(6)(B)(ii)) is amended— 

21 (1) by striking ‘‘$25’’ and inserting ‘‘$35’’; and 

22 (2) by striking ‘‘$500’’ each place it appears and 

23 inserting ‘‘$550’’. 

24 (b) EFFECTIVE DATE.— 
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† HR 1892 EAS2 

1 (1) IN GENERAL.—The amendments made by 

2 subsection (a) shall take effect on the 1st day of the 

3 1st fiscal year that begins on or after the date of the 

4 enactment of this Act, and shall apply to payments 

5 under part D of title IV of the Social Security Act 

6 (42 U.S.C. 651 et seq.) for calendar quarters begin7 ning on or after such 1st day. 

8 (2) DELAY PERMITTED IF STATE LEGISLATION

9 REQUIRED.—If the Secretary of Health and Human 

10 Services determines that State legislation (other than 

11 legislation appropriating funds) is required in order 

12 for a State plan developed pursuant to part D of title 

13 IV of the Social Security Act (42 U.S.C. 651 et seq.) 

14 to meet the requirements imposed by the amendment 

15 made by subsection (a), the plan shall not be regarded 

16 as failing to meet such requirements before the 1st 

17 day of the 1st calendar quarter beginning after the 

18 first regular session of the State legislature that be19 gins after the date of the enactment of this Act. For 

20 purposes of the preceding sentence, if the State has a 

21 2-year legislative session, each year of the session is 

22 deemed to be a separate regular session of the State 

23 legislature. 
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† HR 1892 EAS2 

1 SEC. 53118. INCREASING EFFICIENCY OF PRISON DATA RE2 PORTING. 

3 (a) IN GENERAL.—Section 1611(e)(1)(I)(i)(II) of the 

4 Social Security Act (42 U.S.C. 1382(e)(1)(I)(i)(II)) is 

5 amended by striking ‘‘30 days’’ each place it appears and 

6 inserting ‘‘15 days’’. 

7 (b) EFFECTIVE DATE.—The amendments made by sub8 section (a) shall apply with respect to any payment made 

9 by the Commissioner of Social Security pursuant to section 

10 1611(e)(1)(I)(i)(II) of the Social Security Act (42 U.S.C. 

11 1382(e)(1)(I)(i)(II)) (as amended by such subsection) on or 

12 after the date that is 6 months after the date of enactment 

13 of this Act. 

14 SEC. 53119. PREVENTION AND PUBLIC HEALTH FUND. 

15 Section 4002(b) of the Patient Protection and Afford16 able Care Act (42 U.S.C. 300u–11(b)), as amended by sec17 tion 3103 of Public Law 115–96, is amended by striking 

18 paragraphs (4) through (9) and inserting the following: 

19 ‘‘(4) for fiscal year 2019, $900,000,000; 

20 ‘‘(5) for each of fiscal years 2020 and 2021, 

21 $950,000,000; 

22 ‘‘(6) for each of fiscal years 2022 and 2023, 

23 $1,000,000,000; 

24 ‘‘(7) for each of fiscal years 2024 and 2025, 

25 $1,300,000,000; 
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† HR 1892 EAS2 

1 ‘‘(8) for each of fiscal years 2026 and 2027, 

2 $1,800,000,000; and 

3 ‘‘(9) for fiscal year 2028 and each fiscal year 

4 thereafter, $2,000,000,000.’’. 

5 DIVISION F—IMPROVEMENTS TO 

6 AGRICULTURE PROGRAMS 

7 SEC. 60101. (a) TREATMENT OF SEED COTTON.— 

8 (1) DESIGNATION OF SEED COTTON AS A COV9 ERED COMMODITY.—Section 1111(6) of the Agricul10 tural Act of 2014 (7 U.S.C. 9011(6)) is amended— 

11 (A) by striking ‘‘The term’’ and inserting 

12 the following: 

13 ‘‘(A) IN GENERAL.—The term’’; and 

14 (B) by adding at the end the following: 

15 ‘‘(B) INCLUSION.—Effective beginning with 

16 the 2018 crop year, the term ‘covered commodity’ 

17 includes seed cotton.’’. 

18 (2) REFERENCE PRICE FOR SEED COTTON.—Sec19 tion 1111(18) of the Agricultural Act of 2014 (7 

20 U.S.C. 9011(18)) is amended by adding at the end 

21 the following: 

22 ‘‘(O) For seed cotton, $0.367 per pound.’’. 

23 (3) DEFINITION OF SEED COTTON.—Section 1111 

24 of the Agricultural Act of 2014 (7 U.S.C. 9011) is 

25 amended— 
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1 (A) by redesignating paragraphs (20) 

2 through (24) as paragraphs (21) through (25), 

3 respectively; and 

4 (B) by inserting after paragraph (19) the 

5 following: 

6 ‘‘(20) SEED COTTON.—The term ‘seed cotton’ 

7 means unginned upland cotton that includes both lint 

8 and seed.’’. 

9 (4) PAYMENT YIELD.—Section 1113 of the Agri10 cultural Act of 2014 (7 U.S.C. 9013) is amended by 

11 adding at the end the following: 

12 ‘‘(e) PAYMENT YIELD FOR SEED COTTON.— 

13 ‘‘(1) PAYMENT YIELD.—Subject to paragraph 

14 (2), the payment yield for seed cotton for a farm shall 

15 be equal to 2.4 times the payment yield for upland 

16 cotton for the farm established under section 

17 1104(e)(3) of the Food, Conservation, and Energy Act 

18 of 2008 (7 U.S.C. 8714(e)(3)) (as in effect on Sep19 tember 30, 2013). 

20 ‘‘(2) UPDATE.—At the sole discretion of the 

21 owner of a farm with a yield for upland cotton de22 scribed in paragraph (1), the owner of the farm shall 

23 have a 1-time opportunity to update the payment 

24 yield for upland cotton for the farm, as provided in 
627 

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1 subsection (d), for the purpose of calculating the pay2 ment yield for seed cotton under paragraph (1).’’. 

3 (5) PAYMENT ACRES.—Section 1114(b) of the Ag4 ricultural Act of 2014 (7 U.S.C. 9014(b)) is amended 

5 by adding at the end the following: 

6 ‘‘(4) SEED COTTON.— 

7 ‘‘(A) IN GENERAL.—Not later than 90 days 

8 after the date of enactment of this paragraph, the 

9 Secretary shall require the owner of a farm to al10 locate all generic base acres on the farm under 

11 subparagraph (B) or (C), or both. 

12 ‘‘(B) NO RECENT HISTORY OF COVERED

13 COMMODITIES.—In the case of a farm on which 

14 no covered commodities (including seed cotton) 

15 were planted or were prevented from being plant16 ed at any time during the 2009 through 2016 

17 crop years, the owner of such farm shall allocate 

18 generic base acres on the farm to unassigned 

19 crop base for which no payments may be made 

20 under section 1116 or 1117. 

21 ‘‘(C) RECENT HISTORY OF COVERED COM22 MODITIES.—In the case of a farm not described 

23 in subparagraph (B), the owner of such farm 

24 shall allocate generic base acres on the farm— 
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1 ‘‘(i) subject to subparagraph (D), to 

2 seed cotton base acres in a quantity equal 

3 to the greater of— 

4 ‘‘(I) 80 percent of the generic base 

5 acres on the farm; or 

6 ‘‘(II) the average number of seed 

7 cotton acres planted or prevented from 

8 being planted on the farm during the 

9 2009 through 2012 crop years (not to 

10 exceed the total generic base acres on 

11 the farm); or 

12 ‘‘(ii) to base acres for covered commod13 ities (including seed cotton), by applying 

14 subparagraphs (B), (D), (E), and (F) of 

15 section 1112(a)(3). 

16 ‘‘(D) TREATMENT OF RESIDUAL GENERIC

17 BASE ACRES.—In the case of a farm on which 

18 generic base acres are allocated under subpara19 graph (C)(i), the residual generic base acres shall 

20 be allocated to unassigned crop base for which no 

21 payments may be made under section 1116 or 

22 1117. 

23 ‘‘(E) EFFECT OF FAILURE TO ALLOCATE.— 

24 In the case of a farm not described in subpara25 graph (B) for which the owner of the farm fails 
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† HR 1892 EAS2 

1 to make an election under subparagraph (C), the 

2 owner of the farm shall be deemed to have elected 

3 to allocate all generic base acres in accordance 

4 with subparagraph (C)(i).’’. 

5 (6) RECORDKEEPING REGARDING UNASSIGNED

6 CROP BASE.—Section 1114 of the Agricultural Act of 

7 2014 (7 U.S.C. 9014) is amended by adding at the 

8 end the following: 

9 ‘‘(f) UNASSIGNED CROP BASE.—The Secretary shall 

10 maintain information on generic base acres on a farm allo11 cated as unassigned crop base under subsection (b)(4).’’. 

12 (7) SPECIAL ELECTION PERIOD FOR PRICE LOSS

13 COVERAGE OR AGRICULTURE RISK COVERAGE.—Sec14 tion 1115 of the Agricultural Act of 2014 (7 U.S.C. 

15 9015) is amended— 

16 (A) in subsection (a), by striking ‘‘For’’ and 

17 inserting ‘‘Except as provided in subsection (g), 

18 for’’; and 

19 (B) by adding at the end the following: 

20 ‘‘(g) SPECIAL ELECTION.— 

21 ‘‘(1) IN GENERAL.—In the case of acres allocated 

22 to seed cotton on a farm, all of the producers on the 

23 farm shall be given the opportunity to make a new 

24 1-time election under subsection (a) to reflect the des-
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† HR 1892 EAS2 

1 ignation of seed cotton as a covered commodity for 

2 that crop year under section 1111(6)(B). 

3 ‘‘(2) EFFECT OF FAILURE TO MAKE UNANIMOUS

4 ELECTION.—If all the producers on a farm fail to 

5 make a unanimous election under paragraph (1), the 

6 producers on the farm shall be deemed to have elected 

7 price loss coverage under section 1116 for acres allo8 cated on the farm to seed cotton.’’. 

9 (8) EFFECTIVE PRICE.—Section 1116 of the Ag10 ricultural Act of 2014 (7 U.S.C. 9016) is amended by 

11 adding at the end the following: 

12 ‘‘(h) EFFECTIVE PRICE FOR SEED COTTON.— 

13 ‘‘(1) IN GENERAL.—The effective price for seed 

14 cotton under subsection (b) shall be equal to the mar15 keting year average price for seed cotton, as cal16 culated under paragraph (2). 

17 ‘‘(2) CALCULATION.—The marketing year aver18 age price for seed cotton for a crop year shall be equal 

19 to the quotient obtained by dividing— 

20 ‘‘(A) the sum obtained by adding— 

21 ‘‘(i) the product obtained by multi22 plying— 

23 ‘‘(I) the upland cotton lint mar24 keting year average price; and 
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1 ‘‘(II) the total United States up2 land cotton lint production, measured 

3 in pounds; and 

4 ‘‘(ii) the product obtained by multi5 plying— 

6 ‘‘(I) the cottonseed marketing year 

7 average price; and 

8 ‘‘(II) the total United States cot9 tonseed production, measured in 

10 pounds; by 

11 ‘‘(B) the sum obtained by adding— 

12 ‘‘(i) the total United States upland cot13 ton lint production, measured in pounds; 

14 and 

15 ‘‘(ii) the total United States cottonseed 

16 production, measured in pounds.’’. 

17 (9) DEEMED LOAN RATE FOR SEED COTTON.— 

18 Section 1202 of the Agricultural Act of 2014 (7 

19 U.S.C. 9032) is amended by adding at the end the fol20 lowing: 

21 ‘‘(c) SEED COTTON.— 

22 ‘‘(1) IN GENERAL.—For purposes of section 

23 1116(b)(2) and paragraphs (1)(B)(ii) and 

24 (2)(A)(ii)(II) of section 1117(b), the loan rate for seed 

25 cotton shall be deemed to be equal to $0.25 per pound. 
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† HR 1892 EAS2 

1 ‘‘(2) EFFECT.—Nothing in this subsection au2 thorizes any nonrecourse marketing assistance loan 

3 under this subtitle for seed cotton.’’. 

4 (10) LIMITATION ON STACKED INCOME PROTEC5 TION PLAN FOR PRODUCERS OF UPLAND COTTON.— 

6 Section 508B of the Federal Crop Insurance Act (7 

7 U.S.C. 1508b) is amended by adding at the end the 

8 following: 

9 ‘‘(f) LIMITATION.—Effective beginning with the 2019 

10 crop year, a farm shall not be eligible for the Stacked In11 come Protection Plan for upland cotton for a crop year for 

12 which the farm is enrolled in coverage for seed cotton 

13 under— 

14 ‘‘(1) price loss coverage under section 1116 of the 

15 Agricultural Act of 2014 (7 U.S.C. 9016); or 

16 ‘‘(2) agriculture risk coverage under section 1117 

17 of that Act (7 U.S.C. 9017).’’. 

18 (11) TECHNICAL CORRECTION.—Section 

19 1114(b)(2) of the Agricultural Act of 2014 (7 U.S.C. 

20 9014(b)(2)) is amended by striking ‘‘paragraphs 

21 (1)(B) and (2)(B)’’ and inserting ‘‘paragraphs (1) 

22 and (2)’’. 

23 (12) ADMINISTRATION.—The Secretary of Agri24 culture shall carry out the amendments made by this 
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† HR 1892 EAS2 

1 subsection in accordance with section 1601 of the Ag2 ricultural Act of 2014 (7 U.S.C. 9091). 

3 (13) APPLICATION.—Except as provided in para4 graph (10), the amendments made by this subsection 

5 shall apply beginning with the 2018 crop year. 

6 (b) MARGIN PROTECTION PROGRAM FOR DAIRY PRO7 DUCERS.— 

8 (1) MONTHLY CALCULATION OF ACTUAL DAIRY

9 PRODUCTION MARGIN.— 

10 (A) DEFINITIONS.—Section 1401 of the Ag11 ricultural Act of 2014 (7 U.S.C. 9051) is amend12 ed— 

13 (i) by striking paragraph (4); and 

14 (ii) by redesignating paragraphs (5) 

15 through (11) as paragraphs (4) through 

16 (10), respectively. 

17 (B) CALCULATION OF ACTUAL DAIRY PRO18 DUCTION MARGIN.—Section 1402(b)(1) of the Ag19 ricultural Act of 2014 (7 U.S.C. 9052(b)(1)) is 

20 amended by striking ‘‘consecutive 2-month pe21 riod’’ each place it appears and inserting 

22 ‘‘month’’. 

23 (C) MARGIN PROTECTION PAYMENTS.—Sec24 tion 1406 of the Agricultural Act of 2014 (7 

25 U.S.C. 9056) is amended— 
634 

† HR 1892 EAS2 

1 (i) by striking ‘‘consecutive 2-month 

2 period’’ each place it appears and inserting 

3 ‘‘month’’; and 

4 (ii) in subsection (c)(2)(B), by striking 

5 ‘‘6’’ and inserting ‘‘12’’. 

6 (2) PARTICIPATION OF DAIRY OPERATIONS IN

7 MARGIN PROTECTION PROGRAM.—Section 1404 of the 

8 Agricultural Act of 2014 (7 U.S.C. 9054) is amend9 ed— 

10 (A) in subsection (b)— 

11 (i) in paragraph (1), by inserting ‘‘, 

12 including the establishment of a date each 

13 calendar year by which a dairy operation 

14 shall register for the calendar year’’ before 

15 the period at the end; 

16 (ii) by redesignating paragraphs (2) 

17 and (3) as paragraphs (3) and (4), respec18 tively; and 

19 (iii) by inserting after paragraph (1) 

20 the following: 

21 ‘‘(2) EXTENSION OF ELECTION PERIOD FOR 2018

22 CALENDAR YEAR.—The Secretary shall extend the 

23 election period for the 2018 calendar year by not less 

24 than 90 days after the date of enactment of the Bi25 partisan Budget Act of 2018 or such additional pe-
635 

† HR 1892 EAS2 

1 riod as the Secretary determines is necessary for 

2 dairy operations to make new elections to participate 

3 for that calendar year, including dairy operations 

4 that elected to so participate before that date of enact5 ment.’’; and 

6 (B) in subsection (c), by adding at the end 

7 the following: 

8 ‘‘(4) EXEMPTION.—A limited resource, begin9 ning, veteran, or socially disadvantaged farmer, as 

10 defined by the Secretary, shall be exempt from the ad11 ministrative fee under this subsection.’’. 

12 (3) PRODUCTION HISTORY OF PARTICIPATING

13 DAIRY OPERATIONS.—Section 1405(a) of the Agricul14 tural Act of 2014 (7 U.S.C. 9055(a)) is amended by 

15 adding at the end the following: 

16 ‘‘(3) CONTINUED APPLICABILITY OF BASE PRO17 DUCTION HISTORY.—A production history established 

18 for a dairy operation under paragraph (1) shall be 

19 the base production history for the dairy operation in 

20 subsequent years (as adjusted under paragraph (2)).’’. 

21 (4) PREMIUMS FOR MARGIN PROTECTION PRO22 GRAM.—Section 1407 of the Agricultural Act of 2014 

23 (7 U.S.C. 9057) is amended— 

24 (A) in subsection (b)— 
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1 (i) by striking the subsection heading 

2 and inserting the following: ‘‘TIER I: PRE3 MIUM PER HUNDREDWEIGHT FOR FIRST

4 5,000,000 POUNDS OF PRODUCTION.—’’; 

5 (ii) in paragraph (1), by striking 

6 ‘‘4,000,000’’ and inserting ‘‘5,000,000’’; and 

7 (iii) in paragraph (2)— 

8 (I) by striking ‘‘$0.010’’ and in9 serting ‘‘None’’; 

10 (II) by striking ‘‘$0.025’’ and in11 serting ‘‘None’’; 

12 (III) by striking ‘‘$0.040’’ and in13 serting ‘‘$0.009’’; 

14 (IV) by striking ‘‘$0.055’’ and in15 serting ‘‘$0.016’’; 

16 (V) by striking ‘‘$0.090’’ and in17 serting ‘‘$0.040’’; 

18 (VI) by striking ‘‘$0.217’’ and in19 serting ‘‘$0.063’’; 

20 (VII) by striking ‘‘$0.300’’ and 

21 inserting ‘‘$0.087’’; and 

22 (VIII) by striking ‘‘$0.475’’ and 

23 inserting ‘‘$0.142’’; and 

24 (B) in subsection (c)— 
637 

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1 (i) by striking the subsection heading 

2 and inserting the following: ‘‘TIER II: PRE3 MIUM PER HUNDREDWEIGHT FOR PRODUC4 TION IN EXCESS OF 5,000,000 POUNDS.—’’; 

5 and 

6 (ii) in paragraph (1), by striking 

7 ‘‘4,000,000’’ and inserting ‘‘5,000,000’’. 

8 (5) APPLICATION.—The amendments made by 

9 this subsection shall apply beginning with the 2018 

10 calendar year. 

11 (c) LIMITATION ON CROP INSURANCE LIVESTOCK-RE12 LATED EXPENDITURES.— 

13 (1) IN GENERAL.—Section 523(b) of the Federal 

14 Crop Insurance Act (7 U.S.C. 1523(b)) is amended by 

15 striking paragraph (10). 

16 (2) CONFORMING AMENDMENTS.—Section 516 of 

17 the Federal Crop Insurance Act (7 U.S.C. 1516) is 

18 amended in subsections (a)(2)(C) and (b)(1)(D) by 

19 striking ‘‘subsections (a)(3)(E)(ii) and (b)(10) of sec20 tion 523’’ each place it appears and inserting ‘‘sub21 section (a)(3)(E)(ii) of that section’’. 

22 SEC. 60102. (a) Section 1240B of the Food Security 

23 Act of 1985 (16 U.S.C. 3839aa–2) is amended by striking 

24 subsection (a) and inserting the following: 
638 

† HR 1892 EAS2 

1 ‘‘(a) ESTABLISHMENT.—During each of the 2002 

2 through 2019 fiscal years, the Secretary shall provide pay3 ments to producers that enter into contracts with the Sec4 retary under the program.’’. 

5 (b) Section 1241 of the Food Security Act of 1985 (16 

6 U.S.C. 3841) is amended— 

7 (1) in subsection (a)— 

8 (A) in the matter preceding paragraph (1), 

9 by striking ‘‘2018’’ and inserting ‘‘2018 (and fis10 cal year 2019 in the case of the program speci11 fied in paragraph (5))’’; and 

12 (B) in paragraph (5)(E), by striking ‘‘fiscal 

13 year 2018’’ and inserting ‘‘each of fiscal years 

14 2018 through 2019’’; and 

15 (2) in subsection (b), by striking ‘‘2018’’ and in16 serting ‘‘2018 (and fiscal year 2019 in the case of the 

17 program specified in subsection (a)(5))’’. 

18 This division may be cited as the ‘‘Improvements to 

19 Agriculture Programs Act of 2018’’. 

20 DIVISION G—BUDGETARY 

21 EFFECTS 

22 SEC. 70101. BUDGETARY EFFECTS. 

23 (a) IN GENERAL.—The budgetary effects of division A, 

24 subdivision 2 of division B, and division C and each suc25 ceeding division shall not be entered on either PAYGO 
639 

† HR 1892 EAS2 

1 scorecard maintained pursuant to section 4(d) of the Statu2 tory Pay-As-You-Go Act of 2010. 

3 (b) SENATE PAYGO SCORECARDS.—The budgetary ef4 fects of division A, subdivision 2 of division B, and division 

5 C and each succeeding division shall not be entered on any 

6 PAYGO scorecard maintained for purposes of section 4106 

7 of H. Con. Res. 71 (115th Congress). 

8 (c) CLASSIFICATION OF BUDGETARY EFFECTS.—Not9 withstanding Rule 3 of the Budget Scorekeeping Guidelines 

10 set forth in the joint explanatory statement of the committee 

11 of conference accompanying Conference Report 105–217 

12 and section 250(c)(8) of the Balanced Budget and Emer13 gency Deficit Control Act of 1985, the budgetary effects of 

14 division A, subdivision 2 of division B, and division C and 

15 each succeeding division shall not be estimated— 

16 (1) for purposes of section 251 of such Act; and 

17 (2) for purposes of paragraph (4)(C) of section 

18 3 of the Statutory Pay-As-You-Go Act of 2010 as 

19 being included in an appropriation Act. 

Attest: 

Secretary. 
115TH CONGRESS 

2D SESSION H.R. 1892 

HOUSE AMENDMENT TO 

SENATE AMENDMENT TO 

SENATE AMENDMENT