I 
117TH CONGRESS 
1ST SESSION 
H. R. 259 
To amend the Public Health Service Act to address the increased burden 
that maintaining the health and hygiene of infants and toddlers places 
on families in need, the resultant adverse health effects on children 
and families, and the limited child care options available for infants 
and toddlers who lack sufficient diapers, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 11, 2021 
Ms. LEE of California (for herself, Mrs. CAROLYN B. MALONEY of New York, 
Mrs. WATSON COLEMAN, Mr. POCAN, Ms. MENG, Mr. RUSH, Ms. SCHA-
KOWSKY, Mr. GRIJALVA, Mr. COHEN, Mr. PETERS, Mrs. HAYES, Mr. 
SIRES, Ms. NORTON, and Ms. CHU) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Ways and Means, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend the Public Health Service Act to address the 
increased burden that maintaining the health and hy-
giene of infants and toddlers places on families in need, 
the resultant adverse health effects on children and fami-
lies, and the limited child care options available for in-
fants and toddlers who lack sufficient diapers, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘End Diaper Need Act 
of 2021’’. 
SEC. 2. DIAPER DISTRIBUTION DEMONSTRATION PROJECT. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 399V–7. DIAPER DISTRIBUTION DEMONSTRATION 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall make 
grants to assist eligible entities to conduct demonstration 
projects that implement and evaluate strategies to help 
low-income families to address the diaper needs of infants 
and toddlers. 
‘‘(b) DESIGN OF PROGRAM.—In carrying out the 
grant program under subsection (a), the Secretary shall— 
‘‘(1) consult with relevant stakeholders, includ-
ing agencies, professional associations, and nonprofit 
organizations, on the design of the program; and 
‘‘(2) design the program in such a way that the 
program— 
‘‘(A) decreases diaper need in low-income 
families and meets the unmet diaper needs of 
infants and toddlers in such families through— 
‘‘(i) the distribution of free diapers 
and diapering supplies; 
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‘‘(ii) community outreach to assist in 
participation in existing diaper distribution 
programs; or 
‘‘(iii) improving access to diapers and 
diapering supplies as part of a comprehen-
sive service; and 
‘‘(B) increases the abilities of communities 
and low-income families in those communities 
to provide for the diaper needs of infants and 
toddlers in those communities. 
‘‘(c) ELIGIBLE ENTITIES.—To be eligible for a grant 
under this section, an entity shall— 
‘‘(1) be a State or local governmental entity, an 
Indian Tribe or tribal organization (as defined in 
section 4 of the Indian Self-Determination and Edu-
cation Assistance Act), or a nonprofit organization 
described in section 501(c)(3) of the Internal Rev-
enue Code of 1986 and exempt from taxation under 
section 501(a) of such Code; 
‘‘(2) have experience in the area of— 
‘‘(A) community distributions of basic need 
services, 
including 
experience 
collecting, 
warehousing, and distributing basic necessities 
such as diapers, food, or menstrual products; 
‘‘(B) child care; 
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‘‘(C) child development activities in low-in-
come communities; or 
‘‘(D) motherhood, fatherhood, or parent- 
education efforts serving low-income parents of 
young children; 
‘‘(3) demonstrate competency to implement a 
project, provide fiscal accountability, collect data, 
and prepare reports and other necessary documenta-
tion; 
‘‘(4) demonstrate a willingness to share infor-
mation with researchers, practitioners, and other in-
terested parties; and 
‘‘(5) submit to the Secretary a description of 
the design of the evaluation to be carried out under 
subsection (d)(2) and receive the Secretary’s ap-
proval of such design based on a determination that 
such design is rigorous and is likely to yield informa-
tion that is credible and will be useful to other 
States. 
‘‘(d) USE OF FUNDS.—Amounts provided through a 
grant under this section shall be used to conduct a dem-
onstration project to implement and evaluate strategies to 
help low-income families to address the diaper needs of 
infants and toddlers, which use may include any of the 
following: 
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‘‘(1) To pay for the purchase of diapers and 
diapering supplies and fund diaper distribution dem-
onstration projects that serve low-income families 
with one or more children 3 years of age or younger. 
‘‘(2) Using not more than 25 percent of the 
funds received by the grantee under this section, to 
evaluate the effect of activities under paragraph (1) 
on mitigating the health and developmental risks of 
unmet diaper need among infants, toddlers, and 
other family members in low-income families, includ-
ing the risks of diaper dermatitis, urinary tract in-
fections, and parental and child depression and anx-
iety. 
‘‘(3) To integrate activities under paragraph (1) 
with other basic needs assistance programs serving 
eligible children and their families, including the fol-
lowing: 
‘‘(A) Programs funded by the Temporary 
Assistance for Needy Families program, includ-
ing its State maintenance of effort provisions. 
‘‘(B) Programs designed to support the 
health of eligible children, such as the Chil-
dren’s Health Insurance Program under title 
XXI of the Social Security Act, the Medicaid 
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