833 
(2) INFORMATION.—The information dissemi-
nated under paragraph (1) shall include, at a min-
imum— 
(A) information describing the use, safety, 
efficacy, and availability of emergency contra-
ceptives, and options for access without cost- 
sharing through insurance and other programs; 
(B) a recommendation regarding the use of 
such contraceptives; and 
(C) information explaining how to obtain 
copies of the information developed under sub-
section (a) for distribution to the patients of 
the providers. 
(c) DEFINITIONS.—In this section: 
(1) HEALTH
CARE
PROVIDER.—The term 
‘‘health care provider’’ means an individual who is li-
censed or certified under State law to provide health 
care services and who is operating within the scope 
of such license. Such term shall include a phar-
macist. 
(2) INSTITUTION OF HIGHER EDUCATION.—The 
term ‘‘institution of higher education’’ has the same 
meaning given such term in section 101(a) of the 
Higher Education Act of 1965 (20 U.S.C. 1001(a)). 
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(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of the fiscal years 
2025 through 2029. 
SEC. 5403. DUTIES OF PHARMACIES TO ENSURE PROVISION 
OF FDA-APPROVED CONTRACEPTION. 
Part B of title II of the Public Health Service Act 
(42 U.S.C. 238 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 249. DUTIES OF PHARMACIES TO ENSURE PROVISION 
OF FDA-APPROVED CONTRACEPTION. 
‘‘(a) IN GENERAL.—Subject to subsection (c), a 
pharmacy that receives Food and Drug Administration- 
approved drugs or devices in interstate commerce shall 
maintain compliance with each of the following: 
‘‘(1) If a customer requests a contraceptive or 
a medication related to a contraceptive, including 
emergency contraception, that is in stock, the phar-
macy shall ensure that the requested contraceptive 
or medication is provided to the customer without 
delay. 
‘‘(2) If a customer requests a contraceptive or 
a medication related to a contraceptive that is not 
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in stock and the pharmacy in the normal course of 
business stocks contraception, the pharmacy shall 
immediately inform the customer that the requested 
contraceptive or medication is not in stock and with-
out delay offer the customer the following options: 
‘‘(A) If the customer prefers to obtain the 
requested contraceptive or medication through a 
referral or transfer, the pharmacy shall— 
‘‘(i) locate a pharmacy of the cus-
tomer’s choice or the closest pharmacy 
confirmed to have the requested contracep-
tive or medication in stock; and 
‘‘(ii) refer the customer or transfer 
the prescription to that pharmacy. 
‘‘(B) If the customer prefers for the phar-
macy to order the requested contraceptive or 
medication, the pharmacy shall obtain the con-
traceptive or medication under the pharmacy’s 
standard procedure for expedited ordering of 
medication and notify the customer when the 
contraceptive or medication arrives. 
‘‘(3) The pharmacy shall ensure that— 
‘‘(A) the pharmacy does not operate an en-
vironment in which customers are intimidated, 
threatened, or harassed in the delivery of serv-
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ices relating to a request for contraception or a 
medication related to a contraceptive; 
‘‘(B) the pharmacy’s employees do not 
interfere with or obstruct the delivery of serv-
ices relating to a request for contraception or a 
medication related to a contraceptive; 
‘‘(C) the pharmacy’s employees do not in-
tentionally misrepresent or deceive customers 
about the availability of a contraceptive or a 
medication related to a contraceptive, or the 
mechanism of action of such contraceptive or 
medication; 
‘‘(D) the pharmacy’s employees do not 
breach medical confidentiality with respect to a 
request for a contraceptive or a medication re-
lated to a contraceptive or threaten to breach 
such confidentiality; or 
‘‘(E) the pharmacy’s employees do not 
refuse to return a valid, lawful prescription for 
a contraceptive or a medication related to a 
contraceptive upon customer request. 
‘‘(b) 
CONTRACEPTIVES
NOT
ORDINARILY 
STOCKED.—Nothing in subsection (a)(2) shall be con-
strued to require any pharmacy to comply with such sub-
section if the pharmacy does not ordinarily stock contra-
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ceptives or medications related to contraceptives, as the 
case may be, in the normal course of business. 
‘‘(c) REFUSALS PURSUANT
TO STANDARD PHAR-
MACY PRACTICE.—This section does not prohibit a phar-
macy from refusing to provide a contraceptive or a medi-
cation related to a contraceptive to a customer in accord-
ance with any of the following: 
‘‘(1) If it is unlawful to dispense the requested 
contraceptive or medication to the customer without 
a valid, lawful prescription and no such prescription 
is presented. 
‘‘(2) If the customer is unable to pay for the re-
quested contraceptive or medication. 
‘‘(3) If the employee of the pharmacy refuses to 
provide the requested contraceptive or medication on 
the basis of a professional clinical judgment. 
‘‘(d) RELATION TO OTHER LAW.— 
‘‘(1) RULE
OF
CONSTRUCTION.—Nothing in 
this section shall be construed to invalidate or limit 
rights, remedies, procedures, or legal standards 
under title VII of the Civil Rights Act of 1964. 
‘‘(2) CERTAIN
CLAIMS.—The Religious Free-
dom Restoration Act of 1993 shall not provide a 
basis for a claim concerning, or a defense to a claim 
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under, this section, or provide a basis for challenging 
the application or enforcement of this section. 
‘‘(e) PREEMPTION.—This section does not preempt 
any provision of State law or affect any professional obli-
gation made applicable by a State board or other entity 
responsible for licensing or discipline of pharmacies or 
pharmacists, to the extent that such State law or profes-
sional obligation provides protections for customers that 
are greater than the protections provided by this section. 
‘‘(f) ENFORCEMENT.— 
‘‘(1) CIVIL PENALTY.—A pharmacy that vio-
lates a requirement of subsection (a) is liable to the 
United States for a civil penalty in an amount not 
exceeding $1,000 per day of violation, not to exceed 
$100,000 for all violations adjudicated in a single 
proceeding. 
‘‘(2) PRIVATE CAUSE OF ACTION.—Any person 
aggrieved as a result of a violation of a requirement 
of subsection (a) may, in any court of competent ju-
risdiction, commence a civil action against the phar-
macy involved to obtain appropriate relief, including 
actual and punitive damages, injunctive relief, and a 
reasonable attorney’s fee and costs. 
‘‘(3) LIMITATIONS.—A civil action under para-
graph (1) or (2) may not be commenced against a 
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pharmacy after the expiration of the 5-year period 
beginning on the date on which the pharmacy alleg-
edly engaged in the violation involved. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) CONTRACEPTION.—The term ‘contracep-
tion’ or ‘contraceptive’ means any drug or device ap-
proved by the Food and Drug Administration to pre-
vent pregnancy. 
‘‘(2) EMPLOYEE.—The term ‘employee’ means 
a person hired, by contract or any other form of an 
agreement, by a pharmacy. 
‘‘(3) MEDICATION RELATED TO A CONTRACEP-
TIVE.—The term ‘medication related to a contracep-
tive’ means any drug or device approved by the Food 
and Drug Administration that a medical professional 
determines necessary to use before or in conjunction 
with use of a contraceptive. 
‘‘(4) PHARMACY.—The term ‘pharmacy’ means 
an entity that— 
‘‘(A) is authorized by a State to engage in 
the business of selling prescription drugs at re-
tail; and 
‘‘(B) employs one or more employees. 
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‘‘(5) PRODUCT.—The term ‘product’ means a 
Food and Drug Administration-approved drug or de-
vice. 
‘‘(6) PROFESSIONAL
CLINICAL
JUDGMENT.— 
The term ‘professional clinical judgment’ means a 
clinical judgment, formed with the use of profes-
sional knowledge and skills, in accordance with pre-
vailing medical standards. 
‘‘(7) WITHOUT
DELAY.—The term ‘without 
delay’, with respect to a pharmacy providing, pro-
viding a referral for, or ordering contraception, or 
transferring the prescription for contraception, 
means within the usual and customary timeframe at 
the pharmacy for providing, providing a referral for, 
or ordering other products, or transferring the pre-
scription for other products, respectively. 
‘‘(h) EFFECTIVE DATE.—This section shall take ef-
fect on the 31st day after the date of the enactment of 
this section, without regard to whether the Secretary has 
issued any guidance or final rule regarding this section.’’. 
SEC. 5404. REAL EDUCATION AND ACCESS FOR HEALTHY 
YOUTH ACT. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Real Education and Access for Healthy Youth Act of 
2024’’. 
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(b) DEFINITIONS.—In this section: 
(1) AGE
AND
DEVELOPMENTALLY
APPRO-
PRIATE.—The term ‘‘age and developmentally appro-
priate’’ means topics, messages, and teaching meth-
ods suitable to particular ages, age groups, or devel-
opmental levels, based on cognitive, emotional, so-
cial, and behavioral capacity of most young people at 
that age level. 
(2) CONSENT.—The term ‘‘consent’’ means af-
firmative, conscious, and voluntary agreement to en-
gage in interpersonal, physical, or sexual activity. 
(3) CULTURALLY RESPONSIVE.—The term ‘‘cul-
turally responsive’’ means education and services 
that— 
(A) embrace and actively engage and ad-
just to young people and their various cultural 
identities; 
(B) recognize the ways in which many 
marginalized young people face unique barriers 
in society that result in increased adverse 
health outcomes and associated stereotypes; and 
(C) may address the ways in which racism 
has shaped national health care policy, the last-
ing historical trauma associated with reproduc-
tive health experiments and forced sterilizations 
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of Black, Latine, and Indigenous communities, 
or sexual stereotypes assigned to young People 
of Color or LGBTQ+ people. 
(4) EVIDENCE-INFORMED.—The term ‘‘evi-
dence-informed’’ means incorporates characteristics, 
content, or skills that have been proven to be effec-
tive through evaluation in changing sexual behavior. 
(5) GENDER EXPRESSION.—The term ‘‘gender 
expression’’ means the expression of one’s gender, 
such as through behavior, clothing, haircut, or voice, 
and which may or may not conform to socially de-
fined behaviors and characteristics typically associ-
ated with being either masculine or feminine. 
(6) GENDER
IDENTITY.—The term ‘‘gender 
identity’’ means the gender-related identity, appear-
ance, mannerisms, or other gender-related character-
istics of an individual, regardless of the individual’s 
designated sex at birth. 
(7) INCLUSIVE.—The term ‘‘inclusive’’ means 
content and skills that ensure marginalized young 
people are valued, respected, centered, and sup-
ported in sex education instruction and materials. 
(8) INSTITUTION OF HIGHER EDUCATION.—The 
term ‘‘institution of higher education’’ has the 
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meaning given the term in section 101 of the Higher 
Education Act of 1965 (20 U.S.C. 1001). 
(9) INTERPERSONAL
VIOLENCE.—The term 
‘‘interpersonal violence’’ means abuse, assault, bul-
lying, dating violence, domestic violence, harassment, 
intimate partner violence, or stalking. 
(10) LOCAL EDUCATIONAL AGENCY.—The term 
‘‘local educational agency’’ has the meaning given 
the term in section 8101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 7801). 
(11) MARGINALIZED
YOUNG
PEOPLE.—The 
term ‘‘marginalized young people’’ means young peo-
ple who are disadvantaged by underlying structural 
barriers and social inequities, including young people 
who are— 
(A) Black, Indigenous, Latine, Asian 
American, Native Hawaiian, Pacific Islander, 
and other People of Color; 
(B) immigrants; 
(C) in contact with the foster care system; 
(D) in contact with the juvenile justice sys-
tem; 
(E) experiencing homelessness; 
(F) pregnant or parenting; 
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(G) lesbian, gay, bisexual, transgender, or 
queer; 
(H) living with HIV; 
(I) living with disabilities; 
(J) from families with low-incomes; or 
(K) living in rural areas. 
(12) MEDICALLY ACCURATE AND COMPLETE.— 
The term ‘‘medically accurate and complete’’ means 
that— 
(A) the information provided through the 
education is verified or supported by the weight 
of research conducted in compliance with ac-
cepted scientific methods and is published in 
peer-reviewed journals, where applicable; or 
(B) the education contains information 
that leading professional organizations and 
agencies with relevant expertise in the field rec-
ognize as accurate, objective, and complete. 
(13) 
RESILIENCE.—The 
term 
‘‘resilience’’ 
means the ability to adapt to trauma and tragedy. 
(14) 
SECRETARY.—The 
term 
‘‘Secretary’’ 
means the Secretary of Health and Human Services. 
(15) SEX
EDUCATION.—The term ‘‘sex edu-
cation’’ means high quality teaching and learning 
that— 
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(A) is delivered, to the maximum extent 
practicable, following the National Sexuality 
Education Standards of the Future of Sex Ed 
Initiative; 
(B) is about a broad variety of topics re-
lated to sex and sexuality, including— 
(i) puberty and adolescent develop-
ment; 
(ii) sexual and reproductive anatomy 
and physiology; 
(iii) sexual orientation, gender iden-
tity, and gender expression; 
(iv) contraception, pregnancy, preg-
nancy options, and reproduction; 
(v) HIV and other STIs; 
(vi) consent and healthy relationships; 
and 
(vii) interpersonal violence; 
(C) explores values and beliefs about such 
topics; and 
(D) helps young people in gaining the 
skills that are needed to navigate relationships 
and manage one’s own sexual health. 
(16) SEXUAL
HEALTH
SERVICES.—The term 
‘‘sexual health services’’ includes— 
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846 
(A) sexual health information, education, 
and counseling; 
(B) all methods of contraception approved 
by the Food and Drug Administration; 
(C) routine gynecological care, including 
human papillomavirus (HPV) vaccines and can-
cer screenings; 
(D) pre-exposure prophylaxis or post-expo-
sure prophylaxis; 
(E) substance use and mental health serv-
ices; 
(F) interpersonal violence survivor services; 
and 
(G) other pregnancy and STI prevention, 
care, or treatment services. 
(17) SEXUAL ORIENTATION.—The term ‘‘sexual 
orientation’’ means an individual’s romantic, emo-
tional, or sexual attraction to other people. 
(18) STATE EDUCATIONAL AGENCY.—The term 
‘‘State educational agency’’ has the meaning given 
the term in section 8101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 7801). 
(19) TRAUMA.—The term ‘‘trauma’’ means a 
response to an event, series of events, or set of cir-
cumstances that is experienced or witnessed by an 
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847 
individual or group of people as physically or emo-
tionally harmful or life-threatening with lasting ad-
verse effects on their functioning and mental, phys-
ical, social, emotional, or spiritual well-being. 
(20) TRAUMA-INFORMED AND RESILIENCE-ORI-
ENTED.—The term ‘‘trauma-informed and resil-
ience-oriented’’ means an approach that realizes the 
prevalence of trauma, recognizes the various ways 
individuals, organizations, and communities may re-
spond to trauma differently, recognizes that resil-
ience can be built, and responds by putting this 
knowledge into practice. 
(21) YOUNG PEOPLE.—The term ‘‘young peo-
ple’’ means individuals who are ages 10 through 29 
at the time of commencement of participation in a 
project supported under this section. 
(22) YOUTH-FRIENDLY SEXUAL HEALTH SERV-
ICES.—The term ‘‘youth-friendly sexual health serv-
ices’’ means sexual health services that are provided 
in a confidential, equitable, and accessible manner 
that makes it easy and comfortable for young people 
to seek out and receive services. 
(c) GRANTS FOR SEX EDUCATION AT ELEMENTARY 
AND SECONDARY SCHOOLS AND YOUTH-SERVING ORGA-
NIZATIONS.— 
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(1) PROGRAM AUTHORIZED.—The Secretary, in 
coordination with the Secretary of Education, shall 
award grants, on a competitive basis, to eligible enti-
ties to enable such eligible entities to carry out 
projects that provide young people with sex edu-
cation. 
(2) DURATION.—Grants awarded under this 
section shall be for a period of 5 years. 
(3) ELIGIBLE
ENTITY.—In this section, the 
term ‘‘eligible entity’’ means a public or private enti-
ty that delivers evidence-based sex education to 
young people. 
(4) APPLICATIONS.—An eligible entity desiring 
a grant under this section shall submit an applica-
tion to the Secretary at such time, in such manner, 
and containing such information as the Secretary 
may require. 
(5) PRIORITY.—In awarding grants under this 
section, the Secretary shall give priority to eligible 
entities that are— 
(A) State educational agencies or local 
educational agencies; or 
(B) Indian Tribes or Tribal organizations, 
as defined in section 4 of the Indian Self-Deter-
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849 
mination and Education Assistance Act (25 
U.S.C. 5304). 
(6) USE OF FUNDS.—Each eligible entity that 
receives a grant under this section shall use the 
grant funds to carry out a project that provides 
young people with sex education. 
(d) GRANTS FOR SEX EDUCATION AT INSTITUTIONS 
OF HIGHER EDUCATION.— 
(1) PROGRAM AUTHORIZED.—The Secretary, in 
coordination with the Secretary of Education, shall 
award grants, on a competitive basis, to institutions 
of higher education or consortia of such institutions 
to enable such institutions to provide students with 
age and developmentally appropriate sex education. 
(2) DURATION.—Grants awarded under this 
section shall be for a period of 5 years. 
(3) APPLICATIONS.—An institution of higher 
education or consortium of such institutions desiring 
a grant under this section shall submit an applica-
tion to the Secretary at such time, in such manner, 
and containing such information as the Secretary 
may require. 
(4) PRIORITY.—In awarding grants under this 
section, the Secretary shall give priority to an insti-
tution of higher education that— 
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850 
(A) has an enrollment of needy students, 
as defined in section 318(b) of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1059e(b)); 
(B) is a Hispanic-serving institution, as 
defined in section 502(a) of such Act (20 
U.S.C. 1101a(a)); 
(C) is a Tribal College or University, as 
defined in section 316(b) of such Act (20 
U.S.C. 1059c(b)); 
(D) is an Alaska Native-serving institution, 
as defined in section 317(b) of such Act (20 
U.S.C. 1059d(b)); 
(E) is a Native Hawaiian-serving institu-
tion, as defined in section 317(b) of such Act 
(20 U.S.C. 1059d(b)); 
(F) is a Predominantly Black Institution, 
as defined in section 318(b) of such Act (20 
U.S.C. 1059e(b)); 
(G) is a Native American-serving, non-
tribal institution, as defined in section 319(b) 
of such Act (20 U.S.C. 1059f(b)); 
(H) is an Asian American and Native 
American Pacific Islander-serving institution, as 
defined in section 320(b) of such Act (20 
U.S.C. 1059g(b)); or 
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(I) is a minority institution, as defined in 
section 365 of such Act (20 U.S.C. 1067k), 
with an enrollment of needy students, as de-
fined in section 312 of such Act (20 U.S.C. 
1058). 
(5) USES OF FUNDS.—An institution of higher 
education or consortium of such institutions receiv-
ing a grant under this section shall use grant funds 
to develop and implement a project to integrate sex 
education into the institution of higher education in 
order to reach a large number of students, by car-
rying out 1 or more of the following activities: 
(A) Adopting and incorporating age and 
developmentally appropriate sex education into 
student orientation, general education, or 
courses. 
(B) Developing or adopting and imple-
menting educational programming outside of 
class that delivers age and developmentally ap-
propriate sex education to students. 
(C) Developing or adopting and imple-
menting innovative technology-based approaches 
to deliver age and developmentally appropriate 
sex education to students. 
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(D) Developing or adopting and imple-
menting peer-led activities to generate discus-
sion, educate, and raise awareness among stu-
dents about age and developmentally appro-
priate sex education. 
(E) Developing or adopting and imple-
menting policies and practices to link students 
to sexual health services. 
(e) GRANTS FOR EDUCATOR TRAINING.— 
(1) PROGRAM AUTHORIZED.—The Secretary, in 
coordination with the Secretary of Education, shall 
award grants, on a competitive basis, to eligible enti-
ties to enable such eligible entities to carry out the 
activities described in paragraph (5). 
(2) DURATION.—Grants awarded under this 
section shall be for a period of 5 years. 
(3) ELIGIBLE
ENTITY.—In this section, the 
term ‘‘eligible entity’’ means— 
(A) a State educational agency or local 
educational agency; 
(B) an Indian Tribe or Tribal organiza-
tion, as defined in section 4 of the Indian Self- 
Determination and Education Assistance Act 
(25 U.S.C. 5304); 
(C) a State or local department of health; 
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(D) an educational service agency, as de-
fined in section 8101 of the Elementary and 
Secondary Education Act of 1965 (20 U.S.C. 
7801); 
(E) a nonprofit institution of higher edu-
cation or a consortium of such institutions; or 
(F) a national or statewide nonprofit orga-
nization or consortium of nonprofit organiza-
tions that has as its primary purpose the im-
provement of provision of sex education through 
training and effective teaching of sex education. 
(4) APPLICATION.—An eligible entity desiring a 
grant under this section shall submit an application 
to the Secretary at such time, in such manner, and 
containing such information as the Secretary may 
require. 
(5) AUTHORIZED ACTIVITIES.— 
(A) REQUIRED
ACTIVITY.—Each eligible 
entity receiving a grant under this section shall 
use grant funds for professional development 
and training of relevant teachers, health edu-
cators, faculty, administrators, and staff, in 
order to increase effective teaching of sex edu-
cation to young people. 
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(B) PERMISSIBLE ACTIVITIES.—Each eligi-
ble entity receiving a grant under this section 
may use grant funds to— 
(i) provide training and support for 
educators about the content, skills, and 
professional disposition needed to imple-
ment sex education effectively; 
(ii) develop and provide training and 
support to educators on incorporating anti- 
racist and gender inclusive policies and 
practices in sex education; 
(iii) support the dissemination of in-
formation on effective practices and re-
search findings concerning the teaching of 
sex education; 
(iv) support research on— 
(I) effective sex education teach-
ing practices; and 
(II) the development of assess-
ment instruments and strategies to 
document— 
(aa) young people’s under-
standing of sex education; and 
(bb) the effects of sex edu-
cation; 
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(v) convene conferences on sex edu-
cation, in order to effectively train edu-
cators in the provision of sex education; 
and 
(vi) develop and disseminate appro-
priate research-based materials to foster 
sex education. 
(C) SUBGRANTS.—Each eligible entity re-
ceiving a grant under this section may award 
subgrants to nonprofit organizations that pos-
sess a demonstrated record of providing train-
ing to teachers, health educators, faculty, ad-
ministrators, and staff on sex education to— 
(i) train educators in sex education; 
(ii) support internet or distance learn-
ing related to sex education; 
(iii) promote rigorous academic stand-
ards and assessment techniques to guide 
and measure student performance in sex 
education; 
(iv) encourage replication of best 
practices and model programs to promote 
sex education; 
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(v) develop and disseminate effective, 
research-based sex education learning ma-
terials; or 
(vi) develop academic courses on the 
pedagogy of sex education at institutions 
of higher education. 
(f) AUTHORIZATION OF GRANTS TO SUPPORT THE 
DELIVERY
OF
SEXUAL
HEALTH
SERVICES
TO 
MARGINALIZED YOUNG PEOPLE.— 
(1) PROGRAM
AUTHORIZED.—The Secretary 
shall award grants, on a competitive basis, to eligible 
entities to enable such entities to provide youth- 
friendly sexual health services to marginalized young 
people. 
(2) DURATION.—Grants awarded under this 
section shall be for a period of 5 years. 
(3) ELIGIBLE
ENTITY.—In this section, the 
term ‘‘eligible entity’’ means— 
(A) a public or private youth-serving orga-
nization; or 
(B) a covered entity, as defined in section 
340B of the Public Health Service Act (42 
U.S.C. 256b). 
(4) APPLICATIONS.—An eligible entity desiring 
a grant under this section shall submit an applica-
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tion to the Secretary at such time, in such manner, 
and containing such information as the Secretary 
may require. 
(5) USES OF FUNDS.—Each eligible entity that 
receives a grant under this section may use the 
grant funds to— 
(A) develop and implement an evidence-in-
formed project to deliver sexual health services 
to marginalized young people; 
(B) establish, alter, or modify staff posi-
tions, service delivery policies and practices, 
service delivery locations, service delivery envi-
ronments, service delivery schedules, or other 
services components in order to increase youth- 
friendly sexual health services to marginalized 
young people; 
(C) conduct outreach to marginalized 
young people to invite them to participate in 
the eligible entity’s sexual health services and to 
provide feedback to inform improvements in the 
delivery of such services; 
(D) establish and refine systems of referral 
to connect marginalized young people to other 
sexual health services and supportive services; 
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(E) establish partnerships and collabora-
tions 
with 
entities 
providing 
services 
to 
marginalized young people to link such young 
people to sexual health services, such as by de-
livering health services at locations where they 
congregate, providing transportation to loca-
tions where sexual health services are provided, 
or other linkages to services approaches; 
(F) provide evidence-informed, comprehen-
sive in scope, confidential, equitable, accessible, 
medically accurate and complete, age and devel-
opmentally appropriate, culturally responsive, 
and trauma-informed and resilience-oriented 
sexual health information to marginalized 
young people in the languages and cultural con-
texts that are most appropriate for the 
marginalized young people to be served by the 
eligible entity; 
(G) promote effective communication re-
garding sexual health among marginalized 
young people; and 
(H) provide training and support for eligi-
ble entity personnel and community members 
who work with marginalized young people about 
the content, skills, and professional disposition 
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needed to provide youth-friendly sex education 
and youth-friendly sexual health services. 
(g) REPORTING AND IMPACT EVALUATION.— 
(1) GRANTEE
REPORT
TO
SECRETARY.—For 
each year a grantee receives grant funds under sub-
section (c), (d), (e), or (f) the grantee shall submit 
to the Secretary a report that includes— 
(A) a description of the use of grant funds 
by the grantee; 
(B) a description of how the use of grant 
funds has increased the access of young people 
to sex education or sexual health services; and 
(C) such other information as the Sec-
retary may require. 
(2) SECRETARY’S REPORT TO CONGRESS.—Not 
later than 1 year after the date of the enactment of 
this section, and annually thereafter for a period of 
5 years, the Secretary shall prepare and submit to 
Congress a report on the activities funded under this 
section. The Secretary’s report to Congress shall in-
clude— 
(A) a statement of how grants awarded by 
the Secretary meet the purposes of the grants; 
and 
(B) information about— 
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(i) the number of grantees that are 
receiving grant funds under subsections 
(c), (d), (e), and (f); 
(ii) the specific activities supported by 
grant funds awarded under subsections (c), 
(d), (e), and (f); 
(iii) the number of young people 
served by projects funded under sub-
sections (c),(d), and (f), in the aggregate 
and disaggregated and cross-tabulated by 
grant program, race and ethnicity, sex, 
sexual orientation, gender identity, and 
other characteristics determined by the 
Secretary (except that such disaggregation 
or cross-tabulation shall not be required in 
a case in which the results would reveal 
personally identifiable information about 
an individual young person); 
(iv) the number of teachers, health 
educators, faculty, school administrators, 
and staff trained under subsection (e); and 
(v) the status of the evaluation re-
quired under paragraph (3). 
(3) MULTI-YEAR EVALUATION.— 
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(A) IN
GENERAL.—Not later than 6 
months after the date of the enactment of this 
section, the Secretary shall enter into a contract 
with a nonprofit organization with experience in 
conducting impact evaluations to conduct a 
multi-year evaluation on the impact of the 
projects funded under subsections (c), (d), (e), 
and (f) and to report to Congress and the Sec-
retary on the findings of such evaluation. 
(B) EVALUATION.—The evaluation con-
ducted under this subsection shall— 
(i) be conducted in a manner con-
sistent with relevant, nationally recognized 
professional 
and 
technical 
evaluation 
standards; 
(ii) use sound statistical methods and 
techniques 
relating 
to 
the 
behavioral 
sciences, including quasi-experimental de-
signs, inferential statistics, and other 
methodologies and techniques that allow 
for conclusions to be reached; 
(iii) be carried out by an independent 
organization that has not received a grant 
under subsection (c), (d), (e), or (f); and 
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(iv) be designed to provide informa-
tion on output measures and outcome 
measures to be determined by the Sec-
retary. 
(C) REPORT.—Not later than 6 years after 
the date of enactment of this section, the orga-
nization conducting the evaluation under this 
paragraph shall prepare and submit to the ap-
propriate committees of Congress and the Sec-
retary an evaluation report. Such report shall 
be made publicly available, including on the 
website of the Department of Health and 
Human Services. 
(h) NONDISCRIMINATION.—Activities funded under 
this section shall not discriminate on the basis of actual 
or perceived sex (including sexual orientation and gender 
identity), age, parental status, race, color, ethnicity, na-
tional origin, disability, or religion. Nothing in this section 
shall be construed to invalidate or limit rights, remedies, 
procedures, or legal standards available under any other 
Federal law or any law of a State or a political subdivision 
of a State, including the Civil Rights Act of 1964 (42 
U.S.C. 2000a et seq.), title IX of the Education Amend-
ments of 1972 (20 U.S.C. 1681 et seq.), section 504 of 
the Rehabilitation Act of 1973 (29 U.S.C. 794), the Amer-
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icans with Disabilities Act of 1990 (42 U.S.C. 12101 et 
seq.), and section 1557 of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18116). 
(i) LIMITATION.—No Federal funds provided under 
this section may be used for sex education or sexual health 
services that— 
(1) withhold health-promoting or life-saving in-
formation about sexuality-related topics, including 
HIV; 
(2) are medically inaccurate or incomplete; 
(3) promote gender or racial stereotypes or are 
unresponsive to gender or racial inequities; 
(4) fail to address the needs of sexually active 
young people; 
(5) fail to address the needs of pregnant or par-
enting young people; 
(6) fail to address the needs of survivors of 
interpersonal violence; 
(7) fail to address the needs of young people of 
all physical, developmental, or mental abilities; 
(8) fail to be inclusive of individuals with vary-
ing gender identities, gender expressions, and sexual 
orientations; or 
(9) are inconsistent with the ethical imperatives 
of medicine and public health. 
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(j) AMENDMENTS TO OTHER LAWS.— 
(1) AMENDMENT
TO
THE
PUBLIC
HEALTH 
SERVICE ACT.—Section 2500 of the Public Health 
Service Act (42 U.S.C. 300ee) is amended by strik-
ing subsections (b) through (d) and inserting the fol-
lowing: 
‘‘(b) CONTENTS
OF PROGRAMS.—All programs of 
education and information receiving funds under this sub-
chapter shall include information about the potential ef-
fects of intravenous substance use.’’. 
(2) AMENDMENTS TO THE ELEMENTARY AND 
SECONDARY EDUCATION ACT OF 1965.—Section 8526 
of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7906) is amended— 
(A) by striking paragraphs (3), (5), and 
(6); 
(B) by redesignating paragraph (4) as 
paragraph (3); 
(C) in paragraph (3), as redesignated by 
paragraph (2), by inserting ‘‘or’’ after the semi-
colon; and 
(D) by redesignating paragraph (7) as 
paragraph (4). 
(k) FUNDING.— 
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(1) AUTHORIZATION.—For the purpose of car-
rying out this section, there is authorized to be ap-
propriated $100,000,000 for each of fiscal years 
2025 through 2030. Amounts appropriated under 
this subsection shall remain available until expended. 
(2) RESERVATIONS OF FUNDS.— 
(A) IN GENERAL.—The Secretary— 
(i) shall reserve not more than 30 per-
cent of the amount authorized under para-
graph (1) for the purposes of awarding 
grants for sex education at elementary and 
secondary schools and youth-serving orga-
nizations under subsection (c); 
(ii) shall reserve not more than 10 
percent of the amount authorized under 
paragraph (1) for the purpose of awarding 
grants for sex education at institutions of 
higher education under subsection (d); 
(iii) shall reserve not more than 15 
percent of the amount authorized under 
paragraph (1) for the purpose of awarding 
grants for educator training under sub-
section (e); 
(iv) shall reserve not more than 30 
percent of the amount authorized under 
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paragraph (1) for the purpose of awarding 
grants for sexual health services for 
marginalized youth under subsection (f); 
and 
(v) shall reserve not less than 5 per-
cent of the amount authorized under para-
graph (1) for the purpose of carrying out 
the reporting and impact evaluation re-
quired under subsection (g). 
(B) RESEARCH, TRAINING, AND
TECH-
NICAL
ASSISTANCE.—The Secretary shall re-
serve not less than 10 percent of the amount 
authorized under paragraph (1) for expendi-
tures by the Secretary to provide, directly or 
through a competitive grant process, research, 
training, and technical assistance, including dis-
semination of research and information regard-
ing effective and promising practices, providing 
consultation and resources, and developing re-
sources and materials to support the activities 
of recipients of grants. In carrying out such 
functions, the Secretary shall collaborate with a 
variety of entities that have expertise in sex 
education and sexual health services standards 
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setting, design, development, delivery, research, 
monitoring, and evaluation. 
(3) REPROGRAMMING
OF
ABSTINENCE
ONLY 
UNTIL MARRIAGE PROGRAM FUNDING.—The unobli-
gated balance of funds made available to carry out 
section 510 of the Social Security Act (42 U.S.C. 
710) (as in effect on the day before the date of en-
actment of this section) are transferred and shall be 
used by the Secretary to carry out this section. The 
amounts transferred and made available to carry out 
this section shall remain available until expended. 
(4) REPEAL OF ABSTINENCE ONLY UNTIL MAR-
RIAGE PROGRAM.—Section 510 of the Social Secu-
rity Act (42 U.S.C. 710 et seq.) is repealed. 
SEC. 5405. COMPASSIONATE ASSISTANCE FOR RAPE EMER-
GENCIES. 
(a) MEDICARE.— 
(1) 
LIMITATION
ON
PAYMENT.—Section 
1866(a)(1) of the Social Security Act (42 U.S.C. 
1395cc(a)(1)), as amended by section 5201(f), is 
further amended— 
(A) in subparagraph (W), by moving the 
indentation 2 ems to the left; 
(B) in subparagraph (X), by moving the 
indentation 2 ems to the left; 
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(C) in subparagraph (Y)(ii)(V), by striking 
‘‘and’’ at the end; 
(D) in subparagraph (Z)(iii), by striking 
the period and inserting ‘‘, and’’; and 
(E) by inserting after subparagraph (Z) 
the following new subparagraph: 
‘‘(AA) in the case of a hospital or critical access 
hospital, to adopt and enforce a policy to ensure 
compliance with the requirements of subsection (l) 
and to meet the requirements of such subsection.’’. 
(2) ASSISTANCE TO VICTIMS.—Section 1866 of 
the Social Security Act (42 U.S.C. 1395cc) is 
amended by adding at the end the following new 
subsection: 
‘‘(l) COMPASSIONATE ASSISTANCE FOR RAPE EMER-
GENCIES.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(a)(1)(AA), a hospital meets the requirements of 
this subsection if the hospital provides each of the 
services described in paragraph (2) to each indi-
vidual, whether or not eligible for benefits under this 
title or under any other form of health insurance, 
who comes to the hospital on or after January 1, 
2025, and— 
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‘‘(A) who states to hospital personnel that 
they are victims of sexual assault; 
‘‘(B) who is accompanied by an individual 
who states to hospital personnel that the indi-
vidual is a victim of sexual assault; or 
‘‘(C) whom hospital personnel, during the 
course of treatment and care for the individual, 
have reason to believe is a victim of sexual as-
sault. 
‘‘(2) REQUIRED
SERVICES
DESCRIBED.—For 
purposes of paragraph (1), the services described in 
this subparagraph are the following: 
‘‘(A) Provision of medically and factually 
accurate and unbiased written and oral infor-
mation about emergency contraception that— 
‘‘(i) is written in clear and concise 
language; 
‘‘(ii) is readily comprehensible; 
‘‘(iii) includes an explanation that 
emergency contraceptives— 
‘‘(I) have been approved by the 
Food and Drug Administration for in-
dividuals and are a safe and effective 
way to prevent pregnancy after unpro-
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tected intercourse or contraceptive 
failure if taken in a timely manner; 
‘‘(II) are more effective the soon-
er it is taken; and 
‘‘(III) do not cause an abortion 
and cannot interrupt an established 
pregnancy; 
‘‘(iv) meet such conditions regarding 
the provision of such information in lan-
guages other than English as the Secretary 
may establish; and 
‘‘(v) are provided without regard to 
the ability of the individual or their family 
to pay costs associated with the provision 
of such information to the individual. 
‘‘(B) Immediate offer to provide emergency 
contraception to the individual at the hospital 
and, in the case that such individual accepts 
such offer, immediate provision to such indi-
vidual of such contraception on the same day it 
is requested without regard to the inability of 
the individual or their family to pay costs asso-
ciated with the offer and provision of such con-
traception. 
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‘‘(C) Development and implementation of a 
written policy to ensure that an individual is 
present at the hospital, or on-call, who— 
‘‘(i) has authority to dispense or pre-
scribe emergency contraception, independ-
ently, or under a protocol prepared by a 
physician for the administration of emer-
gency contraception at the hospital to a 
victim of sexual assault; and 
‘‘(ii) is trained to comply with the re-
quirements of this section. 
‘‘(D) Provision of medically and factually 
accurate and unbiased written and oral infor-
mation and counseling about post-exposure pro-
phylaxis (referred to in this paragraph as 
‘PEP’) protocol for the prevention of HIV. 
‘‘(E) Immediate offer to begin PEP to the 
individual at the hospital except in cases where 
the medical professional’s best judgement is 
that further evaluation is required or that such 
a regimen will be substantially detrimental to 
the health of such individual. Such provision 
shall be offered regardless of the individual’s 
ability to pay. Hospitals shall be responsible for 
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ensuring adequate supply of PEP medications 
to provide to patients. 
‘‘(3) HOSPITAL
DEFINED.—For purposes of 
this paragraph, the term ‘hospital’ includes a critical 
access 
hospital, 
as 
defined 
in 
section 
1861(mm)(1).’’. 
(b) LIMITATION ON PAYMENT UNDER MEDICAID.— 
Section 1903(i) of the Social Security Act (42 U.S.C. 
1396b(i)), as amended by section 4106(b)(2), is further 
amended— 
(1) in paragraph (27), by striking ‘‘or’’ after 
the semicolon; 
(2) in paragraph (28), by striking the period 
and inserting ‘‘; or’’; and 
(3) by inserting after paragraph (28) the fol-
lowing new paragraph: 
‘‘(29) with respect to any amount expended for 
care or services furnished under the plan by a hos-
pital on or after January 1, 2025, unless such hos-
pital meets the requirements specified in section 
1866(l) for purposes of title XVIII.’’. 
SEC. 5406. MENSTRUAL EQUITY FOR ALL ACT OF 2024. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Menstrual Equity For All Act of 2024’’. 
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(b) MENSTRUAL PRODUCTS FOR STUDENTS AT ELE-
MENTARY AND SECONDARY SCHOOLS.— 
(1) IN GENERAL.—Section 4108(5)(C) of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7118(5)(C)) is amended— 
(A) in clause (vi), by striking ‘‘or’’ after 
the semicolon; 
(B) in clause (vii), by inserting ‘‘or’’ after 
the semicolon; and 
(C) by adding at the end the following: 
‘‘(viii) provide free menstrual products 
to students who use menstrual products;’’. 
(2) DEFINITIONS.—Section 4102 of the Ele-
mentary and Secondary Education Act of 1965 (20 
U.S.C. 7112) is amended— 
(A) 
by 
redesignating 
paragraphs 
(6) 
through (8) as paragraphs (7) through (9), re-
spectively; and 
(B) by inserting after paragraph (5) the 
following: 
‘‘(6) MENSTRUAL PRODUCTS.—The term ‘men-
strual products’ means sanitary napkins and tam-
pons that conform to applicable industry stand-
ards.’’. 
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(3) RULEMAKING.—Not later than 1 year after 
the date of enactment of this section, the Secretary 
of Education, in consultation with the Secretary of 
Health and Human Services, shall promulgate rules 
with respect to the definition of ‘‘menstrual prod-
ucts’’ in paragraph (6) of section 4102 of the Ele-
mentary and Secondary Education Act of 1965 (20 
U.S.C. 7112), as amended by paragraph (2). 
(c) MENSTRUAL PRODUCTS FOR STUDENTS AT IN-
STITUTIONS OF HIGHER EDUCATION.— 
(1) PURPOSE.—The purpose of this subsection 
is to alleviate— 
(A) the barriers to academic success faced 
by many college and graduate students due to 
the inability of such students to afford to pur-
chase menstrual products; and 
(B) the unique set of burdens that college 
and graduate students experiencing period pov-
erty face that can be compounded by lack of ac-
cess to basic needs such as housing, food, trans-
portation, and access to physical and mental 
health services. 
(2) IN GENERAL.—The Secretary of Education 
shall establish a program to award grants, on a com-
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petitive basis, to not less than 4 institutions of high-
er education to— 
(A) support programs that provide free 
menstrual products to students; and 
(B) report on best practices of such pro-
grams. 
(3) APPLICATION.—To apply for a grant under 
this subsection, an institution of higher education 
shall submit to the Secretary an application in such 
form, at such time, and containing such information 
as the Secretary determines appropriate, including 
an assurance that such grant will be used to carry 
out the activities described in paragraph (5). 
(4) COMMUNITY COLLEGES.—Not less than 50 
percent of the grants awarded under this subsection 
shall be awarded to community colleges. 
(5) GRANT USES.—A grant awarded under this 
subsection may only be used to— 
(A) carry out or expand activities that 
fund programs that support direct provision of 
free menstrual products to students in appro-
priate campus locations, including— 
(i) campus restroom facilities; 
(ii) wellness centers; and 
(iii) on-campus residential buildings; 
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(B) report on best practices of such pro-
grams; 
(C) conduct outreach to students to en-
courage participation in menstrual equity pro-
grams and services; 
(D) help eligible students apply for and en-
roll in local, State, and Federal public assist-
ance programs; and 
(E) coordinate and collaborate with gov-
ernment or community-based organizations to 
carry out the activities described in subpara-
graphs (A) through (D). 
(6) PRIORITY.—In awarding grants under this 
subsection, the Secretary shall prioritize— 
(A) institutions with respect to which not 
less than 25 percent of the enrolled students re-
ceive a Federal Pell Grant; and 
(B) historically Black colleges and univer-
sities, 
Hispanic-serving 
institutions, 
Asian 
American and Native American Pacific Is-
lander-serving institutions, and other minority 
serving institutions. 
(7) DEFINITIONS.—In this subsection: 
(A) 
INSTITUTION
OF
HIGHER
EDU-
CATION.—The term ‘‘institution of higher edu-
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cation’’ has the meaning given that term in sec-
tion 101 of the Higher Education Act of 1965 
(20 U.S.C. 1001)). 
(B) MENSTRUAL
PRODUCT
DEFINED.— 
The term ‘‘menstrual product’’ means a sani-
tary napkin or tampon that conforms to indus-
try standards. 
(8) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated $5,000,000 
out of funds appropriated for a fiscal year to the 
Fund for the Improvement of Postsecondary Edu-
cation under section 741 of the Higher Education 
Act of 1965 (20 U.S.C. 1138) to carry out the grant 
program under this subsection. 
(d) MENSTRUAL PRODUCTS FOR INCARCERATED IN-
DIVIDUALS AND DETAINEES.— 
(1) MENSTRUAL PRODUCTS DEFINED.—In this 
subsection, the term ‘‘menstrual products’’ means 
sanitary napkins and tampons that conform to appli-
cable industry standards. 
(2) REQUIREMENT FOR STATES.—Beginning on 
the date that is 180 days after the date of the enact-
ment of this Act, and annually thereafter, the chief 
executive officer of each State that receives a grant 
under subpart 1 of part E of title I of the Omnibus 
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Crime Control and Safe Streets Act of 1968 (34 
U.S.C. 10151 et seq.) shall submit to the Attorney 
General a certification, in such form and containing 
such information as the Attorney General may re-
quire, that— 
(A) all incarcerated individuals and detain-
ees in the State have access to menstrual prod-
ucts— 
(i) on demand; and 
(ii) at no cost to the incarcerated indi-
viduals and detainees; and 
(B) no visitor of an incarcerated individual 
or detainee of the State is prohibited from vis-
iting an incarcerated individual or detainee due 
to the visitor’s use of menstrual products. 
(3) REDUCTION IN GRANT FUNDING.—In the 
case of a State of which the chief executive officer 
fails to submit a certification required under para-
graph (2) in a fiscal year, the Attorney General shall 
reduce the amount that the State would otherwise 
receive under section 505 of title I of the Omnibus 
Crime Control and Safe Streets Act of 1968 (34 
U.S.C. 10156) by 20 percent for the following fiscal 
year. 
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(4) REALLOCATION.—Amounts not allocated to 
a State under section 505 of title I of the Omnibus 
Crime Control and Safe Streets Act of 1968 (34 
U.S.C. 10156) for a fiscal year pursuant to para-
graph (3) shall be reallocated under such section to 
States that submit certifications under paragraph 
(2). 
(5) AVAILABILITY FOR FEDERAL PRISONERS.— 
The Attorney General shall make rules requiring, 
and the Director of the Bureau of Prisons shall take 
such actions as may be necessary to ensure, the dis-
tribution and accessibility without charge of men-
strual products to prisoners in the custody of the 
Bureau of Prisons, including any prisoner in a Fed-
eral penal or correctional institution, any Federal 
prisoner in a State penal or correctional institution, 
and any Federal prisoner in a facility administered 
by a private detention entity, to ensure that each 
prisoner who requires menstrual products may re-
ceive them in sufficient quantity. 
(6) AVAILABILITY FOR DETAINEES.—The Sec-
retary of Homeland Security shall take such actions 
as may be necessary to ensure that menstrual prod-
ucts are distributed and made accessible to each 
alien detained by the Secretary of Homeland Secu-
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880 
rity, including any alien in a facility administered by 
a private detention entity, at no expense to the alien. 
(e) MENSTRUAL
PRODUCTS
AVAILABILITY
FOR 
HOMELESS INDIVIDUALS UNDER EMERGENCY FOOD AND 
SHELTER GRANT PROGRAM.—Subsection (a) of section 
316 of the McKinney-Vento Homeless Assistance Act (42 
U.S.C. 11346(a)) is amended— 
(1) in paragraph (5), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (6), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(7) guidelines that ensure that amounts pro-
vided under the program to private nonprofit organi-
zations and local governments may be used to pro-
vide sanitary napkins and tampons that conform to 
applicable industry standards.’’. 
(f) MENSTRUAL PRODUCTS COVERED
BY MED-
ICAID.— 
(1) IN GENERAL.—Section 1905 of the Social 
Security Act (42 U.S.C. 1396d), as amended by sec-
tion 5201, is further amended— 
(A) in subsection (a)— 
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881 
(i) in paragraph (32), by striking ‘‘; 
and’’ and inserting a semicolon; 
(ii) by redesignating paragraph (33) 
as paragraph (34); and 
(iii) by inserting after paragraph (32) 
the following new paragraph: 
‘‘(33) menstrual products (as defined in sub-
section (qq)); and’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(qq) MENSTRUAL PRODUCTS.—For purposes of 
subsection (a)(33), the term ‘menstrual products’ means 
menstrual cups, menstrual discs, menstrual underwear, 
and sanitary napkins and tampons, that conform to appli-
cable industry standards.’’. 
(2) EFFECTIVE DATE.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the amendments made by this sub-
section shall apply with respect to medical as-
sistance furnished during or after the first cal-
endar quarter beginning on or after the date 
that is 1 year after the date of the enactment 
of this Act. 
(B) EXCEPTION
FOR
STATE
LEGISLA-
TION.—In the case of a State plan under title 
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882 
XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) that the Secretary of Health and 
Human Services determines requires State leg-
islation in order for the respective plan to meet 
any requirement imposed by amendments made 
by this subsection, the respective plan shall not 
be regarded as failing to comply with the re-
quirements of such title solely on the basis of 
its failure to meet such an additional require-
ment before the first day of the first calendar 
quarter beginning after the close of the first 
regular session of the State legislature that be-
gins after the date of the enactment of this Act. 
For purposes of the previous sentence, in the 
case of a State that has a 2-year legislative ses-
sion, each year of the session shall be consid-
ered to be a separate regular session of the 
State legislature. 
(g) MENSTRUAL PRODUCTS FOR EMPLOYEES.—Sec-
tion 6 of the Occupational Safety and Health Act of 1970 
(29 U.S.C. 655) is amended by adding at the end the fol-
lowing: 
‘‘(h) The Secretary shall by rule promulgate a re-
quirement that each employer with not less than 100 em-
ployees provide menstrual products free of charge for em-
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883 
ployees of the employer. For purposes of the preceding 
sentence, ‘menstrual products’ means sanitary napkins 
and tampons that conform to applicable industry stand-
ards.’’. 
(h) MENSTRUAL PRODUCTS
IN FEDERAL BUILD-
INGS.— 
(1) DEFINITIONS.—In this subsection: 
(A) APPROPRIATE AUTHORITY.—The term 
‘‘appropriate authority’’ means the head of a 
Federal agency, the Architect of the Capitol, or 
any other official authority responsible for the 
operation of a covered public building. 
(B) COVERED PUBLIC BUILDING.— 
(i) IN GENERAL.—The term ‘‘covered 
public building’’ means a public building 
(as defined in section 3301(a) of title 40, 
United States Code) that is open to the 
public and contains a public restroom. 
(ii) INCLUSIONS.—The term ‘‘covered 
public building’’ includes specified build-
ings and grounds (as defined in section 
6301 of title 40, United States Code) and 
the Capitol Buildings (as defined in section 
5101 of that title). 
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884 
(C) COVERED RESTROOM.—The term ‘‘cov-
ered restroom’’ means a restroom in a covered 
public building. 
(D) MENSTRUAL
PRODUCTS.—The term 
‘‘menstrual products’’ means sanitary napkins 
and tampons that conform to applicable indus-
try standards. 
(2) REQUIREMENT.—Each appropriate author-
ity shall ensure that menstrual products are stocked 
in, and available free of charge in, each covered rest-
room in each covered public building under the juris-
diction of that authority. 
(i) MENSTRUAL PRODUCTS IN THE SOCIAL SERVICES 
BLOCK GRANT PROGRAM.— 
(1) INCREASE IN FUNDING FOR SOCIAL SERV-
ICES BLOCK GRANT PROGRAM.— 
(A) IN GENERAL.—The amount specified 
in subsection (c) of section 2003 of the Social 
Security Act (42 U.S.C. 1397b) for purposes of 
subsections (a) and (b) of such section is 
deemed to be $1,900,000,000 for each of fiscal 
years 2025 through 2028, of which, the amount 
equal to $200,000,000, reduced by the amounts 
reserved under subparagraph (B)(ii) for each 
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885 
such fiscal year, shall be obligated by States in 
accordance with paragraph (2). 
(B) APPROPRIATION.— 
(i) IN GENERAL.—Out of any money 
in the Treasury of the United States not 
otherwise appropriated, there is appro-
priated $200,000,000 for each of fiscal 
years 2025 through 2028, to carry out this 
subsection. 
(ii) RESERVATIONS.— 
(I) PURPOSES.—The Secretary 
shall reserve, from the amount appro-
priated under clause (i) to carry out 
this subsection— 
(aa) for each of fiscal years 
2025 through 2028, not more 
than 2 percent of the amount ap-
propriated for the fiscal year for 
purposes of entering into an 
agreement with an eligible entity 
described in clause (iii) to assist 
in providing technical assistance 
and training, to support effective 
policy, practice, research, and 
cross-system collaboration among 
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886 
grantees and subgrantees, and to 
assist in the administration of 
the program described in this 
subsection; and 
(bb) for fiscal year 2025, an 
amount, 
not 
to 
exceed 
$2,000,000, for purposes of con-
ducting 
an 
evaluation 
under 
paragraph (4). 
(II) NO STATE ENTITLEMENT TO 
RESERVED
FUNDS.—The State enti-
tlement under section 2002(a) of the 
Social 
Security 
Act 
(42 
U.S.C. 
1397a(a)) shall not apply to the 
amounts reserved under subclause (I). 
(iii) ELIGIBLE ENTITY DESCRIBED.— 
An eligible entity described in this clause is 
a nonprofit organization described in sec-
tion 501(c)(3) of the Internal Revenue 
Code of 1986 and exempt from taxation 
under section 501(a) of such Code, that— 
(I) has experience in more than 1 
State in the area of community dis-
tributions of basic need services, in-
cluding 
experience 
collecting, 
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887 
warehousing, and distributing basic 
necessities such as menstrual prod-
ucts; 
(II) demonstrates competency to 
implement a project, provide fiscal ac-
countability, collect data, and prepare 
reports and other necessary docu-
mentation; and 
(III) demonstrates a willingness 
to share information with researchers, 
practitioners, and other interested 
parties. 
(2) RULES
GOVERNING
USE
OF
ADDITIONAL 
FUNDS.— 
(A) IN GENERAL.—Funds are used in ac-
cordance with this paragraph if— 
(i) the State, in consultation with rel-
evant stakeholders, including agencies, pro-
fessional associations, and nonprofit orga-
nizations, distributes the funds to eligible 
entities to— 
(I) decrease the unmet need for 
menstrual products by low-income 
menstruating individuals through— 
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888 
(aa) the distribution of free 
menstrual products; 
(bb) community outreach to 
assist in participation in existing 
menstrual product distribution 
programs; or 
(cc) improving access to 
menstrual products among low- 
income individuals; and 
(II) increase the ability of com-
munities and low-income families in 
such communities to provide for the 
need for menstrual products of low-in-
come adults; and 
(ii) the funds are used subject to the 
limitations in section 2005 of the Social 
Security Act (42 U.S.C. 1397d). 
(B) ALLOWABLE USES BY ELIGIBLE ENTI-
TIES.— 
(i) IN
GENERAL.—An eligible entity 
receiving funds made available under para-
graph (1) shall use the funds for any of 
the following: 
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889 
(I) To pay for the purchase and 
distribution of menstrual products 
among low-income individuals. 
(II) To integrate activities car-
ried out under subclause (I) with 
other basic needs assistance programs 
serving low-income families, including 
the following: 
(aa) Programs funded by 
the 
temporary 
assistance 
for 
needy families program under 
part A of title IV of the Social 
Security Act (42 U.S.C. 601 et 
seq.), including the State mainte-
nance of effort provisions of such 
program. 
(bb) Programs designed to 
support the health of eligible chil-
dren, such as the Children’s 
Health Insurance Program under 
title XXI of the Social Security 
Act, the Medicaid program under 
title XIX of such Act, or State 
funded health care programs. 
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890 
(cc) 
Programs 
funded 
through the special supplemental 
nutrition program for women, in-
fants, and children under section 
17 of the Child Nutrition Act of 
1966. 
(dd) Programs that offer 
early home visiting services, in-
cluding the maternal, infant, and 
early childhood home visiting 
program (including the Tribal 
home visiting program) under 
section 511 of the Social Security 
Act (42 U.S.C. 711). 
(III) To provide training or tech-
nical assistance in carrying out activi-
ties under this subsection. 
(IV) To cover administrative 
costs. 
(ii) LIMITATION
ON
USE
OF
FUNDS 
FOR ADMINISTRATIVE COSTS.—An eligible 
entity receiving funds made available under 
this subsection shall not use more than 9 
percent of the funds for administrative 
costs incurred pursuant to this subsection. 
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891 
(C) AVAILABILITY OF FUNDS.— 
(i) FUNDS DISTRIBUTED TO ELIGIBLE 
ENTITIES.—Funds made available under 
paragraph (1) that are distributed to an el-
igible entity by a State for a fiscal year 
may be expended by the eligible entity only 
in such fiscal year or the succeeding fiscal 
year. 
(ii) EVALUATION.—Funds reserved 
under paragraph (1)(B)(ii)(I)(aa) to carry 
out the evaluation under paragraph (4) 
shall be available for expenditure through 
September 30, 2029. 
(D) NO EFFECT ON OTHER PROGRAMS.— 
Any assistance or benefits received by a family 
through funds made available under paragraph 
(1) shall be disregarded for purposes of deter-
mining the family’s eligibility for, or amount of, 
benefits under any other Federal needs-based 
programs. 
(3) ANNUAL
REPORTS.—Section 2004 of the 
Social Security Act shall apply with respect to pay-
ments made to a State under this section in the 
same way it applies with respect to payments made 
to a State under section 2002 of such Act. 
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892 
(4) EVALUATION.—The Secretary, in consulta-
tion with States, the eligible entities described in 
paragraph (1)(B)(iii) receiving funds made available 
under this subsection, shall— 
(A) not later than December 30, 2031, 
complete an evaluation of the effectiveness of 
the assistance program carried out pursuant to 
this subsection, such as the effect of activities 
carried out under this Act on mitigating the 
health risks of unmet menstrual products need 
among individuals in low-income families; 
(B) not later than March 31, 2032, submit 
to the Committees on Energy and Commerce 
and on Ways and Means of the House of Rep-
resentatives and the Committee on Finance of 
the Senate a report on the results of the evalua-
tion; and 
(C) not later than April 30, 2032, publish 
the results of the evaluation on the internet 
website of the Department of Health and 
Human Services. 
(5) GUIDANCE.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary 
shall issue guidance regarding how the provisions of 
this subsection should be carried out, including in-
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893 
formation regarding eligible entities, allowable use of 
funds, and reporting requirements. 
(6) BEST PRACTICES.—The Secretary of Health 
and Human Services, in cooperation with the Sec-
retary of Education, shall develop best practices for 
school officials to use in discussing menstruation 
with students, and shall publish this information on 
the internet website of the Department of Health 
and Human Services. 
(7) DEFINITIONS.—In this subsection: 
(A) MENSTRUAL
PRODUCTS.—The term 
‘‘menstrual products’’ means menstrual cups, 
menstrual discs, menstrual underwear, and san-
itary napkins and tampons, that conform to ap-
plicable industry standards. 
(B) ELIGIBLE ENTITIES.—The term ‘‘eligi-
ble entity’’ means a State or local governmental 
entity, an Indian tribe or tribal organization (as 
defined in section 4 of the Indian Self-Deter-
mination and Education Assistance Act), or a 
nonprofit organization described in section 
501(c)(3) of the Internal Revenue Code of 1986 
and exempt from taxation under section 501(a) 
of such Code that— 
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894 
(i) has experience in the area of com-
munity distributions of basic need services, 
including 
experience 
collecting, 
warehousing, and distributing basic neces-
sities such as diapers, food, or menstrual 
products; 
(ii) demonstrates competency to im-
plement a project, provide fiscal account-
ability, collect data, and prepare reports 
and other necessary documentation; and 
(iii) demonstrates a willingness to 
share information with researchers, practi-
tioners, and other interested parties. 
(C) STATE.—The term ‘‘State’’ has the 
meaning given in section 1101(a)(1) of the So-
cial Security Act for purposes of title XX of 
such Act. 
(8) LIMITATION ON AUTHORIZATION OF APPRO-
PRIATIONS.—For the administration of this sub-
section, there are authorized to be appropriated to 
the Secretary of Health and Human Services not 
more than $6,000,000 for fiscal years 2025 through 
2028. 
(9) 
EXEMPTION
FROM
SEQUESTRATION.— 
Funds made available to carry out this subsection 
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shall be exempt from reduction under any order 
issued under the Balanced Budget and Emergency 
Deficit Control Act of 1985. 
(j) MENSTRUAL PRODUCTS AND TAXATION.— 
(1) IN GENERAL.—It shall be unlawful for a 
State, or unit of local government of a State, to im-
pose a tax on the retail sale of a menstrual product. 
(2) DEFINITIONS.—For purposes of this sub-
section: 
(A) MENSTRUAL
PRODUCT.—The term 
‘‘menstrual products’’ means menstrual cups, 
menstrual discs, menstrual underwear, and san-
itary napkins and tampons, that conform to ap-
plicable industry standards. 
(B) STATE.—The term ‘‘State’’ means any 
of the several States or the District of Colum-
bia. 
(3) EFFECTIVE
DATE.—This subsection shall 
take effect 120 days after the date of the enactment 
of this subsection. 
(k) MENSTRUAL PRODUCTS IN TANF.— 
(1) IN GENERAL.—Section 403(a) of the Social 
Security Act (42 U.S.C. 603(a)) is amended by add-
ing at the end the following: 
‘‘(6) GRANTS FOR MENSTRUAL PRODUCTS.— 
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‘‘(A) IN
GENERAL.—The Secretary may 
make grants, on a competitive basis, for each 
fiscal year to eligible applicants for the grants, 
in such amounts as the Secretary deems appro-
priate to enable the eligible applicants to pro-
vide, to covered families that include an indi-
vidual who is capable of menstruating, such 
benefits as are needed to ensure that the indi-
vidual can purchase menstrual products for per-
sonal use. 
‘‘(B) DEFINITIONS.—In subparagraph (A): 
‘‘(i) COVERED FAMILIES.—The term 
‘covered families’ means families eligible 
for assistance under a State program fund-
ed under this part. 
‘‘(ii) 
ELIGIBLE
APPLICANT.—The 
term ‘eligible applicant’ means— 
‘‘(I) a State to which a grant is 
made under paragraph (1) for a fiscal 
year; and 
‘‘(II) a political subdivision of a 
State that administers the State pro-
gram funded under this part in the 
political subdivision. 
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897 
‘‘(iii) MENSTRUAL
PRODUCTS.—The 
term ‘menstrual products’ means men-
strual cups, menstrual discs, menstrual un-
derwear, and sanitary napkins and tam-
pons, that conform to applicable industry 
standards. 
‘‘(C) CONSIDERATION OF APPLICATIONS.— 
The Secretary shall award grants under this 
paragraph on the basis of how effectively the 
programs proposed by the eligible applicants 
will help low-income individuals suffering from 
material deprivation meet their need for men-
strual products. 
‘‘(D) ADMINISTRATION.—A State or polit-
ical subdivision to which a grant is made under 
this paragraph may use the grant to provide 
benefits under this paragraph in such form and 
in such manner as the State or political subdivi-
sion deems appropriate. 
‘‘(E) TREATMENT OF ASSISTANCE.—Bene-
fits provided using funds made available under 
this paragraph shall not be considered assist-
ance under any State program funded under 
this part. 
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898 
‘‘(F) APPROPRIATION.—Out of any money 
in the Treasury of the United States not other-
wise appropriated, there are appropriated for 
fiscal year 2025 and each succeeding fiscal year 
$10,000,000 for grants under this paragraph.’’. 
(2) EVALUATIONS.—Section 413 of such Act 
(42 U.S.C. 613) is amended by redesignating sub-
section (h) as subsection (i) and inserting after sub-
section (g) the following: 
‘‘(h) EVALUATIONS
OF GRANTS
FOR MENSTRUAL 
PRODUCTS.— 
‘‘(1) IN GENERAL.—The Secretary shall submit 
to the Congress reports, in writing, that evaluate the 
effectiveness of the benefit program provided for in 
section 403(a)(6). Each such report shall, for the 
period covered by the report— 
‘‘(A) describe— 
‘‘(i) the extent of material deprivation 
in the population, including lacking suffi-
cient funds to regularly purchase neces-
sities such as menstrual products; and 
‘‘(ii) the extent to which the program 
alleviated such material deprivation; 
‘‘(B) specify the number and identity of 
the entities to which a grant has been made 
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under such section, and the amount of the 
grant made to each such entity; 
‘‘(C) describe how the grantees used the 
grants to provide benefits under the program; 
‘‘(D) specify the number of individuals who 
received the benefits; 
‘‘(E) describe how efficacious the program 
has been in helping low-income individuals meet 
their need for menstrual products; 
‘‘(F) describe the extent to which the pro-
gram has improved the economic security of the 
benefit recipients; and 
‘‘(G) include such other relevant informa-
tion as the Secretary deems appropriate. 
‘‘(2) TIMING.—The Secretary shall submit a re-
port that meets the requirements of paragraph (1) 
within 2 years after the date of the enactment of 
this paragraph and every 2 years thereafter.’’. 
SEC. 5407. ADDITIONAL FOCUS AREA FOR THE OFFICE ON 
WOMEN’S HEALTH. 
Section 229(b) of the Public Health Service Act (42 
U.S.C. 237a(b)), as amended by sections 5215 and 5301, 
is further amended by adding at the end the following: 
‘‘(10) facilitate the understanding of policy-
makers, health system leaders and providers, con-
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sumers, and other stakeholders concerning optimal 
maternity care and support for the provision of such 
care, including the priorities of— 
‘‘(A) protecting, promoting, and supporting 
the innate capacities of childbearing individuals 
and 
their 
newborns 
for 
childbirth, 
breastfeeding, and attachment; 
‘‘(B) using obstetric interventions only 
when such interventions are supported by 
strong, high-quality evidence, and minimizing 
overuse of maternity practices that have been 
shown to have benefit in limited situations and 
that can expose people, infants, or both to risk 
of harm if used routinely and indiscriminately, 
including overuse of continuous electronic fetal 
monitoring, labor induction, epidural analgesia, 
primary cesarean section, and routine repeat ce-
sarean birth; 
‘‘(C) reliably incorporating noninvasive, 
evidence-based practices that have a docu-
mented correlation with considerable improve-
ment in outcomes with no detrimental side ef-
fects, such as incorporation of smoking ces-
sation programs in pregnancy, maternal immu-
nizations, and proven models (including group 
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prenatal care, midwifery care, and doula sup-
port) that integrate health assessment, edu-
cation, and support into a unified program, and 
supporting evidence-based breastfeeding pro-
motion efforts with respect for a breastfeeding 
individual’s personal decisionmaking; 
‘‘(D) a shared understanding of the quali-
fications of licensed providers of maternity care 
and the best evidence about the safety, satisfac-
tion, outcomes, and costs of maternity care, and 
appropriate deployment of such caregivers with-
in the maternity care workforce to address the 
needs of childbearing individuals and newborns 
and the growing shortage of maternity care-
givers; 
‘‘(E) a shared understanding of the results 
of the best available research comparing hos-
pital, birth center, and planned home births, in-
cluding information about each setting’s safety, 
satisfaction, outcomes, and costs; 
‘‘(F) a shared understanding of the impor-
tance for the safety and choices of birthing 
families of an integrated maternity care system 
with seamless processes for consultation, shared 
care, transfer and transport across maternity 
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care settings, and use of providers when birth-
ing people and their newborns require a higher 
level of care; 
‘‘(G) advancing high-quality, evidence- 
based childbirth education that— 
‘‘(i) promotes a healthy and safe ap-
proach to pregnancy, childbirth, and early 
parenting; 
‘‘(ii) is taught by certified educators, 
peer counselors, and health professionals; 
and 
‘‘(iii) promotes informed decision-
making by childbearing individuals; and 
‘‘(H) developing measures that enable a 
more robust, balanced set of standardized ma-
ternity care measures, including performance 
and quality measures.’’. 
SEC. 5408. INCLUDING SERVICES FURNISHED BY CERTAIN 
STUDENTS, INTERNS, AND RESIDENTS SU-
PERVISED BY CERTIFIED NURSE MIDWIVES 
OR CERTIFIED MIDWIVES WITHIN INPATIENT 
HOSPITAL SERVICES UNDER MEDICARE. 
(a) IN GENERAL.—Section 1861(b) of the Social Se-
curity Act (42 U.S.C. 1395x(b)) is amended— 
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(1) in paragraph (6), by striking ‘‘; or’’ at the 
end and inserting ‘‘, or in the case of services in a 
hospital or osteopathic hospital by a student midwife 
or an intern or resident-in-training under a teaching 
program previously described in this paragraph who 
is in the field of obstetrics and gynecology, if such 
student midwife, intern, or resident-in-training is su-
pervised by a certified nurse-midwife or certified 
midwife to the extent permitted under applicable 
State law and as may be authorized by the hos-
pital;’’; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(8) a certified nurse-midwife or certified mid-
wife where the hospital has a teaching program ap-
proved as specified in paragraph (6), if— 
‘‘(A) the hospital elects to receive any pay-
ment due under this title for reasonable costs of 
such services; and 
‘‘(B) all certified nurse-midwives or cer-
tified midwives in such hospital agree not to bill 
charges for professional services rendered in 
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such hospital to individuals covered under the 
insurance program established by this title.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to services furnished on or after 
the date of the enactment of this Act. 
SEC. 5409. GRANTS TO PROFESSIONAL ORGANIZATIONS 
AND MINORITY-SERVING INSTITUTIONS TO 
INCREASE DIVERSITY IN MATERNAL, REPRO-
DUCTIVE, AND SEXUAL HEALTH PROFES-
SIONALS. 
(a) GRANTS TO HEALTH PROFESSIONAL ORGANIZA-
TIONS.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Administrator 
of the Health Resources and Services Administration 
(referred to in this section as the ‘‘Secretary’’), shall 
carry out a grant program under which the Sec-
retary may make to eligible organizations— 
(A) for fiscal year 2025, planning grants 
described in paragraph (2); and 
(B) for the subsequent 4-year period, im-
plementation grants described in paragraph (3). 
(2) PLANNING GRANTS.— 
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(A) IN
GENERAL.—Planning grants de-
scribed in this paragraph are grants for each of 
the following purposes: 
(i) To collect data and identify any 
workforce inequalities, with respect to a 
health profession, at each of the following 
stages along the health professional con-
tinuum: 
(I) Pipeline availability, with re-
spect to students at the high school 
and college or university levels consid-
ering, and working toward, entrance 
in the profession, including inequal-
ities due to barriers triggered by 
criminal records. 
(II) Entrance into the training 
program for the profession. 
(III) Graduation from such train-
ing program. 
(IV) Entrance into practice, in-
cluding inequalities due to barriers 
triggered by criminal records. 
(V) Retention in practice for 
more than a 5-year period. 
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(ii) To develop one or more strategies 
to address the workforce inequalities with-
in the health profession, as identified 
under (and in response to the findings pur-
suant to) clause (i). 
(B) APPLICATION.—To be eligible to re-
ceive a grant under this paragraph, an eligible 
health professional organization shall submit to 
the Secretary an application in such form and 
manner and containing such information as 
specified by the Secretary. 
(C) AMOUNT.—Each grant awarded under 
this paragraph shall be for an amount not to 
exceed $300,000. 
(D) REPORT.—Each recipient of a grant 
under this paragraph shall submit to the Sec-
retary a report containing— 
(i) information on the extent and dis-
tribution of workforce inequalities identi-
fied through the grant; and 
(ii) reasonable objectives and strate-
gies developed to address such inequalities 
within a 5-, 10-, and 25-year period. 
(3) IMPLEMENTATION GRANTS.— 
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(A) IN GENERAL.—Implementation grants 
described in this paragraph are grants to imple-
ment one or more of the strategies developed 
pursuant to a planning grant awarded under 
paragraph (2). 
(B) APPLICATION.—To be eligible to re-
ceive a grant under this paragraph, an eligible 
health professional organization shall submit to 
the Secretary an application in such form and 
manner as specified by the Secretary. Each 
such application shall contain information on— 
(i) the capability of the organization 
to carry out a strategy described in sub-
paragraph (A); 
(ii) the involvement of partners or 
coalitions; 
(iii) the organization’s plans for devel-
oping sustainability of the implementation 
efforts after the culmination of the grant 
cycle; and 
(iv) any other matter specified by the 
Secretary. 
(C) AMOUNT; 
DURATION.—Each grant 
awarded under this paragraph shall be for an 
amount not to exceed $500,000 for each year of 
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the grant. The term of a grant under this para-
graph shall not exceed 4 years. 
(D) REPORTS.—For each of the first 3 
years for which an eligible health professional 
organization is awarded a grant under this 
paragraph, the organization shall submit to the 
Secretary a report on the activities carried out 
by such organization through the grant during 
such year and objectives for the subsequent 
year. For the fourth year for which an eligible 
health professional organization is awarded a 
grant under this paragraph, the organization 
shall submit to the Secretary a report that in-
cludes an analysis of all the activities carried 
out by the organization through the grant and 
a detailed plan for the continuation of the orga-
nization’s implementation efforts. 
(4) ELIGIBLE HEALTH PROFESSIONAL ORGANI-
ZATION DEFINED.—For purposes of this subsection, 
the term ‘‘eligible health professional organization’’ 
means a professional organization representing ob-
stetrician-gynecologists, certified nurse midwives, 
certified midwives, family practice physicians, nurse 
practitioners whose scope of practice includes preg-
nancy-related or sexual and reproductive health care, 
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physician assistants whose scope of practice includes 
obstetrical or sexual and reproductive health care, 
certified professional midwives, adolescent medicine 
specialists who provide sexual and reproductive 
health care, or pediatricians who provide sexual and 
reproductive health care. 
(b) 
GRANTS
TO
MINORITY-SERVING
INSTITU-
TIONS.— 
(1) IN
GENERAL.—The Secretary shall carry 
out a grant program under which the Secretary may 
make to eligible minority-serving institutions— 
(A) for fiscal years 2025 and 2026, plan-
ning grants described in paragraph (2); and 
(B) for the subsequent 10-year period, im-
plementation grants described in paragraph (3). 
(2) PLANNING GRANTS.— 
(A) IN
GENERAL.—Planning grants de-
scribed in this paragraph are grants for plans 
relating to 1 or more of the following purposes: 
(i) To develop or expand academic 
programs to educate maternity care clini-
cians and maternity care support per-
sonnel, including— 
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(I) nurses who have the intention 
of providing maternity, newborn, or 
sexual and reproductive health care; 
(II) nurse practitioners whose 
scope of practice includes maternity, 
newborn, or sexual and reproductive 
health care; and 
(III) maternity care support per-
sonnel, such as doulas and lactation 
counselors. 
(ii) To develop or expand academic 
programs to educate obstetrician-gyne-
cologists. 
(B) APPLICATION.—To be eligible to re-
ceive a grant under this paragraph, an eligible 
minority-serving institution shall submit to the 
Secretary an application in such form and man-
ner and containing such information as speci-
fied by the Secretary. 
(C) AMOUNT.—Each grant awarded under 
this paragraph shall be for an amount not to 
exceed $400,000 for each of 2 years. 
(D) REPORT.—Each recipient of a grant 
under this paragraph shall submit to the Sec-
retary an annual report describing the planned 
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development or expansion of academic pro-
grams, including— 
(i) the types of clinical or support per-
sonnel to be served and the degrees or cer-
tificates to be conferred; 
(ii) the associated curricula; 
(iii) the faculty and their capabilities 
and commitments, including any plans for 
recruitment; 
(iv) the anticipated number of stu-
dents to be enrolled and plans for their re-
cruitment and social, emotional, and finan-
cial support; and 
(v) the objectives and strategies for 
addressing inequalities and preparing stu-
dents to provide high-quality culturally 
congruent care. 
(3) IMPLEMENTATION GRANTS.— 
(A) IN GENERAL.—Implementation grants 
described in this paragraph are grants to imple-
ment the plans developed under paragraph (2). 
(B) APPLICATION.—To be eligible to re-
ceive a grant under this paragraph, an eligible 
minority-serving institution shall submit to the 
Secretary an application in such form and man-
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ner as specified by the Secretary. Each such ap-
plication shall contain information on the capa-
bility of the institution to carry out a plan de-
scribed in paragraph (2), plans for sustain-
ability of the academic program involved after 
the culmination of the grant cycle, and any 
other matter specified by the Secretary. 
(C) AMOUNT.—Each grant under this 
paragraph shall be for an amount not to exceed 
$1,000,000 for each year during the 10-year 
period of the grant. 
(D) REPORTS.— 
(i) INITIAL PERIOD.—For each of the 
first 9 years for which an eligible minority- 
serving institution is awarded a grant 
under this paragraph, the institution shall 
submit a report to the Secretary on the ac-
tivities carried out by such institution 
through the grant during such year and 
objectives for the subsequent year. 
(ii) FINAL YEAR.—For the tenth year 
for which an eligible minority-serving insti-
tution is awarded a grant under this para-
graph, the organization shall submit to the 
Secretary a report that includes an anal-
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ysis of all the activities carried out by the 
institution through the grant and a de-
tailed plan for continuation of the aca-
demic program. 
(4) MINORITY-SERVING INSTITUTION.—For the 
purposes of this subsection, the term ‘‘minority-serv-
ing institution’’ means any of the following: 
(A) A Hispanic-serving institution, as that 
term is defined in section 502(a) of the Higher 
Education Act of 1965 (20 U.S.C. 1101a(a)). 
(B) A Tribal College or University, as that 
term is defined in section 316(b) of the Higher 
Education Act of 1965 (20 U.S.C. 1059c(b)). 
(C) An Alaska Native-serving institution, 
as that term is defined in section 317(b) of the 
Higher Education Act of 1965 (20 U.S.C. 
1059d(b)). 
(D) A Native Hawaiian-serving institution, 
as that term is defined in section 317(b) of the 
Higher Education Act of 1965 (20 U.S.C. 
1059d(b)). 
(E) A Predominantly Black Institution, as 
that term is defined in section 318(b) of the 
Higher Education Act of 1965 (20 U.S.C. 
1059e(b)). 
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(F) A Native American-serving, nontribal 
institution, as that term is defined in section 
319(b) of the Higher Education Act of 1965 
(20 U.S.C. 1059f(b)). 
(G) An Asian American and Native Amer-
ican Pacific Islander-serving institution, as that 
term is defined in section 320(b) of the Higher 
Education Act of 1965 (20 U.S.C. 1059g(b)). 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out— 
(1) subsection (a), $2,000,000 for fiscal year 
2025 and $3,000,000 for each of the fiscal years 
2026 through 2029; and 
(2) subsection (b), $4,000,000 for each of fiscal 
years 2025 and 2026 and $10,000,000 for each of 
fiscal years 2027 through 2036. 
Subtitle F—Children’s Health 
SEC. 5501. CARING FOR KIDS ACT. 
(a) 
PERMANENT
EXTENSION
OF
CHILDREN’S 
HEALTH INSURANCE PROGRAM.— 
(1) IN GENERAL.—Section 2104(a)(28) of the 
Social Security Act (42 U.S.C. 1397dd(a)(28)) is 
amended to read as follows: 
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‘‘(28) for fiscal year 2029 and each subsequent 
year, such sums as are necessary to fund allotments 
to States under subsections (c) and (m).’’. 
(2) ALLOTMENTS.— 
(A) IN GENERAL.—Section 2104(m) of the 
Social Security Act (42 U.S.C. 1397dd(m)) is 
amended— 
(i) in paragraph (2)(B)— 
(I) in the matter preceding clause 
(i), by striking ‘‘through (27)’’ and in-
serting ‘‘through (28)’’; and 
(II) in clause (i), by striking 
‘‘2023, and 2029’’ and inserting ‘‘and 
2023’’; 
(ii) in paragraph (7)— 
(I) in subparagraph (A), by strik-
ing ‘‘and ending with fiscal year 
2029,’’; and 
(II) in the flush left matter at 
the end, by striking ‘‘fiscal year 2026, 
or fiscal year 2028’’ and inserting 
‘‘fiscal year 2026, or a subsequent 
even-numbered fiscal year’’; 
(iii) in paragraph (9)— 
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(I) by striking ‘‘(10), or (11)’’ 
and inserting ‘‘or (10)’’; and 
(II) by striking ‘‘2023, or 2029,’’ 
and inserting ‘‘or 2023’’; and 
(iv) by striking paragraph (11). 
(B) CONFORMING
AMENDMENT.—Section 
50101(b)(2) of the Bipartisan Budget Act of 
2018 (Public Law 115–123) is repealed. 
(b) PERMANENT EXTENSIONS OF OTHER PROGRAMS 
AND DEMONSTRATION PROJECTS.— 
(1) 
PEDIATRIC
QUALITY
MEASURES
PRO-
GRAM.—Section 1139A(i)(1) of the Social Security 
Act (42 U.S.C. 1320b–9a(i)(1)) is amended— 
(A) in subparagraph (D), by striking ‘‘; 
and’’ and inserting a semicolon; 
(B) in subparagraph (E), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(F) for a subsequent fiscal year, the 
amount appropriated under this paragraph for 
the previous fiscal year, increased by the per-
centage increase in the consumer price index for 
all urban consumers (all items; United States 
city average) over such previous fiscal year, for 
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the purpose of carrying out this section (other 
than subsections (e), (f), and (g)).’’. 
(2) EXPRESS LANE ELIGIBILITY OPTION.—Sec-
tion 1902(e)(13) of the Social Security Act (42 
U.S.C. 1396a(e)(13)) is amended by striking sub-
paragraph (I). 
(3) ASSURANCE OF AFFORDABILITY STANDARD 
FOR CHILDREN AND FAMILIES.— 
(A) IN GENERAL.—Section 2105(d)(3) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1397ee(d)(3)) is amended— 
(i) in the paragraph heading, by strik-
ing ‘‘THROUGH SEPTEMBER 30, 2029’’; and 
(ii) in subparagraph (A), in the mat-
ter preceding clause (i)— 
(I) by striking ‘‘During the pe-
riod that begins on the date of enact-
ment of the Patient Protection and 
Affordable Care Act and ends on Sep-
tember 30, 2029’’ and inserting ‘‘Be-
ginning on the date of the enactment 
of the Patient Protection and Afford-
able Care Act’’; 
(II) by striking ‘‘During the pe-
riod that begins on October 1, 2019, 
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and ends on September 30, 2029’’ 
and inserting ‘‘Beginning on October 
1, 2019’’; and 
(III) by striking ‘‘The preceding 
sentences shall not be construed as 
preventing a State during any such 
periods from’’ and inserting ‘‘The pre-
ceding sentences shall not be con-
strued as preventing a State from’’. 
(B) CONFORMING AMENDMENTS.—Section 
1902(gg)(2) of the Social Security Act (42 
U.S.C. 1396a(gg)(2)) is amended— 
(i) in the paragraph heading, by strik-
ing ‘‘THROUGH SEPTEMBER 30, 2029’’; and 
(ii) by striking ‘‘through September 
30’’ and all that follows through ‘‘ends on 
September 30, 2029’’ and inserting ‘‘(but 
beginning on October 1, 2019’’. 
(4) 
QUALIFYING
STATES
OPTION.—Section 
2105(g)(4) of the Social Security Act (42 U.S.C. 
1397ee(g)(4)) is amended— 
(A) in the paragraph heading, by striking 
‘‘FOR FISCAL YEARS 2009 THROUGH 2029’’ and 
inserting ‘‘AFTER FISCAL YEAR 2008’’; and 
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(B) in subparagraph (A), by striking ‘‘for 
any of fiscal years 2009 through 2029’’ and in-
serting ‘‘for any fiscal year after fiscal year 
2008’’. 
(5) OUTREACH AND ENROLLMENT PROGRAM.— 
Section 2113 of the Social Security Act (42 U.S.C. 
1397mm) is amended— 
(A) in subsection (a)— 
(i) in paragraph (1), by striking ‘‘dur-
ing the period of fiscal years 2009 through 
2029’’ and inserting ‘‘, beginning with fis-
cal year 2009,’’; 
(ii) in paragraph (2)— 
(I) by striking ‘‘10 percent of 
such amounts’’ and inserting ‘‘10 per-
cent of such amounts for the period or 
the fiscal year for which such amounts 
are appropriated’’; and 
(II) by striking ‘‘during such pe-
riod’’ and inserting ‘‘, during such pe-
riod or such fiscal year,’’; and 
(iii) in paragraph (3), by striking 
‘‘For the period of fiscal years 2024 
through 2029, an amount equal to 10 per-
cent of such amounts’’ and inserting ‘‘Be-
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ginning with fiscal year 2024, an amount 
equal to 10 percent of such amounts for 
the period or the fiscal year for which such 
amounts are appropriated’’; and 
(B) in subsection (g)— 
(i) by striking ‘‘and $40,000,000’’ and 
inserting ‘‘$40,000,000’’; and 
(ii) by inserting after ‘‘fiscal years 
2028 
and 
2029,’’ 
the 
following: 
‘‘$12,000,000 for fiscal year 2030, and, 
for each fiscal year after fiscal year 2030, 
the amount appropriated under this sub-
section for the previous fiscal year, in-
creased by the percentage increase in the 
consumer price index for all urban con-
sumers (all items; United States city aver-
age) over such previous fiscal year,’’. 
(6) 
CHILD
ENROLLMENT
CONTINGENCY 
FUND.—Section 2104(n) of the Social Security Act 
(42 U.S.C. 1397dd(n)) is amended— 
(A) in paragraph (2)— 
(i) in subparagraph (A)(ii)— 
(I) 
by 
striking 
‘‘and 
2024 
through 2028’’ and inserting ‘‘and for 
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921 
each fiscal year after fiscal year 
2023’’; and 
(II) by striking ‘‘2023, and 
2029’’ and inserting ‘‘and 2023’’; and 
(ii) in subparagraph (B)— 
(I) by striking ‘‘2024 through 
2028’’ and inserting ‘‘and for each 
fiscal year after fiscal year 2023’’; 
and 
(II) by striking ‘‘2023, and 
2029’’ and inserting ‘‘and 2023’’; and 
(B) in paragraph (3)(A)— 
(i) by striking ‘‘fiscal years 2024 
through 2028’’ and inserting ‘‘a fiscal year 
after fiscal year 2023’’; and 
(ii) by striking ‘‘2023, or 2029’’ and 
inserting ‘‘or 2023’’. 
SEC. 5502. END DIAPER NEED ACT OF 2024. 
(a) TARGETED FUNDING FOR DIAPER ASSISTANCE 
(INCLUDING DIAPERING SUPPLIES AND ADULT INCONTI-
NENCE MATERIALS AND SUPPLIES) THROUGH THE SO-
CIAL SERVICES BLOCK GRANT PROGRAM.— 
(1) INCREASE IN FUNDING FOR SOCIAL SERV-
ICES BLOCK GRANT PROGRAM.— 
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(A) IN GENERAL.—The amount specified 
in subsection (c) of section 2003 of the Social 
Security Act (42 U.S.C. 1397b) for purposes of 
subsections (a) and (b) of such section is 
deemed to be $1,900,000,000 for each of fiscal 
years 2025 through 2028, of which, the amount 
equal to $200,000,000, reduced by the amounts 
reserved under subparagraph (B)(ii) for each 
such fiscal year, shall be obligated by States in 
accordance with paragraph (2). 
(B) APPROPRIATION.— 
(i) IN GENERAL.—Out of any money 
in the Treasury of the United States not 
otherwise appropriated, there is appro-
priated $200,000,000 for each of fiscal 
years 2025 through 2028, to carry out this 
subsection. 
(ii) RESERVATIONS.— 
(I) PURPOSES.—The Secretary 
shall reserve, from the amount appro-
priated under clause (i) to carry out 
this subsection— 
(aa) for each of fiscal years 
2025 through 2028, not more 
than 2 percent of the amount ap-
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propriated for the fiscal year for 
purposes of entering into an 
agreement with a national entity 
described in clause (iii) to assist 
in providing technical assistance 
and training, to support effective 
policy, practice, research, and 
cross-system collaboration among 
grantees and subgrantees, and to 
assist in the administration of 
the program described in this 
subsection; and 
(bb) for fiscal year 2025, an 
amount, 
not 
to 
exceed 
$2,000,000, for purposes of con-
ducting 
an 
evaluation 
under 
paragraph (4). 
(II) NO STATE ENTITLEMENT TO 
RESERVED
FUNDS.—The State enti-
tlement under section 2002(a) of the 
Social 
Security 
Act 
(42 
U.S.C. 
1397a(a)) shall not apply to the 
amounts reserved under subclause (I). 
(iii) NATIONAL ENTITY DESCRIBED.— 
A national entity described in this clause is 
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a nonprofit organization described in sec-
tion 501(c)(3) of the Internal Revenue 
Code of 1986 and exempt from taxation 
under section 501(a) of such Code, that— 
(I) has experience in more than 1 
State in the area of— 
(aa) 
community 
distribu-
tions of basic need services, in-
cluding 
experience 
collecting, 
warehousing, 
and 
distributing 
basic necessities such as diapers, 
food, or menstrual products; 
(bb) child care; 
(cc) child development ac-
tivities in low-income commu-
nities; or 
(dd) 
motherhood, 
father-
hood, or parent education efforts 
serving low-income parents of 
young children; 
(II) demonstrates competency to 
implement a project, provide fiscal ac-
countability, collect data, and prepare 
reports and other necessary docu-
mentation; and 
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(III) demonstrates a willingness 
to share information with researchers, 
practitioners, and other interested 
parties. 
(2) RULES
GOVERNING
USE
OF
ADDITIONAL 
FUNDS.— 
(A) IN GENERAL.—Funds are used in ac-
cordance with this paragraph if— 
(i) the State, in consultation with rel-
evant stakeholders, including agencies, pro-
fessional associations, and nonprofit orga-
nizations, distributes the funds to eligible 
entities to— 
(I) decrease the need for diapers 
and diapering supplies and adult in-
continence materials and supplies in 
low-income families and meet such 
unmet needs of infants and toddlers, 
medically complex children, and low- 
income adults and adults with disabil-
ities in such families through— 
(aa) the distribution of free 
diapers and diapering supplies, 
medically necessary diapers, and 
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adult incontinence materials and 
supplies; 
(bb) community outreach to 
assist in participation in existing 
diaper distribution programs or 
programs that distribute medi-
cally necessary diapers or adult 
incontinence materials and sup-
plies; or 
(cc) improving access to dia-
pers 
and 
diapering 
supplies, 
medically necessary diapers, and 
adult incontinence materials and 
supplies; and 
(II) increase the ability of com-
munities and low-income families in 
such communities to provide for the 
need for diapers and diapering sup-
plies, medically necessary diapers, and 
adult incontinence materials and sup-
plies, of infants and toddlers, medi-
cally complex children, and low-income 
adults and adults with disabilities; 
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(ii) the funds are used subject to the 
limitations in section 2005 of the Social 
Security Act (42 U.S.C. 1397d); 
(iii) the funds are used to supplement, 
not supplant, State general revenue funds 
provided for the purposes described in 
clause (i); and 
(iv) the funds are not used for costs 
that are reimbursable by the Federal 
Emergency Management Agency, under a 
contract for insurance, or by self-insur-
ance. 
(B) ALLOWABLE USES BY ELIGIBLE ENTI-
TIES.—An eligible entity receiving funds made 
available under paragraph (1) shall use the 
funds for any of the following: 
(i) To pay for the purchase and dis-
tribution of diapers and diapering supplies, 
medically necessary diapers, and funding 
diaper (including medically necessary dia-
pers) distribution that serves low-income 
families with— 
(I) 1 or more children 3 years of 
age or younger; or 
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(II) 1 or more medically complex 
children. 
(ii) To pay for the purchase and dis-
tribution of adult incontinence materials 
and supplies and funding distribution of 
such materials and supplies that serves 
low-income families with 1 or more low-in-
come adults or adults with disabilities who 
rely on adult incontinence materials and 
supplies. 
(iii) To integrate activities carried out 
under clause (i) with other basic needs as-
sistance programs serving eligible children 
and their families, including the following: 
(I) Programs funded by the tem-
porary assistance for needy families 
program under part A of title IV of 
the Social Security Act (42 U.S.C. 
601 et seq.), including the State 
maintenance of effort provisions of 
such program. 
(II) Programs designed to sup-
port the health of eligible children, 
such as the Children’s Health Insur-
ance Program under title XXI of the 
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Social Security Act, the Medicaid pro-
gram under title XIX of such Act, or 
State-funded health care programs. 
(III) Programs funded through 
the special supplemental nutrition 
program for women, infants, and chil-
dren under section 17 of the Child 
Nutrition Act of 1966. 
(IV) Programs that offer early 
home visiting services, including the 
maternal, infant, and early childhood 
home visiting program (including the 
Tribal home visiting program) under 
section 511 of the Social Security Act 
(42 U.S.C. 711). 
(V) Programs to provide im-
proved and affordable access to child 
care, 
including 
programs 
funded 
through the Child Care and Develop-
ment Fund, the temporary assistance 
for needy families program under part 
A of title IV of the Social Security 
Act (42 U.S.C. 601 et seq.), or a 
State-funded program. 
(C) AVAILABILITY OF FUNDS.— 
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(i) FUNDS DISTRIBUTED TO ELIGIBLE 
ENTITIES.—Funds made available under 
paragraph (1) that are distributed to an el-
igible entity by a State for a fiscal year 
may be expended by the eligible entity only 
in such fiscal year or the succeeding fiscal 
year. 
(ii) EVALUATION.—Funds reserved 
under paragraph (1)(B)(ii)(I)(aa) to carry 
out the evaluation under paragraph (4) 
shall be available for expenditure during 
the 3-year period that begins on the date 
of enactment of this Act. 
(D) NO EFFECT ON OTHER PROGRAMS.— 
Any assistance or benefits received by a family 
through funds made available under paragraph 
(1) shall be disregarded for purposes of deter-
mining the family’s eligibility for, or amount of, 
benefits under any other Federal needs-based 
programs. 
(3) ANNUAL REPORTS.—A State shall include 
in the annual report required under section 2006 of 
the Social Security Act (42 U.S.C. 1397e) covering 
each of fiscal years 2024 through 2027, information 
detailing how eligible entities, including subgrantees, 
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used funds made available under paragraph (1) to 
distribute diapers and diapering supplies and adult 
incontinence materials and supplies to families in 
need. Each such report shall include the following: 
(A) The number and age of infants, tod-
dlers, medically complex children, and low-in-
come adults and adults with disabilities who re-
ceived assistance or benefits through such 
funds. 
(B) The number of families that have re-
ceived assistance or benefits through such 
funds. 
(C) The number of diapers, medically nec-
essary diapers, or adult incontinence materials 
and supplies (such as adult diapers, briefs, pro-
tective underwear, pull-ons, pull-ups, liners, 
shields, guards, pads, undergarments), and the 
number of each type of diapering or adult in-
continence supply, distributed through the use 
of such funds. 
(D) The ZIP Code or ZIP Codes where the 
eligible entity (or subgrantee) distributed dia-
pers and diapering supplies and adult inconti-
nence materials and supplies. 
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(E) The method or methods the eligible en-
tity (or subgrantee) uses to distribute diapers 
and diapering supplies and, adult incontinence 
materials and supplies. 
(F) Such other information as the Sec-
retary may specify. 
(4) EVALUATION.—The Secretary, in consulta-
tion with States, the national entity described in 
paragraph (1)(B)(iii), and eligible entities receiving 
funds made available under this subsection, shall— 
(A) not later than 2 years after the date 
of enactment of this Act— 
(i) complete an evaluation of the effec-
tiveness of the assistance program carried 
out pursuant to this subsection, such as 
the effect of activities carried out under 
this section on mitigating the health and 
developmental risks of unmet diaper need 
among infants, toddlers, medically complex 
children, and other family members in low- 
income families, including the risks of dia-
per dermatitis, urinary tract infections, 
and parental and child depression and anx-
iety; 
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(A) ADULT
INCONTINENCE
MATERIALS 
AND SUPPLIES.—The term ‘‘adult incontinence 
materials and supplies’’ means those supplies 
that are used to assist low-income adults or 
adults with disabilities and includes adult dia-
pers, briefs, protective underwear, pull-ons, 
pull-ups, liners, shields, guards, pads, undergar-
ments, disposable wipes, over-the-counter adult 
diaper rash cream products, intermittent cath-
eterization, indwelling catheters, condom cath-
eters, urinary drainage bags, external collection 
devices, wearable urinals, and penile clamps. 
(B) ADULTS
WITH
DISABILITIES.—The 
term ‘‘adults with disabilities’’ means individ-
uals who— 
(i) have attained age 18; and 
(ii) have a disability (as such term is 
defined, with respect to an individual, in 
section 3 of the Americans with Disabil-
ities Act of 1990 (42 U.S.C. 12102)). 
(C) DIAPER.—The term ‘‘diaper’’ means 
an absorbent garment that— 
(i) is washable or disposable that may 
be worn by an infant or toddler who is not 
toilet-trained; and 
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(ii) if disposable— 
(I) does not use any latex or 
common allergens; and 
(II) meets or exceeds the quality 
standards for diapers commercially 
available through retail sale in the fol-
lowing categories: 
(aa) Absorbency (with ac-
ceptable rates for first and sec-
ond wetting). 
(bb) Waterproof outer cover. 
(cc) Flexible leg openings. 
(dd) Refastening closures. 
(D) DIAPERING
SUPPLIES.—The term 
‘‘diapering supplies’’ means items, including di-
aper wipes and diaper cream, necessary to en-
sure that— 
(i) an eligible child using a diaper is 
properly cleaned and protected from diaper 
rash; or 
(ii) a medically complex child who 
uses a medically necessary diaper is prop-
erly cleaned and protected from diaper 
rash. 
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936 
(E) ELIGIBLE CHILD.—The term ‘‘eligible 
child’’ means a child who— 
(i) has not attained 4 years of age; 
and 
(ii) is a member of a low-income fam-
ily. 
(F) ELIGIBLE ENTITIES.—The term ‘‘eligi-
ble entity’’ means a State or local governmental 
entity, an Indian tribe or tribal organization (as 
defined in section 4 of the Indian Self-Deter-
mination and Education Assistance Act), or a 
nonprofit organization described in section 
501(c)(3) of the Internal Revenue Code of 1986 
and exempt from taxation under section 501(a) 
of such Code that— 
(i) has experience in the area of— 
(I) community distributions of 
basic need services, including experi-
ence collecting, warehousing, and dis-
tributing basic necessities such as dia-
pers, food, or menstrual products; 
(II) child care; 
(III) child development activities 
in low-income communities; or 
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(IV) motherhood, fatherhood, or 
parent education efforts serving low- 
income parents of young children; 
(ii) demonstrates competency to im-
plement a project, provide fiscal account-
ability, collect data, and prepare reports 
and other necessary documentation; and 
(iii) demonstrates a willingness to 
share information with researchers, practi-
tioners, and other interested parties. 
(G) FEDERAL POVERTY LINE.—The term 
‘‘Federal poverty line’’ means the Federal pov-
erty line as defined by the Office of Manage-
ment and Budget and revised annually in ac-
cordance with section 673(2) of the Omnibus 
Budget Reconciliation Act of 1981 applicable to 
a family of the size involved. 
(H) LOW-INCOME.—The term ‘‘low-in-
come’’, with respect to a family, means a family 
whose self-certified income is not more than 
200 percent of the Federal poverty line. 
(I) MEDICALLY
COMPLEX
CHILD.—The 
term ‘‘medically complex child’’ means an indi-
vidual who has attained age 3 and for whom a 
licensed health care provider has provided a di-
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938 
agnosis of bowel or bladder incontinence, a 
bowel or bladder condition that causes excess 
urine or stool (such as short gut syndrome or 
diabetes insipidus), or a severe skin condition 
that causes skin erosions (such as epidermolysis 
bullosa). 
(J) MEDICALLY NECESSARY DIAPER.—The 
term ‘‘medically necessary diaper’’ means an 
absorbent garment that is— 
(i) washable or disposable; 
(ii) worn by a medically complex child 
who has been diagnosed with bowel or 
bladder incontinence, a bowel or bladder 
condition that causes excess urine or stool 
(such as short gut syndrome or diabetes 
insipidus), or a severe skin condition that 
causes skin erosions (such as epidermolysis 
bullosa) and needs such garment to correct 
or ameliorate such condition; and 
(iii) if disposable— 
(I) does not use any latex or 
common allergens; and 
(II) meets or exceeds the quality 
standards for diapers commercially 
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939 
available through retail sale in the fol-
lowing categories: 
(aa) Absorbency (with ac-
ceptable rates for first and sec-
ond wetting). 
(bb) Waterproof outer cover. 
(cc) Flexible leg openings. 
(dd) Refastening closures. 
(7) EXEMPTION OF PROGRAM FROM SEQUES-
TRATION.— 
(A) IN GENERAL.—Section 255(h) of the 
Balanced Budget and Emergency Deficit Con-
trol Act of 1985 (2 U.S.C. 905(h)) is amended 
by inserting after ‘‘Supplemental Security In-
come Program (28–0406–0–1–609).’’ the fol-
lowing: 
‘‘Targeted funding for States for diaper assist-
ance (including diapering supplies and adult inconti-
nence materials and supplies) through the Social 
Services Block Grant Program.’’. 
(B) 
APPLICABILITY.—The 
amendment 
made by this paragraph shall apply to any se-
questration order issued under the Balanced 
Budget and Emergency Deficit Control Act of 
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940 
1985 (2 U.S.C. 900 et seq.) on or after the 
date of enactment of this Act. 
(b) IMPROVING ACCESS TO DIAPERS FOR MEDICALLY 
COMPLEX CHILDREN.—Section 1915(c) of the Social Se-
curity Act (42 U.S.C. 1396n(c)) is amended by adding at 
the end the following new paragraph: 
‘‘(11)(A) In the case of any waiver under this sub-
section that provides medical assistance to a medically 
complex child who has been diagnosed with bowel or blad-
der incontinence, a bowel or bladder condition that causes 
excess urine or stool (such as short gut syndrome or diabe-
tes insipidus), or a severe skin condition that causes skin 
erosions (such as epidermolysis bullosa), such medical as-
sistance shall include, for the duration of the waiver, the 
provision of 200 medically necessary diapers per month 
and diapering supplies. Such medical assistance may in-
clude the provision of medically necessary diapers in 
amounts greater than 200 if a licensed health care pro-
vider (such as a physician, nurse practitioner, or physician 
assistant) specifies that such greater amounts are nec-
essary for such medically complex child. 
‘‘(B) For purposes of this paragraph: 
‘‘(i) The term ‘medically complex child’ means 
an individual who has attained age 3 and for whom 
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941 
a licensed health care provider has provided a diag-
nosis of 1 or more significant chronic conditions. 
‘‘(ii) The term ‘medically necessary diaper’ 
means an absorbent garment that is— 
‘‘(I) washable or disposable; 
‘‘(II) worn by a medically complex child 
who has been diagnosed with a condition de-
scribed in subparagraph (A) and needs such 
garment to correct or ameliorate such condition; 
and 
‘‘(III) if disposable— 
‘‘(aa) does not use any latex or com-
mon allergens; and 
‘‘(bb) meets or exceeds the quality 
standards for diapers commercially avail-
able through retail sale in the following 
categories: 
‘‘(AA) Absorbency (with accept-
able rates for first and second wet-
ting). 
‘‘(BB) Waterproof outer cover. 
‘‘(CC) Flexible leg openings. 
‘‘(DD) Refastening closures. 
‘‘(iii) The term ‘diapering supplies’ means 
items, including diaper wipes and diaper creams, 
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942 
necessary to ensure that a medically complex child 
who has been diagnosed with a condition described 
in subparagraph (A) and uses a medically necessary 
diaper is properly cleaned and protected from diaper 
rash.’’. 
(c) INCLUSION OF DIAPERS AND DIAPERING SUP-
PLIES AS QUALIFIED MEDICAL EXPENSES.— 
(1) 
HEALTH
SAVINGS
ACCOUNTS.—Section 
223(d)(2) of the Internal Revenue Code of 1986 is 
amended— 
(A) by inserting ‘‘, medically necessary dia-
pers, and diapering supplies’’ after ‘‘menstrual 
care products’’ in the last sentence of subpara-
graph (A); and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(E) MEDICALLY
NECESSARY
DIAPERS 
AND
DIAPERING
SUPPLIES.—For purposes of 
this paragraph— 
‘‘(i) MEDICALLY
NECESSARY
DIA-
PERS.—The term ‘medically necessary dia-
per’ means an absorbent garment which is 
washable or disposable and which is worn 
by an individual who has attained 3 years 
of age because of medical necessity, such 
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943 
as someone who has been diagnosed with 
bowel or bladder incontinence, a bowel or 
bladder condition that causes excess urine 
or stool (such as short gut syndrome or di-
abetes insipidus), or a severe skin condi-
tion that causes skin erosions (such as 
epidermolysis bullosa) and needs such gar-
ment to correct or ameliorate such condi-
tion, to serve a preventative medical pur-
pose, or to correct or ameliorate defects or 
physical or mental illnesses or conditions 
diagnosed by a licensed health care pro-
vider, and, if disposable— 
‘‘(I) does not use any latex or 
common allergens; and 
‘‘(II) meets or exceeds the quality 
standards for diapers commercially 
available through retail sale in the fol-
lowing categories: 
‘‘(aa) Absorbency (with ac-
ceptable rates for first and sec-
ond wetting). 
‘‘(bb) 
Waterproof 
outer 
cover. 
‘‘(cc) Flexible leg openings. 
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‘‘(dd) Refastening closures. 
‘‘(ii) 
DIAPERING
SUPPLIES.—The 
term ‘diapering supplies’ means items, in-
cluding diaper wipes and diaper creams, 
necessary to ensure that an individual 
wearing medically necessary diapers is 
properly cleaned and protected from diaper 
rash.’’. 
(2) ARCHER MSAS.—The last sentence of sec-
tion 220(d)(2)(A) of such Code is amended by in-
serting ‘‘, medically necessary diapers (as defined in 
section 223(d)(2)(E)), and diapering supplies (as de-
fined in section 223(d)(2)(E))’’ after ‘‘menstrual 
care products (as defined in section 223(d)(2)(D))’’. 
(3) HEALTH
FLEXIBLE
SPENDING
ARRANGE-
MENTS
AND
HEALTH
REIMBURSEMENT
ARRANGE-
MENTS.—Section 106(f) of such Code is amended— 
(A) by inserting ‘‘, medically necessary dia-
pers (as defined in section 223(d)(2)(E)), and 
diapering supplies (as defined in section 
223(d)(2)(E))’’ after ‘‘menstrual care products 
(as defined in section 223(d)(2)(D))’’; and 
(B) in the heading, by inserting ‘‘, MEDI-
CALLY NECESSARY DIAPERS, AND DIAPERING 
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SUPPLIES’’ after ‘‘MENSTRUAL CARE PROD-
UCTS’’. 
(4) EFFECTIVE DATES.— 
(A) DISTRIBUTIONS
FROM
CERTAIN
AC-
COUNTS.—The amendments made by para-
graphs (1) and (2) shall apply to amounts paid 
after December 31, 2024. 
(B) REIMBURSEMENTS.—The amendment 
made by paragraph (3) shall apply to expenses 
incurred after December 31, 2024. 
SEC. 5503. DECREASING THE RISK FACTORS FOR SUDDEN 
UNEXPECTED INFANT DEATH AND SUDDEN 
UNEXPLAINED DEATH IN CHILDHOOD. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services, acting through the Administrator of the 
Health Resources and Services Administration and in con-
sultation with the Director of the Centers for Disease Con-
trol and Prevention and the Director of the National Insti-
tutes of Health (in this section referred to as the ‘‘Sec-
retary’’), shall establish and implement a culturally and 
linguistically competent public health awareness and edu-
cation campaign to provide information that is focused on 
decreasing the risk factors for sudden unexpected infant 
death and sudden unexplained death in childhood, includ-
ing educating individuals about safe sleep environments, 
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sleep positions, and reducing exposure to smoking during 
pregnancy and after birth. 
(b) TARGETED POPULATIONS.—The campaign under 
subsection (a) shall be designed to reduce health inequal-
ities through the targeting of populations with high rates 
of sudden unexpected infant death or of sudden unex-
plained death in childhood. 
(c) CONSULTATION.—In establishing and imple-
menting the campaign under subsection (a), the Secretary 
shall consult with national organizations representing (col-
lectively) health care providers, including nurses and phy-
sicians, parents, child care providers, children’s advocacy 
and safety organizations, maternal and child health pro-
grams, nutrition professionals focusing on (collectively) 
people, infants, and children, and other individuals and 
groups determined necessary by the Secretary for such es-
tablishment and implementation. 
(d) GRANTS.— 
(1) IN
GENERAL.—In carrying out the cam-
paign under subsection (a), the Secretary shall 
award grants to national organizations, State and 
local health departments, and community-based or-
ganizations for the conduct of education and out-
reach programs for nurses, parents, child care pro-
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viders, community health workers, public health 
agencies, and community organizations. 
(2) APPLICATION.—To be eligible to receive a 
grant under paragraph (1), an entity shall submit to 
the Secretary an application at such time, in such 
manner, and containing such information as the Sec-
retary may require. 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2025 through 2029. 
Subtitle G—Elder Care 
SEC. 5601. EXPENSES FOR HOUSEHOLD AND ELDER CARE 
SERVICES NECESSARY FOR GAINFUL EM-
PLOYMENT. 
(a) IN GENERAL.—Subpart A of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 is amended by inserting after section 25E the fol-
lowing new section: 
‘‘SEC. 25F. EXPENSES FOR HOUSEHOLD AND ELDER CARE 
SERVICES NECESSARY FOR GAINFUL EM-
PLOYMENT. 
‘‘(a) ALLOWANCE OF CREDIT.— 
‘‘(1) IN GENERAL.—In the case of an individual 
for which there are one or more qualifying individ-
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uals (as defined in subsection (b)(1)) with respect to 
such individual, there shall be allowed as a credit 
against the tax imposed by this chapter for the tax-
able year an amount equal to the applicable percent-
age of the employment-related expenses (as defined 
in subsection (b)(3)) paid by such individual during 
the taxable year. 
‘‘(2) APPLICABLE PERCENTAGE DEFINED.—For 
purposes of paragraph (1), the term ‘applicable per-
centage’ means 35 percent reduced (but not below 
20 percent) by 1 percentage point for each $2,000 
(or fraction thereof) by which the taxpayer’s ad-
justed gross income for the taxable year exceeds 
$15,000. 
‘‘(b) DEFINITIONS OF QUALIFYING INDIVIDUAL AND 
EMPLOYMENT-RELATED EXPENSES.—For purposes of 
this section— 
‘‘(1) 
QUALIFYING
INDIVIDUAL.—The 
term 
‘qualifying individual’ means an individual who— 
‘‘(A) has attained age 50, and 
‘‘(B) satisfies the requirements of any of 
the following clauses: 
‘‘(i) An individual who bears a rela-
tionship to the taxpayer described in sub-
paragraph (C) or (D) of section 152(d)(2) 
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(relating to fathers, mothers, and ances-
tors). 
‘‘(ii) An individual who would be a de-
pendent of the taxpayer (as defined in sec-
tion 152, determined without regard to 
subsections (b)(1) and (b)(2)) as a quali-
fying 
relative 
described 
in 
section 
152(d)(1) if— 
‘‘(I) in lieu of the requirements 
under subparagraphs (B) and (C) of 
such section, with respect to such in-
dividual— 
‘‘(aa) the taxpayer has pro-
vided over one-half of the individ-
ual’s support for the calendar 
year in which such taxable year 
begins and each of the preceding 
4 taxable years, and 
‘‘(bb) the individual’s modi-
fied adjusted gross income for 
the calendar year in which such 
taxable year begins is less than 
the exemption amount (as de-
fined in section 151(d)), 
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‘‘(II) the individual is physically 
or mentally incapable of caring for 
himself or herself, and 
‘‘(III) the individual has the 
same principal place of abode as the 
taxpayer for more than one-half of 
such taxable year. 
‘‘(iii) The spouse of the taxpayer, if 
such spouse is physically or mentally in-
capable of caring for himself or herself. 
‘‘(2) MODIFIED
ADJUSTED
GROSS
INCOME.— 
The term ‘modified adjusted gross income’ means 
adjusted gross income determined without regard to 
section 86. 
‘‘(3) EMPLOYMENT-RELATED EXPENSES.— 
‘‘(A) IN
GENERAL.—The term ‘employ-
ment-related expenses’ means amounts paid for 
the following expenses, but only if such ex-
penses are incurred to enable the taxpayer to be 
gainfully employed for any period for which 
there are one or more qualifying individuals 
with respect to the taxpayer: 
‘‘(i) Expenses for household services 
with respect to the qualifying individual. 
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‘‘(ii) Expenses for the care of a quali-
fying individual, including expenses for res-
pite care and hospice care. 
‘‘(B) EXCEPTION.—The term ‘employ-
ment-related expenses’ shall not include services 
provided outside the taxpayer’s household un-
less such expenses are incurred for the care 
of— 
‘‘(i) a qualifying individual described 
in paragraph (1)(A), or 
‘‘(ii) a qualifying individual (not de-
scribed in paragraph (1)(A)) who regularly 
spends at least 8 hours each day in the 
taxpayer’s household. 
‘‘(C) DEPENDENT
CARE
CENTERS.—The 
term ‘employment-related expenses’ shall not 
include services provided outside the taxpayer’s 
household by a dependent care center (as de-
fined in subparagraph (D)) unless— 
‘‘(i) such center complies with all ap-
plicable laws and regulations of the State 
and local government in which such center 
is located, and 
‘‘(ii) the requirements of subpara-
graph (B) are met. 
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‘‘(D) DEPENDENT
CARE
CENTER
DE-
FINED.—For purposes of this paragraph, the 
term ‘dependent care center’ means any facility 
which— 
‘‘(i) provides care for more than 6 in-
dividuals (other than individuals who re-
side at the facility), and 
‘‘(ii) receives a fee, payment, or grant 
for providing services for any of the indi-
viduals (regardless of whether such facility 
is operated for profit). 
‘‘(c) DOLLAR LIMIT ON AMOUNT CREDITABLE.—The 
amount of the employment-related expenses incurred dur-
ing any taxable year which may be taken into account 
under subsection (a) shall not exceed— 
‘‘(1) if there is 1 qualifying individual with re-
spect to the taxpayer for such taxable year, $3,000, 
or 
‘‘(2) if there are 2 or more qualifying individ-
uals with respect to the taxpayer for such taxable 
year, $6,000. 
The amount determined under this subsection shall be re-
duced by the aggregate amount excludable from gross in-
come under section 129 for the taxable year. 
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‘‘(d) EARNED INCOME LIMITATION.—The amount of 
the employment-related expenses incurred during any tax-
able year which may be taken into account under sub-
section (a) shall not exceed— 
‘‘(1) in the case of an individual who is not 
married at the close of such year, such individual’s 
earned income for such year, or 
‘‘(2) in the case of an individual who is married 
at the close of such year, the lesser of such individ-
ual’s earned income or the earned income of his 
spouse for such year. 
‘‘(e) SPECIAL RULES.—For purposes of this sec-
tion— 
‘‘(1) PLACE
OF
ABODE.—An individual shall 
not be treated as having the same principal place of 
abode of the taxpayer if at any time during the tax-
able year of the taxpayer the relationship between 
the individual and the taxpayer is in violation of 
local law. 
‘‘(2) MARRIED COUPLES MUST FILE JOINT RE-
TURN.—In the case of an individual who is married 
as of the close of the taxable year, the credit shall 
be allowed under subsection (a) only if a joint return 
is filed for the taxable year under section 6013. 
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‘‘(3) MARITAL STATUS.—An individual legally 
separated from his or her spouse under a decree of 
divorce or of separate maintenance shall not be con-
sidered as married. 
‘‘(4) CERTAIN
MARRIED
INDIVIDUALS
LIVING 
APART.—In the case of an individual who is married 
and does not file a joint return for the taxable year, 
if— 
‘‘(A) such individual— 
‘‘(i) maintains as his or her home a 
household which constitutes for more than 
one-half of the taxable year the principal 
place of abode of a qualifying individual, 
and 
‘‘(ii) furnishes over half of the cost of 
maintaining such household during the 
taxable year, and 
‘‘(B) during the last 6 months of such tax-
able year, such individual’s spouse is not a 
member of such household, 
such individual shall not be considered as married. 
‘‘(5) PAYMENTS TO RELATED INDIVIDUALS.— 
No credit shall be allowed under subsection (a) for 
any amount paid by the taxpayer to an individual— 
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‘‘(A) with respect to whom, for the taxable 
year, a deduction under section 151(c) (relating 
to deduction for personal exemptions for de-
pendents) is allowable either to the taxpayer or 
the taxpayer’s spouse, or 
‘‘(B) who— 
‘‘(i) is a child of the taxpayer (within 
the meaning of section 152(f)(1)), and 
‘‘(ii) has not attained the age of 19 at 
the close of the taxable year. 
For purposes of this paragraph, the term ‘taxable 
year’ means the taxable year of the taxpayer in 
which the service (as described in clause (i) of sub-
section (b)(3)(A)) is performed or the care (as de-
scribed in clause (ii) of such subsection) is provided. 
‘‘(6) IDENTIFYING
INFORMATION
REQUIRED 
WITH RESPECT TO SERVICE PROVIDER.—No credit 
shall be allowed under subsection (a) for any amount 
paid to any person unless— 
‘‘(A) the name, address, and taxpayer 
identification number of such person are in-
cluded on the return of tax for the taxable year 
in which the credit under this section is being 
claimed, or 
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956 
‘‘(B) if such person is an organization de-
scribed in section 501(c)(3) and exempt from 
tax under section 501(a), the name and address 
of such person are included on the return of tax 
for the taxable year in which the credit under 
this section is being claimed. 
In the case of a failure to provide the information 
required under the preceding sentence, the preceding 
sentence shall not apply if it is shown that the tax-
payer exercised due diligence in attempting to pro-
vide the information so required. 
‘‘(7) IDENTIFYING
INFORMATION
REQUIRED 
WITH RESPECT TO QUALIFYING INDIVIDUALS.—No 
credit shall be allowed under this section with re-
spect to any qualifying individual unless the TIN of 
such individual is included on the return of tax for 
the taxable year in which the credit under this sec-
tion is being claimed. 
‘‘(f) REGULATIONS.—The Secretary shall prescribe 
such regulations as may be necessary to carry out the pur-
poses of this section.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
for subpart A of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 is amended by in-
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957 
serting after the item relating to section 25E the following 
new item: 
‘‘Sec. 25F. Expenses for household and elder care services necessary for gainful 
employment.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
Subtitle H—Miscellaneous 
Provisions 
SEC. 5701. CLARIFICATION SUPPORTING PERMISSIBLE USE 
OF FUNDS FOR STILLBIRTH PREVENTION AC-
TIVITIES. 
Section 501(a) of the Social Security Act (42 U.S.C. 
701(a)) is amended— 
(1) in paragraph (1)(B), by inserting ‘‘to re-
duce the incidence of stillbirth,’’ after ‘‘among chil-
dren,’’; and 
(2) in paragraph (2), by inserting after ‘‘follow- 
up services’’ the following: ‘‘, and for evidence-based 
programs and activities and outcome research to re-
duce the incidence of stillbirth (including tracking 
and awareness of fetal movements, improvement of 
birth timing for pregnancies with risk factors, initia-
tives that encourage safe sleeping positions during 
pregnancy, screening and surveillance for fetal 
growth restriction, efforts to achieve smoking ces-
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958 
sation during pregnancy, community-based programs 
that provide home visits or other types of support, 
and any other research or evidence-based program-
ming to prevent stillbirths)’’. 
TITLE VI—MENTAL HEALTH AND 
SUBSTANCE USE DISORDERS 
SEC. 6001. SENSE OF CONGRESS. 
It is the sense of the Congress that it is imperative 
that a comprehensive public health approach to addressing 
trauma and mental health care be focused on care delivery 
that is culturally and linguistically appropriate. 
Subtitle A—Access to Care and 
Funding Streams 
SEC. 6101. COVERAGE OF SUBSTANCE USE DISORDER 
COUNSELOR SERVICES AND PEER SUPPORT 
SPECIALIST SERVICES UNDER PART B OF 
THE MEDICARE PROGRAM. 
(a) COVERAGE OF SERVICES.— 
(1) IN
GENERAL.—Section 1861(s)(2) of the 
Social Security Act (42 U.S.C. 1395x(s)(2)), as 
amended by section 4251(c)(1), is amended— 
(A) in subparagraph (JJ), by striking 
‘‘and’’ at the end; 
(B) by inserting ‘‘and’’ at the end of sub-
paragraph (KK); and 
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(C) by adding at the end the following new 
subparagraph: 
‘‘(LL) substance use disorder counselor services 
(as defined in subsection (qqq)(1)), and peer support 
specialist 
services 
(as 
defined 
in 
subsection 
(qqq)(3));’’. 
(2) DEFINITIONS.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x), as amended by sec-
tions 2007(b), 4221(a), and 4251(c)(2), is amended 
by adding at the end the following new subsection: 
‘‘Substance Use Disorder Counselor Services; Substance 
Use Disorder Counselor; Peer Support Specialist 
Services; Peer Support Specialist 
‘‘(qqq)(1) The term ‘substance use disorder counselor 
services’ means services performed by a substance use dis-
order counselor (as defined in paragraph (2)) for the diag-
nosis and treatment of substance use disorder and addic-
tion that the substance use disorder counselor is legally 
authorized to perform under State law (or the State regu-
latory mechanism provided by the State law) of the State 
in which such services are performed, as would otherwise 
be covered if furnished by a physician or as incident to 
a physician’s professional service, but only if no facility 
or other provider charges or is paid any amounts with re-
spect to the furnishing of such services. 
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‘‘(2) The term ‘substance use disorder counselor’ 
means an individual who— 
‘‘(A) has performed at least 2 years of super-
vised substance use disorder counselor practice; 
‘‘(B) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of substance use disorder counselors or 
professional counselors, is licensed or certified as a 
substance use disorder counselor or professional 
counselor in such State; or 
‘‘(C) is a drug and alcohol counselor as defined 
in section 40.281 of title 49, Code of Federal Regu-
lations. 
‘‘(3) The term ‘peer support specialist services’ 
means services performed by a peer support specialist (as 
defined in paragraph (4)) for the well-being of individuals 
needing mental health support that the peer support spe-
cialist is legally authorized to perform under State law (or 
the State regulatory mechanism provided by the State 
law) of the State in which such services are performed, 
as would otherwise be covered if furnished by a physician 
or as incident to a physician’s professional service, but 
only if no facility or other provider charges or is paid any 
amounts with respect to the furnishing of such services. 
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‘‘(4) The term ‘peer support specialist’ means an in-
dividual who— 
‘‘(A) is an individual living in recovery with 
mental illness, addiction, or justice system involve-
ment; 
‘‘(B) has skills learned in formal training; 
‘‘(C) uses assets-based framing in speaking 
about mental health, recovery, and well-being; and 
‘‘(D) delivers services in behavioral health set-
tings to promote mind-body recovery and resil-
iency.’’. 
(3) PROVISION
FOR
PAYMENT
UNDER
PART 
B.—Section 1832(a)(2)(B) of the Social Security 
Act (42 U.S.C. 1395k(a)(2)(B)) is amended by add-
ing at the end the following new clause: 
‘‘(v) substance use disorder counselor 
services and peer support specialist serv-
ices;’’. 
(4) AMOUNT OF PAYMENT.—Section 1833(a)(1) 
of the Social Security Act (42 U.S.C. 1395l(a)(1)), 
as amended by section 4251(c)(3), is amended— 
(A) by striking ‘‘and’’ before ‘‘(II)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (JJ) with respect 
to substance use disorder counselor services and 
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peer support specialist services under section 
1861(s)(2)(LL), the amounts paid shall be 80 
percent of the lesser of the actual charge for 
the services or 75 percent of the amount deter-
mined for payment of a psychologist under sub-
paragraph (L)’’. 
(5) EXCLUSION OF PEER SUPPORT SPECIALIST 
SERVICES FROM SKILLED NURSING FACILITY PRO-
SPECTIVE
PAYMENT
SYSTEM.—Section 
1888(e)(2)(A)(ii) of the Social Security Act (42 
U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting 
‘‘peer support specialist services (as defined in sec-
tion 1861(qqq)(3)),’’ after ‘‘mental health counselor 
services (as defined in section 1861(lll)(3))’’. 
(6) INCLUSION OF SUBSTANCE USE DISORDER 
COUNSELORS AS PRACTITIONERS FOR ASSIGNMENT 
OF CLAIMS.—Section 1842(b)(18)(C) of the Social 
Security Act (42 U.S.C. 1395u(b)(18)(C)) is amend-
ed by adding at the end the following new clauses: 
‘‘(ix) A substance use disorder counselor (as de-
fined in section 1861(qqq)(2)). 
‘‘(x) A peer support specialist (as defined in 
section 1861(qqq)(4)).’’. 
(b) COVERAGE OF CERTAIN MENTAL HEALTH SERV-
ICES PROVIDED IN RURAL HEALTH CLINICS AND FEDER-
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963 
ALLY
QUALIFIED
HEALTH
CENTERS.—Section 
1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 
1395x(aa)(1)(B)) is amended by striking ‘‘or by a mental 
health counselor (as defined in subsection (lll)(4))’’ and 
inserting ‘‘by a mental health counselor (as defined in sub-
section (lll)(4)), by a substance use disorder counselor (as 
defined in subsection (qqq)(2)), or by a peer support spe-
cialist (as defined in subsection (qqq)(4))’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to services furnished 
on or after January 1, 2025. 
SEC. 6102. REAUTHORIZATION OF MINORITY FELLOWSHIP 
PROGRAM. 
Section 597(c) of the Public Health Service Act (42 
U.S.C. 290ll(c)) is amended by striking ‘‘$25,000,000 for 
each of fiscal years 2023 through 2027’’ and inserting 
‘‘$36,700,000 for each of fiscal years 2025 through 
2029’’. 
SEC. 6103. ADDITIONAL FUNDS FOR NATIONAL INSTITUTES 
OF HEALTH. 
(a) IN GENERAL.—In addition to amounts otherwise 
authorized to be appropriated to the National Institutes 
of Health, there is authorized to be appropriated to such 
Institutes $150,000,000 for each of fiscal years 2025 
through 2030— 
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(1) to build relations with communities and 
conduct or support clinical research, including clin-
ical research on racial or ethnic disparities in phys-
ical and mental health; and 
(2) to carry out the Strategic Framework For 
Addressing Youth Mental Health Disparities devel-
oped by the National Institute of Mental Health. 
(b) DEFINITION.—In this section, the term ‘‘clinical 
research’’ has the meaning given to such term in section 
409 of the Public Health Service Act (42 U.S.C. 284d). 
SEC. 6104. ADDITIONAL FUNDS FOR NATIONAL INSTITUTE 
ON MINORITY HEALTH AND HEALTH DISPARI-
TIES. 
In addition to amounts otherwise authorized to be ap-
propriated to the National Institute on Minority Health 
and Health Disparities, there is authorized to be appro-
priated to such Institute $750,000,000 for each of fiscal 
years 2025 through 2030. 
SEC. 6105. GRANTS FOR INCREASING RACIAL AND ETHNIC 
MINORITY ACCESS TO HIGH-QUALITY TRAU-
MA 
SUPPORT 
SERVICES 
AND 
MENTAL 
HEALTH CARE. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Assistant Secretary for Men-
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tal Health and Substance Use, shall award grants to eligi-
ble entities to establish or expand programs for the pur-
pose of increasing racial and ethnic minority access to 
high-quality trauma support services and mental health 
care. 
(b) ELIGIBLE ENTITIES.—To seek a grant under this 
section, an entity shall be a community-based program or 
organization that— 
(1) provides culturally and linguistically appro-
priate programs and resources that are aligned with 
evidence-based practices for trauma-informed care; 
and 
(2) has demonstrated expertise in serving com-
munities of color or can partner with a program that 
has such demonstrated expertise. 
(c) USE OF FUNDS.—As a condition on receipt of a 
grant under this section, a grantee shall agree to use the 
grant to increase racial and ethnic minority access to high- 
quality trauma support services and mental health care, 
such as by— 
(1) establishing and maintaining community- 
based programs providing evidence-based services in 
trauma-informed care and culturally specific services 
and other resources; 
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(2) developing innovative, culturally specific 
strategies and projects to enhance access to trauma- 
informed care and resources for racial and ethnic 
minorities who face obstacles to using more tradi-
tional services and resources (such as obstacles in 
geographic access to providers, insurance coverage, 
and access to audio and video technologies); 
(3) working with State and local governments 
and social service agencies to develop and enhance 
effective strategies to provide culturally specific serv-
ices to racial and ethnic minorities; 
(4) increasing communities’ capacity to provide 
culturally specific resources and support for commu-
nities of color; 
(5) working in cooperation with the community 
to develop education and prevention strategies high-
lighting culturally specific issues and resources re-
garding racial and ethnic minorities; 
(6) providing culturally specific programs for 
racial and ethnic minorities exposed to law enforce-
ment violence; and 
(7) examining the dynamics of culture and its 
impact on victimization and healing. 
(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to eligible entities 
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proposing to serve communities that have faced high rates 
of community trauma, including from exposure to law en-
forcement violence, intergenerational poverty, civil unrest, 
discrimination, or oppression. 
(e) GRANT PERIOD.—The period of a grant under 
this section shall be 4 years. 
(f) EVALUATION.—Not later than 6 months after the 
end of the period of all grants under this section, the Sec-
retary shall— 
(1) conduct an evaluation of the programs 
funded by a grant under this section; 
(2) include in such evaluation an assessment of 
the outcomes of each such program; and 
(3) submit a report on the results of such eval-
uation to the Congress. 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$20,000,000 for each of fiscal years 2025 through 2029. 
Subtitle B—Interprofessional Care 
SEC. 6201. HEALTH PROFESSIONS COMPETENCIES TO AD-
DRESS RACIAL AND ETHNIC MENTAL HEALTH 
INEQUITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Assistant Secretary 
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for Mental Health and Substance Use, shall award grants 
to qualified national organizations for the purposes of— 
(1) developing, and disseminating to health pro-
fessional educational programs, culturally and lin-
guistically appropriate curricula or core com-
petencies addressing mental health inequities among 
racial and ethnic minority groups for use in the 
training of students in the professions of social 
work, psychology, psychiatry, marriage and family 
therapy, mental health counseling, peer support, and 
substance use disorder counseling; and 
(2) certifying community health workers and 
peer wellness specialists with respect to such cur-
ricula and core competencies and integrating and ex-
panding the use of such workers and specialists into 
health care and community-based settings to address 
mental health inequities among racial and ethnic mi-
nority groups. 
(b) CURRICULA; CORE COMPETENCIES.—Organiza-
tions receiving funds under subsection (a) may use the 
funds to engage in the following activities related to the 
development and dissemination of curricula or core com-
petencies described in subsection (a)(1): 
(1) Formation of committees or working groups 
composed of experts from accredited health profes-
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sions schools to identify core competencies relating 
to mental health inequities among racial and ethnic 
minority groups. 
(2) Planning of workshops in collaboration with 
community-based organizations and communities of 
color in national fora to directly facilitate public 
input, including input from communities of color 
with lived experience, into the educational needs as-
sociated with mental health inequities among racial 
and ethnic minority groups. 
(3) Dissemination and promotion of the use of 
curricula or core competencies in undergraduate and 
graduate health professions training programs na-
tionwide. 
(4) Establishing external stakeholder advisory 
boards to provide meaningful input into policy and 
program development and best practices to reduce 
mental health inequities among racial and ethnic 
groups, including participation and leadership from 
communities of color with lived experience of the im-
pacts of mental health inequities. 
(c) DEFINITIONS.—In this section: 
(1) QUALIFIED NATIONAL ORGANIZATION.—The 
term ‘‘qualified national organization’’ means a na-
tional organization that focuses on the education of 
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students in programs of social work, occupational 
therapy, psychology, psychiatry, substance use coun-
seling, and marriage and family therapy. 
(2) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘‘racial and ethnic minority group’’ has the 
meaning given to such term in section 1707(g) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)). 
(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2025 through 2029. 
SEC. 6202. INTERPROFESSIONAL HEALTH CARE TEAMS FOR 
BEHAVIORAL HEALTH CARE. 
Part D of title V of the Public Health Service Act 
(42 U.S.C. 290dd et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 553. INTERPROFESSIONAL HEALTH CARE TEAMS FOR 
PROVISION OF BEHAVIORAL HEALTH CARE 
IN PRIMARY CARE SETTINGS. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Assistant Secretary, shall award grants to eligible entities 
for the purpose of establishing interprofessional health 
care teams that provide behavioral health care. 
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‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity shall be a Federally 
qualified health center (as defined in section 1861(aa) of 
the Social Security Act), rural health clinic, women’s 
health clinic, or behavioral health program (including any 
such program operated by a community-based organiza-
tion) serving a high proportion of individuals from racial 
and ethnic minority groups (as defined in section 
1707(g)). 
‘‘(c) LOAN FORGIVENESS.—To encourage qualified 
and diverse allied health professionals to enter the mental 
health field, an eligible entity receiving a grant under this 
section shall agree to use not less than $10,000 of the 
grant funds on a loan forgiveness program for practi-
tioners who commit to working in the mental health field 
for a period of 2 years. 
‘‘(d) SCIENTIFICALLY AND CULTURALLY BASED.— 
Integrated health care funded through this section shall 
be scientifically and culturally based, taking into consider-
ation the results of the most recent peer-reviewed research 
available, including information on language accessibility, 
cultural humility, diversity of practitioners, and consider-
ation of social determinants of health. 
‘‘(e) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
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priated $20,000,000 for each of fiscal years 2025 through 
2029.’’. 
SEC. 6203. INTEGRATED HEALTH CARE DEMONSTRATION 
PROGRAM. 
Part D of title V of the Public Health Service Act 
(42 U.S.C. 290dd et seq.), as amended by section 6202, 
is amended by adding at the end the following: 
‘‘SEC. 554. INTERPROFESSIONAL HEALTH CARE TEAMS FOR 
PROVISION OF BEHAVIORAL HEALTH CARE 
IN PRIMARY CARE SETTINGS. 
‘‘(a) GRANTS.—The Secretary shall award grants to 
eligible entities for the purpose of establishing interprofes-
sional health care teams that provide behavioral health 
care. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity shall be a Federally 
qualified health center (as defined in section 1861(aa) of 
the Social Security Act), rural health clinic, or behavioral 
health program, serving a high proportion of individuals 
from racial and ethnic minority groups (as defined in sec-
tion 1707(g)). 
‘‘(c) SCIENTIFICALLY
BASED.—Integrated health 
care funded through this section shall be scientifically 
based, taking into consideration the results of the most 
recent peer-reviewed research available. 
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‘‘(d) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $20,000,000 for each of the first 5 fiscal years 
following the date of enactment of the Health Equity and 
Accountability Act 2024.’’. 
Subtitle C—Workforce 
Development 
SEC. 6301. BUILDING AN EFFECTIVE WORKFORCE IN MEN-
TAL HEALTH. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, in coordination with the Assistant Sec-
retary for Mental Health and Substance Use, the Adminis-
trator of the Health Resources and Services Administra-
tion, the Secretary of Labor, and advocacy and behavioral 
and mental health organizations serving vulnerable popu-
lations, including youth and young adults, people with low 
incomes, and people of color, shall— 
(1) develop, strengthen, and implement strate-
gies to bolster career pathways for diverse mental 
health professionals; 
(2) identify the breadth of settings where men-
tal health care and behavioral health care can take 
place; and 
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(3) identify current mental health professional 
workforce shortages, inclusive of shortages of diverse 
mental health professionals. 
(b) CONTENTS.—Strategies under subsection (a) 
shall include— 
(1) the variety of settings where mental health 
professionals are needed, including community-based 
organizations, women’s centers, shelters, organiza-
tions focused on youth development, workforce agen-
cies, job placement and development centers, emer-
gency rooms, the special supplemental nutrition pro-
gram for women, infants, and children under section 
17 of the Child Nutrition Act of 1966 (42 U.S.C. 
1786), food banks, legal aid, and benefit issuers (as 
defined in section 3 of the Food and Nutrition Act 
of 2008 (7 U.S.C. 2012)); 
(2) defining career pathways in mental and be-
havioral health, to help diverse communities under-
stand the variety of careers in mental and behavioral 
health that are available; 
(3) building career pathways in mental and be-
havioral health as part of the curriculum at the 
postsecondary education level; 
(4) providing accessible training and certifi-
cation pathways for diverse lay health workers such 
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as community health workers and other peer support 
specialists to ensure that careers pay a living wage; 
(5) creating incentives for students in the fields 
of occupational therapy, social work, psychology, 
medicine, and nursing to learn more about mental 
health, and to include a mental health rotation, with 
a particular focus in racially and ethnically diverse 
communities, as a part of the health professional 
curricula; 
(6) including training and education for teach-
ers about the basics of section 504 of the Rehabilita-
tion Act of 1973 (29 U.S.C. 794) and individualized 
education programs (as defined in section 614(d) of 
the Individuals with Disabilities Education Act (20 
U.S.C. 1414(d))); 
(7) researching, developing, and implementing 
programs for mental and behavioral health profes-
sionals to prevent burnout; and 
(8) finding better and increased avenues to en-
sure equity by providing better loan forgiveness pro-
grams, including a focus area within the National 
Health Service Corps focused on community trauma. 
(c) USE OF FUNDS.—Programs and activities funded 
under this section shall be consistent with subsection 
(a)(1) and shall include the following: 
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(1) Subgrants to entities serving youth and 
young adults which demonstrate a need for an in-
creased mental health workforce, using strategies de-
scribed in subsection (a)(1). 
(2) Funding towards the Health Resources and 
Services Administration’s Behavioral Health Work-
force Education and Training Program. 
(3) Funding towards the development and im-
plementation of a National Health Service Corps 
program focused on community trauma. 
(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$50,000,000 for each of fiscal years 2025 through 2035. 
SEC. 6302. DEMONSTRATION PROGRAM TO INCREASE LAN-
GUAGE ACCESS AT ELIGIBLE HEALTH CEN-
TERS. 
(a) GRANTS.—The Secretary shall carry out a dem-
onstration program consisting of awarding grants to eligi-
ble health centers to recruit, hire, employ, and supervise 
qualified behavioral health professionals who— 
(1) are proficient in speaking and under-
standing both spoken English and at least one other 
spoken language, including any necessary specialized 
vocabulary, terminology, and phraseology; 
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(2) are able to effectively, accurately, and im-
partially communicate directly with limited English 
proficient individuals in their primary language; and 
(3) are, or will be, employed— 
(A) directly by the eligible health center; or 
(B) through a contract between the eligible 
health center and the qualified behavioral 
health professional under which such profes-
sional provides services as part of the eligible 
health center’s workforce or under supervision 
by the health center, in order to provide behav-
ioral health services in another language. 
(b) PREFERENCE.—In selecting grant recipients 
under subsection (a), the Secretary shall give preference 
to eligible health centers at which at least 10 percent of 
the patients are best served in a language other than 
English, as indicated by data in the Uniform Data System 
of the Health Resources and Services Administration (or 
any successor database). 
(c) OUTREACH.—An eligible health center receiving 
a grant under this section shall use a portion of the grant 
funds to disseminate information about the behavioral 
health services supported through the grant. 
(d) REPORTS.— 
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(1) INITIAL REPORT.—Not later than 6 months 
after the first grants are awarded under subsection 
(a), the Secretary shall submit to the Committee on 
Appropriations and the Committee on Energy and 
Commerce of the House of Representatives, the 
Committee on Appropriations and the Committee on 
Health, Education, Labor, and Pensions of the Sen-
ate, and other appropriate congressional committees, 
a report on the implementation of the program 
under this section. Such report shall include— 
(A) the languages spoken by the qualified 
behavioral health professionals recruited pursu-
ant to a grant under subsection (a); 
(B) the eligible health center at which each 
such professional was placed; 
(C) how many eligible health centers re-
ceived grants under subsection (a); 
(D) an analysis, conducted in consultation 
with the eligible health centers receiving grants 
under subsection (a), of the effectiveness of 
such grants at increasing language access to be-
havioral health services; and 
(E) best practices, developed in consulta-
tion with eligible health centers receiving grants 
under subsection (a), for the recruitment and 
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retention of qualified behavioral health profes-
sionals at such health centers. 
(2) FINAL REPORT.—Not later than the end of 
fiscal year 2026, the Secretary shall submit to the 
Committee on Appropriations and the Committee on 
Energy and Commerce of the House of Representa-
tives, the Committee on Appropriations and the 
Committee on Health, Education, Labor, and Pen-
sions of the Senate, and other appropriate congres-
sional committees, a final report on the implementa-
tion of the program under this section, including the 
information, analysis, and best practices described in 
subparagraphs (A) through (E) of paragraph (1). 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible health center’’ means a 
health center (as defined in section 330 of the Pub-
lic Health Service Act (42 U.S.C. 254b)) that is al-
ready receiving assistance pursuant to one or more 
grants under such section 330 at the time of the 
award to such health center of a supplemental grant 
under subsection (a). 
(2) The term ‘‘qualified behavioral health pro-
fessional’’ means— 
(A) a behavioral and mental health profes-
sional (as defined in section 331(a)(3)(E)(i) of 
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the Public Health Service Act (42 U.S.C. 
254d(a)(3)(E)(i))); 
(B) a substance use disorder counselor; 
(C) an occupational therapist; or 
(D) an individual who— 
(i) has not yet been licensed or cer-
tified to serve as a professional listed in 
any of subparagraphs (A) through (C); 
and 
(ii) will serve at the eligible health 
center under the supervision of a licensed 
individual or certified professional so list-
ed. 
(3) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(f) FUNDING.—Subject to the availability of appro-
priations, out of amounts otherwise appropriated under 
section 760(g) of the Public Health Service Act (42 U.S.C. 
294k(g)), the Secretary is authorized to use up to 
$10,000,000 for each of fiscal years 2025 through 2030 
to carry out this section. 
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SEC. 6303. HEALTH PROFESSIONS COMPETENCIES TO AD-
DRESS RACIAL AND ETHNIC MINORITY MEN-
TAL HEALTH DISPARITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services may award grants to qualified national 
organizations for the purposes of— 
(1) developing, and disseminating to health pro-
fessional educational programs, best practices or 
core competencies addressing mental health dispari-
ties among racial and ethnic minority groups for use 
in the training of students in the professions of so-
cial work, psychology, psychiatry, marriage and fam-
ily therapy, mental health counseling, and substance 
use disorder counseling; and 
(2) certifying community health workers and 
peer wellness specialists with respect to such best 
practices and core competencies and integrating and 
expanding the use of such workers and specialists 
into health care to address mental health disparities 
among racial and ethnic minority groups. 
(b) BEST PRACTICES; CORE COMPETENCIES.—Orga-
nizations receiving funds under subsection (a) may use the 
funds to engage in the following activities related to the 
development and dissemination of best practices or core 
competencies described in subsection (a)(1): 
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(1) Formation of committees or working groups 
composed of experts from accredited health profes-
sions schools to identify best practices and core com-
petencies relating to mental health disparities among 
racial and ethnic minority groups. 
(2) Planning of workshops at the national level 
to allow for public input into the educational needs 
associated with mental health disparities among ra-
cial and ethnic minority groups. 
(3) Dissemination and promotion of the use of 
best practices or core competencies for culturally 
and linguistically appropriate mental health services 
in undergraduate and graduate health professions 
training programs nationwide. 
(4) Establishing external stakeholder advisory 
boards to provide meaningful input into policy and 
program development and best practices to reduce 
mental health disparities among racial and ethnic 
minority groups. 
(c) DEFINITIONS.—In this section: 
(1) QUALIFIED NATIONAL ORGANIZATION.—The 
term ‘‘qualified national organization’’ means a na-
tional organization that focuses on the education of 
students in one or more of the professions of social 
work, psychology, psychiatry, marriage and family 
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therapy, mental health counseling, and substance 
misuse counseling. 
(2) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘‘racial and ethnic minority group’’ has the 
meaning given to such term in section 1707(g) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)). 
Subtitle D—Children’s Mental 
Health 
SEC. 6401. GRANT PROGRAMS TO SUPPORT PEDIATRIC BE-
HAVIORAL HEALTH CARE. 
Part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by inserting after 
subpart V the following new subpart: 
‘‘Subpart VI—Pediatric Behavioral Health Programs 
‘‘SEC. 340A–1. PROGRAM TO IMPROVE ACCESS TO COMMU-
NITY-BASED 
PEDIATRIC 
BEHAVIORAL 
HEALTH CARE. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
Administration, shall award grants, contracts, or coopera-
tive agreements to eligible entities for the purpose of sup-
porting pediatric behavioral health care integration and 
coordination within communities to meet local community 
needs. 
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‘‘(b) ELIGIBLE
ENTITIES.—Entities eligible for 
grants under subsection (a) include— 
‘‘(1) health care providers, including family 
physicians, pediatric medical sub-specialists, and 
surgical specialists; 
‘‘(2) children’s hospitals; 
‘‘(3) facilities that are eligible to receive funds 
under section 340E or 340H; 
‘‘(4) nonprofit medical facilities that predomi-
nantly treat individuals under the age of 21; 
‘‘(5) rural health clinics and Federally qualified 
health centers (as such terms are defined in section 
1861(aa) of the Social Security Act); 
‘‘(6) pediatric mental health and substance use 
disorder providers, such as child and adolescent psy-
chiatrists, psychologists, developmental and behav-
ioral pediatricians, general pediatricians, advanced 
practice nurses, social workers, licensed professional 
counselors, and other licensed professionals that pro-
vide mental health and substance use disorder serv-
ices to patients under 21 years of age; 
‘‘(7) children’s advocacy centers described in 
section 214(c)(2)(B) of the Victims of Child Abuse 
Act of 1990; 
‘‘(8) school-based health centers; and 
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‘‘(9) other entities as determined appropriate by 
the Secretary. 
‘‘(c) PRIORITIZATION.—In making awards under sub-
section (a), the Secretary shall prioritize— 
‘‘(1) applicants that provide children and ado-
lescents from high-need, rural, or under-resourced 
communities with services across the continuum of 
children’s mental health and substance use disorder 
care; and 
‘‘(2) applicants that predominantly provide care 
to children and adolescents that demonstrate plans 
to utilize funds to expand provision of care to chil-
dren, adolescents, and youth under age 21. 
‘‘(d) USE OF FUNDS.—Activities that may be funded 
through an award under subsection (a) include— 
‘‘(1) increasing the capacity of pediatric prac-
tices, family medicine practices, and school-based 
health centers to integrate pediatric mental, emo-
tional, and behavioral health services into their prac-
tices including through co-location of mental, emo-
tional, and behavioral health providers; 
‘‘(2) training for non-clinical pediatric health 
care workers, including care coordinators and navi-
gators, on child and adolescent mental health and 
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substance use disorder, trauma-informed care, and 
local resources to support children and caregivers; 
‘‘(3) expanding evidence-based, integrated mod-
els of care for pediatric mental health and substance 
use disorder services; 
‘‘(4) pediatric practice integration for the provi-
sion of pediatric mental health and substance use 
disorder services; 
‘‘(5) addressing surge capacity for pediatric 
mental health and substance use disorder needs; 
‘‘(6) providing pediatric mental, emotional, and 
behavioral health services to children as delivered by 
mental health and substance use disorder profes-
sionals utilizing telehealth services; 
‘‘(7) establishing or maintaining initiatives to 
allow more children to access care outside of emer-
gency departments, including partial hospitalization, 
step down residency programs, and intensive out-
patient programs; 
‘‘(8) supporting, enhancing, or expanding pedi-
atric mental health and substance use disorder pre-
ventive and crisis intervention services; 
‘‘(9) establishing or maintaining pediatric men-
tal health and substance use disorder urgent care or 
walk-in clinics; 
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‘‘(10) establishing or maintaining community- 
based pediatric mental health and substance use dis-
order initiatives, such as partnerships with schools 
and early childhood education programs; 
‘‘(11) addressing other access and coordination 
gaps to pediatric mental health and substance use 
disorder services in the community for children; and 
‘‘(12) supporting the collection of data on chil-
dren and adolescents’ mental health needs, service 
utilization and availability, and demographic data, to 
capture community needs and identify gaps and bar-
riers in children’s access to care, in a manner that 
protects personal privacy, consistent with applicable 
Federal and State privacy laws. 
‘‘(e) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2025 through 2029. 
‘‘SEC. 340A–2. PEDIATRIC BEHAVIORAL HEALTH WORK-
FORCE TRAINING PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
Administration, shall award grants, contracts, or coopera-
tive agreements to eligible entities for the purpose of sup-
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porting evidence-based pediatric mental health and sub-
stance use disorder workforce training. 
‘‘(b) ELIGIBLE
ENTITIES.—Entities eligible for 
grants under subsection (a) include— 
‘‘(1) children’s hospitals; 
‘‘(2) facilities that are eligible to receive funds 
under section 340E or 340H; 
‘‘(3) nonprofit medical facilities that predomi-
nantly treat individuals under the age of 21; 
‘‘(4) rural health clinics and Federally qualified 
health centers (as such terms are defined in section 
1861(aa) of the Social Security Act); 
‘‘(5) entities that employ mental health and 
substance use disorder professionals, such as child 
and adolescent psychiatrists, psychologists, develop-
mental and behavioral pediatricians, general pedia-
tricians, advanced practice nurses, social workers, li-
censed professional counselors, or other licensed pro-
fessionals that provide mental health or substance 
use disorder services to patients under 21 years of 
age; and 
‘‘(6) other pediatric health care providers as de-
termined appropriate by the Secretary. 
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‘‘(c) USE OF FUNDS.—Activities that may be sup-
ported through an award under subsection (a) include the 
following: 
‘‘(1) Training to enhance the capabilities of the 
existing pediatric workforce, including pediatricians, 
primary care physicians, advanced practice reg-
istered nurses, and other pediatric health care pro-
viders, including expanded training in pediatric men-
tal health and substance use disorders, and cul-
turally and developmentally appropriate care for 
children with mental health conditions. 
‘‘(2) Training to support multi-disciplinary 
teams to provide pediatric mental health and sub-
stance use disorder treatment, including through in-
tegrated care models. 
‘‘(3) Initiatives to accelerate the time to licen-
sure within the pediatric mental health or substance 
use disorder workforce. 
‘‘(4) Activities to expand recruitment and reten-
tion, increase workforce diversity, or enhance work-
force training for critical pediatric mental health 
professions, including— 
‘‘(A) child and adolescent psychiatrists; 
‘‘(B) psychiatric nurses; 
‘‘(C) psychologists; 
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‘‘(D) family therapists; 
‘‘(E) social workers; 
‘‘(F) mental health counselors; 
‘‘(G) developmental and behavioral pedia-
tricians; 
‘‘(H) pediatric substance use disorder spe-
cialists; and 
‘‘(I) other mental health care providers as 
determined appropriate by the Secretary. 
‘‘(d) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2025 through 2029.’’. 
SEC. 6402. INCREASING FEDERAL INVESTMENT IN PEDI-
ATRIC BEHAVIORAL HEALTH SERVICES. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) (as amended by section 2004) is amended by adding 
at the end the following: 
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‘‘TITLE XXXV—ASSISTANCE FOR 
CONSTRUCTION 
AND 
MOD-
ERNIZATION OF CHILDREN’S 
MENTAL HEALTH AND SUB-
STANCE USE DISORDER IN-
FRASTRUCTURE 
‘‘SEC. 3501. INCREASING FEDERAL INVESTMENT IN PEDI-
ATRIC BEHAVIORAL HEALTH SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
Administration, shall award grants, contracts, or coopera-
tive agreements to eligible entities for the purpose of im-
proving their ability to provide pediatric behavioral health 
services, including by— 
‘‘(1) constructing or modernizing sites of care 
for pediatric behavioral health services; 
‘‘(2) expanding capacity to provide pediatric be-
havioral health services, including enhancements to 
digital infrastructure, telehealth capabilities, or other 
improvements to patient care infrastructure; 
‘‘(3) supporting the reallocation of existing re-
sources to accommodate pediatric behavioral health 
patients, including by converting or adding a suffi-
cient number of beds to establish or increase the 
hospital’s inventory of licensed and operational, 
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short-term psychiatric and substance use inpatient 
beds; and 
‘‘(4) addressing gaps in the continuum of care 
for children, by expanding capacity to provide inter-
mediate levels of care, such as intensive outpatient 
services, partial hospitalization programs, and day 
programs that can prevent hospitalizations and sup-
port children as they transition back to their homes 
and communities. 
‘‘(b) ELIGIBILITY.—To be eligible to seek an award 
under this section, an entity shall be a hospital or rural 
health clinic that predominantly treats individuals under 
the age of 21, including any hospital that receives funds 
under section 340E. 
‘‘(c) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2025 through 2029. 
‘‘(d) SUPPLEMENT, NOT SUPPLANT.—Funds pro-
vided under this section shall be used to supplement, not 
supplant Federal and non-Federal funds available for car-
rying out the activities described in this section. 
‘‘(e) REPORTING.— 
‘‘(1) REPORTS FROM AWARD RECIPIENTS.—Not 
later than 180 days after the completion of activities 
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993 
funded by an award under this section, the entity 
that received such award shall submit a report to 
the Secretary on the activities conducted using funds 
from such award, and other information as the Sec-
retary may require. 
‘‘(2) REPORTS TO CONGRESS.—Not later than 
one year after the completion of activities funded by 
an award under this section, the Secretary shall sub-
mit to the Committee on Energy and Commerce of 
the House of Representatives and the Committee on 
Health, Education, Labor, and Pensions of the Sen-
ate a report on the projects and activities conducted 
with funds awarded under this section, and the out-
come of such projects and activities. Such report 
shall include— 
‘‘(A) the number of projects supported by 
awards made under this section; 
‘‘(B) an overview of the impact, if any, of 
such projects on pediatric health care infra-
structure, including any impact on access to pe-
diatric mental health and substance use dis-
order services; 
‘‘(C) recommendations for improving the 
investment program under this section; and 
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‘‘(D) any other considerations as the Sec-
retary determines appropriate.’’. 
SEC. 6403. MENTAL HEALTH IN SCHOOLS. 
(a) TECHNICAL AMENDMENTS.—The second part G 
(relating to services provided through religious organiza-
tions) of title V of the Public Health Service Act (42 
U.S.C. 290kk et seq.) is amended— 
(1) by redesignating such part as part J; and 
(2) by redesignating sections 581 through 584 
as sections 596 through 596C, respectively. 
(b) SCHOOL-BASED MENTAL HEALTH AND CHIL-
DREN.—Section 581 of the Public Health Service Act (42 
U.S.C. 290hh) (relating to children and violence) is 
amended to read as follows: 
‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN 
AND ADOLESCENTS. 
‘‘(a) IN GENERAL.—The Secretary, in consultation 
with the Secretary of Education, shall, through grants, 
contracts, or cooperative agreements awarded to eligible 
entities described in subsection (c), provide comprehensive 
school-based mental health services and supports to assist 
children in local communities and schools (including 
schools funded by the Bureau of Indian Education) deal-
ing with traumatic experiences, grief, bereavement, risk of 
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995 
suicide, and violence. Such services and supports shall 
be— 
‘‘(1) developmentally, linguistically, and cul-
turally appropriate; 
‘‘(2) trauma-informed; and 
‘‘(3) incorporate positive behavioral interven-
tions and supports. 
‘‘(b) ACTIVITIES.—Grants, contracts, or cooperative 
agreements awarded under subsection (a), shall, as appro-
priate, be used for— 
‘‘(1) implementation of school- and community- 
based mental health programs that— 
‘‘(A) build awareness of individual trauma 
and the intergenerational, continuum of impacts 
of trauma on populations; 
‘‘(B) train appropriate staff to identify, 
and screen for, signs of trauma exposure, men-
tal health disorders, or risk of suicide; and 
‘‘(C) incorporate positive behavioral inter-
ventions, family engagement, student treatment, 
and multigenerational supports to foster the 
health and development of children, prevent 
mental health disorders, and ameliorate the im-
pact of trauma; 
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‘‘(2) technical assistance to local communities 
with respect to the development of programs de-
scribed in paragraph (1); 
‘‘(3) facilitating community partnerships among 
families, students, law enforcement agencies, edu-
cation agencies, mental health and substance use 
disorder service systems, family-based mental health 
service systems, child welfare agencies, health care 
providers (including primary care physicians, mental 
health professionals, and other professionals who 
specialize in children’s mental health such as child 
and adolescent psychiatrists), institutions of higher 
education, faith-based programs, trauma networks, 
and other community-based systems to address child 
and adolescent trauma, mental health issues, and vi-
olence; and 
‘‘(4) establishing mechanisms for children and 
adolescents to report incidents of violence or plans 
by other children, adolescents, or adults to commit 
violence. 
‘‘(c) REQUIREMENTS.— 
‘‘(1) IN GENERAL.—To be eligible for a grant, 
contract, or cooperative agreement under subsection 
(a), an entity shall be a partnership that includes— 
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‘‘(A) a State educational agency, as de-
fined in section 8101 of the Elementary and 
Secondary Education Act of 1965, in coordina-
tion with one or more local educational agen-
cies, as defined in section 8101 of the Elemen-
tary and Secondary Education Act of 1965, or 
a consortium of any entities described in sub-
paragraph (B), (C), (D), or (E) of section 
8101(30) of such Act; and 
‘‘(B) at least 1 community-based mental 
health provider, including a public or private 
mental health entity, health care entity, family- 
based mental health entity, trauma network, or 
other community-based entity, as determined by 
the Secretary (and which may include addi-
tional entities such as a human services agency, 
law enforcement or juvenile justice entity, child 
welfare agency, agency, an institution of higher 
education, or another entity, as determined by 
the Secretary). 
‘‘(2) COMPLIANCE WITH HIPAA.—Any patient 
records developed by covered entities through activi-
ties under the grant shall meet the regulations pro-
mulgated under section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996. 
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998 
‘‘(3) COMPLIANCE WITH FERPA.—Section 444 
of the General Education Provisions Act (commonly 
known as the ‘Family Educational Rights and Pri-
vacy Act of 1974’) shall apply to any entity that is 
a member of the partnership in the same manner 
that such section applies to an educational agency or 
institution (as that term is defined in such section). 
‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 
shall ensure that grants, contracts, or cooperative agree-
ments under subsection (a) will be distributed equitably 
among the regions of the country and among urban and 
rural areas. 
‘‘(e) DURATION
OF AWARDS.—With respect to a 
grant, contract, or cooperative agreement under sub-
section (a), the period during which payments under such 
an award will be made to the recipient shall be 5 years, 
with options for renewal. 
‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 
‘‘(1) DEVELOPMENT OF PROCESS.—The Assist-
ant Secretary shall develop a fiscally appropriate 
process for evaluating activities carried out under 
this section. Such process shall include— 
‘‘(A) the development of guidelines for the 
submission of program data by grant, contract, 
or cooperative agreement recipients; 
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999 
‘‘(B) the development of measures of out-
comes (in accordance with paragraph (2)) to be 
applied by such recipients in evaluating pro-
grams carried out under this section; and 
‘‘(C) the submission of annual reports by 
such recipients concerning the effectiveness of 
programs carried out under this section. 
‘‘(2) MEASURES OF OUTCOMES.—The Assistant 
Secretary shall develop measures of outcomes to be 
applied by recipients of assistance under this section 
to evaluate the effectiveness of programs carried out 
under this section, including outcomes related to the 
student, family, and local educational systems sup-
ported by this Act. 
‘‘(3) SUBMISSION OF ANNUAL DATA.—An eligi-
ble entity described in subsection (c) that receives a 
grant, contract, or cooperative agreement under this 
section shall annually submit to the Assistant Sec-
retary a report that includes data to evaluate the 
success of the program carried out by the entity 
based on whether such program is achieving the pur-
poses of the program. Such reports shall utilize the 
measures of outcomes under paragraph (2) in a rea-
sonable manner to demonstrate the progress of the 
program in achieving such purposes. 
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1000 
‘‘(4) EVALUATION BY ASSISTANT SECRETARY.— 
Based on the data submitted under paragraph (3), 
the Assistant Secretary shall annually submit to 
Congress a report concerning the results and effec-
tiveness of the programs carried out with assistance 
received under this section. 
‘‘(5) LIMITATION.—An eligible entity shall use 
not more than 20 percent of amounts received under 
a grant under this section to carry out evaluation 
activities under this subsection. 
‘‘(g) INFORMATION
AND
EDUCATION.—The Sec-
retary shall disseminate best practices based on the find-
ings of the knowledge development and application under 
this section. 
‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF 
APPROPRIATIONS.— 
‘‘(1) AMOUNT OF GRANTS.—A grant under this 
section shall be in an amount that is not more than 
$2,000,000 for each of the first 5 fiscal years fol-
lowing the date of enactment of the Health Equity 
and Accountability Act 2024. The Secretary shall 
determine the amount of each such grant based on 
the population of children up to age 21 of the area 
to be served under the grant. 
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1001 
‘‘(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this section, $300,000,000 for each of fiscal years 
2025 through 2028.’’. 
(c) CONFORMING AMENDMENT.—Part G of title V of 
the Public Health Service Act (42 U.S.C. 290hh et seq.), 
as amended by subsection (b), is amended by striking the 
part designation and heading and inserting the following: 
‘‘PART G—SCHOOL-BASED MENTAL HEALTH’’. 
SEC. 6404. ADDITIONAL SUPPORT FOR YOUTH AND YOUNG 
ADULT MENTAL HEALTH SERVICE PROVI-
SION. 
Section 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended by adding at the end the following new 
subsection: 
‘‘(cc) YOUTH
AND YOUNG ADULT INTERVENTION 
SERVICES.— 
‘‘(1) IN
GENERAL.—Notwithstanding section 
1902(a)(1) (relating to Statewideness), section 
1902(a)(10)(B) (relating to comparability), section 
1902(a)(23)(A) (relating to freedom of choice of 
providers), or section 1902(a)(27) (relating to pro-
vider agreements), a State may, during the 5-year 
period beginning on the first day of the fiscal year 
quarter that begins on or after January 1, 2024, 
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1002 
provide medical assistance for qualifying youth and 
young adult mental health and substance use inter-
vention services (as defined in paragraph (2)(C)) 
under a State plan amendment or waiver approved 
under section 1115 or 1915(c). 
‘‘(2) DEFINITIONS.—For the purposes of this 
subsection: 
‘‘(A) PRIORITY SERVICE.—The term ‘pri-
ority service’ means any of the following if vol-
untarily received and provided in a manner that 
maintains the privacy and confidentiality of pa-
tient information consistent with Federal and 
State requirements: 
‘‘(i) Community-based mobile crisis 
intervention services, as defined in section 
1947. 
‘‘(ii) Telehealth. 
‘‘(iii) Youth peer support. 
‘‘(iv) Screening for adverse childhood 
experiences. 
‘‘(v) Trauma responsive care. 
‘‘(vi) Other priority services for youth, 
as defined by the Secretary. 
‘‘(B) QUALIFIED
MENTAL
HEALTH
PRO-
VIDERS.—The term ‘qualified mental health 
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1003 
providers’ means a behavioral health care pro-
fessional who is capable of conducting an as-
sessment of the individual, in accordance with 
the professional’s permitted scope of practice 
under State law, and other professionals or 
paraprofessionals with appropriate expertise in 
youth and young adult behavioral health or 
mental health, including social workers, peer 
support specialists, recovery coaches, commu-
nity health workers, mental health clinicians, 
and others, as designated by the State and ap-
proved by the Secretary. 
‘‘(C) QUALIFYING
YOUTH
AND
YOUNG 
ADULT MENTAL HEALTH AND SUBSTANCE USE 
INTERVENTION SERVICES DEFINED.—The term 
‘qualifying youth and young adult mental health 
and substance use intervention services’ means, 
with respect to a State, items and services for 
which medical assistance is available under the 
State plan under this title or a waiver of such 
plan, that are— 
‘‘(i) furnished to an individual 16 to 
25 years of age who is— 
‘‘(I) experiencing a mental health 
or substance use disorder crisis; 
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‘‘(II) subject to the juvenile or 
adult justice system as defined in sec-
tion 3102 of title 29, United States 
Code; 
‘‘(III)(aa) experiencing homeless-
ness (as defined in section 41403(6) 
of the Violence Against Women Act of 
1994 (42 U.S.C. 14043e–2(6))); 
‘‘(bb) a homeless child or youth 
(as defined in section 725(2) of the 
McKinney-Vento Homeless Assistance 
Act (42 U.S.C. 11434a(2))); 
‘‘(cc) a runaway, in foster care, 
or has aged out of the foster care sys-
tem; 
‘‘(dd) a child eligible for assist-
ance under section 477 of the Social 
Security Act (42 U.S.C. 677); or 
‘‘(ee) in an out-of-home place-
ment; 
‘‘(IV) pregnant or parenting as 
defined in section 3102 of title 29, 
United States Code; 
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