Title: EHDC Act of 2020
Policy area: Health

Summary:
Ending Health Disparities During COVID-19 Act of 2020 or the EHDC Act of 2020
This bill expands COVID-19 (i.e., coronavirus disease 2019) relief efforts, expands data collection and health literacy, supports research, promotes diversity in the health professional workforce, increases access to telehealth and other health care, and otherwise addresses the health of minority populations and immigrants.
For example, the bill provides funding for emergency aid and services, grants to address COVID-19 health inequities, grants to address social determinants of health, and payments for language services. It also expands COVID-19 testing and contact tracing.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8200 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 8200

   To improve the health of minority individuals during the COVID-19 
                   pandemic, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 11, 2020

Ms. Kelly of Illinois (for herself, Ms. Bass, Mr. Castro of Texas, Ms. 
Judy Chu of California, Mr. Garcia of Illinois, Ms. Haaland, Ms. Lee of 
   California, Mr. Soto, Ms. Sewell of Alabama, Mr. Butterfield, Mr. 
    Sablan, Ms. Barragan, Ms. Clarke of New York, Mr. Cardenas, Mr. 
 Sarbanes, Ms. Pressley, Mr. Thompson of Mississippi, Ms. Escobar, Mr. 
Brendan F. Boyle of Pennsylvania, Mr. Carson of Indiana, Mr. Clay, Mrs. 
     Beatty, Mr. Khanna, Ms. Garcia of Texas, Mr. San Nicolas, Mr. 
    Espaillat, Ms. Jayapal, Mrs. Demings, Mr. Hastings, Mrs. Watson 
  Coleman, Ms. Johnson of Texas, Mr. Grijalva, Ms. Bonamici, and Mr. 
    Lynch) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
   Ways and Means, the Judiciary, Transportation and Infrastructure, 
      Education and Labor, Agriculture, Natural Resources, House 
 Administration, Oversight and Reform, the Budget, and Small Business, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of 
                        the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To improve the health of minority individuals during the COVID-19 
                   pandemic, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ending Health Disparities During 
COVID-19 Act of 2020'' or the ``EHDC Act of 2020''.

SEC. 2. TABLE OF CONTENTS.

Sec. 1. Short title.
Sec. 2. Table of contents.
             TITLE I--RACIAL AND ETHNICITY DATA COLLECTION

                  Subtitle A--Collection and Reporting

Sec. 101. Equitable data collection and disclosure on COVID-19 Act.
Sec. 102. COVID-19 reporting portal.
Sec. 103. Regular CDC reporting on demographic data.
Sec. 104. Amendment to the Public Health Service Act.
Sec. 105. Elimination of prerequisite of direct appropriations for data 
                            collection and analysis.
Sec. 106. Collection of data for the Medicare program.
Sec. 107. Revision of HIPAA claims standards.
Sec. 108. Disparities data collected by the Federal Government.
Sec. 109. Standards for measuring sexual orientation, gender identity, 
                            and socioeconomic status in collection of 
                            health data.
Sec. 110. Improving health data regarding Native Hawaiians and other 
                            Pacific Islanders.
               Subtitle B--Improvements and Modernization

Sec. 121. Federal modernization for health inequities data.
Sec. 122. Modernization of State and local health inequities data.
Sec. 123. Additional reporting to Congress on the race and ethnicity 
                            rates of COVID-19 testing, 
                            hospitalizations, and mortalities.
                TITLE II--EQUITABLE TESTING AND TRACING

                 Subtitle A--Free Testing for Patients

Sec. 201. Sooner coverage of testing for COVID-19.
                 Subtitle B--National Testing Strategy

Sec. 211. COVID-19 testing strategy.
Sec. 212. Coronavirus immigrant families protection.
Sec. 213. ICE detention.
                      Subtitle C--Contact Tracing

Sec. 221. COVID-19 Testing, reaching, and contacting everyone.
Sec. 222. National system for COVID-19 testing, contact tracing, 
                            surveillance, containment, and mitigation.
Sec. 223. Grants.
Sec. 224. Grants to State and Tribal workforce agencies.
              TITLE III--FREE TREATMENT FOR ALL AMERICANS

Sec. 301. Coverage at no cost sharing of COVID-19 vaccine and 
                            treatment.
Sec. 302. Optional coverage at no cost sharing of COVID-19 treatment 
                            and vaccines under Medicaid for uninsured 
                            individuals.
Sec. 303. Coverage of treatments for COVID-19 at no cost sharing under 
                            the Medicare Advantage program.
Sec. 304. Requiring coverage under Medicare PDPS and MA-PD plans, 
                            without the imposition of cost sharing or 
                            utilization management requirements, of 
                            drugs intended to treat COVID-19 during 
                            certain emergencies.
Sec. 305. Coverage of COVID-19 related treatment at no cost sharing.
Sec. 306. Reimbursement for additional health services relating to 
                            coronavirus.
               TITLE IV--FEDERAL HEALTH EQUITY OVERSIGHT

Sec. 401. COVID-19 Racial and Ethnic Disparities Task Force Act of 
                            2020.
Sec. 402. Protection of the HHS Offices of Minority Health.
Sec. 403. Establish an interagency counsel and grant programs on social 
                            determinants of health.
Sec. 404. Accountability and transparency within the Department of 
                            Health and Human Services.
                   TITLE V--EXPANDED INSURANCE ACCESS

Sec. 501. Medicare special enrollment period for individuals residing 
                            in COVID-19 emergency areas.
Sec. 502. Special enrollment period through exchanges; Federal exchange 
                            outreach and educational activities.
Sec. 503. MOMMA's Act.
Sec. 504. Allowing for medical assistance under Medicaid for inmates 
                            during 30-day period preceding release.
Sec. 505. Providing for immediate Medicaid eligibility for former 
                            foster youth.
Sec. 506. Expanded coverage for former foster youth.
Sec. 507. Removing citizenship and immigration barriers to access to 
                            affordable health care under ACA.
Sec. 508. Medicaid in the territories.
Sec. 509. Removing Medicare barrier to health care.
Sec. 510. Removing barriers to health care and nutrition assistance for 
                            children, pregnant persons, and lawfully 
                            present individuals.
Sec. 511. Repeal of requirement for documentation evidencing 
                            citizenship or nationality under the 
                            Medicaid program.
                    TITLE VI--COMMUNITY BASED GRANTS

Sec. 601. Grants for racial and ethnic approaches to community health.
Sec. 602. Grants to promote health for underserved communities.
Sec. 603. Addressing COVID-19 health inequities and improving health 
                            equity.
Sec. 604. Improving social determinants of health.
Sec. 605. Funding to States, localities, and community-based 
                            organizations for emergency aid and 
                            services.
Sec. 606. Supplemental nutrition assistance program.
        TITLE VII--CULTURALLY AND LINGUISTICALLY COMPETENT CARE

Sec. 701. Ensuring standards for culturally and linguistically 
                            appropriate services in health care.
Sec. 702. Culturally and linguistically appropriate health care in the 
                            Public Health Service Act.
Sec. 703. Training tomorrow's doctors for culturally and linguistically 
                            appropriate care: graduate medical 
                            education.
Sec. 704. Federal reimbursement for culturally and linguistically 
                            appropriate services under the Medicare, 
                            Medicaid, and State Children's Health 
                            Insurance Programs.
Sec. 705. Requirements for health programs or activities receiving 
                            Federal funds.
Sec. 706. Report on Federal efforts to provide culturally and 
                            linguistically appropriate health care 
                            services.
Sec. 707. Health professions competencies to address racial and ethnic 
                            mental health disparities.
Sec. 708. Study on the uninsured.
       TITLE VIII--AID TO PROVIDERS SERVING MINORITY COMMUNITIES

Sec. 801. Temporary increase in Medicaid DSH allotments.
Sec. 802. COVID-19-related temporary increase of Medicaid FMAP.
Sec. 803. Appropriation for primary health care.
Sec. 804. Amendment to the Public Health Service Act.
Sec. 805. Pandemic premium pay for essential workers.
Sec. 806. COVID-19 Heroes Fund grants.
Sec. 807. Enforcement and outreach.
   TITLE IX--HEALTH IT AND BRIDGING THE DIGITAL DIVIDE IN HEALTH CARE

Sec. 901. HRSA assistance to health centers for promotion of Health IT.
Sec. 902. Assessment of impact of Health IT on racial and ethnic 
                            minority communities; outreach and adoption 
                            of Health IT in such communities.
Sec. 903. Extending funding to strengthen the Health IT infrastructure 
                            in racial and ethnic minority communities.
Sec. 904. Extending competitive grants for the development of loan 
                            programs to facilitate adoption of 
                            certified EHR technology by providers 
                            serving racial and ethnic minority groups.
Sec. 905. Authorization of appropriations.
Sec. 906. Data collection and assessments conducted in coordination 
                            with minority-serving institutions.
Sec. 907. Study of health information technology in medically 
                            underserved communities.
Sec. 908. Study on the effects of changes to telehealth under the 
                            Medicare and Medicaid programs during the 
                            COVID-19 emergency.
Sec. 909. COVID-19 designation of immediate special authority of 
                            spectrum for Tribes' emergency response in 
                            Indian Country.
Sec. 910. Facilitating the provision of telehealth services across 
                            State lines.
                       TITLE X--PUBLIC AWARENESS

Sec. 1001. Awareness campaigns.
Sec. 1002. Increasing understanding of and improving health literacy.
Sec. 1003. English for speakers of other languages.
Sec. 1004. Influenza, COVID-19, and pneumonia vaccination campaign.
                           TITLE XI--RESEARCH

Sec. 1101. Research and development.
Sec. 1102. CDC field studies pertaining to specific health inequities.
Sec. 1103. Expanding capacity for health outcomes.
Sec. 1104. Data collection and analysis grants to minority-serving 
                            institutions.
Sec. 1105. Safety and effectiveness of drugs with respect to racial and 
                            ethnic background.
Sec. 1106. GAO and NIH reports.
Sec. 1107. Health impact assessments.
Sec. 1108. Tribal funding to research health inequities including 
                            COVID-19.
Sec. 1109. Research endowments at both current and former centers of 
                            excellence.
                          TITLE XII--EDUCATION

Sec. 1201. Grants for schools of medicine in diverse and underserved 
                            areas.
Sec. 1202. Amendment to the Public Health Service Act.
Sec. 1203. Hispanic-serving institutions, Historically Black Colleges 
                            and Universities, Asian American and Native 
                            American Pacific Islander-serving 
                            institutions, Tribal colleges, regional 
                            community-based organizations, and national 
                            minority medical associations.
Sec. 1204. Loan repayment program of Centers for Disease Control and 
                            Prevention.
Sec. 1205. Study and report on strategies for increasing diversity.
Sec. 1206. Amendments to the Pandemic EBT Act.
             TITLE XIII--PUBLIC HEALTH ASSISTANCE TO TRIBES

Sec. 1301. Appropriations for the Indian Health Service.
Sec. 1302. Improving State, local, and Tribal public health security.
Sec. 1303. Provision of items to Indian programs and facilities.
Sec. 1304. Health care access for urban native veterans.
Sec. 1305. Proper and reimbursed care for native veterans.

             TITLE I--RACIAL AND ETHNICITY DATA COLLECTION

                  Subtitle A--Collection and Reporting

SEC. 101. EQUITABLE DATA COLLECTION AND DISCLOSURE ON COVID-19 ACT.

    (a) Findings.--Congress makes the following findings:
            (1) The World Health Organization (WHO) declared COVID-19 a 
        ``Public Health Emergency of International Concern'' on January 
        30, 2020. By late March 2020, there have been over 470,000 
        confirmed cases of, and 20,000 deaths associated with, COVID-19 
        worldwide.
            (2) In the United States, cases of COVID-19 have quickly 
        surpassed those across the world, and as of April 12, 2020, 
        over 500,000 cases and 20,000 deaths have been reported in the 
        United States alone.
            (3) Early reporting on racial inequities in COVID-19 
        testing and treatment have renewed calls for the Centers for 
        Disease Control and Prevention and other relevant subagencies 
        within the Department of Health and Human Services to publicly 
        release racial and demographic information to better inform the 
        pandemic response, specifically in communities of color and in 
        Limited English Proficient (LEP) communities.
            (4) The burden of morbidity and mortality in the United 
        States has historically fallen disproportionately on 
        marginalized communities (those who suffer the most from great 
        public health needs and are the most medically underserved).
            (5) Historically, structures and systems, such as racism, 
        ableism and class oppression, have rendered affected 
        individuals more vulnerable to inequities and have prevented 
        people from achieving their optimal health even when there is 
        not a crisis of pandemic proportions.
            (6) Significant differences in access to health care, 
        specifically to primary health care providers, health care 
        information, and greater perceived discrimination in health 
        care place communities of color, individuals with disabilities, 
        and LEP individuals at greater risk of receiving delayed, and 
        perhaps poorer, health care.
            (7) Stark racial inequities across the United States, 
        including unequal access to stable housing, quality education, 
        and decent employment significantly impact the ability of 
        individuals to take care of their most basic health needs. 
        Communities of color are more likely to experience homelessness 
        and struggle with low-paying jobs or unemployment. To date, 
        experts have cited that 2 in 5 Latino residents in New York 
        City, the current epicenter of the COVID-19 pandemic, are 
        recently unemployed as a direct consequence of COVID-19. And at 
        a time when sheltering in place will save lives, less than 1 in 
        5 Black workers and roughly 1 in 6 Latino workers are able to 
        work from home.
            (8) Communities of color experience higher rates of chronic 
        disease and disabilities, such as diabetes, hypertension, and 
        asthma, than non-Hispanic White communities, which predisposes 
        them to greater risk of complications and mortality should they 
        contract COVID-19.
            (9) Such communities are made even more vulnerable to the 
        uncertainty of the preparation, response, and events 
        surrounding the pandemic public health crisis, COVID-19. For 
        instance, in the recent past, multiple epidemiologic studies 
        and reviews have reported higher rates of hospitalization due 
        to the 2009 H1N1 pandemic among the poor, individuals with 
        disabilities and preexisting conditions, those living in 
        impoverished neighborhoods, and individuals of color and ethnic 
        backgrounds in the United States. These findings highlight the 
        urgency to adapt the COVID-19 response to monitor and act on 
        these inequities via data collection and research by race and 
        ethnicity.
            (10) Research experts recognize that there are underlying 
        differences in illness and death when each of these factors are 
        examined through socioeconomic and racial or ethnic lenses. 
        These socially determinant factors of health accelerate disease 
        and degradation.
            (11) Language barriers are highly correlated with 
        medication noncompliance and inconsistent engagement with 
        health systems. Without language accessibility data and 
        research around COVID-19, these communities are less likely to 
        receive critical testing and preventive health services. Yet, 
        to date, the Centers for Disease Control and Prevention do not 
        disseminate COVID-19 messaging in critical languages, including 
        Mandarin Chinese, Spanish, and Korean within the same timeframe 
        as information in English despite requirements to ensure 
        limited English proficient populations are not discriminated 
        against under title VI of the Civil Rights Act of 1964 and 
        subsequent laws and Federal policies.
            (12) Further, it is critical to disaggregate data further 
        by ancestry to address disparities among Asian American, Native 
        Hawaiian, and Pacific Islander groups. According to the 
        National Equity Atlas, while 13 percent of the Asian population 
        overall lived in poverty in 2015, 39 percent of Burmese people, 
        29 percent of Hmong people, and 21 percent of Pacific Islanders 
        lived in poverty.
            (13) Utilizing disaggregation of enrollment in Affordable 
        Care Act-sponsored health insurance, the Asian and Pacific 
        Islander American Health Forum found that prior to the passage 
        of the Patient Protection and Affordable Care Act (Public Law 
        111-148), Korean Americans had a high uninsured rate of 23 
        percent, compared to just 12 percent for all Asian Americans. 
        Developing targeted outreach efforts assisted 1,000,000 people 
        and resulted in a 56-percent decrease in the uninsured among 
        the Asian, Native Hawaiian, and Pacific Islander population. 
        Such efforts show that disaggregated data is essential to 
        public health mobilizations efforts.
            (14) Without clear understanding of how COVID-19 impacts 
        marginalized racial and ethnic communities, there will be 
        exacerbated risk of endangering the most historically 
        vulnerable of our Nation.
            (15) The consequences of misunderstanding the racial and 
        ethnic impact of COVID-19 expound beyond communities of color 
        such that it would impact all.
            (16) Race and ethnicity are valuable research and practice 
        variables when used and interpreted appropriately. Health data 
        collected on patients by race and ethnicity will boost and more 
        efficiently direct critical resources and inform risk 
        communication development in languages and at appropriate 
        health literacy levels, which resonate with historically 
        vulnerable communities of color.
            (17) To date, there is no public standardized and 
        comprehensive race and ethnicity data repository of COVID-19 
        testing, hospitalizations, or mortality. The inconsistency of 
        data collection by Federal, State, and local health 
        authorities, and the inability to access data by public 
        research institutions and academic organizations, poses a 
        threat to analysis and synthesis of the pandemic impact on 
        communities of color. However, research and medical experts of 
        Historically Black Colleges and Universities, academic health 
        care institutions which are historically and geographically 
        embedded in minoritized and marginalized communities, generally 
        also possess rapport with the communities they serve. They are 
        well-positioned, as trusted thought leaders and health care 
        service providers, to collect data and conduct research toward 
        creating holistic solutions to remedy the inequitable impact of 
        this and future public health crises.
            (18) Well-designed, ethically sound research aligns with 
        the goals of medicine, addresses questions relevant to the 
        population among whom the study will be carried out, balances 
        the potential for benefit against the potential for harm, 
        employs study designs that will yield scientifically valid and 
        significant data, and generates useful knowledge.
            (19) The dearth of racially and ethnically disaggregated 
        data reflecting the health of communities of color underlies 
        the challenges of a fully informed public health response.
            (20) Without collecting race and ethnicity data associated 
        with COVID-19 testing, hospitalizations, morbidities, and 
        mortalities, as well as publicly disclosing it, communities of 
        color will remain at greater risk of disease and death.
    (b) Emergency Funding for Federal Data Collection on the Racial, 
Ethnic, and Other Demographic Disparities of COVID-19.--To conduct or 
support data collection on the racial, ethnic, and other demographic 
implications of COVID-19 in the United States and its territories, 
including support to assist in the capacity building for State and 
local public health departments to collect and transmit racial, ethnic, 
and other demographic data to the relevant Department of Health and 
Human Services agencies, there is authorized to be appropriated--
            (1) to the Centers for Disease Control and Prevention, 
        $12,000,000;
            (2) to State, territorial, and Tribal public health 
        agencies, distributed proportionally based on the total 
        population of their residents who are enrolled in Medicaid or 
        who have no health insurance, $15,000,000;
            (3) to the Indian Health Service, Indian Tribes and Tribal 
        organizations (as defined in section 4 of the Indian Self-
        Determination and Education Assistance Act), and urban Indian 
        organizations (as defined in section 4 of the Indian Health 
        Care Improvement Act), $3,000,000;
            (4) to the Centers for Medicare & Medicaid Services, 
        $5,000,000;
            (5) to the Food and Drug Administration, $5,000,000;
            (6) to the Agency for Healthcare Research and Quality, 
        $5,000,000; and
            (7) to the Office of the National Coordinator for Health 
        Information Technology, $5,000,000.
    (c) COVID-19 Data Collection and Disclosure.--
            (1) Data collection.--The Secretary of Health and Human 
        Services (referred to in this section as the ``Secretary''), 
        acting through the Director of the Centers for Disease Control 
        and Prevention and the Administrator of the Centers for 
        Medicare & Medicaid Services, shall make publicly available on 
        the website of the Centers for Disease Control and Prevention 
        data collected across all surveillance systems relating to 
        COVID-19, disaggregated by race, ethnicity, sex, age, primary 
        language, socioeconomic status, disability status, and county, 
        including the following:
                    (A) Data related to all COVID-19 testing, including 
                the number of individuals tested and the number of 
                tests that were positive.
                    (B) Data related to treatment for COVID-19, 
                including hospitalizations and intensive care unit 
                admissions.
                    (C) Data related to COVID-19 outcomes, including 
                total fatalities and case fatality rates (expressed as 
                the proportion of individuals who were infected with 
                COVID-19 and died from the virus).
            (2) Application of standards.--To the extent practicable, 
        data collection under this subsection shall follow standards 
        developed by the Department of Health and Human Services Office 
        of Minority Health and be collected, analyzed, and reported in 
        accordance with the standards promulgated by the Assistant 
        Secretary for Planning and Evaluation under title XXXI of the 
        Public Health Service Act (42 U.S.C. 300kk et seq.).
            (3) Timeline.--The data made available under this 
        subsection shall be updated on a daily basis throughout the 
        public health emergency.
            (4) Privacy.--In publishing data under this subsection, the 
        Secretary shall take all necessary steps to protect the privacy 
        of individuals whose information is included in such data, 
        including--
                    (A) complying with privacy protections provided 
                under the regulations promulgated under section 264(c) 
                of the Health Insurance Portability and Accountability 
                Act of 1996; and
                    (B) protections from all inappropriate internal use 
                by an entity that collects, stores, or receives the 
                data, including use of such data in determinations of 
                eligibility (or continued eligibility) in health plans, 
                and from inappropriate uses.
            (5) Consultation with tribes.--The Indian Health Service 
        shall consult with Indian Tribes and confer with urban Indian 
        organizations on data collection and reporting.
            (6) Report.--Not later than 60 days after the date on which 
        the Secretary certifies that the public health emergency 
        related to COVID-19 has ended, the Secretary shall make 
        publicly available a summary of the final statistics related to 
        COVID-19.
            (7) Report.--Not later than 60 days after the date on which 
        the Secretary certifies that the public health emergency 
        related to COVID-19 has ended, the Department of Health and 
        Human Services shall compile and submit to the Committee on 
        Health, Education, Labor, and Pensions and the Committee on 
        Finance of the Senate and the Committee on Energy and Commerce 
        and the Committee on Ways and Means of the House of 
        Representatives a preliminary report--
                    (A) describing the testing, hospitalization, 
                mortality rates, and preferred language of patients 
                associated with COVID-19 by race and ethnicity; and
                    (B) proposing evidenced-based response strategies 
                to safeguard the health of these communities in future 
                pandemics.
    (d) Commission on Ensuring Health Equity During the COVID-19 Public 
Health Emergency.--
            (1) In general.--Not later than 30 days after the date of 
        enactment of this Act, the Secretary shall establish a 
        commission, to be known as the ``Commission on Ensuring Health 
        Equity During the COVID-19 Public Health Emergency'' (referred 
        to in this subsection as the ``Commission'') to provide clear 
        and robust guidance on how to improve the collection, analysis, 
        and use of demographic data in responding to future waves of 
        the coronavirus.
            (2) Membership and chairperson.--
                    (A) Membership.--The Commission shall be composed 
                of--
                            (i) the Director of the Centers for Disease 
                        Control and Prevention;
                            (ii) the Director of the National 
                        Institutes of Health;
                            (iii) the Commissioner of Food and Drugs;
                            (iv) the Administrator of the Federal 
                        Emergency Management Agency;
                            (v) the Director of the National Institute 
                        on Minority Health and Health Disparities;
                            (vi) the Director of the Indian Health 
                        Service;
                            (vii) the Administrator of the Centers for 
                        Medicare & Medicaid Services;
                            (viii) the Director of the Agency for 
                        Healthcare Research and Quality;
                            (ix) the Surgeon General;
                            (x) the Administrator of the Health 
                        Resources and Services Administration;
                            (xi) the Director of the Office of Minority 
                        Health;
                            (xii) the Director of the Office of Women's 
                        Health;
                            (xiii) the Chairperson of the National 
                        Council on Disability;
                            (xiv) at least 4 State, local, territorial, 
                        and Tribal public health officials representing 
                        departments of public health, who shall 
                        represent jurisdictions from different regions 
                        of the United States with relatively high 
                        concentrations of historically marginalized 
                        populations, to be appointed by the Secretary; 
                        and
                            (xv) racially and ethnically diverse 
                        representation from at least 3 independent 
                        experts with knowledge or field experience with 
                        racial and ethnic disparities in public health 
                        appointed by the Secretary.
                    (B) Chairperson.--The President of the National 
                Academies of Sciences, Engineering, and Medicine, or 
                designee, shall serve as the chairperson of the 
                Commission.
            (3) Duties.--The Commission shall--
                    (A) examine barriers to collecting, analyzing, and 
                using demographic data;
                    (B) determine how to best use such data to promote 
                health equity across the United States and reduce 
                racial, Tribal, and other demographic disparities in 
                COVID-19 prevalence and outcomes;
                    (C) gather available data related to COVID-19 
                treatment of individuals with disabilities, including 
                denial of treatment for pre-existing conditions, 
                removal or denial of disability related equipment 
                (including ventilators and CPAP), and data on 
                completion of DNR orders, and identify barriers to 
                obtaining accurate and timely data related to COVID-19 
                treatment of such individuals;
                    (D) solicit input from public health officials, 
                community-connected organizations, health care 
                providers, State and local agency officials, and other 
                experts on barriers to, and best practices for, 
                collecting demographic data; and
                    (E) recommend policy changes that the data 
                indicates are necessary to reduce disparities.
            (4) Report.--Not later than 60 days after the date of 
        enactment of this Act, and every 180 days thereafter until the 
        Secretary certifies that the public health emergency related to 
        COVID-19 has ended, the Commission shall submit a written 
        report of its findings and recommendations to Congress and post 
        such report on a website of the Department of Health and Human 
        Services. Such reports shall contain information concerning--
                    (A) how to enhance State, local, territorial, and 
                Tribal capacity to conduct public health research on 
                COVID-19, with a focus on expanded capacity to analyze 
                data on disparities correlated with race, ethnicity, 
                income, sex, age, disability status, specific 
                geographic areas, and other relevant demographic 
                characteristics, and an analysis of what demographic 
                data is currently being collected about COVID-19, the 
                accuracy of that data and any gaps, how this data is 
                currently being used to inform efforts to combat COVID-
                19, and what resources are needed to supplement 
                existing public health data collection;
                    (B) how to collect, process, and disclose to the 
                public the data described in subparagraph (A) in a way 
                that maintains individual privacy while helping direct 
                the State and local response to the virus;
                    (C) how to improve demographic data collection 
                related to COVID-19 in the short- and long-term, 
                including how to continue to grow and value the Tribal 
                sovereignty of data and information concerning Tribal 
                communities;
                    (D) to the extent possible, a preliminary analysis 
                of racial and other demographic disparities in COVID-19 
                mortality, including an analysis of comorbidities and 
                case fatality rates;
                    (E) to the extent possible, a preliminary analysis 
                of sex, gender, sexual orientation, and gender identity 
                disparities in COVID-19 treatment and mortality;
                    (F) an analysis of COVID-19 treatment of 
                individuals with disabilities, including equity of 
                access to treatment and equipment and intersections of 
                disability status with other demographic factors, 
                including race, and recommendations for how to improve 
                transparency and equity of treatment for such 
                individuals during the COVID-19 public health emergency 
                and future emergencies;
                    (G) how to support State, local, and Tribal 
                capacity to eliminate barriers to COVID-19 testing and 
                treatment; and
                    (H) to the extent possible, a preliminary analysis 
                of Federal Government policies that disparately 
                exacerbate the COVID-19 impact, and recommendations to 
                improve racial and other demographic disparities in 
                health outcomes.
            (5) Authorization of appropriations.--There is authorized 
        to be appropriated such sums as may be necessary to carry out 
        this subsection.

SEC. 102. COVID-19 REPORTING PORTAL.

    (a) In General.--Not later than 15 days after the date of enactment 
of this Act, the Secretary of Health and Human Services (referred to in 
this section as the ``Secretary'') shall establish and maintain an 
online portal for use by eligible health care entities to track and 
transmit data regarding their personal protective equipment and medical 
supply inventory and capacity related to COVID-19.
    (b) Eligible Health Care Entities.--In this section, the term 
``eligible health care entity'' means a licensed acute care hospital, 
hospital system, or long-term care facility with confirmed cases of 
COVID-19.
    (c) Submission.--An eligible health care entity shall report using 
the portal under this section on a biweekly basis in order to assist 
the Secretary in tracking usage and need of COVID-related supplies and 
personnel in a regular and real-time manner.
    (d) Included Information.--The Secretary shall design the portal 
under this section to include information on personal protective 
equipment and medical supply inventory and capacity related to COVID-
19, including with respect to the following:
            (1) Personal protective equipment.--Total personal 
        protective equipment inventory, including, in units, the 
        numbers of N95 masks and authorized equivalent respirator 
        masks, surgical masks, exam gloves, face shields, isolation 
        gowns, and coveralls.
            (2) Medical supply.--
                    (A) Total ventilator inventory, including, in 
                units, the number of universal, adult, pediatric, and 
                infant ventilators.
                    (B) Total diagnostic and serological test 
                inventory, including, in units, the number of test 
                platforms, tests, test kits, reagents, transport media, 
                swabs, and other materials or supplies determined 
                necessary by the Secretary.
            (3) Capacity.--
                    (A) Case count measurements, including confirmed 
                positive cases and persons under investigation.
                    (B) Total number of staffed beds, including medical 
                surgical beds, intensive care beds, and critical care 
                beds.
                    (C) Available beds, including medical surgical 
                beds, intensive care beds, and critical care beds.
                    (D) Total number of COVID-19 patients currently 
                utilizing a ventilator.
                    (E) Average number of days a COVID-19 patient is 
                utilizing a ventilator.
                    (F) Total number of additionally needed 
                professionals in each of the following categories: 
                intensivists, critical care physicians, respiratory 
                therapists, registered nurses, certified registered 
                nurse anesthetists, and laboratory personnel.
                    (G) Total number of hospital personnel currently 
                not working due to self-isolation following a known or 
                presumed COVID-19 exposure.
    (e) Access to Information Related to Inventory and Capacity.--The 
Secretary shall ensure that relevant agencies and officials, including 
the Centers for Disease Control and Prevention, the Assistant Secretary 
for Preparedness and Response, and the Federal Emergency Management 
Agency, have access to information related to inventory and capacity 
submitted under this section.
    (f) Weekly Report to Congress.--On a weekly basis, the Secretary 
shall transmit information related to inventory and capacity submitted 
under this section to the appropriate committees of the House and 
Senate.

SEC. 103. REGULAR CDC REPORTING ON DEMOGRAPHIC DATA.

    Not later than 14 days after the date of enactment of this Act, the 
Secretary of Health and Human Services, in coordination with the 
Director of the Centers for Disease Control and Prevention, shall amend 
the reporting under the heading ``Department of Health and Human 
Services--Office of the Secretary--Public Health and Social Service 
Emergency Fund'' in title I of division B of the Paycheck Protection 
Program and Health Care Enhancement Act (Public Law 116-139; 134 Stat. 
620, 626) on the demographic characteristics, including race, ethnicity 
(including breakdowns of major ethnic groups and Tribal affiliations 
within minority populations), age, sex, gender, geographic region, 
primary written and spoken language, disability status, sexual 
orientation, socioeconomic status, occupation, and other relevant 
factors of individuals tested for or diagnosed with COVID-19, to 
include--
            (1) providing technical assistance to State, local, Tribal, 
        and territorial health departments to improve the collection 
        and reporting of such demographic data;
            (2) if such data is not so collected or reported, the 
        reason why the State, local, Tribal, or territorial department 
        of health has not been able to collect or provide such 
        information; and
            (3) making a copy of such report available publicly on the 
        website of the Centers for Disease Control and Prevention.

SEC. 104. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    (a) Purpose.--It is the purpose of the amendment made by this 
section to promote data collection, analysis, and reporting by race, 
ethnicity, sex, primary language, sexual orientation, disability 
status, gender identity, age, and socioeconomic status among federally 
supported health programs.
    (b) Amendment.--The Public Health Service Act is amended by adding 
at the end the following:

``TITLE XXXIV--STRENGTHENING DATA COLLECTION, IMPROVING DATA ANALYSIS, 
                      AND EXPANDING DATA REPORTING

``SEC. 3400. HEALTH DISPARITY DATA.

    ``(a) Requirements.--
            ``(1) In general.--Each health-related program shall--
                    ``(A) require the collection, by the agency or 
                program involved, of data on the race, ethnicity, sex, 
                primary language, sexual orientation, disability 
                status, gender identity, age, and socioeconomic status 
                of each applicant for and recipient of health-related 
                assistance under such program, including--
                            ``(i) using, at a minimum, standards for 
                        data collection on race, ethnicity, sex, 
                        primary language, sexual orientation, gender 
                        identity, age, socioeconomic status, and 
                        disability status as each are developed under 
                        section 3101;
                            ``(ii) collecting data for additional 
                        population groups if such groups can be 
                        aggregated into the race and ethnicity 
                        categories outlined by standards developed 
                        under section 3101;
                            ``(iii) using, where practicable, the 
                        standards developed by the Health and Medicine 
                        Division of the National Academies of Sciences, 
                        Engineering, and Medicine (formerly known as 
                        the `Institute of Medicine') in the 2009 
                        publication, entitled `Race, Ethnicity, and 
                        Language Data: Standardization for Health Care 
                        Quality Improvement'; and
                            ``(iv) where practicable, collecting such 
                        data through self-reporting;
                    ``(B) with respect to the collection of the data 
                described in subparagraph (A), for applicants and 
                recipients who are minors, require communication 
                assistance in speech or writing, and for applicants and 
                recipients who are otherwise legally incapacitated, 
                require that--
                            ``(i) such data be collected from the 
                        parent or legal guardian of such an applicant 
                        or recipient; and
                            ``(ii) the primary language of the parent 
                        or legal guardian of such an applicant or 
                        recipient be collected;
                    ``(C) systematically analyze such data using the 
                smallest appropriate units of analysis feasible to 
                detect racial and ethnic disparities, as well as 
                disparities along the lines of primary language, sex, 
                disability status, sexual orientation, gender identity, 
                age, and socioeconomic status in health and health 
                care, and report the results of such analysis to the 
                Secretary, the Director of the Office for Civil Rights, 
                each agency listed in section 3101(c)(1), the Committee 
                on Health, Education, Labor, and Pensions and the 
                Committee on Finance of the Senate, and the Committee 
                on Energy and Commerce and the Committee on Ways and 
                Means of the House of Representatives;
                    ``(D) provide such data to the Secretary on at 
                least an annual basis; and
                    ``(E) ensure that the provision of assistance to an 
                applicant or recipient of assistance is not denied or 
                otherwise adversely affected because of the failure of 
                the applicant or recipient to provide race, ethnicity, 
                primary language, sex, sexual orientation, disability 
                status, gender identity, age, and socioeconomic status 
                data.
            ``(2) Rules of construction.--Nothing in this subsection 
        shall be construed to--
                    ``(A) permit the use of information collected under 
                this subsection in a manner that would adversely affect 
                any individual providing any such information; or
                    ``(B) diminish any requirements, including such 
                requirements in effect on or after the date of 
                enactment of this section, on health care providers to 
                collect data.
            ``(3) No compelled disclosure of data.--This title does not 
        authorize any health care provider, Federal official, or other 
        entity to compel the disclosure of any data collected under 
        this title. The disclosure of any such data by an individual 
        pursuant to this title shall be strictly voluntary.
    ``(b) Protection of Data.--The Secretary shall ensure (through the 
promulgation of regulations or otherwise) that all data collected 
pursuant to subsection (a) are protected--
            ``(1) under the same privacy protections as the Secretary 
        applies to other health data under the regulations promulgated 
        under section 264(c) of the Health Insurance Portability and 
        Accountability Act of 1996 relating to the privacy of 
        individually identifiable health information and other 
        protections; and
            ``(2) from all inappropriate internal use by any entity 
        that collects, stores, or receives the data, including use of 
        such data in determinations of eligibility (or continued 
        eligibility) in health plans, and from other inappropriate 
        uses, as defined by the Secretary.
    ``(c) National Plan of the Data Council.--The Secretary shall 
develop and implement a national plan to ensure the collection of data 
in a culturally and linguistically appropriate manner, to improve the 
collection, analysis, and reporting of racial, ethnic, sex, primary 
language, sexual orientation, disability status, gender identity, age, 
and socioeconomic status data at the Federal, State, territorial, 
Tribal, and local levels, including data to be collected under 
subsection (a), and to ensure that data collection activities carried 
out under this section are in compliance with standards developed under 
section 3101. The Data Council of the Department of Health and Human 
Services, in consultation with the National Committee on Vital Health 
Statistics, the Office of Minority Health, Office on Women's Health, 
and other appropriate public and private entities, shall make 
recommendations to the Secretary concerning the development, 
implementation, and revision of the national plan. Such plan shall 
include recommendations on how to--
            ``(1) implement subsection (a) while minimizing the cost 
        and administrative burdens of data collection and reporting;
            ``(2) expand knowledge among Federal agencies, States, 
        territories, Indian Tribes, counties, municipalities, health 
        providers, health plans, and the general public that data 
        collection, analysis, and reporting by race, ethnicity, sex, 
        primary language, sexual orientation, gender identity, age, 
        socioeconomic status, and disability status is legal and 
        necessary to assure equity and nondiscrimination in the quality 
        of health care services;
            ``(3) ensure that future patient record systems follow 
        Federal standards promulgated under the Health Information 
        Technology for Economic and Clinical Health Act for the 
        collection and meaningful use of electronic health data on 
        race, ethnicity, sex, primary language, sexual orientation, 
        gender identity, age, socioeconomic status, and disability 
        status;
            ``(4) improve health and health care data collection and 
        analysis for more population groups if such groups can be 
        aggregated into the minimum race and ethnicity categories, 
        including exploring the feasibility of enhancing collection 
        efforts in States, counties, and municipalities for racial and 
        ethnic groups that comprise a significant proportion of the 
        population of the State, county, or municipality;
            ``(5) provide researchers with greater access to racial, 
        ethnic, primary language, sex, sexual orientation, gender 
        identity, age, socioeconomic status data, and disability status 
        data, subject to all applicable privacy and confidentiality 
        requirements, including HIPAA privacy and security law as 
        defined in section 3009; and
            ``(6) safeguard and prevent the misuse of data collected 
        under subsection (a).
    ``(d) Compliance With Standards.--Data collected under subsection 
(a) shall be obtained, maintained, and presented (including for 
reporting purposes) in accordance with standards developed under 
section 3101.
    ``(e) Analysis of Health Disparity Data.--The Secretary, acting 
through the Director of the Agency for Healthcare Research and Quality 
and in coordination with the Assistant Secretary for Planning and 
Evaluation, the Administrator of the Centers for Medicare & Medicaid 
Services, the Director of the National Center for Health Statistics, 
and the Director of the National Institutes of Health, shall provide 
technical assistance to agencies of the Department of Health and Human 
Services in meeting Federal standards for health disparity data 
collection and for analysis of racial, ethnic, and other disparities in 
health and health care in programs conducted or supported by such 
agencies by--
            ``(1) identifying appropriate quality assurance mechanisms 
        to monitor for health disparities;
            ``(2) specifying the clinical, diagnostic, or therapeutic 
        measures which should be monitored;
            ``(3) developing new quality measures relating to racial 
        and ethnic disparities and their overlap with other disparity 
        factors in health and health care;
            ``(4) identifying the level at which data analysis should 
        be conducted; and
            ``(5) sharing data with external organizations for research 
        and quality improvement purposes.
    ``(f) Definitions.--In this section--
            ``(1) the term `health-related program' means a program 
        that is operated by the Secretary, or that receives funding or 
        reimbursement, in whole or in part, either directly or 
        indirectly from the Secretary--
                    ``(A) for activities under the Social Security Act 
                for health care services; or
                    ``(B) for providing Federal financial assistance 
                for health care, biomedical research, or health 
                services research or for otherwise improving the health 
                of the public;
            ``(2) the term `primary language data' includes spoken and 
        written primary language data; and
            ``(3) the term `primary language data collection 
        activities' includes identifying, collecting, storing, 
        tracking, and analyzing primary language data and information 
        on the methods used to meet the language access needs of 
        individuals with limited English proficiency.
    ``(g) 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 2021 through 2025.

``SEC. 3401. ESTABLISHING GRANTS FOR DATA COLLECTION IMPROVEMENT 
              ACTIVITIES.

    ``(a) In General.--The Secretary, acting through the Director of 
the Agency for Healthcare Research and Quality and in consultation with 
the Deputy Assistant Secretary for Minority Health, the Director of the 
National Institutes of Health, the Assistant Secretary for Planning and 
Evaluation, and the Director of the National Center for Health 
Statistics, shall establish a technical assistance program under which 
the Secretary provides grants to eligible entities to assist such 
entities in complying with section 3431.
    ``(b) Types of Assistance.--A grant provided under this section may 
be used to--
            ``(1) enhance or upgrade computer technology that will 
        facilitate collection, analysis, and reporting of racial, 
        ethnic, primary language, sexual orientation, sex, gender 
        identity, socioeconomic status, and disability status data;
            ``(2) improve methods for health data collection and 
        analysis, including additional population groups if such groups 
        can be aggregated into the race and ethnicity categories 
        outlined by standards developed under section 3101;
            ``(3) develop mechanisms for submitting collected data 
        subject to any applicable privacy and confidentiality 
        regulations; and
            ``(4) develop educational programs to inform health plans, 
        health providers, health-related agencies, and the general 
        public that data collection and reporting by race, ethnicity, 
        primary language, sexual orientation, sex, gender identity, 
        disability status, and socioeconomic status are legal and 
        essential for eliminating health and health care disparities.
    ``(c) Eligible Entity.--To be eligible for grants under this 
section, an entity shall be a State, territory, Indian Tribe, 
municipality, county, health provider, health care organization, or 
health plan making a demonstrated effort to bring data collections into 
compliance with section 3431.
    ``(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 2021 through 2025.

``SEC. 3402. OVERSAMPLING OF UNDERREPRESENTED GROUPS IN FEDERAL HEALTH 
              SURVEYS.

    ``(a) National Strategy.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the National Center for Health Statistics of the 
        Centers for Disease Control and Prevention, and other agencies 
        within the Department of Health and Human Services as the 
        Secretary determines appropriate, shall develop and implement 
        an ongoing and sustainable national strategy for oversampling 
        underrepresented populations within the categories of race, 
        ethnicity, sex, primary language, sexual orientation, 
        disability status, gender identity, and socioeconomic status as 
        determined appropriate by the Secretary in Federal health 
        surveys and program data collections. Such national strategy 
        shall include a strategy for oversampling of Native Americans, 
        Asian Americans, Native Hawaiians, and Pacific Islanders.
            ``(2) Consultation.--In developing and implementing a 
        national strategy, as described in paragraph (1), not later 
        than 180 days after the date of the enactment of this section, 
        the Secretary shall--
                    ``(A) consult with representatives of community 
                groups, nonprofit organizations, nongovernmental 
                organizations, and government agencies working with 
                underrepresented populations;
                    ``(B) solicit the participation of representatives 
                from other Federal departments and agencies, including 
                subagencies of the Department of Health and Human 
                Services; and
                    ``(C) consult on, and use as models, the 2014 
                National Health Interview Survey oversample of Native 
                Hawaiian and Pacific Islander populations and the 2017 
                Behavioral Risk Factor Surveillance System oversample 
                of American Indian and Alaska Native communities.
    ``(b) Progress Report.--Not later than 2 years after the date of 
the enactment of this section, the Secretary shall submit to the 
Congress a progress report, which shall include the national strategy 
described in subsection (a)(1).
    ``(c) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2021 through 2025.''.

SEC. 105. ELIMINATION OF PREREQUISITE OF DIRECT APPROPRIATIONS FOR DATA 
              COLLECTION AND ANALYSIS.

    Section 3101 of the Public Health Service Act (42 U.S.C. 300kk) is 
amended--
            (1) by striking subsection (h); and
            (2) by redesignating subsection (i) as subsection (h).

SEC. 106. COLLECTION OF DATA FOR THE MEDICARE PROGRAM.

    Part A of title XI of the Social Security Act (42 U.S.C. 1301 et 
seq.) is amended by adding at the end the following:

             ``collection of data for the medicare program

    ``Sec. 1150C. 
    ``(a) Requirement.--
            ``(1) In general.--The Commissioner of Social Security, in 
        consultation with the Administrator of the Centers for Medicare 
        & Medicaid Services, shall collect data on the race, ethnicity, 
        sex, primary language, sexual orientation, gender identity, 
        socioeconomic status, and disability status of all applicants 
        for Social Security benefits under title II or Medicare 
        benefits under title XVIII.
            ``(2) Data collection standards.--In collecting data under 
        paragraph (1), the Commissioner of Social Security shall at 
        least use the standards for data collection developed under 
        section 3101 of the Public Health Service Act or the standards 
        developed by the Office of Management and Budget, whichever is 
        more disaggregated. In the event there are no standards for the 
        demographic groups listed under paragraph (1), the Commissioner 
        shall consult with stakeholder groups representing the various 
        identities as well as with the Office of Minority Health within 
        the Centers for Medicare & Medicaid Services to develop 
        appropriate standards.
            ``(3) Data for additional population groups.--Where 
        practicable, the information collected by the Commissioner of 
        Social Security under paragraph (1) shall include data for 
        additional population groups if such groups can be aggregated 
        into the race and ethnicity categories outlined by the data 
        collection standards described in paragraph (2).
            ``(4) Collection of data for minors and legally 
        incapacitated individuals.--With respect to the collection of 
        the data described in paragraph (1) of applicants who are under 
        18 years of age or otherwise legally incapacitated, the 
        Commissioner of Social Security shall require that--
                    ``(A) such data be collected from the parent or 
                legal guardian of such an applicant; and
                    ``(B) the primary language of the parent or legal 
                guardian of such an applicant or recipient be used in 
                collecting the data.
            ``(5) Quality of data.--The Commissioner of Social Security 
        shall periodically review the quality and completeness of the 
        data collected under paragraph (1) and make adjustments as 
        necessary to improve both.
            ``(6) Transmission of data.--Upon enrollment in Medicare 
        benefits under title XVIII, the Commissioner of Social Security 
        shall transmit an individual's demographic data as collected 
        under paragraph (1) to the Centers for Medicare and Medicaid 
        Services.
            ``(7) Analysis and reporting of data.--With respect to data 
        transmitted under paragraph (5), the Administrator of the 
        Centers for Medicare and Medicaid Services, in consultation 
        with the Commissioner of Social Security shall--
                    ``(A) require that such data be uniformly analyzed 
                and that such analysis be reported at least annually to 
                Congress;
                    ``(B) incorporate such data in other analysis and 
                reporting on health disparities as appropriate;
                    ``(C) make such data available to researchers, 
                under the protections outlined in paragraph (7);
                    ``(D) provide opportunities to individuals enrolled 
                in Medicare to submit updated data; and
                    ``(E) ensure that the provision of assistance or 
                benefits to an applicant is not denied or otherwise 
                adversely affected because of the failure of the 
                applicant to provide any of the data collected under 
                paragraph (1).
            ``(8) Protection of data.--The Commissioner of Social 
        Security shall ensure (through the promulgation of regulations 
        or otherwise) that all data collected pursuant to subsection 
        (a) is protected--
                    ``(A) under the same privacy protections as the 
                Secretary applies to health data under the regulations 
                promulgated under section 264(c) of the Health 
                Insurance Portability and Accountability Act of 1996 
                (relating to the privacy of individually identifiable 
                health information and other protections); and
                    ``(B) from all inappropriate internal use by any 
                entity that collects, stores, or receives the data, 
                including use of such data in determinations of 
                eligibility (or continued eligibility) in health plans, 
                and from other inappropriate uses, as defined by the 
                Secretary.
    ``(b) Rule of Construction.--Nothing in this section shall be 
construed to permit the use of information collected under this section 
in a manner that would adversely affect any individual providing any 
such information.
    ``(c) Technical Assistance.--The Secretary may, either directly or 
by grant or contract, provide technical assistance to enable any entity 
to comply with the requirements of this section or with regulations 
implementing this section.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $500 million for 2020 and $100 
million for each fiscal year thereafter.''.

SEC. 107. REVISION OF HIPAA CLAIMS STANDARDS.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services shall revise 
the regulations promulgated under part C of title XI of the Social 
Security Act (42 U.S.C. 1320d et seq.), relating to the collection of 
data on race, ethnicity, and primary language in a health-related 
transaction, to require--
            (1) the use, at a minimum, of standards for data collection 
        on race, ethnicity, primary language, disability, sex, sexual 
        orientation, gender identity, and socioeconomic status 
        developed under section 3101 of the Public Health Service Act 
        (42 U.S.C. 300kk); and
            (2) in consultation with the Office of the National 
        Coordinator for Health Information Technology, the designation 
        of the appropriate racial, ethnic, primary language, 
        disability, sex, and other code sets as required for claims and 
        enrollment data.
    (b) Dissemination.--The Secretary of Health and Human Services 
shall disseminate the new standards developed under subsection (a) to 
all entities that are subject to the regulations described in such 
subsection and provide technical assistance with respect to the 
collection of the data involved.
    (c) Compliance.--The Secretary of Health and Human Services shall 
require that entities comply with the new standards developed under 
subsection (a) not later than 2 years after the final promulgation of 
such standards.

SEC. 108. DISPARITIES DATA COLLECTED BY THE FEDERAL GOVERNMENT.

    (a) Repository of Government Data.--The Secretary of Health and 
Human Services, in coordination with the departments, agencies, or 
offices described in subsection (b), shall establish a centralized 
electronic repository of Government data on factors related to the 
health and well-being of the population of the United States.
    (b) Collection; Submission.--Not later than 180 days after the date 
of the enactment of this Act, and January 31 of each year thereafter, 
each department, agency, and office of the Federal Government that has 
collected data on race, ethnicity, sex, primary language, sexual 
orientation, disability status, gender identity, age, or socioeconomic 
status during the preceding calendar year shall submit such data to the 
repository of Government data established under subsection (a).
    (c) Analysis; Public Availability; Reporting.--Not later than April 
30, 2021, and April 30 of each year thereafter, the Secretary of Health 
and Human Services, acting through the Assistant Secretary for Planning 
and Evaluation, the Assistant Secretary for Health, the Director of the 
Agency for Healthcare Research and Quality, the Director of the 
National Center for Health Statistics, the Administrator of the Centers 
for Medicare & Medicaid Services, the Director of the National 
Institute on Minority Health and Health Disparities, and the Deputy 
Assistant Secretary for Minority Health, shall--
            (1) prepare and make available datasets for public use that 
        relate to disparities in health status, health care access, 
        health care quality, health outcomes, public health, and other 
        areas of health and well-being by factors that include race, 
        ethnicity, sex, primary language, sexual orientation, 
        disability status, gender identity, and socioeconomic status;
            (2) ensure that these datasets are publicly identified on 
        the repository established under subsection (a) as 
        ``disparities'' data; and
            (3) submit a report to the Congress on the availability and 
        use of such data by public stakeholders.

SEC. 109. STANDARDS FOR MEASURING SEXUAL ORIENTATION, GENDER IDENTITY, 
              AND SOCIOECONOMIC STATUS IN COLLECTION OF HEALTH DATA.

    Section 3101(a) of the Public Health Service Act (42 U.S.C. 
300kk(a)) is amended--
            (1) in paragraph (1)(A), by inserting ``sexual orientation, 
        gender identity, socioeconomic status,'' before ``and 
        disability status'';
            (2) in paragraph (1)(C), by inserting ``sexual orientation, 
        gender identity, socioeconomic status,'' before ``and 
        disability status''; and
            (3) in paragraph (2)(B), by inserting ``sexual orientation, 
        gender identity, socioeconomic status,'' before ``and 
        disability status''.

SEC. 110. IMPROVING HEALTH DATA REGARDING NATIVE HAWAIIANS AND OTHER 
              PACIFIC ISLANDERS.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 317U the following:

``SEC. 317V. NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER HEALTH DATA.

    ``(a) Definitions.--In this section:
            ``(1) Community group.--The term `community group' means a 
        group of NHOPI who are organized at the community level, and 
        may include a church group, social service group, national 
        advocacy organization, or cultural group.
            ``(2) Nonprofit, nongovernmental organization.--The term 
        `nonprofit, nongovernmental organization' means a group of 
        NHOPI with a demonstrated history of addressing NHOPI issues, 
        including a NHOPI coalition.
            ``(3) Designated organization.--The term `designated 
        organization' means an entity established to represent NHOPI 
        populations and which has statutory responsibilities to 
        provide, or has community support for providing, health care.
            ``(4) Government representatives of nhopi populations.--The 
        term `government representatives of NHOPI populations' means 
        representatives from Hawaii, American Samoa, the Commonwealth 
        of the Northern Mariana Islands, the Federated States of 
        Micronesia, Guam, the Republic of Palau, and the Republic of 
        the Marshall Islands.
            ``(5) Native hawaiians and other pacific islanders 
        (nhopi).--The term `Native Hawaiians and Other Pacific 
        Islanders' or `NHOPI' means people having origins in any of the 
        original peoples of American Samoa, the Commonwealth of the 
        Northern Mariana Islands, the Federated States of Micronesia, 
        Guam, Hawaii, the Republic of the Marshall Islands, the 
        Republic of Palau, or any other Pacific Island.
            ``(6) Insular area.--The term `insular area' means Guam, 
        the Commonwealth of Northern Mariana Islands, American Samoa, 
        the United States Virgin Islands, the Federated States of 
        Micronesia, the Republic of Palau, or the Republic of the 
        Marshall Islands.
    ``(b) National Strategy.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the National Center for Health Statistics (referred 
        to in this section as `NCHS') of the Centers for Disease 
        Control and Prevention, and other agencies within the 
        Department of Health and Human Services as the Secretary 
        determines appropriate, shall develop and implement an ongoing 
        and sustainable national strategy for identifying and 
        evaluating the health status and health care needs of NHOPI 
        populations living in the continental United States, Hawaii, 
        American Samoa, the Commonwealth of the Northern Mariana 
        Islands, the Federated States of Micronesia, Guam, the Republic 
        of Palau, and the Republic of the Marshall Islands.
            ``(2) Consultation.--In developing and implementing a 
        national strategy, as described in paragraph (1), not later 
        than 180 days after the date of enactment of the Ending Health 
        Disparities During COVID-19 Act of 2020, the Secretary--
                    ``(A) shall consult with representatives of 
                community groups, designated organizations, and 
                nonprofit, nongovernmental organizations and with 
                government representatives of NHOPI populations; and
                    ``(B) may solicit the participation of 
                representatives from other Federal departments.
    ``(c) Preliminary Health Survey.--
            ``(1) In general.--The Secretary, acting through the 
        Director of NCHS, shall conduct a preliminary health survey in 
        order to identify the major areas and regions in the 
        continental United States, Hawaii, American Samoa, the 
        Commonwealth of the Northern Mariana Islands, the Federated 
        States of Micronesia, Guam, the Republic of Palau, and the 
        Republic of the Marshall Islands in which NHOPI people reside.
            ``(2) Contents.--The health survey described in paragraph 
        (1) shall include health data and any other data the Secretary 
        determines to be--
                    ``(A) useful in determining health status and 
                health care needs; or
                    ``(B) required for developing or implementing a 
                national strategy.
            ``(3) Methodology.--Methodology for the health survey 
        described in paragraph (1), including plans for designing 
        questions, implementation, sampling, and analysis, shall be 
        developed in consultation with community groups, designated 
        organizations, nonprofit, nongovernmental organizations, and 
        government representatives of NHOPI populations, as determined 
        by the Secretary.
            ``(4) Timeframe.--The survey required under this subsection 
        shall be completed not later than 18 months after the date of 
        enactment of the Ending Health Disparities During COVID-19 Act 
        of 2020.
    ``(d) Progress Report.--Not later than 2 years after the date of 
enactment of the Ending Health Disparities During COVID-19 Act of 2020, 
the Secretary shall submit to Congress a progress report, which shall 
include the national strategy described in subsection (b)(1).
    ``(e) Study and Report by the Health and Medicine Division.--
            ``(1) In general.--The Secretary shall enter into an 
        agreement with the Health and Medicine Division of the National 
        Academies of Sciences, Engineering, and Medicine to conduct a 
        study, with input from stakeholders in insular areas, on each 
        of the following:
                    ``(A) The standards and definitions of health care 
                applied to health care systems in insular areas and the 
                appropriateness of such standards and definitions.
                    ``(B) The status and performance of health care 
                systems in insular areas, evaluated based upon 
                standards and definitions, as the Secretary determines 
                appropriate.
                    ``(C) The effectiveness of donor aid in addressing 
                health care needs and priorities in insular areas.
                    ``(D) The progress toward implementation of 
                recommendations of the Committee on Health Care 
                Services in the United States--Associated Pacific Basin 
                that are set forth in the 1998 report entitled `Pacific 
                Partnerships for Health: Charting a New Course'.
            ``(2) Report.--An agreement described in paragraph (1) 
        shall require the Health and Medicine Division to submit to the 
        Secretary and to Congress, not later than 2 years after the 
        date of the enactment of the Ending Health Disparities During 
        COVID-19 Act of 2020, a report containing a description of the 
        results of the study conducted under paragraph (1), including 
        the conclusions and recommendations of the Health and Medicine 
        Division for each of the items described in subparagraphs (A) 
        through (D) of such paragraph.
    ``(f) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2021 through 2025.''.

               Subtitle B--Improvements and Modernization

SEC. 121. FEDERAL MODERNIZATION FOR HEALTH INEQUITIES DATA.

    (a) In General.--The Secretary of Health and Human Services shall 
work with covered agencies to support the modernization of data 
collection methods and infrastructure at such agencies for the purpose 
of increasing data collection related to health inequities, such as 
racial, ethnic (including breakdowns of major ethnic groups and Tribal 
affiliations within minority populations), socioeconomic, sex, gender, 
age, geographic region, primary written and spoken language, sexual 
orientation, occupation, and disability status disparities.
    (b) Covered Agency Defined.--In this section, the term ``covered 
agency'' means each of the following Federal agencies:
            (1) The Agency for Healthcare Research and Quality.
            (2) The Centers for Disease Control and Prevention.
            (3) The Centers for Medicare & Medicaid Services.
            (4) The Food and Drug Administration.
            (5) The Office of the National Coordinator for Health 
        Information Technology.
            (6) The National Institutes of Health.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to each covered agency to carry out this section 
$4,000,000, to remain available until expended.

SEC. 122. MODERNIZATION OF STATE AND LOCAL HEALTH INEQUITIES DATA.

    (a) In General.--Not later than 6 months after the date of 
enactment of this Act, the Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Director of the Centers for Disease Control and Prevention, shall award 
grants to State, local, Tribal, and territorial health departments in 
order to support the modernization of data collection methods and 
infrastructure for the purposes of increasing data related to health 
inequities, such as racial, ethnic (including breakdowns of major 
ethnic groups and Tribal affiliations within minority populations), 
socioeconomic, sex, gender, age, geographic region, primary written and 
spoken language, sexual orientation, occupation, and disability status 
disparities. The Secretary shall--
            (1) provide guidance, technical assistance, and information 
        to grantees under this section on best practices regarding 
        culturally competent, accurate, and increased data collection 
        and transmission; and
            (2) track performance of grantees under this section to 
        help improve their health inequities data collection by 
        identifying gaps and taking effective steps to support States, 
        localities, and territories in addressing the gaps.
    (b) Report.--Not later than 1 year after the date on which the 
first grant is awarded under this section, the Secretary shall submit 
to the Committee on Energy and Commerce of the House of Representatives 
and the Committee on Health, Education, Labor, and Pensions of the 
Senate an initial report detailing--
            (1) nationwide best practices for ensuring States and 
        localities collect and transmit health inequities data;
            (2) nationwide trends which hinder the collection and 
        transmission of health inequities data;
            (3) Federal best practices for working with States and 
        localities to ensure culturally competent, accurate, and 
        increased data collection and transmission; and
            (4) any recommended changes to legislative or regulatory 
        authority to help improve and increase health inequities data 
        collection.
    (c) Final Report.--Not later than December 31, 2023, the Secretary 
shall--
            (1) update and finalize the initial report under subsection 
        (b); and
            (2) submit such final report to the committees specified in 
        such subsection.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $100,000,000, to remain 
available until expended.

SEC. 123. ADDITIONAL REPORTING TO CONGRESS ON THE RACE AND ETHNICITY 
              RATES OF COVID-19 TESTING, HOSPITALIZATIONS, AND 
              MORTALITIES.

    (a) In General.--Not later than August 1, 2020, the Secretary of 
Health and Human Services (referred to in this section as the 
``Secretary'') shall submit to the Committee on Appropriations and the 
Committee on Energy and Commerce of the House of Representatives and 
the Committee on Appropriations and the Committee on Health, Education, 
Labor, and Pensions of the Senate an initial report--
            (1) describing the testing, positive diagnoses, 
        hospitalization, intensive care admissions, and mortality rates 
        associated with COVID-19, disaggregated by race, ethnicity 
        (including breakdowns of major ethnic groups and Tribal 
        affiliations within minority populations), age, sex, gender, 
        geographic region, primary written and spoken language, 
        disability status, sexual orientation, socioeconomic status, 
        occupation, and other relevant factors as determined by the 
        Secretary;
            (2) including an analysis of any variances of testing, 
        positive diagnoses, hospitalizations, and deaths by demographic 
        characteristics; and
            (3) including proposals for evidenced-based response 
        strategies to reduce disparities related to COVID-19.
    (b) Final Report.--Not later than December 31, 2024, the Secretary 
shall--
            (1) update and finalize the initial report under subsection 
        (a); and
            (2) submit such final report to the committees specified in 
        such subsection.
    (c) Coordination.--In preparing the report submitted under this 
section, the Secretary shall take into account and otherwise coordinate 
such report with reporting required under section 103 and under the 
heading ``Department of Health and Human Services--Office of the 
Secretary--Public Health and Social Service Emergency Fund'' in title I 
of division B of the Paycheck Protection Program and Health Care 
Enhancement Act (Public Law 116-139; 134 Stat. 620, 626).

                TITLE II--EQUITABLE TESTING AND TRACING

                 Subtitle A--Free Testing for Patients

SEC. 201. SOONER COVERAGE OF TESTING FOR COVID-19.

    Section 6001(a) of division F of the Families First Coronavirus 
Response Act (42 U.S.C. 1320b-5 note) is amended by striking 
``beginning on or after'' and inserting ``beginning before, on, or 
after''.

                 Subtitle B--National Testing Strategy

SEC. 211. COVID-19 TESTING STRATEGY.

    (a) Strategy.--Not later than June 15, 2020, the Secretary of 
Health and Human Services (referred to in this section as the 
``Secretary'') shall update the COVID-19 strategic testing plan under 
the heading ``Department of Health and Human Services--Office of the 
Secretary--Public Health and Social Service Emergency Fund'' in title I 
of division B of the Paycheck Protection Program and Health Care 
Enhancement Act (Public Law 116-139, 134 Stat. 620, 626-627) and submit 
to the appropriate congressional committees such updated national plan 
identifying--
            (1) what level of, types of, and approaches to testing 
        (including predicted numbers of tests, populations to be 
        tested, and frequency of testing and the appropriate setting 
        whether a health care setting (such as hospital-based, high-
        complexity laboratory, point-of-care, mobile testing units, 
        pharmacies or community health centers) or non-health care 
        setting (such as workplaces, schools, or child care centers)) 
        are necessary--
                    (A) to sufficiently monitor and contribute to the 
                control of the transmission of SARS-CoV-2 in the United 
                States;
                    (B) to ensure that any reduction in social 
                distancing efforts, when determined appropriate by 
                public health officials, can be undertaken in a manner 
                that optimizes the health and safety of the people of 
                the United States, and reduces disparities (including 
                disparities related to race, ethnicity, sex, age, 
                disability status, socioeconomic status, primary 
                written and spoken language, occupation, and geographic 
                location) in the prevalence of, incidence of, and 
                health outcomes with respect to, COVID-19; and
                    (C) to provide for ongoing surveillance sufficient 
                to support contact tracing, case identification, 
                quarantine, and isolation to prevent future outbreaks 
                of COVID-19;
            (2) specific plans and benchmarks, each with clear 
        timelines, to ensure--
                    (A) such level of, types of, and approaches to 
                testing as are described in paragraph (1), with respect 
                to optimizing health and safety;
                    (B) sufficient availability of all necessary 
                testing materials and supplies, including extraction 
                and testing kits, reagents, transport media, swabs, 
                instruments, analysis equipment, personal protective 
                equipment if necessary for testing (including point-of-
                care testing), and other equipment;
                    (C) allocation of testing materials and supplies in 
                a manner that optimizes public health, including by 
                considering the variable impact of SARS-CoV-2 on 
                specific States, territories, Indian Tribes, Tribal 
                organizations, urban Indian organizations, communities, 
                industries, and professions;
                    (D) sufficient evidence of validation for tests 
                that are deployed as a part of such strategy;
                    (E) sufficient laboratory and analytical capacity, 
                including target turnaround time for test results;
                    (F) sufficient personnel, including personnel to 
                collect testing samples, conduct and analyze results, 
                and conduct testing follow-up, including contact 
                tracing, as appropriate; and
                    (G) enforcement of the Families First Coronavirus 
                Response Act (Public Law 116-127) to ensure patients 
                who are tested are not subject to cost sharing;
            (3) specific plans to ensure adequate testing in rural 
        areas, frontier areas, health professional shortage areas, and 
        medically underserved areas (as defined in section 330I(a) of 
        the Public Health Service Act (42 U.S.C. 254c-14(a))), and for 
        underserved populations, Native Americans (including Indian 
        Tribes, Tribal organizations, and urban Indian organizations), 
        and populations at increased risk related to COVID-19;
            (4) specific plans to ensure accessibility of testing to 
        people with disabilities, older individuals, individuals with 
        limited English proficiency, and individuals with underlying 
        health conditions or weakened immune systems; and
            (5) specific plans for broadly developing and implementing 
        testing for potential immunity in the United States, as 
        appropriate, in a manner sufficient--
                    (A) to monitor and contribute to the control of 
                SARS-CoV-2 in the United States;
                    (B) to ensure that any reduction in social 
                distancing efforts, when determined appropriate by 
                public health officials, can be undertaken in a manner 
                that optimizes the health and safety of the people of 
                the United States; and
                    (C) to reduce disparities (including disparities 
                related to race, ethnicity, sex, age, disability 
                status, socioeconomic status, primary written and 
                spoken language, occupation, and geographic location) 
                in the prevalence of, incidence of, and health outcomes 
                with respect to, COVID-19.
    (b) Coordination.--The Secretary shall carry out this section--
            (1) in coordination with the Administrator of the Federal 
        Emergency Management Agency;
            (2) in collaboration with other agencies and departments, 
        as appropriate; and
            (3) taking into consideration the State plans for COVID-19 
        testing prepared as required under the heading ``Department of 
        Health and Human Services--Office of the Secretary--Public 
        Health and Social Service Emergency Fund'' in title I of 
        division B of the Paycheck Protection Program and Health Care 
        Enhancement Act (Public Law 116-139; 134 Stat. 620, 624).
    (c) Updates.--
            (1) Frequency.--The updated national plan under subsection 
        (a) shall be updated every 30 days until the end of the public 
        health emergency first declared by the Secretary under section 
        319 of the Public Health Service Act (42 U.S.C. 247d) on 
        January 31, 2020, with respect to COVID-19.
            (2) Relation to other law.--Paragraph (1) applies in lieu 
        of the requirement (for updates every 90 days until funds are 
        expended) in the second to last proviso under the heading 
        ``Department of Health and Human Services--Office of the 
        Secretary--Public Health and Social Service Emergency Fund'' in 
        title I of division B of the Paycheck Protection Program and 
        Health Care Enhancement Act (Public Law 116-139; 134 Stat. 620, 
        627).
    (d) Appropriate Congressional Committees.--In this section, the 
term ``appropriate congressional committees'' means--
            (1) the Committee on Appropriations and the Committee on 
        Energy and Commerce of the House of Representatives; and
            (2) the Committee on Appropriations and the Committee on 
        Health, Education, Labor, and Pensions of the Senate.

SEC. 212. CORONAVIRUS IMMIGRANT FAMILIES PROTECTION.

    (a) Definitions.--In this section:
            (1) Coronavirus public health emergency.--The term 
        ``coronavirus public health emergency'' means--
                    (A) an emergency involving Federal primary 
                responsibility determined to exist by the President 
                under section 501(b) of the Robert T. Stafford Disaster 
                Relief and Emergency Assistance Act (42 U.S.C. 5191(b)) 
                with respect to COVID-19 or any other coronavirus with 
                pandemic potential;
                    (B) an emergency declared by a Federal official 
                with respect to coronavirus (as defined in section 506 
                of the Coronavirus Preparedness and Response 
                Supplemental Appropriations Act, 2020 (Public Law 116-
                123));
                    (C) a national emergency declared by the President 
                under the National Emergencies Act (50 U.S.C. 1601 et 
                seq.) with respect to COVID-19 or any other coronavirus 
                with pandemic potential; and
                    (D) a public health emergency declared by the 
                Secretary of Health and Human Services pursuant to 
                section 319 of the Public Health Service Act (42 U.S.C. 
                247(d)) with respect to COVID-19 or any other 
                coronavirus with pandemic potential.
            (2) Coronavirus response law.--The term ``coronavirus 
        response law'' means--
                    (A) the Coronavirus Preparedness and Response 
                Supplemental Appropriations Act, 2020 (Public Law 116-
                123);
                    (B) the Families First Coronavirus Response Act 
                (Public Law 116-127);
                    (C) the Coronavirus Aid, Relief, and Economic 
                Security Act (Public Law 116-136); and
                    (D) any subsequent law enacted as a response to a 
                coronavirus public health emergency.
            (3) COVID-19.--The term ``COVID-19'' means the Coronavirus 
        Disease 2019.
            (4) Enforcement action.--The term ``enforcement action'' 
        means an apprehension, an arrest, a search, an interview, a 
        request for identification, or surveillance for the purposes of 
        immigration enforcement.
            (5) Sensitive location.--The term ``sensitive location'' 
        means all physical space located within 1,000 feet of--
                    (A) a medical treatment or health care facility, 
                including a hospital, an office of a health care 
                practitioner, an accredited health clinic, an alcohol 
                or drug treatment center, an emergent or urgent care 
                facility, and a community health center;
                    (B) a location at which emergency service providers 
                distribute food or provide shelter;
                    (C) an organization that provides--
                            (i) disaster or emergency social services 
                        and assistance;
                            (ii) services for individuals experiencing 
                        homelessness, including food banks and 
                        shelters; or
                            (iii) assistance for children, pregnant 
                        women, victims of crime or abuse, or 
                        individuals with significant mental or physical 
                        disabilities;
                    (D) a public assistance office, including any 
                Federal, State, or municipal location at which 
                individuals may apply for or receive unemployment 
                compensation or report violations of labor and 
                employment laws;
                    (E) a Federal, State, or local courthouse, 
                including the office of the legal counsel or 
                representative of an individual;
                    (F) a domestic violence shelter, rape crisis 
                center, supervised visitation center, family justice 
                center, or victim services provider;
                    (G) an office of the Social Security 
                Administration;
                    (H) a childcare facility or a school, including a 
                preschool, primary school, secondary school, post-
                secondary school up to and including a college or 
                university, and any other institution of learning such 
                as a vocational or trade school;
                    (I) a church, synagogue, mosque or any other 
                institution of worship, such as a building rented for 
                the purpose of a religious service;
                    (J) the site of a funeral, wedding, or any other 
                public religious ceremony;
                    (K) in the case of a jurisdiction in which a 
                shelter-in-place order is in effect during a 
                coronavirus public health emergency, any business 
                location considered to provide an essential service, 
                such as a pharmacy or a grocery store; and
                    (L) any other location specified by the Secretary 
                of Homeland Security.
    (b) Suspension of Adverse Immigration Actions That Deter Immigrant 
Communities From Seeking Health Services in a Public Health 
Emergency.--
            (1) In general.--Beginning on the date on which a 
        coronavirus public health emergency is declared and ending on 
        the date that is 60 days after the date on which the 
        coronavirus public health emergency expires--
                    (A) the Secretary of Homeland Security, the 
                Secretary of State, and the Attorney General shall 
                not--
                            (i) implement the final rule of the 
                        Department of Homeland Security entitled 
                        ``Inadmissibility on Public Charge Grounds'' 
                        (84 Fed. Reg. 41292 (August 14, 2019));
                            (ii) implement the interim final rule of 
                        the Department of State entitled ``Visas: 
                        Ineligibility Based on Public Charge Grounds'' 
                        (84 Fed. Reg. 54996 (October 11, 2019));
                            (iii) implement the proposed rule of the 
                        Department of Justice entitled 
                        ``Inadmissibility on Public Charge Grounds'' 
                        published in the Fall 2018 Uniform Regulatory 
                        Agenda;
                            (iv) conduct any enforcement action against 
                        an individual at, or in transit to or from, a 
                        sensitive location unless the enforcement 
                        action is conducted pursuant to a valid 
                        judicial warrant;
                            (v) detain or remove--
                                    (I) a survivor of domestic 
                                violence, sexual assault, or human 
                                trafficking, or any other individual, 
                                who has a pending application under 
                                section 101(a)(15)(T), 101(a)(15)(U), 
                                106, 240A(b)(2) of the Immigration and 
                                Nationality Act (8 U.S.C. 
                                1101(a)(15)(T), 1101(a)(15)(U), 1105a, 
                                1229b(b)(2)) or section 244(a)(3) of 
                                that Act (as in effect on March 31, 
                                1997); or
                                    (II) a VAWA self-petitioner 
                                described in section 101(a)(51) of that 
                                Act (8 U.S.C. 1101(a)(51)) who has a 
                                pending application for relief under--
                                            (aa) a provision referred 
                                        to in any of subparagraphs (A) 
                                        through (G) of that section; or
                                            (bb) section 101(a)(27)(J) 
                                        of that Act (8 U.S.C. 
                                        1101(a)(27)(J)); and
                            (vi) require an individual subject to 
                        supervision by U.S. Immigration and Customs 
                        Enforcement to report in person.
                    (B) The Attorney General shall conduct fully 
                telephonic bond hearings and allow supporting documents 
                to be faxed and emailed to the appropriate clerk.
                    (C) The Secretary of Homeland Security, to the 
                extent practicable, shall stipulate to bond 
                determinations on written motions.
            (2) Use of benefits funded by coronavirus response law.--
        The Secretary of Homeland Security, the Secretary of State, and 
        the Attorney General shall not consider in any determination 
        affecting the current or future immigration status of any 
        individual the use of any benefit of any program or activity 
        funded in whole or in part by amounts made available under a 
        coronavirus response law.
    (c) Access to COVID-19 Testing and Treatment for All Communities.--
            (1) Clarification regarding emergency services for certain 
        individuals.--Section 1903(v)(2) of the Social Security Act (42 
        U.S.C. 1396b(v)(2)) is amended by adding at the end the 
        following flush sentence:
    ``For purposes of subparagraph (A), care and services described in 
such subparagraph include any in vitro diagnostic product described in 
section 1905(a)(3)(B) that is administered during any portion of the 
emergency period described in such section beginning on or after the 
date of the enactment of this sentence (and the administration of such 
product), any COVID-19 vaccine that is administered during any such 
portion (and the administration of such vaccine), any item or service 
that is furnished during any such portion for the treatment of COVID-19 
or a condition that may complicate the treatment of COVID-19, and any 
services described in section 1916(a)(2)(G).''.
            (2) Emergency medicaid for individuals with suspected 
        covid-19 infections.--Section 1903(v)(3) of the Social Security 
        Act (42 U.S.C. 1396b(v)(3)) is amended by striking ``means a'' 
        and inserting ``means any concern that the individual may have 
        contracted COVID-19 or another.''.
            (3) Treatment of assistance and services provided.--For any 
        period during which a coronavirus public health emergency is in 
        effect--
                    (A) the value of assistance or services provided to 
                any person under a program with respect to which a 
                coronavirus response law establishes or expands 
                eligibility or benefits shall not be considered income 
                or resources; and
                    (B)(i) any medical coverage or services shall be 
                considered treatment for an emergency medical condition 
                (as defined in section 1903(v)(3) of the Social 
                Security Act (42 U.S.C. 1396b(v)(3))) for any purpose 
                under any Federal, State, or local law, including law 
                relating to taxation, welfare, and public assistance 
                programs;
                    (ii) a participating State or political subdivision 
                of a State shall not decrease any assistance otherwise 
                provided to an individual because of the receipt of 
                benefits under the Social Security Act (42 U.S.C. 301 
                et seq.); and
                    (iii) assistance and services described in this 
                subparagraph shall be considered noncash disaster 
                assistance, notwithstanding the form in which the 
                assistance and services are provided, except that cash 
                received by an individual or a household may be treated 
                as income by any public benefit program under the rules 
                applicable before the date of the enactment of this 
                Act.
            (4) Nondiscrimination.--No person shall be, on the basis of 
        actual or perceived immigration status, excluded from 
        participation in, denied the benefits of, or subject to 
        discrimination under, any program or activity funded in whole 
        or in part by amounts made available under a coronavirus 
        response law.
    (d) Language Access and Public Outreach for Public Health.--
            (1) Grants and cooperative agreements.--
                    (A) In general.--The Director of the Centers for 
                Disease Control and Prevention (referred to in this 
                subsection as the ``Director'') shall provide grants 
                to, or enter into cooperative agreements with, 
                community-based organizations for the purpose of 
                supporting culturally and linguistically appropriate 
                preparedness, response, and recovery activities, such 
                as the development of educational programs and 
                materials to promote screening, testing, treatment, and 
                public health practices.
                    (B) Definition of community-based organization.--In 
                this paragraph, the term ``community-based 
                organization'' means an entity that has established 
                relationships with hard-to-reach populations, including 
                racial and ethnic minorities, individuals with limited 
                English proficiency, and individuals with disabilities.
            (2) Translation.--
                    (A) In general.--The Director shall provide for the 
                translation of materials on awareness, screening, 
                testing, and treatment for COVID-19 into the languages 
                described in the language access plan of the Federal 
                Emergency Management Agency dated October 1, 2016, as 
                the languages most frequently encountered.
                    (B) Public availability.--Not later than 7 days 
                after the date on which the materials described in 
                subparagraph (A) are made available to the public in 
                English, the Director shall ensure that the 
                translations required by that subparagraph are made 
                available to the public.
            (3) Hotline.--The Director shall establish an informational 
        hotline line that provides, in the languages referred to in 
        paragraph (2)(A), information to the public directly on COVID-
        19.
            (4) Interagency coordination.--With respect to individuals 
        with limited English proficiency, the Director shall facilitate 
        interagency coordination among agencies activated through the 
        National Response Framework based on the language access 
        standards established under the language access plans of the 
        Federal Emergency Management Agency and the Department of 
        Health and Human Services.
            (5) Authorization of appropriations.--
                    (A) In general.--There is authorized to be 
                appropriated to carry out this subsection $100,000,000 
                for fiscal year 2020, to be available until expended.
                    (B) Grants and cooperative agreements.--Of the 
                amount authorized to be appropriated under subparagraph 
                (A), not less than $50,000,000 shall be made available 
                to carry out paragraph (1).
    (e) Access To Support Measures for Vulnerable Communities.--
            (1) Disaster supplemental nutrition assistance program 
        benefits.--The Robert T. Stafford Disaster Relief and Emergency 
        Assistance Act (42 U.S.C. 5121 et seq.) is amended--
                    (A) in section 102(1) (42 U.S.C. 5122(1)), by 
                inserting ``or pandemic'' after ``catastrophe'';
                    (B) in section 301 (42 U.S.C. 5141), by inserting 
                ``or an emergency due to a pandemic'' after ``major 
                disaster'' each place the term appears;
                    (C) in section 412 (42 U.S.C. 5179)--
                            (i) by inserting ``or an emergency due to a 
                        pandemic'' after ``major disaster'' each place 
                        the term appears;
                            (ii) in subsection (a), by inserting 
                        ``without regard to regular allotments'' before 
                        ``and to make surplus''; and
                            (iii) by adding at the end the following:
    ``(d) Assistance During a Pandemic.--In the case of an emergency 
due to a pandemic, for purposes of providing benefits under this 
section, the Secretary of Agriculture shall remove or delay the 
requirement of an in-person interview, and if an interview occurs, 
provide an alternative to the in-person interview requirement for all 
applicants. Assistance shall be provided based on need and not lost 
provisions.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section, only 
if such sums are designated by Congress as being for an emergency 
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 
and Emergency Deficit Control Act of 1985 (2 U.S.C. 
901(b)(2)(A)(i)).''; and
                    (D) in section 502(a) (42 U.S.C. 5192(a))--
                            (i) in paragraph (7), by striking ``and'' 
                        at the end;
                            (ii) in paragraph (8)(B), by striking the 
                        period at the end and inserting a semicolon; 
                        and
                            (iii) by adding at the end the following:
            ``(9) provide assistance in accordance with section 412.''.
            (2) Access to benefits using individual taxpayer 
        identification number.--Subsection (g)(2)(A) of section 6428 of 
        the Internal Revenue Code of 1986, as added by section 2201 of 
        the Coronavirus Aid, Relief, and Economic Security Act (Public 
        Law 116-136), is amended by inserting before the period at the 
        end ``or a taxpayer identification number''.
            (3) Extension of immigration status and employment 
        authorization.--
                    (A) In general.--Notwithstanding any other 
                provision of law, including the Immigration and 
                Nationality Act (8 U.S.C. 1101 et seq.), the Secretary 
                of Homeland Security shall automatically extend the 
                immigration status and employment authorization, as 
                applicable, of an alien described in subparagraph (B) 
                for the same period for which the status and employment 
                authorization was initially granted.
                    (B) Alien described.--An alien described in this 
                subparagraph is an alien (as defined in section 101(a) 
                of the Immigration and Nationality Act (8 U.S.C. 
                1101(a))) whose immigration status, including 
                permanent, temporary, and deferred status, or whose 
                employment authorization--
                            (i) expired during the 30-day period 
                        preceding the date of the enactment of this 
                        Act; or
                            (ii) will expire not later than--
                                    (I) one year after such date of 
                                enactment; or
                                    (II) 90 days after the date on 
                                which the national emergency declared 
                                by the President under the National 
                                Emergencies Act (50 U.S.C. 1601 et 
                                seq.) with respect to the Coronavirus 
                                Disease 2019 (COVID-19) is rescinded.
            (4) Language access.--Any agency receiving funding under a 
        coronavirus response law shall ensure that all programs and 
        opportunities made available to the general public provide 
        translated materials describing the programs and opportunities 
        into the languages described in the language access plan of the 
        Federal Emergency Management Agency dated October 1, 2016, as 
        the languages most frequently encountered.

SEC. 213. ICE DETENTION.

    (a) Reviewing ICE Detention.--During the public health emergency 
declared by the Secretary of Health and Human Services under section 
319 of the Public Health Service Act (42 U.S.C. 247d) with respect to 
COVID-19, the Secretary of Homeland Security shall review the 
immigration files of all individuals in the custody of U.S. Immigration 
and Customs Enforcement to assess the need for continued detention. The 
Secretary of Homeland Security shall prioritize for release on 
recognizance or alternatives to detention individuals who are not 
subject to mandatory detention laws, unless the individual is a threat 
to public safety or national security.
    (b) Access to Electronic Communications and Hygiene Products.--
During the period described in subsection (c), the Secretary of 
Homeland Security shall ensure that--
            (1) all individuals in the custody of U.S. Immigration and 
        Customs Enforcement--
                    (A) have access to telephonic or video 
                communication at no cost to the detained individual;
                    (B) have access to free, unmonitored telephone 
                calls, at any time, to contact attorneys or legal 
                service providers in a sufficiently private space to 
                protect confidentiality;
                    (C) are permitted to receive legal correspondence 
                by fax or email rather than postal mail; and
                    (D) are provided sufficient soap, hand sanitizer, 
                and other hygiene products; and
            (2) nonprofit organizations providing legal orientation 
        programming or know-your-rights programming to individuals in 
        the custody of U.S. Immigration and Customs Enforcement are 
        permitted broad and flexible access to such individuals--
                    (A) to provide group presentations using remote 
                videoconferencing; and
                    (B) to schedule and provide individual orientations 
                using free telephone calls or remote videoconferencing.
    (c) Period Described.--The period described in this subsection--
            (1) begins on the first day of the public health emergency 
        declared by the Secretary of Health and Human Services under 
        section 319 of the Public Health Service Act (42 U.S.C. 247d) 
        with respect to COVID-19; and
            (2) ends 90 days after the date on which such public health 
        emergency terminates.

                      Subtitle C--Contact Tracing

SEC. 221. COVID-19 TESTING, REACHING, AND CONTACTING EVERYONE.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Director of the Centers for Disease Control and Prevention, 
may award grants to eligible entities to conduct diagnostic testing for 
COVID-19, to trace and monitor the contacts of infected individuals, 
and to support the quarantine of such contacts, through--
            (1) mobile health units; and
            (2) as necessary, testing individuals and providing 
        individuals with services related to testing and quarantine at 
        their residences.
    (b) Permissible Uses of Funds.--A grant recipient under this 
section may use the grant funds, in support of the activities described 
in subsection (a)--
            (1) to hire, train, compensate, and pay the expenses of 
        individuals; and
            (2) to purchase personal protective equipment and other 
        supplies.
    (c) Priority.--In selecting grant recipients under this section, 
the Secretary shall give priority to--
            (1) applicants proposing to conduct activities funded under 
        this section in hot spots and medically underserved 
        communities; and
            (2) applicants that agree, in hiring individuals to carry 
        out activities funded under this section, to hire residents of 
        the area or community where the activities will primarily 
        occur, with higher priority among applicants described in this 
        paragraph given based on the percentage of individuals to be 
        hired from such area or community.
    (d) Distribution.--In selecting grant recipients under this 
section, the Secretary shall ensure that grants are distributed across 
urban and rural areas.
    (e) Federal Privacy Requirements.--Nothing in this section shall be 
construed to supersede any Federal privacy or confidentiality 
requirement, including the regulations promulgated under section 264(c) 
of the Health Insurance Portability and Accountability Act of 1996 
(Public Law 104-191; 110 Stat. 2033) and section 543 of the Public 
Health Service Act (42 U.S.C. 290dd-2).
    (f) Definitions.--In this section:
            (1) The term ``eligible entity'' means--
                    (A) a Federally qualified health center (as defined 
                in section 1861(aa) of the Social Security Act (42 
                U.S.C. 1395x(aa)));
                    (B) a school-based health clinic;
                    (C) a disproportionate share hospital (as defined 
                under the applicable State plan under title XIX of the 
                Social Security Act (42 U.S.C. 1396 et seq.) pursuant 
                to section 1923(a)(1)(A) of such Act (42 U.S.C. 1396r-
                4));
                    (D) an academic medical center;
                    (E) a nonprofit organization (including any such 
                faith-based organization);
                    (F) an institution of higher education (as defined 
                in section 101 of the Higher Education Act of 1965 (20 
                U.S.C. 1001));
                    (G) a high school (as defined in section 8101 of 
                the Elementary and Secondary Education Act of 1965 (20 
                U.S.C. 7801));
                    (H) any Tribal organization including the Indian 
                Health Service and Native American servicing 
                facilities; or
                    (I) any other type of entity that is determined by 
                the Secretary to be an eligible entity for purposes of 
                this section.
            (2) The term ``emergency period'' has the meaning given to 
        that term in section 1135(g)(1)(B) of the Social Security Act 
        (42 U.S.C. 1320b-5(g)(1)(B)).
            (3) The term ``hot spot'' means a geographic area where the 
        rate of infection with the virus that causes COVID-19 exceeds 
        the national average.
            (4) The term ``medically underserved community'' has the 
        meaning given to that term in section 799B of the Public Health 
        Service Act (42 U.S.C. 295p).
            (5) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
    (g) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated--
            (1) $100,000,000,000 for fiscal year 2020; and
            (2) such sums as may be necessary for each of fiscal year 
        2021 and any subsequent fiscal year during which the emergency 
        period continues.

SEC. 222. NATIONAL SYSTEM FOR COVID-19 TESTING, CONTACT TRACING, 
              SURVEILLANCE, CONTAINMENT, AND MITIGATION.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Director of the Centers for Disease Control and Prevention, and in 
coordination with State, local, Tribal, and territorial health 
departments, shall establish and implement a nationwide evidence-based 
system for--
            (1) testing, contact tracing, surveillance, containment, 
        and mitigation with respect to COVID-19;
            (2) offering guidance on voluntary isolation and quarantine 
        of individuals infected with, or exposed to individuals 
        infected with, the virus that causes COVID-19; and
            (3) public reporting on testing, contact tracing, 
        surveillance, and voluntary isolation and quarantine activities 
        with respect to COVID-19.
    (b) Coordination; Technical Assistance.--In carrying out the 
national system under this section, the Secretary shall--
            (1) coordinate State, local, Tribal, and territorial 
        activities related to testing, contact tracing, surveillance, 
        containment, and mitigation with respect to COVID-19, as 
        appropriate; and
            (2) provide technical assistance for such activities, as 
        appropriate.
    (c) Consideration.--In establishing and implementing the national 
system under this section, the Secretary shall take into 
consideration--
            (1) the State plans referred to in the heading ``Public 
        Health and Social Services Emergency Fund'' in title I of 
        division B of the Paycheck Protection Program and Health Care 
        Enhancement Act (Public Law 116-139); and
            (2) the testing strategy submitted under section 211.
    (d) Reporting.--The Secretary shall--
            (1) not later than December 31, 2020, submit to the 
        Committee on Energy and Commerce of the House of 
        Representatives and the Committee on Health, Education, Labor, 
        and Pensions a preliminary report on the effectiveness of the 
        activities carried out pursuant to this subtitle; and
            (2) not later than December 21, 2021, submit to such 
        committees a final report on such effectiveness.

SEC. 223. GRANTS.

    (a) In General.--To implement the national system under section 
222, the Secretary of Health and Human Services (referred to in this 
section as the ``Secretary''), acting through the Director of the 
Centers for Disease Control and Prevention, shall, subject to the 
availability of appropriations, award grants to State, local, Tribal, 
and territorial health departments that seek grants under this section 
to carry out coordinated testing, contact tracing, surveillance, 
containment, and mitigation with respect to COVID-19, including--
            (1) diagnostic and surveillance testing and reporting;
            (2) community-based contact tracing efforts; and
            (3) policies related to voluntary isolation and quarantine 
        of individuals infected with, or exposed to individuals 
        infected with, the virus that causes COVID-19.
    (b) Flexibility.--The Secretary shall ensure that--
            (1) the grants under subsection (a) provide flexibility for 
        State, local, Tribal, and territorial health departments to 
        modify, establish, or maintain evidence-based systems; and
            (2) local health departments receive funding from State 
        health departments or directly from the Centers for Disease 
        Control and Prevention to contribute to such systems, as 
        appropriate.
    (c) Allocations.--
            (1) Formula.--The Secretary, acting through the Director of 
        the Centers for Disease Control and Prevention, shall allocate 
        amounts made available pursuant to subsection (a) in accordance 
        with a formula to be established by the Secretary that provides 
        a minimum level of funding to each State, local, Tribal, and 
        territorial health department that seeks a grant under this 
        section and allocates additional funding based on the following 
        prioritization:
                    (A) The Secretary shall give highest priority to 
                applicants proposing to serve populations in one or 
                more geographic regions with a high burden of COVID-19 
                based on data provided by the Centers for Disease 
                Control and Prevention, or other sources as determined 
                by the Secretary.
                    (B) The Secretary shall give second highest 
                priority to applicants preparing for, or currently 
                working to mitigate, a COVID-19 surge in a geographic 
                region that does not yet have a high number of reported 
                cases of COVID-19 based on data provided by the Centers 
                for Disease Control and Prevention, or other sources as 
                determined by the Secretary.
                    (C) The Secretary shall give third highest priority 
                to applicants proposing to serve high numbers of low-
                income and uninsured populations, including medically 
                underserved populations (as defined in section 
                330(b)(3) of the Public Health Service Act (42 U.S.C. 
                254b(b)(3))), health professional shortage areas (as 
                defined under section 332(a) of the Public Health 
                Service Act (42 U.S.C. 254e(a))), racial and ethnic 
                minorities, or geographically diverse areas, as 
                determined by the Secretary.
            (2) Notification.--Not later than the date that is one week 
        before first awarding grants under this section, the Secretary 
        shall submit to the Committee on Energy and Commerce of the 
        House of Representatives and the Committee on Health, 
        Education, Labor, and Pensions of the Senate a notification 
        detailing the formula established under paragraph (1) for 
        allocating amounts made available pursuant to subsection (a).
    (d) Use of Funds.--A State, local, Tribal, and territorial health 
department receiving a grant under this section shall, to the extent 
possible, use the grant funds for the following activities, or other 
activities deemed appropriate by the Director of the Centers for 
Disease Control and Prevention:
            (1) Testing.--To implement a coordinated testing system 
        that--
                    (A) leverages or modernizes existing testing 
                infrastructure and capacity;
                    (B) is consistent with the updated testing strategy 
                required under section 211;
                    (C) is coordinated with the State plan for COVID-19 
                testing prepared as required under the heading 
                ``Department of Health and Human Services--Office of 
                the Secretary--Public Health and Social Service 
                Emergency Fund'' in title I of division B of the 
                Paycheck Protection Program and Health Care Enhancement 
                Act (Public Law 116-139; 134 Stat. 620, 624);
                    (D) is informed by contact tracing and surveillance 
                activities under this subtitle;
                    (E) is informed by guidelines established by the 
                Centers for Disease Control and Prevention for which 
                populations should be tested;
                    (F) identifies how diagnostic and serological tests 
                in such system shall be validated prior to use;
                    (G) identifies how diagnostic and serological tests 
                and testing supplies will be distributed to implement 
                such system;
                    (H) identifies specific strategies for ensuring 
                testing capabilities and accessibility in medically 
                underserved populations (as defined in section 
                330(b)(3) of the Public Health Service Act (42 U.S.C. 
                254b(b)(3))), health professional shortage areas (as 
                defined under section 332(a) of the Public Health 
                Service Act (42 U.S.C. 254e(a))), racial and ethnic 
                minority populations, and geographically diverse areas, 
                as determined by the Secretary;
                    (I) identifies how testing may be used, and results 
                may be reported, in both health care settings (such as 
                hospitals, laboratories for moderate or high-complexity 
                testing, pharmacies, mobile testing units, and 
                community health centers) and non-health care settings 
                (such as workplaces, schools, childcare centers, or 
                drive-throughs);
                    (J) allows for testing in sentinel surveillance 
                programs, as appropriate; and
                    (K) supports the procurement and distribution of 
                diagnostic and serological tests and testing supplies 
                to meet the goals of the system.
            (2) Contact tracing.--To implement a coordinated contact 
        tracing system that--
                    (A) leverages or modernizes existing contact 
                tracing systems and capabilities, including community 
                health workers, health departments, and Federally 
                qualified health centers;
                    (B) is able to investigate cases of COVID-19, and 
                help to identify other potential cases of COVID-19, 
                through tracing contacts of individuals with positive 
                diagnoses;
                    (C) establishes culturally competent and 
                multilingual strategies for contact tracing, which may 
                include consultation with and support for cultural or 
                civic organizations with established ties to the 
                community;
                    (D) provides individuals identified under the 
                contact tracing program with information and support 
                for containment or mitigation;
                    (E) enables State, local, Tribal, and territorial 
                health departments to work with a nongovernmental, 
                community partner or partners and State and local 
                workforce development systems (as defined in section 
                3(67) of Workforce Innovation and Opportunity Act (29 
                U.S.C. 3102(67))) receiving grants under section 224(b) 
                of this Act to hire and compensate a locally sourced 
                contact tracing workforce, if necessary, to supplement 
                the public health workforce, to--
                            (i) identify the number of contact tracers 
                        needed for the respective State, locality, 
                        territorial, or Tribal health department to 
                        identify all cases of COVID-19 currently in the 
                        jurisdiction and those anticipated to emerge 
                        over the next 18 months in such jurisdiction;
                            (ii) outline qualifications necessary for 
                        contact tracers;
                            (iii) train the existing and newly hired 
                        public health workforce on best practices 
                        related to tracing close contacts of 
                        individuals diagnosed with COVID-19, including 
                        the protection of individual privacy and 
                        cybersecurity protection; and
                            (iv) equip the public health workforce with 
                        tools and resources to enable a rapid response 
                        to new cases;
                    (F) identifies the level of contact tracing needed 
                within the State, locality, territory, or Tribal area 
                to contain and mitigate the transmission of COVID-19;
                    (G) establishes statewide mechanisms to integrate 
                regular evaluation to the Centers for Disease Control 
                and Prevention regarding contact tracing efforts, makes 
                such evaluation publicly available, and to the extent 
                possible provides for such evaluation at the county 
                level; and
                    (H) identifies specific strategies for ensuring 
                contact tracing activities in medically underserved 
                populations (as defined in section 330(b)(3) of the 
                Public Health Service Act (42 U.S.C. 254b(b)(3))), 
                health professional shortage areas (as defined under 
                section 332(a) of the Public Health Service Act (42 
                U.S.C. 254e(a))), racial and ethnic minority 
                populations, and geographically diverse areas, as 
                determined by the Secretary.
            (3) Surveillance.--To strengthen the existing public health 
        surveillance system that--
                    (A) leverages or modernizes existing surveillance 
                systems within the respective State, local, Tribal, or 
                territorial health department and national surveillance 
                systems;
                    (B) detects and identifies trends in COVID-19 at 
                the county level;
                    (C) evaluates State, local, Tribal, and territorial 
                health departments in achieving surveillance 
                capabilities with respect to COVID-19;
                    (D) integrates and improves disease surveillance 
                and immunization tracking; and
                    (E) identifies specific strategies for ensuring 
                disease surveillance in medically underserved 
                populations (as defined in section 330(b)(3) of the 
                Public Health Service Act (42 U.S.C. 254b(b)(3))), 
                health professional shortage areas (as defined under 
                section 332(a) of the Public Health Service Act (42 
                U.S.C. 254e(a))), racial and ethnic minority 
                populations, and geographically diverse areas, as 
                determined by the Secretary.
            (4) Containment and mitigation.--To implement a coordinated 
        containment and mitigation system that--
                    (A) leverages or modernizes existing containment 
                and mitigation strategies within the respective State, 
                local, Tribal, or territorial governments and national 
                containment and mitigation strategies;
                    (B) may provide for, connect to, and leverage 
                existing social services and support for individuals 
                who have been infected with or exposed to COVID-19 and 
                who are isolated or quarantined in their homes, such as 
                through--
                            (i) food assistance programs;
                            (ii) guidance for household infection 
                        control;
                            (iii) information and assistance with 
                        childcare services; and
                            (iv) information and assistance pertaining 
                        to support available under the CARES Act 
                        (Public Law 116-136) and this Act;
                    (C) provides guidance on the establishment of safe, 
                high-quality, facilities for the voluntary isolation of 
                individuals infected with, or quarantine of the 
                contacts of individuals exposed to COVID-19, where 
                hospitalization is not required, which facilities 
                should--
                            (i) be prohibited from making inquiries 
                        relating to the citizenship status of an 
                        individual isolated or quarantined; and
                            (ii) be operated by a non-Federal, 
                        community partner or partners that--
                                    (I) have previously established 
                                relationships in localities;
                                    (II) work with local places of 
                                worship, community centers, medical 
                                facilities, and schools to recruit 
                                local staff for such facilities; and
                                    (III) are fully integrated into 
                                State, local, Tribal, or territorial 
                                containment and mitigation efforts; and
                    (D) identifies specific strategies for ensuring 
                containment and mitigation activities in medically 
                underserved populations (as defined in section 
                330(b)(3) of the Public Health Service Act (42 U.S.C. 
                254b(b)(3))), health professional shortage areas (as 
                defined under section 332(a) of the Public Health 
                Service Act (42 U.S.C. 254e(a))), racial and ethnic 
                minority populations, and geographically diverse areas, 
                as determined by the Secretary.
    (e) Reporting.--The Secretary shall facilitate mechanisms for 
timely, standardized reporting by grantees under this section regarding 
implementation of the systems established under this section and 
coordinated processes with the reporting as required and under the 
heading ``Department of Health and Human Services--Office of the 
Secretary--Public Health and Social Service Emergency Fund'' in title I 
of division B of the Paycheck Protection Program and Health Care 
Enhancement Act (Public Law 116-139, 134 Stat. 620), including--
            (1) a summary of county or local health department level 
        information from the States receiving funding, and information 
        from directly funded localities, territories, and Tribal 
        entities, about the activities that will be undertaken using 
        funding awarded under this section, including subgrants;
            (2) any anticipated shortages of required materials for 
        testing for COVID-19 under subsection (a); and
            (3) other barriers in the prevention, mitigation, or 
        treatment of COVID-19 under this section.
    (f) Public Listing of Awards.--The Secretary shall--
            (1) not later than 7 days after first awarding grants under 
        this section, post in a searchable, electronic format a list of 
        all awards made by the Secretary under this section, including 
        the recipients and amounts of such awards; and
            (2) update such list not less than every 7 days until all 
        funds made available to carry out this section are expended.

SEC. 224. GRANTS TO STATE AND TRIBAL WORKFORCE AGENCIES.

    (a) Definitions.--In this section:
            (1) In general.--Except as otherwise provided, the terms in 
        this section have the meanings given the terms in section 3 of 
        the Workforce Innovation and Opportunity Act (29 U.S.C. 3102).
            (2) Apprenticeship; apprenticeship program.--The term 
        ``apprenticeship'' or ``apprenticeship program'' means an 
        apprenticeship program registered under the Act of August 16, 
        1937 (commonly known as the ``National Apprenticeship Act'') 
        (50 Stat. 664, chapter 663; 29 U.S.C. 50 et seq.), including 
        any requirement, standard, or rule promulgated under such Act, 
        as such requirement, standard, or rule was in effect on 
        December 30, 2019.
            (3) Contact tracing and related positions.--The term 
        ``contact tracing and related positions'' means employment 
        related to contact tracing, surveillance, containment, and 
        mitigation activities as described in paragraphs (2), (3), and 
        (4) of section 223(d).
            (4) Eligible entity.--The term ``eligible entity'' means--
                    (A) a State or territory, including the District of 
                Columbia and Puerto Rico;
                    (B) an Indian Tribe, Tribal organization, Alaska 
                Native entity, Indian-controlled organizations serving 
                Indians, or Native Hawaiian organizations;
                    (C) an outlying area; or
                    (D) a local board, if an eligible entity under 
                subparagraphs (A) through (C) has not applied with 
                respect to the area over which the local board has 
                jurisdiction as of the date on which the local board 
                submits an application under subsection (c).
            (5) Eligible individual.--Notwithstanding section 170(b)(2) 
        of the Workforce Innovation and Opportunity Act (29 U.S.C. 
        3225(b)(2)), the term ``eligible individual'' means an 
        individual seeking or securing employment in contact tracing 
        and related positions and served by an eligible entity or 
        community-based organization receiving funding under this 
        section.
            (6) Secretary.--The term ``Secretary'' means the Secretary 
        of Labor.
    (b) Grants.--
            (1) In general.--Subject to the availability of 
        appropriations under subsection (g), the Secretary shall award 
        national dislocated worker grants under section 170(b)(1)(B) of 
        the Workforce Innovation and Opportunity Act (29 U.S.C. 
        3225(b)(1)(B)) to each eligible entity that seeks a grant to 
        assist local boards and community-based organizations in 
        carrying out activities under subsections (f) and (d), 
        respectively, for the following purposes:
                    (A) To support the recruitment, placement, and 
                training, as applicable, of eligible individuals 
                seeking employment in contact tracing and related 
                positions in accordance with the national system for 
                COVID-19 testing, contact tracing, surveillance, 
                containment, and mitigation established under section 
                222.
                    (B) To assist with the employment transition to new 
                employment or education and training of individuals 
                employed under this section in preparation for and upon 
                termination of such employment.
            (2) Timeline.--The Secretary of Labor shall--
                    (A) issue application requirements under subsection 
                (c) not later than 10 days after the date of enactment 
                of this section; and
                    (B) award grants to an eligible entity under 
                paragraph (1) not later than 10 days after the date on 
                which the Secretary receives an application from such 
                entity.
    (c) Grant Application.--An eligible entity applying for a grant 
under this section shall submit an application to the Secretary, at 
such time and in such form and manner as the Secretary may reasonably 
require, which shall include a description of--
            (1) how the eligible entity will support the recruitment, 
        placement, and training, as applicable, of eligible individuals 
        seeking employment in contact tracing and related positions by 
        partnering with--
                    (A) a State, local, Tribal, or territorial health 
                department; or
                    (B) one or more nonprofit or community-based 
                organizations partnering with such health departments;
            (2) how the activities described in paragraph (1) will 
        support State efforts to address the demand for contact tracing 
        and related positions with respect to--
                    (A) the State plans referred to in the heading 
                ``Public Health and Social Services Emergency Fund'' in 
                title I of division B of the Paycheck Protection 
                Program and Health Care Enhancement Act (Public Law 
                116-139);
                    (B) the testing strategy submitted under section 
                211; and
                    (C) the number of eligible individuals that the 
                State plans to recruit and train under the plans and 
                strategies described in subparagraphs (A) and (B);
            (3) the specific strategies for recruiting and placement of 
        eligible individuals from or residing within the communities in 
        which they will work, including--
                    (A) plans for the recruitment of eligible 
                individuals to serve as contact tracers and related 
                positions, including dislocated workers, individuals 
                with barriers to employment, veterans, new entrants in 
                the workforce, or underemployed or furloughed workers, 
                who are from or reside in or near the local area in 
                which they will serve, and who, to the extent 
                practicable--
                            (i) have experience or a background in 
                        industry-sectors and occupations such as public 
                        health, social services, customer service, case 
                        management, or occupations that require related 
                        qualifications, skills, or competencies, such 
                        as strong interpersonal and communication 
                        skills, needed for contact tracing and related 
                        positions, as described in section 
                        223(d)(2)(E)(ii); or
                            (ii) seek to transition to public health 
                        and public health related occupations upon the 
                        conclusion of employment in contact tracing and 
                        related positions; and
                    (B) how such strategies will take into account the 
                diversity of such community, including racial, ethnic, 
                socioeconomic, linguistic, or geographic diversity;
            (4) the amount, timing, and mechanisms for distribution of 
        funds provided to local boards or through subgrants as 
        described in subsection (d);
            (5) for eligible entities described in subparagraphs (A) 
        through (C) of subsection (a)(4), a description of how the 
        eligible entity will ensure the equitable distribution of funds 
        with respect to--
                    (A) geography (such as urban and rural 
                distribution);
                    (B) medically underserved populations (as defined 
                in section 33(b)(3) of the Public Health Service Act 
                (42 U.S.C. 254b(b)));
                    (C) health professional shortage areas (as defined 
                under section 332(a) of the Public Health Service Act 
                (42 U.S.C. 254e(a))); and
                    (D) the racial and ethnic diversity of the area; 
                and
            (6) for eligible entities who are local boards, a 
        description of how a grant to such eligible entity would serve 
        the equitable distribution of funds as described in paragraph 
        (5).
    (d) Subgrant Authorization and Application Process.--
            (1) In general.--An eligible entity may award a subgrant to 
        one or more community-based organizations for the purposes of 
        partnering with a State or local board to conduct outreach and 
        education activities to inform potentially eligible individuals 
        about employment opportunities in contact tracing and related 
        positions.
            (2) Application.--A community-based organization shall 
        submit an application at such time and in such manner as the 
        eligible entity may reasonably require, including--
                    (A) a demonstration of the community-based 
                organization's established expertise and effectiveness 
                in community outreach in the local area that such 
                organization plans to serve;
                    (B) a demonstration of the community-based 
                organization's expertise in providing employment or 
                public health information to the local areas in which 
                such organization plans to serve; and
                    (C) a description of the expertise of the 
                community-based organization in utilizing culturally 
                competent and multilingual strategies in the provision 
                of services.
    (e) Grant Distribution.--
            (1) Federal distribution.--
                    (A) Use of funds.-- The Secretary of Labor shall 
                use the funds appropriated to carry out this section as 
                follows:
                            (i) Subject to clause (ii), the Secretary 
                        shall distribute funds among eligible entities 
                        in accordance with a formula to be established 
                        by the Secretary that provides a minimum level 
                        of funding to each eligible entity that seeks a 
                        grant under this section and allocates 
                        additional funding as follows:
                                    (I) The formula shall give first 
                                priority based on the number and 
                                proportion of contact tracing and 
                                related positions that the State plans 
                                to recruit, place, and train 
                                individuals as a part of the State 
                                strategy described in subsection 
                                (c)(2)(A).
                                    (II) Subject to subclause (I), the 
                                formula shall give priority in 
                                accordance with section 223(c).
                            (ii) Not more than 2 percent of the funding 
                        for administration of the grants and for 
                        providing technical assistance to recipients of 
                        funds under this section.
                    (B) Equitable distribution.--If the geographic 
                region served by one or more eligible entities 
                overlaps, the Secretary shall distribute funds among 
                such entities in such a manner that ensures equitable 
                distribution with respect to the factors under 
                subsection (c)(5).
            (2) Eligible entity use of funds.--An eligible entity 
        described in subparagraphs (A) through (C) of subsection 
        (a)(4)--
                    (A) shall, not later than 30 days after the date on 
                which the entity receives grant funds under this 
                section, provide not less than 70 percent of grant 
                funds to local boards for the purpose of carrying out 
                activities in subsection (f);
                    (B) may use up to 20 percent of such funds to make 
                subgrants to community-based organizations in the 
                service area to conduct outreach, to potential eligible 
                individuals, as described in subsection (d);
                    (C) in providing funds to local boards and awarding 
                subgrants under this subsection shall ensure the 
                equitable distribution with respect to the factors 
                described in subsection (c)(5); and
                    (D) may use not more than 10 percent of the funds 
                awarded under this section for the administrative costs 
                of carrying out the grant and for providing technical 
                assistance to local boards and community-based 
                organizations.
            (3) Local board use of funds.--A local board, or an 
        eligible entity that is a local board, shall use--
                    (A) not less than 60 percent of the funds for 
                recruitment and training for COVID-19 testing, contact 
                tracing, surveillance, containment, and mitigation 
                established under section 222;
                    (B) not less than 30 percent of the funds to 
                support the transition of individuals hired as contact 
                tracers and related positions into an education or 
                training program, or unsubsidized employment upon 
                completion of such positions; and
                    (C) not more than 10 percent of the funds for 
                administrative costs.
    (f) Eligible Activities.--The State or local boards shall use funds 
awarded under this section to support the recruitment and placement of 
eligible individuals, training and employment transition as related to 
contact tracing and related positions, and for the following 
activities:
            (1) Establishing or expanding partnerships with--
                    (A) State, local, Tribal, and territorial public 
                health departments;
                    (B) community-based health providers, including 
                community health centers and rural health clinics;
                    (C) labor organizations or joint labor management 
                organizations;
                    (D) two-year and four-year institutions of higher 
                education (as defined in section 101 of the Higher 
                Education Act of 1965 (20 U.S.C. 1001)), including 
                institutions eligible to receive funds under section 
                371(a) of the Higher Education Act of 1965 (20 U.S.C. 
                1067q(a)); and
                    (E) community action agencies or other community-
                based organizations serving local areas in which there 
                is a demand for contact tracing and related positions.
            (2) Providing training for contact tracing and related 
        positions in coordination with State, local, Tribal, or 
        territorial health departments that is consistent with the 
        State or territorial testing and contact tracing strategy, and 
        ensuring that eligible individuals receive compensation while 
        participating in such training.
            (3) Providing eligible individuals with--
                    (A) adequate and safe equipment, environments, and 
                facilities for training and supervision, as applicable;
                    (B) information regarding the wages and benefits 
                related to contact tracing and related positions, as 
                compared to State, local, and national averages;
                    (C) supplies and equipment needed by the eligible 
                individuals to support placement of an individual in 
                contact tracing and related positions, as applicable;
                    (D) an individualized employment plan for each 
                eligible individual, as applicable--
                            (i) in coordination with the entity 
                        employing the eligible individual in a contact 
                        tracing and related positions; and
                            (ii) which shall include providing a case 
                        manager to work with each eligible individual 
                        to develop the plan, which may include--
                                    (I) identifying employment and 
                                career goals, and setting appropriate 
                                achievement objectives to attain such 
                                goals; and
                                    (II) exploring career pathways that 
                                lead to in-demand industries and 
                                sectors, including in public health and 
                                related occupations; and
                    (E) services for the period during which the 
                eligible individual is employed in a contact tracing 
                and related position to ensure job retention, which may 
                include--
                            (i) supportive services throughout the term 
                        of employment;
                            (ii) a continuation of skills training as 
                        related to employment in contact tracing and 
                        related positions, that is conducted in 
                        collaboration with the employers of such 
                        individuals;
                            (iii) mentorship services and job retention 
                        support for eligible individuals; or
                            (iv) targeted training for managers and 
                        workers working with eligible individuals (such 
                        as mentors), and human resource 
                        representatives.
            (4) Supporting the transition and placement in unsubsidized 
        employment for eligible individuals serving in contact tracing 
        and related positions after such positions are no longer 
        necessary in the State or local area, including--
                    (A) any additional training and employment 
                activities as described in section 170(d)(4) of the 
                Workforce Innovation and Opportunity Act (29 U.S.C. 
                3225(d)(4));
                    (B) developing the appropriate combination of 
                services to enable the eligible individual to achieve 
                the employment and career goals identified under 
                paragraph (3)(D)(ii)(I); and
                    (C) services to assist eligible individuals in 
                maintaining employment for not less than 12 months 
                after the completion of employment in contact tracing 
                and related positions, as appropriate.
            (5) Any other activities as described in subsections (a)(3) 
        and (b) of section 134 of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3174).
    (g) Limitation.--Notwithstanding section 170(d)(3)(A) of the 
Workforce Innovation and Opportunity Act (29 U.S.C. 3225(d)(3)(A)), a 
person may be employed in a contact tracing and related positions using 
funds under this section for a period not greater than 2 years.
    (h) Reporting by the Department of Labor.--
            (1) In general.--Not later than 120 days of the enactment 
        of this Act, and once grant funds have been expended under this 
        section, the Secretary shall report to the Committee on 
        Education and Labor of the House of Representatives and the 
        Committee on Health, Education, Labor, and Pensions of the 
        Senate, and make publicly available a report containing a 
        description of--
                    (A) the number of eligible individuals recruited, 
                hired, and trained in contact tracing and related 
                positions;
                    (B) the number of individuals successfully 
                transitioned to unsubsidized employment or training at 
                the completion of employment in contact tracing and 
                related positions using funds under this subtitle;
                    (C) the number of such individuals who were 
                unemployed prior to being hired, trained, or deployed 
                as described in paragraph (1);
                    (D) the performance of each program supported by 
                funds under this subtitle with respect to the 
                indicators of performance under section 116 of the 
                Workforce Innovation and Opportunity Act (29 U.S.C. 
                3141), as applicable;
                    (E) the number of individuals in unsubsidized 
                employment within six months and 1 year, respectively, 
                of the conclusion of employment in contact tracing and 
                related positions and, of those, the number of 
                individuals within a State, territorial, or local 
                public health department in an occupation related to 
                public health;
                    (F) any information on how eligible entities, local 
                boards, or community-based organizations that received 
                funding under this subsection were able to support the 
                goals of the national system for COVID-19 testing, 
                contact tracing, surveillance, containment, and 
                mitigation established under section 222 of this Act; 
                and
                    (G) best practices for improving and increasing the 
                transition of individuals employed in contract tracing 
                and related positions to unsubsidized employment.
            (2) Disaggregation.--All data reported under paragraph (1) 
        shall be disaggregated by race, ethnicity, sex, age, and, with 
        respect to individuals with barriers to employment, 
        subpopulation of such individuals, except for when the number 
        of participants in a category is insufficient to yield 
        statistically reliable information or when the results would 
        reveal personally identifiable information about an individual 
        participant.
    (i) Special Rule.--Any funds used for programs under this section 
that are used to fund an apprenticeship or apprenticeship program shall 
only be used for, or provided to, an apprenticeship or apprenticeship 
program that meets the definition of such term subsection (a) of this 
section, including any funds awarded for the purposes of grants, 
contracts, or cooperative agreements, or the development, 
implementation, or administration, of an apprenticeship or an 
apprenticeship program.
    (j) Information Sharing Requirement for HHS.--The Secretary of 
Health and Human Services, acting through the Director of the Centers 
for Disease Control and Prevention, shall provide the Secretary of 
Labor, acting through the Assistant Secretary of the Employment and 
Training Administration, with information on grants under section 223, 
including--
            (1) the formula used to award such grants to State, local, 
        Tribal, and territorial health departments;
            (2) the dollar amounts of and scope of the work funded 
        under such grants;
            (3) the geographic areas served by eligible entities that 
        receive such grants; and
            (4) the number of contact tracers and related positions to 
        be hired using such grants.
    (k) Authorization of Appropriations.--Of the amounts appropriated 
to carry out this subtitle, $500,000,000 shall be used by the Secretary 
of Labor to carry out subsections (a) through (h) of this section.

              TITLE III--FREE TREATMENT FOR ALL AMERICANS

SEC. 301. COVERAGE AT NO COST SHARING OF COVID-19 VACCINE AND 
              TREATMENT.

    (a) Medicaid.--
            (1) In general.--Section 1905(a)(4) of the Social Security 
        Act (42 U.S.C. 1396d(a)(4)) is amended--
                    (A) by striking ``and (D)'' and inserting ``(D)''; 
                and
                    (B) by striking the semicolon at the end and 
                inserting ``; (E) during the portion of the emergency 
                period described in paragraph (1)(B) of section 1135(g) 
                beginning on the date of the enactment of The Heroes 
                Act, a COVID-19 vaccine licensed under section 351 of 
                the Public Health Service Act, or approved or 
                authorized under sections 505 or 564 of the Federal 
                Food, Drug, and Cosmetic Act, and administration of the 
                vaccine; and (F) during such portion of the emergency 
                period described in paragraph (1)(B) of section 
                1135(g), items or services for the prevention or 
                treatment of COVID-19, including drugs approved or 
                authorized under such section 505 or such section 564 
                or, without regard to the requirements of section 
                1902(a)(10)(B) (relating to comparability), in the case 
                of an individual who is diagnosed with or presumed to 
                have COVID-19, during such portion of such emergency 
                period during which such individual is infected (or 
                presumed infected) with COVID-19, the treatment of a 
                condition that may complicate the treatment of COVID-
                19;''.
            (2) Prohibition of cost sharing.--
                    (A) In general.--Subsections (a)(2) and (b)(2) of 
                section 1916 of the Social Security Act (42 U.S.C. 
                1396o) are each amended--
                            (i) in subparagraph (F), by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (G), by striking ``; 
                        and'' and inserting ``;''; and
                            (iii) by adding at the end the following 
                        subparagraphs:
                    ``(H) during the portion of the emergency period 
                described in paragraph (1)(B) of section 1135(g) 
                beginning on the date of the enactment of this 
                subparagraph, a COVID-19 vaccine licensed under section 
                351 of the Public Health Service Act, or approved or 
                authorized under section 505 or 564 of the Federal 
                Food, Drug, and Cosmetic Act, and the administration of 
                such vaccine; or
                    ``(I) during such portion of the emergency period 
                described in paragraph (1)(B) of section 1135(g), any 
                item or service furnished for the treatment of COVID-
                19, including drugs approved or authorized under such 
                section 505 or such section 564 or, in the case of an 
                individual who is diagnosed with or presumed to have 
                COVID-19, during the portion of such emergency period 
                during which such individual is infected (or presumed 
                infected) with COVID-19, the treatment of a condition 
                that may complicate the treatment of COVID-19; and''.
                    (B) Application to alternative cost sharing.--
                Section 1916A(b)(3)(B) of the Social Security Act (42 
                U.S.C. 1396o-1(b)(3)(B)) is amended--
                            (i) in clause (xi), by striking ``any 
                        visit'' and inserting ``any service''; and
                            (ii) by adding at the end the following 
                        clauses:
                            ``(xii) During the portion of the emergency 
                        period described in paragraph (1)(B) of section 
                        1135(g) beginning on the date of the enactment 
                        of this clause, a COVID-19 vaccine licensed 
                        under section 351 of the Public Health Service 
                        Act, or approved or authorized under section 
                        505 or 564 of the Federal Food, Drug, and 
                        Cosmetic Act, and the administration of such 
                        vaccine.
                            ``(xiii) During such portion of the 
                        emergency period described in paragraph (1)(B) 
                        of section 1135(g), an item or service 
                        furnished for the treatment of COVID-19, 
                        including drugs approved or authorized under 
                        such section 505 or such section 564 or, in the 
                        case of an individual who is diagnosed with or 
                        presumed to have COVID-19, during such portion 
                        of such emergency period during which such 
                        individual is infected (or presumed infected) 
                        with COVID-19, the treatment of a condition 
                        that may complicate the treatment of COVID-
                        19.''.
                    (C) Clarification.--The amendments made by this 
                subsection shall apply with respect to a State plan of 
                a territory in the same manner as a State plan of one 
                of the 50 States.
    (b) State Pediatric Vaccine Distribution Program.--Section 1928 of 
the Social Security Act (42 U.S.C. 1396s) is amended--
            (1) in subsection (a)(1)--
                    (A) in subparagraph (A), by striking ``; and'' and 
                inserting a semicolon;
                    (B) in subparagraph (B), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following 
                subparagraph:
                    ``(C) during the portion of the emergency period 
                described in paragraph (1)(B) of section 1135(g) 
                beginning on the date of the enactment of this 
                subparagraph, each vaccine-eligible child (as defined 
                in subsection (b)) is entitled to receive a COVID-19 
                vaccine from a program-registered provider (as defined 
                in subsection (h)(7)) without charge for--
                            ``(i) the cost of such vaccine; or
                            ``(ii) the administration of such 
                        vaccine.'';
            (2) in subsection (c)(2)--
                    (A) in subparagraph (C)(ii), by inserting ``, but, 
                during the portion of the emergency period described in 
                paragraph (1)(B) of section 1135(g) beginning on the 
                date of the enactment of The Heroes Act, may not impose 
                a fee for the administration of a COVID-19 vaccine'' 
                before the period; and
                    (B) by adding at the end the following 
                subparagraph:
                    ``(D) The provider will provide and administer an 
                approved COVID-19 vaccine to a vaccine-eligible child 
                in accordance with the same requirements as apply under 
                the preceding subparagraphs to the provision and 
                administration of a qualified pediatric vaccine to such 
                a child.''; and
            (3) in subsection (d)(1), in the first sentence, by 
        inserting ``, including, during the portion of the emergency 
        period described in paragraph (1)(B) of section 1135(g) 
        beginning on the date of the enactment of The Heroes Act, with 
        respect to a COVID-19 vaccine licensed under section 351 of the 
        Public Health Service Act, or approved or authorized under 
        section 505 or 564 of the Federal Food, Drug, and Cosmetic 
        Act'' before the period.
    (c) CHIP.--
            (1) In general.--Section 2103(c) of the Social Security Act 
        (42 U.S.C. 1397cc(c)) is amended by adding at the end the 
        following paragraph:
            ``(11) Coverage of covid-19 vaccines and treatment.--
        Regardless of the type of coverage elected by a State under 
        subsection (a), child health assistance provided under such 
        coverage for targeted low-income children and, in the case that 
        the State elects to provide pregnancy-related assistance under 
        such coverage pursuant to section 2112, such pregnancy-related 
        assistance for targeted low-income pregnant women (as defined 
        in section 2112(d)) shall include coverage, during the portion 
        of the emergency period described in paragraph (1)(B) of 
        section 1135(g) beginning on the date of the enactment of this 
        paragraph, of--
                    ``(A) a COVID-19 vaccine licensed under section 351 
                of the Public Health Service Act, or approved or 
                authorized under section 505 or 564 of the Federal 
                Food, Drug, and Cosmetic Act, and the administration of 
                such vaccine; and
                    ``(B) any item or service furnished for the 
                treatment of COVID-19, including drugs approved or 
                authorized under such section 505 or such section 564, 
                or, in the case of an individual who is diagnosed with 
                or presumed to have COVID-19, during the portion of 
                such emergency period during which such individual is 
                infected (or presumed infected) with COVID-19, the 
                treatment of a condition that may complicate the 
                treatment of COVID-19.''.
            (2) Prohibition of cost sharing.--Section 2103(e)(2) of the 
        Social Security Act (42 U.S.C. 1397cc(e)(2)), as amended by 
        section 6004(b)(3) of the Families First Coronavirus Response 
        Act, is amended--
                    (A) in the paragraph header, by inserting ``a 
                covid-19 vaccine, covid-19 treatment,'' before ``or 
                pregnancy-related assistance''; and
                    (B) by striking ``visits described in section 
                1916(a)(2)(G), or'' and inserting ``services described 
                in section 1916(a)(2)(G), vaccines described in section 
                1916(a)(2)(H) administered during the portion of the 
                emergency period described in paragraph (1)(B) of 
                section 1135(g) beginning on the date of the enactment 
                of The Heroes Act, items or services described in 
                section 1916(a)(2)(I) furnished during such emergency 
                period, or''.
    (d) Conforming Amendments.--Section 1937 of the Social Security Act 
(42 U.S.C. 1396u-7) is amended--
            (1) in subsection (a)(1)(B), by inserting ``, under 
        subclause (XXIII) of section 1902(a)(10)(A)(ii),'' after 
        ``section 1902(a)(10)(A)(i)''; and
            (2) in subsection (b)(5), by adding before the period the 
        following: ``, and, effective on the date of the enactment of 
        The Heroes Act, must comply with subparagraphs (F) through (I) 
        of subsections (a)(2) and (b)(2) of section 1916 and subsection 
        (b)(3)(B) of section 1916A''.
    (e) Effective Date.--The amendments made by this section shall take 
effect on the date of enactment of this Act and shall apply with 
respect to a COVID-19 vaccine beginning on the date that such vaccine 
is licensed under section 351 of the Public Health Service Act (42 
U.S.C. 262), or approved or authorized under section 505 or 564 of the 
Federal Food, Drug, and Cosmetic Act.

SEC. 302. OPTIONAL COVERAGE AT NO COST SHARING OF COVID-19 TREATMENT 
              AND VACCINES UNDER MEDICAID FOR UNINSURED INDIVIDUALS.

    (a) In General.--Section 1902(a)(10) of the Social Security Act (42 
U.S.C. 1396a(a)(10)) is amended, in the matter following subparagraph 
(G), by striking ``and any visit described in section 1916(a)(2)(G)'' 
and inserting the following: ``, any COVID-19 vaccine that is 
administered during any such portion (and the administration of such 
vaccine), any item or service that is furnished during any such portion 
for the treatment of COVID-19, including drugs approved or authorized 
under section 505 or 564 of the Federal Food, Drug, and Cosmetic Act, 
or, in the case of an individual who is diagnosed with or presumed to 
have COVID-19, during the period such individual is infected (or 
presumed infected) with COVID-19, the treatment of a condition that may 
complicate the treatment of COVID-19, and any services described in 
section 1916(a)(2)(G)''.
    (b) Definition of Uninsured Individual.--
            (1) In general.--Subsection (ss) of section 1902 of the 
        Social Security Act (42 U.S.C. 1396a) is amended to read as 
        follows:
    ``(ss) Uninsured Individual Defined.--For purposes of this section, 
the term `uninsured individual' means, notwithstanding any other 
provision of this title, any individual who is not covered by minimum 
essential coverage (as defined in section 5000A(f)(1) of the Internal 
Revenue Code of 1986).''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect and apply as if included in the enactment of 
        the Families First Coronavirus Response Act (Public Law 116-
        127).
    (c) Clarification Regarding Emergency Services for Certain 
Individuals.--Section 1903(v)(2) of the Social Security Act (42 U.S.C. 
1396b(v)(2)) is amended by adding at the end the following flush 
sentence:
        ``For purposes of subparagraph (A), care and services described 
        in such subparagraph include any in vitro diagnostic product 
        described in section 1905(a)(3)(B) (and the administration of 
        such product), any COVID-19 vaccine (and the administration of 
        such vaccine), any item or service that is furnished for the 
        treatment of COVID-19, including drugs approved or authorized 
        under section 505 or 564 of the Federal Food, Drug, and 
        Cosmetic Act, or a condition that may complicate the treatment 
        of COVID-19, and any services described in section 
        1916(a)(2)(G).''.
    (d) Inclusion of COVID-19 Concern as an Emergency Condition.--
Section 1903(v)(3) of the Social Security Act (42 U.S.C. 1396b(v)(3)) 
is amended by adding at the end the following flush sentence:
        ``Such term includes any indication that an alien described in 
        paragraph (1) may have contracted COVID-19.''.

SEC. 303. COVERAGE OF TREATMENTS FOR COVID-19 AT NO COST SHARING UNDER 
              THE MEDICARE ADVANTAGE PROGRAM.

    (a) In General.--Section 1852(a)(1)(B) of the Social Security Act 
(42 U.S.C. 1395w-22(a)(1)(B)) is amended by adding at the end the 
following new clause:
                            ``(vii) Special coverage rules for 
                        specified covid-19 treatment services.--
                        Notwithstanding clause (i), in the case of a 
                        specified COVID-19 treatment service (as 
                        defined in section 30201(b) of The Heroes Act) 
                        that is furnished during a plan year occurring 
                        during any portion of the emergency period 
                        defined in section 1135(g)(1)(B) beginning on 
                        or after the date of the enactment of this 
                        clause, a Medicare Advantage plan may not, with 
                        respect to such service, impose--
                                    ``(I) any cost-sharing requirement 
                                (including a deductible, copayment, or 
                                coinsurance requirement); and
                                    ``(II) in the case such service is 
                                a critical specified COVID-19 treatment 
                                service (including ventilator services 
                                and intensive care unit services), any 
                                prior authorization or other 
                                utilization management requirement.
                        A Medicare Advantage plan may not take the 
                        application of this clause into account for 
                        purposes of a bid amount submitted by such plan 
                        under section 1854(a)(6).''.
    (b) Implementation.--Notwithstanding any other provision of law, 
the Secretary of Health and Human Services may implement the amendments 
made by this section by program instruction or otherwise.

SEC. 304. REQUIRING COVERAGE UNDER MEDICARE PDPS AND MA-PD PLANS, 
              WITHOUT THE IMPOSITION OF COST SHARING OR UTILIZATION 
              MANAGEMENT REQUIREMENTS, OF DRUGS INTENDED TO TREAT 
              COVID-19 DURING CERTAIN EMERGENCIES.

    (a) Coverage Requirement.--Section 1860D-4(b)(3) of the Social 
Security Act (42 U.S.C. 1395w-104(b)(3)) is amended by adding at the 
end the following new subparagraph:
                    ``(I) Required inclusion of drugs intended to treat 
                covid-19.--
                            ``(i) In general.--Notwithstanding any 
                        other provision of law, a PDP sponsor offering 
                        a prescription drug plan shall, with respect to 
                        a plan year, any portion of which occurs during 
                        the period described in clause (ii), be 
                        required to--
                                    ``(I) include in any formulary--
                                            ``(aa) all covered part D 
                                        drugs with a medically accepted 
                                        indication (as defined in 
                                        section 1860D-2(e)(4)) to treat 
                                        COVID-19 that are marketed in 
                                        the United States; and
                                            ``(bb) all drugs authorized 
                                        under section 564 or 564A of 
                                        the Federal Food, Drug, and 
                                        Cosmetic Act to treat COVID-19; 
                                        and
                                    ``(II) not impose any prior 
                                authorization or other utilization 
                                management requirement with respect to 
                                such drugs described in item (aa) or 
                                (bb) of subclause (I) (other than such 
                                a requirement that limits the quantity 
                                of drugs due to safety).
                            ``(ii) Period described.--For purposes of 
                        clause (i), the period described in this clause 
                        is the period during which there exists the 
                        public health emergency declared by the 
                        Secretary pursuant to section 319 of the Public 
                        Health Service Act on January 31, 2020, 
                        entitled `Determination that a Public Health 
                        Emergency Exists Nationwide as the Result of 
                        the 2019 Novel Coronavirus' (including any 
                        renewal of such declaration pursuant to such 
                        section).''.
    (b) Elimination of Cost Sharing.--
            (1) Elimination of cost sharing for drugs intended to treat 
        covid-19 under standard and alternative prescription drug 
        coverage.--Section 1860D-2 of the Social Security Act (42 
        U.S.C. 1395w-102) is amended--
                    (A) in subsection (b)--
                            (i) in paragraph (1)(A), by striking ``The 
                        coverage'' and inserting ``Subject to paragraph 
                        (8), the coverage'';
                            (ii) in paragraph (2)--
                                    (I) in subparagraph (A), by 
                                inserting after ``Subject to 
                                subparagraphs (C) and (D)'' the 
                                following: ``and paragraph (8)'';
                                    (II) in subparagraph (C)(i), by 
                                striking ``paragraph (4)'' and 
                                inserting ``paragraphs (4) and (8)''; 
                                and
                                    (III) in subparagraph (D)(i), by 
                                striking ``paragraph (4)'' and 
                                inserting ``paragraphs (4) and (8)'';
                            (iii) in paragraph (4)(A)(i), by striking 
                        ``The coverage'' and inserting ``Subject to 
                        paragraph (8), the coverage''; and
                            (iv) by adding at the end the following new 
                        paragraph:
            ``(8) Elimination of cost sharing for drugs intended to 
        treat covid-19.--The coverage does not impose any deductible, 
        copayment, coinsurance, or other cost-sharing requirement for 
        drugs described in section 1860D-4(b)(3)(I)(i)(I) with respect 
        to a plan year, any portion of which occurs during the period 
        during which there exists the public health emergency declared 
        by the Secretary pursuant to section 319 of the Public Health 
        Service Act on January 31, 2020, entitled `Determination that a 
        Public Health Emergency Exists Nationwide as the Result of the 
        2019 Novel Coronavirus' (including any renewal of such 
        declaration pursuant to such section).''; and
                    (B) in subsection (c), by adding at the end the 
                following new paragraph:
            ``(4) Same elimination of cost sharing for drugs intended 
        to treat covid-19.--The coverage is in accordance with 
        subsection (b)(8).''.
            (2) Elimination of cost sharing for drugs intended to treat 
        covid-19 dispensed to individuals who are subsidy eligible 
        individuals.--Section 1860D-14(a) of the Social Security Act 
        (42 U.S.C. 1395w-114(a)) is amended--
                    (A) in paragraph (1)--
                            (i) in subparagraph (D)--
                                    (I) in clause (ii), by striking 
                                ``In the case of'' and inserting 
                                ``Subject to subparagraph (F), in the 
                                case of''; and
                                    (II) in clause (iii), by striking 
                                ``In the case of'' and inserting 
                                ``Subject to subparagraph (F), in the 
                                case of''; and
                            (ii) by adding at the end the following new 
                        subparagraph:
                    ``(F) Elimination of cost sharing for drugs 
                intended to treat covid-19.--Coverage that is in 
                accordance with section 1860D-2(b)(8).''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (B), by striking ``A 
                        reduction'' and inserting ``Subject to 
                        subparagraph (F), a reduction'';
                            (ii) in subparagraph (D), by striking ``The 
                        substitution'' and inserting ``Subject to 
                        subparagraph (F), the substitution'';
                            (iii) in subparagraph (E), by inserting 
                        after ``Subject to'' the following: 
                        ``subparagraph (F) and''; and
                            (iv) by adding at the end the following new 
                        subparagraph:
                    ``(F) Elimination of cost sharing for drugs 
                intended to treat covid-19.--Coverage that is in 
                accordance with section 1860D-2(b)(8).''.
    (c) Implementation.--Notwithstanding any other provision of law, 
the Secretary of Health and Human Services may implement the amendments 
made by this section by program instruction or otherwise.

SEC. 305. COVERAGE OF COVID-19 RELATED TREATMENT AT NO COST SHARING.

    (a) In General.--A group health plan and a health insurance issuer 
offering group or individual health insurance coverage (including a 
grandfathered health plan (as defined in section 1251(e) of the Patient 
Protection and Affordable Care Act)) shall provide coverage, and shall 
not impose any cost sharing (including deductibles, copayments, and 
coinsurance) requirements, for the following items and services 
furnished during any portion of the emergency period defined in 
paragraph (1)(B) of section 1135(g) of the Social Security Act (42 
U.S.C. 1320b-5(g)) beginning on or after the date of the enactment of 
this Act:
            (1) Medically necessary items and services (including in-
        person or telehealth visits in which such items and services 
        are furnished) that are furnished to an individual who has been 
        diagnosed with (or after provision of the items and services is 
        diagnosed with) COVID-19 to treat or mitigate the effects of 
        COVID-19.
            (2) Medically necessary items and services (including in-
        person or telehealth visits in which such items and services 
        are furnished) that are furnished to an individual who is 
        presumed to have COVID-19 but is never diagnosed as such, if 
        the following conditions are met:
                    (A) Such items and services are furnished to the 
                individual to treat or mitigate the effects of COVID-19 
                or to mitigate the impact of COVID-19 on society.
                    (B) Health care providers have taken appropriate 
                steps under the circumstances to make a diagnosis, or 
                confirm whether a diagnosis was made, with respect to 
                such individual, for COVID-19, if possible.
    (b) Items and Services Related to COVID-19.--For purposes of this 
section--
            (1) not later than one week after the date of the enactment 
        of this section, the Secretary of Health and Human Services, 
        Secretary of Labor, and Secretary of the Treasury shall jointly 
        issue guidance specifying applicable diagnoses and medically 
        necessary items and services related to COVID-19; and
            (2) such items and services shall include all items or 
        services that are relevant to the treatment or mitigation of 
        COVID-19, regardless of whether such items or services are 
        ordinarily covered under the terms of a group health plan or 
        group or individual health insurance coverage offered by a 
        health insurance issuer.
    (c) Enforcement.--
            (1) Application with respect to phsa, erisa, and irc.--The 
        provisions of this section shall be applied by the Secretary of 
        Health and Human Services, Secretary of Labor, and Secretary of 
        the Treasury to group health plans and health insurance issuers 
        offering group or individual health insurance coverage as if 
        included in the provisions of part A of title XXVII of the 
        Public Health Service Act, part 7 of the Employee Retirement 
        Income Security Act of 1974, and subchapter B of chapter 100 of 
        the Internal Revenue Code of 1986, as applicable.
            (2) Private right of action.--An individual with respect to 
        whom an action is taken by a group health plan or health 
        insurance issuer offering group or individual health insurance 
        coverage in violation of subsection (a) may commence a civil 
        action against the plan or issuer for appropriate relief. The 
        previous sentence shall not be construed as limiting any 
        enforcement mechanism otherwise applicable pursuant to 
        paragraph (1).
    (d) Implementation.--The Secretary of Health and Human Services, 
Secretary of Labor, and Secretary of the Treasury may implement the 
provisions of this section through sub-regulatory guidance, program 
instruction or otherwise.
    (e) Terms.--The terms ``group health plan'', ``health insurance 
issuer'', ``group health insurance coverage'', and ``individual health 
insurance coverage'' have the meanings given such terms in section 2791 
of the Public Health Service Act (42 U.S.C. 300gg-91), section 733 of 
the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1191b), 
and section 9832 of the Internal Revenue Code of 1986, as applicable.

SEC. 306. REIMBURSEMENT FOR ADDITIONAL HEALTH SERVICES RELATING TO 
              CORONAVIRUS.

    Title V of division A of the Families First Coronavirus Response 
Act (Public Law 116-127) is amended under the heading ``Department of 
Health and Human Services--Office of the Secretary--Public Health and 
Social Services Emergency Fund'' by inserting ``, or treatment related 
to SARS-CoV-2 or COVID-19 for uninsured individuals'' after ``or visits 
described in paragraph (2) of such section for uninsured individuals''.

               TITLE IV--FEDERAL HEALTH EQUITY OVERSIGHT

SEC. 401. COVID-19 RACIAL AND ETHNIC DISPARITIES TASK FORCE ACT OF 
              2020.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall establish an 
interagency task force, to be known as the ``COVID-19 Racial and Ethnic 
Disparities Task Force'' (referred to in this section as the ``task 
force''), to gather data about disproportionately affected communities 
and provide recommendations to combat the racial and ethnic disparities 
in the COVID-19 response throughout the United States and in response 
to future public health crises.
    (b) Membership.--The task force shall be composed of the following:
            (1) The Secretary of Health and Human Services.
            (2) The Assistant Secretary for Planning and Evaluation of 
        the Department of Health and Human Services.
            (3) The Assistant Secretary for Preparedness and Response 
        of the Department of Health and Human Services.
            (4) The Director of the Centers for Disease Control and 
        Prevention.
            (5) The Director of the National Institutes of Health.
            (6) The Commissioner of Food and Drugs.
            (7) The Administrator of the Federal Emergency Management 
        Agency.
            (8) The Director of the National Institute on Minority 
        Health and Health Disparities.
            (9) The Director of the Indian Health Service.
            (10) The Administrator of the Centers for Medicare & 
        Medicaid Services.
            (11) The Director of the Agency for Healthcare Research and 
        Quality.
            (12) The Surgeon General.
            (13) The Administrator of the Health Resources and Services 
        Administration.
            (14) The Director of the Office of Minority Health.
            (15) The Secretary of Housing and Urban Development.
            (16) The Secretary of Education.
            (17) The Secretary of Labor.
            (18) The Secretary of Defense.
            (19) The Secretary of Transportation.
            (20) The Secretary of the Treasury.
            (21) The Administrator of the Small Business 
        Administration.
            (22) The Administrator of the Environmental Protection 
        Agency.
            (23) Five health care professionals with expertise in 
        addressing racial and ethnic disparities, with at least one 
        representative from a rural area, to be appointed by the 
        Secretary.
            (24) Five policy experts specializing in addressing racial 
        and ethnic disparities in education or racial and ethnic 
        economic inequality to be appointed by the Secretary.
            (25) Six representatives from community-based organizations 
        specializing in providing culturally competent care or services 
        and addressing racial and ethnic disparities, to be appointed 
        by the Secretary, with at least one representative from an 
        urban Indian organization and one representative from a 
        national organization that represents Tribal governments with 
        expertise in Tribal public health.
            (26) Six State, local, territorial, or Tribal public health 
        officials representing departments of public health, who shall 
        represent jurisdictions from different regions of the United 
        States with relatively high concentrations of historically 
        marginalized populations, to be appointed by the Secretary, 
        with at least one territorial representative and one 
        representative of a Tribal public health department.
    (c) Administrative Provisions.--
            (1) Appointment of non-government members.--Notwithstanding 
        any other provision of law, the Secretary shall appoint all 
        non-government members of the task force within 30 days of the 
        date enactment of this section.
            (2) Chairperson.--The Secretary shall serve as the 
        chairperson of the task force. The Director of the Office of 
        Minority Health shall serve as the vice chairperson.
            (3) Staff.--The task force shall have 10 full-time staff 
        members.
            (4) Meetings.--Not later than 45 days after the date of 
        enactment of this section, the full task force shall have its 
        first meeting. The task force shall convene at least once a 
        month thereafter.
            (5) Subcommittees.--The chairperson and vice chairperson of 
        the task force are authorized to establish subcommittees to 
        consider specific issues related to the broader mission of 
        addressing racial and ethnic disparities.
    (d) Federal Emergency Management Agency Resource Allocation 
Reporting and Recommendations.--
            (1) Weekly reports.--Not later than 7 days after the task 
        force first meets, and weekly thereafter, the task force shall 
        submit to Congress and the Federal Emergency Management Agency 
        a report that includes--
                    (A) a description of COVID-19 patient outcomes, 
                including cases, hospitalizations, patients on 
                ventilation, and mortality, disaggregated by race and 
                ethnicity (where such data is missing, the task force 
                shall utilize appropriate authorities to improve data 
                collection);
                    (B) the identification of communities that lack 
                resources to combat the COVID-19 pandemic, including 
                personal protective equipment, ventilators, hospital 
                beds, testing kits, testing supplies, vaccinations 
                (when available), resources to conduct surveillance and 
                contact tracing, funding, staffing, and other resources 
                the task force deems essential as needs arise;
                    (C) the identification of communities where racial 
                and ethnic disparities in COVID-19 infection, 
                hospitalization, and death rates are out of proportion 
                to the community's population by a certain threshold, 
                to be determined by the task force based on available 
                public health data;
                    (D) recommendations about how to best allocate 
                critical COVID-19 resources to--
                            (i) communities with disproportionately 
                        high COVID-19 infection, hospitalization, and 
                        death rates; and
                            (ii) communities identified in subparagraph 
                        (C);
                    (E) with respect to communities that are able to 
                reduce racial and ethnic disparities effectively, a 
                description of best practices involved; and
                    (F) an update with respect to the response of the 
                Federal Emergency Management Agency to the task force's 
                previous weeks' recommendations under this section.
            (2) General consultation.--In submitting weekly reports and 
        recommendations under this subsection, the task force shall 
        consult with and notify State, local, territorial, and Tribal 
        officials and community-based organizations from communities 
        identified as disproportionately impacted by COVID-19.
            (3) Consultation with indian tribes.--In submitting weekly 
        reports and recommendations under this subsection, the Director 
        of Indian Health Service shall, in coordination with the task 
        force, consult with Indian Tribes and Tribal organizations that 
        are disproportionately affected by COVID-19 on a government to 
        government basis to identify specific needs and 
        recommendations.
            (4) Dissemination.--Reports under this subsection shall be 
        disseminated to all relevant stakeholders, including State, 
        local, territorial, and Tribal officials, and public health 
        departments.
            (5) Tribal data.--The task force, in consultation with 
        Indian Tribes and Tribal organizations, shall ensure that an 
        Indian Tribe consents to any public reporting of health data.
    (e) COVID-19 Relief Oversight and Implementation Reports.--Not 
later than 14 days after the task force first meets, and not later than 
every 14 days thereafter, the task force shall submit to Congress and 
the relevant Federal agencies a report that includes--
            (1) an examination of funds distributed under COVID-19-
        related relief and stimulus laws (enacted prior to and after 
        the date of enactment of this Act), including the Coronavirus 
        Preparedness and Response Emergency Supplemental Appropriations 
        Act, 2020 (Public Law 116-123), the Families First Coronavirus 
        Response Act (Public Law 116-127), the Coronavirus Aid, Relief, 
        and Economic Security Act (Public Law 116-136), and the 
        Paycheck Protection Program and Health Care Enhancement Act 
        (Public Law 116-139), and how that distribution impacted racial 
        and ethnic disparities with respect to the COVID-19 pandemic; 
        and
            (2) recommendations to relevant Federal agencies about how 
        to disburse any undisbursed funding from COVID-19-related 
        relief and stimulus laws (enacted prior to and after the date 
        of enactment of this Act), including those laws described in 
        paragraph (1), to address racial and ethnic disparities with 
        respect to the COVID-19 pandemic, including recommendations 
        to--
                    (A) the Department of Health and Human Services 
                about disbursement of funds under the Public Health and 
                Social Service Emergency Fund;
                    (B) the Small Business Administration about 
                disbursement of funds under the Paycheck Protection 
                Program and the Economic Injury Disaster Loan Program; 
                and
                    (C) the Department of Education about disbursement 
                of funds under the Education Stabilization Fund.
    (f) Final COVID-19 Reports.--Not later than 90 days after the date 
on which the President declares the end of the COVID-19 public health 
emergency first declared by the Secretary on January 31, 2020, the task 
force shall submit to Congress a report that--
            (1) describes inequities within the health care system, 
        implicit bias, structural racism, and social determinants of 
        health (including housing, nutrition, education, economic, and 
        environmental factors) that contributed to racial and ethnic 
        health disparities with respect to the COVID-19 pandemic and 
        how these factors contributed to such disparities;
            (2) examines the initial Federal response to the COVID-19 
        pandemic and its impact on the racial and ethnic disparities in 
        COVID-19 infection, hospitalization, and death rates; and
            (3) contains recommendations to combat racial and ethnic 
        disparities in future infectious disease responses, including 
        future COVID-19 outbreaks.
    (g) Sunset and Successor Task Force.--
            (1) Sunset.--The task force shall terminate on the date 
        that is 90 days after the date on which the President declares 
        the end of the COVID-19 public health emergency first declared 
        by the Secretary on January 31, 2020.
            (2) Successor.--Upon the termination of the task force 
        under paragraph (1), the Secretary shall establish a permanent 
        Infectious Disease Racial and Ethnic Disparities Task Force 
        based on the membership, convening, and reporting requirements 
        recommended by the task force in reports submitted under this 
        section.
    (h) Authorization of Appropriations.--There is authorized to be 
appropriated, such sums as may be necessary to carry out this section.

SEC. 402. PROTECTION OF THE HHS OFFICES OF MINORITY HEALTH.

    (a) In General.--Pursuant to section 1707A of the Public Health 
Service Act (42 U.S.C. 300u-6a), the Offices of Minority Health 
established within the Centers for Disease Control and Prevention, the 
Health Resources and Services Administration, the Substance Abuse and 
Mental Health Services Administration, the Agency for Healthcare 
Research and Quality, the Food and Drug Administration, and the Centers 
for Medicare & Medicaid Services, are offices that, regardless of 
change in the structure of the Department of Health and Human Services, 
shall report to the Secretary of Health and Human Services.
    (b) Sense of Congress.--It is the sense of the Congress that any 
effort to eliminate or consolidate such Offices of Minority Health 
undermines the progress achieved so far.

SEC. 403. ESTABLISH AN INTERAGENCY COUNSEL AND GRANT PROGRAMS ON SOCIAL 
              DETERMINANTS OF HEALTH.

    (a) Short Title.--This section may be cited as the ``Social 
Determinants Accelerator Act of 2020''.
    (b) Findings; Purposes.--
            (1) Findings.--Congress finds the following:
                    (A) There is a significant body of evidence showing 
                that economic and social conditions have a powerful 
                impact on individual and population health outcomes, 
                including health disparities associated with public 
                health emergencies, and well-being, as well as medical 
                costs.
                    (B) State, local, and Tribal governments and the 
                service delivery partners of such governments face 
                significant challenges in coordinating benefits and 
                services delivered through the Medicaid program and 
                other social services programs because of the 
                fragmented and complex nature of Federal and State 
                funding and administrative requirements.
                    (C) The Federal Government should prioritize and 
                proactively assist State and local governments to 
                strengthen the capacity of State and local governments 
                to improve health and social outcomes for individuals, 
                thereby improving cost-effectiveness and return on 
                investment.
            (2) Purposes.--The purposes of this Act are as follows:
                    (A) To establish effective, coordinated Federal 
                technical assistance to help State and local 
                governments to improve outcomes and cost-effectiveness 
                of, and return on investment from, health and social 
                services programs.
                    (B) To build a pipeline of State and locally 
                designed, cross-sector interventions and strategies 
                that generate rigorous evidence about how to improve 
                health and social outcomes, and increase the cost-
                effectiveness of, and return on investment from, 
                Federal, State, local, and Tribal health and social 
                services programs.
                    (C) To enlist State and local governments and the 
                service providers of such governments as partners in 
                identifying Federal statutory, regulatory, and 
                administrative challenges in improving the health and 
                social outcomes of, cost-effectiveness of, and return 
                on investment from, Federal spending on individuals 
                enrolled in Medicaid.
                    (D) To develop strategies to improve health and 
                social outcomes without denying services to, or 
                restricting the eligibility of, vulnerable populations.
    (c) Social Determinants Accelerator Council.--
            (1) Establishment.--The Secretary of Health and Human 
        Services (referred to in this Act as the ``Secretary''), in 
        coordination with the Administrator of the Centers for Medicare 
        & Medicaid Services (referred to in this Act as the 
        ``Administrator''), shall establish an interagency council, to 
        be known as the Social Determinants Accelerator Interagency 
        Council (referred to in this Act as the ``Council'') to achieve 
        the purposes listed in subsection (b)(1).
            (2) Membership.--
                    (A) Federal composition.--The Council shall be 
                composed of at least one designee from each of the 
                following Federal agencies:
                            (i) The Office of Management and Budget.
                            (ii) The Department of Agriculture.
                            (iii) The Department of Education.
                            (iv) The Indian Health Service.
                            (v) The Department of Housing and Urban 
                        Development.
                            (vi) The Department of Labor.
                            (vii) The Department of Transportation.
                            (viii) Any other Federal agency the Chair 
                        of the Council determines necessary.
                    (B) Designation.--
                            (i) In general.--The head of each agency 
                        specified in subparagraph (A) shall designate 
                        at least one employee to serve as a member of 
                        the Council.
                            (ii) Responsibilities.--An employee 
                        described in this clause shall be a senior 
                        employee of the agency--
                                    (I) whose responsibilities relate 
                                to authorities, policies, and 
                                procedures with respect to the health 
                                and well-being of individuals receiving 
                                medical assistance under a State plan 
                                (or a waiver of such plan) under title 
                                XIX of the Social Security Act (42 
                                U.S.C. 1396 et seq.); or
                                    (II) who has authority to implement 
                                and evaluate transformative initiatives 
                                that harness data or conducts rigorous 
                                evaluation to improve the impact and 
                                cost-effectiveness of federally funded 
                                services and benefits.
                    (C) HHS representation.--In addition to the 
                designees under subparagraph (A), the Council shall 
                include designees from at least three agencies within 
                the Department of Health and Human Services, including 
                the Centers for Medicare & Medicaid Services, at least 
                one of whom shall meet the criteria under this section.
                    (D) OMB role.--The Director of the Office of 
                Management and Budget shall facilitate the timely 
                resolution of Governmentwide and multiagency issues to 
                help the Council achieve consensus recommendations 
                described under this section.
                    (E) Non-federal composition.--The Comptroller 
                General of the United States may designate up to 6 
                Council designees--
                            (i) who have relevant subject matter 
                        expertise, including expertise implementing and 
                        evaluating transformative initiatives that 
                        harness data and conduct evaluations to improve 
                        the impact and cost-effectiveness of Federal 
                        Government services; and
                            (ii) that each represent--
                                    (I) State, local, and Tribal health 
                                and human services agencies;
                                    (II) public housing authorities or 
                                State housing finance agencies;
                                    (III) State and local government 
                                budget offices;
                                    (IV) State Medicaid agencies; or
                                    (V) national consumer advocacy 
                                organizations.
                    (F) Chair.--
                            (i) In general.--The Secretary shall select 
                        the Chair of the Council from among the members 
                        of the Council.
                            (ii) Initiating guidance.--The Chair, on 
                        behalf of the Council, shall identify and 
                        invite individuals from diverse entities to 
                        provide the Council with advice and information 
                        pertaining to addressing social determinants of 
                        health, including--
                                    (I) individuals from State and 
                                local government health and human 
                                services agencies;
                                    (II) individuals from State 
                                Medicaid agencies;
                                    (III) individuals from State and 
                                local government budget offices;
                                    (IV) individuals from public 
                                housing authorities or State housing 
                                finance agencies;
                                    (V) individuals from nonprofit 
                                organizations, small businesses, and 
                                philanthropic organizations;
                                    (VI) advocates;
                                    (VII) researchers; and
                                    (VIII) any other individuals the 
                                Chair determines to be appropriate.
            (3) Duties.--The duties of the Council are--
                    (A) to make recommendations to the Secretary and 
                the Administrator regarding the criteria for making 
                awards under this section;
                    (B) to identify Federal authorities and 
                opportunities for use by States or local governments to 
                improve coordination of funding and administration of 
                Federal programs, the beneficiaries of whom include 
                individuals, and which may be unknown or underutilized 
                and to make information on such authorities and 
                opportunities publicly available;
                    (C) to provide targeted technical assistance to 
                States developing a social determinants accelerator 
                plan under this section, including identifying 
                potential statutory or regulatory pathways for 
                implementation of the plan and assisting in identifying 
                potential sources of funding to implement the plan;
                    (D) to report to Congress annually on the subjects 
                set forth in this section;
                    (E) to develop and disseminate evaluation 
                guidelines and standards that can be used to reliably 
                assess the impact of an intervention or approach that 
                may be implemented pursuant to this Act on outcomes, 
                cost-effectiveness of, and return on investment from 
                Federal, State, local, and Tribal governments, and to 
                facilitate technical assistance, where needed, to help 
                to improve State and local evaluation designs and 
                implementation;
                    (F) to seek feedback from State, local, and Tribal 
                governments, including through an annual survey by an 
                independent third party, on how to improve the 
                technical assistance the Council provides to better 
                equip State, local, and Tribal governments to 
                coordinate health and social service programs;
                    (G) to solicit applications for grants under this 
                section; and
                    (H) to coordinate with other cross-agency 
                initiatives focused on improving the health and well-
                being of low-income and at-risk populations in order to 
                prevent unnecessary duplication between agency 
                initiatives.
            (4) Schedule.--Not later than 60 days after the date of the 
        enactment of this Act, the Council shall convene to develop a 
        schedule and plan for carrying out the duties described in this 
        section, including solicitation of applications for the grants 
        under this section.
            (5) Report to congress.--The Council shall submit an annual 
        report to Congress, which shall include--
                    (A) a list of the Council members;
                    (B) activities and expenditures of the Council;
                    (C) summaries of the interventions and approaches 
                that will be supported by State, local, and Tribal 
                governments that received a grant under this section, 
                including--
                            (i) the best practices and evidence-based 
                        approaches such governments plan to employ to 
                        achieve the purposes listed in this section; 
                        and
                            (ii) a description of how the practices and 
                        approaches will impact the outcomes, cost-
                        effectiveness of, and return on investment 
                        from, Federal, State, local, and Tribal 
                        governments with respect to such purposes;
                    (D) the feedback received from State and local 
                governments on ways to improve the technical assistance 
                of the Council, including findings from a third-party 
                survey and actions the Council plans to take in 
                response to such feedback; and
                    (E) the major statutory, regulatory, and 
                administrative challenges identified by State, local, 
                and Tribal governments that received a grant under 
                subsection (d), and the actions that Federal agencies 
                are taking to address such challenges.
            (6) FACA applicability.--The Federal Advisory Committee Act 
        (5 U.S.C. App.) shall not apply to the Council.
            (7) Council procedures.--The Secretary, in consultation 
        with the Comptroller General of the United States and the 
        Director of the Office of Management and Budget, shall 
        establish procedures for the Council to--
                    (A) ensure that adequate resources are available to 
                effectively execute the responsibilities of the 
                Council;
                    (B) effectively coordinate with other relevant 
                advisory bodies and working groups to avoid unnecessary 
                duplication;
                    (C) create transparency to the public and Congress 
                with regard to Council membership, costs, and 
                activities, including through use of modern technology 
                and social media to disseminate information; and
                    (D) avoid conflicts of interest that would 
                jeopardize the ability of the Council to make decisions 
                and provide recommendations.
    (d) Social Determinants Accelerator Grants to States or Local 
Governments.--
            (1) Grants to states, local governments, and tribes.--Not 
        later than 180 days after the date of the enactment of this 
        Act, the Administrator, in consultation with the Secretary and 
        the Council, shall award on a competitive basis not more than 
        25 grants to eligible applicants described in this section, for 
        the development of social determinants accelerator plans, as 
        described in this section.
            (2) Eligible applicant.--An eligible applicant described in 
        this section is a State, local, or Tribal health or human 
        services agency that--
                    (A) demonstrates the support of relevant parties 
                across relevant State, local, or Tribal jurisdictions; 
                and
                    (B) in the case of an applicant that is a local 
                government agency, provides to the Secretary a letter 
                of support from the lead State health or human services 
                agency for the State in which the local government is 
                located.
            (3) Amount of grant.--The Administrator, in coordination 
        with the Council, shall determine the total amount that the 
        Administrator will make available to each grantee under this 
        section.
            (4) Application.--An eligible applicant seeking a grant 
        under this section shall include in the application the 
        following information:
                    (A) The target population (or populations) that 
                would benefit from implementation of the social 
                determinants accelerator plan proposed to be developed 
                by the applicant.
                    (B) A description of the objective or objectives 
                and outcome goals of such proposed plan, which shall 
                include at least one health outcome and at least one 
                other important social outcome.
                    (C) The sources and scope of inefficiencies that, 
                if addressed by the plan, could result in improved 
                cost-effectiveness of or return on investment from 
                Federal, State, local, and Tribal governments.
                    (D) A description of potential interventions that 
                could be designed or enabled using such proposed plan.
                    (E) The State, local, Tribal, academic, nonprofit, 
                community-based organizations, and other private sector 
                partners that would participate in the development of 
                the proposed plan and subsequent implementation of 
                programs or initiatives included in such proposed plan.
                    (F) Such other information as the Administrator, in 
                consultation with the Secretary and the Council, 
                determines necessary to achieve the purposes of this 
                Act.
            (5) Use of funds.--A recipient of a grant under this 
        section may use funds received through the grant for the 
        following purposes:
                    (A) To convene and coordinate with relevant 
                government entities and other stakeholders across 
                sectors to assist in the development of a social 
                determinant accelerator plan.
                    (B) To identify populations of individuals 
                receiving medical assistance under a State plan (or a 
                waiver of such plan) under title XIX of the Social 
                Security Act (42 U.S.C. 1396 et seq.) who may benefit 
                from the proposed approaches to improving the health 
                and well-being of such individuals through the 
                implementation of the proposed social determinants 
                accelerator plan.
                    (C) To engage qualified research experts to advise 
                on relevant research and to design a proposed 
                evaluation plan, in accordance with the standards and 
                guidelines issued by the Administrator.
                    (D) To collaborate with the Council to support the 
                development of social determinants accelerator plans.
                    (E) To prepare and submit a final social 
                determinants accelerator plan to the Council.
            (6) Contents of plans.--A social determinant accelerator 
        plan developed under this section shall include the following:
                    (A) A description of the target population (or 
                populations) that would benefit from implementation of 
                the social determinants accelerator plan, including an 
                analysis describing the projected impact on the well-
                being of individuals described in paragraph (5)(B).
                    (B) A description of the interventions or 
                approaches designed under the social determinants 
                accelerator plan and the evidence for selecting such 
                interventions or approaches.
                    (C) The objectives and outcome goals of such 
                interventions or approaches, including at least one 
                health outcome and at least one other important social 
                outcome.
                    (D) A plan for accessing and linking relevant data 
                to enable coordinated benefits and services for the 
                jurisdictions described in this section and an 
                evaluation of the proposed interventions and 
                approaches.
                    (E) A description of the State, local, Tribal, 
                academic, nonprofit, or community-based organizations, 
                or any other private sector organizations that would 
                participate in implementing the proposed interventions 
                or approaches, and the role each would play to 
                contribute to the success of the proposed interventions 
                or approaches.
                    (F) The identification of the funding sources that 
                would be used to finance the proposed interventions or 
                approaches.
                    (G) A description of any financial incentives that 
                may be provided, including outcome-focused contracting 
                approaches to encourage service providers and other 
                partners to improve outcomes of, cost-effectiveness of, 
                and return on investment from, Federal, State, local, 
                or Tribal government spending.
                    (H) The identification of the applicable Federal, 
                State, local, or Tribal statutory and regulatory 
                authorities, including waiver authorities, to be 
                leveraged to implement the proposed interventions or 
                approaches.
                    (I) A description of potential considerations that 
                would enhance the impact, scalability, or 
                sustainability of the proposed interventions or 
                approaches and the actions the grant awardee would take 
                to address such considerations.
                    (J) A proposed evaluation plan, to be carried out 
                by an independent evaluator, to measure the impact of 
                the proposed interventions or approaches on the 
                outcomes of, cost-effectiveness of, and return on 
                investment from, Federal, State, local, and Tribal 
                governments.
                    (K) Precautions for ensuring that vulnerable 
                populations will not be denied access to Medicaid or 
                other essential services as a result of implementing 
                the proposed plan.
    (e) Funding.--
            (1) In general.--Out of any money in the Treasury not 
        otherwise appropriated, there is appropriated to carry out this 
        Act $25,000,000, of which up to $5,000,000 may be used to carry 
        out this Act, to remain available for obligation until the date 
        that is 5 years after the date of enactment of this Act.
            (2) Reservation of funds.--
                    (A) In general.--Of the funds made available under 
                paragraph (1), the Secretary shall reserve not less 
                than 20 percent to award grants to eligible applicants 
                for the development of social determinants accelerator 
                plans under this section intended to serve rural 
                populations.
                    (B) Exception.--In the case of a fiscal year for 
                which the Secretary determines that there are not 
                sufficient eligible applicants to award up to 25 grants 
                under section 4 that are intended to serve rural 
                populations and the Secretary cannot satisfy the 20-
                percent requirement, the Secretary may reserve an 
                amount that is less than 20 percent of amounts made 
                available under paragraph (1) to award grants for such 
                purpose.
            (3) Rule of construction.--Nothing in this Act shall 
        prevent Federal agencies represented on the Council from 
        contributing additional funding from other sources to support 
        activities to improve the effectiveness of the Council.

SEC. 404. ACCOUNTABILITY AND TRANSPARENCY WITHIN THE DEPARTMENT OF 
              HEALTH AND HUMAN SERVICES.

    Title XXXIV of the Public Health Service Act is amended by 
inserting after subtitle C the following:

               ``Subtitle D--Strengthening Accountability

``SEC. 3441. ELEVATION OF THE OFFICE OF CIVIL RIGHTS.

    ``(a) In General.--The Secretary shall establish within the Office 
for Civil Rights an Office of Health Disparities, which shall be headed 
by a director to be appointed by the Secretary.
    ``(b) Purpose.--The Office of Health Disparities shall ensure that 
the health programs, activities, and operations of health entities that 
receive Federal financial assistance are in compliance with title VI of 
the Civil Rights Act, including through the following activities:
            ``(1) The development and implementation of an action plan 
        to address racial and ethnic health care disparities, which 
        shall address concerns relating to the Office for Civil Rights 
        as released by the United States Commission on Civil Rights in 
        the report entitled `Health Care Challenge: Acknowledging 
        Disparity, Confronting Discrimination, and Ensuring Equity' 
        (September 1999) in conjunction with the reports by the 
        National Academy of Sciences (formerly known as the Institute 
        of Medicine) entitled `Unequal Treatment: Confronting Racial 
        and Ethnic Disparities in Health Care', `Crossing the Quality 
        Chasm: A New Health System for the 21st Century', `In the 
        Nation's Compelling Interest: Ensuring Diversity in the Health 
        Care Workforce', `The National Partnership for Action to End 
        Health Disparities', and `The Health of Lesbian, Gay, Bisexual, 
        and Transgender People', and other related reports by the 
        National Academy of Sciences. This plan shall be publicly 
        disclosed for review and comment and the final plan shall 
        address any comments or concerns that are received by the 
        Office.
            ``(2) Investigative and enforcement actions against 
        intentional discrimination and policies and practices that have 
        a disparate impact on minorities.
            ``(3) The review of racial, ethnic, gender identity, sexual 
        orientation, sex, disability status, socioeconomic status, and 
        primary language health data collected by Federal health 
        agencies to assess health care disparities related to 
        intentional discrimination and policies and practices that have 
        a disparate impact on minorities. Such review shall include an 
        assessment of health disparities in communities with a 
        combination of these classes.
            ``(4) Outreach and education activities relating to 
        compliance with title VI of the Civil Rights Act.
            ``(5) The provision of technical assistance for health 
        entities to facilitate compliance with title VI of the Civil 
        Rights Act.
            ``(6) Coordination and oversight of activities of the civil 
        rights compliance offices established under section 3442.
            ``(7) Ensuring--
                    ``(A) at a minimum, compliance with the most recent 
                version of the Office of Management and Budget 
                statistical policy directive entitled `Standards for 
                Maintaining, Collecting, and Presenting Federal Data on 
                Race and Ethnicity'; and
                    ``(B) consideration of available data and language 
                standards such as--
                            ``(i) the standards for collecting and 
                        reporting data under section 3101; and
                            ``(ii) the National Standards on Culturally 
                        and Linguistically Appropriate Services of the 
                        Office of Minority Health.
    ``(c) Funding and Staff.--The Secretary shall ensure the 
effectiveness of the Office of Health Disparities by ensuring that the 
Office is provided with--
            ``(1) adequate funding to enable the Office to carry out 
        its duties under this section; and
            ``(2) staff with expertise in--
                    ``(A) epidemiology;
                    ``(B) statistics;
                    ``(C) health quality assurance;
                    ``(D) minority health and health disparities;
                    ``(E) cultural and linguistic competency;
                    ``(F) civil rights; and
                    ``(G) social, behavioral, and economic determinants 
                of health.
    ``(d) Report.--Not later than December 31, 2021, and annually 
thereafter, the Secretary, in collaboration with the Director of the 
Office for Civil Rights and the Deputy Assistant Secretary for Minority 
Health, shall submit a report to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Committee on Energy and 
Commerce of the House of Representatives that includes--
            ``(1) the number of cases filed, broken down by category;
            ``(2) the number of cases investigated and closed by the 
        office;
            ``(3) the outcomes of cases investigated;
            ``(4) the staffing levels of the office including staff 
        credentials;
            ``(5) the number of other lingering and emerging cases in 
        which civil rights inequities can be demonstrated; and
            ``(6) the number of cases remaining open and an explanation 
        for their open status.
    ``(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 2021 through 2026.

``SEC. 3442. ESTABLISHMENT OF HEALTH PROGRAM OFFICES FOR CIVIL RIGHTS 
              WITHIN FEDERAL HEALTH AND HUMAN SERVICES AGENCIES.

    ``(a) In General.--The Secretary shall establish civil rights 
compliance offices in each agency within the Department of Health and 
Human Services that administers health programs.
    ``(b) Purpose of Offices.--Each office established under subsection 
(a) shall ensure that recipients of Federal financial assistance under 
Federal health programs administer programs, services, and activities 
in a manner that--
            ``(1) does not discriminate, either intentionally or in 
        effect, on the basis of race, national origin, language, 
        ethnicity, sex, age, disability, sexual orientation, and gender 
        identity; and
            ``(2) promotes the reduction and elimination of disparities 
        in health and health care based on race, national origin, 
        language, ethnicity, sex, age, disability, sexual orientation, 
        and gender identity.
    ``(c) Powers and Duties.--The offices established in subsection (a) 
shall have the following powers and duties:
            ``(1) The establishment of compliance and program 
        participation standards for recipients of Federal financial 
        assistance under each program administered by the applicable 
        agency, including the establishment of disparity reduction 
        standards to encompass disparities in health and health care 
        related to race, national origin, language, ethnicity, sex, 
        age, disability, sexual orientation, and gender identity.
            ``(2) The development and implementation of program-
        specific guidelines that interpret and apply Department of 
        Health and Human Services guidance under title VI of the Civil 
        Rights Act of 1964 and section 1557 of the Patient Protection 
        and Affordable Care Act to each Federal health program 
        administered by the agency.
            ``(3) The development of a disparity-reduction impact 
        analysis methodology that shall be applied to every rule issued 
        by the agency and published as part of the formal rulemaking 
        process under sections 555, 556, and 557 of title 5, United 
        States Code.
            ``(4) Oversight of data collection, analysis, and 
        publication requirements for all recipients of Federal 
        financial assistance under each Federal health program 
        administered by the agency; compliance with, at a minimum, the 
        most recent version of the Office of Management and Budget 
        statistical policy directive entitled `Standards for 
        Maintaining, Collecting, and Presenting Federal Data on Race 
        and Ethnicity'; and consideration of available data and 
        language standards such as--
                    ``(A) the standards for collecting and reporting 
                data under section 3101; and
                    ``(B) the National Standards on Culturally and 
                Linguistically Appropriate Services of the Office of 
                Minority Health.
            ``(5) The conduct of publicly available studies regarding 
        discrimination within Federal health programs administered by 
        the agency as well as disparity reduction initiatives by 
        recipients of Federal financial assistance under Federal health 
        programs.
            ``(6) Annual reports to the Committee on Health, Education, 
        Labor, and Pensions and the Committee on Finance of the Senate 
        and the Committee on Energy and Commerce and the Committee on 
        Ways and Means of the House of Representatives on the progress 
        in reducing disparities in health and health care through the 
        Federal programs administered by the agency.
    ``(d) Relationship to Office for Civil Rights in the Department of 
Justice.--
            ``(1) Department of health and human services.--The Office 
        for Civil Rights of the Department of Health and Human Services 
        shall provide standard-setting and compliance review 
        investigation support services to the Civil Rights Compliance 
        Office for each agency described in subsection (a), subject to 
        paragraph (2).
            ``(2) Department of justice.--The Office for Civil Rights 
        of the Department of Justice may, as appropriate, institute 
        formal proceedings when a civil rights compliance office 
        established under subsection (a) determines that a recipient of 
        Federal financial assistance is not in compliance with the 
        disparity reduction standards of the applicable agency.
    ``(e) Definition.--In this section, the term `Federal health 
programs' mean programs--
            ``(1) under the Social Security Act (42 U.S.C. 301 et seq.) 
        that pay for health care and services; and
            ``(2) under this Act that provide Federal financial 
        assistance for health care, biomedical research, health 
        services research, and programs designed to improve the 
        public's health, including health service programs.''.

                   TITLE V--EXPANDED INSURANCE ACCESS

SEC. 501. MEDICARE SPECIAL ENROLLMENT PERIOD FOR INDIVIDUALS RESIDING 
              IN COVID-19 EMERGENCY AREAS.

    (a) In General.--Section 1837(i) of the Social Security Act (42 
U.S.C. 1395p(i)) is amended by adding at the end the following new 
paragraph:
            ``(5)(A) In the case of an individual who--
                    ``(i) is eligible under section 1836 to enroll in 
                the medical insurance program established by this part,
                    ``(ii) did not enroll (or elected not to be deemed 
                enrolled) under this section during an enrollment 
                period, and
                    ``(iii) during the emergency period (as described 
                in section 1135(g)(1)(B)), resided in an emergency area 
                (as described in such section),
                there shall be a special enrollment period described in 
                subparagraph (B).
                    ``(B) The special enrollment period referred to in 
                subparagraph (A) is the period that begins not later 
                than July 1, 2020, and ends on the last day of the 
                month in which the emergency period (as described in 
                section 1135(g)(1)(B)) ends.''.
    (b) Coverage Period for Individuals Transitioning From Other 
Coverage.--Section 1838(e) of the Social Security Act (42 U.S.C. 
1395q(e)) is amended--
            (1) by striking ``pursuant to section 1837(i)(3) or 
        1837(i)(4)(B)--'' and inserting the following: ``pursuant to--
            ``(1) section 1837(i)(3) or 1837(i)(4)(B)--'';
            (2) by redesignating paragraphs (1) and (2) as 
        subparagraphs (A) and (B), respectively, and moving the 
        indentation of each such subparagraph 2 ems to the right;
            (3) by striking the period at the end of the subparagraph 
        (B), as so redesignated, and inserting ``; or''; and
            (4) by adding at the end the following new paragraph:
            ``(2) section 1837(i)(5), the coverage period shall begin 
        on the first day of the month following the month in which the 
        individual so enrolls.''.
    (c) Funding.--The Secretary of Health and Human Services shall 
provide for the transfer from the Federal Hospital Insurance Trust Fund 
(as described in section 1817 of the Social Security Act (42 U.S.C. 
1395i)) and the Federal Supplementary Medical Insurance Trust Fund (as 
described in section 1841 of such Act (42 U.S.C. 1395t)), in such 
proportions as determined appropriate by the Secretary, to the Social 
Security Administration, of $30,000,000, to remain available until 
expended, for purposes of carrying out the amendments made by this 
section.
    (d) Implementation.--Notwithstanding any other provision of law, 
the Secretary of Health and Human Services may implement the amendments 
made by this section by program instruction or otherwise.

SEC. 502. SPECIAL ENROLLMENT PERIOD THROUGH EXCHANGES; FEDERAL EXCHANGE 
              OUTREACH AND EDUCATIONAL ACTIVITIES.

    (a) Special Enrollment Period Through Exchanges.--Section 1311(c) 
of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)) 
is amended--
            (1) in paragraph (6)--
                    (A) in subparagraph (C), by striking at the end 
                ``and'';
                    (B) in subparagraph (D), by striking at the end the 
                period and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(E) subject to subparagraph (B) of paragraph (8), 
                the special enrollment period described in subparagraph 
                (A) of such paragraph.''; and
            (2) by adding at the end the following new paragraph:
            ``(8) Special enrollment period for certain public health 
        emergency.--
                    ``(A) In general.--The Secretary shall, subject to 
                subparagraph (B), require an Exchange to provide--
                            ``(i) for a special enrollment period 
                        during the emergency period described in 
                        section 1135(g)(1)(B) of the Social Security 
                        Act--
                                    ``(I) which shall begin on the date 
                                that is one week after the date of the 
                                enactment of this paragraph and which, 
                                in the case of an Exchange established 
                                or operated by the Secretary within a 
                                State pursuant to section 1321(c), 
                                shall be an 8-week period; and
                                    ``(II) during which any individual 
                                who is otherwise eligible to enroll in 
                                a qualified health plan through the 
                                Exchange may enroll in such a qualified 
                                health plan; and
                            ``(ii) that, in the case of an individual 
                        who enrolls in a qualified health plan through 
                        the Exchange during such enrollment period, the 
                        coverage period under such plan shall begin, at 
                        the option of the individual, on April 1, 2020, 
                        or on the first day of the month following the 
                        day the individual selects a plan through such 
                        special enrollment period.
                    ``(B) Exception.--The requirement of subparagraph 
                (A) shall not apply to a State-operated or State-
                established Exchange if such Exchange, prior to the 
                date of the enactment of this paragraph, established or 
                otherwise provided for a special enrollment period to 
                address access to coverage under qualified health plans 
                offered through such Exchange during the emergency 
                period described in section 1135(g)(1)(B) of the Social 
                Security Act.''.
    (b) Federal Exchange Outreach and Educational Activities.--Section 
1321(c) of the Patient Protection and Affordable Care Act (42 U.S.C. 
18041(c)) is amended by adding at the end the following new paragraph:
            ``(3) Outreach and educational activities.--
                    ``(A) In general.--In the case of an Exchange 
                established or operated by the Secretary within a State 
                pursuant to this subsection, the Secretary shall carry 
                out outreach and educational activities for purposes of 
                informing potential enrollees in qualified health plans 
                offered through the Exchange of the availability of 
                coverage under such plans and financial assistance for 
                coverage under such plans. Such outreach and 
                educational activities shall be provided in a manner 
                that is culturally and linguistically appropriate to 
                the needs of the populations being served by the 
                Exchange (including hard-to-reach populations, such as 
                racial and sexual minorities, limited English 
                proficient populations, and young adults).
                    ``(B) Limitation on use of funds.--No funds 
                appropriated under this paragraph shall be used for 
                expenditures for promoting non-ACA compliant health 
                insurance coverage.
                    ``(C) Non-ACA compliant health insurance 
                coverage.--For purposes of subparagraph (B):
                            ``(i) The term `non-ACA compliant health 
                        insurance coverage' means health insurance 
                        coverage, or a group health plan, that is not a 
                        qualified health plan.
                            ``(ii) Such term includes the following:
                                    ``(I) An association health plan.
                                    ``(II) Short-term limited duration 
                                insurance.
                    ``(D) Funding.--There are appropriated, out of any 
                funds in the Treasury not otherwise appropriated, 
                $25,000,000, to remain available until expended--
                            ``(i) to carry out this paragraph; and
                            ``(ii) at the discretion of the Secretary, 
                        to carry out section 1311(i), with respect to 
                        an Exchange established or operated by the 
                        Secretary within a State pursuant to this 
                        subsection.''.
    (c) Implementation.--The Secretary of Health and Human Services may 
implement the provisions of (including amendments made by) this section 
through subregulatory guidance, program instruction, or otherwise.

SEC. 503. MOMMA'S ACT.

    (a) Short Title.--This section may be cited as the ``Mothers and 
Offspring Mortality and Morbidity Awareness Act'' or the ``MOMMA's 
Act''.
    (b) Findings.--Congress finds the following:
            (1) Every year, across the United States, 4,000,000 women 
        give birth, about 700 women suffer fatal complications during 
        pregnancy, while giving birth or during the postpartum period, 
        and 70,000 women suffer near-fatal, partum-related 
        complications.
            (2) The maternal mortality rate is often used as a proxy to 
        measure the overall health of a population. While the infant 
        mortality rate in the United States has reached its lowest 
        point, the risk of death for women in the United States during 
        pregnancy, childbirth, or the postpartum period is higher than 
        such risk in many other developed nations. The estimated 
        maternal mortality rate (per 100,000 live births) for the 48 
        contiguous States and Washington, DC increased from 18.8 
        percent in 2000 to 23.8 percent in 2014 to 26.6 percent in 
        2018. This estimated rate is on par with such rate for 
        underdeveloped nations such as Iraq and Afghanistan.
            (3) International studies estimate the 2015 maternal 
        mortality rate in the United States as 26.4 per 100,000 live 
        births, which is almost twice the 2015 World Health 
        Organization estimation of 14 per 100,000 live births.
            (4) It is estimated that more than 60 percent of maternal 
        deaths in the United States are preventable.
            (5) According to the Centers for Disease Control and 
        Prevention, the maternal mortality rate varies drastically for 
        women by race and ethnicity. There are 12.7 deaths per 100,000 
        live births for White women, 43.5 deaths per 100,000 live 
        births for African-American women, and 14.4 deaths per 100,000 
        live births for women of other ethnicities. While maternal 
        mortality disparately impacts African-American women, this 
        urgent public health crisis traverses race, ethnicity, 
        socioeconomic status, educational background, and geography.
            (6) African-American women are 3 to 4 times more likely to 
        die from causes related to pregnancy and childbirth compared to 
        non-Hispanic White women.
            (7) The findings described in paragraphs (1) through (6) 
        are of major concern to researchers, academics, members of the 
        business community, and providers across the obstetrical 
        continuum represented by organizations such as March of Dimes; 
        the Preeclampsia Foundation; the American College of 
        Obstetricians and Gynecologists; the Society for Maternal-Fetal 
        Medicine; the Association of Women's Health, Obstetric, and 
        Neonatal Nurses; the California Maternal Quality Care 
        Collaborative; Black Women's Health Imperative; the National 
        Birth Equity Collaborative; Black Mamas Matter Alliance; 
        EverThrive Illinois; the National Association of Certified 
        Professional Midwives; PCOS Challenge: The National Polycystic 
        Ovary Syndrome Association; and the American College of Nurse 
        Midwives.
            (8) Hemorrhage, cardiovascular and coronary conditions, 
        cardiomyopathy, infection, embolism, mental health conditions, 
        preeclampsia and eclampsia, polycystic ovary syndrome, 
        infection and sepsis, and anesthesia complications are the 
        predominant medical causes of maternal-related deaths and 
        complications. Most of these conditions are largely preventable 
        or manageable.
            (9) Oral health is an important part of perinatal health. 
        Reducing bacteria in a woman's mouth during pregnancy can 
        significantly reduce her risk of developing oral diseases and 
        spreading decay-causing bacteria to her baby. Moreover, some 
        evidence suggests that women with periodontal disease during 
        pregnancy could be at greater risk for poor birth outcomes, 
        such as preeclampsia, pre-term birth, and low-birth weight. 
        Furthermore, a woman's oral health during pregnancy is a good 
        predictor of her newborn's oral health, and since mothers can 
        unintentionally spread oral bacteria to their babies, putting 
        their children at higher risk for tooth decay, prevention 
        efforts should happen even before children are born, as a 
        matter of pre-pregnancy health and prenatal care during 
        pregnancy.
            (10) The United States has not been able to submit a formal 
        maternal mortality rate to international data repositories 
        since 2007. Thus, no official maternal mortality rate exists 
        for the United States. There can be no maternal mortality rate 
        without streamlining maternal mortality-related data from the 
        State level and extrapolating such data to the Federal level.
            (11) In the United States, death reporting and analysis is 
        a State function rather than a Federal process. States report 
        all deaths--including maternal deaths--on a semi-voluntary 
        basis, without standardization across States. While the Centers 
        for Disease Control and Prevention has the capacity and system 
        for collecting death-related data based on death certificates, 
        these data are not sufficiently reported by States in an 
        organized and standard format across States such that the 
        Centers for Disease Control and Prevention is able to identify 
        causes of maternal death and best practices for the prevention 
        of such death.
            (12) Vital statistics systems often underestimate maternal 
        mortality and are insufficient data sources from which to 
        derive a full scope of medical and social determinant factors 
        contributing to maternal deaths. While the addition of 
        pregnancy checkboxes on death certificates since 2003 have 
        likely improved States' abilities to identify pregnancy-related 
        deaths, they are not generally completed by obstetrical 
        providers or persons trained to recognize pregnancy-related 
        mortality. Thus, these vital forms may be missing information 
        or may capture inconsistent data. Due to varying maternal 
        mortality-related analyses, lack of reliability, and 
        granularity in data, current maternal mortality informatics do 
        not fully encapsulate the myriad medical and socially 
        determinant factors that contribute to such high maternal 
        mortality rates within the United States compared to other 
        developed nations. Lack of standardization of data and data 
        sharing across States and between Federal entities, health 
        networks, and research institutions keep the Nation in the dark 
        about ways to prevent maternal deaths.
            (13) Having reliable and valid State data aggregated at the 
        Federal level are critical to the Nation's ability to quell 
        surges in maternal death and imperative for researchers to 
        identify long-lasting interventions.
            (14) Leaders in maternal wellness highly recommend that 
        maternal deaths be investigated at the State level first, and 
        that standardized, streamlined, de-identified data regarding 
        maternal deaths be sent annually to the Centers for Disease 
        Control and Prevention. Such data standardization and 
        collection would be similar in operation and effect to the 
        National Program of Cancer Registries of the Centers for 
        Disease Control and Prevention and akin to the Confidential 
        Enquiry in Maternal Deaths Programme in the United Kingdom. 
        Such a maternal mortalities and morbidities registry and 
        surveillance system would help providers, academicians, 
        lawmakers, and the public to address questions concerning the 
        types of, causes of, and best practices to thwart, pregnancy-
        related or pregnancy-associated mortality and morbidity.
            (15) The United Nations' Millennium Development Goal 5a 
        aimed to reduce by 75 percent, between 1990 and 2015, the 
        maternal mortality rate, yet this metric has not been achieved. 
        In fact, the maternal mortality rate in the United States has 
        been estimated to have more than doubled between 2000 and 2014. 
        Yet, because national data are not fully available, the United 
        States does not have an official maternal mortality rate.
            (16) Many States have struggled to establish or maintain 
        Maternal Mortality Review Committees (referred to in this 
        section as ``MMRC''). On the State level, MMRCs have lagged 
        because States have not had the resources to mount local 
        reviews. State-level reviews are necessary as only the State 
        departments of health have the authority to request medical 
        records, autopsy reports, and police reports critical to the 
        function of the MMRC.
            (17) The United Kingdom regards maternal deaths as a health 
        systems failure and a national committee of obstetrics experts 
        review each maternal death or near-fatal childbirth 
        complication. Such committee also establishes the predominant 
        course of maternal-related deaths from conditions such as 
        preeclampsia. Consequently, the United Kingdom has been able to 
        reduce its incidence of preeclampsia to less than one in 10,000 
        women--its lowest rate since 1952.
            (18) The United States has no comparable, coordinated 
        Federal process by which to review cases of maternal mortality, 
        systems failures, or best practices. Many States have active 
        MMRCs and leverage their work to impact maternal wellness. For 
        example, the State of California has worked extensively with 
        their State health departments, health and hospital systems, 
        and research collaborative organizations, including the 
        California Maternal Quality Care Collaborative and the Alliance 
        for Innovation on Maternal Health, to establish MMRCs, wherein 
        such State has determined the most prevalent causes of maternal 
        mortality and recorded and shared data with providers and 
        researchers, who have developed and implemented safety bundles 
        and care protocols related to preeclampsia, maternal 
        hemorrhage, and the like. In this way, the State of California 
        has been able to leverage its maternal mortality review board 
        system, generate data, and apply those data to effect changes 
        in maternal care-related protocol. To date, the State of 
        California has reduced its maternal mortality rate, which is 
        now comparable to the low rates of the United Kingdom.
            (19) Hospitals and health systems across the United States 
        lack standardization of emergency obstetrical protocols before, 
        during, and after delivery. Consequently, many providers are 
        delayed in recognizing critical signs indicating maternal 
        distress that quickly escalate into fatal or near-fatal 
        incidences. Moreover, any attempt to address an obstetrical 
        emergency that does not consider both clinical and public 
        health approaches falls woefully under the mark of excellent 
        care delivery. State-based maternal quality collaborative 
        organizations, such as the California Maternal Quality Care 
        Collaborative or entities participating in the Alliance for 
        Innovation on Maternal Health (AIM), have formed obstetrical 
        protocols, tool kits, and other resources to improve system 
        care and response as they relate to maternal complications and 
        warning signs for such conditions as maternal hemorrhage, 
        hypertension, and preeclampsia.
            (20) The Centers for Disease Control and Prevention reports 
        that nearly half of all maternal deaths occur in the immediate 
        postpartum period--the 42 days following a pregnancy--whereas 
        more than one-third of pregnancy-related or pregnancy-
        associated deaths occur while a person is still pregnant. Yet, 
        for women eligible for the Medicaid program on the basis of 
        pregnancy, such Medicaid coverage lapses at the end of the 
        month on which the 60th postpartum day lands.
            (21) The experience of serious traumatic events, such as 
        being exposed to domestic violence, substance use disorder, or 
        pervasive racism, can over-activate the body's stress-response 
        system. Known as toxic stress, the repetition of high-doses of 
        cortisol to the brain, can harm healthy neurological 
        development, which can have cascading physical and mental 
        health consequences, as documented in the Adverse Childhood 
        Experiences study of the Centers for Disease Control and 
        Prevention.
            (22) A growing body of evidence-based research has shown 
        the correlation between the stress associated with one's race--
        the stress of racism--and one's birthing outcomes. The stress 
        of sex and race discrimination and institutional racism has 
        been demonstrated to contribute to a higher risk of maternal 
        mortality, irrespective of one's gestational age, maternal age, 
        socioeconomic status, or individual-level health risk factors, 
        including poverty, limited access to prenatal care, and poor 
        physical and mental health (although these are not nominal 
        factors). African-American women remain the most at risk for 
        pregnancy-associated or pregnancy-related causes of death. When 
        it comes to preeclampsia, for example, which is related to 
        obesity, African-American women of normal weight remain the 
        most at risk of dying during the perinatal period compared to 
        non-African-American obese women.
            (23) The rising maternal mortality rate in the United 
        States is driven predominantly by the disproportionately high 
        rates of African-American maternal mortality.
            (24) African-American women are 3 to 4 times more likely to 
        die from pregnancy or maternal-related distress than are White 
        women, yielding one of the greatest and most disconcerting 
        racial disparities in public health.
            (25) Compared to women from other racial and ethnic 
        demographics, African-American women across the socioeconomic 
        spectrum experience prolonged, unrelenting stress related to 
        racial and gender discrimination, contributing to higher rates 
        of maternal mortality, giving birth to low-weight babies, and 
        experiencing pre-term birth. Racism is a risk-factor for these 
        aforementioned experiences. This cumulative stress often 
        extends across the life course and is situated in everyday 
        spaces where African-American women establish livelihood. 
        Structural barriers, lack of access to care, and genetic 
        predispositions to health vulnerabilities exacerbate African-
        American women's likelihood to experience poor or fatal 
        birthing outcomes, but do not fully account for the great 
        disparity.
            (26) African-American women are twice as likely to 
        experience postpartum depression, and disproportionately higher 
        rates of preeclampsia compared to White women.
            (27) Racism is deeply ingrained in United States systems, 
        including in health care delivery systems between patients and 
        providers, often resulting in disparate treatment for pain, 
        irreverence for cultural norms with respect to health, and 
        dismissiveness. Research has demonstrated that patients respond 
        more warmly and adhere to medical treatment plans at a higher 
        degree with providers of the same race or ethnicity or with 
        providers with great ability to exercise empathy. However, the 
        provider pool is not primed with many people of color, nor are 
        providers (whether student-doctors in training or licensed 
        practitioners) consistently required to undergo implicit bias, 
        cultural competency, or empathy training on a consistent, on-
        going basis.
    (c) Improving Federal Efforts With Respect to Prevention of 
Maternal Mortality.--
            (1) Technical assistance for states with respect to 
        reporting maternal mortality.--Not later than one year after 
        the date of enactment of this Act, the Director of the Centers 
        for Disease Control and Prevention (referred to in this section 
        as the ``Director''), in consultation with the Administrator of 
        the Health Resources and Services Administration, shall provide 
        technical assistance to States that elect to report 
        comprehensive data on maternal mortality, including oral, 
        mental, and breastfeeding health information, for the purpose 
        of encouraging uniformity in the reporting of such data and to 
        encourage the sharing of such data among the respective States.
            (2) Best practices relating to prevention of maternal 
        mortality.--
                    (A) In general.--Not later than one year after the 
                date of enactment of this Act--
                            (i) the Director, in consultation with 
                        relevant patient and provider groups, shall 
                        issue best practices to State maternal 
                        mortality review committees on how best to 
                        identify and review maternal mortality cases, 
                        taking into account any data made available by 
                        States relating to maternal mortality, 
                        including data on oral, mental, and 
                        breastfeeding health, and utilization of any 
                        emergency services; and
                            (ii) the Director, working in collaboration 
                        with the Health Resources and Services 
                        Administration, shall issue best practices to 
                        hospitals, State professional society groups, 
                        and perinatal quality collaboratives on how 
                        best to prevent maternal mortality.
                    (B) Authorization of appropriations.--For purposes 
                of carrying out this subsection, there is authorized to 
                be appropriated $5,000,000 for each of fiscal years 
                2021 through 2025.
            (3) Alliance for innovation on maternal health grant 
        program.--
                    (A) In general.--Not later than one year after the 
                date of enactment of this Act, the Secretary of Health 
                and Human Services (referred to in this subsection as 
                the ``Secretary''), acting through the Associate 
                Administrator of the Maternal and Child Health Bureau 
                of the Health Resources and Services Administration, 
                shall establish a grant program to be known as the 
                Alliance for Innovation on Maternal Health Grant 
                Program (referred to in this subsection as ``AIM'') 
                under which the Secretary shall award grants to 
                eligible entities for the purpose of--
                            (i) directing widespread adoption and 
                        implementation of maternal safety bundles 
                        through collaborative State-based teams; and
                            (ii) collecting and analyzing process, 
                        structure, and outcome data to drive continuous 
                        improvement in the implementation of such 
                        safety bundles by such State-based teams with 
                        the ultimate goal of eliminating preventable 
                        maternal mortality and severe maternal 
                        morbidity in the United States.
                    (B) Eligible entities.--In order to be eligible for 
                a grant under paragraph (1), an entity shall--
                            (i) submit to the Secretary an application 
                        at such time, in such manner, and containing 
                        such information as the Secretary may require; 
                        and
                            (ii) demonstrate in such application that 
                        the entity is an interdisciplinary, multi-
                        stakeholder, national organization with a 
                        national data-driven maternal safety and 
                        quality improvement initiative based on 
                        implementation approaches that have been proven 
                        to improve maternal safety and outcomes in the 
                        United States.
                    (C) Use of funds.--An eligible entity that receives 
                a grant under paragraph (1) shall use such grant 
                funds--
                            (i) to develop and implement, through a 
                        robust, multi-stakeholder process, maternal 
                        safety bundles to assist States and health care 
                        systems in aligning national, State, and 
                        hospital-level quality improvement efforts to 
                        improve maternal health outcomes, specifically 
                        the reduction of maternal mortality and severe 
                        maternal morbidity;
                            (ii) to ensure, in developing and 
                        implementing maternal safety bundles under 
                        subparagraph (A), that such maternal safety 
                        bundles--
                                    (I) satisfy the quality improvement 
                                needs of a State or health care system 
                                by factoring in the results and 
                                findings of relevant data reviews, such 
                                as reviews conducted by a State 
                                maternal mortality review committee; 
                                and
                                    (II) address topics such as--
                                            (aa) obstetric hemorrhage;
                                            (bb) maternal mental 
                                        health;
                                            (cc) the maternal venous 
                                        system;
                                            (dd) obstetric care for 
                                        women with substance use 
                                        disorders, including opioid use 
                                        disorder;
                                            (ee) postpartum care basics 
                                        for maternal safety;
                                            (ff) reduction of 
                                        peripartum racial and ethnic 
                                        disparities;
                                            (gg) reduction of primary 
                                        caesarean birth;
                                            (hh) severe hypertension in 
                                        pregnancy;
                                            (ii) severe maternal 
                                        morbidity reviews;
                                            (jj) support after a severe 
                                        maternal morbidity event;
                                            (kk) thromboembolism;
                                            (ll) optimization of 
                                        support for breastfeeding; and
                                            (mm) maternal oral health; 
                                        and
                            (iii) to provide ongoing technical 
                        assistance at the national and State levels to 
                        support implementation of maternal safety 
                        bundles under subparagraph (A).
                    (D) Maternal safety bundle defined.--For purposes 
                of this subsection, the term ``maternal safety bundle'' 
                means standardized, evidence-informed processes for 
                maternal health care.
                    (E) Authorization of appropriations.--For purposes 
                of carrying out this subsection, there is authorized to 
                be appropriated $10,000,000 for each of fiscal years 
                2021 through 2025.
            (4) Funding for state-based perinatal quality 
        collaboratives development and sustainability.--
                    (A) In general.--Not later than one year after the 
                date of enactment of this Act, the Secretary of Health 
                and Human Services (referred to in this subsection as 
                the ``Secretary''), acting through the Division of 
                Reproductive Health of the Centers for Disease Control 
                and Prevention, shall establish a grant program to be 
                known as the State-Based Perinatal Quality 
                Collaborative grant program under which the Secretary 
                awards grants to eligible entities for the purpose of 
                development and sustainability of perinatal quality 
                collaboratives in every State, the District of 
                Columbia, and eligible territories, in order to 
                measurably improve perinatal care and perinatal health 
                outcomes for pregnant and postpartum women and their 
                infants.
                    (B) Grant amounts.--Grants awarded under this 
                subsection shall be in amounts not to exceed $250,000 
                per year, for the duration of the grant period.
                    (C) State-based perinatal quality collaborative 
                defined.--For purposes of this subsection, the term 
                ``State-based perinatal quality collaborative'' means a 
                network of multidisciplinary teams that--
                            (i) work to improve measurable outcomes for 
                        maternal and infant health by advancing 
                        evidence-informed clinical practices using 
                        quality improvement principles;
                            (ii) work with hospital-based or outpatient 
                        facility-based clinical teams, experts, and 
                        stakeholders, including patients and families, 
                        to spread best practices and optimize resources 
                        to improve perinatal care and outcomes;
                            (iii) employ strategies that include the 
                        use of the collaborative learning model to 
                        provide opportunities for hospitals and 
                        clinical teams to collaborate on improvement 
                        strategies, rapid-response data to provide 
                        timely feedback to hospital and other clinical 
                        teams to track progress, and quality 
                        improvement science to provide support and 
                        coaching to hospital and clinical teams; and
                            (iv) have the goal of improving population-
                        level outcomes in maternal and infant health.
                    (D) Authorization of appropriations.--For purposes 
                of carrying out this subsection, there is authorized to 
                be appropriated $14,000,000 per year for each of fiscal 
                years 2021 through 2025.
            (5) Expansion of medicaid and chip coverage for pregnant 
        and postpartum women.--
                    (A) Requiring coverage of oral health services for 
                pregnant and postpartum women.--
                            (i) Medicaid.--Section 1905 of the Social 
                        Security Act (42 U.S.C. 1396d) is amended--
                                    (I) in subsection (a)(4)--
                                            (aa) by striking ``; and 
                                        (D)'' and inserting ``; (D)''; 
                                        and
                                            (bb) by inserting ``; and 
                                        (E) oral health services for 
                                        pregnant and postpartum women 
                                        (as defined in subsection 
                                        (ee))'' after ``subsection 
                                        (bb))''; and
                                    (II) by adding at the end the 
                                following new subsection:
    ``(ee) Oral Health Services for Pregnant and Postpartum Women.--
            ``(1) In general.--For purposes of this title, the term 
        `oral health services for pregnant and postpartum women' means 
        dental services necessary to prevent disease and promote oral 
        health, restore oral structures to health and function, and 
        treat emergency conditions that are furnished to a woman during 
        pregnancy (or during the 1-year period beginning on the last 
        day of the pregnancy).
            ``(2) Coverage requirements.--To satisfy the requirement to 
        provide oral health services for pregnant and postpartum women, 
        a State shall, at a minimum, provide coverage for preventive, 
        diagnostic, periodontal, and restorative care consistent with 
        recommendations for perinatal oral health care and dental care 
        during pregnancy from the American Academy of Pediatric 
        Dentistry and the American College of Obstetricians and 
        Gynecologists.''.
                            (ii) CHIP.--Section 2103(c)(5)(A) of the 
                        Social Security Act (42 U.S.C. 1397cc(c)(5)(A)) 
                        is amended by inserting ``or a targeted low-
                        income pregnant woman'' after ``targeted low-
                        income child''.
                    (B) Extending medicaid coverage for pregnant and 
                postpartum women.--Section 1902 of the Social Security 
                Act (42 U.S.C. 1396a) is amended--
                            (i) in subsection (e)--
                                    (I) in paragraph (5)--
                                            (aa) by inserting 
                                        ``(including oral health 
                                        services for pregnant and 
                                        postpartum women (as defined in 
                                        section 1905(ee))'' after 
                                        ``postpartum medical assistance 
                                        under the plan''; and
                                            (bb) by striking ``60-day'' 
                                        and inserting ``1-year''; and
                                    (II) in paragraph (6), by striking 
                                ``60-day'' and inserting ``1-year''; 
                                and
                            (ii) in subsection (l)(1)(A), by striking 
                        ``60-day'' and inserting ``1-year''.
                    (C) Extending medicaid coverage for lawful 
                residents.--Section 1903(v)(4)(A) of the Social 
                Security Act (42 U.S.C. 1396b(v)(4)(A)) is amended by 
                striking ``60-day'' and inserting ``1-year''.
                    (D) Extending chip coverage for pregnant and 
                postpartum women.--Section 2112(d)(2)(A) of the Social 
                Security Act (42 U.S.C. 1397ll(d)(2)(A)) is amended by 
                striking ``60-day'' and inserting ``1-year''.
                    (E) Maintenance of effort.--
                            (i) Medicaid.--Section 1902(l) of the 
                        Social Security Act (42 U.S.C. 1396a(l)) is 
                        amended by adding at the end the following new 
                        paragraph:
    ``(5) During the period that begins on the date of enactment of 
this paragraph and ends on the date that is five years after such date 
of enactment, as a condition for receiving any Federal payments under 
section 1903(a) for calendar quarters occurring during such period, a 
State shall not have in effect, with respect to women who are eligible 
for medical assistance under the State plan or under a waiver of such 
plan on the basis of being pregnant or having been pregnant, 
eligibility standards, methodologies, or procedures under the State 
plan or waiver that are more restrictive than the eligibility 
standards, methodologies, or procedures, respectively, under such plan 
or waiver that are in effect on the date of enactment of this 
paragraph.''.
                            (ii) CHIP.--Section 2105(d) of the Social 
                        Security Act (42 U.S.C. 1397ee(d)) is amended 
                        by adding at the end the following new 
                        paragraph:
            ``(4) In eligibility standards for targeted low-income 
        pregnant women.--During the period that begins on the date of 
        enactment of this paragraph and ends on the date that is five 
        years after such date of enactment, as a condition of receiving 
        payments under subsection (a) and section 1903(a), a State that 
        elects to provide assistance to women on the basis of being 
        pregnant (including pregnancy-related assistance provided to 
        targeted low-income pregnant women (as defined in section 
        2112(d)), pregnancy-related assistance provided to women who 
        are eligible for such assistance through application of section 
        1902(v)(4)(A)(i) under section 2107(e)(1), or any other 
        assistance under the State child health plan (or a waiver of 
        such plan) which is provided to women on the basis of being 
        pregnant) shall not have in effect, with respect to such women, 
        eligibility standards, methodologies, or procedures under such 
        plan (or waiver) that are more restrictive than the eligibility 
        standards, methodologies, or procedures, respectively, under 
        such plan (or waiver) that are in effect on the date of 
        enactment of this paragraph.''.
                    (F) Information on benefits.--The Secretary of 
                Health and Human Services shall make publicly available 
                on the internet website of the Department of Health and 
                Human Services, information regarding benefits 
                available to pregnant and postpartum women and under 
                the Medicaid program and the Children's Health 
                Insurance Program, including information on--
                            (i) benefits that States are required to 
                        provide to pregnant and postpartum women under 
                        such programs;
                            (ii) optional benefits that States may 
                        provide to pregnant and postpartum women under 
                        such programs; and
                            (iii) the availability of different kinds 
                        of benefits for pregnant and postpartum women, 
                        including oral health and mental health 
                        benefits, under such programs.
                    (G) Federal funding for cost of extended medicaid 
                and chip coverage for postpartum women.--
                            (i) Medicaid.--Section 1905 of the Social 
                        Security Act (42 U.S.C. 1396d), as amended by 
                        paragraph (1), is further amended--
                                    (I) in subsection (b), by striking 
                                ``and (aa)'' and inserting ``(aa), and 
                                (ff)''; and
                                    (II) by adding at the end the 
                                following:
    ``(ff) Increased FMAP for Extended Medical Assistance for 
Postpartum Women.--Notwithstanding subsection (b), the Federal medical 
assistance percentage for a State, with respect to amounts expended by 
such State for medical assistance for a woman who is eligible for such 
assistance on the basis of being pregnant or having been pregnant that 
is provided during the 305-day period that begins on the 60th day after 
the last day of her pregnancy (including any such assistance provided 
during the month in which such period ends), shall be equal to--
            ``(1) 100 percent for the first 20 calendar quarters during 
        which this subsection is in effect; and
            ``(2) 90 percent for calendar quarters thereafter.''.
                            (ii) CHIP.--Section 2105(c) of the Social 
                        Security Act (42 U.S.C. 1397ee(c)) is amended 
                        by adding at the end the following new 
                        paragraph:
            ``(12) Enhanced payment for extended assistance provided to 
        pregnant women.--Notwithstanding subsection (b), the enhanced 
        FMAP, with respect to payments under subsection (a) for 
        expenditures under the State child health plan (or a waiver of 
        such plan) for assistance provided under the plan (or waiver) 
        to a woman who is eligible for such assistance on the basis of 
        being pregnant (including pregnancy-related assistance provided 
        to a targeted low-income pregnant woman (as defined in section 
        2112(d)), pregnancy-related assistance provided to a woman who 
        is eligible for such assistance through application of section 
        1902(v)(4)(A)(i) under section 2107(e)(1), or any other 
        assistance under the plan (or waiver) provided to a woman who 
        is eligible for such assistance on the basis of being pregnant) 
        during the 305-day period that begins on the 60th day after the 
        last day of her pregnancy (including any such assistance 
        provided during the month in which such period ends), shall be 
        equal to--
                    ``(A) 100 percent for the first 20 calendar 
                quarters during which this paragraph is in effect; and
                    ``(B) 90 percent for calendar quarters 
                thereafter.''.
                    (H) Effective date.--
                            (i) In general.--Subject to subparagraph 
                        (B), the amendments made by this subsection 
                        shall take effect on the first day of the first 
                        calendar quarter that begins on or after the 
                        date that is one year after the date of 
                        enactment of this Act.
                            (ii) Exception for state legislation.--In 
                        the case of a State plan under title XIX of the 
                        Social Security Act or a State child health 
                        plan under title XXI of such Act that the 
                        Secretary of Health and Human Services 
                        determines requires State legislation 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 requirements of such 
                        title solely on the basis of its failure to 
                        meet such an additional requirement before the 
                        first day of the first calendar quarter 
                        beginning after the close of the first regular 
                        session of the State legislature that begins 
                        after the date of enactment of this Act. For 
                        purposes of the previous sentence, in the case 
                        of a State that has a 2-year legislative 
                        session, each year of the session shall be 
                        considered to be a separate regular session of 
                        the State legislature.
            (6) Regional centers of excellence.--Part P of title III of 
        the Public Health Service Act is amended by adding at the end 
        the following new section:

``SEC. 399V-7. REGIONAL CENTERS OF EXCELLENCE ADDRESSING IMPLICIT BIAS 
              AND CULTURAL COMPETENCY IN PATIENT-PROVIDER INTERACTIONS 
              EDUCATION.

    ``(a) In General.--Not later than one year after the date of 
enactment of this section, the Secretary, in consultation with such 
other agency heads as the Secretary determines appropriate, shall award 
cooperative agreements for the establishment or support of regional 
centers of excellence addressing implicit bias and cultural competency 
in patient-provider interactions education for the purpose of enhancing 
and improving how health care professionals are educated in implicit 
bias and delivering culturally competent health care.
    ``(b) Eligibility.--To be eligible to receive a cooperative 
agreement under subsection (a), an entity shall--
            ``(1) be a public or other nonprofit entity specified by 
        the Secretary that provides educational and training 
        opportunities for students and health care professionals, which 
        may be a health system, teaching hospital, community health 
        center, medical school, school of public health, dental school, 
        social work school, school of professional psychology, or any 
        other health professional school or program at an institution 
        of higher education (as defined in section 101 of the Higher 
        Education Act of 1965) focused on the prevention, treatment, or 
        recovery of health conditions that contribute to maternal 
        mortality and the prevention of maternal mortality and severe 
        maternal morbidity;
            ``(2) demonstrate community engagement and participation, 
        such as through partnerships with home visiting and case 
        management programs; and
            ``(3) provide to the Secretary such information, at such 
        time and in such manner, as the Secretary may require.
    ``(c) Diversity.--In awarding a cooperative agreement under 
subsection (a), the Secretary shall take into account any regional 
differences among eligible entities and make an effort to ensure 
geographic diversity among award recipients.
    ``(d) Dissemination of Information.--
            ``(1) Public availability.--The Secretary shall make 
        publicly available on the internet website of the Department of 
        Health and Human Services information submitted to the 
        Secretary under subsection (b)(3).
            ``(2) Evaluation.--The Secretary shall evaluate each 
        regional center of excellence established or supported pursuant 
        to subsection (a) and disseminate the findings resulting from 
        each such evaluation to the appropriate public and private 
        entities.
            ``(3) Distribution.--The Secretary shall share evaluations 
        and overall findings with State departments of health and other 
        relevant State level offices to inform State and local best 
        practices.
    ``(e) Maternal Mortality Defined.--In this section, the term 
`maternal mortality' means death of a woman that occurs during 
pregnancy or within the one-year period following the end of such 
pregnancy.
    ``(f) Authorization of Appropriations.--For purposes of carrying 
out this section, there is authorized to be appropriated $5,000,000 for 
each of fiscal years 2021 through 2025.''.
            (7) Special supplemental nutrition program for women, 
        infants, and children.--Section 17(d)(3)(A)(ii) of the Child 
        Nutrition Act of 1966 (42 U.S.C. 1786(d)(3)(A)(ii)) is 
        amended--
                    (A) by striking the clause designation and heading 
                and all that follows through ``A State'' and inserting 
                the following:
                            ``(ii) Women.--
                                    ``(I) Breastfeeding women.--A 
                                State'';
                    (B) in subclause (I) (as so designated), by 
                striking ``1 year'' and all that follows through 
                ``earlier'' and inserting ``2 years postpartum''; and
                    (C) by adding at the end the following:
                                    ``(II) Postpartum women.--A State 
                                may elect to certify a postpartum woman 
                                for a period of 2 years.''.
            (8) Definitions.--In this section:
                    (A) Maternal mortality.--The term ``maternal 
                mortality'' means death of a woman that occurs during 
                pregnancy or within the one-year period following the 
                end of such pregnancy.
                    (B) Severe maternal morbidity.--The term ``severe 
                maternal morbidity'' includes unexpected outcomes of 
                labor and delivery that result in significant short-
                term or long-term consequences to a woman's health.
    (d) Increasing Excise Taxes on Cigarettes and Establishing Excise 
Tax Equity Among All Tobacco Product Tax Rates.--
            (1) Tax parity for roll-your-own tobacco.--Section 5701(g) 
        of the Internal Revenue Code of 1986 is amended by striking 
        ``$24.78'' and inserting ``$49.56''.
            (2) Tax parity for pipe tobacco.--Section 5701(f) of the 
        Internal Revenue Code of 1986 is amended by striking ``$2.8311 
        cents'' and inserting ``$49.56''.
            (3) Tax parity for smokeless tobacco.--
                    (A) Section 5701(e) of the Internal Revenue Code of 
                1986 is amended--
                            (i) in paragraph (1), by striking ``$1.51'' 
                        and inserting ``$26.84'';
                            (ii) in paragraph (2), by striking ``50.33 
                        cents'' and inserting ``$10.74''; and
                            (iii) by adding at the end the following:
            ``(3) Smokeless tobacco sold in discrete single-use 
        units.--On discrete single-use units, $100.66 per thousand.''.
                    (B) Section 5702(m) of such Code is amended--
                            (i) in paragraph (1), by striking ``or 
                        chewing tobacco'' and inserting ``, chewing 
                        tobacco, or discrete single-use unit'';
                            (ii) in paragraphs (2) and (3), by 
                        inserting ``that is not a discrete single-use 
                        unit'' before the period in each such 
                        paragraph; and
                            (iii) by adding at the end the following:
            ``(4) Discrete single-use unit.--The term `discrete single-
        use unit' means any product containing tobacco that--
                    ``(A) is not intended to be smoked; and
                    ``(B) is in the form of a lozenge, tablet, pill, 
                pouch, dissolvable strip, or other discrete single-use 
                or single-dose unit.''.
            (4) Tax parity for small cigars.--Paragraph (1) of section 
        5701(a) of the Internal Revenue Code of 1986 is amended by 
        striking ``$50.33'' and inserting ``$100.66''.
            (5) Tax parity for large cigars.--
                    (A) In general.--Paragraph (2) of section 5701(a) 
                of the Internal Revenue Code of 1986 is amended by 
                striking ``52.75 percent'' and all that follows through 
                the period and inserting the following: ``$49.56 per 
                pound and a proportionate tax at the like rate on all 
                fractional parts of a pound but not less than 10.066 
                cents per cigar.''.
                    (B) Guidance.--The Secretary of the Treasury, or 
                the Secretary's delegate, may issue guidance regarding 
                the appropriate method for determining the weight of 
                large cigars for purposes of calculating the applicable 
                tax under section 5701(a)(2) of the Internal Revenue 
                Code of 1986.
            (6) Tax parity for roll-your-own tobacco and certain 
        processed tobacco.--Subsection (o) of section 5702 of the 
        Internal Revenue Code of 1986 is amended by inserting ``, and 
        includes processed tobacco that is removed for delivery or 
        delivered to a person other than a person with a permit 
        provided under section 5713, but does not include removals of 
        processed tobacco for exportation'' after ``wrappers thereof''.
            (7) Clarifying tax rate for other tobacco products.--
                    (A) In general.--Section 5701 of the Internal 
                Revenue Code of 1986 is amended by adding at the end 
                the following new subsection:
    ``(i) Other Tobacco Products.--Any product not otherwise described 
under this section that has been determined to be a tobacco product by 
the Food and Drug Administration through its authorities under the 
Family Smoking Prevention and Tobacco Control Act shall be taxed at a 
level of tax equivalent to the tax rate for cigarettes on an estimated 
per use basis as determined by the Secretary.''.
                    (B) Establishing per use basis.--For purposes of 
                section 5701(i) of the Internal Revenue Code of 1986, 
                not later than 12 months after the later of the date of 
                the enactment of this Act or the date that a product 
                has been determined to be a tobacco product by the Food 
                and Drug Administration, the Secretary of the Treasury 
                (or the Secretary of the Treasury's delegate) shall 
                issue final regulations establishing the level of tax 
                for such product that is equivalent to the tax rate for 
                cigarettes on an estimated per use basis.
            (8) Clarifying definition of tobacco products.--
                    (A) In general.--Subsection (c) of section 5702 of 
                the Internal Revenue Code of 1986 is amended to read as 
                follows:
    ``(c) Tobacco Products.--The term `tobacco products' means--
            ``(1) cigars, cigarettes, smokeless tobacco, pipe tobacco, 
        and roll-your-own tobacco, and
            ``(2) any other product subject to tax pursuant to section 
        5701(i).''.
                    (B) Conforming amendments.--Subsection (d) of 
                section 5702 of such Code is amended by striking 
                ``cigars, cigarettes, smokeless tobacco, pipe tobacco, 
                or roll-your-own tobacco'' each place it appears and 
                inserting ``tobacco products''.
            (9) Increasing tax on cigarettes.--
                    (A) Small cigarettes.--Section 5701(b)(1) of such 
                Code is amended by striking ``$50.33'' and inserting 
                ``$100.66''.
                    (B) Large cigarettes.--Section 5701(b)(2) of such 
                Code is amended by striking ``$105.69'' and inserting 
                ``$211.38''.
            (10) Tax rates adjusted for inflation.--Section 5701 of 
        such Code, as amended by subsection (g), is amended by adding 
        at the end the following new subsection:
    ``(j) Inflation Adjustment.--
            ``(1) In general.--In the case of any calendar year 
        beginning after 2021, the dollar amounts provided under this 
        chapter shall each be increased by an amount equal to--
                    ``(A) such dollar amount, multiplied by
                    ``(B) the cost-of-living adjustment determined 
                under section 1(f)(3) for the calendar year, determined 
                by substituting `calendar year 2017' for `calendar year 
                2016' in subparagraph (A)(ii) thereof.
            ``(2) Rounding.--If any amount as adjusted under paragraph 
        (1) is not a multiple of $0.01, such amount shall be rounded to 
        the next highest multiple of $0.01.''.
            (11) Floor stocks taxes.--
                    (A) Imposition of tax.--On tobacco products 
                manufactured in or imported into the United States 
                which are removed before any tax increase date and held 
                on such date for sale by any person, there is hereby 
                imposed a tax in an amount equal to the excess of--
                            (i) the tax which would be imposed under 
                        section 5701 of the Internal Revenue Code of 
                        1986 on the article if the article had been 
                        removed on such date, over
                            (ii) the prior tax (if any) imposed under 
                        section 5701 of such Code on such article.
                    (B) Credit against tax.--Each person shall be 
                allowed as a credit against the taxes imposed by 
                paragraph (1) an amount equal to $500. Such credit 
                shall not exceed the amount of taxes imposed by 
                paragraph (1) on such date for which such person is 
                liable.
                    (C) Liability for tax and method of payment.--
                            (i) Liability for tax.--A person holding 
                        tobacco products on any tax increase date to 
                        which any tax imposed by paragraph (1) applies 
                        shall be liable for such tax.
                            (ii) Method of payment.--The tax imposed by 
                        paragraph (1) shall be paid in such manner as 
                        the Secretary shall prescribe by regulations.
                            (iii) Time for payment.--The tax imposed by 
                        paragraph (1) shall be paid on or before the 
                        date that is 120 days after the effective date 
                        of the tax rate increase.
                    (D) Articles in foreign trade zones.--
                Notwithstanding the Act of June 18, 1934 (commonly 
                known as the Foreign Trade Zone Act, 48 Stat. 998, 19 
                U.S.C. 81a et seq.), or any other provision of law, any 
                article which is located in a foreign trade zone on any 
                tax increase date shall be subject to the tax imposed 
                by paragraph (1) if--
                            (i) internal revenue taxes have been 
                        determined, or customs duties liquidated, with 
                        respect to such article before such date 
                        pursuant to a request made under the 1st 
                        proviso of section 3(a) of such Act; or
                            (ii) such article is held on such date 
                        under the supervision of an officer of the 
                        United States Customs and Border Protection of 
                        the Department of Homeland Security pursuant to 
                        the 2d proviso of such section 3(a).
                    (E) Definitions.--For purposes of this subsection--
                            (i) In general.--Any term used in this 
                        subsection which is also used in section 5702 
                        of such Code shall have the same meaning as 
                        such term has in such section.
                            (ii) Tax increase date.--The term ``tax 
                        increase date'' means the effective date of any 
                        increase in any tobacco product excise tax rate 
                        pursuant to the amendments made by this section 
                        (other than subsection (j) thereof).
                            (iii) Secretary.--The term ``Secretary'' 
                        means the Secretary of the Treasury or the 
                        Secretary's delegate.
                    (F) Controlled groups.--Rules similar to the rules 
                of section 5061(e)(3) of such Code shall apply for 
                purposes of this subsection.
                    (G) Other laws applicable.--All provisions of law, 
                including penalties, applicable with respect to the 
                taxes imposed by section 5701 of such Code shall, 
                insofar as applicable and not inconsistent with the 
                provisions of this subsection, apply to the floor 
                stocks taxes imposed by paragraph (1), to the same 
                extent as if such taxes were imposed by such section 
                5701. The Secretary may treat any person who bore the 
                ultimate burden of the tax imposed by paragraph (1) as 
                the person to whom a credit or refund under such 
                provisions may be allowed or made.
            (12) Effective dates.--
                    (A) In general.--Except as provided in paragraphs 
                (2) through (4), the amendments made by this section 
                shall apply to articles removed (as defined in section 
                5702(j) of the Internal Revenue Code of 1986) after the 
                last day of the month which includes the date of the 
                enactment of this Act.
                    (B) Discrete single-use units and processed 
                tobacco.--The amendments made by subsections (c)(1)(C), 
                (c)(2), and (f) shall apply to articles removed (as 
                defined in section 5702(j) of the Internal Revenue Code 
                of 1986) after the date that is 6 months after the date 
                of the enactment of this Act.
                    (C) Large cigars.--The amendments made by 
                subsection (e) shall apply to articles removed after 
                December 31, 2021.
                    (D) Other tobacco products.--The amendments made by 
                subsection (g)(1) shall apply to products removed after 
                the last day of the month which includes the date that 
                the Secretary of the Treasury (or the Secretary of the 
                Treasury's delegate) issues final regulations 
                establishing the level of tax for such product.

SEC. 504. ALLOWING FOR MEDICAL ASSISTANCE UNDER MEDICAID FOR INMATES 
              DURING 30-DAY PERIOD PRECEDING RELEASE.

    (a) In General.--The subdivision (A) following paragraph (30) of 
section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is 
amended by inserting ``and except during the 30-day period preceding 
the date of release of such individual from such public institution'' 
after ``medical institution''.
    (b) Report.--Not later than June 30, 2022, the Medicaid and CHIP 
Payment and Access Commission shall submit a report to Congress on the 
Medicaid inmate exclusion under the subdivision (A) following paragraph 
(30) of section 1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)). Such report may, to the extent practicable, include the 
following information:
            (1) The number of incarcerated individuals who would 
        otherwise be eligible to enroll for medical assistance under a 
        State plan approved under title XIX of the Social Security Act 
        (42 U.S.C. 1396 et seq.) (or a waiver of such a plan).
            (2) Access to health care for incarcerated individuals, 
        including a description of medical services generally available 
        to incarcerated individuals.
            (3) A description of current practices related to the 
        discharge of incarcerated individuals, including how prisons 
        interact with State Medicaid agencies to ensure that such 
        individuals who are eligible to enroll for medical assistance 
        under a State plan or waiver described in paragraph (1) are so 
        enrolled.
            (4) If determined appropriate by the Commission, 
        recommendations for Congress, the Department of Health and 
        Human Services, or States regarding the Medicaid inmate 
        exclusion.
            (5) Any other information that the Commission determines 
        would be useful to Congress.

SEC. 505. PROVIDING FOR IMMEDIATE MEDICAID ELIGIBILITY FOR FORMER 
              FOSTER YOUTH.

    Section 1002(a)(2) of the SUPPORT for Patients and Communities Act 
(Public Law 115-271) is amended by striking ``January 1, 2023'' and 
inserting ``the date of enactment of the Ending Health Disparities 
During COVID-19 Act of 2020''.

SEC. 506. EXPANDED COVERAGE FOR FORMER FOSTER YOUTH.

    (a) Coverage Continuity for Former Foster Care Children up to Age 
26.--
            (1) In general.--Section 1002(a)(1)(B) of the SUPPORT for 
        Patients and Communities Act (Public Law 115-271) is amended by 
        striking all that follows after ``item (cc),'' and inserting 
        the following: ``by striking `responsibility of the State' and 
        all that follows through `475(8)(B)(iii); and' and inserting 
        `responsibility of a State on the date of attaining 18 years of 
        age (or such higher age as such State has elected under section 
        475(8)(B)(iii)), or who were in such care at any age but 
        subsequently left such care to enter into a legal guardianship 
        with a kinship caregiver (without regard to whether kinship 
        guardianship payments are being made on behalf of the child 
        under this part) or were emancipated from such care prior to 
        attaining age 18;'''.
            (2) Amendments to social security act.--
                    (A) In general.--Section 1902(a)(10)(A)(i)(IX) of 
                the Social Security Act (42 U.S.C. 
                1396a(a)(10)(A)(i)(IX)), as amended by section 1002(a) 
                of the SUPPORT for Patients and Communities Act (Public 
                Law 115-271), is amended--
                            (i) in item (bb), by striking the semicolon 
                        at the end and inserting ``; and''; and
                            (ii) by striking item (dd).
                    (B) Effective date.--The amendments made by this 
                paragraph shall take effect on January 1, 2023.
    (b) Outreach Efforts for Enrollment of Former Foster Children.--
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is 
amended--
            (1) in paragraph (85), by striking ``; and'' and inserting 
        a semicolon;
            (2) in paragraph (86), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (86) the following new 
        paragraph:
            ``(87) not later than January 1, 2020, establish an 
        outreach and enrollment program, in coordination with the State 
        agency responsible for administering the State plan under part 
        E of title IV and any other appropriate or interested agencies, 
        designed to increase the enrollment of individuals who are 
        eligible for medical assistance under the State plan under 
        paragraph (10)(A)(i)(IX) in accordance with best practices 
        established by the Secretary.''.

SEC. 507. REMOVING CITIZENSHIP AND IMMIGRATION BARRIERS TO ACCESS TO 
              AFFORDABLE HEALTH CARE UNDER ACA.

    (a) In General.--
            (1) Premium tax credits.--Section 36B of the Internal 
        Revenue Code of 1986 is amended--
                    (A) in subsection (c)(1)(B)--
                            (i) by amending the heading to read as 
                        follows: ``Special rule for certain individuals 
                        ineligible for medicaid due to status'', and
                            (ii) in clause (ii), by striking ``lawfully 
                        present in the United States, but'' and 
                        inserting ``who'', and
                    (B) by striking subsection (e).
            (2) Cost-sharing reductions.--Section 1402 of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18071) is amended 
        by striking subsection (e).
            (3) Basic health program eligibility.--Section 
        1331(e)(1)(B) of the Patient Protection and Affordable Care Act 
        (42 U.S.C. 18051(e)(1)(B)) is amended by striking ``lawfully 
        present in the United States''.
            (4) Restrictions on federal payments.--Section 1412 of the 
        Patient Protection and Affordable Care Act (42 U.S.C. 18082) is 
        amended by striking subsection (d).
            (5) Requirement to maintain minimum essential coverage.--
        Section 5000A(d) of the Internal Revenue Code of 1986 is 
        amended by striking paragraph (3) and by redesignating 
        paragraph (4) as paragraph (3).
    (b) Conforming Amendments.--
            (1) Section 1411(a) of the Patient Protection and 
        Affordable Care Act (42 U.S.C. 18081(a)) is amended by striking 
        paragraph (1) and redesignating paragraphs (2), (3), and (4) as 
        paragraphs (1), (2), and (3), respectively.
            (2) Section 1312(f) of the Patient Protection and 
        Affordable Care Act (42 U.S.C. 18032(f)) is amended--
                    (A) in the heading, by striking ``; Access Limited 
                to Citizens and Lawful Residents''; and
                    (B) by striking paragraph (3).

SEC. 508. MEDICAID IN THE TERRITORIES.

    (a) Elimination of General Medicaid Funding Limitations (``cap'') 
for Territories.--
            (1) In general.--Section 1108 of the Social Security Act 
        (42 U.S.C. 1308) is amended--
                    (A) in subsection (f), in the matter preceding 
                paragraph (1), by striking ``subsection (g)'' and 
                inserting ``subsections (g) and (h)'';
                    (B) in subsection (g)(2), in the matter preceding 
                subparagraph (A), by inserting ``and subsection (h)'' 
                after ``paragraphs (3) and (5)''; and
                    (C) by adding at the end the following new 
                subsection:
    ``(h) Sunset of Medicaid Funding Limitations for Puerto Rico, the 
Virgin Islands of the United States, Guam, the Northern Mariana 
Islands, and American Samoa.--Subsections (f) and (g) shall not apply 
to Puerto Rico, the Virgin Islands of the United States, Guam, the 
Northern Mariana Islands, and American Samoa beginning with fiscal year 
2020.''.
            (2) Conforming amendments.--
                    (A) Section 1902(j) of the Social Security Act (42 
                U.S.C. 1396a(j)) is amended by striking ``, the 
                limitation in section 1108(f),''.
                    (B) Section 1903(u) of the Social Security Act (42 
                U.S.C. 1396b(u)) is amended by striking paragraph (4).
                    (C) Section 1323(c)(1) of the Patient Protection 
                and Affordable Care Act (42 U.S.C. 18043(c)(1)) is 
                amended by striking ``2019'' and inserting ``2018''.
            (3) Effective date.--The amendments made by this section 
        shall apply beginning with fiscal year 2021.
    (b) Elimination of Specific Federal Medical Assistance Percentage 
(FMAP) Limitation for Territories.--Section 1905(b) of the Social 
Security Act (42 U.S.C. 1396d(b)) is amended, in clause (2), by 
inserting ``for fiscal years before fiscal year 2020'' after ``American 
Samoa''.
    (c) Application of Medicaid Waiver Authority to All of the 
Territories.--
            (1) In general.--Section 1902(j) of the Social Security Act 
        (42 U.S.C. 1396a(j)) is amended--
                    (A) by striking ``American Samoa and the Northern 
                Mariana Islands'' and inserting ``Puerto Rico, the 
                Virgin Islands of the United States, Guam, the Northern 
                Mariana Islands, and American Samoa'';
                    (B) by striking ``American Samoa or the Northern 
                Mariana Islands'' and inserting ``Puerto Rico, the 
                Virgin Islands of the United States, Guam, the Northern 
                Mariana Islands, or American Samoa'';
                    (C) by inserting ``(1)'' after ``(j)'';
                    (D) by inserting ``except as otherwise provided in 
                this subsection,'' after ``Notwithstanding any other 
                requirement of this title''; and
                    (E) by adding at the end the following:
            ``(2) The Secretary may not waive under this subsection the 
        requirement of subsection (a)(10)(A)(i)(IX) (relating to 
        coverage of adults formerly under foster care) with respect to 
        any territory.''.
            (2) Effective date.--The amendments made by this section 
        shall apply beginning October 1, 2021.
    (d) Permitting Medicaid DSH Allotments for Territories.--Section 
1923(f) of the Social Security Act (42 U.S.C. 1396r-4) is amended--
            (1) in paragraph (6), by adding at the end the following 
        new subparagraph:
                    ``(C) Territories.--
                            ``(i) Fiscal year 2020.--For fiscal year 
                        2020, the DSH allotment for Puerto Rico, the 
                        Virgin Islands of the United States, Guam, the 
                        Northern Mariana Islands, and American Samoa 
                        shall bear the same ratio to $300,000,000 as 
                        the ratio of the number of individuals who are 
                        low-income or uninsured and residing in such 
                        respective territory (as estimated from time to 
                        time by the Secretary) bears to the sums of the 
                        number of such individuals residing in all of 
                        the territories.
                            ``(ii) Subsequent fiscal year.--For each 
                        subsequent fiscal year, the DSH allotment for 
                        each such territory is subject to an increase 
                        in accordance with paragraph (2).''; and
            (2) in paragraph (9), by inserting before the period at the 
        end the following: ``, and includes, beginning with fiscal year 
        2021, Puerto Rico, the Virgin Islands of the United States, 
        Guam, the Northern Mariana Islands, and American Samoa''.

SEC. 509. REMOVING MEDICARE BARRIER TO HEALTH CARE.

    (a) Part A.--Section 1818(a)(3) of the Social Security Act (42 
U.S.C. 1395i-2(a)(3)) is amended by striking ``an alien'' and all that 
follows through ``under this section'' and inserting ``an individual 
who is lawfully present in the United States''.
    (b) Part B.--Section 1836(2) of the Social Security Act (42 U.S.C. 
1395o(2)) is amended by striking ``an alien'' and all that follows 
through ``under this part'' and inserting ``an individual who is 
lawfully present in the United States''.

SEC. 510. REMOVING BARRIERS TO HEALTH CARE AND NUTRITION ASSISTANCE FOR 
              CHILDREN, PREGNANT PERSONS, AND LAWFULLY PRESENT 
              INDIVIDUALS.

    (a) Medicaid.--Section 1903(v) of the Social Security Act (42 
U.S.C. 1396b(v)) is amended by striking paragraph (4) and inserting the 
following new paragraph:
    ``(4)(A) Notwithstanding sections 401(a), 402(b), 403, and 421 of 
the Personal Responsibility and Work Opportunity Reconciliation Act of 
1996 and paragraph (1), payment shall be made to a State under this 
section for medical assistance furnished to an alien under this title 
(including an alien described in such paragraph) who meets any of the 
following conditions:
            ``(i) The alien is otherwise eligible for such assistance 
        under the State plan approved under this title (other than the 
        requirement of the receipt of aid or assistance under title IV, 
        supplemental security income benefits under title XVI, or a 
        State supplementary payment) within either or both of the 
        following eligibility categories:
                    ``(I) Children under 21 years of age, including any 
                optional targeted low-income child (as such term is 
                defined in section 1905(u)(2)(B)).
                    ``(II) Pregnant persons during pregnancy and during 
                the 12-month period beginning on the last day of the 
                pregnancy.
            ``(ii) The alien is lawfully present in the United States.
    ``(B) No debt shall accrue under an affidavit of support against 
any sponsor of an alien who meets the conditions specified in 
subparagraph (A) on the basis of the provision of medical assistance to 
such alien under this paragraph and the cost of such assistance shall 
not be considered as an unreimbursed cost.''.
    (b) SCHIP.--Subparagraph (N) of section 2107(e)(1) of the Social 
Security Act (42 U.S.C. 1397gg(e)(1)) is amended to read as follows:
                    ``(N) Paragraph (4) of section 1903(v) (relating to 
                coverage of categories of children, pregnant persons, 
                and other lawfully present individuals).''.
    (c) Supplemental Nutrition Assistance.--Notwithstanding sections 
401(a), 402(a), and 403(a) of the Personal Responsibility and Work 
Opportunity Reconciliation Act of 1996 (8 U.S.C. 1611(a); 1612(a); 
1613(a)) and section 6(f) of the Food and Nutrition Act of 2008 (7 
U.S.C. 2015(f)), persons who are lawfully present in the United States 
shall be not be ineligible for benefits under the supplemental 
nutrition assistance program on the basis of their immigration status 
or date of entry into the United States.
    (d) Eligibility for Families With Children.--Section 421(d)(3) of 
the Personal Responsibility and Work Opportunity Reconciliation Act of 
1996 (8 U.S.C. 1631(d)(3)) is amended by striking ``to the extent that 
a qualified alien is eligible under section 402(a)(2)(J)'' and 
inserting, ``to the extent that a child is a member of a household 
under the supplemental nutrition assistance program''.
    (e) Ensuring Proper Screening.--Section 11(e)(2)(B) of the Food and 
Nutrition Act of 2008 (7 U.S.C. 2020(e)(2)(B)) is amended--
            (1) by redesignating clauses (vi) and (vii) as clauses 
        (vii) and (viii); and
            (2) by inserting after clause (v) the following:
                            ``(vi) shall provide a method for 
                        implementing section 421 of the Personal 
                        Responsibility and Work Opportunity 
                        Reconciliation Act of 1996 (8 U.S.C. 1631) that 
                        does not require any unnecessary information 
                        from persons who may be exempt from that 
                        provision;''.

SEC. 511. REPEAL OF REQUIREMENT FOR DOCUMENTATION EVIDENCING 
              CITIZENSHIP OR NATIONALITY UNDER THE MEDICAID PROGRAM.

    (a) Repeal.--Subsections (i)(22) and (x) of section 1903 of the 
Social Security Act (42 U.S.C. 1396b) are each repealed.
    (b) Conforming Amendments.--
            (1) State payments for medical assistance.--Section 1902 of 
        the Social Security Act (42 U.S.C. 1396a) is amended--
                    (A) by amending paragraph (46) of subsection (a) to 
                read as follows:
            ``(46) provide that information is requested and exchanged 
        for purposes of income and eligibility verification in 
        accordance with a State system which meets the requirements of 
        section 1137 of this Act;'';
                    (B) in subsection (e)(13)(A)(i)--
                            (i) in the matter preceding subclause (I), 
                        by striking ``sections 1902(a)(46)(B) and 
                        1137(d)'' and inserting ``section 1137(d)''; 
                        and
                            (ii) in subclause (IV), by striking 
                        ``1902(a)(46)(B) or''; and
                    (C) by striking subsection (ee).
            (2) Payment to states.--Section 1903 of the Social Security 
        Act (42 U.S.C. 1396b) is amended--
                    (A) in subsection (i), by redesignating paragraphs 
                (23) through (26) as paragraphs (22) through (25), 
                respectively; and
                    (B) by redesignating subsections (y) and (z) as 
                subsections (x) and (y), respectively.
            (3) Repeal.--Subsection (c) of section 6036 of the Deficit 
        Reduction Act of 2005 (42 U.S.C. 1396b note) is repealed.
    (c) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of the Deficit Reduction Act of 
2005.

                    TITLE VI--COMMUNITY BASED GRANTS

SEC. 601. GRANTS FOR RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH.

    (a) Purpose.--It is the purpose of this section to award grants to 
assist communities in mobilizing and organizing resources in support of 
effective and sustainable programs that will reduce or eliminate 
disparities in health and health care experienced by racial and ethnic 
minority individuals.
    (b) Authority To Award Grants.--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 award grants to eligible entities to assist in 
designing, implementing, and evaluating culturally and linguistically 
appropriate, science-based, and community-driven sustainable strategies 
to eliminate racial and ethnic health and health care disparities.
    (c) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall--
            (1) represent a coalition--
                    (A) whose principal purpose is to develop and 
                implement interventions to reduce or eliminate a health 
                or health care disparity in a targeted racial or ethnic 
                minority group in the community served by the 
                coalition; and
                    (B) that includes--
                            (i) members selected from among--
                                    (I) public health departments;
                                    (II) community-based organizations;
                                    (III) university and research 
                                organizations;
                                    (IV) Indian tribes or tribal 
                                organizations (as such terms are 
                                defined in section 4 of the Indian 
                                Self-Determination and Education 
                                Assistance Act (25 U.S.C. 5304)), the 
                                Indian Health Service, or any other 
                                organization that serves Alaska 
                                Natives; and
                                    (V) interested public or private 
                                health care providers or organizations 
                                as determined appropriate by the 
                                Secretary; and
                            (ii) at least 1 member from a community-
                        based organization that represents the targeted 
                        racial or ethnic minority group; and
            (2) submit to the Secretary an application at such time, in 
        such manner, and containing such information as the Secretary 
        may require, which shall include--
                    (A) a description of the targeted racial or ethnic 
                populations in the community to be served under the 
                grant;
                    (B) a description of at least 1 health disparity 
                that exists in the racial or ethnic targeted 
                populations, including health issues such as infant 
                mortality, breast and cervical cancer screening and 
                management, musculoskeletal diseases and obesity, 
                prostate cancer screening and management, 
                cardiovascular disease, diabetes, child and adult 
                immunization levels, oral disease, or other health 
                priority areas as designated by the Secretary; and
                    (C) a demonstration of a proven record of 
                accomplishment of the coalition members in serving and 
                working with the targeted community.
    (d) Sustainability.--The Secretary shall give priority to an 
eligible entity under this section if the entity agrees that, with 
respect to the costs to be incurred by the entity in carrying out the 
activities for which the grant was awarded, the entity (and each of the 
participating partners in the coalition represented by the entity) will 
maintain its expenditures of non-Federal funds for such activities at a 
level that is not less than the level of such expenditures during the 
fiscal year immediately preceding the first fiscal year for which the 
grant is awarded.
    (e) Nonduplication.--Any funds provided to an eligible entity 
through a grant under this section shall--
            (1) supplement, not supplant, any other Federal funds made 
        available to the entity for the purposes of this section; and
            (2) not be used to duplicate the activities of any other 
        health disparity grant program under this Act, including an 
        amendment made by this Act.
    (f) Technical Assistance.--The Secretary may, either directly or by 
grant or contract, provide any entity that receives a grant under this 
section with technical and other nonfinancial assistance necessary to 
meet the requirements of this section.
    (g) Dissemination.--The Secretary shall encourage and enable 
eligible entities receiving grants under this section to share best 
practices, evaluation results, and reports with communities not 
affiliated with such entities, by using the Internet, conferences, and 
other pertinent information regarding the projects funded by this 
section, including through using outreach efforts of the Office of 
Minority Health and the Centers for Disease Control and Prevention.
    (h) Administrative Burdens.--The Secretary shall make every effort 
to minimize duplicative or unnecessary administrative burdens on 
eligible entities receiving grants under this section.
    (i) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section.

SEC. 602. GRANTS TO PROMOTE HEALTH FOR UNDERSERVED COMMUNITIES.

    Part Q of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399Z-3. GRANTS TO PROMOTE HEALTH FOR UNDERSERVED COMMUNITIES.

    ``(a) Grants Authorized.--The Secretary, in collaboration with the 
Administrator of the Health Resources and Services Administration and 
other Federal officials determined appropriate by the Secretary, is 
authorized to award grants to eligible entities--
            ``(1) to promote health for underserved communities, with 
        preference given to projects that benefit racial and ethnic 
        minority women, racial and ethnic minority children, 
        adolescents, and lesbian, gay, bisexual, transgender, queer, or 
        questioning communities; and
            ``(2) to strengthen health outreach initiatives in 
        medically underserved communities, including linguistically 
        isolated populations.
    ``(b) Use of Funds.--Grants awarded pursuant to subsection (a) may 
be used to support the activities of community health workers, 
including such activities--
            ``(1) to educate and provide outreach regarding enrollment 
        in health insurance including the State Children's Health 
        Insurance Program under title XXI of the Social Security Act, 
        Medicare under title XVIII of such Act, and Medicaid under 
        title XIX of such Act;
            ``(2) to educate and provide outreach in a community 
        setting regarding health problems prevalent among underserved 
        communities, and especially among racial and ethnic minority 
        women, racial and ethnic minority children, adolescents, and 
        lesbian, gay, bisexual, transgender, queer, or questioning 
        communities;
            ``(3) to educate and provide experiential learning 
        opportunities and target risk factors and healthy behaviors 
        that impede or contribute to achieving positive health 
        outcomes, including--
                    ``(A) healthy nutrition;
                    ``(B) physical activity;
                    ``(C) overweight or obesity;
                    ``(D) tobacco use, including the use of e-
                cigarettes and vaping;
                    ``(E) alcohol and substance use;
                    ``(F) injury and violence;
                    ``(G) sexual health;
                    ``(H) mental health;
                    ``(I) musculoskeletal health and arthritis;
                    ``(J) prenatal and postnatal care;
                    ``(K) dental and oral health;
                    ``(L) understanding informed consent;
                    ``(M) stigma; and
                    ``(N) environmental hazards;
            ``(4) to promote community wellness and awareness; and
            ``(5) to educate and refer target populations to 
        appropriate health care agencies and community-based programs 
        and organizations in order to increase access to quality health 
        care services, including preventive health services.
    ``(c) Application.--
            ``(1) In general.--Each eligible entity that desires to 
        receive a grant under subsection (a) shall submit an 
        application to the Secretary, at such time, in such manner, and 
        accompanied by such additional information as the Secretary may 
        require.
            ``(2) Contents.--Each application submitted pursuant to 
        paragraph (1) shall--
                    ``(A) describe the activities for which assistance 
                under this section is sought;
                    ``(B) contain an assurance that, with respect to 
                each community health worker program receiving funds 
                under the grant awarded, such program provides in-
                language training and supervision to community health 
                workers to enable such workers to provide authorized 
                program activities in (at least) the most commonly used 
                languages within a particular geographic region;
                    ``(C) contain an assurance that the applicant will 
                evaluate the effectiveness of community health worker 
                programs receiving funds under the grant;
                    ``(D) contain an assurance that each community 
                health worker program receiving funds under the grant 
                will provide culturally competent services in the 
                linguistic context most appropriate for the individuals 
                served by the program;
                    ``(E) contain a plan to document and disseminate 
                project descriptions and results to other States and 
                organizations as identified by the Secretary; and
                    ``(F) describe plans to enhance the capacity of 
                individuals to utilize health services and health-
                related social services under Federal, State, and local 
                programs by--
                            ``(i) assisting individuals in establishing 
                        eligibility under the programs and in receiving 
                        the services or other benefits of the programs; 
                        and
                            ``(ii) providing other services, as the 
                        Secretary determines to be appropriate, which 
                        may include transportation and translation 
                        services.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to those applicants--
            ``(1) who propose to target geographic areas that--
                    ``(A)(i) have a high percentage of residents who 
                are uninsured or underinsured (if the targeted 
                geographic area is located in a State that has elected 
                to make medical assistance available under section 
                1902(a)(10)(A)(i)(VIII) of the Social Security Act to 
                individuals described in such section);
                    ``(ii) have a high percentage of underinsured 
                residents in a particular geographic area (if the 
                targeted geographic area is located in a State that has 
                not so elected); or
                    ``(iii) have a high number of households 
                experiencing extreme poverty; and
                    ``(B) have a high percentage of families for whom 
                English is not their primary language or including 
                smaller limited English-proficient communities within 
                the region that are not otherwise reached by 
                linguistically appropriate health services;
            ``(2) with experience in providing health or health-related 
        social services to individuals who are underserved with respect 
        to such services; and
            ``(3) with documented community activity and experience 
        with community health workers.
    ``(e) Collaboration With Academic Institutions.--The Secretary 
shall encourage community health worker programs receiving funds under 
this section to collaborate with academic institutions, including 
minority-serving institutions. Nothing in this section shall be 
construed to require such collaboration.
    ``(f) Quality Assurance and Cost Effectiveness.--The Secretary 
shall establish guidelines for ensuring the quality of the training and 
supervision of community health workers under the programs funded under 
this section and for ensuring the cost effectiveness of such programs.
    ``(g) Monitoring.--The Secretary shall monitor community health 
worker programs identified in approved applications and shall determine 
whether such programs are in compliance with the guidelines established 
under subsection (f).
    ``(h) Technical Assistance.--The Secretary may provide technical 
assistance to community health worker programs identified in approved 
applications with respect to planning, developing, and operating 
programs under the grant.
    ``(i) Report to Congress.--
            ``(1) In general.--Not later than 4 years after the date on 
        which the Secretary first awards grants under subsection (a), 
        the Secretary shall submit to Congress a report regarding the 
        grant project.
            ``(2) Contents.--The report required under paragraph (1) 
        shall include the following:
                    ``(A) A description of the programs for which grant 
                funds were used.
                    ``(B) The number of individuals served.
                    ``(C) An evaluation of--
                            ``(i) the effectiveness of these programs;
                            ``(ii) the cost of these programs; and
                            ``(iii) the impact of these programs on the 
                        health outcomes of the community residents.
                    ``(D) Recommendations for sustaining the community 
                health worker programs developed or assisted under this 
                section.
                    ``(E) Recommendations regarding training to enhance 
                career opportunities for community health workers.
    ``(j) Definitions.--In this section:
            ``(1) Community health worker.--The term `community health 
        worker' means an individual who promotes health or nutrition 
        within the community in which the individual resides--
                    ``(A) by serving as a liaison between communities 
                and health care agencies;
                    ``(B) by providing guidance and social assistance 
                to community residents;
                    ``(C) by enhancing community residents' ability to 
                effectively communicate with health care providers;
                    ``(D) by providing culturally and linguistically 
                appropriate health or nutrition education;
                    ``(E) by advocating for individual and community 
                health, including dental, oral, mental, and 
                environmental health, or nutrition needs;
                    ``(F) by taking into consideration the needs of the 
                communities served, including the prevalence rates of 
                risk factors that impede achieving positive healthy 
                outcomes among women and children, especially among 
                racial and ethnic minority women and children; and
                    ``(G) by providing referral and followup services.
            ``(2) Community setting.--The term `community setting' 
        means a home or a community organization that serves a 
        population.
            ``(3) Eligible entity.--The term `eligible entity' means--
                    ``(A) a unit of State, territorial, local, or 
                Tribal government (including a federally recognized 
                Tribe or Alaska Native village); or
                    ``(B) a community-based organization.
            ``(4) Medically underserved community.--The term `medically 
        underserved community' means a community--
                    ``(A) that has a substantial number of individuals 
                who are members of a medically underserved population, 
                as defined by section 330(b)(3);
                    ``(B) a significant portion of which is a health 
                professional shortage area as designated under section 
                332; and
                    ``(C) that includes populations that are 
                linguistically isolated, such as geographic areas with 
                a shortage of health professionals able to provide 
                linguistically appropriate services.
            ``(5) Support.--The term `support' means the provision of 
        training, supervision, and materials needed to effectively 
        deliver the services described in subsection (b), reimbursement 
        for services, and other benefits.
    ``(k) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $15,000,000 for each of fiscal 
years 2021 through 2025.''.

SEC. 603. ADDRESSING COVID-19 HEALTH INEQUITIES AND IMPROVING HEALTH 
              EQUITY.

    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, the Secretary of Health and Human Services (referred to in 
this section as the ``Secretary''), acting through the Director of the 
Centers for Disease Control and Prevention, shall award grants to 
eligible entities to establish or expand programs to improve health 
equity regarding COVID-19 and reduce or eliminate inequities, including 
racial and ethnic inequities, in the incidence, prevalence, and health 
outcomes of COVID-19.
    (b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            (1) be a nongovernmental entity or consortium of entities 
        that works to improve health and health equity in populations 
        or communities disproportionately affected by adverse health 
        outcomes, including--
                    (A) racial and ethnic minority communities;
                    (B) Indian Tribes, Tribal organizations, and urban 
                Indian organizations;
                    (C) people with disabilities;
                    (D) English language learners;
                    (E) older adults;
                    (F) low-income communities;
                    (G) justice-involved communities;
                    (H) immigrant communities; and
                    (I) communities on the basis of their sexual 
                orientation or gender identity;
            (2) have demonstrated experience in successfully working in 
        and partnering with such communities, and have an established 
        record of accomplishment in improving health outcomes or 
        preventing, reducing or eliminating health inequities, 
        including racial and ethnic inequities, in those communities;
            (3) communicate with State, local, and Tribal health 
        departments to coordinate grant activities, as appropriate; and
            (4) submit to the Secretary an application at such time, in 
        such manner, and containing such information as the Secretary 
        may require.
    (c) Use of Funds.--An entity shall use amounts received under grant 
under this section to establish, improve upon, or expand programs to 
improve health equity regarding COVID-19 and reduce or eliminate 
inequities, including racial and ethnic inequities, in the incidence, 
prevalence, and health outcomes of COVID-19. Such uses may include--
            (1) acquiring and distributing medical supplies, such as 
        personal protective equipment, to communities that are at an 
        increased risk of COVID-19;
            (2) helping people enroll in a health insurance plan that 
        meets minimum essential coverage;
            (3) increasing the availability of COVID-19 testing and any 
        future COVID-19 treatments or vaccines in communities that are 
        at an increased risk of COVID-19;
            (4) aiding communities and individuals in following 
        guidelines and best practices in regards to COVID-19, including 
        physical distancing guidelines;
            (5) helping communities and COVID-19 survivors recover and 
        cope with the long-term health impacts of COVID-19;
            (6) addressing social determinants of health, such as 
        transportation, nutrition, housing, discrimination, health care 
        access, including mental health care and substance use disorder 
        prevention, treatment, and recovery, health literacy, 
        employment status, and working conditions, education, income, 
        and stress, that impact COVID-19 incidence, prevalence, and 
        health outcomes, and facilitating or providing access to needed 
        services;
            (7) the provision of anti-racism and implicit and explicit 
        bias training for health care providers and other relevant 
        professionals;
            (8) creating and disseminating culturally informed, 
        linguistically appropriate, accessible, and medically accurate 
        outreach and education regarding COVID-19;
            (9) acquiring, retaining, and training a diverse workforce; 
        and
            (10) improving the accessibility to health care, including 
        accessibility to health care providers, mental health care, and 
        COVID-19 testing for people with disabilities.
    (d) Administration.--
            (1) Priority.--In awarding grants under this section, the 
        Secretary shall give priority to eligible entities that are a 
        community-based organization or have an established history of 
        successfully working in and partnering with the community or 
        with populations which the entity intends to provide services 
        under the grant. The Secretary shall also utilize available 
        demographic data to give priority to eligible entities working 
        with populations or communities disproportionately affected by 
        COVID-19.
            (2) Geographical diversity.--The Secretary shall seek to 
        ensure geographical diversity among grant recipients.
            (3) Reduction of burdens.--In administering the grant 
        program under this section, the Secretary shall make every 
        effort to minimize unnecessary administrative burdens on 
        eligible entities receiving such grants.
            (4) Technical assistance.--The Secretary shall provide 
        technical assistance to eligible entities on best practices for 
        applying grants under this section.
    (e) Duration.--A grant awarded under this section shall be for a 
period of 3 years.
    (f) Reporting.--
            (1) By grantee.--Not later than 180 days after the end of a 
        grant period under this section, the grantee shall submit to 
        the Secretary a report on the activities conducted under the 
        grant, including--
                    (A) a description of the impact of grant 
                activities, including on--
                            (i) outreach and education related to 
                        COVID-19; and
                            (ii) improving public health activities 
                        related to COVID-19, including physical 
                        distancing;
                    (B) the number of individuals reached by the 
                activities under the grant and, to the extent known, 
                the disaggregated demographic data of such individuals, 
                such as by race, ethnicity, sex (including sexual 
                orientation and gender identity), income, disability 
                status, or primary language; and
                    (C) any other information the Secretary determines 
                is necessary.
            (2) By secretary.--Not later than 1 year after the end of 
        the grant program under this section, the Secretary shall 
        submit to Congress a report on the grant program, including a 
        summary of the information gathered under paragraph (1).
    (g) Supplement, Not Supplant.--Grants awarded under this Act shall 
be used to supplement and not supplant any other Federal funds made 
available to carry out the activities described in this Act.
    (h) Funding.--Out of funds in the Treasury not otherwise 
appropriated, there are appropriated to carry out this section, 
$500,000,000 for each of fiscal years 2020 through 2022.

SEC. 604. IMPROVING SOCIAL DETERMINANTS OF HEALTH.

    (a) Findings.--Congress finds the following:
            (1) Healthy People 2020 defines social determinants of 
        health as conditions in the environments in which people live, 
        learn, work, play, worship, and age that affect a wide range of 
        health, functioning, and quality-of-life outcomes and risks.
            (2) One of the overarching goals of Healthy People 2020 is 
        to ``create social and physical environments that promote good 
        health for all''.
            (3) Healthy People 2020 developed a ``place-based'' 
        organizing framework, reflecting five key areas of social 
        determinants of health namely--
                    (A) economic stability;
                    (B) education;
                    (C) social and community context;
                    (D) health and health care; and
                    (E) neighborhood and built environment.
            (4) It is estimated that medical care accounts for only 10 
        to 20 percent of the modifiable contributors to healthy 
        outcomes for a population.
            (5) The Centers for Medicare & Medicaid Services has 
        indicated the importance of the social determinants in its work 
        stating that, ``As we seek to foster innovation, rethink rural 
        health, find solutions to the opioid epidemic, and continue to 
        put patients first, we need to take into account social 
        determinants of health and recognize their importance.''.
            (6) The Department of Health and Human Services' Public 
        Health 3.0 initiative recognizes the role of public health in 
        working across sectors on social determinants of health, as 
        well as the role of public health as chief health strategist in 
        communities.
            (7) Through its Health Impact in 5 Years initiative, the 
        Centers for Disease Control and Prevention has highlighted 
        nonclinical, community-wide approaches that show positive 
        health impacts, results within five years, and cost 
        effectiveness or cost savings over the lifetime of the 
        population or earlier.
            (8) Health departments and the Centers for Disease Control 
        and Prevention are not funded for such cross-cutting work.
            (9) Providing grants to public health departments and other 
        eligible entities to coordinate cross-sector collaboration will 
        allow a community-wide, evidence-based approach to address 
        underlying social determinants of health.
    (b) Social Determinants of Health Program.--
            (1) Program.--To the extent and in the amounts made 
        available in advance in appropriations Acts, the Director of 
        the Centers for Disease Control and Prevention (in this section 
        referred to as the ``Director'') shall carry out a program, to 
        be known as the Social Determinants of Health Program (in this 
        section referred to as the ``Program''), to achieve the 
        following goals:
                    (A) Improve health outcomes and reduce health 
                inequities by coordinating social determinants of 
                health activities across the Centers for Disease 
                Control and Prevention.
                    (B) Improve the capacity of public health agencies 
                and community organizations to address social 
                determinants of health in communities.
            (2) Activities.--To achieve the goals listed in paragraph 
        (1), the Director shall carry out activities including the 
        following:
                    (A) Coordinating across the Centers for Disease 
                Control and Prevention to ensure that relevant programs 
                consider and incorporate social determinants of health 
                in grant awards and other activities.
                    (B) Awarding grants under subsection (c) to State, 
                local, territorial, and Tribal health agencies and 
                organizations, and to other eligible entities, to 
                address social determinants of health in target 
                communities.
                    (C) Awarding grants under subsection (d) to 
                nonprofit organizations and public or other nonprofit 
                institutions of higher education--
                            (i) to conduct research on best practices 
                        to improve social determinants of health;
                            (ii) to provide technical assistance, 
                        training, and evaluation assistance to grantees 
                        under subsection (c); and
                            (iii) to disseminate best practices to 
                        grantees under subsection (c).
                    (D) Coordinating, supporting, and aligning 
                activities of the Centers for Disease Control and 
                Prevention related to social determinants of health 
                with activities of other Federal agencies related to 
                social determinants of health, including such 
                activities of agencies in the Department of Health and 
                Human Services such as the Centers for Medicare & 
                Medicaid Services.
                    (E) Collecting and analyzing data related to the 
                social determinants of health.
    (c) Grants To Address Social Determinants of Health.--
            (1) In general.--The Director, as part of the Program, 
        shall award grants to eligible entities to address social 
        determinants of health in their communities.
            (2) Eligibility.--To be eligible to apply for a grant under 
        this subsection, an entity shall be--
                    (A) a State, local, territorial, or Tribal health 
                agency or organization;
                    (B) a qualified nongovernmental entity, as defined 
                by the Director; or
                    (C) a consortium of entities that includes a State, 
                local, territorial, or Tribal health agency or 
                organization.
            (3) Use of funds.--
                    (A) In general.--A grant under this subsection 
                shall be used to address social determinants of health 
                in a target community by designing and implementing 
                innovative, evidence-based, cross-sector strategies.
                    (B) Target community.--For purposes of this 
                subsection, a target community shall be a State, 
                county, city, or other municipality.
            (4) Priority.--In awarding grants under this subsection, 
        the Director shall prioritize applicants proposing to serve 
        target communities with significant unmet health and social 
        needs, as defined by the Director.
            (5) Application.--To seek a grant under this subsection, an 
        eligible entity shall--
                    (A) submit an application at such time, in such 
                manner, and containing such information as the Director 
                may require;
                    (B) propose a set of activities to address social 
                determinants of health through evidence-based, cross-
                sector strategies, which activities may include--
                            (i) collecting quantifiable data from 
                        health care, social services, and other 
                        entities regarding the most significant gaps in 
                        health-promoting social, economic, and 
                        environmental needs;
                            (ii) identifying evidence-based approaches 
                        to meeting the nonmedical, social needs of 
                        populations identified by data collection 
                        described in clause (i), such as unstable 
                        housing or inadequate food;
                            (iii) developing scalable methods to meet 
                        patients' social needs identified in clinical 
                        settings or other sites;
                            (iv) convening entities such as local and 
                        State governmental and nongovernmental 
                        organizations, health systems, payors, and 
                        community-based organizations to review, plan, 
                        and implement community-wide interventions and 
                        strategies to advance health-promoting social 
                        conditions;
                            (v) monitoring and evaluating the impact of 
                        activities funded through the grant on the 
                        health and well-being of the residents of the 
                        target community and on the cost of health 
                        care; and
                            (vi) such other activities as may be 
                        specified by the Director;
                    (C) demonstrate how the eligible entity will 
                collaborate with--
                            (i) health systems;
                            (ii) payors, including, as appropriate, 
                        medicaid managed care organizations (as defined 
                        in section 1903(m)(1)(A) of the Social Security 
                        Act (42 U.S.C. 1396b(m)(1)(A))), Medicare 
                        Advantage plans under part C of title XVIII of 
                        such Act (42 U.S.C. 1395w-21 et seq.), and 
                        health insurance issuers and group health plans 
                        (as such terms are defined in section 2791 of 
                        the Public Health Service Act);
                            (iii) other relevant stakeholders and 
                        initiatives in areas of need, such as the 
                        Accountable Health Communities Model of the 
                        Centers for Medicare & Medicaid Services, 
                        health homes under the Medicaid program under 
                        title XIX of the Social Security Act (42 U.S.C. 
                        1396 et seq.), community-based organizations, 
                        and human services organizations;
                            (iv) other non-health care sector 
                        organizations, including organizations focusing 
                        on transportation, housing, or food access; and
                            (v) local employers; and
                    (D) identify key health inequities in the target 
                community and demonstrate how the proposed efforts of 
                the eligible entity would address such inequities.
            (6) Monitoring and evaluation.--As a condition of receipt 
        of a grant under this subsection, a grantee shall agree to 
        submit an annual report to the Director describing the 
        activities carried out through the grant and the outcomes of 
        such activities.
            (7) Independent national evaluation.--
                    (A) In general.--Not later than 5 years after the 
                first grants are awarded under this subsection, the 
                Director shall provide for the commencement of an 
                independent national evaluation of the Program under 
                this subsection.
                    (B) Report to congress.--Not later than 60 days 
                after receiving the results of such independent 
                national evaluation, the Director shall report such 
                results to the Congress.
    (d) Research and Training.--The Director, as part of the Program--
            (1) shall award grants to nonprofit organizations and 
        public or other nonprofit institutions of higher education--
                    (A) to conduct research on best practices to 
                improve social determinants of health;
                    (B) to provide technical assistance, training, and 
                evaluation assistance to grantees under subsection (c); 
                and
                    (C) to disseminate best practices to grantees under 
                subsection (c); and
            (2) may require a grantee under paragraph (1) to provide 
        technical assistance and capacity building to entities that are 
        eligible entities under subsection (c) but not receiving funds 
        through such subsection.
    (e) Funding.--
            (1) In general.--There is authorized to be appropriated to 
        carry out this section, $50,000,000 for each of fiscal years 
        2021 through 2026.
            (2) Allocation.--Of the amount made available to carry out 
        this section for a fiscal year, not less than 75 percent shall 
        be used for grants under subsections (c) and (d).

SEC. 605. FUNDING TO STATES, LOCALITIES, AND COMMUNITY-BASED 
              ORGANIZATIONS FOR EMERGENCY AID AND SERVICES.

    (a) Funding for States.--
            (1) Increase in funding for social services block grant 
        program.--
                    (A) Appropriation.--Out of any money in the 
                Treasury of the United States not otherwise 
                appropriated, there are appropriated $9,600,000,000, 
                which shall be available for payments under section 
                2002 of the Social Security Act.
                    (B) Deadline for distribution of funds.--Within 45 
                days after the date of the enactment of this Act, the 
                Secretary of Health and Human Services shall distribute 
                the funds made available by this paragraph, which shall 
                be made available to States on an emergency basis for 
                immediate obligation and expenditure.
                    (C) Submission of revised pre-expenditure report.--
                Within 90 days after a State receives funds made 
                available by this paragraph, the State shall submit to 
                the Secretary a revised pre-expenditure report pursuant 
                to title XX of the Social Security Act that describes 
                how the State plans to administer the funds.
                    (D) Obligation of funds by states.--A State to 
                which funds made available by this paragraph are 
                distributed shall obligate the funds not later than 
                December 31, 2020.
                    (E) Expenditure of funds by states.--A grantee to 
                which a State (or a subgrantee to which a grantee) 
                provides funds made available by this paragraph shall 
                expend the funds not later than December 31, 2021.
            (2) Rules governing use of additional funds.--A State to 
        which funds made available by paragraph (1)(B) are distributed 
        shall use the funds in accordance with the following:
                    (A) Purpose.--
                            (i) In general.--The State shall use the 
                        funds only to support the provision of 
                        emergency services to disadvantaged children, 
                        families, and households.
                            (ii) Disadvantaged defined.--In this 
                        paragraph, the term ``disadvantaged'' means, 
                        with respect to an entity, that the entity--
                                    (I) is an individual, or is located 
                                in a community, that is experiencing 
                                material hardship;
                                    (II) is a household in which there 
                                is a child (as defined in section 12(d) 
                                of the Richard B. Russell National 
                                School Lunch Act) or a child served 
                                under section 11(a)(1) of such Act, 
                                who, if not for the closure of the 
                                school attended by the child during a 
                                public health emergency designation and 
                                due to concerns about a COVID-19 
                                outbreak, would receive free or reduced 
                                price school meals pursuant to such 
                                Act;
                                    (III) is an individual, or is 
                                located in a community, with barriers 
                                to employment; or
                                    (IV) is located in a community 
                                that, as of the date of the enactment 
                                of this Act, is not experiencing a 56-
                                day downward trajectory of--
                                            (aa) influenza-like 
                                        illnesses;
                                            (bb) COVID-like syndromic 
                                        cases;
                                            (cc) documented COVID-19 
                                        cases; or
                                            (dd) positive test results 
                                        as a percentage of total COVID-
                                        19 tests.
                    (B) Pass-through to local entities.--
                            (i) In the case of a State in which a 
                        county administers or contributes financially 
                        to the non-Federal share of the amounts 
                        expended in carrying out a State program funded 
                        under title IV of the Social Security Act, the 
                        State may pass funds so made available through 
                        to--
                                    (I) the chief elected official of 
                                the city or urban county that 
                                administers the program; or
                                    (II) local government and 
                                community-based organizations.
                            (ii) In the case of any other State, the 
                        State shall--
                                    (I) pass the funds through to--
                                            (aa)(AA) local governments 
                                        that will expend or distribute 
                                        the funds in consultation with 
                                        community-based organizations 
                                        with experience serving 
                                        disadvantaged families or 
                                        individuals; or
                                            (BB) community-based 
                                        organizations with experience 
                                        serving disadvantaged families 
                                        and individuals; and
                                            (bb) sub-State areas in 
                                        proportions based on the 
                                        population of disadvantaged 
                                        individuals living in the 
                                        areas; and
                                    (II) report to the Secretary on how 
                                the State determined the amounts passed 
                                through pursuant to this clause.
                    (C) Methods.--
                            (i) In general.--The State shall use the 
                        funds only for--
                                    (I) administering emergency 
                                services;
                                    (II) providing short-term cash, 
                                non-cash, or in-kind emergency disaster 
                                relief;
                                    (III) providing services with 
                                demonstrated need in accordance with 
                                objective criteria that are made 
                                available to the public;
                                    (IV) operational costs directly 
                                related to providing services described 
                                in subclauses (I), (II), and (III);
                                    (V) local government emergency 
                                social service operations; and
                                    (VI) providing emergency social 
                                services to rural and frontier 
                                communities that may not have access to 
                                other emergency funding streams.
                            (ii) Administering emergency services 
                        defined.--In clause (i), the term 
                        ``administering emergency services'' means--
                                    (I) providing basic disaster 
                                relief, economic, and well-being 
                                necessities to ensure communities are 
                                able to safely observe shelter-in-place 
                                and social distancing orders;
                                    (II) providing necessary supplies 
                                such as masks, gloves, and soap, to 
                                protect the public against infectious 
                                disease; and
                                    (III) connecting individuals, 
                                children, and families to services or 
                                payments for which they may already be 
                                eligible.
                    (D) Prohibitions.--
                            (i) No individual eligibility 
                        determinations by grantees or subgrantees.--
                        Neither a grantee to which the State provides 
                        the funds nor any subgrantee of such a grantee 
                        may exercise individual eligibility 
                        determinations for the purpose of administering 
                        short-term, non-cash, in-kind emergency 
                        disaster relief to communities.
                            (ii) Applicability of certain social 
                        services block grant funds use limitations.--
                        The State shall use the funds subject to the 
                        limitations in section 2005 of the Social 
                        Security Act, except that, for purposes of this 
                        clause, section 2005(a)(2) and 2005(a)(8) of 
                        such Act shall not apply.
                            (iii) No supplantation of certain state 
                        funds.--The State may use the funds to 
                        supplement, not supplant, State general revenue 
                        funds for social services.
                            (iv) Ban on use for certain costs 
                        reimbursable by fema.--The State may not use 
                        the funds for costs that are reimbursable by 
                        the Federal Emergency Management Agency, under 
                        a contract for insurance, or by self-insurance.
    (b) Funding for Federally Recognized Indian Tribes and Tribal 
Organizations.--
            (1) Grants.--
                    (A) In general.--Within 90 days after the date of 
                the enactment of this Act, the Secretary of Health and 
                Human Services shall make grants to federally 
                recognized Indian Tribes and Tribal organizations.
                    (B) Amount of grant.--The amount of the grant for 
                an Indian Tribe or Tribal organization shall bear the 
                same ratio to the amount appropriated by paragraph (3) 
                as the total amount of grants awarded to the Indian 
                Tribe or Tribal organization under the Low-Income Home 
                Energy Assistance Act of 1981 and the Community Service 
                Block Grant for fiscal year 2020 bears to the total 
                amount of grants awarded to all Indian Tribes and 
                Tribal organizations under such Act and such Grant for 
                the fiscal year.
            (2) Rules governing use of funds.--An entity to which a 
        grant is made under paragraph (1) shall obligate the funds not 
        later than December 31, 2020, and the funds shall be expended 
        by grantees and subgrantees not later than December 31, 2021, 
        and used in accordance with the following:
                    (A) Purpose.--
                            (i) In general.--The grantee shall use the 
                        funds only to support the provision of 
                        emergency services to disadvantaged households.
                            (ii) Disadvantaged defined.--In clause (i), 
                        the term ``disadvantaged'' means, with respect 
                        to an entity, that the entity--
                                    (I) is an individual, or is located 
                                in a community, that is experiencing 
                                material hardship;
                                    (II) is a household in which there 
                                is a child (as defined in section 12(d) 
                                of the Richard B. Russell National 
                                School Lunch Act) or a child served 
                                under section 11(a)(1) of such Act, 
                                who, if not for the closure of the 
                                school attended by the child during a 
                                public health emergency designation and 
                                due to concerns about a COVID-19 
                                outbreak, would receive free or reduced 
                                price school meals pursuant to such 
                                Act;
                                    (III) is an individual, or is 
                                located in a community, with barriers 
                                to employment; or
                                    (IV) is located in a community 
                                that, as of the date of the enactment 
                                of this Act, is not experiencing a 56-
                                day downward trajectory of--
                                            (aa) influenza-like 
                                        illnesses;
                                            (bb) COVID-like syndromic 
                                        cases;
                                            (cc) documented COVID-19 
                                        cases; or
                                            (dd) positive test results 
                                        as a percentage of total COVID-
                                        19 tests.
                    (B) Methods.--
                            (i) In general.--The grantee shall use the 
                        funds only for--
                                    (I) administering emergency 
                                services;
                                    (II) providing short-term, non-
                                cash, in-kind emergency disaster 
                                relief; and
                                    (III) tribal emergency social 
                                service operations.
                            (ii) Administering emergency services 
                        defined.--In clause (i), the term 
                        ``administering emergency services'' means--
                                    (I) providing basic economic and 
                                well-being necessities to ensure 
                                communities are able to safely observe 
                                shelter-in-place and social distancing 
                                orders;
                                    (II) providing necessary supplies 
                                such as masks, gloves, and soap, to 
                                protect the public against infectious 
                                disease; and
                                    (III) connecting individuals, 
                                children, and families to services or 
                                payments for which they may already be 
                                eligible.
                    (C) Prohibitions.--
                            (i) No individual eligibility 
                        determinations by grantees or subgrantees.--
                        Neither the grantee nor any subgrantee may 
                        exercise individual eligibility determinations 
                        for the purpose of administering short-term, 
                        non-cash, in-kind emergency disaster relief to 
                        communities.
                            (ii) Ban on use for certain costs 
                        reimbursable by fema.--The grantee may not use 
                        the funds for costs that are reimbursable by 
                        the Federal Emergency Management Agency, under 
                        a contract for insurance, or by self-insurance.
            (3) Appropriation.--Out of any money in the Treasury of the 
        United States not otherwise appropriated, there are 
        appropriated to the Secretary of Health and Human Services 
        $400,000,000 to carry out this subsection.

SEC. 606. SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM.

    (a) Value of Benefits.--Notwithstanding any other provision of law, 
beginning on June 1, 2020, and for each subsequent month through 
September 30, 2021, the value of benefits determined under section 8(a) 
of the Food and Nutrition Act of 2008 (7 U.S.C. 2017(a)), and 
consolidated block grants for Puerto Rico and American Samoa determined 
under section 19(a) of such Act (7 U.S.C. 2028(a)), shall be calculated 
using 115 percent of the June 2019 value of the thrifty food plan (as 
defined in section 3 of such Act (7 U.S.C. 2012)) if the value of the 
benefits and block grants would be greater under that calculation than 
in the absence of this subsection.
    (b) Minimum Amount.--
            (1) In general.--The minimum value of benefits determined 
        under section 8(a) of the Food and Nutrition Act of 2008 (7 
        U.S.C. 2017(a)) for a household of not more than 2 members 
        shall be $30.
            (2) Effectiveness.--Paragraph (1) shall remain in effect 
        until the date on which 8 percent of the value of the thrifty 
        food plan for a household containing 1 member, rounded to the 
        nearest whole dollar increment, is equal to or greater than 
        $30.
    (c) Requirements for the Secretary.--In carrying out this section, 
the Secretary shall--
            (1) consider the benefit increases described in each of 
        subsections (a) and (b) to be a ``mass change'';
            (2) require a simple process for States to notify 
        households of the increase in benefits;
            (3) consider section 16(c)(3)(A) of the Food and Nutrition 
        Act of 2008 (7 U.S.C. 2025(c)(3)(A)) to apply to any errors in 
        the implementation of this section, without regard to the 120-
        day limit described in that section;
            (4) disregard the additional amount of benefits that a 
        household receives as a result of this section in determining 
        the amount of overissuances under section 13 of the Food and 
        Nutrition Act of 2008 (7 U.S.C. 2022); and
            (5) set the tolerance level for excluding small errors for 
        the purposes of section 16(c) of the Food and Nutrition Act of 
        2008 (7 U.S.C. 2025(c)) at $50 through September 30, 2021.
    (d) Provisions for Impacted Workers.--Notwithstanding any other 
provision of law, the requirements under subsections (d)(1)(A)(ii) and 
(o) of section 6 of the Food and Nutrition Act of 2008 (7 U.S.C. 2015) 
shall not be in effect during the period beginning on June 1, 2020, and 
ending 2 years after the date of enactment of this Act.
    (e) Administrative Expenses.--
            (1) In general.--For the costs of State administrative 
        expenses associated with carrying out this section and 
        administering the supplemental nutrition assistance program 
        established under the Food and Nutrition Act of 2008 (7 U.S.C. 
        2011 et seq.), the Secretary shall make available $150,000,000 
        for fiscal year 2020 and $150,000,000 for fiscal year 2021.
            (2) Timing for fiscal year 2020.--Not later than 60 days 
        after the date of the enactment of this Act, the Secretary 
        shall make available to States amounts for fiscal year 2020 
        under paragraph (1).
            (3) Allocation of funds.--Funds described in paragraph (1) 
        shall be made available as grants to State agencies for each 
        fiscal year as follows:
                    (A) 75 percent of the amounts available for each 
                fiscal year shall be allocated to States based on the 
                share of each State of households that participate in 
                the supplemental nutrition assistance program as 
                reported to the Department of Agriculture for the most 
                recent 12-month period for which data are available, 
                adjusted by the Secretary (as of the date of the 
                enactment of this Act) for participation in disaster 
                programs under section 5(h) of the Food and Nutrition 
                Act of 2008 (7 U.S.C. 2014(h)); and
                    (B) 25 percent of the amounts available for each 
                fiscal year shall be allocated to States based on the 
                increase in the number of households that participate 
                in the supplemental nutrition assistance program as 
                reported to the Department of Agriculture over the most 
                recent 12-month period for which data are available, 
                adjusted by the Secretary (as of the date of the 
                enactment of this Act) for participation in disaster 
                programs under section 5(h) of the Food and Nutrition 
                Act of 2008 (7 U.S.C. 2014(h)).
    (f) SNAP Rules.--No funds (including fees) made available under 
this Act or any other Act for any fiscal year may be used to finalize, 
implement, administer, enforce, carry out, or otherwise give effect 
to--
            (1) the final rule entitled ``Supplemental Nutrition 
        Assistance Program: Requirements for Able-Bodied Adults Without 
        Dependents'' published in the Federal Register on December 5, 
        2019 (84 Fed. Reg. 66782);
            (2) the proposed rule entitled ``Revision of Categorical 
        Eligibility in the Supplemental Nutrition Assistance Program 
        (SNAP)'' published in the Federal Register on July 24, 2019 (84 
        Fed. Reg. 35570); or
            (3) the proposed rule entitled ``Supplemental Nutrition 
        Assistance Program: Standardization of State Heating and 
        Cooling Standard Utility Allowances'' published in the Federal 
        Register on October 3, 2019 (84 Fed. Reg. 52809).
    (g) Certain Exclusions From SNAP Income.--A Federal pandemic 
unemployment compensation payment made to an individual under section 
2104 of the CARES Act (Public Law 116-136) shall not be regarded as 
income and shall not be regarded as a resource for the month of receipt 
and the following 9 months, for the purpose of determining eligibility 
for such individual or any other individual for benefits or assistance, 
or the amount of benefits or assistance, under any programs authorized 
under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.).
    (h) Public Availability.--Not later than 10 days after the date of 
the receipt or issuance of each document listed below, the Secretary 
shall make publicly available on the website of the Department of 
Agriculture the following documents:
            (1) Any State agency request to participate in the 
        supplemental nutrition assistance program online program under 
        section 7(k).
            (2) Any State agency request to waive, adjust, or modify 
        statutory or regulatory requirements under the Food and 
        Nutrition Act of 2008 related to the COVID-19 outbreak.
            (3) The Secretary's approval or denial of each such request 
        under paragraphs (1) or (2).
    (i) Funding.--There are hereby appropriated to the Secretary, out 
of any money not otherwise appropriated, such sums as may be necessary 
to carry out this section.

        TITLE VII--CULTURALLY AND LINGUISTICALLY COMPETENT CARE

SEC. 701. ENSURING STANDARDS FOR CULTURALLY AND LINGUISTICALLY 
              APPROPRIATE SERVICES IN HEALTH CARE.

    (a) Applicability.--This section shall apply to any health program 
or activity, any part of which is receiving Federal financial 
assistance, including credits, subsidies, or contracts of insurance, or 
any program or activity that is administered by an executive agency or 
any entity established under title I of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18001 et seq.) (or amendments made 
thereby).
    (b) Standards.--Each program or activity described in subsection 
(a)--
            (1) shall implement strategies to recruit, retain, and 
        promote individuals at all levels to maintain a diverse staff 
        and leadership that can provide culturally and linguistically 
        appropriate health care to patient populations of the service 
        area of the program or activity;
            (2) shall educate and train governance, leadership, and 
        workforce at all levels and across all disciplines of the 
        program or activity in culturally and linguistically 
        appropriate policies and practices on an ongoing basis at least 
        yearly;
            (3) shall offer and provide language assistance, including 
        trained and competent bilingual staff and interpreter services, 
        to individuals with limited English proficiency or who have 
        other communication needs, at no cost to the individual at all 
        points of contact, and during all hours of operation, to 
        facilitate timely access to health care services and health-
        care-related services;
            (4) shall for each language group consisting of individuals 
        with limited English proficiency that constitutes 5 percent or 
        500 individuals, whichever is less, of the population of 
        persons eligible to be served or likely to be affected or 
        encountered in the service area of the program or activity, 
        make available at a fifth grade reading level--
                    (A) easily understood patient-related materials, 
                including print and multimedia materials, in the 
                language of such language group;
                    (B) information or notices about termination of 
                benefits in such language;
                    (C) signage; and
                    (D) any other documents or types of documents 
                designated by the Secretary;
            (5) shall develop and implement clear goals, policies, 
        operational plans, and management, accountability, and 
        oversight mechanisms to provide culturally and linguistically 
        appropriate services and infuse them throughout the planning 
        and operations of the program or activity;
            (6) shall conduct initial and ongoing organizational 
        assessments of culturally and linguistically appropriate 
        services-related activities and integrate valid linguistic, 
        competence-related National Standards for Culturally and 
        Linguistically Appropriate Services (CLAS) measures into the 
        internal audits, performance improvement programs, patient 
        satisfaction assessments, continuous quality improvement 
        activities, and outcomes-based evaluations of the program or 
        activity and develop ways to standardize the assessments, and 
        such assessments must occur at least yearly;
            (7) shall ensure that, consistent with the privacy 
        protections provided for under the regulations promulgated 
        under section 264(c) of the Health Insurance Portability and 
        Accountability Act of 1996 (42 U.S.C. 1320-2 note), data on an 
        individual required to be collected pursuant to section 3101, 
        including the individual's alternative format preferences and 
        policy modification needs, are--
                    (A) collected in health records;
                    (B) integrated into the management information 
                systems of the program or activity; and
                    (C) periodically updated;
            (8) shall maintain a current demographic, cultural, and 
        epidemiological profile of the community, conduct regular 
        assessments of community health assets and needs, and use the 
        results of such assessments to accurately plan for and 
        implement services that respond to the cultural and linguistic 
        characteristics of the service area of the program or activity;
            (9) shall develop participatory, collaborative partnerships 
        with communities and utilize a variety of formal and informal 
        mechanisms to facilitate community and patient involvement in 
        designing, implementing, and evaluating policies and practices 
        to ensure culturally and linguistically appropriate service-
        related activities;
            (10) shall ensure that conflict and grievance resolution 
        processes are culturally and linguistically appropriate and 
        capable of identifying, preventing, and resolving cross-
        cultural conflicts or complaints by patients;
            (11) shall regularly make available to the public 
        information about their progress and successful innovations in 
        implementing the standards under this section and provide 
        public notice in their communities about the availability of 
        this information; and
            (12) shall, if requested, regularly make available to the 
        head of each Federal entity from which Federal funds are 
        provided, information about the progress and successful 
        innovations of the program or activity in implementing the 
        standards under this section as required by the head of such 
        entity.
    (c) Comments Accepted Through Notice and Comment Rulemaking.--An 
agency carrying out a program described in subsection (a) shall ensure 
that comments with respect to such program that are accepted through 
notice and comment rulemaking be accepted in all languages, may not 
require such comments to be submitted only in English, and must ensure 
these comments are considered equally as comments submitted in English 
during the agency's review of comments submitted.

SEC. 702. CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE IN THE 
              PUBLIC HEALTH SERVICE ACT.

    Title XXXIV of the Public Health Service Act, as amended by section 
104, is further amended by adding at the end the following:

  ``Subtitle B--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE

``SEC. 3403. DEFINITIONS.

    ``(a) In General.--In this title:
            ``(1) Bilingual.--The term `bilingual', with respect to an 
        individual, means a person who has sufficient degree of 
        proficiency in 2 languages.
            ``(2) Cultural.--The term `cultural' means relating to 
        integrated patterns of human behavior that include the 
        language, thoughts, communications, actions, customs, beliefs, 
        values, and institutions of racial, ethnic, religious, or 
        social groups, including lesbian, gay, bisexual, transgender, 
        queer, and questioning individuals, and individuals with 
        physical and mental disabilities.
            ``(3) Culturally and linguistically appropriate.--The term 
        `culturally and linguistically appropriate' means being 
        respectful of and responsive to the cultural and linguistic 
        needs of all individuals.
            ``(4) Effective communication.--The term `effective 
        communication' means an exchange of information between the 
        provider of health care or health-care-related services and the 
        recipient of such services who is limited in English 
        proficiency, or has a communication impairment such as a 
        hearing, vision, speaking, or learning impairment, that enables 
        access to, understanding of, and benefit from health care or 
        health-care-related services, and full participation in the 
        development of their treatment plan.
            ``(5) Grievance resolution process.--The term `grievance 
        resolution process' means all aspects of dispute resolution 
        including filing complaints, grievance and appeal procedures, 
        and court action.
            ``(6) Health care group.--The term `health care group' 
        means a group of physicians organized, at least in part, for 
        the purposes of providing physician services under the Medicaid 
        program under title XIX of the Social Security Act, the State 
        Children's Health Insurance Program under title XXI of such 
        Act, or the Medicare program under title XVIII of such Act and 
        may include a hospital and any other individual or entity 
        furnishing services covered under any such program that is 
        affiliated with the health care group.
            ``(7) Health care services.--The term `health care 
        services' means services that address physical as well as 
        mental health conditions in all care settings.
            ``(8) Health-care-related services.--The term `health-care-
        related services' means human or social services programs or 
        activities that provide access, referrals, or links to health 
        care.
            ``(9) Health educator.--The term `health educator' includes 
        a professional with a baccalaureate degree who is responsible 
        for designing, implementing, and evaluating individual and 
        population health promotion and chronic disease prevention 
        programs.
            ``(10) Indian; indian tribe.--The terms `Indian' and 
        `Indian Tribe' have the meanings given such terms in section 4 
        of the Indian Self-Determination and Education Assistance Act.
            ``(11) Individual with a disability.--The term `individual 
        with a disability' means any individual who has a disability as 
        defined for the purpose of section 504 of the Rehabilitation 
        Act of 1973.
            ``(12) Individual with limited english proficiency.--The 
        term `individual with limited English proficiency' means an 
        individual whose primary language for communication is not 
        English and who has a limited ability to read, write, speak, or 
        understand English.
            ``(13) Integrated health care delivery system.--The term 
        `integrated health care delivery system' means an 
        interdisciplinary system that brings together providers from 
        the primary health, mental health, substance use disorder, and 
        related disciplines to improve the health outcomes of an 
        individual. Such providers may include hospitals, health, 
        mental health, or substance use disorder clinics and providers, 
        home health agencies, ambulatory surgery centers, skilled 
        nursing facilities, rehabilitation centers, and employed, 
        independent, or contracted physicians.
            ``(14) Interpreting; interpretation.--The terms 
        `interpreting' and `interpretation' mean the transmission of a 
        spoken, written, or signed message from one language or format 
        into another, faithfully, accurately, and objectively.
            ``(15) Language access.--The term `language access' means 
        the provision of language services to an individual with 
        limited English proficiency or an individual with communication 
        disabilities designed to enhance that individual's access to, 
        understanding of, or benefit from health care services or 
        health-care-related services.
            ``(16) Language assistance services.--The term `language 
        assistance services' includes--
                    ``(A) oral language assistance, including 
                interpretation in non-English languages provided in-
                person or remotely by a qualified interpreter for an 
                individual with limited English proficiency, and the 
                use of qualified bilingual or multilingual staff to 
                communicate directly with individuals with limited 
                English proficiency;
                    ``(B) written translation, performed by a qualified 
                and competent translator, of written content in paper 
                or electronic form into languages other than English; 
                and
                    ``(C) taglines.
            ``(17) Minority.--
                    ``(A) In general.--The terms `minority' and 
                `minorities' refer to individuals from a minority 
                group.
                    ``(B) Populations.--The term `minority', with 
                respect to populations, refers to racial and ethnic 
                minority groups, members of sexual and gender minority 
                groups, and individuals with a disability.
            ``(18) Minority group.--The term `minority group' has the 
        meaning given the term `racial and ethnic minority group'.
            ``(19) Onsite interpretation.--The term `onsite 
        interpretation' means a method of interpreting or 
        interpretation for which the interpreter is in the physical 
        presence of the provider of health care services or health-
        care-related services and the recipient of such services who is 
        limited in English proficiency or has a communication 
        impairment such as an impairment in hearing, vision, or 
        learning.
            ``(20) Qualified individual with a disability.--The term 
        `qualified individual with a disability' means, with respect to 
        a health program or activity, an individual with a disability 
        who, with or without reasonable modifications to policies, 
        practices, or procedures, the removal of architectural, 
        communication, or transportation barriers, or the provision of 
        auxiliary aids and services, meets the essential eligibility 
        requirements for the receipt of aids, benefits, or services 
        offered or provided by the health program or activity.
            ``(21) Qualified interpreter for an individual with a 
        disability.--The term `qualified interpreter for an individual 
        with a disability', for an individual with a disability--
                    ``(A) means an interpreter who by means of a remote 
                interpreting service or an on-site appearance;
                            ``(i) adheres to generally accepted 
                        interpreter ethics principles, including client 
                        confidentiality; and
                            ``(ii) is able to interpret effectively, 
                        accurately, and impartially, both receptively 
                        and expressively, using any necessary 
                        specialized vocabulary, terminology, and 
                        phraseology; and
                    ``(B) may include sign language interpreters, oral 
                transliterators (individuals who represent or spell in 
                the characters of another alphabet), and cued language 
                transliterators (individuals who represent or spell by 
                using a small number of handshapes).
            ``(22) Qualified interpreter for an individual with limited 
        english proficiency.--The term `qualified interpreter for an 
        individual with limited English proficiency' means an 
        interpreter who via a remote interpreting service or an on-site 
        appearance--
                    ``(A) adheres to generally accepted interpreter 
                ethics principles, including client confidentiality;
                    ``(B) has demonstrated proficiency in speaking and 
                understanding both spoken English and one or more other 
                spoken languages; and
                    ``(C) is able to interpret effectively, accurately, 
                and impartially, both receptively and expressly, to and 
                from such languages and English, using any necessary 
                specialized vocabulary, terminology, and phraseology.
            ``(23) Qualified translator.--The term `qualified 
        translator' means a translator who--
                    ``(A) adheres to generally accepted translator 
                ethics principles, including client confidentiality;
                    ``(B) has demonstrated proficiency in writing and 
                understanding both written English and one or more 
                other written non-English languages; and
                    ``(C) is able to translate effectively, accurately, 
                and impartially to and from such languages and English, 
                using any necessary specialized vocabulary, 
                terminology, and phraseology.
            ``(24) Racial and ethnic minority group.--The term `racial 
        and ethnic minority group' means Indians and Alaska Natives, 
        African Americans (including Caribbean Blacks, Africans, and 
        other Blacks), Asian Americans, Hispanics (including Latinos), 
        and Native Hawaiians and other Pacific Islanders.
            ``(25) Sexual and gender minority group.--The term `sexual 
        and gender minority group' encompasses lesbian, gay, bisexual, 
        and transgender populations, as well as those whose sexual 
        orientation, gender identity and expression, or reproductive 
        development varies from traditional, societal, cultural, or 
        physiological norms.
            ``(26) Sight translation.--The term `sight translation' 
        means the transmission of a written message in one language 
        into a spoken or signed message in another language, or an 
        alternative format in English or another language.
            ``(27) State.--Notwithstanding section 2, the term `State' 
        means each of the several States, the District of Columbia, the 
        Commonwealth of Puerto Rico, the United States Virgin Islands, 
        Guam, American Samoa, and the Commonwealth of the Northern 
        Mariana Islands.
            ``(28) Telephonic interpretation.--The term `telephonic 
        interpretation' (also known as `over the phone interpretation' 
        or `OPI') means, with respect to interpretation for an 
        individual with limited English proficiency, a method of 
        interpretation in which the interpreter is not in the physical 
        presence of the provider of health care services or health-
        care-related services and such individual receiving such 
        services, but the interpreter is connected via telephone.
            ``(29) Translation.--The term `translation' means the 
        transmission of a written message in one language into a 
        written or signed message in another language, and includes 
        translation into another language or alternative format, such 
        as large print font, Braille, audio recording, or CD.
            ``(30) Video remote interpreting services.--The term `video 
        remote interpreting services' means the provision, in health 
        care services or health-care-related services, through a 
        qualified interpreter for an individual with limited English 
        proficiency, of video remote interpreting services that are--
                    ``(A) in real-time, full-motion video, and audio 
                over a dedicated high-speed, wide-bandwidth video 
                connection or wireless connection that delivers high 
                quality video images that do not produce lags, choppy, 
                blurry, or grainy images, or irregular pauses in 
                communication; and
                    ``(B) in a sharply delineated image that is large 
                enough to display.
            ``(31) Vital document.--The term `vital document' includes 
        applications for government programs that provide health care 
        services, medical or financial consent forms, financial 
        assistance documents, letters containing important information 
        regarding patient instructions (such as prescriptions, 
        referrals to other providers, and discharge plans) and 
        participation in a program (such as a Medicaid managed care 
        program), notices pertaining to the reduction, denial, or 
        termination of services or benefits, notices of the right to 
        appeal such actions, and notices advising individuals with 
        limited English proficiency with communication disabilities of 
        the availability of free language services, alternative 
        formats, and other outreach materials.
    ``(b) Reference.--In any reference in this title to a regulatory 
provision applicable to a `handicapped individual', the term 
`handicapped individual' in such provision shall have the same meaning 
as the term `individual with a disability' as defined in subsection 
(a).

``CHAPTER 1--RESOURCES AND INNOVATION FOR CULTURALLY AND LINGUISTICALLY 
                        APPROPRIATE HEALTH CARE

``SEC. 3404. ROBERT T. MATSUI CENTER FOR CULTURALLY AND LINGUISTICALLY 
              APPROPRIATE HEALTH CARE.

    ``(a) Establishment.--The Secretary, acting through the Director of 
the Agency for Healthcare Research and Quality, shall establish and 
support a center to be known as the `Robert T. Matsui Center for 
Culturally and Linguistically Appropriate Health Care' (referred to in 
this section as the `Center') to carry out each of the following 
activities:
            ``(1) Interpretation services.--The Center shall provide 
        resources via the internet to identify and link health care 
        providers to competent interpreter and translation services.
            ``(2) Translation of written material.--
                    ``(A) Vital documents.--The Center shall provide, 
                directly or through contract, vital documents from 
                competent translation services for providers of health 
                care services and health-care-related services at no 
                cost to such providers. Such documents may be submitted 
                by covered entities (as defined in section 92.4 of 
                title 42, Code of Federal Regulations, as in effect on 
                May 16, 2016) for translation into non-English 
                languages or alternative formats at a fifth-grade 
                reading level. Such translation services shall be 
                provided in a timely and reasonable manner. The quality 
                of such translation services shall be monitored and 
                reported publicly.
                    ``(B) Forms.--For each form developed or revised by 
                the Secretary that will be used by individuals with 
                limited English proficiency in health care or health-
                care-related settings, the Center shall translate the 
                form, at a minimum, into the top 15 non-English 
                languages in the United States according to the most 
                recent data from the American Community Survey or its 
                replacement. The translation shall be completed within 
                45 calendar days of the Secretary receiving final 
                approval of the form from the Office of Management and 
                Budget. The Center shall post all translated forms on 
                its website so that other entities may use the same 
                translations.
            ``(3) Toll-free customer service telephone number.--The 
        Center shall provide, through a toll-free number, a customer 
        service line for individuals with limited English proficiency--
                    ``(A) to obtain information about federally 
                conducted or funded health programs, including the 
                Medicare program under title XVIII of the Social 
                Security Act, the Medicaid program under title XIX of 
                such Act, and the State Children's Health Insurance 
                Program under title XXI of such Act, marketplace 
                coverage available pursuant to title XXVII of this Act 
                and the Patient Protection and Affordable Care Act, and 
                other sources of free or reduced care including 
                federally qualified health centers, title X clinics, 
                and public health departments;
                    ``(B) to obtain assistance with applying for or 
                accessing these programs and understanding Federal 
                notices written in English; and
                    ``(C) to learn how to access language services.
            ``(4) Health information clearinghouse.--
                    ``(A) In general.--The Center shall develop and 
                maintain an information clearinghouse to facilitate the 
                provision of language services by providers of health 
                care services and health-care-related services to 
                reduce medical errors, improve medical outcomes, 
                improve cultural competence, reduce health care costs 
                caused by miscommunication with individuals with 
                limited English proficiency, and reduce or eliminate 
                the duplication of efforts to translate materials. The 
                clearinghouse shall include the information described 
                in subparagraphs (B) through (F) and make such 
                information available on the internet and in print.
                    ``(B) Document templates.--The Center shall collect 
                and evaluate for accuracy, develop, and make available 
                templates for standard documents that are necessary for 
                patients and consumers to access and make educated 
                decisions about their health care, including templates 
                for each of the following:
                            ``(i) Administrative and legal documents, 
                        including--
                                    ``(I) intake forms;
                                    ``(II) forms related to the 
                                Medicare program under title XVIII of 
                                the Social Security Act, the Medicaid 
                                program under title XIX of such Act, 
                                and the State Children's Health 
                                Insurance Program under title XXI of 
                                such Act, including eligibility 
                                information for such programs;
                                    ``(III) forms informing patients of 
                                the compliance and consent requirements 
                                pursuant to the regulations under 
                                section 264(c) of the Health Insurance 
                                Portability and Accountability Act of 
                                1996 (42 U.S.C. 1320-2 note); and
                                    ``(IV) documents concerning 
                                informed consent, advanced directives, 
                                and waivers of rights.
                            ``(ii) Clinical information, such as how to 
                        take medications, how to prevent transmission 
                        of a contagious disease, and other prevention 
                        and treatment instructions.
                            ``(iii) Public health, patient education, 
                        and outreach materials, such as immunization 
                        notices, health warnings, or screening notices.
                            ``(iv) Additional health or health-care-
                        related materials as determined appropriate by 
                        the Director of the Center.
                    ``(C) Structure of forms.--In operating the 
                clearinghouse, the Center shall--
                            ``(i) ensure that the documents posted in 
                        English and non-English languages are 
                        culturally and linguistically appropriate;
                            ``(ii) allow public review of the documents 
                        before dissemination in order to ensure that 
                        the documents are understandable and culturally 
                        and linguistically appropriate for the target 
                        populations;
                            ``(iii) allow health care providers to 
                        customize the documents for their use;
                            ``(iv) facilitate access to these 
                        documents;
                            ``(v) provide technical assistance with 
                        respect to the access and use of such 
                        information; and
                            ``(vi) carry out any other activities the 
                        Secretary determines to be useful to fulfill 
                        the purposes of the clearinghouse.
                    ``(D) Language assistance programs.--The Center 
                shall provide for the collection and dissemination of 
                information on current examples of language assistance 
                programs and strategies to improve language services 
                for individuals with limited English proficiency, 
                including case studies using de-identified patient 
                information, program summaries, and program 
                evaluations.
                    ``(E) Culturally and linguistically appropriate 
                materials.--The Center shall provide information 
                relating to culturally and linguistically appropriate 
                health care for minority populations residing in the 
                United States to all health care providers and health-
                care-related services at no cost. Such information 
                shall include--
                            ``(i) tenets of culturally and 
                        linguistically appropriate care;
                            ``(ii) culturally and linguistically 
                        appropriate self-assessment tools;
                            ``(iii) culturally and linguistically 
                        appropriate training tools;
                            ``(iv) strategic plans to increase cultural 
                        and linguistic appropriateness in different 
                        types of providers of health care services and 
                        health-care-related services, including 
                        regional collaborations among health care 
                        organizations; and
                            ``(v) culturally and linguistically 
                        appropriate information for educators, 
                        practitioners, and researchers.
                    ``(F) Translation glossaries.--The Center shall--
                            ``(i) develop and publish on its website 
                        translation glossaries that provide 
                        standardized translations of commonly used 
                        terms and phrases utilized in documents 
                        translated by the Center; and
                            ``(ii) make these glossaries available--
                                    ``(I) free of charge;
                                    ``(II) in the 15 languages in which 
                                the Center translates materials; and
                                    ``(III) in alternative formats in 
                                accordance with the Americans with 
                                Disabilities Act of 1990 (42 U.S.C. 
                                12101 et seq.).
                    ``(G) Information about progress.--The Center shall 
                regularly collect and make publicly available 
                information about the progress of entities receiving 
                grants under section 3402 regarding successful 
                innovations in implementing the obligations under this 
                subsection and provide public notice in the entities' 
                communities about the availability of this information.
    ``(b) Director.--The Center shall be headed by a Director who shall 
be appointed by, and who shall report to, the Director of the Agency 
for Healthcare Research and Quality.
    ``(c) Availability of Language Access.--The Director shall 
collaborate with the Deputy Assistant Secretary for Minority Health, 
the Administrator of the Centers for Medicare & Medicaid Services, and 
the Administrator of the Health Resources and Services Administration 
to notify health care providers and health care organizations about the 
availability of language access services by the Center.
    ``(d) Education.--The Secretary, directly or through contract, 
shall undertake a national education campaign to inform providers, 
individuals with limited English proficiency, individuals with hearing 
or vision impairments, health professionals, graduate schools, and 
community health centers about--
            ``(1) Federal and State laws and guidelines governing 
        access to language services;
            ``(2) the value of using trained and competent interpreters 
        and the risks associated with using family members, friends, 
        minors, and untrained bilingual staff;
            ``(3) funding sources for developing and implementing 
        language services; and
            ``(4) promising practices to effectively provide language 
        services.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2021 through 2025.

``SEC. 3405. INNOVATIONS IN CULTURALLY AND LINGUISTICALLY APPROPRIATE 
              HEALTH CARE GRANTS.

    ``(a) In General.--
            ``(1) Grants.--The Secretary, acting through the Director 
        of the Agency for Healthcare Research and Quality, shall award 
        grants to eligible entities to enable such entities to design, 
        implement, and evaluate innovative, cost-effective programs to 
        improve culturally and linguistically appropriate access to 
        health care services for individuals with limited English 
        proficiency.
            ``(2) Coordination.--The Director of the Agency for 
        Healthcare Research and Quality shall coordinate with, and 
        ensure the participation of, other agencies including the 
        Health Resources and Services Administration, the National 
        Institute on Minority Health and Health Disparities at the 
        National Institutes of Health, and the Office of Minority 
        Health, regarding the design and evaluation of the grants 
        program.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be--
                    ``(A) a city, county, Indian Tribe, State, or 
                subdivision thereof;
                    ``(B) an organization described in section 
                501(c)(3) of the Internal Revenue Code of 1986 and 
                exempt from tax under section 501(a) of such Code;
                    ``(C) a community health, mental health, or 
                substance use disorder center or clinic;
                    ``(D) a solo or group physician practice;
                    ``(E) an integrated health care delivery system;
                    ``(F) a public hospital;
                    ``(G) a health care group, university, or college; 
                or
                    ``(H) any other entity designated by the Secretary; 
                and
            ``(2) prepare and submit to the Secretary an application, 
        at such time, in such manner, and containing such additional 
        information as the Secretary may reasonably require.
    ``(c) Use of Funds.--An entity shall use funds received through a 
grant under this section to--
            ``(1) develop, implement, and evaluate models of providing 
        competent interpretation services through onsite 
        interpretation, telephonic interpretation, or video remote 
        interpreting services;
            ``(2) implement strategies to recruit, retain, and promote 
        individuals at all levels of the organization to maintain a 
        diverse staff and leadership that can promote and provide 
        language services to patient populations of the service area of 
        the entity;
            ``(3) develop and maintain a needs assessment that 
        identifies the current demographic, cultural, and 
        epidemiological profile of the community to accurately plan for 
        and implement language services needed in the service area of 
        the entity;
            ``(4) develop a strategic plan to implement language 
        services;
            ``(5) develop participatory, collaborative partnerships 
        with communities encompassing the patient populations of 
        individuals with limited English proficiency served by the 
        grant to gain input in designing and implementing language 
        services;
            ``(6) develop and implement grievance resolution processes 
        that are culturally and linguistically appropriate and capable 
        of identifying, preventing, and resolving complaints by 
        individuals with limited English proficiency;
            ``(7) develop short-term medical and mental health 
        interpretation training courses and incentives for bilingual 
        health care staff who are asked to provide interpretation 
        services in the workplace;
            ``(8) develop formal training programs, including continued 
        professional development and education programs as well as 
        supervision, for individuals interested in becoming dedicated 
        health care interpreters and culturally and linguistically 
        appropriate providers;
            ``(9) provide staff language training instruction, which 
        shall include information on the practical limitations of such 
        instruction for nonnative speakers;
            ``(10) develop policies that address compensation in salary 
        for staff who receive training to become either a staff 
        interpreter or bilingual provider;
            ``(11) develop other language assistance services as 
        determined appropriate by the Secretary;
            ``(12) develop, implement, and evaluate models of improving 
        cultural competence, including cultural competence programs for 
        community health workers; and
            ``(13) ensure that, consistent with the privacy protections 
        provided for under the regulations promulgated under section 
        264(c) of the Health Insurance Portability and Accountability 
        Act of 1996 and any applicable State privacy laws, data on the 
        individual patient or recipient's race, ethnicity, and primary 
        language are collected (and periodically updated) in health 
        records and integrated into the organization's information 
        management systems or any similar system used to store and 
        retrieve data.
    ``(d) Priority.--In awarding grants under this section, the 
Secretary shall give priority to entities that primarily engage in 
providing direct care and that have developed partnerships with 
community organizations or with agencies with experience in improving 
language access.
    ``(e) Evaluation.--
            ``(1) By grantees.--An entity that receives a grant under 
        this section shall submit to the Secretary an evaluation that 
        describes, in the manner and to the extent required by the 
        Secretary, the activities carried out with funds received under 
        the grant, and how such activities improved access to health 
        care services and health-care-related services and the quality 
        of health care for individuals with limited English 
        proficiency. Such evaluation shall be collected and 
        disseminated through the Robert T. Matsui Center for Culturally 
        and Linguistically Appropriate Health Care established under 
        section 3401. The Director of the Agency for Healthcare 
        Research and Quality shall notify grantees of the availability 
        of technical assistance for the evaluation and provide such 
        assistance upon request.
            ``(2) By secretary.--The Director of the Agency for 
        Healthcare Research and Quality shall evaluate or arrange with 
        other individuals or organizations to evaluate projects funded 
        under this section.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $5,000,000 for each of fiscal 
years 2021 through 2025.

``SEC. 3406. RESEARCH ON CULTURAL AND LANGUAGE COMPETENCE.

    ``(a) In General.--The Secretary, acting through the Director of 
the Agency for Healthcare Research and Quality, shall expand research 
concerning language access in the provision of health care services.
    ``(b) Eligibility.--The Director of the Agency for Healthcare 
Research and Quality may conduct the research described in subsection 
(a) or enter into contracts with other individuals or organizations to 
conduct such research.
    ``(c) Use of Funds.--Research conducted under this section shall be 
designed to do one or more of the following:
            ``(1) To identify the barriers to mental and behavioral 
        services that are faced by individuals with limited English 
        proficiency.
            ``(2) To identify health care providers' and health 
        administrators' attitudes, knowledge, and awareness of the 
        barriers to quality health care services that are faced by 
        individuals with limited English proficiency.
            ``(3) To identify optimal approaches for delivering 
        language access.
            ``(4) To identify best practices for data collection, 
        including--
                    ``(A) the collection by providers of health care 
                services and health-care-related services of data on 
                the race, ethnicity, and primary language of recipients 
                of such services, taking into account existing research 
                conducted by the Government or private sector;
                    ``(B) the development and implementation of data 
                collection and reporting systems; and
                    ``(C) effective privacy safeguards for collected 
                data.
            ``(5) To develop a minimum data collection set for primary 
        language.
            ``(6) To evaluate the most effective ways in which the 
        Secretary can create or coordinate, and subsidize or otherwise 
        fund, telephonic interpretation services for health care 
        providers, taking into consideration, among other factors, the 
        flexibility necessary for such a system to accommodate 
        variations in--
                    ``(A) provider type;
                    ``(B) languages needed and their frequency of use;
                    ``(C) type of encounter;
                    ``(D) time of encounter, including regular business 
                hours and after hours; and
                    ``(E) location of encounter.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2021 through 2025.''.

SEC. 703. TRAINING TOMORROW'S DOCTORS FOR CULTURALLY AND LINGUISTICALLY 
              APPROPRIATE CARE: GRADUATE MEDICAL EDUCATION.

    (a) Direct Graduate Medical Education.--Section 1886(h)(4) of the 
Social Security Act (42 U.S.C. 1395ww(h)(4)) is amended by adding at 
the end the following new subparagraph:
                    ``(L) Treatment of culturally and linguistically 
                appropriate training.--In determining a hospital's 
                number of full-time equivalent residents for purposes 
                of this subsection, all the time that is spent by an 
                intern or resident in an approved medical residency 
                training program for education and training in 
                culturally and linguistically appropriate service 
                delivery, which shall include all diverse populations 
                including people with disabilities and the Lesbian, 
                gay, bisexual, transgender, queer, questioning, 
                questioning and intersex (LGBTQIA) community, shall be 
                counted toward the determination of full-time 
                equivalency.''.
    (b) Indirect Medical Education.--Section 1886(d)(5)(B) of the 
Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) is amended--
            (1) by redesignating the clause (x) added by section 
        5505(b) of the Patient Protection and Affordable Care Act as 
        clause (xi); and
            (2) by adding at the end the following new clause:
            ``(xii) The provisions of subparagraph (L) of subsection 
        (h)(4) shall apply under this subparagraph in the same manner 
        as they apply under such subsection.''.
    (c) Effective Date.--The amendments made by subsections (a) and (b) 
shall apply with respect to payments made to hospitals on or after the 
date that is one year after the date of the enactment of this Act.

SEC. 704. FEDERAL REIMBURSEMENT FOR CULTURALLY AND LINGUISTICALLY 
              APPROPRIATE SERVICES UNDER THE MEDICARE, MEDICAID, AND 
              STATE CHILDREN'S HEALTH INSURANCE PROGRAMS.

    (a) Language Access Grants for Medicare Providers.--
            (1) Establishment.--
                    (A) In general.--Not later than 6 months after the 
                date of the enactment of this Act, the Secretary of 
                Health and Human Services, acting through the Centers 
                for Medicare & Medicaid Services and in consultation 
                with the Center for Medicare and Medicaid Innovation 
                (as referred to in section 1115A of the Social Security 
                Act (42 U.S.C. 1315a)), shall establish a demonstration 
                program under which the Secretary shall award grants to 
                eligible Medicare service providers to improve 
                communication between such providers and Medicare 
                beneficiaries who are limited English proficient, 
                including beneficiaries who live in diverse and 
                underserved communities.
                    (B) Application of innovation rules.--The 
                demonstration project under subparagraph (A) shall be 
                conducted in a manner that is consistent with the 
                applicable provisions of subsections (b), (c), and (d) 
                of section 1115A of the Social Security Act (42 U.S.C. 
                1315a).
                    (C) Number of grants.--To the extent practicable, 
                the Secretary shall award not less than 24 grants under 
                this subsection.
                    (D) Grant period.--Except as provided under 
                paragraph (2)(D), each grant awarded under this 
                subsection shall be for a 3-year period.
            (2) Eligibility requirements.--To be eligible for a grant 
        under this subsection, an entity must meet the following 
        requirements:
                    (A) Medicare provider.--The entity must be--
                            (i) a provider of services under part A of 
                        title XVIII of the Social Security Act (42 
                        U.S.C. 1395c et seq.);
                            (ii) a provider of services under part B of 
                        such title (42 U.S.C. 1395j et seq.);
                            (iii) a Medicare Advantage organization 
                        offering a Medicare Advantage plan under part C 
                        of such title (42 U.S.C. 1395w-21 et seq.); or
                            (iv) a PDP sponsor offering a prescription 
                        drug plan under part D of such title (42 U.S.C. 
                        1395w-101 et seq.).
                    (B) Underserved communities.--The entity must serve 
                a community that, with respect to necessary language 
                services for improving access and utilization of health 
                care among English learners, is disproportionally 
                underserved.
                    (C) Application.--The entity must prepare and 
                submit to the Secretary an application, at such time, 
                in such manner, and accompanied by such additional 
                information as the Secretary may require.
                    (D) Reporting.--In the case of a grantee that 
                received a grant under this subsection in a previous 
                year, such grantee is only eligible for continued 
                payments under a grant under this subsection if the 
                grantee met the reporting requirements under paragraph 
                (9) for such year. If a grantee fails to meet the 
                requirement of such paragraph for the first year of a 
                grant, the Secretary may terminate the grant and 
                solicit applications from new grantees to participate 
                in the demonstration program.
            (3) Distribution.--To the extent feasible, the Secretary 
        shall award--
                    (A) at least 6 grants to providers of services 
                described in paragraph (2)(A)(i);
                    (B) at least 6 grants to service providers 
                described in paragraph (2)(A)(ii);
                    (C) at least 6 grants to organizations described in 
                paragraph (2)(A)(iii); and
                    (D) at least 6 grants to sponsors described in 
                paragraph (2)(A)(iv).
            (4) Considerations in awarding grants.--
                    (A) Variation in grantees.--In awarding grants 
                under this subsection, the Secretary shall select 
                grantees to ensure the following:
                            (i) The grantees provide many different 
                        types of language services.
                            (ii) The grantees serve Medicare 
                        beneficiaries who speak different languages, 
                        and who, as a population, have differing needs 
                        for language services.
                            (iii) The grantees serve Medicare 
                        beneficiaries in both urban and rural settings.
                            (iv) The grantees serve Medicare 
                        beneficiaries in at least two geographic 
                        regions, as defined by the Secretary.
                            (v) The grantees serve Medicare 
                        beneficiaries in at least two large 
                        metropolitan statistical areas with racial, 
                        ethnic, sexual, gender, disability, and 
                        economically diverse populations.
                    (B) Priority for partnerships with community 
                organizations and agencies.--In awarding grants under 
                this subsection, the Secretary shall give priority to 
                eligible entities that have a partnership with--
                            (i) a community organization; or
                            (ii) a consortia of community 
                        organizations, State agencies, and local 
                        agencies,
                that has experience in providing language services.
            (5) Use of funds for competent language services.--
                    (A) In general.--Subject to subparagraph (E), a 
                grantee may only use grant funds received under this 
                subsection to pay for the provision of competent 
                language services to Medicare beneficiaries who are 
                English learners.
                    (B) Competent language services defined.--For 
                purposes of this subsection, the term ``competent 
                language services'' means--
                            (i) interpreter and translation services 
                        that--
                                    (I) subject to the exceptions under 
                                subparagraph (C)--
                                            (aa) if the grantee 
                                        operates in a State that has 
                                        statewide health care 
                                        interpreter standards, meet the 
                                        State standards currently in 
                                        effect; or
                                            (bb) if the grantee 
                                        operates in a State that does 
                                        not have statewide health care 
                                        interpreter standards, utilizes 
                                        competent interpreters who 
                                        follow the National Council on 
                                        Interpreting in Health Care's 
                                        Code of Ethics and Standards of 
                                        Practice and comply with the 
                                        requirements of section 1557 of 
                                        the Patient Protection and 
                                        Affordable Care Act (42 U.S.C. 
                                        18116) as published in the 
                                        Federal Register on May 18, 
                                        2016; and
                                    (II) that, in the case of 
                                interpreter services, are provided 
                                through--
                                            (aa) onsite interpretation;
                                            (bb) telephonic 
                                        interpretation; or
                                            (cc) video interpretation; 
                                        and
                            (ii) the direct provision of health care or 
                        health-care-related services by a competent 
                        bilingual health care provider.
                    (C) Exceptions.--The requirements of subparagraph 
                (B)(i)(I) do not apply, with respect to interpreter and 
                translation services and a grantee--
                            (i) in the case of a Medicare beneficiary 
                        who is an English learner if--
                                    (I) such beneficiary has been 
                                informed, in the beneficiary's primary 
                                language, of the availability of free 
                                interpreter and translation services 
                                and the beneficiary instead requests 
                                that a family member, friend, or other 
                                person provide such services; and
                                    (II) the grantee documents such 
                                request in the beneficiary's medical 
                                record; or
                            (ii) in the case of a medical emergency 
                        where the delay directly associated with 
                        obtaining a competent interpreter or 
                        translation services would jeopardize the 
                        health of the patient.
                Clause (ii) shall not be construed to exempt emergency 
                rooms or similar entities that regularly provide health 
                care services in medical emergencies to patients who 
                are English learners from any applicable legal or 
                regulatory requirements related to providing competent 
                interpreter and translation services without undue 
                delay.
                    (D) Medicare advantage organizations and pdp 
                sponsors.--If a grantee is a Medicare Advantage 
                organization offering a Medicare Advantage plan under 
                part C of title XVIII of the Social Security Act (42 
                U.S.C. 1395w-21 et seq.) or a PDP sponsor offering a 
                prescription drug plan under part D of such title (42 
                U.S.C. 1395w-101 et seq.), such entity must provide at 
                least 50 percent of the grant funds that the entity 
                receives under this subsection directly to the entity's 
                network providers (including all health providers and 
                pharmacists) for the purpose of providing support for 
                such providers to provide competent language services 
                to Medicare beneficiaries who are English learners.
                    (E) Administrative and reporting costs.--A grantee 
                may use up to 10 percent of the grant funds to pay for 
                administrative costs associated with the provision of 
                competent language services and for reporting required 
                under paragraph (9).
            (6) Determination of amount of grant payments.--
                    (A) In general.--Payments to grantees under this 
                subsection shall be calculated based on the estimated 
                numbers of Medicare beneficiaries who are English 
                learners in a grantee's service area utilizing--
                            (i) data on the numbers of English learners 
                        who speak English less than ``very well'' from 
                        the most recently available data from the 
                        Bureau of the Census or other State-based study 
                        the Secretary determines likely to yield 
                        accurate data regarding the number of such 
                        individuals in such service area; or
                            (ii) data provided by the grantee, if the 
                        grantee routinely collects data on the primary 
                        language of the Medicare beneficiaries that the 
                        grantee serves and the Secretary determines 
                        that the data is accurate and shows a greater 
                        number of English learners than would be 
                        estimated using the data under clause (i).
                    (B) Discretion of secretary.--Subject to 
                subparagraph (C), the amount of payment made to a 
                grantee under this subsection may be modified annually 
                at the discretion of the Secretary, based on changes in 
                the data under subparagraph (A) with respect to the 
                service area of a grantee for the year.
                    (C) Limitation on amount.--The amount of a grant 
                made under this subsection to a grantee may not exceed 
                $500,000 for the period under paragraph (1)(D).
            (7) Assurances.--Grantees under this subsection shall, as a 
        condition of receiving a grant under this subsection--
                    (A) ensure that clinical and support staff receive 
                appropriate ongoing education and training in 
                linguistically appropriate service delivery;
                    (B) ensure the linguistic competence of bilingual 
                providers;
                    (C) offer and provide appropriate language services 
                at no additional charge to each patient who is an 
                English learner for all points of contact between the 
                patient and the grantee, in a timely manner during all 
                hours of operation;
                    (D) notify Medicare beneficiaries of their right to 
                receive language services in their primary language;
                    (E) post signage in the primary languages commonly 
                used by the patient population in the service area of 
                the organization; and
                    (F) ensure that--
                            (i) primary language data are collected for 
                        recipients of language services and such data 
                        are consistent with standards developed under 
                        title XXXIV of the Public Health Service Act, 
                        as added by section 202 of this Act, to the 
                        extent such standards are available upon the 
                        initiation of the demonstration program; and
                            (ii) consistent with the privacy 
                        protections provided under the regulations 
                        promulgated pursuant to section 264(c) of the 
                        Health Insurance Portability and Accountability 
                        Act of 1996 (42 U.S.C. 1320d-2 note), if the 
                        recipient of language services is a minor or is 
                        incapacitated, primary language data are 
                        collected on the parent or legal guardian of 
                        such recipient.
            (8) No cost sharing.--Medicare beneficiaries who are 
        English learners shall not have to pay cost sharing or co-
        payments for competent language services provided under this 
        demonstration program.
            (9) Reporting requirements for grantees.--Not later than 
        the end of each calendar year, a grantee that receives funds 
        under this subsection in such year shall submit to the 
        Secretary a report that includes the following information:
                    (A) The number of Medicare beneficiaries to whom 
                competent language services are provided.
                    (B) The primary languages of those Medicare 
                beneficiaries.
                    (C) The types of language services provided to such 
                beneficiaries.
                    (D) Whether such language services were provided by 
                employees of the grantee or through a contract with 
                external contractors or agencies.
                    (E) The types of interpretation services provided 
                to such beneficiaries, and the approximate length of 
                time such service is provided to such beneficiaries.
                    (F) The costs of providing competent language 
                services.
                    (G) An account of the training or accreditation of 
                bilingual staff, interpreters, and translators 
                providing services funded by the grant under this 
                subsection.
            (10) Evaluation and report to congress.--Not later than 1 
        year after the completion of a 3-year grant under this 
        subsection, the Secretary shall conduct an evaluation of the 
        demonstration program under this subsection and shall submit to 
        the Congress a report that includes the following:
                    (A) An analysis of the patient outcomes and the 
                costs of furnishing care to the Medicare beneficiaries 
                who are English learners participating in the project 
                as compared to such outcomes and costs for such 
                Medicare beneficiaries not participating, based on the 
                data provided under paragraph (9) and any other 
                information available to the Secretary.
                    (B) The effect of delivering language services on--
                            (i) Medicare beneficiary access to care and 
                        utilization of services;
                            (ii) the efficiency and cost effectiveness 
                        of health care delivery;
                            (iii) patient satisfaction;
                            (iv) health outcomes; and
                            (v) the provision of culturally appropriate 
                        services provided to such beneficiaries.
                    (C) The extent to which bilingual staff, 
                interpreters, and translators providing services under 
                such demonstration were trained or accredited and the 
                nature of accreditation or training needed by type of 
                provider, service, or other category as determined by 
                the Secretary to ensure the provision of high-quality 
                interpretation, translation, or other language services 
                to Medicare beneficiaries if such services are expanded 
                pursuant to section 1115A(c) of the Social Security Act 
                (42 U.S.C. 1315a(c)).
                    (D) Recommendations, if any, regarding the 
                extension of such project to the entire Medicare 
                Program, subject to the provisions of such section 
                1115A(c).
            (11) Appropriations.--There is appropriated to carry out 
        this subsection, in equal parts from the Federal Hospital 
        Insurance Trust Fund under section 1817 of the Social Security 
        Act (42 U.S.C. 1395i) and the Federal Supplementary Medical 
        Insurance Trust Fund under section 1841 of such Act (42 U.S.C. 
        1395t), $16,000,000 for each fiscal year of the demonstration 
        program.
            (12) English learner defined.--In this subsection, the term 
        ``English learner'' has the meaning given such term in section 
        8101(20) of the Elementary and Secondary Education Act of 1965, 
        except that subparagraphs (A), (B), and (D) of such section 
        shall not apply.
    (b) Language Assistance Services Under the Medicare Program.--
            (1) Inclusion as rural health clinic services.--Section 
        1861 of the Social Security Act (42 U.S.C. 1395x) is amended--
                    (A) in subsection (aa)(1)--
                            (i) in subparagraph (B), by striking 
                        ``and'' at the end;
                            (ii) by adding ``and'' at the end of 
                        subparagraph (C); and
                            (iii) by inserting after subparagraph (C) 
                        the following new subparagraph:
            ``(D) language assistance services as defined in subsection 
        (jjj)(1),''; and
                    (B) by adding at the end the following new 
                subsection:

            ``Language Assistance Services and Related Terms

    ``(kkk)(1) The term `language assistance services' means `language 
access' or `language assistance services' (as those terms are defined 
in section 3400 of the Public Health Service Act) furnished by a 
`qualified interpreter for an individual with limited English 
proficiency' or a `qualified translator' (as those terms are defined in 
such section 3400) to an `individual with limited English proficiency' 
(as defined in such section 3400) or an `English learner' (as defined 
in paragraph (2)).
    ``(2) The term `English learner' has the meaning given that term in 
section 8101(20) of the Elementary and Secondary Education Act of 1965, 
except that subparagraphs (A), (B), and (D) of such section shall not 
apply.''.
            (2) Coverage.--Section 1832(a)(2) of the Social Security 
        Act (42 U.S.C. 1395k(a)(2)) is amended--
                    (A) by striking ``and'' at the end of subparagraph 
                (I);
                    (B) by striking the period at the end of 
                subparagraph (J) and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(K) language assistance services (as defined in 
                section 1861(jjj)(1)).''.
            (3) Payment.--Section 1833(a) of the Social Security Act 
        (42 U.S.C. 1395l(a)) is amended--
                    (A) by striking ``and'' at the end of paragraph 
                (8);
                    (B) by striking the period at the end of paragraph 
                (9) and inserting ``; and''; and
                    (C) by inserting after paragraph (9) the following 
                new paragraph:
            ``(10) in the case of language assistance services (as 
        defined in section 1861(jjj)(1)), 100 percent of the reasonable 
        charges for such services, as determined in consultation with 
        the Medicare Payment Advisory Commission.''.
            (4) Waiver of budget neutrality.--For the 3-year period 
        beginning on the date of enactment of this section, the budget 
        neutrality provision of section 1848(c)(2)(B)(ii) of the Social 
        Security Act (42 U.S.C. 1395w-4(c)(2)(B)(ii)) shall not apply 
        with respect to language assistance services (as defined in 
        section 1861(kkk)(1) of such Act).
    (c) Medicare Parts C and D.--
            (1) In general.--Medicare Advantage plans under part C of 
        title XVIII of the Social Security Act (42 U.S.C. 1395w-21 et 
        seq.) and prescription drug plans under part D of such title 
        (42 U.S.C. 1395q-101) shall comply with title VI of the Civil 
        Rights Act of 1964 (42 U.S.C. 2000d et seq.) and section 1557 
        of the Patient Protection and Affordable Care Act (42 U.S.C. 
        18116) to provide effective language services to enrollees of 
        such plans.
            (2) Medicare advantage plans and prescription drug plans 
        reporting requirement.--Section 1857(e) of the Social Security 
        Act (42 U.S.C. 1395w-27(e)) is amended by adding at the end the 
        following new paragraph:
            ``(5) Reporting requirements relating to effective language 
        services.--A contract under this part shall require a Medicare 
        Advantage organization (and, through application of section 
        1860D-12(b)(3)(D), a contract under section 1860D-12 shall 
        require a PDP sponsor) to annually submit (for each year of the 
        contract) a report that contains information on the internal 
        policies and procedures of the organization (or sponsor) 
        related to recruitment and retention efforts directed to 
        workforce diversity and linguistically and culturally 
        appropriate provision of services in each of the following 
        contexts:
                    ``(A) The collection of data in a manner that meets 
                the requirements of title I of the Ending Health 
                Disparities During COVID-19 Act of 2020, regarding the 
                enrollee population.
                    ``(B) Education of staff and contractors who have 
                routine contact with enrollees regarding the various 
                needs of the diverse enrollee population.
                    ``(C) Evaluation of the language services programs 
                and services offered by the organization (or sponsor) 
                with respect to the enrollee population, such as 
                through analysis of complaints or satisfaction survey 
                results.
                    ``(D) Methods by which the plan provides to the 
                Secretary information regarding the ethnic diversity of 
                the enrollee population.
                    ``(E) The periodic provision of educational 
                information to plan enrollees on the language services 
                and programs offered by the organization (or 
                sponsor).''.
    (d) Improving Language Services in Medicaid and CHIP.--
            (1) Payments to states.--Section 1903(a)(2)(E) of the 
        Social Security Act (42 U.S.C. 1396b(a)(2)(E)), as amended by 
        section 203(g)(3), is further amended by--
                    (A) striking ``75'' and inserting ``95'';
                    (B) striking ``translation or interpretation 
                services'' and inserting ``language assistance 
                services''; and
                    (C) striking ``children of families'' and inserting 
                ``individuals''.
            (2) State plan requirements.--Section 1902(a)(10)(A) of the 
        Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by 
        striking ``and (29)'' and inserting ``(29), and (30)''.
            (3) Definition of medical assistance.--Section 1905(a) of 
        the Social Security Act (42 U.S.C. 1396d(a)) is amended by--
                    (A) in paragraph (29), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (30) as paragraph 
                (31); and
                    (C) by inserting after paragraph (29) the following 
                new paragraph:
            ``(30) language assistance services, as such term is 
        defined in section 1861(kkk)(1), provided in a timely manner to 
        individuals with limited English proficiency as defined in 
        section 3400 of the Public Health Service Act; and''.
            (4) Use of deductions and cost sharing.--Section 1916(a)(2) 
        of the Social Security Act (42 U.S.C. 1396o(a)(2)) is amended 
        by--
                    (A) by striking ``or'' at the end of subparagraph 
                (D);
                    (B) by striking ``; and'' at the end of 
                subparagraph (E) and inserting ``, or''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(F) language assistance services described in 
                section 1905(a)(29); and''.
            (5) CHIP coverage requirements.--Section 2103 of the Social 
        Security Act (42 U.S.C. 1397cc) is amended--
                    (A) in subsection (a), in the matter before 
                paragraph (1), by striking ``and (7)'' and inserting 
                ``(7), and (10)''; and
                    (B) in subsection (c), by adding at the end the 
                following new paragraph:
            ``(10) Language assistance services.--The child health 
        assistance provided to a targeted low-income child shall 
        include coverage of language assistance services, as such term 
        is defined in section 1861(jjj)(1), provided in a timely manner 
        to individuals with limited English proficiency (as defined in 
        section 3400 of the Public Health Service Act).''; and
                    (C) in subsection (e)(2)--
                            (i) in the heading, by striking 
                        ``preventive'' and inserting ``certain''; and
                            (ii) by inserting ``or subsection (c)(10)'' 
                        after ``subsection (c)(1)(D)''.
            (6) Definition of child health assistance.--Section 
        2110(a)(27) of the Social Security Act (42 U.S.C. 
        1397jj(a)(27)) is amended by striking ``translation'' and 
        inserting ``language assistance services as described in 
        section 2103(c)(10)''.
            (7) State data collection.--Pursuant to the reporting 
        requirement described in section 2107(b)(1) of the Social 
        Security Act (42 U.S.C. 1397gg(b)(1)), the Secretary of Health 
        and Human Services shall require that States collect data on--
                    (A) the primary language of individuals receiving 
                child health assistance under title XXI of the Social 
                Security Act (42 U.S.C. 1397aa et seq.); and
                    (B) in the case of such individuals who are minors 
                or incapacitated, the primary language of the 
                individual's parent or guardian.
            (8) CHIP payments to states.--Section 2105 of the Social 
        Security Act (42 U.S.C. 1397ee) is amended--
                    (A) in subsection (a)(1), by striking ``75'' and 
                inserting ``90''; and
                    (B) in subsection (c)(2)(A), by inserting before 
                the period at the end the following: ``, except that 
                expenditures pursuant to clause (iv) of subparagraph 
                (D) of such paragraph shall not count towards this 
                total''.
    (e) Funding Language Assistance Services Furnished by Providers of 
Health Care and Health-Care-Related Services That Serve High Rates of 
Uninsured LEP Individuals.--
            (1) Payment of costs.--
                    (A) In general.--Subject to subparagraph (B), the 
                Secretary of Health and Human Services (referred to in 
                this subsection as the ``Secretary'') shall make 
                payments (on a quarterly basis) directly to eligible 
                entities to support the provision of language 
                assistance services to English learners in an amount 
                equal to an eligible entity's eligible costs for 
                providing such services for the quarter.
                    (B) Funding.--Out of any funds in the Treasury not 
                otherwise appropriated, there are appropriated to the 
                Secretary of Health and Human Services such sums as may 
                be necessary for each of fiscal years 2021 through 
                2025.
                    (C) Relation to medicaid dsh.--Payments under this 
                subsection shall not offset or reduce payments under 
                section 1923 of the Social Security Act (42 U.S.C. 
                1396r-4), nor shall payments under such section be 
                considered when determining uncompensated costs 
                associated with the provision of language assistance 
                services for the purposes of this section.
            (2) Methodology for payment of claims.--
                    (A) In general.--The Secretary shall establish a 
                methodology to determine the average per person cost of 
                language assistance services.
                    (B) Different entities.--In establishing such 
                methodology, the Secretary may establish different 
                methodologies for different types of eligible entities.
                    (C) No individual claims.--The Secretary may not 
                require eligible entities to submit individual claims 
                for language assistance services for individual 
                patients as a requirement for payment under this 
                subsection.
            (3) Data collection instrument.--For purposes of this 
        subsection, the Secretary shall create a standard data 
        collection instrument that is consistent with any existing 
        reporting requirements by the Secretary or relevant accrediting 
        organizations regarding the number of individuals to whom 
        language access are provided.
            (4) Guidelines.--Not later than 6 months after the date of 
        enactment of this Act, the Secretary shall establish and 
        distribute guidelines concerning the implementation of this 
        subsection.
            (5) Reporting requirements.--
                    (A) Report to secretary.--Entities receiving 
                payment under this subsection shall provide the 
                Secretary with a quarterly report on how the entity 
                used such funds. Such report shall contain aggregate 
                (and may not contain individualized) data collected 
                using the instrument under paragraph (3) and shall 
                otherwise be in a form and manner determined by the 
                Secretary.
                    (B) Report to congress.--Not later than 2 years 
                after the date of enactment of this Act, and every 2 
                years thereafter, the Secretary shall submit a report 
                to Congress concerning the implementation of this 
                subsection.
            (6) Definitions.--In this subsection:
                    (A) Eligible costs.--The term ``eligible costs'' 
                means, with respect to an eligible entity that provides 
                language assistance services to English learners, the 
                product of--
                            (i) the average per person cost of language 
                        assistance services, determined according to 
                        the methodology devised under paragraph (2); 
                        and
                            (ii) the number of English learners who are 
                        provided language assistance services by the 
                        entity and for whom no reimbursement is 
                        available for such services under the 
                        amendments made by subsections (a), (b), (c), 
                        or (d) or by private health insurance.
                    (B) Eligible entity.--The term ``eligible entity'' 
                means an entity that--
                            (i) is a Medicaid provider that is--
                                    (I) a physician;
                                    (II) a hospital with a low-income 
                                utilization rate (as defined in section 
                                1923(b)(3) of the Social Security Act 
                                (42 U.S.C. 1396r-4(b)(3))) of greater 
                                than 25 percent; or
                                    (III) a Federally qualified health 
                                center (as defined in section 
                                1905(l)(2)(B) of the Social Security 
                                Act (42 U.S.C. 1396d(l)(2)(B)));
                            (ii) not later than 6 months after the date 
                        of the enactment of this Act, provides language 
                        assistance services to not less than 8 percent 
                        of the entity's total number of patients; and
                            (iii) prepares and submits an application 
                        to the Secretary, at such time, in such manner, 
                        and accompanied by such information as the 
                        Secretary may require, to ascertain the 
                        entity's eligibility for funding under this 
                        subsection.
                    (C) English learner.--The term ``English learner'' 
                has the meaning given such term in section 8101(20) of 
                the Elementary and Secondary Education Act of 1965 (20 
                U.S.C. 7801(20)), except that subparagraphs (A), (B), 
                and (D) of such section shall not apply.
                    (D) Language assistance services.--The term 
                ``language assistance services'' has the meaning given 
                such term in section 1861(kkk)(1) of the Social 
                Security Act, as added by subsection (b).
    (f) Application of Civil Rights Act of 1964, Section 1557 of the 
Affordable Care Act, and Other Laws.--Nothing in this section shall be 
construed to limit otherwise existing obligations of recipients of 
Federal financial assistance under title VI of the Civil Rights Act of 
1964 (42 U.S.C. 2000d et seq.), section 1557 of the Affordable Care 
Act, or other laws that protect the civil rights of individuals.
    (g) Effective Date.--
            (1) In general.--Except as otherwise provided and subject 
        to paragraph (2), the amendments made by this section shall 
        take effect on January 1, 2021.
            (2) Exception if state legislation required.--In the case 
        of a State plan for medical assistance under title XIX of the 
        Social Security Act (42 U.S.C. 1396 et seq.) which the 
        Secretary of Health and Human Services determines requires 
        State legislation (other than legislation appropriating funds) 
        in order for the plan to meet the additional requirement 
        imposed by the amendments made by this section, the State plan 
        shall not be regarded as failing to comply with the 
        requirements of such title solely on the basis of its failure 
        to meet this additional requirement before the first day of the 
        first calendar quarter beginning after the close of the first 
        regular session of the State legislature that begins 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 
        session, each year of such session shall be deemed to be a 
        separate regular session of the State legislature.

SEC. 705. REQUIREMENTS FOR HEALTH PROGRAMS OR ACTIVITIES RECEIVING 
              FEDERAL FUNDS.

    (a) Covered Entity; Covered Program or Activity.--In this section--
            (1) the term ``covered entity'' has the meaning given such 
        term in section 92.4 of title 42, Code of Federal Regulations, 
        as in effect on May 16, 2016; and
            (2) the term ``covered program or activity'' has the 
        meaning given such term in section 92.4 of title 42, Code of 
        Federal Regulations, as in effect on May 16, 2016.
    (b) Requirements.--A covered entity, in order to ensure the right 
of individuals with limited English proficiency to receive access to 
high-quality health care through the covered program or activity, 
shall--
            (1) ensure that appropriate clinical and support staff 
        receive ongoing education and training in culturally and 
        linguistically appropriate service delivery;
            (2) offer and provide appropriate language assistance 
        services at no additional charge to each patient that is an 
        individual with limited English proficiency at all points of 
        contact, in a timely manner during all hours of operation;
            (3) notify patients of their right to receive language 
        services in their primary language; and
            (4) utilize only qualified interpreters for an individual 
        with limited English proficiency or qualified translators, 
        except as provided in subsection (c).
    (c) Exemptions.--The requirements of subsection (b)(4) shall not 
apply as follows:
            (1) When a patient requests the use of family, friends, or 
        other persons untrained in interpretation or translation if 
        each of the following conditions are met:
                    (A) The interpreter requested by the patient is 
                over the age of 18.
                    (B) The covered entity informs the patient in the 
                primary language of the patient that he or she has the 
                option of having the entity provide to the patient an 
                interpreter and translation services without charge.
                    (C) The covered entity informs the patient that the 
                entity may not require an individual with a limited 
                English proficiency to use a family member or friend as 
                an interpreter.
                    (D) The covered entity evaluates whether the person 
                the patient wishes to use as an interpreter is 
                competent. If the covered entity has reason to believe 
                that such person is not competent as an interpreter, 
                the entity provides its own interpreter to protect the 
                covered entity from liability if the patient's 
                interpreter is later found not competent.
                    (E) If the covered entity has reason to believe 
                that there is a conflict of interest between the 
                interpreter and patient, the covered entity may not use 
                the patient's interpreter.
                    (F) The covered entity has the patient sign a 
                waiver, witnessed by at least 1 individual not related 
                to the patient, that includes the information stated in 
                subparagraphs (A) through (E) and is translated into 
                the patient's primary language.
            (2) When a medical emergency exists and the delay directly 
        associated with obtaining competent interpreter or translation 
        services would jeopardize the health of the patient, but only 
        until a competent interpreter or translation service is 
        available.
    (d) Rule of Construction.--Subsection (c)(2) shall not be construed 
to mean that emergency rooms or similar entities that regularly provide 
health care services in medical emergencies are exempt from legal or 
regulatory requirements related to competent interpreter services.

SEC. 706. REPORT ON FEDERAL EFFORTS TO PROVIDE CULTURALLY AND 
              LINGUISTICALLY APPROPRIATE HEALTH CARE SERVICES.

    (a) Report.--Not later than 1 year after the date of enactment of 
this Act and annually thereafter, the Secretary of Health and Human 
Services shall enter into a contract with the National Academy of 
Medicine for the preparation and publication of a report that describes 
Federal efforts to ensure that all individuals with limited English 
proficiency have meaningful access to health care services and health-
care-related services that are culturally and linguistically 
appropriate. Such report shall include--
            (1) a description and evaluation of the activities carried 
        out under this Act;
            (2) a description and analysis of best practices, model 
        programs, guidelines, and other effective strategies for 
        providing access to culturally and linguistically appropriate 
        health care services;
            (3) recommendations on the development and implementation 
        of policies and practices by providers of health care services 
        and health-care-related services for individuals with limited 
        English proficiency, including people with cognitive, hearing, 
        vision, or print impairments;
            (4) recommend guidelines or standards for health literacy 
        and plain language, informed consent, discharge instructions, 
        and written communications, and for improvement of health care 
        access;
            (5) a description of the effect of providing language 
        services on quality of health care and access to care; and
            (6) a description of the costs associated with or savings 
        related to the provision of language services.
    (b) 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 2021 through 2025.

SEC. 707. HEALTH PROFESSIONS COMPETENCIES TO ADDRESS RACIAL AND ETHNIC 
              MENTAL HEALTH DISPARITIES.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Assistant Secretary for Mental Health and Substance Use, 
shall award grants to qualified national organizations for the purposes 
of--
            (1) developing, and disseminating to health professional 
        educational programs curricula or core competencies 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 
        abuse counseling; and
            (2) certifying community health workers and peer wellness 
        specialists with respect to such curricula and core 
        competencies and integrating and expanding the use of such 
        workers and specialists into health care and community-based 
        settings to address mental health disparities among racial and 
        ethnic minority groups.
    (b) Curricula; Core Competencies.--Organizations 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 competencies described in subsection (a)(1):
            (1) Formation of committees or working groups comprised of 
        experts from accredited health professions schools to identify 
        core competencies relating to mental health disparities among 
        racial and ethnic minority groups.
            (2) Planning of workshops in national fora to allow for 
        public input, including input from communities of color with 
        lived experience, into the educational needs associated with 
        mental health disparities 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 nationwide.
            (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 from 
        communities of color with lived experience of the impacts of 
        mental health disparities.
    (c) Definitions.--In this section:
            (1) Qualified national organization.--The term ``qualified 
        national organization'' means a national organization that 
        focuses on the education of students in programs of social 
        work, occupational therapy, psychology, psychiatry, 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 2021 through 2025.

SEC. 708. STUDY ON THE UNINSURED.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall--
            (1) conduct a study, in accordance with the standards under 
        section 3101 of the Public Health Service Act (42 U.S.C. 
        300kk), on the demographic characteristics of the population of 
        individuals who do not have health insurance coverage or oral 
        health coverage; and
            (2) predict, based on such study, the demographic 
        characteristics of the population of individuals who would 
        remain without health insurance coverage after the end of any 
        annual open enrollment or any special enrollment period or upon 
        enactment and implementation of any legislative changes to the 
        Patient Protection and Affordable Care Act (Public Law 111-148) 
        that affect the number of persons eligible for coverage.
    (b) Reporting Requirements.--
            (1) In general.--Not later than 12 months after the date of 
        the enactment of this Act, the Secretary shall submit to the 
        Congress the results of the study under subsection (a)(1) and 
        the prediction made under subsection (a)(2).
            (2) Reporting of demographic characteristics.--The 
        Secretary shall--
                    (A) report the demographic characteristics under 
                paragraphs (1) and (2) of subsection (a) on the basis 
                of racial and ethnic group, and shall stratify the 
                reporting on each racial and ethnic group by other 
                demographic characteristics that can impact access to 
                health insurance coverage, such as sexual orientation, 
                gender identity, primary language, disability status, 
                sex, socioeconomic status, age group, and citizenship 
                and immigration status, in a manner consistent with 
                title I of this Act, including the amendments made by 
                such title; and
                    (B) not use such report to engage in or anticipate 
                any deportation or immigration related enforcement 
                action by any entity, including the Department of 
                Homeland Security.

       TITLE VIII--AID TO PROVIDERS SERVING MINORITY COMMUNITIES

SEC. 801. TEMPORARY INCREASE IN MEDICAID DSH ALLOTMENTS.

    (a) In General.--Section 1923(f)(3) of the Social Security Act (42 
U.S.C. 1396r-4(f)(3)) is amended--
            (1) in subparagraph (A), by striking ``and subparagraph 
        (E)'' and inserting ``and subparagraphs (E) and (F)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(F) Temporary increase in allotments during 
                certain public health emergency.--The DSH allotment for 
                any State for each of fiscal years 2020 and 2021 is 
                equal to 102.5 percent of the DSH allotment that would 
                be determined under this paragraph for the State for 
                each respective fiscal year without application of this 
                subparagraph, notwithstanding subparagraphs (B) and 
                (C). For each fiscal year after fiscal year 2021, the 
                DSH allotment for a State for such fiscal year is equal 
                to the DSH allotment that would have been determined 
                under this paragraph for such fiscal year if this 
                subparagraph had not been enacted.''.
    (b) DSH Allotment Adjustment for Tennessee.--Section 
1923(f)(6)(A)(vi) of the Social Security Act (42 U.S.C. 1396r-
4(f)(6)(A)(vi)) is amended--
            (1) by striking ``Notwithstanding any other provision of 
        this subsection'' and inserting the following:
                                    ``(I) In general.--Notwithstanding 
                                any other provision of this subsection 
                                (except as provided in subclause (II) 
                                of this clause)''; and
            (2) by adding at the end the following:
                                    ``(II) Temporary increase in 
                                allotments.--The DSH allotment for 
                                Tennessee for each of fiscal years 2020 
                                and 2021 shall be equal to 
                                $54,427,500.''.
    (c) Sense of Congress.--It is the sense of Congress that a State 
should prioritize making payments under the State plan of the State 
under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (or 
a waiver of such plan) to disproportionate share hospitals that have a 
higher share of COVID-19 patients relative to other such hospitals in 
the State.

SEC. 802. COVID-19-RELATED TEMPORARY INCREASE OF MEDICAID FMAP.

    (a) In General.--Section 6008 of the Families First Coronavirus 
Response Act (42 U.S.C. 1396d note) is amended--
            (1) in subsection (a)--
                    (A) by inserting ``(or, if later, June 30, 2021)'' 
                after ``last day of such emergency period occurs''; and
                    (B) by striking ``6.2 percentage points.'' and 
                inserting ``the percentage points specified in 
                subsection (e). In no case may the application of this 
                section result in the Federal medical assistance 
                percentage determined for a State being more than 95 
                percent.''; and
            (2) by adding at the end the following new subsections:
    ``(e) Specified Percentage Points.--For purposes of subsection (a), 
the percentage points specified in this subsection are--
            ``(1) for each calendar quarter occurring during the period 
        beginning on the first day of the emergency period described in 
        paragraph (1)(B) of section 1135(g) of the Social Security Act 
        (42 U.S.C. 1320b-5(g)) and ending on June 30, 2020, 6.2 
        percentage points;
            ``(2) for each calendar quarter occurring during the period 
        beginning on July 1, 2020, and ending on June 30, 2021, 14 
        percentage points; and
            ``(3) for each calendar quarter, if any, occurring during 
        the period beginning on July 1, 2021, and ending on the last 
        day of the calendar quarter in which the last day of such 
        emergency period occurs, 6.2 percentage points.
    ``(f) Clarifications.--
            ``(1) In the case of a State that treats an individual 
        described in subsection (b)(3) as eligible for the benefits 
        described in such subsection, for the period described in 
        subsection (a), expenditures for medical assistance and 
        administrative costs attributable to such individual that would 
        not otherwise be included as expenditures under section 1903 of 
        the Social Security Act shall be regarded as expenditures under 
        the State plan approved under title XIX of the Social Security 
        Act or for administration of such State plan.
            ``(2) The limitations on payment under subsections (f) and 
        (g) of section 1108 of the Social Security Act (42 U.S.C. 1308) 
        shall not apply to Federal payments made under section 
        1903(a)(1) of the Social Security Act (42 U.S.C. 1396b(a)(1)) 
        attributable to the increase in the Federal medical assistance 
        percentage under this section.
            ``(3) Expenditures attributable to the increased Federal 
        medical assistance percentage under this section shall not be 
        counted for purposes of the limitations under section 
        2104(b)(4) of such Act (42 U.S.C. 1397dd(b)(4)).
            ``(4) Notwithstanding the first sentence of section 2105(b) 
        of the Social Security Act (42 U.S.C. 1397ee(b)), the 
        application of the increase under this section may result in 
        the enhanced FMAP of a State for a fiscal year under such 
        section exceeding 85 percent, but in no case may the 
        application of such increase before application of the second 
        sentence of such section result in the enhanced FMAP of the 
        State exceeding 95 percent.
    ``(g) Scope of Application.--An increase in the Federal medical 
assistance percentage for a State under this section shall not be taken 
into account for purposes of payments under part D of title IV of the 
Social Security Act (42 U.S.C. 651 et seq.).''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect and apply as if included in the enactment of section 6008 
of the Families First Coronavirus Response Act (Public Law 116-127).

SEC. 803. APPROPRIATION FOR PRIMARY HEALTH CARE.

     For an additional amount for ``Department of Health and Human 
Services--Health Resources and Services Administration--Primary Health 
Care'', $7,600,000,000, to remain available until September 30, 2025, 
for necessary expenses to prevent, prepare for, and respond to 
coronavirus, for grants and cooperative agreements under the Health 
Centers Program, as defined by section 330 of the Public Health Service 
Act, and for grants to Federally qualified health centers, as defined 
in section 1861(aa)(4)(B) of the Social Security Act, and for eligible 
entities under the Native Hawaiian Health Care Improvement Act, 
including maintenance or expansion of health center and system capacity 
and staffing levels: Provided, That sections 330(r)(2)(B), 
330(e)(6)(A)(iii), and 330(e)(6)(B)(iii) shall not apply to funds 
provided under this heading in this section: Provided further, That 
funds provided under this heading in this section may be used to (1) 
purchase equipment and supplies to conduct mobile testing for SARS-CoV-
2 or COVID-19; (2) purchase and maintain mobile vehicles and equipment 
to conduct such testing; and (3) hire and train laboratory personnel 
and other staff to conduct such mobile testing: Provided further, That 
such amount is designated by the Congress as being for an emergency 
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 
and Emergency Deficit Control Act of 1985.

SEC. 804. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    Title XXXIV of the Public Health Service Act, as amended by 
sections 104 and 702, is further amended by adding at the following:

 ``Subtitle C--Reconstruction and Improvement Grants for Public Health 
    Care Facilities Serving Pacific Islanders and the Insular Areas

``SEC. 3407. GRANT SUPPORT FOR QUALITY IMPROVEMENT INITIATIVES.

    ``(a) In General.--The Secretary, in collaboration with the 
Administrator of the Health Resources and Services Administration, the 
Director of the Agency for Healthcare Research and Quality, and the 
Administrator of the Centers for Medicare & Medicaid Services, shall 
award grants to eligible entities for the conduct of demonstration 
projects to improve the quality of and access to health care.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be a health center, hospital, health plan, health 
        system, community clinic, or other health entity determined 
        appropriate by the Secretary--
                    ``(A) that, by legal mandate or explicitly adopted 
                mission, provides patients with access to services 
                regardless of their ability to pay;
                    ``(B) that provides care or treatment for a 
                substantial number of patients who are uninsured, are 
                receiving assistance under a State plan under title XIX 
                of the Social Security Act (or under a waiver of such 
                plan), or are members of vulnerable populations, as 
                determined by the Secretary; and
                    ``(C)(i) with respect to which, not less than 50 
                percent of the entity's patient population is made up 
                of racial and ethnic minority groups; or
                    ``(ii) that--
                            ``(I) serves a disproportionate percentage 
                        of local patients that are from a racial and 
                        ethnic minority group, or that has a patient 
                        population, at least 50 percent of which is 
                        composed of individuals with limited English 
                        proficiency; and
                            ``(II) provides an assurance that amounts 
                        received under the grant will be used only to 
                        support quality improvement activities in the 
                        racial and ethnic minority population served; 
                        and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    ``(c) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to applicants under subsection (b)(2) 
that--
            ``(1) demonstrate an intent to operate as part of a health 
        care partnership, network, collaborative, coalition, or 
        alliance where each member entity contributes to the design, 
        implementation, and evaluation of the proposed intervention; or
            ``(2) intend to use funds to carry out systemwide changes 
        with respect to health care quality improvement, including--
                    ``(A) improved systems for data collection and 
                reporting;
                    ``(B) innovative collaborative or similar 
                processes;
                    ``(C) group programs with behavioral or self-
                management interventions;
                    ``(D) case management services;
                    ``(E) physician or patient reminder systems;
                    ``(F) educational interventions; or
                    ``(G) other activities determined appropriate by 
                the Secretary.
    ``(d) Use of Funds.--An entity shall use amounts received under a 
grant under subsection (a) to support the implementation and evaluation 
of health care quality improvement activities or minority health and 
health care disparity reduction activities that include--
            ``(1) with respect to health care systems, activities 
        relating to improving--
                    ``(A) patient safety;
                    ``(B) timeliness of care;
                    ``(C) effectiveness of care;
                    ``(D) efficiency of care;
                    ``(E) patient centeredness; and
                    ``(F) health information technology; and
            ``(2) with respect to patients, activities relating to--
                    ``(A) staying healthy;
                    ``(B) getting well, mentally and physically;
                    ``(C) living effectively with illness or 
                disability;
                    ``(D) coping with end-of-life issues; and
                    ``(E) shared decision making.
    ``(e) Common Data Systems.--The Secretary shall provide financial 
and other technical assistance to grantees under this section for the 
development of common data systems.
    ``(f) 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 2021 through 2026.

``SEC. 3408. CENTERS OF EXCELLENCE.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall designate 
centers of excellence at public hospitals, and other health systems 
serving large numbers of minority patients, that--
            ``(1) meet the requirements of section 3451(b)(1);
            ``(2) demonstrate excellence in providing care to minority 
        populations; and
            ``(3) demonstrate excellence in reducing disparities in 
        health and health care.
    ``(b) Requirements.--A hospital or health system that serves as a 
center of excellence under subsection (a) shall--
            ``(1) design, implement, and evaluate programs and policies 
        relating to the delivery of care in racially, ethnically, and 
        linguistically diverse populations;
            ``(2) provide training and technical assistance to other 
        hospitals and health systems relating to the provision of 
        quality health care to minority populations; and
            ``(3) develop activities for graduate or continuing medical 
        education that institutionalize a focus on cultural competence 
        training for health care providers.
    ``(c) 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 2021 through 2026.

``SEC. 3409. RECONSTRUCTION AND IMPROVEMENT GRANTS FOR PUBLIC HEALTH 
              CARE FACILITIES SERVING PACIFIC ISLANDERS AND THE INSULAR 
              AREAS.

    ``(a) In General.--The Secretary shall provide direct financial 
assistance to designated health care providers and community health 
centers in American Samoa, Guam, the Commonwealth of the Northern 
Mariana Islands, the United States Virgin Islands, Puerto Rico, and 
Hawaii for the purposes of reconstructing and improving health care 
facilities and services in a culturally competent and sustainable 
manner.
    ``(b) Eligibility.--To be eligible to receive direct financial 
assistance under subsection (a), an entity shall be a public health 
facility or community health center located in American Samoa, Guam, 
the Commonwealth of the Northern Mariana Islands, the United States 
Virgin Islands, Puerto Rico, or Hawaii that--
            ``(1) is owned or operated by--
                    ``(A) the Government of American Samoa, Guam, the 
                Commonwealth of the Northern Mariana Islands, the 
                United States Virgin Islands, Puerto Rico, or Hawaii or 
                a unit of local government; or
                    ``(B) a nonprofit organization; and
            ``(2)(A) provides care or treatment for a substantial 
        number of patients who are uninsured, receiving assistance 
        under title XVIII of the Social Security Act, or a State plan 
        under title XIX of such Act (or under a waiver of such plan), 
        or who are members of a vulnerable population, as determined by 
        the Secretary; or
            ``(B) serves a disproportionate percentage of local 
        patients that are from a racial and ethnic minority group.
    ``(c) Report.--Not later than 180 days after the date of enactment 
of this title and annually thereafter, the Secretary shall submit to 
the Congress and the President a report that includes an assessment of 
health resources and facilities serving populations in American Samoa, 
Guam, the Commonwealth of the Northern Mariana Islands, the United 
States Virgin Islands, Puerto Rico, and Hawaii. In preparing such 
report, the Secretary shall--
            ``(1) consult with and obtain information on all health 
        care facilities needs from the entities receiving direct 
        financial assistance under subsection (a);
            ``(2) include all amounts of Federal assistance received by 
        each such entity in the preceding fiscal year;
            ``(3) review the total unmet needs of health care 
        facilities serving American Samoa, Guam, the Commonwealth of 
        the Northern Mariana Islands, the United States Virgin Islands, 
        Puerto Rico, and Hawaii, including needs for renovation and 
        expansion of existing facilities;
            ``(4) include a strategic plan for addressing the needs of 
        each such population identified in the report; and
            ``(5) evaluate the effectiveness of the care provided by 
        measuring patient outcomes and cost measures.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as necessary to carry out this section.''.

SEC. 805. PANDEMIC PREMIUM PAY FOR ESSENTIAL WORKERS.

    (a) In General.-- Beginning 3 days after an essential work employer 
receives a grant under section 806 from the Secretary of the Treasury, 
the essential work employer shall--
            (1) be required to comply with subsections (b) through (h); 
        and
            (2) be subject to the enforcement requirements of section 
        807.
    (b) Pandemic Premium Pay.--
            (1) In general.--An essential work employer receiving a 
        grant under section 806 shall, in accordance with this 
        subsection, provide each essential worker of the essential work 
        employer with premium pay at a rate equal to $13 for each hour 
        of work performed by the essential worker for the employer from 
        January 27, 2020, until the date that is 60 days after the last 
        day of the COVID-19 Public Health Emergency.
            (2) Maximum amounts.--The total amount of all premium pay 
        under this subsection that an essential work employer is 
        required to provide to an essential worker, including through 
        any retroactive payment under paragraph (3), shall not exceed--
                    (A) for an essential worker who is not a highly-
                compensated essential worker, $10,000 reduced by 
                employer payroll taxes with respect to such premium 
                pay; or
                    (B) for a highly-compensated essential worker, 
                $5,000 reduced by employer payroll taxes with respect 
                to such premium pay.
            (3) Retroactive payment.--For all work performed by an 
        essential worker during the period from January 27, 2020, 
        through the date on which the essential work employer of the 
        worker receives a grant under this title, the essential work 
        employer shall use a portion of the amount of such grant to 
        provide such worker with premium pay under this subsection for 
        such work at the rate provided under paragraph (1). Such amount 
        shall be provided to the essential worker as a lump sum in the 
        next paycheck (or other payment form) that immediately follows 
        the receipt of the grant by the essential work employer. In any 
        case where it is impossible for the employer to arrange for 
        payment of the amount due in such paycheck (or other payment 
        form), such amounts shall be paid as soon as practicable, but 
        in no event later than the second paycheck (or other payment 
        form) following the receipt of the grant by the essential work 
        employer.
            (4) No employer discretion.--An essential work employer 
        receiving a grant under section 806 shall not have any 
        discretion to determine which portions of work performed by an 
        essential worker qualify for premium pay under this subsection, 
        but shall pay such premium pay for any increment of time worked 
        by the essential worker for the essential work employer up to 
        the maximum amount applicable to the essential worker under 
        paragraph (2).
    (c) Prohibition on Reducing Compensation and Displacement.--
            (1) In general.--Any payments made to an essential worker 
        as premium pay under subsection (b) shall be in addition to all 
        other compensation, including all wages, remuneration, or other 
        pay and benefits, that the essential worker otherwise receives 
        from the essential work employer.
            (2) Reduction of compensation.--An essential work employer 
        receiving a grant under section 806 shall not, during the 
        period beginning on the date of enactment of this Act and 
        ending on the date that is 60 days after the last day of the 
        COVID-19 Public Health Emergency, reduce or in any other way 
        diminish, any other compensation, including the wages, 
        remuneration, or other pay or benefits, that the essential work 
        employer provided to the essential worker on the day before the 
        date of enactment of this Act.
            (3) Displacement.--An essential work employer shall not 
        take any action to displace an essential worker (including 
        partial displacement such as a reduction in hours, wages, or 
        employment benefits) for purposes of hiring an individual for 
        an equivalent position at a rate of compensation that is less 
        than is required to be provided to an essential worker under 
        paragraph (2).
    (d) Demarcation From Other Compensation.--The amount of any premium 
pay paid under subsection (b) shall be clearly demarcated as a separate 
line item in each paystub or other document provided to an essential 
worker that details the remuneration the essential worker received from 
the essential work employer for a particular period of time. If any 
essential worker does not otherwise regularly receive any such paystub 
or other document from the employer, the essential work employer shall 
provide such paystub or other document to the essential worker for the 
duration of the period in which the essential work employer provides 
premium pay under subsection (b).
    (e) Exclusion From Wage-Based Calculations.--Any premium pay under 
subsection (b) paid to an essential worker under this section by an 
essential work employer receiving a grant under section 806 shall be 
excluded from the amount of remuneration for work paid to the essential 
worker for purposes of--
            (1) calculating the essential worker's eligibility for any 
        wage-based benefits offered by the essential work employer;
            (2) computing the regular rate at which such essential 
        worker is employed under section 7 of the Fair Labor Standards 
        Act of 1938 (29 U.S.C. 207); and
            (3) determining whether such essential worker is exempt 
        from application of such section 7 under section 13(a)(1) of 
        such Act (29 U.S.C. 213(a)(1)).
    (f) Essential Worker Death.--
            (1) In general.--In any case in which an essential worker 
        of an essential work employer receiving a grant under section 
        806 exhibits symptoms of COVID-19 and dies, the essential work 
        employer shall pay as a lump sum to the next of kin of the 
        essential worker for premium pay under subsection (b)--
                    (A) for an essential worker who is not a highly-
                compensated essential worker, the amount determined 
                under subsection (b)(2)(A) minus the total amount of 
                any premium pay the worker received under subsection 
                (b) prior to the death; or
                    (B) for a highly-compensated essential worker, the 
                amount determined under subsection (b)(2)(B) minus the 
                amount of any premium pay the worker received under 
                subsection (b) prior to the death.
            (2) Treatment of lump sum payments.--
                    (A) Treatment as premium pay.--For purposes of this 
                title, any payment made under this subsection shall be 
                treated as a premium pay under subsection (b).
                    (B) Treatment for purposes of internal revenue code 
                of 1986.--For purposes of the Internal Revenue Code of 
                1986, any payment made under this subsection shall be 
                treated as a payment for work performed by the 
                essential worker.
    (g) Application to Self-Directed Care Workers Funded Through 
Medicaid or the Veteran-Directed Care Program.--
            (1) Medicaid.--In the case of an essential work employer 
        receiving a grant under section 806 that is a covered employer 
        described in paragraph (4) who, under a State Medicaid plan 
        under title XIX of the Social Security Act (42 U.S.C. 1396 et 
        seq.) or under a waiver of such plan, has opted to receive 
        items or services using a self-directed service delivery model, 
        the preceding requirements of this section, including the 
        requirements to provide premium pay under subsection (b) 
        (including a lump sum payment in the event of an essential 
        worker death under subsection (f)) and the requirements of 
        sections 806 and 807, shall apply to the State Medicaid agency 
        responsible for the administration of such plan or waiver with 
        respect to self-directed care workers employed by that 
        employer. In administering payments made under this title to 
        such self-directed care workers on behalf of such employers, a 
        State Medicaid agency shall--
                    (A) exclude and disregard any payments made under 
                this title to such self-directed workers from the 
                individualized budget that applies to the items or 
                services furnished to the individual client employer 
                under the State Medicaid plan or waiver;
                    (B) to the extent practicable, administer and 
                provide payments under this title directly to such 
                self-directed workers through arrangements with 
                entities that provide financial management services in 
                connection with the self-directed service delivery 
                models used under the State Medicaid plan or waiver; 
                and
                    (C) ensure that individual client employers of such 
                self-directed workers are provided notice of, and 
                comply with, the prohibition under section 
                807(b)(1)(B).
            (2) Veteran-directed care program.--In the case of an 
        essential work employer that is a covered employer described in 
        paragraph (4) who is a veteran participating in the Veteran 
        Directed Care program administered by the VA Office of 
        Geriatrics & Extended Care of the Veterans Health 
        Administration, the preceding requirements of this section and 
        sections 806 and 807, shall apply to such VA Office of 
        Geriatrics & Extended Care with respect to self-directed care 
        workers employed by that employer. Paragraph (1) of this 
        subsection shall apply to the administration by the VA Office 
        of Geriatrics & Extended Care of payments made under this title 
        to such self-directed care workers on behalf of such employers 
        in the same manner as such requirements apply to State Medicaid 
        agencies.
            (3) Penalty enforcement.--The Secretary of Labor shall 
        consult with the Secretary of Health and Human Services and the 
        Secretary of Veterans Affairs regarding the enforcement of 
        penalties imposed under section 807(b)(2) with respect to 
        violations of subparagraph (A) or (B) of section 807(b)(1) that 
        involve self-directed workers for which the requirements of 
        this section and sections 806 and 807 are applied to a State 
        Medicaid agency under paragraph (1) or the VA Office of 
        Geriatrics & Extended Care under paragraph (2).
            (4) Covered employer described.--For purposes of paragraphs 
        (1) and (2), a covered employer described in this paragraph 
        means--
                    (A) an entity or person that contracts directly 
                with a State, locality, Tribal government, or the 
                Federal Government, to provide care (which may include 
                items and services) through employees of such entity or 
                person to individuals under the Medicare program under 
                title XVIII of the Social Security Act (42 U.S.C. 1395 
                et seq.), under a State Medicaid plan under title XIX 
                of such Act (42 U.S.C. 1396 et seq.) or under a waiver 
                of such plan, or under any other program established or 
                administered by a State, locality, Tribal government, 
                or the Federal Government;
                    (B) a subcontractor of an entity or person 
                described in subparagraph (A);
                    (C) an individual client (or a representative on 
                behalf of an individual client), an entity, or a 
                person, that employs an individual to provide care 
                (which may include items and services) to the 
                individual client under a self-directed service 
                delivery model through a program established or 
                administered by a State, locality, Tribal government, 
                or the Federal Government; or
                    (D) an individual client (or a representative on 
                behalf of an individual client) that, on their own 
                accord, employs an individual to provide care (which 
                may include items and services) to the individual 
                client using the individual client's own finances.
    (h) Interaction With Stafford Act.--Nothing in this section shall 
nullify, supersede, or otherwise change a State's ability to seek 
reimbursement under section 403 of the Robert T. Stafford Disaster 
Relief and Emergency Assistance Act (42 U.S.C. 5170b) for the costs of 
premium pay based on pre-disaster labor policies for eligible 
employees.
    (i) Calculation of Paid Leave Under FFCRA and FMLA.--
            (1) Families first coronavirus response act.--Section 
        5110(5)(B) of the Families First Coronavirus Response Act (29 
        U.S.C. 2601 note) is amended by adding at the end the 
        following:
                            ``(iii) Pandemic premium pay.--Compensation 
                        received by an employee under section 807(b) of 
                        the EHDC Act of 2020 shall be included as 
                        remuneration for employment paid to the 
                        employee for purposes of computing the regular 
                        rate at which such employee is employed.''.
            (2) Family and medical leave act of 1993.--Section 
        110(b)(2)(B) of the Family and Medical Leave Act of 1993 (29 
        U.S.C. 2620(b)(2)(B)) is amended by adding at the end the 
        following:
                            ``(iii) Pandemic premium pay.--Compensation 
                        received by an employee under section 807(b) of 
                        the EHDC Act of 2020 shall be included as 
                        remuneration for employment paid to the 
                        employee for purposes of computing the regular 
                        rate at which such employee is employed.''.

SEC. 806. COVID-19 HEROES FUND GRANTS.

    (a) Grants.--
            (1) For pandemic premium pay.--The Secretary of the 
        Treasury shall, subject to the availability of amounts provided 
        in this title, award a grant to each essential work employer 
        that applies for a grant, in accordance with this section, for 
        the purpose of providing premium pay to essential workers under 
        section 805(b), including amounts paid under section 805(f).
            (2) Eligibility.--
                    (A) Eligible employers generally.--Any essential 
                work employer shall be eligible for a grant under 
                paragraph (1).
                    (B) Self-directed care workers.--A self-directed 
                care worker employed by an essential work employer 
                other than an essential work employer described in 
                section 805(g), shall be eligible to apply for a grant 
                under paragraph (1) in the same manner as an essential 
                work employer. Such a worker shall provide premium pay 
                to himself or herself in accordance with this section, 
                including the recordkeeping and refund requirements of 
                this section.
    (b) Amount of Grants.--
            (1) In general.--The maximum amount available for making a 
        grant under subsection (a)(1) to an essential work employer 
        shall be equal to the sum of--
                    (A) the amount obtained by multiplying $10,000 by 
                the number of essential workers the employer certifies, 
                in the application submitted under subsection (c)(1), 
                as employing, or providing remuneration to for services 
                or labor, who are paid wages or remuneration by the 
                employer at a rate that is less than the equivalent of 
                $200,000 per year; and
                    (B) the amount obtained by multiplying $5,000 by 
                the number of highly-compensated essential workers the 
                employer certifies, in the application submitted under 
                subsection (c)(1), as employing, or providing 
                remuneration to for services or labor, who are paid 
                wages or remuneration by the employer at a rate that is 
                equal to or greater than the equivalent of $200,000 per 
                year.
            (2) No partial grants.--The Secretary of the Treasury shall 
        not award a grant under this section in an amount less than the 
        maximum described in paragraph (1).
    (c) Grant Application and Disbursal.--
            (1) Application.--Any essential work employer seeking a 
        grant under subsection (a)(1) shall submit an application to 
        the Secretary of the Treasury at such time, in such manner, and 
        complete with such information as the Secretary may require.
            (2) Notice and certification.--
                    (A) In general.--The Secretary of the Treasury 
                shall, within 15 days after receiving a complete 
                application from an essential work employer eligible 
                for a grant under this section--
                            (i) notify the employer of the Secretary's 
                        findings with respect to the requirements for 
                        the grant; and
                            (ii)(I) if the Secretary finds that the 
                        essential work employer meets the requirements 
                        under this section for a grant under subsection 
                        (a), provide a certification to the employer--
                                    (aa) that the employer has met such 
                                requirements;
                                    (bb) of the amount of the grant 
                                payment that the Secretary has 
                                determined the employer shall receive 
                                based on the requirements under this 
                                section; or
                            (II) if the Secretary finds that the 
                        essential work employer does not meet the 
                        requirements under this section for a grant 
                        under subsection (a), provide a notice of 
                        denial stating the reasons for the denial and 
                        provide an opportunity for administrative 
                        review by not later than 10 days after the 
                        denial.
                    (B) Transfer.--Not later than 7 days after making a 
                certification under subparagraph (A)(ii) with respect 
                to an essential work employer, the Secretary of the 
                Treasury shall make the appropriate transfer to the 
                employer of the amount of the grant.
    (d) Use of Funds.--
            (1) In general.--An essential work employer receiving a 
        grant under this section shall use the amount of the grant 
        solely for the following purposes:
                    (A) Providing premium pay under section 805(b) to 
                essential workers in accordance with the requirements 
                for such payments under such section, including 
                providing payments described in section 805(f) to the 
                next of kin of essential workers in accordance with the 
                requirements for such payments under such section.
                    (B) Paying employer payroll taxes with respect to 
                premium pay amounts described in subparagraph (A), 
                including such payments described in section 805(f).
        Each dollar of a grant received by an essential work employer 
        under this title shall be used as provided in subparagraph (A) 
        or (B) or returned to the Secretary of the Treasury.
            (2) No other uses authorized.--An essential work employer 
        who uses any amount of a grant for a purpose not required under 
        paragraph (1) shall be--
                    (A) considered to have misused funds in violation 
                of section 805; and
                    (B) subject to the enforcement and remedies 
                provided under section 807.
            (3) Refund.--
                    (A) In general.--If an essential work employer 
                receives a grant under this section and, for any 
                reason, does not provide every dollar of such grant to 
                essential workers in accordance with the requirements 
                of this title, then the employer shall refund any such 
                dollars to the Secretary of the Treasury not later than 
                June 30, 2021. Any amounts returned to the Secretary 
                shall be deposited into the Fund and be available for 
                any additional grants under this section.
                    (B) Requirement for not reducing compensation.--An 
                essential work employer who is required to refund any 
                amount under this paragraph shall not reduce or 
                otherwise diminish an eligible worker's compensation or 
                benefits in response to or otherwise due to such 
                refund. 
    (e) Recordkeeping.--An essential work employer that receives a 
grant under this section shall--
            (1) maintain records, including payroll records, 
        demonstrating how each dollar of funds received through the 
        grant were provided to essential workers; and
            (2) provide such records to the Secretary of the Treasury 
        or the Secretary of Labor upon the request of either such 
        Secretary.
    (f) Recoupment.--In addition to all other enforcement and remedies 
available under this title or any other law, the Secretary of the 
Treasury shall establish a process under which the Secretary shall 
recoup the amount of any grant awarded under subsection (a)(1) if the 
Secretary determines that the essential work employer receiving the 
grant--
            (1) did not provide all of the dollars of such grant to the 
        essential workers of the employer;
            (2) did not, in fact, have the number of essential workers 
        certified by the employer in accordance with subparagraphs (A) 
        and (B) of subsection (b)(1);
            (3) did not pay the essential workers for the number of 
        hours the employer claimed to have paid; or
            (4) otherwise misused funds or violated this title.
    (g) Special Rule for Certain Employees of Tribal Employers.--
Essential workers of Tribal employers who receive funds under title II 
shall not be eligible to receive funds from grants under this section.
    (h) Tax Treatment.--
            (1) Exclusion from income.--For purposes of the Internal 
        Revenue Code of 1986, any grant received by an essential work 
        employer under this section shall not be included in the gross 
        income of such essential work employer.
            (2) Denial of double benefit.--
                    (A) In general.--In the case of an essential work 
                employer that receives a grant under this section--
                            (i) amounts paid under subsections (b) or 
                        (f) of section 805 shall not be taken into 
                        account as wages for purposes of sections 41, 
                        45A, 51, or 1396 of the Internal Revenue Code 
                        of 1986 or section 2301 of the CARES Act 
                        (Public Law 116-136); and
                            (ii) any deduction otherwise allowable 
                        under such Code for applicable payments during 
                        any taxable year shall be reduced (but not 
                        below zero) by the excess (if any) of--
                                    (I) the aggregate amounts of grants 
                                received under this section; over
                                    (II) the sum of any amount refunded 
                                under subsection (d) plus the aggregate 
                                amount of applicable payments made for 
                                all preceding taxable years.
                    (B) Applicable payments.--For purposes of this 
                paragraph, the term ``applicable payments'' means 
                amounts paid as premium pay under subsections (b) or 
                (f) of section 805 and amounts paid for employer 
                payroll taxes with respect to such amounts.
                    (C) Aggregation rule.--Rules similar to the rules 
                of subsections (a) and (b) of section 52 of the 
                Internal Revenue Code of 1986 shall apply for purposes 
                of this section.
            (3) Information reporting.--The Secretary of the Treasury 
        shall submit to the Commissioner of Internal Revenue statements 
        containing--
                    (A) the name and tax identification number of each 
                essential work employer receiving a grant under this 
                section;
                    (B) the amount of such grant; and
                    (C) any amounts refunded under subsection (d)(3).
    (i) Reports.--
            (1) In general.--Not later than 30 days after obligating 
        the last dollar of the funds appropriated under this title, the 
        Secretary of the Treasury shall submit a report, to the 
        Committees of Congress described in paragraph (2), that--
                    (A) certifies that all funds appropriated under 
                this title have been obligated; and
                    (B) indicates the number of pending applications 
                for grants under this section that will be rejected due 
                to the lack of funds.
            (2) Committees of congress.--The Committees of Congress 
        described in this paragraph are--
                    (A) the Committee on Ways and Means of the House of 
                Representatives;
                    (B) the Committee on Education and Labor of the 
                House of Representatives;
                    (C) the Committee on Finance of the Senate; and
                    (D) the Committee on Health, Education, Labor, and 
                Pensions of the Senate.

SEC. 807. ENFORCEMENT AND OUTREACH.

    (a) Duties of Secretary of Labor.--The Secretary of Labor shall--
            (1) have authority to enforce the requirements of section 
        805, in accordance with subsections (b) through (e);
            (2) conduct outreach as described in subsection (f); and
            (3) coordinate with the Secretary of the Treasury as needed 
        to carry out the Secretary of Labor's responsibilities under 
        this section.
    (b) Prohibited Acts, Penalties, and Enforcement.--
            (1) Prohibited acts.--It shall be unlawful for a person 
        to--
                    (A) violate any provision of section 805 applicable 
                to such person; or
                    (B) discharge or in any other manner discriminate 
                against any essential worker because such essential 
                worker has filed any complaint or instituted or caused 
                to be instituted any proceeding under or related to 
                this title, or has testified or is about to testify in 
                any such proceeding.
            (2) Enforcement and penalties.--
                    (A) Premium pay violations.--A violation described 
                in paragraph (1)(A) shall be deemed a violation of 
                section 7 of the Fair Labor Standards Act of 1938 (29 
                U.S.C. 207) and unpaid amounts required under this 
                section shall be treated as unpaid overtime 
                compensation under such section 7 for the purposes of 
                sections 15 and 16 of such Act (29 U.S.C. 215 and 216).
                    (B) Discharge or discrimination.--A violation of 
                paragraph (1)(B) shall be deemed a violation of section 
                15(a)(3) of the Fair Labor Standards Act of 1938 (29 
                U.S.C. 215(a)(3)).
    (c) Investigation.--
            (1) In general.--To ensure compliance with the provisions 
        of section 805, including any regulation or order issued under 
        that section, the Secretary of Labor shall have the 
        investigative authority provided under section 11(a) of the 
        Fair Labor Standards Act of 1938 (29 U.S.C. 211(a)). For the 
        purposes of any investigation provided for in this subsection, 
        the Secretary of Labor shall have the subpoena authority 
        provided for under section 9 of such Act (29 U.S.C. 209).
            (2) State agencies.--The Secretary of Labor may, for the 
        purpose of carrying out the functions and duties under this 
        section, utilize the services of State and local agencies in 
        accordance with section 11(b) of the Fair Labor Standards Act 
        of 1938 (29 U.S.C. 211(b)).
    (d) Essential Worker Enforcement.--
            (1) Right of action.--An action alleging a violation of 
        paragraph (1) or (2) of subsection (b) may be maintained 
        against an essential work employer receiving a grant under 
        section 806 in any Federal or State court of competent 
        jurisdiction by one or more essential workers or their 
        representative for and on behalf of the essential workers, or 
        the essential workers and others similarly situated, in the 
        same manner, and subject to the same remedies (including 
        attorney's fees and costs of the action), as an action brought 
        by an employee alleging a violation of section 7 or 15(a)(3), 
        respectively, of the Fair Labor Standards Act of 1938 (29 
        U.S.C. 207, 215(a)(3)).
            (2) No waiver.--In an action alleging a violation of 
        paragraph (1) or (2) of subsection (b) brought by one or more 
        essential workers or their representative for and on behalf of 
        the persons as described in paragraph (1), to enforce the 
        rights in section 805, no court of competent jurisdiction may 
        grant the motion of an essential work employer receiving a 
        grant under section 806 to compel arbitration, under chapter 1 
        of title 9, United States Code, or any analogous State 
        arbitration statute, of the claims involved. An essential 
        worker's right to bring an action described in paragraph (1) or 
        subsection (b)(2)(A) on behalf of similarly situated essential 
        workers to enforce such rights may not be subject to any 
        private agreement that purports to require the essential 
        workers to pursue claims on an individual basis.
    (e) Recordkeeping.--An essential work employer receiving a grant 
under section 806 shall make, keep, and preserve records pertaining to 
compliance with section 805 in accordance with section 11(c) of the 
Fair Labor Standards Act of 1938 (29 U.S.C. 211(c)) and in accordance 
with regulations prescribed by the Secretary of Labor.
    (f) Outreach and Education.--Out of amounts appropriated to the 
Secretary of the Treasury under section 805 for a fiscal year, the 
Secretary of the Treasury shall transfer to the Secretary of Labor, 
$3,000,000, of which the Secretary of Labor shall use--
            (1) $2,500,000 for outreach to essential work employers and 
        essential workers regarding the premium pay under section 805; 
        and
            (2) $500,000 to implement an advertising campaign 
        encouraging large essential work employers to provide the same 
        premium pay provided for by section 805 using the large 
        essential work employers' own funds and without utilizing 
        grants under this title.
    (g) Clarification of Enforcing Official.--Nothing in the Government 
Employee Rights Act of 1991 (42 U.S.C. 2000e-16a et seq.) or section 
3(e)(2)(C) of the Fair Labor Standards Act of 1938 (29 U.S.C. 
203(e)(2)(C)) shall be construed to prevent the Secretary of Labor from 
carrying out the authority of the Secretary under this section in the 
case of State employees described in section 304(a) of the Government 
Employee Rights Act of 1991 (42 U.S.C. 2000e-16c(a)).

   TITLE IX--HEALTH IT AND BRIDGING THE DIGITAL DIVIDE IN HEALTH CARE

SEC. 901. HRSA ASSISTANCE TO HEALTH CENTERS FOR PROMOTION OF HEALTH IT.

    The Secretary of Health and Human Services, acting through the 
Administrator of the Health Resources and Services Administration, 
shall expand and intensify the programs and activities of the 
Administration (directly or through grants or contracts) to provide 
technical assistance and resources to health centers (as defined in 
section 330(a) of the Public Health Service Act (42 U.S.C. 254b(a))) to 
adopt and meaningfully use certified EHR technology for the management 
of chronic diseases and health conditions and reduction of health 
disparities.

SEC. 902. ASSESSMENT OF IMPACT OF HEALTH IT ON RACIAL AND ETHNIC 
              MINORITY COMMUNITIES; OUTREACH AND ADOPTION OF HEALTH IT 
              IN SUCH COMMUNITIES.

    (a) National Coordinator for Health Information Technology.--Not 
later than 18 months after the date of enactment of this Act, the 
National Coordinator for Health Information Technology (referred to in 
this section as the ``National Coordinator'') shall--
            (1) conduct an evaluation of the level of interoperability, 
        access, use, and accessibility of electronic health records in 
        racial and ethnic minority communities, focusing on whether 
        patients in such communities have providers who use electronic 
        health records, and the degree to which patients in such 
        communities can access, exchange, and use without special 
        effort their health information in those electronic health 
        records, and indicating whether such providers--
                    (A) are participating in the Medicare program under 
                title XVIII of the Social Security Act (42 U.S.C. 1395 
                et seq.) or a State plan under title XIX of such Act 
                (42 U.S.C. 1396 et seq.) (or a waiver of such plan);
                    (B) have received incentive payments or incentive 
                payment adjustments under Medicare and Medicaid 
                Electronic Health Records Incentive Programs (as 
                defined in subsection (c)(2));
                    (C) are MIPS eligible professionals, as defined in 
                paragraph (1)(C) of section 1848(q) of the Social 
                Security Act (42 U.S.C. 1395w-4(q)), for purposes of 
                the Merit-Based Incentive Payment System under such 
                section; or
                    (D) have been recruited by any of the Health 
                Information Technology Regional Extension Centers 
                established under section 3012 of the Public Health 
                Service Act (42 U.S.C. 300jj-32);
            (2) publish the results of such evaluation including the 
        race and ethnicity of such providers and the populations served 
        by such providers; and
            (3) not later than 12 months after the enactment of this 
        Act, shall promulgate a certification criterion and module of 
        certified EHR technology that stratifies quality measures by 
        disparity characteristics, including race, ethnicity, language, 
        gender, gender identity, sexual orientation, socioeconomic 
        status, and disability status, as those characteristics are 
        defined in certified EHR technology; and reports to Centers for 
        Medicare & Medicaid Services the quality measures stratified by 
        race and at least two other disparity characteristics.
The term ``quality measures'' refers to the quality measures specified 
in MIPS.
    (b) National Center for Health Statistics.--As soon as practicable 
after the date of enactment of this Act, the Director of the National 
Center for Health Statistics shall provide to Congress a more detailed 
analysis of the data presented in National Center for Health Statistics 
data brief entitled ``Adoption of Certified Electronic Health Record 
Systems and Electronic Information Sharing in Physician Offices: United 
States, 2013 and 2014'' (NCHS Data Brief No. 236).
    (c) Centers for Medicare & Medicaid Services.--
            (1) In general.--As part of the process of collecting 
        information, with respect to a provider, at registration and 
        attestation for purposes of Medicare and Medicaid Electronic 
        Health Records Incentive Programs (as defined in paragraph (2)) 
        or the Merit-Based Incentive Payment System under section 
        1848(q) of the Social Security Act (42 U.S.C. 1395w-4(q)), the 
        Secretary of Health and Human Services shall collect the race 
        and ethnicity of such provider.
            (2) Medicare and medicaid electronic health records 
        incentive programs defined.--For purposes of paragraph (1), the 
        term ``Medicare and Medicaid Electronic Health Records 
        Incentive Programs'' means the incentive programs under section 
        1814(l)(3), subsections (a)(7) and (o) of section 1848, 
        subsections (l) and (m) of section 1853, subsections 
        (b)(3)(B)(ix)(I) and (n) of section 1886, and subsections 
        (a)(3)(F) and (t) of section 1903 of the Social Security Act 
        (42 U.S.C. 1395f(l)(3), 1395w-4, 1395w-23, 1395ww, and 1396b).
    (d) National Coordinator's Assessment of Impact of HIT.--Section 
3001(c)(6)(C) of the Public Health Service Act (42 U.S.C. 300jj-
11(c)(6)(C)) is amended--
            (1) in the heading by inserting ``, racial and ethnic 
        minority communities,'' after ``health disparities'';
            (2) by inserting ``, in communities with a high proportion 
        of individuals from racial and ethnic minority groups (as 
        defined in section 1707(g)), including people with disabilities 
        in these groups,'' after ``communities with health 
        disparities'';
            (3) by striking ``The National Coordinator'' and inserting 
        the following:
                            ``(i) In general.--The National 
                        Coordinator''; and
            (4) by adding at the end the following:
                            ``(ii) Criteria.--In any publication under 
                        clause (i), the National Coordinator shall 
                        include best practices for encouraging 
                        partnerships between the Federal Government, 
                        States, and private entities to expand outreach 
                        for and the adoption of certified EHR 
                        technology in communities with a high 
                        proportion of individuals from racial and 
                        ethnic minority groups (as so defined), while 
                        also maintaining the accessibility requirements 
                        of section 508 of the Rehabilitation Act of 
                        1973 to encourage patient involvement in 
                        patient health care. The National Coordinator 
                        shall--
                                    ``(I) not later than 6 months after 
                                the submission of the report required 
                                under section 822 of the Ending Health 
                                Disparities During COVID-19 Act of 
                                2020, establish criteria for evaluating 
                                the impact of health information 
                                technology on communities with a high 
                                proportion of individuals from racial 
                                and ethnic minority groups (as so 
                                defined) taking into account the 
                                findings in such report; and
                                    ``(II) not later than 1 year after 
                                the submission of such report, conduct 
                                and publish the results of an 
                                evaluation of such impact.''.

SEC. 903. EXTENDING FUNDING TO STRENGTHEN THE HEALTH IT INFRASTRUCTURE 
              IN RACIAL AND ETHNIC MINORITY COMMUNITIES.

    Section 3011 of the Public Health Service Act (42 U.S.C. 300jj-31) 
is amended--
            (1) in subsection (a), in the matter preceding paragraph 
        (1), by inserting ``, including with respect to communities 
        with a high proportion of individuals from racial and ethnic 
        minority groups (as defined in section 1707(g))'' before the 
        colon; and
            (2) by adding at the end the following new subsection:
    ``(e) Annual Report on Expenditures.--The National Coordinator 
shall report annually to Congress on activities and expenditures under 
this section.''.

SEC. 904. EXTENDING COMPETITIVE GRANTS FOR THE DEVELOPMENT OF LOAN 
              PROGRAMS TO FACILITATE ADOPTION OF CERTIFIED EHR 
              TECHNOLOGY BY PROVIDERS SERVING RACIAL AND ETHNIC 
              MINORITY GROUPS.

    Section 3014(e) of the Public Health Service Act (42 U.S.C. 300jj-
34(e)) is amended, in the matter preceding paragraph (1), by inserting 
``, including with respect to communities with a high proportion of 
individuals from racial and ethnic minority groups (as defined in 
section 1707(g))'' after ``health care provider to''.

SEC. 905. AUTHORIZATION OF APPROPRIATIONS.

    Section 3018 of the Public Health Service Act (42 U.S.C. 300jj-38) 
is amended by striking ``fiscal years 2009 through 2013'' and inserting 
``fiscal years 2021 through 2026''.

SEC. 906. DATA COLLECTION AND ASSESSMENTS CONDUCTED IN COORDINATION 
              WITH MINORITY-SERVING INSTITUTIONS.

    Section 3001(c)(6) of the Public Health Service Act (42 U.S.C. 
300jj-11(c)(6)) is amended by adding at the end the following new 
subparagraph:
                    ``(F) Data collection and assessments conducted in 
                coordination with minority-serving institutions.--
                            ``(i) In general.--In carrying out 
                        subparagraph (C) with respect to communities 
                        with a high proportion of individuals from 
                        racial and ethnic minority groups (as defined 
                        in section 1707(g)), the National Coordinator 
                        shall, to the greatest extent possible, 
                        coordinate with an entity described in clause 
                        (ii).
                            ``(ii) Minority-serving institutions.--For 
                        purposes of clause (i), an entity described in 
                        this clause is a Historically Black College or 
                        University, a Hispanic-serving institution, a 
                        tribal college or university, or an Asian-
                        American-, Native American-, or Pacific 
                        Islander-serving institution with an accredited 
                        public health, health policy, or health 
                        services research program.''.

SEC. 907. STUDY OF HEALTH INFORMATION TECHNOLOGY IN MEDICALLY 
              UNDERSERVED COMMUNITIES.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Secretary of Health and Human Services shall--
            (1) enter into an agreement with the National Academies of 
        Sciences, Engineering, and Medicine to conduct a study on the 
        development, implementation, and effectiveness of health 
        information technology within medically underserved areas (as 
        described in subsection (c)); and
            (2) submit a report to Congress describing the results of 
        such study, including any recommendations for legislative or 
        administrative action.
    (b) Study.--The study described in subsection (a)(1) shall--
            (1) identify barriers to successful implementation of 
        health information technology in medically underserved areas;
            (2) survey a cross-section of individuals in medically 
        underserved areas and report their opinions about the various 
        topics of study;
            (3) examine the degree of interoperability among health 
        information technology and users of health information 
        technology in medically underserved areas, including patients, 
        providers, and community services;
            (4) examine the impact of health information technology on 
        providing quality care and reducing the cost of care to 
        individuals in such areas, including the impact of such 
        technology on improved health outcomes for individuals, 
        including which technology worked for which population and how 
        it improved health outcomes for that population;
            (5) examine the impact of health information technology on 
        improving health care-related decisions by both patients and 
        providers in such areas;
            (6) identify specific best practices for using health 
        information technology to foster the consistent provision of 
        physical accessibility and reasonable policy accommodations in 
        health care to individuals with disabilities in such areas;
            (7) assess the feasibility and costs associated with the 
        use of health information technology in such areas;
            (8) evaluate whether the adoption and use of qualified 
        electronic health records (as defined in section 3000 of the 
        Public Health Service Act (42 U.S.C. 300jj)) is effective in 
        reducing health disparities, including analysis of clinical 
        quality measures reported by providers who are participating in 
        the Medicare program under title XVIII of the Social Security 
        Act (42 U.S.C. 1395 et seq.) or a State plan under title XIX of 
        such Act (42 U.S.C. 1396 et seq.) (or a waiver of such plan), 
        pursuant to programs to encourage the adoption and use of 
        certified EHR technology;
            (9) identify providers in medically underserved areas that 
        are not electing to adopt and use electronic health records and 
        determine what barriers are preventing those providers from 
        adopting and using such records; and
            (10) examine urban and rural community health systems and 
        determine the impact that health information technology may 
        have on the capacity of primary health providers in those 
        systems.
    (c) Medically Underserved Area.--The term ``medically underserved 
area'' means--
            (1) a population that has been designated as a medically 
        underserved population under section 330(b)(3) of the Public 
        Health Service Act (42 U.S.C. 254b(b)(3));
            (2) an area that has been designated as a health 
        professional shortage area under section 332 of the Public 
        Health Service Act (42 U.S.C. 254e);
            (3) an area or population that has been designated as a 
        medically underserved community under section 799B of the 
        Public Health Service Act (42 U.S.C. 295p); or
            (4) another area or population that--
                    (A) experiences significant barriers to accessing 
                quality health services; and
                    (B) has a high prevalence of diseases or conditions 
                described in title VII, with such diseases or 
                conditions having a disproportionate impact on racial 
                and ethnic minority groups (as defined in section 
                1707(g) of the Public Health Service Act (42 U.S.C. 
                300u-6(g))) or a subgroup of people with disabilities 
                who have specific functional impairments.

SEC. 908. STUDY ON THE EFFECTS OF CHANGES TO TELEHEALTH UNDER THE 
              MEDICARE AND MEDICAID PROGRAMS DURING THE COVID-19 
              EMERGENCY.

    (a) In General.--Not later than 1 year after the end of the 
emergency period described in section 1135(g)(1)(B) of the Social 
Security Act (42 U.S.C. 1320b-5(g)(1)(B)), the Secretary of Health and 
Human Services (in this section referred to as the ``Secretary'') shall 
conduct a study and submit to the Committee on Energy and Commerce and 
the Committee on Ways and Means of the House of Representatives and the 
Committee on Finance of the Senate an interim report on any changes 
made to the provision or availability of telehealth services under part 
A or B of title XVIII of the Social Security Act (42 U.S.C. 1395 et 
seq.) during such period. Such report shall include the following:
            (1) A summary of utilization of all health care services 
        furnished under such part A or B during such period, including 
        the number of--
                    (A) in-person outpatient visits, inpatient 
                admissions, and in-person emergency department visits; 
                and
                    (B) telehealth visits, broken down by--
                            (i) the number of such visits furnished via 
                        audio-visual technology compared to the number 
                        of such visits furnished via audio-only 
                        technology;
                            (ii) the number of such visits furnished by 
                        each type of provider of services or supplier 
                        (as defined in section 1861 of such Act (42 
                        U.S.C. 1395x) and including a Federally 
                        qualified health center or rural health clinic 
                        (as so defined)), including a specification of 
                        the specialty of each such provider or supplier 
                        (if applicable); and
                            (iii) the type of service provided, 
                        including level of service and diagnoses 
                        associated with the telehealth visit.
            (2) A description of any changes in utilization patterns 
        for the care settings described in paragraph (1) over the 
        course of such period compared to such patterns prior to such 
        period.
            (3) An analysis of utilization of telehealth services under 
        such part A or B during such period, broken down by age, sex 
        (including sexual orientation and gender identity where 
        possible), race and ethnicity, disability status, primary 
        language, geographic region (including by rural health areas 
        (as defined by the Health Resources & Services Administration), 
        non-rural health areas, health professional shortage areas (as 
        defined in section 332(a)(1) of the Public Health Service Act 
        (42 U.S.C. 254e(a)(1))), medically underserved communities (as 
        defined in section 799B(6) of such Act (42 U.S.C. 295p(6))), 
        areas with medically underserved populations (as defined in 
        section 330(b)(3) of such Act (42 U.S.C. 254b(b)(3))), and by 
        State), and income level (as measured directly or indirectly, 
        such as by patient's zip code tabulation area median income as 
        publicly reported by the United States Census Bureau), and of 
        any trends in such utilization during such period, so broken 
        down. Such analysis shall include the number of telehealth 
        visits performed by providers of services or suppliers licensed 
        in a State different from the State where the individual 
        receiving such telehealth services is located at the time such 
        services are furnished. Such analysis may not include any 
        individually identifiable information or protected health 
        information.
            (4) A description of expenditures and any savings under 
        such part A or B attributable to use of such telehealth 
        services during such period.
            (5) A description of any instances of fraud identified by 
        the Secretary, acting through the Office of the Inspector 
        General or other relevant agencies and departments, with 
        respect to such telehealth services furnished under such part A 
        or B during such period and a comparison of the number of such 
        instances with the number of instances of fraud so identified 
        with respect to in-person services so furnished during such 
        period.
            (6) A description of any privacy concerns with respect to 
        the furnishing of such telehealth services (such as 
        cybersecurity or ransomware concerns), including a description 
        of any actions taken by the Secretary, acting through the 
        Health Sector Cybersecurity Coordination Center or other 
        relevant agencies and departments, during such period to assist 
        health care providers secure telecommunications systems.
            (7) An analysis of health care quality related to 
        telehealth (which may include patient health outcomes (such as 
        morbidity, mortality, healthcare utilization, and disease-
        specific management metrics), safety metrics, quality measures, 
        health equity focused measures, patient satisfaction, provider 
        satisfaction, and other inputs and sources as determined by the 
        Secretary).
            (8) An analysis of any other outcomes or metrics related to 
        telehealth, as determined appropriate by the Secretary.
    (b) Input.--In conducting the study and submitting the report under 
subsection (a), the Secretary--
            (1)(A) consult with relevant stakeholders (such as 
        patients, caregivers, patient advocacy groups, minority or 
        tribal groups (including Urban Indian Organization (UIOs)), 
        health care professionals (including behavioral health 
        professionals), hospitals, State medical boards, State nursing 
        boards, the Federation of State Medical Boards, National 
        Council of State Boards of Nursing, medical professional 
        employers (such as hospitals, medical groups, staffing 
        companies), telehealth groups, health professional liability 
        providers, public and private payers, and State leaders); and
            (B) solicit public comments on such report before the 
        submission of such report; and
            (2) shall endeavor to include as many racially, ethnically, 
        geographically, linguistically, and professionally diverse 
        perspectives as possible.
    (c) Final Report.--Not later than December 31, 2024, the Secretary 
shall--
            (1) update and finalize the interim report under subsection 
        (a); and
            (2) submit such updated and finalized report to the 
        committees specified in such subsection.
    (d) Grants for Medicaid Reports.--
            (1) In general.--Not later than 2 years after the end of 
        the emergency period described in section 1135(g)(1)(B) of the 
        Social Security Act (42 U.S.C. 1320b-5(g)(1)(B)), the Secretary 
        shall award grants to States with a State plan (or waiver of 
        such plan) in effect under title XIX of the Social Security Act 
        (42 U.S.C. 1396r) that submit an application under this 
        subsection for purposes of enabling such States to study and 
        submit reports to the Secretary on any changes made to the 
        provision or availability of telehealth services under such 
        plans (or such waivers) during such period.
            (2) Eligibility.--To be eligible to receive a grant under 
        paragraph (1), a State shall--
                    (A) provide benefits for telehealth services under 
                the State plan (or waiver of such plan) in effect under 
                title XIX of the Social Security Act (42 U.S.C. 1396r);
                    (B) be able to differentiate telehealth from in-
                person visits within claims data submitted under such 
                plan (or such waiver) during such period; and
                    (C) submit to the Secretary an application at such 
                time, in such manner, and containing such information 
                (including the amount of the grant requested) as the 
                Secretary may require.
            (3) Use of funds.--An State shall use amounts received 
        under a grant under this subsection to conduct a study and 
        report findings regarding the effects of changes to telehealth 
        services offered under the State plan (or waiver of such plan) 
        of such State under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) during such period in accordance with 
        paragraph (4).
            (4) Reports.--
                    (A) Interim report.--Not later 1 year after the 
                date a State receives a grant under this subsection, 
                the State shall submit to the Secretary an interim 
                report that--
                            (i) details any changes made to the 
                        provision or availability of telehealth 
                        benefits (such as eligibility, coverage, or 
                        payment changes) under the State plan (or 
                        waiver of such plan) of the State under title 
                        XIX of the Social Security Act (42 U.S.C. 1396 
                        et seq.) during the emergency period described 
                        in paragraph (1); and
                            (ii) contains--
                                    (I) a summary and description of 
                                the type described in paragraphs (1) 
                                and (2), respectively, of subsection 
                                (a); and
                                    (II) to the extent practicable, an 
                                analysis of the type described in 
                                paragraph (3) of subsection (a),
                        except that any reference in such subsection to 
                        ``such part A or B'' shall, for purposes of 
                        subclauses (I) and (II), be treated as a 
                        reference to such State plan (or waiver).
                    (B) Final report.--Not later than 3 years after the 
                date a State receives a grant under this subsection, 
                the State shall update and finalize the interim report 
                and submit such final report to the Secretary.
                    (C) Report by secretary.--Not later than the 
                earlier of the date that is 1 year after the submission 
                of all final reports under subparagraph (B) and 
                December 31, 2028, the Secretary shall submit to 
                Congress a report on the grant program, including a 
                summary of the reports received from States under this 
                paragraph.
            (5) Modification authority.--The Secretary may modify any 
        deadline described in paragraph (4) or any information required 
        to be included in a report made under this subsection to 
        provide flexibility for States to modify the scope of the study 
        and timeline for such reports.
            (6) Technical assistance.--The Secretary shall provide such 
        technical assistance as may be necessary to a State receiving a 
        grant under this subsection in order to assist such state in 
        conducting studies and submitting reports under this 
        subsection.
            (7) State.--For purposes of this subsection, the term 
        ``State'' means each of the several States, the District of 
        Columbia, and each territory of the United States.
    (e) Authorization of Appropriations.--
            (1) Medicare.--For the purpose of carrying out subsections 
        (a) through (c), there are authorized to be appropriated such 
        sums as may be necessary for each of the fiscal years 2020 
        through 2024.
            (2) Medicaid.--For the purpose of carrying out subsection 
        (d), there are authorized to be appropriated such sums as may 
        be necessary for each of the fiscal years 2022 through 2028.

SEC. 909. COVID-19 DESIGNATION OF IMMEDIATE SPECIAL AUTHORITY OF 
              SPECTRUM FOR TRIBES' EMERGENCY RESPONSE IN INDIAN 
              COUNTRY.

    (a) Findings.--Congress finds the following:
            (1) The immediate grant of emergency special temporary 
        authority of available spectrum that will efficiently support 
        temporary wireless broadband networks and allow Indian Tribes 
        to provide Tribal members with wireless broadband service over 
        Tribal lands or Hawaiian Home Lands during the COVID-19 crisis 
        due to the increased demand for telecommunications and 
        disproportionate impacts of the COVID-19 pandemic in Indian 
        Country is essential.
            (2) Reservations are the most digitally disconnected areas 
        in the United States that lack basic access to broadband and 
        wireless services at rates comparable to, and in some cases 
        lower than, third-world countries.
            (3) In 2018, the Government Accountability Office and the 
        Federal Communications Commission reported that only 65 percent 
        of American Indian and Alaska Natives (AI/ANs) living on Tribal 
        lands had access to fixed broadband services, and only 68 
        percent of AI/AN households on rural Tribal lands had telephone 
        services. This is a stark comparison to only 8 percent of the 
        national average that lacks access to fixed broadband services.
            (4) Indian Tribes have previously encountered substantial 
        barriers to accessing broadband and other communications 
        services on Tribal lands to deploy telecommunication services 
        for the safety and well-being of Tribal members and to decrease 
        the alarming rates of unnecessary loss of lives that AI/ANs 
        disproportionately experience, especially through the lack of 
        access to health care services and emergency resources, as 
        demonstrated during the COVID-19 pandemic that continues to 
        disproportionately impact Indian Country.
            (5) Indian Tribes' lack of access to broadband services on 
        Tribal lands and Hawaiian Home Lands during the COVID-19 
        pandemic further highlights the digital divide in Indian 
        Country.
            (6) The Government Accountability Office found that health 
        information technology systems at the Indian Health Service 
        rank as the Federal Government's third-highest need for agency 
        system modernization, since 50 percent of Indian Health Service 
        facilities depend on outdated circuit connections based on one 
        or two TI circuit lines (3 Mbps), creating slower response 
        times than any other health facility system in the United 
        States.
            (7) A 2018 Tribal health reform comment filed with the 
        Federal Communications Commission has further stated that 
        approximately 1.5 million people living on Tribal lands lack 
        access to broadband and, of the 75 percent of rural Indian 
        Health Service facilities, many still lack reliable broadband 
        networks for American Indians and Alaska Natives (AI/ANs) to 
        access telehealth or clinical health care services, which is a 
        critical need in the most geographically isolated areas of the 
        country with some of the highest poverty rates, and lack of 
        access to reliable transportation.
            (8) The Bureau of Indian Education has stated that recent 
        estimates from 142 out of 174 schools have indicated that 
        approximately 15 to 95 percent of students do not have access 
        to internet services at home depending on Bureau school 
        location and limitations on data caps during the COVID-19 
        crisis.
    (b) Deployment of Wireless Broadband Service on Tribal Lands and 
Hawaiian Home Lands.--
            (1) Funding of grants for immediate deployment of wireless 
        broadband service on tribal lands and hawaiian home lands.--In 
        addition to any other amounts made available, out of any money 
        in the Treasury of the United States not otherwise 
        appropriated, there are appropriated--
                    (A) $297,500,000 for grants under the community 
                facilities grant program under section 306(a)(19) of 
                the Consolidated Farm and Rural Development Act to 
                Indian Tribes, qualifying Tribal entities, and the 
                Director of the Department of Hawaiian Home Lands, for 
                the immediate deployment of wireless broadband service 
                on Tribal lands and Hawaiian Home Lands, respectively, 
                through the use of emergency special temporary 
                authority granted under paragraph (2) of this 
                subsection, including backhaul costs, repairs to 
                damaged infrastructure, the cost of the repairs to 
                which would be less expensive than the cost of new 
                infrastructure and would support the emergency special 
                temporary use, and the Federal share applicable to 
                grants from such amount shall be 100 percent, which 
                amount shall remain available for one year from the 
                enactment of this Act; and
                    (B) $3,000,000 for grants under the community 
                facilities technical assistance and training grant 
                program under section 306(a)(26) of such Act, without 
                regard to sections 306(a)(26)(B) and 306(a)(26)(C) of 
                such Act, to assist Indian Tribes, qualifying Tribal 
                entities, and the Director of the Department of 
                Hawaiian Home Lands in preparing applications for the 
                grants referred to in subparagraph (B) of this 
                paragraph, which amount shall remain available for one 
                year from the enactment of this Act.
        Grants referred to under subparagraph (B) shall be available to 
        Indian Tribes, qualifying Tribal entities and shall also be 
        available to inter-Tribal government organizations, 
        universities, and colleges with Tribal serving institutions for 
        the purposes stated herein.
            (2) Emergency special temporary authority to use available 
        and efficient spectrum on tribal lands and hawaiian home 
        lands.--
                    (A) Grant of authority.--Not later than 10 days 
                after receiving a request from an Indian Tribe, a 
                qualifying Tribal entity, or the Director of the 
                Department of Hawaiian Home Lands for emergency special 
                temporary authority to use electromagnetic spectrum 
                described in subparagraph (C) for the provision of 
                wireless broadband service over the Tribal lands over 
                which the Indian Tribe or qualifying Tribal entity has 
                jurisdiction or (in the case of a request from the 
                Director of the Department of Hawaiian Home Lands) over 
                the Hawaiian Home Lands, allowing unlicensed radio 
                transmitters to operate for such provision on such 
                spectrum at locations on such Tribal lands or Hawaiian 
                Home Lands where such spectrum is not being used, the 
                Commission shall grant such request on a secondary non-
                interference basis.
                    (B) Duration.--A grant of emergency special 
                temporary authority under subparagraph (A) shall be for 
                a period of operation to begin not later than 6 months 
                after the date of the enactment of this Act and to 
                remain in operation for not longer than 6 months, 
                absent extensions granted by the Commission pursuant to 
                the procedures of the Commission relating to special 
                temporary authority.
                    (C) Electromagnetic spectrum described.--The 
                electromagnetic spectrum described in this subparagraph 
                for utilization on the temporary basis is any portion 
                of the electromagnetic spectrum--
                            (i) that is--
                                    (I) between the frequencies of 2496 
                                megahertz and 2690 megahertz, 
                                inclusive;
                                    (II) in the white spaces of the 
                                television broadcast spectrum between 
                                the frequencies of 470 megahertz and 
                                790 megahertz, inclusive, excluding 
                                those frequencies utilized for other 
                                purposes under subpart H of part 15 of 
                                title 47, Code of Federal Regulations;
                                    (III) between the frequencies of 
                                5925 megahertz and 7125 megahertz, 
                                inclusive; or
                                    (IV) between frequencies of 3550 
                                megahertz and 3700 megahertz, 
                                inclusive; and
                            (ii) with respect to the Tribal lands or 
                        Hawaiian Home Lands over which authority to use 
                        such spectrum is requested under subparagraph 
                        (A), is not assigned to any licensee.
            (3) Definitions.--In this subsection:
                    (A) Commission.--The term ``Commission'' means the 
                Federal Communications Commission.
                    (B) Hawaiian home lands.--The term ``Hawaiian Home 
                Lands'' means lands held in trust for Native Hawaiians 
                by Hawaii pursuant to the Hawaiian Homes Commission 
                Act, 1920.
                    (C) Indian tribe.--The term ``Indian Tribe'' means 
                the governing body of any individually identified and 
                federally recognized Indian or Alaska Native Tribe, 
                band, nation, pueblo, village, community, affiliated 
                tribal group, or component reservation in the list 
                published pursuant to section 104(a) of the Federally 
                Recognized Indian Tribe List Act of 1994 (25 U.S.C. 
                5131(a)).
                    (D) Qualifying tribal entity.--The term 
                ``qualifying Tribal entity'' means an entity designated 
                by the Indian Tribe with jurisdiction over particular 
                Tribal lands for which the spectrum access is sought. 
                The following may be designated as a qualifying Tribal 
                entity:
                            (i) Indian Tribes.
                            (ii) Tribal consortia which consists of two 
                        or more Indian Tribes, or an Indian Tribe and 
                        an entity that is more than 50 percent owned 
                        and controlled by one or more Indian Tribes.
                            (iii) Federally chartered Tribal 
                        corporations created under section 17 of the 
                        Indian Reorganization Act (25 U.S.C. 5124), and 
                        created under section 4 of the Oklahoma Indian 
                        Welfare Act (25 U.S.C. 5204).
                            (iv) Entities that are more than 50 percent 
                        owned and controlled by an Indian Tribe or 
                        Indian Tribes.
                    (E) Entity that is more than 50 percent owned and 
                controlled by one or more indian tribes.--The term 
                ``entity that is more than 50 percent owned and 
                controlled by one or more Indian Tribes'' means an 
                entity over which one or more Indian Tribes have both 
                de facto and de jure control of the entity. De jure 
                control of the entity is evidenced by ownership of 
                greater than 50 percent of the voting stock of a 
                corporation, or in the case of a partnership, general 
                partnership interests. De facto control of an entity is 
                determined on a case-by-case basis. An Indian Tribe or 
                Indian Tribes must demonstrate indicia of control to 
                establish that such Indian Tribe or Indian Tribes 
                retain de facto control of the applicant seeking 
                eligibility as a ``qualifying Tribal entity'', 
                including the following:
                            (i) The Indian Tribe or Indian Tribes 
                        constitute or appoint more than 50 percent of 
                        the board of directors or management committee 
                        of the entity.
                            (ii) The Indian Tribe or Indian Tribes have 
                        authority to appoint, promote, demote, and fire 
                        senior executives who control the day-to-day 
                        activities of the entity.
                            (iii) The Indian Tribe or Indian Tribes 
                        play an integral role in the management 
                        decisions of the entity.
                            (iv) The Indian Tribe or Indian Tribes have 
                        the authority to make decisions or otherwise 
                        engage in practices or activities that 
                        determine or significantly influence--
                                    (I) the nature or types of services 
                                offered by such an entity;
                                    (II) the terms upon which such 
                                services are offered; or
                                    (III) the prices charged for such 
                                services.
                    (F) Tribal lands.--The term ``Tribal lands'' has 
                the meaning given that term in section 73.7000 of title 
                47, Code of Federal Regulations, as of April 16, 2020, 
                and includes the definition ``Indian Country'' as 
                defined in section 1151 of title 18, United States 
                Code, and includes fee simple and restricted fee land 
                held by an Indian Tribe.
                    (G) Wireless broadband service.--The term 
                ``wireless broadband service'' means wireless broadband 
                internet access service that is delivered--
                            (i) with a download speed of not less than 
                        25 megabits per second and an upload speed of 
                        not less than 3 megabits per second; and
                            (ii) through--
                                    (I) mobile service;
                                    (II) fixed point-to-point 
                                multipoint service;
                                    (III) fixed point-to-point service; 
                                or
                                    (IV) broadcast service.

SEC. 910. FACILITATING THE PROVISION OF TELEHEALTH SERVICES ACROSS 
              STATE LINES.

    (a) In General.--For purposes of expediting the provision of 
telehealth services, for which payment is made under the Medicare 
Program, across State lines, the Secretary of Health and Human Services 
shall, in consultation with representatives of States, physicians, 
health care practitioners, and patient advocates, encourage and 
facilitate the adoption of provisions allowing for multistate 
practitioner practice across State lines.
    (b) Definitions.--In subsection (a):
            (1) Telehealth service.--The term ``telehealth service'' 
        has the meaning given that term in subparagraph (F) of section 
        1834(m)(4) of the Social Security Act (42 U.S.C. 1395m(m)(4)).
            (2) Physician, practitioner.--The terms ``physician'' and 
        ``practitioner'' have the meaning given those terms in 
        subparagraphs (D) and (E), respectively, of such section.
            (3) Medicare program.--The term ``Medicare Program'' means 
        the program of health insurance administered by the Secretary 
        of Health and Human Services under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.).

                       TITLE X--PUBLIC AWARENESS

SEC. 1001. AWARENESS CAMPAIGNS.

    The Secretary of Health and Human Services, acting through the 
Director of the Centers for Disease Control and Prevention and in 
coordination with other offices and agencies, as appropriate, shall 
award competitive grants or contracts to one or more public or private 
entities, including faith-based organizations, to carry out 
multilingual and culturally appropriate awareness campaigns. Such 
campaigns shall--
            (1) be based on available scientific evidence;
            (2) increase awareness and knowledge of COVID-19, including 
        countering stigma associated with COVID-19;
            (3) improve information on the availability of COVID-19 
        diagnostic testing; and
            (4) promote cooperation with contact tracing efforts.

SEC. 1002. INCREASING UNDERSTANDING OF AND IMPROVING HEALTH LITERACY.

    (a) In General.--The Secretary, acting through the Director of the 
Agency for Healthcare Research and Quality with respect to grants under 
subsection (c)(1) and through the Administrator of the Health Resources 
and Services Administration with respect to grants under subsection 
(c)(2), in consultation with the Director of the National Institute on 
Minority Health and Health Disparities and the Deputy Assistant 
Secretary for Minority Health, shall award grants to eligible entities 
to improve health care for patient populations that have low functional 
health literacy.
    (b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            (1) be a hospital, health center or clinic, health plan, or 
        other health entity (including a nonprofit minority health 
        organization or association); and
            (2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may reasonably require.
    (c) Use of Funds.--
            (1) Agency for healthcare research and quality.--A grant 
        awarded under subsection (a) through the Director of the Agency 
        for Healthcare Research and Quality shall be used--
                    (A) to define and increase the understanding of 
                health literacy;
                    (B) to investigate the correlation between low 
                health literacy and health and health care;
                    (C) to clarify which aspects of health literacy 
                have an effect on health outcomes; and
                    (D) for any other activity determined appropriate 
                by the Director.
            (2) Health resources and services administration.--A grant 
        awarded under subsection (a) through the Administrator of the 
        Health Resources and Services Administration shall be used to 
        conduct demonstration projects for interventions for patients 
        with low health literacy that may include--
                    (A) the development of new disease management 
                programs for patients with low health literacy;
                    (B) the tailoring of disease management programs 
                addressing mental, physical, oral, and behavioral 
                health conditions for patients with low health 
                literacy;
                    (C) the translation of written health materials for 
                patients with low health literacy;
                    (D) the identification, implementation, and testing 
                of low health literacy screening tools;
                    (E) the conduct of educational campaigns for 
                patients and providers about low health literacy;
                    (F) the conduct of educational campaigns concerning 
                health directed specifically at patients with mental 
                disabilities, including those with cognitive and 
                intellectual disabilities, designed to reduce the 
                incidence of low health literacy among these 
                populations, which shall have instructional materials 
                in the plain language standards promulgated under the 
                Plain Writing Act of 2010 (5 U.S.C. 301 note) for 
                Federal agencies; and
                    (G) other activities determined appropriate by the 
                Administrator.
    (d) Definitions.--In this section, the term ``low health literacy'' 
means the inability of an individual to obtain, process, and understand 
basic health information and services needed to make appropriate health 
decisions.
    (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 2021 through 2025.

SEC. 1003. ENGLISH FOR SPEAKERS OF OTHER LANGUAGES.

    (a) Grants Authorized.--The Secretary of Education is authorized to 
provide grants to eligible entities for the provision of English as a 
second language (in this section referred to ``ESL'') instruction and 
shall determine, after consultation with appropriate stakeholders, the 
mechanism for administering and distributing such grants.
    (b) Eligible Entity Defined.--In this section, the term ``eligible 
entity'' means a State or community-based organization that employs and 
serves minority populations.
    (c) Application.--An eligible entity may apply for a grant under 
this section by submitting such information as the Secretary of 
Education may require and in such form and manner as the Secretary may 
require.
    (d) Use of Grant.--As a condition of receiving a grant under this 
section, an eligible entity shall--
            (1) develop and implement a plan for assuring the 
        availability of ESL instruction that effectively integrates 
        information about the nature of the United States health care 
        system, how to access care, and any special language skills 
        that may be required for individuals to access and regularly 
        negotiate the system effectively;
            (2) develop a plan, including, where appropriate, public-
        private partnerships, for making ESL instruction progressively 
        available to all individuals seeking instruction; and
            (3) maintain current ESL instruction efforts by using funds 
        available under this section to supplement rather than supplant 
        any funds expended for ESL instruction in the State as of 
        January 1, 2020.
    (e) Additional Duties of the Secretary.--The Secretary of Education 
shall--
            (1) collect and publicize annual data on how much Federal, 
        State, and local governments spend on ESL instruction;
            (2) collect data from State and local governments to 
        identify the unmet needs of English language learners for 
        appropriate ESL instruction, including--
                    (A) the preferred written and spoken language of 
                such English language learners;
                    (B) the extent of waiting lists for ESL 
                instruction, including how many programs maintain 
                waiting lists and, for programs that do not have 
                waiting lists, the reasons why not;
                    (C) the availability of programs to geographically 
                isolated communities;
                    (D) the impact of course enrollment policies, 
                including open enrollment, on the availability of ESL 
                instruction;
                    (E) the number individuals in the State and each 
                participating locality;
                    (F) the effectiveness of the instruction in meeting 
                the needs of individuals receiving instruction and 
                those needing instruction;
                    (G) as assessment of the need for programs that 
                integrate job training and ESL instruction, to assist 
                individuals to obtain better jobs; and
                    (H) the availability of ESL slots by State and 
                locality;
            (3) determine the cost and most appropriate methods of 
        making ESL instruction available to all English language 
        learners seeking instruction; and
            (4) not later than 1 year after the date of enactment of 
        this Act, issue a report to Congress that assesses the 
        information collected in paragraphs (1), (2), and (3) and makes 
        recommendations on steps that should be taken to progressively 
        realize the goal of making ESL instruction available to all 
        English language learners seeking instruction.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary of Education $250,000,000 for each of 
fiscal years 2021 through 2024 to carry out this section.

SEC. 1004. INFLUENZA, COVID-19, AND PNEUMONIA VACCINATION CAMPAIGN.

    (a) In General.--The Secretary of Health and Human Services shall--
            (1) enhance the annual campaign by the Department of Health 
        and Human Services to increase the number of people vaccinated 
        each year for influenza, pneumonia, and COVID-19; and
            (2) include in such campaign the use of written educational 
        materials, public service announcements, physician education, 
        and any other means which the Secretary deems effective.
    (b) Materials and Announcements.--In carrying out the annual 
campaign described in subsection (a), the Secretary of Health and Human 
Services shall ensure that--
            (1) educational materials and public service announcements 
        are readily and widely available in communities experiencing 
        disparities in the incidence and mortality rates of influenza, 
        pneumonia, and COVID-19; and
            (2) the campaign uses targeted, culturally appropriate 
        messages and messengers to reach underserved communities.
    (c) 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 2021 through 2025.

                           TITLE XI--RESEARCH

SEC. 1101. RESEARCH AND DEVELOPMENT.

    The Secretary of Health and Human Services, in coordination with 
the Director of the Centers for Disease Control and Prevention and in 
collaboration with the Director of the National Institutes of Health, 
the Director of the Agency for Healthcare Research and Quality, the 
Commissioner of Food and Drugs, and the Administrator of the Centers 
for Medicare & Medicaid Services, shall support research and 
development on more efficient and effective strategies--
            (1) for the surveillance of SARS-CoV-2 and COVID-19;
            (2) for the testing and identification of individuals 
        infected with COVID-19; and
            (3) for the tracing of contacts of individuals infected 
        with COVID-19.

SEC. 1102. CDC FIELD STUDIES PERTAINING TO SPECIFIC HEALTH INEQUITIES.

    (a) In General.--Not later than 90 days after the date of enactment 
of this Act, the Secretary of Health and Human Services (referred to in 
this section as the ``Secretary''), acting through the Centers for 
Disease Control and Prevention, in collaboration with State, local, 
Tribal, and territorial health departments, shall complete (by the 
reporting deadline in subsection (b)) field studies to better 
understand health inequities that are not currently tracked by the 
Secretary. Such studies shall include an analysis of--
            (1) the impact of socioeconomic status on health care 
        access and disease outcomes, including COVID-19 outcomes;
            (2) the impact of disability status on health care access 
        and disease outcomes, including COVID-19 outcomes;
            (3) the impact of language preference on health care access 
        and disease outcomes, including COVID-19 outcomes;
            (4) factors contributing to disparities in health outcomes 
        for the COVID-19 pandemic; and
            (5) other topics related to disparities in health outcomes 
        for the COVID-19 pandemic, as determined by the Secretary.
    (b) Report.--Not later than December 31, 2021, the Secretary shall 
submit to the Committee on Energy and Commerce of the House of 
Representatives and the Committee on Health, Education, Labor, and 
Pensions of the Senate an initial report on the results of the field 
studies under this section.
    (c) Final Report.--Not later than December 31, 2023, the Secretary 
shall--
            (1) update and finalize the initial report under subsection 
        (b); and
            (2) submit such final report to the committees specified in 
        such subsection.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $25,000,000, to remain available 
until expended.

SEC. 1103. EXPANDING CAPACITY FOR HEALTH OUTCOMES.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Administrator of the Health Resources and Services Administration, 
shall award grants to eligible entities to develop and expand the use 
of technology-enabled collaborative learning and capacity building 
models to respond to ongoing and real-time learning, health care 
information sharing, and capacity building needs related to COVID-19.
    (b) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall have experience providing technology-
enabled collaborative learning and capacity building health care 
services--
            (1) in rural areas, frontier areas, health professional 
        shortage areas, or medically underserved area; or
            (2) to medically underserved populations or Indian Tribes.
    (c) Use of Funds.--An eligible entity receiving a grant under this 
section shall use funds received through the grant--
            (1) to advance quality of care in response to COVID-19, 
        with particular emphasis on rural and underserved areas and 
        populations;
            (2) to protect medical personnel and first responders 
        through sharing real-time learning through virtual communities 
        of practice;
            (3) to improve patient outcomes for conditions affected or 
        exacerbated by COVID-19, including improvement of care for 
        patients with complex chronic conditions; and
            (4) to support rapid uptake by health care professionals of 
        emerging best practices and treatment protocols around COVID-
        19.
    (d) Optional Additional Uses of Funds.--An eligible entity 
receiving a grant under this section may use funds received through the 
grant for--
            (1) equipment to support the use and expansion of 
        technology-enabled collaborative learning and capacity building 
        models, including hardware and software that enables distance 
        learning, health care provider support, and the secure exchange 
        of electronic health information;
            (2) the participation of multidisciplinary expert team 
        members to facilitate and lead technology-enabled collaborative 
        learning sessions, and professionals and staff assisting in the 
        development and execution of technology-enabled collaborative 
        learning;
            (3) the development of instructional programming and the 
        training of health care providers and other professionals that 
        provide or assist in the provision of services through 
        technology-enabled collaborative learning and capacity building 
        models; and
            (4) other activities consistent with achieving the 
        objectives of the grants awarded under this section.
    (e) Technology-Enabled Collaborative Learning and Capacity Building 
Model Defined.--In this section, the term ``technology-enabled 
collaborative learning and capacity building model'' has the meaning 
given that term in section 2(7) of the Expanding Capacity for Health 
Outcomes Act (Public Law 114-270; 130 Stat. 1395).
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $20,000,000, to remain available 
until expended.

SEC. 1104. DATA COLLECTION AND ANALYSIS GRANTS TO MINORITY-SERVING 
              INSTITUTIONS.

    (a) Authority.--The Secretary of Health and Human Services, acting 
through the Director of the National Institute on Minority Health and 
Health Disparities and the Deputy Assistant Secretary for Minority 
Health, shall award grants to eligible entities to access and analyze 
racial and ethnic data on disparities in health and health care, and 
where possible other data on disparities in health and health care, to 
monitor and report on progress to reduce and eliminate disparities in 
health and health care.
    (b) Eligible Entity.--In this section, the term ``eligible entity'' 
means an entity that has an accredited public health, health policy, or 
health services research program and is any of the following:
            (1) A part B institution, as defined in section 322 of the 
        Higher Education Act of 1965 (20 U.S.C. 1061).
            (2) A Hispanic-serving institution, as defined in section 
        502 of such Act (20 U.S.C. 1101a).
            (3) A Tribal College or University, as defined in section 
        316 of such Act (20 U.S.C. 1059c).
            (4) An Asian American and Native American Pacific Islander-
        serving institution, as defined in section 371(c) of such Act 
        (20 U.S.C. 1067q(c)).
    (c) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2021 through 2025.

SEC. 1105. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL AND 
              ETHNIC BACKGROUND.

    (a) In General.--Chapter V of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 351 et seq.) is amended by adding after section 505F the 
following:

``SEC. 505G. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL 
              AND ETHNIC BACKGROUND.

    ``(a) Preapproval Studies.--If there is evidence that there may be 
a disparity on the basis of racial or ethnic background or other 
demographic characteristics (such as age, sex, gender) as to the safety 
or effectiveness of a drug or biological product or if such product 
addresses a disease that disproportionately impacts certain racial or 
ethnic groups or other demographic characteristics (such as age, sex, 
gender), then--
            ``(1)(A) in the case of a drug, the investigations required 
        under section 505(b)(1)(A) shall include adequate and well-
        controlled investigations of the disparity; or
            ``(B) in the case of a biological product, the evidence 
        required under section 351(a) of the Public Health Service Act 
        for approval of a biologics license application for the 
        biological product shall include adequate and well-controlled 
        investigations of the disparity; and
            ``(2) if the investigations described in subparagraph (A) 
        or (B) of paragraph (1) confirm that there is such a disparity, 
        the labeling of the drug or biological product shall include 
        appropriate information about the disparity.
    ``(b) Postmarket Studies.--
            ``(1) In general.--If there is evidence that there may be a 
        disparity on the basis of racial or ethnic background or other 
        demographic characteristics (such as age, sex, gender) as to 
        the safety or effectiveness of a drug for which there is an 
        approved application under section 505 of this Act or of a 
        biological product for which there is an approved license under 
        section 351 of the Public Health Service Act, the Secretary may 
        by order require the holder of the approved application or 
        license to conduct, by a date specified by the Secretary, 
        postmarket studies to investigate the disparity.
            ``(2) Labeling.--If the Secretary determines that the 
        postmarket studies confirm that there is a disparity described 
        in paragraph (1), the labeling of the drug or biological 
        product shall include appropriate information about the 
        disparity.
            ``(3) Study design.--The Secretary may, in an order under 
        paragraph (1), specify all aspects of the design of the 
        postmarket studies required under such paragraph for a drug or 
        biological product, including the number of studies and study 
        participants, and the other demographic characteristics of the 
        study participants.
            ``(4) Modifications of study design.--The Secretary may, by 
        order and as necessary, modify any aspect of the design of a 
        postmarket study required in an order under paragraph (1) after 
        issuing such order.
            ``(5) Study results.--The results from a study required 
        under paragraph (1) shall be submitted to the Secretary as a 
        supplement to the drug application or biologics license 
        application.
    ``(c) Applications Under Section 505(j).--
            ``(1) In general.--A drug for which an application has been 
        submitted or approved under section 505(j) shall not be 
        considered ineligible for approval under that section or 
        misbranded under section 502 on the basis that the labeling of 
        the drug omits information relating to a disparity on the basis 
        of racial or ethnic background or other demographic 
        characteristics (such as age, sex, gender) as to the safety or 
        effectiveness of the drug as to the safety or effectiveness of 
        the drug, whether derived from investigations or studies 
        required under this section or derived from other sources, when 
        the omitted information is protected by patent or by 
        exclusivity under section 505(j)(5)(F).
            ``(2) Labeling.--Notwithstanding paragraph (1), the 
        Secretary may require that the labeling of a drug approved 
        under section 505(j) that omits information relating to a 
        disparity on the basis of racial or ethnic background (such as 
        age, sex, gender) as to the safety or effectiveness of the drug 
        include a statement of any appropriate contraindications, 
        warnings, or precautions related to the disparity that the 
        Secretary considers necessary.
    ``(d) Definition.--The term `evidence that there may be a disparity 
on the basis of racial or ethnic background or other demographic 
characteristics (such as age, sex, gender) as to the safety or 
effectiveness', with respect to a drug or biological product, 
includes--
            ``(1) evidence that there is a disparity on the basis of 
        racial or ethnic background or other demographic 
        characteristics (such as age, sex, gender) as to safety or 
        effectiveness of a drug or biological product in the same 
        chemical class as the drug or biological product;
            ``(2) evidence that there is a disparity on the basis of 
        racial or ethnic background or other demographic 
        characteristics (such as age, sex, gender) in the way the drug 
        or biological product is metabolized;
            ``(3) other evidence as the Secretary may determine 
        appropriate; and
            ``(4) if such product addresses a disease/condition that 
        evidence shows disproportionately impacts certain racial or 
        ethnic groups or other demographic characteristics (such as 
        age, sex, gender).''.
    (b) Enforcement.--Section 502 of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 352) is amended by adding at the end the 
following:
    ``(ee) If it is a drug and the holder of the approved application 
under section 505 or license under section 351 of the Public Health 
Service Act for the drug has failed to complete the investigations or 
studies, or comply with any other requirement, of section 505G.''.
    (c) Drug Fees.--Section 736(a)(1)(A)(ii) of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 379h(a)(1)(A)(ii)) is amended by inserting 
after ``are not required'' the following: ``, including postmarket 
studies required under section 505G''.

SEC. 1106. GAO AND NIH REPORTS.

    (b) GAO Report on NIH Grant Racial and Ethnic Diversity.--
            (1) In general.--The Comptroller General of the United 
        States shall conduct a study on the racial and ethnic diversity 
        among the following groups:
                    (A) All applicants for grants, contracts, and 
                cooperative agreements awarded by the National 
                Institutes of Health during the period beginning on 
                January 1, 2009, and ending December 31, 2019.
                    (B) All recipients of such grants, contracts, and 
                cooperative agreements during such period.
                    (C) All members of the peer review panels of such 
                applicants and recipients, respectively.
            (2) Report.--Not later than 6 months after the date of the 
        enactment of this Act, the Comptroller General shall complete 
        the study under paragraph (1) and submit to Congress a report 
        containing the results of such study.
    (c) GAO Report.--Not later than one year after the date of the 
enactment of this Act and biennially thereafter until 2024, the 
Comptroller General of the United States shall submit to Congress a 
report that identifies--
            (1) the racial and ethnic diversity of community-based 
        organizations that applied for Federal funding provided 
        pursuant to Coronavirus Preparedness and Response Supplemental 
        Appropriations Act (Public Law 116-123), Families First 
        Coronavirus Response Act (Public Law 116-127), Coronavirus Aid, 
        Relief, and Economic Security Act (Public Law 116-136), and 
        Paycheck Protection Program and Health Care Enhancement Act 
        (Public Law 116-139);
            (2) the percentage of such organizations that were awarded 
        such funding; and
            (3) the impact of such community-based organizations' 
        efforts on reducing health disparities within racial and ethnic 
        minority groups.
    (d) Annual Report on Activities of National Institute on Minority 
Health and Health Disparities.--The Director of the National Institute 
on Minority Health and Health Disparities shall prepare an annual 
report on the activities carried out or to be carried out by such 
institute, and shall submit each such report to the Committee on 
Health, Education, Labor, and Pensions of the Senate, the Committee on 
Energy and Commerce of the House of Representatives, the Secretary of 
Health and Human Services, and the Director of the National Institutes 
of Health. With respect to the fiscal year involved, the report shall--
            (1) describe and evaluate the progress made in health 
        disparities research conducted or supported by institutes and 
        centers of the National Institutes of Health;
            (2) summarize and analyze expenditures made for activities 
        with respect to health disparities research conducted or 
        supported by the National Institutes of Health;
            (3) include a separate statement applying the requirements 
        of paragraphs (1) and (2) specifically to minority health 
        disparities research; and
            (4) contain such recommendations as the Director of the 
        Institute considers appropriate.

SEC. 1107. HEALTH IMPACT ASSESSMENTS.

    (a) Findings.--Congress makes the following findings:
            (1) Health Impact Assessment is a tool to help planners, 
        health officials, decision makers, and the public make more 
        informed decisions about the potential health effects of 
        proposed plans, policies, programs, and projects in order to 
        maximize health benefits and minimize harms.
            (2) Health Impact Assessments fosters community leadership, 
        ownership and participation in decision-making processes.
            (3) Health Impact Assessments can build community support 
        and reduce opposition to a project or policy, thereby 
        facilitating economic growth by aiding the development of 
        consensus regarding new development proposals.
            (4) Health Impact Assessments facilitate collaboration 
        across sectors.
    (b) Purposes.--It is the purpose of this section to--
            (1) provide more information about the potential human 
        health effects of policy decisions and the distribution of 
        those effects;
            (2) improve how health is considered in planning and 
        decisionmaking processes; and
            (3) build stronger, healthier communities through the use 
        of Health Impact Assessment.
    (c) Health Impact Assessments.--Part P of title III of the Public 
Health Service Act (42 U.S.C. 280g et seq.), as amended by section 
796A, is further amended by adding at the end the following:

``SEC. 399V-12. HEALTH IMPACT ASSESSMENTS.

    ``(a) Definitions.--In this section:
            ``(1) Administrator.--The term `Administrator' means the 
        Administrator of the Environmental Protection Agency.
            ``(2) Director.--The term `Director' means the Director of 
        the Centers for Disease Control and Prevention.
            ``(3) Health impact assessment.--The term `health impact 
        assessment' means a systematic process that uses an array of 
        data sources and analytic methods and considers input from 
        stakeholders to determine the potential effects of a proposed 
        policy, plan, program, or project on the health of a population 
        and the distribution of those effects within the population. 
        Such term includes identifying and recommending appropriate 
        actions on monitoring and maximizing potential benefits and 
        minimizing the potential harms.
            ``(4) Health disparity.--The term `health disparity' means 
        a particular type of health difference that is closely linked 
        with social, economic, or environmental disadvantage and that 
        adversely affects groups of people who have systematically 
        experienced greater obstacles to health based on their racial 
        or ethnic group; religion; socioeconomic status; gender; age; 
        mental health; cognitive, sensory, or physical disability; 
        sexual orientation or gender identity; geographic location; 
        citizenship status; or other characteristics historically 
        linked to discrimination or exclusion.
    ``(b) Establishment.--The Secretary, acting through the Director 
and in collaboration with the Administrator, shall--
            ``(1) in consultation with the Director of the National 
        Center for Chronic Disease Prevention and Health Promotion and 
        relevant offices within the Department of Housing and Urban 
        Development, the Department of Transportation, and the 
        Department of Agriculture, establish a program at the National 
        Center for Environmental Health at the Centers for Disease 
        Control and Prevention focused on advancing the field of health 
        impact assessment that includes--
                    ``(A) collecting and disseminating best practices;
                    ``(B) administering capacity building grants to 
                States to support grantees in initiating health impact 
                assessments, in accordance with subsection (d);
                    ``(C) providing technical assistance;
                    ``(D) developing training tools and providing 
                training on conducting health impact assessment and the 
                implementation of built environment and health 
                indicators;
                    ``(E) making information available, as appropriate, 
                regarding the existence of other community healthy 
                living tools, checklists, and indices that help connect 
                public health to other sectors, and tools to help 
                examine the effect of the indoor built environment and 
                building codes on population health;
                    ``(F) conducting research and evaluations of health 
                impact assessments; and
                    ``(G) awarding competitive extramural research 
                grants;
            ``(2) develop guidance and guidelines to conduct health 
        impact assessments in accordance with subsection (c); and
            ``(3) establish a grant program to allow States to fund 
        eligible entities to conduct health impact assessments.
    ``(c) Guidance.--
            ``(1) In general.--Not later than 1 year after the date of 
        enactment of the Ending Health Disparities during COVID-19 Act 
        of 2020, the Secretary, acting through the Director, shall 
        issue final guidance for conducting the health impact 
        assessments. In developing such guidance the Secretary shall--
                    ``(A) consult with the Director of the National 
                Center for Environmental Health and, the Director of 
                the National Center for Chronic Disease Prevention and 
                Health Promotion, and relevant offices within the 
                Department of Housing and Urban Development, the 
                Department of Transportation, and the Department of 
                Agriculture; and
                    ``(B) consider available international health 
                impact assessment guidance, North American health 
                impact assessment practice standards, and 
                recommendations from the National Academy of Science.
            ``(2) Content.--The guidance under this subsection shall 
        include--
                    ``(A) background on national and international 
                efforts to bridge urban planning, climate forecasting, 
                and public health institutions and disciplines, 
                including a review of health impact assessment best 
                practices internationally;
                    ``(B) evidence-based direct and indirect pathways 
                that link land-use planning, transportation, and 
                housing policy and objectives to human health outcomes;
                    ``(C) data resources and quantitative and 
                qualitative forecasting methods to evaluate both the 
                status of health determinants and health effects, 
                including identification of existing programs that can 
                disseminate these resources;
                    ``(D) best practices for inclusive public 
                involvement in conducting health impact assessments; 
                and
                    ``(E) technical assistance for other agencies 
                seeking to develop their own guidelines and procedures 
                for health impact assessment.
    ``(d) Grant Program.--
            ``(1) In general.--The Secretary, acting through the 
        Director and in collaboration with the Administrator, shall--
                    ``(A) award grants to States to fund eligible 
                entities for capacity building or to prepare health 
                impact assessments; and
                    ``(B) ensure that States receiving a grant under 
                this subsection further support training and technical 
                assistance for grantees under the program by funding 
                and overseeing appropriate local, State, Tribal, 
                Federal, institution of higher education, or nonprofit 
                health impact assessment experts to provide such 
                technical assistance.
            ``(2) Applications.--
                    ``(A) In general.--To be eligible to receive a 
                grant under this section, an eligible entity shall--
                            ``(i) be a State, Indian tribe, or tribal 
                        organization that includes individuals or 
                        populations the health of which are, or will 
                        be, affected by an activity or a proposed 
                        activity; and
                            ``(ii) submit to the Secretary an 
                        application in accordance with this subsection, 
                        at such time, in such manner, and containing 
                        such additional information as the Secretary 
                        may require.
                    ``(B) Inclusion.--An application under this 
                subsection shall include a list of proposed activities 
                that require or would benefit from conducting a health 
                impact assessment within six months of awarding funds. 
                The list should be accompanied by supporting 
                documentation, including letters of support, from 
                potential conductors of health impact assessments for 
                the listed proposed activities. Each application should 
                also include an assessment by the eligible entity of 
                the health of the population of its jurisdiction and 
                describe potential adverse or positive effects on 
                health that the proposed activities may create.
                    ``(C) Preference.--Preference in awarding funds 
                under this section may be given to eligible entities 
                that demonstrate the potential to significantly improve 
                population health or lower health care costs as a 
                result of potential health impact assessment work.
            ``(3) Use of funds.--
                    ``(A) In general.--An entity receiving a grant 
                under this section shall use such grant funds to 
                conduct health impact assessment capacity building or 
                to fund subgrantees in conducting a health impact 
                assessment for a proposed activity in accordance with 
                this subsection.
                    ``(B) Purposes.--The purposes of a health impact 
                assessment under this subsection are--
                            ``(i) to facilitate the involvement of 
                        tribal, State, and local public health 
                        officials in community planning, 
                        transportation, housing, and land use decisions 
                        and other decisions affecting the built 
                        environment to identify any potential health 
                        concern or health benefit relating to an 
                        activity or proposed activity;
                            ``(ii) to provide for an investigation of 
                        any health-related issue of concern raised in a 
                        planning process, an environmental impact 
                        assessment process, or policy appraisal 
                        relating to a proposed activity;
                            ``(iii) to describe and compare 
                        alternatives (including no-action alternatives) 
                        to a proposed activity to provide clarification 
                        with respect to the potential health outcomes 
                        associated with the proposed activity and, 
                        where appropriate, to the related benefit-cost 
                        or cost-effectiveness of the proposed activity 
                        and alternatives;
                            ``(iv) to contribute, when applicable, to 
                        the findings of a planning process, policy 
                        appraisal, or an environmental impact statement 
                        with respect to the terms and conditions of 
                        implementing a proposed activity or related 
                        mitigation recommendations, as necessary;
                            ``(v) to ensure that the disproportionate 
                        distribution of negative impacts among 
                        vulnerable populations is minimized as much as 
                        possible;
                            ``(vi) to engage affected community members 
                        and ensure adequate opportunity for public 
                        comment on all stages of the health impact 
                        assessment;
                            ``(vii) where appropriate, to consult with 
                        local and county health departments and 
                        appropriate organizations, including planning, 
                        transportation, and housing organizations and 
                        providing them with information and tools 
                        regarding how to conduct and integrate health 
                        impact assessment into their work; and
                            ``(viii) to inspect homes, water systems, 
                        and other elements that pose risks to lead 
                        exposure, with an emphasis on areas that pose a 
                        higher risk to children.
            ``(4) Assessments.--Health impact assessments carried out 
        using grant funds under this section shall--
                    ``(A) take appropriate health factors into 
                consideration as early as practicable during the 
                planning, review, or decisionmaking processes;
                    ``(B) assess the effect on the health of 
                individuals and populations of proposed policies, 
                projects, or plans that result in modifications to the 
                built environment; and
                    ``(C) assess the distribution of health effects 
                across various factors, such as race, income, 
                ethnicity, age, disability status, gender, and 
                geography.
            ``(5) Eligible activities.--
                    ``(A) In general.--Eligible entities funded under 
                this subsection shall conduct an evaluation of any 
                proposed activity to determine whether it will have a 
                significant adverse or positive effect on the health of 
                the affected population in the jurisdiction of the 
                eligible entity, based on the criteria described in 
                subparagraph (B).
                    ``(B) Criteria.--The criteria described in this 
                subparagraph include, as applicable to the proposed 
                activity, the following:
                            ``(i) Any substantial adverse effect or 
                        significant health benefit on health outcomes 
                        or factors known to influence health, including 
                        the following:
                                    ``(I) Physical activity.
                                    ``(II) Injury.
                                    ``(III) Mental health.
                                    ``(IV) Accessibility to health-
                                promoting goods and services.
                                    ``(V) Respiratory health.
                                    ``(VI) Chronic disease.
                                    ``(VII) Nutrition.
                                    ``(VIII) Land use changes that 
                                promote local, sustainable food 
                                sources.
                                    ``(IX) Infectious disease, 
                                including COVID-19.
                                    ``(X) Health disparities.
                                    ``(XI) Existing air quality, ground 
                                or surface water quality or quantity, 
                                or noise levels.
                                    ``(XII) Lead exposure.
                                    ``(XIII) Drinking water quality and 
                                accessibility.
                            ``(ii) Other factors that may be 
                        considered, including--
                                    ``(I) the potential for a proposed 
                                activity to result in systems failure 
                                that leads to a public health 
                                emergency, pandemic, or other 
                                infectious or biochemical agent;
                                    ``(II) the probability that the 
                                proposed activity will result in a 
                                significant increase in tourism, 
                                economic development, or employment in 
                                the jurisdiction of the eligible 
                                entity;
                                    ``(III) any other significant 
                                potential hazard or enhancement to 
                                human health, as determined by the 
                                eligible entity; or
                                    ``(IV) whether the evaluation of a 
                                proposed activity would duplicate 
                                another analysis or study being 
                                undertaken in conjunction with the 
                                proposed activity.
                    ``(C) Factors for consideration.--In evaluating a 
                proposed activity under subparagraph (A), an eligible 
                entity may take into consideration any reasonable, 
                direct, indirect, or cumulative effect that can be 
                clearly related to potential health effects and that is 
                related to the proposed activity, including the effect 
                of any action that is--
                            ``(i) included in the long-range plan 
                        relating to the proposed activity;
                            ``(ii) likely to be carried out in 
                        coordination with the proposed activity;
                            ``(iii) dependent on the occurrence of the 
                        proposed activity; or
                            ``(iv) likely to have a disproportionate 
                        impact on high-risk or vulnerable populations.
            ``(6) Requirements.--A health impact assessment prepared 
        with funds awarded under this subsection shall incorporate the 
        following, after conducting the screening phase (identifying 
        projects or policies for which a health impact assessment would 
        be valuable and feasible) through the application process:
                    ``(A) Scoping.--Identifying which health effects to 
                consider and the research methods to be utilized.
                    ``(B) Assessing risks and benefits.--Assessing the 
                baseline health status and factors known to influence 
                the health status in the affected community, which may 
                include aggregating and synthesizing existing health 
                assessment evidence and data from the community.
                    ``(C) Developing recommendations.--Suggesting 
                changes to proposals to promote positive or mitigate 
                adverse health effects.
                    ``(D) Reporting.--Synthesizing the assessment and 
                recommendations and communicating the results to 
                decision makers.
                    ``(E) Monitoring and evaluating.--Tracking the 
                decision and implementation effect on health 
                determinants and health status.
            ``(7) Plan.--An eligible entity that is awarded a grant 
        under this section shall develop and implement a plan, to be 
        approved by the Director, for meaningful and inclusive 
        stakeholder involvement in all phases of the health impact 
        assessment. Stakeholders may include community leaders, 
        community-based organizations, youth-serving organizations, 
        planners, public health experts, State and local public health 
        departments and officials, health care experts or officials, 
        housing experts or officials, and transportation experts or 
        officials.
            ``(8) Submission of findings.--An eligible entity that is 
        awarded a grant under this section shall submit the findings of 
        any funded health impact assessment activities to the Secretary 
        and make these findings publicly available.
            ``(9) Assessment of impacts.--An eligible entity that is 
        awarded a grant under this section shall ensure the assessment 
        of the distribution of health impacts (related to the proposed 
        activity) across race, ethnicity, income, age, gender, 
        disability status, and geography.
            ``(10) Conduct of assessment.--To the greatest extent 
        feasible, a health impact assessment shall be conducted under 
        this section in a manner that respects the needs and timing of 
        the decision-making process it evaluates.
            ``(11) Methodology.--In preparing a health impact 
        assessment under this subsection, an eligible entity or partner 
        shall follow the guidance published under subsection (c).
    ``(e) Health Impact Assessment Database.--The Secretary, acting 
through the Director and in collaboration with the Administrator, shall 
establish, maintain, and make publicly available a health impact 
assessment database, including--
            ``(1) a catalog of health impact assessments received under 
        this section;
            ``(2) an inventory of tools used by eligible entities to 
        conduct health impact assessments; and
            ``(3) guidance for eligible entities with respect to the 
        selection of appropriate tools described in paragraph (2).
    ``(f) Evaluation of Grantee Activities.--The Secretary shall award 
competitive grants to Prevention Research Centers, or nonprofit 
organizations or academic institutions with expertise in health impact 
assessments to--
            ``(1) assist grantees with the provision of training and 
        technical assistance in the conducting of health impact 
        assessments;
            ``(2) evaluate the activities carried out with grants under 
        subsection (d); and
            ``(3) assist the Secretary in disseminating evidence, best 
        practices, and lessons learned from grantees.
    ``(g) Report to Congress.--Not later than 1 year after the date of 
enactment of the Ending Health Disparities During COVID-19 Act of 2020, 
the Secretary shall submit to Congress a report concerning the 
evaluation of the programs under this section, including 
recommendations as to how lessons learned from such programs can be 
incorporated into future guidance documents developed and provided by 
the Secretary and other Federal agencies, as appropriate.
    ``(h) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary.

``SEC. 399V-13. IMPLEMENTATION OF RESEARCH FINDINGS TO IMPROVE HEALTH 
              OUTCOMES THROUGH THE BUILT ENVIRONMENT.

    ``(a) Research Grant Program.--The Secretary, in collaboration with 
the Administrator of the Environmental Protection Agency (referred to 
in this section as the `Administrator'), shall award grants to public 
agencies or private nonprofit institutions to implement evidence-based 
programming to improve human health through improvements to the built 
environment and subsequently human health, by addressing--
            ``(1) levels of physical activity;
            ``(2) consumption of nutritional foods;
            ``(3) rates of crime;
            ``(4) air, water, and soil quality;
            ``(5) risk or rate of injury;
            ``(6) accessibility to health-promoting goods and services;
            ``(7) chronic disease rates;
            ``(8) community design;
            ``(9) housing; or transportation options;
            ``(10) ability to reduce the spread of infectious diseases 
        (such as COVID-19); and
            ``(11) other factors, as the Secretary determines 
        appropriate.
    ``(b) Applications.--A public agency or private nonprofit 
institution desiring a grant under this section shall submit to the 
Secretary an application at such time, in such manner, and containing 
such agreements, assurances, and information as the Secretary, in 
consultation with the Administrator, may require.
    ``(c) Research.--The Secretary, in consultation with the 
Administrator, shall support, through grants awarded under this 
section, research that--
            ``(1) uses evidence-based research to improve the built 
        environment and human health;
            ``(2) examines--
                    ``(A) the scope and intensity of the impact that 
                the built environment (including the various 
                characteristics of the built environment) has on the 
                human health; or
                    ``(B) the distribution of such impacts by--
                            ``(i) location; and
                            ``(ii) population subgroup;
            ``(3) is used to develop--
                    ``(A) measures and indicators to address health 
                impacts and the connection of health to the built 
                environment;
                    ``(B) efforts to link the measures to 
                transportation, land use, and health databases; and
                    ``(C) efforts to enhance the collection of built 
                environment surveillance data;
            ``(4) distinguishes carefully between personal attitudes 
        and choices and external influences on behavior to determine 
        how much the association between the built environment and the 
        health of residents, versus the lifestyle preferences of the 
        people that choose to live in the neighborhood, reflects the 
        physical characteristics of the neighborhood; and
            ``(5)(A) identifies or develops effective intervention 
        strategies focusing on enhancements to the built environment 
        that promote increased use physical activity, access to 
        nutritious foods, or other health-promoting activities by 
        residents; and
            ``(B) in developing the intervention strategies under 
        subparagraph (A), ensures that the intervention strategies will 
        reach out to high-risk or vulnerable populations, including 
        low-income urban and rural communities and aging populations, 
        in addition to the general population.
    ``(d) Surveys.--The Secretary may allow recipients of grants under 
this section to use such grant funds to support the expansion of 
national surveys and data tracking systems to provide more detailed 
information about the connection between the built environment and 
health.
    ``(e) Priority.--In awarding grants under this section, the 
Secretary and the Administrator shall give priority to entities with 
programming that incorporates--
            ``(1) interdisciplinary approaches; or
            ``(2) the expertise of the public health, physical 
        activity, urban planning, land use, and transportation research 
        communities in the United States and abroad.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section. 
The Secretary may allocate not more than 20 percent of the amount so 
appropriated for a fiscal year for purposes of conducting research 
under subsection (c).''.

SEC. 1108. TRIBAL FUNDING TO RESEARCH HEALTH INEQUITIES INCLUDING 
              COVID-19.

    (a) In General.--Not later than 6 months after the date of 
enactment of this Act, the Director of the Indian Health Service, in 
coordination with Tribal Epidemiology Centers and other Federal 
agencies, as appropriate, shall conduct or support research and field 
studies for the purposes of improved understanding of Tribal health 
inequities among American Indians and Alaska Natives, including with 
respect to--
            (1) disparities related to COVID-19;
            (2) public health surveillance and infrastructure regarding 
        unmet needs in Indian country and Urban Indian communities;
            (3) population-based health disparities;
            (4) barriers to health care services;
            (5) the impact of socioeconomic status; and
            (6) factors contributing to Tribal health inequities.
    (b) Consultation, Confer, and Coordination.--In carrying out this 
section, the Director of the Indian Health Service shall--
            (1) consult with Indian Tribes and Tribal organizations;
            (2) confer with Urban Indian organizations;
            (3) coordinate with the Director of the Centers for Disease 
        Control and Prevention and the Director of the National 
        Institutes of Health.
    (c) Process.--Not later than 60 days after the date of enactment of 
this Act, the Director of the Indian Health Service shall establish a 
nationally representative panel to establish processes and procedures 
for the research and field studies conducted or supported under 
subsection (a). The Director shall ensure that, at a minimum, the panel 
consists of the following individuals:
            (1) Elected Tribal leaders or their designees.
            (2) Tribal public health practitioners and experts from the 
        national and regional levels.
    (d) Duties.--The panel established under subsection (c) shall, at a 
minimum--
            (1) advise the Director of the Indian Health Service on the 
        processes and procedures regarding the design, implementation, 
        and evaluation of, and reporting on, research and field studies 
        conducted or supported under this section;
            (2) develop and share resources on Tribal public health 
        data surveillance and reporting, including best practices; and
            (3) carry out such other activities as may be appropriate 
        to establish processes and procedures for the research and 
        field studies conducted or supported under subsection (a).
    (e) Report.--Not later than 1 year after expending all funds made 
available to carry out this section, the Director of the Indian Health 
Service, in coordination with the panel established under subsection 
(c), shall submit an initial report on the results of the research and 
field studies under this section to--
            (1) the Committee on Energy and Commerce and the Committee 
        on Natural Resources of the House of Representatives; and
            (2) the Committee on Indian Affairs and the Committee on 
        Health, Education, Labor, and Pensions of the Senate.
    (f) Tribal Data Sovereignty.--The Director of the Indian Health 
Service shall ensure that all research and field studies conducted or 
supported under this section are tribally-directed and carried out in a 
manner which ensures Tribal-direction of all data collected under this 
section--
            (1) according to Tribal best practices regarding research 
        design and implementation, including by ensuring the consent of 
        the Tribes involved to public reporting of Tribal data;
            (2) according to all relevant and applicable Tribal, 
        professional, institutional, and Federal standards for 
        conducting research and governing research ethics;
            (3) with the prior and informed consent of any Indian Tribe 
        participating in the research or sharing data for use under 
        this section; and
            (4) in a manner that respects the inherent sovereignty of 
        Indian Tribes, including Tribal governance of data and 
        research.
    (g) Final Report.--Not later than December 31, 2023, the Director 
of the Indian Health Service shall--
            (1) update and finalize the initial report under subsection 
        (e); and
            (2) submit such final report to the committees specified in 
        such subsection.
    (h) Definitions.--In this section:
            (1) The terms ``Indian Tribe'' and ``Tribal organization'' 
        have the meanings given to such terms in section 4 of the 
        Indian Self-Determination and Education Assistance Act (25 
        U.S.C. 5304).
            (2) The term ``Urban Indian organization'' has the meaning 
        given to such term in section 4 of the Indian Health Care 
        Improvement Act (25 U.S.C. 1603).
    (i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $25,000,000, to remain available 
until expended.

SEC. 1109. RESEARCH ENDOWMENTS AT BOTH CURRENT AND FORMER CENTERS OF 
              EXCELLENCE.

    Paragraph (1) of section 464z-3(h) of the Public Health Service Act 
(42 U.S.C. 285t(h)) is amended to read as follows:
            ``(1) In general.--The Director of the Institute may carry 
        out a program to facilitate minority health disparities 
        research and other health disparities research by providing for 
        research endowments--
                    ``(A) at current or former centers of excellence 
                under section 736; and
                    ``(B) at current or former centers of excellence 
                under section 464z-4.''.

                          TITLE XII--EDUCATION

SEC. 1201. GRANTS FOR SCHOOLS OF MEDICINE IN DIVERSE AND UNDERSERVED 
              AREAS.

    Subpart II of part C of title VII of the Public Health Service Act 
is amended by inserting after section 749B of such Act (42 U.S.C. 293m) 
the following:

``SEC. 749C. SCHOOLS OF MEDICINE IN UNDERSERVED AREAS.

    ``(a) Grants.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, may award grants to 
institutions of higher education (including multiple institutions of 
higher education applying jointly) for the establishment, improvement, 
and expansion of an allopathic or osteopathic school of medicine, or a 
branch campus of an allopathic or osteopathic school of medicine.
    ``(b) Priority.--In selecting grant recipients under this section, 
the Secretary shall give priority to institutions of higher education 
that--
            ``(1) propose to use the grant for an allopathic or 
        osteopathic school of medicine, or a branch campus of an 
        allopathic or osteopathic school of medicine, in a combined 
        statistical area with fewer than 200 actively practicing 
        physicians per 100,000 residents according to the medical board 
        (or boards) of the State (or States) involved;
            ``(2) have a curriculum that emphasizes care for diverse 
        and underserved populations; or
            ``(3) are minority-serving institutions described in the 
        list in section 371(a) of the Higher Education Act of 1965.
    ``(c) Use of Funds.--The activities for which a grant under this 
section may be used include--
            ``(1) planning and constructing--
                    ``(A) a new allopathic or osteopathic school of 
                medicine in an area in which no other school is based; 
                or
                    ``(B) a branch campus of an allopathic or 
                osteopathic school of medicine in an area in which no 
                such school is based;
            ``(2) accreditation and planning activities for an 
        allopathic or osteopathic school of medicine or branch campus;
            ``(3) hiring faculty and other staff to serve at an 
        allopathic or osteopathic school of medicine or branch campus;
            ``(4) recruitment and enrollment of students at an 
        allopathic or osteopathic school of medicine or branch campus;
            ``(5) supporting educational programs at an allopathic or 
        osteopathic school of medicine or branch campus;
            ``(6) modernizing infrastructure or curriculum at an 
        existing allopathic or osteopathic school of medicine or branch 
        campus thereof;
            ``(7) expanding infrastructure or curriculum at existing an 
        allopathic or osteopathic school of medicine or branch campus; 
        and
            ``(8) other activities that the Secretary determines 
        further the development, improvement, and expansion of an 
        allopathic or osteopathic school of medicine or branch campus 
        thereof.
    ``(d) Definitions.--In this section:
            ``(1) The term `branch campus' means a geographically 
        separate site at least 100 miles from the main campus of a 
        school of medicine where at least one student completes at 
        least 60 percent of the student's training leading to a degree 
        of doctor of medicine.
            ``(2) The term `institution of higher education' has the 
        meaning given to such term in section 101(a) of the Higher 
        Education Act of 1965.
    ``(e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $1,000,000,000, to remain 
available until expended.''.

SEC. 1202. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    Title XXXIV of the Public Health Service Act, as amended by as 
amended by sections 104, 702, and 806, is amended by adding at the end 
the following:

          ``Subtitle D--Diversifying the Health Care Workplace

``SEC. 3410. NATIONAL WORKING GROUP ON WORKFORCE DIVERSITY.

    ``(a) In General.--The Secretary, acting through the Bureau of 
Health Workforce of the Health Resources and Services Administration, 
shall award a grant to an entity determined appropriate by the 
Secretary for the establishment of a national working group on 
workforce diversity.
    ``(b) Representation.--In establishing the national working group 
under subsection (a):
            ``(1) The grantee shall ensure that the group has 
        representatives of each of the following:
                    ``(A) The Health Resources and Services 
                Administration.
                    ``(B) The Department of Health and Human Services 
                Data Council.
                    ``(C) The Office of Minority Health of the 
                Department of Health and Human Services.
                    ``(D) The Substance Abuse and Mental Health 
                Services Administration.
                    ``(E) The Bureau of Labor Statistics of the 
                Department of Labor.
                    ``(F) The National Institute on Minority Health and 
                Health Disparities.
                    ``(G) The Agency for Healthcare Research and 
                Quality.
                    ``(H) The Institute of Medicine Study Committee for 
                the 2004 workforce diversity report.
                    ``(I) The Indian Health Service.
                    ``(J) The Department of Education.
                    ``(K) Minority-serving academic institutions.
                    ``(L) Consumer organizations.
                    ``(M) Health professional associations, including 
                those that represent underrepresented minority 
                populations.
                    ``(N) Researchers in the area of health workforce.
                    ``(O) Health workforce accreditation entities.
                    ``(P) Private (including nonprofit) foundations 
                that have sponsored workforce diversity initiatives.
                    ``(Q) Local and State health departments.
                    ``(R) Representatives of community members to be 
                included on admissions committees for health profession 
                schools pursuant to subsection (c)(9).
                    ``(S) National community-based organizations that 
                serve as a national intermediary to their urban 
                affiliate members and have demonstrated capacity to 
                train health care professionals.
                    ``(T) The Veterans Health Administration.
                    ``(U) Other entities determined appropriate by the 
                Secretary.
            ``(2) The grantee shall ensure that, in addition to the 
        representatives under paragraph (1), the working group has not 
        less than 5 health professions students representing various 
        health profession fields and levels of training.
    ``(c) Activities.--The working group established under subsection 
(a) shall convene at least twice each year to complete the following 
activities:
            ``(1) Review public and private health workforce diversity 
        initiatives.
            ``(2) Identify successful health workforce diversity 
        programs and practices.
            ``(3) Examine challenges relating to the development and 
        implementation of health workforce diversity initiatives.
            ``(4) Draft a national strategic work plan for health 
        workforce diversity, including recommendations for public and 
        private sector initiatives.
            ``(5) Develop a framework and methods for the evaluation of 
        current and future health workforce diversity initiatives.
            ``(6) Develop recommended standards for workforce diversity 
        that could be applicable to all health professions programs and 
        programs funded under this Act.
            ``(7) Develop guidelines to train health professionals to 
        care for a diverse population.
            ``(8) Develop a workforce data collection or tracking 
        system to identify where racial and ethnic minority health 
        professionals practice.
            ``(9) Develop a strategy for the inclusion of community 
        members on admissions committees for health profession schools.
            ``(10) Help with monitoring and implementation of standards 
        for diversity, equity, and inclusion.
            ``(11) Other activities determined appropriate by the 
        Secretary.
    ``(d) Annual Report.--Not later than 1 year after the establishment 
of the working group under subsection (a), and annually thereafter, the 
working group shall prepare and make available to the general public 
for comment, an annual report on the activities of the working group. 
Such report shall include the recommendations of the working group for 
improving health workforce diversity.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2021 through 2025.

``SEC. 3412. TECHNICAL CLEARINGHOUSE FOR HEALTH WORKFORCE DIVERSITY.

    ``(a) In General.--The Secretary, acting through the Deputy 
Assistant Secretary for Minority Health, and in collaboration with the 
Bureau of Health Workforce within the Health Resources and Services 
Administration and the National Institute on Minority Health and Health 
Disparities, shall establish a technical clearinghouse on health 
workforce diversity within the Office of Minority Health and coordinate 
current and future clearinghouses related to health workforce 
diversity.
    ``(b) Information and Services.--The clearinghouse established 
under subsection (a) shall offer the following information and 
services:
            ``(1) Information on the importance of health workforce 
        diversity.
            ``(2) Statistical information relating to underrepresented 
        minority representation in health and allied health professions 
        and occupations.
            ``(3) Model health workforce diversity practices and 
        programs, including integrated models of care.
            ``(4) Admissions policies that promote health workforce 
        diversity and are in compliance with Federal and State laws.
            ``(5) Retainment policies that promote completion of health 
        profession degrees for underserved populations.
            ``(6) Lists of scholarship, loan repayment, and loan 
        cancellation grants as well as fellowship information for 
        underserved populations for health professions schools.
            ``(7) Foundation and other large organizational initiatives 
        relating to health workforce diversity.
    ``(c) Consultation.--In carrying out this section, the Secretary 
shall consult with non-Federal entities which may include minority 
health professional associations and minority sections of major health 
professional associations to ensure the adequacy and accuracy of 
information.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2021 through 2025.

``SEC. 3413. SUPPORT FOR INSTITUTIONS COMMITTED TO WORKFORCE DIVERSITY, 
              EQUITY, AND INCLUSION.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration and the Centers for 
Disease Control and Prevention, shall award grants to eligible entities 
that demonstrate a commitment to health workforce diversity.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be an educational institution or entity that 
        historically produces or trains meaningful numbers of 
        underrepresented minority health professionals, including--
                    ``(A) part B institutions, as defined in section 
                322 of the Higher Education Act of 1965;
                    ``(B) Hispanic-serving health professions schools;
                    ``(C) Hispanic-serving institutions, as defined in 
                section 502 of such Act;
                    ``(D) Tribal colleges or universities, as defined 
                in section 316 of such Act;
                    ``(E) Asian American and Native American Pacific 
                Islander-serving institutions, as defined in section 
                371(c) of such Act;
                    ``(F) institutions that have programs to recruit 
                and retain underrepresented minority health 
                professionals, in which a significant number of the 
                enrolled participants are underrepresented minorities;
                    ``(G) health professional associations, which may 
                include underrepresented minority health professional 
                associations; and
                    ``(H) institutions, including national and regional 
                community-based organizations with demonstrated 
                commitment to a diversified workforce--
                            ``(i) located in communities with 
                        predominantly underrepresented minority 
                        populations;
                            ``(ii) with whom partnerships have been 
                        formed for the purpose of increasing workforce 
                        diversity; and
                            ``(iii) in which at least 20 percent of the 
                        enrolled participants are underrepresented 
                        minorities; and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under a grant under 
subsection (a) shall be used to expand existing workforce diversity 
programs, implement new workforce diversity programs, or evaluate 
existing or new workforce diversity programs, including with respect to 
mental health care professions. Such programs shall enhance diversity 
by considering minority status as part of an individualized 
consideration of qualifications. Possible activities may include--
            ``(1) educational outreach programs relating to 
        opportunities in the health professions;
            ``(2) scholarship, fellowship, grant, loan repayment, and 
        loan cancellation programs;
            ``(3) postbaccalaureate programs;
            ``(4) academic enrichment programs, particularly targeting 
        those who would not be competitive for health professions 
        schools;
            ``(5) supporting workforce diversity in kindergarten 
        through 12th grade and other health pipeline programs;
            ``(6) mentoring programs;
            ``(7) internship or rotation programs involving hospitals, 
        health systems, health plans, and other health entities;
            ``(8) community partnership development for purposes 
        relating to workforce diversity; or
            ``(9) leadership training.
    ``(d) Reports.--Not later than 1 year after receiving a grant under 
this section, and annually for the term of the grant, a grantee shall 
submit to the Secretary a report that summarizes and evaluates all 
activities conducted under the grant.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2021 through 2025.

``SEC. 3414. CAREER DEVELOPMENT FOR SCIENTISTS AND RESEARCHERS.

    ``(a) In General.--The Secretary, acting through the Director of 
the National Institutes of Health, the Director of the Centers for 
Disease Control and Prevention, the Commissioner of Food and Drugs, the 
Director of the Agency for Healthcare Research and Quality, and the 
Administrator of the Health Resources and Services Administration, 
shall award grants that expand existing opportunities for scientists 
and researchers and promote the inclusion of underrepresented 
minorities in the health professions.
    ``(b) Research Funding.--The head of each agency listed in 
subsection (a) shall establish or expand existing programs to provide 
research funding to scientists and researchers in training. Under such 
programs, the head of each such entity shall give priority in 
allocating research funding to support health research in traditionally 
underserved communities, including underrepresented minority 
communities, and research classified as community or participatory.
    ``(c) Data Collection.--The head of each agency listed in 
subsection (a) shall collect data on the number (expressed as an 
absolute number and a percentage) of underrepresented minority and 
nonminority applicants who receive and are denied agency funding at 
every stage of review. Such data shall be reported annually to the 
Secretary and the appropriate committees of Congress.
    ``(d) Student Loan Reimbursement.--The Secretary shall establish a 
student loan reimbursement program to provide student loan 
reimbursement assistance to researchers who focus on racial and ethnic 
disparities in health. The Secretary shall promulgate regulations to 
define the scope and procedures for the program under this subsection.
    ``(e) Student Loan Cancellation.--The Secretary shall establish a 
student loan cancellation program to provide student loan cancellation 
assistance to researchers who focus on racial and ethnic disparities in 
health. Students participating in the program shall make a minimum 5-
year commitment to work at an accredited health profession school. The 
Secretary shall promulgate additional regulations to define the scope 
and procedures for the program under this subsection.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2021 through 2025.

``SEC. 3415. CAREER SUPPORT FOR NONRESEARCH HEALTH PROFESSIONALS.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, the Assistant Secretary 
for Mental Health and Substance Use, the Administrator of the Health 
Resources and Services Administration, and the Administrator of the 
Centers for Medicare & Medicaid Services, shall establish a program to 
award grants to eligible individuals for career support in nonresearch-
related health and wellness professions.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an individual shall--
            ``(1) be a student in a health professions school, a 
        graduate of such a school who is working in a health 
        profession, an individual working in a health or wellness 
        profession (including mental and behavioral health), or a 
        faculty member of such a school; and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--An individual shall use amounts received under 
a grant under this section to--
            ``(1) support the individual's health activities or 
        projects that involve underserved communities, including racial 
        and ethnic minority communities;
            ``(2) support health-related career advancement activities;
            ``(3) to pay, or as reimbursement for payments of, student 
        loans or training or credentialing costs for individuals who 
        are health professionals and are focused on health issues 
        affecting underserved communities, including racial and ethnic 
        minority communities; and
            ``(4) to establish and promote leadership training programs 
        to decrease health disparities and to increase cultural 
        competence with the goal of increasing diversity in leadership 
        positions.
    ``(d) Definition.--In this section, the term `career in 
nonresearch-related health and wellness professions' means employment 
or intended employment in the field of public health, health policy, 
health management, health administration, medicine, nursing, pharmacy, 
psychology, social work, psychiatry, other mental and behavioral 
health, allied health, community health, social work, or other fields 
determined appropriate by the Secretary, other than in a position that 
involves research.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2021 through 2025.

``SEC. 3416. RESEARCH ON THE EFFECT OF WORKFORCE DIVERSITY ON QUALITY.

    ``(a) In General.--The Director of the Agency for Healthcare 
Research and Quality, in collaboration with the Deputy Assistant 
Secretary for Minority Health and the Director of the National 
Institute on Minority Health and Health Disparities, shall award grants 
to eligible entities to expand research on the link between health 
workforce diversity and quality health care.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be a clinical, public health, or health services 
        research entity or other entity determined appropriate by the 
        Director; and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under a grant awarded under 
subsection (a) shall be used to support research that investigates the 
effect of health workforce diversity on--
            ``(1) language access;
            ``(2) cultural competence;
            ``(3) patient satisfaction;
            ``(4) timeliness of care;
            ``(5) safety of care;
            ``(6) effectiveness of care;
            ``(7) efficiency of care;
            ``(8) patient outcomes;
            ``(9) community engagement;
            ``(10) resource allocation;
            ``(11) organizational structure;
            ``(12) compliance of care; or
            ``(13) other topics determined appropriate by the Director.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Director shall give individualized consideration to all relevant 
aspects of the applicant's background. Consideration of prior research 
experience involving the health of underserved communities shall be 
such a factor.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2021 through 2025.

``SEC. 3417. HEALTH DISPARITIES EDUCATION PROGRAM.

    ``(a) Establishment.--The Secretary, acting through the Office of 
Minority Health, in collaboration with the National Institute on 
Minority Health and Health Disparities, the Office for Civil Rights, 
the Centers for Disease Control and Prevention, the Centers for 
Medicare & Medicaid Services, the Health Resources and Services 
Administration, and other appropriate public and private entities, 
shall establish and coordinate a health and health care disparities 
education program to support, develop, and implement educational 
initiatives and outreach strategies that inform health care 
professionals and the public about the existence of and methods to 
reduce racial and ethnic disparities in health and health care.
    ``(b) Activities.--The Secretary, through the education program 
established under subsection (a), shall, through the use of public 
awareness and outreach campaigns targeting the general public and the 
medical community at large--
            ``(1) disseminate scientific evidence for the existence and 
        extent of racial and ethnic disparities in health care, 
        including disparities that are not otherwise attributable to 
        known factors such as access to care, patient preferences, or 
        appropriateness of intervention, as described in the 2002 
        Institute of Medicine Report entitled `Unequal Treatment: 
        Confronting Racial and Ethnic Disparities in Health Care', as 
        well as the impact of disparities related to age, disability 
        status, socioeconomic status, sex, gender identity, and sexual 
        orientation on racial and ethnic minorities;
            ``(2) disseminate new research findings to health care 
        providers and patients to assist them in understanding, 
        reducing, and eliminating health and health care disparities;
            ``(3) disseminate information about the impact of 
        linguistic and cultural barriers on health care quality and the 
        obligation of health providers who receive Federal financial 
        assistance to ensure that individuals with limited English 
        proficiency have access to language access services;
            ``(4) disseminate information about the importance and 
        legality of racial, ethnic, disability status, socioeconomic 
        status, sex, gender identity, and sexual orientation, and 
        primary language data collection, analysis, and reporting;
            ``(5) design and implement specific educational initiatives 
        to health care providers relating to health and health care 
        disparities;
            ``(6) assess the impact of the programs established under 
        this section in raising awareness of health and health care 
        disparities and providing information on available resources; 
        and
            ``(7) design and implement specific educational initiatives 
        to educate the health care workforce relating to unconscious 
        bias.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2021 through 2025.''.

SEC. 1203. HISPANIC-SERVING INSTITUTIONS, HISTORICALLY BLACK COLLEGES 
              AND UNIVERSITIES, ASIAN AMERICAN AND NATIVE AMERICAN 
              PACIFIC ISLANDER-SERVING INSTITUTIONS, TRIBAL COLLEGES, 
              REGIONAL COMMUNITY-BASED ORGANIZATIONS, AND NATIONAL 
              MINORITY MEDICAL ASSOCIATIONS.

    Part B of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.) is amended by adding at the end the following:

``SEC. 742. HISPANIC-SERVING INSTITUTIONS, HISTORICALLY BLACK COLLEGES 
              AND UNIVERSITIES, ASIAN AMERICAN AND NATIVE AMERICAN 
              PACIFIC ISLANDER-SERVING INSTITUTIONS, AND TRIBAL 
              COLLEGES.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration and in consultation 
with the Secretary of Education, shall award grants to Hispanic-serving 
institutions, Historically Black Colleges and Universities, Asian 
American and Native American Pacific Islander-serving institutions, 
Tribal Colleges or Universities, regional community-based 
organizations, and national minority medical associations, for 
counseling, mentoring and providing information on financial assistance 
to prepare underrepresented minority individuals to enroll in and 
graduate from health professional schools and to increase services for 
underrepresented minority students including--
            ``(1) mentoring with underrepresented health professionals; 
        and
            ``(2) providing financial assistance information for 
        continued education and applications to health professional 
        schools.
    ``(b) Definitions.--In this section:
            ``(1) Asian american and native american pacific islander-
        serving institution.--The term `Asian American and Native 
        American Pacific Islander-serving institution' has the meaning 
        given such term in section 320(b) of the Higher Education Act 
        of 1965.
            ``(2) Hispanic-serving institution.--The term `Hispanic-
        serving institution' means an entity that--
                    ``(A) is a school or program for which there is a 
                definition under 799B;
                    ``(B) has an enrollment of full-time equivalent 
                students that is made up of at least 9 percent Hispanic 
                students;
                    ``(C) has been effective in carrying out programs 
                to recruit Hispanic individuals to enroll in and 
                graduate from the school;
                    ``(D) has been effective in recruiting and 
                retaining Hispanic faculty members;
                    ``(E) has a significant number of graduates who are 
                providing health services to medically underserved 
                populations or to individuals in health professional 
                shortage areas; and
                    ``(F) is a Hispanic Center of Excellence in Health 
                Professions Education designated under section 
                736(d)(2) of the Public Health Service Act (42 U.S.C. 
                293(d)(2)).
            ``(3) Historically black colleges and university.--The term 
        `historically black college and university' has the meaning 
        given the term `part B institution' as defined in section 322 
        of the Higher Education Act of 1965.
            ``(4) Tribal college or university.--The term `Tribal 
        College or University' has the meaning given such term in 
        section 316(b) of the Higher Education Act of 1965.
    ``(c) Certain Loan Repayment Programs.--In carrying out the 
National Health Service Corps Loan Repayment Program established under 
subpart III of part D of title III and the loan repayment program under 
section 317F, the Secretary shall ensure, notwithstanding such subpart 
or section, that loan repayments of not less than $50,000 per year per 
person are awarded for repayment of loans incurred for enrollment or 
participation of underrepresented minority individuals in health 
professional schools and other health programs described in this 
section.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2021 through 2026.''.

SEC. 1204. LOAN REPAYMENT PROGRAM OF CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    Section 317F(c)(1) of the Public Health Service Act (42 U.S.C. 
247b-7(c)(1)) is amended--
            (1) by striking ``and'' after ``1994,''; and
            (2) by inserting before the period at the end the 
        following: ``, $750,000 for fiscal year 2020, and such sums as 
        may be necessary for each of the fiscal years 2021 through 
        2025''.

SEC. 1205. STUDY AND REPORT ON STRATEGIES FOR INCREASING DIVERSITY.

    (a) Study.--The Comptroller General of the United States shall 
conduct a study on strategies for increasing the diversity of the 
health professional workforce. Such study shall include an analysis of 
strategies for increasing the number of health professionals from 
rural, lower income, and underrepresented minority communities, 
including which strategies are most effective for achieving such goal.
    (b) Report.--Not later than 2 years after the date of enactment of 
this Act, the Comptroller General shall submit to Congress a report on 
the study conducted under subsection (a), together with recommendations 
for such legislation and administrative action as the Comptroller 
General determines appropriate.

SEC. 1206. AMENDMENTS TO THE PANDEMIC EBT ACT.

    Section 1101 of the Families First Coronavirus Response Act (Public 
Law 116-127) is amended--
            (1) in subsection (a)--
                    (A) by striking ``fiscal year 2020'' and inserting 
                ``fiscal years 2020 and 2021'';
                    (B) by striking ``during which the school would 
                otherwise be in session''; and
                    (C) by inserting ``until the school reopens'' after 
                ``assistance'';
            (2) in subsection (b)--
                    (A) by inserting ``and State agency plans for child 
                care covered children in accordance with subsection 
                (i)'' after ``with eligible children'';
                    (B) by inserting ``, a plan to enroll children who 
                become eligible children during a public health 
                emergency designation'' before ``, and issuances'';
                    (C) by striking ``in an amount not less than the 
                value of meals at the free rate over the course of 5 
                school days'' and inserting ``in accordance with 
                subsection (h)(1)''; and
                    (D) by inserting ``and for each child care covered 
                child in the household'' before the period at the end;
            (3) in subsection (c), by inserting ``or child care 
        center'' after ``school'';
            (4) by amending subsection (e) to read as follows:
    ``(e) Release of Information.--Notwithstanding any other provision 
of law, the Secretary of Agriculture may authorize--
            ``(1) State educational agencies and school food 
        authorities administering a school lunch program under the 
        Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et 
        seq.) to release to appropriate officials administering the 
        supplemental nutrition assistance program such information as 
        may be necessary to carry out this section with respect to 
        eligible children; and
            ``(2) State agencies administering a child and adult care 
        food program under section 17 of the Richard B. Russell 
        National School Lunch Act (42 U.S.C. 1766) to release to 
        appropriate officials administering the supplemental nutrition 
        assistance program such information as may be necessary to 
        carry out this section with respect to child care covered 
        children.'';
            (5) by amending subsection (g) to read as follows:
    ``(g) Availability of Commodities.--
            ``(1) In general.--Subject to paragraph (2), during fiscal 
        year 2020, the Secretary of Agriculture may purchase 
        commodities for emergency distribution in any area of the 
        United States during a public health emergency designation.
            ``(2) Purchases.--Funds made available to carry out this 
        subsection on or after the date of the enactment of the Child 
        Nutrition and Related Programs Recovery Act may only be used to 
        purchase commodities for emergency distribution--
                    ``(A) under commodity distribution programs and 
                child nutrition programs that were established and 
                administered by the Food and Nutrition Service on or 
                before the day before the date of the enactment of the 
                Families First Coronavirus Response Act (Public Law 
                116-127);
                    ``(B) to Tribal organizations (as defined in 
                section 3 of the Food and Nutrition Act of 2008 (7 
                U.S.C. 2012)), that are not administering the food 
                distribution program established under section 4(b) of 
                the Food and Nutrition Act of 2008 (7 U.S.C. 2013(b)); 
                or
                    ``(C) to emergency feeding organizations that are 
                eligible recipient agencies (as such terms are defined 
                in section 201A of the Emergency Food Assistance Act of 
                1983 (7 U.S.C. 7501)).'';
            (6) by redesignating subsections (h) and (i) as subsections 
        (l) and (m);
            (7) by inserting after subsection (g) the following:
    ``(h) Amount of Benefits.--
            ``(1) In general.--A household shall receive benefits under 
        this section in an amount equal to 1 breakfast and 1 lunch at 
        the free rate for each eligible child or child care covered 
        child in such household for each day.
            ``(2) Treatment of newly eligible children.--In the case of 
        a child who becomes an eligible child during a public health 
        emergency designation, the Secretary and State agency shall--
                    ``(A) if such child becomes an eligible child 
                during school year 2019-2020, treat such child as if 
                such child was an eligible child as of the date the 
                school in which the child is enrolled closed; and
                    ``(B) if such child becomes an eligible child after 
                school year 2019-2020, treat such child as an eligible 
                child as of the first day of the month in which such 
                child becomes so eligible.
    ``(i) Child Care Covered Child Assistance.--
            ``(1) In general.--During fiscal years 2020 and 2021, in 
        any case in which a child care center is closed for at least 5 
        consecutive days during a public health emergency designation, 
        each household containing at least 1 member who is a child care 
        covered child attending the child care center shall be eligible 
        until the schools in the State in which such child care center 
        is located reopen, as determined by the Secretary, to receive 
        assistance pursuant to--
                    ``(A) a State agency plan approved under subsection 
                (b) that includes--
                            ``(i) an application by the State agency 
                        seeking to participate in the program under 
                        this subsection; and
                            ``(ii) a State agency plan for temporary 
                        emergency standards of eligibility and levels 
                        of benefits under the Food and Nutrition Act of 
                        2008 (7 U.S.C. 2011 et seq.) for households 
                        with child care covered children; or
                    ``(B) an addendum application described in 
                paragraph (2).
            ``(2) Addendum application.--In the case of a State agency 
        that submits a plan to the Secretary of Agriculture under 
        subsection (b) that does not include an application or plan 
        described in clauses (i) and (ii) of paragraph (1)(A), such 
        State agency may apply to participate in the program under this 
        subsection by submitting to the Secretary of Agriculture an 
        addendum application for approval that includes a State agency 
        plan described in such clause (ii).
            ``(3) Requirements for participation.--A State agency may 
        not participate in the program under this subsection if--
                    ``(A) the State agency plan submitted by such State 
                agency under subsection (b) with respect to eligible 
                children is not approved by the Secretary under such 
                subsection; or
                    ``(B) the State agency plan submitted by such State 
                agency under subsection (b) or this subsection with 
                respect to child care covered children is not approved 
                by the Secretary under either such subsection.
            ``(4) Automatic enrollment.--
                    ``(A) In general.--Subject to subparagraph (B), the 
                Secretary shall deem a child who is less than 6 years 
                of age to be a child care covered child eligible to 
                receive assistance under this subsection if--
                            ``(i) the household with such child attests 
                        that such child is a child care covered child;
                            ``(ii) such child resides in a household 
                        that includes an eligible child;
                            ``(iii) such child receives cash assistance 
                        benefits under 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.);
                            ``(iv) such child receives assistance under 
                        the Child Care and Development Block Grant Act 
                        of 1990 (42 U.S.C. 9857 et seq.);
                            ``(v) such child is--
                                    ``(I) enrolled as a participant in 
                                a Head Start program authorized under 
                                the Head Start Act (42 U.S.C. 9831 et 
                                seq.);
                                    ``(II) a foster child whose care 
                                and placement is the responsibility of 
                                an agency that administers a State plan 
                                under part B or E of title IV of the 
                                Social Security Act (42 U.S.C. 621 et 
                                seq.);
                                    ``(III) a foster child who a court 
                                has placed with a caretaker household; 
                                or
                                    ``(IV) a homeless child or youth 
                                (as defined in section 725(2) of the 
                                McKinney-Vento Homeless Assistance Act 
                                (42 U.S.C. 11434a(2)));
                            ``(vi) such child participates in the 
                        special supplemental nutrition program for 
                        women, infants, and children under section 17 
                        of the Child Nutrition Act of 1966 (42 U.S.C. 
                        1786);
                            ``(vii) through the use of information 
                        obtained by the State agency for the purpose of 
                        participating in the supplemental nutrition 
                        assistance program under the Food and Nutrition 
                        Act of 2008 (7 U.S.C. 2011 et seq.), the State 
                        agency elects to treat as a child care covered 
                        child each child less than 6 years of age who 
                        is a member of a household that receives 
                        supplemental nutrition assistance program 
                        benefits under such Act; or
                            ``(viii) the State in which such child 
                        resides determines that such child is a child 
                        care covered child, using State data approved 
                        by the Secretary.
                    ``(B) Acceptance of any form of automatic 
                enrollment.--
                            ``(i) One category.--For purposes of 
                        deeming a child to be a child care covered 
                        child under subparagraph (A), a State agency 
                        may not be required to show that a child meets 
                        more than one requirement specified in clauses 
                        (i) through (viii) of such subparagraph.
                            ``(ii) Deeming requirement.--If a State 
                        agency submits to the Secretary information 
                        that a child meets any one of the requirements 
                        specified in clauses (i) through (viii) of 
                        subparagraph (A), the Secretary shall deem such 
                        child a child care covered child under such 
                        subparagraph.
    ``(j) Exclusions.--The provisions of section 16 of the Food and 
Nutrition Act of 2008 (7 U.S.C. 2025) relating to quality control shall 
not apply with respect to assistance provided under this section.
    ``(k) Feasibility Analysis.--
            ``(1) In general.--Not later than 30 days after the date of 
        the enactment of the Child Nutrition and Related Programs 
        Recovery Act, the Secretary shall submit to the Education and 
        Labor Committee and the Agriculture Committee of the House of 
        Representatives and the Committee on Agriculture, Nutrition, 
        and Forestry of the Senate a report on--
                    ``(A) the feasibility of implementing the program 
                for eligible children under this section using an EBT 
                system in Puerto Rico, the Commonwealth of the Northern 
                Mariana Islands, and American Samoa similar to the 
                manner in which the supplemental nutrition assistance 
                program under the Food and Nutrition Act of 2008 is 
                operated in the States, including an analysis of--
                            ``(i) the current nutrition assistance 
                        program issuance infrastructure;
                            ``(ii) the availability of--
                                    ``(I) an EBT system, including the 
                                ability for authorized retailers to 
                                accept EBT cards; and
                                    ``(II) EBT cards;
                            ``(iii) the ability to limit purchases 
                        using nutrition assistance program benefits to 
                        food for home consumption; and
                            ``(iv) the availability of reliable data 
                        necessary for the implementation of such 
                        program under this section for eligible 
                        children and child care covered children, 
                        including the names of such children and the 
                        mailing addresses of their households; and
                    ``(B) the feasibility of implementing the program 
                for child care covered children under subsection (i) in 
                Puerto Rico, the Commonwealth of the Northern Mariana 
                Islands, and American Samoa, including with respect to 
                such program each analysis specified in clauses (i) 
                through (iv) of subparagraph (A).
            ``(2) Contingent availability of participation.--Beginning 
        30 days after the date of the enactment of the Child Nutrition 
        and Related Programs Recovery Act, Puerto Rico, the 
        Commonwealth of the Northern Mariana Islands, and American 
        Samoa may each--
                    ``(A) submit a plan under subsection (b), unless 
                the Secretary makes a finding, based on the analysis 
                provided under paragraph (1)(A), that the 
                implementation of the program for eligible children 
                under this section is not feasible in such territories; 
                and
                    ``(B) submit a plan under subsection (i), unless 
                the Secretary makes a finding, based on the analysis 
                provided under paragraph (1)(B), that the 
                implementation of the program for child care covered 
                children under subsection (i) is not feasible in such 
                territories.
            ``(3) Treatment of plans submitted by territories.--
        Notwithstanding any other provision of law, with respect to a 
        plan submitted pursuant to this subsection by Puerto Rico, the 
        Commonwealth of the Northern Mariana Islands, or American Samoa 
        under subsection (b) or subsection (i), the Secretary shall 
        treat such plan in the same manner as a plan submitted by a 
        State agency under such subsection, including with respect to 
        the terms of funding provided under subsection (m).'';
            (8) in subsection (l), as redesigned by paragraph (7)--
                    (A) by redesignating paragraph (1) as paragraph 
                (3);
                    (B) by redesignating paragraphs (2) and (3) as 
                paragraphs (5) and (6), respectively;
                    (C) by inserting before paragraph (3) (as so 
                redesignated) the following:
            ``(1) The term `child care center' means an organization 
        described in subparagraph (A) or (B) of section 17(a)(2) of the 
        Richard B. Russell National School Lunch Act (42 U.S.C. 
        1766(a)(2)) and a family or group day care home.
            ``(2) The term `child care covered child' means a child 
        served under section 17 of the Richard B. Russell National 
        School Lunch Act (42 U.S.C. 1766) who, if not for the closure 
        of the child care center attended by the child during a public 
        health emergency designation and due to concerns about a COVID-
        19 outbreak, would receive meals under such section at the 
        child care center.''; and
                    (D) by inserting after paragraph (3) (as so 
                redesignated) the following:
            ``(4) The term `free rate' means--
                    ``(A) with respect to a breakfast, the rate of a 
                free breakfast under the school breakfast program under 
                section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 
                1773); and
                    ``(B) with respect to a lunch, the rate of a free 
                lunch under the school lunch program under the Richard 
                B. Russell National School Lunch Act (42 U.S.C. 1771 et 
                seq.).''; and
            (9) in subsection (m), as redesignated by paragraph (7), by 
        inserting ``(including all administrative expenses)'' after 
        ``this section''.

             TITLE XIII--PUBLIC HEALTH ASSISTANCE TO TRIBES

SEC. 1301. APPROPRIATIONS FOR THE INDIAN HEALTH SERVICE.

    HEROES Act Division A, Title V--Department of Health & Human 
Services--Indian Health Service--The $2.1 billion in COVID-19 response 
funding for the Indian Health Service.

SEC. 1302. IMPROVING STATE, LOCAL, AND TRIBAL PUBLIC HEALTH SECURITY.

    Section 319C-1 of the Public Health Service Act (42 U.S.C. 247d-3a) 
is amended--
            (1) in the section heading, by striking ``and local'' and 
        inserting ``, local, and tribal'';
            (2) in subsection (b)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (B), by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (C), by striking 
                        ``and'' at the end and inserting ``or''; and
                            (iii) by adding at the end the following:
                    ``(D) be an Indian Tribe, Tribal organization, or a 
                consortium of Indian Tribes or Tribal organizations; 
                and''; and
                    (B) in paragraph (2)--
                            (i) in the matter preceding subparagraph 
                        (A), by inserting ``, as applicable'' after 
                        ``including'';
                            (ii) in subparagraph (A)(viii)--
                                    (I) by inserting ``and Tribal'' 
                                after ``with State'';
                                    (II) by striking ``(as defined in 
                                section 8101 of the Elementary and 
                                Secondary Education Act of 1965)'' and 
                                inserting ``and Tribal educational 
                                agencies (as defined in sections 8101 
                                and 6132, respectively, of the 
                                Elementary and Secondary Education Act 
                                of 1965)''; and
                                    (III) by inserting ``and Tribal'' 
                                after ``and State'';
                            (iii) in subparagraph (G), by striking 
                        ``and tribal'' and inserting ``Tribal, and 
                        urban Indian organization''; and
                            (iv) in subparagraph (H), by inserting ``, 
                        Indian Tribes, and urban Indian organizations'' 
                        after ``public health'';
            (3) in subsection (e), by inserting ``Indian Tribes, Tribal 
        organizations, urban Indian organizations,'' after ``local 
        emergency plans,'';
            (4) in subsection (g)(1), by striking ``tribal officials'' 
        and inserting ``Tribal officials'';
            (5) in subsection (h)--
                    (A) in paragraph (1)(A)--
                            (i) by striking ``through 2023'' and 
                        inserting ``and 2020''; and
                            (ii) by inserting before the period ``; and 
                        $690,000,000 for each of fiscal years 2021 
                        through 2023 for awards pursuant to paragraph 
                        (3) (subject to the authority of the Secretary 
                        to make awards pursuant to paragraphs (4) and 
                        (5)) and paragraph (8), of which not less than 
                        $5,000,000 shall be reserved each fiscal year 
                        for awards under paragraph (8)'';
                    (B) in subsection (h)(2)(B), by striking ``tribal 
                public'' and inserting ``Tribal public'';
                    (C) in the heading of paragraph (3), by inserting 
                ``for states'' after ``amount''; and
                    (D) by adding at the end the following:
            ``(8) Tribal eligible entities.--
                    ``(A) Determination of funding amount.--
                            ``(i) In general.--The Secretary shall 
                        award at least 10 cooperative agreements under 
                        this section, in amounts not less than the 
                        minimum amount determined under clause (ii), to 
                        eligible entities described in subsection 
                        (b)(1)(D) that submits to the Secretary an 
                        application that meets the criteria of the 
                        Secretary for the receipt of such an award and 
                        that meets other reasonable implementation 
                        conditions established by the Secretary, in 
                        consultation with Indian Tribes, for such 
                        awards. If the Secretary receives more than 10 
                        applications under this section from eligible 
                        entities described in subsection (b)(1)(D) that 
                        meet the criteria and conditions described in 
                        the previous sentence, the Secretary, in 
                        consultation with Indian Tribes, may make 
                        additional awards under this section to such 
                        entities.
                            ``(ii) Minimum amount.--In determining the 
                        minimum amount of an award pursuant to clause 
                        (i), the Secretary, in consultation with Indian 
                        Tribes, shall first determine an amount the 
                        Secretary considers appropriate for the 
                        eligible entity.
                    ``(B) Available until expended.--Amounts provided 
                to a Tribal eligible entity under a cooperative 
                agreement under this section for a fiscal year and 
                remaining unobligated at the end of such year shall 
                remain available to such entity during the entirety of 
                the performance period, for the purposes for which said 
                funds were provided.
                    ``(C) No matching requirement.--Subparagraphs (B), 
                (C), and (D) of paragraph (1) shall not apply with 
                respect to cooperative agreements awarded under this 
                section to eligible entities described in subsection 
                (b)(1)(D).''; and
            (6) by adding at the end the following:
    ``(l) Special Rules Related to Tribal Eligible Entities.--
            ``(1) Modifications.--After consultation with Indian 
        Tribes, the Secretary may make necessary and appropriate 
        modifications to the program under this section to facilitate 
        the use of the cooperative agreement program by eligible 
        entities described in subsection (b)(1)(D).
            ``(2) Waivers.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the Secretary may waive or specify 
                alternative requirements for any provision of this 
                section (including regulations) that the Secretary 
                administers in connection with this section if the 
                Secretary finds that the waiver or alternative 
                requirement is necessary for the effective delivery and 
                administration of this program with respect to eligible 
                entities described in subsection (b)(1)(D).
                    ``(B) Exception.--The Secretary may not waive or 
                specify alternative requirements under subparagraph (A) 
                relating to labor standards or the environment.
            ``(3) Consultation.--The Secretary shall consult with 
        Indian Tribes and Tribal organizations on the design of this 
        program with respect to such Tribes and organizations to ensure 
        the effectiveness of the program in enhancing the security of 
        Indian Tribes with respect to public health emergencies.
            ``(4) Reporting.--
                    ``(A) In general.--Not later than 2 years after the 
                date of enactment of this subsection, and as an 
                addendum to the biennial evaluations required under 
                subsection (k), the Secretary, in coordination with the 
                Director of the Indian Health Service, shall--
                            ``(i) conduct a review of the 
                        implementation of this section with respect to 
                        eligible entities described in subsection 
                        (b)(1)(D), including any factors that may have 
                        limited its success; and
                            ``(ii) submit a report describing the 
                        results of the review described in clause (i) 
                        to--
                                    ``(I) the Committee on Indian 
                                Affairs, the Committee on Health, 
                                Education, Labor, and Pensions, and the 
                                Committee on Appropriations of the 
                                Senate; and
                                    ``(II) the Subcommittee for 
                                Indigenous Peoples of the United States 
                                of the Committee on Natural Resources, 
                                the Committee on Energy and Commerce, 
                                and the Committee on Appropriations of 
                                the House of Representatives.
                    ``(B) Analysis of tribal public health emergency 
                infrastructure limitation.--The Secretary shall include 
                in the initial report submitted under subparagraph (A) 
                a description of any public health emergency 
                infrastructure limitation encountered by eligible 
                entities described in subsection (b)(1)(D).''.

SEC. 1303. PROVISION OF ITEMS TO INDIAN PROGRAMS AND FACILITIES.

    (a) Strategic National Stockpile.--Section 319F-2(a)(3)(G) of the 
Public Health Service Act (42 U.S.C. 247d-6b(a)(3)(G)) is amended by 
inserting ``, and, in the case that the Secretary deploys the stockpile 
under this subparagraph, ensure, in coordination with the applicable 
States and programs and facilities, that appropriate drugs, vaccines 
and other biological products, medical devices, and other supplies are 
deployed by the Secretary directly to health programs or facilities 
operated by the Indian Health Service, an Indian Tribe, a Tribal 
organization (as those terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance Act (25 U.S.C. 5304)), or 
an inter-Tribal consortium (as defined in section 501 of the Indian 
Self-Determination and Education Assistance Act (25 U.S.C. 5381)) or 
through an urban Indian organization (as defined in section 4 of the 
Indian Health Care Improvement Act), while avoiding duplicative 
distributions to such programs or facilities'' before the semicolon.
    (b) Distribution of Qualified Pandemic or Epidemic Products to IHS 
Facilities.--Title III of the Public Health Service Act (42 U.S.C. 241 
et seq.) is amended by inserting after section 319F-4 the following:

``SEC. 319F-5. DISTRIBUTION OF QUALIFIED PANDEMIC OR EPIDEMIC PRODUCTS 
              TO INDIAN PROGRAMS AND FACILITIES.

    ``In the case that the Secretary distributes qualified pandemic or 
epidemic products (as defined in section 319F-3(i)(7)) to States or 
other entities, the Secretary shall ensure, in coordination with the 
applicable States and programs and facilities, that, as appropriate, 
such products are distributed directly to health programs or facilities 
operated by the Indian Health Service, an Indian Tribe, a Tribal 
organization (as those terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance Act (25 U.S.C. 5304)), or 
an inter-Tribal consortium (as defined in section 501 of the Indian 
Self-Determination and Education Assistance Act (25 U.S.C. 5381)) or 
through an urban Indian organization (as defined in section 4 of the 
Indian Health Care Improvement Act), while avoiding duplicative 
distributions to such programs or facilities.''.

SEC. 1304. HEALTH CARE ACCESS FOR URBAN NATIVE VETERANS.

    Section 405 of the Indian Health Care Improvement Act (25 U.S.C. 
1645) is amended--
            (1) in subsection (a)(1), by inserting ``urban Indian 
        organizations,'' before ``and tribal organizations''; and
            (2) in subsection (c)--
                    (A) by inserting ``urban Indian organization,'' 
                before ``or tribal organization''; and
                    (B) by inserting ``an urban Indian organization,'' 
                before ``or a tribal organization''.

SEC. 1305. PROPER AND REIMBURSED CARE FOR NATIVE VETERANS.

    Section 405(c) of the Indian Health Care Improvement Act (25 U.S.C. 
1645(c)) is amended by inserting before the period at the end the 
following: ``, regardless of whether such services are provided 
directly by the Service, an Indian tribe, or tribal organization, 
through contract health services, or through a contract for travel 
described in section 213(b)''.
                                 <all>