117 S1530 IS: Universal School Meals Program Act of 2021
U.S. Senate
2021-05-10
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

II117th CONGRESS1st SessionS. 1530IN THE SENATE OF THE UNITED STATESMay 10, 2021Mr. Sanders (for himself, Mrs. Gillibrand, Ms. Warren, Mr. Padilla, Mr. Blumenthal, Mr. Booker, Mr. Van Hollen, Ms. Smith, Mr. Wyden, Mr. Heinrich, and Mr. Leahy) introduced the following bill; which was read twice and referred to the Committee on Agriculture, Nutrition, and ForestryA BILLTo amend the Child Nutrition Act of 1966 and the Richard B. Russell National School Lunch Act to make breakfasts and lunches free for all children, and for other purposes.1.Short title; table of contents(a)Short titleThis Act may be cited as the Universal School Meals Program Act of 2021.(b)Table of contentsThe table of contents for this Act is as follows:Sec. 1. Short title; table of contents.Sec. 2. Effective date.TITLE I—School Breakfast ProgramSec. 101. Free school breakfast program.TITLE II—School Lunch ProgramSec. 201. Apportionment to States.Sec. 202. Nutritional and other program requirements.Sec. 203. Special assistance program.Sec. 204. Price for a paid lunch.Sec. 205. Summer food service program for children.Sec. 206. Summer Electronic Benefit Transfer for Children Program.Sec. 207. Child and adult care food program.Sec. 208. Meals and supplements for children in afterschool care.Sec. 209. Access to local foods: farm to school program.Sec. 210. Fresh fruit and vegetable program.Sec. 211. Training, technical assistance, and Food Service Management Institute.Sec. 212. Reimbursement of school meal delinquent debt program.Sec. 213. Conforming amendments.TITLE III—Elementary and Secondary Education DataSec. 301. Measure of poverty.TITLE IV—Amendments to Other Programs and LawsSec. 401. Supplemental nutrition assistance program.Sec. 402. Higher Education Act of 1965.Sec. 403. Elementary and Secondary Education Act of 1965.Sec. 404. America COMPETES Act.Sec. 405. Workforce Innovation and Opportunity Act.Sec. 406. National Science Foundation Authorization Act of 2002.Sec. 407. Child care and development block grant.Sec. 408. Children’s Health Act of 2000.Sec. 409. Juvenile justice and delinquency prevention.2.Effective dateUnless otherwise provided, this Act, and the amendments made by this Act, shall take effect 1 year after the date of enactment of this Act.ISchool Breakfast Program101.Free school breakfast program(a)In generalSection 4(a) of the Child Nutrition Act of 1966 (42 U.S.C. 1773(a)) is amended, in the first sentence—(1)by striking is hereby and inserting are; and(2)by inserting to provide free breakfast to all children enrolled at those schools before in accordance.(b)Apportionment to StatesSection 4(b) of the Child Nutrition Act of 1966 (42 U.S.C. 1773(b)) is amended—(1)in paragraph (1)—(A)in subparagraph (A)(i), by striking subclause (II) and inserting the following:(II)the national average payment for free breakfasts, as specified in subparagraph (B).;(B)by striking subparagraph (B) and inserting the following:(B)Payment amounts(i)In generalThe national average payment for each free breakfast shall be $2.72, adjusted annually for inflation in accordance with clause (ii) and rounded in accordance with clause (iii).(ii)Inflation adjustment(I)In generalThe annual inflation adjustment under clause (i) shall reflect changes in the cost of operating the free breakfast program under this section, as indicated by the change in the Consumer Price Index for food away from home for all urban consumers.(II)BasisEach inflation annual adjustment under clause (i) shall reflect the changes in the Consumer Price Index for food away from home for the most recent 12-month period for which that data is available.(iii)RoundingOn July 1, 2021, and annually thereafter, the national average payment rate for free breakfast shall be—(I)adjusted to the nearest lower-cent increment; and(II)based on the unrounded amounts for the preceding 12-month period.;(C)by striking subparagraphs (C) and (E); and(D)by redesignating subparagraph (D) as subparagraph (C);(2)by striking paragraphs (2) and (3);(3)by redesignating paragraphs (4) and (5) as paragraphs (2) and (3), respectively; and(4)in paragraph (3) (as so redesignated), by striking paragraph (3) or (4) and inserting paragraph (2).(c)State disbursement to schoolsSection 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773) is amended by striking subsection (c) and inserting the following:(c)State disbursement to schoolsFunds apportioned and paid to any State for the purpose of this section shall be disbursed by the State educational agency to schools selected by the State educational agency to assist those schools in operating a breakfast program..(d)No collection of debt(1)In generalNotwithstanding any other provision of the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.) or any other provision of law, effective beginning on the date of enactment of this Act, as a condition of participation in the breakfast program under section 4 of that Act (42 U.S.C. 1773), a school—(A)shall not collect any debt owed to the school for unpaid meal charges; and(B)shall continue to accrue debt for unpaid meal charges—(i)for the purpose of receiving reimbursement under section 212; and(ii)until the effective date specified in section 2.(2)Child Nutrition Act of 1966(A)In generalSection 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773) is amended by striking subsection (d) and inserting the following:(d)No collection of debtA school participating in the free breakfast program under this section shall not collect any debt owed to the school for unpaid meal charges..(B)Conforming amendmentSection 23(a) of the Child Nutrition Act of 1966 (42 U.S.C. 1793(a)) is amended by striking school in severe need, as described in section 4(d)(1) and inserting the following:school—(1)that has a free breakfast program under section 4 or seeks to initiate a free breakfast program under that section; and(2)of which not less than 40 percent of the students are identified students (as defined in paragraph (8) of section 1113(a) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a))).(e)Nutritional and other program requirementsSection 4(e) of the Child Nutrition Act of 1966 (42 U.S.C. 1773(e)) is amended—(1)in paragraph (1)(A), in the second sentence, by striking free or and all that follows through the period at the end and inserting free to all children enrolled at a school participating in the school breakfast program.; and(2)in paragraph (2), in the second sentence, by striking the full charge to the student for a breakfast meeting the requirements of this section or.(f)Prohibition on breakfast shaming, meal denial(1)In generalEffective beginning on the date of enactment of this Act, a school or school food authority—(A)shall not—(i)physically segregate or otherwise discriminate against any child participating in the breakfast program under section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773); or(ii)overtly identify a child described in clause (i) by a special token or ticket, an announced or published list of names, or any other means; and(B)shall provide the program meal to any child eligible under the program.(2)Child Nutrition Act of 1966Section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773) is amended by adding at the end the following:(f)Prohibition on breakfast shamingA school or school food authority shall not—(1)physically segregate or otherwise discriminate against any child participating in the free breakfast program under this section; or(2)overtly identify a child described in paragraph (1) by a special token or ticket, an announced or published list of names, or any other means..(g)Department of Defense Overseas Dependents' SchoolsSection 20(b) of the Child Nutrition Act of 1966 (42 U.S.C. 1789(b)) is amended—(1)by striking and reduced-price; and(2)by striking and shall and all that follows through section.(h)Conforming amendmentsThe Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.) is amended—(1)by striking or reduced price each place it appears;(2)by striking and reduced price each place it appears; and(3)by striking a reduced price each place it appears. IISchool Lunch Program201.Apportionment to StatesSection 4(b) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1753(b)) is amended—(1)by striking paragraph (2) and inserting the following:(2)Payment amounts(A)In generalThe national average payment for each free lunch shall be $3.81, adjusted annually for inflation in accordance with subparagraph (C) and rounded in accordance with subparagraph (D).(B)Additional payment for local food(i)Definition of locally-sourced farm productIn this subparagraph, the term locally-sourced farm product means a farm product that—(I)is marketed to consumers—(aa)directly; or(bb)through intermediated channels (such as food hubs and cooperatives); and(II)with respect to the school food authority purchasing the farm product, is produced and distributed—(aa)in the State in which the school food authority is located; or(bb)not more than 250 miles from the location of the school food authority.(ii)Additional payment eligibilityDuring a school year, a school food authority shall receive an additional payment described in clause (iii) if the State certifies that the school food authority served meals (including breakfasts, lunches, suppers, and supplements) during the last school year of which not less than 25 percent were made with locally-sourced farm products.(iii)Payment amount(I)In generalThe additional payment amount under this subparagraph shall be—(aa)$0.30 for each free lunch and supper;(bb)$0.21 for each free breakfast; and(cc)$0.08 for each free supplement.(II)AdjustmentsEach additional payment amount under subclause (I) shall be adjusted annually in accordance with subparagraph (C) and rounded in accordance with subparagraph (D).(iv)DisbursementThe State agency shall disburse funds made available under this clause to school food authorities eligible to receive additional reimbursement.(C)Inflation adjustment(i)In generalThe annual inflation adjustment under subparagraphs (A) and (B)(iii) shall reflect changes in the cost of operating the free lunch program under this Act, as indicated by the change in the Consumer Price Index for food away from home for all urban consumers.(ii)BasisEach annual inflation adjustment under subparagraphs (A) and (B)(iii) shall reflect the changes in the Consumer Price Index for food away from home for the most recent 12-month period for which that data is available.(D)RoundingOn July 1, 2021, and annually thereafter, the national average payment rate for free lunch and the additional payment amount for free breakfast, lunch, supper, and supplement under subparagraph (B) shall be—(i)adjusted to the nearest lower-cent increment; and(ii)based on the unrounded amounts for the preceding 12-month period.; and(2)by striking paragraph (3).202.Nutritional and other program requirements(a)Elimination of free lunch eligibility requirements(1)In generalSection 9 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758) is amended by striking subsection (b) and inserting the following:(b)EligibilityAll children enrolled in a school that participates in the school lunch program under this Act shall be eligible to receive free lunch under this Act.. (2)Conforming amendments(A)Section 9 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758) is amended—(i)in subsection (c), in the third sentence, by striking or at a reduced cost; and(ii)in subsection (e), by striking , reduced price,.(B)Section 18 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769) is amended—(i)by striking subsection (j); and(ii)by redesignating subsection (k) as subsection (j).(C)Section 28(b)(4) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769i(b)(4)) is amended—(i)by striking subparagraph (B); and(ii)in subparagraph (A), by striking the subparagraph designation and heading and all that follows through the Secretary and inserting The Secretary.(D)Section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786) is amended—(i)in subsection (d)(2)(A)—(I)by striking clause (i); and(II)by redesignating clauses (ii) and (iii) as clauses (i) and (ii), respectively; and(ii)in subsection (f)(17), by striking Notwithstanding subsection (d)(2)(A)(i), not later and inserting Not later.(E)Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended by striking paragraph (7) and inserting the following:(7)provide safeguards which restrict the use or disclosure of information concerning applicants and recipients to purposes directly connected with the administration of the plan;.(F)Section 1154(a)(2)(A)(i) of title 10, United States Code, is amended by striking in accordance with section 9(b)(1) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758(b)(1).(G)Section 4301 of the Food, Conservation, and Energy Act of 2008 (42 U.S.C. 1758a) is repealed.(b)No collection of debt(1)In generalNotwithstanding any other provision of the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) or any other provision of law, effective beginning on the date of enactment of this Act, as a condition of participation in the school lunch program under that Act, a school—(A)shall not collect any debt owed to the school for unpaid meal charges; and(B)shall continue to accrue debt for unpaid meal charges—(i)for the purpose of receiving reimbursement under section 213; and(ii)until the effective date specified in section 2.(2)National School Lunch Act(A)In generalSection 9 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758) is amended by striking subsection (d) and inserting the following:(d)No collection of debtA school participating in the school lunch program under this Act shall not collect any debt owed to the school for unpaid meal charges..(B)Conforming amendmentsSection 9(b)(8)(A) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1758(b)(8)(A)) is amended by striking or subsection (d).203.Special assistance program(a)In generalSection 11 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1759a) is repealed.(b)Conforming amendments(1)Section 6 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1755) is amended—(A)in subsection (a)(2), by striking sections 11 and 13 and inserting section 13; and(B)in subsection (e)(1), in the matter preceding subparagraph (A), by striking section 4, this section, and section 11 and inserting this section and section 4.(2)Section 7(d) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1756(d)) is amended by striking or 11.(3)Section 8(g) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1757(g)) is amended by striking and under section 11 of this Act.(4)Section 12(f) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1760(f)) is amended by striking 11,.(5)Section 7(a) of the Child Nutrition Act of 1966 (42 U.S.C. 1766(a)) is amended—(A)in paragraph (1)(A), by striking 4, 11, and 17 and inserting 4 and 17; and(B)in paragraph (2)(A), by striking sections 4 and 11 and inserting section 4.204.Price for a paid lunchSection 12 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1760) is amended—(1)by striking subsection (p); and(2)by redesignating subsections (q) and (r) as subsections (p) and (q), respectively.205.Summer food service program for childrenSection 13 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1761) is amended—(1)in subsection (a)—(A)in paragraph (2), by adding at the end the following:(C)WaiverIf the Secretary determines that a program requirement under this section limits the access of children to meals served under this section, the Secretary may waive that program requirement.(D)EligibilityAll children shall be eligible to participate in the program under this section.; and(B)in paragraph (5), by striking only for and all that follows through the period at the end and inserting for meals served to all children.;(2)in subsection (b)(2), by striking may only serve and all that follows through migrant children;(3)by striking subsection (c) and inserting the following:(c)Payments(1)In generalPayments shall be made to service institutions for meals served—(A)during the months of May through September;(B)during school vacation at any time during an academic school year;(C)during a teacher in-service day; and(D)on days that school is closed during the months of October through April due to a natural disaster, building repair, court order, or similar cause, as determined by the Secretary.(2)Limitation on paymentsA service institution shall receive payments under this section for not more than 3 meals and 1 supplement per child per day.; and(4)in subsection (f)(3), by striking , except that and all that follows through section.206.Summer Electronic Benefit Transfer for Children ProgramSection 13(a) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1761(a)) is amended by adding at the end the following:(13)Summer Electronic Benefit Transfer for Children Program(A)DefinitionsIn this paragraph:(i)EBT cardThe term EBT card means an electronic benefit transfer card.(ii)Eligible householdThe term eligible household means a household with—(I)an income that does not exceed 200 percent of the poverty line (as defined in section 673 of the Community Services Block Grant Act (42 U.S.C. 9902)); and(II)1 or more children.(iii)ProgramThe term Program means the Summer Electronic Benefit Transfer for Children Program established under subparagraph (B).(B)EstablishmentThe Secretary shall establish a national program, to be known as the Summer Electronic Benefit Transfer for Children Program, under which the Secretary shall issue EBT cards to eligible households to provide food assistance during the summer months.(C)EBT amount(i)In generalThe value of an EBT card provided under the Program to an eligible household shall be $60 per month per child (adjusted for inflation).(ii)Annual limitationNo eligible household shall receive benefits under the Program for more than 3 months in a calendar year.(D)Administration(i)In generalExcept as provided under this paragraph, the Program shall be based on the summer electronic benefit transfer for children demonstration program carried out pursuant to section 749(g) of the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2010 (Public Law 111–80; 123 Stat. 2132).(ii)SNAP or WIC(I)In generalSubject to subclause (II), a State shall administer the Program through the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.).(II)WIC optionIf a State has participated in the demonstration program described in clause (i) before the effective date specified in section 2 of the Universal School Meals Program Act of 2021, the State may elect to administer the Program through the special supplemental nutrition program for women, infants, and children established by section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786).(E)Authorization of appropriationsThere are authorized to be appropriated to the Secretary to carry out this paragraph such sums as are necessary for fiscal year 2021 and each fiscal year thereafter..207.Child and adult care food programSection 17 of the Richard B. Russell National School Lunch Act (42 U.S.C. 1766) is amended—(1)in subsection (a)(2), by striking subparagraph (B) and inserting the following:(B)any other private organization providing nonresidential child care or day care outside school hours for school children;;(2)by striking subsection (c) and inserting the following:(c)Free mealsNotwithstanding any other provision of law—(1)all meals and supplements served under the program authorized under this section shall be provided for free to participants of the program; and(2)an institution that serves those meals and supplements shall be reimbursed—(A)in the case of breakfast, at the rate established for free breakfast under section 4(b)(1)(B)(i) of the Child Nutrition Act of 1966 (42 U.S.C. 1773(b)(1)(B)(i));(B)in the case of lunch, at the rate established for free lunch under section 4(b)(2)(A); and(C)in the case of a supplemental meal, $0.96, adjusted for inflation in accordance with section 4(b)(2)(C).; (3)in subsection (f)—(A)in paragraph (2), by striking subparagraph (B) and inserting the following:(B)Limitation to reimbursementsAn institution may claim reimbursement under this paragraph for not more than 3 meals and 1 supplement per day per child.; and(B)by striking paragraph (3); and(4)in subsection (r)—(A)in the subsection heading, by striking Program for at-risk school children and inserting Afterschool meal and snack program;(B)by striking at-risk school each place it appears and inserting eligible;(C)in paragraph (1)—(i)in the paragraph heading, by striking at-risk school and inserting eligible; and(ii)in subparagraph (B), by striking operated and all that follows through the period at the end and inserting a period; and(D)in paragraph (4)(A), by striking only for and all that follows through the period at the end and inserting the following:for—(i)not more than 1 meal and 1 supplement per child per day served on a regular school day; and(ii)not more than 3 meals and 1 supplement per child per day served on any day other than a regular school day..208.Meals and supplements for children in afterschool careSection 17A of the Richard B. Russell National School Lunch Act (42 U.S.C. 1766a) is amended—(1)in the section heading, by striking Meal supplements and inserting Meals and supplements;(2)in subsection (a)(1), by striking meal supplements and inserting free meals and supplements;(3)in subsection (b), by inserting meals and before supplements; and(4)by striking subsection (c) and inserting the following:(c)Reimbursement(1)In general(A)MealsA free meal provided under this section to a child shall be reimbursed at a rate of $3.81, adjusted annually for inflation in accordance with paragraph (3)(A) and rounded in accordance with paragraph (3)(B).(B)SupplementsA free supplement provided under this section to a child shall be reimbursed at the rate at which free supplements are reimbursed under section 17(c)(2)(C).(2)Limitation to reimbursementsAn institution may claim reimbursement under this section for not more than 1 meal and 1 supplement per day per child served on a regular school day.(3)Inflation; rounding(A)Inflation adjustment(i)In generalThe annual inflation adjustment under paragraph (1)(A) shall reflect changes in the cost of operating the program under this section, as indicated by the change in the Consumer Price Index for food away from home for all urban consumers.(ii)BasisEach inflation annual adjustment under paragraph (1)(A) shall reflect the changes in the Consumer Price Index for food away from home for the most recent 12-month period for which that data is available.(B)RoundingOn July 1, 2021, and annually thereafter, the reimbursement rate for a free meal under this section shall be—(i)adjusted to the nearest lower-cent increment; and(ii)based on the unrounded amounts for the preceding 12-month period..209.Access to local foods: farm to school programSection 18(g)(5) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769(g)(5)) is amended by striking subparagraph (B) and inserting the following:(B)serve a high proportion of identified students (as defined in paragraph (8) of section 1113(a) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)));. 210.Fresh fruit and vegetable programSection 19(d) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769a(d)) is amended—(1)in paragraph (1)—(A)in the matter preceding subparagraph (A), by striking paragraph (2) of this subsection and;(B)in subparagraph (A), in the matter preceding clause (i), by striking school— and all that follows through submits in clause (ii) and inserting school that submits;(C)in subparagraph (B), by striking schools and all that follows through Act and inserting high-need schools (as defined in section 2211(b) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6631(b))); and(D)in subparagraph (D)—(i)by striking clause (i); and(ii)by redesignating clauses (ii) through (iv) as clauses (i) through (iii), respectively; and(2)by striking paragraphs (2) and (3) and inserting the following:(2)Outreach to high-need schoolsPrior to making decisions regarding school participation in the program, a State agency shall inform high-need schools (as defined in section 2211(b) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6631(b))), including Tribal schools, of the eligibility of the schools for the program..211.Training, technical assistance, and Food Service Management InstituteSection 21(a)(1)(B) of the Richard B. Russell National School Lunch Act (42 U.S.C. 1769b–1(a)(1)(B)) is amended in the matter preceding clause (i) by striking certified to receive free or reduced price meals and inserting who are identified students (as defined in paragraph (8) of section 1113(a) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)).212.Reimbursement of school meal delinquent debt program(a)DefinitionsIn this section:(1)Delinquent debtThe term delinquent debt means the debt owed by a parent or guardian of a child to a school—(A)as of the effective date specified in section 2; and(B)for meals served by the school under—(i)the school breakfast program under section 4 of the Child Nutrition Act of 1966 (42 U.S.C. 1773);(ii)the school lunch program established under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.); or(iii)both of the programs described in clauses (i) and (ii).(2)ProgramThe term program means the program established under subsection (b)(1).(3)SecretaryThe term Secretary means the Secretary of Agriculture.(b)Reimbursement program(1)EstablishmentNot later than 60 days after the effective date specified in section 2, the Secretary shall establish a program under which the Secretary shall reimburse each school participating in a program described in clause (i) or (ii) of subsection (a)(1)(B) for all delinquent debt.(2)Form for reimbursementTo carry out the program, the Secretary shall design and distribute a form to State agencies to collect data on all delinquent debt in applicable schools in the State, grouped by school food authority.(3)Completion dateThe Secretary shall provide all reimbursements under the program not later than 180 days after the effective date specified in section 2.(c)ReportNot later than 2 years after the effective date specified in section 2, the Comptroller General of the United States shall submit to Congress and make publicly available a report that describes the successes and challenges of the program.213.Conforming amendmentsThe Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) is amended—(1)by striking or reduced price each place it appears;(2)by striking or a reduced price each place it appears;(3)by striking and reduced price each place it appears; and(4)by striking a reduced price each place it appears. IIIElementary and Secondary Education Data301.Measure of povertySection 1113(a) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)) is amended—(1)in paragraph (5)(A), by striking the number of children eligible for a free or reduced price lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) and inserting the number of identified students; and(2)by adding at the end the following:(8)Identified students defined(A)In generalIn this subsection, the term identified students means the number of students—(i)who are—(I)homeless children and youths, as defined under section 725(2) of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11434a(2));(II)runaway and homeless youth served by programs established under the Runaway and Homeless Youth Act (34 U.S.C. 11201 et seq.);(III)migratory children, as defined under section 1309; or(IV)foster children;(ii)who are eligible for and receiving medical assistance under the program of medical assistance established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); or(iii)who participate (or who are part of a household that participates) in at least one of the following:(I)The supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.).(II)A State program funded under the program of block grants to States for temporary assistance for needy families established under part A of title IV of the Social Security Act (42 U.S.C. 601 et seq.).(III)The food distribution program on Indian reservations established under section 4(b) of the Food and Nutrition Act of 2008 (7 U.S.C. 2013(b)).(IV)A Head Start program authorized under the Head Start Act (42 U.S.C. 9831 et seq.) or a comparable State-funded Head Start or pre-kindergarten program.(B)MultiplierIn determining the number of identified students under subparagraph (A), the local educational agency shall multiply the number determined under such subparagraph by 1.6..IVAmendments to Other Programs and Laws401.Supplemental nutrition assistance program(a)Agreement for direct certification(1)In generalSection 11 of the Food and Nutrition Act of 2008 (7 U.S.C. 2020) is amended—(A)by striking subsection (u); and(B)by redesignating subsections (v) through (x) as subsections (u) through (w), respectively.(2)Conforming amendmentsSection 11(e) of the Food and Nutrition Act of 2008 (7 U.S.C. 2020(e)) is amended—(A)in paragraph (8)(F), by striking or subsection (u); and(B)in paragraph (26)(B), by striking (x) and inserting (w).(b)Nutrition education and obesity prevention grant programSection 28(a) of the Food and Nutrition Act of 2008 (7 U.S.C. 2036a(a)) is amended by striking paragraph (1) and inserting the following:(1)an individual eligible for benefits under this Act;.402.Higher Education Act of 1965(a)Teacher quality enhancementSubparagraph (A) of section 200(11) of the Higher Education Act of 1965 (20 U.S.C. 1021(11)) is amended to read as follows:(A)In generalThe term high-need school means a school that is in the highest quartile of schools in a ranking of all schools served by a local educational agency, ranked in descending order by percentage of students from low-income families enrolled in such schools, as determined by the local educational agency based on one of the following measures of poverty:(i)The percentage of students aged 5 through 17 in poverty counted in the most recent census data approved by the Secretary.(ii)The percentage of students in families receiving assistance under the State program funded under the program of block grants to States for temporary assistance for needy families established under part A of title IV of the Social Security Act (42 U.S.C. 601 et seq.).(iii)The percentage of students eligible to receive medical assistance under the program of medical assistance established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).(iv)A composite of two or more of the measures described in clauses (i) through (iii)..(b)GEAR UpSubparagraph (A) of section 404B(d)(1) of the Higher Education Act of 1965 (20 U.S.C. 1070a–22(d)(1)) is amended to read as follows:(A)provide services under this chapter to at least one grade level of students, beginning not later than 7th grade, in a participating school—(i)that has a 7th grade; and(ii)in which—(I)at least 50 percent of the students enrolled are identified students (as defined in section 1113(a)(8) of the Elementary and Secondary Education Act of 1965); or(II)if an eligible entity determines that it would promote the effectiveness of a program, an entire grade level of students, beginning not later than the 7th grade, reside in public housing, as defined in section 3(b)(1) of the United States Housing Act of 1937 (42 U.S.C. 1437a(b)(1))..(c)Simplified needs testSection 479(d)(2) of the Higher Education Act of 1965 (20 U.S.C. 1087ss(d)(2)) is amended—(1)by striking subparagraph (C); and(2)by redesignating subparagraphs (D) through (F) as subparagraphs (C) through (E), respectively.(d)Early Federal Pell Grant commitment demonstration programSection 894(b) of the Higher Education Act of 1965 (20 U.S.C. 1161y(b)) is amended—(1)in paragraph (1)(B), by striking qualify for a free or reduced price school lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.) and inserting are identified students (as defined in section 1113(a)(8) of the Elementary and Secondary Education Act of 1965); and(2)in paragraph (5), by striking eligible for a free or reduced price school lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.) and inserting identified students (as defined in section 1113(a)(8) of the Elementary and Secondary Education Act of 1965).403.Elementary and Secondary Education Act of 1965(a)Literacy education for allSection 2221(b)(3)(B) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6641(b)(3)(B)) is amended—(1)by striking clause (i); and(2)by redesignating clauses (ii) and (iii) as clauses (i) and (ii), respectively.(b)Grants for education innovation and researchSection 4611(d)(2) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7261(d)(2)) is amended—(1)by striking subparagraph (B); and(2)by redesignating subparagraphs (C) and (D) as subparagraphs (B) and (C), respectively.(c)Eligibility for heavily impacted local educational agenciesItem (bb) of section 7003(b)(2)(B)(i)(III) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7703(b)(2)(B)(i)(III)) is amended to read as follows:(bb)has an enrollment of children described in subsection (a)(1) that constitutes a percentage of the total student enrollment of the agency that is not less than 30 percent; or. 404.America COMPETES ActSection 6122(3) of the America COMPETES Act (20 U.S.C. 9832(3)) is amended by striking data on children eligible for free or reduced-price lunches under the Richard B. Russell National School Lunch Act,.405.Workforce Innovation and Opportunity ActSection 3(36)(A) of the Workforce Innovation and Opportunity Act (29 U.S.C. 3102(36)(A)) is amended—(1)by striking clause (iv); and(2)by redesignating clauses (v) and (vi) as clauses (iv) and (v), respectively.406.National Science Foundation Authorization Act of 2002Section 4(8) of the National Science Foundation Authorization Act of 2002 (42 U.S.C. 1862n note) is amended—(1)by striking subparagraph (A); and(2)by redesignating subparagraphs (B) and (C) as subparagraphs (A) and (B), respectively.407.Child care and development block grantSection 658O(b) of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858m(b)) is amended—(1)in paragraph (1)(B), by striking school lunch factor and inserting identified students factor; and(2)by striking paragraph (3) and inserting the following:(3)Identified students factorThe term identified students factor means the ratio of the number of children in the State who are identified students (as defined in paragraph (8) of section 1113(a) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)) to the number of such children in all the States as determined annually by the Secretary of Education..408.Children’s Health Act of 2000Section 1404(b) of the Children’s Health Act of 2000 (42 U.S.C. 9859c(b)) is amended—(1)in paragraph (1)(B), by striking school lunch factor and inserting identified students factor; and(2)by amending paragraph (3) to read as follows:(3)Identified students factorIn this subsection, the term identified students factor means the ratio of the number of children in the State who are identified students (as defined in paragraph (8) of section 1113(a) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6313(a)) to the number of such children in all the States as determined annually by the Secretary of Education..409.Juvenile justice and delinquency preventionSection 252(i) of the Juvenile Justice and Delinquency Prevention Act of 1974 (34 U.S.C. 11162(i)) is amended to read as follows:(i)Free school lunches for incarcerated juveniles(1)In generalA juvenile who is incarcerated in an eligible juvenile detention center is eligible to receive free lunch under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.).(2)GuidanceNot later than 1 year after the date of the enactment of the Universal School Meals Program Act of 2021, the Attorney General, in consultation with the Secretary of Agriculture, shall provide guidance to States relating to the options for school food authorities in the States to apply for reimbursement for free lunches under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) for juveniles who are incarcerated.(3)Eligible juvenile detention center definedIn this subsection, the term eligible juvenile detention center does not include any private, for-profit detention center..


113 S2879 IS: Sustainable Chemistry Research and Development Act of 2014
U.S. Senate
2014-09-18
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

		II
		113th CONGRESS2d Session
		S. 2879
		IN THE SENATE OF THE UNITED STATES

			September 18, 2014
			Mr. Coons (for himself, Ms. Collins, Mr. Rockefeller, and Mr. Isakson) introduced the following bill; which was read twice and referred to the Committee on Commerce, Science, and Transportation

		A BILL
		To provide for the implementation of a Sustainable Chemistry Program, and for other purposes.

		1.Short title
			This Act may be cited as the
		  Sustainable Chemistry Research and Development Act of 2014.
		2.DefinitionsIn this Act—(1)Advisory councilThe term Advisory Council means the advisory council established under section 3(d).(2)Interagency working groupThe term Interagency Working Group means the interagency working group established under section 3(c).(3)ProgramThe term Program means the Sustainable Chemistry Program described in section 3.(4)Sustainable chemistryThe term sustainable chemistry means the design, development, demonstration, and commercialization of high-quality chemicals and
			 materials, chemical processes and products, and manufacturing processes
			 that eliminate or reduce chemical risks to benefit human health and the
			 environment across the chemical lifecycle, to the highest extent
			 practicable, through—(A)increasing the use of more sustainable, renewable, or recycled substances and materials;(B)increasing the use of substitutes for rare substances;(C)promoting safe and more efficient manufacturing;(D)minimizing lifecycle impacts, including environmental and health impacts;(E)optimizing product design and encouraging the reduction of waste and the reuse or recycling of
			 chemicals and materials to account for the end of life or the final
			 disposition of the product; or(F)increasing the design and use of safe molecules, chemicals, materials, chemistries, and chemical
			 processes.3.Sustainable Chemistry Program(a)In generalThe President shall establish an interagency Sustainable Chemistry Program to promote and
			 coordinate Federal sustainable chemistry research, development,
			 demonstration, technology transfer, commercialization, education, and
			 training activities.(b)Program activitiesThe activities of the Program shall be designed to—(1)provide sustained support for sustainable chemistry research, development, demonstration,
			 technology transfer, commercialization, education, and training through—(A)merit-based competitive grants to individual investigators and teams of investigators, including,
			 to the extent practicable, young investigators, for research and
			 development;(B)grants to fund collaborative research and development partnerships among universities, industry,
			 and nonprofit organizations;(C)grants, loans, and loan guarantees to aid in the technology transfer and commercialization of
			 sustainable chemicals, materials, processes, and products;(D)incentive prize competitions and challenges;(E)coordination of sustainable chemistry research, development, demonstration, and technology transfer
			 conducted at Federal laboratories and agencies; and(F)to the extent practicable, encouragement of consideration of sustainable chemistry in, as
			 appropriate—(i)the conduct of Federal	and State science and engineering research and development; and(ii)the solicitation and evaluation of applicable proposals for science and engineering research and
			 development;(2)examine methods by which the Federal Government can create incentives for consideration and use of
			 sustainable chemistry processes and products, including innovative
			 financing mechanisms;(3)facilitate the adoption of sustainable chemistry innovations and methods;(4)expand the education and training of undergraduate and graduate students and professional
			 scientists and engineers, including through partnerships with industry, in
			 sustainable chemistry science and engineering;(5)collect and disseminate information on sustainable chemistry research, development, and technology
			 transfer including information on—(A)incentives and impediments to development, manufacturing,  and commercialization;(B)accomplishments;(C)best practices; and(D)costs and benefits;(6)support (including through technical assistance, participation, financial support, or other forms
			 of support)  venues for outreach and dissemination of sustainable
			 chemistry advances such as symposia,
			 forums, conferences, and written materials in collaboration with, as
			 appropriate, industry, academia, scientific and professional societies,
			 and other relevant groups;(7)support (including through technical assistance, participation, financial support, or other forms
			 of support) economic, legal, and other appropriate social science research
			 to identify barriers to
			 commercialization and methods to advance commercialization of sustainable
			 chemistry;(8)provide for public input and outreach to be integrated into the Program by the convening of public
			 discussions, through mechanisms such as public meetings, consensus
			 conferences, and educational events, as appropriate; and(9)develop metrics to track the outputs and outcomes of the Program.(c)Interagency working group(1)EstablishmentNot later than 180 days after the date of enactment of this Act, the President, in consultation
			 with the Office of Science and Technology Policy, shall establish an
			 Interagency Working Group that shall include representatives from the
			 National Science Foundation, the National Institute of Standards and
			 Technology, the Department of Energy, the Environmental Protection Agency,
			 the Department of Agriculture, the Department of Defense, the National
			 Institutes of Health, and any other agency that the
			 President may designate to oversee the planning, management, and
			 coordination of the Program.(2)GovernanceThe Director of the National Science Foundation and the Assistant Administrator for Research and
			 Development of the Environmental Protection Agency, or their designees,
			 shall serve as co-chairs of the Interagency Working Group.(3)ResponsibilitiesIn overseeing the planning, management, and coordination of the Program, the Interagency Working
			 Group shall—(A)establish goals and priorities for the Program, in consultation with the Advisory Council;(B)provide for interagency coordination, including budget coordination, of activities under the
			 Program;(C)meet not later than 90 days from its establishment and periodically thereafter; and(D)consult with the Advisory Council on a regular basis.(d)Advisory Council(1)EstablishmentNot later than 180 days after the date of the establishment of the Interagency Working Group, the
			 co-chairs of
			 the Interagency Working Group shall establish an Advisory Council on
			 Sustainable Chemistry that shall make recommendations to the Interagency
			 Working Group and provide it with ongoing advice and assistance.(2)MembershipThe Advisory Council members shall not be employees of the Federal Government and shall include a
			 diverse representation of knowledgeable individuals from the private
			 sector (including small- and medium-sized enterprises from across the
			 value
			 chain), academia, State and tribal governments, and nongovernmental
			 organizations and others who are in a position to provide expertise.(3)Conflict of interest(A)In generalThe Interagency Working Group shall make its best efforts to ensure that—(i)no individual appointed to serve on the Advisory Council has a conflict of interest
			 that is relevant to the functions to be performed, unless such conflict is
			 promptly and publicly disclosed and the Interagency Working Group
			 determines that		    the conflict is unavoidable;(ii)the Advisory Council membership is fairly balanced as determined by the Interagency Working Group
			 to be appropriate for the	       functions to be performed;(iii)any products of the Interagency Working Group will be the result of the Interagency Working Group's
			 independent judgment; and(iv)the		meetings and proceedings of the Advisory Council be open and available to the
			 public.(B)Notification of conflictsThe Interagency Working Group shall require that individuals nominated or appointed to serve on the
			 Advisory Council inform the Interagency Working Group of any
				  conflicts of interest that are relevant to the functions to be
			 performed.(C)FACA applicabilityAll proceedings and meetings of the Advisory Council shall be subject to the Federal Advisory
			 Committee Act (5 U.S.C. App.).(4)GovernanceThe co-chairs of the Interagency Working Group—(A)may appoint new members of the Advisory Council as needed; and(B)shall appoint the original Chair to serve a term of 1 year.(5)Appointment of chairThe Advisory Council shall appoint a Chair from among the members of the Advisory Council after the
			 term of the original Chair appointed under paragraph (3)(B) expires.(e)Agency budget requests(1)In generalEach Federal agency and department participating in the Program shall, as part of its annual
			 request for appropriations to the Office of Management and Budget, submit
			 a report to the Office of Management and Budget that—(A)identifies the activities of the agency or department that contribute directly to the Program; and(B)states the portion of the agency or department's request for appropriations that is allocated to
			 those activities.(2)Annual budget request to CongressThe President shall include in the annual budget request to Congress a statement of the portion of
			 the annual budget request for each agency or department that will be
			 allocated to
			 activities undertaken pursuant to the Program.(f)Report to Congress(1)In generalNot later than 2 years after the date of enactment of this Act, the Interagency Working Group shall
			 submit a report to the Committee on Science, Space, and Technology and
			 the Committee on Energy and Commerce of the House of Representatives and
			 the
			 Committee on Environment and Public Works and the Committee on Commerce,
			 Science, and Transportation of the Senate that shall include—(A)a summary of federally funded sustainable chemistry research, development, demonstration,
			 technology transfer, commercialization, education, and  training
			 activities;(B)a summary of the financial resources allocated to sustainable chemistry initiatives;(C)an analysis of the progress made toward achieving the goals and priorities of this Act, and
			 recommendations for future program activities;(D)an assessment of the benefits of expanding existing, federally supported regional innovation and
			 manufacturing hubs to include sustainable chemistry and the value of
			 directing the creation of one or more dedicated sustainable chemistry
			 centers of excellence or hubs; and(E)an evaluation of steps taken and future strategies to avoid duplication of efforts, streamline
			 interagency coordination, facilitate information sharing, and spread best
			 practices between participating agencies in the Program.(2)Submission to GAOThe Interagency Working Group shall also submit the report described in paragraph (1) to the
			 Government Accountability Office for consideration in future congressional
			 inquiries.4.Partnerships in Sustainable Chemistry(a)AuthorizationThe Interagency Working Group shall lead the agencies participating in the Program to carry out a
			 joint, coordinated program to award grants to institutions of higher
			 education to establish partnerships with companies across the value chain
			 in the chemical industry, including small- and medium-sized enterprises,
			 to—(1)create collaborative research, development, demonstration, technology transfer, and
			 commercialization programs; and(2)train students and retrain professional scientists and engineers  in the use of sustainable
			 chemistry concepts and strategies by methods
			 including—(A)developing curricular materials and courses for undergraduate and graduate levels and for the
			 professional development of scientists and engineers; and(B)publicizing the availability of professional development courses in sustainable chemistry and
			 recruiting scientists and engineers to pursue such courses.(b)GuidelinesThe Interagency Working Group shall establish guidelines and criteria for—(1)a partnership between a company in the chemical industry and an institution of higher education
			 eligible for a grant under subsection (a); and(2)the grant application and awarding process, which shall include—(A)competitive, merit-based review of each grant application; and(B)cost-sharing from non-Federal sources by members of the partnerships.5.Study of sustainable chemistryThe Director of the National Science Foundation shall enter into an arrangement with the National
			 Research Council to conduct a study that shall—(1)assess the current status of sustainable chemistry research in the United States, and suggest
			 high-priority research and development needs within sustainable chemistry;(2)examine the status of sustainable chemistry in the education of chemists and chemical engineers and
			 other relevant professions and identify recommendations to improve and
			 broaden the implementation of sustainable chemistry practices in science
			 and engineering education, including examining the role of toxicology,
			 chemical hazard and risk assessment, lifecycle assessment, and
			 environmental fate and effects in science and engineering education;(3)examine case studies of successful and unsuccessful attempts at commercialization and adoption of
			 sustainable chemistry processes and products in the United States and
			 abroad and recommend research areas, priorities, and public policy options
			 that would help to overcome identified barriers to commercialization; and(4)using available economic analyses, discuss the potential economic impact of sustainable chemistry,
			 including job creation.6.National strategy and implementation planNot later than 2 years after the release of the study described in section 5, the Interagency
			 Working Group, in consultation with the Advisory Council, shall produce a
			 national strategy and accompanying implementation plan for sustainable
			 chemistry that provides a framework for advancing sustainable chemistry
			 research, development, technology transfer, commercialization, and
			 education and training.7.PrioritizationIn carrying out this Act, the Interagency Working Group shall prioritize support for activities
			 that achieve, to the highest extent practicable, the goals of sustainable
			 chemistry.


114 HR 1130 IH: Chronic Kidney Disease Improvement in Research and Treatment Act of 2015
U.S. House of Representatives
2015-02-26
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I
114th CONGRESS 1st Session
H. R. 1130
IN THE HOUSE OF REPRESENTATIVES

February 26, 2015
Mr. Marino (for himself, Mr. Lewis, and Mr. Roskam) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL
To improve the understanding of, and promote access to treatment for, chronic kidney disease, and for other purposes.

1.Short titleThis Act may be cited as the Chronic Kidney Disease Improvement in Research and Treatment Act of 2015.  2.Table of contentsThe table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Title I—Improving Understanding of Chronic Kidney Disease through Expanded Research and Coordination
Sec. 101. Identifying gaps in chronic kidney disease research.
Sec. 102. Coordinating research on chronic kidney disease.
Sec. 103. Understanding the progression of kidney disease and treatment of kidney failure in minority populations.
Title II—Promoting Access to Chronic Kidney Disease Treatments
Sec. 201. Increasing access to Medicare kidney disease education benefit.
Sec. 202. Improving access to chronic kidney disease treatment in underserved rural and urban areas.
Sec. 203. Promoting access to home dialysis treatments.
Sec. 204. Expand access for patients with acute kidney injury.
Title III—Creating Economic Stability for Providers Caring for Individuals with Chronic Kidney Disease
Sec. 301. Stabilizing Medicare payments for services provided to beneficiaries with stage V chronic kidney disease receiving dialysis services.
Sec. 302. Allowing individuals with kidney failure to retain access to private insurance.
Sec. 303. Providing individuals with kidney failure access to managed care and coordinated care programs.
IImproving Understanding of Chronic Kidney Disease through Expanded Research and Coordination
101.Identifying gaps in chronic kidney disease research
(a)ReportNot later than one year after the date of enactment of this Act, the Comptroller General of the United States shall develop and submit to the Congress a comprehensive report assessing the adequacy of Federal expenditures in chronic kidney disease research relative to Federal expenditures for chronic kidney disease care.  (b)ContentsThe report required by this section shall—
(1)analyze the current chronic kidney disease research projects being funded by Federal agencies;  (2)identify, including by surveying the kidney care community, areas of chronic kidney disease knowledge gaps that are not part of current Federal research efforts;
(3)report on the level of Federal expenditures on kidney research as compared to the amount of Federal expenditures on treating individuals with chronic kidney disease; and  (4)identify areas of kidney failure knowledge gaps in research to assess treatment patterns associated with providing care to minority populations that are disproportionately affected by kidney failure.
102.Coordinating research on chronic kidney disease
(a)Interagency committeeThe Secretary of Health and Human Services shall establish and maintain an interagency committee for the purpose of improving the coordination of chronic kidney disease research.  (b)ReportsFor the purpose described in subsection (a), the interagency committee established under such subsection shall issue public reports that—
(1)include a strategic plan, including recommendations for— (A)improving communication and coordination among Federal agencies;
(B)procedures for monitoring Federal chronic kidney disease research activities; and  (C)ways to maximize the efficiency of the Federal chronic kidney disease research investment and minimize the potential for unnecessary duplication;
(2)include a portfolio analysis that provides information on chronic kidney disease research projects, organized by the strategic plan objectives; and  (3)address such other topics as the interagency committee determines appropriate.
(c)MeetingsThe interagency committee established under subsection (a) shall meet not less than semi-annually.  103.Understanding the progression of kidney disease and treatment of kidney failure in minority populationsNot later than one year after the date of enactment of this Act, the Secretary of Health and Human Services shall—
(1)complete a study on— (A)the social, behavioral, and biological factors leading to kidney disease;
(B)efforts to slow the progression of kidney disease in minority populations that are disproportionately affected by such disease; and  (C)treatment patterns associated with providing care, under the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and through private health insurance, to minority populations that are disproportionately affected by kidney failure; and
(2)submit a report to the Congress on the results of such study.  IIPromoting Access to Chronic Kidney Disease Treatments 201.Increasing access to Medicare kidney disease education benefit (a)In generalSection 1861(ggg) of the Social Security Act (42 U.S.C. 1395x(ggg)) is amended—
(1)in paragraph (1)— (A)in subparagraph (A), by inserting  or stage V after stage IV; and
(B)in subparagraph (B), by inserting or of a physician assistant, nurse practitioner, or clinical nurse specialist (as defined in section 1861(aa)(5)) assisting in the treatment of the individual’s kidney condition after kidney condition; and  (2)in paragraph (2)—
(A)by striking subparagraph (B); and  (B)in subparagraph (A)—
(i)by striking (A) after (2);  (ii)by striking and at the end of clause (i);
(iii)by striking the period at the end of clause (ii) and inserting ; and;  (iv)by redesignating clauses (i) and (ii) as subparagraphs (A) and (B), respectively; and
(v)by adding at the end the following:  (C)a renal dialysis facility subject to the requirements of section 1881(b)(1) with personnel who—
(i)provide the services described in paragraph (1); and  (ii)is a physician (as defined in subsection (r)(1)) or a physician assistant, nurse practitioner, or clinical nurse specialist (as defined in subsection (aa)(5))..
(b)Payment to renal dialysis facilitiesSection 1881(b) of such Act (42 U.S.C. 1395rr(b)) is amended by adding at the end the following new paragraph:  (15)For purposes of paragraph (14), the single payment for renal dialysis services under such paragraph shall not take into account the amount of payment for kidney disease education services (as defined in section 1861(ggg)). Instead, payment for such services shall be made to the renal dialysis facility on an assignment-related basis under section 1848..
(c)Effective dateThe amendments made by this section apply to kidney disease education services furnished on or after January 1, 2016.  202.Improving access to chronic kidney disease treatment in underserved rural and urban areas (a)Definition of primary care servicesSection 331(a)(3)(D) of the Public Health Service Act (42 U.S.C. 254d(a)(3)(D)) is amended by inserting and includes renal dialysis services before the period at the end.
(b)National Health Service Corps Scholarship ProgramSection 338A(a)(2) of the Public Health Service Act (42 U.S.C. 254l(a)(2)) is amended by inserting , including nephrologists and non-physician practitioners providing renal dialysis services before the period at the end.  (c)National Health Service Corps Loan Repayment ProgramSection 338B(a)(2) of the Public Health Service Act (42 U.S.C. 254l–1(a)(2)) is amended by inserting , including nephrologists and non-physician practitioners providing renal dialysis services before the period at the end.
203.Promoting access to home dialysis treatmentsSection 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the following new subclause:  (IX)A renal dialysis facility (as defined in section 1881)..
204.Expand access for patients with acute kidney injurySection 1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended— (1)in paragraph (1), by inserting or acute kidney injury after individuals who have been determined to have end stage renal disease;
(2)in paragraph (2)(A), by inserting or acute kidney injury after end stage renal disease;  (3)in paragraph (2)(B), by inserting or acute kidney injury after end stage renal disease;
(4)in paragraph (3), in the matter preceding subparagraph (A), by inserting or acute kidney injury after end stage renal disease;  (5)in paragraph (11)(A), by inserting or acute kidney injury after end stage renal disease;
(6)in paragraph (11)(B), by inserting or acute kidney injury after end stage renal disease;  (7)in paragraph (14)(B)—
(A)in clause (ii), by inserting or acute kidney injury after end stage renal disease;  (B)in clause (iii), by inserting or acute kidney injury after end stage renal disease; and
(C)in clause (iv), by inserting or acute kidney injury after end stage renal disease; and  (8)in paragraph (14)(H)(i), by inserting or acute kidney injury after end stage renal disease.
IIICreating Economic Stability for Providers Caring for Individuals with Chronic Kidney Disease
301.Stabilizing Medicare payments for services provided to beneficiaries with stage V chronic kidney disease receiving dialysis servicesSection 1881(b)(14) of the Social Security Act (42 U.S.C. 1395rr(b)(14)) is amended— (1)in subparagraph (D), in the matter preceding clause (i), by striking Such system and inserting Subject to subparagraph (J), such system; and
(2)by adding at the end the following new subparagraph:  (J) (i)For payment for renal dialysis services furnished on or after January 1, 2016, under the system under this paragraph—
(I)the payment adjustment described in clause (i) of subparagraph (D) shall not take into account comorbidities;  (II)the payment adjustment described in clause (ii) of such subparagraph shall not be included;
(III)the standardization factor described in the final rule published in the Federal Register on November 8, 2012 (77 Fed. Reg. 67470), shall be established using the most currently available data (and not historical data) and adjusted on an annual basis, based on such available data, to account for any change in utilization of drugs and any modification in adjustors applied under this paragraph; and  (IV)the Secretary shall take into account reasonable costs consistent with paragraph (2)(B) when calculating such payments.
(ii)Not later than January 1, 2016, the Secretary shall amend the ESRD facility cost report to— (I)include the per treatment network fee (as described in paragraph (7)) as an allowable cost; and
(II)eliminate the limitation for reporting medical director fees on such reports in order to take into account the wages of a board-certified nephrologist..  302.Allowing individuals with kidney failure to retain access to private insurance (a)In generalSection 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 1395y(b)(1)(C)) is amended—
(1)in the last sentence, by inserting and before January 1, 2016 after prior to such date; and  (2)by adding at the end the following new sentence: Effective for items and services furnished on or after January 1, 2016 (with respect to periods beginning on or after the date that is 42 months prior to such date), clauses (i) and (ii) shall be applied by substituting 42-month for 12-month each place it appears..
(b)Effective dateThe amendments made by this subsection shall take effect on the date of enactment of this Act. For purposes of determining an individual’s status under section 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 1395y(b)(1)(C)), as amended by subsection (a), an individual who is within the coordinating period as of the date of enactment of this Act shall have that period extended to the full 42 months described in the last sentence of such section, as added by the amendment made by subsection (a)(2).  303.Providing individuals with kidney failure access to managed care and coordinated care programs (a)Expanding access to Medicare Advantage (1)Eligibility under Medicare Advantage (A)In generalSection 1851(a)(3) of the Social Security Act (42 U.S.C. 1395w–21(a)(3)) is amended—
(i)by striking subparagraph (B); and  (ii)by striking eligible individual.— and all that follows through In this title and inserting eligible individual.—In this title.
(B)Conforming amendmentSection 1852(b)(1) of the Social Security Act (42 U.S.C. 1395w–22(b)(1)) is amended— (i)by striking subparagraph (B); and
(ii)by striking Beneficiaries.— and all that follows through A Medicare+Choice organization and inserting Beneficiaries.—A Medicare Advantage organization.  (C)Effective dateThe amendments made by this paragraph shall apply with respect to plan years beginning on or after January 1, 2016.
(2)EducationSection 1851(d)(2)(A)(iii) of the Social Security Act (42 U.S.C. 1395w–21(d)(2)(A)(iii)) is amended by inserting before the period at the end the following , including any additional information that individuals determined to have end stage renal disease may need to make informed decisions with respect to such an election.  (3)Quality metricsSection 1852(e)(3)(A) of the Social Security Act (42 U.S.C. 1395w–22(e)(3)(A)) is amended by adding at the end the following new clause:

(v)Requirements with respect to individuals with ESRDIn addition to the data required to be collected, analyzed, and reported under clause (i) and notwithstanding the limitations under subparagraph (B), as part of the quality improvement program under paragraph (1), each MA organization shall provide for the collection, analysis, and reporting of data, determined in consultation with the kidney care community, that permits the measurement of health outcomes and other indices of quality with respect to individuals determined to have end stage renal disease..  (b)Permanent extension of Medicare Advantage ESRD Special Needs Plans authoritySection 1859(f)(1) of the Social Security Act (42 U.S.C. 1395w–28(f)(1)) is amended by inserting , in the case of a specialized MA plan for special needs individuals who have not been determined to have end stage renal disease, before for periods before January 1, 2017.
(c)Voluntary ESRD coordinated care gainsharing program
(1)In generalSection 1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended by adding at the end the following new paragraph:  (15) (A)Not later than January 1, 2017, the Secretary shall, in accordance with this paragraph, establish an ESRD Care Coordination gainsharing program for nephrologists, renal dialysis facilities, and providers of services that develop coordinated care organizations to provide a full range of clinical and supportive services (as described in subparagraph (D)) to individuals determined to have end stage renal disease.
(B)Under such program, subject to subparagraph (C), the payment amounts renal dialysis facilities and providers of services described in subparagraph (A) would otherwise receive under paragraph (14) and nephrologists described in subparagraph (A) would otherwise receive under section 1848 with respect to dialysis services furnished by such a facility, provider, or nephrologist during a year, shall be increased by a portion of the amount (as determined by the Secretary) of actual reductions in expenditure under this title attributable to the coordinated care organization developed by such facility, provider, or nephrologist involved, taking into account non-dialysis expenditures under parts A and B, during the preceding calendar year. The payment amount under this subparagraph shall be provided to a nephrologist, renal dialysis facility, and provider of services that developed the coordinated care organization no later than March 31 of the year after the year during which such services are provided by such nephrologist, facility, or provider.  (C)The aggregate incentive payment amounts provided under such program for a year may not exceed the amount equal to 2 percent less than the estimated total amount of non-dialysis expenditures under parts A and B for 2016 for items and services that are not related to dialysis or transplant services.
(D)For purposes of subparagraph (A), the full range of clinical and supportive services includes at least the following: (i)Primary care and other preventative services.
(ii)Specialty care for co-morbidities or non-renal acute conditions, including at least podiatry, cardiology, and orthopedics.  (iii)Vascular access.
(iv)Laboratory testing and diagnostic imaging.  (v)Pharmacy care management.
(vi)Patient, family, and caregiver education.  (vii)Psychiatric, behavioral therapy, and counseling services.
(E)In providing payment incentive amounts under such program, the Secretary shall apply a risk adjustment methodology that— (i)uses risk adjuster factors applied under part C; and
(ii)adjusts such payments to exclude the top 2 percent of outliers.  (F)In establishing such program, the Secretary shall ensure that each of the following is satisfied:
(i)The program allows for all types and sizes of renal dialysis facilities and providers of services described in subparagraph (A), including profit and not-for-profit, urban and rural, as well as all other types and sizes of such facilities and providers, to participate.  (ii)The program rewards high quality, efficient facilities and providers through gain-sharing.
(iii)For purposes of determining the actual reductions in expenditures under this title attributable to a coordinated care organization described in subparagraph (A), the program includes a market-based benchmark system that will not be rebased against which such expenditures shall be compared.  (iv)The program results in reductions of expenditures under parts A and B for services that are not dialysis-related services.
(v)The program allows new applicants to participate in the program after the initial implementation period.  (vi)The program establishes clear quality metrics in consultation with the kidney care community.
(vii)The program provides for waivers of Federal laws or requirements, in consultation with interested stakeholders.  (viii)Under such program the Secretary attributes individuals described in subparagraph (A) who receive treatment through a care coordination organization described in such subparagraph to such organization rather than to any other payment model that requires beneficiary attribution.
(ix)Under such program the Secretary provides quarterly Medicare parts A and B claims data to facilities and providers described in subparagraph (A) participating in such program.  (G)Not later than three years after the date of the implementation of the ESRD Care Coordination gainsharing program, the Secretary shall submit to the Congress a report on the waivers granted under subparagraph (F)(vii) and the effectiveness of such waivers in allowing the coordination of care..
(2)Conforming amendments
(A)Section 1881Section 1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended— (i)in each of paragraphs (12)(A) and (13)(A), by striking paragraph (14) and inserting paragraphs (14) and (15); and
(ii)in paragraph (14)(A)(i), by inserting and paragraph (15) after Subject to subparagraph (E).  (B)Section 1848Section 1848 of the Social Security Act (42 U.S.C. 1395w–4) is amended by adding at the end the following new subsection:

(q)Voluntary ESRD coordinated care programFor provisions related to incentive payment amounts to nephrologists under the ESRD Care Coordination gainsharing program, see section 1881(b)(15)..  (d)Patient information requirementThe Secretary of Health and Human Services shall require hospitals that furnish items and services to individuals entitled to benefits under part A of title XVIII of the Social Security Act or eligible for benefits under part B of such title and who subsequently receive dialysis services at a renal dialysis facility (as defined in section 1881 of such Act (42 U.S.C. 1395rr)) to provide to such facility health information with respect to such individual, including a discharge summary and co-morbidity information, upon request of the facility, not later than 7 days after notification by the hospital of the provision of such services to such individual or of the determination that such individual has end stage renal disease, as applicable.