End Diaper Need Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 1846 To amend the Public Health Service Act to address the increased burden that maintaining the health and hygiene of infants and toddlers places on families in need, the resultant adverse health effects on children and families, and the limited child care options available for infants and toddlers who lack sufficient diapers, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 21, 2019 Ms. LEE of California (for herself, Ms. MOORE, Mr. KHANNA, Ms. OMAR, Mr. HASTINGS, Ms. NORTON, Ms. JACKSON LEE, Mr. MCNERNEY, Mr. NAD- LER, Mr. RUSH, Mr. COHEN, Mrs. CAROLYN B. MALONEY of New York, Ms. PRESSLEY, Mrs. KIRKPATRICK, Mr. GRIJALVA, Mr. TAKANO, Ms. WILD, Mr. POCAN, Ms. OCASIO-CORTEZ, Ms. JAYAPAL, Ms. MCCOLLUM, Ms. SCHAKOWSKY, Mr. PETERS, Ms. SEWELL of Alabama, and Ms. DELAURO) introduced the following bill; which was referred to the Com- mittee 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 amend the Public Health Service Act to address the increased burden that maintaining the health and hy- giene of infants and toddlers places on families in need, the resultant adverse health effects on children and fami- lies, and the limited child care options available for in- fants and toddlers who lack sufficient diapers, and for other purposes. VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 2 •HR 1846 IH Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘End Diaper Need Act 4 of 2019’’. 5 SEC. 2. DIAPER DISTRIBUTION DEMONSTRATION PROJECT. 6 Part P of title III of the Public Health Service Act 7 (42 U.S.C. 280g et seq.) is amended by adding at the end 8 the following: 9 ‘‘SEC. 399V–7. DIAPER DISTRIBUTION DEMONSTRATION 10 PROGRAM. 11 ‘‘(a) ESTABLISHMENT.—The Secretary shall make 12 grants to assist eligible entities to conduct demonstration 13 projects that implement and evaluate strategies to help 14 low-income families to address the diaper needs of infants 15 and toddlers. 16 ‘‘(b) DESIGN OF PROGRAM.—In carrying out the 17 grant program under subsection (a), the Secretary shall— 18 ‘‘(1) consult with relevant stakeholders, includ- 19 ing agencies, professional associations, and nonprofit 20 organizations, on the design of the program; and 21 ‘‘(2) design the program in such a way that the 22 program— 23 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 3 •HR 1846 IH ‘‘(A) decreases diaper need in low-income 1 families and meets the unmet diaper needs of 2 infants and toddlers in such families through— 3 ‘‘(i) the distribution of free diapers 4 and diapering supplies; 5 ‘‘(ii) community outreach to assist in 6 participation in existing diaper distribution 7 programs; or 8 ‘‘(iii) improving access to diapers and 9 diapering supplies as part of a comprehen- 10 sive service; and 11 ‘‘(B) increases the abilities of communities 12 and low-income families in those communities 13 to provide for the diaper needs of infants and 14 toddlers in those communities. 15 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible for a grant 16 under this section, an entity shall— 17 ‘‘(1) be a State or local governmental entity, an 18 Indian Tribe or tribal organization (as defined in 19 section 4 of the Indian Self-Determination and Edu- 20 cation Assistance Act), or a nonprofit organization 21 described in section 501(c)(3) of the Internal Rev- 22 enue Code of 1986 and exempt from taxation under 23 section 501(a) of such Code; 24 ‘‘(2) have experience in the area of— 25 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 4 •HR 1846 IH ‘‘(A) community distributions of basic need 1 services, including experience collecting, 2 warehousing, and distributing basic necessities 3 such as diapers, food, or menstrual products; 4 ‘‘(B) child care; 5 ‘‘(C) child development activities in low-in- 6 come communities; or 7 ‘‘(D) motherhood, fatherhood, or parent- 8 education efforts serving low-income parents of 9 young children; 10 ‘‘(3) demonstrate competency to implement a 11 project, provide fiscal accountability, collect data, 12 and prepare reports and other necessary documenta- 13 tion; 14 ‘‘(4) demonstrate a willingness to share infor- 15 mation with researchers, practitioners, and other in- 16 terested parties; and 17 ‘‘(5) submit to the Secretary a description of 18 the design of the evaluation to be carried out under 19 subsection (d)(2) and receive the Secretary’s ap- 20 proval of such design based on a determination that 21 such design is rigorous and is likely to yield informa- 22 tion that is credible and will be useful to other 23 States. 24 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 5 •HR 1846 IH ‘‘(d) USE OF FUNDS.—Amounts provided through a 1 grant under this section shall be used to conduct a dem- 2 onstration project to implement and evaluate strategies to 3 help low-income families to address the diaper needs of 4 infants and toddlers, which use may include any of the 5 following: 6 ‘‘(1) To pay for the purchase of diapers and 7 diapering supplies and fund diaper distribution dem- 8 onstration projects that serve low-income families 9 with one or more children 3 years of age or younger. 10 ‘‘(2) Using not more than 25 percent of the 11 funds received by the grantee under this section, to 12 evaluate the effect of activities under paragraph (1) 13 on mitigating the health and developmental risks of 14 unmet diaper need among infants, toddlers, and 15 other family members in low-income families, includ- 16 ing the risks of diaper dermatitis, urinary tract in- 17 fections, and parental and child depression and anx- 18 iety. 19 ‘‘(3) To integrate activities under paragraph (1) 20 with other basic needs assistance programs serving 21 eligible children and their families, including the fol- 22 lowing: 23 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 6 •HR 1846 IH ‘‘(A) Programs funded by the Temporary 1 Assistance for Needy Families program, includ- 2 ing its State maintenance of effort provisions. 3 ‘‘(B) Programs designed to support the 4 health of eligible children, such as the Chil- 5 dren’s Health Insurance Program under title 6 XXI of the Social Security Act, the Medicaid 7 program under title XIX of such Act, or State- 8 funded health care programs. 9 ‘‘(C) Programs funded through the Special 10 Supplemental Nutrition Program for Women, 11 Infants, and Children. 12 ‘‘(D) Programs that offer early home vis- 13 iting services, including the Nurse-Family Part- 14 nership and the Maternal, Infant, and Early 15 Childhood Home Visiting (MIECHV) Program 16 (including the Tribal Home Visiting Program). 17 ‘‘(E) Programs to provide improved and 18 affordable access to child care, including pro- 19 grams funded through the Child Care and De- 20 velopment Fund, the Temporary Assistance for 21 Needy Families program, or a State-funded 22 program. 23 ‘‘(e) NO EFFECT ON OTHER PROGRAMS.—Any as- 24 sistance or benefits received by a family as a result of a 25 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 7 •HR 1846 IH project established pursuant to this section shall be dis- 1 regarded for purposes of determining the family’s eligi- 2 bility for, or amount of, benefits under any other Federal 3 needs-based programs. 4 ‘‘(f) REPORTS.—As a condition of receiving a grant 5 under this section for a fiscal year, the grantee shall sub- 6 mit to the Secretary, not later than 6 months after the 7 end of the fiscal year, a report that specifies, by month 8 and fiscal year, the following: 9 ‘‘(1) The number of infants and toddlers and 10 the age of the infant and toddlers who received as- 11 sistance from the grantee’s diaper distribution 12 project. 13 ‘‘(2) The number of families that have received 14 assistance from the grantee’s diaper distribution 15 project. 16 ‘‘(3) The number of diapers, and the number of 17 each type of diapering supply, distributed under the 18 grantee’s diaper distribution project. 19 ‘‘(4) The ZIP Code or ZIP Codes where the 20 grantee distributed diapers and diaper supplies. 21 ‘‘(5) The method or methods the grantee uses 22 to distribute diapers and diapering supplies. 23 ‘‘(6) Such other information as the Secretary 24 may specify. 25 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 8 •HR 1846 IH ‘‘(g) EVALUATION.—The Secretary, in consultation 1 with each grantee under this section, shall— 2 ‘‘(1) not later than 2 years after the date of en- 3 actment of the End Diaper Need Act of 2019— 4 ‘‘(A) complete an evaluation of the effec- 5 tiveness of the program carried out pursuant to 6 this section; 7 ‘‘(B) submit to the relevant congressional 8 committees a report on the results of such eval- 9 uation; and 10 ‘‘(C) publish the results of the evaluation 11 on the internet website of the Department of 12 Health and Human Services; and 13 ‘‘(2)(A) not later than 3 years after the date of 14 enactment of the End Diaper Need Act of 2019, up- 15 date the evaluation required by paragraph (1)(A); 16 and 17 ‘‘(B) not later than 90 days after completion of 18 the updated evaluation under subparagraph (A)— 19 ‘‘(i) submit to the relevant congressional 20 committees a report describing the results of 21 such updated evaluation; and 22 ‘‘(ii) publish the results of such evaluation 23 on the internet website of the Department of 24 Health and Human Services. 25 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 9 •HR 1846 IH ‘‘(h) DEFINITIONS.—In this section: 1 ‘‘(1) DIAPER.—The term ‘diaper’ means an ab- 2 sorbent garment that— 3 ‘‘(A) is washable or disposable that may be 4 worn by an infant or toddler who is not toilet- 5 trained; and 6 ‘‘(B) if disposable— 7 ‘‘(i) does not use any latex or common 8 allergens; and 9 ‘‘(ii) meets or exceeds the quality 10 standards for diapers commercially avail- 11 able through retail sale in the following 12 categories: 13 ‘‘(I) Absorbency (with acceptable 14 rates for first and second wetting). 15 ‘‘(II) Waterproof outer cover. 16 ‘‘(III) Flexible leg openings. 17 ‘‘(IV) Refastening closures. 18 ‘‘(2) DIAPERING SUPPLIES.—The term ‘dia- 19 pering supplies’ means items, including diaper wipes 20 and diaper cream, necessary to ensure that a child 21 using a diaper is properly cleaned and protected 22 from diaper rash. 23 ‘‘(3) ELIGIBLE CHILD.—The term ‘eligible 24 child’ means a child who— 25 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 10 •HR 1846 IH ‘‘(A) has not attained 4 years of age; and 1 ‘‘(B) is a member of a family whose self- 2 certified income is not more than 200 percent 3 of the Federal poverty line. 4 ‘‘(4) FEDERAL POVERTY LINE.—The term 5 ‘Federal poverty line’ means the Federal poverty line 6 as defined by the Office of Management and Budget 7 and revised annually in accordance with section 8 673(2) of the Omnibus Budget Reconciliation Act of 9 1981 applicable to a family of the size involved. 10 ‘‘(5) LOW-INCOME.—The term ‘low-income’, 11 with respect to a family, means a family whose self- 12 certified income is not more than 200 percent of the 13 Federal poverty line. 14 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 15 ‘‘(1) IN GENERAL.—To carry out this section, 16 there is authorized to be appropriated $100,000,000 17 for each of fiscal years 2020 through 2023. 18 ‘‘(2) AVAILABILITY OF FUNDS.—Funds pro- 19 vided to a grantee under this section for a fiscal 20 year may be expended by the grantee only in such 21 fiscal year or the succeeding fiscal year.’’. 22 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 11 •HR 1846 IH SEC. 3. IMPROVING ACCESS TO DIAPERS FOR MEDICALLY 1 COMPLEX CHILDREN. 2 Section 1915(c) of the Social Security Act (42 U.S.C. 3 1396n(c)) is amended by adding at the end the following 4 new paragraph: 5 ‘‘(11)(A) In the case of any waiver under this sub- 6 section that provides medical assistance to a medically 7 complex child who has been diagnosed with bowel or blad- 8 der incontinence, a bowel or bladder condition that causes 9 excess urine or stool (such as short gut syndrome or diabe- 10 tes insipidus), or a severe skin condition that causes skin 11 erosions (such as epidermolysis bullosa), such medical as- 12 sistance shall include, for the duration of the waiver, the 13 provision of 200 medically necessary diapers per month 14 and diapering supplies. Such medical assistance may in- 15 clude the provision of medically necessary diapers in 16 amounts greater than 200 if a licensed health care pro- 17 vider (such as a physician, nurse practitioner, or physician 18 assistant) specifies that such greater amounts are nec- 19 essary for such medically complex child. 20 ‘‘(B) For purposes of this paragraph— 21 ‘‘(i) the term ‘medically complex child’ means 22 an individual who is at least three years of age and 23 for whom a licensed health care provider has pro- 24 vided a diagnosis of one or more significant chronic 25 conditions; 26 VerDate Sep 11 2014 20:59 Apr 04, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H1846.IH H1846 amozie on DSK9F9SC42PROD with BILLS 12 •HR 1846 IH ‘‘(ii) the term ‘medically necessary diaper’ 1 means an absorbent garment that is— 2 ‘‘(I) washable or disposable; and 3 ‘‘(II) worn by a medically complex child 4 who has been diagnosed with a condition de- 5 scribed in subparagraph (A) and needs such 6 garment to correct or ameliorate such condition; 7 and 8 ‘‘(iii) the term ‘diapering supplies’ means items, 9 including diaper wipes and diaper creams, necessary 10 to ensure that a medically complex child who has 11 been diagnosed with a condit [Text truncated for display. Full text available on Congress.gov.]