U:\2018REPT\Supp\CRSupp.xml AMENDMENT NO.llll SEN. APPRO. Calendar No.lll Purpose: In the nature of a substitute. IN THE SENATE OF THE UNITED STATES—115th Cong., 2d Sess. (no.) lllllll (title) llllllllllllllllllllllllllllll lllllllllllllllllllllllllllllllll lllllllllllllllllllllllllllllllll Referred to the Committee on llllllllll and ordered to be printed Ordered to lie on the table and to be printed AMENDMENT IN THE NATURE OF A SUBSTITUTE intended to be proposed by lllllll Viz: 1 Strike all after the enacting clause and insert the fol- 2 lowing: 3 SECTION 1. SHORT TITLE. 4 (a) SHORT TITLE.—This Act may be cited as the 5 ‘‘Bipartisan Budget Act of 2018’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 2 1 DIVISION B—SUPPLEMENTAL APPRO- 2 PRIATIONS, TAX RELIEF, AND MED- 3 ICAID CHANGES RELATING TO CER- 4 TAIN DISASTERS AND FURTHER EX- 5 TENSION 6 PRIATIONS OF CONTINUING APPRO- 7 Subdivision 1—Further Additional Supple8 mental Appropriations for Disaster Relief 9 Requirements Act, 2018 10 The following sums in this subdivision are appro- 11 priated, out of any money in the Treasury not otherwise 12 appropriated, for the fiscal year ending September 30, 13 2018 and for other purposes, namely: 14 TITLE I 15 DEPARTMENT OF AGRICULTURE 16 AGRICULTURAL PROGRAMS 17 18 19 PROCESSING, RESEARCH OFFICE OF THE AND MARKETING SECRETARY For an additional amount for the ‘‘Office of the Sec- 20 retary’’, $2,360,000,000, which shall remain available 21 until December 31, 2019, for necessary expenses related 22 to crops, trees, bushes, and vine losses related to the con23 sequences of Hurricanes Harvey, Irma, Maria, and other 24 hurricanes and wildfires occurring in calendar year 2017 25 under such terms and conditions as determined by the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 3 1 Secretary: Provided, That the Secretary may provide as2 sistance for such losses in the form of block grants to eligi3 ble states and territories: Provided further, That the total 4 amount of payments received under this heading and ap5 plicable policies of crop insurance under the Federal Crop 6 Insurance Act (7 U.S.C. 1501 et seq.) or the Noninsured 7 Crop Disaster Assistance Program (NAP) under section 8 196 of the Federal Agriculture Improvement and Reform 9 Act of 1996 (7 U.S.C. 7333) shall not exceed 85 percent 10 of the loss as determined by the Secretary: Provided fur11 ther, That the total amount of payments received under 12 this heading for producers who did not obtain a policy or 13 plan of insurance for an insurable commodity for the 2017 14 crop year, or 2018 crop year as applicable, under the Fed15 eral Crop Insurance Act (7 U.S.C. 1501 et seq.) for the 16 crop incurring the losses or did not file the required paper17 work and pay the service fee by the applicable State filing 18 deadline for a noninsurable commodity for the 2017 crop 19 year, or 2018 crop year as applicable, under NAP for the 20 crop incurring the losses shall not exceed 65 percent of 21 the loss as determined by the Secretary: Provided further, 22 That producers receiving payments under this heading, as 23 determined by the Secretary, shall be required to purchase 24 crop insurance where crop insurance is available for the 25 next two available crop years, and producers receiving pay- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 4 1 ments under this heading shall be required to purchase 2 coverage under NAP where crop insurance is not available 3 in the next two available crop years, as determined by the 4 Secretary: Provided further, That, not later than 90 days 5 after the end of fiscal year 2018, the Secretary shall sub6 mit a report to the Congress specifying the type, amount, 7 and method of such assistance by state and territory and 8 the status of the amounts obligated and plans for further 9 expenditure and include improvements that can be made 10 to Federal Crop Insurance policies, either administratively 11 or legislatively, to increase participation, particularly 12 among underserved producers, in higher levels of coverage 13 in future years for crops qualifying for assistance under 14 this heading: Provided further, That such amount is des15 ignated by the Congress as being for an emergency re16 quirement pursuant to section 251(b)(2)(A)(i) of the Bal17 anced Budget and Emergency Deficit Control Act of 1985. 18 19 OFFICE OF INSPECTOR GENERAL For an additional amount for ‘‘Office of Inspector 20 General’’, $2,500,000, to remain available until expended, 21 for oversight and audit of programs, grants, and activities 22 funded by this subdivision and administered by the De23 partment of Agriculture: Provided, That such amount is 24 designated by the Congress as being for an emergency re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 5 1 quirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985. 3 AGRICULTURAL RESEARCH SERVICE 4 BUILDINGS AND FACILITIES 5 For an additional amount for ‘‘Buildings and Facili- 6 ties’’, $22,000,000, to remain available until expended, for 7 necessary expenses related to the consequences of Hurri8 canes Harvey, Irma, and Maria: Provided, That such 9 amount is designated by the Congress as being for an 10 emergency requirement pursuant to section 11 251(b)(2)(A)(i) of the Balanced Budget and Emergency 12 Deficit Control Act of 1985. 13 FARM SERVICE AGENCY 14 EMERGENCY CONSERVATION PROGRAM 15 For an additional amount for the ‘‘Emergency Con- 16 servation Program’’, for necessary expenses related to the 17 consequences of Hurricanes Harvey, Irma, and Maria and 18 of wildfires occurring in calendar year 2017, and other 19 natural disasters, $400,000,000, to remain available until 20 expended: Provided, That such amount is designated by 21 the Congress as being for an emergency requirement pur22 suant to section 251(b)(2)(A)(i) of the Balanced Budget 23 and Emergency Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 6 1 NATURAL RESOURCES CONSERVATION SERVICE 2 WATERSHED AND FLOOD PREVENTION OPERATIONS 3 For an additional amount for ‘‘Watershed and Flood 4 Prevention Operations’’, for necessary expenses for the 5 Emergency Watershed Protection Program related to the 6 consequences of Hurricanes Harvey, Irma, and Maria and 7 of wildfires occurring in calendar year 2017, and other 8 natural disasters, $541,000,000, to remain available until 9 expended: Provided, That such amount is designated by 10 the Congress as being for an emergency requirement pur11 suant to section 251(b)(2)(A)(i) of the Balanced Budget 12 and Emergency Deficit Control Act of 1985. 13 RURAL DEVELOPMENT PROGRAMS 14 RURAL HOUSING SERVICE 15 RURAL HOUSING INSURANCE FUND PROGRAM ACCOUNT 16 For an additional amount for ‘‘Rural Housing Insur- 17 ance Fund Program Account’’, $18,672,000, to remain 18 available until September 30, 2019, for the cost of direct 19 loans, including the cost of modifying loans as defined in 20 section 502 of the Congressional Budget Act of 1974, for 21 the rehabilitation of section 515 rental housing (42 U.S.C. 22 1485) in areas impacted by Hurricanes Harvey, Irma, and 23 Maria where owners were not required to carry national 24 flood insurance: Provided, That such amount is designated 25 by the Congress as being for an emergency requirement February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 7 1 pursuant to section 251(b)(2)(A)(i) of the Balanced Budg2 et and Emergency Deficit Control Act of 1985. 3 RURAL UTILITIES SERVICE 4 RURAL WATER AND WASTE DISPOSAL PROGRAM ACCOUNT 5 For an additional amount for the ‘‘Rural Water and 6 Waste Disposal Program Account’’, $165,475,000, to re7 main available until expended, for grants to repair drink8 ing water systems and sewer and solid waste disposal sys9 tems impacted by Hurricanes Harvey, Irma, and Maria: 10 Provided, That not to exceed $2,000,000 of the amount 11 appropriated under this heading shall be for technical as12 sistance grants for rural water and waste systems pursu13 ant to section 306(a)(22) of the Consolidated Farm and 14 Rural Development Act: Provided further, That such 15 amount is designated by the Congress as being for an 16 emergency requirement pursuant to section 17 251(b)(2)(A)(i) of the Balanced Budget and Emergency 18 Deficit Control Act of 1985. 19 DOMESTIC FOOD PROGRAMS 20 FOOD AND NUTRITION SERVICE 21 SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR 22 WOMEN, INFANTS, AND CHILDREN (WIC) 23 For an additional amount for the ‘‘Special Supple- 24 mental Nutrition Program for Women, Infants, and Chil25 dren’’, $14,000,000, to remain available until September February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 8 1 30, 2019, for infrastructure grants to the Commonwealth 2 of Puerto Rico and the U.S. Virgin Islands to assist in 3 the repair and restoration of buildings, equipment, tech4 nology, and other infrastructure damaged as a con5 sequence of Hurricanes Irma and Maria: Provided, That 6 such amount is designated by the Congress as being for 7 an emergency requirement pursuant to section 8 251(b)(2)(A)(i) of the Balanced Budget and Emergency 9 Deficit Control Act of 1985. 10 11 COMMODITY ASSISTANCE PROGRAM For an additional amount for ‘‘Commodity Assistance 12 Program’’ for the emergency food assistance program as 13 authorized by section 27(a) of the Food and Nutrition Act 14 of 2008 (7 U.S.C. 2036(a)) and section 204(a)(1) of the 15 Emergency Food Assistance Act of 1983 (7 U.S.C. 16 7508(a)(1)), $24,000,000, to remain available until Sep17 tember 30, 2019, for necessary expenses of those jurisdic18 tions that received a major disaster or emergency declara19 tion pursuant to section 401 or 501, respectively, of the 20 Robert T. Stafford Disaster Relief and Emergency Assist21 ance Act (42 U.S.C. 5170, 5191) related to the con22 sequences of Hurricanes Harvey, Irma, and Maria or due 23 to wildfires in 2017: Provided, That notwithstanding any 24 other provisions of the Emergency Food Assistance Act 25 of 1983, the Secretary of Agriculture may provide re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 9 1 sources to Puerto Rico, the Virgin Islands of the United 2 States, and affected States, as determined by the Sec3 retary, to assist affected families and individuals without 4 regard to sections 204 and 214 of such Act (7 U.S.C. 5 7508, 7515) by allocating additional foods and funds for 6 administrative expenses from resources specifically appro7 priated, transferred, or reprogrammed: Provided further, 8 That such amount is designated by the Congress as being 9 for an emergency requirement pursuant to section 10 251(b)(2)(A)(i) of the Balanced Budget and Emergency 11 Deficit Control Act of 1985. 12 RELATED AGENCIES AND FOOD AND DRUG 13 ADMINISTRATION 14 DEPARTMENT OF HEALTH AND HUMAN SERVICES 15 FOOD AND DRUG ADMINISTRATION 16 BUILDINGS AND FACILITIES 17 (INCLUDING TRANSFER OF FUNDS) 18 For an additional amount for ‘‘Buildings and Facili- 19 ties’’, $7,600,000, to remain available until expended, for 20 necessary expenses related to the consequences of Hurri21 canes Harvey, Irma, and Maria: Provided, That such 22 amount may be transferred to ‘‘Department of Health and 23 Human Services—Food and Drug Administration—Sala24 ries and Expenses’’ for costs related to repair of facilities, 25 for replacement of equipment, and for other increases in February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 10 1 facility-related costs: Provided further, That obligations in2 curred for the purposes provided herein prior to the date 3 of enactment of this subdivision may be charged to funds 4 appropriated by this paragraph: Provided further, That 5 such amount is designated by the Congress as being for 6 an emergency requirement pursuant to section 7 251(b)(2)(A)(i) of the Balanced Budget and Emergency 8 Deficit Control Act of 1985. 9 10 GENERAL PROVISION—THIS TITLE SEC. 20101. (a) Section 1501(b) of the Agricultural 11 Act of 2014 (7 U.S.C. 9081(b)) is amended— 12 (1) in paragraph (1), in the matter before sub- 13 paragraph (A), by inserting ‘‘sold livestock for a re- 14 duced sale price, or both’’ after ‘‘normal mortality,’’; 15 (2) in paragraph (2), by striking ‘‘applicable 16 livestock on the day before the date of death of the 17 livestock, as determined by the Secretary.’’ and in- 18 serting the following: 19 ‘‘affected livestock, as determined by the Secretary, 20 on, as applicable— 21 22 ‘‘(A) the day before the date of death of the livestock; or 23 ‘‘(B) the day before the date of the event 24 that caused the harm to the livestock that re- 25 sulted in a reduced sale price.’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 11 1 2 (3) by adding at the end the following new paragraph: 3 ‘‘(4) A payment made under paragraph (1) to 4 an eligible producer on a farm that sold livestock for 5 a reduced sale price shall— 6 ‘‘(A) be made if the sale occurs within a 7 reasonable period following the event, as deter- 8 mined by the Secretary; and 9 10 11 ‘‘(B) be reduced by the amount that the producer received for the sale.’’. (b) Section 1501(d)(1) of the Agricultural Act of 12 2014 (7 U.S.C. 9081(d)(1)) is amended by striking ‘‘not 13 more than $20,000,000 of’’. 14 (c) Section 1501(e)(4)(C) of the Agricultural Act of 15 2014 (7 U.S.C. 9081(e)(4)(C)) is amended by striking 16 ‘‘500 acres’’ and inserting ‘‘1,000 acres’’. 17 (d) Section 1501 of the Agricultural Act of 2014 (7 18 U.S.C. 9081) is amended— 19 (1) in subsection (e)(4)— 20 (A) by striking subparagraph (B); and 21 (B) by redesignating subparagraph (C), as 22 amended by subsection (c), as subparagraph 23 (B); and 24 (2) in subsection (f)(2), by striking ‘‘subsection 25 February 7, 2018 (10:12 p.m.) (e)’’ and inserting ‘‘subsections (b) and (e)’’. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 12 1 (e) Section 1501 of the Agricultural Act of 2014 (7 2 U.S.C. 9081), as amended by this section, shall apply with 3 respect to losses described in such section 1501 incurred 4 on or after January 1, 2017. 5 (f) The amounts provided by subsections (a) through 6 (e) for fiscal year 2018 are designated by the Congress 7 as being for an emergency requirement pursuant to sec8 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer9 gency Deficit Control Act of 1985. 10 TITLE II 11 DEPARTMENT OF COMMERCE 12 ECONOMIC DEVELOPMENT ADMINISTRATION 13 ECONOMIC DEVELOPMENT ASSISTANCE PROGRAMS 14 (INCLUDING TRANSFERS OF FUNDS) 15 Pursuant to section 703 of the Public Works and 16 Economic Development Act (42 U.S.C. 3233), for an addi17 tional amount for ‘‘Economic Development Assistance 18 Programs’’ for necessary expenses related to flood mitiga19 tion, disaster relief, long-term recovery, and restoration of 20 infrastructure in areas that received a major disaster des21 ignation as a result of Hurricanes Harvey, Irma, and 22 Maria, and of wildfires and other natural disasters occur23 ring in calendar year 2017 under the Robert T. Stafford 24 Disaster Relief and Emergency Assistance Act (42 U.S.C. 25 5121 et seq.), $600,000,000, to remain available until ex- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 13 1 pended: Provided, That the amount provided under this 2 heading is designated by the Congress as being for an 3 emergency requirement pursuant to section 4 251(b)(2)(A)(i) of the Balanced Budget and Emergency 5 Deficit Control Act of 1985: Provided further, That within 6 the amount appropriated, up to 2 percent of funds may 7 be transferred to the ‘‘Salaries and Expenses’’ account for 8 administration and oversight activities: Provided further, 9 That within the amount appropriated, $1,000,000 shall be 10 transferred to the ‘‘Office of Inspector General’’ account 11 for carrying out investigations and audits related to the 12 funding provided under this heading. 13 NATIONAL OCEANIC AND ATMOSPHERIC 14 ADMINISTRATION 15 OPERATIONS, RESEARCH, AND FACILITIES 16 For an additional amount for ‘‘Operations, Research, 17 and Facilities’’ for necessary expenses related to the con18 sequences of Hurricanes Harvey, Irma, and Maria, 19 $120,904,000, to remain available until September 30, 20 2019, as follows: 21 (1) $12,904,000 for repair and replacement of 22 observing assets, Federal real property, and equip- 23 ment; 24 25 February 7, 2018 (10:12 p.m.) (2) $18,000,000 for marine debris assessment and removal; U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 14 1 2 (3) $40,000,000 for mapping, charting, and geodesy services; and 3 (4) $50,000,000 to improve weather fore- 4 casting, hurricane intensity forecasting and flood 5 forecasting and mitigation capabilities, including 6 data assimilation from ocean observing platforms 7 and satellites: 8 Provided, That the amount provided under this heading 9 is designated by the Congress as being for an emergency 10 requirement pursuant to section 251(b)(2)(A)(i) of the 11 Balanced Budget and Emergency Deficit Control Act of 12 1985: Provided further, That the National Oceanic and At13 mospheric Administration shall submit a spending plan to 14 the Committees on Appropriations of the House of Rep15 resentatives and the Senate within 45 days after the date 16 of enactment of this subdivision. 17 18 PROCUREMENT, ACQUISITION AND CONSTRUCTION For an additional amount for ‘‘Procurement, Acquisi- 19 tion and Construction’’ for necessary expenses related to 20 the consequences of Hurricanes Harvey, Irma, and Maria, 21 $79,232,000, to remain available until September 30, 22 2020, as follows: 23 24 February 7, 2018 (10:12 p.m.) (1) $29,232,000 for repair and replacement of Federal real property and observing assets; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 15 1 (2) $50,000,000 for improvements to oper- 2 ational and research weather supercomputing infra- 3 structure and for improvement of satellite ground 4 services used in hurricane intensity and track pre- 5 diction: 6 Provided, That the amount provided under this heading 7 is designated by the Congress as being for an emergency 8 requirement pursuant to section 251(b)(2)(A)(i) of the 9 Balanced Budget and Emergency Deficit Control Act of 10 1985: Provided further, That the National Oceanic and At11 mospheric Administration shall submit a spending plan to 12 the Committees on Appropriations of the House of Rep13 resentatives and the Senate within 45 days after the date 14 of enactment of this subdivision. 15 16 FISHERIES DISASTER ASSISTANCE For an additional amount for ‘‘Fisheries Disaster As- 17 sistance’’ for necessary expenses associated with the miti18 gation of fishery disasters, $200,000,000, to remain avail19 able until expended: Provided, That funds shall be used 20 for mitigating the effects of commercial fishery failures 21 and fishery resource disasters declared by the Secretary 22 of Commerce in calendar year 2017, as well those declared 23 by the Secretary to be a direct result of Hurricanes Har24 vey, Irma, or Maria: Provided further, That the amount 25 provided under this heading is designated by the Congress February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 16 1 as being for an emergency requirement pursuant to sec2 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer3 gency Deficit Control Act of 1985. 4 DEPARTMENT OF JUSTICE 5 UNITED STATES MARSHALS SERVICE 6 SALARIES AND EXPENSES 7 For an additional amount for ‘‘Salaries and Ex- 8 penses’’ for necessary expenses related to the con9 sequences of Hurricanes Harvey, Irma, and Maria, 10 $2,500,000: Provided, That the amount provided under 11 this heading is designated by the Congress as being for 12 an emergency requirement pursuant to section 13 251(b)(2)(A)(i) of the Balanced Budget and Emergency 14 Deficit Control Act of 1985. 15 FEDERAL BUREAU 16 17 OF INVESTIGATION SALARIES AND EXPENSES For an additional amount for ‘‘Salaries and Ex- 18 penses’’ for necessary expenses related to the con19 sequences of Hurricanes Harvey, Irma, and Maria, 20 $21,200,000: Provided, That the amount provided under 21 this heading is designated by the Congress as being for 22 an emergency requirement pursuant to section 23 251(b)(2)(A)(i) of the Balanced Budget and Emergency 24 Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 17 1 DRUG ENFORCEMENT ADMINISTRATION 2 SALARIES AND EXPENSES 3 For an additional amount for ‘‘Salaries and Ex- 4 penses’’ for necessary expenses related to the con5 sequences of Hurricanes Harvey, Irma, and Maria, 6 $11,500,000: Provided, That the amount provided under 7 this heading is designated by the Congress as being for 8 an emergency requirement pursuant to section 9 251(b)(2)(A)(i) of the Balanced Budget and Emergency 10 Deficit Control Act of 1985. 11 FEDERAL PRISON SYSTEM 12 SALARIES AND EXPENSES 13 For an additional amount for ‘‘Salaries and Ex- 14 penses’’ for necessary expenses related to the con15 sequences of Hurricanes Harvey, Irma, and Maria, 16 $16,000,000: Provided, That the amount provided under 17 this heading is designated by the Congress as being for 18 an emergency requirement pursuant to section 19 251(b)(2)(A)(i) of the Balanced Budget and Emergency 20 Deficit Control Act of 1985. 21 22 BUILDINGS AND FACILITIES For an additional amount for ‘‘Buildings and Facili- 23 ties’’ for necessary expenses related to the consequences 24 of Hurricanes Harvey, Irma, and Maria, $34,000,000, to 25 remain available until expended: Provided, That the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 18 1 amount provided under this heading is designated by the 2 Congress as being for an emergency requirement pursuant 3 to section 251(b)(2)(A)(i) of the Balanced Budget and 4 Emergency Deficit Control Act of 1985. 5 SCIENCE 6 NATIONAL AERONAUTICS 7 CONSTRUCTION AND ENVIRONMENTAL COMPLIANCE AND 8 RESTORATION 9 AND SPACE ADMINISTRATION For an additional amount for ‘‘Construction and En- 10 vironmental Compliance and Restoration’’ for repairs at 11 National Aeronautics and Space Administration facilities 12 damaged by hurricanes during 2017, $81,300,000, to re13 main available until expended: Provided, That the amount 14 provided under this heading is designated by the Congress 15 as being for an emergency requirement pursuant to sec16 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer17 gency Deficit Control Act of 1985. 18 NATIONAL SCIENCE FOUNDATION 19 RESEARCH AND RELATED ACTIVITIES 20 For an additional amount for ‘‘Research and Related 21 Activities’’ for necessary expenses to repair National 22 Science Foundation radio observatory facilities damaged 23 by hurricanes that occurred during 2017, $16,300,000, to 24 remain available until expended: Provided, That the 25 amount provided under this heading is designated by the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 19 1 Congress as being for an emergency requirement pursuant 2 to section 251(b)(2)(A)(i) of the Balanced Budget and 3 Emergency Deficit Control Act of 1985: Provided further, 4 That the National Science Foundation shall submit a 5 spending plan to the Committees on Appropriations of the 6 House of Representatives and the Senate within 45 days 7 after the date of enactment of this subdivision. 8 RELATED AGENCIES 9 LEGAL SERVICES CORPORATION 10 11 PAYMENT TO THE LEGAL SERVICES CORPORATION For an additional amount for ‘‘Payment to the Legal 12 Services Corporation’’ to carry out the purposes of the 13 Legal Services Corporation Act by providing for necessary 14 expenses related to the consequences of Hurricanes Har15 vey, Irma, and Maria and of the calendar year 2017 16 wildfires, $15,000,000: Provided, That the amount made 17 available under this heading shall be used only to provide 18 the mobile resources, technology, and disaster coordina19 tors necessary to provide storm-related services to the 20 Legal Services Corporation client population and only in 21 the areas significantly affected by Hurricanes Harvey, 22 Irma, and Maria and by the calendar year 2017 wildfires: 23 Provided further, That such amount is designated by the 24 Congress as being for an emergency requirement pursuant 25 to section 251(b)(2)(A)(i) of the Balanced Budget and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 20 1 Emergency Deficit Control Act of 1985: Provided further, 2 That none of the funds appropriated in this subdivision 3 to the Legal Services Corporation shall be expended for 4 any purpose prohibited or limited by, or contrary to any 5 of the provisions of, sections 501, 502, 503, 504, 505, and 6 506 of Public Law 105–119, and all funds appropriated 7 in this subdivision to the Legal Services Corporation shall 8 be subject to the same terms and conditions set forth in 9 such sections, except that all references in sections 502 10 and 503 to 1997 and 1998 shall be deemed to refer in11 stead to 2017 and 2018, respectively, and except that sec12 tions 501 and 503 of Public Law 104–134 (referenced by 13 Public Law 105–119) shall not apply to the amount made 14 available under this heading: Provided further, That, for 15 the purposes of this subdivision, the Legal Services Cor16 poration shall be considered an agency of the United 17 States Government. 18 19 GENERAL PROVISION—THIS TITLE SEC. 20201. (a) In recognition of the consistency of 20 the Mid-Barataria Sediment Diversion, Mid-Breton Sound 21 Sediment Diversion, and Calcasieu Ship Channel Salinity 22 Control Measures projects, as selected by the 2017 Lou23 isiana Comprehensive Master Plan for a Sustainable 24 Coast, with the findings and policy declarations in section 25 2(6) of the Marine Mammal Protection Act (16 U.S.C. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 21 1 1361 et seq., as amended) regarding maintaining the 2 health and stability of the marine ecosystem, within 120 3 days of the enactment of this section, the Secretary of 4 Commerce shall issue a waiver pursuant to section 5 101(a)(3)(A) and this section to section 101(a) and sec6 tion 102(a) of the Act, for such projects that will remain 7 in effect for the duration of the construction, operations 8 and maintenance of the projects. No rulemaking, permit, 9 determination, or other condition or limitation shall be re10 quired when issuing a waiver pursuant to this section. 11 (b) Upon issuance of a waiver pursuant to this sec- 12 tion, the State of Louisiana shall, in consultation with the 13 Secretary of Commerce: 14 (1) To the extent practicable and consistent 15 with the purposes of the projects, minimize impacts 16 on marine mammal species and population stocks; 17 and 18 19 February 7, 2018 (10:12 p.m.) (2) Monitor and evaluate the impacts of the projects on such species and population stocks. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 22 1 TITLE III 2 DEPARTMENT OF DEFENSE 3 DEPARTMENT OF DEFENSE—MILITARY 4 OPERATION AND MAINTENANCE 5 OPERATION 6 AND MAINTENANCE, ARMY For an additional amount for ‘‘Operation and Main- 7 tenance, Army’’, $20,110,000, for necessary expenses re8 lated to the consequences of Hurricanes Harvey, Irma, 9 and Maria: Provided, That such amount is designated by 10 the Congress as being for an emergency requirement pur11 suant to section 251(b)(2)(A)(i) of the Balanced Budget 12 and Emergency Deficit Control Act of 1985. 13 14 OPERATION AND MAINTENANCE, NAVY For an additional amount for ‘‘Operation and Main- 15 tenance, Navy’’, $267,796,000, for necessary expenses re16 lated to the consequences of Hurricanes Harvey, Irma, 17 and Maria: Provided, That such amount is designated by 18 the Congress as being for an emergency requirement pur19 suant to section 251(b)(2)(A)(i) of the Balanced Budget 20 and Emergency Deficit Control Act of 1985. 21 OPERATION 22 For an additional amount for ‘‘Operation and Main- AND MAINTENANCE, MARINE CORPS 23 tenance, Marine Corps’’, $17,920,000, for necessary ex24 penses related to the consequences of Hurricanes Harvey, 25 Irma, and Maria: Provided, That such amount is des- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 23 1 ignated by the Congress as being for an emergency re2 quirement pursuant to section 251(b)(2)(A)(i) of the Bal3 anced Budget and Emergency Deficit Control Act of 1985. 4 5 OPERATION AND MAINTENANCE, AIR FORCE For an additional amount for ‘‘Operation and Main- 6 tenance, Air Force’’, $20,916,000, for necessary expenses 7 related to the consequences of Hurricanes Harvey, Irma, 8 and Maria: Provided, That such amount is designated by 9 the Congress as being for an emergency requirement pur10 suant to section 251(b)(2)(A)(i) of the Balanced Budget 11 and Emergency Deficit Control Act of 1985. 12 13 OPERATION AND MAINTENANCE, DEFENSE-WIDE For an additional amount for ‘‘Operation and Main- 14 tenance, Defense-Wide’’, $2,650,000, for necessary ex15 penses related to the consequences of Hurricanes Harvey, 16 Irma, and Maria: Provided, That such amount is des17 ignated by the Congress as being for an emergency re18 quirement pursuant to section 251(b)(2)(A)(i) of the Bal19 anced Budget and Emergency Deficit Control Act of 1985. 20 OPERATION 21 For an additional amount for ‘‘Operation and Main- AND MAINTENANCE, ARMY RESERVE 22 tenance, Army Reserve’’, $12,500,000, for necessary ex23 penses related to the consequences of Hurricanes Harvey, 24 Irma, and Maria: Provided, That such amount is des25 ignated by the Congress as being for an emergency re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 24 1 quirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985. 3 OPERATION 4 For an additional amount for ‘‘Operation and Main- AND MAINTENANCE, NAVY RESERVE 5 tenance, Navy Reserve’’, $2,922,000, for necessary ex6 penses related to the consequences of Hurricanes Harvey, 7 Irma, and Maria: Provided, That such amount is des8 ignated by the Congress as being for an emergency re9 quirement pursuant to section 251(b)(2)(A)(i) of the Bal10 anced Budget and Emergency Deficit Control Act of 1985. 11 OPERATION 12 AND MAINTENANCE, AIR FORCE RESERVE For an additional amount for ‘‘Operation and Main- 13 tenance, Air Force Reserve’’, $5,770,000, for necessary 14 expenses related to the consequences of Hurricanes Har15 vey, Irma, and Maria: Provided, That such amount is des16 ignated by the Congress as being for an emergency re17 quirement pursuant to section 251(b)(2)(A)(i) of the Bal18 anced Budget and Emergency Deficit Control Act of 1985. 19 20 21 OPERATION AND MAINTENANCE, ARMY NATIONAL GUARD For an additional amount for ‘‘Operation and Main- 22 tenance, Army National Guard’’, $55,471,000, for nec23 essary expenses related to the consequences of Hurricanes 24 Harvey, Irma, and Maria: Provided, That such amount is 25 designated by the Congress as being for an emergency re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 25 1 quirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985. 3 PROCUREMENT 4 OTHER PROCUREMENT, NAVY 5 For an additional amount for ‘‘Other Procurement, 6 Navy’’ $18,000,000, to remain available until September 7 30, 2020, for necessary expenses related to the con8 sequences of Hurricanes Harvey, Irma, and Maria: Pro9 vided, That such amount is designated by the Congress 10 as being for an emergency requirement pursuant to sec11 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer12 gency Deficit Control Act of 1985. 13 REVOLVING AND MANAGEMENT FUNDS 14 DEFENSE WORKING CAPITAL FUNDS 15 For an additional amount for ‘‘Defense Working 16 Capital Funds’’ for the Navy Working Capital Fund, 17 $9,486,000, for necessary expenses related to the con18 sequences of Hurricanes Harvey, Irma, and Maria: Pro19 vided, That such amount is designated by the Congress 20 as being for an emergency requirement pursuant to sec21 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer22 gency Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 26 1 OTHER DEPARTMENT OF DEFENSE PROGRAMS 2 3 DEFENSE HEALTH PROGRAM For an additional amount for operation and mainte- 4 nance for ‘‘Defense Health Program’’, $704,000, for nec5 essary expenses related to the consequences of Hurricanes 6 Harvey, Irma, and Maria: Provided, That such amount is 7 designated by the Congress as being for an emergency re8 quirement pursuant to section 251(b)(2)(A)(i) of the Bal9 anced Budget and Emergency Deficit Control Act of 1985. 10 TITLE IV 11 CORPS OF ENGINEERS—CIVIL 12 DEPARTMENT OF THE ARMY 13 INVESTIGATIONS 14 For an additional amount for ‘‘Investigations’’ for 15 necessary expenses related to the completion, or initiation 16 and completion, of flood and storm damage reduction, in17 cluding shore protection, studies which are currently au18 thorized or which are authorized after the date of enact19 ment of this subdivision, to reduce risk from future floods 20 and hurricanes, at full Federal expense, $135,000,000, to 21 remain available until expended: Provided, That of such 22 amount, not less than $75,000,000 is available for such 23 studies in States and insular areas that were impacted by 24 Hurricanes Harvey, Irma, and Maria: Provided further, 25 That funds made available under this heading shall be for February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 27 1 high-priority studies of projects in States and insular 2 areas with more than one flood-related major disaster de3 clared pursuant to the Robert T. Stafford Disaster Relief 4 and Emergency Assistance Act (42 U.S.C. 5121 et seq.) 5 in calendar years 2014, 2015, 2016, or 2017: Provided 6 further, That such amount is designated by the Congress 7 as being for an emergency requirement pursuant to sec8 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer9 gency Deficit Control Act of 1985: Provided further, That 10 the Assistant Secretary of the Army for Civil Works shall 11 provide a monthly report to the Committees on Appropria12 tions of the House of Representatives and the Senate de13 tailing the allocation and obligation of these funds, includ14 ing new studies selected to be initiated using funds pro15 vided under this heading, beginning not later than 60 days 16 after the enactment of this subdivision. 17 18 CONSTRUCTION For an additional amount for ‘‘Construction’’ for nec- 19 essary expenses to address emergency situations at Corps 20 of Engineers projects, and to construct, and rehabilitate 21 and repair damages caused by natural disasters, to Corps 22 of Engineers projects, $15,055,000,000, to remain avail23 able until expended: Provided, That of such amount, 24 $15,000,000,000 is available to construct flood and storm 25 damage reduction, including shore protection, projects February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 28 1 which are currently authorized or which are authorized 2 after the date of enactment of this subdivision, and flood 3 and storm damage reduction, including shore protection, 4 projects which have signed Chief’s Reports as of the date 5 of enactment of this subdivision or which are studied using 6 funds provided under the heading ‘‘Investigations’’ if the 7 Secretary determines such projects to be technically fea8 sible, economically justified, and environmentally accept9 able, in States and insular areas with more than one flood10 related major disaster declared pursuant to the Robert T. 11 Stafford Disaster Relief and Emergency Assistance Act 12 (42 U.S.C. 5121 et seq.) in calendar years 2014, 2015, 13 2016, or 2017: Provided further, That of the amounts in 14 the preceding proviso, not less than $10,425,000,000 shall 15 be available for such projects within States and insular 16 areas that were impacted by Hurricanes Harvey, Irma, 17 and Maria: Provided further, That all repair, rehabilita18 tion, study, design, and construction of Corps of Engi19 neers projects in Puerto Rico and the United States Virgin 20 Islands, using funds provided under this heading, shall be 21 conducted at full Federal expense: Provided further, That 22 for projects receiving funding under this heading, the pro23 visions of section 902 of the Water Resources Develop24 ment Act of 1986 shall not apply to these funds: Provided 25 further, That the completion of ongoing construction February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 29 1 projects receiving funds provided under this heading shall 2 be at full Federal expense with respect to such funds: Pro3 vided further, That using funds provided under this head4 ing, the non-Federal cash contribution for projects eligible 5 for funding pursuant to the first proviso shall be financed 6 in accordance with the provisions of section 103(k) of Pub7 lic Law 99–662 over a period of 30 years from the date 8 of completion of the project or separable element: Provided 9 further, That up to $50,000,000 of the funds made avail10 able under this heading shall be used for continuing au11 thorities projects to reduce the risk of flooding and storm 12 damage: Provided further, That any projects using funds 13 appropriated under this heading shall be initiated only 14 after non-Federal interests have entered into binding 15 agreements with the Secretary requiring, where applicable, 16 the non-Federal interests to pay 100 percent of the oper17 ation, maintenance, repair, replacement, and rehabilita18 tion costs of the project and to hold and save the United 19 States free from damages due to the construction or oper20 ation and maintenance of the project, except for damages 21 due to the fault or negligence of the United States or its 22 contractors: Provided further, That such amount is des23 ignated by the Congress as being for an emergency re24 quirement pursuant to section 251(b)(2)(A)(i) of the Bal25 anced Budget and Emergency Deficit Control Act of 1985: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 30 1 Provided further, That the Assistant Secretary of the 2 Army for Civil Works shall provide a monthly report to 3 the Committees on Appropriations of the House of Rep4 resentatives and the Senate detailing the allocation and 5 obligation of these funds, beginning not later than 60 days 6 after the enactment of this subdivision. 7 8 MISSISSIPPI RIVER AND TRIBUTARIES For an additional amount for ‘‘Mississippi River and 9 Tributaries’’ for necessary expenses to address emergency 10 situations at Corps of Engineers projects, and to con11 struct, and rehabilitate and repair damages to Corps of 12 Engineers projects, caused by natural disasters, 13 $770,000,000, to remain available until expended: Pro14 vided, That of such amount, $400,000,000 is available to 15 construct flood and storm damage reduction projects 16 which are currently authorized or which are authorized 17 after the date of enactment of this subdivision: Provided 18 further, That such amount is designated by the Congress 19 as being for an emergency requirement pursuant to sec20 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer21 gency Deficit Control Act of 1985: Provided further, That 22 the Assistant Secretary of the Army for Civil Works shall 23 provide a monthly report to the Committees on Appropria24 tions of the House of Representatives and the Senate de25 tailing the allocation and obligation of these funds, begin- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 31 1 ning not later than 60 days after the enactment of this 2 subdivision. 3 4 OPERATION AND MAINTENANCE For an additional amount for ‘‘Operation and Main- 5 tenance’’ for necessary expenses to dredge Federal naviga6 tion projects in response to, and repair damages to Corps 7 of Engineers Federal projects caused by, natural disasters, 8 $608,000,000, to remain available until expended, of 9 which such sums as are necessary to cover the Federal 10 share of eligible operation and maintenance costs for 11 coastal harbors and channels, and for inland harbors shall 12 be derived from the Harbor Maintenance Trust Fund: 13 Provided, That such amount is designated by the Congress 14 as being for an emergency requirement pursuant to sec15 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer16 gency Deficit Control Act of 1985: Provided further, That 17 the Assistant Secretary of the Army for Civil Works shall 18 provide a monthly report to the Committees on Appropria19 tions of the House of Representatives and the Senate de20 tailing the allocation and obligation of these funds, begin21 ning not later than 60 days after the enactment of this 22 subdivision. 23 24 FLOOD CONTROL AND COASTAL EMERGENCIES For an additional amount for ‘‘Flood Control and 25 Coastal Emergencies’’, as authorized by section 5 of the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 32 1 Act of August 18, 1941 (33 U.S.C. 701n), for necessary 2 expenses to prepare for flood, hurricane and other natural 3 disasters and support emergency operations, repairs, and 4 other activities in response to such disasters, as authorized 5 by law, $810,000,000, to remain available until expended: 6 Provided, That funding utilized for authorized shore pro7 tection projects shall restore such projects to the full 8 project profile at full Federal expense: Provided further, 9 That such amount is designated by the Congress as being 10 for an emergency requirement pursuant to section 11 251(b)(2)(A)(i) of the Balanced Budget and Emergency 12 Deficit Control Act of 1985: Provided further, That the 13 Assistant Secretary of the Army for Civil Works shall pro14 vide a monthly report to the Committees on Appropria15 tions of the House of Representatives and the Senate de16 tailing the allocation and obligation of these funds, begin17 ning not later than 60 days after the enactment of this 18 subdivision. 19 20 EXPENSES For an additional amount for ‘‘Expenses’’ for nec- 21 essary expenses to administer and oversee the obligation 22 and expenditure of amounts provided in this title for the 23 Corps of Engineers, $20,000,000, to remain available 24 until expended: Provided, That such amount is designated 25 by the Congress as being for an emergency requirement February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 33 1 pursuant to section 251(b)(2)(A)(i) of the Balanced Budg2 et and Emergency Deficit Control Act of 1985: Provided 3 further, That the Assistant Secretary of the Army for Civil 4 Works shall provide a monthly report to the Committees 5 on Appropriations of the House of Representatives and the 6 Senate detailing the allocation and obligation of these 7 funds, beginning not later than 60 days after enactment 8 of this subdivision. 9 DEPARTMENT OF ENERGY 10 ENERGY PROGRAMS 11 ELECTRICITY DELIVERY 12 AND ENERGY RELIABILITY For an additional amount for ‘‘Electricity Delivery 13 and Energy Reliability’’, $13,000,000, to remain available 14 until expended, for necessary expenses related to the con15 sequences of Hurricanes Harvey, Irma, and Maria, includ16 ing technical assistance related to electric grids: Provided, 17 That such amount is designated by the Congress as being 18 for an emergency requirement pursuant to section 19 251(b)(2)(A)(i) of the Balanced Budget and Emergency 20 Deficit Control Act of 1985. 21 22 STRATEGIC PETROLEUM RESERVE For an additional amount for ‘‘Strategic Petroleum 23 Reserve’’, $8,716,000, to remain available until expended, 24 for necessary expenses related to damages caused by Hur25 ricanes Harvey, Irma, and Maria: Provided, That such February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 34 1 amount is designated by the Congress as being for an 2 emergency requirement pursuant to section 3 251(b)(2)(A)(i) of the Balanced Budget and Emergency 4 Deficit Control Act of 1985. 5 6 GENERAL PROVISIONS—THIS TITLE SEC. 20401. In fiscal year 2018, and each fiscal year 7 thereafter, the Chief of Engineers of the U.S. Army Corps 8 of Engineers shall transmit to the Congress, after reason9 able opportunity for comment, but without change, by the 10 Assistant Secretary of the Army for Civil Works, a month11 ly report, the first of which shall be transmitted to Con12 gress not later than 2 days after the date of enactment 13 of this subdivision and monthly thereafter, which includes 14 detailed estimates of damages to each Corps of Engineers 15 project, caused by natural disasters or otherwise. 16 SEC. 20402. From the unobligated balances of 17 amounts made available to the U.S. Army Corps of Engi18 neers, $518,900,000 under the heading ‘‘Corps of Engi19 neers—Civil, Flood Control and Coastal Emergencies’’ 20 and $210,000,000 under the heading ‘‘Corps of Engi21 neers—Civil, Operations and Maintenance’’ in title X of 22 the Disaster Relief Appropriations Act, 2013 (Public Law 23 113–2; 127 Stat. 25) shall be transferred to ‘‘Corps of 24 Engineers—Civil, Construction’’, to remain available until 25 expended, to rehabilitate, repair and construct Corps of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 35 1 Engineers projects: Provided, That those projects may 2 only include construction expenses, including cost sharing, 3 as described under the heading ‘‘Corps of Engineers— 4 Civil, Construction’’ in title X of that Act or other con5 struction expenses related to the consequences of Hurri6 cane Sandy: Provided further, That amounts transferred 7 pursuant to this section that were previously designated 8 by the Congress as an emergency requirement pursuant 9 to the Balanced Budget and Emergency Deficit Control 10 Act are designated by the Congress as an emergency re11 quirement pursuant to section 251(b)(2)(A)(i) of the Bal12 anced Budget and Emergency Deficit Control Act of 1985: 13 Provided further, That the Assistant Secretary of the 14 Army for Civil Works shall provide a monthly report to 15 the Committees on Appropriations of the House of Rep16 resentatives and the Senate detailing the allocation and 17 obligation of these funds, beginning not later than 60 days 18 after the enactment of this subdivision. 19 TITLE V 20 INDEPENDENT AGENCIES 21 GENERAL SERVICES ADMINISTRATION 22 REAL PROPERTY ACTIVITIES 23 FEDERAL BUILDINGS FUND 24 For an additional amount to be deposited in the 25 ‘‘Federal Buildings Fund’’, $126,951,000, to remain February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 36 1 available until expended, for necessary expenses related to 2 the consequences of Hurricanes Harvey, Maria, and Irma 3 for repair and alteration of buildings under the custody 4 and control of the Administrator of General Services, and 5 real property management and related activities not other6 wise provided for: Provided, That funds may be used to 7 reimburse the ‘‘Federal Buildings Fund’’ for obligations 8 incurred for this purpose prior to enactment of this sub9 division: Provided further, That not more than 10 $15,000,000 shall be available for tenant improvements 11 in damaged U.S. courthouses: Provided further, That such 12 amount is designated by the Congress as being for an 13 emergency requirement pursuant to section 14 251(b)(2)(A)(i) of the Balanced Budget and Emergency 15 Deficit Control Act of 1985. 16 SMALL BUSINESS ADMINISTRATION 17 OFFICE OF INSPECTOR GENERAL 18 For an additional amount for the ‘‘Office of Inspector 19 General’’, $7,000,000, to remain available until expended: 20 Provided, That such amount is designated by the Congress 21 as being for an emergency requirement pursuant to sec22 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer23 gency Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 37 1 DISASTER LOANS PROGRAM ACCOUNT 2 (INCLUDING TRANSFER OF FUNDS) 3 For an additional amount for the ‘‘Disaster Loans 4 Program Account’’ for the cost of direct loans authorized 5 by section 7(b) of the Small Business Act, 6 $1,652,000,000, to remain available until expended: Pro7 vided, That up to $618,000,000 may be transferred to and 8 merged with ‘‘Salaries and Expenses’’ for administrative 9 expenses to carry out the disaster loan program authorized 10 by section 7(b) of the Small Business Act: Provided fur11 ther, That none of the funds provided under this heading 12 may be used for indirect administrative expenses: Provided 13 further, That the amount provided under this heading is 14 designated by the Congress as being for an emergency re15 quirement pursuant to section 251(b)(2)(A)(i) of the Bal16 anced Budget and Emergency Deficit Control Act of 1985. 17 TITLE VI 18 DEPARTMENT OF HOMELAND SECURITY 19 DEPARTMENTAL MANAGEMENT, OPERATIONS, 20 INTELLIGENCE, AND OVERSIGHT 21 22 23 OFFICE OF INSPECTOR GENERAL OPERATIONS AND SUPPORT For an additional amount for ‘‘Operations and Sup- 24 port’’ for necessary expenses related to the consequences 25 of Hurricanes Harvey, Irma, and Maria, $25,000,000, to February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 38 1 remain available until September 30, 2020, for audits and 2 investigations of activities funded by this title: Provided, 3 That such amount is designated by the Congress as being 4 for an emergency requirement pursuant to section 5 251(b)(2)(A)(i) of the Balanced Budget and Emergency 6 Deficit Control Act of 1985. 7 SECURITY, ENFORCEMENT, AND 8 INVESTIGATIONS 9 U.S. CUSTOMS 10 11 AND BORDER PROTECTION OPERATIONS AND SUPPORT For an additional amount for ‘‘Operations and Sup- 12 port’’ for necessary expenses related to the consequences 13 of Hurricanes Harvey, Irma, and Maria, $104,494,000, 14 to remain available until September 30, 2019: Provided, 15 That such amount is designated by the Congress as being 16 for an emergency requirement pursuant to section 17 251(b)(2)(A)(i) of the Balanced Budget and Emergency 18 Deficit Control Act of 1985: Provided further, That not 19 more than $39,400,000 may be used to carry out U.S. 20 Customs and Border Protection activities in fiscal year 21 2018 in Puerto Rico and the United States Virgin Islands, 22 in addition to any other amounts available for such pur23 poses. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 39 1 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS 2 For an additional amount for ‘‘Procurement, Con- 3 struction, and Improvements’’ for necessary expenses re4 lated to the consequences of Hurricanes Harvey, Irma, 5 and Maria, including for the reconstruction of facilities af6 fected, $45,000,000, to remain available until September 7 30, 2022: Provided, That such amount is designated by 8 the Congress as being for an emergency requirement pur9 suant to section 251(b)(2)(A)(i) of the Balanced Budget 10 and Emergency Deficit Control Act of 1985: Provided fur11 ther, That funds are provided to carry out U.S. Customs 12 and Border Protection activities in Puerto Rico and the 13 United States Virgin Islands, in addition to any other 14 amounts available for such purposes. 15 16 17 U.S. IMMIGRATION AND CUSTOMS ENFORCEMENT OPERATIONS AND SUPPORT For an additional amount for ‘‘Operations and Sup- 18 port’’ for necessary expenses related to the consequences 19 of Hurricanes Harvey, Irma, and Maria, $30,905,000, to 20 remain available until September 30, 2019: Provided, 21 That such amount is designated by the Congress as being 22 for an emergency requirement pursuant to section 23 251(b)(2)(A)(i) of the Balanced Budget and Emergency 24 Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 40 1 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS 2 For an additional amount for ‘‘Procurement, Con- 3 struction, and Improvements’’ for necessary expenses re4 lated to the consequences of Hurricanes Harvey, Irma, 5 and Maria, $33,052,000, to remain available until Sep6 tember 30, 2022: Provided, That such amount is des7 ignated by the Congress as being for an emergency re8 quirement pursuant to section 251(b)(2)(A)(i) of the Bal9 anced Budget and Emergency Deficit Control Act of 1985. 10 TRANSPORTATION SECURITY ADMINISTRATION 11 OPERATIONS AND SUPPORT 12 For an additional amount for ‘‘Operations and Sup- 13 port’’ for necessary expenses related to the consequences 14 of Hurricanes Harvey, Irma, and Maria, $10,322,000, to 15 remain available until September 30, 2019: Provided, 16 That such amount is designated by the Congress as being 17 for an emergency requirement pursuant to section 18 251(b)(2)(A)(i) of the Balanced Budget and Emergency 19 Deficit Control Act of 1985. 20 COAST GUARD 21 OPERATING EXPENSES 22 For an additional amount for ‘‘Operating Expenses’’ 23 for necessary expenses related to the consequences of Hur24 ricanes Harvey, Irma, and Maria, $112,136,000, to re25 main available until September 30, 2019: Provided, That February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 41 1 such amount is designated by the Congress as being for 2 an emergency requirement pursuant to section 3 251(b)(2)(A)(i) of the Balanced Budget and Emergency 4 Deficit Control Act of 1985. 5 ENVIRONMENTAL COMPLIANCE AND RESTORATION 6 For an additional amount for ‘‘Environmental Com- 7 pliance and Restoration’’ for necessary expenses related 8 to the consequences of Hurricanes Harvey, Irma, and 9 Maria, $4,038,000, to remain available until September 10 30, 2022: Provided, That such amount is designated by 11 the Congress as being for an emergency requirement pur12 suant to section 251(b)(2)(A)(i) of the Balanced Budget 13 and Emergency Deficit Control Act of 1985. 14 ACQUISITION, CONSTRUCTION, AND IMPROVEMENTS 15 For an additional amount for Acquisition, Construc- 16 tion, and Improvements’’ for necessary expenses related 17 to the consequences of Hurricanes Harvey, Irma, Maria, 18 and Matthew, $718,919,000, to remain available until 19 September 30, 2022: Provided, That, not later than 60 20 days after enactment of this subdivision, the Secretary of 21 Homeland Security, or her designee, shall submit to the 22 Committees on Appropriations of the House of Represent23 atives and the Senate a detailed expenditure plan for 24 funds appropriated under this heading: Provided further, 25 That such amount is designated by the Congress as being February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 42 1 for an emergency requirement pursuant to section 2 251(b)(2)(A)(i) of the Balanced Budget and Emergency 3 Deficit Control Act of 1985. 4 PROTECTION, PREPAREDNESS, RESPONSE, AND 5 RECOVERY 6 FEDERAL EMERGENCY MANAGEMENT AGENCY 7 OPERATIONS AND SUPPORT 8 For an additional amount for ‘‘Operations and Sup- 9 port’’ for necessary expenses related to the consequences 10 of Hurricanes Harvey, Irma, and Maria, $58,800,000, to 11 remain available until September 30, 2019: Provided, 12 That such amount is designated by the Congress as being 13 for an emergency requirement pursuant to section 14 251(b)(2)(A)(i) of the Balanced Budget and Emergency 15 Deficit Control Act of 1985. 16 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS 17 For an additional amount for ‘‘Procurement, Con- 18 struction, and Improvements’’ for necessary expenses re19 lated to the consequences of Hurricanes Harvey, Irma, 20 and Maria, $1,200,000, to remain available until Sep21 tember 30, 2020: Provided, That such amount is des22 ignated by the Congress as being for an emergency re23 quirement pursuant to section 251(b)(2)(A)(i) of the Bal24 anced Budget and Emergency Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 43 1 2 DISASTER RELIEF FUND For an additional amount for ‘‘Disaster Relief Fund’’ 3 for major disasters declared pursuant to the Robert T. 4 Stafford Disaster Relief and Emergency Assistance Act 5 (42 U.S.C. 5121 et seq.), $23,500,000,000, to remain 6 available until expended: Provided, That the Adminis7 trator of the Federal Emergency Management Agency 8 shall publish on the Agency’s website not later than 5 days 9 after an award of a public assistance grant under section 10 406 or 428 of the Robert T. Stafford Disaster Relief and 11 Emergency Assistance Act (42 U.S.C. 5172 or 5189f) that 12 is in excess of $1,000,000, the specifics of each such grant 13 award: Provided further, That for any mission assignment 14 or mission assignment task order to another Federal de15 partment or agency regarding a major disaster in excess 16 of $1,000,000, not later than 5 days after the issuance 17 of such mission assignment or mission assignment task 18 order, the Administrator shall publish on the Agency’s 19 website the following: the name of the impacted State, the 20 disaster declaration for such State, the assigned agency, 21 the assistance requested, a description of the disaster, the 22 total cost estimate, and the amount obligated: Provided 23 further, That not later than 10 days after the last day 24 of each month until a mission assignment or mission as25 signment task order described in the preceding proviso is February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 44 1 completed and closed out, the Administrator shall update 2 any changes to the total cost estimate and the amount 3 obligated: Provided further, That for a disaster declaration 4 related to Hurricanes Harvey, Irma, or Maria, the Admin5 istrator shall submit to the Committees on Appropriations 6 of the House of Representatives and the Senate, not later 7 than 5 days after the first day of each month beginning 8 after the date of enactment of this subdivision, and shall 9 publish on the Agency’s website, not later than 10 days 10 after the first day of each such month, an estimate or ac11 tual amount, if available, for the current fiscal year of the 12 cost of the following categories of spending: public assist13 ance, individual assistance, operations, mitigation, admin14 istrative, and any other relevant category (including emer15 gency measures and disaster resources): Provided, further, 16 That not later than 10 days after the first day of each 17 month, the Administrator shall publish on the Agency’s 18 website the report (referred to as the Disaster Relief 19 Monthly Report) as required by Public Law 114–4: Pro20 vided further, That of the amounts provided under this 21 heading for the Disaster Relief Fund, up to $150,000,000 22 shall be transferred to the Disaster Assistance Direct 23 Loan Program Account for the cost to lend a territory 24 or possession of the United States that portion of assist25 ance for which the territory or possession is responsible February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 45 1 under the cost-sharing provisions of the major disaster 2 declaration for Hurricanes Irma or Maria, as authorized 3 under section 319 of the Robert T. Stafford Disaster Re4 lief and Emergency Assistance Act (42 U.S.C. 5162): Pro5 vided further, That of the amount provided under this 6 paragraph for transfer, up to $1,000,000 may be trans7 ferred to the Disaster Assistance Direct Loan Program 8 Account for administrative expenses to carry out the Ad9 vance of Non-Federal Share program, as authorized by 10 section 319 of the Robert T. Stafford Disaster Relief and 11 Emergency Assistance Act (42 U.S.C. 5162): Provided 12 further, That such amount is designated by the Congress 13 as being for an emergency requirement pursuant to sec14 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer15 gency Deficit Control Act of 1985. 16 RESEARCH, DEVELOPMENT, TRAINING, AND 17 SERVICES 18 FEDERAL LAW ENFORCEMENT TRAINING CENTERS 19 OPERATIONS AND SUPPORT 20 For an additional amount for ‘‘Operations and Sup- 21 port’’ for necessary expenses related to the consequences 22 of Hurricanes Harvey, Irma, and Maria, $5,374,000, to 23 remain available until September 30, 2019: Provided, 24 That such amount is designated by the Congress as being 25 for an emergency requirement pursuant to section February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 46 1 251(b)(2)(A)(i) of the Balanced Budget and Emergency 2 Deficit Control Act of 1985. 3 PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS 4 For an additional amount for ‘‘Procurement, Con- 5 struction, and Improvements’’ for necessary expenses re6 lated to the consequences of Hurricanes Harvey, Irma, 7 and Maria, $5,000,000, to remain available until Sep8 tember 30, 2022: Provided, That such amount is des9 ignated by the Congress as being for an emergency re10 quirement pursuant to section 251(b)(2)(A)(i) of the Bal11 anced Budget and Emergency Deficit Control Act of 1985. 12 13 GENERAL PROVISIONS—THIS TITLE SEC. 20601. The Administrator of the Federal Emer- 14 gency Management Agency may provide assistance, pursu15 ant to section 428 of the Robert T. Stafford Disaster Re16 lief and Emergency Assistance Act (42 U.S.C. 5121 et 17 seq.), for critical services as defined in section 406 of the 18 Robert T. Stafford Disaster Relief and Emergency Assist19 ance Act for the duration of the recovery for incidents 20 DR–4336–PR, DR–4339–PR, DR–4340-USVI, and DR– 21 4335–USVI to— 22 (1) replace or restore the function of a facility 23 or system to industry standards without regard to 24 the pre-disaster condition of the facility or system; 25 and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 47 1 (2) replace or restore components of the facility 2 or system not damaged by the disaster where nec- 3 essary to fully effectuate the replacement or restora- 4 tion of disaster-damaged components to restore the 5 function of the facility or system to industry stand- 6 ards. 7 SEC. 20602. Notwithstanding section 404 or 420 of 8 the Robert T. Stafford Disaster Relief and Emergency As9 sistance Act (42 U.S.C. 5170c and 8187), for fiscal years 10 2017 and 2018, the President shall provide hazard mitiga11 tion assistance in accordance with such section 404 in any 12 area in which assistance was provided under such section 13 420. 14 SEC. 20603. The third proviso of the second para- 15 graph in title I of Public Law 115–72 under the heading 16 ‘‘Federal Emergency Management Agency—Disaster Re17 lief Fund’’ shall be amended by striking ‘‘180 days’’ and 18 inserting ‘‘365 days’’: Provided, That amounts repurposed 19 pursuant to this section that were previously designated 20 by the Congress as an emergency requirement pursuant 21 to the Balanced Budget and Emergency Deficit Control 22 Act are designated by the Congress as an emergency re23 quirement pursuant to section 251(b)(2)(A)(i) of the Bal24 anced Budget and Emergency Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 48 1 2 SEC. 20604. (a) DEFINITION PROFIT OF PRIVATE NON- FACILITY.—Section 102(11)(B) of the Robert T. 3 Stafford Disaster Relief and Emergency Assistance Act 4 (42 U.S.C. 5122(11)(B)) is amended to read as follows: 5 ‘‘(A) IN GENERAL.—The term ‘private 6 nonprofit facility’ means private nonprofit edu- 7 cational (without regard to the religious char- 8 acter of the facility), utility, irrigation, emer- 9 gency, medical, rehabilitational, and temporary 10 or permanent custodial care facilities (including 11 those for the aged and disabled) and facilities 12 on Indian reservations, as defined by the Presi- 13 dent. 14 ‘‘(B) ADDITIONAL FACILITIES.—In addi- 15 tion to the facilities described in subparagraph 16 (A), the term ‘private nonprofit facility’ in- 17 cludes any private nonprofit facility that pro- 18 vides essential social services to the general 19 public (including museums, zoos, performing 20 arts facilities, community arts centers, commu- 21 nity centers, libraries, homeless shelters, senior 22 citizen centers, rehabilitation facilities, shelter 23 workshops, broadcasting facilities, houses of 24 worship, and facilities that provide health and 25 safety services of a governmental nature), as February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 49 1 defined by the President. No house of worship 2 may be excluded from this definition because 3 leadership or membership in the organization 4 operating the house of worship is limited to per- 5 sons who share a religious faith or practice.’’. 6 (b) REPAIR, RESTORATION, AND REPLACEMENT OF 7 DAMAGED FACILITIES.—Section 406(a)(3) of the Robert 8 T. Stafford Disaster Relief and Emergency Assistance Act 9 (42 U.S.C. 5172(a)(3)) is amended by adding at the end 10 the following: 11 ‘‘(C) RELIGIOUS FACILITIES.—A church, 12 synagogue, mosque, temple, or other house of 13 worship, educational facility, or any other pri- 14 vate nonprofit facility, shall be eligible for con- 15 tributions under paragraph (1)(B), without re- 16 gard to the religious character of the facility or 17 the primary religious use of the facility. No 18 house of worship, educational facility, or any 19 other private nonprofit facility may be excluded 20 from receiving contributions under paragraph 21 (1)(B) because leadership or membership in the 22 organization operating the house of worship is 23 limited to persons who share a religious faith or 24 practice.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 50 1 (c) APPLICABILITY.—This section and the amend- 2 ments made by this section shall apply— 3 (1) to the provision of assistance in response to 4 a major disaster or emergency declared on or after 5 August 23, 2017; or 6 (2) with respect to— 7 (A) any application for assistance that, as 8 of the date of enactment of this Act, is pending 9 before Federal Emergency Management Agen- 10 cy; and 11 (B) any application for assistance that has 12 been denied, where a challenge to that denial is 13 not yet finally resolved as of the date of enact- 14 ment of this Act. 15 SEC. 20605. (a) The Federal share of assistance, in- 16 cluding direct Federal assistance, provided under section 17 407 of the Robert T. Stafford Disaster Relief and Emer18 gency Assistance Act (42 U.S.C. 5173), with respect to 19 a major disaster declared pursuant to such Act for dam20 ages resulting from a wildfire in calendar year 2017, shall 21 be 90 percent of the eligible costs under such section. 22 (b) The Federal share provided by subsection (a) 23 shall apply to assistance provided before, on, or after the 24 date of enactment of this Act. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 51 1 FEDERAL COST-SHARE ADJUSTMENTS FOR REPAIR, RES- 2 TORATION, AND REPLACEMENT OF DAMAGED FA- 3 CILITIES 4 SEC. 20606. Section 406(b) of the Robert T. Stafford 5 Disaster Relief and Emergency Assistance Act (42 U.S.C. 6 5172(b)) is amended by inserting after paragraph (2) the 7 following: 8 9 ‘‘(3) INCREASED FEDERAL SHARE.— ‘‘(A) INCENTIVE MEASURES.—The Presi- 10 dent may provide incentives to a State or Tribal 11 government to invest in measures that increase 12 readiness for, and resilience from, a major dis- 13 aster by recognizing such investments through 14 a sliding scale that increases the minimum Fed- 15 eral share to 85 percent. Such measures may 16 include— 17 18 ‘‘(i) the adoption of a mitigation plan approved under section 322; 19 ‘‘(ii) investments in disaster relief, in- 20 surance, and emergency management pro- 21 grams; 22 ‘‘(iii) encouraging the adoption and 23 enforcement of the latest published edi- 24 tions of relevant consensus-based codes, 25 specifications, and standards that incor- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 52 1 porate the latest hazard-resistant designs 2 and establish minimum acceptable criteria 3 for the design, construction, and mainte- 4 nance of residential structures and facili- 5 ties that may be eligible for assistance 6 under this Act for the purpose of pro- 7 tecting the health, safety, and general wel- 8 fare of the buildings’ users against disas- 9 ters; 10 11 ‘‘(iv) facilitating participation in the community rating system; and 12 ‘‘(v) funding mitigation projects or 13 granting tax incentives for projects that re- 14 duce risk. 15 ‘‘(B) COMPREHENSIVE GUIDANCE.—Not 16 later than 1 year after the date of enactment of 17 this paragraph, the President, acting through 18 the Administrator, shall issue comprehensive 19 guidance to State and Tribal governments re- 20 garding the measures and investments, weight- 21 ed appropriately based on actuarial assessments 22 of eligible actions, that will be recognized for 23 the purpose of increasing the Federal share 24 under this section. Guidance shall ensure that 25 the agency’s review of eligible measures and in- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 53 1 vestments does not unduly delay determining 2 the appropriate Federal cost share. 3 ‘‘(C) REPORT.—One year after the 4 issuance of the guidance required by subpara- 5 graph (B), the Administrator shall submit to 6 the Committee on Transportation and Infra- 7 structure of the House of Representatives and 8 the Committee on Homeland Security and Gov- 9 ernmental Affairs of the Senate a report re- 10 garding the analysis of the Federal cost shares 11 paid under this section. 12 ‘‘(D) SAVINGS CLAUSE.—Nothing in this 13 paragraph prevents the President from increas- 14 ing the Federal cost share above 85 percent.’’. 15 SEC. 20607. Division F of the Consolidated Appro- 16 priations Act, 2017, is amended by inserting the following 17 at the end of Title V: 18 ‘‘SEC. 545. (a) PREMIUM PAY AUTHORITY.—During 19 calendar year 2017, any premium pay that is funded, ei20 ther directly or through reimbursement, by the ‘Federal 21 Emergency Management Agency—Disaster Relief Fund’ 22 shall be exempted from the aggregate of basic pay and 23 premium pay calculated under section 5547(a) of title 5, 24 United States Code, and any other provision of law lim- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 54 1 iting the aggregate amount of premium pay payable on 2 a biweekly or calendar year basis. 3 ‘‘(b) OVERTIME AUTHORITY.—During calendar year 4 2017, any overtime that is funded, either directly or 5 through reimbursement, by the ‘Federal Emergency Man6 agement Agency—Disaster Relief Fund’ shall be exempt7 ed from any annual limit on the amount of overtime pay8 able in a calendar or fiscal year. 9 ‘‘(c) APPLICABILITY OF AGGREGATE LIMITATION ON 10 PAY.—In determining whether an employee’s pay exceeds 11 the applicable annual rate of basic pay payable under sec12 tion 5307 of title 5, United States Code, the head of an 13 Executive agency shall not include pay exempted under 14 this section. 15 ‘‘(d) LIMITATION OF PAY AUTHORITY.—Pay exempt- 16 ed from otherwise applicable limits under subsection (a) 17 shall not cause the aggregate pay earned for the calendar 18 year in which the exempted pay is earned to exceed the 19 rate of basic pay payable for a position at level II of the 20 Executive Schedule under section 5313 of title 5, United 21 States Code. 22 ‘‘(e) EFFECTIVE DATE.—This section shall take ef- 23 fect as if enacted on December 31, 2016.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 55 1 TITLE VII 2 DEPARTMENT OF THE INTERIOR 3 4 5 UNITED STATES FISH AND WILDLIFE SERVICE CONSTRUCTION For an additional amount for ‘‘Construction’’ for nec- 6 essary expenses related to the consequences of Hurricanes 7 Harvey, Irma, and Maria, $210,629,000, to remain avail8 able until expended: Provided, That such amount is des9 ignated by the Congress as being for an emergency re10 quirement pursuant to section 251(b)(2)(A)(i) of the Bal11 anced Budget and Emergency Deficit Control Act of 1985. 12 NATIONAL PARK SERVICE 13 HISTORIC PRESERVATION FUND 14 For an additional amount for the ‘‘Historic Preserva- 15 tion Fund’’ for necessary expenses related to the con16 sequences of Hurricanes Harvey, Irma, and Maria, 17 $50,000,000, to remain available until September 30, 18 2019, including costs to States and territories necessary 19 to complete compliance activities required by section 20 306108 of title 54, United States Code (formerly section 21 106 of the National Historic Preservation Act) and costs 22 needed to administer the program: Provided, That grants 23 shall only be available for areas that have received a major 24 disaster declaration pursuant to the Robert T. Stafford 25 Disaster Relief and Emergency Assistance Act (42 U.S.C. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 56 1 5121 et seq.): Provided further, That individual grants 2 shall not be subject to a non-Federal matching require3 ment: Provided further, That such amount is designated 4 by the Congress as being for an emergency requirement 5 pursuant to section 251(b)(2)(A)(i) of the Balanced Budg6 et and Emergency Deficit Control Act of 1985. 7 8 CONSTRUCTION For an additional amount for ‘‘Construction’’ for nec- 9 essary expenses related to the consequences of Hurricanes 10 Harvey, Irma, and Maria, $207,600,000, to remain avail11 able until expended: Provided, That such amount is des12 ignated by the Congress as being for an emergency re13 quirement pursuant to section 251(b)(2)(A)(i) of the Bal14 anced Budget and Emergency Deficit Control Act of 1985. 15 UNITED STATES GEOLOGICAL SURVEY 16 SURVEYS, INVESTIGATIONS, AND RESEARCH 17 For an additional amount for ‘‘Surveys, Investiga- 18 tions, and Research’’ for necessary expenses related to the 19 consequences of Hurricanes Harvey, Irma, and Maria, and 20 in those areas impacted by a major disaster declared pur21 suant to the Robert T. Stafford Disaster Relief and Emer22 gency Assistance Act (42 U.S.C. 5121 et seq.) with re23 spect to wildfires in 2017, $42,246,000, to remain avail24 able until expended: Provided, That such amount is des25 ignated by the Congress as being for an emergency re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 57 1 quirement pursuant to section 251(b)(2)(A)(i) of the Bal2 anced Budget and Emergency Deficit Control Act of 1985. 3 DEPARTMENTAL OFFICES 4 INSULAR AFFAIRS 5 ASSISTANCE TO TERRITORIES 6 For an additional amount for ‘‘Technical Assistance’’ 7 for financial management expenses related to the con8 sequences of Hurricanes Irma and Maria, $3,000,000, to 9 remain available until expended: Provided, That such 10 amount is designated by the Congress as being for an 11 emergency requirement pursuant to section 12 251(b)(2)(A)(i) of the Balanced Budget and Emergency 13 Deficit Control Act of 1985. 14 15 16 OFFICE OF INSPECTOR GENERAL SALARIES AND EXPENSES For an additional amount for ‘‘Salaries and Ex- 17 penses’’ for necessary expenses related to the con18 sequences of Hurricanes Harvey, Irma, and Maria, 19 $2,500,000, to remain available until expended: Provided, 20 That such amount is designated by the Congress as being 21 for an emergency requirement pursuant to section 22 251(b)(2)(A)(i) of the Balanced Budget and Emergency 23 Deficit Control Act of 1985. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 58 1 ENVIRONMENTAL PROTECTION AGENCY 2 HAZARDOUS SUBSTANCE SUPERFUND 3 For an additional amount for ‘‘Hazardous Substance 4 Superfund’’ for necessary expenses related to the con5 sequences of Hurricanes Harvey, Irma, and Maria, 6 $6,200,000, to remain available until expended: Provided, 7 That such amount is designated by the Congress as being 8 for an emergency requirement pursuant to section 9 251(b)(2)(A)(i) of the Balanced Budget and Emergency 10 Deficit Control Act of 1985. 11 LEAKING UNDERGROUND STORAGE TANK TRUST FUND 12 PROGRAM 13 For an additional amount for ‘‘Leaking Underground 14 Storage Tank Fund’’ for necessary expenses related to the 15 consequences of Hurricanes Harvey, Irma, and Maria, 16 $7,000,000, to remain available until expended: Provided, 17 That such amount is designated by the Congress as being 18 for an emergency requirement pursuant to section 19 251(b)(2)(A)(i) of the Balanced Budget and Emergency 20 Deficit Control Act of 1985. 21 22 STATE AND TRIBAL ASSISTANCE GRANTS For an additional amount for ‘‘State and Tribal As- 23 sistance Grants’’ for necessary expenses related to the con24 sequences of Hurricanes Harvey, Irma, and Maria for the 25 hazardous waste financial assistance grants program and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 59 1 for other solid waste management activities, $50,000,000, 2 to remain available until expended: Provided, That none 3 of these funds allocated within Region 2 shall be subject 4 to cost share requirements under section 3011(b) of the 5 Solid Waste Disposal Act: Provided further, That such 6 amount is designated by the Congress as being for an 7 emergency requirement pursuant to section 8 251(b)(2)(A)(i) of the Balanced Budget and Emergency 9 Deficit Control Act of 1985. 10 ADMINISTRATIVE PROVISION—ENVIRONMENTAL 11 PROTECTION AGENCY 12 Of amounts previously appropriated for capitalization 13 grants for the State Revolving Funds under title VI of 14 the Federal Water Pollution Control Act or under section 15 1452 of the Safe Drinking Water Act to a State or terri16 tory included as part of a disaster declaration related to 17 Hurricanes Irma and Maria, all existing grant funds that 18 are available but not drawn down shall not be subject to 19 the matching or cost share requirements of sections 20 602(b)(2), 602(b)(3) of the Federal Water Pollution Con21 trol Act nor the matching requirements of section 1452(e) 22 of the Safe Drinking Water Act and shall be awarded to 23 such state or territory: Provided, That, notwithstanding 24 the requirements of section 603(d) of the Federal Water 25 Pollution Control Act or section 1452(f) of the Safe February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 60 1 Drinking Water Act, the state or territory shall utilize the 2 full amount of such funds, excluding existing loans, to pro3 vide additional subsidization to eligible recipients in the 4 form of forgiveness of principal, negative interest loans or 5 grants or any combination of these: Provided further, That 6 such funds may be used for eligible projects whose purpose 7 is to repair damage incurred as a result of Hurricanes 8 Irma and Maria, reduce flood damage risk and vulner9 ability or to enhance resiliency to rapid hydrologic change 10 or a natural disaster at treatment works as defined by 11 section 212 of the Federal Water Pollution Control Act 12 or a public drinking water system under section 1452 of 13 the Safe Drinking Water Act: Provided further, That any 14 project involving the repair or replacement of a lead serv15 ice line shall replace the entire lead service line, not just 16 a portion. 17 RELATED AGENCIES 18 DEPARTMENT OF AGRICULTURE 19 FOREST SERVICE 20 STATE AND PRIVATE FORESTRY 21 For an additional amount for ‘‘State and Private 22 Forestry’’ for necessary expenses related to the con23 sequences of Hurricanes Harvey, Irma, and Maria, 24 $7,500,000, to remain available until expended: Provided, 25 That such amount is designated by the Congress as being February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 61 1 for an emergency requirement pursuant to section 2 251(b)(2)(A)(i) of the Balanced Budget and Emergency 3 Deficit Control Act of 1985. 4 5 NATIONAL FOREST SYSTEM For an additional amount for ‘‘National Forest Sys- 6 tem’’ for necessary expenses related to the consequences 7 of Hurricanes Harvey, Irma, and Maria, $20,652,000, to 8 remain available until expended: Provided, That such 9 amount is designated by the Congress as being for an 10 emergency requirement pursuant to section 11 251(b)(2)(A)(i) of the Balanced Budget and Emergency 12 Deficit Control Act of 1985. 13 14 CAPITAL IMPROVEMENT AND MAINTENANCE For an additional amount for ‘‘Capital Improvement 15 and Maintenance’’ for necessary expenses related to the 16 consequences of Hurricanes Harvey, Irma, and Maria, and 17 the 2017 fire season, $91,600,000, to remain available 18 until expended: Provided, That such amount is designated 19 by the Congress as being for an emergency requirement 20 pursuant to section 251(b)(2)(A)(i) of the Balanced Budg21 et and Emergency Deficit Control Act of 1985. 22 23 GENERAL PROVISION—THIS TITLE SEC. 20701. Agencies receiving funds appropriated 24 by this title shall each provide a monthly report to the 25 Committees on Appropriations of the House of Represent- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 62 1 atives and the Senate detailing the allocation and obliga2 tion of these funds by account, beginning not later than 3 90 days after enactment of this Act. 4 TITLE VIII 5 DEPARTMENT OF LABOR 6 EMPLOYMENT AND TRAINING ADMINISTRATION 7 TRAINING AND EMPLOYMENT SERVICES 8 (INCLUDING TRANSFERS OF FUNDS) 9 For an additional amount for ‘‘Training and Employ- 10 ment Services’’, $100,000,000, for the dislocated workers 11 assistance national reserve for necessary expenses directly 12 related to the consequences of Hurricanes Harvey, Maria, 13 and Irma and those jurisdictions that received a major dis14 aster declaration pursuant to the Robert T. Stafford Dis15 aster Relief and Emergency Assistance Act (42 U.S.C. 16 5121 et seq.) due to wildfires in 2017, which shall be avail17 able from the date of enactment of this subdivision 18 through September 30, 2019: Provided, That the Sec19 retary of Labor may transfer up to $2,500,000 of such 20 funds to any other Department of Labor account for re21 construction and recovery needs, including worker protec22 tion activities: Provided further, That these sums may be 23 used to replace grant funds previously obligated to the im24 pacted areas: Provided further, That of the amount pro25 vided, up to $500,000, to remain available until expended, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 63 1 shall be transferred to ‘‘Office of Inspector General’’for 2 oversight of activities responding to such hurricanes and 3 wildfires: Provided further, That such amount is des4 ignated by the Congress as being for an emergency re5 quirement pursuant to section 251(b)(2)(A)(i) of the Bal6 anced Budget and Emergency Deficit Control Act of 1985. 7 JOB CORPS 8 For an additional amount for ‘‘Job Corps’’ for con- 9 struction, rehabilitation and acquisition for Job Corps 10 Centers in Puerto Rico, $30,900,000, which shall be avail11 able upon the date of enactment of this subdivision and 12 remain available for obligation through June 30, 2021: 13 Provided, That such amount is designated by the Congress 14 as being for an emergency requirement pursuant to sec15 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer16 gency Deficit Control Act of 1985. 17 GENERAL PROVISIONS—DEPARTMENT OF LABOR 18 DEFERRAL OF INTEREST PAYMENTS FOR VIRGIN ISLANDS 19 SEC. 20801. Notwithstanding any other provision of 20 law, the interest payment of the Virgin Islands that was 21 due under section 1202(b)(1) of the Social Security Act 22 on September 29, 2017, shall not be due until September 23 28, 2018, and no interest shall accrue on such amount 24 through September 28, 2018: Provided, That such amount 25 is designated by the Congress as being for an emergency February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 64 1 requirement pursuant to section 251(b)(2)(A)(i) of the 2 Balanced Budget and Emergency Deficit Control Act of 3 1985. 4 5 FLEXIBILITY IN USE OF FUNDS UNDER WIOA SEC. 20802. (a) IN GENERAL.—Notwithstanding sec- 6 tion 133(b)(4) of the Workforce Innovation and Oppor7 tunity Act, in States, as defined by section 3(56) of such 8 Act, affected by Hurricanes Harvey, Irma, and Maria, a 9 local board, as defined by section 3(33) of such Act, in 10 a local area, as defined by section 3(32) of such Act, af11 fected by such Hurricanes may transfer, if such transfer 12 is approved by the Governor, up to 100 percent of the 13 funds allocated to the local area for Program Years 2016 14 and 2017 for Youth Workforce Investment activities under 15 paragraphs (2) or (3) of section 128(b) of such Act, for 16 Adult employment and training activities under para17 graphs (2)(A) or (3) of section 133(b) of such Act, or for 18 Dislocated Worker employment and training activities 19 under paragraph (2)(B) of section 133(b) of such Act 20 among— 21 (1) adult employment and training activities; 22 (2) dislocated worker employment and training 23 24 February 7, 2018 (10:12 p.m.) activities; and (3) youth workforce investment activities. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 65 1 (b) THE VIRGIN ISLANDS.—Except for the funds re- 2 served to carry out required statewide activities under sec3 tions 127(b) and 134(a)(2) of the Workforce Innovation 4 and Opportunity Act, the Governor of the Virgin Islands 5 may authorize the transfer of up to 100 percent of the 6 remaining funds provided to the Virgin Islands for Pro7 gram Years 2016 and 2017 for Youth Workforce Invest8 ment activities under section 127(b)(1)(B) of such Act, 9 for Adult employment and training activities under section 10 132(b)(1)(A) of such Act, or for Dislocated Worker em11 ployment and training activities under section 12 133(b)(2)(A) of such Act among— 13 (1) adult employment and training activities; 14 (2) dislocated worker employment and training 15 activities; and 16 (3) youth workforce investment activities. 17 DEPARTMENT OF HEALTH AND HUMAN 18 SERVICES 19 CENTERS FOR DISEASE CONTROL AND PREVENTION 20 CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT 21 (INCLUDING TRANSFER OF FUNDS) 22 For an additional amount for ‘‘CDC-Wide Activities 23 and Program Support’’, $200,000,000, to remain avail24 able until September 30, 2020, for response, recovery, 25 preparation, mitigation, and other expenses directly re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 66 1 lated to the consequences of Hurricanes Harvey, Irma, 2 and Maria: Provided, That obligations incurred for the 3 purposes provided herein prior to the date of enactment 4 of this subdivision may be charged to funds appropriated 5 by this paragraph: Provided further, That of the amount 6 provided, not less than $6,000,000 shall be transferred to 7 the ‘‘Buildings and Facilities’’ account for the purposes 8 provided herein: Provided further, That such amount is 9 designated by the Congress as being for an emergency re10 quirement pursuant to section 251(b)(2)(A)(i) of the Bal11 anced Budget and Emergency Deficit Control Act of 1985. 12 13 14 NATIONAL INSTITUTES OF HEALTH OFFICE OF THE DIRECTOR For an additional amount for fiscal year 2018 for 15 ‘‘Office of the Director’’, $50,000,000, to remain available 16 until September 30, 2020, for response, recovery, and 17 other expenses directly related to the consequences of 18 Hurricanes Harvey, Irma, and Maria: Provided, That obli19 gations incurred for these purposes prior to the date of 20 enactment of this subdivision may be charged to funds ap21 propriated by this paragraph: Provided further, That 22 funds appropriated by this paragraph may be used for 23 construction grants or contracts under section 404I of the 24 Public Health Service Act without regard to section 25 404I(c)(2): Provided further, That such amount is des- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 67 1 ignated by the Congress as being for an emergency re2 quirement pursuant to section 251(b)(2)(A)(i) of the Bal3 anced Budget and Emergency Deficit Control Act of 1985. 4 5 6 ADMINISTRATION FOR CHILDREN AND FAMILIES CHILDREN AND FAMILIES SERVICES PROGRAMS For an additional amount for ‘‘Children and Families 7 Services Programs’’, $650,000,000, to remain available 8 until September 30, 2021, for Head Start programs, for 9 necessary expenses directly related to the consequences of 10 Hurricanes Harvey, Irma, and Maria, including making 11 payments under the Head Start Act: Provided, That none 12 of the funds appropriated in this paragraph shall be in13 cluded in the calculation of the ‘‘base grant’’ in subsequent 14 fiscal years, as such term is defined in sections 15 640(a)(7)(A), 641A(h)(1)(B), or 645(d)(3) of the Head 16 Start Act: Provided further, That funds appropriated in 17 this paragraph are not subject to the allocation require18 ments of section 640(a) of the Head Start Act: Provided 19 further, That funds appropriated in this paragraph shall 20 not be available for costs that are reimbursed by the Fed21 eral Emergency Management Agency, under a contract for 22 insurance, or by self-insurance: Provided further, That up 23 to $12,500,000 shall be available for Federal administra24 tive expenses: Provided further, That obligations incurred 25 for the purposes provided herein prior to the date of enact- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 68 1 ment of this subdivision may be charged to funds appro2 priated under this heading: Provided further, That such 3 amount is designated by the Congress as being for an 4 emergency requirement pursuant to section 5 251(b)(2)(A)(i) of the Balanced Budget and Emergency 6 Deficit Control Act of 1985. 7 OFFICE OF THE SECRETARY 8 PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY 9 FUND 10 11 (INCLUDING TRANSFERS OF FUNDS) For an additional amount for the ‘‘Public Health and 12 Social Services Emergency Fund’’, $162,000,000, to re13 main available until September 30, 2020, for response, re14 covery, preparation, mitigation and other expenses directly 15 related to the consequences of Hurricanes Harvey, Irma, 16 and Maria, including activities authorized under section 17 319(a) of the Public Health Service Act (referred to in 18 this subdivision as the ‘‘PHS Act’’): Provided, That of the 19 amount provided, $60,000,000 shall be transferred to 20 ‘‘Health Resources and Services Administration—Primary 21 Health Care’’, for expenses related to the consequences of 22 Hurricanes Harvey, Irma, and Maria for disaster response 23 and recovery, for the Health Centers Program under sec24 tion 330 of the PHS Act: Provided further, That not less 25 than $50,000,000, of amounts transferred under the pre- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 69 1 ceding proviso, shall be available for alteration, renovation, 2 construction, equipment, and other capital improvement 3 costs as necessary to meet the needs of areas affected by 4 Hurricanes Harvey, Irma, and Maria: Provided further, 5 That the time limitation in section 330(e)(3) of the PHS 6 Act shall not apply to funds made available under the pre7 ceding proviso: Provided further, That of the amount pro8 vided, not less than $20,000,000 shall be transferred to 9 ‘‘Substance Abuse and Mental Health Services Adminis10 tration—Health Surveillance and Program Support’’ for 11 grants, contracts, and cooperative agreements for behav12 ioral health treatment, crisis counseling, and other related 13 helplines, and for other similar programs to provide sup14 port to individuals impacted by Hurricanes Harvey, Irma, 15 and Maria: Provided further, That of the amount provided, 16 up to $2,000,000, to remain available until expended, shall 17 be transferred to ‘‘Office of the Secretary—Office of In18 spector General’’ for oversight of activities responding to 19 such hurricanes: Provided further, That obligations in20 curred for the purposes provided herein prior to the date 21 of enactment of this subdivision may be charged to funds 22 appropriated under this heading: Provided further, That 23 funds appropriated in this paragraph shall not be available 24 for costs that are reimbursed by the Federal Emergency 25 Management Agency, under a contract for insurance, or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 70 1 by self-insurance: Provided further, That such amount is 2 designated by the Congress as being for an emergency re3 quirement pursuant to section 251(b)(2)(A)(i) of the Bal4 anced Budget and Emergency Deficit Control Act of 1985. 5 GENERAL PROVISION—DEPARTMENT OF HEALTH AND 6 HUMAN SERVICES 7 DIRECT HIRE AUTHORITY FOR CERTAIN EMERGENCY 8 RESPONSE POSITIONS 9 SEC. 20803. (a) IN GENERAL.—As the Secretary of 10 Health and Human Services determines necessary to re11 spond to a critical hiring need for emergency response po12 sitions, after providing public notice and without regard 13 to the provisions of sections 3309 through 3319 of title 14 5, United States Code, the Secretary may appoint can15 didates directly to the following positions, consistent with 16 subsection (b), to perform critical work directly relating 17 to the consequences of Hurricanes Harvey, Irma, and 18 Maria: 19 (1) Intermittent disaster-response personnel in 20 the National Disaster Medical System, under section 21 2812 of the Public Health Service Act (42 U.S.C. 22 300hh–11). 23 (2) Term or temporary related positions in the 24 Centers for Disease Control and Prevention and the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 71 1 Office of the Assistant Secretary for Preparedness 2 and Response. 3 (b) EXPIRATION.—The authority under subsection 4 (a) shall expire 270 days after the date of enactment of 5 this section. 6 DEPARTMENT OF EDUCATION 7 HURRICANE EDUCATION RECOVERY 8 (INCLUDING TRANSFER OF FUNDS) 9 For an additional amount for ‘‘Hurricane Education 10 Recovery’’ for necessary expenses related to the con11 sequences of Hurricanes Harvey, Irma, and Maria, or 12 wildfires in 2017 for which a major disaster or emergency 13 has been declared under sections 401 or 501 of the Robert 14 T. Stafford Disaster Relief and Emergency Assistance Act 15 (42 U.S.C. 5170 and 5190) (referred to under this head16 ing as ‘‘covered disaster or emergency’’), $2,700,000,000, 17 to remain available through September 30, 2022, for as18 sisting in meeting the educational needs of individuals af19 fected by a covered disaster or emergency: Provided, That 20 such amount is designated by the Congress as being for 21 an emergency requirement pursuant to section 22 251(b)(2)(A)(i) of the Balanced Budget and Emergency 23 Deficit Control Act of 1985: Provided further, That— 24 February 7, 2018 (10:12 p.m.) (1) such funds shall be used— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 72 1 (A) to make awards to eligible entities for 2 immediate aid to restart school operations, in 3 accordance with paragraph (2); 4 (B) for temporary emergency impact aid 5 for displaced students, in accordance with para- 6 graph (2); 7 (C) for emergency assistance to institu- 8 tions of higher education and students attend- 9 ing institutions of higher education in an area 10 directly affected by a covered disaster or emer- 11 gency in accordance with paragraph (3); 12 (D) for payments to institutions of higher 13 education to help defray the unexpected ex- 14 penses associated with enrolling displaced stu- 15 dents from institutions of higher education di- 16 rectly affected by a covered disaster or emer- 17 gency, in accordance with paragraph (4); and 18 (E) to provide assistance to local edu- 19 cational agencies serving homeless children and 20 youth in accordance with paragraph (5); 21 (2) immediate aid to restart school operations 22 and temporary emergency impact aid for displaced 23 students described in subparagraphs (A) and (B) of 24 paragraph (1) shall be provided under the statutory 25 terms and conditions that applied to assistance February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 73 1 under sections 102 and 107 of title IV of division B 2 of Public Law 109–148, respectively, except that 3 such sections shall be applied so that— 4 (A) each reference to a major disaster de- 5 clared in accordance with section 401 of the 6 Robert T. Stafford Disaster Relief and Emer- 7 gency Assistance Act (42 U.S.C. 5170) shall be 8 to a major disaster or emergency declared by 9 the President in accordance with section 401 or 10 501, respectively, of such Act; 11 (B) each reference to Hurricane Katrina 12 or Hurricane Rita shall be a reference to a cov- 13 ered disaster or emergency; 14 (C) each reference to August 22, 2005 15 shall be to the date that is one week prior to 16 the date that the major disaster or emergency 17 was declared for the area; 18 (D) each reference to the States of Lou- 19 isiana, Mississippi, Alabama, and Texas shall be 20 to the States or territories affected by a covered 21 disaster or emergency, and each reference to 22 the State educational agencies of Louisiana, 23 Mississippi, Alabama, or Texas shall be a ref- 24 erence to the State educational agencies that February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 74 1 serve the states or territories affected by a cov- 2 ered disaster or emergency; 3 (E) each reference to the 2005–2006 4 school year shall be to the 2017–2018 school 5 year; 6 (F) the references in section 102(h)(1) of 7 title IV of division B of Public Law 109–148 to 8 the number of non-public and public elementary 9 schools and secondary schools in the State shall 10 be to the number of students in non-public and 11 public elementary schools and secondary schools 12 in the State, and the reference in such section 13 to the National Center for Data Statistics Com- 14 mon Core of Data for the 2003–2004 school 15 year shall be to the most recent and appro- 16 priate data set for the 2016–2017 school year; 17 (G) in determining the amount of imme- 18 diate aid provided to restart school operations 19 as described in section 102(b) of title IV of di- 20 vision B of Public Law 109–148, the Secretary 21 shall consider the number of students enrolled, 22 during the 2016–2017 school year, in elemen- 23 tary schools and secondary schools that were 24 closed as a result of a covered disaster or emer- 25 gency; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 75 1 (H) in determining the amount of emer- 2 gency impact aid that a State educational agen- 3 cy is eligible to receive under paragraph (1)(B), 4 the 5 107(d)(1)(B) of such title, provide— Secretary shall, subject to section 6 (i) $9,000 for each displaced student 7 who is an English learner, as that term is 8 defined in section 8101 of the Elementary 9 and Secondary Education Act of 1965 (20 10 U.S.C. 7801); 11 (ii) $10,000 for each displaced stu- 12 dent who is a child with a disability (re- 13 gardless of whether the child is an English 14 learner); and 15 (iii) $8,500 for each displaced student 16 who is not a child with a disability or an 17 English learner; 18 (I) with respect to the emergency impact 19 aid provided under paragraph (1)(B), the Sec- 20 retary may modify the State educational agency 21 and 22 timelines in section 107(c) of such title; and local educational agency application 23 (J) each reference to a public elementary 24 school may include, as determined by the local 25 educational agency, a publicly-funded preschool February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 76 1 program that enrolls children below the age of 2 kindergarten entry and is part of an elementary 3 school; 4 (3) $100,000,000 of the funds made available 5 under this heading shall be for programs authorized 6 under subpart 3 of Part A, part C of title IV and 7 part B of title VII of the Higher Education Act of 8 1965 (20 U.S.C. 1087–51 et seq., 1138 et seq.) for 9 institutions located in an area affected by a covered 10 disaster or emergency, and students enrolled in such 11 institutions, except that— 12 (A) any requirements relating to matching, 13 Federal share, reservation of funds, or mainte- 14 nance of effort under such parts that would 15 otherwise be applicable to that assistance shall 16 not apply; 17 18 (B) such assistance may be used for student financial assistance; 19 (C) such assistance may also be used for 20 faculty and staff salaries, equipment, student 21 supplies and instruments, or any purpose au- 22 thorized under the Higher Education Act of 23 1965, by institutions of higher education that 24 are located in areas affected by a covered dis- 25 aster or emergency; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 77 1 (D) the Secretary shall prioritize, to the 2 extent possible, students who are homeless or at 3 risk of becoming homeless as a result of dis- 4 placement, and institutions that have sustained 5 extensive damage, by a covered disaster or 6 emergency; 7 (4) up to $75,000,000 of the funds made avail- 8 able under this heading shall be for payments to in- 9 stitutions of higher education to help defray the un- 10 expected expenses associated with enrolling displaced 11 students from institutions of higher education at 12 which operations have been disrupted by a covered 13 disaster or emergency, in accordance with criteria 14 established by the Secretary and made publicly avail- 15 able; 16 (5) $25,000,000 of the funds made available 17 under this heading shall be available to provide as- 18 sistance to local educational agencies serving home- 19 less children and youths displaced by a covered dis- 20 aster or emergency, consistent with section 723 of 21 the McKinney-Vento Homeless Assistance Act (42 22 U.S.C. 11431–11435) and with section 106 of title 23 IV of division B of Public Law 109-148, except that 24 funds shall be disbursed based on demonstrated need 25 and the number of homeless children and youth en- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 78 1 rolled as a result of displacement by a covered dis- 2 aster or emergency; 3 (6) section 437 of the General Education Provi- 4 sions Act (20 U.S.C. 1232) and section 553 of title 5 5, United States Code, shall not apply to activities 6 under this heading; 7 (7) $4,000,000 of the funds made available 8 under this heading, to remain available until ex- 9 pended, shall be transferred to the Office of the In- 10 spector General of the Department of Education for 11 oversight of activities supported with funds appro- 12 priated under this heading, and up to $3,000,000 of 13 the funds made available under this heading shall be 14 for program administration; 15 (8) up to $35,000,000 of the funds made avail- 16 able under this heading shall be to carry out activi- 17 ties authorized under section 4631(b) of the Elemen- 18 tary and Secondary Education Act of 1965 (20 19 U.S.C. 7281(b)): Provided, That obligations incurred 20 for the purposes provided herein prior to the date of 21 enactment of this subdivision may be charged to 22 funds appropriated under this paragraph; 23 (9) the Secretary may waive, modify, or provide 24 extensions for certain requirements of the Higher 25 Education Act of 1965 (20 U.S.C. 1001 et seq.) for February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 79 1 affected individuals, affected students, and affected 2 institutions in covered disaster or emergency areas 3 in the same manner as the Secretary was authorized 4 to waive, modify, or provide extensions for certain 5 requirements of such Act under provisions of subtitle 6 B of title IV of division B of Public Law 109–148 7 for affected individuals, affected students, and af- 8 fected institutions in areas affected by Hurricane 9 Katrina and Hurricane Rita, except that the cost as- 10 sociated with any action taken by the Secretary 11 under this paragraph is designated by the Congress 12 as being for an emergency requirement pursuant to 13 section 251(b)(2)(A)(i) of the Balanced Budget and 14 Emergency Deficit Control Act of 1985; and 15 (10) if any provision under this heading or ap- 16 plication of such provision to any person or cir- 17 cumstance is held to be unconstitutional, the remain- 18 der of the provisions under this heading and the ap- 19 plication of such provisions to any person or cir- 20 cumstance shall not be affected thereby. 21 GENERAL PROVISION—DEPARTMENT 22 OF EDUCATION SEC. 20804. (a) Notwithstanding any other provision 23 of law, the Secretary of Education is hereby authorized 24 to forgive any outstanding balance owed to the Depart25 ment of Education under the HBCU Hurricane Supple- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 80 1 mental Loan program established pursuant to section 2 2601 of Public Law 109–234, as modified by section 307 3 of title III of division F of the Consolidated Appropria4 tions Act, 2012 (Public Law 112–74), as carried forward 5 by the Continuing Appropriations Resolution, 2013 (Pub6 lic Law 112–175). 7 (b) There are authorized to be appropriated, and 8 there are hereby appropriated, such sums as may be nec9 essary to carry out subsection (a): Provided, That such 10 amount is designated by the Congress as an emergency 11 requirement pursuant to section 251(b)(2)(A)(i) of the 12 Balance Budget and Emergency Deficit Control Act of 13 1985. 14 GENERAL PROVISIONS—THIS TITLE 15 (INCLUDING TRANSFER OF FUNDS) 16 SEC. 20805. Funds appropriated to the Department 17 of Health and Human Services by this title may be trans18 ferred to, and merged with, other appropriation accounts 19 under the headings ‘‘Centers for Disease Control and Pre20 vention’’ and ‘‘Public Health and Social Services Emer21 gency Fund’’ for the purposes specified in this title fol22 lowing consultation with the Office of Management and 23 Budget: Provided, That the Committees on Appropriations 24 in the House of Representatives and the Senate shall be 25 notified 10 days in advance of any such transfer: Provided February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 81 1 further, That, upon a determination that all or part of the 2 funds transferred from an appropriation are not nec3 essary, such amounts may be transferred back to that ap4 propriation: Provided further, That none of the funds 5 made available by this title may be transferred pursuant 6 to the authority in section 205 of division H of Public Law 7 115–31 or section 241(a) of the PHS Act. 8 SEC. 20806. Not later than 30 days after enactment 9 of this subdivision, the Secretary of Health and Human 10 Services shall provide a detailed spend plan of anticipated 11 uses of funds made available in this title, including esti12 mated personnel and administrative costs, to the Commit13 tees on Appropriations: Provided, That such plans shall 14 be updated and submitted to the Committees on Appro15 priations every 60 days until all funds are expended or 16 expire. 17 SEC. 20807. Unless otherwise provided for by this 18 title, the additional amounts appropriated by this title to 19 appropriations accounts shall be available under the au20 thorities and conditions applicable to such appropriations 21 accounts for fiscal year 2018. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 82 1 TITLE IX 2 LEGISLATIVE BRANCH 3 GOVERNMENT ACCOUNTABILITY OFFICE 4 SALARIES 5 AND EXPENSES For an additional amount for ‘‘Salaries and Ex- 6 penses’’, $14,000,000, to remain available until expended, 7 for audits and investigations relating to Hurricanes Har8 vey, Irma, and Maria and the 2017 wildfires: Provided, 9 That such amount is designated by the Congress as being 10 for an emergency requirement pursuant to section 11 251(b)(2)(A)(i) of the Balanced Budget and Emergency 12 Deficit Control Act of 1985. 13 TITLE X 14 DEPARTMENT OF DEFENSE 15 MILITARY CONSTRUCTION, NAVY 16 AND MARINE CORPS For an additional amount for ‘‘Military Construction, 17 Navy and Marine Corps’’, $201,636,000, to remain avail18 able until September 30, 2022, for necessary expenses re19 lated to the consequences of Hurricanes Harvey, Irma, 20 and Maria: Provided, That none of the funds made avail21 able to the Navy and Marine Corps for recovery efforts 22 related to Hurricanes Harvey, Irma, and Maria in this 23 subdivision shall be available for obligation until the Com24 mittees on Appropriations of the House of Representatives 25 and the Senate receive form 1391 for each specific re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 83 1 quest: Provided further, That, not later than 60 days after 2 enactment of this subdivision, the Secretary of the Navy, 3 or his designee, shall submit to the Committees on Appro4 priations of House of Representatives and the Senate a 5 detailed expenditure plan for funds provided under this 6 heading: Provided further, That such funds may be obli7 gated or expended for planning and design and military 8 construction projects not otherwise authorized by law: 9 Provided further, That such amount is designated by the 10 Congress as being for an emergency requirement pursuant 11 to section 251(b)(2)(A)(i) of the Balanced Budget and 12 Emergency Deficit Control Act of 1985. 13 MILITARY CONSTRUCTION, ARMY NATIONAL GUARD 14 For an additional amount for ‘‘Military Construction, 15 Army National Guard’’, $519,345,000, to remain available 16 until September 30, 2022, for necessary expenses related 17 to the consequences of Hurricanes Harvey, Irma, and 18 Maria: Provided, That none of the funds made available 19 to the Army National Guard for recovery efforts related 20 to Hurricanes Harvey, Irma, and Maria in this subdivision 21 shall be available for obligation until the Committees on 22 Appropriations of the House of Representatives and the 23 Senate receive form 1391 for each specific request: Pro24 vided further, That, not later than 60 days after enact25 ment of this subdivision, the Director of the Army Na- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 84 1 tional Guard, or his designee, shall submit to the Commit2 tees on Appropriations of the House of Representatives 3 and the Senate a detailed expenditure plan for funds pro4 vided under this heading: Provided further, That such 5 funds may be obligated or expended for planning and de6 sign and military construction projects not otherwise au7 thorized by law: Provided further, That such amount is 8 designated by the Congress as being for an emergency re9 quirement pursuant to section 251(b)(2)(A)(i) of the Bal10 anced Budget and Emergency Deficit Control Act of 1985. 11 DEPARTMENT OF VETERANS AFFAIRS 12 VETERANS HEALTH ADMINISTRATION 13 MEDICAL SERVICES 14 For an additional amount for ‘‘Medical Services’’, 15 $11,075,000, to remain available until September 30, 16 2019, for necessary expenses related to the consequences 17 of Hurricanes Harvey, Irma, and Maria: Provided, That 18 such amount is designated by the Congress as being for 19 an emergency requirement pursuant to section 20 251(b)(2)(A)(i) of the Balanced Budget and Emergency 21 Deficit Control Act of 1985. 22 23 MEDICAL SUPPORT AND COMPLIANCE For an additional amount for ‘‘Medical Support and 24 Compliance’’, $3,209,000, to remain available until Sep25 tember 30, 2019, for necessary expenses related to the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 85 1 consequences of Hurricanes Harvey, Irma, and Maria: 2 Provided, That such amount is designated by the Congress 3 as being for an emergency requirement pursuant to sec4 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer5 gency Deficit Control Act of 1985. 6 7 MEDICAL FACILITIES For an additional amount for ‘‘Medical Facilities’’, 8 $75,108,000, to remain available until September 30, 9 2022, for necessary expenses related to the consequences 10 of Hurricanes Harvey, Irma, and Maria: Provided, That 11 none of these funds shall be available for obligation until 12 the Secretary of Veterans Affairs submits to the Commit13 tees on Appropriations of the House of Representatives 14 and the Senate a detailed expenditure plan for funds pro15 vided under this heading: Provided further, That such 16 amount is designated by the Congress as being for an 17 emergency requirement pursuant to section 18 251(b)(2)(A)(i) of the Balanced Budget and Emergency 19 Deficit Control Act of 1985. 20 DEPARTMENTAL ADMINISTRATION 21 CONSTRUCTION, MINOR PROJECTS 22 For an additional amount for ‘‘Construction, Minor 23 Projects’’, $4,088,000, to remain available until Sep24 tember 30, 2022, for necessary expenses related to the 25 consequences of Hurricanes Harvey, Irma, and Maria: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 86 1 Provided, That such amount is designated by the Congress 2 as being for an emergency requirement pursuant to sec3 tion 251(b)(2)(A)(i) of the Balanced Budget and Emer4 gency Deficit Control Act of 1985. 5 6 GENERAL PROVISION—THIS TITLE SEC. 21001. Notwithstanding section 18236(b) of 7 title 10, United States Code, the Secretary of Defense 8 shall contribute to Puerto Rico, 100 percent of the total 9 cost of construction (including the cost of architectural, 10 engineering and design services) for the acquisition, con11 struction, expansion, rehabilitation, or conversion of the 12 Arroyo readiness center under paragraph (5) of section 13 18233(a) of title 10, United States Code. 14 TITLE XI 15 DEPARTMENT OF TRANSPORTATION 16 FEDERAL AVIATION ADMINISTRATION 17 OPERATIONS 18 (AIRPORT AND AIRWAY TRUST FUND) 19 For an additional amount for ‘‘Operations’’, 20 $35,000,000, to be derived from the Airport and Airway 21 Trust Fund and to remain available until expended, for 22 necessary expenses related to the consequences of Hurri23 canes Harvey, Irma, and Maria, and other hurricanes oc24 curring in calendar year 2017: Provided, That such 25 amount is designated by the Congress as being for an February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 87 1 emergency requirement pursuant to section 2 251(b)(2)(A)(i) of the Balanced Budget and Emergency 3 Deficit Control Act of 1985. 4 FACILITIES AND EQUIPMENT 5 (AIRPORT AND AIRWAY TRUST FUND) 6 For an additional amount for ‘‘Facilities and Equip- 7 ment’’, $79,589,000, to be derived from the Airport and 8 Airway Trust Fund and to remain available until ex9 pended, for necessary expenses related to the consequences 10 of Hurricanes Harvey, Irma, and Maria, and other hurri11 canes occurring in calendar year 2017: Provided, That 12 such amount is designated by the Congress as being for 13 an emergency requirement pursuant to section 14 251(b)(2)(A)(i) of the Balanced Budget and Emergency 15 Deficit Control Act of 1985. 16 FEDERAL HIGHWAY ADMINISTRATION 17 FEDERAL-AID HIGHWAYS 18 EMERGENCY RELIEF PROGRAM 19 For an additional amount for the ‘‘Emergency Relief 20 Program’’ as authorized under section 125 of title 23, 21 United States Code, $1,374,000,000, to remain available 22 until expended: Provided, That notwithstanding section 23 125(d)(4) of title 23, United States Code, no limitation 24 on the total obligations for projects under section 125 of 25 such title shall apply to the Virgin Islands, Guam, Amer- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 88 1 ican Samoa, and the Commonwealth of the Northern Mar2 iana Islands for fiscal year 2018 and fiscal year 2019: 3 Provided further, That notwithstanding subsection (e) of 4 section 120 of title 23, United States Code, for this fiscal 5 year and hereafter, the Federal share for Emergency Re6 lief funds made available under section 125 of such title 7 to respond to damage caused by Hurricanes Irma and 8 Maria, shall be 100 percent for Puerto Rico: Provided fur9 ther, That such amount is designated by the Congress as 10 being for an emergency requirement pursuant to section 11 251(b)(2)(A)(i) of the Balanced Budget and Emergency 12 Deficit Control Act of 1985. 13 FEDERAL TRANSIT ADMINISTRATION 14 PUBLIC TRANSPORTATION EMERGENCY RELIEF PROGRAM 15 For an additional amount for the ‘‘Public Transpor- 16 tation Emergency Relief Program’’ as authorized under 17 section 5324 of title 49, United States Code, 18 $330,000,000 to remain available until expended, for tran19 sit systems affected by Hurricanes Harvey, Irma, and 20 Maria with major disaster declarations in 2017: Provided, 21 That not more than three-quarters of one percent of the 22 funds for public transportation emergency relief shall be 23 available for administrative expenses and ongoing program 24 management oversight as authorized under sections 5334 25 and 5338(f)(2) of such title and shall be in addition to February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 89 1 any other appropriations for such purpose: Provided fur2 ther, That such amount is designated by the Congress as 3 being for an emergency requirement pursuant to section 4 251(b)(2)(A)(i) of the Balanced Budget and Emergency 5 Deficit Control Act of 1985. 6 MARITIME ADMINISTRATION 7 OPERATIONS AND TRAINING 8 For an additional amount for ‘‘Operations and Train- 9 ing’’, $10,000,000, to remain available until expended, for 10 necessary expenses, including for dredging, related to 11 damage to Maritime Administration facilities resulting 12 from Hurricane Harvey: Provided, That such amount is 13 designated by the Congress as being for an emergency re14 quirement pursuant to section 251(b)(2)(A)(i) of the Bal15 anced Budget and Emergency Deficit Control Act of 1985. 16 17 18 GENERAL PROVISION—DEPARTMENT OF TRANSPORTATION SEC. 21101. Notwithstanding 49 U.S.C. 5302, for 19 fiscal years 2018, 2019, and 2020 the Secretary of Trans20 portation shall treat an area as an ‘‘urbanized area’’ for 21 purposes of 49 U.S.C. 5307 and 5336(a) until the next 22 decennial census following the enactment of this Act if the 23 area was defined and designated as an ‘‘urbanized’’ area 24 by the Secretary of Commerce in the 2000 decennial cen25 sus and the population of such area fell below 50,000 after February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 90 1 the 2000 decennial census as a result of a major disaster: 2 Provided, That an area treated as an ‘‘urbanized area’’ 3 for purposes of this section shall be assigned the popu4 lation and square miles of the urbanized area designated 5 by the Secretary of Commerce in the 2000 decennial cen6 sus: Provided further, That the term ‘‘major disaster’’ has 7 the meaning given such term in section 102(2) of the Dis8 aster Relief Act of 1974 (42 U.S.C. 5122(2)). 9 DEPARTMENT OF HOUSING AND URBAN 10 DEVELOPMENT 11 COMMUNITY PLANNING AND DEVELOPMENT 12 COMMUNITY DEVELOPMENT FUND 13 (INCLUDING TRANSFERS OF FUNDS) 14 For an additional amount for ‘‘Community Develop- 15 ment Fund’’, $28,000,000,000, to remain available until 16 expended, for necessary expenses for activities authorized 17 under title I of the Housing and Community Development 18 Act of 1974 (42 U.S.C. 5301 et seq.) related to disaster 19 relief, long-term recovery, restoration of infrastructure 20 and housing, economic revitalization, and mitigation in the 21 most impacted and distressed areas resulting from a 22 major declared disaster that occurred in 2017 (except as 23 otherwise provided under this heading) pursuant to the 24 Robert T. Stafford Disaster Relief and Emergency Assist25 ance Act (42 U.S.C. 5121 et seq.): Provided, That funds February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 91 1 shall be awarded directly to the State, unit of general local 2 government, or Indian tribe (as such term is defined in 3 section 102 of the Housing and Community Development 4 Act of 1974) at the discretion of the Secretary: Provided 5 further, That of the amounts made available under this 6 heading, up to $16,000,000,000 shall be allocated to meet 7 unmet needs for grantees that have received or will receive 8 allocations under this heading for major declared disasters 9 that occurred in 2017 or under the same heading of Divi10 sion B of Public Law 115–56, except that, of the amounts 11 made available under this proviso, no less than 12 $11,000,000,000 shall be allocated to the States and units 13 of local government affected by Hurricane Maria, and of 14 such amounts allocated to such grantees affected by Hur15 ricane Maria, $2,000,000,000 shall be used to provide en16 hanced or improved electrical power systems: Provided fur17 ther, That to the extent amounts under the previous pro18 viso are insufficient to meet all unmet needs, the allocation 19 amounts related to infrastructure shall be reduced propor20 tionally based on the total infrastructure needs of all 21 grantees: Provided further, That of the amounts made 22 available under this heading, no less than 23 $12,000,000,000 shall be allocated for mitigation activi24 ties to all grantees of funding provided under this heading, 25 section 420 of division L of Public Law 114–113, section February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 92 1 145 of division C of Public Law 114–223, section 192 of 2 division C of Public Law 114–223 (as added by section 3 101(3) of division A of Public Law 114–254), section 421 4 of division K of Public Law 115–31, and the same heading 5 in division B of Public Law 115–56, and that such mitiga6 tion activities shall be subject to the same terms and con7 ditions under this subdivision, as determined by the Sec8 retary: Provided further, That all such grantees shall re9 ceive an allocation of funds under the preceding proviso 10 in the same proportion that the amount of funds each 11 grantee received or will receive under the second proviso 12 of this heading or the headings and sections specified in 13 the previous proviso bears to the amount of all funds pro14 vided to all grantees specified in the previous proviso: Pro15 vided further, That of the amounts made available under 16 the second and fourth provisos of this heading, the Sec17 retary shall allocate to all such grantees an aggregate 18 amount not less than 33 percent of each such amounts 19 of funds provided under this heading within 60 days after 20 the enactment of this subdivision based on the best avail21 able data (especially with respect to data for all such 22 grantees affected by Hurricanes Harvey, Irma, and 23 Maria), and shall allocate no less than 100 percent of the 24 funds provided under this heading by no later than De25 cember 1, 2018: Provided further, That the Secretary shall February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 93 1 not prohibit the use of funds made available under this 2 heading and the same heading in division B of Public Law 3 115–56 for non-federal share as authorized by section 4 105(a)(9) of the Housing and Community Development 5 Act of 1974 (42 U.S.C. 5305(a)(9)): Provided further, 6 That of the amounts made available under this heading, 7 grantees may establish grant programs to assist small 8 businesses for working capital purposes to aid in recovery: 9 Provided further, That as a condition of making any grant, 10 the Secretary shall certify in advance that such grantee 11 has in place proficient financial controls and procurement 12 processes and has established adequate procedures to pre13 vent any duplication of benefits as defined by section 312 14 of the Robert T. Stafford Disaster Relief and Emergency 15 Assistance Act (42 U.S.C. 5155), to ensure timely expend16 iture of funds, to maintain comprehensive websites regard17 ing all disaster recovery activities assisted with these 18 funds, and to detect and prevent waste, fraud, and abuse 19 of funds: Provided further, That with respect to any such 20 duplication of benefits, the Secretary and any grantee 21 under this section shall not take into consideration or re22 duce the amount provided to any applicant for assistance 23 from the grantee where such applicant applied for and was 24 approved, but declined assistance related to such major 25 declared disasters that occurred in 2014, 2015, 2016, and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 94 1 2017 from the Small Business Administration under sec2 tion 7(b) of the Small Business Act (15 U.S.C. 636(b)): 3 Provided further, That the Secretary shall require grantees 4 to maintain on a public website information containing 5 common reporting criteria established by the Department 6 that permits individuals and entities awaiting assistance 7 and the general public to see how all grant funds are used, 8 including copies of all relevant procurement documents, 9 grantee administrative contracts and details of ongoing 10 procurement processes, as determined by the Secretary: 11 Provided further, That prior to the obligation of funds a 12 grantee shall submit a plan to the Secretary for approval 13 detailing the proposed use of all funds, including criteria 14 for eligibility and how the use of these funds will address 15 long-term recovery and restoration of infrastructure and 16 housing, economic revitalization, and mitigation in the 17 most impacted and distressed areas: Provided further, 18 That such funds may not be used for activities reimburs19 able by, or for which funds are made available by, the Fed20 eral Emergency Management Agency or the Army Corps 21 of Engineers: Provided further, That funds allocated under 22 this heading shall not be considered relevant to the non23 disaster formula allocations made pursuant to section 106 24 of the Housing and Community Development Act of 1974 25 (42 U.S.C. 5306): Provided further, That a State, unit of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 95 1 general local government, or Indian tribe may use up to 2 5 percent of its allocation for administrative costs: Pro3 vided further, That the sixth proviso under this heading 4 in the Supplemental Appropriations for Disaster Relief 5 Requirements Act, 2017 (division B of Public Law 115– 6 56) is amended by striking ‘‘State or subdivision thereof’’ 7 and inserting ‘‘State, unit of general local government, or 8 Indian tribe (as such term is defined in section 102 of 9 the Housing and Community Development Act of 1974 10 (42 U.S.C. 5302))’’: Provided further, That in admin11 istering the funds under this heading, the Secretary of 12 Housing and Urban Development may waive, or specify 13 alternative requirements for, any provision of any statute 14 or regulation that the Secretary administers in connection 15 with the obligation by the Secretary or the use by the re16 cipient of these funds (except for requirements related to 17 fair housing, nondiscrimination, labor standards, and the 18 environment), if the Secretary finds that good cause exists 19 for the waiver or alternative requirement and such waiver 20 or alternative requirement would not be inconsistent with 21 the overall purpose of title I of the Housing and Commu22 nity Development Act of 1974: Provided further, That, 23 notwithstanding the preceding proviso, recipients of funds 24 provided under this heading that use such funds to supple25 ment Federal assistance provided under section 402, 403, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 96 1 404, 406, 407, 408(c)(4), or 502 of the Robert T. Stafford 2 Disaster Relief and Emergency Assistance Act (42 U.S.C. 3 5121 et seq.) may adopt, without review or public com4 ment, any environmental review, approval, or permit per5 formed by a Federal agency, and such adoption shall sat6 isfy the responsibilities of the recipient with respect to 7 such environmental review, approval or permit: Provided 8 further, That, notwithstanding section 104(g)(2) of the 9 Housing and Community Development Act of 1974 (42 10 U.S.C. 5304(g)(2)), the Secretary may, upon receipt of 11 a request for release of funds and certification, imme12 diately approve the release of funds for an activity or 13 project assisted under this heading if the recipient has 14 adopted an environmental review, approval or permit 15 under the preceding proviso or the activity or project is 16 categorically excluded from review under the National En17 vironmental Policy Act of 1969 (42 U.S.C. 4321 et seq.): 18 Provided further, That the Secretary shall publish via no19 tice in the Federal Register any waiver, or alternative re20 quirement, to any statute or regulation that the Secretary 21 administers pursuant to title I of the Housing and Com22 munity Development Act of 1974 no later than 5 days be23 fore the effective date of such waiver or alternative re24 quirement: Provided further, That the eighth proviso 25 under this heading in the Supplemental Appropriations for February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 97 1 Disaster Relief Requirements Act, 2017 (division B of 2 Public Law 115–56) is amended by inserting ‘‘408(c)(4),’’ 3 after ‘‘407,’’: Provided further, That of the amounts made 4 available under this heading, up to $15,000,000 shall be 5 made available for capacity building and technical assist6 ance, including assistance on contracting and procurement 7 processes, to support States, units of general local govern8 ment, or Indian tribes (and their subrecipients) that re9 ceive allocations pursuant to this heading, received dis10 aster recovery allocations under the same heading in Pub11 lic Law 115–56, or may receive similar allocations for dis12 aster recovery in future appropriations Acts: Provided fur13 ther, That of the amounts made available under this head14 ing, up to $10,000,000 shall be transferred, in aggregate, 15 to ‘‘Department of Housing and Urban Development— 16 Program Office Salaries and Expenses—Community Plan17 ning and Development’’ for necessary costs, including in18 formation technology costs, of administering and over19 seeing the obligation and expenditure of amounts under 20 this heading: Provided further, That the amount specified 21 in the preceding proviso shall be combined with funds ap22 propriated under the same heading and for the same pur23 pose in Public Law 115–56 and the aggregate of such 24 amounts shall be available for any of the purposes speci25 fied under this heading or the same heading in Public Law February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 98 1 115–56 without limitation: Provided further, That, of the 2 funds made available under this heading, $10,000,000 3 shall be transferred to the Office of the Inspector General 4 for necessary costs of overseeing and auditing funds made 5 available under this heading: Provided further, That such 6 amount is designated by the Congress as being for an 7 emergency requirement pursuant to section 8 251(b)(2)(A)(i) of the Balanced Budget and Emergency 9 Deficit Control Act of 1985: Provided further, That 10 amounts repurposed pursuant to this section that were 11 previously designated by the Congress as an emergency 12 requirement pursuant to the Balanced Budget and Emer13 gency Deficit Control Act are designated by the Congress 14 as an emergency requirement pursuant to section 15 251(b)(2)(A)(i) of the Balanced Budget and Emergency 16 Deficit Control Act of 1985. 17 GENERAL PROVISIONS—DEPARTMENT 18 19 OF HOUSING AND URBAN DEVELOPMENT SEC. 21102. Any funds made available under the 20 heading ‘‘Community Development Fund’’ under this sub21 division that remain available, after the other funds under 22 such heading have been allocated for necessary expenses 23 for activities authorized under such heading, shall be used 24 for additional mitigation activities in the most impacted 25 and distressed areas resulting from a major declared dis- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 99 1 aster that occurred in 2014, 2015, 2016 or 2017: Pro2 vided, That such remaining funds shall be awarded to 3 grantees of funding provided for disaster relief under the 4 heading ‘‘Community Development Fund’’ in this subdivi5 sion, section 420 of division L of Public Law 114–113, 6 section 145 of division C of Public Law 114–223, section 7 192 of division C of Public Law 114–223 (as added by 8 section 101(3) of division A of Public Law 114–254), sec9 tion 421 of division K of Public Law 115–31, and the 10 same heading in division B of Public Law 115–56 subject 11 to the same terms and conditions under this subdivision 12 and such Acts respectively: Provided further, That each 13 such grantee shall receive an allocation from such remain14 ing funds in the same proportion that the amount of funds 15 such grantee received under this subdivision and under the 16 Acts specified in the previous proviso bears to the amount 17 of all funds provided to all grantees specified in the pre18 vious proviso. 19 SEC. 21103. For 2018, the Secretary of Housing and 20 Urban Development may make temporary adjustments to 21 the section 8 housing choice voucher annual renewal fund22 ing allocations and administrative fee eligibility determina23 tions for public housing agencies located in the most im24 pacted and distressed areas in which a major Presi25 dentially declared disaster occurred during 2017 under February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 100 1 title IV of the Robert T. Stafford Disaster Relief and 2 Emergency Assistance Act (42 U.S.C. 5170 et seq.), to 3 avoid significant adverse funding impacts that would oth4 erwise result from the disaster, or to facilitate leasing up 5 to a public housing agency’s authorized level of units 6 under contract (but not to exceed such level), upon request 7 by and in consultation with a public housing agency and 8 supported by documentation as required by the Secretary 9 that demonstrates the need for the adjustment. 10 TITLE XII 11 GENERAL PROVISIONS—THIS SUBDIVISION 12 SEC. 21201. Each amount appropriated or made 13 available by this subdivision is in addition to amounts oth14 erwise appropriated for the fiscal year involved. 15 SEC. 21202. No part of any appropriation contained 16 in this subdivision shall remain available for obligation be17 yond the current fiscal year unless expressly so provided 18 herein. 19 SEC. 21203. Unless otherwise provided for by this 20 subdivision, the additional amounts appropriated by this 21 subdivision to appropriations accounts shall be available 22 under the authorities and conditions applicable to such ap23 propriations accounts for fiscal year 2018. 24 SEC. 21204. Each amount designated in this subdivi- 25 sion by the Congress as being for an emergency require- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 101 1 ment pursuant to section 251(b)(2)(A)(i) of the Balanced 2 Budget and Emergency Deficit Control Act of 1985 shall 3 be available (or rescinded or transferred, if applicable) 4 only if the President subsequently so designates all such 5 amounts and transmits such designations to the Congress. 6 SEC. 21205. For purposes of this subdivision, the 7 consequences or impacts of any hurricane shall include 8 damages caused by the storm at any time during the en9 tirety of its duration as a cyclone, as defined by the Na10 tional Hurricane Center. 11 SEC. 21206. Any amount appropriated by this sub- 12 division, designated by the Congress as an emergency re13 quirement pursuant to section 251(b)(2)(A)(i) of the Bal14 anced Budget and Emergency Deficit Control Act of 1985 15 and subsequently so designated by the President, and 16 transferred pursuant to transfer authorities provided by 17 this subdivision shall retain such designation. 18 SEC. 21207. The terms and conditions applicable to 19 the funds provided in this subdivision, including those pro20 vided by this title, shall also apply to the funds made avail21 able in division B of Public Law 115–56 and in division 22 A of Public Law 115–72. 23 SEC. 21208. (a) Section 305 of division A of the Ad- 24 ditional Supplemental Appropriations for Disaster Relief February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 102 1 Requirements Act, 2017 (Public Law 115–72) is amend2 ed— 3 (1) in subsection (a)— 4 (A) by striking ‘‘(1) Not later than Decem- 5 ber 31, 2017,’’ and inserting ‘‘Not later than 6 March 31, 2018,’’; and 7 (B) by striking paragraph (2); and 8 (2) in subsection (b), by striking ‘‘receiving 9 funds under this division’’ and inserting ‘‘expending 10 more than $10,000,000 of funds provided by this di- 11 vision and division B of Public Law 115–56 in any 12 one fiscal year’’. 13 (b) Section 305 of division A of the Additional Sup- 14 plemental Appropriations for Disaster Relief Require15 ments Act, 2017 (Public Law 115–72), as amended by 16 this section, shall apply to funds appropriated by this divi17 sion as if they had been appropriated by that division. 18 (c) In order to proactively prepare for oversight of 19 future disaster relief funding, not later than one year after 20 the date of enactment of this Act, the Director of the Of21 fice of Management and Budget shall issue standard guid22 ance for Federal agencies to use in designing internal con23 trol plans for disaster relief funding. This guidance shall 24 leverage existing internal control review processes and 25 shall include, at a minimum, the following elements: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 103 1 (1) Robust criteria for identifying and docu- 2 menting incremental risks and mitigating controls 3 related to the funding. 4 (2) Guidance for documenting the linkage be- 5 tween the incremental risks related to disaster fund- 6 ing and efforts to address known internal control 7 risks. 8 SEC. 21209. Any agency or department provided 9 funding in excess of $3,000,000,000 by this subdivision, 10 including the Federal Emergency Management Agency, 11 the Department of Housing and Urban Development, and 12 the Corps of Engineers, is directed to provide a report to 13 the Committees on Appropriations of the House of Rep14 resentatives and the Senate regarding its efforts to provide 15 adequate resources and technical assistance for small, low16 income communities affected by natural disasters. 17 SEC. 21210. (a) Not later than 180 days after the 18 date of enactment of this subdivision and in coordination 19 with the Administrator of the Federal Emergency Man20 agement Agency, with support and contributions from the 21 Secretary of the Treasury, the Secretary of Energy, and 22 other Federal agencies having responsibilities defined 23 under the National Disaster Recovery Framework, the 24 Governor of the Commonwealth of Puerto Rico shall sub25 mit to Congress a report describing the Commonwealth’s February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 104 1 12- and 24-month economic and disaster recovery plan 2 that— 3 (1) defines the priorities, goals, and expected 4 outcomes of the recovery effort for the Common- 5 wealth, based on damage assessments prepared pur- 6 suant to Federal law, if applicable, including— 7 (A) housing; 8 (B) economic issues, including workforce 9 development and industry expansion and cul- 10 tivation; 11 (C) health and social services; 12 (D) natural and cultural resources; 13 (E) governance and civic institutions; 14 (F) electric power systems and grid res- 15 16 17 toration; (G) environmental issues, including solid waste facilities; and 18 (H) other infrastructure systems, including 19 repair, restoration, replacement, and improve- 20 ment of public infrastructure such water and 21 wastewater treatment facilities, communications 22 networks, and transportation infrastructure; 23 (2) is consistent with— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 105 1 (A) the Commonwealth’s fiscal capacity to 2 provide long-term operation and maintenance of 3 rebuilt or replaced assets; 4 (B) alternative procedures and associated 5 programmatic guidance adopted by the Admin- 6 istrator of the Federal Emergency Management 7 Agency pursuant to section 428 of the Robert 8 T. Stafford Disaster Relief and Emergency As- 9 sistance Act (42 U.S.C. 5189f); and 10 (C) actions as may be necessary to miti- 11 gate vulnerabilities to future extreme weather 12 events and natural disasters and increase com- 13 munity resilience, including encouraging the 14 adoption and enforcement of the latest pub- 15 lished editions of relevant consensus-based 16 codes, specifications, and standards that incor- 17 porate the latest hazard-resistant designs and 18 establish minimum acceptable criteria for the 19 design, construction, and maintenance of resi- 20 dential structures and facilities for the purpose 21 of protecting the health, safety, and general 22 welfare of the buildings’ users against disasters; 23 (3) promotes transparency and accountability 24 through appropriate public notification, outreach, 25 and hearings; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 106 1 (4) identifies performance metrics for assessing 2 and reporting on the progress toward achieving the 3 Commonwealth’s recovery goals, as identified under 4 paragraph (1); 5 6 (5) is developed in coordination with the Oversight Board established under PROMESA; and 7 (6) is certified by that Oversight Board to be 8 consistent with the purpose set forth in section 9 101(a) of PROMESA (48 U.S.C. 2121(a)). 10 (b) At the end of every 30-day period before the sub- 11 mission of the report described in subsection (a), the Gov12 ernor of the Commonwealth of Puerto Rico, in coordina13 tion with the Administrator of the Federal Emergency 14 Management Agency, shall provide to Congress interim 15 status updates on progress developing such report. 16 (c) At the end of every 180-day period after the sub- 17 mission of the report described in subsection (a), the Gov18 ernor of the Commonwealth of Puerto Rico, in coordina19 tion with the Administrator of the Federal Emergency 20 Management Agency, shall make public a report on 21 progress achieving the goals set forth in such report. 22 (d) During the development, and after the submis- 23 sion, of the report required in subsection (a), the Over24 sight Board may provide to Congress reports on the status 25 of coordination with the Governor of Puerto Rico. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 107 1 (e) Amounts made available by this subdivision to a 2 covered territory for response to or recovery from Hurri3 cane Irma or Hurricane Maria in an aggregate amount 4 greater than $10,000,000 may be reviewed by the Over5 sight Board under the Oversight Board’s authority under 6 204(b)(2) of PROMESA (48 U.S.C. 2144(b)(2)). 7 (f) When developing a Fiscal Plan while the recovery 8 plan required under subsection (a) is in development and 9 in effect, the Oversight Board shall use and incorporate, 10 to the greatest extent feasible, damage assessments pre11 pared pursuant to Federal law. 12 (g) For purposes of this section, the terms ‘‘covered 13 territory’’ and ‘‘Oversight Board’’ have the meaning given 14 those term in section 5 of PROMESA (48 U.S.C. 2104). 15 This subdivision may be cited as the ‘‘Further Addi- 16 tional Supplemental Appropriations for Disaster Relief 17 Requirements Act, 2018’’. 22 SUBDIVISION 2—TAX RELIEF AND MEDICAID CHANGES RELATING TO CERTAIN DISASTERS TITLE I—CALIFORNIA FIRES 23 SEC. 20101. DEFINITIONS. 18 19 20 21 24 February 7, 2018 (10:12 p.m.) For purposes of this title— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 108 1 (1) CALIFORNIA WILDFIRE DISASTER ZONE.— 2 The term ‘‘California wildfire disaster zone’’ means 3 that portion of the California wildfire disaster area 4 determined by the President to warrant individual or 5 individual and public assistance from the Federal 6 Government under the Robert T. Stafford Disaster 7 Relief and Emergency Assistance Act by reason of 8 wildfires in California. 9 (2) CALIFORNIA WILDFIRE DISASTER AREA.— 10 The term ‘‘California wildfire disaster area’’ means 11 an area with respect to which between January 1, 12 2017 through January 18, 2018 a major disaster 13 has been declared by the President under section 14 401 of such Act by reason of wildfires in California. 15 SEC. 20102. SPECIAL DISASTER-RELATED RULES FOR USE 16 OF RETIREMENT FUNDS. 17 18 (a) TAX-FAVORED WITHDRAWALS FROM RETIREMENT 19 PLANS.— (1) IN GENERAL.—Section 72(t) of the Internal 20 Revenue Code of 1986 shall not apply to any quali- 21 fied wildfire distribution. 22 (2) AGGREGATE 23 (A) IN DOLLAR LIMITATION.— GENERAL.—For purposes of this 24 subsection, the aggregate amount of distribu- 25 tions received by an individual which may be February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 109 1 treated as qualified wildfire distributions for 2 any taxable year shall not exceed the excess (if 3 any) of— 4 (i) $100,000, over 5 (ii) the aggregate amounts treated as 6 qualified wildfire distributions received by 7 such individual for all prior taxable years. 8 (B) TREATMENT 9 TIONS.—If OF PLAN DISTRIBU- a distribution to an individual would 10 (without regard to subparagraph (A)) be a 11 qualified wildfire distribution, a plan shall not 12 be treated as violating any requirement of the 13 Internal Revenue Code of 1986 merely because 14 the plan treats such distribution as a qualified 15 wildfire 16 amount of such distributions from all plans 17 maintained by the employer (and any member 18 of any controlled group which includes the em- 19 ployer) to such individual exceeds $100,000. 20 distribution, (C) CONTROLLED unless the GROUP.—For aggregate purposes 21 of subparagraph (B), the term ‘‘controlled 22 group’’ means any group treated as a single 23 employer under subsection (b), (c), (m), or (o) 24 of section 414 of the Internal Revenue Code of 25 1986. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 110 1 2 (3) AMOUNT (A) IN DISTRIBUTED MAY BE REPAID.— GENERAL.—Any individual who re- 3 ceives a qualified wildfire distribution may, at 4 any time during the 3-year period beginning on 5 the day after the date on which such distribu- 6 tion was received, make one or more contribu- 7 tions in an aggregate amount not to exceed the 8 amount of such distribution to an eligible retire- 9 ment plan of which such individual is a bene- 10 ficiary and to which a rollover contribution of 11 such distribution could be made under section 12 402(c), 403(a)(4), 403(b)(8), 408(d)(3), or 13 457(e)(16), of the Internal Revenue Code of 14 1986, as the case may be. 15 (B) TREATMENT OF REPAYMENTS OF DIS- 16 TRIBUTIONS 17 PLANS OTHER THAN IRAS.—For 18 the Internal Revenue Code of 1986, if a con- 19 tribution is made pursuant to subparagraph (A) 20 with respect to a qualified wildfire distribution 21 from an eligible retirement plan other than an 22 individual retirement plan, then the taxpayer 23 shall, to the extent of the amount of the con- 24 tribution, be treated as having received the 25 qualified wildfire distribution in an eligible roll- February 7, 2018 (10:12 p.m.) FROM ELIGIBLE RETIREMENT purposes of U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 111 1 over 2 402(c)(4) of such Code) and as having trans- 3 ferred the amount to the eligible retirement 4 plan in a direct trustee to trustee transfer with- 5 in 60 days of the distribution. 6 distribution (as (C) TREATMENT defined OF in section REPAYMENTS FOR 7 DISTRIBUTIONS FROM IRAS.—For 8 the Internal Revenue Code of 1986, if a con- 9 tribution is made pursuant to subparagraph (A) 10 with respect to a qualified wildfire distribution 11 from an individual retirement plan (as defined 12 by section 7701(a)(37) of such Code), then, to 13 the extent of the amount of the contribution, 14 the qualified wildfire distribution shall be treat- 15 ed as a distribution described in section 16 408(d)(3) of such Code and as having been 17 transferred to the eligible retirement plan in a 18 direct trustee to trustee transfer within 60 days 19 of the distribution. 20 (4) DEFINITIONS.—For purposes of this sub- 21 22 purposes of section— (A) QUALIFIED WILDFIRE DISTRIBU- 23 TION.—Except 24 the term ‘‘qualified wildfire distribution’’ means 25 any distribution from an eligible retirement February 7, 2018 (10:12 p.m.) as provided in paragraph (2), U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 112 1 plan made on or after October 8, 2017, and be- 2 fore January 1, 2019, to an individual whose 3 principal place of abode during any portion of 4 the period from October 8, 2017, to December 5 31, 2017, is located in the California wildfire 6 disaster area and who has sustained an eco- 7 nomic loss by reason of the wildfires to which 8 the declaration of such area relates. 9 (B) ELIGIBLE RETIREMENT PLAN.—The 10 term ‘‘eligible retirement plan’’ shall have the 11 meaning 12 402(c)(8)(B) of the Internal Revenue Code of 13 1986. 14 (5) INCOME 15 16 given such term by section INCLUSION SPREAD OVER 3-YEAR PERIOD.— (A) IN GENERAL.—In the case of any 17 qualified wildfire distribution, unless the tax- 18 payer elects not to have this paragraph apply 19 for any taxable year, any amount required to be 20 included in gross income for such taxable year 21 shall be so included ratably over the 3-taxable- 22 year period beginning with such taxable year. 23 24 February 7, 2018 (10:12 p.m.) (B) SPECIAL RULE.—For purposes of sub- paragraph (A), rules similar to the rules of sub- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 113 1 paragraph (E) of section 408A(d)(3) of the In- 2 ternal Revenue Code of 1986 shall apply. 3 (6) SPECIAL 4 RULES.— (A) EXEMPTION OF DISTRIBUTIONS FROM 5 TRUSTEE TO TRUSTEE TRANSFER AND WITH- 6 HOLDING 7 401(a)(31), 402(f), and 3405 of the Internal 8 Revenue Code of 1986, qualified wildfire dis- 9 tributions shall not be treated as eligible roll- 10 11 RULES.—For purposes of sections over distributions. (B) QUALIFIED WILDFIRE DISTRIBUTIONS 12 TREATED AS MEETING PLAN DISTRIBUTION RE- 13 QUIREMENTS.—For 14 enue Code of 1986, a qualified wildfire distribu- 15 tion shall be treated as meeting the require- 16 ments 17 403(b)(7)(A)(ii), 403(b)(11), and 457(d)(1)(A) 18 of such Code. 19 (b) RECONTRIBUTIONS of purposes the Internal Rev- sections OF 401(k)(2)(B)(i), WITHDRAWALS FOR 20 HOME PURCHASES.— 21 22 (1) RECONTRIBUTIONS.— (A) IN GENERAL.—Any individual who re- 23 ceived a qualified distribution may, during the 24 period beginning on October 8, 2017, and end- 25 ing on June 30, 2018, make one or more con- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 114 1 tributions in an aggregate amount not to exceed 2 the amount of such qualified distribution to an 3 eligible retirement plan (as defined in section 4 402(c)(8)(B) of the Internal Revenue Code of 5 1986) of which such individual is a beneficiary 6 and to which a rollover contribution of such dis- 7 tribution could be made under section 402(c), 8 403(a)(4), 403(b)(8), or 408(d)(3), of such 9 Code, as the case may be. 10 (B) TREATMENT OF REPAYMENTS.—Rules 11 similar to the rules of subparagraphs (B) and 12 (C) of subsection (a)(3) shall apply for purposes 13 of this subsection. 14 (2) QUALIFIED DISTRIBUTION.—For purposes 15 of this subsection, the term ‘‘qualified distribution’’ 16 means any distribution— 17 (A) described in section 18 401(k)(2)(B)(i)(IV), 403(b)(7)(A)(ii) (but only 19 to the extent such distribution relates to finan- 20 cial hardship), 403(b)(11)(B), or 72(t)(2)(F), 21 of the Internal Revenue Code of 1986, 22 23 (B) received after March 31, 2017, and before January 15, 2018, and 24 (C) which was to be used to purchase or 25 construct a principal residence in the California February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 115 1 wildfire disaster area but which was not so pur- 2 chased or constructed on account of the 3 wildfires to which the declaration of such area 4 relates. 5 6 (c) LOANS FROM QUALIFIED PLANS.— (1) INCREASE IN LIMIT ON LOANS NOT TREAT- 7 ED AS DISTRIBUTIONS.—In 8 from a qualified employer plan (as defined under 9 section 72(p)(4) of the Internal Revenue Code of 10 1986) to a qualified individual made during the pe- 11 riod beginning on the date of the enactment of this 12 Act and ending on December 31, 2018— the case of any loan 13 (A) clause (i) of section 72(p)(2)(A) of 14 such Code shall be applied by substituting 15 ‘‘$100,000’’ for ‘‘$50,000’’, and 16 (B) clause (ii) of such section shall be ap- 17 plied by substituting ‘‘the present value of the 18 nonforfeitable accrued benefit of the employee 19 under the plan’’ for ‘‘one-half of the present 20 value of the nonforfeitable accrued benefit of 21 the employee under the plan’’. 22 (2) DELAY OF REPAYMENT.—In the case of a 23 qualified individual with an outstanding loan on or 24 after October 8, 2017, from a qualified employer February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 116 1 plan (as defined in section 72(p)(4) of the Internal 2 Revenue Code of 1986)— 3 (A) if the due date pursuant to subpara- 4 graph (B) or (C) of section 72(p)(2) of such 5 Code for any repayment with respect to such 6 loan occurs during the period beginning on Oc- 7 tober 8, 2017, and ending on December 31, 8 2018, such due date shall be delayed for 1 year, 9 (B) any subsequent repayments with re- 10 spect to any such loan shall be appropriately 11 adjusted to reflect the delay in the due date 12 under paragraph (1) and any interest accruing 13 during such delay, and 14 (C) in determining the 5-year period and 15 the term of a loan under subparagraph (B) or 16 (C) of section 72(p)(2) of such Code, the period 17 described in subparagraph (A) shall be dis- 18 regarded. 19 (3) QUALIFIED INDIVIDUAL.—For purposes of 20 this subsection, the term ‘‘qualified individual’’ 21 means any individual whose principal place of abode 22 during any portion of the period from October 8, 23 2017, to December 31, 2017, is located in the Cali- 24 fornia wildfire disaster area and who has sustained February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 117 1 an economic loss by reason of wildfires to which the 2 declaration of such area relates. 3 (d) PROVISIONS RELATING 4 TO PLAN AMEND- MENTS.— 5 (1) IN GENERAL.—If this subsection applies to 6 any amendment to any plan or annuity contract, 7 such plan or contract shall be treated as being oper- 8 ated in accordance with the terms of the plan during 9 the period described in paragraph (2)(B)(i). 10 11 12 (2) AMENDMENTS TO WHICH SUBSECTION AP- PLIES.— (A) IN GENERAL.—This subsection shall 13 apply to any amendment to any plan or annuity 14 contract which is made— 15 (i) pursuant to any provision of this 16 section, or pursuant to any regulation 17 issued by the Secretary or the Secretary of 18 Labor under any provision of this section, 19 and 20 (ii) on or before the last day of the 21 first plan year beginning on or after Janu- 22 ary 1, 2019, or such later date as the Sec- 23 retary may prescribe. 24 In the case of a governmental plan (as defined 25 in section 414(d) of the Internal Revenue Code February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 118 1 of 1986), clause (ii) shall be applied by sub- 2 stituting the date which is 2 years after the 3 date otherwise applied under clause (ii). 4 (B) CONDITIONS.—This subsection shall 5 not apply to any amendment unless— 6 (i) during the period— 7 (I) beginning on the date that 8 this section or the regulation de- 9 scribed in subparagraph (A)(i) takes 10 effect (or in the case of a plan or con- 11 tract amendment not required by this 12 section or such regulation, the effec- 13 tive date specified by the plan), and 14 (II) ending on the date described 15 in subparagraph (A)(ii) (or, if earlier, 16 the date the plan or contract amend- 17 ment is adopted), 18 the plan or contract is operated as if such plan 19 or contract amendment were in effect, and 20 (ii) such plan or contract amendment 21 22 applies retroactively for such period. SEC. 20103. EMPLOYEE RETENTION CREDIT FOR EMPLOY- 23 24 ERS AFFECTED BY CALIFORNIA WILDFIRES. (a) IN GENERAL.—For purposes of section 38 of the 25 Internal Revenue Code of 1986, in the case of an eligible February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 119 1 employer, the California wildfire employee retention credit 2 shall be treated as a credit listed in subsection (b) of such 3 section. For purposes of this subsection, the California 4 wildfire employee retention credit for any taxable year is 5 an amount equal to 40 percent of the qualified wages with 6 respect to each eligible employee of such employer for such 7 taxable year. For purposes of the preceding sentence, the 8 amount of qualified wages which may be taken into ac9 count with respect to any individual shall not exceed 10 $6,000. 11 12 13 (b) DEFINITIONS.—For purposes of this section— (1) ELIGIBLE EMPLOYER.—The term ‘‘eligible employer’’ means any employer— 14 (A) which conducted an active trade or 15 business on October 8, 2017, in the California 16 wildfire disaster zone, and 17 (B) with respect to whom the trade or 18 business described in subparagraph (A) is inop- 19 erable on any day after October 8, 2017, and 20 before January 1, 2018, as a result of damage 21 sustained by reason of the wildfires to which 22 such declaration of such area relates. 23 (2) ELIGIBLE EMPLOYEE.—The term ‘‘eligible 24 employee’’ means with respect to an eligible em- 25 ployer an employee whose principal place of employ- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 120 1 ment on October 8, 2017, with such eligible em- 2 ployer was in the California wildfire disaster zone. 3 (3) QUALIFIED WAGES.—The term ‘‘qualified 4 wages’’ means wages (as defined in section 51(c)(1) 5 of the Internal Revenue Code of 1986, but without 6 regard to section 3306(b)(2)(B) of such Code) paid 7 or incurred by an eligible employer with respect to 8 an eligible employee on any day after October 8, 9 2017, and before January 1, 2018, which occurs 10 during the period— 11 (A) beginning on the date on which the 12 trade or business described in paragraph (1) 13 first became inoperable at the principal place of 14 employment of the employee immediately before 15 the wildfires to which the declaration of the 16 California wildfire disaster area relates, and 17 (B) ending on the date on which such 18 trade or business has resumed significant oper- 19 ations at such principal place of employment. 20 Such term shall include wages paid without regard 21 to whether the employee performs no services, per- 22 forms services at a different place of employment 23 than such principal place of employment, or per- 24 forms services at such principal place of employment 25 before significant operations have resumed. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 121 1 (c) CERTAIN RULES TO APPLY.—For purposes of 2 this section, rules similar to the rules of sections 51(i)(1), 3 52, and 280C(a) of the Internal Revenue Code of 1986, 4 shall apply. 5 (d) EMPLOYEE NOT TAKEN INTO ACCOUNT MORE 6 THAN ONCE.—An employee shall not be treated as an eli7 gible employee for purposes of this section for any period 8 with respect to any employer if such employer is allowed 9 a credit under section 51 of the Internal Revenue Code 10 of 1986 with respect to such employee for such period. 11 SEC. 20104. ADDITIONAL DISASTER-RELATED TAX RELIEF 12 13 PROVISIONS. (a) TEMPORARY SUSPENSION OF LIMITATIONS ON 14 CHARITABLE CONTRIBUTIONS.— 15 (1) IN GENERAL.—Except as otherwise pro- 16 vided in paragraph (2), subsection (b) of section 170 17 of the Internal Revenue Code of 1986 shall not 18 apply to qualified contributions and such contribu- 19 tions shall not be taken into account for purposes of 20 applying subsections (b) and (d) of such section to 21 other contributions. 22 (2) TREATMENT OF EXCESS CONTRIBUTIONS.— 23 For purposes of section 170 of the Internal Revenue 24 Code of 1986— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 122 1 2 (A) INDIVIDUALS.—In the case of an individual— 3 (i) LIMITATION.—Any qualified con- 4 tribution shall be allowed only to the ex- 5 tent that the aggregate of such contribu- 6 tions does not exceed the excess of the tax- 7 payer’s contribution base (as defined in 8 subparagraph (H) of section 170(b)(1) of 9 such Code) over the amount of all other 10 charitable contributions allowed under sec- 11 tion 170(b)(1) of such Code. 12 (ii) CARRYOVER.—If the aggregate 13 amount of qualified contributions made in 14 the contribution year (within the meaning 15 of section 170(d)(1) of such Code) exceeds 16 the limitation of clause (i), such excess 17 shall be added to the excess described in 18 the portion of subparagraph (A) of such 19 section which precedes clause (i) thereof 20 for purposes of applying such section. 21 (B) CORPORATIONS.—In the case of a cor- 22 poration— 23 (i) LIMITATION.—Any qualified con- 24 tribution shall be allowed only to the ex- 25 tent that the aggregate of such contribu- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 123 1 tions does not exceed the excess of the tax- 2 payer’s taxable income (as determined 3 under paragraph (2) of section 170(b) of 4 such Code) over the amount of all other 5 charitable contributions allowed under such 6 paragraph. 7 (ii) CARRYOVER.—Rules similar to the 8 rules of subparagraph (A)(ii) shall apply 9 for purposes of this subparagraph. 10 (3) EXCEPTION TO OVERALL LIMITATION ON 11 ITEMIZED DEDUCTIONS.—So 12 allowed under section 170 of the Internal Revenue 13 Code of 1986 as does not exceed the qualified con- 14 tributions paid during the taxable year shall not be 15 treated as an itemized deduction for purposes of sec- 16 tion 68 of such Code. 17 18 (4) QUALIFIED (A) IN much of any deduction CONTRIBUTIONS.— GENERAL.—For purposes of this 19 subsection, the term ‘‘qualified contribution’’ 20 means any charitable contribution (as defined 21 in section 170(c) of the Internal Revenue Code 22 of 1986) if— 23 (i) such contribution— 24 (I) is paid during the period be- 25 ginning on October 8, 2017, and end- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 124 1 ing on December 31, 2018, in cash to 2 an organization described in section 3 170(b)(1)(A) of such Code, and 4 (II) is made for relief efforts in 5 the California wildfire disaster area, 6 (ii) the taxpayer obtains from such or- 7 ganization contemporaneous written ac- 8 knowledgment (within the meaning of sec- 9 tion 170(f)(8) of such Code) that such con- 10 tribution was used (or is to be used) for 11 relief efforts described in clause (i)(II), 12 and 13 (iii) the taxpayer has elected the ap- 14 plication of this subsection with respect to 15 such contribution. 16 (B) EXCEPTION.—Such term shall not in- 17 clude a contribution by a donor if the contribu- 18 tion is— 19 (i) to an organization described in sec- 20 tion 509(a)(3) of the Internal Revenue 21 Code of 1986, or 22 (ii) for the establishment of a new, or 23 maintenance of an existing, donor advised 24 fund (as defined in section 4966(d)(2) of 25 such Code). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 125 1 (C) APPLICATION OF ELECTION TO PART- 2 NERSHIPS AND S CORPORATIONS.—In 3 of a partnership or S corporation, the election 4 under subparagraph (A)(iii) shall be made sepa- 5 rately by each partner or shareholder. 6 7 (b) SPECIAL RULES LATED 8 9 FOR the case QUALIFIED DISASTER-RE- PERSONAL CASUALTY LOSSES.— (1) IN GENERAL.—If an individual has a net disaster loss for any taxable year— 10 (A) the amount determined under section 11 165(h)(2)(A)(ii) of the Internal Revenue Code 12 of 1986 shall be equal to the sum of— 13 (i) such net disaster loss, and 14 (ii) so much of the excess referred to 15 in the matter preceding clause (i) of sec- 16 tion 165(h)(2)(A) of such Code (reduced 17 by the amount in clause (i) of this sub- 18 paragraph) as exceeds 10 percent of the 19 adjusted gross income of the individual, 20 (B) section 165(h)(1) of such Code shall 21 be applied by substituting ‘‘$500’’ for ‘‘$500 22 ($100 for taxable years beginning after Decem- 23 ber 31, 2009)’’, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 126 1 (C) the standard deduction determined 2 under section 63(c) of such Code shall be in- 3 creased by the net disaster loss, and 4 (D) section 56(b)(1)(E) of such Code shall 5 not apply to so much of the standard deduction 6 as is attributable to the increase under sub- 7 paragraph (C) of this paragraph. 8 (2) NET DISASTER LOSS.—For purposes of this 9 subsection, the term ‘‘net disaster loss’’ means the 10 excess of qualified disaster-related personal casualty 11 losses over personal casualty gains (as defined in 12 section 165(h)(3)(A) of the Internal Revenue Code 13 of 1986). 14 (3) QUALIFIED DISASTER-RELATED PERSONAL 15 CASUALTY 16 section, the term ‘‘qualified disaster-related personal 17 casualty losses’’ means losses described in section 18 165(c)(3) of the Internal Revenue Code of 1986 19 which arise in the California wildfire disaster area 20 on or after October 8, 2017, and which are attrib- 21 utable to the wildfires to which the declaration of 22 such area relates. 23 (c) SPECIAL RULE 24 COME.— February 7, 2018 (10:12 p.m.) LOSSES.—For FOR purposes of this sub- DETERMINING EARNED IN- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 127 1 (1) IN GENERAL.—In the case of a qualified in- 2 dividual, if the earned income of the taxpayer for the 3 taxable year which includes any portion of the period 4 from October 8, 2017, to December 31, 2017, is less 5 than the earned income of the taxpayer for the pre- 6 ceding taxable year, the credits allowed under sec- 7 tions 24(d) and 32 of the Internal Revenue Code of 8 1986 may, at the election of the taxpayer, be deter- 9 mined by substituting— 10 11 (A) such earned income for the preceding taxable year, for 12 (B) such earned income for the taxable 13 year which includes any portion of the period 14 from October 8, 2017, to December 31, 2017. 15 (2) QUALIFIED INDIVIDUAL.—For purposes of 16 this subsection, the term ‘‘qualified individual’’ 17 means any individual whose principal place of abode 18 during any portion of the period from October 8, 19 2017, to December 31, 2017, was located— 20 21 (A) in the California wildfire disaster zone, or 22 (B) in the California wildfire disaster area 23 (but outside the California wildfire disaster 24 zone) and such individual was displaced from 25 such principal place of abode by reason of the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 128 1 wildfires to which the declaration of such area 2 relates. 3 (3) EARNED INCOME.—For purposes of this 4 subsection, the term ‘‘earned income’’ has the mean- 5 ing given such term under section 32(c) of the Inter- 6 nal Revenue Code of 1986. 7 8 (4) SPECIAL RULES.— (A) APPLICATION TO JOINT RETURNS.— 9 For purposes of paragraph (1), in the case of 10 a joint return for a taxable year which includes 11 any portion of the period from October 8, 2017, 12 to December 31, 2017— 13 14 (i) such paragraph shall apply if either spouse is a qualified individual, and 15 (ii) the earned income of the taxpayer 16 for the preceding taxable year shall be the 17 sum of the earned income of each spouse 18 for such preceding taxable year. 19 (B) UNIFORM APPLICATION OF ELEC- 20 TION.—Any 21 shall apply with respect to both sections 24(d) 22 and 32, of the Internal Revenue Code of 1986. 23 election made under paragraph (1) (C) ERRORS TREATED AS MATHEMATICAL 24 ERROR.—For 25 Internal Revenue Code of 1986, an incorrect February 7, 2018 (10:12 p.m.) purposes of section 6213 of the U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 129 1 use on a return of earned income pursuant to 2 paragraph (1) shall be treated as a mathe- 3 matical or clerical error. 4 (D) NO EFFECT ON DETERMINATION OF 5 GROSS INCOME, ETC.—Except 6 vided in this subsection, the Internal Revenue 7 Code of 1986 shall be applied without regard to 8 any substitution under paragraph (1). 9 11 TITLE II—TAX RELIEF FOR HURRICANES HARVEY, IRMA, AND MARIA 12 SEC. 20201. TAX RELIEF FOR HURRICANES HARVEY, IRMA, 10 13 14 as otherwise pro- AND MARIA. (a) MODIFICATION OF HURRICANES HARVEY AND 15 IRMA DISASTER AREAS.—Subsections (a)(2) and (b)(2) of 16 section 501 of the Disaster Tax Relief and Airport and 17 Airway Extension Act of 2017 (Public Law 115–63; 131 18 Stat. 1173) are both amended by striking ‘‘September 21, 19 2017’’ and inserting ‘‘October 17, 2017’’. 20 (b) EMPLOYEE RETENTION CREDIT.—Subsections 21 (a)(3), (b)(3), and (c)(3) of section 503 of the Disaster 22 Tax Relief and Airport and Airway Extension Act of 2017 23 (Public Law 115–63; 131 Stat. 1181) are each amended 24 by striking ‘‘sections 51(i)(1) and 52’’ and inserting ‘‘sec25 tions 51(i)(1), 52, and 280C(a)’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 130 1 (c) EFFECTIVE DATE.—The amendments made by 2 this section shall take effect as if included in the provisions 3 of title V of the Disaster Tax Relief and Airport and Air4 way Extension Act of 2017 to which such amendments 5 relate. 9 TITLE III—HURRICANE MARIA RELIEF FOR PUERTO RICO AND THE VIRGIN ISLANDS MEDICAID PROGRAMS 10 SEC. 20301. HURRICANE MARIA RELIEF FOR PUERTO RICO 11 AND THE VIRGIN ISLANDS MEDICAID PRO- 12 GRAMS. 6 7 8 13 (a) INCREASED CAPS.—Section 1108(g)(5) of the So- 14 cial Security Act (42 U.S.C. 1308(g)(5)) is amended— 15 (1) in subparagraph (A), by striking ‘‘subpara- 16 graph (B)’’ and inserting ‘‘subparagraphs (B), (C), 17 (D), and (E)’’; and 18 19 (2) by adding at the end the following new subparagraphs: 20 ‘‘(C) Subject to subparagraphs (D) and (E), for 21 the period beginning January 1, 2018, and ending 22 September 30, 2019— 23 ‘‘(i) the amount of the increase otherwise 24 provided under subparagraphs (A) and (B) for February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 131 1 Puerto Rico shall be further increased by 2 $3,600,000,000; and 3 ‘‘(ii) the amount of the increase otherwise 4 provided under subparagraph (A) for the Virgin 5 Islands 6 $106,931,000. 7 ‘‘(D) For the period described in subparagraph 8 (C), the amount of the increase otherwise provided 9 under subparagraph (A)— shall be further increased by 10 ‘‘(i) for Puerto Rico shall be further in- 11 creased by $1,200,000,000 if the Secretary cer- 12 tifies that Puerto Rico has taken reasonable 13 and appropriate steps during such period, in ac- 14 cordance with a timeline established by the Sec- 15 retary, to— 16 ‘‘(I) implement methods, satisfactory 17 to the Secretary, for the collection and re- 18 porting of reliable data to the Transformed 19 Medicaid Statistical Information System 20 (T–MSIS) (or a successor system); and 21 ‘‘(II) demonstrate progress in estab- 22 lishing a State medicaid fraud control unit 23 described in section 1903(q); and 24 ‘‘(ii) for the Virgin Islands shall be further 25 increased by $35,644,000 if the Secretary cer- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 132 1 tifies that the Virgin Islands has taken reason- 2 able and appropriate steps during such period, 3 in accordance with a timeline established by the 4 Secretary, to meet the conditions for certifi- 5 cation specified in subclauses (I) and (II) of 6 clause (i). 7 ‘‘(E) Notwithstanding any other provision of 8 title XIX, during the period in which the additional 9 funds provided under subparagraphs (C) and (D) 10 are available for Puerto Rico and the Virgin Islands, 11 respectively, with respect to payments from such ad- 12 ditional funds for amounts expended by Puerto Rico 13 and the Virgin Islands under such title, the Sec- 14 retary shall increase the Federal medical assistance 15 percentage or other rate that would otherwise apply 16 to such payments to 100 percent.’’. 17 (b) DISREGARD OF CERTAIN EXPENDITURES FROM 18 SPENDING CAP.—Section 1108(g)(4) of the Social Secu19 rity Act (42 U.S.C. 1308(g)(4)) is amended— 20 21 (1) by inserting ‘‘for a calendar quarter of such fiscal year,’’ after ‘‘section 1903(a)(3)’’; and 22 (2) by striking ‘‘of such fiscal year for a cal- 23 endar quarter of such fiscal year,’’ and inserting ‘‘of 24 such fiscal year, and with respect to fiscal years be- 25 ginning with fiscal year 2018, if the Virgin Islands February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 133 1 qualifies for a payment under section 1903(a)(6) for 2 a calendar quarter (beginning on or after January 1, 3 2018) of such fiscal year,’’. 4 (c) REPORT TO CONGRESS.—Not later than July 1, 5 2018, the Secretary of Health and Human Services shall 6 submit a report to the Committee on Energy and Com7 merce of the House of Representatives and the Committee 8 on Finance of the Senate that— 9 (1) describes the steps taken by Puerto Rico 10 and the Virgin Islands to meet the conditions for 11 certification specified in clauses (i) and (ii ), respec- 12 tively, of section 1108(g)(5)(D) of the Social Secu- 13 rity Act (42 U.S.C. 1308(g)(5)(D)) (as amended by 14 subsection (a) of this section); and 15 (2) specifies timelines for each such territory to, 16 as a condition of eligibility for any additional in- 17 creases in the amounts determined for Puerto Rico 18 or the Virgin Islands, respectively, under subsection 19 (g) of section 1108 of such Act (42 U.S.C. 1308) for 20 purposes of payments under title XIX of such Act 21 for fiscal year 2019, complete— 22 (A) implementation of methods, satisfac- 23 tory to the Secretary, for the collection and re- 24 porting of reliable data to the Transformed February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 134 1 Medicaid Statistical Information System (T– 2 MSIS) (or a successor system); and 3 (B) the establishment of a State medicaid 4 fraud control unit described in section 1903(q) 5 of 6 1396d(q)). the Social Security Act (42 U.S.C. 7 TITLE IV—BUDGETARY EFFECTS 8 SEC. 20401. EMERGENCY DESIGNATION. 9 This subdivision is designated as an emergency re- 10 quirement pursuant to section 4(g) of the Statutory Pay11 As-You-Go Act of 2010 (2 U.S.C. 933(g)). 12 SEC. 20402. DESIGNATION IN SENATE. 13 In the Senate, this subdivision is designated as an 14 emergency requirement pursuant to section 4112(a) of H. 15 Con. Res. 71 (115th Congress), the concurrent resolution 16 on the budget for fiscal year 2018. 17 Subdivision 3—Further Extension of 18 Continuing Appropriations Act, 2018 19 SEC. 20101. The Continuing Appropriations Act, 20 2018 (division D of Public Law 115–56) is further amend21 ed by— 22 23 February 7, 2018 (10:12 p.m.) (1) striking the date specified in section 106(3) and inserting ‘‘March 23, 2018’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 135 1 (2) inserting after section 155 the following 2 new sections: 3 ‘‘SEC. 156. In addition to amounts provided by sec- 4 tion 101, amounts are provided for ‘Department of Com5 merce—Bureau of the Census—Periodic Census and Pro6 grams’ at a rate for operations of $182,000,000 for an 7 additional amount for the 2020 Decennial Census Pro8 gram; and such amounts may be apportioned up to the 9 rate for operations necessary to maintain the schedule and 10 deliver the required data according to statutory deadlines 11 in the 2020 Decennial Census Program. 12 ‘‘SEC. 157. Notwithstanding section 101, the matter 13 preceding the first proviso and the first proviso under the 14 heading ‘Power Marketing Administrations—Operation 15 and Maintenance, Southeastern Power Administration’ in 16 division D of Public Law 115–31 shall be applied by sub17 stituting ‘$6,379,000’ for ‘$1,000,000’ each place it ap18 pears. 19 ‘‘SEC. 158. As authorized by section 404 of the Bi- 20 partisan Budget Act of 2015 (Public Law 114–74; 42 21 U.S.C. 6239 note), the Secretary of Energy shall draw 22 down and sell not to exceed $350,000,000 of crude oil 23 from the Strategic Petroleum Reserve in fiscal year 2018: 24 Provided, That the proceeds from such drawdown and sale 25 shall be deposited into the ‘Energy Security and Infra- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 136 1 structure Modernization Fund’ (in this section referred to 2 as the ‘Fund’) during fiscal year 2018: Provided further, 3 That in addition to amounts otherwise made available by 4 section 101, any amounts deposited in the Fund shall be 5 made available and shall remain available until expended 6 at a rate for operations of $350,000,000, for necessary 7 expenses in carrying out the Life Extension II project for 8 the Strategic Petroleum Reserve. 9 ‘‘SEC. 159. Amounts made available by section 101 10 for ‘The Judiciary—Courts of Appeals, District Courts, 11 and Other Judicial Services—Fees of Jurors and Commis12 sioners’ may be apportioned up to the rate for operations 13 necessary to accommodate increased juror usage. 14 ‘‘SEC. 160. Section 144 of the Continuing Appropria- 15 tions Act, 2018 (division D of Public Law 115–56), as 16 amended by the Further Additional Continuing Appro17 priations Act, 2018 (division A of Public Law 115–96), 18 is amended by (1) striking ‘$11,761,000’ and inserting 19 ‘$22,247,000’, and (2) striking ‘$1,104,000’ and inserting 20 ‘$1,987,000’. 21 ‘‘SEC. 161. Section 458(a)(4) of the Higher Edu- 22 cation Act of 1965 (20 U.S.C. 1087h(a)(4)) shall be ap23 plied by substituting ‘2018’ for ‘2017’. 24 ‘‘SEC. 162. For the purpose of carrying out section 25 435(a)(2) of the Higher Education Act of 1965 (HEA) February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 137 1 (20 U.S.C. 1085(a)(2)), during the period covered by this 2 Act the Secretary of Education may waive the requirement 3 under section 435(a)(5)(A)(ii) of the HEA (20 U.S.C. 4 1085(a)(5)(A)(ii)) for an institution of higher education 5 that offers an associate degree, is a public institution, and 6 is located in an economically distressed county, defined as 7 a county that ranks in the lowest 5 percent of all counties 8 in the United States based on a national index of county 9 economic status: Provided, That this section shall apply 10 to an institution of higher education that otherwise would 11 be ineligible to participate in a program under part A of 12 title IV of the HEA on or after the date of enactment 13 of this Act due to the application of section 435(a)(2) of 14 the HEA. 15 ‘‘SEC. 163. Notwithstanding any other provision of 16 law, funds made available by this Act for military con17 struction, land acquisition, and family housing projects 18 and activities may be obligated and expended to carry out 19 planning and design and military construction projects au20 thorized by law: Provided, That funds and authority pro21 vided by this section may be used notwithstanding sections 22 102 and 104: Provided further, That such funds may be 23 used only for projects identified by the Department of the 24 Air Force in its January 29, 2018, letter sent to the Com25 mittees on Appropriations of both Houses of Congress de- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 138 1 tailing urgently needed fiscal year 2018 construction re2 quirements. 3 ‘‘SEC. 164. (a) Section 116(h)(3)(D) of title 49, 4 United States Code, is amended— 5 ‘‘(1) in clause (i), by striking ‘During the 2- 6 year period beginning on the date of enactment of 7 this section, the’; inserting ‘The’; and inserting the 8 following after the first sentence: ‘Any such funds or 9 limitation of obligations or portions thereof trans- 10 ferred to the Bureau may be transferred back to and 11 merged with the original account.’; and 12 ‘‘(2) in clause (ii) by striking ‘During the 2- 13 year period beginning on the date of enactment of 14 this section, the’; inserting ‘The’; and inserting the 15 following after the first sentence: ‘Any such funds or 16 limitation of obligations or portions thereof trans- 17 ferred to the Bureau may be transferred back to and 18 merged with the original account.’. 19 ‘‘(b) Section 503(l)(4) of the Railroad Revitalization 20 and Regulatory Reform Act of 1976 (45 U.S.C. 823(l)(4)) 21 is amended— 22 ‘‘(1) in the heading by striking ‘Safety and op- 23 erations account’ and inserting ‘National Surface 24 Transportation and Innovative Finance Bureau ac- 25 count’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 139 1 ‘‘(2) in subparagraph (A) by striking ‘Safety 2 and Operations account of the Federal Railroad Ad- 3 ministration’ and inserting ‘National Surface Trans- 4 portation and Innovative Finance Bureau account’. 5 ‘‘SEC. 165. Section 24(o) of the United States Hous- 6 ing Act of 1937 (42 U.S.C. 1437v) shall be applied by 7 substituting the date specified in section 106(3) for ‘Sep8 tember 30, 2017’.’’. 9 This subdivision may be cited as the ‘‘Further Exten- 10 sion of Continuing Appropriations Act, 2018’’. 11 12 13 DIVISION C—BUDGETARY AND OTHER MATTERS SEC. 30001. TABLE OF CONTENTS. 14 The table of contents for this division is as follows: DIVISION C—BUDGETARY AND OTHER MATTERS Sec. 30001. Table of contents. TITLE I—BUDGET ENFORCEMENT Sec. 30101. Amendments to the Balanced Budget and Emergency Deficit Control Act of 1985. Sec. 30102. Balances on the PAYGO Scorecards. Sec. 30103. Authority for fiscal year 2019 budget resolution in the Senate. Sec. 30104. Authority for fiscal year 2019 budget resolution in the House of Representatives. Sec. 30105. Exercise of rulemaking powers. TITLE II—OFFSETS Sec. Sec. Sec. Sec. Sec. Sec. 30201. 30202. 30203. 30204. 30205. 30206. Customs user fees. Aviation security service fees. Extension of certain immigration fees. Strategic Petroleum Reserve drawdown. Elimination of surplus funds of Federal reserve banks. Reemployment services and eligibility assessments. TITLE III—TEMPORARY EXTENSION OF PUBLIC DEBT LIMIT February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 140 Sec. 30301. Temporary extension of public debt limit. TITLE IV—JOINT SELECT COMMITTEES Subtitle A—Joint Select Committee on Solvency of Multiemployer Pension Plans Sec. Sec. Sec. Sec. 30421. 30422. 30423. 30424. Definitions. Establishment of Joint Select Committee. Funding. Consideration of joint committee bill in the Senate. Subtitle B—Joint Select Committee on Budget and Appropriations Process Reform Sec. Sec. Sec. Sec. 30441. 30442. 30443. 30444. Definitions. Establishment of Joint Select Committee. Funding. Consideration of joint committee bill in the Senate. 2 TITLE I—BUDGET ENFORCEMENT 3 SEC. 30101. AMENDMENTS TO THE BALANCED BUDGET AND 4 EMERGENCY DEFICIT CONTROL ACT OF 1985. 5 (a) REVISED DISCRETIONARY SPENDING LIMITS.— 1 6 Section 251(c) of the Balanced Budget and Emergency 7 Deficit Control Act of 1985 (2 U.S.C. 901(c)) is amended 8 by striking paragraphs (5) and (6) and inserting the fol9 lowing: 10 ‘‘(5) for fiscal year 2018— 11 ‘‘(A) for the revised security category, 12 $629,000,000,000 in new budget authority; and 13 ‘‘(B) for the revised nonsecurity category 14 $579,000,000,000 in new budget authority; 15 ‘‘(6) for fiscal year 2019— 16 ‘‘(A) for the revised security category, 17 $647,000,000,000 in new budget authority; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 141 1 2 3 ‘‘(B) for the revised nonsecurity category, $597,000,000,000 in new budget authority;’’. (b) DIRECT SPENDING ADJUSTMENTS 4 YEARS 2018 AND FOR FISCAL 2019.—Section 251A of the Balanced 5 Budget and Emergency Deficit Control Act of 1985 (2 6 U.S.C. 901a), is amended— 7 (1) in paragraph (5)(B), in the matter pre- 8 ceding clause (i), by striking ‘‘and (11)’’ and insert- 9 ing ‘‘, (11), and (12)’’; and 10 (2) by adding at the end the following: 11 ‘‘(12) IMPLEMENTING DIRECT SPENDING RE- 12 DUCTIONS FOR FISCAL YEARS 2018 AND 2019.—(A) 13 OMB shall make the calculations necessary to imple- 14 ment the direct spending reductions calculated pur- 15 suant to paragraphs (3) and (4) without regard to 16 the amendment made to section 251(c) revising the 17 discretionary spending limits for fiscal years 2018 18 and 2019 by the Bipartisan Budget Act of 2018. 19 ‘‘(B) Paragraph (5)(B) shall not be imple- 20 mented for fiscal years 2018 and 2019.’’. 21 (c) EXTENSION OF DIRECT SPENDING REDUCTIONS 22 THROUGH FISCAL YEAR 2027.—Section 251A(6) of the 23 Balanced Budget and Emergency Deficit Control Act of 24 1985 (2 U.S.C. 901a(6)) is amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 142 1 (1) in subparagraph (B), in the matter pre- 2 ceding clause (i), by striking ‘‘for fiscal year 2022, 3 for fiscal year 2023, for fiscal year 2024, and for 4 fiscal year 2025’’ and inserting ‘‘for each of fiscal 5 years 2022 through 2027’’; and 6 (2) in subparagraph (C), in the matter pre- 7 ceding clause (i), by striking ‘‘fiscal year 2025’’ and 8 inserting ‘‘fiscal year 2027’’. 9 SEC. 30102. BALANCES ON THE PAYGO SCORECARDS. 10 Effective on the date of enactment of this Act, the 11 balances on the PAYGO scorecards established pursuant 12 to paragraphs (4) and (5) of section 4(d) of the Statutory 13 Pay-As-You-Go Act of 2010 (2 U.S.C. 933(d)) shall be 14 zero. 15 SEC. 30103. AUTHORITY FOR FISCAL YEAR 2019 BUDGET 16 17 RESOLUTION IN THE SENATE. (a) FISCAL YEAR 2019.—For purposes of enforcing 18 the Congressional Budget Act of 1974 (2 U.S.C. 621 et 19 seq.) after April 15, 2018, and enforcing budgetary points 20 of order in prior concurrent resolutions on the budget, the 21 allocations, aggregates, and levels provided for in sub22 section (b) shall apply in the Senate in the same manner 23 as for a concurrent resolution on the budget for fiscal year 24 2019 with appropriate budgetary levels for fiscal years 25 2020 through 2028. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 143 1 (b) COMMITTEE ALLOCATIONS, AGGREGATES, AND 2 LEVELS.—After April 15, 2018, but not later than May 3 15, 2018, the Chairman of the Committee on the Budget 4 of the Senate shall file— 5 (1) for the Committee on Appropriations, com- 6 mittee allocations for fiscal year 2019 consistent 7 with discretionary spending limits set forth in sec- 8 tion 251(c)(6) of the Balanced Budget and Emer- 9 gency Deficit Control Act of 1985, as amended by 10 this Act, for the purposes of enforcing section 302 11 of the Congressional Budget Act of 1974 (2 U.S.C. 12 633); 13 (2) for all committees other than the Com- 14 mittee on Appropriations, committee allocations for 15 fiscal years 2019, 2019 through 2023, and 2019 16 through 2028 consistent with the most recent base- 17 line of the Congressional Budget Office, as adjusted 18 for the budgetary effects of any provision of law en- 19 acted during the period beginning on the date such 20 baseline is issued and ending on the date of submis- 21 sion of such statement, for the purposes of enforcing 22 section 302 of the Congressional Budget Act of 23 1974 (2 U.S.C. 633); 24 (3) aggregate spending levels for fiscal year 25 2019 in accordance with the allocations established February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 144 1 under paragraphs (1) and (2), for the purpose of en- 2 forcing section 311 of the Congressional Budget Act 3 of 1974 (2 U.S.C. 642); 4 (4) aggregate revenue levels for fiscal years 5 2019, 2019 through 2023, and 2019 through 2028 6 consistent with the most recent baseline of the Con- 7 gressional Budget Office, as adjusted for the budg- 8 etary effects of any provision of law enacted during 9 the period beginning on the date such baseline is 10 issued and ending on the date of submission of such 11 statement, for the purpose of enforcing section 311 12 of the Congressional Budget Act of 1974 (2 U.S.C. 13 642); and 14 (5) levels of Social Security revenues and out- 15 lays for fiscal years 2019, 2019 through 2023, and 16 2019 through 2028 consistent with the most recent 17 baseline of the Congressional Budget Office, as ad- 18 justed for the budgetary effects of any provision of 19 law enacted during the period beginning on the date 20 such baseline is issued and ending on the date of 21 submission of such statement, for the purpose of en- 22 forcing sections 302 and 311 of the Congressional 23 Budget Act of 1974 (2 U.S.C. 633 and 642). 24 (c) ADDITIONAL MATTER.—The filing referred to in 25 subsection (b) may also include for fiscal year 2019 the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 145 1 deficit-neutral reserve funds contained in title III of H. 2 Con. Res. 71 (115th Congress) updated by one fiscal year. 3 (d) EXPIRATION.—This section shall expire if a con- 4 current resolution on the budget for fiscal year 2019 is 5 agreed to by the Senate and the House of Representatives 6 pursuant to section 301 of the Congressional Budget Act 7 of 1974 (2 U.S.C. 632). 8 SEC. 30104. AUTHORITY FOR FISCAL YEAR 2019 BUDGET 9 RESOLUTION IN THE HOUSE OF REPRESENT- 10 11 ATIVES. (a) FISCAL YEAR 2019.—If a concurrent resolution 12 on the budget for fiscal year 2019 has not been adopted 13 by April 15, 2018, for the purpose of enforcing the Con14 gressional Budget Act of 1974, the allocations, aggre15 gates, and levels provided for in subsection (b) shall apply 16 in the House of Representatives after April 15, 2018, in 17 the same manner as for a concurrent resolution on the 18 budget for fiscal year 2019 with appropriate budgetary 19 levels for fiscal year 2019 and for fiscal years 2020 20 through 2028. 21 (b) COMMITTEE ALLOCATIONS, AGGREGATES, AND 22 LEVELS.—In the House of Representatives, the Chair of 23 the Committee on the Budget shall submit a statement 24 for publication in the Congressional Record after April 15, 25 2018, but not later than May 15, 2018, containing— February 7, 2018 (10:12 p.m.) 8REPT\Supp\CRSupp.mnl SEN . AP R0. x] L11 43 DJ February 7. 2018 (10:12 pm.) 146 (1) for the Committee on Appropriations, com- mittee allocations for ?scal year 2019 for discre- tionary budget authority at the total level set forth in section 251(c)( of the Balanced Budget and? Emergency De?cit Control Act of 1985.{ and the out? lays flowing therefrom, and allocations for ?scal year 2019 for current law mandatory budget authority and outlays, for the purpose of en? forcing section 302 of the Congressional Budget Act of 1974; (2) for all committees other than the Com? mittee on ApprOpriations, committee allocations for ?scal year 2019 and for the period of fiscal years 2019 through 2028 at the levels included in the most recent baseline of the Congressional Budget Of?ce, as adjusted for the budgetary effects of any provision of law enacted during the period beginning on the date such baseline is issued and ending on the date of submission of such statement, for the purpose of enforcing section 302 of the Congres? sional Budget Act of 1974; and (3) aggregate spending levels for fiscal year 2019 and aggregate revenue levels for ?scal year 2019 and for the period of ?scal years 2019 through 2028, at the levels included in the most recent base? 3? as amended bl Jd?ftS U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 147 1 line of the Congressional Budget Office, as adjusted 2 for the budgetary effects of any provision of law en- 3 acted during the period beginning on the date such 4 baseline is issued and ending on the date of submis- 5 sion of such statement, for the purpose of enforcing 6 section 311 of the Congressional Budget Act of 7 1974. 8 (c) ADDITIONAL MATTER.—The statement referred 9 to in subsection (b) may also include for fiscal year 2019, 10 the matter contained in the provisions referred to in sub11 section (f)(1). 12 13 (d) FISCAL YEAR 2019 ALLOCATION MITTEE ON TO THE COM- APPROPRIATIONS.—If the statement referred 14 to in subsection (b) is not filed by May 15, 2018, then 15 the matter referred to in subsection (b)(1) shall be sub16 mitted by the Chair of the Committee on the Budget for 17 publication in the Congressional Record on the next day 18 that the House of Representatives is in session. 19 (e) ADJUSTMENTS.—The chair of the Committee on 20 the Budget of the House of Representatives may adjust 21 the levels included in the statement referred to in sub22 section (b) to reflect the budgetary effects of any legisla23 tion enacted during the 115th Congress that reduces the 24 deficit or as otherwise necessary. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 148 1 (f) APPLICATION.—Upon submission of the state- 2 ment referred to in subsection (b)— 3 (1) all references in sections 5101 through 4 5112, sections 5201 through 5205, section 5301, 5 and section 5401 of House Concurrent Resolution 6 71 (115th Congress) to a fiscal year shall be consid- 7 ered for all purposes in the House to be references 8 to the succeeding fiscal year; and 9 (2) all references in the provisions referred to 10 in paragraph (1) to allocations, aggregates, or other 11 appropriate levels in ‘‘this concurrent resolution’’, 12 ‘‘the most recently agreed to concurrent resolution 13 on the budget’’, or ‘‘this resolution’’ shall be consid- 14 ered for all purposes in the House to be references 15 to the allocations, aggregates, or other appropriate 16 levels contained in the statement referred to in sub- 17 section (b), as adjusted. 18 (g) EXPIRATION.—Subsections (a) through (f) shall 19 no longer apply if a concurrent resolution on the budget 20 for fiscal year 2019 is agreed to by the Senate and House 21 of Representatives. 22 SEC. 30105. EXERCISE OF RULEMAKING POWERS. 23 Sections 30103 and 30104 are enacted by the Con- 24 gress— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 149 1 (1) as an exercise of the rulemaking power of 2 the Senate and the House of Representatives, re- 3 spectively, and as such they shall be considered as 4 part of the rules of each House, respectively, or of 5 that House to which they specifically apply, and 6 such rules shall supersede other rules only to the ex- 7 tent that they are inconsistent therewith; and 8 (2) with full recognition of the constitutional 9 right of either House to change such rules (so far 10 as relating to such House) at any time, in the same 11 manner, and to the same extent as in the case of 12 any other rule of such House. TITLE II—OFFSETS 13 14 SEC. 30201. CUSTOMS USER FEES. 15 (a) IN GENERAL.—Section 13031(j)(3) of the Con- 16 solidated Omnibus Budget Reconciliation Act of 1985 (19 17 U.S.C. 58c(j)(3)) is amended— 18 (1) in subparagraph (A), by striking ‘‘January 19 14, 2026’’ and inserting ‘‘February 24, 2027’’; and 20 (2) in subparagraph (B)(i), by striking ‘‘Sep- 21 tember 30, 2025’’ and inserting ‘‘September 30, 22 2027’’. 23 (b) RATE FOR MERCHANDISE PROCESSING FEES.— 24 Section 503 of the United States–Korea Free Trade 25 Agreement Implementation Act (Public Law 112–41; 19 February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 150 1 U.S.C. 3805 note) is amended by striking ‘‘January 14, 2 2026’’ and inserting ‘‘February 24, 2027’’. 3 SEC. 30202. AVIATION SECURITY SERVICE FEES. 4 Paragraph (4) of section 44940(i) of title 49, United 5 States Code, is amended by adding at the end the fol6 lowing new subparagraphs: 7 ‘‘(M) $1,640,000,000 for fiscal year 2026. 8 ‘‘(N) 9 10 $1,680,000,000 for fiscal year 2027.’’. SEC. 30203. EXTENSION OF CERTAIN IMMIGRATION FEES. 11 (a) VISA WAIVER PROGRAM.—Section 12 217(h)(3)(B)(iii) of the Immigration and Nationality Act 13 (8 U.S.C. 1187(h)(3)(B)(iii)) is amended by striking 14 ‘‘September 30, 2020’’ and inserting ‘‘September 30, 15 2027’’. 16 (b) L-1 AND H-1B VISAS.—Section 411 of the Air 17 Transportation Safety and System Stabilization Act (49 18 U.S.C. 40101 note) is amended by striking ‘‘September 19 30, 2025’’ each place it appears and inserting ‘‘September 20 30, 2027’’. 21 SEC. 30204. STRATEGIC PETROLEUM RESERVE DRAWDOWN. 22 23 (a) DRAWDOWN AND SALE.— (1) IN GENERAL.—Notwithstanding section 161 24 of the Energy Policy and Conservation Act (42 25 U.S.C. 6241), except as provided in subsection (b), February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 151 1 the Secretary of Energy shall draw down and sell 2 from the Strategic Petroleum Reserve— 3 (A) 30,000,000 barrels of crude oil during 4 the period of fiscal years 2022 through 2025; 5 (B) 35,000,000 barrels of crude oil during 6 fiscal year 2026; and 7 (C) 35,000,000 barrels of crude oil during 8 fiscal year 2027. 9 (2) DEPOSIT OF AMOUNTS RECEIVED FROM 10 SALE.—Amounts 11 graph (1) shall be deposited in the general fund of 12 the Treasury during the fiscal year in which the sale 13 occurs. 14 (b) EMERGENCY PROTECTION.—The Secretary of received from a sale under para- 15 Energy may not draw down and sell crude oil under this 16 section in quantities that would limit the authority to sell 17 petroleum products under subsection (h) of section 161 18 of the Energy Policy and Conservation Act (42 U.S.C. 19 6241) in the full quantity authorized by that subsection. 20 21 (c) STRATEGIC PETROLEUM DRAWDOWN CONDITIONS AND LIMITATIONS.— 22 (1) CONDITIONS.—Section 161(h)(1) of the En- 23 ergy Policy and Conservation Act (42 U.S.C. 24 6241(h)(1)) is amended in subparagraph (B) by 25 striking ‘‘shortage; and’’ and all that follows through February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 152 1 ‘‘Secretary of’’ in subparagraph (C) and inserting 2 the following: ‘‘shortage; 3 ‘‘(C) the Secretary has found that action 4 taken under this subsection will not impair the 5 ability of the United States to carry out obliga- 6 tions of the United States under the inter- 7 national energy program; and 8 ‘‘(D) the Secretary of’’. 9 (2) LIMITATIONS.—Section 161(h)(2) of the 10 Energy Policy and Conservation Act (42 U.S.C. 11 6241(h)(2)) is amended by striking ‘‘450,000,000’’ 12 each place it appears and inserting ‘‘350,000,000’’. 13 SEC. 30205. ELIMINATION OF SURPLUS FUNDS OF FEDERAL 14 RESERVE BANKS. 15 Section 7(a)(3)(A) of the Federal Reserve Act (12 16 U.S.C. 289(a)(3)(A)) is amended by striking 17 ‘‘$10,000,000,000’’ and inserting ‘‘$7,500,000,000’’. 18 SEC. 30206. REEMPLOYMENT SERVICES AND ELIGIBILITY 19 20 ASSESSMENTS. (a) IN GENERAL.—Title III of the Social Security 21 Act (42 U.S.C. 501 et seq.) is amended by adding at the 22 end the following: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 153 1 ‘‘SEC. 306. GRANTS TO STATES FOR REEMPLOYMENT SERV- 2 ICES AND ELIGIBILITY ASSESSMENTS. 3 ‘‘(a) IN GENERAL.—The Secretary of Labor (in this 4 section referred to as the ‘Secretary’) shall award grants 5 under this section for a fiscal year to eligible States to 6 conduct a program of reemployment services and eligibility 7 assessments for individuals referred to reemployment serv8 ices as described in section 303(j) for weeks in such fiscal 9 year for which such individuals receive unemployment 10 compensation. 11 ‘‘(b) PURPOSES.—The purposes of this section are to 12 accomplish the following goals: 13 ‘‘(1) To improve employment outcomes of indi- 14 viduals that receive unemployment compensation and 15 to reduce the average duration of receipt of such 16 compensation through employment. 17 ‘‘(2) To strengthen program integrity and re- 18 duce improper payments of unemployment com- 19 pensation by States through the detection and pre- 20 vention of such payments to individuals who are not 21 eligible for such compensation. 22 ‘‘(3) To promote alignment with the broader vi- 23 sion of the Workforce Innovation and Opportunity 24 Act (29 U.S.C. 3101 et seq.) of increased program 25 integration and service delivery for job seekers, in- 26 cluding claimants for unemployment compensation. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 154 1 ‘‘(4) To establish reemployment services and 2 eligibility assessments as an entry point for individ- 3 uals receiving unemployment compensation into 4 other workforce system partner programs. 5 ‘‘(c) EVIDENCE-BASED STANDARDS.— 6 ‘‘(1) IN GENERAL.—In carrying out a State 7 program of reemployment services and eligibility as- 8 sessments using grant funds awarded to the State 9 under this section, a State shall use such funds only 10 for interventions demonstrated to reduce the number 11 of weeks for which program participants receive un- 12 employment compensation by improving employment 13 outcomes for program participants. 14 ‘‘(2) EXPANDING EVIDENCE-BASED INTERVEN- 15 TIONS.—In 16 paragraph (1), a State shall— addition to the requirement imposed by 17 ‘‘(A) for fiscal years 2023 and 2024, use 18 no less than 25 percent of the grant funds 19 awarded to the State under this section for 20 interventions with a high or moderate causal 21 evidence rating that show a demonstrated ca- 22 pacity to improve employment and earnings 23 outcomes for program participants; 24 ‘‘(B) for fiscal years 2025 and 2026, use 25 no less than 40 percent of such grant funds for February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 155 1 interventions described in subparagraph (A); 2 and 3 ‘‘(C) for fiscal years beginning after fiscal 4 year 2026, use no less than 50 percent of such 5 grant funds for interventions described in sub- 6 paragraph (A). 7 8 ‘‘(d) EVALUATIONS.— ‘‘(1) REQUIRED EVALUATIONS.—Any interven- 9 tion without a high or moderate causal evidence rat- 10 ing used by a State in carrying out a State program 11 of reemployment services and eligibility assessments 12 under this section shall be under evaluation at the 13 time of use. 14 ‘‘(2) FUNDING LIMITATION.—A State shall use 15 not more than 10 percent of grant funds awarded to 16 the State under this section to conduct or cause to 17 be conducted evaluations of interventions used in 18 carrying out a program under this section (including 19 evaluations conducted pursuant to paragraph (1)). 20 ‘‘(e) STATE PLAN.— 21 ‘‘(1) IN GENERAL.—As a condition of eligibility 22 to receive a grant under this section for a fiscal 23 year, a State shall submit to the Secretary, at such 24 time and in such manner as the Secretary may re- 25 quire, a State plan that outlines how the State in- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 156 1 tends to conduct a program of reemployment serv- 2 ices and eligibility assessments under this section, 3 including— 4 5 ‘‘(A) assurances that, and a description of how, the program will provide— 6 ‘‘(i) proper notification to partici- 7 pating individuals of the program’s eligi- 8 bility conditions, requirements, and bene- 9 fits, including the issuance of warnings 10 and simple, clear notifications to ensure 11 that participating individuals are fully 12 aware of the consequences of failing to ad- 13 here to such requirements, including poli- 14 cies related to non-attendance or non-ful- 15 fillment of work search requirements; and 16 ‘‘(ii) reasonable scheduling accom- 17 modations to maximize participation for el- 18 igible individuals; 19 ‘‘(B) assurances that, and a description of 20 how, the program will conform with the pur- 21 poses outlined in subsection (b) and satisfy the 22 requirement to use evidence-based standards 23 under subsection (c), including— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 157 1 ‘‘(i) a description of the evidence- 2 based interventions the State plans to use 3 to speed reemployment; 4 ‘‘(ii) an explanation of how such inter- 5 ventions are appropriate to the population 6 served; and 7 ‘‘(iii) if applicable, a description of the 8 evaluation structure the State plans to use 9 for interventions without at least a mod- 10 erate or high causal evidence rating, which 11 may include national evaluations conducted 12 by the Department of Labor or by other 13 entities; and 14 ‘‘(C) a description of any reemployment ac- 15 tivities and evaluations conducted in the prior 16 fiscal year, and any data collected on— 17 18 ‘‘(i) characteristics of program participants; 19 ‘‘(ii) the number of weeks for which 20 program participants receive unemploy- 21 ment compensation; and 22 ‘‘(iii) employment and other outcomes 23 for program participants consistent with 24 State performance accountability measures 25 provided by the State unemployment com- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 158 1 pensation program and in section 116(b) 2 of the Workforce Innovation and Oppor- 3 tunity Act (29 U.S.C. 3141(b)). 4 ‘‘(2) APPROVAL.—The Secretary shall approve 5 any State plan, that is timely submitted to the Sec- 6 retary, in such manner as the Secretary may re- 7 quire, that satisfies the conditions described in para- 8 graph (1). 9 ‘‘(3) DISAPPROVAL AND REVISION.—If the Sec- 10 retary determines that a State plan submitted pur- 11 suant to this subsection fails to satisfy the condi- 12 tions described in paragraph (1), the Secretary 13 shall— 14 ‘‘(A) disapprove such plan; 15 ‘‘(B) provide to the State, not later than 16 30 days after the date of receipt of the State 17 plan, a written notice of such disapproval that 18 includes a description of any portion of the plan 19 that was not approved and the reason for the 20 disapproval of each such portion; and 21 ‘‘(C) provide the State with an opportunity 22 to correct any such failure and submit a revised 23 State plan. 24 25 February 7, 2018 (10:12 p.m.) ‘‘(f) ALLOCATION OF FUNDS.— ‘‘(1) BASE FUNDING.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 159 1 ‘‘(A) IN GENERAL.—For each fiscal year 2 after fiscal year 2020, the Secretary shall allo- 3 cate a percentage equal to the base funding per- 4 centage for such fiscal year of the funds made 5 available for grants under this section among 6 the States awarded such a grant for such fiscal 7 year using a formula prescribed by the Sec- 8 retary based on the rate of insured unemploy- 9 ment (as defined in section 203(e)(1) of the 10 Federal-State Extended Unemployment Com- 11 pensation Act of 1970 (26 U.S.C. 3304 note)) 12 in the State for a period to be determined by 13 the Secretary. In developing such formula with 14 respect to a State, the Secretary shall consider 15 the importance of avoiding sharp reductions in 16 grant funding to a State over time. 17 ‘‘(B) BASE FUNDING PERCENTAGE.—For 18 purposes of subparagraph (A), the term ‘base 19 funding percentage’ means— 20 ‘‘(i) for fiscal years 2021 through 21 2026, 89 percent; and 22 ‘‘(ii) for fiscal years after 2026, 84 23 24 25 February 7, 2018 (10:12 p.m.) percent. ‘‘(2) MENTS.— RESERVATION FOR OUTCOME PAY- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 160 1 ‘‘(A) IN GENERAL.—Of the amounts made 2 available for grants under this section for each 3 fiscal year after 2020, the Secretary shall re- 4 serve a percentage equal to the outcome res- 5 ervation percentage for such fiscal year for out- 6 come payments to increase the amount other- 7 wise awarded to a State under paragraph (1). 8 Such outcome payments shall be paid to States 9 conducting reemployment services and eligibility 10 assessments under this section that, during the 11 previous fiscal year, met or exceeded the out- 12 come goals provided in subsection (b)(1) related 13 to reducing the average duration of receipt of 14 unemployment compensation by improving em- 15 ployment outcomes. 16 ‘‘(B) OUTCOME RESERVATION PERCENT- 17 AGE.—For 18 term ‘outcome reservation percentage’ means— 19 ‘‘(i) for fiscal years 2021 through 20 21 22 purposes of subparagraph (A), the 2026, 10 percent; and ‘‘(ii) for fiscal years after 2026, 15 percent. 23 ‘‘(3) RESERVATION FOR RESEARCH AND TECH- 24 NICAL ASSISTANCE.—Of the amounts made available 25 for grants under this section for each fiscal year February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 161 1 after 2020, the Secretary may reserve not more than 2 1 percent to conduct research and provide technical 3 assistance to States. 4 ‘‘(4) CONSULTATION AND PUBLIC COMMENT.— 5 Not later than September 30, 2019, the Secretary 6 shall— 7 ‘‘(A) consult with the States and seek pub- 8 lic comment in developing the allocation for- 9 mula under paragraph (1) and the criteria for 10 carrying out the reservations under paragraph 11 (2); and 12 ‘‘(B) make publicly available the allocation 13 formula and criteria developed pursuant to sub- 14 clause (A). 15 ‘‘(g) NOTIFICATION TO CONGRESS.—Not later than 16 90 days prior to making any changes to the allocation for17 mula or the criteria developed pursuant to subsection 18 (f)(5)(A), the Secretary shall submit to Congress, includ19 ing to the Committee on Ways and Means and the Com20 mittee on Appropriations of the House of Representatives 21 and the Committee on Finance and the Committee on Ap22 propriations of the Senate, a notification of any such 23 change. 24 ‘‘(h) SUPPLEMENT NOT SUPPLANT.—Funds made 25 available to carry out this section shall be used to supple- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 162 1 ment the level of Federal, State, and local public funds 2 that, in the absence of such availability, would be ex3 pended to provide reemployment services and eligibility as4 sessments to individuals receiving unemployment com5 pensation, and in no case to supplant such Federal, State, 6 or local public funds. 7 8 ‘‘(i) DEFINITIONS.—In this section: ‘‘(1) CAUSAL EVIDENCE RATING.—The terms 9 ‘high causal evidence rating’ and ‘moderate causal 10 evidence rating’ shall have the meaning given such 11 terms by the Secretary of Labor. 12 ‘‘(2) ELIGIBLE STATE.—The term ‘eligible 13 State’ means a State that has in effect a State plan 14 approved by the Secretary in accordance with sub- 15 section (e). 16 ‘‘(3) INTERVENTION.—The term ‘intervention’ 17 means a service delivery strategy for the provision of 18 State reemployment services and eligibility assess- 19 ment activities under this section. 20 ‘‘(4) STATE.—The term ‘State’ has the mean- 21 ing given the term in section 205 of the Federal- 22 State Extended Unemployment Compensation Act of 23 1970 (26 U.S.C. 3304 note). 24 ‘‘(5) UNEMPLOYMENT 25 February 7, 2018 (10:12 p.m.) COMPENSATION.—The term unemployment compensation means ‘regular U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 163 1 compensation’, ‘extended compensation’, and ‘addi- 2 tional compensation’ (as such terms are defined by 3 section 205 of the Federal-State Extended Unem- 4 ployment Compensation Act of 1970 (26 U.S.C. 5 3304 note)).’’. 6 (b) REPORT.—Not later than 3 years after the date 7 of enactment of this Act, the Secretary of Labor shall sub8 mit to Congress a report to describe promising interven9 tions used by States to provide reemployment assistance. 10 (c) ADJUSTMENT TO DISCRETIONARY SPENDING 11 LIMITS.—Section 251(b)(2) of the Balanced Budget and 12 Emergency Deficit Control Act of 1985 (2 U.S.C. 13 901(b)(2)) is amended by adding at the end the following: 14 ‘‘(E) REEMPLOYMENT 15 GIBILITY ASSESSMENTS.— 16 ‘‘(i) IN SERVICES AND ELI- GENERAL.—If a bill or joint 17 resolution making appropriations for a fis- 18 cal year is enacted that specifies an 19 amount for grants to States under section 20 306 of the Social Security Act, then the 21 adjustment for that fiscal year shall be the 22 additional new budget authority provided 23 in that Act for such grants for that fiscal 24 year, but shall not exceed— 25 February 7, 2018 (10:12 p.m.) ‘‘(I) for fiscal year 2018, $0; U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 164 1 ‘‘(II) 2 $33,000,000; 3 for ‘‘(III) 4 for fiscal year 2019, fiscal year 2020, fiscal year 2021, $58,000,000; and 5 ‘‘(IV) for 6 $83,000,000. 7 ‘‘(ii) DEFINITION.—As used in this 8 subparagraph, the term ‘additional new 9 budget authority’ means the amount pro- 10 vided for a fiscal year, in excess of 11 $117,000,000, in an appropriation Act and 12 specified to pay for grants to States under 13 section 306 of the Social Security Act.’’. 14 (d) OTHER BUDGETARY ADJUSTMENTS.—Section 15 314 of the Congressional Budget Act of 1974 (2 U.S.C. 16 645) is amended by adding at the end the following: 17 18 ‘‘(g) ADJUSTMENT AND 19 FOR REEMPLOYMENT SERVICES ELIGIBILITY ASSESSMENTS.— ‘‘(1) IN GENERAL.— 20 ‘‘(A) ADJUSTMENTS.—If the Committee on 21 Appropriations of either House reports an ap- 22 propriation measure for any of fiscal years 23 2022 through 2027 that provides budget au- 24 thority for grants under section 306 of the So- 25 cial Security Act, or if a conference committee February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 165 1 submits a conference report thereon, the chair- 2 man of the Committee on the Budget of the 3 House of Representatives or the Senate shall 4 make the adjustments referred to in subpara- 5 graph (B) to reflect the additional new budget 6 authority provided for such grants in that 7 measure or conference report and the outlays 8 resulting therefrom, consistent with subpara- 9 graph (D). 10 ‘‘(B) TYPES OF ADJUSTMENTS.—The ad- 11 justments referred to in this subparagraph con- 12 sist of adjustments to— 13 ‘‘(i) the discretionary spending limits 14 for that fiscal year as set forth in the most 15 recently adopted concurrent resolution on 16 the budget; 17 ‘‘(ii) the allocations to the Committees 18 on Appropriations of the Senate and the 19 House of Representatives for that fiscal 20 year under section 302(a); and 21 ‘‘(iii) the appropriate budget aggre- 22 gates for that fiscal year in the most re- 23 cently adopted concurrent resolution on the 24 budget. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 166 1 ‘‘(C) ENFORCEMENT.—The adjusted dis- 2 cretionary spending limits, allocations, and ag- 3 gregates under this paragraph shall be consid- 4 ered the appropriate limits, allocations, and ag- 5 gregates for purposes of congressional enforce- 6 ment of this Act and concurrent budget resolu- 7 tions under this Act. 8 9 ‘‘(D) LIMITATION.—No adjustment may be made under this subsection in excess of— 10 ‘‘(i) 11 $133,000,000; 12 ‘‘(ii) 13 $258,000,000; 14 ‘‘(iii) 15 $433,000,000; 16 ‘‘(iv) 17 $533,000,000; 18 ‘‘(v) 19 for for for for for fiscal year 2022, fiscal year 2023, fiscal year 2024, fiscal year 2025, fiscal year 2026, fiscal year 2027, $608,000,000; and 20 ‘‘(vi) 21 $633,000,000. for 22 ‘‘(E) DEFINITION.—As used in this subsection, 23 the term ‘additional new budget authority’ means 24 the amount provided for a fiscal year, in excess of 25 $117,000,000, in an appropriation measure or con- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 167 1 ference report (as the case may be) and specified to 2 pay for grants to States under section 306 of the 3 Social Security Act. 4 ‘‘(2) REPORT ON 302(B) LEVEL.—Following any 5 adjustment made under paragraph (1), the Commit- 6 tees on Appropriations of the Senate and the House 7 of Representatives may report appropriately revised 8 suballocations pursuant to section 302(b) to carry 9 out this subsection.’’. 11 TITLE III—TEMPORARY EXTENSION OF PUBLIC DEBT LIMIT 12 SEC. 30301. TEMPORARY EXTENSION OF PUBLIC DEBT 10 13 14 LIMIT. (a) IN GENERAL.—Section 3101(b) of title 31, 15 United States Code, shall not apply for the period begin16 ning on the date of the enactment of this Act and ending 17 on March 1, 2019. 18 (b) SPECIAL RULE RELATING TO OBLIGATIONS 19 ISSUED DURING EXTENSION PERIOD.—Effective on 20 March 2, 2019, the limitation in effect under section 21 3101(b) of title 31, United States Code, shall be increased 22 to the extent that— 23 (1) the face amount of obligations issued under 24 chapter 31 of such title and the face amount of obli- 25 gations whose principal and interest are guaranteed February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 168 1 by the United States Government (except guaran- 2 teed obligations held by the Secretary of the Treas- 3 ury) outstanding on March 2, 2019, exceeds 4 (2) the face amount of such obligations out- 5 standing on the date of the enactment of this Act. 6 (c) RESTORING CONGRESSIONAL AUTHORITY OVER 7 THE 8 9 NATIONAL DEBT.— (1) EXTENSION GATIONS.—An LIMITED TO NECESSARY OBLI- obligation shall not be taken into ac- 10 count under subsection (b)(1) unless the issuance of 11 such obligation was necessary to fund a commitment 12 incurred pursuant to law by the Federal Government 13 that required payment before March 2, 2019. 14 (2) PROHIBITION ON CREATION OF CASH RE- 15 SERVE DURING EXTENSION PERIOD.—The 16 of the Treasury shall not issue obligations during 17 the period specified in subsection (a) for the purpose 18 of increasing the cash balance above normal oper- 19 ating balances in anticipation of the expiration of 20 such period. February 7, 2018 (10:12 p.m.) Secretary U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 169 5 TITLE IV—JOINT SELECT COMMITTEES Subtitle A—Joint Select Committee on Solvency of Multiemployer Pension Plans 6 SEC. 30421. DEFINITIONS. 1 2 3 4 7 In this subtitle— 8 (1) the term ‘‘joint committee’’ means the Joint 9 Select Committee on Solvency of Multiemployer Pen- 10 sion Plans established under section 30422(a); and 11 (2) the term ‘‘joint committee bill’’ means a bill 12 consisting of the proposed legislative language of the 13 joint committee recommended in accordance with 14 section 30422(b)(2)(B)(ii) and introduced under sec- 15 tion 30424(a). 16 SEC. 30422. ESTABLISHMENT OF JOINT SELECT COM- 17 MITTEE. 18 19 (a) ESTABLISHMENT MITTEE.—There OF JOINT SELECT COM- is established a joint select committee of 20 Congress to be known as the ‘‘Joint Select Committee on 21 Solvency of Multiemployer Pension Plans’’. 22 (b) IMPLEMENTATION.— 23 (1) GOAL.—The goal of the joint committee is 24 to improve the solvency of multiemployer pension February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 170 1 plans and the Pension Benefit Guaranty Corpora- 2 tion. 3 4 (2) DUTIES.— (A) IN GENERAL.—The joint committee 5 shall provide recommendations and legislative 6 language that will significantly improve the sol- 7 vency of multiemployer pension plans and the 8 Pension Benefit Guaranty Corporation. 9 10 11 (B) REPORT, RECOMMENDATIONS, AND LEGISLATIVE LANGUAGE.— (i) IN GENERAL.—Not later than No- 12 vember 30, 2018, the joint committee shall 13 vote on— 14 (I) a report that contains a de- 15 tailed statement of the findings, con- 16 clusions, and recommendations of the 17 joint committee; and 18 (II) proposed legislative language 19 to carry out the recommendations de- 20 scribed in subclause (I). 21 (ii) APPROVAL 22 ISLATIVE LANGUAGE.— 23 (I) IN OF REPORT AND LEG- GENERAL.—The report of 24 the joint committee and the proposed 25 legislative February 7, 2018 (10:12 p.m.) language described in U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 171 1 clause (i) shall only be approved upon 2 receiving the votes of— 3 (aa) a majority of joint com- 4 mittee members appointed by the 5 Speaker of the House of Rep- 6 resentatives and the Majority 7 Leader of the Senate; and 8 (bb) a majority of joint com- 9 mittee members appointed by the 10 Minority Leader of the House of 11 Representatives and the Minority 12 Leader of the Senate. 13 (II) AVAILABILITY.—The text of 14 any report and proposed legislative 15 language shall be publicly available in 16 electronic form at least 24 hours prior 17 to its consideration. 18 (iii) ADDITIONAL VIEWS.—A member 19 of the joint committee who gives notice of 20 an intention to file supplemental, minority, 21 or additional views at the time of the final 22 joint committee vote on the approval of the 23 report and legislative language under 24 clause (ii) shall be entitled to 2 calendar 25 days after the day of such notice in which February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 172 1 to file such views in writing with the co- 2 chairs. Such views shall then be included 3 in the joint committee report and printed 4 in the same volume, or part thereof, and 5 their inclusion shall be noted on the cover 6 of the report. In the absence of timely no- 7 tice, the joint committee report may be 8 printed and transmitted immediately with- 9 out such views. 10 (iv) TRANSMISSION OF REPORT AND 11 LEGISLATIVE 12 and legislative language are approved by 13 the joint committee pursuant to clause (ii), 14 the joint committee shall submit the joint 15 committee report and legislative language 16 described in clause (i) to the President, the 17 Vice President, the Speaker of the House 18 of Representatives, and the majority and 19 minority leaders of each House of Con- 20 gress not later than 15 calendar days after 21 such approval. 22 LANGUAGE.—If (v) REPORT the report AND LEGISLATIVE LAN- 23 GUAGE TO BE MADE PUBLIC.—Upon 24 approval of the joint committee report and 25 legislative language pursuant to clause (ii), February 7, 2018 (10:12 p.m.) the U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 173 1 the joint committee shall promptly make 2 the full report and legislative language, 3 and a record of any vote, available to the 4 public. 5 6 (3) MEMBERSHIP.— (A) IN GENERAL.—The joint committee 7 shall be composed of 16 members appointed 8 pursuant to subparagraph (B). 9 10 (B) APPOINTMENT.—Members of the joint committee shall be appointed as follows: 11 (i) The Speaker of the House of Rep- 12 resentatives shall appoint 4 members from 13 among Members of the House of Rep- 14 resentatives. 15 (ii) The Minority Leader of the House 16 of Representatives shall appoint 4 mem- 17 bers from among Members of the House of 18 Representatives. 19 (iii) The Majority Leader of the Sen- 20 ate shall appoint 4 members from among 21 Members of the Senate. 22 (iv) The Minority Leader of the Sen- 23 ate shall appoint 4 members from among 24 Members of the Senate. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 174 1 (C) CO-CHAIRS.—Two of the appointed 2 members of the joint committee will serve as co- 3 chairs. The Speaker of the House of Represent- 4 atives and the Majority Leader of the Senate 5 shall jointly appoint one co-chair, and the Mi- 6 nority Leader of the House of Representatives 7 and the Minority Leader of the Senate shall 8 jointly appoint the second co-chair. The co- 9 chairs shall be appointed not later than 14 cal- 10 endar days after the date of enactment of this 11 Act. 12 (D) DATE.—Members of the joint com- 13 mittee shall be appointed not later than 14 cal- 14 endar days after the date of enactment of this 15 Act. 16 (E) PERIOD OF APPOINTMENT.—Members 17 shall be appointed for the life of the joint com- 18 mittee. Any vacancy in the joint committee 19 shall not affect its powers, but shall be filled 20 not later than 14 calendar days after the date 21 on which the vacancy occurs, in the same man- 22 ner as the original appointment was made. If a 23 member of the joint committee ceases to be a 24 Member of the House of Representatives or the 25 Senate, as the case may be, the member is no February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 175 1 longer a member of the joint committee and a 2 vacancy shall exist. 3 (4) ADMINISTRATION.— 4 (A) IN GENERAL.—To enable the joint 5 committee to exercise its powers, functions, and 6 duties under this subtitle, there are authorized 7 to be disbursed by the Senate the actual and 8 necessary expenses of the joint committee ap- 9 proved by the co-chairs, subject to the rules and 10 regulations of the Senate. 11 (B) EXPENSES.—To enable the joint com- 12 mittee to exercise its powers, functions, and du- 13 ties under this subtitle, there are authorized to 14 be appropriated for each fiscal year such sums 15 as may be necessary, to be disbursed by the 16 Secretary of the Senate on vouchers signed by 17 the co-chairs. 18 (C) QUORUM.—Nine members of the joint 19 committee shall constitute a quorum for pur- 20 poses of voting and meeting, and 5 members of 21 the joint committee shall constitute a quorum 22 for holding hearings. 23 (D) VOTING.—No proxy voting shall be al- 24 lowed on behalf of the members of the joint 25 committee. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 176 1 2 (E) MEETINGS.— (i) INITIAL MEETING.—Not later than 3 30 calendar days after the date of enact- 4 ment of this Act, the joint committee shall 5 hold its first meeting. 6 (ii) AGENDA.—The co-chairs of the 7 joint committee shall provide an agenda to 8 the joint committee members not less than 9 48 hours in advance of any meeting. 10 (F) HEARINGS.— 11 (i) IN GENERAL.—The joint com- 12 mittee may, for the purpose of carrying 13 out this section, hold such hearings, sit 14 and act at such times and places, require 15 attendance of witnesses and production of 16 books, papers, and documents, take such 17 testimony, receive such evidence, and ad- 18 minister such oaths as the joint committee 19 considers advisable. 20 21 (ii) HEARING PROCEDURES AND RE- SPONSIBILITIES OF CO-CHAIRS.— 22 (I) ANNOUNCEMENT.—The co- 23 chairs of the joint committee shall 24 make a public announcement of the 25 date, place, time, and subject matter February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 177 1 of any hearing to be conducted, not 2 less than 7 days in advance of such 3 hearing, unless the co-chairs deter- 4 mine that there is good cause to begin 5 such hearing at an earlier date. 6 (II) EQUAL REPRESENTATION OF 7 WITNESSES.—Each 8 entitled to select an equal number of 9 witnesses for each hearing held by the 10 co-chair shall be joint committee. 11 (III) WRITTEN STATEMENT.—A 12 witness appearing before the joint 13 committee shall file a written state- 14 ment of proposed testimony at least 2 15 calendar days before the appearance 16 of the witness, unless the requirement 17 is waived by the co-chairs, following 18 their determination that there is good 19 cause for failure to comply with such 20 requirement. 21 (G) MINIMUM 22 INGS 23 shall hold— 24 25 February 7, 2018 (10:12 p.m.) AND NUMBER OF PUBLIC MEET- HEARINGS.—The joint committee (i) not less than a total of 5 public meetings or public hearings; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 178 1 (ii) not less than 3 public hearings, 2 which may include field hearings. 3 (H) TECHNICAL ASSISTANCE.—Upon writ- 4 ten request of the co-chairs, a Federal agency, 5 including legislative branch agencies, shall pro- 6 vide technical assistance to the joint committee 7 in order for the joint committee to carry out its 8 duties. 9 (I) STAFFING.— 10 (i) DETAILS.—Employees of the legis- 11 lative branch may be detailed to the joint 12 committee on a nonreimbursable basis. 13 (ii) STAFF DIRECTOR.—The co-chairs, 14 acting jointly, may designate one such em- 15 ployee as staff director of the joint com- 16 mittee. 17 (c) ETHICAL STANDARDS.—Members on the joint 18 committee who serve in the House of Representatives shall 19 be governed by the ethics rules and requirements of the 20 House. Members of the Senate who serve on the joint com21 mittee shall comply with the ethics rules of the Senate. 22 (d) TERMINATION.—The joint committee shall termi- 23 nate on December 31, 2018 or 30 days after submission 24 of its report and legislative recommendations pursuant to 25 this section whichever occurs first. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 179 1 SEC. 30423. FUNDING. 2 To enable the joint committee to exercise its powers, 3 functions, and duties under this subtitle, there are author4 ized to be paid not more than $500,000 from the appro5 priations account for ‘‘Expenses of Inquiries and Inves6 tigations’’ of the Senate, such sums to be disbursed by 7 the Secretary of the Senate, in accordance with Senate 8 rules and procedures, upon vouchers signed by the co9 chairs. The funds authorized under this section shall be 10 available during the period beginning on the date of enact11 ment of this Act and ending on January 2, 2019. 12 SEC. 30424. CONSIDERATION OF JOINT COMMITTEE BILL IN 13 14 THE SENATE. (a) INTRODUCTION.—Upon receipt of proposed legis- 15 lative language approved in accordance with section 16 30422(b)(2)(B)(ii), the language shall be introduced in 17 the Senate (by request) on the next day on which the Sen18 ate is in session by the Majority Leader of the Senate or 19 by a Member of the Senate designated by the Majority 20 Leader of the Senate. 21 (b) COMMITTEE CONSIDERATION.—A joint com- 22 mittee bill introduced in the Senate under subsection (a) 23 shall be jointly referred to the Committee on Finance and 24 the Committee on Health, Education, Labor, and Pen25 sions, which committees shall report the bill without any 26 revision and with a favorable recommendation, an unfavorFebruary 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 180 1 able recommendation, or without recommendation, no 2 later than 7 session days after introduction of the bill. If 3 either committee fails to report the bill within that period, 4 that committee shall be automatically discharged from 5 consideration of the bill, and the bill shall be placed on 6 the appropriate calendar. 7 8 (c) MOTION TO PROCEED TO CONSIDERATION.— (1) IN GENERAL.—Notwithstanding rule XXII 9 of the Standing Rules of the Senate, it is in order, 10 not later than 2 days of session after the date on 11 which a joint committee bill is reported or dis- 12 charged from the Committee on Finance and the 13 Committee on Health, Education, Labor, and Pen- 14 sions, for the Majority Leader of the Senate or the 15 Majority Leader’s designee to move to proceed to the 16 consideration of the joint committee bill. It shall also 17 be in order for any Member of the Senate to move 18 to proceed to the consideration of the joint com- 19 mittee bill at any time after the conclusion of such 20 2-day period. 21 (2) CONSIDERATION OF MOTION.—Consider- 22 ation of the motion to proceed to the consideration 23 of the joint committee bill and all debatable motions 24 and appeals in connection therewith shall not exceed 25 10 hours, which shall be divided equally between the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 181 1 Majority and Minority Leaders or their designees. A 2 motion to further limit debate is in order, shall re- 3 quire an affirmative vote of three-fifths of Members 4 duly chosen and sworn, and is not debatable. 5 (3) VOTE THRESHOLD.—The motion to proceed 6 to the consideration of the joint committee bill shall 7 only be agreed to upon an affirmative vote of three- 8 fifths of Members duly chosen and sworn. 9 (4) LIMITATIONS.—The motion is not subject 10 to a motion to postpone. All points of order against 11 the motion to proceed to the joint committee bill are 12 waived. A motion to reconsider the vote by which the 13 motion is agreed to or disagreed to shall not be in 14 order. 15 (5) DEADLINE.—Not later than the last day of 16 the 115th Congress, the Senate shall vote on a mo- 17 tion to proceed to the joint committee bill. 18 (6) COMPANION MEASURES.—For purposes of 19 this subsection, the term ‘‘joint committee bill’’ in- 20 cludes a bill of the House of Representatives that is 21 a companion measure to the joint committee bill in- 22 troduced in the Senate. 23 (d) RULES 24 Congress— February 7, 2018 (10:12 p.m.) OF SENATE.—This section is enacted by U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 182 1 (1) as an exercise of the rulemaking power of 2 the Senate, and as such is deemed a part of the 3 rules of the Senate, but applicable only with respect 4 to the procedure to be followed in the Senate in the 5 case of a joint committee bill, and supersede other 6 rules only to the extent that they are inconsistent 7 with such rules; and 8 (2) with full recognition of the constitutional 9 right of the Senate to change the rules (so far as re- 10 lating to the procedure of the Senate) at any time, 11 in the same manner, and to the same extent as in 12 the case of any other rule of the Senate. 15 Subtitle B—Joint Select Committee on Budget and Appropriations Process Reform 16 SEC. 30441. DEFINITIONS. 13 14 17 In this subtitle— 18 (1) the term ‘‘joint committee’’ means the Joint 19 Select Committee on Budget and Appropriations 20 Process Reform established under section 30442(a); 21 and 22 (2) the term ‘‘joint committee bill’’ means a bill 23 consisting of the proposed legislative language of the 24 joint committee recommended in accordance with February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 183 1 section 30442(b)(2)(B)(ii) and introduced under sec- 2 tion 30444(a). 3 SEC. 30442. ESTABLISHMENT OF JOINT SELECT COM- 4 MITTEE. 5 6 (a) ESTABLISHMENT MITTEE.—There OF JOINT SELECT COM- is established a joint select committee of 7 Congress to be known as the ‘‘Joint Select Committee on 8 Budget and Appropriations Process Reform’’. 9 10 11 12 13 (b) IMPLEMENTATION.— (1) GOAL.—The goal of the joint committee is to reform the budget and appropriations process. (2) DUTIES.— (A) IN GENERAL.—The joint committee 14 shall provide recommendations and legislative 15 language that will significantly reform the 16 budget and appropriations process. 17 18 19 (B) REPORT, RECOMMENDATIONS, AND LEGISLATIVE LANGUAGE.— (i) IN GENERAL.—Not later than No- 20 vember 30, 2018, the joint committee shall 21 vote on— 22 (I) a report that contains a de- 23 tailed statement of the findings, con- 24 clusions, and recommendations of the 25 joint committee; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 184 1 (II) proposed legislative language 2 to carry out the recommendations de- 3 scribed in subclause (I). 4 (ii) APPROVAL 5 ISLATIVE LANGUAGE.— 6 (I) IN OF REPORT AND LEG- GENERAL.—The report of 7 the joint committee and the proposed 8 legislative 9 clause (i) shall only be approved upon 10 language described in receiving the votes of— 11 (aa) a majority of joint com- 12 mittee members appointed by the 13 Speaker of the House of Rep- 14 resentatives and the Majority 15 Leader of the Senate; and 16 (bb) a majority of joint com- 17 mittee members appointed by the 18 Minority Leader of the House of 19 Representatives and the Minority 20 Leader of the Senate. 21 (II) AVAILABILITY.—The text of 22 any report and proposed legislative 23 language shall be publicly available in 24 electronic form at least 24 hours prior 25 to its consideration. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 185 1 (iii) ADDITIONAL VIEWS.—A member 2 of the joint committee who gives notice of 3 an intention to file supplemental, minority, 4 or additional views at the time of the final 5 joint committee vote on the approval of the 6 report and legislative language under 7 clause (ii) shall be entitled to 2 calendar 8 days after the day of such notice in which 9 to file such views in writing with the co- 10 chairs. Such views shall then be included 11 in the joint committee report and printed 12 in the same volume, or part thereof, and 13 their inclusion shall be noted on the cover 14 of the report. In the absence of timely no- 15 tice, the joint committee report may be 16 printed and transmitted immediately with- 17 out such views. 18 (iv) TRANSMISSION OF REPORT AND 19 LEGISLATIVE 20 and legislative language are approved by 21 the joint committee pursuant to clause (ii), 22 the joint committee shall submit the joint 23 committee report and legislative language 24 described in clause (i) to the President, the 25 Vice President, the Speaker of the House February 7, 2018 (10:12 p.m.) LANGUAGE.—If the report U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 186 1 of Representatives, and the majority and 2 minority leaders of each House of Con- 3 gress not later than 15 calendar days after 4 such approval. 5 (v) REPORT AND LEGISLATIVE LAN- 6 GUAGE TO BE MADE PUBLIC.—Upon 7 approval of the joint committee report and 8 legislative language pursuant to clause (ii), 9 the joint committee shall promptly make 10 the full report and legislative language, 11 and a record of any vote, available to the 12 public. 13 14 the (3) MEMBERSHIP.— (A) IN GENERAL.—The joint committee 15 shall be composed of 16 members appointed 16 pursuant to subparagraph (B). 17 18 (B) APPOINTMENT.—Members of the joint committee shall be appointed as follows: 19 (i) The Speaker of the House of Rep- 20 resentatives shall appoint 4 members from 21 among Members of the House of Rep- 22 resentatives. 23 (ii) The Minority Leader of the House 24 of Representatives shall appoint 4 mem- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 187 1 bers from among Members of the House of 2 Representatives. 3 (iii) The Majority Leader of the Sen- 4 ate shall appoint 4 members from among 5 Members of the Senate. 6 (iv) The Minority Leader of the Sen- 7 ate shall appoint 4 members from among 8 Members of the Senate. 9 (C) CO-CHAIRS.—Two of the appointed 10 members of the joint committee will serve as co- 11 chairs. The Speaker of the House of Represent- 12 atives and the Majority Leader of the Senate 13 shall jointly appoint one co-chair, and the Mi- 14 nority Leader of the House of Representatives 15 and the Minority Leader of the Senate shall 16 jointly appoint the second co-chair. The co- 17 chairs shall be appointed not later than 14 cal- 18 endar days after the date of enactment of this 19 Act. 20 (D) DATE.—Members of the joint com- 21 mittee shall be appointed not later than 14 cal- 22 endar days after the date of enactment of this 23 Act. 24 25 February 7, 2018 (10:12 p.m.) (E) PERIOD OF APPOINTMENT.—Members shall be appointed for the life of the joint com- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 188 1 mittee. Any vacancy in the joint committee 2 shall not affect its powers, but shall be filled 3 not later than 14 calendar days after the date 4 on which the vacancy occurs, in the same man- 5 ner as the original appointment was made. If a 6 member of the joint committee ceases to be a 7 Member of the House of Representatives or the 8 Senate, as the case may be, the member is no 9 longer a member of the joint committee and a 10 vacancy shall exist. 11 (4) ADMINISTRATION.— 12 (A) IN GENERAL.—To enable the joint 13 committee to exercise its powers, functions, and 14 duties under this subtitle, there are authorized 15 to be disbursed by the Senate the actual and 16 necessary expenses of the joint committee ap- 17 proved by the co-chairs, subject to the rules and 18 regulations of the Senate. 19 (B) EXPENSES.—To enable the joint com- 20 mittee to exercise its powers, functions, and du- 21 ties under this subtitle, there are authorized to 22 be appropriated for each fiscal year such sums 23 as may be necessary, to be disbursed by the 24 Secretary of the Senate on vouchers signed by 25 the co-chairs. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 189 1 (C) QUORUM.—Nine members of the joint 2 committee shall constitute a quorum for pur- 3 poses of voting and meeting, and 5 members of 4 the joint committee shall constitute a quorum 5 for holding hearings. 6 (D) VOTING.—No proxy voting shall be al- 7 lowed on behalf of the members of the joint 8 committee. 9 10 (E) MEETINGS.— (i) INITIAL MEETING.—Not later than 11 30 calendar days after the date of enact- 12 ment of this Act, the joint committee shall 13 hold its first meeting. 14 (ii) AGENDA.—The co-chairs of the 15 joint committee shall provide an agenda to 16 the joint committee members not less than 17 48 hours in advance of any meeting. 18 (F) HEARINGS.— 19 (i) IN GENERAL.—The joint com- 20 mittee may, for the purpose of carrying 21 out this section, hold such hearings, sit 22 and act at such times and places, require 23 attendance of witnesses and production of 24 books, papers, and documents, take such 25 testimony, receive such evidence, and ad- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 190 1 minister such oaths as the joint committee 2 considers advisable. 3 4 (ii) HEARING PROCEDURES AND RE- SPONSIBILITIES OF CO-CHAIRS.— 5 (I) ANNOUNCEMENT.—The co- 6 chairs of the joint committee shall 7 make a public announcement of the 8 date, place, time, and subject matter 9 of any hearing to be conducted, not 10 less than 7 days in advance of such 11 hearing, unless the co-chairs deter- 12 mine that there is good cause to begin 13 such hearing at an earlier date. 14 (II) EQUAL REPRESENTATION OF 15 WITNESSES.—Each 16 entitled to select an equal number of 17 witnesses for each hearing held by the 18 joint committee. 19 (III) WRITTEN co-chair shall be STATEMENT.—A 20 witness appearing before the joint 21 committee shall file a written state- 22 ment of proposed testimony at least 2 23 calendar days before the appearance 24 of the witness, unless the requirement 25 is waived by the co-chairs, following February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 191 1 their determination that there is good 2 cause for failure to comply with such 3 requirement. 4 (G) MINIMUM 5 INGS 6 shall hold— AND 7 8 NUMBER OF PUBLIC MEET- HEARINGS.—The joint committee (i) not less than a total of 5 public meetings or public hearings; and 9 (ii) not less than 3 public hearings, 10 which may include field hearings. 11 (H) TECHNICAL ASSISTANCE.—Upon writ- 12 ten request of the co-chairs, a Federal agency, 13 including legislative branch agencies, shall pro- 14 vide technical assistance to the joint committee 15 in order for the joint committee to carry out its 16 duties. 17 (I) STAFFING.— 18 (i) DETAILS.—Employees of the legis- 19 lative branch may be detailed to the joint 20 committee on a nonreimbursable basis. 21 (ii) STAFF DIRECTOR.—The co-chairs, 22 acting jointly, may designate one such em- 23 ployee as staff director of the joint com- 24 mittee. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 192 1 (c) ETHICAL STANDARDS.—Members on the joint 2 committee who serve in the House of Representatives shall 3 be governed by the ethics rules and requirements of the 4 House. Members of the Senate who serve on the joint com5 mittee shall comply with the ethics rules of the Senate. 6 (d) TERMINATION.—The joint committee shall termi- 7 nate on December 31, 2018 or 30 days after submission 8 of its report and legislative recommendations pursuant to 9 this section whichever occurs first. 10 SEC. 30443. FUNDING. 11 To enable the joint committee to exercise its powers, 12 functions, and duties under this subtitle, there are author13 ized to be paid not more than $500,000 from the appro14 priations account for ‘‘Expenses of Inquiries and Inves15 tigations’’ of the Senate, such sums to be disbursed by 16 the Secretary of the Senate, in accordance with Senate 17 rules and procedures, upon vouchers signed by the co18 chairs. The funds authorized under this section shall be 19 available during the period beginning on the date of enact20 ment of this Act and ending on January 2, 2019. 21 SEC. 30444. CONSIDERATION OF JOINT COMMITTEE BILL IN 22 23 THE SENATE. (a) INTRODUCTION.—Upon receipt of proposed legis- 24 lative language approved in accordance with section 25 30442(b)(2)(B)(ii), the language shall be introduced in February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 193 1 the Senate (by request) on the next day on which the Sen2 ate is in session by the Majority Leader of the Senate or 3 by a Member of the Senate designated by the Majority 4 Leader of the Senate. 5 (b) COMMITTEE CONSIDERATION.—A joint com- 6 mittee bill introduced in the Senate under subsection (a) 7 shall be referred to the Committee on the Budget, which 8 shall report the bill without any revision and with a favor9 able recommendation, an unfavorable recommendation, or 10 without recommendation, no later than 7 session days 11 after introduction of the bill. If the Committee on the 12 Budget fails to report the bill within that period, the com13 mittee shall be automatically discharged from consider14 ation of the bill, and the bill shall be placed on the appro15 priate calendar. 16 17 (c) MOTION TO PROCEED TO CONSIDERATION.— (1) IN GENERAL.—Notwithstanding rule XXII 18 of the Standing Rules of the Senate, it is in order, 19 not later than 2 days of session after the date on 20 which a joint committee bill is reported or dis- 21 charged from the Committee on the Budget, for the 22 Majority Leader of the Senate or the Majority Lead- 23 er’s designee to move to proceed to the consideration 24 of the joint committee bill. It shall also be in order 25 for any Member of the Senate to move to proceed February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 194 1 to the consideration of the joint committee bill at 2 any time after the conclusion of such 2-day period. 3 (2) CONSIDERATION OF MOTION.—Consider- 4 ation of the motion to proceed to the consideration 5 of the joint committee bill and all debatable motions 6 and appeals in connection therewith shall not exceed 7 10 hours, which shall be divided equally between the 8 Majority and Minority Leaders or their designees. A 9 motion to further limit debate is in order, shall re- 10 quire an affirmative vote of three-fifths of Members 11 duly chosen and sworn, and is not debatable. 12 (3) VOTE THRESHOLD.—The motion to proceed 13 to the consideration of the joint committee bill shall 14 only be agreed to upon an affirmative vote of three- 15 fifths of Members duly chosen and sworn. 16 (4) LIMITATIONS.—The motion is not subject 17 to a motion to postpone. All points of order against 18 the motion to proceed to the joint committee bill are 19 waived. A motion to reconsider the vote by which the 20 motion is agreed to or disagreed to shall not be in 21 order. 22 (5) DEADLINE.—Not later than the last day of 23 the 115th Congress, the Senate shall vote on a mo- 24 tion to proceed to the joint committee bill. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 195 1 (d) RULES OF SENATE.—This section is enacted by 2 Congress— 3 (1) as an exercise of the rulemaking power of 4 the Senate, and as such is deemed a part of the 5 rules of the Senate, but applicable only with respect 6 to the procedure to be followed in the Senate in the 7 case of a joint committee bill, and supersede other 8 rules only to the extent that they are inconsistent 9 with such rules; and 10 (2) with full recognition of the constitutional 11 right of the Senate to change the rules (so far as re- 12 lating to the procedure of the Senate) at any time, 13 in the same manner, and to the same extent as in 14 the case of any other rule of the Senate. DIVISION D—REVENUE MEASURES 15 16 17 SEC. 40001. TABLE OF CONTENTS. 18 The table of contents for this division is as follows: DIVISION D—REVENUE MEASURES Sec. 40001. Table of contents. TITLE I—EXTENSION OF EXPIRING PROVISIONS Sec. 40101. Amendment of Internal Revenue Code of 1986. Subtitle A—Tax Relief for Families and Individuals Sec. 40201. Extension of exclusion from gross income of discharge of qualified principal residence indebtedness. Sec. 40202. Extension of mortgage insurance premiums treated as qualified residence interest. Sec. 40203. Extension of above-the-line deduction for qualified tuition and related expenses. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 196 Subtitle B—Incentives for Growth, Jobs, Investment, and Innovation Sec. Sec. Sec. Sec. 40301. 40302. 40303. 40304. Sec. 40305. Sec. 40306. Sec. 40307. Sec. 40308. Sec. 40309. Sec. 40310. Sec. 40311. Sec. 40312. Extension of Indian employment tax credit. Extension of railroad track maintenance credit. Extension of mine rescue team training credit. Extension of classification of certain race horses as 3-year property. Extension of 7-year recovery period for motorsports entertainment complexes. Extension of accelerated depreciation for business property on an Indian reservation. Extension of election to expense mine safety equipment. Extension of special expensing rules for certain productions. Extension of deduction allowable with respect to income attributable to domestic production activities in Puerto Rico. Extension of special rule relating to qualified timber gain. Extension of empowerment zone tax incentives. Extension of American Samoa economic development credit. Subtitle C—Incentives for Energy Production and Conservation Sec. 40401. Extension of credit for nonbusiness energy property. Sec. 40402. Extension and modification of credit for residential energy property. Sec. 40403. Extension of credit for new qualified fuel cell motor vehicles. Sec. 40404. Extension of credit for alternative fuel vehicle refueling property. Sec. 40405. Extension of credit for 2-wheeled plug-in electric vehicles. Sec. 40406. Extension of second generation biofuel producer credit. Sec. 40407. Extension of biodiesel and renewable diesel incentives. Sec. 40408. Extension of production credit for Indian coal facilities. Sec. 40409. Extension of credits with respect to facilities producing energy from certain renewable resources. Sec. 40410. Extension of credit for energy-efficient new homes. Sec. 40411. Extension and phaseout of energy credit. Sec. 40412. Extension of special allowance for second generation biofuel plant property. Sec. 40413. Extension of energy efficient commercial buildings deduction. Sec. 40414. Extension of special rule for sales or dispositions to implement FERC or State electric restructuring policy for qualified electric utilities. Sec. 40415. Extension of excise tax credits relating to alternative fuels. Sec. 40416. Extension of Oil Spill Liability Trust Fund financing rate. Subtitle D—Modifications of Energy Incentives Sec. 40501. Modifications of credit for production from advanced nuclear power facilities. TITLE II—MISCELLANEOUS PROVISIONS Sec. 41101. Amendment of Internal Revenue Code of 1986. Sec. 41102. Modifications to rum cover over. Sec. 41103. Extension of waiver of limitations with respect to excluding from gross income amounts received by wrongfully incarcerated individuals. Sec. 41104. Individuals held harmless on improper levy on retirement plans. Sec. 41105. Modification of user fee requirements for installment agreements. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 197 Sec. Sec. Sec. Sec. 41106. 41107. 41108. 41109. Sec. 41110. Sec. 41111. Sec. 41112. Sec. 41113. Sec. 41114. Sec. 41115. Sec. 41116. Sec. 41117. Sec. 41118. Sec. 41119. Form 1040SR for seniors. Attorneys fees relating to awards to whistleblowers. Clarification of whistleblower awards. Clarification regarding excise tax based on investment income of private colleges and universities. Exception from private foundation excess business holding tax for independently-operated philanthropic business holdings. Rule of construction for Craft Beverage Modernization and Tax Reform. Simplification of rules regarding records, statements, and returns. Modification of rules governing hardship distributions. Modification of rules relating to hardship withdrawals from cash or deferred arrangements. Opportunity Zones rule for Puerto Rico. Tax home of certain citizens or residents of the United States living abroad. Treatment of foreign persons for returns relating to payments made in settlement of payment card and third party network transactions. Repeal of shift in time of payment of corporate estimated taxes. Enhancement of carbon dioxide sequestration credit. 2 TITLE I—EXTENSION OF EXPIRING PROVISIONS 3 SEC. 40101. AMENDMENT OF INTERNAL REVENUE CODE OF 1 4 5 1986. Except as otherwise expressly provided, whenever in 6 this title an amendment or repeal is expressed in terms 7 of an amendment to, or repeal of, a section or other provi8 sion, the reference shall be considered to be made to a 9 section or other provision of the Internal Revenue Code 10 of 1986. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 198 2 Subtitle A—Tax Relief for Families and Individuals 3 SEC. 40201. EXTENSION OF EXCLUSION FROM GROSS IN- 4 COME OF DISCHARGE OF QUALIFIED PRIN- 5 CIPAL RESIDENCE INDEBTEDNESS. 1 6 (a) IN GENERAL.—Section 108(a)(1)(E) is amended 7 by striking ‘‘January 1, 2017’’ each place it appears and 8 inserting ‘‘January 1, 2018’’. 9 (b) EFFECTIVE DATE.—The amendments made by 10 this section shall apply to discharges of indebtedness after 11 December 31, 2016. 12 SEC. 40202. EXTENSION OF MORTGAGE INSURANCE PRE- 13 MIUMS TREATED AS QUALIFIED RESIDENCE 14 INTEREST. 15 (a) IN GENERAL.—Subclause (I) of section 16 163(h)(3)(E)(iv) is amended by striking ‘‘December 31, 17 2016’’ and inserting ‘‘December 31, 2017’’. 18 (b) EFFECTIVE DATE.—The amendment made by 19 this section shall apply to amounts paid or accrued after 20 December 31, 2016. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 199 1 SEC. 40203. EXTENSION OF ABOVE-THE-LINE DEDUCTION 2 FOR QUALIFIED TUITION AND RELATED EX- 3 PENSES. 4 (a) IN GENERAL.—Section 222(e) is amended by 5 striking ‘‘December 31, 2016’’ and inserting ‘‘December 6 31, 2017’’. 7 (b) EFFECTIVE DATE.—The amendment made by 8 this section shall apply to taxable years beginning after 9 December 31, 2016. 11 Subtitle B—Incentives for Growth, Jobs, Investment, and Innovation 12 SEC. 40301. EXTENSION OF INDIAN EMPLOYMENT TAX 10 13 CREDIT. 14 (a) IN GENERAL.—Section 45A(f) is amended by 15 striking ‘‘December 31, 2016’’ and inserting ‘‘December 16 31, 2017’’. 17 (b) EFFECTIVE DATE.—The amendment made by 18 this section shall apply to taxable years beginning after 19 December 31, 2016. 20 SEC. 40302. EXTENSION OF RAILROAD TRACK MAINTE- 21 22 NANCE CREDIT. (a) IN GENERAL.—Section 45G(f) is amended by 23 striking ‘‘January 1, 2017’’ and inserting ‘‘January 1, 24 2018’’. 25 February 7, 2018 (10:12 p.m.) (b) EFFECTIVE DATE.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 200 1 (1) IN GENERAL.—The amendment made by 2 this section shall apply to expenditures paid or in- 3 curred in taxable years beginning after December 4 31, 2016. 5 (2) SAFE HARBOR ASSIGNMENTS.—Assign- 6 ments, including related expenditures paid or in- 7 curred, under paragraph (2) of section 45G(b) of the 8 Internal Revenue Code of 1986 for taxable years 9 ending after January 1, 2017, and before January 10 1, 2018, shall be treated as effective as of the close 11 of such taxable year if made pursuant to a written 12 agreement entered into no later than 90 days fol- 13 lowing the date of the enactment of this Act. 14 SEC. 40303. EXTENSION OF MINE RESCUE TEAM TRAINING 15 CREDIT. 16 (a) IN GENERAL.—Section 45N(e) is amended by 17 striking ‘‘December 31, 2016’’ and inserting ‘‘December 18 31, 2017’’. 19 (b) EFFECTIVE DATE.—The amendment made by 20 this section shall apply to taxable years beginning after 21 December 31, 2016. 22 SEC. 40304. EXTENSION OF CLASSIFICATION OF CERTAIN 23 RACE HORSES AS 3-YEAR PROPERTY. 24 (a) IN GENERAL.—Section 168(e)(3)(A)(i) is amend- 25 ed— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 201 1 (1) by striking ‘‘January 1, 2017’’ in subclause 2 (I) and inserting ‘‘January 1, 2018’’, and 3 (2) by striking ‘‘December 31, 2016’’ in sub- 4 clause (II) and inserting ‘‘December 31, 2017’’. 5 (b) EFFECTIVE DATE.—The amendments made by 6 this section shall apply to property placed in service after 7 December 31, 2016. 8 SEC. 40305. EXTENSION OF 7-YEAR RECOVERY PERIOD FOR 9 MOTORSPORTS 10 ENTERTAINMENT COM- PLEXES. 11 (a) IN GENERAL.—Section 168(i)(15)(D) is amended 12 by striking ‘‘December 31, 2016’’ and inserting ‘‘Decem13 ber 31, 2017’’. 14 (b) EFFECTIVE DATE.—The amendment made by 15 this section shall apply to property placed in service after 16 December 31, 2016. 17 SEC. 40306. EXTENSION OF ACCELERATED DEPRECIATION 18 FOR BUSINESS PROPERTY ON AN INDIAN 19 RESERVATION. 20 (a) IN GENERAL.—Section 168(j)(9) is amended by 21 striking ‘‘December 31, 2016’’ and inserting ‘‘December 22 31, 2017’’. 23 (b) EFFECTIVE DATE.—The amendment made by 24 this section shall apply to property placed in service after 25 December 31, 2016. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 202 1 SEC. 40307. EXTENSION OF ELECTION TO EXPENSE MINE 2 SAFETY EQUIPMENT. 3 (a) IN GENERAL.—Section 179E(g) is amended by 4 striking ‘‘December 31, 2016’’ and inserting ‘‘December 5 31, 2017’’. 6 (b) EFFECTIVE DATE.—The amendment made by 7 this section shall apply to property placed in service after 8 December 31, 2016. 9 SEC. 40308. EXTENSION OF SPECIAL EXPENSING RULES 10 FOR CERTAIN PRODUCTIONS. 11 (a) IN GENERAL.—Section 181(g) is amended by 12 striking ‘‘December 31, 2016’’ and inserting ‘‘December 13 31, 2017’’. 14 (b) EFFECTIVE DATE.—The amendment made by 15 this section shall apply to productions commencing after 16 December 31, 2016. 17 SEC. 40309. EXTENSION OF DEDUCTION ALLOWABLE WITH 18 RESPECT TO INCOME ATTRIBUTABLE TO DO- 19 MESTIC PRODUCTION ACTIVITIES IN PUERTO 20 RICO. 21 For purposes of applying section 199(d)(8)(C) of the 22 Internal Revenue Code of 1986 with respect to taxable 23 years beginning during 2017, such section shall be ap24 plied— 25 26 February 7, 2018 (10:12 p.m.) (1) by substituting ‘‘first 12 taxable years’’ for ‘‘first 11 taxable years’’, and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 203 1 (2) by substituting ‘‘January 1, 2018’’ for 2 3 ‘‘January 1, 2017’’. SEC. 40310. EXTENSION OF SPECIAL RULE RELATING TO 4 QUALIFIED TIMBER GAIN. 5 For purposes of applying section 1201(b) of the In- 6 ternal Revenue Code of 1986 with respect to taxable years 7 beginning during 2017, such section shall be applied by 8 substituting ‘‘2016 or 2017’’ for ‘‘2016’’. 9 SEC. 40311. EXTENSION OF EMPOWERMENT ZONE TAX IN- 10 11 CENTIVES. (a) IN GENERAL.— 12 (1) EXTENSION.—Section 1391(d)(1)(A)(i) is 13 amended by striking ‘‘December 31, 2016’’ and in- 14 serting ‘‘December 31, 2017’’. 15 (2) TREATMENT OF CERTAIN TERMINATION 16 DATES SPECIFIED IN NOMINATIONS.—In 17 a designation of an empowerment zone the nomina- 18 tion for which included a termination date which is 19 contemporaneous with the date specified in subpara- 20 graph (A)(i) of section 1391(d)(1) of the Internal 21 Revenue Code of 1986 (as in effect before the enact- 22 ment of this Act), subparagraph (B) of such section 23 shall not apply with respect to such designation if, 24 after the date of the enactment of this section, the 25 entity which made such nomination amends the February 7, 2018 (10:12 p.m.) the case of U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 204 1 nomination to provide for a new termination date in 2 such manner as the Secretary of the Treasury (or 3 the Secretary’s designee) may provide. 4 (b) EFFECTIVE DATE.—The amendment made by 5 subsection (a)(1) shall apply to taxable years beginning 6 after December 31, 2016. 7 SEC. 40312. EXTENSION OF AMERICAN SAMOA ECONOMIC 8 9 DEVELOPMENT CREDIT. (a) IN GENERAL.—Section 119 of division A of the 10 Tax Relief and Health Care Act of 2006 is amended— 11 (1) in subsection (d)— 12 (A) by striking ‘‘January 1, 2017’’ each 13 place it appears and inserting ‘‘January 1, 14 2018’’, 15 (B) by striking ‘‘first 11 taxable years’’ in 16 paragraph (1) and inserting ‘‘first 12 taxable 17 years’’, and 18 (C) by striking ‘‘first 5 taxable years’’ in 19 paragraph (2) and inserting ‘‘first 6 taxable 20 years’’, and 21 (2) in subsection (e), by adding at the end the 22 following: ‘‘References in this subsection to section 23 199 of the Internal Revenue Code of 1986 shall be 24 treated as references to such section as in effect be- 25 fore its repeal.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 205 1 (b) EFFECTIVE DATE.—The amendments made by 2 this section shall apply to taxable years beginning after 3 December 31, 2016. 5 Subtitle C—Incentives for Energy Production and Conservation 6 SEC. 40401. EXTENSION OF CREDIT FOR NONBUSINESS EN- 4 7 ERGY PROPERTY. 8 (a) IN GENERAL.—Section 25C(g)(2) is amended by 9 striking ‘‘December 31, 2016’’ and inserting ‘‘December 10 31, 2017’’. 11 (b) EFFECTIVE DATE.—The amendment made by 12 this section shall apply to property placed in service after 13 December 31, 2016. 14 SEC. 40402. EXTENSION AND MODIFICATION OF CREDIT 15 16 FOR RESIDENTIAL ENERGY PROPERTY. (a) IN GENERAL.—Section 25D(h) is amended by 17 striking ‘‘December 31, 2016’’ and all that follows and 18 inserting ‘‘December 31, 2021.’’. 19 (b) PHASEOUT.— 20 (1) IN GENERAL.—Section 25D(a) is amended 21 by striking ‘‘the sum of—’’ and all that follows and 22 inserting ‘‘the sum of the applicable percentages 23 of— 24 25 February 7, 2018 (10:12 p.m.) ‘‘(1) the qualified solar electric property expenditures, U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 206 1 ‘‘(2) the qualified solar water heating property 2 expenditures, 3 ‘‘(3) the qualified fuel cell property expendi- 4 tures, 5 ‘‘(4) the qualified small wind energy property 6 expenditures, and 7 ‘‘(5) the qualified geothermal heat pump prop- 8 erty expenditures, 9 made by the taxpayer during such year.’’. 10 (2) CONFORMING AMENDMENT.—Section 11 25D(g) is amended by striking ‘‘paragraphs (1) and 12 (2) of’’. 13 (c) EFFECTIVE DATE.—The amendment made by 14 this section shall apply to property placed in service after 15 December 31, 2016. 16 SEC. 40403. EXTENSION OF CREDIT FOR NEW QUALIFIED 17 18 FUEL CELL MOTOR VEHICLES. (a) IN GENERAL.—Section 30B(k)(1) is amended by 19 striking ‘‘December 31, 2016’’ and inserting ‘‘December 20 31, 2017’’. 21 (b) EFFECTIVE DATE.—The amendment made by 22 this section shall apply to property purchased after De23 cember 31, 2016. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 207 1 SEC. 40404. EXTENSION OF CREDIT FOR ALTERNATIVE 2 FUEL VEHICLE REFUELING PROPERTY. 3 (a) IN GENERAL.—Section 30C(g) is amended by 4 striking ‘‘December 31, 2016’’ and inserting ‘‘December 5 31, 2017’’. 6 (b) EFFECTIVE DATE.—The amendment made by 7 this section shall apply to property placed in service after 8 December 31, 2016. 9 SEC. 40405. EXTENSION OF CREDIT FOR 2-WHEELED PLUG- 10 IN ELECTRIC VEHICLES. 11 (a) IN GENERAL.—Section 30D(g)(3)(E)(ii) is 12 amended by striking ‘‘January 1, 2017’’ and inserting 13 ‘‘January 1, 2018’’. 14 (b) EFFECTIVE DATE.—The amendment made by 15 this section shall apply to vehicles acquired after Decem16 ber 31, 2016. 17 SEC. 40406. EXTENSION OF SECOND GENERATION BIOFUEL 18 19 PRODUCER CREDIT. (a) IN GENERAL.—Section 40(b)(6)(J)(i) is amended 20 by striking ‘‘January 1, 2017’’ and inserting ‘‘January 1, 21 2018’’. 22 (b) EFFECTIVE DATE.—The amendment made by 23 this section shall apply to qualified second generation 24 biofuel production after December 31, 2016. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 208 1 SEC. 40407. EXTENSION OF BIODIESEL AND RENEWABLE 2 3 4 DIESEL INCENTIVES. (a) INCOME TAX CREDIT.— (1) IN GENERAL.—Subsection (g) of section 5 40A is amended by striking ‘‘December 31, 2016’’ 6 and inserting ‘‘December 31, 2017’’. 7 (2) EFFECTIVE DATE.—The amendment made 8 by this subsection shall apply to fuel sold or used 9 after December 31, 2016. 10 11 (b) EXCISE TAX INCENTIVES.— (1) IN GENERAL.—Section 6426(c)(6) is 12 amended by striking ‘‘December 31, 2016’’ and in- 13 serting ‘‘December 31, 2017’’. 14 (2) PAYMENTS.—Section 6427(e)(6)(B) is 15 amended by striking ‘‘December 31, 2016’’ and in- 16 serting ‘‘December 31, 2017’’. 17 (3) EFFECTIVE DATE.—The amendments made 18 by this subsection shall apply to fuel sold or used 19 after December 31, 2016. 20 (4) SPECIAL RULE FOR 2017.—Notwithstanding 21 any other provision of law, in the case of any bio- 22 diesel mixture credit properly determined under sec- 23 tion 6426(c) of the Internal Revenue Code of 1986 24 for the period beginning on January 1, 2017, and 25 ending on December 31, 2017, such credit shall be 26 allowed, and any refund or payment attributable to February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 209 1 such credit (including any payment under section 2 6427(e) of such Code) shall be made, only in such 3 manner as the Secretary of the Treasury (or the 4 Secretary’s delegate) shall provide. Such Secretary 5 shall issue guidance within 30 days after the date of 6 the enactment of this Act providing for a one-time 7 submission of claims covering periods described in 8 the preceding sentence. Such guidance shall provide 9 for a 180-day period for the submission of such 10 claims (in such manner as prescribed by such Sec- 11 retary) to begin not later than 30 days after such 12 guidance is issued. Such claims shall be paid by such 13 Secretary not later than 60 days after receipt. If 14 such Secretary has not paid pursuant to a claim 15 filed under this subsection within 60 days after the 16 date of the filing of such claim, the claim shall be 17 paid with interest from such date determined by 18 using the overpayment rate and method under sec- 19 tion 6621 of such Code. 20 SEC. 40408. EXTENSION OF PRODUCTION CREDIT FOR IN- 21 22 DIAN COAL FACILITIES. (a) IN GENERAL.—Section 45(e)(10)(A) is amended 23 by striking ‘‘11-year period’’ each place it appears and in24 serting ‘‘12-year period’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 210 1 (b) EFFECTIVE DATE.—The amendment made by 2 this section shall apply to coal produced after December 3 31, 2016. 4 SEC. 40409. EXTENSION OF CREDITS WITH RESPECT TO FA- 5 CILITIES PRODUCING ENERGY FROM CER- 6 TAIN RENEWABLE RESOURCES. 7 (a) IN GENERAL.—The following provisions of sec- 8 tion 45(d) are each amended by striking ‘‘January 1, 9 2017’’ each place it appears and inserting ‘‘January 1, 10 2018’’: 11 (1) Paragraph (2)(A). 12 (2) Paragraph (3)(A). 13 (3) Paragraph (4)(B). 14 (4) Paragraph (6). 15 (5) Paragraph (7). 16 (6) Paragraph (9). 17 (7) Paragraph (11)(B). 18 (b) EXTENSION 19 FACILITIES AS OF ELECTION TO TREAT QUALIFIED ENERGY PROPERTY.—Section 20 48(a)(5)(C)(ii) is amended by striking ‘‘January 1, 2017’’ 21 and inserting ‘‘January 1, 2018’’. 22 (c) EFFECTIVE DATE.—The amendments made by 23 this section shall take effect on January 1, 2017. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 211 1 SEC. 40410. EXTENSION OF CREDIT FOR ENERGY-EFFI- 2 CIENT NEW HOMES. 3 (a) IN GENERAL.—Section 45L(g) is amended by 4 striking ‘‘December 31, 2016’’ and inserting ‘‘December 5 31, 2017’’. 6 (b) EFFECTIVE DATE.—The amendment made by 7 this section shall apply to homes acquired after December 8 31, 2016. 9 SEC. 40411. EXTENSION AND PHASEOUT OF ENERGY CRED- 10 11 IT. (a) EXTENSION OF SOLAR AND THERMAL ENERGY 12 PROPERTY.—Section 48(a)(3)(A) is amended— 13 (1) by striking ‘‘periods ending before January 14 1, 2017’’ in clause (ii) and inserting ‘‘property the 15 construction of which begins before January 1, 16 2022’’, and 17 (2) by striking ‘‘periods ending before January 18 1, 2017’’ in clause (vii) and inserting ‘‘property the 19 construction of which begins before January 1, 20 2022’’. 21 (b) PHASEOUT OF 30-PERCENT CREDIT RATE 22 FIBER-OPTIC SOLAR, QUALIFIED FUEL CELL, FOR AND 23 QUALIFIED SMALL WIND ENERGY PROPERTY.— 24 25 February 7, 2018 (10:12 p.m.) (1) IN GENERAL.—Section 48(a) is amended by adding at the end the following new paragraph: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 212 1 ‘‘(7) PHASEOUT FOR 2 QUALIFIED 3 WIND ENERGY PROPERTY.— 4 ‘‘(A) IN FUEL CELL, FIBER-OPTIC AND QUALIFIED GENERAL.—Subject SOLAR, SMALL to subpara- 5 graph (B), in the case of any qualified fuel cell 6 property, qualified small wind property, or en- 7 ergy property described in paragraph (3)(A)(ii), 8 the energy percentage determined under para- 9 graph (2) shall be equal to— 10 ‘‘(i) in the case of any property the 11 construction of which begins after Decem- 12 ber 31, 2019, and before January 1, 2021, 13 26 percent, and 14 ‘‘(ii) in the case of any property the 15 construction of which begins after Decem- 16 ber 31, 2020, and before January 1, 2022, 17 22 percent. 18 ‘‘(B) PLACED IN SERVICE DEADLINE.—In 19 the case of any energy property described in 20 subparagraph (A) which is not placed in service 21 before January 1, 2024, the energy percentage 22 determined under paragraph (2) shall be equal 23 to 0 percent.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 213 1 (2) CONFORMING AMENDMENT.—Section 2 48(a)(2)(A) is amended by striking ‘‘paragraph (6)’’ 3 and inserting ‘‘paragraphs (6) and (7)’’. 4 (3) CLARIFICATION RELATING TO PHASEOUT 5 FOR 6 amended by inserting ‘‘which is treated as energy 7 property by reason of this paragraph’’ after ‘‘using 8 wind to produce electricity’’. 9 (c) EXTENSION 10 WIND ERTY.—Section FACILITIES.—Section OF 48(a)(5)(E) is QUALIFIED FUEL CELL PROP- 48(c)(1)(D) is amended by striking ‘‘for 11 any period after December 31, 2016’’ and inserting ‘‘the 12 construction of which does not begin before January 1, 13 2022’’. 14 (d) EXTENSION OF QUALIFIED MICROTURBINE 15 PROPERTY.—Section 48(c)(2)(D) is amended by striking 16 ‘‘for any period after December 31, 2016’’ and inserting 17 ‘‘the construction of which does not begin before January 18 1, 2022’’. 19 (e) EXTENSION OF COMBINED HEAT AND POWER 20 SYSTEM PROPERTY.—Section 48(c)(3)(A)(iv) is amended 21 by striking ‘‘which is placed in service before January 1, 22 2017’’ and inserting ‘‘the construction of which begins be23 fore January 1, 2022’’. 24 25 (f) EXTENSION ERGY February 7, 2018 (10:12 p.m.) OF QUALIFIED SMALL WIND EN- PROPERTY.—Section 48(c)(4)(C) is amended by U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 214 1 striking ‘‘for any period after December 31, 2016’’ and 2 inserting ‘‘the construction of which does not begin before 3 January 1, 2022’’. 4 (g) EFFECTIVE DATE.— 5 (1) IN GENERAL.—Except as otherwise pro- 6 vided in this subsection, the amendments made by 7 this section shall apply to periods after December 8 31, 2016, under rules similar to the rules of section 9 48(m) of the Internal Revenue Code of 1986 (as in 10 effect on the day before the date of the enactment 11 of the Revenue Reconciliation Act of 1990). 12 (2) EXTENSION OF COMBINED HEAT AND 13 POWER SYSTEM PROPERTY.—The 14 by subsection (e) shall apply to property placed in 15 service after December 31, 2016. 16 (3) PHASEOUTS AND amendment made TERMINATIONS.—The 17 amendments made by subsection (b) shall take effect 18 on the date of the enactment of this Act. 19 SEC. 40412. EXTENSION OF SPECIAL ALLOWANCE FOR SEC- 20 OND GENERATION BIOFUEL PLANT PROP- 21 ERTY. 22 (a) IN GENERAL.—Section 168(l)(2)(D) is amended 23 by striking ‘‘January 1, 2017’’ and inserting ‘‘January 1, 24 2018’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 215 1 (b) EFFECTIVE DATE.—The amendment made by 2 this section shall apply to property placed in service after 3 December 31, 2016. 4 SEC. 40413. EXTENSION OF ENERGY EFFICIENT COMMER- 5 CIAL BUILDINGS DEDUCTION. 6 (a) IN GENERAL.—Section 179D(h) is amended by 7 striking ‘‘December 31, 2016’’ and inserting ‘‘December 8 31, 2017’’. 9 (b) EFFECTIVE DATE.—The amendment made by 10 this section shall apply to property placed in service after 11 December 31, 2016. 12 SEC. 40414. EXTENSION OF SPECIAL RULE FOR SALES OR 13 DISPOSITIONS 14 STATE ELECTRIC RESTRUCTURING POLICY 15 FOR QUALIFIED ELECTRIC UTILITIES. 16 (a) IN GENERAL.—Section 451(k)(3), as amended by TO IMPLEMENT FERC OR 17 section 13221 of Public Law 115-97, is amended by strik18 ing ‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 19 (b) EFFECTIVE DATE.—The amendment made by 20 this section shall apply to dispositions after December 31, 21 2016. 22 SEC. 40415. EXTENSION OF EXCISE TAX CREDITS RELATING 23 24 TO ALTERNATIVE FUELS. (a) EXTENSION 25 TAX CREDITS.— February 7, 2018 (10:12 p.m.) OF ALTERNATIVE FUELS EXCISE U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 216 1 (1) IN GENERAL.—Sections 6426(d)(5) and 2 6426(e)(3) are each amended by striking ‘‘December 3 31, 2016’’ and inserting ‘‘December 31, 2017’’. 4 (2) OUTLAY PAYMENTS FOR ALTERNATIVE 5 FUELS.—Section 6 ing ‘‘December 31, 2016’’ and inserting ‘‘December 7 31, 2017’’. 8 9 6427(e)(6)(C) is amended by strik- (3) EFFECTIVE DATE.—The amendments made by this subsection shall apply to fuel sold or used 10 after December 31, 2016. 11 (b) SPECIAL RULE FOR 2017.—Notwithstanding any 12 other provision of law, in the case of any alternative fuel 13 credit properly determined under section 6426(d) of the 14 Internal Revenue Code of 1986 for the period beginning 15 on January 1, 2017, and ending on December 31, 2017, 16 such credit shall be allowed, and any refund or payment 17 attributable to such credit (including any payment under 18 section 6427(e) of such Code) shall be made, only in such 19 manner as the Secretary of the Treasury (or the Sec20 retary’s delegate) shall provide. Such Secretary shall issue 21 guidance within 30 days after the date of the enactment 22 of this Act providing for a one-time submission of claims 23 covering periods described in the preceding sentence. Such 24 guidance shall provide for a 180-day period for the sub25 mission of such claims (in such manner as prescribed by February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 217 1 such Secretary) to begin not later than 30 days after such 2 guidance is issued. Such claims shall be paid by such Sec3 retary not later than 60 days after receipt. If such Sec4 retary has not paid pursuant to a claim filed under this 5 subsection within 60 days after the date of the filing of 6 such claim, the claim shall be paid with interest from such 7 date determined by using the overpayment rate and meth8 od under section 6621 of such Code. 9 SEC. 40416. EXTENSION OF OIL SPILL LIABILITY TRUST 10 FUND FINANCING RATE. 11 (a) IN GENERAL.—Section 4611(f)(2) is amended by 12 striking ‘‘December 31, 2017’’ and inserting ‘‘December 13 31, 2018’’. 14 (b) EFFECTIVE DATE.—The amendment made by 15 this section shall apply on and after the first day of the 16 first calendar month beginning after the date of the enact17 ment of this Act. 19 Subtitle D—Modifications of Energy Incentives 20 SEC. 40501. MODIFICATIONS OF CREDIT FOR PRODUCTION 21 FROM ADVANCED NUCLEAR POWER FACILI- 22 TIES. 18 23 (a) TREATMENT OF UNUTILIZED 24 AMOUNTS.—Section 45J(b) is amended— February 7, 2018 (10:12 p.m.) LIMITATION U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 218 1 2 3 4 5 6 7 (1) by inserting ‘‘or any amendment to’’ after ‘‘enactment of’’ in paragraph (4), and (2) by adding at the end the following new paragraph: ‘‘(5) ALLOCATION OF UNUTILIZED LIMITA- TION.— ‘‘(A) IN GENERAL.—Any unutilized na- 8 tional megawatt capacity limitation shall be al- 9 located by the Secretary under paragraph (3) 10 as rapidly as is practicable after December 31, 11 2020— 12 ‘‘(i) first to facilities placed in service 13 on or before such date to the extent that 14 such facilities did not receive an allocation 15 equal to their full nameplate capacity, and 16 ‘‘(ii) then to facilities placed in service 17 after such date in the order in which such 18 facilities are placed in service. 19 ‘‘(B) UNUTILIZED NATIONAL MEGAWATT 20 CAPACITY LIMITATION.—The 21 national megawatt capacity limitation’ means 22 the excess (if any) of— term ‘unutilized 23 ‘‘(i) 6,000 megawatts, over 24 ‘‘(ii) the aggregate amount of national 25 megawatt capacity limitation allocated by February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 219 1 the Secretary before January 1, 2021, re- 2 duced by any amount of such limitation 3 which was allocated to a facility which was 4 not placed in service before such date. 5 ‘‘(C) COORDINATION WITH OTHER PROVI- 6 SIONS.—In 7 megawatt capacity limitation allocated by the 8 Secretary pursuant to this paragraph— the case of any unutilized national 9 ‘‘(i) such allocation shall be treated 10 for purposes of this section in the same 11 manner as an allocation of national mega- 12 watt capacity limitation, and 13 ‘‘(ii) subsection (d)(1)(B) shall not 14 apply to any facility which receives such al- 15 location.’’. 16 17 (b) TRANSFER CREDIT BY CERTAIN PUBLIC EN- TITIES.— 18 (1) IN 19 GENERAL.—Section 45J is amended— (A) by redesignating subsection (e) as sub- 20 section (f), and 21 (B) by inserting after subsection (d) the 22 following new subsection: 23 24 OF ‘‘(e) TRANSFER OF CREDIT BY CERTAIN PUBLIC ENTITIES.— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 220 1 2 ‘‘(1) IN with respect to a credit under subsection (a) for any taxable year— 3 4 GENERAL.—If, ‘‘(A) a qualified public entity would be the taxpayer (but for this paragraph), and 5 ‘‘(B) such entity elects the application of 6 this paragraph for such taxable year with re- 7 spect to all (or any portion specified in such 8 election) of such credit, 9 the eligible project partner specified in such election, 10 and not the qualified public entity, shall be treated 11 as the taxpayer for purposes of this title with re- 12 spect to such credit (or such portion thereof). 13 14 15 16 ‘‘(2) DEFINITIONS.—For purposes of this subsection— ‘‘(A) QUALIFIED PUBLIC ENTITY.—The term ‘qualified public entity’ means— 17 ‘‘(i) a Federal, State, or local govern- 18 ment entity, or any political subdivision, 19 agency, or instrumentality thereof, 20 ‘‘(ii) a mutual or cooperative electric 21 company described in section 501(c)(12) or 22 1381(a)(2), or 23 ‘‘(iii) a not-for-profit electric utility 24 which had or has received a loan or loan February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 221 1 guarantee under the Rural Electrification 2 Act of 1936. 3 ‘‘(B) ELIGIBLE PROJECT PARTNER.—The 4 term ‘eligible project partner’ means any person 5 who— 6 ‘‘(i) is responsible for, or participates 7 in, the design or construction of the ad- 8 vanced nuclear power facility to which the 9 credit under subsection (a) relates, 10 ‘‘(ii) participates in the provision of 11 the nuclear steam supply system to such 12 facility, 13 14 ‘‘(iii) participates in the provision of nuclear fuel to such facility, 15 ‘‘(iv) is a financial institution pro- 16 viding financing for the construction or op- 17 eration of such facility, or 18 19 20 21 ‘‘(v) has an ownership interest in such facility. ‘‘(3) SPECIAL RULES.— ‘‘(A) APPLICATION TO PARTNERSHIPS.—In 22 the case of a credit under subsection (a) which 23 is determined at the partnership level— 24 ‘‘(i) for purposes of paragraph (1)(A), 25 a qualified public entity shall be treated as February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 222 1 the taxpayer with respect to such entity’s 2 distributive share of such credit, and 3 ‘‘(ii) the term ‘eligible project partner’ 4 shall include any partner of the partner- 5 ship. 6 ‘‘(B) TAXABLE YEAR IN WHICH CREDIT 7 TAKEN INTO ACCOUNT.—In 8 credit (or portion thereof) with respect to which 9 an election is made under paragraph (1), such 10 credit shall be taken into account in the first 11 taxable year of the eligible project partner end- 12 ing with, or after, the qualified public entity’s 13 taxable year with respect to which the credit 14 was determined. the case of any 15 ‘‘(C) TREATMENT 16 PRIVATE USE RULES.—For 17 141(b)(1), any benefit derived by an eligible 18 project partner in connection with an election 19 under this subsection shall not be taken into ac- 20 count as a private business use.’’. 21 (2) SPECIAL OF TRANSFER UNDER purposes of section RULE FOR PROCEEDS OF TRANS- 22 FERS 23 COMPANIES.—Section 24 adding at the end the following new subparagraph: February 7, 2018 (10:12 p.m.) FOR MUTUAL OR COOPERATIVE ELECTRIC 501(c)(12) is amended by U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 223 1 ‘‘(I) In the case of a mutual or cooperative 2 electric company described in this paragraph or 3 an organization described in section 1381(a)(2), 4 income received or accrued in connection with 5 an election under section 45J(e)(1) shall be 6 treated as an amount collected from members 7 for the sole purpose of meeting losses and ex- 8 penses.’’. 9 (c) EFFECTIVE DATES.— 10 (1) TREATMENT OF UNUTILIZED LIMITATION 11 AMOUNTS.—The 12 shall take effect on the date of the enactment of this 13 Act. 14 amendment made by subsection (a) (2) TRANSFER OF CREDIT BY CERTAIN PUBLIC 15 ENTITIES.—The 16 (b) shall apply to taxable years beginning after the 17 date of the enactment of this Act. 18 19 TITLE II—MISCELLANEOUS PROVISIONS 20 SEC. 41101. AMENDMENT OF INTERNAL REVENUE CODE OF 21 22 amendments made by subsection 1986. Except as otherwise expressly provided, whenever in 23 this title an amendment or repeal is expressed in terms 24 of an amendment to, or repeal of, a section or other provi25 sion, the reference shall be considered to be made to a February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 224 1 section or other provision of the Internal Revenue Code 2 of 1986. 3 SEC. 41102. MODIFICATIONS TO RUM COVER OVER. 4 5 (a) EXTENSION.— (1) IN GENERAL.—Section 7652(f)(1) is 6 amended by striking ‘‘January 1, 2017’’ and insert- 7 ing ‘‘January 1, 2022’’. 8 (2) EFFECTIVE DATE.—The amendment made 9 by this subsection shall apply to distilled spirits 10 brought into the United States after December 31, 11 2016. 12 (b) DETERMINATION OF TAXES ON RUM.— 13 14 15 (1) IN GENERAL.—Section 7652(e) is amended by adding at the end the following new paragraph: ‘‘(5) DETERMINATION OF AMOUNT OF TAXES 16 COLLECTED.—For 17 amount of taxes collected under section 5001(a)(1) 18 shall be determined without regard to section 19 5001(c).’’. 20 purposes of this subsection, the (2) EFFECTIVE DATE.—The amendment made 21 by this subsection shall apply to distilled spirits 22 brought into the United States after December 31, 23 2017. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 225 1 SEC. 41103. EXTENSION OF WAIVER OF LIMITATIONS WITH 2 RESPECT TO EXCLUDING FROM GROSS IN- 3 COME AMOUNTS RECEIVED BY WRONGFULLY 4 INCARCERATED INDIVIDUALS. 5 (a) IN GENERAL.—Section 304(d) of the Protecting 6 Americans from Tax Hikes Act of 2015 (26 U.S.C. 139F 7 note) is amended by striking ‘‘1-year’’ and inserting ‘‘38 year’’. 9 (b) EFFECTIVE DATE.—The amendment made by 10 this section shall take effect on the date of the enactment 11 of this Act. 12 SEC. 41104. INDIVIDUALS HELD HARMLESS ON IMPROPER 13 14 LEVY ON RETIREMENT PLANS. (a) IN GENERAL.—Section 6343 is amended by add- 15 ing at the end the following new subsection: 16 ‘‘(f) INDIVIDUALS HELD HARMLESS ON WRONGFUL 17 LEVY, ETC. ON RETIREMENT PLAN.— 18 ‘‘(1) IN GENERAL.—If the Secretary determines 19 that an individual’s account or benefit under an eli- 20 gible 21 402(c)(8)(B)) has been levied upon in a case to 22 which subsection (b) or (d)(2)(A) applies and prop- 23 erty or an amount of money is returned to the indi- 24 vidual— retirement plan (as defined in section 25 ‘‘(A) the individual may contribute such 26 property or an amount equal to the sum of— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 226 1 2 3 4 ‘‘(i) the amount of money so returned by the Secretary, and ‘‘(ii) interest paid under subsection (c) on such amount of money, 5 into such eligible retirement plan if such con- 6 tribution is permitted by the plan, or into an in- 7 dividual retirement plan (other than an endow- 8 ment contract) to which a rollover contribution 9 of a distribution from such eligible retirement 10 plan is permitted, but only if such contribution 11 is made not later than the due date (not includ- 12 ing extensions) for filing the return of tax for 13 the taxable year in which such property or 14 amount of money is returned, and 15 ‘‘(B) the Secretary shall, at the time such 16 property or amount of money is returned, notify 17 such individual that a contribution described in 18 subparagraph (A) may be made. 19 ‘‘(2) TREATMENT AS ROLLOVER.—The distribu- 20 tion on account of the levy and any contribution 21 under paragraph (1) with respect to the return of 22 such distribution shall be treated for purposes of 23 this title as if such distribution and contribution 24 were described in section 402(c), 402A(c)(3), February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 227 1 403(a)(4), 403(b)(8), 408(d)(3), 408A(d)(3), or 2 457(e)(16), whichever is applicable; except that— 3 ‘‘(A) the contribution shall be treated as 4 having been made for the taxable year in which 5 the distribution on account of the levy occurred, 6 and the interest paid under subsection (c) shall 7 be treated as earnings within the plan after the 8 contribution and shall not be included in gross 9 income, and 10 ‘‘(B) such contribution shall not be taken 11 into account under section 408(d)(3)(B). 12 ‘‘(3) REFUND, 13 14 ETC., OF INCOME TAX ON LEVY.— ‘‘(A) IN GENERAL.—If any amount is in- 15 cludible in gross income for a taxable year by 16 reason of a distribution on account of a levy re- 17 ferred to in paragraph (1) and any portion of 18 such amount is treated as a rollover contribu- 19 tion under paragraph (2), any tax imposed by 20 chapter 1 on such portion shall not be assessed, 21 and if assessed shall be abated, and if collected 22 shall be credited or refunded as an overpayment 23 made on the due date for filing the return of 24 tax for such taxable year. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 228 1 ‘‘(B) EXCEPTION.—Subparagraph (A) 2 shall not apply to a rollover contribution under 3 this subsection which is made from an eligible 4 retirement plan which is not a Roth IRA or a 5 designated Roth account (within the meaning of 6 section 402A) to a Roth IRA or a designated 7 Roth account under an eligible retirement plan. 8 ‘‘(4) INTEREST.—Notwithstanding subsection 9 (d), interest shall be allowed under subsection (c) in 10 a case in which the Secretary makes a determination 11 described in subsection (d)(2)(A) with respect to a 12 levy upon an individual retirement plan. 13 ‘‘(5) TREATMENT OF INHERITED ACCOUNTS.— 14 For 15 408(d)(3)(C) shall be disregarded in determining 16 whether an individual retirement plan is a plan to 17 which a rollover contribution of a distribution from 18 the plan levied upon is permitted.’’. 19 (b) EFFECTIVE DATE.—The amendment made by purposes of paragraph (1)(A), section 20 this section shall apply to amounts paid under subsections 21 (b), (c), and (d)(2)(A) of section 6343 of the Internal Rev22 enue Code of 1986 in taxable years beginning after De23 cember 31, 2017. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 229 1 SEC. 41105. MODIFICATION OF USER FEE REQUIREMENTS 2 3 FOR INSTALLMENT AGREEMENTS. (a) IN GENERAL.—Section 6159 is amended by re- 4 designating subsection (f) as subsection (g) and by insert5 ing after subsection (e) the following new subsection: 6 7 ‘‘(f) INSTALLMENT AGREEMENT FEES.— ‘‘(1) LIMITATION ON FEE AMOUNT.—The 8 amount of any fee imposed on an installment agree- 9 ment under this section may not exceed the amount 10 of such fee as in effect on the date of the enactment 11 of this subsection. 12 ‘‘(2) WAIVER OR REIMBURSEMENT.—In the 13 case of any taxpayer with an adjusted gross income, 14 as determined for the most recent year for which 15 such information is available, which does not exceed 16 250 percent of the applicable poverty level (as deter- 17 mined by the Secretary)— 18 ‘‘(A) if the taxpayer has agreed to make 19 payments under the installment agreement by 20 electronic payment through a debit instrument, 21 no fee shall be imposed on an installment agree- 22 ment under this section, and 23 ‘‘(B) if the taxpayer is unable to make 24 payments under the installment agreement by 25 electronic payment through a debit instrument, 26 the Secretary shall, upon completion of the in- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 230 1 stallment agreement, pay the taxpayer an 2 amount equal to any such fees imposed.’’. 3 (b) EFFECTIVE DATE.—The amendments made by 4 this section shall apply to agreements entered into on or 5 after the date which is 60 days after the date of the enact6 ment of this Act. 7 SEC. 41106. FORM 1040SR FOR SENIORS. 8 (a) IN GENERAL.—The Secretary of the Treasury (or 9 the Secretary’s delegate) shall make available a form, to 10 be known as ‘‘Form 1040SR’’, for use by individuals to 11 file the return of tax imposed by chapter 1 of the Internal 12 Revenue Code of 1986. Such form shall be as similar as 13 practicable to Form 1040EZ, except that— 14 (1) the form shall be available only to individ- 15 uals who have attained age 65 as of the close of the 16 taxable year, 17 18 (2) the form may be used even if income for the taxable year includes— 19 (A) social security benefits (as defined in 20 section 86(d) of the Internal Revenue Code of 21 1986), 22 (B) distributions from qualified retirement 23 plans (as defined in section 4974(c) of such 24 Code), annuities or other such deferred pay- 25 ment arrangements, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 231 1 (C) interest and dividends, or 2 (D) capital gains and losses taken into ac- 3 count in determining adjusted net capital gain 4 (as defined in section 1(h)(3) of such Code), 5 and 6 (3) the form shall be available without regard 7 to the amount of any item of taxable income or the 8 total amount of taxable income for the taxable year. 9 (b) EFFECTIVE DATE.—The form required by sub- 10 section (a) shall be made available for taxable years begin11 ning after the date of the enactment of this Act. 12 SEC. 41107. ATTORNEYS FEES RELATING TO AWARDS TO 13 14 WHISTLEBLOWERS. (a) IN GENERAL.—Paragraph (21) of section 62(a) 15 is amended to read as follows: 16 17 18 ‘‘(21) ATTORNEYS’ FEES RELATING TO AWARDS TO WHISTLEBLOWERS.— ‘‘(A) IN GENERAL.—Any deduction allow- 19 able under this chapter for attorney fees and 20 court costs paid by, or on behalf of, the tax- 21 payer in connection with any award under— 22 ‘‘(i) section 7623(b), or 23 ‘‘(ii) in the case of taxable years be- 24 ginning after December 31, 2017, any ac- 25 tion brought under— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 232 1 ‘‘(I) section 21F of the Securities 2 Exchange Act of 1934 (15 U.S.C. 3 78u-6), 4 ‘‘(II) a State law relating to false 5 or fraudulent claims that meets the 6 requirements 7 1909(b) of the Social Security Act (42 8 U.S.C. 1396h(b)), or 9 described in section ‘‘(III) section 23 of the Com- 10 modity Exchange Act (7 U.S.C. 26). 11 ‘‘(B) MAY NOT EXCEED AWARD.—Sub- 12 paragraph (A) shall not apply to any deduction 13 in excess of the amount includible in the tax- 14 payer’s gross income for the taxable year on ac- 15 count of such award.’’. 16 (b) EFFECTIVE DATE.—The amendment made by 17 this section shall apply to taxable years beginning after 18 December 31, 2017. 19 SEC. 41108. CLARIFICATION OF WHISTLEBLOWER AWARDS. 20 21 (a) DEFINITION OF PROCEEDS.— (1) IN GENERAL.—Section 7623 is amended by 22 adding at the end the following new subsection: 23 ‘‘(c) PROCEEDS.—For purposes of this section, the 24 term ‘proceeds’ includes— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 233 1 ‘‘(1) penalties, interest, additions to tax, and 2 additional amounts provided under the internal rev- 3 enue laws, and 4 ‘‘(2) any proceeds arising from laws for which 5 the Internal Revenue Service is authorized to admin- 6 ister, enforce, or investigate, including— 7 ‘‘(A) criminal fines and civil forfeitures, 8 and 9 ‘‘(B) violations 10 ments.’’. 11 (2) CONFORMING of reporting require- AMENDMENTS.—Paragraphs 12 (1) and (2)(A) of section 7623(b) are each amended 13 by striking ‘‘collected proceeds (including penalties, 14 interest, additions to tax, and additional amounts) 15 resulting from the action’’ and inserting ‘‘proceeds 16 collected as a result of the action’’. 17 (b) AMOUNT 18 REGARD TO OF PROCEEDS DETERMINED WITHOUT AVAILABILITY.—Paragraphs (1) and (2)(A) 19 of section 7623(b) are each amended by inserting ‘‘(deter20 mined without regard to whether such proceeds are avail21 able to the Secretary)’’ after ‘‘in response to such action’’. 22 (c) DISPUTED AMOUNT THRESHOLD.—Section 23 7623(b)(5)(B) is amended by striking ‘‘tax, penalties, in24 terest, additions to tax, and additional amounts’’ and in25 serting ‘‘proceeds’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 234 1 (d) EFFECTIVE DATE.—The amendments made by 2 this section shall apply to information provided before, on, 3 or after the date of the enactment of this Act with respect 4 to which a final determination for an award has not been 5 made before such date of enactment. 6 SEC. 41109. CLARIFICATION REGARDING EXCISE TAX 7 BASED ON INVESTMENT INCOME OF PRIVATE 8 COLLEGES AND UNIVERSITIES. 9 (a) IN GENERAL.—Subsection (b)(1) of section 4968, 10 as added by section 13701(a) of Public Law 115–97, is 11 amended— 12 (1) by inserting ‘‘tuition-paying’’ after ‘‘500’’ in 13 subparagraph (A), and 14 (2) by inserting ‘‘tuition-paying’’ after ‘‘50 per- 15 cent of the’’ in subparagraph (B). 16 (b) EFFECTIVE DATE.—The amendments made by 17 this section shall apply to taxable years beginning after 18 December 31, 2017. 19 SEC. 41110. EXCEPTION FROM PRIVATE FOUNDATION EX- 20 CESS BUSINESS HOLDING TAX FOR INDE- 21 PENDENTLY-OPERATED 22 BUSINESS HOLDINGS. 23 PHILANTHROPIC (a) IN GENERAL.—Section 4943 is amended by add- 24 ing at the end the following new subsection: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 235 1 ‘‘(g) EXCEPTION 2 TO 3 NESS.— 4 FOR CERTAIN HOLDINGS LIMITED INDEPENDENTLY-OPERATED PHILANTHROPIC BUSI- ‘‘(1) IN GENERAL.—Subsection (a) shall not 5 apply with respect to the holdings of a private foun- 6 dation in any business enterprise which meets the 7 requirements of paragraphs (2), (3), and (4) for the 8 taxable year. 9 10 ‘‘(2) OWNERSHIP.—The requirements of this paragraph are met if— 11 ‘‘(A) 100 percent of the voting stock in the 12 business enterprise is held by the private foun- 13 dation at all times during the taxable year, and 14 ‘‘(B) all the private foundation’s ownership 15 interests in the business enterprise were ac- 16 quired by means other than by purchase. 17 ‘‘(3) ALL 18 PROFITS TO CHARITY.— ‘‘(A) IN GENERAL.—The requirements of 19 this paragraph are met if the business enter- 20 prise, not later than 120 days after the close of 21 the taxable year, distributes an amount equal to 22 its net operating income for such taxable year 23 to the private foundation. 24 25 February 7, 2018 (10:12 p.m.) ‘‘(B) NET OPERATING INCOME.—For pur- poses of this paragraph, the net operating in- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 236 1 come of any business enterprise for any taxable 2 year is an amount equal to the gross income of 3 the business enterprise for the taxable year, re- 4 duced by the sum of— 5 ‘‘(i) the deductions allowed by chapter 6 1 for the taxable year which are directly 7 connected with the production of such in- 8 come, 9 ‘‘(ii) the tax imposed by chapter 1 on 10 the business enterprise for the taxable 11 year, and 12 ‘‘(iii) an amount for a reasonable re- 13 serve for working capital and other busi- 14 ness needs of the business enterprise. 15 ‘‘(4) INDEPENDENT OPERATION.—The require- 16 ments of this paragraph are met if, at all times dur- 17 ing the taxable year— 18 ‘‘(A) no substantial contributor (as defined 19 in section 4958(c)(3)(C)) to the private founda- 20 tion or family member (as determined under 21 section 4958(f)(4)) of such a contributor is a 22 director, officer, trustee, manager, employee, or 23 contractor of the business enterprise (or an in- 24 dividual having powers or responsibilities simi- 25 lar to any of the foregoing), February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 237 1 ‘‘(B) at least a majority of the board of di- 2 rectors of the private foundation are persons 3 who are not— 4 5 ‘‘(i) directors or officers of the business enterprise, or 6 ‘‘(ii) family members (as so deter- 7 mined) of a substantial contributor (as so 8 defined) to the private foundation, and 9 ‘‘(C) there is no loan outstanding from the 10 business enterprise to a substantial contributor 11 (as so defined) to the private foundation or to 12 any family member of such a contributor (as so 13 determined). 14 ‘‘(5) CERTAIN 15 EXCLUDED.—This DEEMED PRIVATE FOUNDATIONS subsection shall not apply to— 16 ‘‘(A) any fund or organization treated as a 17 private foundation for purposes of this section 18 by reason of subsection (e) or (f), 19 20 21 22 23 ‘‘(B) any trust described in section 4947(a)(1) (relating to charitable trusts), and ‘‘(C) any trust described in section 4947(a)(2) (relating to split-interest trusts).’’. (b) EFFECTIVE DATE.—The amendment made by 24 this section shall apply to taxable years beginning after 25 December 31, 2017. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 238 1 SEC. 41111. RULE OF CONSTRUCTION FOR CRAFT BEV- 2 ERAGE MODERNIZATION AND TAX REFORM. 3 (a) IN GENERAL.—Subpart A of part IX of subtitle 4 C of title I of Public Law 115-97 is amended by adding 5 at the end the following new section: 6 ‘‘SEC. 13809. RULE OF CONSTRUCTION. 7 ‘‘Nothing in this subpart, the amendments made by 8 this subpart, or any regulation promulgated under this 9 subpart or the amendments made by this subpart, shall 10 be construed to preempt, supersede, or otherwise limit or 11 restrict any State, local, or tribal law that prohibits or 12 regulates the production or sale of distilled spirits, wine, 13 or malt beverages.’’. 14 (b) EFFECTIVE DATE.—The amendment made by 15 this section shall take effect as if included in Public Law 16 115-97. 17 SEC. 18 19 41112. SIMPLIFICATION OF RULES REGARDING RECORDS, STATEMENTS, AND RETURNS. (a) IN GENERAL.—Subsection (a) of section 5555 is 20 amended by adding at the end the following: ‘‘For cal21 endar quarters beginning after the date of the enactment 22 of this sentence, and before January 1, 2020, the Sec23 retary shall permit a person to employ a unified system 24 for any records, statements, and returns required to be 25 kept, rendered, or made under this section for any beer 26 produced in the brewery for which the tax imposed by secFebruary 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 239 1 tion 5051 has been determined, including any beer which 2 has been removed for consumption on the premises of the 3 brewery.’’. 4 (b) EFFECTIVE DATE.—The amendment made by 5 this section shall apply to calendar quarters beginning 6 after the date of the enactment of this Act. 7 SEC. 41113. MODIFICATION OF RULES GOVERNING HARD- 8 9 SHIP DISTRIBUTIONS. (a) IN GENERAL.—Not later than 1 year after the 10 date of the enactment of this Act, the Secretary of the 11 Treasury shall modify Treasury Regulation section 12 1.401(k)–1(d)(3)(iv)(E) to— 13 14 15 (1) delete the 6-month prohibition on contributions imposed by paragraph (2) thereof, and (2) make any other modifications necessary to 16 carry 17 401(k)(2)(B)(i)(IV) of the Internal Revenue Code of 18 1986. 19 (b) EFFECTIVE DATE.—The revised regulations out the purposes of section 20 under this section shall apply to plan years beginning after 21 December 31, 2018. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 240 1 SEC. 41114. MODIFICATION OF RULES RELATING TO HARD- 2 SHIP WITHDRAWALS FROM CASH OR DE- 3 FERRED ARRANGEMENTS. 4 (a) IN GENERAL.—Section 401(k) is amended by 5 adding at the end the following: 6 ‘‘(14) SPECIAL RULES RELATING TO HARDSHIP 7 WITHDRAWALS.—For 8 (2)(B)(i)(IV)— 9 purposes ‘‘(A) AMOUNTS WHICH of MAY paragraph BE 10 DRAWN.—The 11 tributed upon hardship of the employee: WITH- following amounts may be dis- 12 ‘‘(i) Contributions to a profit-sharing 13 or stock bonus plan to which section 14 402(e)(3) applies. 15 ‘‘(ii) Qualified nonelective contribu- 16 tions (as defined in subsection (m)(4)(C)). 17 ‘‘(iii) Qualified matching contributions 18 19 described in paragraph (3)(D)(ii)(I). ‘‘(iv) Earnings on any contributions 20 described in clause (i), (ii), or (iii). 21 ‘‘(B) NO REQUIREMENT TO TAKE AVAIL- 22 ABLE LOAN.—A 23 ed as failing to be made upon the hardship of 24 an employee solely because the employee does 25 not take any available loan under the plan.’’. February 7, 2018 (10:12 p.m.) distribution shall not be treat- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 241 1 (b) CONFORMING AMENDMENT.—Section 2 401(k)(2)(B)(i)(IV) is amended to read as follows: 3 ‘‘(IV) subject to the provisions of 4 paragraph (14), upon hardship of the 5 employee, or’’. 6 (c) EFFECTIVE DATE.—The amendments made by 7 this section shall apply to plan years beginning after De8 cember 31, 2018. 9 SEC. 41115. OPPORTUNITY ZONES RULE FOR PUERTO RICO. 10 (a) IN GENERAL.—Subsection (b) of section 1400Z- 11 1 is amended by adding at the end the following new para12 graph: 13 ‘‘(3) SPECIAL RULE FOR PUERTO RICO.—Each 14 population census tract in Puerto Rico that is a low- 15 income community shall be deemed to be certified 16 and designated as a qualified opportunity zone, ef- 17 fective on the date of the enactment of Public Law 18 115-97.’’. 19 (b) CONFORMING AMENDMENT.—Section 1400Z- 20 1(d)(1) is amended by inserting ‘‘and subsection (b)(3)’’ 21 after ‘‘paragraph (2)’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 242 1 SEC. 41116. TAX HOME OF CERTAIN CITIZENS OR RESI- 2 DENTS 3 ABROAD. 4 OF THE UNITED STATES LIVING (a) IN GENERAL.—Paragraph (3) of section 911(d) 5 is amended by inserting before the period at the end of 6 the second sentence the following: ‘‘, unless such indi7 vidual is serving in an area designated by the President 8 of the United States by Executive order as a combat zone 9 for purposes of section 112 in support of the Armed 10 Forces of the United States’’. 11 (b) EFFECTIVE DATE.—The amendment made by 12 this section shall apply to taxable years beginning after 13 December 31, 2017. 14 SEC. 41117. TREATMENT OF FOREIGN PERSONS FOR RE- 15 TURNS RELATING TO PAYMENTS MADE IN 16 SETTLEMENT OF PAYMENT CARD AND THIRD 17 PARTY NETWORK TRANSACTIONS. 18 (a) IN GENERAL.—Section 6050W(d)(1)(B) is 19 amended by adding at the end the following: ‘‘Notwith20 standing the preceding sentence, a person with only a for21 eign address shall not be treated as a participating payee 22 with respect to any payment settlement entity solely be23 cause such person receives payments from such payment 24 settlement entity in dollars.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 243 1 (b) EFFECTIVE DATE.—The amendment made by 2 this section shall apply to returns for calendar years begin3 ning after December 31, 2017. 4 SEC. 41118. REPEAL OF SHIFT IN TIME OF PAYMENT OF 5 CORPORATE ESTIMATED TAXES. 6 The Trade Preferences Extension Act of 2015 is 7 amended by striking section 803 (relating to time for pay8 ment of corporate estimated taxes). 9 SEC. 41119. ENHANCEMENT OF CARBON DIOXIDE SEQUES- 10 TRATION CREDIT. 11 (a) IN GENERAL.—Section 45Q is amended to read 12 as follows: 13 ‘‘SEC. 45Q. CREDIT FOR CARBON OXIDE SEQUESTRATION. 14 ‘‘(a) GENERAL RULE.—For purposes of section 38, 15 the carbon oxide sequestration credit for any taxable year 16 is an amount equal to the sum of— 17 18 ‘‘(1) $20 per metric ton of qualified carbon oxide which is— 19 ‘‘(A) captured by the taxpayer using car- 20 bon capture equipment which is originally 21 placed in service at a qualified facility before 22 the date of the enactment of the Bipartisan 23 Budget Act of 2018, and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 244 1 ‘‘(B) disposed of by the taxpayer in secure 2 geological storage and not used by the taxpayer 3 as described in paragraph (2)(B), 4 ‘‘(2) $10 per metric ton of qualified carbon 5 oxide which is— 6 ‘‘(A) captured by the taxpayer using car- 7 bon capture equipment which is originally 8 placed in service at a qualified facility before 9 the date of the enactment of the Bipartisan 10 Budget Act of 2018, and 11 ‘‘(B)(i) used by the taxpayer as a tertiary 12 injectant in a qualified enhanced oil or natural 13 gas recovery project and disposed of by the tax- 14 payer in secure geological storage, or 15 ‘‘(ii) utilized by the taxpayer in a manner 16 described in subsection (f)(5), 17 ‘‘(3) the applicable dollar amount (as deter- 18 mined under subsection (b)(1)) per metric ton of 19 qualified carbon oxide which is— 20 ‘‘(A) captured by the taxpayer using car- 21 bon capture equipment which is originally 22 placed in service at a qualified facility on or 23 after the date of the enactment of the Bipar- 24 tisan Budget Act of 2018, during the 12-year February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 245 1 period beginning on the date the equipment was 2 originally placed in service, and 3 ‘‘(B) disposed of by the taxpayer in secure 4 geological storage and not used by the taxpayer 5 as described in paragraph (4)(B), and 6 ‘‘(4) the applicable dollar amount (as deter- 7 mined under subsection (b)(1)) per metric ton of 8 qualified carbon oxide which is— 9 ‘‘(A) captured by the taxpayer using car- 10 bon capture equipment which is originally 11 placed in service at a qualified facility on or 12 after the date of the enactment of the Bipar- 13 tisan Budget Act of 2018, during the 12-year 14 period beginning on the date the equipment was 15 originally placed in service, and 16 ‘‘(B)(i) used by the taxpayer as a tertiary 17 injectant in a qualified enhanced oil or natural 18 gas recovery project and disposed of by the tax- 19 payer in secure geological storage, or 20 21 22 ‘‘(ii) utilized by the taxpayer in a manner described in subsection (f)(5). ‘‘(b) APPLICABLE DOLLAR AMOUNT; ADDITIONAL 23 EQUIPMENT; ELECTION.— 24 February 7, 2018 (10:12 p.m.) ‘‘(1) APPLICABLE DOLLAR AMOUNT.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 246 1 2 ‘‘(A) IN GENERAL.—The applicable dollar amount shall be an amount equal to— 3 ‘‘(i) for any taxable year beginning in 4 a calendar year after 2016 and before 5 2027— 6 ‘‘(I) for purposes of paragraph 7 (3) of subsection (a), the dollar 8 amount established by linear inter- 9 polation between $22.66 and $50 for 10 each calendar year during such pe- 11 riod, and 12 ‘‘(II) for purposes of paragraph 13 (4) of such subsection, the dollar 14 amount established by linear inter- 15 polation between $12.83 and $35 for 16 each calendar year during such pe- 17 riod, and 18 ‘‘(ii) for any taxable year beginning in 19 a calendar year after 2026— 20 ‘‘(I) for purposes of paragraph 21 (3) of subsection (a), an amount equal 22 to the product of $50 and the infla- 23 tion adjustment factor for such cal- 24 endar year determined under section 25 43(b)(3)(B) for such calendar year, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 247 1 determined by substituting ‘2025’ for 2 ‘1990’, and 3 ‘‘(II) for purposes of paragraph 4 (4) of such subsection, an amount 5 equal to the product of $35 and the 6 inflation adjustment factor for such 7 calendar year determined under sec- 8 tion 43(b)(3)(B) for such calendar 9 year, 10 determined by substituting ‘2025’ for ‘1990’. 11 ‘‘(B) ROUNDING.—The applicable dollar 12 amount determined under subparagraph (A) 13 shall be rounded to the nearest cent. 14 ‘‘(2) INSTALLATION OF ADDITIONAL CARBON 15 CAPTURE EQUIPMENT ON EXISTING QUALIFIED FA- 16 CILITY.—In 17 service before the date of the enactment of the Bi- 18 partisan Budget Act of 2018, for which additional 19 carbon capture equipment is placed in service on or 20 after the date of the enactment of such Act, the 21 amount of qualified carbon oxide which is captured 22 by the taxpayer shall be equal to— 23 24 February 7, 2018 (10:12 p.m.) the case of a qualified facility placed in ‘‘(A) for purposes of paragraphs (1)(A) and (2)(A) of subsection (a), the lesser of— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 248 1 ‘‘(i) the total amount of qualified car- 2 bon oxide captured at such facility for the 3 taxable year, or 4 ‘‘(ii) the total amount of the carbon 5 dioxide capture capacity of the carbon cap- 6 ture equipment in service at such facility 7 on the day before the date of the enact- 8 ment of the Bipartisan Budget Act of 9 2018, and 10 ‘‘(B) for purposes of paragraphs (3)(A) 11 and (4)(A) of such subsection, an amount (not 12 less than zero) equal to the excess of— 13 14 15 16 ‘‘(i) the amount described in clause (i) of subparagraph (A), over ‘‘(ii) the amount described in clause (ii) of such subparagraph. 17 ‘‘(3) ELECTION.—For purposes of determining 18 the carbon oxide sequestration credit under this sec- 19 tion, a taxpayer may elect to have the dollar 20 amounts applicable under paragraph (1) or (2) of 21 subsection (a) apply in lieu of the dollar amounts 22 applicable under paragraph (3) or (4) of such sub- 23 section for each metric ton of qualified carbon oxide 24 which is captured by the taxpayer using carbon cap- 25 ture equipment which is originally placed in service February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 249 1 at a qualified facility on or after the date of the en- 2 actment of the Bipartisan Budget Act of 2018. 3 ‘‘(c) QUALIFIED CARBON OXIDE.—For purposes of 4 this section— 5 6 7 ‘‘(1) IN GENERAL.—The term ‘qualified carbon oxide’ means— ‘‘(A) any carbon dioxide which— 8 ‘‘(i) is captured from an industrial 9 source by carbon capture equipment which 10 is originally placed in service before the 11 date of the enactment of the Bipartisan 12 Budget Act of 2018, 13 ‘‘(ii) would otherwise be released into 14 the atmosphere as industrial emission of 15 greenhouse gas or lead to such release, and 16 ‘‘(iii) is measured at the source of 17 capture and verified at the point of dis- 18 posal, injection, or utilization, 19 ‘‘(B) any carbon dioxide or other carbon 20 oxide which— 21 ‘‘(i) is captured from an industrial 22 source by carbon capture equipment which 23 is originally placed in service on or after 24 the date of the enactment of the Bipar- 25 tisan Budget Act of 2018, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 250 1 ‘‘(ii) would otherwise be released into 2 the atmosphere as industrial emission of 3 greenhouse gas or lead to such release, and 4 ‘‘(iii) is measured at the source of 5 capture and verified at the point of dis- 6 posal, injection, or utilization, or 7 ‘‘(C) in the case of a direct air capture fa- 8 9 10 cility, any carbon dioxide which— ‘‘(i) is captured directly from the ambient air, and 11 ‘‘(ii) is measured at the source of cap- 12 ture and verified at the point of disposal, 13 injection, or utilization. 14 ‘‘(2) RECYCLED CARBON OXIDE.—The term 15 ‘qualified carbon oxide’ includes the initial deposit of 16 captured carbon oxide used as a tertiary injectant. 17 Such term does not include carbon oxide that is re- 18 captured, recycled, and re-injected as part of the en- 19 hanced oil and natural gas recovery process. 20 ‘‘(d) QUALIFIED FACILITY.—For purposes of this 21 section, the term ‘qualified facility’ means any industrial 22 facility or direct air capture facility— 23 24 February 7, 2018 (10:12 p.m.) ‘‘(1) the construction of which begins before January 1, 2024, and— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 251 1 2 ‘‘(A) construction of carbon capture equipment begins before such date, or 3 ‘‘(B) the original planning and design for 4 such facility includes installation of carbon cap- 5 ture equipment, and 6 ‘‘(2) which captures— 7 ‘‘(A) in the case of a facility which emits 8 not more than 500,000 metric tons of carbon 9 oxide into the atmosphere during the taxable 10 year, not less than 25,000 metric tons of quali- 11 fied carbon oxide during the taxable year which 12 is utilized in a manner described in subsection 13 (f)(5), 14 ‘‘(B) in the case of an electricity gener- 15 ating facility which is not described in subpara- 16 graph (A), not less than 500,000 metric tons of 17 qualified carbon oxide during the taxable year, 18 or 19 ‘‘(C) in the case of a direct air capture fa- 20 cility or any facility not described in subpara- 21 graph (A) or (B), not less than 100,000 metric 22 tons of qualified carbon oxide during the tax- 23 able year. 24 25 February 7, 2018 (10:12 p.m.) ‘‘(e) DEFINITIONS.—For purposes of this section— ‘‘(1) DIRECT AIR CAPTURE FACILITY.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 252 1 ‘‘(A) IN GENERAL.—Subject to subpara- 2 graph (B), the term ‘direct air capture facility’ 3 means any facility which uses carbon capture 4 equipment to capture carbon dioxide directly 5 from the ambient air. 6 ‘‘(B) EXCEPTION.—The term ‘direct air 7 capture facility’ shall not include any facility 8 which captures carbon dioxide— 9 ‘‘(i) which is deliberately released 10 from 11 springs, or 12 13 naturally occurring subsurface ‘‘(ii) using natural photosynthesis. ‘‘(2) QUALIFIED ENHANCED OIL OR NATURAL 14 GAS RECOVERY PROJECT.—The 15 hanced oil or natural gas recovery project’ has the 16 meaning given the term ‘qualified enhanced oil re- 17 covery project’ by section 43(c)(2), by substituting 18 ‘crude oil or natural gas’ for ‘crude oil’ in subpara- 19 graph (A)(i) thereof. 20 ‘‘(3) TERTIARY term ‘qualified en- INJECTANT.—The term ‘ter- 21 tiary injectant’ has the same meaning as when used 22 within section 193(b)(1). 23 ‘‘(f) SPECIAL RULES.— 24 25 February 7, 2018 (10:12 p.m.) ‘‘(1) ONLY QUALIFIED CARBON OXIDE CAP- TURED AND DISPOSED OF OR USED WITHIN THE U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 253 1 UNITED STATES TAKEN INTO ACCOUNT.—The 2 under this section shall apply only with respect to 3 qualified carbon oxide the capture and disposal, use, 4 or utilization of which is within— 5 6 7 credit ‘‘(A) the United States (within the meaning of section 638(1)), or ‘‘(B) a possession of the United States 8 (within the meaning of section 638(2)). 9 ‘‘(2) SECURE GEOLOGICAL STORAGE.—The Sec- 10 retary, in consultation with the Administrator of the 11 Environmental Protection Agency, the Secretary of 12 Energy, and the Secretary of the Interior, shall es- 13 tablish regulations for determining adequate security 14 measures for the geological storage of qualified car- 15 bon oxide under subsection (a) such that the quali- 16 fied carbon oxide does not escape into the atmos- 17 phere. Such term shall include storage at deep saline 18 formations, oil and gas reservoirs, and unminable 19 coal seams under such conditions as the Secretary 20 may determine under such regulations. 21 ‘‘(3) CREDIT 22 ‘‘(A) IN ATTRIBUTABLE TO TAXPAYER.— GENERAL.—Except as provided in 23 subparagraph (B) or in any regulations pre- 24 scribed by the Secretary, any credit under this 25 section shall be attributable to— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 254 1 ‘‘(i) in the case of qualified carbon 2 oxide captured using carbon capture equip- 3 ment which is originally placed in service 4 at a qualified facility before the date of the 5 enactment of the Bipartisan Budget Act of 6 2018, the person that captures and phys- 7 ically or contractually ensures the disposal, 8 utilization, or use as a tertiary injectant of 9 such qualified carbon oxide, and 10 ‘‘(ii) in the case of qualified carbon 11 oxide captured using carbon capture equip- 12 ment which is originally placed in service 13 at a qualified facility on or after the date 14 of the enactment of the Bipartisan Budget 15 Act of 2018, the person that owns the car- 16 bon capture equipment and physically or 17 contractually ensures the capture and dis- 18 posal, utilization, or use as a tertiary 19 injectant of such qualified carbon oxide. 20 ‘‘(B) ELECTION.—If the person described 21 in subparagraph (A) makes an election under 22 this subparagraph in such time and manner as 23 the Secretary may prescribe by regulations, the 24 credit under this section— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 255 1 ‘‘(i) shall be allowable to the person 2 that disposes of the qualified carbon oxide, 3 utilizes the qualified carbon oxide, or uses 4 the qualified carbon oxide as a tertiary 5 injectant, and 6 ‘‘(ii) shall not be allowable to the per- 7 son described in subparagraph (A). 8 ‘‘(4) RECAPTURE.—The Secretary shall, by reg- 9 ulations, provide for recapturing the benefit of any 10 credit allowable under subsection (a) with respect to 11 any qualified carbon oxide which ceases to be cap- 12 tured, disposed of, or used as a tertiary injectant in 13 a manner consistent with the requirements of this 14 section. 15 16 17 ‘‘(5) UTILIZATION OF QUALIFIED CARBON OXIDE.— ‘‘(A) IN GENERAL.—For purposes of this 18 section, utilization of qualified carbon oxide 19 means— 20 ‘‘(i) the fixation of such qualified car- 21 bon 22 chemosynthesis, such as through the grow- 23 ing of algae or bacteria, oxide through photosynthesis or 24 ‘‘(ii) the chemical conversion of such 25 qualified carbon oxide to a material or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 256 1 chemical compound in which such qualified 2 carbon oxide is securely stored, or 3 ‘‘(iii) the use of such qualified carbon 4 oxide for any other purpose for which a 5 commercial market exists (with the excep- 6 tion of use as a tertiary injectant in a 7 qualified enhanced oil or natural gas recov- 8 ery project), as determined by the Sec- 9 retary. 10 11 ‘‘(B) MEASUREMENT.— ‘‘(i) IN GENERAL.—For purposes of 12 determining the amount of qualified carbon 13 oxide utilized by the taxpayer under para- 14 graph (2)(B)(ii) or (4)(B)(ii) of subsection 15 (a), such amount shall be equal to the met- 16 ric tons of qualified carbon oxide which the 17 taxpayer demonstrates, based upon an 18 analysis of lifecycle greenhouse gas emis- 19 sions and subject to such requirements as 20 the Secretary, in consultation with the Sec- 21 retary of Energy and the Administrator of 22 the Environmental Protection Agency, de- 23 termines appropriate, were— 24 25 February 7, 2018 (10:12 p.m.) ‘‘(I) captured and permanently isolated from the atmosphere, or U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 257 1 2 ‘‘(II) displaced from being emitted into the atmosphere, 3 through use of a process described in sub- 4 paragraph (A). 5 ‘‘(ii) LIFECYCLE GREENHOUSE GAS 6 EMISSIONS.—For 7 the term ‘lifecycle greenhouse gas emis- 8 sions’ has the same meaning given such 9 term under subparagraph (H) of section 10 211(o)(1) of the Clean Air Act (42 U.S.C. 11 7545(o)(1)), as in effect on the date of the 12 enactment of the Bipartisan Budget Act of 13 2018, except that ‘product’ shall be sub- 14 stituted for ‘fuel’ each place it appears in 15 such subparagraph. 16 17 ‘‘(6) ELECTION ‘‘(A) IN purposes of clause (i), FOR APPLICABLE FACILITIES.— GENERAL.—For purposes of this 18 section, in the case of an applicable facility, for 19 any taxable year in which such facility captures 20 not less than 500,000 metric tons of qualified 21 carbon oxide during the taxable year, the per- 22 son described in paragraph (3)(A)(ii) may elect 23 to have such facility, and any carbon capture 24 equipment placed in service at such facility, 25 deemed as having been placed in service on the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 258 1 date of the enactment of the Bipartisan Budget 2 Act of 2018. 3 ‘‘(B) APPLICABLE FACILITY.—For pur- 4 poses of this paragraph, the term ‘applicable fa- 5 cility’ means a qualified facility— 6 ‘‘(i) which was placed in service before 7 the date of the enactment of the Bipar- 8 tisan Budget Act of 2018, and 9 ‘‘(ii) for which no taxpayer claimed a 10 credit under this section in regards to such 11 facility for any taxable year ending before 12 the date of the enactment of such Act. 13 ‘‘(7) INFLATION ADJUSTMENT.—In the case of 14 any taxable year beginning in a calendar year after 15 2009, there shall be substituted for each dollar 16 amount contained in paragraphs (1) and (2) of sub- 17 section (a) an amount equal to the product of— 18 ‘‘(A) such dollar amount, multiplied by 19 ‘‘(B) the inflation adjustment factor for 20 such calendar year determined under section 21 43(b)(3)(B) for such calendar year, determined 22 by substituting ‘2008’ for ‘1990’. 23 24 ‘‘(g) APPLICATION BON OF SECTION FOR CERTAIN CAR- CAPTURE EQUIPMENT.—In the case of any carbon 25 capture equipment placed in service before the date of the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 259 1 enactment of the Bipartisan Budget Act of 2018, the cred2 it under this section shall apply with respect to qualified 3 carbon oxide captured using such equipment before the 4 end of the calendar year in which the Secretary, in con5 sultation with the Administrator of the Environmental 6 Protection Agency, certifies that, during the period begin7 ning after October 3, 2008, a total of 75,000,000 metric 8 tons of qualified carbon oxide have been taken into ac9 count in accordance with— 10 ‘‘(1) subsection (a) of this section, as in effect 11 on the day before the date of the enactment of the 12 Bipartisan Budget Act of 2018, and 13 ‘‘(2) paragraphs (1) and (2) of subsection (a) 14 of this section. 15 ‘‘(h) REGULATIONS.—The Secretary may prescribe 16 such regulations and other guidance as may be necessary 17 or appropriate to carry out this section, including regula18 tions or other guidance to— 19 ‘‘(1) ensure proper allocation under subsection 20 (a) for qualified carbon oxide captured by a taxpayer 21 during the taxable year ending after the date of the 22 enactment of the Bipartisan Budget Act of 2018, 23 and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 260 1 ‘‘(2) determine whether a facility satisfies the 2 requirements under subsection (d)(1) during such 3 taxable year.’’. 4 (b) EFFECTIVE DATE.—The amendment made by 5 this section shall apply to taxable years beginning after 6 December 31, 2017. 7 8 9 DIVISION E—HEALTH AND HUMAN SERVICES EXTENDERS SEC. 50100. SHORT TITLE; TABLE OF CONTENTS. 10 (a) SHORT TITLE.—This division may be cited as the 11 ‘‘Advancing Chronic Care, Extenders, and Social Services 12 (ACCESS) Act’’ 13 (b) TABLE OF CONTENTS.—The table of contents for 14 this division is as follows: DIVISION E—HEALTH AND HUMAN SERVICES EXTENDERS Sec. 50100. Short title; table of contents. TITLE I—CHIP Sec. 50101. Funding extension of the Children’s Health Insurance Program through fiscal year 2027. Sec. 50102. Extension of pediatric quality measures program. Sec. 50103. Extension of outreach and enrollment program. TITLE II—MEDICARE EXTENDERS Sec. 50201. Extension of work GPCI floor. Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy. Sec. 50203. Medicare ambulance services. Sec. 50204. Extension of increased inpatient hospital payment adjustment for certain low-volume hospitals. Sec. 50205. Extension of the Medicare-dependent hospital (MDH) program. Sec. 50206. Extension of funding for quality measure endorsement, input, and selection; reporting requirements. Sec. 50207. Extension of funding outreach and assistance for low-income programs; State health insurance assistance program reporting requirements. Sec. 50208. Extension of home health rural add-on. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 261 TITLE III—CREATING HIGH-QUALITY RESULTS AND OUTCOMES NECESSARY TO IMPROVE CHRONIC (CHRONIC) CARE Subtitle A—Receiving High Quality Care in the Home Sec. 50301. Extending the Independence at Home Demonstration Program. Sec. 50302. Expanding access to home dialysis therapy. Subtitle B—Advancing Team-Based Care Sec. 50311. Providing continued access to Medicare Advantage special needs plans for vulnerable populations. Subtitle C—Expanding Innovation and Technology Sec. 50321. Adapting benefits to meet the needs of chronically ill Medicare Advantage enrollees. Sec. 50322. Expanding supplemental benefits to meet the needs of chronically ill Medicare Advantage enrollees. Sec. 50323. Increasing convenience for Medicare Advantage enrollees through telehealth. Sec. 50324. Providing accountable care organizations the ability to expand the use of telehealth. Sec. 50325. Expanding the use of telehealth for individuals with stroke. Subtitle D—Identifying the Chronically Ill Population Sec. 50331. Providing flexibility for beneficiaries to be part of an accountable care organization. Subtitle E—Empowering Individuals and Caregivers in Care Delivery Sec. 50341. Eliminating barriers to care coordination under accountable care organizations. Sec. 50342. GAO study and report on longitudinal comprehensive care planning services under Medicare part B. Subtitle F—Other Policies to Improve Care for the Chronically Ill Sec. 50351. GAO study and report on improving medication synchronization. Sec. 50352. GAO study and report on impact of obesity drugs on patient health and spending. Sec. 50353. HHS study and report on long-term risk factors for chronic conditions among Medicare beneficiaries. Sec. 50354. Providing prescription drug plans with parts A and B claims data to promote the appropriate use of medications and improve health outcomes. TITLE IV—PART B IMPROVEMENT ACT AND OTHER PART B ENHANCEMENTS Subtitle A—Medicare Part B Improvement Act Sec. 50401. Home infusion therapy services temporary transitional payment. Sec. 50402. Orthotist’s and prosthetist’s clinical notes as part of the patient’s medical record. Sec. 50403. Independent accreditation for dialysis facilities and assurance of high quality surveys. Sec. 50404. Modernizing the application of the Stark rule under Medicare. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 262 Subtitle B—Additional Medicare Provisions Sec. 50411. Making permanent the removal of the rental cap for durable medical equipment under Medicare with respect to speech generating devices. Sec. 50412. Increased civil and criminal penalties and increased sentences for Federal health care program fraud and abuse. Sec. 50413. Reducing the volume of future EHR-related significant hardship requests. Sec. 50414. Strengthening rules in case of competition for diabetic testing strips. TITLE V—OTHER HEALTH EXTENDERS Sec. 50501. Extension for family-to-family health information centers. Sec. 50502. Extension for sexual risk avoidance education. Sec. 50503. Extension for personal responsibility education. TITLE VI—CHILD AND FAMILY SERVICES AND SUPPORTS EXTENDERS Subtitle A—Continuing the Maternal, Infant, and Early Childhood Home Visiting Program Sec. Sec. Sec. Sec. Sec. 50601. 50602. 50603. 50604. 50605. Continuing evidence-based home visiting program. Continuing to demonstrate results to help families. Reviewing statewide needs to target resources. Improving the likelihood of success in high-risk communities. Option to fund evidence-based home visiting on a pay for outcome basis. Sec. 50606. Data exchange standards for improved interoperability. Sec. 50607. Allocation of funds. Subtitle B—Extension of Health Professions Workforce Demonstration Projects Sec. 50611. Extension of health workforce demonstration projects for low-income individuals. TITLE VII—FAMILY FIRST PREVENTION SERVICES ACT Subtitle A—Investing in Prevention and Supporting Families Sec. 50701. Short title. Sec. 50702. Purpose. PART I—PREVENTION ACTIVITIES UNDER TITLE IV–E Sec. 50711. Foster care prevention services and programs. Sec. 50712. Foster care maintenance payments for children with parents in a licensed residential family-based treatment facility for substance abuse. Sec. 50713. Title IV–E payments for evidence-based kinship navigator programs. PART II—ENHANCED SUPPORT UNDER TITLE IV–B February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 263 Sec. 50721. Elimination of time limit for family reunification services while in foster care and permitting time-limited family reunification services when a child returns home from foster care. Sec. 50722. Reducing bureaucracy and unnecessary delays when placing children in homes across State lines. Sec. 50723. Enhancements to grants to improve well-being of families affected by substance abuse. PART III—MISCELLANEOUS Sec. 50731. Reviewing and improving licensing standards for placement in a relative foster family home. Sec. 50732. Development of a statewide plan to prevent child abuse and neglect fatalities. Sec. 50733. Modernizing the title and purpose of title IV–E. Sec. 50734. Effective dates. PART IV—ENSURING THE NECESSITY OF A PLACEMENT THAT IS NOT FOSTER FAMILY HOME IN A Sec. 50741. Limitation on Federal financial participation for placements that are not in foster family homes. Sec. 50742. Assessment and documentation of the need for placement in a qualified residential treatment program. Sec. 50743. Protocols to prevent inappropriate diagnoses. Sec. 50744. Additional data and reports regarding children placed in a setting that is not a foster family home. Sec. 50745. Criminal records checks and checks of child abuse and neglect registries for adults working in child-care institutions and other group care settings. Sec. 50746. Effective dates; application to waivers. PART V—CONTINUING SUPPORT FOR CHILD AND FAMILY SERVICES Sec. 50751. Supporting and retaining foster families for children. Sec. 50752. Extension of child and family services programs. Sec. 50753. Improvements to the John H. Chafee foster care independence program and related provisions. PART VI—CONTINUING INCENTIVES TO STATES TO PROMOTE ADOPTION AND LEGAL GUARDIANSHIP Sec. 50761. Reauthorizing adoption and legal guardianship incentive programs. PART VII—TECHNICAL CORRECTIONS Sec. 50771. Technical corrections to data exchange standards to improve program coordination. Sec. 50772. Technical corrections to State requirement to address the developmental needs of young children. PART VIII—ENSURING STATES REINVEST SAVINGS RESULTING FROM INCREASE IN ADOPTION ASSISTANCE Sec. 50781. Delay of adoption assistance phase-in. Sec. 50782. GAO study and report on State reinvestment of savings resulting from increase in adoption assistance. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 264 TITLE VIII—SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS Sec. 50801. Short title. Sec. 50802. Social impact partnerships to pay for results. TITLE IX—PUBLIC HEALTH PROGRAMS Sec. 50901. Extension for community health centers, the National Health Service Corps, and teaching health centers that operate GME programs. Sec. 50902. Extension for special diabetes programs. TITLE X—MISCELLANEOUS HEALTH CARE POLICIES Sec. 51001. Home health payment reform. Sec. 51002. Information to satisfy documentation of Medicare eligibility for home health services. Sec. 51003. Technical amendments to Public Law 114–10. Sec. 51004. Expanded access to Medicare intensive cardiac rehabilitation programs. Sec. 51005. Extension of blended site neutral payment rate for certain longterm care hospital discharges; temporary adjustment to site neutral payment rates. Sec. 51006. Recognition of attending physician assistants as attending physicians to serve hospice patients. Sec. 51007. Extension of enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2017. Sec. 51008. Allowing physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. Sec. 51009. Transitional payment rules for certain radiation therapy services under the physician fee schedule. TITLE XI—PROTECTING SENIORS’ ACCESS TO MEDICARE ACT Sec. 52001. Repeal of the Independent Payment Advisory Board. TITLE XII—OFFSETS Sec. 53101. Modifying reductions in Medicaid DSH allotments. Sec. 53102. Third party liability in Medicaid and CHIP. Sec. 53103. Treatment of lottery winnings and other lump-sum income for purposes of income eligibility under Medicaid. Sec. 53104. Rebate obligation with respect to line extension drugs. Sec. 53105. Medicaid Improvement Fund. Sec. 53106. Physician fee schedule update. Sec. 53107. Payment for outpatient physical therapy services and outpatient occupational therapy services furnished by a therapy assistant. Sec. 53108. Reduction for non-emergency ESRD ambulance transports. Sec. 53109. Hospital transfer policy for early discharges to hospice care. Sec. 53110. Medicare payment update for home health services. Sec. 53111. Medicare payment update for skilled nursing facilities. Sec. 53112. Preventing the artificial inflation of star ratings after the consolidation of Medicare Advantage plans offered by the same organization. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 265 Sec. 53113. Sunsetting exclusion of biosimilars from Medicare part D coverage gap discount program. Sec. 53114. Adjustments to Medicare part B and part D premium subsidies for higher income individuals. Sec. 53115. Medicare Improvement Fund. Sec. 53116. Closing the Donut Hole for Seniors. Sec. 53117. Modernizing child support enforcement fees. Sec. 53118. Increasing efficiency of prison data reporting. Sec. 53119. Prevention and Public Health Fund. 1 TITLE I—CHIP 2 SEC. 50101. FUNDING EXTENSION OF THE CHILDREN’S 3 HEALTH 4 FISCAL YEAR 2027. 5 INSURANCE PROGRAM THROUGH (a) IN GENERAL.—Section 2104(a) of the Social Se- 6 curity Act (42 U.S.C. 1397dd(a)), as amended by section 7 3002(a) of the HEALTHY KIDS Act (division C of Pub8 lic Law 115–120), is amended— 9 10 11 12 13 14 (1) in paragraph (25), by striking ‘‘; and’’ and inserting a semicolon; (2) in paragraph (26), by striking the period at the end and inserting a semicolon; and (3) by adding at the end the following new paragraphs: 15 ‘‘(27) for each of fiscal years 2024 through 16 2026, such sums as are necessary to fund allotments 17 to States under subsections (c) and (m); and 18 19 February 7, 2018 (10:12 p.m.) ‘‘(28) for fiscal year 2027, for purposes of making two semi-annual allotments— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 266 1 ‘‘(A) $7,650,000,000 for the period begin- 2 ning on October 1, 2026, and ending on March 3 31, 2027; and 4 ‘‘(B) $7,650,000,000 for the period begin- 5 ning on April 1, 2027, and ending on Sep- 6 tember 30, 2027.’’. 7 8 (b) ALLOTMENTS.— (1) IN GENERAL.—Section 2104(m) of the So- 9 cial Security Act (42 U.S.C. 1397dd(m)), as amend- 10 ed by section 3002(b) of the HEALTHY KIDS Act 11 (division C of Public Law 115–120), is amended— 12 (A) in paragraph (2)(B)— 13 14 (i) in the matter preceding clause (i), by striking ‘‘(25)’’ and inserting ‘‘(27)’’; 15 (ii) in clause (i), by striking ‘‘and 16 2023’’ and inserting ‘‘, 2023, and 2027’’; 17 and 18 (iii) in clause (ii)(I), by striking ‘‘(or, 19 in the case of fiscal year 2018, under para- 20 graph (4))’’ and inserting ‘‘(or, in the case 21 of fiscal year 2018 or 2024, under para- 22 graph (4) or (10), respectively)’’; 23 (B) in paragraph (5)— 24 25 February 7, 2018 (10:12 p.m.) (i) by striking ‘‘or (10)’’ and inserting ‘‘(10), or (11)’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 267 1 (ii) by striking ‘‘or 2023,’’ and insert- 2 ing ‘‘2023, or 2027,’’; 3 (C) in paragraph (7)— 4 5 (i) in subparagraph (A), by striking ‘‘2023’’ and inserting ‘‘2027,’’; and 6 (ii) in the matter following subpara- 7 graph (B), by striking ‘‘or fiscal year 8 2022’’ and inserting ‘‘fiscal year 2022, fis- 9 cal year 2024, or fiscal year 2026’’; 10 11 12 13 (D) in paragraph (9)— (i) by striking ‘‘or (10)’’ and inserting ‘‘(10), or (11)’’; and (ii) by striking ‘‘or 2023,’’ and insert- 14 ing ‘‘2023, or 2027,’’; and 15 (E) by adding at the end the following: 16 17 ‘‘(11) FOR FISCAL YEAR ‘‘(A) FIRST 2027.— HALF.—Subject to paragraphs 18 (5) and (7), from the amount made available 19 under subparagraph (A) of paragraph (28) of 20 subsection (a) for the semi-annual period de- 21 scribed in such subparagraph, increased by the 22 amount of the appropriation for such period 23 under section 50101(b)(2) of the Advancing 24 Chronic Care, Extenders, and Social Services 25 Act, the Secretary shall compute a State allot- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 268 1 ment for each State (including the District of 2 Columbia and each commonwealth and terri- 3 tory) for such semi-annual period in an amount 4 equal to the first half ratio (described in sub- 5 paragraph (D)) of the amount described in sub- 6 paragraph (C). 7 ‘‘(B) SECOND HALF.—Subject to para- 8 graphs (5) and (7), from the amount made 9 available under subparagraph (B) of paragraph 10 (28) of subsection (a) for the semi-annual pe- 11 riod described in such subparagraph, the Sec- 12 retary shall compute a State allotment for each 13 State (including the District of Columbia and 14 each commonwealth and territory) for such 15 semi-annual period in an amount equal to the 16 amount made available under such subpara- 17 graph, multiplied by the ratio of— 18 19 ‘‘(i) the amount of the allotment to such State under subparagraph (A); to 20 ‘‘(ii) the total of the amount of all of 21 the allotments made available under such 22 subparagraph. 23 ‘‘(C) FULL YEAR AMOUNT BASED ON 24 REBASED AMOUNT.—The 25 this subparagraph for a State is equal to the February 7, 2018 (10:12 p.m.) amount described in U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 269 1 Federal payments to the State that are attrib- 2 utable to (and countable towards) the total 3 amount of allotments available under this sec- 4 tion to the State in fiscal year 2026 (including 5 payments made to the State under subsection 6 (n) for fiscal year 2026 as well as amounts re- 7 distributed to the State in fiscal year 2026), 8 multiplied by the allotment increase factor 9 under paragraph (6) for fiscal year 2027. 10 ‘‘(D) FIRST HALF RATIO.—The first half 11 ratio described in this subparagraph is the ratio 12 of— 13 14 15 ‘‘(i) the sum of— ‘‘(I) the amount made available under subsection (a)(28)(A); and 16 ‘‘(II) the amount of the appro- 17 priation for such period under section 18 50101(b)(2) of the Advancing Chronic 19 Care, Extenders, and Social Services 20 Act; to 21 ‘‘(ii) the sum of— 22 23 24 25 February 7, 2018 (10:12 p.m.) ‘‘(I) the amount described in clause (i); and ‘‘(II) the amount made available under subsection (a)(28)(B).’’. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 270 1 (2) ONE-TIME APPROPRIATION FOR FISCAL 2 YEAR 3 of Health and Human Services, out of any money in 4 the Treasury not otherwise appropriated, such sums 5 as are necessary to fund allotments to States under 6 subsections (c) and (m) of section 2104 of the Social 7 Security Act (42 U.S.C. 1397dd) for fiscal year 8 2027, taking into account the full year amounts cal- 9 culated for States under paragraph (11)(C) of sub- 10 section (m) of such section (as added by paragraph 11 (1)) and the amounts appropriated under subpara- 12 graphs (A) and (B) of subsection (a)(28) of such 13 section (as added by subsection (a)). Such amount 14 shall accompany the allotment made for the period 15 beginning on October 1, 2026, and ending on March 16 31, 2027, under paragraph (28)(A) of section 17 2104(a) of such Act (42 U.S.C. 1397dd(a)), to re- 18 main available until expended. Such amount shall be 19 used to provide allotments to States under para- 20 graph (11) of section 2104(m) of such Act for the 21 first 6 months of fiscal year 2027 in the same man- 22 ner as allotments are provided under subsection 23 (a)(28)(A) of such section 2104 and subject to the 24 same terms and conditions as apply to the allot- 25 ments provided from such subsection (a)(28)(A). February 7, 2018 (10:12 p.m.) 2027.—There is appropriated to the Secretary U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 271 1 2 (c) EXTENSION TINGENCY OF THE CHILD ENROLLMENT CON- FUND.—Section 2104(n) of the Social Security 3 Act (42 U.S.C. 1397dd(n)), as amended by section 4 3002(c) of the HEALTHY KIDS Act (division C of Public 5 Law 115–120), is amended— 6 7 (1) in paragraph (2)— (A) in subparagraph (A)(ii)— 8 (i) by striking ‘‘and 2018 through 9 2022’’ and inserting ‘‘2018 through 2022, 10 11 and 2024 through 2026’’; and (ii) by striking ‘‘and 2023’’ and in- 12 serting ‘‘2023, and 2027’’; and 13 (B) in subparagraph (B)— 14 (i) by striking ‘‘and 2018 through 15 2022’’ and inserting ‘‘2018 through 2022, 16 and 2024 through 2026’’; and 17 18 19 20 (ii) by striking ‘‘and 2023’’ and inserting ‘‘2023, and 2027’’; and (2) in paragraph (3)(A), in the matter preceding clause (i)— 21 (A) by striking ‘‘or in any of fiscal years 22 2018 through 2022’’ and inserting ‘‘fiscal years 23 2018 through 2022, or fiscal years 2024 24 through 2026’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 272 1 (B) by striking ‘‘or 2023’’ and inserting 2 ‘‘2023, or 2027’’. 3 (d) EXTENSION OF QUALIFYING STATES OPTION.— 4 Section 2105(g)(4) of the Social Security Act (42 U.S.C. 5 1397ee(g)(4)), as amended by section 3002(d) of the 6 HEALTHY KIDS Act (division C of Public Law 115– 7 120), is amended— 8 (1) in the paragraph heading, by striking 9 ‘‘THROUGH 2023’’ and inserting ‘‘THROUGH 2027’’; 10 and 11 (2) in subparagraph (A), by striking ‘‘2023’’ 12 and inserting ‘‘2027’’. 13 (e) EXTENSION 14 TION.—Section OF EXPRESS LANE ELIGIBILITY OP- 1902(e)(13)(I) of the Social Security Act 15 (42 U.S.C. 1396a(e)(13)(I)), as amended by section 16 3002(e) of the HEALTHY KIDS Act (division C of Public 17 Law 115–120), is amended by striking ‘‘2023’’ and insert18 ing ‘‘2027’’. 19 (f) ASSURANCE OF ELIGIBILITY STANDARD FOR 20 CHILDREN AND FAMILIES.— 21 (1) IN GENERAL.—Section 2105(d)(3) of the 22 Social Security Act (42 U.S.C. 1397ee(d)(3)), as 23 amended by section 3002(f)(1) of the HEALTHY 24 KIDS Act (division C of Public Law 115–120), is 25 amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 273 1 (A) in the paragraph heading, by striking 2 ‘‘THROUGH SEPTEMBER 30, 2023’’ 3 ‘‘THROUGH SEPTEMBER and inserting 30, 2027’’; and 4 (B) in subparagraph (A), in the matter 5 preceding clause (i), by striking ‘‘2023’’ each 6 place it appears and inserting ‘‘2027’’. 7 (2) CONFORMING AMENDMENTS.—Section 8 1902(gg)(2) of the Social Security Act (42 U.S.C. 9 1396a(gg)(2)), as amended by section 3002(f)(2) of 10 the HEALTHY KIDS Act (division C of Public Law 11 115–120), is amended— 12 (A) in the paragraph heading, by striking 13 ‘‘THROUGH 14 ing ‘‘THROUGH 15 30, 2023’’ and insert- SEPTEMBER 30, 2027’’; and (B) by striking ‘‘2023,’’ each place it ap- 16 17 SEPTEMBER pears and inserting ‘‘2027’’. SEC. 50102. EXTENSION OF PEDIATRIC QUALITY MEASURES 18 19 PROGRAM. (a) IN GENERAL.—Section 1139A(i)(1) of the Social 20 Security Act (42 U.S.C. 1320b–9a(i)(1)), as amended by 21 section 3003(b) of the HEALTHY KIDS Act (division C 22 of Public Law 115–120), is amended— 23 24 February 7, 2018 (10:12 p.m.) (1) in subparagraph (B), by striking ‘‘; and’’ and inserting a semicolon; U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 274 1 2 (2) in subparagraph (C), by striking the period at the end and inserting ‘‘; and’’; and 3 4 (3) by adding at the end the following new subparagraph: 5 ‘‘(D) for the period of fiscal years 2024 6 through 2027, $60,000,000 for the purpose of 7 carrying out this section (other than sub- 8 sections (e), (f), and (g)).’’. 9 (b) MAKING REPORTING MANDATORY.—Section 10 1139A of the Social Security Act (42 U.S.C. 1320b–9a) 11 is amended— 12 13 (1) in subsection (a)— (A) in the heading for paragraph (4), by 14 inserting ‘‘AND 15 ‘‘REPORTING’’; 16 MANDATORY REPORTING’’ (B) in paragraph (4)— 17 (i) by striking ‘‘Not later than’’ and 18 inserting the following: 19 ‘‘(A) VOLUNTARY 20 after REPORTING.—Not later than’’; and 21 (ii) by adding at the end the fol- 22 lowing: 23 ‘‘(B) MANDATORY REPORTING.—Begin- 24 ning with the annual State report on fiscal year 25 2024 required under subsection (c)(1), the Sec- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 275 1 retary shall require States to use the initial core 2 measurement set and any updates or changes to 3 that set to report information regarding the 4 quality of pediatric health care under titles XIX 5 and XXI using the standardized format for re- 6 porting information and procedures developed 7 under subparagraph (A).’’; and 8 (C) in paragraph (6)(B), by inserting 9 ‘‘and, beginning with the report required on 10 January 1, 2025, and for each annual report 11 thereafter, the status of mandatory reporting by 12 States under titles XIX and XXI, utilizing the 13 initial core quality measurement set and any 14 updates or changes to that set’’ before the 15 semicolon; and 16 (2) in subsection (c)(1)(A), by inserting ‘‘and, 17 beginning with the annual report on fiscal year 18 2024, all of the core measures described in sub- 19 section (a) and any updates or changes to those 20 measures’’ before the semicolon. 21 SEC. 50103. EXTENSION OF OUTREACH AND ENROLLMENT 22 23 PROGRAM. (a) IN GENERAL.—Section 2113 of the Social Secu- 24 rity Act (42 U.S.C. 1397mm), as amended by section February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 276 1 3004(a) of the HEALTHY KIDS Act (division C of Pub2 lic Law 115–120), is amended— 3 4 (1) in subsection (a)(1), by striking ‘‘2023’’ and inserting ‘‘2027’’; and 5 (2) in subsection (g)— 6 (A) by striking ‘‘and $120,000,000’’ and 7 inserting ‘‘, $120,000,000’’; and 8 (B) by inserting ‘‘, and $48,000,000 for 9 the period of fiscal years 2024 through 2027’’ 10 11 after ‘‘2023’’. (b) 12 2113(a) ADDITIONAL of the RESERVED Social Security FUNDS.—Section Act (42 U.S.C. 13 1397mm(a)) is amended— 14 15 16 17 18 (1) in paragraph (1), by striking ‘‘paragraph (2)’’ and inserting ‘‘paragraphs (2) and (3)’’; and (2) by adding at the end the following new paragraph: ‘‘(3) TEN PERCENT SET ASIDE FOR EVALU- 19 ATING AND PROVIDING TECHNICAL ASSISTANCE TO 20 GRANTEES.—For 21 through 2027, an amount equal to 10 percent of 22 such amounts shall be used by the Secretary for the 23 purpose of evaluating and providing technical assist- 24 ance to eligible entities awarded grants under this 25 section.’’. February 7, 2018 (10:12 p.m.) the period of fiscal years 2024 U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 277 1 2 (c) USE ROLLMENT 3 2113(h) of OF RESERVED FUNDS AND the RETENTION Social FOR NATIONAL EN- STRATEGIES.—Section Security Act (42 U.S.C. 4 1397mm(h)) is amended— 5 (1) in paragraph (5), by striking ‘‘; and’’ and 6 inserting a semicolon; 7 (2) by redesignating paragraph (6) as para- 8 graph (7); and 9 (3) by inserting after paragraph (5) the fol- 10 lowing new paragraph: 11 ‘‘(6) the development of materials and toolkits 12 and the provision of technical assistance to States 13 regarding enrollment and retention strategies for eli- 14 gible children under this title and title XIX; and’’. TITLE II—MEDICARE EXTENDERS 15 16 17 SEC. 50201. EXTENSION OF WORK GPCI FLOOR. 18 Section 1848(e)(1)(E) of the Social Security Act (42 19 U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘Janu20 ary 1, 2018’’ and inserting ‘‘January 1, 2020’’. 21 SEC. 50202. REPEAL OF MEDICARE PAYMENT CAP FOR 22 THERAPY SERVICES; LIMITATION TO ENSURE 23 APPROPRIATE THERAPY. 24 Section 1833(g) of the Social Security Act (42 U.S.C. 25 1395l(g)) is amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 278 1 (1) in paragraph (1)— 2 (A) by striking ‘‘Subject to paragraphs (4) 3 and (5)’’ and inserting ‘‘(A) Subject to para- 4 graphs (4) and (5)’’; 5 (B) in the subparagraph (A), as inserted 6 and designated by subparagraph (A) of this 7 paragraph, by adding at the end the following 8 new sentence: ‘‘The preceding sentence shall 9 not apply to expenses incurred with respect to 10 services furnished after December 31, 2017.’’; 11 and 12 13 14 (C) by adding at the end the following new subparagraph: ‘‘(B) With respect to services furnished during 2018 15 or a subsequent year, in the case of physical therapy serv16 ices of the type described in section 1861(p), speech-lan17 guage pathology services of the type described in such sec18 tion through the application of section 1861(ll)(2), and 19 physical therapy services and speech-language pathology 20 services of such type which are furnished by a physician 21 or as incident to physicians’ services, with respect to ex22 penses incurred in any calendar year, any amount that 23 is more than the amount specified in paragraph (2) for 24 the year shall not be considered as incurred expenses for February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 279 1 purposes of subsections (a) and (b) unless the applicable 2 requirements of paragraph (7) are met.’’; 3 (2) in paragraph (3)— 4 (A) by striking ‘‘Subject to paragraphs (4) 5 and (5)’’ and inserting ‘‘(A) Subject to para- 6 graphs (4) and (5)’’; 7 (B) in the subparagraph (A), as inserted 8 and designated by subparagraph (A) of this 9 paragraph, by adding at the end the following 10 new sentence: ‘‘The preceding sentence shall 11 not apply to expenses incurred with respect to 12 services furnished after December 31, 2017.’’; 13 and 14 15 16 (C) by adding at the end the following new subparagraph:. ‘‘(B) With respect to services furnished during 2018 17 or a subsequent year, in the case of occupational therapy 18 services (of the type that are described in section 1861(p) 19 through the operation of section 1861(g) and of such type 20 which are furnished by a physician or as incident to physi21 cians’ services), with respect to expenses incurred in any 22 calendar year, any amount that is more than the amount 23 specified in paragraph (2) for the year shall not be consid24 ered as incurred expenses for purposes of subsections (a) February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 280 1 and (b) unless the applicable requirements of paragraph 2 (7) are met.’’; 3 (3) in paragraph (5)— 4 (A) by redesignating subparagraph (D) as 5 paragraph (8) and moving such paragraph to 6 immediately follow paragraph (7), as added by 7 paragraph (4) of this section; and 8 (B) in subparagraph (E)(iv), by inserting 9 ‘‘, except as such process is applied under para- 10 graph (7)(B)’’ before the period at the end; and 11 (4) by adding at the end the following new 12 paragraph: 13 ‘‘(7) For purposes of paragraphs (1)(B) and (3)(B), 14 with respect to services described in such paragraphs, the 15 requirements described in this paragraph are as follows: 16 ‘‘(A) INCLUSION OF APPROPRIATE MODIFIER.— 17 The claim for such services contains an appropriate 18 modifier (such as the KX modifier described in para- 19 graph (5)(B)) indicating that such services are medi- 20 cally necessary as justified by appropriate docu- 21 mentation in the medical record involved. 22 23 24 25 February 7, 2018 (10:12 p.m.) ‘‘(B) TARGETED MEDICAL REVIEW FOR CER- TAIN SERVICES ABOVE THRESHOLD.— ‘‘(i) IN GENERAL.—In the case where ex- penses that would be incurred for such services U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 281 1 would exceed the threshold described in clause 2 (ii) for the year, such services shall be subject 3 to the process for medical review implemented 4 under paragraph (5)(E). 5 6 ‘‘(ii) THRESHOLD.—The threshold under this clause for— 7 ‘‘(I) a year before 2028, is $3,000; 8 ‘‘(II) 2028, is the amount specified in 9 subclause (I) increased by the percentage 10 increase in the MEI (as defined in section 11 1842(i)(3)) for 2028; and 12 ‘‘(III) a subsequent year, is the 13 amount specified in this clause for the pre- 14 ceding year increased by the percentage in- 15 crease in the MEI (as defined in section 16 1842(i)(3)) for such subsequent year; 17 except that if an increase under subclause (II) 18 or (III) for a year is not a multiple of $10, it 19 shall be rounded to the nearest multiple of $10. 20 ‘‘(iii) APPLICATION.—The threshold under 21 clause (ii) shall be applied separately— 22 23 ‘‘(I) for physical therapy services and speech-language pathology services; and 24 25 February 7, 2018 (10:12 p.m.) ‘‘(II) for occupational therapy services. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 282 1 ‘‘(iv) FUNDING.—For purposes of carrying 2 out this subparagraph, the Secretary shall pro- 3 vide for the transfer, from the Federal Supple- 4 mentary Medical Insurance Trust Fund under 5 section 1841 to the Centers for Medicare & 6 Medicaid Services Program Management Ac- 7 count, of $5,000,000 for each fiscal year begin- 8 ning with fiscal year 2018, to remain available 9 until expended. Such funds may not be used by 10 a contractor under section 1893(h) for medical 11 reviews under this subparagraph.’’. 12 SEC. 50203. MEDICARE AMBULANCE SERVICES. 13 (a) EXTENSION OF CERTAIN GROUND AMBULANCE 14 ADD-ON PAYMENTS.— 15 (1) GROUND AMBULANCE.—Section 16 1834(l)(13)(A) of the Social Security Act (42 U.S.C. 17 1395m(l)(13)(A)) is amended by striking ‘‘2018’’ 18 and inserting ‘‘2023’’ each place it appears. 19 (2) SUPER RURAL AMBULANCE.—Section 20 1834(l)(12)(A) of the Social Security Act (42 U.S.C. 21 1395m(l)(12)(A)) is amended, in the first sentence, 22 by striking ‘‘2018’’ and inserting ‘‘2023’’. 23 (b) REQUIRING GROUND AMBULANCE PROVIDERS OF 24 SERVICES AND SUPPLIERS TO SUBMIT COST AND OTHER 25 INFORMATION.—Section 1834(l) of the Social Security February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 283 1 Act (42 U.S.C. 1395m(l)) is amended by adding at the 2 end the following new paragraph: 3 4 5 ‘‘(17) SUBMISSION OF COST AND OTHER INFOR- MATION.— ‘‘(A) DEVELOPMENT OF DATA COLLECTION 6 SYSTEM.—The 7 collection system (which may include use of a 8 cost survey) to collect cost, revenue, utilization, 9 and other information determined appropriate 10 by the Secretary with respect to providers of 11 services (in this paragraph referred to as ‘pro- 12 viders’) and suppliers of ground ambulance 13 services. Such system shall be designed to col- 14 lect information— Secretary shall develop a data 15 ‘‘(i) needed to evaluate the extent to 16 which reported costs relate to payment 17 rates under this subsection; 18 ‘‘(ii) on the utilization of capital 19 equipment and ambulance capacity, includ- 20 ing information consistent with the type of 21 information described in section 1121(a); 22 and 23 ‘‘(iii) on different types of ground am- 24 bulance services furnished in different geo- 25 graphic locations, including rural areas February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 284 1 and low population density areas described 2 in paragraph (12). 3 ‘‘(B) SPECIFICATION 4 5 6 OF DATA COLLEC- TION SYSTEM.— ‘‘(i) IN GENERAL.—The Secretary shall— 7 ‘‘(I) not later than December 31, 8 2019, specify the data collection sys- 9 tem under subparagraph (A); and 10 ‘‘(II) identify the providers and 11 suppliers of ground ambulance serv- 12 ices that would be required to submit 13 information under such data collection 14 system, including the representative 15 sample described in clause (ii). 16 ‘‘(ii) 17 18 DETERMINATION OF REP- RESENTATIVE SAMPLE.— ‘‘(I) IN GENERAL.—Not later 19 than December 31, 2019, with respect 20 to the data collection for the first year 21 under such system, and for each sub- 22 sequent year through 2024, the Sec- 23 retary shall determine a representative 24 sample to submit information under 25 the data collection system. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 285 1 ‘‘(II) REQUIREMENTS.—The 2 sample under subclause (I) shall be 3 representative of the different types of 4 providers and suppliers of ground am- 5 bulance services (such as those pro- 6 viders and suppliers that are part of 7 an emergency service or part of a gov- 8 ernment organization) and the geo- 9 graphic locations in which ground am- 10 bulance services are furnished (such 11 as urban, rural, and low population 12 density areas). 13 ‘‘(III) LIMITATION.—The Sec- 14 retary shall not include an individual 15 provider or supplier of ground ambu- 16 lance services in the sample under 17 subclause (I) in 2 consecutive years, 18 to the extent practicable. 19 ‘‘(C) REPORTING OF COST INFORMA- 20 TION.—For 21 ground ambulance services identified by the 22 Secretary under subparagraph (B)(i)(II) as 23 being required to submit information under the 24 data collection system with respect to a period 25 for the year shall submit to the Secretary infor- February 7, 2018 (10:12 p.m.) each year, a provider or supplier of U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 286 1 mation specified under the system. Such infor- 2 mation shall be submitted in a form and man- 3 ner, and at a time, specified by the Secretary 4 for purposes of this subparagraph. 5 6 7 ‘‘(D) PAYMENT REDUCTION FOR FAILURE TO REPORT.— ‘‘(i) IN GENERAL.—Beginning Janu- 8 ary 1, 2022, subject to clause (ii), a 10 9 percent reduction to payments under this 10 subsection shall be made for the applicable 11 period (as defined in clause (ii)) to a pro- 12 vider or supplier of ground ambulance 13 services that— 14 ‘‘(I) is required to submit infor- 15 mation under the data collection sys- 16 tem with respect to a period under 17 subparagraph (C); and 18 ‘‘(II) does not sufficiently submit 19 such information, as determined by 20 the Secretary. 21 ‘‘(ii) 22 FINED.—For 23 term ‘applicable period’ means, with re- 24 spect to a provider or supplier of ground 25 ambulance services, a year specified by the February 7, 2018 (10:12 p.m.) APPLICABLE PERIOD DE- purposes of clause (i), the U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 287 1 Secretary not more than 2 years after the 2 end of the period with respect to which the 3 Secretary has made a determination under 4 clause (i)(II) that the provider or supplier 5 of ground ambulance services failed to suf- 6 ficiently submit information under the data 7 collection system. 8 ‘‘(iii) HARDSHIP EXEMPTION.—The 9 Secretary may exempt a provider or sup- 10 plier from the payment reduction under 11 clause (i) with respect to an applicable pe- 12 riod in the event of significant hardship, 13 such as a natural disaster, bankruptcy, or 14 other similar situation that the Secretary 15 determines interfered with the ability of 16 the provider or supplier of ground ambu- 17 lance services to submit such information 18 in a timely manner for the specified period. 19 ‘‘(iv) INFORMAL REVIEW.—The Sec- 20 retary shall establish a process under 21 which a provider or supplier of ground am- 22 bulance services may seek an informal re- 23 view of a determination that the provider 24 or supplier is subject to the payment re- 25 duction under clause (i). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 288 1 2 ‘‘(E) ONGOING DATA COLLECTION.— ‘‘(i) REVISION OF DATA COLLECTION 3 SYSTEM.—The 4 retary determines appropriate and, if avail- 5 able, taking into consideration the report 6 (or reports) under subparagraph (F), re- 7 vise the data collection system under sub- 8 paragraph (A). 9 Secretary may, as the Sec- ‘‘(ii) SUBSEQUENT DATA COLLEC- 10 TION.—In 11 the extent to which reported costs relate to 12 payment rates under this subsection and 13 for other purposes the Secretary deems ap- 14 propriate, the Secretary shall require pro- 15 viders and suppliers of ground ambulance 16 services to submit information for years 17 after 2024 as the Secretary determines ap- 18 propriate, but in no case less often than 19 once every 3 years. 20 ‘‘(F) GROUND 21 TION SYSTEM STUDY.— 22 order to continue to evaluate ‘‘(i) IN AMBULANCE DATA COLLEC- GENERAL.—Not later than 23 March 15, 2023, and as determined nec- 24 essary by the Medicare Payment Advisory 25 Commission thereafter, such Commission February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 289 1 shall assess, and submit to Congress a re- 2 port on, information submitted by pro- 3 viders and suppliers of ground ambulance 4 services through the data collection system 5 under subparagraph (A), the adequacy of 6 payments for ground ambulance services 7 under this subsection, and geographic vari- 8 ations in the cost of furnishing such serv- 9 ices. 10 11 ‘‘(ii) CONTENTS.—A report under clause (i) shall contain the following: 12 ‘‘(I) An analysis of information 13 submitted through the data collection 14 system. 15 ‘‘(II) An analysis of any burden 16 on providers and suppliers of ground 17 ambulance services associated with the 18 data collection system. 19 ‘‘(III) A recommendation as to 20 whether information should continue 21 to be submitted through such data 22 collection system or if such system 23 should be revised under subparagraph 24 (E)(i). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 290 1 ‘‘(IV) Other information deter- 2 mined appropriate by the Commission. 3 ‘‘(G) PUBLIC AVAILABILITY.—The Sec- 4 retary shall post information on the results of 5 the data collection under this paragraph on the 6 Internet website of the Centers for Medicare & 7 Medicaid Services, as determined appropriate 8 by the Secretary. 9 ‘‘(H) IMPLEMENTATION.—The Secretary 10 shall implement this paragraph through notice 11 and comment rulemaking. 12 ‘‘(I) ADMINISTRATION.—Chapter 35 of 13 title 44, United States Code, shall not apply to 14 the collection of information required under this 15 subsection. 16 ‘‘(J) LIMITATIONS ON REVIEW.—There 17 shall be no administrative or judicial review 18 under section 1869, section 1878, or otherwise 19 of the data collection system or identification of 20 respondents under this paragraph. 21 ‘‘(K) FUNDING FOR IMPLEMENTATION.— 22 For purposes of carrying out subparagraph (A), 23 the Secretary shall provide for the transfer, 24 from the Federal Supplementary Medical Insur- 25 ance Trust Fund under section 1841, of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 291 1 $15,000,000 to the Centers for Medicare & 2 Medicaid Services Program Management Ac- 3 count for fiscal year 2018. Amounts transferred 4 under this subparagraph shall remain available 5 until expended.’’. 6 SEC. 50204. EXTENSION OF INCREASED INPATIENT HOS- 7 PITAL PAYMENT ADJUSTMENT FOR CERTAIN 8 LOW-VOLUME HOSPITALS. 9 (a) IN GENERAL.—Section 1886(d)(12) of the Social 10 Security Act (42 U.S.C. 1395ww(d)(12)) is amended— 11 (1) in subparagraph (B), in the matter pre- 12 ceding clause (i), by striking ‘‘fiscal year 2018’’ and 13 inserting ‘‘fiscal year 2023’’; 14 (2) in subparagraph (C)— 15 (A) in clause (i)— 16 (i) by striking ‘‘through 2017’’ the 17 first 18 ‘‘through 2022’’; and place it appears and inserting 19 (ii) by striking ‘‘ and has less than 20 800 discharges’’ and all that follows 21 through the period at the end and insert- 22 ing the following ‘‘and has— 23 ‘‘(I) with respect to each of fiscal 24 years 2005 through 2010, less than 25 800 discharges during the fiscal year; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 292 1 ‘‘(II) with respect to each of fis- 2 cal years 2011 through 2018, less 3 than 1,600 discharges of individuals 4 entitled to, or enrolled for, benefits 5 under part A during the fiscal year or 6 portion of fiscal year; 7 ‘‘(III) with respect to each of fis- 8 cal years 2019 through 2022, less 9 than 3,800 discharges during the fis- 10 cal year; and 11 ‘‘(IV) with respect to fiscal year 12 2023 and each subsequent fiscal year, 13 less than 800 discharges during the 14 fiscal year.’’; and 15 (B) in clause (ii)— 16 (i) by striking ‘‘subparagraph (B)’’ 17 and inserting ‘‘subparagraphs (B) and 18 (D)’’; and 19 (ii) by inserting ‘‘(except as provided 20 in clause (i)(II) and subparagraph (D)(i))’’ 21 after ‘‘regardless’’; and 22 23 24 February 7, 2018 (10:12 p.m.) (3) in subparagraph (D)— (A) by striking ‘‘through 2017’’ and inserting ‘‘through 2022’’; U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 293 1 (B) by striking ‘‘hospitals with 200 or 2 fewer’’ and inserting the following: ‘‘hospitals— 3 ‘‘(i) with respect to each of fiscal 4 years 2011 through 2018, with 200 or 5 fewer’’; 6 (C) by striking the period at the end and 7 inserting ‘‘or portion of fiscal year; and’’; and 8 (D) by adding at the end the following new 9 clause: 10 ‘‘(ii) with respect to each of fiscal 11 years 2019 through 2022, with 500 or 12 fewer discharges in the fiscal year to 0 per- 13 cent for low-volume hospitals with greater 14 than 3,800 discharges in the fiscal year.’’. 15 (b) MEDPAC REPORT 16 CREASED 17 FOR 18 ON EXTENSION OF IN- INPATIENT HOSPITAL PAYMENT ADJUSTMENT CERTAIN LOW-VOLUME HOSPITALS.— (1) IN GENERAL.—Not later than March 15, 19 2022, the Medicare Payment Advisory Commission 20 shall submit to Congress a report on the extension 21 of the increased inpatient hospital payment adjust- 22 ment for certain low-volume hospitals under section 23 1886(d)(12) of the Social Security Act (42 U.S.C. 24 1395ww(d)(12)) under the provisions of, and amend- 25 ments made by, this section. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 294 1 (2) CONTENTS.—The report under paragraph 2 (1) shall include an evaluation of the effects of such 3 extension on the following: 4 (A) Beneficiary utilization of inpatient hos- 5 pital services under title XVIII of the Social Se- 6 curity Act (42 U.S.C. 1395 et seq.). 7 (B) The financial status of hospitals with 8 a low volume of Medicare or total inpatient ad- 9 missions. 10 (C) Program spending under such title 11 XVIII. 12 (D) Other matters relevant to evaluating 13 14 the effects of such extension. SEC. 50205. EXTENSION OF THE MEDICARE-DEPENDENT 15 16 HOSPITAL (MDH) PROGRAM. (a) IN GENERAL.—Section 1886(d)(5)(G) of the So- 17 cial Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amend18 ed— 19 20 21 22 23 24 25 February 7, 2018 (10:12 p.m.) (1) in clause (i), by striking ‘‘October 1, 2017’’ and inserting ‘‘October 1, 2022’’; (2) in clause (ii)(II), by striking ‘‘October 1, 2017’’ and inserting ‘‘October 1, 2022’’; and (3) in clause (iv), by striking subclause (I) and inserting the following new subclause: ‘‘(I) that is located in— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 295 1 ‘‘(aa) a rural area; or 2 ‘‘(bb) a State with no rural area (as de- 3 fined in paragraph (2)(D)) and satisfies any of 4 the criteria in subclause (I), (II), or (III) of 5 paragraph (8)(E)(ii),’’; and 6 (4) by inserting after subclause (IV) the fol- 7 lowing new flush sentences: 8 ‘‘Subclause (I)(bb) shall apply for purposes of payment 9 under clause (ii) only for discharges of a hospital occur10 ring on or after the effective date of a determination of 11 medicare-dependent small rural hospital status made by 12 the Secretary with respect to the hospital after the date 13 of the enactment of this sentence. For purposes of apply14 ing subclause (II) of paragraph (8)(E)(ii) under subclause 15 (I)(bb), such subclause (II) shall be applied by inserting 16 ‘as of January 1, 2018,’ after ‘such State’ each place it 17 appears.’’. 18 19 (b) CONFORMING AMENDMENTS.— (1) EXTENSION OF TARGET AMOUNT.—Section 20 1886(b)(3)(D) of the Social Security Act (42 U.S.C. 21 1395ww(b)(3)(D)) is amended— 22 (A) in the matter preceding clause (i), by 23 striking ‘‘October 1, 2017’’ and inserting ‘‘Oc- 24 tober 1, 2022’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 296 1 (B) in clause (iv), by striking ‘‘through fis- 2 cal year 2017’’ and inserting ‘‘through fiscal 3 year 2022’’. 4 (2) PERMITTING 5 CLASSIFICATION.—Section 6 bus Budget Reconciliation Act of 1993 (42 U.S.C. 7 1395ww note) is amended by striking ‘‘through fis- 8 cal year 2017’’ and inserting ‘‘through fiscal year 9 2022’’. 10 HOSPITALS TO DECLINE RE- 13501(e)(2) of the Omni- (c) GAO STUDY AND REPORT.— 11 (1) STUDY.—The Comptroller General of the 12 United States (in this subsection referred to as the 13 ‘‘Comptroller General’’) shall conduct a study on the 14 medicare-dependent, small rural hospital program 15 under section 1886(d) of the Social Security Act (42 16 U.S.C. 1395x(d)). Such study shall include an anal- 17 ysis of the following: 18 (A) The payor mix of medicare-dependent, 19 small rural hospitals (as defined in paragraph 20 (5)(G)(iv) of such section 1886(d)), how such 21 mix will trend in future years (based on current 22 trends and projections), and whether or not the 23 requirement under subclause (IV) of such para- 24 graph should be revised. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 297 1 (B) The characteristics of medicare-de- 2 pendent, small rural hospitals that meet the re- 3 quirement of such subclause (IV) through the 4 application 5 (a)(iii)(B) of section 412.108 of title 42, Code 6 of Federal Regulations, including Medicare in- 7 patient and outpatient utilization, payor mix, 8 and financial status (including Medicare and 9 total margins), and whether or not Medicare 10 payments for such hospitals should be revised. 11 (C) Such other items related to medicare- 12 dependent, small rural hospitals as the Comp- 13 troller General determines appropriate. 14 (2) REPORT.—Not later than 2 years after the 15 date of the enactment of this Act, the Comptroller 16 General shall submit to Congress a report containing 17 the results of the study conducted under paragraph 18 (1), together with recommendations for such legisla- 19 tion and administrative action as the Comptroller 20 General determines appropriate. February 7, 2018 (10:12 p.m.) of paragraph (a)(iii)(A) or U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 298 1 SEC. 50206. EXTENSION OF FUNDING FOR QUALITY MEAS- 2 URE ENDORSEMENT, INPUT, AND SELECTION; 3 REPORTING REQUIREMENTS. 4 (a) EXTENSION OF FUNDING.—Section 1890(d)(2) 5 of the Social Security Act (42 U.S.C. 1395aaa(d)(2)) is 6 amended— 7 (1) in the first sentence— 8 (A) by striking ‘‘2014 and’’ and inserting 9 ‘‘2014,’’; and 10 (B) by inserting the following before the 11 period: ‘‘, and $7,500,000 for each of fiscal 12 years 2018 and 2019’’; and 13 (2) by adding at the end the following new sen- 14 tence: ‘‘Amounts transferred for each of fiscal years 15 2018 and 2019 shall be in addition to any unobli- 16 gated funds transferred for a preceding fiscal year 17 that are available under the preceding sentence.’’ 18 (b) ANNUAL REPORT 19 GRESS.—Section BY SECRETARY TO CON- 1890 of the Social Security Act (42 20 U.S.C. 1395aaa) is amended by adding at the end the fol21 lowing new subsection: 22 23 ‘‘(e) ANNUAL REPORT GRESS.—By BY SECRETARY TO CON- not later than March 1 of each year (begin- 24 ning with 2019), the Secretary shall submit to Congress 25 a report containing the following: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 299 1 ‘‘(1) A comprehensive plan that identifies the 2 quality measurement needs of programs and initia- 3 tives of the Secretary and provides a strategy for 4 using the entity with a contract under subsection (a) 5 and any other entity the Secretary has contracted 6 with or may contract with to perform work associ- 7 ated with section 1890A to help meet those needs, 8 specifically with respect to the programs under this 9 title and title XIX. In years after the first plan 10 under this paragraph is submitted, the requirements 11 of this paragraph may be met by providing an up- 12 date to the plan. 13 ‘‘(2) The amount of funding provided under 14 subsection (d) for purposes of carrying out this sec- 15 tion and section 1890A that has been obligated by 16 the Secretary, the amount of funding provided that 17 has been expended, and the amount of funding pro- 18 vided that remains unobligated. 19 ‘‘(3) With respect to the activities described 20 under this section or section 1890A, a description of 21 how the funds described in paragraph (2) have been 22 obligated or expended, including how much of that 23 funding has been obligated or expended for work 24 performed by the Secretary, the entity with a con- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 300 1 tract under subsection (a), and any other entity the 2 Secretary has contracted with to perform work. 3 ‘‘(4) A description of the activities for which 4 the funds described in paragraph (2) were used, in- 5 cluding task orders and activities assigned to the en- 6 tity with a contract under subsection (a), activities 7 performed by the Secretary, and task orders and ac- 8 tivities assigned to any other entity the Secretary 9 has contracted with to perform work related to car- 10 rying out section 1890A. 11 ‘‘(5) The amount of funding described in para- 12 graph (2) that has been obligated or expended for 13 each of the activities described in paragraph (4). 14 ‘‘(6) Estimates for, and descriptions of, obliga- 15 tions and expenditures that the Secretary anticipates 16 will be needed in the succeeding two year period to 17 carry out each of the quality measurement activities 18 required under this section and section 1890A, in- 19 cluding any obligations that will require funds to be 20 expended in a future year.’’. 21 (c) REVISIONS 22 SENSUS-BASED 23 RETARY.— February 7, 2018 (10:12 p.m.) TO ENTITY ANNUAL REPORT FROM CONTO CONGRESS AND THE SEC- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 301 1 (1) IN GENERAL.—Section 1890(b)(5)(A) of the 2 Social Security Act (42 U.S.C. 1395aaa(b)(5)(A)) is 3 amended— 4 (A) by redesignating clauses (i) through 5 (vi) as subclauses (I) through (VI), respectively, 6 and moving the margins accordingly; 7 (B) in the matter preceding subclause (I), 8 as redesignated by subparagraph (A), by strik- 9 ing ‘‘containing a description of—’’ and insert- 10 ing ‘‘containing the following: 11 12 13 ‘‘(i) A description of—’’; and (C) by adding at the end the following new clauses: 14 ‘‘(ii) An itemization of financial infor- 15 mation for the fiscal year ending Sep- 16 tember 30 of the preceding year, includ- 17 ing— 18 ‘‘(I) annual revenues of the enti- 19 ty (including any government funding, 20 private sector contributions, grants, 21 membership revenues, and investment 22 revenue); 23 ‘‘(II) annual expenses of the enti- 24 ty (including grants paid, benefits 25 paid, salaries or other compensation, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 302 1 fundraising expenses, and overhead 2 costs); and 3 ‘‘(III) a breakdown of the 4 amount awarded per contracted task 5 order and the specific projects funded 6 in each task order assigned to the en- 7 tity. 8 ‘‘(iii) Any updates or modifications of 9 internal policies and procedures of the en- 10 tity as they relate to the duties of the enti- 11 ty under this section, including— 12 ‘‘(I) specifically identifying any 13 modifications to the disclosure of in- 14 terests and conflicts of interests for 15 committees, work groups, task forces, 16 and advisory panels of the entity; and 17 ‘‘(II) information on external 18 stakeholder participation in the duties 19 of the entity under this section (in- 20 cluding complete rosters for all com- 21 mittees, work groups, task forces, and 22 advisory panels funded through gov- 23 ernment contracts, descriptions of rel- 24 evant interests and any conflicts of in- 25 terest for members of all committees, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 303 1 work groups, task forces, and advisory 2 panels, and the total percentage by 3 health care sector of all convened 4 committees, work groups, task forces, 5 and advisory panels.’’. 6 (2) EFFECTIVE DATE.—The amendments made 7 by this subsection shall apply to reports submitted 8 for years beginning with 2019. 9 (d) GAO STUDY AND REPORT.— 10 (1) STUDY.—The Comptroller General of the 11 United States shall conduct a study on health care 12 quality measurement efforts funded under sections 13 1890 and 1890A of the Social Security Act (42 14 U.S.C. 1395aaa; 1395aaa–1). Such study shall in- 15 clude an examination of the following: 16 (A) The extent to which the Secretary of 17 Health and Human Services (in this subsection 18 referred to as the ‘‘Secretary’’) has set and 19 prioritized objectives to be achieved for each of 20 the quality measurement activities required 21 under such sections 1890 and 1890A. 22 (B) The efforts that the Secretary has un- 23 dertaken to meet quality measurement objec- 24 tives associated with such sections 1890 and 25 1890A, including division of responsibilities for February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 304 1 those efforts within the Department of Health 2 and Human Services and through contracts 3 with a consensus-based entity under subsection 4 (a) of such section 1890 (in this subsection re- 5 ferred to as the ‘‘consensus-based entity’’) and 6 other entities, and the extent of any overlap 7 among the work performed by the Secretary, 8 the consensus-based entity, the Measure Appli- 9 cations Partnership (MAP) convened by such 10 entity to provide input to the Secretary on the 11 selection of quality and efficiency measures, and 12 any other entities the Secretary has contracted 13 with to perform work related to carrying out 14 such sections 1890 and 1890A. 15 (C) The total amount of funding provided 16 to the Secretary for purposes of carrying out 17 such sections 1890 and 1890A, the amount of 18 such funding that has been obligated or ex- 19 pended by the Secretary, and the amount of 20 such funding that remains unobligated. 21 (D) How the funds described in subpara- 22 graph (C) have been allocated, including how 23 much of the funding has been allocated for 24 work performed by the Secretary, the con- 25 sensus-based entity, and any other entity the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 305 1 Secretary has contracted with to perform work 2 related to carrying out such sections 1890 and 3 1890A, respectively, and descriptions of such 4 work. 5 (E) The extent to which the Secretary has 6 developed a comprehensive and long-term plan 7 to ensure that it can achieve quality measure- 8 ment objectives related to carrying out such 9 sections 1890 and 1890A in a timely manner 10 and with efficient use of available resources, in- 11 cluding the roles of the consensus-based entity, 12 the Measure Applications Partnership (MAP), 13 and any other entity the Secretary has con- 14 tracted with to perform work related to such 15 sections 1890 and 1890A in helping the Sec- 16 retary achieve those objectives. 17 (2) REPORT.—Not later than 18 months after 18 the date of enactment of this Act, the Comptroller 19 General of the United States shall submit to Con- 20 gress a report containing the results of the study 21 conducted under paragraph (1), together with rec- 22 ommendations for such legislation and administra- 23 tive action as the Comptroller General determines 24 appropriate. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 306 1 SEC. 50207. EXTENSION OF FUNDING OUTREACH AND AS- 2 SISTANCE 3 STATE 4 PROGRAM REPORTING REQUIREMENTS. 5 6 FOR HEALTH LOW-INCOME PROGRAMS; INSURANCE ASSISTANCE (a) FUNDING EXTENSIONS.— (1) ADDITIONAL FUNDING FOR STATE HEALTH 7 INSURANCE 8 section 119 of the Medicare Improvements for Pa- 9 tients and Providers Act of 2008 (42 U.S.C. 1395b– 10 3 note), as amended by section 3306 of the Patient 11 Protection and Affordable Care Act (Public Law 12 111–148), section 610 of the American Taxpayer 13 Relief Act of 2012 (Public Law 112–240), section 14 1110 of the Pathway for SGR Reform Act of 2013 15 (Public Law 113–67), section 110 of the Protecting 16 Access to Medicare Act of 2014 (Public Law 113– 17 93), and section 208 of the Medicare Access and 18 CHIP Reauthorization Act of 2015 (Public Law 19 114–10) is amended— 20 21 22 23 24 25 February 7, 2018 (10:12 p.m.) PROGRAMS.—Subsection (a)(1)(B) of (A) in clause (vi), by striking ‘‘and’’ at the end; (B) in clause (vii), by striking the period at the end and inserting ‘‘; and’’; and (C) by adding at the end the following new clauses: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 307 1 ‘‘(viii) 2 for ‘‘(ix) 4 $13,000,000.’’. (2) ADDITIONAL for fiscal ON AGING.—Subsection 7 119, as so amended, is amended— 8 2019, of (b)(1)(B) of such section (B) in clause (vii), by striking the period at the end and inserting ‘‘; and’’; and (C) by inserting after clause (vii) the following new clauses: 14 ‘‘(viii) 15 $7,500,000; and for 16 ‘‘(ix) 17 $7,500,000.’’. 18 year end; 12 13 of (A) in clause (vi), by striking ‘‘and’’ at the 10 11 2018, FUNDING FOR AREA AGENCIES 6 9 year $13,000,000; and 3 5 fiscal (3) ADDITIONAL for fiscal fiscal year 2018, of year 2019, of FUNDING FOR AGING AND DIS- 19 ABILITY RESOURCE CENTERS.—Subsection 20 of such section 119, as so amended, is amended— 21 (A) in clause (vi), by striking ‘‘and’’ at the 22 23 24 February 7, 2018 (10:12 p.m.) (c)(1)(B) end; (B) in clause (vii), by striking the period at the end and inserting ‘‘; and’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 308 1 (C) by inserting after clause (vii) the fol- 2 lowing new clauses: 3 ‘‘(viii) 4 $5,000,000; and for 5 ‘‘(ix) 6 $5,000,000.’’. 7 for (4) ADDITIONAL fiscal fiscal FUNDING year 2018, of year 2019, of FOR CONTRACT 8 WITH THE NATIONAL CENTER FOR BENEFITS AND 9 OUTREACH 10 ENROLLMENT.—Subsection such section 119, as so amended, is amended— 11 (A) in clause (vi), by striking ‘‘and’’ at the 12 end; 13 (B) in clause (vii), by striking the period 14 at the end and inserting ‘‘; and’’; and 15 (C) by inserting after clause (vii) the fol- 16 lowing new clauses: 17 ‘‘(viii) 18 for fiscal year 2018, of year 2019, of $12,000,000; and 19 ‘‘(ix) 20 $12,000,000.’’. 21 22 (d)(2) of for fiscal (b) STATE HEALTH INSURANCE ASSISTANCE PROGRAM REPORTING REQUIREMENTS.—Beginning not later 23 than April 1, 2019, and biennially thereafter, the Agency 24 for Community Living shall electronically post on its 25 website the following information, with respect to grants February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 309 1 to States for State health insurance assistance programs, 2 (such information to be presented by State and by entity 3 receiving funds from the State to carry out such a pro4 gram funded by such grant): 5 (1) The amount of Federal funding provided to 6 each such State for such program for the period in- 7 volved and the amount of Federal funding provided 8 by each such State for such program to each such 9 entity for the period involved. 10 (2) Information as the Secretary may specify, 11 with respect to such programs carried out through 12 such grants, consistent with the terms and condi- 13 tions for receipt of such grants. 14 SEC. 50208. EXTENSION OF HOME HEALTH RURAL ADD-ON. 15 16 (a) EXTENSION.— (1) IN GENERAL.—Section 421 of the Medicare 17 Prescription Drug, Improvement, and Modernization 18 Act of 2003 (Public Law 108–173; 117 Stat. 2283; 19 42 U.S.C. 1395fff note), as amended by section 20 5201(b) of the Deficit Reduction Act of 2005 (Pub- 21 lic Law 109–171; 120 Stat. 46), section 3131(c) of 22 the Patient Protection and Affordable Care Act 23 (Public Law 111–148; 124 Stat. 428), and section 24 210 of the Medicare Access and CHIP Reauthoriza- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 310 1 tion Act of 2015 (Public Law 114–10; 129 Stat. 2 151) is amended— 3 (A) in subsection (a), by striking ‘‘January 4 1, 2018’’ and inserting ‘‘January 1, 2019’’ each 5 place it appears; 6 7 (B) by redesignating subsections (b) and (c) as subsections (c) and (d), respectively; 8 (C) in each of subsections (c) and (d), as 9 so redesignated, by striking ‘‘subsection (a)’’ 10 11 12 13 14 and inserting ‘‘subsection (a) or (b)’’; and (D) by inserting after subsection (a) the following new subsection: ‘‘(b) SUBSEQUENT TEMPORARY INCREASE.— ‘‘(1) IN GENERAL.—The Secretary shall in- 15 crease the payment amount otherwise made under 16 such section 1895 for home health services furnished 17 in a county (or equivalent area) in a rural area (as 18 defined in such section 1886(d)(2)(D)) that, as de- 19 termined by the Secretary— 20 ‘‘(A) is in the highest quartile of all coun- 21 ties (or equivalent areas) based on the number 22 of Medicare home health episodes furnished per 23 100 individuals who are entitled to, or enrolled 24 for, benefits under part A of title XVIII of the 25 Social Security Act or enrolled for benefits February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 311 1 under part B of such title (but not enrolled in 2 a plan under part C of such title)— 3 4 5 ‘‘(i) in the case of episodes and visits ending during 2019, by 1.5 percent; and ‘‘(ii) in the case of episodes and visits 6 ending during 2020, by 0.5 percent; 7 ‘‘(B) has a population density of 6 individ- 8 uals or fewer per square mile of land area and 9 is not described in subparagraph (A)— 10 11 12 13 14 15 16 ‘‘(i) in the case of episodes and visits ending during 2019, by 4 percent; ‘‘(ii) in the case of episodes and visits ending during 2020, by 3 percent; ‘‘(iii) in the case of episodes and visits ending during 2021, by 2 percent; and ‘‘(iv) in the case of episodes and visits 17 ending during 2022, by 1 percent; and 18 ‘‘(C) is not described in either subpara- 19 20 21 22 23 24 25 February 7, 2018 (10:12 p.m.) graph (A) or (B)— ‘‘(i) in the case of episodes and visits ending during 2019, by 3 percent; ‘‘(ii) in the case of episodes and visits ending during 2020, by 2 percent; and ‘‘(iii) in the case of episodes and visits ending during 2021, by 1 percent. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 312 1 2 ‘‘(2) RULES FOR DETERMINATIONS.— ‘‘(A) NO SWITCHING.—For purposes of 3 this subsection, the determination by the Sec- 4 retary as to which subparagraph of paragraph 5 (1) applies to a county (or equivalent area) 6 shall be made a single time and shall apply for 7 the duration of the period to which this sub- 8 section applies. 9 ‘‘(B) UTILIZATION.—In determining which 10 counties (or equivalent areas) are in the highest 11 quartile under paragraph (1)(A), the following 12 rules shall apply: 13 14 ‘‘(i) The Secretary shall use data from 2015. 15 ‘‘(ii) The Secretary shall exclude data 16 from the territories (and the territories 17 shall not be described in such paragraph). 18 ‘‘(iii) The Secretary may exclude data 19 from counties (or equivalent areas) in rural 20 areas with a low volume of home health 21 episodes (and if data is so excluded with 22 respect to a county (or equivalent area), 23 such county (or equivalent area) shall not 24 be described in such paragraph). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 313 1 ‘‘(C) POPULATION DENSITY.—In deter- 2 mining population density under paragraph 3 (1)(B), the Secretary shall use data from the 4 2010 decennial Census. 5 ‘‘(3) LIMITATIONS ON REVIEW.—There shall be 6 no administrative or judicial review under section 7 1869, section 1878, or otherwise of determinations 8 under paragraph (1).’’. 9 (2) REQUIREMENT TO SUBMIT COUNTY DATA 10 ON CLAIM FORM.—Section 11 curity Act (42 U.S.C. 1395fff(c)) is amended— 12 13 14 15 16 1895(c) of the Social Se- (A) in paragraph (1), by striking ‘‘and’’ at the end; (B) in paragraph (2), by striking the period at the end and inserting ‘‘; and’’; and (C) by adding at the end the following new 17 paragraph: 18 ‘‘(3) in the case of home health services fur- 19 nished on or after January 1, 2019, the claim con- 20 tains the code for the county (or equivalent area) in 21 which the home health service was furnished.’’. 22 (b) HHS OIG ANALYSIS.—Not later than January 23 1, 2023, the Inspector General of the Department of 24 Health and Human Services shall submit to Congress— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 314 1 (1) an analysis of the home health claims and 2 utilization of home health services by county (or 3 equivalent area) under the Medicare program; and 4 (2) recommendations the Inspector General de- 5 termines appropriate based on such analysis. 12 TITLE III—CREATING HIGHQUALITY RESULTS AND OUTCOMES NECESSARY TO IMPROVE CHRONIC (CHRONIC) CARE Subtitle A—Receiving High Quality Care in the Home 13 SEC. 50301. EXTENDING THE INDEPENDENCE AT HOME 6 7 8 9 10 11 14 15 DEMONSTRATION PROGRAM. (a) IN GENERAL.—Section 1866E of the Social Secu- 16 rity Act (42 U.S.C. 1395cc–5) is amended— 17 18 19 20 21 (1) in subsection (e)— (A) in paragraph (1)— (i) by striking ‘‘An agreement’’ and inserting ‘‘Agreements’’; and (ii) by striking ‘‘5-year’’ and inserting 22 ‘‘7-year’’; and 23 (B) in paragraph (5)— 24 25 February 7, 2018 (10:12 p.m.) (i) by striking ‘‘10,000’’ and inserting ‘‘15,000’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 315 1 (ii) by adding at the end the following 2 new sentence: ‘‘An applicable beneficiary 3 that participates in the demonstration pro- 4 gram by reason of the increase from 5 10,000 to 15,000 in the preceding sentence 6 pursuant to the amendment made by sec- 7 tion 50301(a)(1)(B)(i) of the Advancing 8 Chronic Care, Extenders, and Social Serv- 9 ices Act shall be considered in the spend- 10 ing target estimates under paragraph (1) 11 of subsection (c) and the incentive pay- 12 ment calculations under paragraph (2) of 13 such subsection for the sixth and seventh 14 years of such program.’’; 15 (2) in subsection (g), in the first sentence, by 16 inserting ‘‘, including, to the extent practicable, with 17 respect to the use of electronic health information 18 systems, as described in subsection (b)(1)(A)(vi)’’ 19 after ‘‘under the demonstration program’’; and 20 (3) in subsection (i)(1)(A), by striking ‘‘will not 21 receive an incentive payment for the second of 2’’ 22 and inserting ‘‘did not achieve savings for the third 23 of 3’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 316 1 (b) EFFECTIVE DATE.—The amendment made by 2 subsection (a)(3) shall take effect as if included in the en3 actment of Public Law 111–148. 4 SEC. 50302. EXPANDING ACCESS TO HOME DIALYSIS THER- 5 6 APY. (a) IN GENERAL.—Section 1881(b)(3) of the Social 7 Security Act (42 U.S.C. 1395rr(b)(3)) is amended— 8 9 (1) by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively; 10 (2) in clause (ii), as redesignated by paragraph 11 (1), by striking ‘‘on a comprehensive’’ and insert 12 ‘‘subject to subparagraph (B), on a comprehensive’’; 13 (3) by striking ‘‘With respect to’’ and inserting 14 ‘‘(A) With respect to’’; and 15 (4) by adding at the end the following new sub- 16 paragraph: 17 ‘‘(B)(i) For purposes of subparagraph (A)(ii), subject 18 to clause (ii), an individual determined to have end stage 19 renal disease receiving home dialysis may choose to receive 20 monthly end stage renal disease-related clinical assess21 ments furnished on or after January 1, 2019, via tele22 health. 23 ‘‘(ii) Clause (i) shall apply to an individual only if 24 the individual receives a face-to-face clinical assessment, 25 without the use of telehealth— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 317 1 2 ‘‘(I) in the case of the initial 3 months of home dialysis of such individual, at least monthly; and 3 ‘‘(II) after such initial 3 months, at least once 4 every 3 consecutive months.’’. 5 (b) ORIGINATING SITE REQUIREMENTS.— 6 (1) IN GENERAL.—Section 1834(m) of the So- 7 cial Security Act (42 U.S.C. 1395m(m)) is amend- 8 ed— 9 10 (A) in paragraph (4)(C)(ii), by adding at the end the following new subclauses: 11 ‘‘(IX) A renal dialysis facility, 12 but only for purposes of section 13 1881(b)(3)(B). 14 ‘‘(X) The home of an individual, 15 but only for purposes of section 16 1881(b)(3)(B).’’; and 17 (B) by adding at the end the following new 18 paragraph: 19 ‘‘(5) TREATMENT OF HOME DIALYSIS MONTHLY 20 ESRD-RELATED 21 ments described in paragraph (4)(C)(i) shall not 22 apply with respect to telehealth services furnished on 23 or after January 1, 2019, for purposes of section 24 1881(b)(3)(B), at an originating site described in February 7, 2018 (10:12 p.m.) VISIT.—The geographic require- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 318 1 subclause 2 (4)(C)(ii).’’. 3 (VI), (2) NO (IX), or (X) of paragraph FACILITY FEE IF ORIGINATING SITE 4 FOR HOME DIALYSIS THERAPY IS THE HOME.—Sec- 5 tion 1834(m)(2)(B) of the Social Security (42 6 U.S.C. 1395m(m)(2)(B)) is amended— 7 (A) by redesignating clauses (i) and (ii) as 8 subclauses (I) and (II), and indenting appro- 9 priately; 10 (B) in subclause (II), as redesignated by 11 subparagraph (A), by striking ‘‘clause (i) or 12 this clause’’ and inserting ‘‘subclause (I) or this 13 subclause’’; 14 15 (C) by striking ‘‘SITE.—With respect to’’ and inserting ‘‘SITE.— 16 ‘‘(i) IN GENERAL.—Subject to clause 17 (ii), with respect to’’; and 18 (D) by adding at the end the following new 19 20 clause: ‘‘(ii) NO FACILITY FEE IF ORIGI- 21 NATING SITE FOR HOME DIALYSIS THER- 22 APY IS THE HOME.—No 23 be paid under this subparagraph to an 24 originating site described in paragraph 25 (4)(C)(ii)(X).’’. February 7, 2018 (10:12 p.m.) facility fee shall U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 319 1 2 (c) CLARIFICATION REGARDING TELEHEALTH PROVIDED TO BENEFICIARIES.—Section 1128A(i)(6) of the 3 Social Security Act (42 U.S.C. 1320a–7a(i)(6)) is amend4 ed— 5 6 7 8 9 10 (1) in subparagraph (H), by striking ‘‘or’’ at the end; (2) in subparagraph (I), by striking the period at the end and inserting ‘‘; or’’; and (3) by adding at the end the following new subparagraph: 11 ‘‘(J) the provision of telehealth tech- 12 nologies (as defined by the Secretary) on or 13 after January 1, 2019, by a provider of services 14 or a renal dialysis facility (as such terms are 15 defined for purposes of title XVIII) to an indi- 16 vidual with end stage renal disease who is re- 17 ceiving home dialysis for which payment is 18 being made under part B of such title, if— 19 ‘‘(i) the telehealth technologies are not 20 offered as part of any advertisement or so- 21 licitation; 22 ‘‘(ii) the telehealth technologies are 23 provided for the purpose of furnishing tele- 24 health services related to the individual’s 25 end stage renal disease; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 320 1 ‘‘(iii) the provision of the telehealth 2 technologies meets any other requirements 3 set forth in regulations promulgated by the 4 Secretary.’’. 5 (d) CONFORMING AMENDMENT.—Section 1881(b)(1) 6 of the Social Security Act (42 U.S.C. 1395rr(b)(1)) is 7 amended by striking ‘‘paragraph (3)(A)’’ and inserting 8 ‘‘paragraph (3)(A)(i)’’. 10 Subtitle B—Advancing Team-Based Care 11 SEC. 50311. PROVIDING CONTINUED ACCESS TO MEDICARE 9 12 ADVANTAGE 13 VULNERABLE POPULATIONS. 14 SPECIAL NEEDS PLANS FOR (a) EXTENSION.—Section 1859(f)(1) of the Social 15 Security Act (42 U.S.C. 1395w–28(f)(1)) is amended by 16 striking ‘‘and for periods before January 1, 2019’’. 17 18 (b) INCREASED INTEGRATION OF DUAL SNPS.— (1) IN GENERAL.—Section 1859(f) of the Social 19 Security Act (42 U.S.C. 1395w–28(f)) is amended— 20 (A) in paragraph (3), by adding at the end 21 22 23 24 25 February 7, 2018 (10:12 p.m.) the following new subparagraph: ‘‘(F) The plan meets the requirements applicable under paragraph (8).’’; and (B) by adding at the end the following new paragraph: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 321 1 2 3 ‘‘(8) INCREASED INTEGRATION OF DUAL SNPS.— ‘‘(A) DESIGNATED CONTACT.—The Sec- 4 retary, acting through the Federal Coordinated 5 Health Care Office established under section 6 2602 of Public Law 111–148, shall serve as a 7 dedicated point of contact for States to address 8 misalignments that arise with the integration of 9 specialized MA plans for special needs individ- 10 uals described in subsection (b)(6)(B)(ii) under 11 this paragraph and, consistent with such role, 12 shall establish— 13 ‘‘(i) a uniform process for dissemi- 14 nating to State Medicaid agencies informa- 15 tion under this title impacting contracts 16 between such agencies and such plans 17 under this subsection; and 18 ‘‘(ii) basic resources for States inter- 19 ested in exploring such plans as a platform 20 for integration, such as a model contract 21 or other tools to achieve those goals. 22 ‘‘(B) UNIFIED 23 24 25 February 7, 2018 (10:12 p.m.) GRIEVANCES AND APPEALS PROCESS.— ‘‘(i) IN GENERAL.—Not later than April 1, 2020, the Secretary shall establish U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 322 1 procedures, to the extent feasible as deter- 2 mined by the Secretary, unifying griev- 3 ances and appeals procedures under sec- 4 tions 5 1902(a)(5), and 1932(b)(4) for items and 6 services provided by specialized MA plans 7 for special needs individuals described in 8 subsection (b)(6)(B)(ii) under this title 9 and title XIX. With respect to items and 10 services described in the preceding sen- 11 tence, procedures established under this 12 clause shall apply in place of otherwise ap- 13 plicable grievances and appeals procedures. 14 The Secretary shall solicit comment in de- 15 veloping such procedures from States, 16 plans, beneficiaries and their representa- 17 tives, and other relevant stakeholders. 1852(f), 1852(g), 1902(a)(3), 18 ‘‘(ii) PROCEDURES.—The procedures 19 established under clause (i) shall be in- 20 cluded in the plan contract under para- 21 graph (3)(D) and shall— 22 ‘‘(I) adopt the provisions for the 23 enrollee that are most protective for 24 the enrollee and, to the extent feasible 25 as determined by the Secretary, are February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 323 1 compatible with unified timeframes 2 and consolidated access to external re- 3 view under an integrated process; 4 ‘‘(II) take into account dif- 5 ferences in State plans under title 6 XIX to the extent necessary; 7 8 9 ‘‘(III) be easily navigable by an enrollee; and ‘‘(IV) include the elements de- 10 scribed in clause (iii), as applicable. 11 ‘‘(iii) ELEMENTS DESCRIBED.—Both 12 unified appeals and unified grievance pro- 13 cedures shall include, as applicable, the fol- 14 lowing elements described in this clause: 15 ‘‘(I) Single written notification of 16 all applicable grievances and appeal 17 rights under this title and title XIX. 18 For purposes of this subparagraph, 19 the Secretary may waive the require- 20 ments under section 1852(g)(1)(B) 21 when the specialized MA plan covers 22 items or services under this part or 23 under title XIX. 24 ‘‘(II) Single pathways for resolu- 25 tion of any grievance or appeal related February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 324 1 to a particular item or service pro- 2 vided by specialized MA plans for spe- 3 cial needs individuals described in 4 subsection (b)(6)(B)(ii) under this 5 title and title XIX. 6 ‘‘(III) Notices written in plain 7 language and available in a language 8 and format that is accessible to the 9 enrollee, including in non-English lan- 10 guages that are prevalent in the serv- 11 ice area of the specialized MA plan. 12 ‘‘(IV) Unified timeframes for 13 grievances 14 such as an individual’s filing of a 15 grievance or appeal, a plan’s acknowl- 16 edgment and resolution of a grievance 17 or appeal, and notification of decisions 18 with respect to a grievance or appeal. 19 ‘‘(V) Requirements for how the 20 plan must process, track, and resolve 21 grievances and appeals, to ensure 22 beneficiaries are notified on a timely 23 basis of decisions that are made 24 throughout the grievance or appeals 25 process and are able to easily deter- February 7, 2018 (10:12 p.m.) and appeals processes, U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 325 1 mine the status of a grievance or ap- 2 peal. 3 ‘‘(iv) CONTINUATION OF BENEFITS 4 PENDING APPEAL.—The 5 under clause (i) shall, with respect to all 6 benefits under parts A and B and title 7 XIX subject to appeal under such proce- 8 dures, incorporate provisions under current 9 law and implementing regulations that pro- 10 vide continuation of benefits pending ap- 11 peal under this title and title XIX. 12 ‘‘(C) REQUIREMENT unified procedures FOR UNIFIED GRIEV- 13 ANCES AND APPEALS.—For 14 quent years, the contract of a specialized MA 15 plan for special needs individuals described in 16 subsection (b)(6)(B)(ii) with a State Medicaid 17 agency under paragraph (3)(D) shall require 18 the use of unified grievances and appeals proce- 19 dures as described in subparagraph (B). 20 21 22 ‘‘(D) REQUIREMENTS 2021 and subse- FOR INTEGRA- GENERAL.—For 2021 and TION.— ‘‘(i) IN 23 subsequent years, a specialized MA plan 24 for special needs individuals described in 25 subsection (b)(6)(B)(ii) shall meet one or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 326 1 more of the following requirements, to the 2 extent permitted under State law, for inte- 3 gration of benefits under this title and title 4 XIX: 5 ‘‘(I) The specialized MA plan 6 must meet the requirements of con- 7 tracting with the State Medicaid 8 agency described in paragraph (3)(D) 9 in addition to coordinating long-term 10 services and supports or behavioral 11 health services, or both, by meeting an 12 additional minimum set of require- 13 ments determined by the Secretary 14 through 15 Health Care Office established under 16 section 2602 of the Patient Protection 17 and Affordable Care Act based on 18 input from stakeholders, such as noti- 19 fying the State in a timely manner of 20 hospitalizations, emergency room vis- 21 its, and hospital or nursing home dis- 22 charges of enrollees, assigning one 23 primary care provider for each en- 24 rollee, or sharing data that would ben- 25 efit the coordination of items and February 7, 2018 (10:12 p.m.) the Federal Coordinated U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 327 1 services under this title and the State 2 plan under title XIX. Such minimum 3 set of requirements must be included 4 in the contract of the specialized MA 5 plan with the State Medicaid agency 6 under such paragraph. 7 ‘‘(II) The specialized MA plan 8 must meet the requirements of a fully 9 integrated plan described in section 10 1853(a)(1)(B)(iv)(II) (other than the 11 requirement that the plan have simi- 12 lar average levels of frailty, as deter- 13 mined by the Secretary, as the PACE 14 program), or enter into a capitated 15 contract with the State Medicaid 16 agency to provide long-term services 17 and supports or behavioral health 18 services, or both. 19 ‘‘(III) In the case of a specialized 20 MA plan that is offered by a parent 21 organization that is also the parent 22 organization of a Medicaid managed 23 care organization providing long term 24 services and supports or behavioral 25 services under a contract under sec- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 328 1 tion 1903(m), the parent organization 2 must assume clinical and financial re- 3 sponsibility 4 under this title and title XIX with re- 5 spect to any individual who is enrolled 6 in both the specialized MA plan and 7 the Medicaid managed care organiza- 8 tion. 9 ‘‘(ii) SUSPENSION for benefits provided OF ENROLLMENT 10 FOR FAILURE TO MEET REQUIREMENTS 11 DURING INITIAL PERIOD.—During 12 riod of plan years 2021 through 2025, if 13 the Secretary determines that a specialized 14 MA plan for special needs individuals de- 15 scribed in subsection (b)(6)(B)(ii) has 16 failed to comply with clause (i), the Sec- 17 retary may provide for the application 18 against the Medicare Advantage organiza- 19 tion offering the plan of the remedy de- 20 scribed in section 1857(g)(2)(B) in the 21 same manner as the Secretary may apply 22 such remedy, and in accordance with the 23 same procedures as would apply, in the 24 case of an MA organization determined by 25 the Secretary to have engaged in conduct February 7, 2018 (10:12 p.m.) the pe- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 329 1 described in section 1857(g)(1). If the Sec- 2 retary applies such remedy to a Medicare 3 Advantage organization under the pre- 4 ceding sentence, the organization shall sub- 5 mit to the Secretary (at a time, and in a 6 form and manner, specified by the Sec- 7 retary) information describing how the 8 plan will come into compliance with clause 9 (i). 10 ‘‘(E) STUDY 11 ‘‘(i) IN AND REPORT TO CONGRESS.— GENERAL.—Not later than 12 March 15, 2022, and, subject to clause 13 (iii), biennially thereafter through 2032, 14 the Medicare Payment Advisory Commis- 15 sion established under section 1805, in 16 consultation with the Medicaid and CHIP 17 Payment and Access Commission estab- 18 lished under section 1900, shall conduct 19 (and submit to the Secretary and the Com- 20 mittees on Ways and Means and Energy 21 and Commerce of the House of Represent- 22 atives and the Committee on Finance of 23 the Senate a report on) a study to deter- 24 mine how specialized MA plans for special 25 needs individuals described in subsection February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 330 1 (b)(6)(B)(ii) perform among each other 2 based on data from Healthcare Effective- 3 ness Data and Information Set (HEDIS) 4 quality measures, reported on the plan 5 level, as required under section 1852(e)(3) 6 (or such other measures or data sources 7 that are available and appropriate, such as 8 encounter data and Consumer Assessment 9 of Healthcare Providers and Systems data, 10 as specified by such Commissions as ena- 11 bling an accurate evaluation under this 12 subparagraph). Such study shall include, 13 as 14 groups of specialized MA plans for special 15 needs individuals described in subsection 16 (b)(6)(B)(ii): feasible, the following comparison 17 ‘‘(I) A comparison group of such 18 plans that are described in subpara- 19 graph (D)(i)(I). 20 ‘‘(II) A comparison group of such 21 plans that are described in subpara- 22 graph (D)(i)(II). 23 ‘‘(III) A comparison group of 24 such plans operating within the Fi- 25 nancial February 7, 2018 (10:12 p.m.) Alignment Initiative dem- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 331 1 onstration for the period for which 2 such plan is so operating and the 3 demonstration is in effect, and, in the 4 case that an integration option that is 5 not with respect to specialized MA 6 plans for special needs individuals is 7 established after the conclusion of the 8 demonstration involved. 9 ‘‘(IV) A comparison group of 10 such plans that are described in sub- 11 paragraph (D)(i)(III). 12 ‘‘(V) A comparison group of MA 13 plans, as feasible, not described in a 14 previous subclause of this clause, with 15 respect to the performance of such 16 plans for enrollees who are special 17 needs individuals described in sub- 18 section (b)(6)(B)(ii). 19 ‘‘(ii) ADDITIONAL REPORTS.—Begin- 20 ning with 2033 and every five years there- 21 after, the Medicare Payment Advisory 22 Commission, in consultation with the Med- 23 icaid and CHIP Payment and Access Com- 24 mission, shall conduct a study described in 25 clause (i).’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 332 1 (2) CONFORMING TO RESPON- COORDINATED HEALTH AMENDMENT 2 SIBILITIES 3 CARE OFFICE.—Section 4 148 (42 U.S.C. 1315b(d)) is amended by adding at 5 the end the following new paragraphs: OF FEDERAL 2602(d) of Public Law 111– 6 ‘‘(6) To act as a designated contact for States 7 under subsection (f)(8)(A) of section 1859 of the So- 8 cial Security Act (42 U.S.C. 1395w–28) with respect 9 to the integration of specialized MA plans for special 10 needs 11 (b)(6)(B)(ii) of such section. individuals described in subsection 12 ‘‘(7) To be responsible, subject to the final ap- 13 proval of the Secretary, for developing regulations 14 and guidance related to the implementation of a uni- 15 fied grievance and appeals process as described in 16 subparagraphs (B) and (C) of section 1859(f)(8) of 17 the Social Security Act (42 U.S.C. 1395w–28(f)(8)). 18 ‘‘(8) To be responsible, subject to the final ap- 19 proval of the Secretary, for developing regulations 20 and guidance related to the integration or alignment 21 of policy and oversight under the Medicare program 22 under title XVIII of such Act and the Medicaid pro- 23 gram under title XIX of such Act regarding special- 24 ized MA plans for special needs individuals described 25 in subsection (b)(6)(B)(ii) of such section 1859.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 333 1 (c) IMPROVEMENTS TO SEVERE OR DISABLING 2 CHRONIC CONDITION SNPS.— 3 (1) CARE MANAGEMENT REQUIREMENTS.—Sec- 4 tion 1859(f)(5) of the Social Security Act (42 5 U.S.C. 1395w–28(f)(5)) is amended— 6 (A) by striking ‘‘ALL 7 ments’’ and inserting ‘‘ALL 8 9 ‘‘(A) IN SNPS.—The require- SNPS.— GENERAL.—Subject to subpara- graph (B), the requirements’’; 10 (B) by redesignating subparagraphs (A) 11 and (B) as clauses (i) and (ii), respectively, and 12 indenting appropriately; and 13 (C) in clause (ii), as redesignated by sub- 14 paragraph (B), by redesignating clauses (i) 15 through (iii) as subclauses (I) through (III), re- 16 spectively, and indenting appropriately; and 17 18 19 (D) by adding at the end the following new subparagraph: ‘‘(B) IMPROVEMENTS TO CARE MANAGE- 20 MENT REQUIREMENTS FOR SEVERE OR DIS- 21 ABLING CHRONIC CONDITION SNPS.—For 22 and subsequent years, in the case of a special- 23 ized MA plan for special needs individuals de- 24 scribed in subsection (b)(6)(B)(iii), the require- February 7, 2018 (10:12 p.m.) 2020 U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 334 1 ments described in this paragraph include the 2 following: 3 ‘‘(i) The interdisciplinary team under 4 subparagraph (A)(ii)(III) includes a team 5 of providers with demonstrated expertise, 6 including training in an applicable spe- 7 cialty, in treating individuals similar to the 8 targeted population of the plan. 9 ‘‘(ii) Requirements developed by the 10 Secretary to provide face-to-face encoun- 11 ters with individuals enrolled in the plan 12 not less frequently than on an annual 13 basis. 14 ‘‘(iii) As part of the model of care 15 under clause (i) of subparagraph (A), the 16 results of the initial assessment and an- 17 nual reassessment under clause (ii)(I) of 18 such subparagraph of each individual en- 19 rolled in the plan are addressed in the indi- 20 vidual’s individualized care plan under 21 clause (ii)(II) of such subparagraph. 22 ‘‘(iv) As part of the annual evaluation 23 and approval of such model of care, the 24 Secretary shall take into account whether February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 335 1 the plan fulfilled the previous year’s goals 2 (as required under the model of care). 3 ‘‘(v) The Secretary shall establish a 4 minimum benchmark for each element of 5 the model of care of a plan. The Secretary 6 shall only approve a plan’s model of care 7 under this paragraph if each element of 8 the model of care meets the minimum 9 benchmark applicable under the preceding 10 sentence.’’. 11 (2) REVISIONS TO THE DEFINITION OF A SE- 12 VERE OR DISABLING CHRONIC CONDITIONS SPECIAL- 13 IZED NEEDS INDIVIDUAL.— 14 (A) IN GENERAL.—Section 15 1859(b)(6)(B)(iii) of the Social Security Act 16 (42 U.S.C. 1395w–28(b)(6)(B)(iii)) is amend- 17 ed— 18 19 20 (i) by striking ‘‘who have’’ and inserting ‘‘who— ‘‘(I) before January 1, 2022, 21 have’’; 22 (ii) in subclause (I), as added by 23 clause (i), by striking the period at the end 24 and inserting ‘‘; and’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 336 1 (iii) by adding at the end the fol- 2 lowing new subclause: 3 ‘‘(II) on or after January 1, 4 2022, have one or more comorbid and 5 medically complex chronic conditions 6 that is life threatening or significantly 7 limits overall health or function, have 8 a high risk of hospitalization or other 9 adverse health outcomes, and require 10 intensive care coordination and that is 11 listed under subsection (f)(9)(A).’’. 12 (B) PANEL OF CLINICAL ADVISORS.—Sec- 13 tion 1859(f) of the Social Security Act (42 14 U.S.C. 1395w–28(f)), as amended by subsection 15 (b), is amended by adding at the end the fol- 16 lowing new paragraph: 17 ‘‘(9) LIST OF CONDITIONS FOR CLARIFICATION 18 OF THE DEFINITION OF A SEVERE OR DISABLING 19 CHRONIC 20 VIDUAL.— 21 CONDITIONS ‘‘(A) IN SPECIALIZED GENERAL.—Not NEEDS INDI- later than De- 22 cember 31, 2020, and every 5 years thereafter, 23 subject to subparagraphs (B) and (C), the Sec- 24 retary shall convene a panel of clinical advisors February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 337 1 to establish and update a list of conditions that 2 meet each of the following criteria: 3 ‘‘(i) Conditions that meet the defini- 4 tion of a severe or disabling chronic condi- 5 tion under subsection (b)(6)(B)(iii) on or 6 after January 1, 2022. 7 ‘‘(ii) Conditions that require prescrip- 8 tion drugs, providers, and models of care 9 that are unique to the specific population 10 of enrollees in a specialized MA plan for 11 special needs individuals described in such 12 subsection on or after such date and— 13 ‘‘(I) as a result of access to, and 14 enrollment in, such a specialized MA 15 plan for special needs individuals, in- 16 dividuals with such condition would 17 have a reasonable expectation of slow- 18 ing or halting the progression of the 19 disease, improving health outcomes 20 and decreasing overall costs for indi- 21 viduals diagnosed with such condition 22 compared to available options of care 23 other than through such a specialized 24 MA plan for special needs individuals; 25 or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 338 1 ‘‘(II) have a low prevalence in the 2 general population of beneficiaries 3 under this title or a disproportionally 4 high per-beneficiary cost under this 5 title. 6 ‘‘(B) INCLUSION OF CERTAIN CONDI- 7 TIONS.—The 8 graph (A) shall include HIV/AIDS, end stage 9 renal disease, and chronic and disabling mental 10 conditions listed under subpara- illness. 11 ‘‘(C) REQUIREMENT.—In establishing and 12 updating the list under subparagraph (A), the 13 panel shall take into account the availability of 14 varied benefits, cost-sharing, and supplemental 15 benefits under the model described in para- 16 graph (2) of section 1859(h), including the ex- 17 pansion under paragraph (1) of such section.’’. 18 19 (d) QUALITY MEASUREMENT FOR SNPS AND AT THE DETERMINATION 20 QUALITY MEASUREMENT AT THE OF PLAN LEVEL FEASABILITY PLAN LEVEL FOR OF ALL 21 MA PLANS.—Section 1853(o) of the Social Security Act 22 (42 U.S.C. 1395w–23(o)) is amended by adding at the end 23 the following new paragraphs: 24 ‘‘(6) QUALITY 25 LEVEL FOR SNPS.— February 7, 2018 (10:12 p.m.) MEASUREMENT AT THE PLAN U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 339 1 ‘‘(A) IN GENERAL.—Subject to subpara- 2 graph (B), the Secretary may require reporting 3 of data under section 1852(e) for, and apply 4 under this subsection, quality measures at the 5 plan level for specialized MA plans for special 6 needs individuals instead of at the contract 7 level. 8 ‘‘(B) CONSIDERATIONS.—Prior to applying 9 quality measurement at the plan level under 10 this paragraph, the Secretary shall— 11 ‘‘(i) take into consideration the min- 12 imum number of enrollees in a specialized 13 MA plan for special needs individuals in 14 order to determine if a statistically signifi- 15 cant or valid measurement of quality at 16 the plan level is possible under this para- 17 graph; 18 ‘‘(ii) take into consideration the im- 19 pact of such application on plans that 20 serve a disproportionate number of individ- 21 uals dually eligible for benefits under this 22 title and under title XIX; 23 ‘‘(iii) if quality measures are reported 24 at the plan level, ensure that MA plans are February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 340 1 not required to provide duplicative infor- 2 mation; and 3 ‘‘(iv) ensure that such reporting does 4 not interfere with the collection of encoun- 5 ter data submitted by MA organizations or 6 the administration of any changes to the 7 program under this part as a result of the 8 collection of such data. 9 ‘‘(C) APPLICATION.—If the Secretary ap- 10 plies quality measurement at the plan level 11 under this paragraph— 12 ‘‘(i) such quality measurement may 13 include Medicare Health Outcomes Survey 14 (HOS), Healthcare Effectiveness Data and 15 Information Set (HEDIS), Consumer As- 16 sessment of Healthcare Providers and Sys- 17 tems (CAHPS) measures and quality 18 measures under part D; and 19 ‘‘(ii) the Secretary shall consider ap- 20 plying administrative actions, such as rem- 21 edies described in section 1857(g)(2), at 22 the plan level. 23 ‘‘(7) DETERMINATION OF FEASIBILITY OF 24 QUALITY MEASUREMENT AT THE PLAN LEVEL FOR 25 ALL MA PLANS.— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 341 1 ‘‘(A) DETERMINATION OF FEASIBILITY.— 2 The Secretary shall determine the feasibility of 3 requiring reporting of data under section 4 1852(e) for, and applying under this subsection, 5 quality measures at the plan level for all MA 6 plans under this part. 7 ‘‘(B) CONSIDERATION OF CHANGE.—After 8 making a determination under subparagraph 9 (A), the Secretary shall consider requiring such 10 reporting and applying such quality measures 11 at the plan level as described in such subpara- 12 graph’’. 13 (e) GAO STUDY 14 TEGRATION AND REPORT ON STATE-LEVEL IN- BETWEEN DUAL SNPS AND MEDICAID.— 15 (1) STUDY.—The Comptroller General of the 16 United States (in this subsection referred to as the 17 ‘‘Comptroller General’’) shall conduct a study on 18 State-level integration between specialized MA plans 19 for special needs individuals described in subsection 20 (b)(6) (B)(ii) of section 1859 of the Social Security 21 Act (42 U.S.C. 1395w–28) and the Medicaid pro- 22 gram under title XIX of such Act (42 U.S.C. 1396 23 et seq.). Such study shall include an analysis of the 24 following: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 342 1 (A) The characteristics of States in which 2 the State agency responsible for administering 3 the State plan under such title XIX has a con- 4 tract with such a specialized MA plan and that 5 delivers long-term services and supports under 6 the State plan under such title XIX through a 7 managed care program, including the require- 8 ments under such State plan with respect to 9 long-term services and supports. 10 11 12 (B) The types of such specialized MA plans, which may include the following: (i) A plan described in section 13 1853(a)(1)(B)(iv)(II) of such Act (42 14 U.S.C. 1395w–23(a)(1)(B)(iv)(II)). 15 (ii) A plan that meets the require- 16 ments described in subsection (f)(3)(D) of 17 such section 1859. 18 (iii) A plan described in clause (ii) 19 that also meets additional requirements es- 20 tablished by the State. 21 (C) The characteristics of individuals en- 22 rolled in such specialized MA plans. 23 (D) As practicable, the following with re- 24 spect to State programs for the delivery of long- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 343 1 term services and supports under such title 2 XIX through a managed care program: 3 (i) Which populations of individuals 4 are eligible to receive such services and 5 supports. 6 (ii) Whether all such services and sup- 7 ports are provided on a capitated basis or 8 if any of such services and supports are 9 carved out and provided through fee-for 10 service. 11 (E) As practicable, how the availability 12 and variation of integration arrangements of 13 such specialized MA plans offered in States af- 14 fects spending, service delivery options, access 15 to community-based care, and utilization of 16 care. 17 (F) The efforts of State Medicaid pro- 18 grams to transition dually-eligible beneficiaries 19 receiving 20 (LTSS) from institutional settings to home and 21 community-based settings and related financial 22 impacts of such transitions. long-term services and supports 23 (G) Barriers and opportunities for making 24 further progress on dual integration, as well as 25 recommendations for legislation or administra- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 344 1 tive action to expedite or refine pathways to- 2 ward fully integrated care. 3 (2) REPORT.—Not later than 2 years after the 4 date of the enactment of this Act, the Comptroller 5 General shall submit to Congress a report containing 6 the results of the study conducted under paragraph 7 (1), together with recommendations for such legisla- 8 tion and administrative action as the Comptroller 9 General determines appropriate. 11 Subtitle C—Expanding Innovation and Technology 12 SEC. 50321. ADAPTING BENEFITS TO MEET THE NEEDS OF 13 CHRONICALLY ILL MEDICARE ADVANTAGE 14 ENROLLEES. 10 15 Section 1859 of the Social Security Act (42 U.S.C. 16 1395w–28) is amended by adding at the end the following 17 new subsection: 18 ‘‘(h) NATIONAL TESTING OF MEDICARE ADVANTAGE 19 VALUE-BASED INSURANCE DESIGN MODEL.— 20 ‘‘(1) IN GENERAL.—In implementing the Medi- 21 care Advantage Value-Based Insurance Design 22 model that is being tested under section 1115A(b), 23 the Secretary shall revise the testing of the model 24 under such section to cover, effective not later than 25 January 1, 2020, all States. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 345 1 ‘‘(2) TERMINATION AND MODIFICATION PROVI- 2 SION NOT APPLICABLE UNTIL JANUARY 1, 2022.— 3 The provisions of section 1115A(b)(3)(B) shall apply 4 to the Medicare Advantage Value-Based Insurance 5 Design model, including such model as revised under 6 paragraph (1), beginning January 1, 2022, but shall 7 not apply to such model, as so revised, prior to such 8 date. 9 ‘‘(3) FUNDING.—The Secretary shall allocate 10 funds made available under section 1115A(f)(1) to 11 design, implement, and evaluate the Medicare Ad- 12 vantage Value-Based Insurance Design model, as re- 13 vised under paragraph (1).’’. 14 SEC. 50322. EXPANDING SUPPLEMENTAL BENEFITS TO 15 MEET THE NEEDS OF CHRONICALLY ILL 16 MEDICARE ADVANTAGE ENROLLEES. 17 (a) IN GENERAL.—Section 1852(a)(3) of the Social 18 Security Act (42 U.S.C. 1395w–22(a)(3)) is amended— 19 (1) in subparagraph (A), by striking ‘‘Each’’ 20 and inserting ‘‘Subject to subparagraph (D), each’’; 21 and 22 23 February 7, 2018 (10:12 p.m.) (2) by adding at the end the following new subparagraph: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 346 1 ‘‘(D) EXPANDING SUPPLEMENTAL BENE- 2 FITS TO MEET THE NEEDS OF CHRONICALLY 3 ILL ENROLLEES.— 4 ‘‘(i) IN GENERAL.—For plan year 5 2020 and subsequent plan years, in addi- 6 tion to any supplemental health care bene- 7 fits otherwise provided under this para- 8 graph, an MA plan, including a specialized 9 MA plan for special needs individuals (as 10 defined in section 1859(b)(6)), may pro- 11 vide supplemental benefits described in 12 clause (ii) to a chronically ill enrollee (as 13 defined in clause (iii)). 14 15 16 ‘‘(ii) SUPPLEMENTAL BENEFITS DE- SCRIBED.— ‘‘(I) IN GENERAL.—Supplemental 17 benefits described in this clause are 18 supplemental benefits that, with re- 19 spect to a chronically ill enrollee, have 20 a reasonable expectation of improving 21 or maintaining the health or overall 22 function of the chronically ill enrollee 23 and may not be limited to being pri- 24 marily health related benefits. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 347 1 ‘‘(II) AUTHORITY TO WAIVE UNI- 2 FORMITY REQUIREMENTS.—The 3 retary may, only with respect to sup- 4 plemental 5 chronically ill enrollee under this sub- 6 paragraph, waive the uniformity re- 7 quirements under this part, as deter- 8 mined appropriate by the Secretary. 9 ‘‘(iii) CHRONICALLY benefits provided ILL Sec- to a ENROLLEE 10 DEFINED.—In 11 ‘chronically ill enrollee’ means an enrollee 12 in an MA plan that the Secretary deter- 13 mines— this subparagraph, the term 14 ‘‘(I) has one or more comorbid 15 and medically complex chronic condi- 16 tions that is life threatening or signifi- 17 cantly limits the overall health or 18 function of the enrollee; 19 ‘‘(II) has a high risk of hos- 20 pitalization or other adverse health 21 outcomes; and 22 23 24 February 7, 2018 (10:12 p.m.) ‘‘(III) requires intensive care coordination.’’. (b) GAO STUDY AND REPORT.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 348 1 (1) STUDY.—The Comptroller General of the 2 United States (in this subsection referred to as the 3 ‘‘Comptroller General’’) shall conduct a study on 4 supplemental benefits provided to enrollees in Medi- 5 care Advantage plans under part C of title XVIII of 6 the Social Security Act, including specialized MA 7 plans for special needs individuals (as defined in sec- 8 tion 1859(b)(6) of such Act (42 U.S.C. 1395w– 9 28(b)(6))). To the extend data are available, such 10 study shall include an analysis of the following: 11 (A) The type of supplemental benefits pro- 12 vided to such enrollees, the total number of en- 13 rollees receiving each supplemental benefit, and 14 whether the supplemental benefit is covered by 15 the standard benchmark cost of the benefit or 16 with an additional premium. 17 18 (B) The frequency in which supplemental benefits are utilized by such enrollees. 19 20 (C) The impact supplemental benefits have on— 21 (i) indicators of the quality of care re- 22 ceived by such enrollees, including overall 23 health and function of the enrollees; 24 (ii) the utilization of items and serv- 25 ices for which benefits are available under February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 349 1 the original Medicare fee-for-service pro- 2 gram option under parts A and B of such 3 title XVIII by such enrollees; and 4 (iii) the amount of the bids submitted 5 by Medicare Advantage Organizations for 6 Medicare Advantage plans under such part 7 C. 8 (2) CONSULTATION.—In conducting the study 9 under paragraph (1), the Comptroller General shall, 10 as necessary, consult with the Centers for Medicare 11 & Medicaid Services and Medicare Advantage orga- 12 nizations offering Medicare Advantage plans. 13 (3) REPORT.—Not later than 5 years after the 14 date of the enactment of this Act, the Comptroller 15 General shall submit to Congress a report containing 16 the results of the study conducted under paragraph 17 (1), together with recommendations for such legisla- 18 tion and administrative action as the Comptroller 19 General determines appropriate. 20 SEC. 50323. INCREASING CONVENIENCE FOR MEDICARE AD- 21 VANTAGE 22 HEALTH. 23 ENROLLEES THROUGH (a) IN GENERAL.—Section 1852 of the Social Secu- 24 rity Act (42 U.S.C. 1395w–22) is amended— February 7, 2018 (10:12 p.m.) TELE- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 350 1 2 3 (1) in subsection (a)(1)(B)(i), by inserting ‘‘, subject to subsection (m),’’ after ‘‘means’’; and (2) by adding at the end the following new sub- 4 section: 5 ‘‘(m) PROVISION OF ADDITIONAL TELEHEALTH 6 BENEFITS.— 7 ‘‘(1) MA PLAN OPTION.—For plan year 2020 8 and subsequent plan years, subject to the require- 9 ments of paragraph (3), an MA plan may provide 10 additional telehealth benefits (as defined in para- 11 graph (2)) to individuals enrolled under this part. 12 13 14 15 ‘‘(2) ADDITIONAL TELEHEALTH BENEFITS DE- FINED.— ‘‘(A) IN GENERAL.—For purposes of this subsection and section 1854: 16 ‘‘(i) DEFINITION.—The term ‘addi- 17 tional telehealth benefits’ means services— 18 ‘‘(I) for which benefits are avail- 19 able under part B, including services 20 for which payment is not made under 21 section 1834(m) due to the conditions 22 for payment under such section; and 23 ‘‘(II) that are identified for such 24 year as clinically appropriate to fur- 25 nish using electronic information and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 351 1 telecommunications technology when a 2 physician 3 1861(r)) or practitioner (described in 4 section 1842(b)(18)(C)) providing the 5 service is not at the same location as 6 the plan enrollee. 7 ‘‘(ii) EXCLUSION (as 8 FRASTRUCTURE 9 MENTS.—The defined in section OF CAPITAL AND IN- COSTS AND INVEST- term ‘additional telehealth 10 benefits’ does not include capital and infra- 11 structure costs and investments relating to 12 such benefits. 13 ‘‘(B) PUBLIC COMMENT.—Not later than 14 November 30, 2018, the Secretary shall solicit 15 comments on— 16 ‘‘(i) what types of items and services 17 (including those provided through supple- 18 mental health care benefits, such as remote 19 patient 20 store and forward technologies, and other 21 non-face-to-face communication) should be 22 considered to be additional telehealth bene- 23 fits; and February 7, 2018 (10:12 p.m.) monitoring, secure messaging, U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 352 1 ‘‘(ii) the requirements for the provi- 2 sion or furnishing of such benefits (such as 3 training and coordination requirements). 4 ‘‘(3) REQUIREMENTS FOR ADDITIONAL TELE- 5 HEALTH BENEFITS.—The Secretary shall specify re- 6 quirements for the provision or furnishing of addi- 7 tional telehealth benefits, including with respect to 8 the following: 9 ‘‘(A) Physician or practitioner qualifica- 10 tions (other than licensure) and other require- 11 ments such as specific training. 12 ‘‘(B) Factors necessary for the coordina- 13 tion of such benefits with other items and serv- 14 ices including those furnished in-person. 15 ‘‘(C) Such other areas as determined by 16 the Secretary. 17 ‘‘(4) ENROLLEE CHOICE.—If an MA plan pro- 18 vides a service as an additional telehealth benefit (as 19 defined in paragraph (2))— 20 ‘‘(A) the MA plan shall also provide access 21 to such benefit through an in-person visit (and 22 not only as an additional telehealth benefit); 23 and 24 ‘‘(B) an individual enrollee shall have dis- 25 cretion as to whether to receive such service February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 353 1 through the in-person visit or as an additional 2 telehealth benefit. 3 ‘‘(5) TREATMENT UNDER MA.—For purposes of 4 this subsection and section 1854, if a plan provides 5 additional telehealth benefits, such additional tele- 6 health benefits shall be treated as if they were bene- 7 fits under the original Medicare fee-for-service pro- 8 gram option. 9 ‘‘(6) CONSTRUCTION.—Nothing in this sub- 10 section shall be construed as affecting the require- 11 ment under subsection (a)(1) that MA plans provide 12 enrollees with items and services (other than hospice 13 care) for which benefits are available under parts A 14 and B, including benefits available under section 15 1834(m).’’. 16 (b) CLARIFICATION REGARDING INCLUSION IN BID 17 AMOUNT.—Section 1854(a)(6)(A)(ii)(I) of the Social Se18 curity Act (42 U.S.C. 1395w–24(a)(6)(A)(ii)(I)) is 19 amended by inserting ‘‘, including, for plan year 2020 and 20 subsequent plan years, the provision of additional tele21 health benefits as described in section 1852(m)’’ before 22 the semicolon at the end. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 354 1 SEC. 50324. PROVIDING ACCOUNTABLE CARE ORGANIZA- 2 TIONS THE ABILITY TO EXPAND THE USE OF 3 TELEHEALTH. 4 (a) IN GENERAL.—Section 1899 of the Social Secu- 5 rity Act (42 U.S.C. 1395jjj) is amended by adding at the 6 end the following new subsection: 7 8 ‘‘(l) PROVIDING ACOS THE 9 THE ABILITY TO EXPAND USE OF TELEHEALTH SERVICES.— ‘‘(1) IN GENERAL.—In the case of telehealth 10 services for which payment would otherwise be made 11 under this title furnished on or after January 1, 12 2020, for purposes of this subsection only, the fol- 13 lowing shall apply with respect to such services fur- 14 nished by a physician or practitioner participating in 15 an applicable ACO (as defined in paragraph (2)) to 16 a Medicare fee-for-service beneficiary assigned to the 17 applicable ACO: 18 ‘‘(A) INCLUSION OF HOME AS ORIGINATING 19 SITE.—Subject 20 beneficiary shall be treated as an originating 21 site described in section 1834(m)(4)(C)(ii). to paragraph (3), the home of a 22 ‘‘(B) NO 23 LIMITATION.—The 24 section 1834(m)(4)(C)(i) shall not apply with 25 respect to an originating site described in sec- 26 tion 1834(m)(4)(C)(ii) (including the home of a February 7, 2018 (10:12 p.m.) APPLICATION OF GEOGRAPHIC geographic limitation under U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 355 1 beneficiary under subparagraph (A)), subject to 2 State licensing requirements. 3 ‘‘(2) DEFINITIONS.—In this subsection: 4 ‘‘(A) APPLICABLE ACO.—The term ‘appli- 5 cable ACO’ means an ACO participating in a 6 model tested or expanded under section 1115A 7 or under this section— 8 9 ‘‘(i) that operates under a two-sided model— 10 ‘‘(I) described in section 11 425.600(a) of title 42, Code of Fed- 12 eral Regulations; or 13 ‘‘(II) tested or expanded under 14 section 1115A; and 15 ‘‘(ii) for which Medicare fee-for-serv- 16 ice beneficiaries are assigned to the ACO 17 using a prospective assignment method, as 18 determined appropriate by the Secretary. 19 ‘‘(B) HOME.—The term ‘home’ means, 20 with respect to a Medicare fee-for-service bene- 21 ficiary, the place of residence used as the home 22 of the beneficiary. 23 ‘‘(3) TELEHEALTH SERVICES RECEIVED IN THE 24 HOME.—In 25 in paragraph (1) where the home of a Medicare fee- February 7, 2018 (10:12 p.m.) the case of telehealth services described U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 356 1 for-service beneficiary is the originating site, the fol- 2 lowing shall apply: 3 ‘‘(A) NO FACILITY FEE.—There shall be 4 no facility fee paid to the originating site under 5 section 1834(m)(2)(B). 6 ‘‘(B) EXCLUSION OF CERTAIN SERVICES.— 7 No payment may be made for such services that 8 are inappropriate to furnish in the home setting 9 such as services that are typically furnished in 10 11 inpatient settings such as a hospital.’’. (b) STUDY AND REPORT.— 12 (1) STUDY.— 13 (A) IN GENERAL.—The Secretary of 14 Health and Human Services (in this subsection 15 referred to as the ‘‘Secretary’’) shall conduct a 16 study on the implementation of section 1899(l) 17 of the Social Security Act, as added by sub- 18 section (a). Such study shall include an analysis 19 of the utilization of, and expenditures for, tele- 20 health services under such section. 21 (B) COLLECTION OF DATA.—The Sec- 22 retary may collect such data as the Secretary 23 determines necessary to carry out the study 24 under this paragraph. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 357 1 (2) REPORT.—Not later than January 1, 2026, 2 the Secretary shall submit to Congress a report con- 3 taining the results of the study conducted under 4 paragraph (1), together with recommendations for 5 such legislation and administrative action as the 6 Secretary determines appropriate. 7 SEC. 50325. EXPANDING THE USE OF TELEHEALTH FOR IN- 8 9 DIVIDUALS WITH STROKE. Section 1834(m) of the Social Security Act (42 10 U.S.C. 1395m(m)), as amended by section 50302(b)(1), 11 is amended— 12 (1) in paragraph (4)(C)(i), in the matter pre- 13 ceding subclause (I), by striking ‘‘The term’’ and in- 14 serting ‘‘Except as provided in paragraph (6), the 15 term’’; and 16 17 18 19 20 (2) by adding at the end the following new paragraph: ‘‘(6) TREATMENT OF STROKE TELEHEALTH SERVICES.— ‘‘(A) NON-APPLICATION OF ORIGINATING 21 SITE REQUIREMENTS.—The 22 scribed in paragraph (4)(C) shall not apply with 23 respect to telehealth services furnished on or 24 after January 1, 2019, for purposes of diag- 25 nosis, evaluation, or treatment of symptoms of February 7, 2018 (10:12 p.m.) requirements de- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 358 1 an acute stroke, as determined by the Sec- 2 retary. 3 ‘‘(B) INCLUSION OF CERTAIN SITES.— 4 With respect to telehealth services described in 5 subparagraph (A), the term ‘originating site’ 6 shall include any hospital (as defined in section 7 1861(e)) or critical access hospital (as defined 8 in section 1861(mm)(1)), any mobile stroke 9 unit (as defined by the Secretary), or any other 10 site determined appropriate by the Secretary, at 11 which the eligible telehealth individual is located 12 at the time the service is furnished via a tele- 13 communications system. 14 ‘‘(C) NO ORIGINATING SITE FACILITY FEE 15 FOR NEW SITES.—No 16 under paragraph (2)(B) to an originating site 17 with respect to a telehealth service described in 18 subparagraph (A) if the originating site does 19 not otherwise meet the requirements for an 20 originating site under paragraph (4)(C).’’. February 7, 2018 (10:12 p.m.) facility fee shall be paid U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 359 2 Subtitle D—Identifying the Chronically Ill Population 3 SEC. 50331. PROVIDING FLEXIBILITY FOR BENEFICIARIES 4 TO BE PART OF AN ACCOUNTABLE CARE OR- 5 GANIZATION. 1 6 Section 1899(c) of the Social Security Act (42 U.S.C. 7 1395jjj(c)) is amended— 8 (1) by redesignating paragraphs (1) and (2) as 9 subparagraphs (A) and (B), respectively, and indent- 10 11 12 13 14 15 16 17 18 ing appropriately; (2) by striking ‘‘ACOS.—The Secretary’’ and inserting ‘‘ACOS.— ‘‘(1) IN GENERAL.—Subject to paragraph (2), the Secretary’’; and (3) by adding at the end the following new paragraph: ‘‘(2) PROVIDING FLEXIBILITY.— ‘‘(A) CHOICE OF PROSPECTIVE ASSIGN- 19 MENT.—For 20 for agreements entered into or renewed on or 21 after January 1, 2020), in the case where an 22 ACO established under the program is in a 23 Track that provides for the retrospective assign- 24 ment of Medicare fee-for-service beneficiaries to 25 the ACO, the Secretary shall permit the ACO February 7, 2018 (10:12 p.m.) each agreement period (effective U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 360 1 to choose to have Medicare fee-for-service bene- 2 ficiaries assigned prospectively, rather than ret- 3 rospectively, to the ACO for an agreement pe- 4 riod. 5 ‘‘(B) ASSIGNMENT BASED ON VOLUNTARY 6 IDENTIFICATION BY MEDICARE FEE-FOR-SERV- 7 ICE BENEFICIARIES.— 8 ‘‘(i) IN GENERAL.—For performance 9 year 2018 and each subsequent perform- 10 ance year, if a system is available for elec- 11 tronic designation, the Secretary shall per- 12 mit a Medicare fee-for-service beneficiary 13 to voluntarily identify an ACO professional 14 as the primary care provider of the bene- 15 ficiary for purposes of assigning such bene- 16 ficiary to an ACO, as determined by the 17 Secretary. 18 ‘‘(ii) NOTIFICATION PROCESS.—The 19 Secretary shall establish a process under 20 which a Medicare fee-for-service bene- 21 ficiary is— 22 ‘‘(I) notified of their ability to 23 make an identification described in 24 clause (i); and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 361 1 ‘‘(II) informed of the process by 2 which they may make and change 3 such identification. 4 ‘‘(iii) SUPERSEDING CLAIMS-BASED 5 ASSIGNMENT.—A 6 by a Medicare fee-for-service beneficiary 7 under this subparagraph shall supersede 8 any claims-based assignment otherwise de- 9 termined by the Secretary.’’. 10 12 Subtitle E—Empowering Individuals and Caregivers in Care Delivery 13 SEC. 50341. ELIMINATING BARRIERS TO CARE COORDINA- 14 TION UNDER ACCOUNTABLE CARE ORGANI- 15 ZATIONS. 11 16 voluntary identification (a) IN GENERAL.—Section 1899 of the Social Secu- 17 rity Act (42 U.S.C. 1395jjj), as amended by section 18 50324(a), is amended— 19 20 (1) in subsection (b)(2), by adding at the end the following new subparagraph: 21 ‘‘(I) An ACO that seeks to operate an 22 ACO Beneficiary Incentive Program pursuant 23 to subsection (m) shall apply to the Secretary 24 at such time, in such manner, and with such in- 25 formation as the Secretary may require.’’; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 362 1 (2) by adding at the end the following new sub- 2 section: 3 ‘‘(m) AUTHORITY TO PROVIDE INCENTIVE PAY- 4 MENTS TO 5 FYING BENEFICIARIES WITH RESPECT TO QUALI- PRIMARY CARE SERVICES.— 6 ‘‘(1) PROGRAM.— 7 ‘‘(A) IN GENERAL.—In order to encourage 8 Medicare fee-for-service beneficiaries to obtain 9 medically necessary primary care services, an 10 ACO participating under this section under a 11 payment model described in clause (i) or (ii) of 12 paragraph (2)(B) may apply to establish an 13 ACO Beneficiary Incentive Program to provide 14 incentive payments to such beneficiaries who 15 are furnished qualifying services in accordance 16 with this subsection. The Secretary shall permit 17 such an ACO to establish such a program at 18 the Secretary’s discretion and subject to such 19 requirements, including program integrity re- 20 quirements, as the Secretary determines nec- 21 essary. 22 ‘‘(B) IMPLEMENTATION.—The Secretary 23 shall implement this subsection on a date deter- 24 mined appropriate by the Secretary. Such date February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 363 1 shall be no earlier than January 1, 2019, and 2 no later than January 1, 2020. 3 ‘‘(2) CONDUCT 4 ‘‘(A) OF PROGRAM.— DURATION.—Subject to subpara- 5 graph (H), an ACO Beneficiary Incentive Pro- 6 gram established under this subsection shall be 7 conducted for such period (of not less than 1 8 year) as the Secretary may approve. 9 ‘‘(B) SCOPE.—An ACO Beneficiary Incen- 10 tive Program established under this subsection 11 shall provide incentive payments to all of the 12 following Medicare fee-for-service beneficiaries 13 who are furnished qualifying services by the 14 ACO: 15 ‘‘(i) With respect to the Track 2 and 16 Track 3 payment models described in sec- 17 tion 425.600(a) of title 42, Code of Fed- 18 eral Regulations (or in any successor regu- 19 lation), 20 ficiaries who are preliminarily prospectively 21 or prospectively assigned (or otherwise as- 22 signed, as determined by the Secretary) to 23 the ACO. Medicare fee-for-service bene- 24 ‘‘(ii) With respect to any future pay- 25 ment models involving two-sided risk, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 364 1 Medicare fee-for-service beneficiaries who 2 are assigned to the ACO, as determined by 3 the Secretary. 4 ‘‘(C) QUALIFYING SERVICE.—For purposes 5 of this subsection, a qualifying service is a pri- 6 mary care service, as defined in section 425.20 7 of title 42, Code of Federal Regulations (or in 8 any successor regulation), with respect to which 9 coinsurance applies under part B, furnished 10 through an ACO by— 11 ‘‘(i) an ACO professional described in 12 subsection (h)(1)(A) who has a primary 13 care specialty designation included in the 14 definition of primary care physician under 15 section 425.20 of title 42, Code of Federal 16 Regulations (or any successor regulation); 17 ‘‘(ii) an ACO professional described in 18 subsection (h)(1)(B); or 19 ‘‘(iii) a Federally qualified health cen- 20 ter or rural health clinic (as such terms 21 are defined in section 1861(aa)). 22 ‘‘(D) INCENTIVE PAYMENTS.—An incentive 23 payment made by an ACO pursuant to an ACO 24 Beneficiary 25 under this subsection shall be— February 7, 2018 (10:12 p.m.) Incentive Program established U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 365 1 ‘‘(i) in an amount up to $20, with 2 such maximum amount updated annually 3 by the percentage increase in the consumer 4 price index for all urban consumers 5 (United States city average) for the 12- 6 month period ending with June of the pre- 7 vious year; 8 ‘‘(ii) in the same amount for each 9 Medicare fee-for-service beneficiary de- 10 scribed in clause (i) or (ii) of subparagraph 11 (B) without regard to enrollment of such a 12 beneficiary in a medicare supplemental pol- 13 icy (described in section 1882(g)(1)), in a 14 State Medicaid plan under title XIX or a 15 waiver of such a plan, or in any other 16 health insurance policy or health benefit 17 plan; 18 ‘‘(iii) made for each qualifying service 19 furnished to such a beneficiary described 20 in clause (i) or (ii) of subparagraph (B) 21 during a period specified by the Secretary; 22 and 23 ‘‘(iv) made no later than 30 days after 24 a qualifying service is furnished to such a February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 366 1 beneficiary described in clause (i) or (ii) of 2 subparagraph (B). 3 ‘‘(E) NO 4 SECRETARY.—The 5 any separate payment to an ACO for the costs, 6 including incentive payments, of carrying out 7 an ACO Beneficiary Incentive Program estab- 8 lished under this subsection. Nothing in this 9 subparagraph shall be construed as prohibiting 10 an ACO from using shared savings received 11 under this section to carry out an ACO Bene- 12 ficiary Incentive Program. 13 ‘‘(F) NO SEPARATE PAYMENTS FROM THE Secretary shall not make APPLICATION TO SHARED SAV- 14 INGS CALCULATION.—Incentive 15 by an ACO under this subsection shall be dis- 16 regarded for purposes of calculating bench- 17 marks, estimated average per capita Medicare 18 expenditures, and shared savings under this 19 section. 20 ‘‘(G) REPORTING payments made REQUIREMENTS.—An 21 ACO conducting an ACO Beneficiary Incentive 22 Program under this subsection shall, at such 23 times and in such format as the Secretary may 24 require, report to the Secretary such informa- 25 tion and retain such documentation as the Sec- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 367 1 retary may require, including the amount and 2 frequency of incentive payments made and the 3 number of Medicare fee-for-service beneficiaries 4 receiving such payments. 5 ‘‘(H) TERMINATION.—The Secretary may 6 terminate an ACO Beneficiary Incentive Pro- 7 gram established under this subsection at any 8 time for reasons determined appropriate by the 9 Secretary. 10 ‘‘(3) EXCLUSION OF INCENTIVE PAYMENTS.— 11 Any payment made under an ACO Beneficiary In- 12 centive Program established under this subsection 13 shall not be considered income or resources or other- 14 wise taken into account for purposes of— 15 ‘‘(A) determining eligibility for benefits or 16 assistance (or the amount or extent of benefits 17 or assistance) under any Federal program or 18 under any State or local program financed in 19 whole or in part with Federal funds; or 20 ‘‘(B) any Federal or State laws relating to 21 taxation.’’; 22 (3) in subsection (e), by inserting ‘‘, including 23 an ACO Beneficiary Incentive Program under sub- 24 sections (b)(2)(I) and (m)’’ after ‘‘the program’’; 25 and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 368 1 (4) in subsection (g)(6), by inserting ‘‘or of an 2 ACO Beneficiary Incentive Program under sub- 3 sections (b)(2)(I) and (m)’’ after ‘‘under subsection 4 (d)(4)’’. 5 (b) AMENDMENT TO SECTION 1128B.—Section 6 1128B(b)(3) of the Social Security Act (42 U.S.C. 1320a– 7 7b(b)(3)) is amended— 8 9 10 11 12 13 (1) by striking ‘‘and’’ at the end of subparagraph (I); (2) by striking the period at the end of subparagraph (J) and inserting ‘‘; and’’; and (3) by adding at the end the following new subparagraph: 14 ‘‘(K) an incentive payment made to a 15 Medicare fee-for-service beneficiary by an ACO 16 under an ACO Beneficiary Incentive Program 17 established under subsection (m) of section 18 1899, if the payment is made in accordance 19 with the requirements of such subsection and 20 meets such other conditions as the Secretary 21 may establish.’’. 22 (c) EVALUATION AND REPORT.— 23 (1) EVALUATION.—The Secretary of Health 24 and Human Services (in this subsection referred to 25 as the ‘‘Secretary’’) shall conduct an evaluation of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 369 1 the ACO Beneficiary Incentive Program established 2 under subsections (b)(2)(I) and (m) of section 1899 3 of the Social Security Act (42 U.S.C. 1395jjj), as 4 added by subsection (a). The evaluation shall include 5 an analysis of the impact of the implementation of 6 the Program on expenditures and beneficiary health 7 outcomes under title XVIII of the Social Security 8 Act (42 U.S.C. 1395 et seq.). 9 (2) REPORT.—Not later than October 1, 2023, 10 the Secretary shall submit to Congress a report con- 11 taining the results of the evaluation under para- 12 graph (1), together with recommendations for such 13 legislation and administrative action as the Sec- 14 retary determines appropriate. 15 SEC. 50342. GAO STUDY AND REPORT ON LONGITUDINAL 16 COMPREHENSIVE CARE PLANNING SERVICES 17 UNDER MEDICARE PART B. 18 (a) STUDY.—The Comptroller General shall conduct 19 a study on the establishment under part B of the Medicare 20 program under title XVIII of the Social Security Act of 21 a payment code for a visit for longitudinal comprehensive 22 care planning services. Such study shall include an anal23 ysis of the following to the extent such information is 24 available: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 370 1 (1) The frequency with which services similar to 2 longitudinal comprehensive care planning services 3 are furnished to Medicare beneficiaries, which pro- 4 viders of services and suppliers are furnishing those 5 services, whether Medicare reimbursement is being 6 received for those services, and, if so, through which 7 codes those services are being reimbursed. 8 (2) Whether, and the extent to which, longitu- 9 dinal comprehensive care planning services would 10 overlap, and could therefore result in duplicative 11 payment, with services covered under the hospice 12 benefit as well as the chronic care management code, 13 evaluation and management codes, or other codes 14 that already exist under part B of the Medicare pro- 15 gram. 16 (3) Any barriers to hospitals, skilled nursing fa- 17 cilities, hospice programs, home health agencies, and 18 other applicable providers working with a Medicare 19 beneficiary to engage in the care planning process 20 and complete the necessary documentation to sup- 21 port the treatment and care plan of the beneficiary 22 and provide such documentation to other providers 23 and the beneficiary or the beneficiary’s representa- 24 tive. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 371 1 (4) Any barriers to providers, other than the 2 provider furnishing longitudinal comprehensive care 3 planning services, accessing the care plan and asso- 4 ciated documentation for use related to the care of 5 the Medicare beneficiary. 6 (5) Potential options for ensuring that applica- 7 ble providers are notified of a patient’s existing lon- 8 gitudinal care plan and that applicable providers 9 consider that plan in making their treatment deci- 10 sions, and what the challenges might be in imple- 11 menting such options. 12 (6) Stakeholder’s views on the need for the de- 13 velopment of quality metrics with respect to longitu- 14 dinal comprehensive care planning services, such as 15 measures related to— 16 (A) the process of eliciting input from the 17 Medicare beneficiary or from a legally author- 18 ized representative and documenting in the 19 medical record the patient-directed care plan; 20 (B) the effectiveness and patient- 21 centeredness of the care plan in organizing de- 22 livery of services consistent with the plan; 23 (C) the availability of the care plan and as- 24 sociated documentation to other providers that 25 care for the beneficiary; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 372 1 (D) the extent to which the beneficiary re- 2 ceived services and support that is free from 3 discrimination based on advanced age, disability 4 status, or advanced illness. 5 (7) Stakeholder’s views on how such quality 6 metrics would provide information on— 7 8 (A) the goals, values, and preferences of the beneficiary; 9 (B) the documentation of the care plan; 10 11 12 13 (C) services furnished to the beneficiary; and (D) outcomes of treatment. (8) Stakeholder’s views on— 14 (A) the type of training and education 15 needed for applicable providers, individuals, and 16 caregivers in order to facilitate longitudinal 17 comprehensive care planning services; 18 (B) the types of providers of services and 19 suppliers that should be included in the inter- 20 disciplinary team of an applicable provider; and 21 (C) the characteristics of Medicare bene- 22 ficiaries that would be most appropriate to re- 23 ceive longitudinal comprehensive care planning 24 services, such as individuals with advanced dis- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 373 1 ease and individuals who need assistance with 2 multiple activities of daily living. 3 (9) Stakeholder’s views on the frequency with 4 which longitudinal comprehensive care planning 5 services should be furnished. 6 (b) REPORT.—Not later than 18 months after the 7 date of the enactment of this Act, the Comptroller General 8 shall submit to Congress a report containing the results 9 of the study conducted under subsection (a), together with 10 recommendations for such legislation and administrative 11 action as the Comptroller General determines appropriate. 12 13 (c) DEFINITIONS.—In this section: (1) APPLICABLE PROVIDER.—The term ‘‘appli- 14 cable provider’’ means a hospice program (as defined 15 in subsection (dd)(2) of section 1861 of the Social 16 Security Act (42 U.S.C. 1395ww)) or other provider 17 of services (as defined in subsection (u) of such sec- 18 tion) or supplier (as defined in subsection (d) of 19 such section) that— 20 (A) furnishes longitudinal comprehensive 21 care planning services through an interdiscipli- 22 nary team; and 23 24 February 7, 2018 (10:12 p.m.) (B) meets such other requirements as the Secretary may determine to be appropriate. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 374 1 (2) COMPTROLLER GENERAL.—The term 2 ‘‘Comptroller General’’ means the Comptroller Gen- 3 eral of the United States. 4 5 (3) term (A) includes the personnel described in subsection (dd)(2)(B)(i) of such section 1861; 8 9 TEAM.—The ‘‘interdisciplinary team’’ means a group that— 6 7 INTERDISCIPLINARY (B) may include a chaplain, minister, or other clergy; and 10 (C) may include other direct care per- 11 sonnel. 12 (4) LONGITUDINAL COMPREHENSIVE CARE 13 PLANNING SERVICES.—The 14 prehensive care planning services’’ means a vol- 15 untary shared decisionmaking process that is fur- 16 nished by an applicable provider through an inter- 17 disciplinary team and includes a conversation with 18 Medicare beneficiaries who have received a diagnosis 19 of a serious or life-threatening illness. The purpose 20 of such services is to discuss a longitudinal care plan 21 that addresses the progression of the disease, treat- 22 ment options, the goals, values, and preferences of 23 the beneficiary, and the availability of other re- 24 sources and social supports that may reduce the February 7, 2018 (10:12 p.m.) term ‘‘longitudinal com- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 375 1 beneficiary’s health risks and promote self-manage- 2 ment and shared decisionmaking. 3 (5) SECRETARY.—The term ‘‘Secretary’’ means 4 the Secretary of Health and Human Services. 7 Subtitle F—Other Policies to Improve Care for the Chronically Ill 8 SEC. 50351. GAO STUDY AND REPORT ON IMPROVING MEDI- 5 6 9 10 CATION SYNCHRONIZATION. (a) STUDY.—The Comptroller General of the United 11 States (in this section referred to as the ‘‘Comptroller 12 General’’) shall conduct a study on the extent to which 13 Medicare prescription drug plans (MA–PD plans and 14 stand alone prescription drug plans) under part D of title 15 XVIII of the Social Security Act and private payors use 16 programs that synchronize pharmacy dispensing so that 17 individuals may receive multiple prescriptions on the same 18 day to facilitate comprehensive counseling and promote 19 medication adherence. The study shall include a analysis 20 of the following: 21 22 (1) The extent to which pharmacies have adopted such programs. 23 (2) The common characteristics of such pro- 24 grams, including how pharmacies structure coun- 25 seling sessions under such programs and the types February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 376 1 of payment and other arrangements that Medicare 2 prescription drug plans and private payors employ 3 under such programs to support the efforts of phar- 4 macies. 5 6 (3) How such programs compare for Medicare prescription drug plans and private payors. 7 (4) What is known about how such programs 8 affect patient medication adherence and overall pa- 9 tient health outcomes, including if adherence and 10 outcomes vary by patient subpopulations, such as 11 disease state and socioeconomic status. 12 (5) What is known about overall patient satis- 13 faction with such programs and satisfaction with 14 such programs, including within patient subpopula- 15 tions, such as disease state and socioeconomic sta- 16 tus. 17 18 (6) The extent to which laws and regulations of the Medicare program support such programs. 19 (7) Barriers to the use of medication synchroni- 20 zation programs by Medicare prescription drug 21 plans. 22 (b) REPORT.—Not later than 18 months after the 23 date of the enactment of this Act, the Comptroller General 24 shall submit to Congress a report containing the results 25 of the study under subsection (a), together with rec- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 377 1 ommendations for such legislation and administrative ac2 tion as the Comptroller General determines appropriate. 3 SEC. 50352. GAO STUDY AND REPORT ON IMPACT OF OBE- 4 SITY 5 SPENDING. 6 DRUGS ON PATIENT HEALTH AND (a) STUDY.—The Comptroller General of the United 7 States (in this section referred to as the ‘‘Comptroller 8 General’’) shall, to the extent data are available, conduct 9 a study on the use of prescription drugs to manage the 10 weight of obese patients and the impact of coverage of 11 such drugs on patient health and on health care spending. 12 Such study shall examine the use and impact of these obe13 sity drugs in the non-Medicare population and for Medi14 care beneficiaries who have such drugs covered through 15 an MA–PD plan (as defined in section 1860D–1(a)(3)(C) 16 of the Social Security Act (42 U.S.C. 1395w– 17 101(a)(3)(C))) as a supplemental health care benefit. The 18 study shall include an analysis of the following: 19 20 (1) The prevalence of obesity in the Medicare and non-Medicare population. 21 (2) The utilization of obesity drugs. 22 (3) The distribution of Body Mass Index by in- 23 dividuals taking obesity drugs, to the extent prac- 24 ticable. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 378 1 (4) What is known about the use of obesity 2 drugs in conjunction with the receipt of other items 3 or services, such as behavioral counseling, and how 4 these compare to items and services received by 5 obese individuals who do not take obesity drugs. 6 7 (5) Physician considerations and attitudes related to prescribing obesity drugs. 8 (6) The extent to which coverage policies cease 9 or limit coverage for individuals who fail to receive 10 clinical benefit. 11 (7) What is known about the extent to which 12 individuals who take obesity drugs adhere to the pre- 13 scribed regimen. 14 (8) What is known about the extent to which 15 individuals who take obesity drugs maintain weight 16 loss over time. 17 (9) What is known about the subsequent impact 18 such drugs have on medical services that are directly 19 related to obesity, including with respect to sub- 20 populations determined based on the extent of obe- 21 sity. 22 (10) What is known about the spending associ- 23 ated with the care of individuals who take obesity 24 drugs, compared to the spending associated with the 25 care of individuals who do not take such drugs. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 379 1 (b) REPORT.—Not later than 18 months after the 2 date of the enactment of this Act, the Comptroller General 3 shall submit to Congress a report containing the results 4 of the study under subsection (a), together with rec5 ommendations for such legislation and administrative ac6 tion as the Comptroller General determines appropriate. 7 SEC. 50353. HHS STUDY AND REPORT ON LONG-TERM RISK 8 FACTORS FOR CHRONIC CONDITIONS AMONG 9 MEDICARE BENEFICIARIES. 10 (a) STUDY.—The Secretary of Health and Human 11 Services (in this section referred to as the ‘‘Secretary’’) 12 shall conduct a study on long-term cost drivers to the 13 Medicare program, including obesity, tobacco use, mental 14 health conditions, and other factors that may contribute 15 to the deterioration of health conditions among individuals 16 with chronic conditions in the Medicare population. The 17 study shall include an analysis of any barriers to collecting 18 and analyzing such information and how to remove any 19 such barriers (including through legislation and adminis20 trative actions). 21 (b) REPORT.—Not later than 18 months after the 22 date of the enactment of this Act, the Secretary shall sub23 mit to Congress a report containing the results of the 24 study under subsection (a), together with recommenda25 tions for such legislation and administrative action as the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 380 1 Secretary determines appropriate. The Secretary shall also 2 post such report on the Internet website of the Depart3 ment of Health and Human Services. 4 SEC. 50354. PROVIDING PRESCRIPTION DRUG PLANS WITH 5 PARTS A AND B CLAIMS DATA TO PROMOTE 6 THE APPROPRIATE USE OF MEDICATIONS 7 AND IMPROVE HEALTH OUTCOMES. 8 Section 1860D–4(c) of the Social Security Act (42 9 U.S.C. 1395w–104(c)) is amended by adding at the end 10 the following new paragraph: 11 ‘‘(6) PROVIDING PRESCRIPTION DRUG PLANS 12 WITH PARTS A AND B CLAIMS DATA TO PROMOTE 13 THE APPROPRIATE USE OF MEDICATIONS AND IM- 14 PROVE HEALTH OUTCOMES.— 15 ‘‘(A) PROCESS.—Subject to subparagraph 16 (B), the Secretary shall establish a process 17 under which a PDP sponsor of a prescription 18 drug plan may submit a request for the Sec- 19 retary to provide the sponsor, on a periodic 20 basis and in an electronic format, beginning in 21 plan year 2020, data described in subparagraph 22 (D) with respect to enrollees in such plan. Such 23 data shall be provided without regard to wheth- 24 er such enrollees are described in clause (ii) of 25 paragraph (2)(A). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 381 1 ‘‘(B) PURPOSES.—A PDP sponsor may 2 use the data provided to the sponsor pursuant 3 to subparagraph (A) for any of the following 4 purposes: 5 ‘‘(i) To optimize therapeutic outcomes 6 through improved medication use, as such 7 phrase is used in clause (i) of paragraph 8 (2)(A). 9 ‘‘(ii) To improving care coordination 10 so as to prevent adverse health outcomes, 11 such as preventable emergency department 12 visits and hospital readmissions. 13 ‘‘(iii) For any other purpose deter- 14 mined appropriate by the Secretary. 15 ‘‘(C) LIMITATIONS ON DATA USE.—A PDP 16 sponsor shall not use data provided to the spon- 17 sor pursuant to subparagraph (A) for any of 18 the following purposes: 19 20 ‘‘(i) To inform coverage determinations under this part. 21 ‘‘(ii) To conduct retroactive reviews of 22 medically accepted indications determina- 23 tions. 24 ‘‘(iii) To facilitate enrollment changes 25 to a different prescription drug plan or an February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 382 1 MA–PD plan offered by the same parent 2 organization. 3 ‘‘(iv) To inform marketing of benefits. 4 ‘‘(v) For any other purpose that the 5 Secretary determines is necessary to in- 6 clude in order to protect the identity of in- 7 dividuals entitled to, or enrolled for, bene- 8 fits under this title and to protect the se- 9 curity of personal health information. 10 ‘‘(D) DATA DESCRIBED.—The data de- 11 scribed in this clause are standardized extracts 12 (as determined by the Secretary) of claims data 13 under parts A and B for items and services fur- 14 nished under such parts for time periods speci- 15 fied by the Secretary. Such data shall include 16 data as current as practicable.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 383 5 TITLE IV—PART B IMPROVEMENT ACT AND OTHER PART B ENHANCEMENTS Subtitle A—Medicare Part B Improvement Act 6 SEC. 50401. HOME INFUSION THERAPY SERVICES TEM- 1 2 3 4 7 8 PORARY TRANSITIONAL PAYMENT. (a) IN GENERAL.—Section 1834(u) of the Social Se- 9 curity Act (42 U.S.C. 1395m(u)) is amended, by adding 10 at the end the following new paragraph: 11 12 13 14 15 ‘‘(7) HOME INFUSION THERAPY SERVICES TEM- PORARY TRANSITIONAL PAYMENT.— ‘‘(A) TEMPORARY TRANSITIONAL PAY- MENT.— ‘‘(i) IN GENERAL.—The Secretary 16 shall, in accordance with the payment 17 methodology described in subparagraph 18 (B) and subject to the provisions of this 19 paragraph, provide a home infusion ther- 20 apy services temporary transitional pay- 21 ment under this part to an eligible home 22 infusion supplier (as defined in subpara- 23 graph (F)) for items and services described 24 in subparagraphs (A) and (B) of section 25 1861(iii)(2)) furnished during the period February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 384 1 specified in clause (ii) by such supplier in 2 coordination with the furnishing of transi- 3 tional home infusion drugs (as defined in 4 clause (iii)). 5 ‘‘(ii) PERIOD SPECIFIED.—For pur- 6 poses of clause (i), the period specified in 7 this clause is the period beginning on Jan- 8 uary 1, 2019, and ending on the day be- 9 fore the date of the implementation of the 10 11 payment system under paragraph (1)(A). ‘‘(iii) TRANSITIONAL HOME INFUSION 12 DRUG 13 paragraph, the term ‘transitional home in- 14 fusion drug’ has the meaning given to the 15 term ‘home infusion drug’ under section 16 1861(iii)(3)(C)), except that clause (ii) of 17 such section shall not apply if a drug de- 18 scribed in such clause is identified in 19 clauses (i), (ii), (iii) or (iv) of subpara- 20 graph (C) as of the date of the enactment 21 of this paragraph. 22 ‘‘(B) PAYMENT DEFINED.—For purposes of this METHODOLOGY.—For pur- 23 poses of this paragraph, the Secretary shall es- 24 tablish a payment methodology, with respect to 25 items and services described in subparagraph February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 385 1 (A)(i). Under such payment methodology the 2 Secretary shall— 3 ‘‘(i) create the three payment cat- 4 egories described in clauses (i), (ii), and 5 (iii) of subparagraph (C); 6 7 ‘‘(ii) assign drugs to such categories, in accordance with such clauses; 8 9 ‘‘(iii) assign appropriate Healthcare Common Procedure Coding System 10 (HCPCS) codes to each payment category; 11 and 12 ‘‘(iv) establish a single payment 13 amount for each such payment category, in 14 accordance with subparagraph (D), for 15 each infusion drug administration calendar 16 day in the individual’s home for drugs as- 17 signed to such category. 18 ‘‘(C) PAYMENT 19 CATEGORIES.— ‘‘(i) PAYMENT CATEGORY 1.—The 20 Secretary shall create a payment category 21 1 and assign to such category drugs which 22 are covered under the Local Coverage De- 23 termination on External Infusion Pumps 24 (LCD number L33794) and billed with the 25 following HCPCS codes (as identified as of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 386 1 January 1, 2018, and as subsequently 2 modified by the Secretary): J0133, J0285, 3 J0287, J0288, J0289, J0895, J1170, 4 J1250, J1265, J1325, J1455, J1457, 5 J1570, J2175, J2260, J2270, J2274, 6 J2278, J3010, or J3285. 7 ‘‘(ii) PAYMENT CATEGORY 2.—The 8 Secretary shall create a payment category 9 2 and assign to such category drugs which 10 are covered under such local coverage de- 11 termination and billed with the following 12 HCPCS codes (as identified as of January 13 1, 2018, and as subsequently modified by 14 the Secretary): J1555 JB, J1559 JB, 15 J1561 JB, J1562 JB, J1569 JB, or 16 J1575 JB. 17 ‘‘(iii) PAYMENT CATEGORY 3.—The 18 Secretary shall create a payment category 19 3 and assign to such category drugs which 20 are covered under such local coverage de- 21 termination and billed with the following 22 HCPCS codes (as identified as of January 23 1, 2018, and as subsequently modified by 24 the Secretary): J9000, J9039, J9040, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 387 1 J9065, J9100, J9190, J9200, J9360, or 2 J9370. 3 ‘‘(iv) INFUSION 4 WISE INCLUDED.—With 5 that are not included in payment category 6 1, 2, or 3 under clause (i), (ii), or (iii), re- 7 spectively, the Secretary shall assign to the 8 most appropriate of such categories, as de- 9 termined by the Secretary, drugs which 10 DRUGS NOT OTHER- respect to drugs are— 11 ‘‘(I) covered under such local cov- 12 erage determination and billed under 13 HCPCS codes J7799 or J7999 (as 14 identified as of July 1, 2017, and as 15 subsequently modified by the Sec- 16 retary); or 17 ‘‘(II) billed under any code that 18 is implemented after the date of the 19 enactment of this paragraph and in- 20 cluded in such local coverage deter- 21 mination or included in subregulatory 22 guidance as a home infusion drug de- 23 scribed in subparagraph (A)(i). 24 February 7, 2018 (10:12 p.m.) ‘‘(D) PAYMENT AMOUNTS.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 388 1 ‘‘(i) IN GENERAL.—Under the pay- 2 ment methodology, the Secretary shall pay 3 eligible home infusion suppliers, with re- 4 spect to items and services described in 5 subparagraph (A)(i) furnished during the 6 period described in subparagraph (A)(ii) by 7 such supplier to an individual, at amounts 8 equal to the amounts determined under the 9 physician fee schedule established under 10 section 1848 for services furnished during 11 the year for codes and units of such codes 12 described in clauses (ii), (iii), and (iv) with 13 respect to drugs included in the payment 14 category under subparagraph (C) specified 15 in the respective clause, determined with- 16 out application of the geographic adjust- 17 ment under subsection (e) of such section. 18 ‘‘(ii) PAYMENT AMOUNT FOR CAT- 19 EGORY 1.—For 20 codes and units described in this clause, 21 with respect to drugs included in payment 22 category 1 described in subparagraph 23 (C)(i), are one unit of HCPCS code 96365 24 plus three units of HCPCS code 96366 (as February 7, 2018 (10:12 p.m.) purposes of clause (i), the U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 389 1 identified as of January 1, 2018, and as 2 subsequently modified by the Secretary). 3 ‘‘(iii) PAYMENT AMOUNT FOR CAT- 4 EGORY 2.—For 5 codes and units described in this clause, 6 with respect to drugs included in payment 7 category 2 described in subparagraph 8 (C)(i), are one unit of HCPCS code 96369 9 plus three units of HCPCS code 96370 (as 10 identified as of January 1, 2018, and as 11 subsequently modified by the Secretary). 12 purposes of clause (i), the ‘‘(iv) PAYMENT AMOUNT FOR CAT- 13 EGORY 3.—For 14 codes and units described in this clause, 15 with respect to drugs included in payment 16 category 3 described in subparagraph 17 (C)(i), are one unit of HCPCS code 96413 18 plus three units of HCPCS code 96415 (as 19 identified as of January 1, 2018, and as 20 subsequently modified by the Secretary). 21 ‘‘(E) CLARIFICATIONS.— 22 ‘‘(i) INFUSION purposes of clause (i), the DRUG ADMINISTRATION 23 DAY.—For 24 with respect to the furnishing of transi- 25 tional home infusion drugs or home infu- February 7, 2018 (10:12 p.m.) purposes of this subsection, U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 390 1 sion drugs to an individual by an eligible 2 home infusion supplier or a qualified home 3 infusion therapy supplier, a reference to 4 payment to such supplier for an infusion 5 drug administration calendar day in the in- 6 dividual’s home shall refer to payment only 7 for the date on which professional services 8 (as described in section 1861(iii)(2)(A)) 9 were furnished to administer such drugs to 10 such individual. For purposes of the pre- 11 vious sentence, an infusion drug adminis- 12 tration calendar day shall include all such 13 drugs administered to such individual on 14 such day. 15 ‘‘(ii) TREATMENT OF MULTIPLE 16 DRUGS ADMINISTERED ON SAME INFUSION 17 DRUG ADMINISTRATION DAY.—In 18 that an eligible home infusion supplier, 19 with respect to an infusion drug adminis- 20 tration calendar day in an individual’s 21 home, furnishes to such individual transi- 22 tional home infusion drugs which are not 23 all assigned to the same payment category 24 under subparagraph (C), payment to such 25 supplier for such infusion drug administra- February 7, 2018 (10:12 p.m.) the case U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 391 1 tion calendar day in the individual’s home 2 shall be a single payment equal to the 3 amount of payment under this paragraph 4 for the drug, among all such drugs so fur- 5 nished to such individual during such cal- 6 endar day, for which the highest payment 7 would be made under this paragraph. 8 ‘‘(F) ELIGIBLE 9 PLIERS.—In HOME INFUSION SUP- this paragraph, the term ‘eligible 10 home infusion supplier’ means a supplier that is 11 enrolled under this part as a pharmacy that 12 provides external infusion pumps and external 13 infusion pump supplies and that maintains all 14 pharmacy licensure requirements in the State in 15 which the applicable infusion drugs are admin- 16 istered. 17 ‘‘(G) IMPLEMENTATION.—Notwithstanding 18 any other provision of law, the Secretary may 19 implement this paragraph by program instruc- 20 tion or otherwise.’’. 21 (b) CONFORMING AMENDMENTS.—(1) Section 22 1842(b)(6)(I) of the Social Security Act (42 U.S.C. 23 1395u(b)(6)(I)) is amended by inserting ‘‘or, in the case 24 of items and services described in clause (i) of section 25 1834(u)(7)(A) furnished to an individual during the pe- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 392 1 riod described in clause (ii) of such section, payment shall 2 be made to the eligible home infusion therapy supplier’’ 3 after ‘‘payment shall be made to the qualified home infu4 sion therapy supplier’’. 5 (2) Section 5012(d) of the 21st Century Cures Act 6 is amended by inserting the following before the period 7 at the end: ‘‘, except that the amendments made by para8 graphs (1) and (2) of subsection (c) shall apply to items 9 and services furnished on or after January 1, 2019’’. 10 SEC. 50402. ORTHOTIST’S AND PROSTHETIST’S CLINICAL 11 NOTES AS PART OF THE PATIENT’S MEDICAL 12 RECORD. 13 Section 1834(h) of the Social Security Act (42 U.S.C. 14 1395m(h)) is amended by adding at the end the following 15 new paragraph: 16 ‘‘(5) DOCUMENTATION CREATED BY 17 ORTHOTISTS AND PROSTHETISTS.—For 18 determining the reasonableness and medical neces- 19 sity of orthotics and prosthetics, documentation cre- 20 ated by an orthotist or prosthetist shall be consid- 21 ered part of the individual’s medical record to sup- 22 port documentation created by eligible professionals 23 described in section 1848(k)(3)(B).’’. February 7, 2018 (10:12 p.m.) purposes of U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 393 1 SEC. 50403. INDEPENDENT ACCREDITATION FOR DIALYSIS 2 FACILITIES AND ASSURANCE OF HIGH QUAL- 3 ITY SURVEYS. 4 5 6 7 (a) ACCREDITATION AND SURVEYS.— (1) IN GENERAL.—Section 1865 of the Social Security Act (42 U.S.C. 1395bb) is amended— (A) in subsection (a)— 8 (i) in paragraph (1), in the matter 9 preceding subparagraph (A), by striking 10 ‘‘or the conditions and requirements under 11 section 1881(b)’’; and 12 (ii) in paragraph (4), by inserting 13 ‘‘(including a renal dialysis facility)’’ after 14 ‘‘facility’’; and 15 (B) by adding at the end the following new 16 17 subsection: ‘‘(e) With respect to an accreditation body that has 18 received approval from the Secretary under subsection 19 (a)(3)(A) for accreditation of provider entities that are re20 quired to meet the conditions and requirements under sec21 tion 1881(b), in addition to review and oversight authori22 ties otherwise applicable under this title, the Secretary 23 shall (as the Secretary determines appropriate) conduct, 24 with respect to such accreditation body and provider enti25 ties, any or all of the following as frequently as is other- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 394 1 wise required to be conducted under this title with respect 2 to other accreditation bodies or other provider entities: 3 4 ‘‘(1) Validation surveys referred to in subsection (d). 5 ‘‘(2) Accreditation program reviews (as defined 6 in section 488.8(c) of title 42 of the Code of Federal 7 Regulations, or a successor regulation). 8 ‘‘(3) Performance reviews (as defined in section 9 488.8(a) of title 42 of the Code of Federal Regula- 10 11 tions, or a successor regulation).’’. (2) TIMING FOR ACCEPTANCE OF REQUESTS 12 FROM ACCREDITATION ORGANIZATIONS.—Not 13 than 90 days after the date of enactment of this 14 Act, the Secretary of Health and Human Services 15 shall begin accepting requests from national accredi- 16 tation bodies for a finding described in section 17 1865(a)(3)(A) of the Social Security Act (42 U.S.C. 18 1395bb(a)(3)(A)) for purposes of accrediting pro- 19 vider entities that are required to meet the condi- 20 tions and requirements under section 1881(b) of 21 such Act (42 U.S.C. 1395rr(b)). 22 (b) REQUIREMENT FOR TIMING OF later SURVEYS OF 23 NEW DIALYSIS FACILITIES.—Section 1881(b)(1) of the 24 Social Security Act (42 U.S.C. 1395rr(b)(1)) is amended 25 by adding at the end the following new sentence: ‘‘Begin- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 395 1 ning 180 days after the date of the enactment of this sen2 tence, an initial survey of a provider of services or a renal 3 dialysis facility to determine if the conditions and require4 ments under this paragraph are met shall be initiated not 5 later than 90 days after such date on which both the pro6 vider enrollment form (without regard to whether such 7 form is submitted prior to or after such date of enactment) 8 has been determined by the Secretary to be complete and 9 the provider’s enrollment status indicates approval is 10 pending the results of such survey.’’. 11 SEC. 50404. MODERNIZING THE APPLICATION OF THE 12 STARK RULE UNDER MEDICARE. 13 14 (a) CLARIFICATION AND OF THE WRITING REQUIREMENT SIGNATURE REQUIREMENT FOR ARRANGEMENTS 15 PURSUANT TO THE STARK RULE.— 16 (1) WRITING REQUIREMENT.—Section 17 1877(h)(1) of the Social Security Act (42 U.S.C. 18 1395nn(h)(1)) is amended by adding at the end the 19 following new subparagraph: 20 ‘‘(D) WRITTEN REQUIREMENT CLARIFIED.—In 21 the case of any requirement pursuant to this section 22 for a compensation arrangement to be in writing, 23 such requirement shall be satisfied by such means as 24 determined by the Secretary, including by a collec- 25 tion of documents, including contemporaneous docu- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 396 1 ments evidencing the course of conduct between the 2 parties involved.’’. 3 (2) SIGNATURE REQUIREMENT.—Section 4 1877(h)(1) of the Social Security Act (42 U.S.C. 5 1395nn(h)(1)), as amended by paragraph (1), is fur- 6 ther amended by adding at the end the following 7 new subparagraph: 8 ‘‘(E) SPECIAL 9 QUIREMENTS.—In RULE FOR SIGNATURE RE- the case of any requirement 10 pursuant to this section for a compensation ar- 11 rangement to be in writing and signed by the 12 parties, such signature requirement shall be 13 met if— 14 ‘‘(i) not later than 90 consecutive cal- 15 endar days immediately following the date 16 on which the compensation arrangement 17 became noncompliant, the parties obtain 18 the required signatures; and 19 ‘‘(ii) the compensation arrangement 20 otherwise complies with all criteria of the 21 applicable exception.’’. 22 (b) INDEFINITE HOLDOVER 23 MENTS AND 24 SUANT TO THE FOR LEASE ARRANGE- PERSONAL SERVICES ARRANGEMENTS PURSTARK RULE.—Section 1877(e) of the So- 25 cial Security Act (42 U.S.C. 1395nn(e)) is amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 397 1 2 3 (1) in paragraph (1), by adding at the end the following new subparagraph: ‘‘(C) HOLDOVER LEASE ARRANGE- 4 MENTS.—In 5 rangement for the lease of office space or equip- 6 ment, which immediately follows a lease ar- 7 rangement described in subparagraph (A) for 8 the use of such office space or subparagraph 9 (B) for the use of such equipment and that ex- 10 pired after a term of at least 1 year, payments 11 made by the lessee to the lessor pursuant to 12 such holdover lease arrangement, if— the case of a holdover lease ar- 13 ‘‘(i) the lease arrangement met the 14 conditions of subparagraph (A) for the 15 lease of office space or subparagraph (B) 16 for the use of equipment when the ar- 17 rangement expired; 18 ‘‘(ii) the holdover lease arrangement is 19 on the same terms and conditions as the 20 immediately preceding arrangement; and 21 ‘‘(iii) the holdover arrangement con- 22 tinues to satisfy the conditions of subpara- 23 graph (A) for the lease of office space or 24 subparagraph (B) for the use of equip- 25 ment.’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 398 1 2 (2) in paragraph (3), by adding at the end the following new subparagraph: 3 ‘‘(C) HOLDOVER PERSONAL SERVICE AR- 4 RANGEMENT.—In 5 sonal service arrangement, which immediately 6 follows an arrangement described in subpara- 7 graph (A) that expired after a term of at least 8 1 year, remuneration from an entity pursuant 9 to such holdover personal service arrangement, 10 the case of a holdover per- if— 11 ‘‘(i) the personal service arrangement 12 met the conditions of subparagraph (A) 13 when the arrangement expired; 14 ‘‘(ii) the holdover personal service ar- 15 rangement is on the same terms and condi- 16 tions as the immediately preceding ar- 17 rangement; and 18 ‘‘(iii) the holdover arrangement con- 19 tinues to satisfy the conditions of subpara- 20 graph (A).’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 399 2 Subtitle B—Additional Medicare Provisions 3 SEC. 50411. MAKING PERMANENT THE REMOVAL OF THE 4 RENTAL CAP FOR DURABLE MEDICAL EQUIP- 5 MENT UNDER MEDICARE WITH RESPECT TO 6 SPEECH GENERATING DEVICES. 1 7 Section 1834(a)(2)(A)(iv) of the Social Security Act 8 (42 U.S.C. 1395m(a)(2)(A)(iv)) is amended by striking 9 ‘‘and before October 1, 2018,’’. 10 SEC. 50412. INCREASED CIVIL AND CRIMINAL PENALTIES 11 AND INCREASED SENTENCES FOR FEDERAL 12 HEALTH CARE PROGRAM FRAUD AND ABUSE. 13 (a) INCREASED CIVIL MONEY PENALTIES AND 14 CRIMINAL FINES.— 15 (1) INCREASED CIVIL MONEY PENALTIES.—Sec- 16 tion 1128A of the Social Security Act (42 U.S.C. 17 1320a–7a) is amended— 18 19 20 21 22 23 (A) in subsection (a), in the matter following paragraph (10)— (i) by striking ‘‘$10,000’’ and inserting ‘‘$20,000’’ each place it appears; (ii) by striking ‘‘$15,000’’ and inserting ‘‘$30,000’’; and 24 (iii) by striking ‘‘$50,000’’ and insert- 25 ing ‘‘$100,000’’ each place it appears; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 400 1 (B) in subsection (b)— 2 (i) in paragraph (1), in the flush text 3 following subparagraph (B), by striking 4 ‘‘$2,000’’ and inserting ‘‘$5,000’’; 5 (ii) in paragraph (2), by striking 6 ‘‘$2,000’’ and inserting ‘‘$5,000’’; and 7 (iii) in paragraph (3)(A)(i), by strik- 8 ing ‘‘$5,000’’ and inserting ‘‘$10,000’’. 9 (2) INCREASED CRIMINAL FINES.—Section 10 1128B of such Act (42 U.S.C. 1320a–7b) is amend- 11 ed— 12 13 14 15 16 (A) in subsection (a), in the matter following paragraph (6)— (i) by striking ‘‘$25,000’’ and inserting ‘‘$100,000’’; and (ii) by striking ‘‘$10,000’’ and insert- 17 ing ‘‘$20,000’’; 18 (B) in subsection (b)— 19 (i) in paragraph (1), in the flush text 20 following subparagraph (B), by striking 21 ‘‘$25,000’’ and inserting ‘‘$100,000’’; and 22 (ii) in paragraph (2), in the flush text 23 following subparagraph (B), by striking 24 ‘‘$25,000’’ and inserting ‘‘$100,000’’; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 401 1 (C) 2 in subsection (c), by striking ‘‘$25,000’’ and inserting ‘‘$100,000’’; 3 (D) in subsection (d), in the flush text fol- 4 lowing paragraph (2), by striking ‘‘$25,000’’ 5 and inserting ‘‘$100,000’’; and 6 (E) in subsection (e), by striking ‘‘$2,000’’ 7 and inserting ‘‘$4,000’’. 8 9 (b) INCREASED SENTENCES ING FOR FELONIES INVOLV- FEDERAL HEALTH CARE PROGRAM FRAUD AND 10 ABUSE.— 11 (1) FALSE 12 TIONS.—Section 13 (42 U.S.C. 1320a–7b(a)) is amended, in the matter 14 following paragraph (6), by striking ‘‘not more than 15 five years or both, or (ii)’’ and inserting ‘‘not more 16 than 10 years or both, or (ii)’’. 17 18 STATEMENTS AND REPRESENTA- 1128B(a) of the Social Security Act (2) ANTIKICKBACK.—Section 1128B(b) of such Act (42 U.S.C. 1320a–7b(b)) is amended— 19 (A) in paragraph (1), in the flush text fol- 20 lowing subparagraph (B), by striking ‘‘not more 21 than five years’’ and inserting ‘‘not more than 22 10 years’’; and 23 (B) in paragraph (2), in the flush text fol- 24 lowing subparagraph (B), by striking ‘‘not more February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 402 1 than five years’’ and inserting ‘‘not more than 2 10 years’’. 3 (3) FALSE STATEMENT OR REPRESENTATION 4 WITH RESPECT TO CONDITIONS OR OPERATIONS OF 5 FACILITIES.—Section 6 U.S.C. 1320a–7b(c)) is amended by striking ‘‘not 7 more than five years’’ and inserting ‘‘not more than 8 10 years’’. 9 (4) EXCESS 1128B(c) of such Act (42 CHARGES.—Section 1128B(d) of 10 such Act (42 U.S.C. 1320a–7b(d)) is amended, in 11 the flush text following paragraph (2), by striking 12 ‘‘not more than five years’’ and inserting ‘‘not more 13 than 10 years’’. 14 (c) EFFECTIVE DATE.—The amendments made by 15 this section shall apply to acts committed after the date 16 of the enactment of this Act. 17 SEC. 50413. REDUCING THE VOLUME OF FUTURE EHR-RE- 18 19 LATED SIGNIFICANT HARDSHIP REQUESTS. Section 1848(o)(2)(A) of the Social Security Act (42 20 U.S.C. 1395w–4(o)(2)(A)) and section 1886(n)(3)(A) of 21 such Act (42 U.S.C. 1395ww(n)(3)(A)) are each amended 22 in the last sentence by striking ‘‘by requiring’’ and all that 23 follows through ‘‘this paragraph’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 403 1 SEC. 50414. STRENGTHENING RULES IN CASE OF COMPETI- 2 3 TION FOR DIABETIC TESTING STRIPS. (a) SPECIAL RULE IN CASE OF COMPETITION FOR 4 DIABETIC TESTING STRIPS.— 5 (1) IN GENERAL.—Paragraph (10) of section 6 1847(b) of the Social Security Act (42 U.S.C. 7 1395w–3(b)) is amended— 8 (A) in subparagraph (A), by striking the 9 second sentence and inserting the following new 10 sentence: ‘‘With respect to bids to furnish such 11 types of products on or after January 1, 2019, 12 the volume for such types of products shall be 13 determined by the Secretary through the use of 14 multiple sources of data (from mail order and 15 non-mail order Medicare markets), including 16 market-based data measuring sales of diabetic 17 testing strip products that are not exclusively 18 sold by a single retailer from such markets.’’; 19 and 20 21 22 (B) by adding at the end the following new subparagraphs: ‘‘(C) DEMONSTRATION OF ABILITY TO 23 FURNISH TYPES OF DIABETIC TESTING STRIP 24 PRODUCTS.—With 25 abetic testing strip products on or after Janu- 26 ary 1, 2019, an entity shall attest to the Sec- February 7, 2018 (10:12 p.m.) respect to bids to furnish di- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 404 1 retary that the entity has the ability to obtain 2 an inventory of the types and quantities of dia- 3 betic testing strip products that will allow the 4 entity to furnish such products in a manner 5 consistent with its bid and— 6 ‘‘(i) demonstrate to the Secretary, 7 through letters of intent with manufactur- 8 ers, wholesalers, or other suppliers, or 9 other evidence as the Secretary may speci- 10 fy, such ability; or 11 ‘‘(ii) demonstrate to the Secretary 12 that it made a good faith attempt to obtain 13 such a letter of intent or such other evi- 14 dence. 15 ‘‘(D) USE OF UNLISTED TYPES IN CAL- 16 CULATION OF PERCENTAGE.—With 17 bids to furnish diabetic testing strip products 18 on or after January 1, 2019, in determining 19 under subparagraph (A) whether a bid sub- 20 mitted by an entity under such subparagraph 21 covers 50 percent (or such higher percentage as 22 the Secretary may specify) of all types of dia- 23 betic testing strip products, the Secretary may 24 not attribute a percentage to types of diabetic 25 testing strip products that the Secretary does February 7, 2018 (10:12 p.m.) respect to U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 405 1 not identify by brand, model, and market share 2 volume. 3 4 ‘‘(E) ADHERENCE ‘‘(i) IN TO DEMONSTRATION.— GENERAL.—In the case of an 5 entity that is furnishing diabetic testing 6 strip products on or after January 1, 7 2019, under a contract entered into under 8 the competition conducted pursuant to 9 paragraph (1), the Secretary shall estab- 10 lish a process to monitor, on an ongoing 11 basis, the extent to which such entity con- 12 tinues to cover the product types included 13 in the entity’s bid. 14 ‘‘(ii) TERMINATION.—If the Secretary 15 determines that an entity described in 16 clause (i) fails to maintain in inventory, or 17 otherwise 18 (through requirements, contracts, or other- 19 wise) a type of product included in the en- 20 tity’s bid, the Secretary may terminate 21 such contract unless the Secretary finds 22 that the failure of the entity to maintain 23 inventory of, or ready access to, the prod- 24 uct is the result of the discontinuation of 25 the product by the product manufacturer, February 7, 2018 (10:12 p.m.) maintain ready access to U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 406 1 a market-wide shortage of the product, or 2 the introduction of a newer model or 3 version of the product in the market in- 4 volved.’’. 5 (b) CODIFYING AND EXPANDING ANTI-SWITCHING 6 RULE.—Section 1847(b) of the Social Security Act (42 7 U.S.C. 1395w–3(b)), as amended by subsection (a)(1), is 8 further amended— 9 10 11 12 13 14 15 (1) by redesignating paragraph (11) as paragraph (12); and (2) by inserting after paragraph (10) the following new paragraph: ‘‘(11) ADDITIONAL SPECIAL RULES IN CASE OF COMPETITION FOR DIABETIC TESTING STRIPS.— ‘‘(A) IN GENERAL.—With respect to an en- 16 tity that is furnishing diabetic testing strip 17 products to individuals under a contract entered 18 into under the competitive acquisition program 19 established under this section, the entity shall 20 furnish to each individual a brand of such prod- 21 ucts that is compatible with the home blood glu- 22 cose monitor selected by the individual. 23 ‘‘(B) PROHIBITION ON INFLUENCING AND 24 INCENTIVIZING.—An 25 paragraph (A) may not attempt to influence or February 7, 2018 (10:12 p.m.) entity described in sub- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 407 1 incentivize an individual to switch the brand of 2 glucose monitor or diabetic testing strip product 3 selected by the individual, including by— 4 5 ‘‘(i) persuading, pressuring, or advising the individual to switch; or 6 ‘‘(ii) furnishing information about al- 7 ternative brands to the individual where 8 the individual has not requested such in- 9 formation. 10 11 ‘‘(C) PROVISION OF INFORMATION.— ‘‘(i) STANDARDIZED INFORMATION.— 12 Not later than January 1, 2019, the Sec- 13 retary shall develop and make available to 14 entities described in subparagraph (A) 15 standardized information that describes 16 the rights of an individual with respect to 17 such an entity. The information described 18 in the preceding sentence shall include in- 19 formation regarding— 20 21 ‘‘(I) the requirements established under subparagraphs (A) and (B); 22 ‘‘(II) the right of the individual 23 to purchase diabetic testing strip 24 products from another mail order sup- 25 plier of such products or a retail phar- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 408 1 macy if the entity is not able to fur- 2 nish the brand of such product that is 3 compatible with the home blood glu- 4 cose monitor selected by the indi- 5 vidual; and 6 ‘‘(III) the right of the individual 7 to return diabetic testing strip prod- 8 ucts furnished to the individual by the 9 entity. 10 ‘‘(ii) REQUIREMENT.—With respect to 11 diabetic testing strip products furnished on 12 or after the date on which the Secretary 13 develops 14 under clause (i), an entity described in 15 subparagraph (A) may not communicate 16 directly to an individual until the entity 17 has verbally provided the individual with 18 such standardized information. 19 ‘‘(D) ORDER the standardized REFILLS.—With information respect to 20 diabetic testing strip products furnished on or 21 after January 1, 2019, the Secretary shall re- 22 quire an entity furnishing diabetic testing strip 23 products to an individual to contact and receive 24 a request from the individual for such products February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 409 1 not more than 14 days prior to dispensing a re- 2 fill of such products to the individual.’’. 3 (c) IMPLEMENTATION; NON-APPLICATION OF THE 4 PAPERWORK REDUCTION ACT.— 5 (1) IMPLEMENTATION.—Notwithstanding any 6 other provision of law, the Secretary of Health and 7 Human Services may implement the provisions of, 8 and amendments made by, this section by program 9 instruction or otherwise. 10 (2) NON-APPLICATION OF THE PAPERWORK RE- 11 DUCTION 12 States Code (commonly referred to as the ‘‘Paper- 13 work Reduction Act of 1995’’), shall not apply to 14 this section or the amendments made by this section. ACT.—Chapter 35 of title 44, United 16 TITLE V—OTHER HEALTH EXTENDERS 17 SEC. 50501. EXTENSION FOR FAMILY-TO-FAMILY HEALTH 15 18 19 INFORMATION CENTERS. Section 501(c) of the Social Security Act (42 U.S.C. 20 701(c)) is amended— 21 (1) in paragraph (1)(A)— 22 23 24 25 February 7, 2018 (10:12 p.m.) (A) in clause (v), by striking ‘‘and’’ at the end; (B) in clause (vi), by striking the period at the end and inserting ‘‘; and’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 410 1 (C) by adding at the end the following new 2 clause: 3 ‘‘(vii) $6,000,000 for each of fiscal years 2018 4 and 2019.’’; 5 (2) in paragraph (3)(C), by inserting before the 6 period the following: ‘‘, and with respect to fiscal 7 years 2018 and 2019, such centers shall also be de- 8 veloped in all territories and at least one such center 9 shall be developed for Indian tribes’’; and 10 (3) by amending paragraph (5) to read as fol- 11 lows: 12 ‘‘(5) For purposes of this subsection— 13 ‘‘(A) the term ‘Indian tribe’ has the meaning 14 given such term in section 4 of the Indian Health 15 Care Improvement Act (25 U.S.C. 1603); 16 ‘‘(B) the term ‘State’ means each of the 50 17 States and the District of Columbia; and 18 ‘‘(C) the term ‘territory’ means Puerto Rico, 19 Guam, American Samoa, the Virgin Islands, and the 20 Northern Mariana Islands.’’. 21 SEC. 50502. EXTENSION FOR SEXUAL RISK AVOIDANCE EDU- 22 23 CATION. (a) IN GENERAL.—Section 510 of the Social Security 24 Act (42 U.S.C. 710) is amended to read as follows: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 411 1 ‘‘SEC. 510. SEXUAL RISK AVOIDANCE EDUCATION. 2 3 ‘‘(a) IN GENERAL.— ‘‘(1) ALLOTMENTS TO STATES.—For the pur- 4 pose described in subsection (b), the Secretary shall, 5 for each of fiscal years 2018 and 2019, allot to each 6 State which has transmitted an application for the 7 fiscal year under section 505(a) an amount equal to 8 the product of— 9 ‘‘(A) the amount appropriated pursuant to 10 subsection (e)(1) for the fiscal year, minus the 11 amount reserved under subsection (e)(2) for the 12 fiscal year; and 13 ‘‘(B) the proportion that the number of 14 low-income children in the State bears to the 15 total of such numbers of children for all the 16 States. 17 ‘‘(2) OTHER 18 ALLOTMENTS.— ‘‘(A) OTHER ENTITIES.—For the purpose 19 described in subsection (b), the Secretary shall, 20 for each of fiscal years 2018 and 2019, for any 21 State which has not transmitted an application 22 for the fiscal year under section 505(a), allot to 23 one or more entities in the State the amount 24 that would have been allotted to the State 25 under paragraph (1) if the State had submitted 26 such an application. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 412 1 ‘‘(B) PROCESS.—The Secretary shall select 2 the recipients of allotments under subparagraph 3 (A) by means of a competitive grant process 4 under which— 5 ‘‘(i) not later than 30 days after the 6 deadline for the State involved to submit 7 an application for the fiscal year under 8 section 505(a), the Secretary publishes a 9 notice soliciting grant applications; and 10 ‘‘(ii) not later than 120 days after 11 such deadline, all such applications must 12 be submitted. 13 ‘‘(b) PURPOSE.— 14 ‘‘(1) IN GENERAL.—Except for research under 15 paragraph (5) and information collection and report- 16 ing under paragraph (6), the purpose of an allot- 17 ment under subsection (a) to a State (or to another 18 entity in the State pursuant to subsection (a)(2)) is 19 to enable the State or other entity to implement edu- 20 cation exclusively on sexual risk avoidance (meaning 21 voluntarily refraining from sexual activity). 22 ‘‘(2) REQUIRED COMPONENTS.—Education on 23 sexual risk avoidance pursuant to an allotment 24 under this section shall— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 413 1 ‘‘(A) ensure that the unambiguous and pri- 2 mary emphasis and context for each topic de- 3 scribed in paragraph (3) is a message to youth 4 that normalizes the optimal health behavior of 5 avoiding nonmarital sexual activity; 6 ‘‘(B) be medically accurate and complete; 7 ‘‘(C) be age-appropriate; 8 ‘‘(D) be based on adolescent learning and 9 developmental theories for the age group receiv- 10 ing the education; and 11 ‘‘(E) be culturally appropriate, recognizing 12 the experiences of youth from diverse commu- 13 nities, backgrounds, and experiences. 14 ‘‘(3) TOPICS.—Education on sexual risk avoid- 15 ance pursuant to an allotment under this section 16 shall address each of the following topics: 17 ‘‘(A) The holistic individual and societal 18 benefits associated with personal responsibility, 19 self-regulation, goal setting, healthy decision- 20 making, and a focus on the future. 21 ‘‘(B) The advantage of refraining from 22 nonmarital sexual activity in order to improve 23 the future prospects and physical and emotional 24 health of youth. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 414 1 ‘‘(C) The increased likelihood of avoiding 2 poverty when youth attain self-sufficiency and 3 emotional maturity before engaging in sexual 4 activity. 5 ‘‘(D) The foundational components of 6 healthy relationships and their impact on the 7 formation of healthy marriages and safe and 8 stable families. 9 ‘‘(E) How other youth risk behaviors, such 10 as drug and alcohol usage, increase the risk for 11 teen sex. 12 ‘‘(F) How to resist and avoid, and receive 13 help regarding, sexual coercion and dating vio- 14 lence, recognizing that even with consent teen 15 sex remains a youth risk behavior. 16 ‘‘(4) CONTRACEPTION.—Education on sexual 17 risk avoidance pursuant to an allotment under this 18 section shall ensure that— 19 ‘‘(A) any information provided on contra- 20 ception is medically accurate and complete and 21 ensures that students understand that contra- 22 ception offers physical risk reduction, but not 23 risk elimination; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 415 1 ‘‘(B) the education does not include dem- 2 onstrations, simulations, or distribution of con- 3 traceptive devices. 4 ‘‘(5) RESEARCH.— 5 ‘‘(A) IN GENERAL.—A State or other enti- 6 ty receiving an allotment pursuant to subsection 7 (a) may use up to 20 percent of such allotment 8 to build the evidence base for sexual risk avoid- 9 ance education by conducting or supporting re- 10 search. 11 ‘‘(B) REQUIREMENTS.—Any research con- 12 ducted or supported pursuant to subparagraph 13 (A) shall be— 14 ‘‘(i) rigorous; 15 ‘‘(ii) evidence-based; and 16 ‘‘(iii) designed and conducted by inde- 17 pendent researchers who have experience 18 in conducting and publishing research in 19 peer-reviewed outlets. 20 ‘‘(6) INFORMATION COLLECTION AND REPORT- 21 ING.—A 22 pursuant to subsection (a) shall, as specified by the 23 Secretary— February 7, 2018 (10:12 p.m.) State or other entity receiving an allotment U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 416 1 ‘‘(A) collect information on the programs 2 and activities funded through the allotment; 3 and 4 5 6 7 ‘‘(B) submit reports to the Secretary on the data from such programs and activities. ‘‘(c) NATIONAL EVALUATION.— ‘‘(1) IN GENERAL.—The Secretary shall— 8 ‘‘(A) in consultation with appropriate State 9 and local agencies, conduct one or more rig- 10 orous evaluations of the education funded 11 through this section and associated data; and 12 ‘‘(B) submit a report to the Congress on 13 the results of such evaluations, together with a 14 summary of the information collected pursuant 15 to subsection (b)(6). 16 ‘‘(2) CONSULTATION.—In conducting the eval- 17 uations required by paragraph (1), including the es- 18 tablishment of rigorous evaluation methodologies, 19 the Secretary shall consult with relevant stake- 20 holders and evaluation experts. 21 ‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.— 22 ‘‘(1) Sections 503, 507, and 508 apply to allot- 23 ments under subsection (a) to the same extent and 24 in the same manner as such sections apply to allot- 25 ments under section 502(c). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 417 1 ‘‘(2) Sections 505 and 506 apply to allotments 2 under subsection (a) to the extent determined by the 3 Secretary to be appropriate. 4 ‘‘(e) DEFINITIONS.—In this section: 5 ‘‘(1) The term ‘age-appropriate’ means suitable 6 (in terms of topics, messages, and teaching methods) 7 to the developmental and social maturity of the par- 8 ticular age or age group of children or adolescents, 9 based on developing cognitive, emotional, and behav- 10 ioral capacity typical for the age or age group. 11 ‘‘(2) The term ‘medically accurate and com- 12 plete’ means verified or supported by the weight of 13 research conducted in compliance with accepted sci- 14 entific methods and— 15 16 ‘‘(A) published in peer-reviewed journals, where applicable; or 17 ‘‘(B) comprising information that leading 18 professional organizations and agencies with 19 relevant expertise in the field recognize as accu- 20 rate, objective, and complete. 21 ‘‘(3) The term ‘rigorous’, with respect to re- 22 search or evaluation, means using— 23 ‘‘(A) established scientific methods for 24 measuring the impact of an intervention or pro- 25 gram model in changing behavior (specifically February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 418 1 sexual activity or other sexual risk behaviors), 2 or reducing pregnancy, among youth; or 3 ‘‘(B) other evidence-based methodologies 4 established by the Secretary for purposes of this 5 section. 6 ‘‘(4) The term ‘youth’ refers to one or more in- 7 dividuals who have attained age 10 but not age 20. 8 ‘‘(f) FUNDING.— 9 ‘‘(1) IN GENERAL.—To carry out this section, 10 there is appropriated, out of any money in the 11 Treasury not otherwise appropriated, $75,000,000 12 for each of fiscal years 2018 and 2019. 13 ‘‘(2) RESERVATION.—The Secretary shall re- 14 serve, for each of fiscal years 2018 and 2019, not 15 more than 20 percent of the amount appropriated 16 pursuant to paragraph (1) for administering the 17 program under this section, including the conducting 18 of national evaluations and the provision of technical 19 assistance to the recipients of allotments.’’. 20 (b) EFFECTIVE DATE.—The amendment made by 21 this section shall take effect as if enacted on October 1, 22 2017. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 419 1 SEC. 50503. EXTENSION FOR PERSONAL RESPONSIBILITY 2 3 EDUCATION. (a) IN GENERAL.—Section 513 of the Social Security 4 Act (42 U.S.C. 713) is amended— 5 6 7 (1) in subsection (a)(1)(A), by striking ‘‘2017’’ and inserting ‘‘2019’’; and (2) in subsection (a)(4)— 8 (A) in subparagraph (A), by striking 9 ‘‘2017’’ each place it appears and inserting 10 11 12 ‘‘2019’’; and (B) in subparagraph (B)— (i) in the subparagraph heading, by 13 striking ‘‘3-YEAR 14 ‘‘COMPETITIVE GRANTS’’ and inserting PREP GRANTS’’; and 15 (ii) in clause (i), by striking ‘‘solicit 16 applications to award 3-year grants in each 17 of fiscal years 2012 through 2017’’ and in- 18 serting ‘‘continue through fiscal year 2019 19 grants awarded for any of fiscal years 20 2015 through 2017’’; 21 (3) in subsection (c)(1), by inserting after 22 ‘‘youth with HIV/AIDS,’’ the following: ‘‘victims of 23 human trafficking,’’; and 24 25 February 7, 2018 (10:12 p.m.) (4) in subsection (f), by striking ‘‘2017’’ and inserting ‘‘2019’’. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 420 1 (b) EFFECTIVE DATE.—The amendments made by 2 this section shall take effect as if enacted on October 1, 3 2017. 9 TITLE VI—CHILD AND FAMILY SERVICES AND SUPPORTS EXTENDERS Subtitle A—Continuing the Maternal, Infant, and Early Childhood Home Visiting Program 10 SEC. 50601. CONTINUING EVIDENCE-BASED HOME VISITING 4 5 6 7 8 11 PROGRAM. 12 Section 511(j)(1)(H) of the Social Security Act (42 13 U.S.C. 711(j)(1)(H)) is amended by striking ‘‘fiscal year 14 2017’’ and inserting ‘‘each of fiscal years 2017 through 15 2022’’. 16 SEC. 50602. CONTINUING TO DEMONSTRATE RESULTS TO 17 HELP FAMILIES. 18 19 (a) REQUIRE SERVICE DELIVERY MODELS TO DEMONSTRATE IMPROVEMENT IN APPLICABLE BENCHMARK 20 AREAS.—Section 511 of the Social Security Act (42 21 U.S.C. 711) is amended in each of subsections (d)(1)(A) 22 and (h)(4)(A) by striking ‘‘each of’’. 23 24 (b) DEMONSTRATION QUENT OF IMPROVEMENTS IN SUBSE- YEARS.—Section 511(d)(1) of such Act (42 U.S.C. 25 711(d)(1)) is amended by adding at the end the following: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 421 1 2 3 ‘‘(D) DEMONSTRATION OF IMPROVEMENTS IN SUBSEQUENT YEARS.— ‘‘(i) CONTINUED MEASUREMENT OF 4 IMPROVEMENT 5 MARK AREAS.—The 6 demonstrating improvements for eligible 7 families as specified in subparagraphs (A) 8 and (B), shall continue to track and re- 9 port, not later than 30 days after the end 10 of fiscal year 2020 and every 3 years 11 thereafter, information demonstrating that 12 the program results in improvements for 13 the eligible families participating in the 14 program in at least 4 of the areas specified 15 in subparagraph (A) that the service deliv- 16 ery model or models selected by the entity 17 are intended to improve. 18 IN APPLICABLE BENCH- eligible entity, after ‘‘(ii) CORRECTIVE ACTION PLAN.—If 19 the eligible entity fails to demonstrate im- 20 provement in at least 4 of the areas speci- 21 fied in subparagraph (A), as compared to 22 eligible families who do not receive services 23 under an early childhood home visitation 24 program, the entity shall develop and im- 25 plement a plan to improve outcomes in February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 422 1 each of the areas specified in subparagraph 2 (A) that the service delivery model or mod- 3 els selected by the entity are intended to 4 improve, subject to approval by the Sec- 5 retary. The plan shall include provisions 6 for the Secretary to monitor implementa- 7 tion of the plan and conduct continued 8 oversight 9 through submission by the entity of reg- of the program, 10 ular reports to the Secretary. 11 ‘‘(iii) TECHNICAL including ASSISTANCE.—The 12 Secretary shall provide an eligible entity 13 required to develop and implement an im- 14 provement plan under clause (ii) with tech- 15 nical assistance to develop and implement 16 the plan. The Secretary may provide the 17 technical assistance directly or through 18 grants, contracts, or cooperative agree- 19 ments. 20 ‘‘(iv) NO IMPROVEMENT OR FAILURE 21 TO SUBMIT REPORT.—If 22 termines after a period of time specified by 23 the Secretary that an eligible entity imple- 24 menting an improvement plan under clause 25 (ii) has failed to demonstrate any improve- February 7, 2018 (10:12 p.m.) the Secretary de- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 423 1 ment in at least 4 of the areas specified in 2 subparagraph (A), or if the Secretary de- 3 termines that an eligible entity has failed 4 to submit the report required by clause (i), 5 the Secretary shall terminate the grant 6 made to the entity under this section and 7 may include any unexpended grant funds 8 in grants made to nonprofit organizations 9 under subsection (h)(2)(B).’’. 10 (c) INCLUDING 11 BENCHMARKS IN INFORMATION ON APPLICABLE APPLICATION.—Section 511(e)(5) of 12 such Act (42 U.S.C. 711(e)(5)) is amended by inserting 13 ‘‘that the service delivery model or models selected by the 14 entity are intended to improve’’ before the period at the 15 end. 16 SEC. 50603. REVIEWING STATEWIDE NEEDS TO TARGET RE- 17 18 SOURCES. Section 511(b)(1) of the Social Security Act (42 19 U.S.C. 711(b)(1)) is amended by striking ‘‘Not later 20 than’’ and all that follows through ‘‘section 505(a))’’ and 21 inserting ‘‘Each State shall, as a condition of receiving 22 payments from an allotment for the State under section 23 502, conduct a statewide needs assessment (which may be 24 separate from but in coordination with the statewide needs 25 assessment required under section 505(a) and which shall February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 424 1 be reviewed and updated by the State not later than Octo2 ber 1, 2020)’’. 3 SEC. 50604. IMPROVING THE LIKELIHOOD OF SUCCESS IN 4 HIGH-RISK COMMUNITIES. 5 Section 511(d)(4)(A) of the Social Security Act (42 6 U.S.C. 711(d)(4)(A)) is amended by inserting ‘‘, taking 7 into account the staffing, community resource, and other 8 requirements to operate at least one approved model of 9 home visiting and demonstrate improvements for eligible 10 families’’ before the period. 11 SEC. 50605. OPTION TO FUND EVIDENCE-BASED HOME VIS- 12 ITING ON A PAY FOR OUTCOME BASIS. 13 (a) IN GENERAL.—Section 511(c) of the Social Secu- 14 rity Act (42 U.S.C. 711(c)) is amended by redesignating 15 paragraphs (3) and (4) as paragraphs (4) and (5), respec16 tively, and by inserting after paragraph (2) the following: 17 ‘‘(3) AUTHORITY TO USE GRANT FOR A PAY 18 FOR OUTCOMES INITIATIVE.—An 19 which a grant is made under paragraph (1) may use 20 up to 25 percent of the grant for outcomes or suc- 21 cess payments related to a pay for outcomes initia- 22 tive that will not result in a reduction of funding for 23 services delivered by the entity under a childhood 24 home visitation program under this section while the February 7, 2018 (10:12 p.m.) eligible entity to U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 425 1 eligible entity develops or operates such an initia- 2 tive.’’. 3 (b) DEFINITION 4 TIVE.—Section OF PAY FOR OUTCOMES INITIA- 511(k) of such Act (42 U.S.C. 711(k)) is 5 amended by adding at the end the following: 6 ‘‘(4) PAY FOR OUTCOMES INITIATIVE.—The 7 term ‘pay for outcomes initiative’ means a perform- 8 ance-based grant, contract, cooperative agreement, 9 or other agreement awarded by a public entity in 10 which a commitment is made to pay for improved 11 outcomes achieved as a result of the intervention 12 that result in social benefit and direct cost savings 13 or cost avoidance to the public sector. Such an ini- 14 tiative shall include— 15 ‘‘(A) a feasibility study that describes how 16 the proposed intervention is based on evidence 17 of effectiveness; 18 ‘‘(B) a rigorous, third-party evaluation 19 that uses experimental or quasi-experimental 20 design or other research methodologies that 21 allow for the strongest possible causal infer- 22 ences to determine whether the initiative has 23 met its proposed outcomes as a result of the 24 intervention; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 426 1 2 ‘‘(C) an annual, publicly available report on the progress of the initiative; and 3 ‘‘(D) a requirement that payments are 4 made to the recipient of a grant, contract, or 5 cooperative agreement only when agreed upon 6 outcomes are achieved, except that this require- 7 ment shall not apply with respect to payments 8 to a third party conducting the evaluation de- 9 scribed in subparagraph (B).’’. 10 (c) EXTENDED AVAILABILITY OF FUNDS.—Section 11 511(j)(3) of such Act (42 U.S.C. 711(j)(3)) is amended— 12 (1) by striking ‘‘(3) AVAILABILITY.—Funds’’ 13 and inserting the following: 14 ‘‘(3) AVAILABILITY.— 15 ‘‘(A) IN GENERAL.—Except as provided in 16 subparagraph (B), funds’’; and 17 (2) by adding at the end the following: 18 ‘‘(B) FUNDS FOR PAY FOR OUTCOMES INI- 19 TIATIVES.—Funds 20 entity under this section for a fiscal year (or 21 portion of a fiscal year) for a pay for outcomes 22 initiative shall remain available for expenditure 23 by the eligible entity for not more than 10 years 24 after the funds are so made available.’’. February 7, 2018 (10:12 p.m.) made available to an eligible U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 427 1 SEC. 50606. DATA EXCHANGE STANDARDS FOR IMPROVED 2 3 INTEROPERABILITY. (a) IN GENERAL.—Section 511(h) of the Social Secu- 4 rity Act (42 U.S.C. 711(h)) is amended by adding at the 5 end the following: 6 7 ‘‘(5) DATA EXCHANGE STANDARDS FOR IM- PROVED INTEROPERABILITY.— 8 ‘‘(A) DESIGNATION 9 CHANGE STANDARDS.— AND USE OF DATA EX- 10 ‘‘(i) DESIGNATION.—The head of the 11 department or agency responsible for ad- 12 ministering a program funded under this 13 section shall, in consultation with an inter- 14 agency work group established by the Of- 15 fice of Management and Budget and con- 16 sidering State government perspectives, 17 designate data exchange standards for nec- 18 essary categories of information that a 19 State agency operating the program is re- 20 quired to electronically exchange with an- 21 other State agency under applicable Fed- 22 eral law. 23 ‘‘(ii) DATA EXCHANGE STANDARDS 24 MUST BE NONPROPRIETARY AND INTER- 25 OPERABLE.—The 26 designated under clause (i) shall, to the ex- February 7, 2018 (10:12 p.m.) data exchange standards U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 428 1 tent practicable, be nonproprietary and 2 interoperable. 3 ‘‘(iii) OTHER REQUIREMENTS.—In 4 designating data exchange standards under 5 this paragraph, the Secretary shall, to the 6 extent practicable, incorporate— 7 ‘‘(I) interoperable standards de- 8 veloped and maintained by an inter- 9 national voluntary consensus stand- 10 ards body, as defined by the Office of 11 Management and Budget; 12 ‘‘(II) interoperable standards de- 13 veloped and maintained by intergov- 14 ernmental partnerships, such as the 15 National 16 Model; and 17 ‘‘(III) Information Exchange interoperable standards 18 developed and maintained by Federal 19 entities 20 tracting and financial assistance. 21 22 ‘‘(B) DATA with authority over con- EXCHANGE STANDARDS FOR FEDERAL REPORTING.— 23 ‘‘(i) DESIGNATION.—The head of the 24 department or agency responsible for ad- 25 ministering a program referred to in this February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 429 1 section shall, in consultation with an inter- 2 agency work group established by the Of- 3 fice of Management and Budget, and con- 4 sidering State government perspectives, 5 designate data exchange standards to gov- 6 ern Federal reporting and exchange re- 7 quirements under applicable Federal law. 8 ‘‘(ii) REQUIREMENTS.—The data ex- 9 change reporting standards required by 10 clause (i) shall, to the extent practicable— 11 ‘‘(I) incorporate a widely accept- 12 ed, nonproprietary, searchable, com- 13 puter-readable format; 14 ‘‘(II) be consistent with and im- 15 plement applicable accounting prin- 16 ciples; 17 ‘‘(III) be implemented in a man- 18 ner that is cost-effective and improves 19 program efficiency and effectiveness; 20 and 21 ‘‘(IV) be capable of being contin- 22 ually upgraded as necessary. 23 ‘‘(iii) INCORPORATION OF NONPROPRI- 24 ETARY STANDARDS.—In 25 exchange standards under this paragraph, February 7, 2018 (10:12 p.m.) designating data U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 430 1 the Secretary shall, to the extent prac- 2 ticable, incorporate existing nonproprietary 3 standards, such as the eXtensible Mark up 4 Language. 5 ‘‘(iv) RULE OF CONSTRUCTION.— 6 Nothing in this paragraph shall be con- 7 strued to require a change to existing data 8 exchange standards for Federal reporting 9 about a program referred to in this sec- 10 tion, if the head of the department or 11 agency responsible for administering the 12 program finds the standards to be effective 13 and efficient.’’. 14 (b) EFFECTIVE DATE.—The amendment made by 15 subsection (a) shall take effect on the date that is 2 years 16 after the date of enactment of this Act. 17 SEC. 50607. ALLOCATION OF FUNDS. 18 Section 511(j) of the Social Security Act (42 U.S.C. 19 711(j)) is amended by adding at the end the following: 20 ‘‘(4) ALLOCATION OF FUNDS.—To the extent 21 that the grant amount awarded under this section to 22 an eligible entity is determined on the basis of rel- 23 ative population or poverty considerations, the Sec- 24 retary shall make the determination using the most February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 431 1 accurate Federal data available for the eligible enti- 2 ty.’’. 5 Subtitle B—Extension of Health Professions Workforce Demonstration Projects 6 SEC. 50611. EXTENSION OF HEALTH WORKFORCE DEM- 7 ONSTRATION PROJECTS FOR LOW-INCOME 8 INDIVIDUALS. 3 4 9 Section 2008(c)(1) of the Social Security Act (42 10 U.S.C. 1397g(c)(1)) is amended by striking ‘‘2017’’ and 11 inserting ‘‘2019’’. 15 TITLE VII—FAMILY FIRST PREVENTION SERVICES ACT Subtitle A—Investing in Prevention and Supporting Families 16 SEC. 50701. SHORT TITLE. 12 13 14 17 This subtitle may be cited as the ‘‘Bipartisan Budget 18 Act of 2018’’. 19 SEC. 50702. PURPOSE. 20 The purpose of this subtitle is to enable States to 21 use Federal funds available under parts B and E of title 22 IV of the Social Security Act to provide enhanced support 23 to children and families and prevent foster care place24 ments through the provision of mental health and sub25 stance abuse prevention and treatment services, in-home February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 432 1 parent skill-based programs, and kinship navigator serv2 ices. 3 PART I—PREVENTION ACTIVITIES UNDER TITLE 4 IV–E 5 SEC. 50711. FOSTER CARE PREVENTION SERVICES AND 6 PROGRAMS. 7 (a) STATE OPTION.—Section 471 of the Social Secu- 8 rity Act (42 U.S.C. 671) is amended— 9 (1) in subsection (a)(1), by striking ‘‘and’’ and 10 all that follows through the semicolon and inserting 11 ‘‘, adoption assistance in accordance with section 12 473, and, at the option of the State, services or pro- 13 grams specified in subsection (e)(1) of this section 14 for children who are candidates for foster care or 15 who are pregnant or parenting foster youth and the 16 parents or kin caregivers of the children, in accord- 17 ance with the requirements of that subsection;’’; and 18 (2) by adding at the end the following: 19 20 ‘‘(e) PREVENTION AND FAMILY SERVICES AND PRO- GRAMS.— 21 ‘‘(1) IN GENERAL.—Subject to the succeeding 22 provisions of this subsection, the Secretary may 23 make a payment to a State for providing the fol- 24 lowing services or programs for a child described in 25 paragraph (2) and the parents or kin caregivers of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 433 1 the child when the need of the child, such a parent, 2 or such a caregiver for the services or programs are 3 directly related to the safety, permanence, or well- 4 being of the child or to preventing the child from en- 5 tering foster care: 6 ‘‘(A) MENTAL HEALTH AND SUBSTANCE 7 ABUSE PREVENTION AND TREATMENT SERV- 8 ICES.—Mental 9 vention and treatment services provided by a 10 qualified clinician for not more than a 12- 11 month period that begins on any date described 12 in paragraph (3) with respect to the child. 13 health and substance abuse pre- ‘‘(B) IN-HOME PARENT SKILL-BASED PRO- 14 GRAMS.—In-home 15 for not more than a 12-month period that be- 16 gins on any date described in paragraph (3) 17 with respect to the child and that include par- 18 enting skills training, parent education, and in- 19 dividual and family counseling. 20 ‘‘(2) CHILD parent skill-based programs DESCRIBED.—For purposes of 21 paragraph (1), a child described in this paragraph is 22 the following: 23 ‘‘(A) A child who is a candidate for foster 24 care (as defined in section 475(13)) but can re- 25 main safely at home or in a kinship placement February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 434 1 with receipt of services or programs specified in 2 paragraph (1). 3 ‘‘(B) A child in foster care who is a preg- 4 nant or parenting foster youth. 5 ‘‘(3) DATE DESCRIBED.—For purposes of para- 6 graph (1), the dates described in this paragraph are 7 the following: 8 ‘‘(A) The date on which a child is identi- 9 fied in a prevention plan maintained under 10 paragraph (4) as a child who is a candidate for 11 foster care (as defined in section 475(13)). 12 ‘‘(B) The date on which a child is identi- 13 fied in a prevention plan maintained under 14 paragraph (4) as a pregnant or parenting foster 15 youth in need of services or programs specified 16 in paragraph (1). 17 ‘‘(4) REQUIREMENTS RELATED TO PROVIDING 18 SERVICES AND PROGRAMS.—Services 19 specified in paragraph (1) may be provided under 20 this subsection only if specified in advance in the 21 child’s prevention plan described in subparagraph 22 (A) and the requirements in subparagraphs (B) 23 through (E) are met: 24 25 February 7, 2018 (10:12 p.m.) ‘‘(A) PREVENTION and programs PLAN.—The State maintains a written prevention plan for the U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 435 1 child that meets the following requirements (as 2 applicable): 3 ‘‘(i) CANDIDATES.—In the case of a 4 child who is a candidate for foster care de- 5 scribed in paragraph (2)(A), the prevention 6 plan shall— 7 ‘‘(I) identify the foster care pre- 8 vention strategy for the child so that 9 the child may remain safely at home, 10 live temporarily with a kin caregiver 11 until 12 achieved, or live permanently with a 13 kin caregiver; reunification can be safely 14 ‘‘(II) list the services or pro- 15 grams to be provided to or on behalf 16 of the child to ensure the success of 17 that prevention strategy; and 18 ‘‘(III) comply with such other re- 19 quirements as the Secretary shall es- 20 tablish. 21 ‘‘(ii) PREGNANT OR PARENTING FOS- 22 TER YOUTH.—In 23 a pregnant or parenting foster youth de- 24 scribed in paragraph (2)(B), the preven- 25 tion plan shall— February 7, 2018 (10:12 p.m.) the case of a child who is U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 436 1 ‘‘(I) be included in the child’s 2 case plan required under section 3 475(1); 4 ‘‘(II) list the services or pro- 5 grams to be provided to or on behalf 6 of the youth to ensure that the youth 7 is prepared (in the case of a pregnant 8 foster youth) or able (in the case of a 9 parenting foster youth) to be a par- 10 ent; 11 ‘‘(III) describe the foster care 12 prevention strategy for any child born 13 to the youth; and 14 ‘‘(IV) comply with such other re- 15 quirements as the Secretary shall es- 16 tablish. 17 ‘‘(B) TRAUMA-INFORMED.—The services or 18 programs to be provided to or on behalf of a 19 child are provided under an organizational 20 structure and treatment framework that in- 21 volves understanding, recognizing, and respond- 22 ing to the effects of all types of trauma and in 23 accordance with recognized principles of a trau- 24 ma-informed February 7, 2018 (10:12 p.m.) approach and trauma-specific U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 437 1 interventions to address trauma’s consequences 2 and facilitate healing. 3 ‘‘(C) ONLY SERVICES AND PROGRAMS PRO- 4 VIDED IN ACCORDANCE WITH PROMISING, SUP- 5 PORTED, OR WELL-SUPPORTED PRACTICES PER- 6 MITTED.— 7 ‘‘(i) IN GENERAL.—Only State ex- 8 penditures for services or programs speci- 9 fied in subparagraph (A) or (B) of para- 10 graph (1) that are provided in accordance 11 with practices that meet the requirements 12 specified in clause (ii) of this subparagraph 13 and that meet the requirements specified 14 in clause (iii), (iv), or (v), respectively, for 15 being a promising, supported, or well-sup- 16 ported practice, shall be eligible for a Fed- 17 eral matching payment under section 18 474(a)(6)(A). 19 ‘‘(ii) GENERAL PRACTICE REQUIRE- 20 MENTS.—The 21 ments specified in this clause are the fol- 22 lowing: general practice require- 23 ‘‘(I) The practice has a book, 24 manual, or other available writings 25 that specify the components of the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 438 1 practice protocol and describe how to 2 administer the practice. 3 ‘‘(II) There is no empirical basis 4 suggesting that, compared to its likely 5 benefits, the practice constitutes a 6 risk of harm to those receiving it. 7 ‘‘(III) If multiple outcome studies 8 have been conducted, the overall 9 weight of evidence supports the bene- 10 fits of the practice. 11 ‘‘(IV) Outcome measures are reli- 12 able and valid, and are administrated 13 consistently and accurately across all 14 those receiving the practice. 15 ‘‘(V) There is no case data sug- 16 gesting a risk of harm that was prob- 17 ably caused by the treatment and that 18 was severe or frequent. 19 ‘‘(iii) PROMISING PRACTICE.—A prac- 20 tice shall be considered to be a ‘promising 21 practice’ if the practice is superior to an 22 appropriate comparison practice using con- 23 ventional standards of statistical signifi- 24 cance (in terms of demonstrated meaning- 25 ful improvements in validated measures of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 439 1 important child and parent outcomes, such 2 as mental health, substance abuse, and 3 child safety and well-being), as established 4 by the results or outcomes of at least one 5 study that— 6 ‘‘(I) was rated by an independent 7 systematic review for the quality of 8 the study design and execution and 9 determined to be well-designed and 10 well-executed; and 11 ‘‘(II) utilized some form of con- 12 trol (such as an untreated group, a 13 placebo group, or a wait list study). 14 ‘‘(iv) SUPPORTED PRACTICE.—A prac- 15 tice shall be considered to be a ‘supported 16 practice’ if— 17 ‘‘(I) the practice is superior to an 18 appropriate comparison practice using 19 conventional standards of statistical 20 significance (in terms of demonstrated 21 meaningful improvements in validated 22 measures of important child and par- 23 ent outcomes, such as mental health, 24 substance abuse, and child safety and 25 well-being), as established by the re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 440 1 sults or outcomes of at least one study 2 that— 3 ‘‘(aa) was rated by an inde- 4 pendent systematic review for the 5 quality of the study design and 6 execution and determined to be 7 well-designed and well-executed; 8 ‘‘(bb) was a rigorous ran- 9 dom-controlled trial (or, if not 10 available, a study using a rig- 11 orous 12 search design); and quasi-experimental re- 13 ‘‘(cc) was carried out in a 14 usual care or practice setting; 15 and 16 ‘‘(II) the study described in sub- 17 clause (I) established that the practice 18 has a sustained effect (when com- 19 pared to a control group) for at least 20 6 months beyond the end of the treat- 21 ment. 22 ‘‘(v) WELL-SUPPORTED PRACTICE.—A 23 practice shall be considered to be a ‘well- 24 supported practice’ if— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 441 1 ‘‘(I) the practice is superior to an 2 appropriate comparison practice using 3 conventional standards of statistical 4 significance (in terms of demonstrated 5 meaningful improvements in validated 6 measures of important child and par- 7 ent outcomes, such as mental health, 8 substance abuse, and child safety and 9 well-being), as established by the re- 10 sults or outcomes of at least two stud- 11 ies that— 12 ‘‘(aa) were rated by an inde- 13 pendent systematic review for the 14 quality of the study design and 15 execution and determined to be 16 well-designed and well-executed; 17 ‘‘(bb) were rigorous random- 18 controlled trials (or, if not avail- 19 able, studies using a rigorous 20 quasi-experimental research de- 21 sign); and 22 ‘‘(cc) were carried out in a 23 usual care or practice setting; 24 and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 442 1 ‘‘(II) at least one of the studies 2 described in subclause (I) established 3 that the practice has a sustained ef- 4 fect (when compared to a control 5 group) for at least 1 year beyond the 6 end of treatment. 7 ‘‘(D) GUIDANCE 8 AND 9 GRAMS.— 10 PRE-APPROVED ‘‘(i) IN ON PRACTICES CRITERIA SERVICES GENERAL.—Not AND PRO- later than Oc- 11 tober 1, 2018, the Secretary shall issue 12 guidance to States regarding the practices 13 criteria required for services or programs 14 to satisfy the requirements of subpara- 15 graph (C). The guidance shall include a 16 pre-approved list of services and programs 17 that satisfy the requirements. 18 ‘‘(ii) UPDATES.—The Secretary shall 19 issue updates to the guidance required by 20 clause (i) as often as the Secretary deter- 21 mines necessary. 22 ‘‘(E) OUTCOME ASSESSMENT AND REPORT- 23 ING.—The 24 Secretary the following information with respect 25 to each child for whom, or on whose behalf February 7, 2018 (10:12 p.m.) State shall collect and report to the U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 443 1 mental health and substance abuse prevention 2 and treatment services or in-home parent skill- 3 based programs are provided during a 12- 4 month period beginning on the date the child is 5 determined by the State to be a child described 6 in paragraph (2): 7 ‘‘(i) The specific services or programs 8 provided and the total expenditures for 9 each of the services or programs. 10 11 ‘‘(ii) The duration of the services or programs provided. 12 ‘‘(iii) In the case of a child described 13 in paragraph (2)(A), the child’s placement 14 status at the beginning, and at the end, of 15 the 1-year period, respectively, and wheth- 16 er the child entered foster care within 2 17 years after being determined a candidate 18 for foster care. 19 20 ‘‘(5) STATE PLAN COMPONENT.— ‘‘(A) IN GENERAL.—A State electing to 21 provide services or programs specified in para- 22 graph (1) shall submit as part of the State plan 23 required by subsection (a) a prevention services 24 and programs plan component that meets the 25 requirements of subparagraph (B). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 444 1 ‘‘(B) PREVENTION SERVICES AND PRO- 2 GRAMS PLAN COMPONENT.—In 3 the requirements of this subparagraph, a pre- 4 vention services and programs plan component, 5 with respect to each 5-year period for which the 6 plan component is in operation in the State, 7 shall include the following: order to meet 8 ‘‘(i) How providing services and pro- 9 grams specified in paragraph (1) is ex- 10 pected to improve specific outcomes for 11 children and families. 12 ‘‘(ii) How the State will monitor and 13 oversee the safety of children who receive 14 services and programs specified in para- 15 graph (1), including through periodic risk 16 assessments throughout the period in 17 which the services and programs are pro- 18 vided on behalf of a child and reexamina- 19 tion of the prevention plan maintained for 20 the child under paragraph (4) for the pro- 21 vision of the services or programs if the 22 State determines the risk of the child en- 23 tering foster care remains high despite the 24 provision of the services or programs. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 445 1 ‘‘(iii) With respect to the services and 2 programs specified in subparagraphs (A) 3 and (B) of paragraph (1), information on 4 the specific promising, supported, or well- 5 supported practices the State plans to use 6 to provide the services or programs, includ- 7 ing a description of— 8 ‘‘(I) the services or programs and 9 whether the practices used are prom- 10 ising, supported, or well-supported; 11 ‘‘(II) how the State plans to im- 12 plement the services or programs, in- 13 cluding how implementation of the 14 services or programs will be continu- 15 ously monitored to ensure fidelity to 16 the practice model and to determine 17 outcomes achieved and how informa- 18 tion learned from the monitoring will 19 be used to refine and improve prac- 20 tices; 21 22 23 24 February 7, 2018 (10:12 p.m.) ‘‘(III) how the State selected the services or programs; ‘‘(IV) the target population for the services or programs; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 446 1 ‘‘(V) how each service or pro- 2 gram 3 through a well-designed and rigorous 4 process, which may consist of an on- 5 going, cross-site evaluation approved 6 by the Secretary. 7 ‘‘(iv) A description of the consultation 8 that the State agencies responsible for ad- 9 ministering the State plans under this part 10 and part B engage in with other State 11 agencies 12 health programs, including mental health 13 and substance abuse prevention and treat- 14 ment services, and with other public and 15 private agencies with experience in admin- 16 istering child and family services, including 17 community-based organizations, in order to 18 foster a continuum of care for children de- 19 scribed in paragraph (2) and their parents 20 or kin caregivers. provided responsible will for be evaluated administering 21 ‘‘(v) A description of how the State 22 shall assess children and their parents or 23 kin caregivers to determine eligibility for 24 services or programs specified in para- 25 graph (1). February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 447 1 ‘‘(vi) A description of how the services 2 or programs specified in paragraph (1) 3 that are provided for or on behalf of a 4 child and the parents or kin caregivers of 5 the child will be coordinated with other 6 child and family services provided to the 7 child and the parents or kin caregivers of 8 the child under the State plans in effect 9 under subparts 1 and 2 of part B. 10 ‘‘(vii) Descriptions of steps the State 11 is taking to support and enhance a com- 12 petent, skilled, and professional child wel- 13 fare workforce to deliver trauma-informed 14 and evidence-based services, including— 15 ‘‘(I) ensuring that staff is quali- 16 fied to provide services or programs 17 that are consistent with the prom- 18 ising, supported, or well-supported 19 practice models selected; and 20 ‘‘(II) developing appropriate pre- 21 vention plans, and conducting the risk 22 assessments required under clause 23 (iii). 24 ‘‘(viii) A description of how the State 25 will provide training and support for case- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 448 1 workers in assessing what children and 2 their families need, connecting to the fami- 3 lies served, knowing how to access and de- 4 liver the needed trauma-informed and evi- 5 dence-based services, and overseeing and 6 evaluating the continuing appropriateness 7 of the services. 8 ‘‘(ix) A description of how caseload 9 size and type for prevention caseworkers 10 will be determined, managed, and overseen. 11 ‘‘(x) An assurance that the State will 12 report to the Secretary such information 13 and data as the Secretary may require 14 with respect to the provision of services 15 and programs specified in paragraph (1), 16 including information and data necessary 17 to determine the performance measures for 18 the State under paragraph (6) and compli- 19 ance with paragraph (7). 20 ‘‘(C) REIMBURSEMENT FOR SERVICES 21 UNDER THE PREVENTION PLAN COMPONENT.— 22 ‘‘(i) LIMITATION.—Except as provided 23 in subclause (ii), a State may not receive 24 a Federal payment under this part for a 25 given promising, supported, or well-sup- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 449 1 ported practice unless (in accordance with 2 subparagraph (B)(iii)(V)) the plan includes 3 a well-designed and rigorous evaluation 4 strategy for that practice. 5 ‘‘(ii) WAIVER OF LIMITATION.—The 6 Secretary may waive the requirement for a 7 well-designed and rigorous evaluation of 8 any well-supported practice if the Sec- 9 retary deems the evidence of the effective- 10 ness of the practice to be compelling and 11 the State meets the continuous quality im- 12 provement requirements included in sub- 13 paragraph (B)(iii)(II) with regard to the 14 practice. 15 ‘‘(6) PREVENTION 16 ‘‘(A) SERVICES MEASURES.— ESTABLISHMENT; ANNUAL UP- 17 DATES.—Beginning 18 annually thereafter, the Secretary shall estab- 19 lish the following prevention services measures 20 based on information and data reported by 21 States that elect to provide services and pro- 22 grams specified in paragraph (1): 23 with fiscal year 2021, and ‘‘(i) PERCENTAGE OF CANDIDATES 24 FOR FOSTER CARE WHO DO NOT ENTER 25 FOSTER CARE.—The February 7, 2018 (10:12 p.m.) percentage of can- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 450 1 didates for foster care for whom, or on 2 whose behalf, the services or programs are 3 provided who do not enter foster care, in- 4 cluding those placed with a kin caregiver 5 outside of foster care, during the 12-month 6 period in which the services or programs 7 are provided and through the end of the 8 succeeding 12-month period. 9 ‘‘(ii) PER-CHILD SPENDING.—The 10 total amount of expenditures made for 11 mental health and substance abuse preven- 12 tion and treatment services or in-home 13 parent skill-based programs, respectively, 14 for, or on behalf of, each child described in 15 paragraph (2). 16 ‘‘(B) DATA.—The Secretary shall establish 17 and annually update the prevention services 18 measures— 19 ‘‘(i) based on the median State values 20 of the information reported under each 21 clause of subparagraph (A) for the 3 then 22 most recent years; and 23 ‘‘(ii) taking into account State dif- 24 ferences in the price levels of consumption 25 goods and services using the most recent February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 451 1 regional price parities published by the Bu- 2 reau of Economic Analysis of the Depart- 3 ment of Commerce or such other data as 4 the Secretary determines appropriate. 5 ‘‘(C) PUBLICATION 6 SERVICES MEASURES.—The 7 nually make available to the public the preven- 8 tion services measures of each State. 9 ‘‘(7) MAINTENANCE 10 11 OF STATE PREVENTION Secretary shall an- OF EFFORT FOR STATE FOSTER CARE PREVENTION EXPENDITURES.— ‘‘(A) IN GENERAL.—If a State elects to 12 provide services and programs specified in para- 13 graph (1) for a fiscal year, the State foster care 14 prevention expenditures for the fiscal year shall 15 not be less than the amount of the expenditures 16 for fiscal year 2014 (or, at the option of a State 17 described in subparagraph (E), fiscal year 2015 18 or fiscal year 2016 (whichever the State 19 elects)). 20 ‘‘(B) STATE 21 EXPENDITURES.—The 22 prevention expenditures’ means the following: 23 FOSTER CARE PREVENTION ‘‘(i) TANF; term ‘State foster care IV–B; SSBG.—State ex- 24 penditures for foster care prevention serv- 25 ices and activities under the State program February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 452 1 funded under part A (including from 2 amounts made available by the Federal 3 Government), under the State plan devel- 4 oped under part B (including any such 5 amounts), or under the Social Services 6 Block Grant Programs under subtitle A of 7 title XX (including any such amounts). 8 ‘‘(ii) OTHER STATE PROGRAMS.— 9 State expenditures for foster care preven- 10 tion services and activities under any State 11 program that is not described in clause (i) 12 (other than any State expenditures for fos- 13 ter care prevention services and activities 14 under the State program under this part 15 (including under a waiver of the pro- 16 gram)). 17 ‘‘(C) STATE EXPENDITURES.—The term 18 ‘State expenditures’ means all State or local 19 funds that are expended by the State or a local 20 agency including State or local funds that are 21 matched or reimbursed by the Federal Govern- 22 ment and State or local funds that are not 23 matched or reimbursed by the Federal Govern- 24 ment. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 453 1 ‘‘(D) DETERMINATION OF PREVENTION 2 SERVICES 3 shall require each State that elects to provide 4 services and programs specified in paragraph 5 (1) to report the expenditures specified in sub- 6 paragraph (B) for fiscal year 2014 and for such 7 fiscal years thereafter as are necessary to deter- 8 mine whether the State is complying with the 9 maintenance of effort requirement in subpara- 10 graph (A). The Secretary shall specify the spe- 11 cific services and activities under each program 12 referred to in subparagraph (B) that are ‘pre- 13 vention services and activities’ for purposes of 14 the reports. 15 ACTIVITIES.—The AND ‘‘(E) STATE DESCRIBED.—For Secretary purposes of 16 subparagraph (A), a State is described in this 17 subparagraph if the population of children in 18 the State in 2014 was less than 200,000 (as de- 19 termined by the United States Census Bureau). 20 ‘‘(8) PROHIBITION AGAINST USE OF STATE FOS- 21 TER CARE PREVENTION EXPENDITURES AND FED- 22 ERAL IV–E PREVENTION FUNDS FOR MATCHING OR 23 EXPENDITURE REQUIREMENT.—A 24 to provide services and programs specified in para- 25 graph (1) shall not use any State foster care preven- February 7, 2018 (10:12 p.m.) State that elects U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 454 1 tion expenditures for a fiscal year for the State 2 share of expenditures under section 474(a)(6) for a 3 fiscal year. 4 5 ‘‘(9) ADMINISTRATIVE COSTS.—Expenditures described in section 474(a)(6)(B)— 6 ‘‘(A) shall not be eligible for payment 7 under subparagraph (A), (B), or (E) of section 8 474(a)(3); and 9 ‘‘(B) shall be eligible for payment under 10 section 474(a)(6)(B) without regard to whether 11 the expenditures are incurred on behalf of a 12 child who is, or is potentially, eligible for foster 13 care maintenance payments under this part. 14 ‘‘(10) APPLICATION.— 15 ‘‘(A) IN GENERAL.—The provision of serv- 16 ices or programs under this subsection to or on 17 behalf of a child described in paragraph (2) 18 shall not be considered to be receipt of aid or 19 assistance under the State plan under this part 20 for purposes of eligibility for any other program 21 established under this Act. 22 ‘‘(B) CANDIDATES IN KINSHIP CARE.—A 23 child described in paragraph (2) for whom such 24 services or programs under this subsection are 25 provided for more than 6 months while in the February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 455 1 home of a kin caregiver, and who would satisfy 2 the AFDC eligibility requirement of section 3 472(a)(3)(A)(ii)(II) but for residing in the 4 home of the caregiver for more than 6 months, 5 is deemed to satisfy that requirement for pur- 6 poses of determining whether the child is eligi- 7 ble for foster care maintenance payments under 8 section 472.’’. 9 (b) DEFINITION.—Section 475 of such Act (42 10 U.S.C. 675) is amended by adding at the end the fol11 lowing: 12 ‘‘(13) The term ‘child who is a candidate for 13 foster care’ means, a child who is identified in a pre- 14 vention plan under section 471(e)(4)(A) as being at 15 imminent risk of entering foster care (without re- 16 gard to whether the child would be eligible for foster 17 care maintenance payments under section 472 or is 18 or would be eligible for adoption assistance or kin- 19 ship guardianship assistance payments under section 20 473) but who can remain safely in the child’s home 21 or in a kinship placement as long as services or pro- 22 grams specified in section 471(e)(1) that are nec- 23 essary to prevent the entry of the child into foster 24 care are provided. The term includes a child whose 25 adoption or guardianship arrangement is at risk of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 456 1 a disruption or dissolution that would result in a 2 foster care placement.’’. 3 (c) PAYMENTS UNDER TITLE IV–E.—Section 474(a) 4 of such Act (42 U.S.C. 674(a)) is amended— 5 6 (1) in paragraph (5), by striking the period at the end and inserting ‘‘; plus’’; and 7 (2) by adding at the end the following: 8 ‘‘(6) subject to section 471(e)— 9 10 ‘‘(A) for each quarter— ‘‘(i) subject to clause (ii)— 11 ‘‘(I) beginning after September 12 30, 2019, and before October 1, 2026, 13 an amount equal to 50 percent of the 14 total amount expended during the 15 quarter for the provision of services or 16 programs specified in subparagraph 17 (A) or (B) of section 471(e)(1) that 18 are provided in accordance with prom- 19 ising, supported, or well-supported 20 practices that meet the applicable cri- 21 teria specified for the practices in sec- 22 tion 471(e)(4)(C); and 23 ‘‘(II) beginning after September 24 30, 2026, an amount equal to the 25 Federal medical assistance percentage February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 457 1 (which shall be as defined in section 2 1905(b), in the case of a State other 3 than the District of Columbia, or 70 4 percent, in the case of the District of 5 Columbia) of the total amount ex- 6 pended during the quarter for the pro- 7 vision of services or programs speci- 8 fied in subparagraph (A) or (B) of 9 section 471(e)(1) that are provided in 10 accordance with promising, supported, 11 or well-supported practices that meet 12 the applicable criteria specified for the 13 practices in section 471(e)(4)(C) (or, 14 with respect to the payments made 15 during the quarter under a coopera- 16 tive agreement or contract entered 17 into by the State and an Indian tribe, 18 tribal organization, or tribal consor- 19 tium for the administration or pay- 20 ment of funds under this part, an 21 amount equal to the Federal medical 22 assistance 23 apply under section 479B(d) (in this 24 paragraph referred to as the ‘tribal 25 FMAP’) if the Indian tribe, tribal or- February 7, 2018 (10:12 p.m.) percentage that would U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 458 1 ganization, or tribal consortium made 2 the payments under a program oper- 3 ated under that section, unless the 4 tribal FMAP is less than the Federal 5 medical assistance percentage that ap- 6 plies to the State); except that 7 ‘‘(ii) not less than 50 percent of the 8 total amount expended by a State under 9 clause (i) for a fiscal year shall be for the 10 provision of services or programs specified 11 in subparagraph (A) or (B) of section 12 471(e)(1) that are provided in accordance 13 with well-supported practices; plus 14 ‘‘(B) for each quarter specified in subpara- 15 graph (A), an amount equal to the sum of the 16 following proportions of the total amount ex- 17 pended during the quarter— 18 ‘‘(i) 50 percent of so much of the ex- 19 penditures as are found necessary by the 20 Secretary for the proper and efficient ad- 21 ministration of the State plan for the pro- 22 vision of services or programs specified in 23 section 471(e)(1), including expenditures 24 for activities approved by the Secretary 25 that promote the development of necessary February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 459 1 processes and procedures to establish and 2 implement the provision of the services and 3 programs for individuals who are eligible 4 for the services and programs and expendi- 5 tures attributable to data collection and re- 6 porting; and 7 ‘‘(ii) 50 percent of so much of the ex- 8 penditures with respect to the provision of 9 services and programs specified in section 10 471(e)(1) as are for training of personnel 11 employed or preparing for employment by 12 the State agency or by the local agency ad- 13 ministering the plan in the political sub- 14 division and of the members of the staff of 15 State-licensed or State-approved child wel- 16 fare agencies providing services to children 17 described in section 471(e)(2) and their 18 parents or kin caregivers, including on how 19 to determine who are individuals eligible 20 for the services or programs, how to iden- 21 tify and provide appropriate services and 22 programs, and how to oversee and evaluate 23 the ongoing appropriateness of the services 24 and programs.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 460 1 (d) TECHNICAL ASSISTANCE 2 CLEARINGHOUSE, 3 TIONS.—Section AND BEST PRACTICES, AND DATA COLLECTION AND EVALUA- 476 of such Act (42 U.S.C. 676) is 4 amended by adding at the end the following: 5 ‘‘(d) TECHNICAL ASSISTANCE AND BEST PRACTICES, 6 CLEARINGHOUSE, DATA COLLECTION, AND EVALUATIONS 7 RELATING AND PROGRAMS.— 8 9 TO PREVENTION SERVICES ‘‘(1) TECHNICAL TICES.—The ASSISTANCE AND BEST PRAC- Secretary shall provide to States and, 10 as applicable, to Indian tribes, tribal organizations, 11 and tribal consortia, technical assistance regarding 12 the provision of services and programs described in 13 section 471(e)(1) and shall disseminate best prac- 14 tices with respect to the provision of the services and 15 programs, including how to plan and implement a 16 well-designed and rigorous evaluation of a prom- 17 ising, supported, or well-supported practice. 18 ‘‘(2) CLEARINGHOUSE OF PROMISING, SUP- 19 PORTED, AND WELL-SUPPORTED PRACTICES.—The 20 Secretary shall, directly or through grants, con- 21 tracts, or interagency agreements, evaluate research 22 on the practices specified in clauses (iii), (iv), and 23 (v), respectively, of section 471(e)(4)(C), and pro- 24 grams that meet the requirements described in sec- 25 tion 427(a)(1), including culturally specific, or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 461 1 location- or population-based adaptations of the 2 practices, to identify and establish a public clearing- 3 house of the practices that satisfy each category de- 4 scribed by such clauses. In addition, the clearing- 5 house shall include information on the specific out- 6 comes associated with each practice, including 7 whether the practice has been shown to prevent child 8 abuse and neglect and reduce the likelihood of foster 9 care placement by supporting birth families and kin- 10 ship families and improving targeted supports for 11 pregnant and parenting youth and their children. 12 ‘‘(3) DATA COLLECTION AND EVALUATIONS.— 13 The Secretary, directly or through grants, contracts, 14 or interagency agreements, may collect data and 15 conduct evaluations with respect to the provision of 16 services and programs described in section 471(e)(1) 17 for purposes of assessing the extent to which the 18 provision of the services and programs— 19 20 21 22 23 24 February 7, 2018 (10:12 p.m.) ‘‘(A) reduces the likelihood of foster care placement; ‘‘(B) increases use of kinship care arrangements; or ‘‘(C) improves child well-being. ‘‘(4) REPORTS TO CONGRESS.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 462 1 ‘‘(A) IN GENERAL.—The Secretary shall 2 submit to the Committee on Finance of the 3 Senate and the Committee on Ways and Means 4 of the House of Representatives periodic reports 5 based on the provision of services and programs 6 described in section 471(e)(1) and the activities 7 carried out under this subsection. 8 ‘‘(B) PUBLIC AVAILABILITY.—The Sec- 9 retary shall make the reports to Congress sub- 10 mitted under this paragraph publicly available. 11 ‘‘(5) APPROPRIATION.—Out of any money in 12 the Treasury of the United States not otherwise ap- 13 propriated, there are appropriated to the Secretary 14 $1,000,000 for fiscal year 2018 and each fiscal year 15 thereafter to carry out this subsection.’’. 16 (e) APPLICATION 17 DIAN 18 19 20 21 22 23 February 7, 2018 (10:12 p.m.) TO PROGRAMS OPERATED BY IN- TRIBAL ORGANIZATIONS.— (1) IN GENERAL.—Section 479B of such Act (42 U.S.C. 679c) is amended— (A) in subsection (c)(1)— (i) in subparagraph (C)(i)— (I) in subclause (II), by striking ‘‘and’’ after the semicolon; U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 463 1 (II) in subclause (III), by strik- 2 ing the period at the end and insert- 3 ing ‘‘; and’’; and 4 5 (III) by adding at the end the following: 6 ‘‘(IV) at the option of the tribe, 7 organization, or consortium, services 8 and programs specified in section 9 471(e)(1) to children described in sec- 10 tion 471(e)(2) and their parents or 11 kin caregivers, in accordance with sec- 12 tion 471(e) and subparagraph (E).’’; 13 and 14 (ii) by adding at the end the fol- 15 lowing: 16 ‘‘(E) PREVENTION SERVICES AND PRO- 17 GRAMS FOR CHILDREN AND THEIR PARENTS 18 AND KIN CAREGIVERS.— 19 ‘‘(i) IN GENERAL.—In the case of a 20 tribe, organization, or consortium that 21 elects to provide services and programs 22 specified in section 471(e)(1) to children 23 described in section 471(e)(2) and their 24 parents or kin caregivers under the plan, 25 the Secretary shall specify the require- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 464 1 ments applicable to the provision of the 2 services and programs. The requirements 3 shall, to the greatest extent practicable, be 4 consistent with the requirements applicable 5 to States under section 471(e) and shall 6 permit the provision of the services and 7 programs in the form of services and pro- 8 grams that are adapted to the culture and 9 context of the tribal communities served. 10 ‘‘(ii) PERFORMANCE MEASURES.—The 11 Secretary shall establish specific perform- 12 ance measures for each tribe, organization, 13 or consortium that elects to provide serv- 14 ices and programs specified in section 15 471(e)(1). 16 shall, to the greatest extent practicable, be 17 consistent with the prevention services 18 measures required for States under section 19 471(e)(6) but shall allow for consideration 20 of factors unique to the provision of the 21 services by tribes, organizations, or con- 22 sortia.’’; and 23 (B) in subsection (d)(1), by striking ‘‘and 24 February 7, 2018 (10:12 p.m.) The performance (5)’’ and inserting ‘‘(5), and (6)(A)’’. measures U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 465 1 (2) CONFORMING AMENDMENT.—The heading 2 for subsection (d) of section 479B of such Act (42 3 U.S.C. 679c) is amended by striking ‘‘FOR FOSTER 4 CARE MAINTENANCE 5 PAYMENTS’’. 6 (f) APPLICATION 7 RITORIES.—Section TO AND ADOPTION ASSISTANCE PROGRAMS OPERATED BY TER- 1108(a)(2) of the Social Security Act 8 (42 U.S.C. 1308(a)(2)) is amended by striking ‘‘or 9 413(f)’’ and inserting ‘‘413(f), or 474(a)(6)’’. 10 SEC. 50712. FOSTER CARE MAINTENANCE PAYMENTS FOR 11 CHILDREN WITH PARENTS IN A LICENSED 12 RESIDENTIAL 13 FACILITY FOR SUBSTANCE ABUSE. 14 FAMILY-BASED TREATMENT (a) IN GENERAL.—Section 472 of the Social Security 15 Act (42 U.S.C. 672) is amended— 16 (1) in subsection (a)(2)(C), by striking ‘‘or’’ 17 and inserting ‘‘, with a parent residing in a licensed 18 residential family-based treatment facility, but only 19 to the extent permitted under subsection (j), or in 20 a’’; and 21 (2) by adding at the end the following: 22 ‘‘(j) CHILDREN PLACED WITH A PARENT RESIDING 23 IN A LICENSED RESIDENTIAL FAMILY-BASED TREAT- 24 MENT FACILITY FOR SUBSTANCE ABUSE.— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 466 1 ‘‘(1) IN GENERAL.—Notwithstanding the pre- 2 ceding provisions of this section, a child who is eligi- 3 ble for foster care maintenance payments under this 4 section, or who would be eligible for the payments if 5 the eligibility were determined without regard to 6 paragraphs (1)(B) and (3) of subsection (a), shall be 7 eligible for the payments for a period of not more 8 than 12 months during which the child is placed 9 with a parent who is in a licensed residential family- 10 based treatment facility for substance abuse, but 11 only if— 12 ‘‘(A) the recommendation for the place- 13 ment is specified in the child’s case plan before 14 the placement; 15 ‘‘(B) the treatment facility provides, as 16 part of the treatment for substance abuse, par- 17 enting skills training, parent education, and in- 18 dividual and family counseling; and 19 ‘‘(C) the substance abuse treatment, par- 20 enting skills training, parent education, and in- 21 dividual and family counseling is provided 22 under an organizational structure and treat- 23 ment framework that involves understanding, 24 recognizing, and responding to the effects of all 25 types of trauma and in accordance with recog- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 467 1 nized principles of a trauma-informed approach 2 and trauma-specific interventions to address the 3 consequences of trauma and facilitate healing. 4 ‘‘(2) APPLICATION.—With respect to children 5 for whom foster care maintenance payments are 6 made under paragraph (1), only the children who 7 satisfy the requirements of paragraphs (1)(B) and 8 (3) of subsection (a) shall be considered to be chil- 9 dren with respect to whom foster care maintenance 10 payments are made under this section for purposes 11 of subsection (h) or section 473(b)(3)(B).’’. 12 (b) CONFORMING AMENDMENT.—Section 474(a)(1) 13 of such Act (42 U.S.C. 674(a)(1)) is amended by inserting 14 ‘‘subject to section 472(j),’’ before ‘‘an amount equal to 15 the Federal’’ the first place it appears. 16 SEC. 50713. TITLE IV–E PAYMENTS FOR EVIDENCE-BASED 17 KINSHIP NAVIGATOR PROGRAMS. 18 Section 474(a) of the Social Security Act (42 U.S.C. 19 674(a)), as amended by section 50711(c), is amended— 20 21 (1) in paragraph (6), by striking the period at the end and inserting ‘‘; plus’’; and 22 (2) by adding at the end the following: 23 ‘‘(7) an amount equal to 50 percent of the 24 amounts expended by the State during the quarter 25 as the Secretary determines are for kinship navi- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 468 1 gator programs that meet the requirements de- 2 scribed in section 427(a)(1) and that the Secretary 3 determines are operated in accordance with prom- 4 ising, supported, or well-supported practices that 5 meet the applicable criteria specified for the prac- 6 tices in section 471(e)(4)(C), without regard to 7 whether the expenditures are incurred on behalf of 8 children who are, or are potentially, eligible for fos- 9 ter care maintenance payments under this part.’’. 10 PART II—ENHANCED SUPPORT UNDER TITLE IV– 11 B 12 SEC. 50721. ELIMINATION OF TIME LIMIT FOR FAMILY RE- 13 UNIFICATION SERVICES WHILE IN FOSTER 14 CARE AND PERMITTING TIME-LIMITED FAM- 15 ILY 16 CHILD RETURNS HOME FROM FOSTER CARE. 17 (a) IN GENERAL.—Section 431(a)(7) of the Social REUNIFICATION SERVICES WHEN A 18 Security Act (42 U.S.C. 629a(a)(7)) is amended— 19 (1) in the paragraph heading, by striking 20 ‘‘TIME-LIMITED 21 and 22 23 24 February 7, 2018 (10:12 p.m.) FAMILY’’ and inserting ‘‘FAMILY’’; (2) in subparagraph (A)— (A) by striking ‘‘time-limited family’’ and inserting ‘‘family’’; U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 469 1 (B) by inserting ‘‘or a child who has been 2 returned home’’ after ‘‘child care institution’’; 3 and 4 (C) by striking ‘‘, but only during the 15- 5 month period that begins on the date that the 6 child, pursuant to section 475(5)(F), is consid- 7 ered to have entered foster care’’ and inserting 8 ‘‘and to ensure the strength and stability of the 9 reunification. In the case of a child who has 10 been returned home, the services and activities 11 shall only be provided during the 15-month pe- 12 riod that begins on the date that the child re- 13 turns home’’. 14 (b) CONFORMING AMENDMENTS.— 15 (1) Section 430 of such Act (42 U.S.C. 629) is 16 amended in the matter preceding paragraph (1), by 17 striking ‘‘time-limited’’. 18 (2) Subsections (a)(4), (a)(5)(A), and (b)(1) of 19 section 432 of such Act (42 U.S.C. 629b) are 20 amended by striking ‘‘time-limited’’ each place it ap- 21 pears. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 470 1 SEC. 50722. REDUCING BUREAUCRACY AND UNNECESSARY 2 DELAYS 3 HOMES ACROSS STATE LINES. 4 (a) STATE WHEN PLACING PLAN CHILDREN IN REQUIREMENT.—Section 5 471(a)(25) of the Social Security Act (42 U.S.C. 6 671(a)(25)) is amended— 7 8 (1) by striking ‘‘provide’’ and inserting ‘‘provides’’; and 9 (2) by inserting ‘‘, which, in the case of a State 10 other than the Commonwealth of Puerto Rico, the 11 United States Virgin Islands, Guam, or American 12 Samoa, not later than October 1, 2027, shall include 13 the use of an electronic interstate case-processing 14 system’’ before the first semicolon. 15 (b) EXEMPTION OF INDIAN TRIBES.—Section 16 479B(c) of such Act (42 U.S.C. 679c(c)) is amended by 17 adding at the end the following: 18 ‘‘(4) INAPPLICABILITY OF STATE PLAN RE- 19 QUIREMENT TO HAVE IN EFFECT PROCEDURES PRO- 20 VIDING FOR THE USE OF AN ELECTRONIC INTER- 21 STATE 22 ment in section 471(a)(25) that a State plan provide 23 that the State shall have in effect procedures pro- 24 viding for the use of an electronic interstate case- 25 processing system shall not apply to an Indian tribe, February 7, 2018 (10:12 p.m.) CASE-PROCESSING SYSTEM.—.The require- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 471 1 tribal organization, or tribal consortium that elects 2 to operate a program under this part.’’. 3 (c) FUNDING 4 TRONIC 5 PEDITE THE FOR THE DEVELOPMENT OF AN INTERSTATE CASE-PROCESSING SYSTEM INTERSTATE PLACEMENT 6 FOSTER CARE OR GUARDIANSHIP, OF OR FOR ELEC- TO EX- CHILDREN IN ADOPTION.— 7 Section 437 of such Act (42 U.S.C. 629g) is amended by 8 adding at the end the following: 9 ‘‘(g) FUNDING FOR THE DEVELOPMENT OF AN 10 ELECTRONIC INTERSTATE CASE-PROCESSING SYSTEM 11 EXPEDITE 12 IN 13 TION.— THE INTERSTATE PLACEMENT FOSTER CARE OR GUARDIANSHIP, OF TO CHILDREN OR FOR ADOP- 14 ‘‘(1) PURPOSE.—The purpose of this subsection 15 is to facilitate the development of an electronic inter- 16 state case-processing system for the exchange of 17 data and documents to expedite the placements of 18 children in foster, guardianship, or adoptive homes 19 across State lines. 20 ‘‘(2) REQUIREMENTS.—A State that seeks 21 funding under this subsection shall submit to the 22 Secretary the following: 23 ‘‘(A) A description of the goals and out- 24 comes to be achieved, which goals and outcomes 25 must result in— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 472 1 ‘‘(i) reducing the time it takes for a 2 child to be provided with a safe and appro- 3 priate 4 across State lines; permanent living arrangement 5 ‘‘(ii) improving administrative proc- 6 esses and reducing costs in the foster care 7 system; and 8 ‘‘(iii) the secure exchange of relevant 9 case files and other necessary materials in 10 real time, and timely communications and 11 placement decisions regarding interstate 12 placements of children. 13 ‘‘(B) A description of the activities to be 14 funded in whole or in part with the funds, in- 15 cluding the sequencing of the activities. 16 ‘‘(C) A description of the strategies for in- 17 tegrating programs and services for children 18 who are placed across State lines. 19 ‘‘(D) Such other information as the Sec- 20 retary may require. 21 ‘‘(3) FUNDING AUTHORITY.—The Secretary 22 may provide funds to a State that complies with 23 paragraph (2). In providing funds under this sub- 24 section, the Secretary shall prioritize States that are February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 473 1 not yet connected with the electronic interstate case- 2 processing system referred to in paragraph (1). 3 ‘‘(4) USE OF FUNDS.—A State to which fund- 4 ing is provided under this subsection shall use the 5 funding to support the State in connecting with, or 6 enhancing or expediting services provided under, the 7 electronic interstate case-processing system referred 8 to in paragraph (1). 9 ‘‘(5) EVALUATIONS.—Not later than 1 year 10 after the final year in which funds are awarded 11 under this subsection, the Secretary shall submit to 12 the Congress, and make available to the general 13 public by posting on a website, a report that con- 14 tains the following information: 15 ‘‘(A) How using the electronic interstate 16 case-processing system developed pursuant to 17 paragraph (4) has changed the time it takes for 18 children to be placed across State lines. 19 ‘‘(B) The number of cases subject to the 20 Interstate Compact on the Placement of Chil- 21 dren that were processed through the electronic 22 interstate case-processing system, and the num- 23 ber of interstate child placement cases that 24 were processed outside the electronic interstate February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 474 1 case-processing system, by each State in each 2 year. 3 ‘‘(C) The progress made by States in im- 4 plementing the electronic interstate case-proc- 5 essing system. 6 ‘‘(D) How using the electronic interstate 7 case-processing system has affected various 8 metrics related to child safety and well-being, 9 including the time it takes for children to be 10 placed across State lines. 11 ‘‘(E) How using the electronic interstate 12 case-processing system has affected administra- 13 tive costs and caseworker time spent on placing 14 children across State lines. 15 ‘‘(6) DATA INTEGRATION.—The Secretary, in 16 consultation with the Secretariat for the Interstate 17 Compact on the Placement of Children and the 18 States, shall assess how the electronic interstate 19 case-processing system developed pursuant to para- 20 graph (4) could be used to better serve and protect 21 children that come to the attention of the child wel- 22 fare system, by— 23 ‘‘(A) connecting the system with other 24 data systems (such as systems operated by 25 State law enforcement and judicial agencies, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 475 1 systems operated by the Federal Bureau of In- 2 vestigation for the purposes of the Innocence 3 Lost National Initiative, and other systems); 4 ‘‘(B) simplifying and improving reporting 5 related to paragraphs (34) and (35) of section 6 471(a) regarding children or youth who have 7 been identified as being a sex trafficking victim 8 or children missing from foster care; and 9 ‘‘(C) improving the ability of States to 10 quickly comply with background check require- 11 ments of section 471(a)(20), including checks of 12 child abuse and neglect registries as required by 13 section 471(a)(20)(B).’’. 14 (d) RESERVATION OF FUNDS TO IMPROVE THE 15 INTERSTATE PLACEMENT OF CHILDREN.—Section 437(b) 16 of such Act (42 U.S.C. 629g(b)) is amended by adding 17 at the end the following: 18 ‘‘(4) IMPROVING THE INTERSTATE PLACEMENT 19 OF 20 $5,000,000 of the amount made available for fiscal 21 year 2018 for grants under subsection (g), and the 22 amount so reserved shall remain available through 23 fiscal year 2022.’’. February 7, 2018 (10:12 p.m.) CHILDREN.—The Secretary shall reserve U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 476 1 SEC. 50723. ENHANCEMENTS TO GRANTS TO IMPROVE 2 WELL-BEING 3 SUBSTANCE ABUSE. 4 OF FAMILIES AFFECTED BY Section 437(f) of the Social Security Act (42 U.S.C. 5 629g(f)) is amended— 6 (1) in the subsection heading, by striking ‘‘IN- 7 CREASE THE 8 THE 9 FECTED BY’’ WELL-BEING PERMANENCY OUTCOMES VENTION 11 BEING 12 FOR, CHILDREN 13 OIN, OPIOIDS, 15 16 FOR, TO IMPROVE CHILDREN AF- and inserting ‘‘IMPLEMENT IV–E PRE- 10 14 OF, AND SERVICES, OF, AND AND IMPROVE THE WELL- IMPROVE PERMANENCY OUTCOMES AND AND FAMILIES AFFECTED BY HER- OTHER’’; (2) by striking paragraph (2) and inserting the following: ‘‘(2) REGIONAL PARTNERSHIP DEFINED.—In 17 this subsection, the term ‘regional partnership’ 18 means a collaborative agreement (which may be es- 19 tablished on an interstate, State, or intrastate basis) 20 entered into by the following: 21 ‘‘(A) MANDATORY 22 PARTNERS FOR ALL PARTNERSHIP GRANTS.— 23 ‘‘(i) The State child welfare agency 24 that is responsible for the administration 25 of the State plan under this part and part 26 E. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 477 1 ‘‘(ii) The State agency responsible for 2 administering the substance abuse preven- 3 tion and treatment block grant provided 4 under subpart II of part B of title XIX of 5 the Public Health Service Act. 6 ‘‘(B) MANDATORY PARTNERS FOR PART- 7 NERSHIP GRANTS PROPOSING TO SERVE CHIL- 8 DREN IN OUT-OF-HOME PLACEMENTS.—If 9 partnership proposes to serve children in out-of- 10 home placements, the Juvenile Court or Admin- 11 istrative Office of the Court that is most appro- 12 priate to oversee the administration of court 13 programs in the region to address the popu- 14 lation of families who come to the attention of 15 the court due to child abuse or neglect. 16 17 18 19 20 21 22 23 February 7, 2018 (10:12 p.m.) ‘‘(C) OPTIONAL PARTNERS.—At the the option of the partnership, any of the following: ‘‘(i) An Indian tribe or tribal consortium. ‘‘(ii) Nonprofit child welfare service providers. ‘‘(iii) For-profit child welfare service providers. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 478 1 ‘‘(iv) Community health service pro- 2 viders, including substance abuse treat- 3 ment providers. 4 5 ‘‘(v) Community mental health providers. 6 ‘‘(vi) Local law enforcement agencies. 7 ‘‘(vii) School personnel. 8 ‘‘(viii) Tribal child welfare agencies 9 (or a consortia of the agencies). 10 ‘‘(ix) Any other providers, agencies, 11 personnel, officials, or entities that are re- 12 lated to the provision of child and family 13 services under a State plan approved under 14 this subpart. 15 ‘‘(D) EXCEPTION FOR REGIONAL PART- 16 NERSHIPS WHERE THE LEAD APPLICANT IS AN 17 INDIAN TRIBE OR TRIBAL CONSORTIA.—If 18 Indian tribe or tribal consortium enters into a 19 regional partnership for purposes of this sub- 20 section, the Indian tribe or tribal consortium— 21 ‘‘(i) may (but is not required to) in- 22 clude the State child welfare agency as a 23 partner in the collaborative agreement; an 24 ‘‘(ii) may not enter into a collabo- 25 rative agreement only with tribal child wel- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 479 1 fare agencies (or a consortium of the agen- 2 cies); and 3 ‘‘(iii) if the condition described in 4 paragraph (2)(B) applies, may include 5 tribal court organizations in lieu of other 6 judicial partners.’’; 7 8 (3) in paragraph (3)— (A) in subparagraph (A)— 9 10 (i) by striking ‘‘2012 through 2016’’ and inserting ‘‘2017 through 2021’’; and 11 (ii) by striking ‘‘$500,000 and not 12 more than $1,000,000’’ and inserting 13 ‘‘$250,000 14 $1,000,000’’; 15 (B) in subparagraph (B)— 16 17 and not more than (i) in the subparagraph heading, by inserting ‘‘; PLANNING’’ after ‘‘APPROVAL’’; 18 (ii) in clause (i), by striking ‘‘clause 19 (ii)’’ and inserting ‘‘clauses (ii) and (iii)’’; 20 and 21 22 23 (iii) by adding at the end the following: ‘‘(iii) SUFFICIENT PLANNING.—A 24 grant awarded under this subsection shall 25 be disbursed in two phases: a planning February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 480 1 phase (not to exceed 2 years) and an im- 2 plementation phase. The total disburse- 3 ment to a grantee for the planning phase 4 may not exceed $250,000, and may not ex- 5 ceed the total anticipated funding for the 6 implementation phase.’’; and 7 (C) by adding at the end the following: 8 ‘‘(D) LIMITATION 9 CAL YEAR.—No ON PAYMENT FOR A FIS- payment shall be made under 10 subparagraph (A) or (C) for a fiscal year until 11 the Secretary determines that the eligible part- 12 nership has made sufficient progress in meeting 13 the goals of the grant and that the members of 14 the eligible partnership are coordinating to a 15 reasonable degree with the other members of 16 the eligible partnership.’’; 17 (4) in paragraph (4)— 18 19 20 (A) in subparagraph (B)— (i) in clause (i), by inserting ‘‘, parents, and families’’ after ‘‘children’’; 21 (ii) in clause (ii), by striking ‘‘safety 22 and permanence for such children; and’’ 23 and inserting ‘‘safe, permanent caregiving 24 relationships for the children;’’; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 481 1 (iii) in clause (iii), by striking ‘‘or’’ 2 and inserting ‘‘increase reunification rates 3 for children who have been placed in out- 4 of-home care, or decrease’’; and 5 (iv) by redesignating clause (iii) as 6 clause (v) and inserting after clause (ii) 7 the following: 8 ‘‘(iii) improve the substance abuse 9 treatment outcomes for parents including 10 retention in treatment and successful com- 11 pletion of treatment; 12 ‘‘(iv) facilitate the implementation, de- 13 livery, and effectiveness of prevention serv- 14 ices and programs under section 471(e); 15 and’’; 16 (B) in subparagraph (D), by striking 17 18 19 ‘‘where appropriate,’’; and (C) by striking subparagraphs (E) and (F) and inserting the following: 20 ‘‘(E) A description of a plan for sustaining 21 the services provided by or activities funded 22 under the grant after the conclusion of the 23 grant period, including through the use of pre- 24 vention services and programs under section 25 471(e) and other funds provided to the State February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 482 1 for child welfare and substance abuse preven- 2 tion and treatment services. 3 ‘‘(F) Additional information needed by the 4 Secretary to determine that the proposed activi- 5 ties and implementation will be consistent with 6 research or evaluations showing which practices 7 and approaches are most effective.’’; 8 (5) in paragraph (5)(A), by striking ‘‘abuse 9 treatment’’ and inserting ‘‘use disorder treatment in- 10 cluding medication assisted treatment and in-home 11 substance abuse disorder treatment and recovery’’; 12 13 14 (6) in paragraph (7)— (A) by striking ‘‘and’’ at the end of subparagraph (C); and 15 (B) by redesignating subparagraph (D) as 16 subparagraph (E) and inserting after subpara- 17 graph (C) the following: 18 ‘‘(D) demonstrate a track record of suc- 19 cessful collaboration among child welfare, sub- 20 stance abuse disorder treatment and mental 21 health agencies; and’’; 22 (7) in paragraph (8)— 23 February 7, 2018 (10:12 p.m.) (A) in subparagraph (A)— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 483 1 (i) by striking ‘‘establish indicators 2 that will be’’ and inserting ‘‘review indica- 3 tors that are’’; and 4 (ii) by striking ‘‘in using funds made 5 available under such grants to achieve the 6 purpose of this subsection’’ and inserting 7 ‘‘and establish a set of core indicators re- 8 lated to child safety, parental recovery, 9 parenting capacity, and family well-being. 10 In developing the core indicators, to the 11 extent possible, indicators shall be made 12 consistent with the outcome measures de- 13 scribed in section 471(e)(6)’’; and 14 (B) in subparagraph (B)— 15 (i) in the matter preceding clause (i), 16 by inserting ‘‘base the performance meas- 17 ures on lessons learned from prior rounds 18 of regional partnership grants under this 19 subsection, and’’ before ‘‘consult’’; and 20 21 22 23 24 25 February 7, 2018 (10:12 p.m.) (ii) by striking clauses (iii) and (iv) and inserting the following: ‘‘(iii) Other stakeholders or constituencies as determined by the Secretary.’’; (8) in paragraph (9)(A), by striking clause (i) and inserting the following: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 484 1 ‘‘(i) SEMIANNUAL REPORTS.—Not 2 later than September 30 of each fiscal year 3 in which a recipient of a grant under this 4 subsection is paid funds under the grant, 5 and every 6 months thereafter, the grant 6 recipient shall submit to the Secretary a 7 report on the services provided and activi- 8 ties carried out during the reporting pe- 9 riod, progress made in achieving the goals 10 of the program, the number of children, 11 adults, and families receiving services, and 12 such additional information as the Sec- 13 retary determines is necessary. The report 14 due not later than September 30 of the 15 last such fiscal year shall include, at a 16 minimum, data on each of the performance 17 indicators included in the evaluation of the 18 regional partnership.’’; and 19 (9) in paragraph (10), by striking ‘‘2012 20 through 2016’’ and inserting ‘‘2017 through 2021’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 485 1 2 PART III—MISCELLANEOUS SEC. 50731. REVIEWING AND IMPROVING LICENSING 3 STANDARDS FOR PLACEMENT IN A RELATIVE 4 FOSTER FAMILY HOME. 5 6 (a) IDENTIFICATION CENSING OF REPUTABLE MODEL LI- STANDARDS.—Not later than October 1, 2018, 7 the Secretary of Health and Human Services shall identify 8 reputable model licensing standards with respect to the li9 censing of foster family homes (as defined in section 10 472(c)(1) of the Social Security Act). 11 (b) STATE PLAN REQUIREMENT.—Section 471(a) of 12 the Social Security Act (42 U.S.C. 671(a)) is amended— 13 14 15 16 (1) in paragraph (34)(B), by striking ‘‘and’’ after the semicolon; (2) in paragraph (35)(B), by striking the period at the end and inserting a semicolon; and 17 (3) by adding at the end the following: 18 ‘‘(36) provides that, not later than April 1, 19 2019, the State shall submit to the Secretary infor- 20 mation addressing— 21 ‘‘(A) whether the State licensing standards 22 are in accord with model standards identified 23 by the Secretary, and if not, the reason for the 24 specific deviation and a description as to why 25 having a standard that is reasonably in accord February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 486 1 with the corresponding national model stand- 2 ards is not appropriate for the State; 3 ‘‘(B) whether the State has elected to 4 waive standards established in 471(a)(10)(A) 5 for relative foster family homes (pursuant to 6 waiver authority provided by 471(a)(10)(D)), a 7 description of which standards the State most 8 commonly waives, and if the State has not 9 elected to waive the standards, the reason for 10 not waiving these standards; 11 ‘‘(C) if the State has elected to waive 12 standards specified in subparagraph (B), how 13 caseworkers are trained to use the waiver au- 14 thority and whether the State has developed a 15 process or provided tools to assist caseworkers 16 in waiving nonsafety standards per the author- 17 ity provided in 471(a)(10)(D) to quickly place 18 children with relatives; and 19 ‘‘(D) a description of the steps the State is 20 taking to improve caseworker training or the 21 process, if any; and’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 487 1 SEC. 50732. DEVELOPMENT OF A STATEWIDE PLAN TO PRE- 2 VENT CHILD ABUSE AND NEGLECT FATALI- 3 TIES. 4 Section 422(b)(19) of the Social Security Act (42 5 U.S.C. 622(b)(19)) is amended to read as follows: 6 7 ‘‘(19) document steps taken to track and prevent child maltreatment deaths by including— 8 ‘‘(A) a description of the steps the State is 9 taking to compile complete and accurate infor- 10 mation on the deaths required by Federal law 11 to be reported by the State agency referred to 12 in paragraph (1), including gathering relevant 13 information on the deaths from the relevant or- 14 ganizations in the State including entities such 15 as State vital statistics department, child death 16 review teams, law enforcement agencies, offices 17 of medical examiners, or coroners; and 18 ‘‘(B) a description of the steps the State is 19 taking to develop and implement a comprehen- 20 sive, statewide plan to prevent the fatalities 21 that involves and engages relevant public and 22 private agency partners, including those in pub- 23 lic health, law enforcement, and the courts.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 488 1 SEC. 50733. MODERNIZING THE TITLE AND PURPOSE OF 2 TITLE IV–E. 3 (a) PART HEADING.—The heading for part E of title 4 IV of the Social Security Act (42 U.S.C. 670 et seq.) is 5 amended to read as follows: 6 ‘‘PART E—FEDERAL PAYMENTS FOR FOSTER 7 CARE, PREVENTION, AND PERMANENCY’’. 8 (b) PURPOSE.—The first sentence of section 470 of 9 such Act (42 U.S.C. 670) is amended— 10 (1) by striking ‘‘1995) and’’ and inserting 11 ‘‘1995),’’; 12 (2) by inserting ‘‘kinship guardianship assist- 13 ance, and prevention services or programs specified 14 in section 471(e)(1),’’ after ‘‘needs,’’; and 15 (3) by striking ‘‘(commencing with the fiscal 16 17 year which begins October 1, 1980)’’. SEC. 50734. EFFECTIVE DATES. 18 19 (a) EFFECTIVE DATES.— (1) IN GENERAL.—Except as provided in para- 20 graph (2), subject to subsection (b), the amend- 21 ments made by parts I through III of this subtitle 22 shall take effect on October 1, 2018. 23 (2) EXCEPTIONS.—The amendments made by 24 sections 50711(d), 50731, and 50733 shall take ef- 25 fect on the date of enactment of this Act. 26 (b) TRANSITION RULE.— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 489 1 (1) IN GENERAL.—In the case of a State plan 2 under part B or E of title IV of the Social Security 3 Act which the Secretary of Health and Human Serv- 4 ices determines requires State legislation (other than 5 legislation appropriating funds) in order for the plan 6 to meet the additional requirements imposed by the 7 amendments made by parts I through III of this 8 subtitle, the State plan shall not be regarded as fail- 9 ing to comply with the requirements of such part 10 solely on the basis of the failure of the plan to meet 11 such additional requirements before the first day of 12 the first calendar quarter beginning after the close 13 of the first regular session of the State legislature 14 that begins after the date of enactment of this Act. 15 For purposes of the previous sentence, in the case 16 of a State that has a 2-year legislative session, each 17 year of the session shall be deemed to be a separate 18 regular session of the State legislature. 19 (2) APPLICATION TO PROGRAMS OPERATED BY 20 INDIAN TRIBAL ORGANIZATIONS.—In 21 Indian tribe, tribal organization, or tribal consortium 22 which the Secretary of Health and Human Services 23 determines requires time to take action necessary to 24 comply with the additional requirements imposed by 25 the amendments made by parts I through III of this February 7, 2018 (10:12 p.m.) the case of an U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 490 1 subtitle (whether the tribe, organization, or tribal 2 consortium has a plan under section 479B of the So- 3 cial Security Act or a cooperative agreement or con- 4 tract entered into with a State), the Secretary shall 5 provide the tribe, organization, or tribal consortium 6 with such additional time as the Secretary deter- 7 mines is necessary for the tribe, organization, or 8 tribal consortium to take the action to comply with 9 the additional requirements before being regarded as 10 failing to comply with the requirements. 11 PART IV—ENSURING THE NECESSITY OF A 12 PLACEMENT THAT IS NOT IN A FOSTER FAM- 13 ILY HOME 14 SEC. 50741. LIMITATION ON FEDERAL FINANCIAL PARTICI- 15 PATION FOR PLACEMENTS THAT ARE NOT IN 16 FOSTER FAMILY HOMES. 17 18 (a) LIMITATION ON FEDERAL FINANCIAL PARTICIPATION.— 19 (1) IN GENERAL.—Section 472 of the Social 20 Security Act (42 U.S.C. 672), as amended by sec- 21 tion 50712(a), is amended— 22 (A) in subsection (a)(2)(C), by inserting ‘‘, 23 but only to the extent permitted under sub- 24 section (k)’’ after ‘‘institution’’; and 25 February 7, 2018 (10:12 p.m.) (B) by adding at the end the following: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 491 1 2 ‘‘(k) LIMITATION ON FEDERAL FINANCIAL PARTICI- PATION.— 3 ‘‘(1) IN GENERAL.—Beginning with the third 4 week for which foster care maintenance payments 5 are made under this section on behalf of a child 6 placed in a child-care institution, no Federal pay- 7 ment shall be made to the State under section 8 474(a)(1) for amounts expended for foster care 9 maintenance payments on behalf of the child un- 10 less— 11 ‘‘(A) the child is placed in a child-care in- 12 stitution that is a setting specified in paragraph 13 (2) (or is placed in a licensed residential family- 14 based treatment facility consistent with sub- 15 section (j)); and 16 ‘‘(B) in the case of a child placed in a 17 qualified residential treatment program (as de- 18 fined in paragraph (4)), the requirements speci- 19 fied in paragraph (3) and section 475A(c) are 20 met. 21 ‘‘(2) SPECIFIED SETTINGS FOR PLACEMENT.— 22 The settings for placement specified in this para- 23 graph are the following: 24 25 February 7, 2018 (10:12 p.m.) ‘‘(A) A qualified residential treatment program (as defined in paragraph (4)). U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 492 1 ‘‘(B) A setting specializing in providing 2 prenatal, post-partum, or parenting supports 3 for youth. 4 ‘‘(C) In the case of a child who has at- 5 tained 18 years of age, a supervised setting in 6 which the child is living independently. 7 ‘‘(D) A setting providing high-quality resi- 8 dential care and supportive services to children 9 and youth who have been found to be, or are 10 at risk of becoming, sex trafficking victims, in 11 accordance with section 471(a)(9)(C). 12 ‘‘(3) ASSESSMENT TO DETERMINE APPRO- 13 PRIATENESS OF PLACEMENT IN A QUALIFIED RESI- 14 DENTIAL TREATMENT PROGRAM.— 15 ‘‘(A) DEADLINE FOR ASSESSMENT.—In 16 the case of a child who is placed in a qualified 17 residential treatment program, if the assess- 18 ment required under section 475A(c)(1) is not 19 completed within 30 days after the placement is 20 made, no Federal payment shall be made to the 21 State under section 474(a)(1) for any amounts 22 expended for foster care maintenance payments 23 on behalf of the child during the placement. 24 25 February 7, 2018 (10:12 p.m.) ‘‘(B) DEADLINE PLACEMENT.—If FOR TRANSITION OUT OF the assessment required under U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 493 1 section 475A(c)(1) determines that the place- 2 ment of a child in a qualified residential treat- 3 ment program is not appropriate, a court dis- 4 approves such a placement under section 5 475A(c)(2), or a child who has been in an ap- 6 proved placement in a qualified residential 7 treatment program is going to return home or 8 be placed with a fit and willing relative, a legal 9 guardian, or an adoptive parent, or in a foster 10 family home, Federal payments shall be made 11 to the State under section 474(a)(1) for 12 amounts expended for foster care maintenance 13 payments on behalf of the child while the child 14 remains in the qualified residential treatment 15 program only during the period necessary for 16 the child to transition home or to such a place- 17 ment. In no event shall a State receive Federal 18 payments under section 474(a)(1) for amounts 19 expended for foster care maintenance payments 20 on behalf of a child who remains placed in a 21 qualified residential treatment program after 22 the end of the 30-day period that begins on the 23 date a determination is made that the place- 24 ment is no longer the recommended or approved 25 placement for the child. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 494 1 ‘‘(4) QUALIFIED RESIDENTIAL TREATMENT 2 PROGRAM.—For 3 ‘qualified residential treatment program’ means a 4 program that— purposes of this part, the term 5 ‘‘(A) has a trauma-informed treatment 6 model that is designed to address the needs, in- 7 cluding clinical needs as appropriate, of chil- 8 dren with serious emotional or behavioral dis- 9 orders or disturbances and, with respect to a 10 child, is able to implement the treatment identi- 11 fied for the child by the assessment of the child 12 required under section 475A(c); 13 ‘‘(B) subject to paragraphs (5) and (6), 14 has registered or licensed nursing staff and 15 other licensed clinical staff who— 16 17 ‘‘(i) provide care within the scope of their practice as defined by State law; 18 ‘‘(ii) are on-site according to the 19 treatment model referred to in subpara- 20 graph (A); and 21 ‘‘(iii) are available 24 hours a day and 22 7 days a week; 23 ‘‘(C) to extent appropriate, and in accord- 24 ance with the child’s best interests, facilitates February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 495 1 participation of family members in the child’s 2 treatment program; 3 ‘‘(D) facilitates outreach to the family 4 members of the child, including siblings, docu- 5 ments how the outreach is made (including con- 6 tact information), and maintains contact infor- 7 mation for any known biological family and fic- 8 tive kin of the child; 9 ‘‘(E) documents how family members are 10 integrated into the treatment process for the 11 child, including post-discharge, and how sibling 12 connections are maintained; 13 ‘‘(F) provides discharge planning and fam- 14 ily-based aftercare support for at least 6 15 months post-discharge; and 16 ‘‘(G) is licensed in accordance with section 17 471(a)(10) and is accredited by any of the fol- 18 lowing independent, not-for-profit organizations: 19 ‘‘(i) The Commission on Accreditation 20 of Rehabilitation Facilities (CARF). 21 ‘‘(ii) The Joint Commission on Ac- 22 creditation of Healthcare Organizations 23 (JCAHO). 24 25 February 7, 2018 (10:12 p.m.) ‘‘(iii) The Council on Accreditation (COA). U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 496 1 ‘‘(iv) Any other independent, not-for- 2 profit accrediting organization approved by 3 the Secretary. 4 ‘‘(5) ADMINISTRATIVE COSTS.—The prohibition 5 in paragraph (1) on Federal payments under section 6 474(a)(1) shall not be construed as prohibiting Fed- 7 eral payments for administrative expenditures in- 8 curred on behalf of a child placed in a child-care in- 9 stitution and for which payment is available under 10 11 section 474(a)(3). ‘‘(6) RULE OF CONSTRUCTION.—The require- 12 ments in paragraph (4)(B) shall not be construed as 13 requiring a qualified residential treatment program 14 to acquire nursing and behavioral health staff solely 15 through means of a direct employer to employee re- 16 lationship.’’. 17 (2) CONFORMING AMENDMENT.—Section 18 474(a)(1) of the Social Security Act (42 U.S.C. 19 674(a)(1)), as amended by section 50712(b), is 20 amended by striking ‘‘section 472(j)’’ and inserting 21 ‘‘subsections (j) and (k) of section 472’’. 22 (b) DEFINITION OF FOSTER FAMILY HOME, CHILD- 23 CARE INSTITUTION.—Section 472(c) of such Act (42 24 U.S.C. 672(c)(1)) is amended to read as follows: 25 February 7, 2018 (10:12 p.m.) ‘‘(c) DEFINITIONS.—For purposes of this part: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 497 1 ‘‘(1) FOSTER 2 ‘‘(A) IN FAMILY HOME.— GENERAL.—The term ‘foster fam- 3 ily home’ means the home of an individual or 4 family— 5 ‘‘(i) that is licensed or approved by 6 the State in which it is situated as a foster 7 family home that meets the standards es- 8 tablished for the licensing or approval; and 9 ‘‘(ii) in which a child in foster care 10 has been placed in the care of an indi- 11 vidual, who resides with the child and who 12 has been licensed or approved by the State 13 to be a foster parent— 14 ‘‘(I) that the State deems capable 15 of adhering to the reasonable and pru- 16 dent parent standard; 17 ‘‘(II) that provides 24-hour sub- 18 stitute care for children placed away 19 from their parents or other care- 20 takers; and 21 ‘‘(III) that provides the care for 22 not more than six children in foster 23 care. 24 25 February 7, 2018 (10:12 p.m.) ‘‘(B) STATE FLEXIBILITY.—The number of foster children that may be cared for in a home U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 498 1 under subparagraph (A) may exceed the numer- 2 ical limitation in subparagraph (A)(ii)(III), at 3 the option of the State, for any of the following 4 reasons: 5 ‘‘(i) To allow a parenting youth in fos- 6 ter care to remain with the child of the 7 parenting youth. 8 9 ‘‘(ii) To allow siblings to remain together. 10 ‘‘(iii) To allow a child with an estab- 11 lished meaningful relationship with the 12 family to remain with the family. 13 ‘‘(iv) To allow a family with special 14 training or skills to provide care to a child 15 who has a severe disability. 16 ‘‘(C) RULE OF CONSTRUCTION.—Subpara- 17 graph (A) shall not be construed as prohibiting 18 a foster parent from renting the home in which 19 the parent cares for a foster child placed in the 20 parent’s care. 21 ‘‘(2) CHILD-CARE 22 ‘‘(A) IN INSTITUTION.— GENERAL.—The term ‘child-care 23 institution’ means a private child-care institu- 24 tion, or a public child-care institution which ac- 25 commodates no more than 25 children, which is February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 499 1 licensed by the State in which it is situated or 2 has been approved by the agency of the State 3 responsible for licensing or approval of institu- 4 tions of this type as meeting the standards es- 5 tablished for the licensing. 6 ‘‘(B) SUPERVISED SETTINGS.—In the case 7 of a child who has attained 18 years of age, the 8 term shall include a supervised setting in which 9 the individual is living independently, in accord- 10 ance with such conditions as the Secretary shall 11 establish in regulations. 12 ‘‘(C) EXCLUSIONS.—The term shall not in- 13 clude detention facilities, forestry camps, train- 14 ing schools, or any other facility operated pri- 15 marily for the detention of children who are de- 16 termined to be delinquent.’’. 17 (c) TRAINING 18 OTHER LEGAL FOR STATE JUDGES, ATTORNEYS, PERSONNEL IN CHILD AND WELFARE 19 CASES.—Section 438(b)(1) of such Act (42 U.S.C. 20 629h(b)(1)) is amended in the matter preceding subpara21 graph (A) by inserting ‘‘shall provide for the training of 22 judges, attorneys, and other legal personnel in child wel23 fare cases on Federal child welfare policies and payment 24 limitations with respect to children in foster care who are February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 500 1 placed in settings that are not a foster family home,’’ after 2 ‘‘with respect to the child,’’. 3 4 (d) ASSURANCE TICE 5 OF NONIMPACT ON JUVENILE JUS- SYSTEM.— (1) STATE PLAN REQUIREMENT.—Section 6 471(a) of such Act (42 U.S.C. 671(a)), as amended 7 by section 50731, is further amended by adding at 8 the end the following: 9 ‘‘(37) includes a certification that, in response 10 to the limitation imposed under section 472(k) with 11 respect to foster care maintenance payments made 12 on behalf of any child who is placed in a setting that 13 is not a foster family home, the State will not enact 14 or advance policies or practices that would result in 15 a significant increase in the population of youth in 16 the State’s juvenile justice system.’’. 17 (2) GAO STUDY AND REPORT.—The Comp- 18 troller General of the United States shall evaluate 19 the impact, if any, on State juvenile justice systems 20 of the limitation imposed under section 472(k) of 21 the Social Security Act (as added by section 22 50741(a)(1)) on foster care maintenance payments 23 made on behalf of any child who is placed in a set- 24 ting that is not a foster family home, in accordance 25 with the amendments made by subsections (a) and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 501 1 (b) of this section. In particular, the Comptroller 2 General shall evaluate the extent to which children 3 in foster care who also are subject to the juvenile 4 justice system of the State are placed in a facility 5 under the jurisdiction of the juvenile justice system 6 and whether the lack of available congregate care 7 placements under the jurisdiction of the child wel- 8 fare systems is a contributing factor to that result. 9 Not later than December 31, 2025, the Comptroller 10 General shall submit to Congress a report on the re- 11 sults of the evaluation. 12 SEC. 50742. ASSESSMENT AND DOCUMENTATION OF THE 13 NEED FOR PLACEMENT IN A QUALIFIED RES- 14 IDENTIAL TREATMENT PROGRAM. 15 Section 475A of the Social Security Act (42 U.S.C. 16 675a) is amended by adding at the end the following: 17 ‘‘(c) ASSESSMENT, DOCUMENTATION, 18 DETERMINATION REQUIREMENTS FOR AND JUDICIAL PLACEMENT IN A 19 QUALIFIED RESIDENTIAL TREATMENT PROGRAM.—In 20 the case of any child who is placed in a qualified residen21 tial treatment program (as defined in section 472(k)(4)), 22 the following requirements shall apply for purposes of ap23 proving the case plan for the child and the case system 24 review procedure for the child: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 502 1 ‘‘(1)(A) Within 30 days of the start of each 2 placement in such a setting, a qualified individual 3 (as defined in subparagraph (D)) shall— 4 ‘‘(i) assess the strengths and needs of the 5 child using an age-appropriate, evidence-based, 6 validated, functional assessment tool approved 7 by the Secretary; 8 ‘‘(ii) determine whether the needs of the 9 child can be met with family members or 10 through placement in a foster family home or, 11 if not, which setting from among the settings 12 specified in section 472(k)(2) would provide the 13 most effective and appropriate level of care for 14 the child in the least restrictive environment 15 and be consistent with the short- and long-term 16 goals for the child, as specified in the perma- 17 nency plan for the child; and 18 ‘‘(iii) develop a list of child-specific short- 19 and long-term mental and behavioral health 20 goals. 21 ‘‘(B)(i) The State shall assemble a family and 22 permanency team for the child in accordance with 23 the requirements of clauses (ii) and (iii). The quali- 24 fied individual conducting the assessment required 25 under subparagraph (A) shall work in conjunction February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 503 1 with the family of, and permanency team for, the 2 child while conducting and making the assessment. 3 ‘‘(ii) The family and permanency team shall 4 consist of all appropriate biological family members, 5 relative, and fictive kin of the child, as well as, as 6 appropriate, professionals who are a resource to the 7 family of the child, such as teachers, medical or 8 mental health providers who have treated the child, 9 or clergy. In the case of a child who has attained 10 age 14, the family and permanency team shall in- 11 clude the members of the permanency planning team 12 for the child that are selected by the child in accord- 13 ance with section 475(5)(C)(iv). 14 15 ‘‘(iii) The State shall document in the child’s case plan— 16 ‘‘(I) the reasonable and good faith effort of 17 the State to identify and include all the individ- 18 uals described in clause (ii) on the child’s fam- 19 ily and permanency team; 20 ‘‘(II) all contact information for members 21 of the family and permanency team, as well as 22 contact information for other family members 23 and fictive kin who are not part of the family 24 and permanency team; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 504 1 ‘‘(III) evidence that meetings of the family 2 and permanency team, including meetings relat- 3 ing to the assessment required under subpara- 4 graph (A), are held at a time and place conven- 5 ient for family; 6 ‘‘(IV) if reunification is the goal, evidence 7 demonstrating that the parent from whom the 8 child was removed provided input on the mem- 9 bers of the family and permanency team; 10 ‘‘(V) evidence that the assessment required 11 under subparagraph (A) is determined in con- 12 junction with the family and permanency team; 13 ‘‘(VI) the placement preferences of the 14 family and permanency team relative to the as- 15 sessment that recognizes children should be 16 placed with their siblings unless there is a find- 17 ing by the court that such placement is con- 18 trary to their best interest; and 19 ‘‘(VII) if the placement preferences of the 20 family and permanency team and child are not 21 the placement setting recommended by the 22 qualified individual conducting the assessment 23 under subparagraph (A), the reasons why the 24 preferences of the team and of the child were 25 not recommended. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 505 1 ‘‘(C) In the case of a child who the qualified in- 2 dividual conducting the assessment under subpara- 3 graph (A) determines should not be placed in a fos- 4 ter family home, the qualified individual shall specify 5 in writing the reasons why the needs of the child 6 cannot be met by the family of the child or in a fos- 7 ter family home. A shortage or lack of foster family 8 homes shall not be an acceptable reason for deter- 9 mining that the needs of the child cannot be met in 10 a foster family home. The qualified individual also 11 shall specify in writing why the recommended place- 12 ment in a qualified residential treatment program is 13 the setting that will provide the child with the most 14 effective and appropriate level of care in the least re- 15 strictive environment and how that placement is con- 16 sistent with the short- and long-term goals for the 17 child, as specified in the permanency plan for the 18 child. 19 ‘‘(D)(i) Subject to clause (ii), in this subsection, 20 the term ‘qualified individual’ means a trained pro- 21 fessional or licensed clinician who is not an employee 22 of the State agency and who is not connected to, or 23 affiliated with, any placement setting in which chil- 24 dren are placed by the State. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 506 1 ‘‘(ii) The Secretary may approve a request of a 2 State to waive any requirement in clause (i) upon a 3 submission by the State, in accordance with criteria 4 established by the Secretary, that certifies that the 5 trained professionals or licensed clinicians with re- 6 sponsibility for performing the assessments de- 7 scribed in subparagraph (A) shall maintain objec- 8 tivity with respect to determining the most effective 9 and appropriate placement for a child. 10 ‘‘(2) Within 60 days of the start of each place- 11 ment in a qualified residential treatment program, a 12 family or juvenile court or another court (including 13 a tribal court) of competent jurisdiction, or an ad- 14 ministrative body appointed or approved by the 15 court, independently, shall— 16 ‘‘(A) consider the assessment, determina- 17 tion, and documentation made by the qualified 18 individual conducting the assessment under 19 paragraph (1); 20 ‘‘(B) determine whether the needs of the 21 child can be met through placement in a foster 22 family home or, if not, whether placement of 23 the child in a qualified residential treatment 24 program provides the most effective and appro- 25 priate level of care for the child in the least re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 507 1 strictive environment and whether that place- 2 ment is consistent with the short- and long- 3 term goals for the child, as specified in the per- 4 manency plan for the child; and 5 ‘‘(C) approve or disapprove the placement. 6 ‘‘(3) The written documentation made under 7 paragraph (1)(C) and documentation of the deter- 8 mination and approval or disapproval of the place- 9 ment in a qualified residential treatment program by 10 a court or administrative body under paragraph (2) 11 shall be included in and made part of the case plan 12 for the child. 13 ‘‘(4) As long as a child remains placed in a 14 qualified residential treatment program, the State 15 agency shall submit evidence at each status review 16 and each permanency hearing held with respect to 17 the child— 18 ‘‘(A) demonstrating that ongoing assess- 19 ment of the strengths and needs of the child 20 continues to support the determination that the 21 needs of the child cannot be met through place- 22 ment in a foster family home, that the place- 23 ment in a qualified residential treatment pro- 24 gram provides the most effective and appro- 25 priate level of care for the child in the least re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 508 1 strictive environment, and that the placement is 2 consistent with the short- and long-term goals 3 for the child, as specified in the permanency 4 plan for the child; 5 ‘‘(B) documenting the specific treatment or 6 service needs that will be met for the child in 7 the placement and the length of time the child 8 is expected to need the treatment or services; 9 and 10 ‘‘(C) documenting the efforts made by the 11 State agency to prepare the child to return 12 home or to be placed with a fit and willing rel- 13 ative, a legal guardian, or an adoptive parent, 14 or in a foster family home. 15 ‘‘(5) In the case of any child who is placed in 16 a qualified residential treatment program for more 17 than 12 consecutive months or 18 nonconsecutive 18 months (or, in the case of a child who has not at- 19 tained age 13, for more than 6 consecutive or non- 20 consecutive months), the State agency shall submit 21 to the Secretary— 22 ‘‘(A) the most recent versions of the evi- 23 dence and documentation specified in paragraph 24 (4); and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 509 1 ‘‘(B) the signed approval of the head of 2 the State agency for the continued placement of 3 the child in that setting.’’. 4 SEC. 50743. PROTOCOLS TO PREVENT INAPPROPRIATE DI- 5 6 AGNOSES. (a) STATE PLAN REQUIREMENT.—Section 7 422(b)(15)(A) of the Social Security Act (42 U.S.C. 8 622(b)(15)(A)) is amended— 9 10 (1) in clause (vi), by striking ‘‘and’’ after the semicolon; 11 12 (2) by redesignating clause (vii) as clause (viii); and 13 (3) by inserting after clause (vi) the following: 14 ‘‘(vii) the procedures and protocols 15 the State has established to ensure that 16 children in foster care placements are not 17 inappropriately diagnosed with mental ill- 18 ness, other emotional or behavioral dis- 19 orders, medically fragile conditions, or de- 20 velopmental disabilities, and placed in set- 21 tings that are not foster family homes as 22 a result of the inappropriate diagnoses; 23 and’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 510 1 (b) EVALUATION.—Section 476 of such Act (42 2 U.S.C. 676), as amended by section 50711(d), is further 3 amended by adding at the end the following: 4 5 ‘‘(e) EVALUATION OF STATE PROCEDURES AND PROTOCOLS TO PREVENT INAPPROPRIATE DIAGNOSES 6 MENTAL ILLNESS OR OF OTHER CONDITIONS.—The Sec- 7 retary shall conduct an evaluation of the procedures and 8 protocols established by States in accordance with the re9 quirements of section 422(b)(15)(A)(vii). The evaluation 10 shall analyze the extent to which States comply with and 11 enforce the procedures and protocols and the effectiveness 12 of various State procedures and protocols and shall iden13 tify best practices. Not later than January 1, 2020, the 14 Secretary shall submit a report on the results of the eval15 uation to Congress.’’. 16 SEC. 50744. ADDITIONAL DATA AND REPORTS REGARDING 17 CHILDREN PLACED IN A SETTING THAT IS 18 NOT A FOSTER FAMILY HOME. 19 Section 479A(a)(7)(A) of the Social Security Act (42 20 U.S.C. 679b(a)(7)(A)) is amended by striking clauses (i) 21 through (vi) and inserting the following: 22 23 ‘‘(i) with respect to each such placement— 24 ‘‘(I) the type of the placement 25 setting, including whether the place- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 511 1 ment is shelter care, a group home 2 and if so, the range of the child popu- 3 lation in the home, a residential treat- 4 ment facility, a hospital or institution 5 providing medical, rehabilitative, or 6 psychiatric care, a setting specializing 7 in providing prenatal, post-partum, or 8 parenting supports, or some other 9 kind of child-care institution and if so, 10 what kind; 11 ‘‘(II) the number of children in 12 the placement setting and the age, 13 race, ethnicity, and gender of each of 14 the children; 15 ‘‘(III) for each child in the place- 16 ment setting, the length of the place- 17 ment of the child in the setting, 18 whether the placement of the child in 19 the setting is the first placement of 20 the child and if not, the number and 21 type of previous placements of the 22 child, and whether the child has spe- 23 cial needs or another diagnosed men- 24 tal or physical illness or condition; 25 and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 512 1 ‘‘(IV) the extent of any special- 2 ized education, treatment, counseling, 3 or other services provided in the set- 4 ting; and 5 ‘‘(ii) separately, the number and ages 6 of children in the placements who have a 7 permanency plan of another planned per- 8 manent living arrangement; and’’. 9 SEC. 50745. CRIMINAL RECORDS CHECKS AND CHECKS OF 10 CHILD ABUSE AND NEGLECT REGISTRIES 11 FOR ADULTS WORKING IN CHILD-CARE INSTI- 12 TUTIONS AND OTHER GROUP CARE SET- 13 TINGS. 14 (a) STATE PLAN REQUIREMENT.—Section 15 471(a)(20) of the Social Security Act (42 U.S.C. 16 671(a)(20)) is amended— 17 18 19 20 21 22 23 24 February 7, 2018 (10:12 p.m.) (1) in subparagraph (A)(ii), by striking ‘‘and’’ after the semicolon; (2) in subparagraph (B)(iii), by striking ‘‘and’’after the semicolon; (3) in subparagraph (C), by adding ‘‘and’’ after the semicolon; and (4) by inserting after subparagraph (C), the following new subparagraph: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 513 1 ‘‘(D) provides procedures for any child- 2 care institution, including a group home, resi- 3 dential treatment center, shelter, or other con- 4 gregate care setting, to conduct criminal 5 records 6 checks of national crime information databases 7 (as defined in section 534(f)(3)(A) of title 28, 8 United States Code), and checks described in 9 subparagraph (B) of this paragraph, on any 10 adult working in a child-care institution, includ- 11 ing a group home, residential treatment center, 12 shelter, or other congregate care setting, unless 13 the State reports to the Secretary the alter- 14 native criminal records checks and child abuse 15 registry checks the State conducts on any adult 16 working in a child-care institution, including a 17 group home, residential treatment center, shel- 18 ter, or other congregate care setting, and why 19 the checks specified in this subparagraph are 20 not appropriate for the State;’’. 21 checks, including fingerprint-based (b) TECHNICAL AMENDMENTS.—Subparagraphs (A) 22 and (C) of section 471(a)(20) of the Social Security Act 23 (42 U.S.C. 671(a)(20)) are each amended by striking 24 ‘‘section 534(e)(3)(A)’’ 25 534(f)(3)(A)’’. February 7, 2018 (10:12 p.m.) and inserting ‘‘section U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 514 1 SEC. 50746. EFFECTIVE DATES; APPLICATION TO WAIVERS. 2 3 (a) EFFECTIVE DATES.— (1) IN GENERAL.—Subject to paragraph (2) 4 and subsections (b), (c), and (d), the amendments 5 made by this part shall take effect as if enacted on 6 January 1, 2018. 7 (2) TRANSITION RULE.—In the case of a State 8 plan under part B or E of title IV of the Social Se- 9 curity Act which the Secretary of Health and 10 Human Services determines requires State legisla- 11 tion (other than legislation appropriating funds) in 12 order for the plan to meet the additional require- 13 ments imposed by the amendments made by this 14 part, the State plan shall not be regarded as failing 15 to comply with the requirements of part B or E of 16 title IV of such Act solely on the basis of the failure 17 of the plan to meet the additional requirements be- 18 fore the first day of the first calendar quarter begin- 19 ning after the close of the first regular session of the 20 State legislature that begins after the date of enact- 21 ment of this Act. For purposes of the previous sen- 22 tence, in the case of a State that has a 2-year legis- 23 lative session, each year of the session shall be 24 deemed to be a separate regular session of the State 25 legislature. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 515 1 2 (b) LIMITATION PATION FOR ON FEDERAL FINANCIAL PARTICI- PLACEMENTS THAT ARE NOT IN FOSTER 3 FAMILY HOMES AND RELATED PROVISIONS.— 4 (1) IN GENERAL.—The amendments made by 5 sections 50741(a), 50741(b), 50741(d), and 50742 6 shall take effect on October 1, 2019. 7 (2) STATE OPTION TO DELAY EFFECTIVE DATE 8 FOR NOT MORE THAN 2 YEARS.—If 9 a delay in the effective date, the Secretary of Health 10 and Human Services shall delay the effective date 11 provided for in paragraph (1) with respect to the 12 State for the amount of time requested by the State, 13 not to exceed 2 years. If the effective date is so de- 14 layed for a period with respect to a State under the 15 preceding sentence, then— a State requests 16 (A) notwithstanding section 50734, the 17 date that the amendments made by section 18 50711(c) take effect with respect to the State 19 shall be delayed for the period; and 20 (B) in applying section 474(a)(6) of the 21 Social Security Act with respect to the State, 22 ‘‘on or after the date this paragraph takes ef- 23 fect with respect to the State’’ is deemed to be 24 substituted for ‘‘after September 30, 2019’’ in 25 subparagraph (A)(i)(I) of such section. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 516 1 (c) CRIMINAL RECORDS CHECKS AND CHECKS OF 2 CHILD ABUSE AND NEGLECT REGISTRIES FOR ADULTS 3 WORKING CHILD-CARE INSTITUTIONS AND OTHER IN 4 GROUP CARE SETTINGS.—Subject to subsection (a)(2), 5 the amendments made by section 50745 shall take effect 6 on October 1, 2018. 7 (d) APPLICATION TO STATES WITH WAIVERS.—In 8 the case of a State that, on the date of enactment of this 9 Act, has in effect a waiver approved under section 1130 10 of the Social Security Act (42 U.S.C. 1320a–9), the 11 amendments made by this part shall not apply with re12 spect to the State before the expiration (determined with13 out regard to any extensions) of the waiver to the extent 14 the amendments are inconsistent with the terms of the 15 waiver. 16 PART V—CONTINUING SUPPORT FOR CHILD AND 17 FAMILY SERVICES 18 SEC. 50751. SUPPORTING AND RETAINING FOSTER FAMI- 19 LIES FOR CHILDREN. 20 21 (a) SUPPORTING AS A AND RETAINING FOSTER PARENTS FAMILY SUPPORT SERVICE.—Section 431(a)(2)(B) 22 of the Social Security Act (42 U.S.C. 631(a)(2)(B)) is 23 amended by redesignating clauses (iii) through (vi) as 24 clauses (iv) through (vii), respectively, and inserting after 25 clause (ii) the following: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 517 1 ‘‘(iii) To support and retain foster 2 families so they can provide quality family- 3 based settings for children in foster care.’’. 4 (b) SUPPORT FOR FOSTER FAMILY HOMES.—Section 5 436 of such Act (42 U.S.C. 629f) is amended by adding 6 at the end the following: 7 ‘‘(c) SUPPORT FOR FOSTER FAMILY HOMES.—Out 8 of any money in the Treasury of the United States not 9 otherwise appropriated, there are appropriated to the Sec10 retary for fiscal year 2018, $8,000,000 for the Secretary 11 to make competitive grants to States, Indian tribes, or 12 tribal consortia to support the recruitment and retention 13 of high-quality foster families to increase their capacity 14 to place more children in family settings, focused on 15 States, Indian tribes, or tribal consortia with the highest 16 percentage of children in non-family settings. The amount 17 appropriated under this subparagraph shall remain avail18 able through fiscal year 2022.’’. 19 SEC. 50752. EXTENSION OF CHILD AND FAMILY SERVICES 20 21 PROGRAMS. (a) EXTENSION OF STEPHANIE TUBBS JONES CHILD 22 WELFARE SERVICES PROGRAM.—Section 425 of the So23 cial Security Act (42 U.S.C. 625) is amended by striking 24 ‘‘2012 through 2016’’ and inserting ‘‘2017 through 25 2021’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 518 1 (b) EXTENSION OF PROMOTING SAFE AND STABLE 2 FAMILIES PROGRAM AUTHORIZATIONS.— 3 (1) IN GENERAL.—Section 436(a) of such Act 4 (42 U.S.C. 629f(a)) is amended by striking all that 5 follows ‘‘$345,000,000’’ and inserting ‘‘for each of 6 fiscal years 2017 through 2021.’’. 7 (2) DISCRETIONARY GRANTS.—Section 437(a) 8 of such Act (42 U.S.C. 629g(a)) is amended by 9 striking ‘‘2012 through 2016’’ and inserting ‘‘2017 10 through 2021’’. 11 (c) EXTENSION OF FUNDING RESERVATIONS 12 MONTHLY CASEWORKER VISITS 13 NERSHIP AND FOR REGIONAL PART- GRANTS.—Section 436(b) of such Act (42 14 U.S.C. 629f(b)) is amended— 15 (1) in paragraph (4)(A), by striking ‘‘2012 16 through 2016’’ and inserting ‘‘2017 through 2021’’; 17 and 18 (2) in paragraph (5), by striking ‘‘2012 19 through 2016’’ and inserting ‘‘2017 through 2021’’. 20 (d) REAUTHORIZATION OF FUNDING FOR STATE 21 COURTS.— 22 (1) EXTENSION OF PROGRAM.—Section 23 438(c)(1) of such Act (42 U.S.C. 629h(c)(1)) is 24 amended by striking ‘‘2012 through 2016’’ and in- 25 serting ‘‘2017 through 2021’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 519 1 (2) EXTENSION OF FEDERAL SHARE.—Section 2 438(d) of such Act (42 U.S.C. 629h(d)) is amended 3 by striking ‘‘2012 through 2016’’ and inserting 4 ‘‘2017 through 2021’’. 5 (e) REPEAL OF EXPIRED PROVISIONS.—Section 6 438(e) of such Act (42 U.S.C. 629h(e)) is repealed. 7 SEC. 50753. IMPROVEMENTS TO THE JOHN H. CHAFEE FOS- 8 TER CARE INDEPENDENCE PROGRAM AND 9 RELATED PROVISIONS. 10 (a) AUTHORITY TO SERVE FORMER FOSTER YOUTH 11 UP TO AGE 23.—Section 477 of the Social Security Act 12 (42 U.S.C. 677) is amended— 13 (1) in subsection (a)(5), by inserting ‘‘(or 23 14 years of age, in the case of a State with a certifi- 15 cation under subsection (b)(3)(A)(ii) to provide as- 16 sistance and services to youths who have aged out 17 of foster care and have not attained such age, in ac- 18 cordance with such subsection)’’ after ‘‘21 years of 19 age’’; 20 21 22 (2) in subsection (b)(3)(A)— (A) by inserting ‘‘(i)’’ before ‘‘A certification’’; 23 (B) by striking ‘‘children who have left fos- 24 ter care’’ and all that follows through the pe- 25 riod and inserting ‘‘youths who have aged out February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 520 1 of foster care and have not attained 21 years of 2 age.’’; and 3 (C) by adding at the end the following: 4 ‘‘(ii) If the State has elected under section 5 475(8)(B) to extend eligibility for foster care to 6 all children who have not attained 21 years of 7 age, or if the Secretary determines that the 8 State agency responsible for administering the 9 State plans under this part and part B uses 10 State funds or any other funds not provided 11 under this part to provide services and assist- 12 ance for youths who have aged out of foster 13 care that are comparable to the services and as- 14 sistance the youths would receive if the State 15 had made such an election, the certification re- 16 quired under clause (i) may provide that the 17 State will provide assistance and services to 18 youths who have aged out of foster care and 19 have not attained 23 years of age.’’; and 20 (3) in subsection (b)(3)(B), by striking ‘‘chil- 21 dren who have left foster care’’ and all that follows 22 through the period and inserting ‘‘youths who have 23 aged out of foster care and have not attained 21 24 years of age (or 23 years of age, in the case of a 25 State with a certification under subparagraph (A)(i) February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 521 1 to provide assistance and services to youths who 2 have aged out of foster care and have not attained 3 such 4 (A)(ii)).’’. 5 (b) age, in AUTHORITY accordance TO with subparagraph REDISTRIBUTE UNSPENT 6 FUNDS.—Section 477(d) of such Act (42 U.S.C. 677(d)) 7 is amended— 8 (1) in paragraph (4), by inserting ‘‘or does not 9 expend allocated funds within the time period speci- 10 fied under section 477(d)(3)’’ after ‘‘provided by the 11 Secretary’’; and 12 (2) by adding at the end the following: 13 ‘‘(5) 14 15 REDISTRIBUTION OF UNEXPENDED AMOUNTS.— ‘‘(A) AVAILABILITY OF AMOUNTS.—To the 16 extent that amounts paid to States under this 17 section in a fiscal year remain unexpended by 18 the States at the end of the succeeding fiscal 19 year, the Secretary may make the amounts 20 available for redistribution in the second suc- 21 ceeding fiscal year among the States that apply 22 for additional funds under this section for that 23 second succeeding fiscal year. 24 February 7, 2018 (10:12 p.m.) ‘‘(B) REDISTRIBUTION.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 522 1 ‘‘(i) IN GENERAL.—The Secretary 2 shall redistribute the amounts made avail- 3 able under subparagraph (A) for a fiscal 4 year among eligible applicant States. In 5 this subparagraph, the term ‘eligible appli- 6 cant State’ means a State that has applied 7 for additional funds for the fiscal year 8 under subparagraph (A) if the Secretary 9 determines that the State will use the 10 funds for the purpose for which originally 11 allotted under this section. 12 ‘‘(ii) AMOUNT TO BE REDISTRIB- 13 UTED.—The 14 each eligible applicant State shall be the 15 amount so made available multiplied by the 16 State foster care ratio, (as defined in sub- 17 section (c)(4), except that, in such sub- 18 section, ‘all eligible applicant States (as de- 19 fined in subsection (d)(5)(B)(i))’ shall be 20 substituted for ‘all States’). 21 ‘‘(iii) TREATMENT amount to be redistributed to OF REDISTRIBUTED 22 AMOUNT.—Any 23 a State under this paragraph shall be re- 24 garded as part of the allotment of the February 7, 2018 (10:12 p.m.) amount made available to U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 523 1 State under this section for the fiscal year 2 in which the redistribution is made. 3 ‘‘(C) TRIBES.—For purposes of this para- 4 graph, the term ‘State’ includes an Indian tribe, 5 tribal organization, or tribal consortium that re- 6 ceives an allotment under this section.’’. 7 8 (c) EXPANDING CATION AND 9 10 AND CLARIFYING THE USE OF EDU- TRAINING VOUCHERS.— (1) IN GENERAL.—Section 477(i)(3) of such Act (42 U.S.C. 677(i)(3)) is amended— 11 (A) by striking ‘‘on the date’’ and all that 12 follows through ‘‘23’’ and inserting ‘‘to remain 13 eligible until they attain 26’’; and 14 (B) by inserting ‘‘, but in no event may a 15 youth participate in the program for more than 16 5 years (whether or not consecutive)’’ before 17 the period. 18 (2) CONFORMING AMENDMENT.—Section 19 477(i)(1) of such Act (42 U.S.C. 677(i)(1)) is 20 amended by inserting ‘‘who have attained 14 years 21 of age’’ before the period. 22 (d) OTHER IMPROVEMENTS.—Section 477 of such 23 Act (42 U.S.C. 677), as amended by subsections (a), (b), 24 and (c), is amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 524 (1) in the section heading, by striking ‘‘INDE- 1 2 PENDENCE PROGRAM’’ 3 FOR 4 HOOD’’; 5 6 SUCCESSFUL and inserting ‘‘PROGRAM TRANSITION TO ADULT- (2) in subsection (a)— (A) in paragraph (1)— 7 (i) by striking ‘‘identify children who 8 are likely to remain in foster care until 18 9 years of age and to help these children 10 make the transition to self-sufficiency by 11 providing services’’ and inserting ‘‘support 12 all youth who have experienced foster care 13 at age 14 or older in their transition to 14 adulthood through transitional services’’; 15 (ii) by inserting ‘‘and post-secondary 16 education’’ after ‘‘high school diploma’’; 17 and 18 (iii) by striking ‘‘training in daily liv- 19 ing skills, training in budgeting and finan- 20 cial management skills’’ and inserting 21 ‘‘training and opportunities to practice 22 daily living skills (such as financial literacy 23 training and driving instruction)’’; 24 (B) in paragraph (2), by striking ‘‘who are 25 likely to remain in foster care until 18 years of February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 525 1 age receive the education, training, and services 2 necessary to obtain employment’’ and inserting 3 ‘‘who have experienced foster care at age 14 or 4 older achieve meaningful, permanent connec- 5 tions with a caring adult’’; 6 (C) in paragraph (3), by striking ‘‘who are 7 likely to remain in foster care until 18 years of 8 age prepare for and enter postsecondary train- 9 ing and education institutions’’ and inserting 10 ‘‘who have experienced foster care at age 14 or 11 older engage in age or developmentally appro- 12 priate activities, positive youth development, 13 and experiential learning that reflects what 14 their peers in intact families experience’’; and 15 (D) by striking paragraph (4) and redesig- 16 nating paragraphs (5) through (8) as para- 17 graphs (4) through (7); 18 (3) in subsection (b)— 19 20 21 22 (A) in paragraph (2)(D), by striking ‘‘adolescents’’ and inserting ‘‘youth’’; and (B) in paragraph (3)— (i) in subparagraph (D)— 23 (I) by inserting ‘‘including train- 24 ing on youth development’’ after ‘‘to 25 provide training’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 526 1 (II) by striking ‘‘adolescents pre- 2 paring for independent living’’ and all 3 that follows through the period and 4 inserting ‘‘youth preparing for a suc- 5 cessful transition to adulthood and 6 making a permanent connection with 7 a caring adult.’’; 8 (ii) in subparagraph (H), by striking 9 ‘‘adolescents’’ each place it appears and in- 10 11 serting ‘‘youth’’; and (iii) in subparagraph (K)— 12 13 (I) by striking ‘‘an adolescent’’ and inserting ‘‘a youth’’; and 14 (II) by striking ‘‘the adolescent’’ 15 each place it appears and inserting 16 ‘‘the youth’’; and 17 18 19 (4) in subsection (f), by striking paragraph (2) and inserting the following: ‘‘(2) REPORT TO CONGRESS.—Not later than 20 October 1, 2019, the Secretary shall submit to the 21 Committee on Ways and Means of the House of 22 Representatives and the Committee on Finance of 23 the Senate a report on the National Youth in Tran- 24 sition Database and any other databases in which 25 States report outcome measures relating to children February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 527 1 in foster care and children who have aged out of fos- 2 ter care or left foster care for kinship guardianship 3 or adoption. The report shall include the following: 4 ‘‘(A) A description of the reasons for entry 5 into foster care and of the foster care experi- 6 ences, such as length of stay, number of place- 7 ment settings, case goal, and discharge reason 8 of 17-year-olds who are surveyed by the Na- 9 tional Youth in Transition Database and an 10 analysis of the comparison of that description 11 with the reasons for entry and foster care expe- 12 riences of children of other ages who exit from 13 foster care before attaining age 17. 14 ‘‘(B) A description of the characteristics of 15 the individuals who report poor outcomes at 16 ages 19 and 21 to the National Youth in Tran- 17 sition Database. 18 ‘‘(C) Benchmarks for determining what 19 constitutes a poor outcome for youth who re- 20 main in or have exited from foster care and 21 plans the executive branch will take to incor- 22 porate these benchmarks in efforts to evaluate 23 child welfare agency performance in providing 24 services to children transitioning from foster 25 care. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 528 1 ‘‘(D) An analysis of the association be- 2 tween types of placement, number of overall 3 placements, time spent in foster care, and other 4 factors, and outcomes at ages 19 and 21. 5 ‘‘(E) An analysis of the differences in out- 6 comes for children in and formerly in foster 7 care at age 19 and 21 among States.’’. 8 (e) CLARIFYING DOCUMENTATION PROVIDED 9 FOSTER YOUTH LEAVING FOSTER TO CARE.—Section 10 475(5)(I) of such Act (42 U.S.C. 675(5)(I)) is amended 11 by inserting after ‘‘REAL ID Act of 2005’’ the following: 12 ‘‘, and any official documentation necessary to prove that 13 the child was previously in foster care’’. 14 PART VI—CONTINUING INCENTIVES TO STATES 15 TO PROMOTE ADOPTION AND LEGAL GUARD- 16 IANSHIP 17 SEC. 18 19 50761. REAUTHORIZING ADOPTION AND LEGAL GUARDIANSHIP INCENTIVE PROGRAMS. (a) IN GENERAL.—Section 473A of the Social Secu- 20 rity Act (42 U.S.C. 673b) is amended— 21 (1) in subsection (b)(4), by striking ‘‘2013 22 through 2015’’ and inserting ‘‘2016 through 2020’’; 23 (2) in subsection (h)(1)(D), by striking ‘‘2016’’ 24 February 7, 2018 (10:12 p.m.) and inserting ‘‘2021’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 529 1 (3) in subsection (h)(2), by striking ‘‘2016’’ 2 and inserting ‘‘2021’’. 3 (b) EFFECTIVE DATE.—The amendments made by 4 subsection (a) shall take effect as if enacted on October 5 1, 2017. 6 PART VII—TECHNICAL CORRECTIONS 7 SEC. 50771. TECHNICAL CORRECTIONS TO DATA EXCHANGE 8 STANDARDS TO IMPROVE PROGRAM COORDI- 9 NATION. 10 (a) IN GENERAL.—Section 440 of the Social Security 11 Act (42 U.S.C. 629m) is amended to read as follows: 12 ‘‘SEC. 440. DATA EXCHANGE STANDARDS FOR IMPROVED 13 14 INTEROPERABILITY. ‘‘(a) DESIGNATION.—The Secretary shall, in con- 15 sultation with an interagency work group established by 16 the Office of Management and Budget and considering 17 State government perspectives, by rule, designate data ex18 change standards to govern, under this part and part E— 19 ‘‘(1) necessary categories of information that 20 State agencies operating programs under State 21 plans approved under this part are required under 22 applicable Federal law to electronically exchange 23 with another State agency; and 24 25 February 7, 2018 (10:12 p.m.) ‘‘(2) Federal reporting and data exchange required under applicable Federal law. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 530 1 ‘‘(b) REQUIREMENTS.—The data exchange standards 2 required by paragraph (1) shall, to the extent prac3 ticable— 4 ‘‘(1) incorporate a widely accepted, non-propri- 5 etary, searchable, computer-readable format, such as 6 the Extensible Markup Language; 7 ‘‘(2) contain interoperable standards developed 8 and maintained by intergovernmental partnerships, 9 such as the National Information Exchange Model; 10 ‘‘(3) incorporate interoperable standards devel- 11 oped and maintained by Federal entities with au- 12 thority over contracting and financial assistance; 13 14 ‘‘(4) be consistent with and implement applicable accounting principles; 15 ‘‘(5) be implemented in a manner that is cost- 16 effective and improves program efficiency and effec- 17 tiveness; and 18 ‘‘(6) be capable of being continually upgraded 19 as necessary. 20 ‘‘(c) RULE OF CONSTRUCTION.—Nothing in this sub- 21 section shall be construed to require a change to existing 22 data exchange standards found to be effective and effi23 cient.’’. 24 (b) EFFECTIVE DATE.—Not later than the date that 25 is 24 months after the date of the enactment of this sec- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 531 1 tion, the Secretary of Health and Human Services shall 2 issue a proposed rule that— 3 (1) identifies federally required data exchanges, 4 include specification and timing of exchanges to be 5 standardized, and address the factors used in deter- 6 mining whether and when to standardize data ex- 7 changes; and 8 (2) specifies State implementation options and 9 describes future milestones. 10 SEC. 50772. TECHNICAL CORRECTIONS TO STATE REQUIRE- 11 MENT TO ADDRESS THE DEVELOPMENTAL 12 NEEDS OF YOUNG CHILDREN. 13 Section 422(b)(18) of the Social Security Act (42 14 U.S.C. 622(b)(18)) is amended by striking ‘‘such chil15 dren’’ and inserting ‘‘all vulnerable children under 5 years 16 of age’’. 17 PART VIII—ENSURING STATES REINVEST SAV18 INGS RESULTING FROM INCREASE IN ADOP- 19 TION ASSISTANCE 20 SEC. 50781. DELAY OF ADOPTION ASSISTANCE PHASE-IN. 21 (a) IN GENERAL.—The table in section 473(e)(1)(B) 22 of the Social Security Act (42 U.S.C. 673(e)(1)(B)) is 23 amended by striking the last 2 rows and inserting the fol24 lowing: ‘‘2017 through 2023 ............................ 2 February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 532 2024 ..................................................... 2025 or thereafter ................................ 1 2 (or, in the case of a child for whom an adoption assistance agreement is entered into under this section on or after July 1, 2024, any age) any age.’’. (b) EFFECTIVE DATE.—The amendment made by 2 this section shall take effect as if enacted on January 1, 3 2018. 4 SEC. 50782. GAO STUDY AND REPORT ON STATE REINVEST- 5 MENT OF SAVINGS RESULTING FROM IN- 6 CREASE IN ADOPTION ASSISTANCE. 7 (a) STUDY.—The Comptroller General of the United 8 States shall study the extent to which States are com9 plying with the requirements of section 473(a)(8) of the 10 Social Security Act (42 U.S.C. 673(a)(8)) relating to the 11 effects of phasing out the AFDC income eligibility require12 ments for adoption assistance payments under section 473 13 of the Social Security Act, as enacted by section 402 of 14 the Fostering Connections to Success and Increasing 15 Adoptions Act of 2008 (Public Law 110–351; 122 Stat. 16 3975) and amended by section 206 of the Preventing Sex 17 Trafficking and Strengthening Families Act (Public Law 18 113–183; 128 Stat. 1919). In particular, the Comptroller 19 General shall analyze the extent to which States are com20 plying with the following requirements under section 21 473(a)(8)(D) of the Social Security Act: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 533 1 (1) The requirement to spend an amount equal 2 to the amount of the savings (if any) in State ex- 3 penditures under part E of title IV of the Social Se- 4 curity Act resulting from phasing out the AFDC in- 5 come eligibility requirements for adoption assistance 6 payments under section 473 of such Act to provide 7 to children of families any service that may be pro- 8 vided under part B or E of title IV of such Act. 9 (2) The requirement that a State shall spend 10 not less than 30 percent of the amount of any sav- 11 ings described in paragraph (1) on post-adoption 12 services, post-guardianship services, and services to 13 support and sustain positive permanent outcomes for 14 children who otherwise might enter into foster care 15 under the responsibility of the State, with at least 2⁄3 16 of the spending by the State to comply with the 30 17 percent requirement being spent on post-adoption 18 and post-guardianship services. 19 (b) REPORT.—The Comptroller General of the 20 United States shall submit to the Committee on Finance 21 of the Senate, the Committee on Ways and Means of the 22 House of Representatives, and the Secretary of Health 23 and Human Services a report that contains the results of 24 the study required by subsection (a), including rec- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 534 1 ommendations to ensure compliance with laws referred to 2 in subsection (a). 5 TITLE VIII—SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS 6 SEC. 50801. SHORT TITLE. 3 4 7 This subtitle may be cited as the ‘‘Social Impact 8 Partnerships to Pay for Results Act’’. 9 SEC. 50802. SOCIAL IMPACT PARTNERSHIPS TO PAY FOR 10 RESULTS. 11 Title XX of the Social Security Act (42 U.S.C. 1397 12 et seq.) is amended— 13 (1) in the title heading, by striking ‘‘TO 14 STATES’’ and inserting ‘‘AND PROGRAMS’’; and 15 (2) by adding at the end the following: 16 ‘‘Subtitle C—Social Impact Demonstration Projects 17 ‘‘PURPOSES 18 ‘‘SEC. 2051. The purposes of this subtitle are the fol- 19 lowing: 20 ‘‘(1) To improve the lives of families and indi- 21 viduals in need in the United States by funding so- 22 cial programs that achieve real results. 23 ‘‘(2) To redirect funds away from programs 24 that, based on objective data, are ineffective, and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 535 1 into programs that achieve demonstrable, measur- 2 able results. 3 ‘‘(3) To ensure Federal funds are used effec- 4 tively on social services to produce positive outcomes 5 for both service recipients and taxpayers. 6 ‘‘(4) To establish the use of social impact part- 7 nerships to address some of our Nation’s most 8 pressing problems. 9 ‘‘(5) To facilitate the creation of public-private 10 partnerships that bundle philanthropic or other pri- 11 vate resources with existing public spending to scale 12 up effective social interventions already being imple- 13 mented by private organizations, nonprofits, chari- 14 table organizations, and State and local governments 15 across the country. 16 ‘‘(6) To bring pay-for-performance to the social 17 sector, allowing the United States to improve the im- 18 pact and effectiveness of vital social services pro- 19 grams while redirecting inefficient or duplicative 20 spending. 21 ‘‘(7) To incorporate outcomes measurement and 22 randomized controlled trials or other rigorous meth- 23 odologies for assessing program impact. 24 25 ‘‘SOCIAL IMPACT PARTNERSHIP APPLICATION ‘‘SEC. 2052. (a) NOTICE.—Not later than 1 year 26 after the date of the enactment of this subtitle, the SecFebruary 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 536 1 retary of the Treasury, in consultation with the Federal 2 Interagency Council on Social Impact Partnerships, shall 3 publish in the Federal Register a request for proposals 4 from States or local governments for social impact part5 nership projects in accordance with this section. 6 ‘‘(b) REQUIRED OUTCOMES FOR SOCIAL IMPACT 7 PARTNERSHIP PROJECT.—To qualify as a social impact 8 partnership project under this subtitle, a project must 9 produce one or more measurable, clearly defined outcomes 10 that result in social benefit and Federal, State, or local 11 savings through any of the following: 12 ‘‘(1) Increasing work and earnings by individ- 13 uals in the United States who are unemployed for 14 more than 6 consecutive months. 15 ‘‘(2) Increasing employment and earnings of in- 16 dividuals who have attained 16 years of age but not 17 25 years of age. 18 19 20 21 ‘‘(3) Increasing employment among individuals receiving Federal disability benefits. ‘‘(4) Reducing the dependence of low-income families on Federal means-tested benefits. 22 ‘‘(5) Improving rates of high school graduation. 23 ‘‘(6) Reducing teen and unplanned pregnancies. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 537 1 ‘‘(7) Improving birth outcomes and early child- 2 hood health and development among low-income 3 families and individuals. 4 ‘‘(8) Reducing rates of asthma, diabetes, or 5 other preventable diseases among low-income fami- 6 lies and individuals to reduce the utilization of emer- 7 gency and other high-cost care. 8 9 10 11 ‘‘(9) Increasing the proportion of children living in two-parent families. ‘‘(10) Reducing incidences and adverse consequences of child abuse and neglect. 12 ‘‘(11) Reducing the number of youth in foster 13 care by increasing adoptions, permanent guardian- 14 ship arrangements, reunifications, or placements 15 with a fit and willing relative, or by avoiding placing 16 children in foster care by ensuring they can be cared 17 for safely in their own homes. 18 ‘‘(12) Reducing the number of children and 19 youth in foster care residing in group homes, child 20 care institutions, agency-operated foster homes, or 21 other non-family foster homes, unless it is deter- 22 mined that it is in the interest of the child’s long- 23 term health, safety, or psychological well-being to 24 not be placed in a family foster home. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 538 1 2 ‘‘(13) Reducing the number of children returning to foster care. 3 ‘‘(14) Reducing recidivism among juvenile of- 4 fenders, individuals released from prison, or other 5 high-risk populations. 6 7 ‘‘(15) Reducing the rate of homelessness among our most vulnerable populations. 8 ‘‘(16) Improving the health and well-being of 9 those with mental, emotional, and behavioral health 10 11 12 13 14 15 16 needs. ‘‘(17) Improving the educational outcomes of special-needs or low-income children. ‘‘(18) Improving the employment and well-being of returning United States military members. ‘‘(19) Increasing the financial stability of lowincome families. 17 ‘‘(20) Increasing the independence and employ- 18 ability of individuals who are physically or mentally 19 disabled. 20 ‘‘(21) Other measurable outcomes defined by 21 the State or local government that result in positive 22 social outcomes and Federal savings. 23 ‘‘(c) APPLICATION REQUIRED.—The notice described 24 in subsection (a) shall require a State or local government February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 539 1 to submit an application for the social impact partnership 2 project that addresses the following: 3 ‘‘(1) The outcome goals of the project. 4 ‘‘(2) A description of each intervention in the 5 project and anticipated outcomes of the intervention. 6 ‘‘(3) Rigorous evidence demonstrating that the 7 intervention can be expected to produce the desired 8 outcomes. 9 10 ‘‘(4) The target population that will be served by the project. 11 ‘‘(5) The expected social benefits to participants 12 who receive the intervention and others who may be 13 impacted. 14 ‘‘(6) Projected Federal, State, and local govern- 15 ment costs and other costs to conduct the project. 16 ‘‘(7) Projected Federal, State, and local govern- 17 ment savings and other savings, including an esti- 18 mate of the savings to the Federal Government, on 19 a program-by-program basis and in the aggregate, if 20 the project is implemented and the outcomes are 21 achieved as a result of the intervention. 22 ‘‘(8) If savings resulting from the successful 23 completion of the project are estimated to accrue to 24 the State or local government, the likelihood of the 25 State or local government to realize those savings. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 540 1 2 ‘‘(9) A plan for delivering the intervention through a social impact partnership model. 3 ‘‘(10) A description of the expertise of each 4 service provider that will administer the intervention, 5 including a summary of the experience of the service 6 provider in delivering the proposed intervention or a 7 similar intervention, or demonstrating that the serv- 8 ice provider has the expertise necessary to deliver 9 the proposed intervention. 10 ‘‘(11) An explanation of the experience of the 11 State or local government, the intermediary, or the 12 service provider in raising private and philanthropic 13 capital to fund social service investments. 14 ‘‘(12) The detailed roles and responsibilities of 15 each entity involved in the project, including any 16 State or local government entity, intermediary, serv- 17 ice provider, independent evaluator, investor, or 18 other stakeholder. 19 ‘‘(13) A summary of the experience of the serv- 20 ice provider in delivering the proposed intervention 21 or a similar intervention, or a summary dem- 22 onstrating the service provider has the expertise nec- 23 essary to deliver the proposed intervention. 24 ‘‘(14) A summary of the unmet need in the 25 area where the intervention will be delivered or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 541 1 among the target population who will receive the 2 intervention. 3 ‘‘(15) The proposed payment terms, the meth- 4 odology used to calculate outcome payments, the 5 payment schedule, and performance thresholds. 6 ‘‘(16) The project budget. 7 ‘‘(17) The project timeline. 8 ‘‘(18) The criteria used to determine the eligi- 9 bility of an individual for the project, including how 10 selected populations will be identified, how they will 11 be referred to the project, and how they will be en- 12 rolled in the project. 13 ‘‘(19) The evaluation design. 14 ‘‘(20) The metrics that will be used in the eval- 15 uation to determine whether the outcomes have been 16 achieved as a result of the intervention and how the 17 metrics will be measured. 18 ‘‘(21) An explanation of how the metrics used 19 in the evaluation to determine whether the outcomes 20 achieved as a result of the intervention are inde- 21 pendent, objective indicators of impact and are not 22 subject to manipulation by the service provider, 23 intermediary, or investor. 24 ‘‘(22) A summary explaining the independence 25 of the evaluator from the other entities involved in February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 542 1 the project and the evaluator’s experience in con- 2 ducting rigorous evaluations of program effective- 3 ness including, where available, well-implemented 4 randomized controlled trials on the intervention or 5 similar interventions. 6 ‘‘(23) The capacity of the service provider to 7 deliver the intervention to the number of partici- 8 pants the State or local government proposes to 9 serve in the project. 10 ‘‘(24) A description of whether and how the 11 State or local government and service providers plan 12 to sustain the intervention, if it is timely and appro- 13 priate to do so, to ensure that successful interven- 14 tions continue to operate after the period of the so- 15 cial impact partnership. 16 ‘‘(d) PROJECT INTERMEDIARY INFORMATION RE- 17 QUIRED.—The application described in subsection (c) shall 18 also contain the following information about any inter19 mediary for the social impact partnership project (whether 20 an intermediary is a service provider or other entity): 21 ‘‘(1) Experience and capacity for providing or 22 facilitating the provision of the type of intervention 23 proposed. 24 February 7, 2018 (10:12 p.m.) ‘‘(2) The mission and goals. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 543 1 ‘‘(3) Information on whether the intermediary 2 is already working with service providers that pro- 3 vide this intervention or an explanation of the capac- 4 ity of the intermediary to begin working with service 5 providers to provide the intervention. 6 ‘‘(4) Experience working in a collaborative envi- 7 ronment across government and nongovernmental 8 entities. 9 ‘‘(5) Previous experience collaborating with 10 public or private entities to implement evidence- 11 based programs. 12 13 14 15 ‘‘(6) Ability to raise or provide funding to cover operating costs (if applicable to the project). ‘‘(7) Capacity and infrastructure to track outcomes and measure results, including— 16 ‘‘(A) capacity to track and analyze pro- 17 gram performance and assess program impact; 18 and 19 ‘‘(B) experience with performance-based 20 awards or performance-based contracting and 21 achieving project milestones and targets. 22 ‘‘(8) Role in delivering the intervention. 23 ‘‘(9) How the intermediary would monitor pro- 24 gram success, including a description of the interim 25 benchmarks and outcome measures. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 544 1 ‘‘(e) FEASIBILITY STUDIES FUNDED THROUGH 2 OTHER SOURCES.—The notice described in subsection (a) 3 shall permit a State or local government to submit an ap4 plication for social impact partnership funding that con5 tains information from a feasibility study developed for 6 purposes other than applying for funding under this sub7 title. 8 ‘‘AWARDING 9 10 SOCIAL IMPACT PARTNERSHIP AGREEMENTS ‘‘SEC. 2053. (a) TIMELINE MENT.—Not IN AWARDING AGREE- later than 6 months after receiving an appli- 11 cation in accordance with section 2052, the Secretary, in 12 consultation with the Federal Interagency Council on So13 cial Impact Partnerships, shall determine whether to enter 14 into an agreement for a social impact partnership project 15 with a State or local government. 16 ‘‘(b) CONSIDERATIONS IN AWARDING AGREEMENT.— 17 In determining whether to enter into an agreement for a 18 social impact partnership project (the application for 19 which was submitted under section 2052) the Secretary, 20 in consultation with the Federal Interagency Council on 21 Social Impact Partnerships and the head of any Federal 22 agency administering a similar intervention or serving a 23 population similar to that served by the project, shall con24 sider each of the following: 25 26 February 7, 2018 (10:12 p.m.) ‘‘(1) The recommendations made by the Commission on Social Impact Partnerships. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 545 1 ‘‘(2) The value to the Federal Government of 2 the outcomes expected to be achieved if the outcomes 3 specified in the agreement are achieved as a result 4 of the intervention. 5 ‘‘(3) The likelihood, based on evidence provided 6 in the application and other evidence, that the State 7 or local government in collaboration with the inter- 8 mediary and the service providers will achieve the 9 outcomes. 10 ‘‘(4) The savings to the Federal Government if 11 the outcomes specified in the agreement are achieved 12 as a result of the intervention. 13 ‘‘(5) The savings to the State and local govern- 14 ments if the outcomes specified in the agreement are 15 achieved as a result of the intervention. 16 ‘‘(6) The expected quality of the evaluation that 17 would be conducted with respect to the agreement. 18 ‘‘(7) The capacity and commitment of the State 19 or local government to sustain the intervention, if 20 appropriate and timely and if the intervention is suc- 21 cessful, beyond the period of the social impact part- 22 nership. 23 ‘‘(c) AGREEMENT AUTHORITY.— 24 25 February 7, 2018 (10:12 p.m.) ‘‘(1) AGREEMENT REQUIREMENTS.—In accord- ance with this section, the Secretary, in consultation U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 546 1 with the Federal Interagency Council on Social Im- 2 pact Partnerships and the head of any Federal agen- 3 cy administering a similar intervention or serving a 4 population similar to that served by the project, may 5 enter into an agreement for a social impact partner- 6 ship project with a State or local government if the 7 Secretary, in consultation with the Federal Inter- 8 agency Council on Social Impact Partnerships, de- 9 termines that each of the following requirements are 10 met: 11 ‘‘(A) The State or local government agrees 12 to achieve one or more outcomes as a result of 13 the intervention, as specified in the agreement 14 and validated by independent evaluation, in 15 order to receive payment. 16 ‘‘(B) The Federal payment to the State or 17 local government for each specified outcome 18 achieved as a result of the intervention is less 19 than or equal to the value of the outcome to the 20 Federal Government over a period not to exceed 21 10 years, as determined by the Secretary, in 22 consultation with the State or local government. 23 ‘‘(C) The duration of the project does not 24 February 7, 2018 (10:12 p.m.) exceed 10 years. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 547 1 ‘‘(D) The State or local government has 2 demonstrated, through the application sub- 3 mitted under section 2052, that, based on prior 4 rigorous experimental evaluations or rigorous 5 quasi-experimental studies, the intervention can 6 be expected to achieve each outcome specified in 7 the agreement. 8 ‘‘(E) The State, local government, inter- 9 mediary, or service provider has experience rais- 10 ing private or philanthropic capital to fund so- 11 cial service investments (if applicable to the 12 project). 13 ‘‘(F) The State or local government has 14 shown that each service provider has experience 15 delivering the intervention, a similar interven- 16 tion, or has otherwise demonstrated the exper- 17 tise necessary to deliver the intervention. 18 ‘‘(2) PAYMENT.—The Secretary shall pay the 19 State or local government only if the independent 20 evaluator described in section 2055 determines that 21 the social impact partnership project has met the re- 22 quirements specified in the agreement and achieved 23 an outcome as a result of the intervention, as speci- 24 fied in the agreement and validated by independent 25 evaluation. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 548 1 ‘‘(d) NOTICE OF AGREEMENT AWARD.—Not later 2 than 30 days after entering into an agreement under this 3 section the Secretary shall publish a notice in the Federal 4 Register that includes, with regard to the agreement, the 5 following: 6 7 8 9 10 11 ‘‘(1) The outcome goals of the social impact partnership project. ‘‘(2) A description of each intervention in the project. ‘‘(3) The target population that will be served by the project. 12 ‘‘(4) The expected social benefits to participants 13 who receive the intervention and others who may be 14 impacted. 15 ‘‘(5) The detailed roles, responsibilities, and 16 purposes of each Federal, State, or local government 17 entity, intermediary, service provider, independent 18 evaluator, investor, or other stakeholder. 19 ‘‘(6) The payment terms, the methodology used 20 to calculate outcome payments, the payment sched- 21 ule, and performance thresholds. 22 ‘‘(7) The project budget. 23 ‘‘(8) The project timeline. 24 ‘‘(9) The project eligibility criteria. 25 ‘‘(10) The evaluation design. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 549 1 ‘‘(11) The metrics that will be used in the eval- 2 uation to determine whether the outcomes have been 3 achieved as a result of each intervention and how 4 these metrics will be measured. 5 ‘‘(12) The estimate of the savings to the Fed- 6 eral, State, and local government, on a program-by- 7 program basis and in the aggregate, if the agree- 8 ment is entered into and implemented and the out- 9 comes are achieved as a result of each intervention. 10 ‘‘(e) AUTHORITY TO TRANSFER ADMINISTRATION OF 11 AGREEMENT.—The Secretary may transfer to the head of 12 another Federal agency the authority to administer (in13 cluding making payments under) an agreement entered 14 into under subsection (c), and any funds necessary to do 15 so. 16 ‘‘(f) REQUIREMENT ON FUNDING USED TO BENEFIT 17 CHILDREN.—Not less than 50 percent of all Federal pay18 ments made to carry out agreements under this section 19 shall be used for initiatives that directly benefit children. 20 ‘‘FEASIBILITY 21 22 STUDY FUNDING ‘‘SEC. 2054. (a) REQUESTS SIBILITY FOR FUNDING FOR FEA- STUDIES.—The Secretary shall reserve a portion 23 of the amount made available to carry out this subtitle 24 to assist States or local governments in developing feasi25 bility studies to apply for social impact partnership fund26 ing under section 2052. To be eligible to receive funding February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 550 1 to assist with completing a feasibility study, a State or 2 local government shall submit an application for feasibility 3 study funding addressing the following: 4 5 ‘‘(1) A description of the outcome goals of the social impact partnership project. 6 ‘‘(2) A description of the intervention, including 7 anticipated program design, target population, an 8 estimate regarding the number of individuals to be 9 served, and setting for the intervention. 10 11 12 13 ‘‘(3) Evidence to support the likelihood that the intervention will produce the desired outcomes. ‘‘(4) A description of the potential metrics to be used. 14 ‘‘(5) The expected social benefits to participants 15 who receive the intervention and others who may be 16 impacted. 17 ‘‘(6) Estimated costs to conduct the project. 18 ‘‘(7) Estimates of Federal, State, and local gov- 19 ernment savings and other savings if the project is 20 implemented and the outcomes are achieved as a re- 21 sult of each intervention. 22 ‘‘(8) An estimated timeline for implementation 23 and completion of the project, which shall not exceed 24 10 years. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 551 1 ‘‘(9) With respect to a project for which the 2 State or local government selects an intermediary to 3 operate the project, any partnerships needed to suc- 4 cessfully execute the project and the ability of the 5 intermediary to foster the partnerships. 6 ‘‘(10) The expected resources needed to com- 7 plete the feasibility study for the State or local gov- 8 ernment to apply for social impact partnership fund- 9 ing under section 2052. 10 ‘‘(b) FEDERAL SELECTION OF APPLICATIONS FOR 11 FEASIBILITY STUDY.—Not later than 6 months after re12 ceiving an application for feasibility study funding under 13 subsection (a), the Secretary, in consultation with the 14 Federal Interagency Council on Social Impact Partner15 ships and the head of any Federal agency administering 16 a similar intervention or serving a population similar to 17 that served by the project, shall select State or local gov18 ernment feasibility study proposals for funding based on 19 the following: 20 21 22 23 24 25 February 7, 2018 (10:12 p.m.) ‘‘(1) The recommendations made by the Commission on Social Impact Partnerships. ‘‘(2) The likelihood that the proposal will achieve the desired outcomes. ‘‘(3) The value of the outcomes expected to be achieved as a result of each intervention. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 552 1 ‘‘(4) The potential savings to the Federal Gov- 2 ernment if the social impact partnership project is 3 successful. 4 ‘‘(5) The potential savings to the State and 5 local governments if the project is successful. 6 ‘‘(c) PUBLIC DISCLOSURE.—Not later than 30 days 7 after selecting a State or local government for feasibility 8 study funding under this section, the Secretary shall cause 9 to be published on the website of the Federal Interagency 10 Council on Social Impact Partnerships information ex11 plaining why a State or local government was granted fea12 sibility study funding. 13 14 ‘‘(d) FUNDING RESTRICTION.— ‘‘(1) FEASIBILITY STUDY RESTRICTION.—The 15 Secretary may not provide feasibility study funding 16 under this section for more than 50 percent of the 17 estimated total cost of the feasibility study reported 18 in the State or local government application sub- 19 mitted under subsection (a). 20 ‘‘(2) AGGREGATE RESTRICTION.—Of the total 21 amount made available to carry out this subtitle, the 22 Secretary may not use more than $10,000,000 to 23 provide feasibility study funding to States or local 24 governments under this section. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 553 1 ‘‘(3) NO GUARANTEE OF FUNDING.—The Sec- 2 retary shall have the option to award no funding 3 under this section. 4 ‘‘(e) SUBMISSION 5 QUIRED.—Not OF FEASIBILITY STUDY RE- later than 9 months after the receipt of 6 feasibility study funding under this section, a State or 7 local government receiving the funding shall complete the 8 feasibility study and submit the study to the Federal 9 Interagency Council on Social Impact Partnerships. 10 ‘‘(f) DELEGATION OF AUTHORITY.—The Secretary 11 may transfer to the head of another Federal agency the 12 authorities provided in this section and any funds nec13 essary to exercise the authorities. 14 ‘‘EVALUATIONS 15 ‘‘SEC. 2055. (a) AUTHORITY TO ENTER INTO 16 AGREEMENTS.—For each State or local government 17 awarded a social impact partnership project approved by 18 the Secretary under this subtitle, the head of the relevant 19 agency, as recommended by the Federal Interagency 20 Council on Social Impact Partnerships and determined by 21 the Secretary, shall enter into an agreement with the State 22 or local government to pay for all or part of the inde23 pendent evaluation to determine whether the State or local 24 government project has achieved a specific outcome as a 25 result of the intervention in order for the State or local February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 554 1 government to receive outcome payments under this sub2 title. 3 ‘‘(b) EVALUATOR QUALIFICATIONS.—The head of the 4 relevant agency may not enter into an agreement with a 5 State or local government unless the head determines that 6 the evaluator is independent of the other parties to the 7 agreement and has demonstrated substantial experience in 8 conducting rigorous evaluations of program effectiveness 9 including, where available and appropriate, well-imple10 mented randomized controlled trials on the intervention or 11 similar interventions. 12 ‘‘(c) METHODOLOGIES TO BE USED.—The evaluation 13 used to determine whether a State or local government 14 will receive outcome payments under this subtitle shall use 15 experimental designs using random assignment or other 16 reliable, evidence-based research methodologies, as cer17 tified by the Federal Interagency Council on Social Impact 18 Partnerships, that allow for the strongest possible causal 19 inferences when random assignment is not feasible. 20 ‘‘(d) PROGRESS REPORT.— 21 ‘‘(1) SUBMISSION 22 OF REPORT.—The inde- pendent evaluator shall— 23 ‘‘(A) not later than 2 years after a project 24 has been approved by the Secretary and bian- 25 nually thereafter until the project is concluded, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 555 1 submit to the head of the relevant agency and 2 the Federal Interagency Council on Social Im- 3 pact Partnerships a written report summarizing 4 the progress that has been made in achieving 5 each outcome specified in the agreement; and 6 ‘‘(B) before the scheduled time of the first 7 outcome payment and before the scheduled time 8 of each subsequent payment, submit to the 9 head of the relevant agency and the Federal 10 Interagency Council on Social Impact Partner- 11 ships a written report that includes the results 12 of the evaluation conducted to determine wheth- 13 er an outcome payment should be made along 14 with information on the unique factors that 15 contributed to achieving or failing to achieve 16 the outcome, the challenges faced in attempting 17 to achieve the outcome, and information on the 18 improved future delivery of this or similar inter- 19 ventions. 20 ‘‘(2) SUBMISSION TO THE SECRETARY AND 21 CONGRESS.—Not 22 the written report pursuant to paragraph (1)(B), the 23 Federal Interagency Council on Social Impact Part- 24 nerships shall submit the report to the Secretary February 7, 2018 (10:12 p.m.) later than 30 days after receipt of U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 556 1 and each committee of jurisdiction in the House of 2 Representatives and the Senate. 3 ‘‘(e) FINAL REPORT.— 4 ‘‘(1) SUBMISSION OF REPORT.—Within 6 5 months after the social impact partnership project is 6 completed, the independent evaluator shall— 7 ‘‘(A) evaluate the effects of the activities 8 undertaken pursuant to the agreement with re- 9 gard to each outcome specified in the agree- 10 ment; and 11 ‘‘(B) submit to the head of the relevant 12 agency and the Federal Interagency Council on 13 Social Impact Partnerships a written report 14 that includes the results of the evaluation and 15 the conclusion of the evaluator as to whether 16 the State or local government has fulfilled each 17 obligation of the agreement, along with infor- 18 mation on the unique factors that contributed 19 to the success or failure of the project, the chal- 20 lenges faced in attempting to achieve the out- 21 come, and information on the improved future 22 delivery of this or similar interventions. 23 ‘‘(2) SUBMISSION TO THE SECRETARY AND 24 CONGRESS.—Not 25 the written report pursuant to paragraph (1)(B), the February 7, 2018 (10:12 p.m.) later than 30 days after receipt of U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 557 1 Federal Interagency Council on Social Impact Part- 2 nerships shall submit the report to the Secretary 3 and each committee of jurisdiction in the House of 4 Representatives and the Senate. 5 ‘‘(f) LIMITATION ON COST OF EVALUATIONS.—Of 6 the amount made available under this subtitle for social 7 impact partnership projects, the Secretary may not obli8 gate more than 15 percent to evaluate the implementation 9 and outcomes of the projects. 10 ‘‘(g) DELEGATION OF AUTHORITY.—The Secretary 11 may transfer to the head of another Federal agency the 12 authorities provided in this section and any funds nec13 essary to exercise the authorities. 14 ‘‘FEDERAL 15 16 INTERAGENCY COUNCIL ON SOCIAL IMPACT PARTNERSHIPS ‘‘SEC. 2056. (a) ESTABLISHMENT.—There is estab- 17 lished the Federal Interagency Council on Social Impact 18 Partnerships (in this section referred to as the ‘Council’) 19 to— 20 ‘‘(1) coordinate with the Secretary on the ef- 21 forts of social impact partnership projects funded 22 under this subtitle; 23 24 ‘‘(2) advise and assist the Secretary in the development and implementation of the projects; 25 ‘‘(3) advise the Secretary on specific pro- 26 grammatic and policy matter related to the projects; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 558 1 2 ‘‘(4) provide subject-matter expertise to the Secretary with regard to the projects; 3 ‘‘(5) certify to the Secretary that each State or 4 local government that has entered into an agreement 5 with the Secretary for a social impact partnership 6 project under this subtitle and each evaluator se- 7 lected by the head of the relevant agency under sec- 8 tion 2055 has access to Federal administrative data 9 to assist the State or local government and the eval- 10 uator in evaluating the performance and outcomes of 11 the project; 12 ‘‘(6) address issues that will influence the fu- 13 ture of social impact partnership projects in the 14 United States; 15 ‘‘(7) provide guidance to the executive branch 16 on the future of social impact partnership projects 17 in the United States; 18 ‘‘(8) prior to approval by the Secretary, certify 19 that each State and local government application for 20 a social impact partnership contains rigorous, inde- 21 pendent data and reliable, evidence-based research 22 methodologies to support the conclusion that the 23 project will yield savings to the State or local gov- 24 ernment or the Federal Government if the project 25 outcomes are achieved; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 559 1 ‘‘(9) certify to the Secretary, in the case of each 2 approved social impact partnership that is expected 3 to yield savings to the Federal Government, that the 4 project will yield a projected savings to the Federal 5 Government if the project outcomes are achieved, 6 and coordinate with the relevant Federal agency to 7 produce an after-action accounting once the project 8 is complete to determine the actual Federal savings 9 realized, and the extent to which actual savings 10 aligned with projected savings; and 11 ‘‘(10) provide periodic reports to the Secretary 12 and make available reports periodically to Congress 13 and the public on the implementation of this sub- 14 title. 15 ‘‘(b) COMPOSITION OF COUNCIL.—The Council shall 16 have 11 members, as follows: 17 ‘‘(1) CHAIR.—The Chair of the Council shall be 18 the Director of the Office of Management and Budg- 19 et. 20 ‘‘(2) OTHER MEMBERS.—The head of each of 21 the following entities shall designate one officer or 22 employee of the entity to be a Council member: 23 ‘‘(A) The Department of Labor. 24 ‘‘(B) The Department of Health and 25 February 7, 2018 (10:12 p.m.) Human Services. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 560 1 ‘‘(C) The Social Security Administration. 2 ‘‘(D) The Department of Agriculture. 3 ‘‘(E) The Department of Justice. 4 ‘‘(F) The Department of Housing and 5 Urban Development. 6 ‘‘(G) The Department of Education. 7 ‘‘(H) The Department of Veterans Affairs. 8 ‘‘(I) The Department of the Treasury. 9 ‘‘(J) The Corporation for National and 10 Community Service. 11 ‘‘COMMISSION 12 ‘‘SEC. 2057. (a) ESTABLISHMENT.—There is estab- ON SOCIAL IMPACT PARTNERSHIPS 13 lished the Commission on Social Impact Partnerships (in 14 this section referred to as the ‘Commission’). 15 ‘‘(b) DUTIES.—The duties of the Commission shall 16 be to— 17 ‘‘(1) assist the Secretary and the Federal Inter- 18 agency Council on Social Impact Partnerships in re- 19 viewing applications for funding under this subtitle; 20 ‘‘(2) make recommendations to the Secretary 21 and the Federal Interagency Council on Social Im- 22 pact Partnerships regarding the funding of social 23 impact partnership agreements and feasibility stud- 24 ies; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 561 1 ‘‘(3) provide other assistance and information 2 as requested by the Secretary or the Federal Inter- 3 agency Council on Social Impact Partnerships. 4 ‘‘(c) COMPOSITION.—The Commission shall be com- 5 posed of nine members, of whom— 6 7 8 9 10 11 12 13 14 15 16 17 ‘‘(1) one shall be appointed by the President, who will serve as the Chair of the Commission; ‘‘(2) one shall be appointed by the Majority Leader of the Senate; ‘‘(3) one shall be appointed by the Minority Leader of the Senate; ‘‘(4) one shall be appointed by the Speaker of the House of Representatives; ‘‘(5) one shall be appointed by the Minority Leader of the House of Representatives; ‘‘(6) one shall be appointed by the Chairman of the Committee on Finance of the Senate; 18 ‘‘(7) one shall be appointed by the ranking 19 member of the Committee on Finance of the Senate; 20 ‘‘(8) one member shall be appointed by the 21 Chairman of the Committee on Ways and Means of 22 the House of Representatives; and 23 ‘‘(9) one shall be appointed by the ranking 24 member of the Committee on Ways and Means of 25 the House of Representatives. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 562 1 ‘‘(d) QUALIFICATIONS OF COMMISSION MEMBERS.— 2 The members of the Commission shall— 3 4 ‘‘(1) be experienced in finance, economics, pay for performance, or program evaluation; 5 ‘‘(2) have relevant professional or personal ex- 6 perience in a field related to one or more of the out- 7 comes listed in this subtitle; or 8 ‘‘(3) be qualified to review applications for so- 9 cial impact partnership projects to determine wheth- 10 er the proposed metrics and evaluation methodolo- 11 gies are appropriately rigorous and reliant upon 12 independent data and evidence-based research. 13 ‘‘(e) TIMING OF APPOINTMENTS.—The appointments 14 of the members of the Commission shall be made not later 15 than 120 days after the date of the enactment of this sub16 title, or, in the event of a vacancy, not later than 90 days 17 after the date the vacancy arises. If a member of Congress 18 fails to appoint a member by that date, the President may 19 select a member of the President’s choice on behalf of the 20 member of Congress. Notwithstanding the preceding sen21 tence, if not all appointments have been made to the Com22 mission as of that date, the Commission may operate with 23 no fewer than five members until all appointments have 24 been made. 25 February 7, 2018 (10:12 p.m.) ‘‘(f) TERM OF APPOINTMENTS.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 563 1 2 3 4 5 6 ‘‘(1) IN GENERAL.—The members appointed under subsection (c) shall serve as follows: ‘‘(A) Three members shall serve for 2 years. ‘‘(B) Three members shall serve for 3 years. 7 ‘‘(C) Three members (one of which shall be 8 Chair of the Commission appointed by the 9 President) shall serve for 4 years. 10 ‘‘(2) ASSIGNMENT OF TERMS.—The Commis- 11 sion shall designate the term length that each mem- 12 ber appointed under subsection (c) shall serve by 13 unanimous agreement. In the event that unanimous 14 agreement cannot be reached, term lengths shall be 15 assigned to the members by a random process. 16 ‘‘(g) VACANCIES.—Subject to subsection (e), in the 17 event of a vacancy in the Commission, whether due to the 18 resignation of a member, the expiration of a member’s 19 term, or any other reason, the vacancy shall be filled in 20 the manner in which the original appointment was made 21 and shall not affect the powers of the Commission. 22 ‘‘(h) APPOINTMENT POWER.—Members of the Com- 23 mission appointed under subsection (c) shall not be sub24 ject to confirmation by the Senate. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 564 1 ‘‘LIMITATION 2 ON USE OF FUNDS ‘‘SEC. 2058. Of the amounts made available to carry 3 out this subtitle, the Secretary may not use more than 4 $2,000,000 in any fiscal year to support the review, ap5 proval, and oversight of social impact partnership projects, 6 including activities conducted by— 7 ‘‘(1) the Federal Interagency Council on Social 8 Impact Partnerships; and 9 ‘‘(2) any other agency consulted by the Sec- 10 retary before approving a social impact partnership 11 project or a feasibility study under section 2054. 12 ‘‘NO 13 FEDERAL FUNDING FOR CREDIT ENHANCEMENTS ‘‘SEC. 2059. No amount made available to carry out 14 this subtitle may be used to provide any insurance, guar15 antee, or other credit enhancement to a State or local gov16 ernment under which a Federal payment would be made 17 to a State or local government as the result of a State 18 or local government failing to achieve an outcome specified 19 in an agreement. 20 21 ‘‘AVAILABILITY OF FUNDS ‘‘SEC. 2060. Amounts made available to carry out 22 this subtitle shall remain available until 10 years after the 23 date of the enactment of this subtitle. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 565 1 2 ‘‘WEBSITE ‘‘SEC. 2061. The Federal Interagency Council on So- 3 cial Impact Partnerships shall establish and maintain a 4 public website that shall display the following: 5 ‘‘(1) A copy of, or method of accessing, each 6 notice published regarding a social impact partner- 7 ship project pursuant to this subtitle. 8 9 ‘‘(2) A copy of each feasibility study funded under this subtitle. 10 ‘‘(3) For each State or local government that 11 has entered into an agreement with the Secretary 12 for a social impact partnership project, the website 13 shall contain the following information: 14 ‘‘(A) The outcome goals of the project. 15 ‘‘(B) A description of each intervention in 16 17 18 the project. ‘‘(C) The target population that will be served by the project. 19 ‘‘(D) The expected social benefits to par- 20 ticipants who receive the intervention and oth- 21 ers who may be impacted. 22 ‘‘(E) The detailed roles, responsibilities, 23 and purposes of each Federal, State, or local 24 government entity, intermediary, service pro- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 566 1 vider, independent evaluator, investor, or other 2 stakeholder. 3 ‘‘(F) The payment terms, methodology 4 used to calculate outcome payments, the pay- 5 ment schedule, and performance thresholds. 6 ‘‘(G) The project budget. 7 ‘‘(H) The project timeline. 8 ‘‘(I) The project eligibility criteria. 9 ‘‘(J) The evaluation design. 10 ‘‘(K) The metrics used to determine wheth- 11 er the proposed outcomes have been achieved 12 and how these metrics are measured. 13 ‘‘(4) A copy of the progress reports and the 14 final reports relating to each social impact partner- 15 ship project. 16 ‘‘(5) An estimate of the savings to the Federal, 17 State, and local government, on a program-by-pro- 18 gram basis and in the aggregate, resulting from the 19 successful completion of the social impact partner- 20 ship project. 21 22 ‘‘REGULATIONS ‘‘SEC. 2062. The Secretary, in consultation with the 23 Federal Interagency Council on Social Impact Partner24 ships, may issue regulations as necessary to carry out this 25 subtitle. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 567 1 2 ‘‘DEFINITIONS ‘‘SEC. 2063. In this subtitle: 3 ‘‘(1) AGENCY.—The term ‘agency’ has the 4 meaning given that term in section 551 of title 5, 5 United States Code. 6 ‘‘(2) INTERVENTION.—The term ‘intervention’ 7 means a specific service delivered to achieve an im- 8 pact through a social impact partnership project. 9 10 11 ‘‘(3) SECRETARY.—The term ‘Secretary’ means the Secretary of the Treasury. ‘‘(4) SOCIAL IMPACT PARTNERSHIP PROJECT.— 12 The term ‘social impact partnership project’ means 13 a project that finances social services using a social 14 impact partnership model. 15 ‘‘(5) SOCIAL IMPACT PARTNERSHIP MODEL.— 16 The term ‘social impact partnership model’ means a 17 method of financing social services in which— 18 ‘‘(A) Federal funds are awarded to a State 19 or local government only if a State or local gov- 20 ernment achieves certain outcomes agreed on by 21 the State or local government and the Sec- 22 retary; and 23 ‘‘(B) the State or local government coordi- 24 nates with service providers, investors (if appli- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 568 1 cable to the project), and (if necessary) an 2 intermediary to identify— 3 ‘‘(i) 4 an intervention expected to produce the outcome; 5 ‘‘(ii) a service provider to deliver the 6 intervention to the target population; and 7 ‘‘(iii) investors to fund the delivery of 8 the intervention. 9 ‘‘(6) STATE.—The term ‘State’ means each 10 State of the United States, the District of Columbia, 11 each commonwealth, territory or possession of the 12 United States, and each federally recognized Indian 13 tribe. 14 ‘‘FUNDING 15 ‘‘SEC. 2064. Out of any money in the Treasury of 16 the United States not otherwise appropriated, there is 17 hereby appropriated $100,000,000 for fiscal year 2018 to 18 carry out this subtitle.’’. 20 TITLE IX—PUBLIC HEALTH PROGRAMS 21 SEC. 50901. EXTENSION FOR COMMUNITY HEALTH CEN- 19 22 TERS, 23 CORPS, AND TEACHING HEALTH CENTERS 24 THAT OPERATE GME PROGRAMS. 25 THE NATIONAL HEALTH SERVICE (a) COMMUNITY HEALTH CENTERS FUNDING.—Sec- 26 tion 10503(b)(1)(F) of the Patient Protection and AffordFebruary 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 569 1 able Care Act (42 U.S.C. 254b–2(b)(1)(F)), as amended 2 by section 3101 of Public Law 115-96, is amended to read 3 as follows: 4 ‘‘(F) $3,800,000,000 for fiscal year 2018 5 and $4,000,000,000 for fiscal year 2019.’’. 6 (b) OTHER COMMUNITY HEALTH CENTERS PROVI- 7 SIONS.—Section 330 of the Public Health Service Act (42 8 U.S.C. 254b) is amended— 9 10 11 12 13 14 15 16 (1) in subsection (b)(1)(A)(ii), by striking ‘‘abuse’’ and inserting ‘‘use disorder’’; (2) in subsection (b)(2)(A), by striking ‘‘abuse’’ and inserting ‘‘use disorder’’; (3) in subsection (c)— (A) in paragraph (1), by striking subparagraphs (B) through (D); (B) by striking ‘‘(1) IN GENERAL’’ and all 17 that follows through ‘‘The Secretary’’ and in- 18 serting the following: 19 ‘‘(1) CENTERS.—The Secretary’’; and 20 (C) in paragraph (1), as amended, by re- 21 designating clauses (i) through (v) as subpara- 22 graphs (A) through (E) and moving the margin 23 of each of such redesignated subparagraph 2 24 ems to the left; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 570 1 (4) by striking subsection (d) and inserting the 2 following: 3 ‘‘(d) IMPROVING QUALITY OF CARE.— 4 ‘‘(1) SUPPLEMENTAL AWARDS.—The Secretary 5 may award supplemental grant funds to health cen- 6 ters funded under this section to implement evi- 7 dence-based models for increasing access to high- 8 quality primary care services, which may include 9 models related to— 10 11 ‘‘(A) improving the delivery of care for individuals with multiple chronic conditions; 12 ‘‘(B) workforce configuration; 13 ‘‘(C) reducing the cost of care; 14 ‘‘(D) enhancing care coordination; 15 ‘‘(E) expanding the use of telehealth and 16 technology-enabled collaborative learning and 17 capacity building models; 18 ‘‘(F) care integration, including integration 19 of behavioral health, mental health, or sub- 20 stance use disorder services; and 21 ‘‘(G) addressing emerging public health or 22 substance use disorder issues to meet the health 23 needs of the population served by the health 24 center. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 571 1 ‘‘(2) SUSTAINABILITY.—In making supple- 2 mental awards under this subsection, the Secretary 3 may consider whether the health center involved has 4 submitted a plan for continuing the activities funded 5 under this subsection after supplemental funding is 6 expended. 7 ‘‘(3) SPECIAL CONSIDERATION.—The Secretary 8 may give special consideration to applications for 9 supplemental funding under this subsection that 10 seek to address significant barriers to access to care 11 in areas with a greater shortage of health care pro- 12 viders and health services relative to the national av- 13 erage.’’; 14 15 16 17 (5) in subsection (e)(1)— (A) in subparagraph (B)— (i) by striking ‘‘2 years’’ and inserting ‘‘1 year’’; and 18 (ii) by adding at the end the fol- 19 lowing: ‘‘The Secretary shall not make a 20 grant under this paragraph unless the ap- 21 plicant provides assurances to the Sec- 22 retary that within 120 days of receiving 23 grant funding for the operation of the 24 health center, the applicant will submit, for 25 approval by the Secretary, an implementa- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 572 1 tion plan to meet the requirements of sub- 2 section (k)(3). The Secretary may extend 3 such 120-day period for achieving compli- 4 ance upon a demonstration of good cause 5 by the health center.’’; and 6 (B) in subparagraph (C)— 7 8 (i) in the subparagraph heading, by striking ‘‘AND PLANS’’; 9 (ii) by striking ‘‘or plan (as described 10 in subparagraphs (B) and (C) of sub- 11 section (c)(1))’’; 12 (iii) by striking ‘‘or plan, including 13 the purchase’’ and inserting the following: 14 ‘‘including— 15 ‘‘(i) the purchase’’; 16 (iv) by inserting ‘‘, which may include 17 data and information systems’’ after ‘‘of 18 equipment’’; 19 20 21 22 23 24 25 February 7, 2018 (10:12 p.m.) (v) by striking the period at the end and inserting a semicolon; and (vi) by adding at the end the following: ‘‘(ii) the provision of training and technical assistance; and ‘‘(iii) other activities that— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 573 1 ‘‘(I) reduce costs associated with 2 the provision of health services; 3 ‘‘(II) improve access to, and 4 availability of, health services provided 5 to individuals served by the centers; 6 ‘‘(III) enhance the quality and 7 coordination of health services; or 8 ‘‘(IV) improve the health status 9 10 of communities.’’; (6) in subsection (e)(5)(B)— 11 12 (A) in the heading of subparagraph (B), by striking ‘‘AND PLANS’’; and 13 (B) by striking ‘‘and subparagraphs (B) 14 and (C) of subsection (c)(1) to a health center 15 or to a network or plan’’ and inserting ‘‘to a 16 health center or to a network’’; 17 (7) in subsection (e), by adding at the end the 18 19 20 21 22 23 24 February 7, 2018 (10:12 p.m.) following: ‘‘(6) NEW ACCESS POINTS AND EXPANDED SERVICES.— ‘‘(A) APPROVAL OF NEW ACCESS POINTS.— ‘‘(i) IN GENERAL.—The Secretary may approve applications for grants under U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 574 1 subparagraph (A) or (B) of paragraph (1) 2 to establish new delivery sites. 3 ‘‘(ii) SPECIAL CONSIDERATION.—In 4 carrying out clause (i), the Secretary may 5 give special consideration to applicants 6 that have demonstrated the new delivery 7 site will be located within a sparsely popu- 8 lated area, or an area which has a level of 9 unmet need that is higher relative to other 10 11 applicants. ‘‘(iii) CONSIDERATION OF APPLICA- 12 TIONS.—In 13 Secretary shall approve applications for 14 grants in such a manner that the ratio of 15 the medically underserved populations in 16 rural areas which may be expected to use 17 the services provided by the applicants in- 18 volved to the medically underserved popu- 19 lations in urban areas which may be ex- 20 pected to use the services provided by the 21 applicants is not less than two to three or 22 greater than three to two. 23 carrying out clause (i), the ‘‘(iv) SERVICE AREA OVERLAP.—If in 24 carrying out clause (i) the applicant pro- 25 poses to serve an area that is currently February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 575 1 served by another health center funded 2 under this section, the Secretary may con- 3 sider whether the award of funding to an 4 additional health center in the area can be 5 justified based on the unmet need for addi- 6 tional services within the catchment area. 7 ‘‘(B) APPROVAL 8 9 OF EXPANDED SERVICE APPLICATIONS.— ‘‘(i) IN GENERAL.—The Secretary 10 may approve applications for grants under 11 subparagraph (A) or (B) of paragraph (1) 12 to expand the capacity of the applicant to 13 provide required primary health services 14 described in subsection (b)(1) or additional 15 health services described in subsection 16 (b)(2). 17 ‘‘(ii) PRIORITY EXPANSION 18 PROJECTS.—In 19 Secretary may give special consideration to 20 expanded service applications that seek to 21 address emerging public health or behav- 22 ioral health, mental health, or substance 23 abuse issues through increasing the avail- 24 ability of additional health services de- 25 scribed in subsection (b)(2) in an area in February 7, 2018 (10:12 p.m.) carrying out clause (i), the U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 576 1 which there are significant barriers to ac- 2 cessing care. 3 ‘‘(iii) CONSIDERATION OF APPLICA- 4 TIONS.—In 5 Secretary shall approve applications for 6 grants in such a manner that the ratio of 7 the medically underserved populations in 8 rural areas which may be expected to use 9 the services provided by the applicants in- 10 volved to the medically underserved popu- 11 lations in urban areas which may be ex- 12 pected to use the services provided by such 13 applicants is not less than two to three or 14 greater than three to two.’’; 15 carrying out clause (i), the (8) in subsection (h)— 16 (A) in paragraph (1), by striking ‘‘and 17 children and youth at risk of homelessness’’ and 18 inserting ‘‘, children and youth at risk of home- 19 lessness, homeless veterans, and veterans at 20 risk of homelessness’’; and 21 (B) in paragraph (5)— 22 (i) by striking subparagraph (B); 23 (ii) by redesignating subparagraph 24 February 7, 2018 (10:12 p.m.) (C) as subparagraph (B); and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 577 1 2 (iii) in subparagraph (B) (as so redesignated)— 3 (I) in the subparagraph heading, 4 by striking ‘‘ABUSE’’ and inserting 5 ‘‘USE 6 7 8 9 10 11 DISORDER’’; and (II) by striking ‘‘abuse’’ and inserting ‘‘use disorder’’; (9) in subsection (k)— (A) in paragraph (2)— (i) in the paragraph heading, by inserting ‘‘UNMET’’ before ‘‘NEED’’; 12 (ii) in the matter preceding subpara- 13 graph (A), by inserting ‘‘or subsection 14 (e)(6)’’ after ‘‘subsection (e)(1)’’; 15 (iii) in subparagraph (A), by inserting 16 ‘‘unmet’’ before ‘‘need for health services’’; 17 (iv) in subparagraph (B), by striking 18 ‘‘and’’ at the end; 19 (v) in subparagraph (C), by striking 20 the period at the end and inserting ‘‘; 21 and’’; and 22 (vi) by adding after subparagraph (C) 23 the following: 24 ‘‘(D) in the case of an application for a 25 grant pursuant to subsection (e)(6), a dem- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 578 1 onstration that the applicant has consulted with 2 appropriate State and local government agen- 3 cies, and health care providers regarding the 4 need for the health services to be provided at 5 the proposed delivery site.’’; 6 (B) in paragraph (3)— 7 (i) in the matter preceding subpara- 8 graph (A), by inserting ‘‘or subsection 9 (e)(6)’’ after ‘‘subsection (e)(1)(B)’’; 10 (ii) in subparagraph (B), by striking 11 ‘‘in the catchment area of the center’’ and 12 inserting ‘‘, including other health care 13 providers that provide care within the 14 catchment area, local hospitals, and spe- 15 cialty providers in the catchment area of 16 the center, to provide access to services not 17 available through the health center and to 18 reduce the non-urgent use of hospital 19 emergency departments’’; 20 (iii) in subparagraph (H)(ii), by in- 21 serting ‘‘who shall be directly employed by 22 the center’’ after ‘‘approves the selection of 23 a director for the center’’; 24 25 February 7, 2018 (10:12 p.m.) (iv) in subparagraph (L), by striking ‘‘and’’ at the end; U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 579 1 (v) in subparagraph (M), by striking 2 the period and inserting ‘‘; and’’; and 3 (vi) by inserting after subparagraph 4 (M), the following: 5 ‘‘(N) the center has written policies and 6 procedures in place to ensure the appropriate 7 use of Federal funds in compliance with appli- 8 cable Federal statutes, regulations, and the 9 terms and conditions of the Federal award.’’; 10 and 11 (C) by striking paragraph (4); 12 (10) in subsection (l), by adding at the end the 13 following: ‘‘Funds expended to carry out activities 14 under this subsection and operational support activi- 15 ties under subsection (m) shall not exceed 3 percent 16 of the amount appropriated for this section for the 17 fiscal year involved.’’; 18 (11) in subsection (q)(4), by adding at the end 19 the following: ‘‘A waiver provided by the Secretary 20 under this paragraph may not remain in effect for 21 more than 1 year and may not be extended after 22 such period. An entity may not receive more than 23 one waiver under this paragraph in consecutive 24 years.’’; 25 February 7, 2018 (10:12 p.m.) (12) in subsection (r)(3)— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 580 1 (A) by striking ‘‘appropriate committees of 2 Congress a report concerning the distribution of 3 funds under this section’’ and inserting the fol- 4 lowing: ‘‘Committee on Health, Education, 5 Labor, and Pensions of the Senate, and the 6 Committee on Energy and Commerce of the 7 House of Representatives, a report including, at 8 a minimum— 9 10 ‘‘(A) the distribution of funds for carrying out this section’’; 11 (B) by striking ‘‘populations. Such report 12 shall include an assessment’’ and inserting the 13 following: ‘‘populations; 14 ‘‘(B) an assessment’’; 15 (C) by striking ‘‘and the rationale for any 16 substantial changes in the distribution of 17 funds.’’ and inserting a semicolon; and 18 (D) by adding at the end the following: 19 ‘‘(C) the distribution of awards and fund- 20 ing for new or expanded services in each of 21 rural areas and urban areas; 22 ‘‘(D) the distribution of awards and fund- 23 ing for establishing new access points, and the 24 number of new access points created; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 581 1 ‘‘(E) the amount of unexpended funding 2 for loan guarantees and loan guarantee author- 3 ity under title XVI; 4 5 6 7 8 9 10 11 ‘‘(F) the rationale for any substantial changes in the distribution of funds; ‘‘(G) the rate of closures for health centers and access points; ‘‘(H) the number and reason for any grants awarded pursuant to subsection (e)(1)(B); and ‘‘(I) the number and reason for any waiv- 12 ers provided pursuant to subsection (q)(4).’’; 13 (13) in subsection (r), by adding at the end the 14 following new paragraph: 15 ‘‘(5) FUNDING FOR PARTICIPATION OF HEALTH 16 CENTERS IN ALL OF US RESEARCH PROGRAM.—In 17 addition to any amounts made available pursuant to 18 paragraph (1) of this subsection, section 402A of 19 this Act, or section 10503 of the Patient Protection 20 and Affordable Care Act, there is authorized to be 21 appropriated, and there is appropriated, out of any 22 monies in the Treasury not otherwise appropriated, 23 to the Secretary $25,000,000 for fiscal year 2018 to 24 support the participation of health centers in the All February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 582 1 of Us Research Program under the Precision Medi- 2 cine Initiative under section 498E of this Act.’’; and 3 4 (14) by striking subsection (s). (c) NATIONAL HEALTH SERVICE CORPS.—Section 5 10503(b)(2)(F) of the Patient Protection and Affordable 6 Care Act (42 U.S.C. 254b–2(b)(2)(F)), as amended by 7 section 3101 of Public Law 115-96, is amended to read 8 as follows: 9 10 11 ‘‘(F) $310,000,000 for each of fiscal years 2018 and 2019.’’. (d) TEACHING HEALTH CENTERS THAT OPERATE 12 GRADUATE MEDICAL EDUCATION PROGRAMS.— 13 (1) PAYMENTS.—Subsection (a) of section 14 340H of the Public Health Service Act (42 U.S.C. 15 256h) is amended to read as follows: 16 ‘‘(a) PAYMENTS.— 17 ‘‘(1) IN GENERAL.—Subject to subsection 18 (h)(2), the Secretary shall make payments under 19 this section for direct expenses and indirect expenses 20 to qualified teaching health centers that are listed as 21 sponsoring institutions by the relevant accrediting 22 body for, as appropriate— 23 ‘‘(A) maintenance of filled positions at ex- 24 isting approved graduate medical residency 25 training programs; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 583 1 ‘‘(B) expansion of existing approved grad- 2 uate medical residency training programs; and 3 ‘‘(C) establishment of new approved grad- 4 uate medical residency training programs. 5 ‘‘(2) PER RESIDENT AMOUNT.—In making pay- 6 ments under paragraph (1), the Secretary shall con- 7 sider the cost of training residents at teaching 8 health centers and the implications of the per resi- 9 dent amount on approved graduate medical resi- 10 dency training programs at teaching health centers. 11 ‘‘(3) PRIORITY.—In making payments under 12 paragraph (1)(C), the Secretary shall give priority to 13 qualified teaching health centers that— 14 ‘‘(A) serve a health professional shortage 15 area with a designation in effect under section 16 332 or a medically underserved community (as 17 defined in section 799B); or 18 ‘‘(B) are located in a rural area (as de- 19 fined in section 1886(d)(2)(D) of the Social Se- 20 curity Act).’’. 21 (2) FUNDING.—Paragraph (1) of section 22 340H(g) of the Public Health Service Act (42 23 U.S.C. 256h(g)), as amended by section 3101 of 24 Public Law 115-96, is amended by striking ‘‘and 25 $30,000,000 for the period of the first and second February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 584 1 quarters of fiscal year 2018,’’ and inserting ‘‘and 2 $126,500,000 for each of fiscal years 2018 and 3 2019,’’. 4 (3) ANNUAL REPORTING.—Subsection (h)(1) of 5 section 340H of the Public Health Service Act (42 6 U.S.C. 256h) is amended— 7 8 9 10 11 12 (A) by redesignating subparagraph (D) as subparagraph (H); and (B) by inserting after subparagraph (C) the following: ‘‘(D) The number of patients treated by residents described in paragraph (4). 13 ‘‘(E) The number of visits by patients 14 treated by residents described in paragraph (4). 15 ‘‘(F) Of the number of residents described 16 in paragraph (4) who completed their residency 17 training at the end of such residency academic 18 year, the number and percentage of such resi- 19 dents entering primary care practice (meaning 20 any of the areas of practice listed in the defini- 21 tion of a primary care residency program in 22 section 749A). 23 ‘‘(G) Of the number of residents described 24 in paragraph (4) who completed their residency 25 training at the end of such residency academic February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 585 1 year, the number and percentage of such resi- 2 dents who entered practice at a health care fa- 3 cility— 4 ‘‘(i) primarily serving a health profes- 5 sional shortage area with a designation in 6 effect under section 332 or a medically un- 7 derserved community (as defined in section 8 799B); or 9 ‘‘(ii) located in a rural area (as de- 10 fined in section 1886(d)(2)(D) of the So- 11 cial Security Act).’’. 12 (4) REPORT ON TRAINING COSTS.—Not later 13 than March 31, 2019, the Secretary of Health and 14 Human Services shall submit to the Congress a re- 15 port on the direct graduate expenses of approved 16 graduate medical residency training programs, and 17 the indirect expenses associated with the additional 18 costs of teaching residents, of qualified teaching 19 health centers (as such terms are used or defined in 20 section 340H of the Public Health Service Act (42 21 U.S.C. 256h)). 22 (5) DEFINITION.—Subsection (j) of section 23 340H of the Public Health Service Act (42 U.S.C. 24 256h) is amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 586 1 (A) by redesignating paragraphs (2) and 2 (3) as paragraphs (3) and (4), respectively; and 3 (B) by inserting after paragraph (1) the 4 following: 5 ‘‘(2) NEW APPROVED GRADUATE MEDICAL 6 RESIDENCY TRAINING PROGRAM.—The 7 approved graduate medical residency training pro- 8 gram’ means an approved graduate medical resi- 9 dency training program for which the sponsoring 10 qualified teaching health center has not received a 11 payment under this section for a previous fiscal year 12 (other than pursuant to subsection (a)(1)(C)).’’. 13 (6) TECHNICAL term ‘new CORRECTION.—Subsection (f) 14 of section 340H (42 U.S.C. 256h) is amended by 15 striking ‘‘hospital’’ each place it appears and insert- 16 ing ‘‘teaching health center’’. 17 (7) PAYMENTS FOR PREVIOUS FISCAL YEARS.— 18 The provisions of section 340H of the Public Health 19 Service Act (42 U.S.C. 256h), as in effect on the 20 day before the date of enactment of Public Law 115- 21 96, shall continue to apply with respect to payments 22 under such section for fiscal years before fiscal year 23 2018. 24 (e) APPLICATION.—Amounts appropriated pursuant 25 to this section for fiscal year 2018 or 2019 are subject February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 587 1 to the requirements contained in Public Law 115–31 for 2 funds for programs authorized under sections 330 through 3 340 of the Public Health Service Act (42 U.S.C. 254b– 4 256). 5 (f) CONFORMING AMENDMENTS.—Paragraph (4) of 6 section 3014(h) of title 18, United States Code, as amend7 ed by section 3101 of Public Law 115-96, is amended by 8 striking ‘‘and section 3101(d) of the CHIP and Public 9 Health Funding Extension Act’’ and inserting ‘‘and sec10 tion 50901(e) of the Advancing Chronic Care, Extenders, 11 and Social Services Act’’. 12 SEC. 50902. EXTENSION FOR SPECIAL DIABETES PRO- 13 GRAMS. 14 15 (a) SPECIAL DIABETES PROGRAM BETES.—Section FOR TYPE I DIA- 330B(b)(2)(D) of the Public Health 16 Service Act (42 U.S.C. 254c–2(b)(2)(D)), as amended by 17 section 3102 of Public Law 115-96, is amended to read 18 as follows: 19 ‘‘(D) $150,000,000 for each of fiscal years 20 2018 and 2019, to remain available until ex- 21 pended.’’. 22 (b) SPECIAL DIABETES PROGRAM FOR INDIANS.— 23 Subparagraph (D) of section 330C(c)(2) of the Public 24 Health Service Act (42 U.S.C. 254c–3(c)(2)), as amended February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 588 1 by section 3102 of Public Law 115-96, is amended to read 2 as follows: 3 ‘‘(D) $150,000,000 for each of fiscal years 4 2018 and 2019, to remain available until ex- 5 pended.’’. TITLE X—MISCELLANEOUS HEALTH CARE POLICIES 6 7 8 SEC. 51001. HOME HEALTH PAYMENT REFORM. 9 (a) BUDGET NEUTRAL TRANSITION 10 UNIT OF PAYMENT FOR TO A 30-DAY HOME HEALTH SERVICES.—Sec- 11 tion 1895(b) of the Social Security Act (42 U.S.C. 12 1395fff(b)) is amended— 13 14 15 (1) in paragraph (2)— (A) by striking ‘‘PAYMENT.—In defining’’ and inserting ‘‘PAYMENT.— 16 ‘‘(A) IN 17 (B) by adding at the end the following new 18 19 GENERAL.—In defining’’; and subparagraph: ‘‘(B) 30-DAY UNIT OF SERVICE.—For pur- 20 poses of implementing the prospective payment 21 system with respect to home health units of 22 service furnished during a year beginning with 23 2020, the Secretary shall apply a 30-day unit of 24 service as the unit of service applied under this 25 paragraph.’’; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 589 1 2 3 4 (2) in paragraph (3)— (A) in subparagraph (A), by adding at the end the following new clause: ‘‘(iv) BUDGET NEUTRALITY FOR 5 2020.—With 6 health units of service furnished that end 7 during the 12-month period beginning Jan- 8 uary 1, 2020, the Secretary shall calculate 9 a standard prospective payment amount 10 (or amounts) for 30-day units of service 11 (as described in paragraph (2)(B)) for the 12 prospective payment system under this 13 subsection. Such standard prospective pay- 14 ment amount (or amounts) shall be cal- 15 culated in a manner such that the esti- 16 mated aggregate amount of expenditures 17 under the system during such period with 18 application of paragraph (2)(B) is equal to 19 the estimated aggregate amount of expend- 20 itures that otherwise would have been 21 made under the system during such period 22 if paragraph (2)(B) had not been enacted. 23 The previous sentence shall be applied be- 24 fore (and not affect the application of) 25 paragraph (3)(B). In calculating such February 7, 2018 (10:12 p.m.) respect to payments for home U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 590 1 amount (or amounts), the Secretary shall 2 make assumptions about behavior changes 3 that could occur as a result of the imple- 4 mentation of paragraph (2)(B) and the 5 case-mix adjustment factors established 6 under paragraph (4)(B) and shall provide 7 a description of such assumptions in the 8 notice and comment rulemaking used to 9 implement this clause.’’; and 10 11 12 13 14 (B) by adding at the end the following new subparagraph: ‘‘(D) BEHAVIOR ASSUMPTIONS AND AD- JUSTMENTS.— ‘‘(i) IN GENERAL.—The Secretary 15 shall annually determine the impact of dif- 16 ferences 17 changes 18 (3)(A)(iv)) and actual behavior changes on 19 estimated aggregate expenditures under 20 this subsection with respect to years begin- 21 ning with 2020 and ending with 2026. 22 between (as assumed described ‘‘(ii) PERMANENT in behavior paragraph ADJUSTMENTS.— 23 The Secretary shall, at a time and in a 24 manner determined appropriate, through 25 notice and comment rulemaking, provide February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 591 1 for one or more permanent increases or de- 2 creases to the standard prospective pay- 3 ment amount (or amounts) for applicable 4 years, on a prospective basis, to offset for 5 such increases or decreases in estimated 6 aggregate 7 under clause (i)). 8 9 expenditures ‘‘(iii) TEMPORARY RETROSPECTIVE (as determined ADJUSTMENTS FOR BEHAVIOR.—The Sec- 10 retary shall, at a time and in a manner de- 11 termined appropriate, through notice and 12 comment rulemaking, provide for one or 13 more temporary increases or decreases to 14 the payment amount for a unit of home 15 health services (as determined under para- 16 graph (4)) for applicable years, on a pro- 17 spective basis, to offset for such increases 18 or decreases in estimated aggregate ex- 19 penditures (as determined under clause 20 (i)). Such a temporary increase or decrease 21 shall apply only with respect to the year 22 for which such temporary increase or de- 23 crease is made, and the Secretary shall not 24 take into account such a temporary in- 25 crease or decrease in computing such February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 592 1 amount under this subsection for a subse- 2 quent year.’’; and 3 (3) in paragraph (4)(B)— 4 5 (A) by striking ‘‘FACTORS.—The Secretary’’ and inserting ‘‘FACTORS.— 6 ‘‘(i) IN GENERAL.—The Secretary’’; 7 and 8 (B) by adding at the end the following new 9 clause: 10 ‘‘(ii) TREATMENT OF THERAPY 11 THRESHOLDS.—For 12 years, the Secretary shall eliminate the use 13 of therapy thresholds (established by the 14 Secretary) in case mix adjustment factors 15 established under clause (i) for calculating 16 payments under the prospective payment 17 system under this subsection.’’. 18 19 2020 and subsequent (b) TECHNICAL EXPERT PANEL.— (1) IN GENERAL.—During the period beginning 20 on January 1, 2018, and ending on December 31, 21 2018, the Secretary of Health and Human Services 22 shall hold at least one session of a technical expert 23 panel, the participants of which shall include home 24 health providers, patient representatives, and other 25 relevant stakeholders. The technical expert panel February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 593 1 shall identify and prioritize recommendations with 2 respect to the prospective payment system for home 3 health services under section 1895(b) of the Social 4 Security Act (42 U.S.C. 1395fff(b)), on the fol- 5 lowing: 6 (A) The Home Health Groupings Model, 7 as described in the proposed rule ‘‘Medicare 8 and Medicaid Programs; CY 2018 Home 9 Health Prospective Payment System Rate Up- 10 date and Proposed CY 2019 Case-Mix Adjust- 11 ment Methodology Refinements; Home Health 12 Value-Based Purchasing Model; and Home 13 Health Quality Reporting Requirements’’ (82 14 Fed. Reg. 35294 through 35332 (July 28, 15 2017)). 16 (B) Alternative case-mix models to the 17 Home Health Groupings Model that were sub- 18 mitted during 2017 as comments in response to 19 proposed rule making, including patient-focused 20 factors that consider the risks of hospitalization 21 and readmission to a hospital, improvement or 22 maintenance of functionality of individuals to 23 increase the capacity for self-care, quality of 24 care, and resource utilization. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 594 1 (2) INAPPLICABILITY OF FACA.—The provisions 2 of the Federal Advisory Committee Act (5 U.S.C. 3 App.) shall not apply to the technical expert panel 4 under paragraph (1). 5 (3) REPORT.—Not later than April 1, 2019, the 6 Secretary of Health and Human Services shall sub- 7 mit to the Committee on Ways and Means and the 8 Committee on Energy and Commerce of the House 9 of Representatives and the Committee on Finance of 10 the Senate a report on the recommendations of such 11 panel described in such paragraph. 12 (4) NOTICE AND COMMENT RULEMAKING.—Not 13 later than December 31, 2019, the Secretary of 14 Health and Human Services shall pursue notice and 15 comment rulemaking on a case-mix system with re- 16 spect to the prospective payment system for home 17 health services under section 1895(b) of the Social 18 Security Act (42 U.S.C. 1395fff(b)). 19 (c) REPORTS.— 20 (1) INTERIM REPORT.—Not later than March 21 15, 2022, the Medicare Payment Advisory Commis- 22 sion shall submit to Congress an interim report on 23 the application of a 30-day unit of service as the 24 unit of service applied under section 1895(b)(2) of 25 the Social Security Act (42 U.S.C. 1395fff(b)(2)), as February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 595 1 amended by subsection (a), including an analysis of 2 the level of payments provided to home health agen- 3 cies as compared to the cost of delivering home 4 health services, and any unintended consequences, 5 including with respect to behavioral changes and 6 quality. 7 (2) FINAL REPORT.—Not later than March 15, 8 2026, such Commission shall submit to Congress a 9 final report on such application and any such con- 10 11 sequences. SEC. 51002. INFORMATION TO SATISFY DOCUMENTATION 12 OF 13 HEALTH SERVICES. 14 MEDICARE ELIGIBILITY FOR HOME (a) PART A.—Section 1814(a) of the Social Security 15 Act (42 U.S.C. 1395f(a)) is amended by inserting before 16 ‘‘For purposes of paragraph (2)(C),’’ the following new 17 sentence: ‘‘For purposes of documentation for physician 18 certification and recertification made under paragraph (2) 19 on or after January 1, 2019, and made with respect to 20 home health services furnished by a home health agency, 21 in addition to using documentation in the medical record 22 of the physician who so certifies or the medical record of 23 the acute or post-acute care facility (in the case that home 24 health services were furnished to an individual who was 25 directly admitted to the home health agency from such a February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 596 1 facility), the Secretary may use documentation in the med2 ical record of the home health agency as supporting mate3 rial, as appropriate to the case involved.’’. 4 (b) PART B.—Section 1835(a) of the Social Security 5 Act (42 U.S.C. 1395n(a)) is amended by inserting before 6 ‘‘For purposes of paragraph (2)(A),’’ the following new 7 sentence: ‘‘For purposes of documentation for physician 8 certification and recertification made under paragraph (2) 9 on or after January 1, 2019, and made with respect to 10 home health services furnished by a home health agency, 11 in addition to using documentation in the medical record 12 of the physician who so certifies or the medical record of 13 the acute or post-acute care facility (in the case that home 14 health services were furnished to an individual who was 15 directly admitted to the home health agency from such a 16 facility), the Secretary may use documentation in the med17 ical record of the home health agency as supporting mate18 rial, as appropriate to the case involved.’’. 19 SEC. 51003. TECHNICAL AMENDMENTS TO PUBLIC LAW 114– 20 21 10. (a) MIPS TRANSITION.—Section 1848 of the Social 22 Security Act (42 U.S.C. 1395w–4) is amended— 23 24 February 7, 2018 (10:12 p.m.) (1) in subsection (q)— (A) in paragraph (1)— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 597 1 (i) in subparagraph (B), by striking 2 ‘‘items and services’’ and inserting ‘‘cov- 3 ered professional services (as defined in 4 subsection (k)(3)(A))’’; and 5 6 7 8 9 (ii) in subparagraph (C)(iv)— (I) by amending subclause (I) to read as follows: ‘‘(I) The minimum number (as determined by the Secretary) of— 10 ‘‘(aa) for performance peri- 11 ods beginning before January 1, 12 2018, individuals enrolled under 13 this part who are treated by the 14 eligible professional for the per- 15 formance period involved; and 16 ‘‘(bb) for performance peri- 17 ods beginning on or after Janu- 18 ary 1, 2018, individuals enrolled 19 under this part who are fur- 20 nished covered professional serv- 21 ices (as defined in subsection 22 (k)(3)(A)) by the eligible profes- 23 sional for the performance period 24 involved.’’; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 598 1 (II) in subclause (II), by striking 2 ‘‘items and services’’ and inserting 3 ‘‘covered professional services (as de- 4 fined in subsection (k)(3)(A))’’; and 5 6 7 8 (III) by amending subclause (III) to read as follows: ‘‘(III) The minimum amount (as determined by the Secretary) of— 9 ‘‘(aa) for performance peri- 10 ods beginning before January 1, 11 2018, allowed charges billed by 12 such professional under this part 13 for such performance period; and 14 ‘‘(bb) for performance peri- 15 ods beginning on or after Janu- 16 ary 1, 2018, allowed charges for 17 covered professional services (as 18 defined in subsection (k)(3)(A)) 19 billed by such professional for 20 such performance period.’’; 21 (B) in paragraph (5)(D)— 22 (i) in clause (i)(I), by inserting ‘‘sub- 23 ject to clause (iii),’’ after ‘‘clauses (i) and 24 (ii) of paragraph (2)(A),’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 599 1 2 3 (ii) by adding at the end the following new clause: ‘‘(iii) TRANSITION YEARS.—For each 4 of the second, third, fourth, and fifth years 5 for which the MIPS applies to payments, 6 the performance score for the performance 7 category described in paragraph (2)(A)(ii) 8 shall not take into account the improve- 9 ment of the professional involved.’’; 10 11 12 (C) in paragraph (5)(E)— (i) in clause (i)(I)(bb)— (I) in the heading by striking 13 ‘‘FIRST 14 ‘‘FIRST 2 YEARS’’ 5 YEARS’’; and inserting and 15 (II) by striking ‘‘the first and 16 second years’’ and inserting ‘‘each of 17 the first through fifth years’’; 18 (ii) in clause (i)(II)(bb)— 19 20 (I) in the heading, by striking ‘‘2 YEARS’’ and inserting ‘‘5 YEARS’’; and 21 (II) by striking the second sen- 22 tence and inserting the following new 23 sentences: ‘‘For each of the second, 24 third, fourth, and fifth years for 25 which the MIPS applies to payments, February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 600 1 not less than 10 percent and not more 2 than 30 percent of such score shall be 3 based on performance with respect to 4 the category described in clause (ii) of 5 paragraph (2)(A). Nothing in the pre- 6 vious sentence shall be construed, with 7 respect to a performance period for a 8 year described in the previous sen- 9 tence, as preventing the Secretary 10 from basing 30 percent of such score 11 for such year with respect to the cat- 12 egory described in such clause (ii), if 13 the Secretary determines, based on in- 14 formation posted under subsection 15 (r)(2)(I) that sufficient resource use 16 measures are ready for adoption for 17 use under the performance category 18 under paragraph (2)(A)(ii) for such 19 performance period.’’; 20 (D) in paragraph (6)(D)— 21 (i) in clause (i), in the second sen- 22 tence, by striking ‘‘Such performance 23 threshold’’ 24 clauses (iii) and (iv), such performance 25 threshold’’; February 7, 2018 (10:12 p.m.) and inserting ‘‘Subject to U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 601 1 (ii) in clause (ii)— 2 (I) in the first sentence, by in- 3 serting ‘‘(beginning with 2019 and 4 ending with 2024)’’ after ‘‘for each 5 year of the MIPS’’; and 6 (II) in the second sentence, by 7 inserting ‘‘subject to clause (iii),’’ 8 after ‘‘For each such year,’’; 9 (iii) in clause (iii)— 10 11 (I) in the heading, by striking ‘‘2’’ and inserting ‘‘5’’; and 12 (II) in the first sentence, by 13 striking ‘‘two years’’ and inserting 14 ‘‘five years’’; and 15 (iv) by adding at the end the following 16 17 new clause: ‘‘(iv) ADDITIONAL SPECIAL RULE FOR 18 THIRD, FOURTH AND FIFTH YEARS OF 19 MIPS.—For 20 adjustment factors under subparagraph 21 (A), in addition to the requirements speci- 22 fied in clause (iii), the Secretary shall in- 23 crease the performance threshold with re- 24 spect to each of the third, fourth, and fifth 25 years to which the MIPS applies to ensure February 7, 2018 (10:12 p.m.) purposes of determining MIPS U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 602 1 a gradual and incremental transition to the 2 performance threshold described in clause 3 (i) (as estimated by the Secretary) with re- 4 spect to the sixth year to which the MIPS 5 applies.’’; 6 (E) in paragraph (6)(E)— 7 (i) by striking ‘‘In the case of items 8 and services’’ and inserting ‘‘In the case of 9 covered professional services (as defined in 10 subsection (k)(3)(A))’’; and 11 (ii) by striking ‘‘under this part with 12 respect to such items and services’’ and in- 13 serting ‘‘under this part with respect to 14 such covered professional services’’; and 15 (F) in paragraph (7), in the first sentence, 16 by striking ‘‘items and services’’ and inserting 17 ‘‘covered professional services (as defined in 18 subsection (k)(3)(A))’’; 19 (2) in subsection (r)(2), by adding at the end 20 the following new subparagraph: 21 ‘‘(I) INFORMATION.—The Secretary shall, 22 not later than December 31st of each year (be- 23 ginning with 2018), post on the Internet 24 website of the Centers for Medicare & Medicaid 25 Services information on resource use measures February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 603 1 in use under subsection (q), resource use meas- 2 ures under development and the time-frame for 3 such development, potential future resource use 4 measure topics, a description of stakeholder en- 5 gagement, and the percent of expenditures 6 under part A and this part that are covered by 7 resource use measures.’’; and 8 (3) in subsection (s)(5)(B), by striking ‘‘section 9 1833(z)(2)(C)’’ 10 1833(z)(3)(D)’’. 11 (b) PHYSICIAN-FOCUSED PAYMENT MODEL TECH- 12 NICAL and inserting ADVISORY COMMITTEE PROVISION ‘‘section OF INITIAL 13 PROPOSAL FEEDBACK.—Section 1868(c)(2)(C) of the So14 cial Security Act (42 U.S.C. 1395ee(c)(2)(C)) is amended 15 to read as follows: 16 ‘‘(C) COMMITTEE 17 SUBMITTED.—The 18 basis— 19 20 REVIEW OF MODELS Committee, on a periodic ‘‘(i) shall review models submitted under subparagraph (B); 21 ‘‘(ii) may provide individuals and 22 stakeholder entities who submitted such 23 models with— 24 ‘‘(I) initial feedback on such 25 models regarding the extent to which February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 604 1 such models meet the criteria de- 2 scribed in subparagraph (A); and 3 ‘‘(II) an explanation of the basis 4 for the feedback provided under sub- 5 clause (I); and 6 ‘‘(iii) shall prepare comments and rec- 7 ommendations 8 models meet the criteria described in sub- 9 paragraph (A) and submit such comments 10 11 regarding whether such and recommendations to the Secretary.’’. SEC. 51004. EXPANDED ACCESS TO MEDICARE INTENSIVE 12 13 CARDIAC REHABILITATION PROGRAMS. Section 1861(eee)(4)(B) of the Social Security Act 14 (42 U.S.C. 1395x(eee)(4)(B)) is amended— 15 (1) in clause (v), by striking ‘‘or’’ at the end; 16 (2) in clause (vi), by striking the period at the 17 18 19 end and inserting a semicolon; and (3) by adding at the end the following new clauses: 20 ‘‘(vii) stable, chronic heart failure (defined 21 as patients with left ventricular ejection fraction 22 of 35 percent or less and New York Heart As- 23 sociation (NYHA) class II to IV symptoms de- 24 spite being on optimal heart failure therapy for 25 at least 6 weeks); or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 605 1 ‘‘(viii) any additional condition for which 2 the Secretary has determined that a cardiac re- 3 habilitation program shall be covered, unless 4 the Secretary determines, using the same proc- 5 ess used to determine that the condition is cov- 6 ered for a cardiac rehabilitation program, that 7 such coverage is not supported by the clinical 8 evidence.’’. 9 SEC. 51005. EXTENSION OF BLENDED SITE NEUTRAL PAY- 10 MENT RATE FOR CERTAIN LONG-TERM CARE 11 HOSPITAL 12 JUSTMENT 13 RATES. 14 DISCHARGES; TO SITE TEMPORARY NEUTRAL AD- PAYMENT (a) EXTENSION.—Section 1886(m)(6)(B)(i) of the 15 Social Security Act (42 U.S.C. 1395ww(m)(6)(B)(i)) is 16 amended— 17 (1) in subclause (I), by striking ‘‘fiscal year 18 2016 or fiscal year 2017’’ and inserting ‘‘fiscal years 19 2016 through 2019’’; and 20 (2) in subclause (II), by striking ‘‘2018’’ and 21 inserting ‘‘2020’’. 22 (b) TEMPORARY ADJUSTMENT TO SITE NEUTRAL 23 PAYMENT RATES.—Section 1886(m)(6)(B) of the Social 24 Security Act (42 U.S.C. 1395ww(m)(6)(B)) is amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 606 1 (1) in clause (ii), in the matter preceding sub- 2 clause (I), by striking ‘‘In this paragraph’’ and in- 3 serting ‘‘Subject to clause (iv), in this paragraph’’; 4 and 5 (2) by adding at the end the following new 6 clause: 7 ‘‘(iv) ADJUSTMENT.—For each of fis- 8 cal years 2018 through 2026, the amount 9 that would otherwise apply under clause 10 (ii)(I) for the year (determined without re- 11 gard to this clause) shall be reduced by 4.6 12 percent.’’. 13 SEC. 51006. RECOGNITION OF ATTENDING PHYSICIAN AS- 14 SISTANTS AS ATTENDING PHYSICIANS TO 15 SERVE HOSPICE PATIENTS. 16 (a) RECOGNITION 17 SISTANTS AS 18 PICE 19 OF ATTENDING PHYSICIAN AS- ATTENDING PHYSICIANS TO SERVE HOS- PATIENTS.— (1) IN GENERAL.—Section 1861(dd)(3)(B) of 20 the Social Security Act (42 U.S.C. 1395x(dd)(3)(B)) 21 is amended— 22 23 February 7, 2018 (10:12 p.m.) (A) by striking ‘‘or nurse’’ and inserting ‘‘, the nurse’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 607 1 (B) by inserting ‘‘, or the physician assist- 2 ant (as defined in such subsection)’’ after ‘‘sub- 3 section (aa)(5))’’. 4 (2) CLARIFICATION 5 SICIAN ASSISTANTS.—Section 1814(a)(7)(A)(i)(I) of 6 the Act 7 1395f(a)(7)(A)(i)(I)) is amended by inserting ‘‘or a 8 physician assistant’’ after ‘‘a nurse practitioner’’. 9 (b) EFFECTIVE DATE.—The amendments made by Social OF HOSPICE ROLE OF PHY- Security (42 U.S.C. 10 this section shall apply to items and services furnished on 11 or after January 1, 2019. 12 SEC. 51007. EXTENSION OF ENFORCEMENT INSTRUCTION 13 ON SUPERVISION REQUIREMENTS FOR OUT- 14 PATIENT THERAPEUTIC SERVICES IN CRIT- 15 ICAL ACCESS AND SMALL RURAL HOSPITALS 16 THROUGH 2017. 17 Section 1 of Public Law 113–198, as amended by sec- 18 tion 1 of Public Law 114–112 and section 16004(a) of 19 the 21st Century Cures Act (Public Law 114–255), is 20 amended— 21 22 23 24 February 7, 2018 (10:12 p.m.) (1) in the section heading, by striking ‘‘2016’’ and inserting ‘‘2017’’; and (2) by striking ‘‘and 2016’’ and inserting ‘‘2016, and 2017’’. U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 608 1 SEC. 51008. ALLOWING PHYSICIAN ASSISTANTS, NURSE 2 PRACTITIONERS, AND CLINICAL NURSE SPE- 3 CIALISTS TO SUPERVISE CARDIAC, INTEN- 4 SIVE CARDIAC, AND PULMONARY REHABILI- 5 TATION PROGRAMS. 6 7 (a) CARDIAC TION AND INTENSIVE CARDIAC REHABILITA- PROGRAMS.—Section 1861(eee) of the Social Secu- 8 rity Act (42 U.S.C. 1395x(eee)) is amended— 9 (1) in paragraph (1)— 10 11 (A) by striking ‘‘physician-supervised’’; and 12 (B) by inserting ‘‘under the supervision of 13 a physician (as defined in subsection (r)(1)) or 14 a physician assistant, nurse practitioner, or 15 clinical nurse specialist (as those terms are de- 16 fined in subsection (aa)(5))’’ before the period 17 at the end; 18 (2) in paragraph (2)— 19 (A) in subparagraph (A)(iii), by striking 20 the period at the end and inserting a semicolon; 21 and 22 (B) in subparagraph (B), by striking ‘‘a 23 physician’’ and inserting ‘‘a physician (as de- 24 fined in subsection (r)(1)) or a physician assist- 25 ant, nurse practitioner, or clinical nurse spe- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 609 1 cialist (as those terms are defined in subsection 2 (aa)(5))’’; and 3 (3) in paragraph (4)(A), in the matter pre- 4 ceding clause (i)— 5 6 (A) by striking ‘‘physician-supervised’’; and 7 (B) by inserting ‘‘under the supervision of 8 a physician (as defined in subsection (r)(1)) or 9 a physician assistant, nurse practitioner, or 10 clinical nurse specialist (as those terms are de- 11 fined in subsection (aa)(5))’’ after ‘‘paragraph 12 (3)’’. 13 (b) PULMONARY REHABILITATION PROGRAMS.—Sec- 14 tion 1861(fff)(1) of the Social Security Act (42 U.S.C. 15 1395x(fff)(1)) is amended— 16 (1) by striking ‘‘physician-supervised’’; and 17 (2) by inserting ‘‘under the supervision of a 18 physician (as defined in subsection (r)(1)) or a phy- 19 sician assistant, nurse practitioner, or clinical nurse 20 specialist (as those terms are defined in subsection 21 (aa)(5))’’ before the period at the end. 22 (c) EFFECTIVE DATE.—The amendments made by 23 this section shall apply to items and services furnished on 24 or after January 1, 2024. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 610 1 SEC. 51009. TRANSITIONAL PAYMENT RULES FOR CERTAIN 2 RADIATION THERAPY SERVICES UNDER THE 3 PHYSICIAN FEE SCHEDULE. 4 Section 1848 of the Social Security Act (42 U.S.C. 5 1395w–4) is amended— 6 (1) in subsection (b)(11), by striking ‘‘2017 7 and 2018’’ and inserting ‘‘2017, 2018, and 2019’’; 8 and 9 (2) in subsection (c)(2)(K)(iv), by striking 10 ‘‘2017 and 2018’’ and inserting ‘‘2017, 2018, and 11 2019’’. 14 TITLE XI—PROTECTING SENIORS’ ACCESS TO MEDICARE ACT 15 SEC. 52001. REPEAL OF THE INDEPENDENT PAYMENT ADVI- 12 13 16 17 SORY BOARD. (a) REPEAL.—Section 1899A of the Social Security 18 Act (42 U.S.C. 1395kkk) is repealed. 19 20 (b) CONFORMING AMENDMENTS.— (1) LOBBYING COOLING-OFF PERIOD.—Para- 21 graph (3) of section 207(c) of title 18, United States 22 Code, is repealed. 23 (2) GAO STUDY AND REPORT.—Section 24 3403(b) of the Patient Protection and Affordable 25 Care Act (42 U.S.C. 1395kkk–1) is repealed. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 611 1 (3) MEDPAC REVIEW AND COMMENT.—Section 2 1805(b) of the Social Security Act (42 U.S.C. 3 1395b–6(b)) is amended— 4 (A) by striking paragraph (4); 5 (B) by redesignating paragraphs (5) 6 through (8) as paragraphs (4) through (7), re- 7 spectively; and 8 (C) by redesignating the paragraph (9) 9 that was redesignated by section 3403(c)(1) of 10 the Patient Protection and Affordable Care Act 11 (Public Law 111–148) as paragraph (8). 12 (4) NAME CHANGE.—Section 10320(b) of the 13 Patient Protection and Affordable Care Act (Public 14 Law 111–148) is repealed. 15 (5) RULE OF CONSTRUCTION.—Section 16 10320(c) of the Patient Protection and Affordable 17 Care Act (Public Law 111–148) is repealed. 18 TITLE XII—OFFSETS 19 SEC. 53101. MODIFYING REDUCTIONS IN MEDICAID DSH AL- 20 21 LOTMENTS. Section 1923(f)(7)(A) of the Social Security Act (42 22 U.S.C. 1396r–4(f)(7)(A)) is amended— 23 (1) in clause (i), in the matter preceding sub- 24 clause (I), by striking ‘‘2018’’ and inserting ‘‘2020’’; 25 and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 612 1 (2) in clause (ii), by striking subclauses (I) 2 through (VIII) and inserting the following: 3 ‘‘(I) $4,000,000,000 for fiscal 4 year 2020; and 5 ‘‘(II) $8,000,000,000 for each of 6 7 fiscal years 2021 through 2025.’’. SEC. 53102. THIRD PARTY LIABILITY IN MEDICAID AND 8 CHIP. 9 (a) MODIFICATION 10 RULES RELATED TO OF THIRD PARTY LIABILITY SPECIAL TREATMENT OF CERTAIN 11 TYPES OF CARE AND PAYMENTS.— 12 (1) IN GENERAL.—Section 1902(a)(25)(E) of 13 the Social Security Act (42 U.S.C. 1396a(a)(25)(E)) 14 is amended, in the matter preceding clause (i), by 15 striking ‘‘prenatal or’’. 16 (2) EFFECTIVE DATE.—The amendment made 17 by paragraph (1) shall take effect on the date of en- 18 actment of this Act. 19 (b) DELAY IN EFFECTIVE DATE 20 CERTAIN BIPARTISAN BUDGET ACT 21 AND OF REPEAL OF 2013 AMEND- MENTS.— 22 (1) REPEAL.—Effective as of September 30, 23 2017, subsection (b) of section 202 of the Bipartisan 24 Budget Act of 2013 (Public Law 113–67; 127 Stat. 25 1177; 42 U.S.C. 1396a note) (including any amend- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 613 1 ments made by such subsection) is repealed and the 2 provisions amended by such subsection shall be ap- 3 plied and administered as if such amendments had 4 never been enacted. 5 (2) DELAY IN EFFECTIVE DATE.—Subsection 6 (c) of section 202 of the Bipartisan Budget Act of 7 2013 (Public Law 113–67; 127 Stat. 1177; 42 8 U.S.C. 1396a note) is amended to read as follows: 9 ‘‘(c) EFFECTIVE DATE.—The amendments made by 10 subsection (a) shall take effect on October 1, 2019.’’. 11 (3) EFFECTIVE DATE; TREATMENT.—The re- 12 peal and amendment made by this subsection shall 13 take effect as if enacted on September 30, 2017, and 14 shall apply with respect to any open claims, includ- 15 ing claims pending, generated, or filed, after such 16 date. The amendments made by subsections (a) and 17 (b) of section 202 of the Bipartisan Budget Act of 18 2013 (Public Law 113–67; 127 Stat. 1177; 42 19 U.S.C. 1396a note) that took effect on October 1, 20 2017, are null and void and section 1902(a)(25) of 21 the Social Security Act (42 U.S.C. 1396a(a)(25)) 22 shall be applied and administered as if such amend- 23 ments had not taken effect on such date. 24 (c) GAO STUDY AND REPORT.—Not later than 18 25 months after the date of enactment of this Act, the Comp- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 614 1 troller General of the United States shall submit a report 2 to the Committee on Energy and Commerce of the House 3 of Representatives and the Committee on Finance of the 4 Senate on the impacts of the amendments made by sub5 sections (a)(1) and (b)(2), including— 6 (1) the impact, or potential effect, of such 7 amendments on access to prenatal and preventive 8 pediatric care (including early and periodic screen- 9 ing, diagnostic, and treatment services) covered 10 under State plans under such title (or waivers of 11 such plans); 12 (2) the impact, or potential effect, of such 13 amendments on access to services covered under 14 such plans or waivers for individuals on whose behalf 15 child support enforcement is being carried out by a 16 State agency under part D of title IV of such Act; 17 and 18 (3) the impact, or potential effect, on providers 19 of services under such plans or waivers of delays in 20 payment or related issues that result from such 21 amendments. 22 (d) APPLICATION TO CHIP.— 23 (1) IN GENERAL.—Section 2107(e)(1) of the 24 Social Security Act (42 U.S.C. 1397gg(e)(1)) is 25 amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 615 1 (A) by redesignating subparagraphs (B) 2 through (R) as subparagraphs (C) through (S), 3 respectively; and 4 (B) by inserting after subparagraph (A) 5 the following new subparagraph: 6 ‘‘(B) Section 1902(a)(25) (relating to third 7 party liability).’’. 8 (2) 9 MANDATORY REPORTING.—Section 1902(a)(25)(I)(i) of the Social Security Act (42 10 U.S.C. 1396a(a)(25)(I)(i)) is amended— 11 (A) by striking ‘‘medical assistance under 12 the State plan’’ and inserting ‘‘medical assist- 13 ance under a State plan (or under a waiver of 14 the plan)’’; 15 (B) by striking ‘‘(and, at State option, 16 child’’ and inserting ‘‘and child’’; and 17 (C) by striking ‘‘title XXI)’’ and inserting 18 ‘‘title XXI’’. 19 SEC. 53103. TREATMENT OF LOTTERY WINNINGS AND 20 OTHER LUMP-SUM INCOME FOR PURPOSES 21 OF INCOME ELIGIBILITY UNDER MEDICAID. 22 (a) IN GENERAL.—Section 1902 of the Social Secu- 23 rity Act (42 U.S.C. 1396a) is amended— 24 25 February 7, 2018 (10:12 p.m.) (1) in subsection (a)(17), by striking ‘‘(e)(14), (e)(14)’’ and inserting ‘‘(e)(14), (e)(15)’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 616 1 2 3 (2) in subsection (e)(14), by adding at the end the following new subparagraph: ‘‘(K) TREATMENT OF CERTAIN LOTTERY 4 WINNINGS AND INCOME RECEIVED AS A LUMP 5 SUM.— 6 ‘‘(i) IN GENERAL.—In the case of an 7 individual who is the recipient of qualified 8 lottery winnings (pursuant to lotteries oc- 9 curring on or after January 1, 2018) or 10 qualified lump sum income (received on or 11 after such date) and whose eligibility for 12 medical assistance is determined based on 13 the application of modified adjusted gross 14 income under subparagraph (A), a State 15 shall, in determining such eligibility, in- 16 clude such winnings or income (as applica- 17 ble) as income received— 18 ‘‘(I) in the month in which such 19 winnings or income (as applicable) is 20 received 21 winnings or income is less than 22 $80,000; if the amount of such 23 ‘‘(II) over a period of 2 months 24 if the amount of such winnings or in- 25 come (as applicable) is greater than or February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 617 1 equal to $80,000 but less than 2 $90,000; 3 ‘‘(III) over a period of 3 months 4 if the amount of such winnings or in- 5 come (as applicable) is greater than or 6 equal to $90,000 but less than 7 $100,000; and 8 ‘‘(IV) over a period of 3 months 9 plus 1 additional month for each in- 10 crement of $10,000 of such winnings 11 or income (as applicable) received, not 12 to exceed a period of 120 months (for 13 winnings or income of $1,260,000 or 14 more), if the amount of such winnings 15 or income is greater than or equal to 16 $100,000. 17 ‘‘(ii) COUNTING IN EQUAL INSTALL- 18 MENTS.—For 19 (III), and (IV) of clause (i), winnings or 20 income to which such subclause applies 21 shall be counted in equal monthly install- 22 ments over the period of months specified 23 under such subclause. 24 ‘‘(iii) HARDSHIP 25 February 7, 2018 (10:12 p.m.) purposes of subclauses (II), EXEMPTION.—An in- dividual whose income, by application of U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 618 1 clause (i), exceeds the applicable eligibility 2 threshold established by the State, shall 3 continue to be eligible for medical assist- 4 ance to the extent that the State deter- 5 mines, under procedures established by the 6 State (in accordance with standards speci- 7 fied by the Secretary), that the denial of 8 eligibility of the individual would cause an 9 undue medical or financial hardship as de- 10 termined on the basis of criteria estab- 11 lished by the Secretary. 12 ‘‘(iv) NOTIFICATIONS AND ASSIST- 13 ANCE REQUIRED IN CASE OF LOSS OF ELI- 14 GIBILITY.—A 15 an individual who loses eligibility for med- 16 ical assistance under the State plan (or a 17 waiver of such plan) by reason of clause 18 (i)— State shall, with respect to 19 ‘‘(I) before the date on which the 20 individual loses such eligibility, inform 21 the individual— 22 ‘‘(aa) of the individual’s op- 23 portunity to enroll in a qualified 24 health plan offered through an 25 Exchange established under title February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 619 1 I of the Patient Protection and 2 Affordable Care Act during the 3 special enrollment period speci- 4 fied in section 9801(f)(3) of the 5 Internal Revenue Code of 1986 6 (relating to loss of Medicaid or 7 CHIP coverage); and 8 ‘‘(bb) of the date on which 9 the individual would no longer be 10 considered ineligible by reason of 11 clause (i) to receive medical as- 12 sistance under the State plan or 13 under any waiver of such plan 14 and be eligible to reapply to re- 15 ceive such medical assistance; 16 and 17 ‘‘(II) provide technical assistance 18 to the individual seeking to enroll in 19 such a qualified health plan. 20 ‘‘(v) QUALIFIED LOTTERY WINNINGS 21 DEFINED.—In 22 ‘qualified lottery winnings’ means winnings 23 from a sweepstakes, lottery, or pool de- 24 scribed in paragraph (3) of section 4402 of 25 the Internal Revenue Code of 1986 or a February 7, 2018 (10:12 p.m.) this subparagraph, the term U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 620 1 lottery operated by a multistate or multi- 2 jurisdictional lottery association, including 3 amounts awarded as a lump sum payment. 4 ‘‘(vi) QUALIFIED LUMP SUM INCOME 5 DEFINED.—In 6 ‘qualified lump sum income’ means income 7 that is received as a lump sum from mone- 8 tary winnings from gambling (as defined 9 by the Secretary and including gambling 10 activities described in section 1955(b)(4) of 11 title 18, United States Code).’’. 12 13 this subparagraph, the term (b) RULES OF CONSTRUCTION.— (1) INTERCEPTION OF LOTTERY WINNINGS AL- 14 LOWED.—Nothing 15 section (a)(2) shall be construed as preventing a 16 State from intercepting the State lottery winnings 17 awarded to an individual in the State to recover 18 amounts paid by the State under the State Medicaid 19 plan under title XIX of the Social Security Act (42 20 U.S.C. 1396 et seq.) for medical assistance fur- 21 nished to the individual. 22 (2) APPLICABILITY in the amendment made by sub- LIMITED TO ELIGIBILITY OF 23 RECIPIENT OF LOTTERY WINNINGS OR LUMP SUM 24 INCOME.—Nothing 25 section (a)(2) shall be construed, with respect to a February 7, 2018 (10:12 p.m.) in the amendment made by sub- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 621 1 determination of household income for purposes of a 2 determination of eligibility for medical assistance 3 under the State plan under title XIX of the Social 4 Security Act (42 U.S.C. 1396 et seq.) (or a waiver 5 of such plan) made by applying modified adjusted 6 gross income under subparagraph (A) of section 7 1902(e)(14) of such Act (42 U.S.C. 1396a(e)(14)), 8 as limiting the eligibility for such medical assistance 9 of any individual that is a member of the household 10 other than the individual who received qualified lot- 11 tery winnings or qualified lump-sum income (as de- 12 fined 13 1902(e)(14), as added by subsection (a)(2) of this 14 section). 15 in subparagraph (K) of such section SEC. 53104. REBATE OBLIGATION WITH RESPECT TO LINE 16 EXTENSION DRUGS. 17 (a) IN GENERAL.—Section 1927(c)(2)(C) of the So- 18 cial Security Act (42 U.S.C. 1396r–8(c)(2)(C)) is amend19 ed by striking ‘‘(C) 20 TIONS.—In TREATMENT OF NEW FORMULA- the case’’ and all that follows through the pe- 21 riod at the end of the first sentence and inserting the fol22 lowing: 23 24 February 7, 2018 (10:12 p.m.) ‘‘(C) TREATMENT TIONS.— OF NEW FORMULA- U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 622 1 ‘‘(i) IN GENERAL.—In the case of a 2 drug that is a line extension of a single 3 source drug or an innovator multiple 4 source drug that is an oral solid dosage 5 form, the rebate obligation for a rebate pe- 6 riod with respect to such drug under this 7 subsection shall be the greater of the 8 amount described in clause (ii) for such 9 drug or the amount described in clause 10 11 (iii) for such drug. ‘‘(ii) AMOUNT 1.—For purposes of 12 clause (i), the amount described in this 13 clause with respect to a drug described in 14 clause (i) and rebate period is the amount 15 computed under paragraph (1) for such 16 drug, increased by the amount computed 17 under subparagraph (A) and, as applicable, 18 subparagraph (B) for such drug and re- 19 bate period. 20 ‘‘(iii) AMOUNT 2.—For purposes of 21 clause (i), the amount described in this 22 clause with respect to a drug described in 23 clause (i) and rebate period is the amount 24 computed under paragraph (1) for such 25 drug, increased by the product of— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 623 1 ‘‘(I) the average manufacturer 2 price for the rebate period of the line 3 extension of a single source drug or 4 an innovator multiple source drug 5 that is an oral solid dosage form; 6 ‘‘(II) the highest additional re- 7 bate (calculated as a percentage of av- 8 erage manufacturer price) under this 9 paragraph for the rebate period for 10 any strength of the original single 11 source drug or innovator multiple 12 source drug; and 13 ‘‘(III) the total number of units 14 of each dosage form and strength of 15 the line extension product paid for 16 under the State plan in the rebate pe- 17 riod (as reported by the State).’’. 18 (b) EFFECTIVE DATE.—The amendments made sub- 19 section (a) shall apply with respect to rebate periods be20 ginning on or after October 1, 2018. 21 SEC. 53105. MEDICAID IMPROVEMENT FUND. 22 Section 1941(b) of the Social Security Act (42 U.S.C. 23 1396w–1(b)) is amended— 24 25 February 7, 2018 (10:12 p.m.) (1) in paragraph (1), by striking ‘‘$5,000,000’’ and inserting ‘‘$0’’; and U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 624 1 (2) in paragraph (3)(A), by 2 ‘‘$980,000,000’’ and inserting ‘‘$0’’. 3 SEC. 53106. PHYSICIAN FEE SCHEDULE UPDATE. 4 striking Section 1848(d)(18) of the Social Security Act (42 5 U.S.C. 1395w–4(d)(18)) is amended by striking ‘‘para6 graph (1)(C)’’ and all that follows and inserting the fol7 lowing: ‘‘paragraph (1)(C)— 8 ‘‘(A) for 2016 and each subsequent year 9 through 2018 shall be 0.5 percent; and 10 ‘‘(B) for 2019 shall be 0.25 percent.’’. 11 SEC. 53107. PAYMENT FOR OUTPATIENT PHYSICAL THER- 12 APY SERVICES AND OUTPATIENT OCCUPA- 13 TIONAL THERAPY SERVICES FURNISHED BY 14 A THERAPY ASSISTANT. 15 Section 1834 of the Social Security Act (42 U.S.C. 16 1395m) is amended by adding at the end the following 17 new subsection: 18 ‘‘(v) PAYMENT FOR OUTPATIENT OCCUPATIONAL THER- OUTPATIENT PHYSICAL THER- 19 APY SERVICES 20 APY SERVICES FURNISHED 21 AND ‘‘(1) IN BY A THERAPY ASSISTANT.— GENERAL.—In the case of an out- 22 patient physical therapy service or outpatient occu- 23 pational therapy service furnished on or after Janu- 24 ary 1, 2022, for which payment is made under sec- 25 tion 1848 or subsection (k), that is furnished in February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 625 1 whole or in part by a therapy assistant (as defined 2 by the Secretary), the amount of payment for such 3 service shall be an amount equal to 85 percent of 4 the amount of payment otherwise applicable for the 5 service under this part. Nothing in the preceding 6 sentence shall be construed to change applicable re- 7 quirements with respect to such services. 8 ‘‘(2) USE OF MODIFIER.— 9 ‘‘(A) ESTABLISHMENT.—Not later than 10 January 1, 2019, the Secretary shall establish 11 a modifier to indicate (in a form and manner 12 specified by the Secretary), in the case of an 13 outpatient physical therapy service or out- 14 patient occupational therapy service furnished 15 in whole or in part by a therapy assistant (as 16 so defined), that the service was furnished by a 17 therapy assistant. 18 ‘‘(B) REQUIRED USE.—Each request for 19 payment, or bill submitted, for an outpatient 20 physical therapy service or outpatient occupa- 21 tional therapy service furnished in whole or in 22 part by a therapy assistant (as so defined) on 23 or after January 1, 2020, shall include the 24 modifier established under subparagraph (A) 25 for each such service. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 626 1 ‘‘(3) IMPLEMENTATION.—The Secretary shall 2 implement this subsection through notice and com- 3 ment rulemaking.’’. 4 SEC. 53108. REDUCTION FOR NON-EMERGENCY ESRD AM- 5 BULANCE TRANSPORTS. 6 Section 1834(l)(15) of the Social Security Act (42. 7 U.S.C. 1395m(l)(15)) is amended by striking ‘‘on or after 8 October 1, 2013’’ and inserting ‘‘during the period begin9 ning on October 1, 2013, and ending on September 30, 10 2018, and by 23 percent for such services furnished on 11 or after October 1, 2018’’. 12 SEC. 53109. HOSPITAL TRANSFER POLICY FOR EARLY DIS- 13 14 CHARGES TO HOSPICE CARE. (a) IN GENERAL.—Section 1886(d)(5)(J) of the So- 15 cial Security Act (42 U.S.C. 1395ww(d)(5)(J)) is amend16 ed— 17 18 19 20 21 22 23 February 7, 2018 (10:12 p.m.) (1) in clause (ii)— (A) in subclause (III), by striking ‘‘or’’ at the end; (B) by redesignating subclause (IV) as subclause (V); and (C) by inserting after subclause (III) the following new subclause: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 627 1 ‘‘(IV) for discharges occurring on or after Octo- 2 ber 1, 2018, is provided hospice care by a hospice 3 program; or’’; and 4 (2) in clause (iv)— 5 (A) by inserting after the first sentence the 6 following new sentence: ‘‘The Secretary shall in- 7 clude in the proposed rule published for fiscal 8 year 2019, a description of the effect of clause 9 (ii)(IV).’’; and 10 (B) in subclause (I), by striking ‘‘and 11 (III)’’ and inserting ‘‘(III), and, in the case of 12 proposed and final rules for fiscal year 2019 13 and subsequent fiscal years, (IV)’’. 14 (b) MEDPAC EVALUATION AND REPORT.— 15 (1) EVALUATION.—The Medicare Payment Ad- 16 visory Commission (in this subsection referred to as 17 the ‘‘Commission’’) shall conduct an evaluation of 18 the effects of the amendments made by subsection 19 (a), including the effects on— 20 (A) the numbers of discharges of patients 21 from an inpatient hospital setting to a hospice 22 program; 23 (B) the lengths of stays of patients in an 24 inpatient hospital setting who are discharged to 25 a hospice program; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 628 1 (C) spending under the Medicare program 2 under title XVIII of the Social Security Act; 3 and 4 (D) other areas determined appropriate by 5 the Commission. 6 (2) CONSIDERATION.—In conducting the eval- 7 uation under paragraph (1), the Commission shall 8 consider factors such as whether the timely access to 9 hospice care by patients admitted to a hospital has 10 been affected through changes to hospital policies or 11 behaviors made as a result of such amendments. 12 (3) PRELIMINARY RESULTS.—Not later than 13 March 15, 2020, the Commission shall provide Con- 14 gress with preliminary results on the evaluation 15 being conducted under paragraph (1). 16 (4) REPORT.—Not later than March 15, 2021, 17 the Commission shall submit to Congress a report 18 on the evaluation conducted under paragraph (1). 19 SEC. 53110. MEDICARE PAYMENT UPDATE FOR HOME 20 21 HEALTH SERVICES. Section 1895(b)(3)(B) of the Social Security Act (42 22 U.S.C. 1395fff(b)(3)(B)) is amended— 23 (1) in clause (iii), in the last sentence, by in- 24 serting before the period at the end the following: 25 ‘‘and for 2020 shall be 1.5 percent’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 629 1 (2) in clause (vi), by inserting ‘‘and 2020’’ after 2 3 ‘‘except 2018’’. SEC. 53111. MEDICARE PAYMENT UPDATE FOR SKILLED 4 NURSING FACILITIES. 5 Section 1888(e)(5)(B) of the Social Security Act (42 6 U.S.C. 1395yy(e)(5)(B)) is amended— 7 (1) in clause (i), by striking ‘‘and (iii)’’ and in- 8 serting ‘‘, (iii), and (iv)’’; 9 (2) in clause (ii), by striking ‘‘clause (iii)’’ and 10 inserting ‘‘clauses (iii) and (iv)’’; and 11 (3) by adding at the end the following new 12 clause: 13 ‘‘(iv) SPECIAL RULE FOR FISCAL 14 YEAR 2019.—For 15 similar annual period specified in clause 16 (i)), the skilled nursing facility market bas- 17 ket percentage, after application of clause 18 (ii), is equal to 2.4 percent.’’. 19 SEC. 53112. PREVENTING THE ARTIFICIAL INFLATION OF 20 STAR RATINGS AFTER THE CONSOLIDATION 21 OF MEDICARE ADVANTAGE PLANS OFFERED 22 BY THE SAME ORGANIZATION. 23 fiscal year 2019 (or other Section 1853(o)(4) of the Social Security Act (42 24 U.S.C. 1395w–23(o)(4)) is amended by adding at the end 25 the following new subparagraph: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 630 1 ‘‘(D) SPECIAL RULE TO PREVENT THE AR- 2 TIFICIAL INFLATION OF STAR RATINGS AFTER 3 THE CONSOLIDATION OF MEDICARE ADVANTAGE 4 PLANS 5 TION.— 6 OFFERED ‘‘(i) IN BY A SINGLE ORGANIZA- GENERAL.—If— 7 ‘‘(I) a Medicare Advantage orga- 8 nization has entered into more than 9 one contract with the Secretary with 10 respect to the offering of Medicare 11 Advantage plans; and 12 ‘‘(II) on or after January 1, 13 2019, the Secretary approves a re- 14 quest from the organization to con- 15 solidate the plans under one or more 16 contract (in this subparagraph re- 17 ferred to as a ‘closed contract’) with 18 the plans offered under a separate 19 contract (in this subparagraph re- 20 ferred to as the ‘continuing contract’); 21 with respect to the continuing contract, the 22 Secretary shall adjust the quality rating 23 under the 5-star rating system and any 24 quality increase under this subsection and 25 rebate amounts under section 1854 to re- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 631 1 flect an enrollment-weighted average of 2 scores or ratings for the continuing and 3 closed contracts, as determined appropriate 4 by the Secretary. 5 ‘‘(ii) APPLICATION.—An adjustment 6 under clause (i) shall apply for any year 7 for which the quality rating of the con- 8 tinuing contract is based primarily on a 9 measurement period that is prior to the 10 first year in which a closed contract is no 11 longer offered.’’. 12 SEC. 53113. SUNSETTING EXCLUSION OF BIOSIMILARS 13 FROM MEDICARE PART D COVERAGE GAP 14 DISCOUNT PROGRAM. 15 Section 1860D–14A(g)(2)(A) of the Social Security 16 Act (42 U.S.C. 1395w–114a(g)(2)(A)) is amended by in17 serting ‘‘, with respect to a plan year before 2019,’’ after 18 ‘‘other than’’. 19 SEC. 53114. ADJUSTMENTS TO MEDICARE PART B AND 20 PART D PREMIUM SUBSIDIES FOR HIGHER 21 INCOME INDIVIDUALS. 22 (a) IN GENERAL.—Section 1839(i)(3)(C)(i) of the 23 Social Security Act (42 U.S.C. 1395r(i)(3)(C)(i)) is 24 amended— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 632 1 (1) in subclause (II), in the matter preceding 2 the table, by striking ‘‘years beginning with’’; and 3 (2) by adding at the end the following new sub- 4 clause: 5 ‘‘(III) Subject to paragraph (5), 6 for years beginning with 2019: ‘‘If the modified adjusted gross income is: .... More than $85,000 but not more than $107,000 .......... More than $107,000 but not more than $133,500 ........ More than $133,500 but not more than $160,000 ........ More than $160,000 but less than $500,000 ................ At least $500,000 ........................................................... 7 The applicable percentage is: 35 percent 50 percent 65 percent 80 percent 85 percent.’’. (b) JOINT RETURNS.—Section 1839(i)(3)(C)(ii) of 8 the Social Security Act (42 U.S.C. 1395r(i)(3)(C)(ii)) is 9 amended by inserting before the period the following: ‘‘ex10 cept, with respect to the dollar amounts applied in the last 11 row of the table under subclause (III) of such clause (and 12 the second dollar amount specified in the second to last 13 row of such table), clause (i) shall be applied by sub14 stituting dollar amounts which are 150 percent of such 15 dollar amounts for the calendar year’’. 16 (c) INFLATION ADJUSTMENT.—Section 1839(i)(5) of 17 the Social Security Act (42 U.S.C. 1395r(i)(5)) is amend18 ed— 19 (1) in subparagraph (A), by striking ‘‘In the 20 case’’ and inserting ‘‘Subject to subparagraph (C), 21 in the case’’; February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 633 1 (2) in subparagraph (B), by striking ‘‘subpara- 2 graph (A)’’ and inserting ‘‘subparagraph (A) or 3 (C)’’; and 4 5 6 7 8 9 10 11 (3) by adding at the end the following new subparagraph: ‘‘(C) TREATMENT OF ADJUSTMENTS FOR CERTAIN HIGHER INCOME INDIVIDUALS.— ‘‘(i) IN GENERAL.—Subparagraph (A) shall not apply with respect to each dollar amount in paragraph (3) of $500,000. ‘‘(ii) ADJUSTMENT BEGINNING 2028.— 12 In the case of any calendar year beginning 13 after 2027, each dollar amount in para- 14 graph (3) of $500,000 shall be increased 15 by an amount equal to— 16 17 ‘‘(I) such dollar amount, multiplied by 18 ‘‘(II) the percentage (if any) by 19 which the average of the Consumer 20 Price Index for all urban consumers 21 (United States city average) for the 22 12-month period ending with August 23 of the preceding calendar year exceeds 24 such average for the 12-month period 25 ending with August 2026.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 634 1 SEC. 53115. MEDICARE IMPROVEMENT FUND. 2 Section 1898(b)(1) of the Social Security Act (42 3 U.S.C. 1395iii(b)(1)) is amended by striking 4 ‘‘$220,000,000’’ and inserting ‘‘$0’’. 5 SEC. 53116. CLOSING THE DONUT HOLE FOR SENIORS. 6 (a) CLOSING DONUT HOLE SOONER.—Section 7 1860D–2(b)(2)(D) of the Social Security Act (42 U.S.C. 8 1395w–102(b)(2)(D))— 9 10 (1) in clause (i), by amending subclause (I) to read as follows: 11 ‘‘(I) equal to the difference be- 12 tween— 13 ‘‘(aa) the applicable gap per- 14 centage (specified in clause (ii) 15 for the year); and 16 ‘‘(bb) the discount percent- 17 age specified in section 1860D– 18 14A(g)(4)(A) for such applicable 19 drugs (or, in the case of a year 20 after 2018, 50 percent); or’’; and 21 22 23 (2) in clause (ii)— (A) in subclause (IV), by adding ‘‘and’’ at the end; 24 (B) by striking subclause (V); and 25 (C) in subclause (VI)— February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 635 1 (i) by striking ‘‘2020’’ and inserting 2 ‘‘2019’’; and 3 (ii) by redesignating such subclause as 4 subclause (V). 5 (b) LOWERING DISCOUNTED PRICE.—Section 6 1860D–14A(g)(4)(A) of the Social Security Act (42 7 U.S.C. 1395w–114a(g)(4)(A)) is amended by inserting 8 ‘‘(or, with respect to a plan year after plan year 2018, 9 30 percent)’’ after ‘‘50 percent’’. 10 SEC. 53117. MODERNIZING CHILD SUPPORT ENFORCEMENT 11 12 FEES. (a) IN GENERAL.—Section 454(6)(B)(ii) of the So- 13 cial Security Act (42 U.S.C. 654(6)(B)(ii)) is amended— 14 (1) by striking ‘‘$25’’ and inserting ‘‘$35’’; and 15 (2) by striking ‘‘$500’’ each place it appears 16 and inserting ‘‘$550’’. 17 (b) EFFECTIVE DATE.— 18 (1) IN GENERAL.—The amendments made by 19 subsection (a) shall take effect on the 1st day of the 20 1st fiscal year that begins on or after the date of the 21 enactment of this Act, and shall apply to payments 22 under part D of title IV of the Social Security Act 23 (42 U.S.C. 651 et seq.) for calendar quarters begin- 24 ning on or after such 1st day. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 636 1 (2) DELAY PERMITTED IF STATE LEGISLATION 2 REQUIRED.—If 3 Services determines that State legislation (other 4 than legislation appropriating funds) is required in 5 order for a State plan developed pursuant to part D 6 of title IV of the Social Security Act (42 U.S.C. 651 7 et seq.) to meet the requirements imposed by the 8 amendment made by subsection (a), the plan shall 9 not be regarded as failing to meet such requirements 10 before the 1st day of the 1st calendar quarter begin- 11 ning after the first regular session of the State legis- 12 lature that begins after the date of the enactment of 13 this Act. For purposes of the preceding sentence, if 14 the State has a 2-year legislative session, each year 15 of the session is deemed to be a separate regular 16 session of the State legislature. 17 the Secretary of Health and Human SEC. 53118. INCREASING EFFICIENCY OF PRISON DATA RE- 18 19 PORTING. (a) IN GENERAL.—Section 1611(e)(1)(I)(i)(II) of the 20 Social Security Act (42 U.S.C. 1382(e)(1)(I)(i)(II)) is 21 amended by striking ‘‘30 days’’ each place it appears and 22 inserting ‘‘15 days’’. 23 (b) EFFECTIVE DATE.—The amendments made by 24 subsection (a) shall apply with respect to any payment 25 made by the Commissioner of Social Security pursuant to February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 637 1 section 1611(e)(1)(I)(i)(II) of the Social Security Act (42 2 U.S.C. 1382(e)(1)(I)(i)(II)) (as amended by such sub3 section) on or after the date that is 6 months after the 4 date of enactment of this Act. 5 SEC. 53119. PREVENTION AND PUBLIC HEALTH FUND. 6 Section 4002(b) of the Patient Protection and Af- 7 fordable Care Act (42 U.S.C. 300u-11(b)), as amended 8 by section 3103 of Public Law 115-96, is amended by 9 striking paragraphs (4) through (9) and inserting the fol10 lowing: 11 ‘‘(4) for fiscal year 2019, $900,000,000; 12 ‘‘(5) for each of fiscal years 2020 and 2021, 13 14 15 16 17 18 19 20 21 $950,000,000; ‘‘(6) for each of fiscal years 2022 and 2023, $1,000,000,000; ‘‘(7) for each of fiscal years 2024 and 2025, $1,300,000,000; ‘‘(8) for each of fiscal years 2026 and 2027, $1,800,000,000; and ‘‘(9) for fiscal year 2028 and each fiscal year thereafter, $2,000,000,000.’’. 22 DIVISION F—IMPROVEMENTS TO 23 AGRICULTURE PROGRAMS 24 February 7, 2018 (10:12 p.m.) SEC. 60101. (a) TREATMENT OF SEED COTTON.— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 638 1 (1) DESIGNATION 2 ERED COMMODITY.—Section 3 tural Act of 2014 (7 U.S.C. 9011(6)) is amended— 4 (A) by striking ‘‘The term’’ and inserting 5 OF SEED COTTON AS A COV- 1111(6) of the Agricul- the following: 6 ‘‘(A) IN 7 (B) by adding at the end the following: 8 ‘‘(B) 9 GENERAL.—The term’’; and INCLUSION.—Effective beginning with the 2018 crop year, the term ‘covered com- 10 modity’ includes seed cotton.’’. 11 (2) REFERENCE PRICE FOR SEED COTTON.— 12 Section 1111(18) of the Agricultural Act of 2014 (7 13 U.S.C. 9011(18)) is amended by adding at the end 14 the following: 15 16 ‘‘(O) For seed cotton, $0.367 per pound.’’. (3) DEFINITION OF SEED COTTON.—Section 17 1111 of the Agricultural Act of 2014 (7 U.S.C. 18 9011) is amended— 19 (A) by redesignating paragraphs (20) 20 through (24) as paragraphs (21) through (25), 21 respectively; and 22 23 February 7, 2018 (10:12 p.m.) (B) by inserting after paragraph (19) the following: U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 639 1 ‘‘(20) SEED COTTON.—The term ‘seed cotton’ 2 means unginned upland cotton that includes both 3 lint and seed.’’. 4 (4) PAYMENT YIELD.—Section 1113 of the Ag- 5 ricultural Act of 2014 (7 U.S.C. 9013) is amended 6 by adding at the end the following: 7 ‘‘(e) PAYMENT YIELD FOR SEED COTTON.— 8 ‘‘(1) PAYMENT YIELD.—Subject to paragraph 9 (2), the payment yield for seed cotton for a farm 10 shall be equal to 2.4 times the payment yield for up- 11 land cotton for the farm established under section 12 1104(e)(3) of the Food, Conservation, and Energy 13 Act of 2008 (7 U.S.C. 8714(e)(3)) (as in effect on 14 September 30, 2013). 15 ‘‘(2) UPDATE.—At the sole discretion of the 16 owner of a farm with a yield for upland cotton de- 17 scribed in paragraph (1), the owner of the farm shall 18 have a 1-time opportunity to update the payment 19 yield for upland cotton for the farm, as provided in 20 subsection (d), for the purpose of calculating the 21 payment yield for seed cotton under paragraph 22 (1).’’. 23 (5) PAYMENT ACRES.—Section 1114(b) of the 24 Agricultural Act of 2014 (7 U.S.C. 9014(b)) is 25 amended by adding at the end the following: February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 640 1 2 ‘‘(4) SEED COTTON.— ‘‘(A) IN GENERAL.—Not later than 90 3 days after the date of enactment of this para- 4 graph, the Secretary shall require the owner of 5 a farm to allocate all generic base acres on the 6 farm under subparagraph (B) or (C), or both. 7 ‘‘(B) NO 8 COMMODITIES.—In 9 no covered commodities (including seed cotton) 10 were planted or were prevented from being 11 planted at any time during the 2009 through 12 2016 crop years, the owner of such farm shall 13 allocate generic base acres on the farm to unas- 14 signed crop base for which no payments may be 15 made under section 1116 or 1117. 16 RECENT HISTORY OF COVERED ‘‘(C) RECENT the case of a farm on which HISTORY OF COVERED COM- 17 MODITIES.—In 18 in subparagraph (B), the owner of such farm 19 shall allocate generic base acres on the farm— 20 ‘‘(i) subject to subparagraph (D), to 21 seed cotton base acres in a quantity equal 22 to the greater of— 23 24 February 7, 2018 (10:12 p.m.) the case of a farm not described ‘‘(I) 80 percent of the generic base acres on the farm; or U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 641 1 ‘‘(II) the average number of seed 2 cotton acres planted or prevented 3 from being planted on the farm dur- 4 ing the 2009 through 2012 crop years 5 (not to exceed the total generic base 6 acres on the farm); or 7 ‘‘(ii) to base acres for covered com- 8 modities (including seed cotton), by apply- 9 ing subparagraphs (B), (D), (E), and (F) 10 of section 1112(a)(3). 11 ‘‘(D) TREATMENT OF RESIDUAL GENERIC 12 BASE ACRES.—In 13 generic base acres are allocated under subpara- 14 graph (C)(i), the residual generic base acres 15 shall be allocated to unassigned crop base for 16 which no payments may be made under section 17 1116 or 1117. 18 the case of a farm on which ‘‘(E) EFFECT OF FAILURE TO ALLO- 19 CATE.—In 20 subparagraph (B) for which the owner of the 21 farm fails to make an election under subpara- 22 graph (C), the owner of the farm shall be 23 deemed to have elected to allocate all generic 24 base acres in accordance with subparagraph 25 (C)(i).’’. February 7, 2018 (10:12 p.m.) the case of a farm not described in U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 642 1 (6) RECORDKEEPING REGARDING UNASSIGNED 2 CROP BASE.—Section 3 of 2014 (7 U.S.C. 9014) is amended by adding at 4 the end the following: 5 ‘‘(f) UNASSIGNED CROP BASE.—The Secretary shall 1114 of the Agricultural Act 6 maintain information on generic base acres on a farm allo7 cated as unassigned crop base under subsection (b)(4).’’. 8 9 (7) SPECIAL LOSS ELECTION COVERAGE OR PERIOD AGRICULTURE 10 ERAGE.—Section 11 2014 (7 U.S.C. 9015) is amended— FOR RISK PRICE COV- 1115 of the Agricultural Act of 12 (A) in subsection (a), by striking ‘‘For’’ 13 and inserting ‘‘Except as provided in subsection 14 (g), for’’; and 15 16 17 (B) by adding at the end the following: ‘‘(g) SPECIAL ELECTION.— ‘‘(1) IN GENERAL.—In the case of acres allo- 18 cated to seed cotton on a farm, all of the producers 19 on the farm shall be given the opportunity to make 20 a new 1-time election under subsection (a) to reflect 21 the designation of seed cotton as a covered com- 22 modity for that crop year under section 1111(6)(B). 23 ‘‘(2) EFFECT OF FAILURE TO MAKE UNANI- 24 MOUS ELECTION.—If 25 fail to make a unanimous election under paragraph February 7, 2018 (10:12 p.m.) all the producers on a farm U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 643 1 (1), the producers on the farm shall be deemed to 2 have elected price loss coverage under section 1116 3 for acres allocated on the farm to seed cotton.’’. 4 (8) EFFECTIVE PRICE.—Section 1116 of the 5 Agricultural Act of 2014 (7 U.S.C. 9016) is amend- 6 ed by adding at the end the following: 7 ‘‘(h) EFFECTIVE PRICE FOR SEED COTTON.— 8 ‘‘(1) IN GENERAL.—The effective price for seed 9 cotton under subsection (b) shall be equal to the 10 marketing year average price for seed cotton, as cal- 11 culated under paragraph (2). 12 ‘‘(2) CALCULATION.—The marketing year aver- 13 age price for seed cotton for a crop year shall be 14 equal to the quotient obtained by dividing— 15 16 17 ‘‘(A) the sum obtained by adding— ‘‘(i) the product obtained by multiplying— 18 19 ‘‘(I) the upland cotton lint marketing year average price; and 20 ‘‘(II) the total United States up- 21 land cotton lint production, measured 22 in pounds; and 23 ‘‘(ii) the product obtained by multi- 24 February 7, 2018 (10:12 p.m.) plying— U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 644 1 ‘‘(I) the cottonseed marketing 2 year average price; and 3 ‘‘(II) the total United States cot- 4 tonseed 5 pounds; by 6 measured in ‘‘(B) the sum obtained by adding— 7 ‘‘(i) the total United States upland 8 cotton 9 pounds; and 10 lint production, measured in ‘‘(ii) the total United States cotton- 11 12 production, seed production, measured in pounds.’’. (9) DEEMED LOAN RATE FOR SEED COTTON.— 13 Section 1202 of the Agricultural Act of 2014 (7 14 U.S.C. 9032) is amended by adding at the end the 15 following: 16 ‘‘(c) SEED COTTON.— 17 ‘‘(1) IN GENERAL.—For purposes of section 18 1116(b)(2) 19 (2)(A)(ii)(II) of section 1117(b), the loan rate for 20 seed cotton shall be deemed to be equal to $0.25 per 21 pound. and paragraphs (1)(B)(ii) and 22 ‘‘(2) EFFECT.—Nothing in this subsection au- 23 thorizes any nonrecourse marketing assistance loan 24 under this subtitle for seed cotton.’’. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 645 1 (10) LIMITATION ON STACKED INCOME PRO- 2 TECTION PLAN FOR PRODUCERS OF UPLAND COT- 3 TON.—Section 4 Act (7 U.S.C. 1508b) is amended by adding at the 5 end the following: 6 ‘‘(f) LIMITATION.—Effective beginning with the 2019 508B of the Federal Crop Insurance 7 crop year, a farm shall not be eligible for the Stacked In8 come Protection Plan for upland cotton for a crop year 9 for which the farm is enrolled in coverage for seed cotton 10 under— 11 12 13 14 15 ‘‘(1) price loss coverage under section 1116 of the Agricultural Act of 2014 (7 U.S.C. 9016); or ‘‘(2) agriculture risk coverage under section 1117 of that Act (7 U.S.C. 9017).’’. (11) TECHNICAL CORRECTION.—Section 16 1114(b)(2) of the Agricultural Act of 2014 (7 17 U.S.C. 9014(b)(2)) is amended by striking ‘‘para- 18 graphs (1)(B) and (2)(B)’’ and inserting ‘‘para- 19 graphs (1) and (2)’’. 20 (12) ADMINISTRATION.—The Secretary of Agri- 21 culture shall carry out the amendments made by this 22 subsection in accordance with section 1601 of the 23 Agricultural Act of 2014 (7 U.S.C. 9091). 24 (13) APPLICATION.—Except as provided in 25 paragraph (10), the amendments made by this sub- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 646 1 section shall apply beginning with the 2018 crop 2 year. 3 (b) MARGIN PROTECTION PROGRAM FOR DAIRY PRO- 4 DUCERS.— 5 (1) MONTHLY 6 PRODUCTION MARGIN.— CALCULATION OF ACTUAL DAIRY 7 (A) DEFINITIONS.—Section 1401 of the 8 Agricultural Act of 2014 (7 U.S.C. 9051) is 9 amended— 10 (i) by striking paragraph (4); and 11 (ii) by redesignating paragraphs (5) 12 through (11) as paragraphs (4) through 13 (10), respectively. 14 (B) CALCULATION 15 DUCTION MARGIN.—Section 16 Agricultural Act of 2014 (7 U.S.C. 9052(b)(1)) 17 is amended by striking ‘‘consecutive 2-month 18 period’’ each place it appears and inserting 19 ‘‘month’’. 20 (C) MARGIN OF ACTUAL DAIRY PRO- 1402(b)(1) of the PROTECTION PAYMENTS.— 21 Section 1406 of the Agricultural Act of 2014 (7 22 U.S.C. 9056) is amended— 23 (i) by striking ‘‘consecutive 2-month 24 period’’ each place it appears and inserting 25 ‘‘month’’; and February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 647 1 2 3 (ii) in subsection (c)(2)(B), by striking ‘‘6’’ and inserting ‘‘12’’. (2) PARTICIPATION OF DAIRY OPERATIONS IN 4 MARGIN PROTECTION PROGRAM.—Section 5 the Agricultural Act of 2014 (7 U.S.C. 9054) is 6 amended— 7 1404 of (A) in subsection (b)— 8 (i) in paragraph (1), by inserting ‘‘, 9 including the establishment of a date each 10 calendar year by which a dairy operation 11 shall register for the calendar year’’ before 12 the period at the end; 13 (ii) by redesignating paragraphs (2) 14 and (3) as paragraphs (3) and (4), respec- 15 tively; and 16 (iii) by inserting after paragraph (1) 17 the following: 18 ‘‘(2) EXTENSION OF ELECTION PERIOD FOR 19 2018 CALENDAR YEAR.—The 20 the election period for the 2018 calendar year by not 21 less than 90 days after the date of enactment of the 22 Bipartisan Budget Act of 2018 or such additional 23 period as the Secretary determines is necessary for 24 dairy operations to make new elections to participate 25 for that calendar year, including dairy operations February 7, 2018 (10:12 p.m.) Secretary shall extend U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 648 1 that elected to so participate before that date of en- 2 actment.’’; and 3 (B) in subsection (c), by adding at the end 4 the following: 5 ‘‘(4) EXEMPTION.—A limited resource, begin- 6 ning, veteran, or socially disadvantaged farmer, as 7 defined by the Secretary, shall be exempt from the 8 administrative fee under this subsection.’’. 9 (3) PRODUCTION HISTORY OF PARTICIPATING 10 DAIRY OPERATIONS.—Section 11 cultural Act of 2014 (7 U.S.C. 9055(a)) is amended 12 by adding at the end the following: 13 ‘‘(3) CONTINUED 1405(a) of the Agri- APPLICABILITY OF BASE PRO- 14 DUCTION 15 lished for a dairy operation under paragraph (1) 16 shall be the base production history for the dairy op- 17 eration in subsequent years (as adjusted under para- 18 graph (2)).’’. 19 HISTORY.—A (4) PREMIUMS production history estab- FOR MARGIN PROTECTION PRO- 20 GRAM.—Section 21 2014 (7 U.S.C. 9057) is amended— 22 1407 of the Agricultural Act of (A) in subsection (b)— 23 (i) by striking the subsection heading 24 and inserting the following: ‘‘TIER I: PRE- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 649 1 MIUM 2 5,000,000 POUNDS PER HUNDREDWEIGHT OF FOR FIRST PRODUCTION.—’’; 3 (ii) in paragraph (1), by striking 4 ‘‘4,000,000’’ and inserting ‘‘5,000,000’’; 5 and 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 (iii) in paragraph (2)— (I) by striking ‘‘$0.010’’ and inserting ‘‘None’’; (II) by striking ‘‘$0.025’’ and inserting ‘‘None’’; (III) by striking ‘‘$0.040’’ and inserting ‘‘$0.009’’; (IV) by striking ‘‘$0.055’’ and inserting ‘‘$0.016’’; (V) by striking ‘‘$0.090’’ and inserting ‘‘$0.040’’; (VI) by striking ‘‘$0.217’’ and inserting ‘‘$0.063’’; (VII) by striking ‘‘$0.300’’ and inserting ‘‘$0.087’’; and (VIII) by striking ‘‘$0.475’’ and inserting ‘‘$0.142’’; and (B) in subsection (c)— 24 (i) by striking the subsection heading 25 and inserting the following: ‘‘TIER II: PRE- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 650 1 MIUM 2 DUCTION 3 POUNDS.—’’; and 4 PER HUNDREDWEIGHT EXCESS IN OF FOR PRO- 5,000,000 (ii) in paragraph (1), by striking 5 ‘‘4,000,000’’ and inserting ‘‘5,000,000’’. 6 (5) APPLICATION.—The amendments made by 7 this subsection shall apply beginning with the 2018 8 calendar year. 9 (c) LIMITATION 10 RELATED 11 ON CROP INSURANCE LIVESTOCK- EXPENDITURES.— (1) IN GENERAL.—Section 523(b) of the Fed- 12 eral Crop Insurance Act (7 U.S.C. 1523(b)) is 13 amended by striking paragraph (10). 14 (2) CONFORMING AMENDMENTS.—Section 516 15 of the Federal Crop Insurance Act (7 U.S.C. 1516) 16 is amended in subsections (a)(2)(C) and (b)(1)(D) 17 by striking ‘‘subsections (a)(3)(E)(ii) and (b)(10) of 18 section 523’’ each place it appears and inserting 19 ‘‘subsection (a)(3)(E)(ii) of that section’’. 20 SEC. 60102. (a) Section 1240B of the Food Security 21 Act of 1985 (16 U.S.C. 3839aa–2) is amended by striking 22 subsection (a) and inserting the following: 23 ‘‘(a) ESTABLISHMENT.—During each of the 2002 24 through 2019 fiscal years, the Secretary shall provide pay- February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 651 1 ments to producers that enter into contracts with the Sec2 retary under the program.’’. 3 (b) Section 1241 of the Food Security Act of 1985 4 (16 U.S.C. 3841) is amended— 5 (1) in subsection (a)— 6 (A) in the matter preceding paragraph (1), 7 by striking ‘‘2018’’ and inserting ‘‘2018 (and 8 fiscal year 2019 in the case of the program 9 specified in paragraph (5))’’; and 10 (B) in paragraph (5)(E), by striking ‘‘fis- 11 cal year 2018’’ and inserting ‘‘each of fiscal 12 years 2018 through 2019’’; and 13 (2) in subsection (b), by striking ‘‘2018’’ and 14 inserting ‘‘2018 (and fiscal year 2019 in the case of 15 the program specified in subsection (a)(5))’’. 16 This division may be cited as the ‘‘Improvements to 17 Agriculture Programs Act of 2018’’. DIVISION G—BUDGETARY EFFECTS 18 19 20 SEC. 70101. BUDGETARY EFFECTS. 21 (a) IN GENERAL.—The budgetary effects of division 22 A, subdivision 2 of division B, and division C and each 23 succeeding division shall not be entered on either PAYGO 24 scorecard maintained pursuant to section 4(d) of the Stat25 utory Pay-As-You-Go Act of 2010. February 7, 2018 (10:12 p.m.) U:\2018REPT\Supp\CRSupp.xml SEN. APPRO. 652 1 (b) SENATE PAYGO SCORECARDS.—The budgetary 2 effects of division A, subdivision 2 of division B, and divi3 sion C and each succeeding division shall not be entered 4 on any PAYGO scorecard maintained for purposes of sec5 tion 4106 of H. Con. Res. 71 (115th Congress). 6 (c) CLASSIFICATION OF BUDGETARY EFFECTS.— 7 Notwithstanding Rule 3 of the Budget Scorekeeping 8 Guidelines set forth in the joint explanatory statement of 9 the committee of conference accompanying Conference Re10 port 105–217 and section 250(c)(8) of the Balanced 11 Budget and Emergency Deficit Control Act of 1985, the 12 budgetary effects of division A, subdivision 2 of division 13 B, and division C and each succeeding division shall not 14 be estimated— 15 (1) for purposes of section 251 of such Act; and 16 (2) for purposes of paragraph (4)(C) of section 17 3 of the Statutory Pay-As-You-Go Act of 2010 as 18 being included in an appropriation Act. February 7, 2018 (10:12 p.m.)