115 HR 3922 RH: Community Health And Medical Professionals Improve Our Nation Act of 2017
U.S. House of Representatives
2017-10-03
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EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the Community Health And Medical Professionals Improve Our Nation Act of 2017
or the CHAMPION Act
. 2.The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Title I—Extension of Public Health Programs
Sec. 101. Extension for community health centers and the National Health Service Corps.
Sec. 102. Extension for special diabetes programs.
Sec. 103. Reauthorization of program of payments to teaching health centers that operate graduate
medical education programs.
Sec. 104. Extension for family-to-family health information centers.
Sec. 105. Youth empowerment program; personal responsibility education.
Title II—Offsets
Sec. 201. Providing for qualified health plan grace period requirements for issuer receipt of
advance payments of cost-sharing reductions and premium tax credits that
are more consistent with State law grace period requirements.
Sec. 202. Prevention and Public Health Fund.
<enum>I</enum><header>Extension of Public Health Programs</header>
<section id="H84B7EBDEFE7640D88A689D1C2DCAA727"><enum>101.</enum><header>Extension for community health centers and the National Health Service Corps</header>
<subsection id="H3F82F3CEDDA44D88A947712F26D6E9CB"><enum>(a)</enum><header>Community health centers funding</header><text display-inline="yes-display-inline">Section 10503(b)(1)(E) of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254b-2">42 U.S.C. 254b–2(b)(1)(E)</external-xref>) is amended by striking <quote>2017</quote> and inserting <quote>2019</quote>.</text>
</subsection><subsection id="H53DD68AB72334A4EB019D018100622B0"><enum>(b)</enum><header>Other community health centers provisions</header><text>Section 330 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254b">42 U.S.C. 254b</external-xref>) is amended—</text> <paragraph id="H51E899DDE80B44EBABEFE3F346C3A78D"><enum>(1)</enum><text>in subsection (b)(1)(A)(ii), by striking <quote>abuse</quote> and inserting <quote>use disorder</quote>;</text>
</paragraph><paragraph id="H530B6676DC7F43A1B5AB75BFFE9F9EFF"><enum>(2)</enum><text>in subsection (b)(2)(A), by striking <quote>abuse</quote> and inserting <quote>use disorder</quote>;</text> </paragraph><paragraph id="H14B100FD6A6B4B0CBB35385F37AAEAD3"><enum>(3)</enum><text>in subsection (c)—</text>
<subparagraph id="H5BA4BB9F66714DD4ACABBF204E72B9CD"><enum>(A)</enum><text>in paragraph (1), by striking subparagraphs (B) through (D);</text> </subparagraph><subparagraph id="H2F8AA1037ADD4D03A9B277BBAF9A41BF"><enum>(B)</enum><text>by striking <quote>(1) <header-in-text level="paragraph" style="OLC">In general</header-in-text></quote> and all that follows through <quote>The Secretary</quote> and inserting the following:</text>
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<paragraph id="H796A9127F72B4E6194255104BCF5C056"><enum>(1)</enum><header>Centers</header><text display-inline="yes-display-inline">The Secretary</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block> </subparagraph><subparagraph id="H7043FD09C09E4C71BFDA6B010D2938DC"><enum>(C)</enum><text>in paragraph (1), as amended, by redesignating clauses (i) through (v) as subparagraphs (A) through (E) and moving the margin of each of such redesignated subparagraph 2 ems to the left;</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H67061CC071954B44A00854338782F324"><enum>(4)</enum><text display-inline="yes-display-inline">by striking subsection (d) and inserting the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H8CE6A8A1D39B4DA09E5E574F6AD0630A" reported-display-style="italic" style="OLC"> <subsection id="H7286505218984DF587AB2A163C8A8A18"><enum>(d)</enum><header>Improving quality of care</header> <paragraph id="HA945882F44C04205B8AE1367FEBD3F2E"><enum>(1)</enum><header>Supplemental awards</header><text>The Secretary may award supplemental grant funds to health centers funded under this section to implement evidence-based models for increasing access to high-quality primary care services, which may include models related to—</text>
<subparagraph id="HD7351EAD41794AB9AB199BDCE770B0CC"><enum>(A)</enum><text>improving the delivery of care for individuals with multiple chronic conditions;</text> </subparagraph><subparagraph id="H6E975F273E7D470FB0508F31BC3D87B0"><enum>(B)</enum><text>workforce configuration;</text>
</subparagraph><subparagraph id="H23D9306F1FDF460FBC34C1C52EE7CA22"><enum>(C)</enum><text>reducing the cost of care;</text> </subparagraph><subparagraph id="HDDBA656D89DB4677BB1045E9D04522DB"><enum>(D)</enum><text>enhancing care coordination;</text>
</subparagraph><subparagraph id="H73B11F4CC731410893BA39F5C95C60FF"><enum>(E)</enum><text>expanding the use of telehealth and technology-enabled collaborative learning and capacity building models;</text>
</subparagraph><subparagraph id="H4F8F66847D5C4E0AA782D86C9F630EFB"><enum>(F)</enum><text>care integration, including integration of behavioral health, mental health, or substance use disorder services; and</text>
</subparagraph><subparagraph id="H7176A6D671304FF6AB99AE47533A6536"><enum>(G)</enum><text>addressing emerging public health or substance use disorder issues to meet the health needs of the population served by the health center.</text>
</subparagraph></paragraph><paragraph id="H56C80837BCBA4B81B8BF022A0C2C5562"><enum>(2)</enum><header>Sustainability</header><text>In making supplemental awards under this subsection, the Secretary may consider whether the health center involved has submitted a plan for continuing the activities funded under this subsection after supplemental funding is expended.</text>
</paragraph><paragraph id="H6DF064084D334D638F40F9FF2C396505"><enum>(3)</enum><header>Special consideration</header><text>The Secretary may give special consideration to applications for supplemental funding under this subsection that seek to address significant barriers to access to care in areas with a greater shortage of health care providers and health services relative to the national average.</text></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H8C63F8CE8C7447DCBA6955E64C626538"><enum>(5)</enum><text>in subsection (e)(1)—</text> <subparagraph id="HAE0A37BDB57A4045AAAA01BFA21B2A93"><enum>(A)</enum><text>in subparagraph (B)—</text>
<clause id="H20AFFBF14B484547A800114B327D720D"><enum>(i)</enum><text>by striking <quote>2 years</quote> and inserting <quote>1 year</quote>; and</text> </clause><clause id="HC99693357CDE4FE18EA03E7DD46BEA15"><enum>(ii)</enum><text>by adding at the end the following: <quote>The Secretary shall not make a grant under this paragraph unless the applicant provides assurances to the Secretary that within 120 days of receiving grant funding for the operation of the health center, the applicant will submit, for approval by the Secretary, an implementation plan to meet the requirements of subsection (l)(3). The Secretary may extend such 120-day period for achieving compliance upon a demonstration of good cause by the health center.</quote>; and</text>
</clause></subparagraph><subparagraph id="H3C61613BA39246BF84C1972F3FF5D628"><enum>(B)</enum><text>in subparagraph (C)—</text> <clause id="HFD2D82FE7D00420594888429F9CEE23F"><enum>(i)</enum><text>in the subparagraph heading, by striking <quote><header-in-text level="subparagraph" style="OLC">and plans</header-in-text></quote>;</text>
</clause><clause id="H60585B64CD58406581DAB451A646C932"><enum>(ii)</enum><text>by striking <quote>or plan (as described in subparagraphs (B) and (C) of subsection (c)(1))</quote>;</text> </clause><clause id="HF3C664FBBE4B43BFB35936D61FF2135B"><enum>(iii)</enum><text>by striking <quote>or plan, including the purchase</quote> and inserting the following: “including—</text>
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<clause id="HE0316703D815454FBC0F923565F1D48C"><enum>(i)</enum><text>the purchase</text></clause><after-quoted-block>;</after-quoted-block></quoted-block> </clause><clause id="H32D969D557A8445E99CE1E7FB3D11DC8"><enum>(iv)</enum><text>by inserting <quote>, which may include data and information systems </quote> after <quote>of equipment</quote>;</text>
</clause><clause id="H2F35AC21E57643CDAAF604F9E451FE5C"><enum>(v)</enum><text>by striking the period at the end and inserting a semicolon; and</text> </clause><clause id="H98C3331CBDE54455BB65D62C07D2E163"><enum>(vi)</enum><text>by adding at the end the following:</text>
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<clause id="H2B53A5BC538D4E9C89DF3D6513A996DD"><enum>(ii)</enum><text>the provision of training and technical assistance; and</text> </clause><clause id="HFF5451E730584C7A8A2AE3D1D3A952E2"><enum>(iii)</enum><text>other activities that—</text>
<subclause id="H0377428486574BF090D84BA631E9963F"><enum>(I)</enum><text>reduce costs associated with the provision of health services;</text> </subclause><subclause id="HF2E1856EEA6C4875A0050D040C37BA47"><enum>(II)</enum><text>improve access to, and availability of, health services provided to individuals served by the centers;</text>
</subclause><subclause id="H992A52F8C2CF42C5903960F3D8A3D953"><enum>(III)</enum><text>enhance the quality and coordination of health services; or</text> </subclause><subclause id="HEEB24EC784C3456BB2CC848B595AF96D"><enum>(IV)</enum><text>improve the health status of communities.</text></subclause></clause><after-quoted-block>;</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph display-inline="no-display-inline" id="H5424EDC4988745D088165E7186B9AD4A"><enum>(6)</enum><text display-inline="yes-display-inline">in subsection (e)(5)(B)—</text> <subparagraph id="H469971026D224BB4846D79A71A28AA37"><enum>(A)</enum><text>in the heading of subparagraph (B), by striking <quote><header-in-text level="subparagraph" style="OLC">and plans</header-in-text></quote>; and</text>
</subparagraph><subparagraph id="HA9BDBFAAE70447828E9130BCEA567041"><enum>(B)</enum><text>by striking <quote>and subparagraphs (B) and (C) of subsection (c)(1) to a health center or to a network or plan</quote> and inserting <quote>to a health center or to a network</quote>;</text> </subparagraph></paragraph><paragraph id="H7A6D3FD35DAA48DFB48D5CA23E4D53D0"><enum>(7)</enum><text>by striking subsection (s);</text>
</paragraph><paragraph id="H7EFA7D75A27F4C3281AD3EE23E6718B0"><enum>(8)</enum><text>by redesignating subsections (g) through (r) as subsections (h) through (s), respectively;</text> </paragraph><paragraph id="HED80FB6E52C04648826C9FD0B361FC24"><enum>(9)</enum><text>by inserting after subsection (f), the following:</text>
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<subsection id="H57309F94D3B04A1CA339517639B401E2"><enum>(g)</enum><header>New access points and expanded services</header>
<paragraph id="HD7A456593DE04587B0E4F2B861D8AB9C"><enum>(1)</enum><header>Approval of new access points</header>
<subparagraph id="H65796603445D4F53A678B1CC190C4663"><enum>(A)</enum><header>In general</header><text>The Secretary may approve applications for grants under subparagraph (A) or (B) of subsection (e)(1) to establish new delivery sites.</text>
</subparagraph><subparagraph id="HC292C585CA574B1F957F10AD3CE44EFA"><enum>(B)</enum><header>Special consideration</header><text>In carrying out subparagraph (A), the Secretary may give special consideration to applicants that have demonstrated the new delivery site will be located within a sparsely populated area, or an area which has a level of unmet need that is higher relative to other applicants.</text>
</subparagraph><subparagraph id="H9534F271E640487381E2FC0C0C90FF6E"><enum>(C)</enum><header>Consideration of applications</header><text display-inline="yes-display-inline">In carrying out subparagraph (A), the Secretary shall approve applications for grants under subparagraphs (A) and (B) of subsection (e)(1) in such a manner that the ratio of the medically underserved populations in rural areas which may be expected to use the services provided by the applicants involved to the medically underserved populations in urban areas which may be expected to use the services provided by the applicants is not less than two to three or greater than three to two.</text>
</subparagraph><subparagraph id="H8BAD467FB9AC47C59C3FBBCAFD6A6657"><enum>(D)</enum><header>Service area overlap</header><text>If in carrying out subparagraph (A) the applicant proposes to serve an area that is currently served by another health center funded under this section, the Secretary may consider whether the award of funding to an additional health center in the area can be justified based on the unmet need for additional services within the catchment area.</text>
</subparagraph></paragraph><paragraph id="HFA63F92F8A89469C8A1FD56044660C45"><enum>(2)</enum><header>Approval of expanded service applications</header>
<subparagraph id="H3CF02D5109FA44FA81042FC0DB0F39F5"><enum>(A)</enum><header>In general</header><text>The Secretary may approve applications for grants under subparagraph (A) or (B) of subsection (e)(1) to expand the capacity of the applicant to provide required primary health services described in subsection (b)(1) or additional health services described in subsection (b)(2).</text>
</subparagraph><subparagraph id="H71807CCAC8BF4324994551A2612B1B09"><enum>(B)</enum><header>Priority expansion projects</header><text>In carrying out subparagraph (A), the Secretary may give special consideration to expanded service applications that seek to address emerging public health or behavioral health, mental health, or substance abuse issues through increasing the availability of additional health services described in subsection (b)(2) in an area in which there are significant barriers to accessing care.</text>
</subparagraph><subparagraph id="HBEDE5F6137E64085BDE77AD68CBFBCA1"><enum>(C)</enum><header>Consideration of applications</header><text>In carrying out subparagraph (A), the Secretary shall approve applications for applicants in such a manner that the ratio of the medically underserved populations in rural areas which may be expected to use the services provided by the applicants involved to the medically underserved populations in urban areas which may be expected to use the services provided by such applicants is not less than two to three or greater than three to two.</text></subparagraph></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H9E434198DF0641D2A0C765115FF0E1A5"><enum>(10)</enum><text>in subsection (i) (as so redesignated)—</text> <subparagraph id="HA8362B9A5CBD48089B60380E96E2FFE4"><enum>(A)</enum><text>in paragraph (1), by striking <quote>and children and youth at risk of homelessness</quote> and inserting <quote>, children and youth at risk of homelessness, homeless veterans, and veterans at risk of homelessness</quote>; and</text>
</subparagraph><subparagraph id="HA51FA3F9E9074951B950F1BF61FAED7E"><enum>(B)</enum><text>in paragraph (5)—</text> <clause id="H1925B8BAD28042DFA035D3BD3857273A"><enum>(i)</enum><text>by striking subparagraph (B);</text>
</clause><clause id="HBCD368AAE0A94EE280A94E8149DC79A7"><enum>(ii)</enum><text>by redesignating subparagraph (C) as subparagraph (B); and</text> </clause><clause id="H7B796937880746139DE87B27A8779C56"><enum>(iii)</enum><text>in subparagraph (B) (as so redesignated)—</text>
<subclause id="HE275FB63608D417E87C6459F8085C121"><enum>(I)</enum><text>in the subparagraph heading, by striking <quote><header-in-text level="subparagraph" style="OLC">abuse</header-in-text></quote> and inserting <quote><header-in-text level="subparagraph" style="OLC">use disorder</header-in-text></quote>; and</text> </subclause><subclause id="HE583B43FC9664AF59A5AAA28C53A6385"><enum>(II)</enum><text>by striking <quote>abuse</quote> and inserting <quote>use disorder</quote>;</text>
</subclause></clause></subparagraph></paragraph><paragraph id="H26F3BFDC06B9446A84C33DB1707A82A7"><enum>(11)</enum><text>in subsection (l) (as so redesignated)—</text> <subparagraph id="HF68E7A3CD3E647D2B25ADCD2DB4CBF7D"><enum>(A)</enum><text>in paragraph (2)—</text>
<clause id="H5B6098B2922449688638FB075280ED8A"><enum>(i)</enum><text>in the paragraph heading, by inserting <quote><header-in-text level="paragraph" style="OLC">unmet</header-in-text></quote> before <quote><header-in-text level="paragraph" style="OLC">need</header-in-text></quote>;</text> </clause><clause id="H6693F2FDB46741559C732ED13CDA48D3"><enum>(ii)</enum><text>in the matter preceding subparagraph (A), by inserting <quote>and an application for a grant under subsection (g)</quote> after <quote>subsection (e)(1)</quote>;</text>
</clause><clause id="H1E4F4B1F43B44D11BF573B11BC9EDA41"><enum>(iii)</enum><text>in subparagraph (A), by inserting <quote>unmet</quote> before <quote>need for health services</quote>;</text> </clause><clause id="HFC5F94A26A9A4BC49358AA5BF93459F5"><enum>(iv)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text>
</clause><clause id="H164D3B5276804D0583D53B4A24C7B121"><enum>(v)</enum><text>in subparagraph (C), by striking the period at the end and inserting <quote>; and</quote>; and</text> </clause><clause id="H0F4724A3D13A4A6CB08B3BC706186778"><enum>(vi)</enum><text>by adding after subparagraph (C) the following:</text>
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<subparagraph id="H424C0A3BB7204B889F9A862B727B0EED"><enum>(D)</enum><text>in the case of an application for a grant pursuant to subsection (g)(1), a demonstration that the applicant has consulted with appropriate State and local government agencies, and health care providers regarding the need for the health services to be provided at the proposed delivery site.</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="HE6E7FA6E92644C658AAE262DFF222843"><enum>(B)</enum><text>in paragraph (3)—</text> <clause id="HF0E344DBEB4041A59700FD402DF4AE96"><enum>(i)</enum><text>in the matter preceding subparagraph (A), by inserting <quote>or subsection (g)</quote> after <quote>subsection (e)(1)(B)</quote>;</text>
</clause><clause id="HAB4FB8B6E3FF40CC9F5E9CCEAE2207BE"><enum>(ii)</enum><text>in subparagraph (B), by striking <quote>in the catchment area of the center</quote> and inserting <quote>, including other health care providers that provide care within the catchment area, local hospitals, and specialty providers in the catchment area of the center, to provide access to services not available through the health center and to reduce the non-urgent use of hospital emergency departments</quote>;</text>
</clause><clause id="H4D1FF6BBCAD643329E9C663C1942F820"><enum>(iii)</enum><text>in subparagraph (H)(ii), by inserting <quote>who shall be directly employed by the center</quote> after <quote>approves the selection of a director for the center</quote>;</text> </clause><clause id="HB13CC6B328914384B5EDF06915EF81ED"><enum>(iv)</enum><text>in subparagraph (L), by striking <quote>and</quote> at the end;</text>
</clause><clause id="HDE8E2A0D310444D99DDC95E404501B54"><enum>(v)</enum><text>in subparagraph (M), by striking the period and inserting <quote>; and</quote>; and</text> </clause><clause id="HDB020F2DC66D4E42A31B6BF8BE227B68"><enum>(vi)</enum><text>by inserting after subparagraph (M), the following:</text>
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<subparagraph id="HFA148D17F511460D8DB33E065D9AB4A8"><enum>(N)</enum><text>the center has written policies and procedures in place to ensure the appropriate use of Federal funds in compliance with applicable Federal statutes, regulations, and the terms and conditions of the Federal award.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="HF6643D1F40A94311A57342B022B27C1E"><enum>(C)</enum><text>by striking paragraph (4);</text> </subparagraph></paragraph><paragraph id="H7A2047E29DDA4C3683B3B3B4E0EA08A7"><enum>(12)</enum><text>in subsection (m) (as so redesignated), by adding at the end the following: <quote>Funds expended to carry out activities under this subsection and operational support activities under subsection (n) shall not exceed 3 percent of the amount appropriated for this section for the fiscal year involved.</quote>;</text>
</paragraph><paragraph id="HAD1F38A7897C470CB64C3F02996E52A7"><enum>(13)</enum><text>in subsection (q) (as so redesignated), by striking <quote>grants for new health centers under subsections (c) and (e)</quote> and inserting <quote>operating grants under subsection (e), applications for new access points and expanded service pursuant to subsection (g)</quote>;</text>
</paragraph><paragraph id="H967A2A07B09F47FD84AE4F133725B487"><enum>(14)</enum><text>in subsection (r)(4) (as so redesignated), by adding at the end the following: <quote>A waiver provided by the Secretary under this paragraph may not remain in effect for more than 1 year and may not be extended after such period. An entity may not receive more than one waiver under this paragraph in consecutive years.</quote>;</text>
</paragraph><paragraph id="H6C5E5C33824849209BE308C2B8F6FD82"><enum>(15)</enum><text>in subsection (s)(3) (as so redesignated)—</text> <subparagraph id="H16375BF9B7F1436694C5BCB6054ED95D"><enum>(A)</enum><text>by striking <quote>appropriate committees of Congress a report concerning the distribution of funds under this section</quote> and inserting the following: “Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, a report including, at a minimum—</text>
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<subparagraph id="H74ACAEC588D2477AA115D76A10D58FB2"><enum>(A)</enum><text>the distribution of funds for carrying out this section</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block> </subparagraph><subparagraph id="HA8DD44A512DD45CD826A834FB5C9D5E1"><enum>(B)</enum><text>by striking <quote>populations. Such report shall include an assessment</quote> and inserting the following: “populations;</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H03DFE8B7EB6F4C648A39C0FD647F6060" reported-display-style="italic" style="OLC">
<subparagraph id="H6AED5763DB4A4C4B9DC260C0E3575903"><enum>(B)</enum><text>an assessment</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block> </subparagraph><subparagraph id="HDECBA9B2D3A2405EAB9E1D6AA3376AF5"><enum>(C)</enum><text>by striking <quote>and the rationale for any substantial changes in the distribution of funds.</quote> and inserting a semicolon; and</text>
</subparagraph><subparagraph id="HF0BD78EF5DA34206B30C05FD37128CB6"><enum>(D)</enum><text>by adding at the end the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HBEE1A9A04519460B9676DB8276AD9959" reported-display-style="italic" style="OLC"> <subparagraph id="H2C7A375527584AF0A3D31F6260C94A1C"><enum>(C)</enum><text>the distribution of awards and funding for new or expanded services in each of rural areas and urban areas;</text>
</subparagraph><subparagraph id="HB94CA918C8D147498DDB45917F0C0F23"><enum>(D)</enum><text>the distribution of awards and funding for establishing new access points, and the number of new access points created;</text>
</subparagraph><subparagraph id="H12FB1D0DC113468389615350E960DFD8"><enum>(E)</enum><text>the amount of unexpended funding for loan guarantees and loan guarantee authority under title XVI;</text> </subparagraph><subparagraph id="HD2E3A68294AE45949494EB17BBFB4154"><enum>(F)</enum><text>the rationale for any substantial changes in the distribution of funds;</text>
</subparagraph><subparagraph id="H9022DCFBF9B1491DAE1B0F4323341042"><enum>(G)</enum><text>the rate of closures for health centers and access points;</text> </subparagraph><subparagraph id="H23A84DA178C54B118CD113C9D09B7B8F"><enum>(H)</enum><text>the number and reason for any grants awarded pursuant to subsection (e)(1)(B); and</text>
</subparagraph><subparagraph id="H642F3D1072EA4759BA0D58DB7B3DA5B2"><enum>(I)</enum><text>the number and reason for any waivers provided pursuant to subsection (r)(4).</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="HA7BB4BBF6B7B49598422E90ED1AB598A"><enum>(16)</enum><text display-inline="yes-display-inline">in subsection (s) (as so redesignated) by adding at the end the following new paragraph:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H531B1E9F814D4541AF0A87B52469C8ED" reported-display-style="italic" style="OLC">
<paragraph id="HDE7C49686423487F885956248FA8A94C"><enum>(5)</enum><header>Funding for participation of health centers in All of Us Research Program</header><text display-inline="yes-display-inline">In addition to any amounts made available pursuant to subsection (d) of this section, paragraph (1) of this subsection, section 402A of this Act, or section 10503 of the Patient Protection and Affordable Care Act, there is authorized to be appropriated, and there is appropriated, out of any monies in the Treasury not otherwise appropriated, to the Secretary $25,000,000 for fiscal year 2018 to support the participation of health centers in the All of Us Research Program under the Precision Medicine Initiative under section 498E of this Act.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HF2D972F3FEF94C6CA9A7ECF67F176D65"><enum>(c)</enum><header>National Health Service Corps</header><text>Section 10503(b)(2)(E) of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254b-2">42 U.S.C. 254b–2(b)(2)(E)</external-xref>) is amended by striking <quote>2017</quote> and inserting <quote>2019</quote>.</text>
</subsection><subsection id="HDCAC383173AE47E69BC483FD45293DDB"><enum>(d)</enum><header>Application</header><text display-inline="yes-display-inline">Amounts appropriated pursuant to this section for fiscal year 2018 or 2019 are subject to the requirements contained in <external-xref legal-doc="public-law" parsable-cite="pl/115/31">Public Law 115–31</external-xref> for funds for programs authorized under sections 330 through 340 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254b">42 U.S.C. 254b–256</external-xref>).</text>
</subsection><subsection id="H32ACF0AC8A404468B84BDA9B514503C3"><enum>(e)</enum><header>Conforming amendments</header><text>Section 3014(h) of title 18, United States Code, is amended—</text> <paragraph id="HF05290BB7CCC439E88D9666FD45EAD48"><enum>(1)</enum><text>in paragraph (1), by striking <quote>, as amended by section 221 of the Medicare Access and CHIP Reauthorization Act of 2015,</quote>; and</text>
</paragraph><paragraph id="HE842FF02878D469899AFEB65089F9481"><enum>(2)</enum><text>in paragraph (4), by inserting <quote>and section 101(d) of the <short-title>Community Health And Medical Professionals Improve Our Nation Act of 2017</short-title></quote> after <quote>section 221(c) of the Medicare Access and CHIP Reauthorization Act of 2015</quote>.</text> </paragraph></subsection></section><section id="H24D59AF1485B4A79A54D0F9F60E39034"><enum>102.</enum><header>Extension for special diabetes programs</header> <subsection id="HD817ABBF7E204037B1843A424AF8247A"><enum>(a)</enum><header>Special diabetes program for type I diabetes</header><text display-inline="yes-display-inline">Section 330B(b)(2)(C) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254c-2">42 U.S.C. 254c–2(b)(2)(C)</external-xref>) is amended by striking <quote>2017</quote> and inserting <quote>2019</quote>.</text>
</subsection><subsection id="HFAFF8547D1E34B45B18615E1E1689B6D"><enum>(b)</enum><header>Special diabetes program for Indians</header><text>Section 330C(c)(2) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254c-3">42 U.S.C. 254c–3(c)(2)</external-xref>) is amended—</text> <paragraph id="H85A081224E91475AA3A601BAA5C49902"><enum>(1)</enum><text>in subparagraph (C), by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="H8D98E793F1374C44A99F4590AAA404E8"><enum>(2)</enum><text>in subparagraph (D), by striking the period at the end and inserting <quote>and $112,500,000 for the period consisting of the second, third, and fourth quarters of fiscal year 2018; and</quote>; and</text>
</paragraph><paragraph id="H0915BBF3210C43538D1269BBB7B1F978"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H7522C5B53AB341EDB15BFC056F91373B" reported-display-style="italic" style="OLC"> <subparagraph id="HF6444EEAE2B44F5EA200EF6EC946616A"><enum>(E)</enum><text display-inline="yes-display-inline">$150,000,000 for fiscal year 2019.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="HAEC46C6B99B1474086FAB1FC5196585D"><enum>103.</enum><header>Reauthorization of program of payments to teaching health centers that operate graduate medical
education programs</header>
<subsection id="H0FDECB8219134719ABA940C2674072FD"><enum>(a)</enum><header>Payments</header><text display-inline="yes-display-inline">Subsection (a) of section 340H of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/256h">42 U.S.C. 256h</external-xref>) is amended to read as follows:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H4D68427E4845449DBA3EEC21A1B3E1F5" reported-display-style="italic" style="OLC">
<subsection id="H353C475D32F9491CAFC5E7C4DAB7789C"><enum>(a)</enum><header>Payments</header>
<paragraph id="H5744E3E4DA194F5CBAA69FB76A5F877B"><enum>(1)</enum><header>In general</header><text>Subject to subsection (h)(2), the Secretary shall make payments under this section for direct expenses and indirect expenses to qualified teaching health centers that are listed as sponsoring institutions by the relevant accrediting body for—</text>
<subparagraph id="H5CA71F03C20A43BC9A184EC9075B2BC0"><enum>(A)</enum><text>maintenance of existing approved graduate medical residency training programs;</text> </subparagraph><subparagraph id="HC5FC40ED104949D2A0C5171CC1A290A8"><enum>(B)</enum><text display-inline="yes-display-inline">expansion of existing approved graduate medical residency training programs; and</text>
</subparagraph><subparagraph id="HE10C05B076344C2FBE24031AF6D5F1FC"><enum>(C)</enum><text>establishment of new approved graduate medical residency training programs, as appropriate.</text> </subparagraph></paragraph><paragraph id="HDCF08EC999EF41C998F091370EE15A1F"><enum>(2)</enum><header>Priority</header><text display-inline="yes-display-inline">In making payments pursuant to paragraph (1)(C), the Secretary shall give priority to qualified teaching health centers that—</text>
<subparagraph id="H549B51A8467B4A91BACC1A63BE21EB90"><enum>(A)</enum><text>serve a health professional shortage area with a designation in effect under section 332 or a medically underserved community (as defined in section 799B); or</text>
</subparagraph><subparagraph id="H3A16978CDD5D4CC0A69E6211E7C682B1"><enum>(B)</enum><text>are located in a rural area (as defined in section 1886(d)(2)(D) of the Social Security Act).</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="H1F06626832DA4192B96B4B306DD9AF8D"><enum>(b)</enum><header>Funding</header><text>Subsection (g) of section 340H of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/256h">42 U.S.C. 256h</external-xref>) is amended—</text>
<paragraph id="HE7F74FE88C5244BBB079501C646588FF"><enum>(1)</enum><text>by striking <quote>To carry out</quote> and inserting the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H8A35966F3DD84ADEA60A457763155D81" reported-display-style="italic" style="OLC"> <paragraph id="H13159E88399D4D01B350B9D7359509A3"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">To carry out</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HF6D3274B6AB94A8DBE7E23BC16E13336"><enum>(2)</enum><text>by striking <quote>and $15,000,000 for the first quarter of fiscal year 2018</quote> and inserting <quote>, $15,000,000 for the first quarter of fiscal year 2018, $111,500,000 for the period consisting of the second, third, and fourth quarters of fiscal year 2018, and $126,500,000 for fiscal year 2019, to remain available until expended</quote>; and</text>
</paragraph><paragraph id="HDAC364960A264C85B6B089B586652276"><enum>(3)</enum><text>by adding at the end the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HFE58E620FD4043BC8F2311AC1F5F6BDF" reported-display-style="italic" style="OLC"> <paragraph id="H031FFD52DFA84F55BF7EA557067BB94A"><enum>(2)</enum><header>Administrative expenses</header><text>Of the amount made available to carry out this section for any fiscal year, the Secretary may not use more than 5 percent of such amount for the expenses of administering this section.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H30A3687008F24B4FB0CE6E75CAA5B042"><enum>(c)</enum><header>Annual reporting</header><text>Subsection (h)(1) of section 340H of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/256h">42 U.S.C. 256h</external-xref>) is amended—</text> <paragraph id="H50F1DF36740E4E58A19835B03F74348E"><enum>(1)</enum><text>by redesignating subparagraph (D) as subparagraph (H); and</text>
</paragraph><paragraph id="HBE9F9AB662714FBCA3EAB2A84266E839"><enum>(2)</enum><text>by inserting after subparagraph (C) the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HAFC0D2E84F7D4A3E982A4E26834AB4BA" reported-display-style="italic" style="OLC"> <subparagraph id="H0659443858A743A2B0A1F1BE2DFD754A"><enum>(D)</enum><text display-inline="yes-display-inline">The number of patients treated by residents described in paragraph (4).</text>
</subparagraph><subparagraph id="HF84A7641DEA6471CBD294D4EE44CC1A3"><enum>(E)</enum><text>The number of visits by patients treated by residents described in paragraph (4).</text> </subparagraph><subparagraph id="H94594E9563A34C1FBA0C647FC9B29DE3"><enum>(F)</enum><text display-inline="yes-display-inline">Of the number of residents described in paragraph (4) who completed their residency training at the end of such residency academic year, the number and percentage of such residents entering primary care practice (meaning any of the areas of practice listed in the definition of a primary care residency program in section 749A).</text>
</subparagraph><subparagraph id="H10EAB8FFB6404E7E97265DE678E6BF19"><enum>(G)</enum><text display-inline="yes-display-inline">Of the number of residents described in paragraph (4) who completed their residency training at the end of such residency academic year, the number and percentage of such residents who entered practice at a health care facility—</text>
<clause id="H197F943383A140D4A609C09173290DE4"><enum>(i)</enum><text display-inline="yes-display-inline">primarily serving a health professional shortage area with a designation in effect under section 332 or a medically underserved community (as defined in section 799B); or</text>
</clause><clause id="H4675760709C645F2B42443ADA4D1019C"><enum>(ii)</enum><text display-inline="yes-display-inline">located in a rural area (as defined in section 1886(d)(2)(D) of the Social Security Act).</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection id="H708AAE9FACF04EF4BCC763E07361FA75"><enum>(d)</enum><header>Report on training costs</header><text display-inline="yes-display-inline">Not later than March 31, 2019, the Secretary of Health and Human Services shall submit to the Congress a report on the direct graduate expenses of approved graduate medical residency training programs, and the indirect expenses associated with the additional costs of teaching residents, of qualified teaching health centers (as such terms are used or defined in section 340H of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/256h">42 U.S.C. 256h</external-xref>)).</text>
</subsection><subsection id="H8723F664611F46AEBE61722BFE941175"><enum>(e)</enum><header>Definition</header><text display-inline="yes-display-inline">Subsection (j) of section 340H of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/256h">42 U.S.C. 256h</external-xref>) is amended—</text> <paragraph id="HBC172C2657764CF6B2C14D7018304803"><enum>(1)</enum><text>by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and</text>
</paragraph><paragraph id="H27682450591E46A2B78E1547080369DC"><enum>(2)</enum><text>by inserting after paragraph (1) the following:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H314D5C1D1F314B0BA802C81188C794E9" reported-display-style="italic" style="OLC"> <paragraph id="H6917D58C7B3A4F1B9768AEBE07C595F3"><enum>(2)</enum><header>New approved graduate medical residency training program</header><text display-inline="yes-display-inline">The term <term>new approved graduate medical residency training program</term> means an approved graduate medical residency training program for which the sponsoring qualified teaching health center has not received a payment under this section for a previous fiscal year (other than pursuant to subsection (a)(1)(C)).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HF160D344E21F4224B891C8D8D70FA0C3"><enum>(f)</enum><header>Technical correction</header><text display-inline="yes-display-inline">Subsection (f) of section 340H (<external-xref legal-doc="usc" parsable-cite="usc/42/256h">42 U.S.C. 256h</external-xref>) is amended by striking <quote>hospital</quote> each place it appears and inserting <quote>teaching health center</quote>.</text> </subsection><subsection id="H01344B8827BF4756B87655D1414F1B60"><enum>(g)</enum><header>Payments for previous fiscal years</header><text display-inline="yes-display-inline">The provisions of section 340H of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/256h">42 U.S.C. 256h</external-xref>), as in effect on the day before the date of enactment of this Act, shall continue to apply with respect to payments under such section for fiscal years before fiscal year 2018.</text>
</subsection></section><section id="HB79ABE758B6F4172A4E00F1E3B2ADB55" section-type="subsequent-section"><enum>104.</enum><header>Extension for family-to-family health information centers</header><text display-inline="no-display-inline">Section 501(c) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/701">42 U.S.C. 701(c)</external-xref>) is amended—</text> <paragraph id="HFC4A4691FB794C6B9475DAF11E580334"><enum>(1)</enum><text>in paragraph (1)(A)—</text>
<subparagraph id="H06FE7DC71C014DA082AACBE1A3BD97CD"><enum>(A)</enum><text>in clause (v), by striking <quote>and</quote> at the end;</text> </subparagraph><subparagraph id="H9CF2122B4B874C2E95264A5AB83B9DB7"><enum>(B)</enum><text>in clause (vi), by striking the period at the end and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="H9E6FAC1AEE5A4943862EC22CAAC1DEAE"><enum>(C)</enum><text>by adding at the end the following new clause:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H21D4FE2D172F4E86A7390489EAABB8DE" reported-display-style="italic" style="traditional"> <clause id="HF842C7B18F3E4378AFFA781116072D2C" indent="up2"><enum>(vii)</enum><text>$6,000,000 for each of fiscal years 2018 and 2019.</text></clause><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HC9165DA607F947E0BCF3E998C64B57BC"><enum>(2)</enum><text>in paragraph (3)(C), by inserting before the period the following: <quote>, and with respect to fiscal years 2018 and 2019, such centers shall also be developed in all territories and at least one such center shall be developed for Indian tribes</quote>; and</text>
</paragraph><paragraph id="HC881A7877150485E994012B6E1044CC3"><enum>(3)</enum><text>by amending paragraph (5) to read as follows:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="HA541CE5906CC45ED9EDC4E5EDF257821" reported-display-style="italic" style="traditional"> <paragraph id="HFED1B8BC142A473096DF506578CB2334" indent="up1"><enum>(5)</enum><text>For purposes of this subsection—</text>
<subparagraph id="H4512682FDF32422FB64F3BBC5686E6AA"><enum>(A)</enum><text display-inline="yes-display-inline">the term <quote>Indian tribe</quote> has the meaning given such term in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>);</text>
</subparagraph><subparagraph id="H8BE9B83F3CC84665A798D8227DD783F8"><enum>(B)</enum><text>the term <quote>State</quote> means each of the 50 States and the District of Columbia; and</text> </subparagraph><subparagraph id="HDC5D5BCE9C1B4A67B2C8E5C68C0F329B"><enum>(C)</enum><text>the term <quote>territory</quote> means Puerto Rico, Guam, American Samoa, the Virgin Islands, and the Northern Mariana Islands.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="H5E8EE339F61041A9A77578E1146541B5"><enum>105.</enum><header>Youth empowerment program; personal responsibility education</header>
<subsection id="H0F4075BD734946C583784C5692896318"><enum>(a)</enum><header>Youth empowerment program</header>
<paragraph id="H7A782740FD91493B9D05C9DA3DCED145"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 510 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/710">42 U.S.C. 710</external-xref>) is amended to read as follows:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H4D3E0A7636364CBB8CEA4A23CA7735A5" reported-display-style="italic" style="OLC"> <section id="HFF1EC3CF5CD54ECE889AFE97D58BA379"><enum>510.</enum><header>Youth empowerment program</header> <subsection id="HD450E362983F48C2B3CFDCD17A2874C4"><enum>(a)</enum><header>In general</header> <paragraph id="HE21F9831796545228173CDE89EB5901F"><enum>(1)</enum><header>Allotments to States</header><text display-inline="yes-display-inline">For the purpose described in subsection (b), the Secretary shall, for each of fiscal years 2018 and 2019, allot to each State which has transmitted an application for the fiscal year under section 505(a) an amount equal to the product of—</text>
<subparagraph id="H51EFC2CF3E934B199EE20C88F5D75E67"><enum>(A)</enum><text>the amount appropriated pursuant to subsection (e)(1) for the fiscal year, minus the amount reserved under subsection (e)(2) for the fiscal year; and</text>
</subparagraph><subparagraph id="H8D55157889F948BF8794D762474B3BE6"><enum>(B)</enum><text display-inline="yes-display-inline">the proportion that the number of low-income children in the State bears to the total of such numbers of children for all the States.</text>
</subparagraph></paragraph><paragraph id="H95717A2523DE41E495E5DD8E36D0FAE5"><enum>(2)</enum><header>Other allotments</header>
<subparagraph id="HAE9EC829357B4D46AFAAF066B10B283C"><enum>(A)</enum><header>Other entities</header><text display-inline="yes-display-inline">For the purpose described in subsection (b), the Secretary shall, for each of fiscal years 2018 and 2019, for any State which has not transmitted an application for the fiscal year under section 505(a), allot to one or more entities in the State the amount that would have been allotted to the State under paragraph (1) if the State had submitted such an application.</text>
</subparagraph><subparagraph id="H6D467C7B3E4F4D6F8C5BC0EC7960EAB3"><enum>(B)</enum><header>Process</header><text>The Secretary shall select the recipients of allotments under subparagraph (A) by means of a competitive grant process under which—</text>
<clause id="HFD1997B8B26943D8BDC26DE0C08155D9"><enum>(i)</enum><text>not later than 30 days after the deadline for the State involved to submit an application for the fiscal year under section 505(a), the Secretary publishes a notice soliciting grant applications; and</text>
</clause><clause id="HB057A9C525154C56A4C3D9F9832C849F"><enum>(ii)</enum><text>not later than 120 days after such deadline, all such applications must be submitted.</text> </clause></subparagraph></paragraph></subsection><subsection id="HB3F77D1C5B334EAC8627E9E129F8076D"><enum>(b)</enum><header>Purpose</header> <paragraph id="HD9C78E48006D425FADA85361814C6ECA"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Except for research under paragraph (5) and information collection and reporting under paragraph (6), the purpose of an allotment under subsection (a) to a State (or to another entity in the State pursuant to subsection (a)(2)) is to enable the State or other entity to implement education exclusively on sexual risk avoidance (meaning voluntarily refraining from sexual activity).</text>
</paragraph><paragraph id="H938843FDADEB4E949D79901834CDF688"><enum>(2)</enum><header>Required components</header><text>Education on sexual risk avoidance pursuant to an allotment under this section shall—</text> <subparagraph id="H006911813D6D4B71A059C7C7551E1138"><enum>(A)</enum><text>ensure that the unambiguous and primary emphasis and context for each topic described in paragraph (3) is a message to youth that normalizes the optimal health behavior of avoiding nonmarital sexual activity;</text>
</subparagraph><subparagraph id="H79039E8FA25F4298847B4F22715436CB"><enum>(B)</enum><text>be medically accurate and complete;</text> </subparagraph><subparagraph id="HFDC54777CE5A4ADB8010151D1A72A36D"><enum>(C)</enum><text>be age-appropriate; and</text>
</subparagraph><subparagraph id="H906B32589BDD4F7FB47515A227035ED6"><enum>(D)</enum><text display-inline="yes-display-inline">be based on adolescent learning and developmental theories for the age group receiving the education.</text>
</subparagraph></paragraph><paragraph id="H7BEDD23F63104FCFBDA6C9F510E74CC2"><enum>(3)</enum><header>Topics</header><text display-inline="yes-display-inline">Education on sexual risk avoidance pursuant to an allotment under this section shall address each of the following topics:</text>
<subparagraph id="H957CFBF8CC0A445585E0475DC9AF5F11"><enum>(A)</enum><text>The holistic individual and societal benefits associated with personal responsibility, self-regulation, goal setting, healthy decisionmaking, and a focus on the future.</text>
</subparagraph><subparagraph id="H891A0DB8C0BB40CB92940CE70EE88C27"><enum>(B)</enum><text>The advantage of refraining from nonmarital sexual activity in order to improve the future prospects and physical and emotional health of youth.</text>
</subparagraph><subparagraph id="H6B42D69BCCF74E5D906FF1113B3BA3FB"><enum>(C)</enum><text display-inline="yes-display-inline">The increased likelihood of avoiding poverty when youth attain self-sufficiency and emotional maturity before engaging in sexual activity.</text>
</subparagraph><subparagraph id="H1E20BB97E2A64EFB86FA574CF84A566F"><enum>(D)</enum><text>The foundational components of healthy relationships and their impact on the formation of healthy marriages and safe and stable families.</text>
</subparagraph><subparagraph id="HDB4E7527158B46ECBF2712361351F728"><enum>(E)</enum><text>How other youth risk behaviors, such as drug and alcohol usage, increase the risk for teen sex.</text> </subparagraph><subparagraph id="HF1750C5C9E3E44BBB5BA2854E2D713B6"><enum>(F)</enum><text display-inline="yes-display-inline">How to resist and avoid, and receive help regarding, sexual coercion and dating violence, recognizing that even with consent teen sex remains a youth risk behavior.</text>
</subparagraph></paragraph><paragraph id="HF47734EDA54947C3B4B703D8D7F4A760"><enum>(4)</enum><header>Contraception</header><text display-inline="yes-display-inline">Education on sexual risk avoidance pursuant to an allotment under this section shall ensure that—</text> <subparagraph id="HE2028B84F0E54AD19A38892F760F2A44"><enum>(A)</enum><text display-inline="yes-display-inline">any information provided on contraception is medically accurate and ensures that students understand that contraception offers physical risk reduction, but not risk elimination; and</text>
</subparagraph><subparagraph id="H7FBF6D6B5D4F4F80AF98AF0BA24B34B8"><enum>(B)</enum><text>the education does not include demonstrations, simulations, or distribution of contraceptive devices.</text>
</subparagraph></paragraph><paragraph id="H85004A4C45964A599D9C8C8F44A5934B"><enum>(5)</enum><header>Research</header>
<subparagraph id="H3A397196FC264DE38E3215E23655BB9A"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">A State or other entity receiving an allotment pursuant to subsection (a) may use up to 20 percent of such allotment to build the evidence base for sexual risk avoidance education by conducting or supporting research.</text>
</subparagraph><subparagraph id="HBFC4DF38D7D945F4B1A3CE2731003781"><enum>(B)</enum><header>Requirements</header><text>Any research conducted or supported pursuant to subparagraph (A) shall be—</text> <clause id="H9B09176F64F74B3EBAED4AD85AE0BF72"><enum>(i)</enum><text>rigorous;</text>
</clause><clause id="H7BF1DB53F28744209602B2697DFE02D5"><enum>(ii)</enum><text>evidence-based; and</text> </clause><clause id="HA592384F22D3425D854C779DE64F5A34"><enum>(iii)</enum><text>designed and conducted by independent researchers who have experience in conducting and publishing research in peer-reviewed outlets.</text>
</clause></subparagraph></paragraph><paragraph id="HD9002AF4DB504E91A874BE7C3A03C4EC"><enum>(6)</enum><header>Information collection and reporting</header><text display-inline="yes-display-inline">A State or other entity receiving an allotment pursuant to subsection (a) shall, as specified by the Secretary—</text>
<subparagraph id="HA1D522E5F38745268AC269D8F3305999"><enum>(A)</enum><text>collect information on the programs and activities funded through the allotment; and</text> </subparagraph><subparagraph id="H90EAB61EE9FA4506B0B750DE601A11C1"><enum>(B)</enum><text display-inline="yes-display-inline">submit reports to the Secretary on the data from such programs and activities.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H9B5CE31532B249369E7C494DF49F33FB"><enum>(c)</enum><header>National evaluation</header>
<paragraph commented="no" id="H1D4E297A216F4CCF9263FF6093FEED62"><enum>(1)</enum><header>In general</header><text>The Secretary shall—</text> <subparagraph commented="no" id="HD3F72026A59442139D464322DE96E06C"><enum>(A)</enum><text display-inline="yes-display-inline">in consultation with appropriate State and local agencies, conduct one or more rigorous evaluations of the education funded through this section and associated data; and</text>
</subparagraph><subparagraph commented="no" id="H26D368ABEA0A4B46B5652534584497F7"><enum>(B)</enum><text display-inline="yes-display-inline">submit a report to the Congress on the results of such evaluations, together with a summary of the information collected pursuant to subsection (b)(6).</text>
</subparagraph></paragraph><paragraph commented="no" id="H7015E6CB78554556A07539A6D611E628"><enum>(2)</enum><header>Consultation</header><text>In conducting the evaluations required by paragraph (1), including the establishment of evaluation methodologies, the Secretary shall consult with relevant stakeholders.</text>
</paragraph></subsection><subsection id="H194E1BACF8014ECFB8298E5A369CF094"><enum>(d)</enum><header>Applicability of certain provisions</header>
<paragraph id="H98431A114B6B442E8FCEEC519F3F08DE"><enum>(1)</enum><text display-inline="yes-display-inline">Sections 503, 507, and 508 apply to allotments under subsection (a) to the same extent and in the same manner as such sections apply to allotments under section 502(c).</text>
</paragraph><paragraph id="HF529374435AF4713A8A956AC7911ECE9"><enum>(2)</enum><text display-inline="yes-display-inline">Sections 505 and 506 apply to allotments under subsection (a) to the extent determined by the Secretary to be appropriate.</text>
</paragraph></subsection><subsection id="HCDEFB708AC6E49078AFA88EF711357D3"><enum>(e)</enum><header>Funding</header>
<paragraph id="H5960A6908DD847C3BC8CDC01F614753C"><enum>(1)</enum><header>In general</header><text>To carry out this section, there is appropriated, out of any money in the Treasury not otherwise appropriated, $75,000,000 for each of fiscal years 2018 and 2019.</text>
</paragraph><paragraph id="H388A0B812CBA42528E6DFEE98E86C751"><enum>(2)</enum><header>Reservation</header><text display-inline="yes-display-inline">The Secretary shall reserve, for each of fiscal years 2018 and 2019, not more than 20 percent of the amount appropriated pursuant to paragraph (1) for administering the program under this section, including the conducting of national evaluations and the provision of technical assistance to the recipients of allotments.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H661600CBFBE64DC7A5A95E698CEB286D"><enum>(2)</enum><header>Effective date</header><text>The amendment made by this section takes effect on October 1, 2017.</text> </paragraph></subsection><subsection commented="no" id="HCAA42FBE508947909AA893F4D6C0069E"><enum>(b)</enum><header>Personal responsibility education</header> <paragraph commented="no" id="H34397A84E0D545A58D8C0118C4EF0B33"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 513 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/713">42 U.S.C. 713</external-xref>) is amended—</text>
<subparagraph commented="no" id="H3ABA33A89D33419093FF52E8DF8617DA"><enum>(A)</enum><text>in subsection (a)(1)(A), by striking <quote>2017</quote> and inserting <quote>2019</quote>; and</text> </subparagraph><subparagraph commented="no" id="H0FC30735006949BB9170C4FED1B1588B"><enum>(B)</enum><text>in subsection (a)(4)—</text>
<clause commented="no" id="H199B96704CCE440AA676B8300C5D2CDE"><enum>(i)</enum><text>in subparagraph (A), by striking <quote>2017</quote> each place it appears and inserting <quote>2019</quote>; and</text> </clause><clause commented="no" id="H5858B707B7B24069BA9EE388BB429A12"><enum>(ii)</enum><text>in subparagraph (B)—</text>
<subclause commented="no" id="H64995C3C32F244158DBB444E2F974976"><enum>(I)</enum><text>in the subparagraph heading, by striking <quote><header-in-text level="subparagraph" style="OLC">3-year grants</header-in-text></quote> and inserting <quote><header-in-text level="subparagraph" style="OLC">Competitive PREP grants</header-in-text></quote>; and</text> </subclause><subclause commented="no" id="H48826E039DED4F07AEF69E7E951F2128"><enum>(II)</enum><text display-inline="yes-display-inline">in clause (i), by striking <quote>solicit applications to award 3-year grants in each of fiscal years 2012 through 2017</quote> and inserting <quote>continue through fiscal year 2019 grants awarded for any of fiscal years 2015 through 2017</quote>;</text>
</subclause></clause></subparagraph><subparagraph commented="no" id="H6A183FA6BB344A378E229919EBF3EFB0"><enum>(C)</enum><text>in subsection (c)(1), by inserting after <quote>youth with HIV/AIDS,</quote> the following: <quote>victims of human trafficking,</quote>; and</text> </subparagraph><subparagraph commented="no" id="H104C26B989B142DCBEC544A4465AB0BD"><enum>(D)</enum><text display-inline="yes-display-inline">in subsection (f), by striking <quote>2017</quote> and inserting <quote>2019</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" id="H3430A60214C94B6C804EC8F899168C83"><enum>(2)</enum><header>Effective date</header><text display-inline="yes-display-inline">The amendments made by this subsection take effect on October 1, 2017.</text> </paragraph></subsection></section><enum>II</enum><header>Offsets</header> <section id="HA8EE5FAE491C4686888068B8ADEFB012"><enum>201.</enum><header>Providing for qualified health plan grace period requirements for issuer receipt of advance payments of cost-sharing reductions and premium tax credits that are more consistent with State law grace period requirements</header> <subsection id="H10525B5904914169BD05DAE65995E5BE"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1412(c) of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/18082">42 U.S.C. 18082(c)</external-xref>) is amended—</text>
<paragraph id="HFF3C9D0AEFA84C94A74E4BAF43EF6F8B"><enum>(1)</enum><text>in paragraph (2)—</text> <subparagraph id="H35D0AC0009EF4D2E9BCC5BE1402C7821"><enum>(A)</enum><text>in subparagraph (B)(iv)(II), by striking <quote>a 3-month grace period</quote> and inserting <quote>a grace period specified in subparagraph (C)</quote>; and</text>
</subparagraph><subparagraph id="H6E446E67B1BD4F3CA57BEC6425924C35"><enum>(B)</enum><text>by adding at the end the following new subparagraphs:</text> <quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H7C75E4A1571143E19EF2B636979E0A1F" reported-display-style="italic" style="OLC"> <subparagraph id="HC58E95BD4480410C83C337CFF5D42BA8"><enum>(C)</enum><header>Grace period specified</header><text display-inline="yes-display-inline">For purposes of subparagraph (B)(iv)(II), the grace period specified in this subparagraph is—</text>
<clause id="HA85D28D01D8A4DB68C4CEAAC6BD621F8"><enum>(i)</enum><text>for plan years beginning before January 1, 2018, a 3-month grace period; and</text> </clause><clause id="H071CF530E6F644BB91D8E593854BF2A9"><enum>(ii)</enum><text>for plan years beginning on or after January 1, 2018—</text>
<subclause id="H5D70A50BB35848F0980C95825BEEF4E6"><enum>(I)</enum><text>in the case of an Exchange operating in a State that has a State law grace period in place, such State law grace period; and</text>
</subclause><subclause id="H44A708CF352048819C4AEF535C514DEF"><enum>(II)</enum><text>in the case of an Exchange operating in a State that does not have a State law grace period in place, a 1-month grace period.</text>
</subclause></clause></subparagraph><subparagraph id="H763917200B11493DA8D6689CB07F3C36"><enum>(D)</enum><header>State law grace period</header><text>For purposes of subparagraph (C), the term <quote>State law grace period</quote> means, with respect to a State, a grace period for nonpayment of premiums before discontinuing coverage that is applicable under the State law to health insurance coverage offered in the individual market of the State.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HA5349B0057AB4DA387DB54CC7D7FFDE4"><enum>(2)</enum><text>in paragraph (3), by adding at the end the following new sentence: <quote>The requirements of paragraph (2)(B)(iv) apply to an issuer of a qualified health plan receiving an advanced payment under this paragraph in the same manner and to the same extent that such requirements apply to an issuer of a qualified health plan receiving an advanced payment under paragraph (2)(A).</quote>.</text>
</paragraph></subsection><subsection id="H2EB68D101BC34B0CA40CEA81F983C0DC"><enum>(b)</enum><header>Report on aligning grace periods for Medicaid, Medicare, and Exchange plans</header><text display-inline="yes-display-inline">Not later than two years after the date of full implementation of subsection (a), the Comptroller General of the United States shall submit to Congress a report on—</text>
<paragraph id="H699CB0021A87486CB513C1FA129E971B"><enum>(1)</enum><text>the effects on consumers of aligning grace periods applied under the Medicaid program under title XIX of the Social Security Act, under the Medicare program under parts C and D of title XVIII of such Act, and under qualified health plans offered on an Exchange established under title I of the Patient Protection and Affordable Care Act, including the extent to which such an alignment of grace periods may help to avoid enrollment status confusion for individuals under such Medicaid program, Medicare program, and qualified health plans; and</text>
</paragraph><paragraph id="H257DD9D76B6844A0BECD5DE5B433929B"><enum>(2)</enum><text>the extent to which such an alignment of grace periods may reduce fraud, waste, and abuse under the Medicaid program.</text>
</paragraph></subsection></section><section id="HAF6A0603062B42BAB3987474D66F334E"><enum>202.</enum><header>Prevention and Public Health Fund</header><text display-inline="no-display-inline">Section 4002(b) of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300u-11">42 U.S.C. 300u–11(b)</external-xref>) is amended by striking paragraphs (3) through (8) and inserting the following new paragraphs:</text>
<quoted-block changed="added" committee-id="HIF00" display-inline="no-display-inline" id="H39C3F5C00BFA4D018A7CA835614E16CC" reported-display-style="italic" style="OLC">
<paragraph id="HF21AF72AFA044EE99A65F68F99A2363C"><enum>(3)</enum><text display-inline="yes-display-inline">for fiscal year 2018, $900,000,000;</text> </paragraph><paragraph commented="no" id="H0E2BDF258BA147F7BD9FB237782825E7"><enum>(4)</enum><text>for fiscal year 2019, $500,000,000;</text>
</paragraph><paragraph commented="no" id="H480304EB6AA94A4EB532620D13780C64"><enum>(5)</enum><text>for fiscal year 2020, $500,000,000;</text> </paragraph><paragraph commented="no" id="HD818E7842B7F4A20A8E6F7344B08C184"><enum>(6)</enum><text>for fiscal year 2021, $500,000,000;</text>
</paragraph><paragraph commented="no" id="H5DA1D2E003BB445189753782E3A98699"><enum>(7)</enum><text>for fiscal year 2022, $500,000,000;</text> </paragraph><paragraph commented="no" id="H09C3BC3E07F742D7936548690448E6D5"><enum>(8)</enum><text>for fiscal year 2023, $500,000,000;</text>
</paragraph><paragraph commented="no" id="H97E45FB3BD174CE3850F970B71248764"><enum>(9)</enum><text>for fiscal year 2024, $500,000,000;</text> </paragraph><paragraph commented="no" id="HE78659424F7D479DBFFDC095CB60F37E"><enum>(10)</enum><text>for fiscal year 2025, $750,000,000;</text>
</paragraph><paragraph commented="no" id="H1DF12E0D95A341A8B63AAC4699A6088C"><enum>(11)</enum><text>for fiscal year 2026, $1,000,000,000; and</text> </paragraph><paragraph commented="no" id="H60C2F550DF7E468290F7583AA6E3F6A1"><enum>(12)</enum><text>for fiscal year 2027 and each fiscal year thereafter, $2,000,000,000.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section>
October 19, 2017
Reported from the Committee on Energy and Commerce with an amendmentOctober 19, 2017The Committee on Ways and Means discharged; committed to the Committee of the Whole House on the State of the Union and ordered to
be printed