[Congressional Record Volume 145, Number 115 (Wednesday, September 8, 1999)]
[Senate]
[Pages S10615-S10616]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. LUGAR:
  S. 1570. A bill to amend the National School Lunch Act and the Child 
Nutrition Act of 1966 to promote identification of children eligible 
for benefits under, and enrollment of children in, the medicaid and 
State Children's Health Insurance programs; to the Committee on 
Agriculture, Nutrition, and Forestry.


                     S-CHIP IMPROVEMENT ACT OF 1999

  Mr. LUGAR. Mr. President, I rise today to introduce the Access to 
Children's Health Insurance Program Act. Joining me in this effort is 
my colleague from Indiana in the other body, Representative Julia 
Carson.
  Congress created the S-CHIP program in the Balanced Budget Act of 
1997 as a new federal-state partnership to expand health insurance 
coverage for low-income children not eligible for Medicaid. Under S-
CHIP states may cover children in families up to 200 percent of the 
federal poverty level or, in states with Medicaid income levels for 
children already at or above 200 percent of poverty, within 50 percent 
over the state's current Medicaid income eligibility limit. Congress 
provided over $4 billion annually to match state expenditures for this 
program.
  Implementation of the S-CHIP program has been slow. States have faced 
both normal start-up problems as well as other obstacles to identifying 
and enrolling eligible children. There are an estimated 11 million 
children who are uninsured with 7.5 million who could be eligible for 
the S-CHIP program. Congress envisioned that 5 million children would 
receive services under S-CHIP. As of July 1999, according to the Kaiser 
Family Foundation, only 1.3 million children were enrolled on S-CHIP, 
less than half the projected enrollment in 1999.
  The federal child nutrition programs of school lunch, child care 
feeding and WIC are important sources of information on potentially 
eligible children as well as a contact point with their parents. 
Typically these programs collect income information that can be used to 
identify eligible children, and even enroll children into federal 
health insurance programs. However there are limits on the disclosure 
of school lunch data. While state and local health programs and other 
means-tested nutrition programs may receive this data, Medicaid and S-
CHIP may not.
  Our bill will expand disclosure, subject to privacy provisions, to 
the state health agency running Medicaid and S-CHIP. As an added 
protection, both the State and local education authority must agree to 
this new disclosure.
  The bill will also expand on a demonstration basis the use of WIC 
administrative funds. With the new authority, WIC clinics will be able 
to take a more active role in the identification and enrollment of 
children onto the S-CHIP and Medicaid programs. However, since funding 
for WIC is discretionary and funds for required program activities are 
tight, the number of sites will be limited. The General Accounting 
Office will be required to determine the added cost of the program.
  Finally the bill will fund demonstration grants to states. The 
demonstration projects will integrate nutrition program grantees 
(schools, child care centers and WIC clinics) and other social service 
programs with the federal health care programs for low income children. 
States will form comprehensive informational and enrollment projects to 
be eligible for the funding.
  Mr. President, this bill removes bureaucratic barriers so that more 
poor children may receive the health care they need. It does this by 
allowing one government entity to share information it possesses with 
another government entity responsible for health care. I urge my 
colleagues to support this bill.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1570

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

[[Page S10616]]

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``SCHIP Improvement Act of 
     1999''.

     SEC. 2. LIMITED WAIVER OF CONFIDENTIALITY REQUIREMENT.

       Section 9(b)(2)(C)(iii) of the National School Lunch Act 
     (42 U.S.C. 1758(b)(2)(C)(iii)) is amended--
       (1) in subclause (II), by striking ``and'' at the end;
       (2) in subclause (III), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(IV) a person directly connected with the administration 
     of a State plan under title XIX of the Social Security Act 
     (42 U.S.C. 1396 et seq.) or a State child health plan under 
     title XXI of that Act (42 U.S.C. 1397aa et seq.) for the 
     purpose of identifying children eligible for benefits under, 
     and enrolling children in, any such plan, except that this 
     subclause shall apply with respect to the agency from which 
     the information would be obtained only if the State and the 
     agency so elect.''.

     SEC. 3. DEMONSTRATION PROJECT.

       (a) In General.--Section 17 of the Child Nutrition Act of 
     1966 (42 U.S.C. 1786) is amended by adding at the end the 
     following:
       ``(q) Demonstration Project Relating to Use of WIC Funds 
     for Identification and Enrollment of Children in Certain 
     Health Programs.--
       ``(1) In general.--The Secretary shall establish a 
     demonstration project in not more than 40 local agencies in 
     not fewer than 2 States under which costs of nutrition 
     services and administration (as defined in subsection (b)(4)) 
     shall include the costs of identification of children 
     eligible for benefits under, and enrollment of children in--
       ``(A) a State plan under title XIX of the Social Security 
     Act (42 U.S.C. 1396 et seq.); and
       ``(B) a State child health plan under title XXI of that Act 
     (42 U.S.C. 1397aa et seq.).
       ``(2) Report on evaluation of costs.--Not later than 18 
     months after the date of enactment of this subsection, the 
     Comptroller General of the United States shall submit to 
     Congress a report evaluating the costs associated with 
     implementation of the demonstration project, including an 
     evaluation of the Federal and State costs per child enrolled 
     in a State plan described in paragraph (1).
       ``(3) Termination of authority.--The authority provided by 
     this subsection terminates September 30, 2003.''.
       (b) Technical Amendments.--Section 17 of the Child 
     Nutrition Act of 1966 (42 U.S.C. 1786)--
       (1) in subsection (b)(4), by striking ``(4)'' and all that 
     follows through ``means'' and inserting ``(4) `Costs of 
     nutrition services and administration' or `nutrition services 
     and administration' means''; and
       (2) in subsection (h)(1)(A), by striking ``costs incurred 
     by State and local agencies for nutrition services and 
     administration'' and inserting ``costs of nutrition services 
     and administration incurred by State and local agencies''.

     SEC. 3. GRANTS FOR IDENTIFICATION AND ENROLLMENT EFFORTS.

       Section 12 of the National School Lunch Act (42 U.S.C. 
     1760) is amended by adding at the end the following:
       ``(p) Grants for Identification and Enrollment Efforts.--
       ``(1) In general.--The Secretary shall make grants to 
     States to carry out State plans to involve eligible entities 
     described in paragraph (2) in the identification of children 
     eligible for benefits under, and enrollment of children in--
       ``(A) a State plan under title XIX of the Social Security 
     Act (42 U.S.C. 1396 et seq.); and
       ``(B) a State child health plan under title XXI of the 
     Social Security Act (42 U.S.C. 1397aa et seq.).
       ``(2) Eligible entities.--An eligible entity referred to in 
     paragraph (1) is--
       ``(A) a school or school food authority participating in 
     the school lunch program under this Act;
       ``(B) an institution participating in the child and adult 
     care food program under section 17;
       ``(C) a local agency participating in the special 
     supplemental nutrition program for women, infants, and 
     children under section 17 of the Child Nutrition Act of 1966 
     (42 U.S.C. 1786); or
       ``(D) any other nongovernmental social service provider.
       ``(3) Use of funds for wic demonstration project.--The 
     authorized uses of grant funds under this subsection shall 
     include carrying out the demonstration project under section 
     17(q) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(q)).
       ``(4) Funding.--Out of any moneys in the Treasury not 
     otherwise appropriated, the Secretary of the Treasury shall 
     provide to the Secretary to carry out this subsection 
     $6,000,000 for each of fiscal years 2000 through 2003. The 
     Secretary shall be entitled to receive the funds and shall 
     accept the funds, without further Act of appropriation.''.

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