[Congressional Record Volume 153, Number 77 (Thursday, May 10, 2007)]
[Senate]
[Pages S5937-S5948]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN:
  S. 1364. A bill to amend titles XIX and XXI of the Social Security 
Act to extend the State Children's Health Insurance Program (SCHIPS) 
and stremline enrollment under SCHIP and Medicaid, and for other 
purposes; to the Committee on Finance.
  Mr. DURBIN. Mr. President, over 25 years ago, a member of the Select 
Panel for the Promotion of Child Health said in a statement to 
Congress, ``Children are one-third of our population and all of our 
future.'' We must protect the health and welfare of our nation's 
children if we are to secure the future of our country. This year we 
have a tremendous opportunity to ensure that security. With the 
reauthorization of the State Children's Health Insurance Program, 
SCHIP, we can improve the health and health care of our Nation's 
future, for the over 70 million children in America and, in particular, 
the 9 million children who have no health coverage.
  Since the creation of SCHIP 10 years ago, more than 6.2 million 
children have been covered by this vital program, including over 
290,000 children in Illinois. As the first State to provide coverage 
for all children, Illinois has been a leader in the movement to change 
the course of health care in this country. Since 1993, SCHIP, its 
relationship to Medicaid, and the flexibility that this administration 
has permitted the programs to have, have made it possible for Illinois 
to provide health care to the more than 313,000 children who did not 
have access to it before.
  Nearly 1 million Illinois families have at least one uninsured family 
member, and the face of the uninsured is changing. The uninsured are 
not only the mother and daughter living in downtown Chicago. The 
uninsured includes the family who runs a small business in the suburbs, 
the family farm in central Illinois, and the single father working at a 
factory downstate.
  The majority of kids without health care coverage come from working 
families, families like Mr. and Mrs. Buss and their three young sons. 
Lisa Buss and her husband own a small home inspection company. They 
paid over $9,000 last year alone on regular medical care, without any 
catastrophic events or emergencies. That's a lot of money for a family 
living in the suburbs of Chicago. There is also the Hickey family of 
Godfrey, Illinois. After an

[[Page S5938]]

unfortunate accident, their son broke a couple of bones in his hand. 
Without insurance, they were hesitant to see the specialist at the 
suggestion of the emergency room physicians, but for the health of 
their son, they did so. For a 5 minute visit, they paid close to 
$1,000. Mr. Hickey works in the construction trade and work had been 
slow. Susan is a teacher for the Alton School District. They were given 
no financial assistance except to be offered a payment plan. Now, the 
Hickeys have to find a way to pay for their house payment and their 
utilities, rising gas prices, and this medical treatment.
  The unnecessary burden and anxiety caused by health care is an 
unfortunate reality for too many, and children often bear the brunt of 
this hardship. Kids should not have to wait until their fever is 103 
degrees to see a doctor. Kids should be able to obtain glasses when 
they are straining to see the chalkboard. Kids should be able to obtain 
antibiotics when that ``cold'' just won't go away. Our parents should 
not have to worry about whether they can afford to take their son to a 
bone specialist.
  As is often the case, States are leading the way with children's 
health coverage initiatives. In 2005, my State of Illinois was the 
first State to ensure health care coverage for all children. Since 
then, many States have taken on the challenge of expanding health care 
coverage. The State of the States 2007 report by AcademyHealth 
indicates that more than a dozen States have enacted innovative 
policies to expand coverage. These range from comprehensive health care 
reform in States such as Massachusetts, Vermont, and Maine; to public-
private partnerships in States such as Arkansas, Montana, New Mexico, 
Oklahoma, Rhode Island, Tennessee, and Utah; to initiatives to cover 
all children in Illinois and Pennsylvania.
  Democratic and Republican governors alike are exploring ways to reach 
the uninsured, proving that children's health and health care coverage 
are American issues, not partisan issues. One important way to insure 
more children is through a strong reauthorization of SCHIP.
  Today, with the introduction of the Healthy Kids Act, I propose SCHIP 
reauthorization legislation that builds on the progress made in these 
States. First, the bill provides States with more funding to enroll 
children who are eligible but not enrolled in SCHIP. These kids account 
for more than half of all uninsured children.
  Second, the Healthy Kids Act will eliminate obvious barriers to 
coverage and simplify enrollment procedures. For example, seven States 
have reported declines in Medicaid enrollments because of new 
citizenship requirements. Approximately 65 percent of internists report 
serving patients with Limited English Proficiency; for children living 
in these families, making language assistance services available is a 
critical precursor to quality care. My bill proposes options for States 
to reach the neediest children through SCHIP by reducing some of these 
barriers. For example, the bill provides for funds for language 
assistance services.
  Third, the bill also supports the establishment of medical homes, a 
network of providers for children that helps prevent them from falling 
through the cracks. The bill puts forth an effort to create pediatric 
quality and performance measures. The Healthy Kids Act also establishes 
a disease prevention and treatment demonstration project for ethnic and 
racial minority children, using research that specifically examines 
disparities in minority children enrolled in Medicaid/SCHIP. We can 
reduce health disparities and improve health outcomes for this 
population.
  Finally, the bill creates a commission to study children's health 
coverage. The Commission on Children's Health Coverage will develop 
policy recommendations and track the program's overall performance. 
Feedback and analysis of SCHIP's performance is critical to improving 
the program in the future.
  SCHIP has been an unparalleled success and a model for health 
insurance coverage that both Democrats and Republicans can be proud of. 
Ensuring health care coverage for children in need is a priority for 
both sides of the aisle. The reauthorization of SCHIP is a rare 
opportunity for the Federal Government to expand its support for 
policies in States like Illinois and others. Let's take a step forward 
and work to provide basic health insurance for all children. Healthy 
children grow into healthy adults, in turn, these individuals are 
happier and spend less money on health care in the long run. The SCHIP 
program is critical for our Nation's health and economic future.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1364

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Healthy 
     Kids Act of 2007''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.

                      TITLE I--EXTENSION OF SCHIP

Sec. 101. Extension of SCHIP program; increase in allotments to take 
              into account growth in child population and health care 
              costs.
Sec. 102. 2-year initial availability of SCHIP allotments.
Sec. 103. Redistribution of unused allotments to address State funding 
              shortfalls.

    TITLE II--STATE OPTIONS FOR INCREASING COVERAGE OF CHILDREN AND 
                PREGNANT WOMEN UNDER MEDICAID AND SCHIP

Sec. 201. Bonus payments for States that implement administrative 
              policies to streamline enrollment process.
Sec. 202. State option to provide for ``express lane'' and simplified 
              determinations of a child's financial eligibility for 
              medical assistance under Medicaid or child health 
              assistance under SCHIP.
Sec. 203. Information technology connections to improve health coverage 
              determinations.
Sec. 204. State option to expand or add coverage of certain pregnant 
              women under Medicaid and SCHIP.
Sec. 205. Optional coverage of legal immigrants under Medicaid and 
              SCHIP.
Sec. 206. Authorizing adjustment of SCHIP allotment due to increased 
              outreach.
Sec. 207. Model of Interstate coordinated enrollment and coverage 
              process.
Sec. 208. Authority for qualifying States to use portion of SCHIP 
              allotment for any fiscal year for certain Medicaid 
              expenditures.
Sec. 209. Application of Medicaid outreach procedures to all pregnant 
              women and children.
Sec. 210. No impact on section 1115 waivers.
Sec. 211. Elimination of counting Medicaid child presumptive 
              eligibility costs against title XXI allotment.
Sec. 212. Prohibiting limitations on enrollment.

         TITLE III--ELIMINATION OF CERTAIN BARRIERS TO COVERAGE

Sec. 301. State option to require certain individuals to present 
              satisfactory documentary evidence of proof of citizenship 
              or nationality for purposes of eligibility for Medicaid.
Sec. 302. Increased Federal matching rate for language services 
              provided under Medicaid or SCHIP.

 TITLE IV--GRANTS TO PROMOTE INNOVATIVE OUTREACH AND ENROLLMENT UNDER 
                           MEDICAID AND SCHIP

Sec. 401. Grants to promote innovative outreach and enrollment under 
              Medicaid and SCHIP.

            TITLE V--IMPROVING THE QUALITY OF PEDIATRIC CARE

Sec. 501. Requiring coverage of EPSDT services, including dental 
              services, State option to provide supplemental coverage 
              of dental services.
Sec. 502. Pediatric quality and performance measures program.
Sec. 503. Grants to States for demonstration projects transforming 
              delivery of pediatric care.
Sec. 504. Report by the comptroller general on design and 
              implementation of a demonstration project evaluating 
              existing quality and performance measures for children's 
              inpatient hospital services.
Sec. 505. Medical home demonstration project.
Sec. 506. Disease prevention and treatment demonstration projects for 
              ethnic and racial minority children.

[[Page S5939]]

           TITLE VI--COMMISSION ON CHILDREN'S HEALTH COVERAGE

Sec. 601. Commission on Children's Health Coverage.

                      TITLE I--EXTENSION OF SCHIP

     SEC. 101. EXTENSION OF SCHIP PROGRAM; INCREASE IN ALLOTMENTS 
                   TO TAKE INTO ACCOUNT GROWTH IN CHILD POPULATION 
                   AND HEALTH CARE COSTS.

       (a) In General.--Section 2104 of the Social Security Act 
     (42 U.S.C. 1397dd) is amended--
       (1) in subsection (a)--
       (A) by striking ``and'' at the end of paragraph (9);
       (B) by striking the period at the end of paragraph (10) and 
     inserting ``; and''; and
       (C) by adding at the end the following new paragraph:
       ``(11) for each fiscal year 2008 and each subsequent fiscal 
     year, $7,500,000,000 multiplied by the population and cost 
     inflation factor for that fiscal year, as determined under 
     subsection (i).''; and
       (2) by adding at the end the following new subsection:
       ``(i) Population and Cost Inflation Factor.--For purposes 
     of subsection (a)(11), the population and cost inflation 
     factor for a fiscal year is equal to the product of the 
     following:
       ``(1) Child population growth factor.--One plus the 
     percentage increase in the population of children under 20 
     years of age in the United States from July 1, 2007, to July 
     1 during the fiscal year involved, as projected by the 
     Secretary based on the most recent published estimates of the 
     Bureau of the Census before the beginning of the fiscal year 
     involved.
       ``(2) Per capita health care growth factor.--One plus the 
     percentage increase in the projected per capita amount of 
     National Health Expenditures from fiscal year 2007 to the 
     fiscal year involved, as most recently published by the 
     Secretary before the beginning of the fiscal year 
     involved.''.
       (b) Additional Allotments to Territories.--Section 
     2104(c)(4)(B) of such Act (42 U.S.C. 1397dd(c)(4)(B)) is 
     amended by striking ``and $40,000,000 for fiscal year 2007'' 
     and inserting ``$40,000,000 for fiscal year 2007, and for 
     each of fiscal years 2008 through 2017, the amount 
     appropriated under this subparagraph for the preceding fiscal 
     year increased by the population and cost inflation factor 
     for that fiscal year, as determined under subsection (i)''.

     SEC. 102. 2-YEAR INITIAL AVAILABILITY OF SCHIP ALLOTMENTS.

       Section 2104(e) of the Social Security Act (42 U.S.C. 
     1397dd(e)) is amended to read as follows:
       ``(e) Availability of Amounts Allotted.--
       ``(1) In general.--Except as provided in paragraphs (2) and 
     (3), amounts allotted to a State pursuant to this section--
       ``(A) for each of fiscal years 1998 through 2007, shall 
     remain available for expenditure by the State through the end 
     of the second succeeding fiscal year; and
       ``(B) for fiscal year 2008 and each fiscal year thereafter, 
     shall remain available for expenditure by the State through 
     the end of the succeeding fiscal year.
       ``(2) Availability of amounts reallotted.--Subject to 
     paragraph (3), amounts reallotted to a State under subsection 
     (f) shall be available for expenditure by the State through 
     the end of the fiscal year in which they are reallotted.
       ``(3) Permanent availability of unused funds.--Reallotted 
     funds that are not used by the end of the fiscal year 
     described in paragraph (2) shall be subject to reallotment 
     under subsection (f) in subsequent fiscal years subject to 
     such paragraph and shall remain available for subsequent 
     reallotment until expended.''.

     SEC. 103. REDISTRIBUTION OF UNUSED ALLOTMENTS TO ADDRESS 
                   STATE FUNDING SHORTFALLS.

       Section 2104(f) of the Social Security Act (42 U.S.C. 
     1397dd(f)) is amended--
       (1) by striking ``The Secretary'' and inserting the 
     following:
       ``(1) In general.--The Secretary'';
       (2) by striking ``States that have fully expended the 
     amount of their allotments under this section'' and inserting 
     ``States that the Secretary determines with respect to the 
     fiscal year for which unused allotments are available for 
     redistribution under this subsection, are shortfall States 
     described in paragraph (2) for such fiscal year''; and
       (3) by adding at the end the following new paragraph:
       ``(2) Shortfall states described.--
       ``(A) In general.--For purposes of paragraph (1), with 
     respect to a fiscal year, a shortfall State described in this 
     subparagraph is a State with a State child health plan 
     approved under this title for which the Secretary estimates 
     on the basis of the most recent data available to the 
     Secretary, that the projected expenditures under such plan 
     for the State for the fiscal year will exceed the sum of--
       ``(i) the amount of the State's allotments for any 
     preceding fiscal years that remain available for expenditure 
     and that will not be expended by the end of the immediately 
     preceding fiscal year; and
       ``(ii) the amount of the State's allotment for the fiscal 
     year (taking into account any increase made in such allotment 
     under section 2104(j), as added by section 205(a) of the 
     Healthy Kids Act of 2007).
       ``(B) Proration rule.--If the amounts available for 
     redistribution under paragraph (1) for a fiscal year are less 
     than the total amounts of the estimated shortfalls determined 
     for the year under subparagraph (A), the amount to be 
     reallotted under such paragraph for each shortfall State 
     shall be reduced proportionally.
       ``(C) Retrospective adjustment.--The Secretary may adjust 
     the estimates and determinations made under paragraph (1) and 
     this paragraph with respect to a fiscal year as necessary on 
     the basis of the amounts reported by States not later than 
     November 30 of the succeeding fiscal year, as approved by the 
     Secretary.''.

    TITLE II--STATE OPTIONS FOR INCREASING COVERAGE OF CHILDREN AND 
                PREGNANT WOMEN UNDER MEDICAID AND SCHIP

     SEC. 201. BONUS PAYMENTS FOR STATES THAT IMPLEMENT 
                   ADMINISTRATIVE POLICIES TO STREAMLINE 
                   ENROLLMENT PROCESS.

       (a) Bonus in FMAP and Enhanced FMAP for Application of 
     Streamline Enrollment Procedures Under Medicaid and SCHIP.--
     Section 2102 of the Social Security Act (42 U.S.C. 1397bb) is 
     amended by adding at the end the following new subsection:
       ``(d) Streamline Enrollment Procedures.--
       ``(1) Increase in federal matching rate.--
       ``(A) In general.--In the case of a State that meets the 
     conditions described in subparagraph (B) (relating to 
     agreeing to implement administrative enrollment policies 
     under this title and title XIX) for a fiscal year, the 
     Federal medical assistance percentage (for purposes of title 
     XIX only) and the enhanced FMAP (for purposes of this title, 
     but determined without regard to the application of this 
     subsection to the Federal medical assistance percentage under 
     title XIX) otherwise computed for such fiscal year as applied 
     to medical assistance for children and child health 
     assistance, respectively, shall be increased by such number 
     of percentage points as the Secretary determines is necessary 
     to provide an incentive for the State to satisfy the 
     conditions described in subparagraph (B) (but not to exceed 
     such number of percentage points that would result in a 
     Federal medical assistance percentage or enhanced FMAP for 
     the State that would exceed 83 or 85 percent, respectively).
       ``(B) Agreeing to remove enrollment and access barriers.--
     The conditions described in this subparagraph, for a State 
     for a fiscal year are that the State agrees to do the 
     following:
       ``(i) Presumptive eligibility for children.--The State 
     agrees--

       ``(I) to provide presumptive eligibility for children under 
     this title and title XIX in accordance with section 1920A; 
     and
       ``(II) to treat any items or services that are provided to 
     an uncovered child (as defined in section 2110(c)(8)) who is 
     determined ineligible for medical assistance under title XIX 
     as child health assistance for purposes of paying a provider 
     of such items or services, so long as such items or services 
     would be considered child health assistance for a targeted 
     low-income child under this title.

       ``(ii) 12-month continuous eligibility.--The State agrees 
     to provide that eligibility of children for assistance under 
     this title and title XIX shall not be regularly redetermined 
     more often than once every year.
       ``(iii) Automatic renewal.--The State agrees to provide for 
     the automatic renewal of the eligibility of children for 
     assistance under this title and under title XIX if the 
     child's family does not report any changes to family income 
     or other relevant circumstances, subject to verification of 
     information from databases available to the State for such 
     purpose.
       ``(iv) Elimination of asset test.--The State has amended 
     its plans under this title and title XIX so that no asset or 
     resource test is applied for eligibility under this title or 
     title XIX with respect to children.
       ``(v) Administrative verification of income.--The State 
     agrees to permit the family of a child applying for child 
     health assistance under this title or medical assistance 
     under title XIX to declare and certify, by signature under 
     penalty of perjury, the family income for purposes of 
     collecting financial eligibility information.''.
       (b) Conforming Medicaid Amendments.--
       (1) In general.--Section 1905(b) of the Social Security Act 
     (42 U.S.C. 1396d(b)) is amended by inserting ``and section 
     2102(d)(1)'' after ``section 1933(d)''.
       (2) Increase in medicaid cap for territories.--Section 
     1108(g) of such Act (42 U.S.C. 1308(g)) is amended--
       (A) in paragraph (2), by striking ``paragraph (3)'' and 
     inserting ``paragraphs (3) and (4)''; and
       (B) by adding at the end the following new paragraph:
       ``(4) Disregard of increased expenditures directly 
     attributable to increase in fmap for application of 
     streamlined enrollment procedures.--The limitation of 
     paragraph (2) shall not apply to payment under title XIX to a 
     territory insofar as such payment is attributable to an 
     increase in the Federal medical assistance percentage under 
     subparagraph (A) of section 2102(d)(1).''.
       (c) Effective Date.--The amendments made by this section 
     shall apply beginning with fiscal year 2007.

[[Page S5940]]

     SEC. 202. STATE OPTION TO PROVIDE FOR ``EXPRESS LANE'' AND 
                   SIMPLIFIED DETERMINATIONS OF A CHILD'S 
                   FINANCIAL ELIGIBILITY FOR MEDICAL ASSISTANCE 
                   UNDER MEDICAID OR CHILD HEALTH ASSISTANCE UNDER 
                   SCHIP.

       (a) Medicaid.--Section 1902(e) of the Social Security Act 
     (42 U.S.C. 1396a(e)) is amended by adding at the end the 
     following:
       ``(13)(A) At the option of the State, the plan may provide 
     that eligibility requirements (including such requirements 
     applicable to redeterminations or renewals of eligibility) 
     for medical assistance relating to income, assets (or 
     resources), or citizenship status are met for a child who is 
     under an age specified by the State (not to exceed 21 years 
     of age) by using a determination made within a reasonable 
     period (as determined by the State) before its use for this 
     purpose, of the child's family or household income, or if 
     applicable for purposes of determining eligibility under this 
     title or title XXI, assets or resources, or citizenship 
     status, respectively, (notwithstanding any other provision of 
     law, including sections 1902(a)(46)(B), 1903(x), and 
     1137(d)), by a Federal or State agency, or a public or 
     private entity making such determination on behalf of such 
     agency, specified by the plan, including an agency 
     administering the State program funded under part A of title 
     IV, the Food Stamp Act of 1977, the Richard B. Russell 
     National School Lunch Act, or the Child Nutrition Act of 
     1966, notwithstanding any differences in budget unit, 
     disregard, deeming, or other methodology, but only if--
       ``(i) the agency has fiscal liabilities or responsibilities 
     affected by such determination; and
       ``(ii) the agency or entity notifies the child's family--
       ``(I) of the information which shall be disclosed in 
     accordance with this subparagraph;
       ``(II) that the information disclosed will be used solely 
     for purposes of determining eligibility for medical 
     assistance under this title or for child health assistance 
     under title XXI; and
       ``(III) that interagency agreements limit the use of such 
     information to that purpose; and
       ``(iii) the requirements of section 1939 are satisfied.
       ``(B) Nothing in this paragraph shall be construed to 
     relieve a State of the obligation to determine, on another 
     basis, eligibility for medical assistance under this title or 
     for child health assistance under title XXI if a child is 
     determined ineligible for such assistance on the basis of 
     information furnished pursuant to this paragraph.
       ``(C) If a State applies the eligibility process described 
     in subparagraph (A) to individuals eligible under this title 
     and to individuals eligible under title XXI, the State may, 
     at its option, implement its duties under subparagraphs (A) 
     and (B) of section 2102(b)(3) using either or both of the 
     following approaches:
       ``(i) The State may--
       ``(I) establish a threshold percentage of the Federal 
     poverty level (that shall exceed the income eligibility level 
     applicable for a population of individuals under this title 
     by 30 percentage points (as a fraction of the Federal poverty 
     level) or such other higher number of percentage points as 
     the State determines reflects the typical application of 
     income methodologies by the non-health program and the State 
     plan under this title); and
       ``(II) provide that, with respect to any individual within 
     such population whom a non-health agency determines has 
     income that does not exceed such threshold percentage for 
     such population, such individual is eligible for medical 
     assistance under this title (regardless of whether such 
     individual would otherwise be determined to be eligible to 
     receive such assistance).
     In exercising the approach under this clause, a State shall 
     inform families whose children are enrolled in a State child 
     health plan under title XXI based on having family income 
     above the threshold described in subclause (I) that they may 
     qualify for medical assistance under this title and, at their 
     option, can seek a regular eligibility determination for such 
     assistance for their child.
       ``(ii) Regardless of whether a State otherwise provides for 
     presumptive eligibility under section 1920A, a State may 
     provide presumptive eligibility under this title, consistent 
     with subsection (e) of section 1920A, to a child who, based 
     on a determination by a non-health agency, would qualify for 
     child health assistance under a State child health plan under 
     title XXI. During such presumptive eligibility period, the 
     State may determine the child's eligibility for medical 
     assistance under this title, pursuant to subparagraph (A) of 
     section 2102(b)(3), based on telephone contact with family 
     members, access to data available in electronic or paper 
     form, and other means of gathering information that are less 
     burdensome to the family than completing an application form 
     on behalf of the child. The procedures described in the 
     previous sentence may be used regardless of whether the State 
     uses similar procedures under other circumstances for 
     purposes of determining eligibility for medical assistance 
     under this title.
       ``(D) At the option of a State, the eligibility process 
     described in subparagraph (A) may apply to an individual who 
     is not a child.
       ``(E)(i) At the option of a State, an individual determined 
     to be eligible for medical assistance or child health 
     assistance pursuant to subparagraph (A), (C), or (D) or other 
     procedures through which eligibility is determined based on 
     data obtained from sources other than the individual may 
     receive medical assistance under this title if such 
     individual (or, in the case of an individual under age 19 (or 
     if the State elects the option under subparagraph (A), age 20 
     or 21) who is not authorized to consent to medical care, the 
     individual's parent, guardian, or other caretaker relative) 
     has acknowledged notice of such determination and has 
     consented to such eligibility determination. The State (at 
     its option) may waive any otherwise applicable requirements 
     for signatures by or on behalf of an individual who has so 
     consented.
       ``(ii) In the case of an individual enrolled pursuant to 
     clause (i), the State shall inform the individual (or, in the 
     case of an individual under age 19 (or if the State elects 
     the option under subparagraph (A), age 20 or 21), the 
     individual's parent, guardian, or other caretaker relative) 
     about the significance of such enrollment, including 
     appropriate methods to access covered services.
       ``(F) For purposes of this paragraph--
       ``(i) the term `non-health agency' means an agency or 
     entity described in subparagraph (A); and
       ``(ii) the term `non-health benefits' means the benefits or 
     assistance provided by a non-health agency.''.
       (b) SCHIP.--Section 2107(e)(1) of such Act (42 U.S.C. 
     1397gg(e)(1)) is amended by redesignating subparagraphs (B) 
     through (E) as subparagraphs (C) through (F) and by inserting 
     after subparagraph (B) the following new subparagraph:
       ``(C) Section 1902(e)(13) (relating to the State option to 
     base a determination of a child's eligibility for assistance 
     on determinations made by a program providing nutrition or 
     other public assistance (except that the State option under 
     subparagraph (D) of such section shall apply under this title 
     only if an individual is pregnant)).''.
       (c) Presumptive Eligibility.--Section 1920A of such Act (42 
     U.S.C. 1396r-1a) is amended--
       (1) in subsection (b)(3)(A)(i), is amended by striking ``or 
     (IV)'' and inserting ``(IV) is an agency or entity described 
     in section 1902(e)(13)(A), or (V)''; and
       (2) by adding at the end the following:
       ``(e) In the case of a State with a child health plan under 
     title XXI that provides for presumptive eligibility under 
     such plan for children, the State shall make a reasonable 
     effort to place each presumptively eligible child in the 
     program under this title or title XXI for which the child 
     appears most likely to qualify. During the child's period of 
     presumptive eligibility, the State shall receive Federal 
     matching funds under section 1903 or section 2105, depending 
     on the program in which the child has been placed. If at the 
     conclusion of such period, the child is found to qualify for, 
     and is enrolled in, the program established under this title 
     or title XXI when the child was enrolled in the program under 
     the other such title during such period, the State's receipt 
     of Federal matching funds shall be adjusted both 
     retroactively and prospectively so that Federal matching 
     funds are provided, both during and following such period of 
     presumptive eligibility, based on the program in which the 
     child is enrolled.''.
       (d) Signature Requirements.--Section 1902(a) of such Act 
     (42 U.S.C. 1396a(a)) is amended by adding at the end the 
     following: ``Notwithstanding any other provision of law, a 
     signature under penalty of perjury shall not be required on 
     an application form for medical assistance as to any element 
     of eligibility for which eligibility is based on information 
     received from a source other than applicant, rather than on 
     representations from the applicant. Notwithstanding any other 
     provision of law, any signature requirement for an 
     application for medical assistance may be satisfied through 
     an electronic signature, as defined in section 1710(1) of the 
     Government Paperwork Elimination Act (44 U.S.C. 3504 
     note).''.

     SEC. 203. INFORMATION TECHNOLOGY CONNECTIONS TO IMPROVE 
                   HEALTH COVERAGE DETERMINATIONS.

       (a) Enhanced Federal Funding for Improvements Related to 
     Implementation of Certain Model Outreach and Enrollment 
     Practices.--
       (1) In general.--Section 1903(a)(3)(A) of the Social 
     Security Act (42 U.S.C. 1396b(a)(3)(A)) is amended--
       (A) by striking ``and'' at the end of clause (i); and
       (B) by adding at the end the following new clause:
       ``(iii) 75 percent of so much of the sums expended during 
     such quarter as are attributable to the design, development, 
     or installation of such mechanized claims processing and 
     information retrieval systems and the implementation of 
     administrative systems and processes (including modification 
     of eligibility computer systems to permit the exchange of 
     electronic information with other Federal or State programs) 
     as the Secretary determines are directly related to the 
     implementation of a model outreach and enrollment practice 
     described in subparagraph (B), (C), (D), (E), or (F) of 
     section 1905(y)(3), and''.
       (2) Conforming amendment to ensure availability for 
     territories.--Section 1108(g) of such Act (42 U.S.C. 
     1308(g)), as amended by section 201(b)(2)(B), is amended--
       (A) in paragraph (2), by striking ``and (4)'' and inserting 
     ``, (4), and (5)''; and
       (B) by adding at the end the following new paragraph:

[[Page S5941]]

       ``(5) Additional increase for certain expenditures.--With 
     respect to fiscal year 2008 and each fiscal year thereafter, 
     if Puerto Rico, the Virgin Islands, Guam, the Northern 
     Mariana Islands, or American Samoa qualify for a payment 
     under section 1903(a)(3)(A)(iii) for a calendar quarter of 
     such fiscal year, the additional Federal financial 
     participation under such section shall not be counted towards 
     the limitation on expenditures under title XIX for such 
     commonwealth or territory otherwise determined under 
     subsection (f) and this subsection for such fiscal year.''.
       (b) Authorization of Information Disclosure.--
       (1) In general.--Title XIX of such Act (42 U.S.C. 1396 et 
     seq.) is amended--
       (A) by redesignating section 1939 as section 1940; and
       (B) by inserting after section 1938 the following:


            ``AUTHORIZATION TO RECEIVE PERTINENT INFORMATION

       ``Sec. 1939.  (a) In General.--Notwithstanding any other 
     provision of law, a Federal or State agency or private entity 
     in possession of the sources of data potentially pertinent to 
     eligibility determinations under this title or title XXI 
     (including eligibility files maintained by programs described 
     in section 1902(e)(13)(A), information described in paragraph 
     (2) or (3) of section 1137(a), vital records information 
     about births in any State, and information described in 
     sections 453(i) and 1902(a)(25)(I)) is authorized to convey 
     such data or information to a State agency administering a 
     State plan under this title or title XXI, if--
       ``(1) such data or information are used only to establish 
     or verify eligibility or provide coverage under this title or 
     title XXI; and
       ``(2) an interagency or other agreement, consistent with 
     standards developed by the Secretary, prevents the 
     unauthorized use, disclosure, or modification of such data 
     and otherwise meets applicable Federal requirements 
     safeguarding privacy and data security.
       ``(b) Requirements for Conveyance.--Data or information may 
     be conveyed pursuant to this section only if the following 
     requirements are met:
       ``(1) The individual whose circumstances are described in 
     the data or information (or such individual's parent, 
     guardian, caretaker relative, or authorized representative) 
     has either provided advance consent to disclosure or has not 
     objected to disclosure after receiving advance notice of 
     disclosure and a reasonable opportunity to object.
       ``(2) Such data or information are used solely for the 
     purposes of--
       ``(A) identifying individuals who are eligible or 
     potentially eligible for assistance under this title or title 
     XXI and enrolling such individuals in the State plans 
     established under such titles; and
       ``(B) verifying the eligibility of individuals for 
     assistance under the State plans established under this title 
     or title XXI.
       ``(3) An interagency or other agreement, consistent with 
     standards developed by the Secretary--
       ``(A) prevents the unauthorized use, disclosure, or 
     modification of such data and otherwise meets applicable 
     Federal requirements safeguarding privacy and data security; 
     and
       ``(B) requires the State agencies administering the State 
     plans established under this title and title XXI to use the 
     data and information obtained under this section to seek to 
     enroll individuals in such plans.
       ``(c) Criminal Penalty.--A person described in the 
     subsection (a) who publishes, divulges, discloses, or makes 
     known in any manner, or to any extent not authorized by 
     Federal law, any information obtained under this section 
     shall be fined not more than $1,000 or imprisoned not more 
     than 1 year, or both for each such unauthorized activity.
       ``(d) Rule of Construction.--The limitations and 
     requirements that apply to disclosure pursuant to this 
     section shall not be construed to prohibit the conveyance or 
     disclosure of data or information otherwise permitted under 
     Federal law (without regard to this section).''.
       (2) Conforming amendment to assure access to national new 
     hires database.--Section 453(i)(1) of such Act (42 U.S.C. 
     653(i)(1)) is amended by striking ``and programs funded under 
     part A'' and inserting ``, programs funded under part A, and 
     State plans approved under title XIX or XXI''.
       (3) Conforming amendment to provide schip programs with 
     access to national income data.--Section 6103(l)(7)(D)(ii) of 
     the Internal Revenue Code of 1986 is amended by inserting 
     ``or title XXI'' after ``title XIX''.
       (4) Conforming amendment to provide access to data about 
     enrollment in insurance for purposes of evaluating 
     applications and for schip.--Section 1902(a)(25)(I)(i) of the 
     Social Security Act (42 U.S.C. 1396a(a)(25)(I)(i)) is 
     amended--
       (A) by inserting ``(and, at State option, individuals who 
     are potentially eligible or who apply)'' after ``with respect 
     to individuals who are eligible''; and
       (B) by inserting ``under this title (and, at State option, 
     child health assistance under title XXI)'' after ``the State 
     plan''.

     SEC. 204. STATE OPTION TO EXPAND OR ADD COVERAGE OF CERTAIN 
                   PREGNANT WOMEN UNDER MEDICAID AND SCHIP.

       (a) Medicaid.--
       (1) Authority to expand coverage.--Section 1902(l)(2)(A)(i) 
     of the Social Security Act (42 U.S.C. 1396a(l)(2)(A)(i)) is 
     amended by inserting ``(or such higher percentage as the 
     State may elect for purposes of expenditures for medical 
     assistance for pregnant women described in section 
     1905(u)(4)(A))'' after ``185 percent''.
       (2) Enhanced matching funds available if certain conditions 
     met.--Section 1905 of such Act (42 U.S.C. 1396d) is amended--
       (A) in the fourth sentence of subsection (b), by striking 
     ``or subsection (u)(3)'' and inserting ``, (u)(3), or 
     (u)(4)''; and
       (B) in subsection (u)--
       (i) by redesignating paragraph (4) as paragraph (5); and
       (ii) by inserting after paragraph (3) the following new 
     paragraph:
       ``(4) For purposes of the fourth sentence of subsection (b) 
     and section 2105(a), the expenditures described in this 
     paragraph are the following:
       ``(A) Certain pregnant women.--If the conditions described 
     in subparagraph (B) are met, expenditures for medical 
     assistance for pregnant women described in subsection (n) or 
     in section 1902(l)(1)(A) in a family the income of which 
     exceeds 185 percent of the poverty line, but does not exceed 
     the income eligibility level established under title XXI for 
     a targeted low-income child.
       ``(B) Conditions.--The conditions described in this 
     subparagraph are the following:
       ``(i) The State plans under this title and title XXI do not 
     provide coverage for pregnant women described in subparagraph 
     (A) with higher family income without covering such pregnant 
     women with a lower family income.
       ``(ii) The State does not apply an effective income level 
     for pregnant women that is lower than the effective income 
     level (expressed as a percent of the poverty line and 
     considering applicable income disregards) specified under the 
     State plan under subsection (a)(10)(A)(i)(III) or (l)(2)(A) 
     of section 1902, on the date of enactment of this paragraph 
     to be eligible for medical assistance as a pregnant woman.
       ``(C) Definition of poverty line.--In this subsection, the 
     term `poverty line' has the meaning given such term in 
     section 2110(c)(5).''.
       (3) Payment from title xxi allotment for medicaid expansion 
     costs.--Section 2105(a)(1) of such Act (42 U.S.C. 
     1397ee(a)(1)), as amended by section 211, is amended by 
     striking subparagraph (B) and inserting the following new 
     subparagraph:
       ``(B) for the portion of the payments made for expenditures 
     described in section 1905(u)(4)(A) that represents the 
     additional amount paid for such expenditures as a result of 
     the enhanced FMAP being substituted for the Federal medical 
     assistance percentage of such expenditures;''.
       (b) CHIP.--
       (1) Coverage.--Title XXI of such Act(42 U.S.C. 1397aa et 
     seq.) is amended by adding at the end the following new 
     section:

     ``SEC. 2111. OPTIONAL COVERAGE OF TARGETED LOW-INCOME 
                   PREGNANT WOMEN.

       ``(a) Optional Coverage.--Notwithstanding any other 
     provision of this title, a State may provide for coverage, 
     through an amendment to its State child health plan under 
     section 2102, of pregnancy-related assistance for targeted 
     low-income pregnant women in accordance with this section, 
     but only if--
       ``(1) the State has established an income eligibility level 
     for pregnant women under subsection (a)(10)(A)(i)(III) or 
     (l)(2)(A) of section 1902 that is at least 185 percent of the 
     income official poverty line; and
       ``(2) the State meets the conditions described in section 
     1905(u)(4)(B).
       ``(b) Definitions.--For purposes of this title:
       ``(1) Pregnancy-related assistance.--The term `pregnancy-
     related assistance' has the meaning given the term `child 
     health assistance' in section 2110(a) as if any reference to 
     targeted low-income children were a reference to targeted 
     low-income pregnant women.
       ``(2) Targeted low-income pregnant woman.--The term 
     `targeted low-income pregnant woman' means a woman--
       ``(A) during pregnancy and through the end of the month in 
     which the 60-day period (beginning on the last day of her 
     pregnancy) ends;
       ``(B) whose family income exceeds the effective income 
     level (expressed as a percent of the poverty line and 
     considering applicable income disregards) specified under 
     subsection (a)(10)(A)(i)(III) or (l)(2)(A) of section 1902, 
     on January 1, 2008, to be eligible for medical assistance as 
     a pregnant woman under title XIX but does not exceed the 
     income eligibility level established under the State child 
     health plan under this title for a targeted low-income child; 
     and
       ``(C) who satisfies the requirements of paragraphs (1)(A), 
     (1)(C), (2), and (3) of section 2110(b) in the same manner as 
     a child applying for child health assistance would have to 
     satisfy such requirements.
       ``(c) References to Terms and Special Rules.--In the case 
     of, and with respect to, a State providing for coverage of 
     pregnancy-related assistance to targeted low-income pregnant 
     women under subsection (a), the following special rules 
     apply:
       ``(1) Any reference in this title (other than in subsection 
     (b)) to a targeted low-income child is deemed to include a 
     reference to a targeted low-income pregnant woman.
       ``(2) Any such reference to child health assistance with 
     respect to such women is deemed a reference to pregnancy-
     related assistance.

[[Page S5942]]

       ``(3) Any such reference to a child is deemed a reference 
     to a woman during pregnancy and the period described in 
     subsection (b)(2)(A).
       ``(4) In applying section 2102(b)(3)(B), any reference to 
     children found through screening to be eligible for medical 
     assistance under the State Medicaid plan under title XIX is 
     deemed a reference to pregnant women.
       ``(5) There shall be no exclusion of benefits for services 
     described in subsection (b)(1) based on any preexisting 
     condition and no waiting period (including any waiting period 
     imposed to carry out section 2102(b)(3)(C)) shall apply.
       ``(6) In applying section 2103(e)(3)(B) in the case of a 
     pregnant woman provided coverage under this section, the 
     limitation on total annual aggregate cost sharing shall be 
     applied to such pregnant woman.
       ``(7) The reference in section 2107(e)(1)(F) to section 
     1920A (relating to presumptive eligibility for children) is 
     deemed a reference to section 1920 (relating to presumptive 
     eligibility for pregnant women).
       ``(d) Automatic Enrollment for Children Born to Women 
     Receiving Pregnancy-Related Assistance.--If a child is born 
     to a targeted low-income pregnant woman who was receiving 
     pregnancy-related assistance under this section on the date 
     of the child's birth, the child shall be deemed to have 
     applied for child health assistance under the State child 
     health plan and to have been found eligible for such 
     assistance under such plan or to have applied for medical 
     assistance under title XIX and to have been found eligible 
     for such assistance under such title, as appropriate, on the 
     date of such birth and to remain eligible for such assistance 
     until the child attains 1 year of age. During the period in 
     which a child is deemed under the preceding sentence to be 
     eligible for child health or medical assistance, the child 
     health or medical assistance eligibility identification 
     number of the mother shall also serve as the identification 
     number of the child, and all claims shall be submitted and 
     paid under such number (unless the State issues a separate 
     identification number for the child before such period 
     expires).''.
       (2) Additional conforming amendments.--
       (A) No cost sharing for pregnancy-related benefits.--
     Section 2103(e)(2) (42 U.S.C. 1397cc(e)(2)) is amended--
       (i) in the heading, by inserting ``or pregnancy-related 
     services'' after ``preventive services''; and
       (ii) by inserting before the period at the end the 
     following: ``or for pregnancy-related services''.
       (B) No waiting period.--Section 2102(b)(1)(B) (42 U.S.C. 
     1397bb(b)(1)(B)) is amended--
       (i) in clause (i), by striking ``, and'' at the end and 
     inserting a semicolon;
       (ii) in clause (ii), by striking the period at the end and 
     inserting ``; and''; and
       (iii) by adding at the end the following new clause:
       ``(iii) may not apply a waiting period (including a waiting 
     period to carry out paragraph (3)(C)) in the case of a 
     targeted low-income pregnant woman.''.
       (c) Other Amendments to Medicaid.--
       (1) Eligibility of a newborn.--Section 1902(e)(4) (42 
     U.S.C. 1396a(e)(4)) is amended in the first sentence by 
     striking ``so long as the child is a member of the woman's 
     household and the woman remains (or would remain if pregnant) 
     eligible for such assistance''.
       (2) Application of qualified entities to presumptive 
     eligibility for pregnant women under medicaid.--Section 
     1920(b) (42 U.S.C. 1396r-1(b)) is amended by adding after 
     paragraph (2) the following new flush sentence:
     ``The term `qualified provider' includes a qualified entity 
     as defined in section 1920A(b)(3).''.

     SEC. 205. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS UNDER 
                   MEDICAID AND SCHIP.

       (a) Medicaid Program.--Section 1903(v) of the Social 
     Security Act (42 U.S.C. 1396b(v)) is amended--
       (1) in paragraph (1), by striking ``paragraph (2)'' and 
     inserting ``paragraphs (2) and (4)''; and
       (2) by adding at the end the following new paragraph:
       ``(4)(A) A State may elect (in a plan amendment under this 
     title) to provide medical assistance under this title, 
     notwithstanding sections 401(a), 402(b), 403, and 421 of the 
     Personal Responsibility and Work Opportunity Reconciliation 
     Act of 1996, for aliens who are lawfully residing in the 
     United States (including battered aliens described in section 
     431(c) of such Act) and who are otherwise eligible for such 
     assistance, within either or both of the following 
     eligibility categories:
       ``(i) Pregnant women.--Women during pregnancy (and during 
     the 60-day period beginning on the last day of the 
     pregnancy).
       ``(ii) Children.--Individuals under 21 years of age, 
     including optional targeted low-income children described in 
     section 1905(u)(2)(B).
       ``(B) In the case of a State that has elected to provide 
     medical assistance to a category of aliens under subparagraph 
     (A), no debt shall accrue under an affidavit of support 
     against any sponsor of such an alien on the basis of 
     provision of assistance to such category and the cost of such 
     assistance shall not be considered as an unreimbursed 
     cost.''.
       (b) SCHIP.--Section 2107(e)(1) of such Act (42 U.S.C. 
     1397gg(e)(1)), as amended by section 202(b), is amended by 
     redesignating subparagraphs (D) and (E) as subparagraph (E) 
     and (F), respectively, and by inserting after subparagraph 
     (C) the following new subparagraph:
       ``(D) Section 1903(v)(4) (relating to optional coverage of 
     categories of lawfully residing immigrant children), but only 
     if the State has elected to apply such section to the 
     category of children under title XIX.''.
       (c) Effective Date.--The amendments made by this section 
     take effect on October 1, 2007, and apply to medical 
     assistance and child health assistance furnished on or after 
     such date.
       (d) Construction.--Nothing in this section shall be 
     construed as affecting eligibility of aliens who are not 
     lawfully residing in the United States to benefits under the 
     Medicaid program under title XIX of the Social Security Act 
     or under the State children's health insurance program 
     (SCHIP) under title XXI of such Act.

     SEC. 206. AUTHORIZING ADJUSTMENT OF SCHIP ALLOTMENT DUE TO 
                   INCREASED OUTREACH.

       (a) In General.--Section 2104 of the Social Security Act 
     (42 U.S.C. 1397dd), as amended by section 101, is further 
     amended by adding at the end the following new subsection:
       ``(j) Authorizing Allotment Adjustment Due to Increased 
     Outreach.--
       ``(1) In general.--Notwithstanding the previous provisions 
     of this section, if the Secretary determines that--
       ``(A) a State has an increase in the average number of 
     children enrolled under its State child health plan in a 
     fiscal year that exceeds the enrollment of children projected 
     under paragraph (2) for the State for such fiscal year, and
       ``(B) the total Federal expenditures under the State child 
     health plan (or waiver) under this title exceeds the amount 
     of the allotment made available to the State for the fiscal 
     year,
     the Secretary shall increase the allotment under this section 
     for the State for the fiscal year by the amount specified in 
     paragraph (3). There are hereby appropriated, out of any 
     money in the Treasury not otherwise appropriated, such sums 
     as may be necessary to provide for such increase in 
     allotment.
       ``(2) Projected enrollment of children.--The projected 
     enrollment of children for a State under this paragraph for a 
     fiscal year is equal to the average number of children 
     enrolled under the State child health plan in fiscal year 
     2007 increased, for each subsequent fiscal year through the 
     fiscal year involved, by a factor equal to the population 
     growth of children in the State for such fiscal year, as 
     projected by the Secretary before the beginning of the fiscal 
     year involved.
       ``(3) Amount of allotment increase.--
       ``(A) In general.--Subject to subparagraph (B), the amount 
     of the allotment increase under this subsection for a State 
     for a fiscal year shall be an amount equal to the product 
     of--
       ``(i) the number by which the average number of children 
     enrolled under the State child health plan in the fiscal year 
     exceeds the enrollment of children projected under paragraph 
     (2) for such State for such fiscal year; and
       ``(ii) the per capita expenditures for children under the 
     State child health plan for the previous year, increased by 
     the average annual rate of increase (for the three previous 
     fiscal years) in the amount of such per capita expenditures.
     The amount of the allotment increase under this subsection 
     shall not be subject to administrative or judicial review.
       ``(B) Limitation.--
       ``(i) In general.--Subject to clause (ii), in no case shall 
     the sum of the allotment increases for all States under this 
     subsection for a fiscal year exceed an amount equal to 20 
     percent of the total Federal payments to all of the States 
     otherwise made under this title for the fiscal year. If such 
     sum exceeds such amount, subject to clause (ii), the 
     allotment increase for each State under this subsection for 
     the fiscal year shall be reduced in a pro rata manner in 
     order that such sum does not exceed such amount.
       ``(ii) Congressional approval of additional amounts.--If 
     the Secretary estimates that the allotment increases that 
     should be provided under this subsection, but for clause (i), 
     would exceed the limitation established under such clause, 
     the Secretary shall submit to Congress a request for 
     supplemental appropriations for the purpose of meeting such 
     shortfall.
       ``(4) Clarification.--An adjustment in an allotment shall 
     not be made under this subsection due to excess State 
     expenditures resulting from a growth in per capita costs, 
     increased reimbursement to providers, or other factors not 
     directly related to outreach to eligible, but previously 
     unenrolled children.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall take effect beginning with allotments for fiscal year 
     2008.

     SEC. 207. MODEL OF INTERSTATE COORDINATED ENROLLMENT AND 
                   COVERAGE PROCESS.

       In order to assure continuity of coverage of low-income 
     children under the Medicaid program and the State Children's 
     Health Insurance Program (SCHIP), the Secretary of Health and 
     Human Services, in consultation with State Medicaid and SCHIP 
     directors, shall develop and disseminate a model process for 
     the coordination of the enrollment and coverage under such 
     programs of children who, because of migration of families, 
     emergency evacuations, educational needs, or otherwise, 
     frequently change their State of residency or otherwise are 
     temporarily

[[Page S5943]]

     present outside of the State of their residency.

     SEC. 208. AUTHORITY FOR QUALIFYING STATES TO USE PORTION OF 
                   SCHIP ALLOTMENT FOR ANY FISCAL YEAR FOR CERTAIN 
                   MEDICAID EXPENDITURES.

       Section 2105(g)(1)(A) of the Social Security Act (42 U.S.C. 
     1397ee(g)(1)(A)), as amended by section 201(b) of the 
     National Institutes of Health Reform Act of 2006 (Public Law 
     109-482) is amended by striking ``fiscal year 1998, 1999, 
     2000, 2001, 2004, 2005, 2006, or 2007'' and inserting ``a 
     fiscal year''.

     SEC. 209. APPLICATION OF MEDICAID OUTREACH PROCEDURES TO ALL 
                   PREGNANT WOMEN AND CHILDREN.

       (a) In General.--Section 1902(a)(55) of the Social Security 
     Act (42 U.S.C. 1396a(a)(55)) is amended by striking 
     ``individuals for medical assistance under subsection 
     (a)(10)(A)(i)(IV), (a)(10)(A)(i)(VI), (a)(10)(A)(i)(VII), or 
     (a)(10)(A)(ii)(IX)'' and inserting ``child and pregnant women 
     for medical assistance (including under clauses (i)(IV), 
     (i)(VI), (i)(VII), and (ii)(IX) of paragraph (10)(A))''.
       (b) Effective Date.--
       (1) In general.--
       (2) Exception for state legislation.--In the case of a 
     State plan under title XIX of the Social Security Act, which 
     the Secretary of Health and Human Services determines 
     requires State legislation in order for the plan to meet the 
     additional requirements imposed by the amendment made by 
     subsection (a), the State plan shall not be regarded as 
     failing to comply with the requirements of such Act solely on 
     the basis of its failure to meet these additional 
     requirements before the first day of the first calendar 
     quarter beginning after the close of the first regular 
     session of the State legislature that begins after the date 
     of enactment of this Act. For purposes of the previous 
     sentence, in the case of a State that has a 2-year 
     legislative session, each year of the session shall be 
     considered to be a separate regular session of the State 
     legislature.

     SEC. 210. NO IMPACT ON SECTION 1115 WAIVERS.

       Nothing in this Act shall be construed to affect State 
     flexibility on eligibility and waivers approved by the 
     Federal government under section 1115 of the Social Security 
     Act (42 U.S.C. 1315).

     SEC. 211. ELIMINATION OF COUNTING MEDICAID CHILD PRESUMPTIVE 
                   ELIGIBILITY COSTS AGAINST TITLE XXI ALLOTMENT.

       Section 2105(a)(1) of the Social Security Act (42 U.S.C. 
     1397ee(a)(1)) is amended--
       (1) in the matter preceding subparagraph (A), by striking 
     ``(or, in the case of expenditures described in subparagraph 
     (B), the Federal medical assistance percentage (as defined in 
     the first sentence of section 1905(b)))''; and
       (2) by amending subparagraph (B) to read as follows:
       ``(B) [reserved]''.

     SEC. 212. PROHIBITING LIMITATIONS ON ENROLLMENT.

       (a) In General.--Section 2102(b)(3)(B) of the Social 
     Security Act (42 U.S.C. 1397bb(b)(3)(B)) is amended--
       (1) by striking ``and'' at the end of clause (i);
       (2) by striking the period at the end of clause (ii) and 
     inserting ``; and''; and
       (3) by adding at the end the following new clause:
       ``(iii) shall not impose, with respect to enrollment of 
     targeted low-income children under the State child health 
     plan, any enrollment cap or other numerical limitation on 
     enrollment, any waiting list, any procedures designed to 
     delay the consideration of applications for enrollment, or 
     similar limitation with respect to enrollment.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply to State child health plans as of October 1, 
     2007.

         TITLE III--ELIMINATION OF CERTAIN BARRIERS TO COVERAGE

     SEC. 301. STATE OPTION TO REQUIRE CERTAIN INDIVIDUALS TO 
                   PRESENT SATISFACTORY DOCUMENTARY EVIDENCE OF 
                   PROOF OF CITIZENSHIP OR NATIONALITY FOR 
                   PURPOSES OF ELIGIBILITY FOR MEDICAID.

       (a) In General.--Section 1902(a)(46) of the Social Security 
     Act (42 U.S.C. 1396a(a)(46)) is amended--
       (1) by inserting ``(A)'' after ``(46)'';
       (2) by adding ``and'' after the semicolon; and
       (3) by adding at the end the following new subparagraph:
       ``(B) at the option of the State and subject to section 
     1903(x), require that, with respect to an individual (other 
     than an individual described in section 1903(x)(1)) who 
     declares to be a citizen or national of the United States for 
     purposes of establishing initial eligibility for medical 
     assistance under this title (or, at State option, for 
     purposes of renewing or redetermining such eligibility to the 
     extent that such satisfactory documentary evidence of 
     citizenship or nationality has not yet been presented), there 
     is presented satisfactory documentary evidence of citizenship 
     or nationality of the individual (using criteria determined 
     by the State, which shall be no more restrictive than the 
     criteria used by the Social Security Administration to 
     determine citizenship, and which shall accept as such 
     evidence a document issued by a federally recognized Indian 
     tribe evidencing membership or enrollment in, or affiliation 
     with, such tribe (such as a tribal enrollment card or 
     certificate of degree of Indian blood, and, with respect to 
     those federally recognized Indian tribes located within 
     States having an international border whose membership 
     includes individuals who are not citizens of the United 
     States, such other forms of documentation (including tribal 
     documentation, if appropriate) that the Secretary, after 
     consulting with such tribes, determines to be satisfactory 
     documentary evidence of citizenship or nationality for 
     purposes of satisfying the requirement of this 
     subparagraph));''.
       (b) Limitation on Waiver Authority.--Notwithstanding any 
     provision of section 1115 of the Social Security Act (42 
     U.S.C. 1315), or any other provision of law, the Secretary 
     may not waive the requirements of section 1902(a)(46)(B) of 
     such Act (42 U.S.C. 1396a(a)(46)(B)) with respect to a State.
       (c) Conforming Amendments.--Section 1903 of such Act (42 
     U.S.C. 1396b) is amended--
       (1) in subsection (i)--
       (A) in paragraph (20), by adding ``or'' after the 
     semicolon;
       (B) in paragraph (21), by striking ``; or'' and inserting a 
     period; and
       (C) by striking paragraph (22); and
       (2) in subsection (x) (as amended by section 405(c)(1)(A) 
     of division B of the Tax Relief and Health Care Act of 2006 
     (Public Law 109-432))--
       (A) by striking paragraphs (1) and (3);
       (B) by redesignating paragraph (2) as paragraph (1);
       (C) in paragraph (1), as so redesignated, by striking 
     ``paragraph (1)'' and inserting ``section 1902(a)(46)(B)''; 
     and
       (D) by adding at the end the following new paragraphs:
       ``(2) In the case of an individual declaring to be a 
     citizen or national of the United States with respect to whom 
     a State requires the presentation of satisfactory documentary 
     evidence of citizenship or nationality under section 
     1902(a)(46)(B), the individual shall be provided at least the 
     reasonable opportunity to present satisfactory documentary 
     evidence of citizenship or nationality under this subsection 
     as is provided under clauses (i) and (ii) of section 
     1137(d)(4)(A) to an individual for the submittal to the State 
     of evidence indicating a satisfactory immigration status.
       ``(3)(A) In addition to the criteria established by the 
     State for purposes of section 1902(a)(46)(B), a State shall 
     deem presentation of the following documents to be 
     `satisfactory documentary evidence of citizenship or 
     nationality' (and shall not favor presentation of 1 type of 
     document described over another):
       ``(i) Any document described in subparagraph (B).
       ``(ii) Any document described in subparagraph (C) when 
     presented with any document described in subparagraph (D).
       ``(iii) Any document described in subparagraph (E) if the 
     requirements of that subparagraph are met.
       ``(B) The following are documents described in this 
     subparagraph:
       ``(i) A United States passport.
       ``(ii) Form N-550 or N-570 (Certificate of Naturalization).
       ``(iii) Form N-560 or N-561 (Certificate of United States 
     Citizenship).
       ``(iv) A valid State-issued driver's license or other 
     identity document described in section 274A(b)(1)(D) of the 
     Immigration and Nationality Act, but only if the State 
     issuing the license or such document requires proof of United 
     States citizenship before issuance of such license or 
     document or obtains a social security number from the 
     applicant and verifies before certification that such number 
     is valid and assigned to the applicant who is a citizen.
       ``(v) Such other document as the Secretary may specify, by 
     regulation, that provides proof of United States citizenship 
     or nationality and that provides a reliable means of 
     documentation of personal identity.
       ``(C) The following are documents described in this 
     subparagraph:
       ``(i) A certificate of birth in the United States.
       ``(ii) Form FS-545 or Form DS-1350 (Certification of Birth 
     Abroad).
       ``(iii) Form I-197 (United States Citizen Identification 
     Card).
       ``(iv) Form FS-240 (Report of Birth Abroad of a Citizen of 
     the United States).
       ``(v) Such other document (not described in subparagraph 
     (B)(iv)) as the Secretary may specify that provides proof of 
     United States citizenship or nationality.
       ``(D) The following are documents described in this 
     subparagraph:
       ``(i) Any identity document described in section 
     274A(b)(1)(D) of the Immigration and Nationality Act.
       ``(ii) Any other documentation of personal identity of such 
     other type as the Secretary finds, by regulation, provides a 
     reliable means of identification.
       ``(E) A document described in this subparagraph is an 
     affidavit of citizenship or identity, or both, which need not 
     be notarized or witnessed, but only if the individual has 
     been unable to acquire other satisfactory documentary 
     evidence within the reasonable opportunity period established 
     by the State, despite a good faith effort to do so. An 
     individual shall be deemed unable to acquire such documentary 
     evidence--
       ``(i) if there is good reason to believe that such 
     documentary evidence does not exist;
       ``(ii) if, after a timely request for such documentary 
     evidence, it has not been received by the State or the 
     individual within the reasonable opportunity period 
     established by the State;

[[Page S5944]]

       ``(iii) if such documentary evidence cannot be acquired at 
     a nominal cost to the individual; or
       ``(iv) in such additional situations as the Secretary may 
     describe.
       ``(F)(i) A reference in this paragraph to a form includes a 
     reference to any successor form.
       ``(ii) Any legible copy of a form described in this 
     paragraph shall be accepted as if it were the original of 
     such form.''.
       (d) Clarification of Rules for Children Born in the United 
     States to Mothers Eligible for Medicaid.--Section 1903(x) of 
     such Act (42 U.S.C. 1396b(x)), as amended by subsection 
     (c)(2), is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (C), by striking ``or'' at the end;
       (B) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (C) by inserting after subparagraph (C) the following new 
     subparagraph:
       ``(D) pursuant to the application of section 1902(e)(4) 
     (and, in the case of an individual who is eligible for 
     medical assistance on such basis, the individual shall be 
     deemed to have provided satisfactory documentary evidence of 
     citizenship or nationality and shall not be required to 
     provide further documentary evidence on any date that occurs 
     during or after the period in which the individual is 
     eligible for medical assistance on such basis); or''; and
       (2) by adding at the end the following new paragraph:
       ``(4) Nothing in subparagraph (A) or (B) of section 
     1902(a)(46), the preceding paragraphs of this subsection, or 
     the Deficit Reduction Act of 2005, including section 6036 of 
     such Act, shall be construed as changing the requirement of 
     section 1902(e)(4) that a child born in the United States to 
     an alien mother for whom medical assistance for the delivery 
     of such child is available as treatment of an emergency 
     medical condition pursuant to subsection (v) shall be deemed 
     eligible for medical assistance during the first year of such 
     child's life.''.
       (e) Effective Date.--
       (1) Retroactive application.--The amendments made by this 
     section shall take effect as if included in the enactment of 
     the Deficit Reduction Act of 2005 (Public Law 109-171; 120 
     Stat. 4).
       (2) Restoration of eligibility.--In the case of an 
     individual who, during the period that began on July 1, 2006, 
     and ends on the date of enactment of this Act, was determined 
     to be ineligible for medical assistance under a State 
     Medicaid program solely as a result of the application of 
     subsections (i)(22) and (x) of section 1903 of the Social 
     Security Act (as in effect during such period), but who would 
     have been determined eligible for such assistance if such 
     subsections, as amended by this section, had applied to the 
     individual, a State may deem the individual to be eligible 
     for such assistance as of the date that the individual was 
     determined to be ineligible for such medical assistance on 
     such basis.

     SEC. 302. INCREASED FEDERAL MATCHING RATE FOR LANGUAGE 
                   SERVICES PROVIDED UNDER MEDICAID OR SCHIP.

       (a) In General.--Section 1903(a)(3) of the Social Security 
     Act (42 U.S.C. 1396b(a)(3)) is amended--
       (1) in subparagraph (E)(ii), by striking ``plus'' at the 
     end; and
       (2) by adding at the end the following:
       ``(3) 85 percent of the sums expended with respect to costs 
     incurred during such quarter as are attributable to the 
     provision of language services on behalf of individuals with 
     limited English proficiency who apply for or receive medical 
     assistance under the State plan (including any provisions of 
     the plan implemented pursuant to any waiver authority of the 
     Secretary) or child health assistance under title XXI; 
     plus''.
       (b) Effective Date.--The amendments made by subsection (a) 
     take effect on October 1, 2007, and apply to language 
     services provided on or after that date.

 TITLE IV--GRANTS TO PROMOTE INNOVATIVE OUTREACH AND ENROLLMENT UNDER 
                           MEDICAID AND SCHIP

     SEC. 401. GRANTS TO PROMOTE INNOVATIVE OUTREACH AND 
                   ENROLLMENT UNDER MEDICAID AND SCHIP.

       Title XXI of the Social Security Act (42 U.S.C. 1397aa et 
     seq.), as amended by section 204(b), is amended by adding at 
     the end the following:

     ``SEC. 2112. EXPANDED OUTREACH AND ENROLLMENT ACTIVITIES.

       ``(a) Grants to Conduct Innovative Outreach and Enrollment 
     Efforts.--
       ``(1) In general.--The Secretary shall award grants to 
     eligible entities to--
       ``(A) conduct innovative outreach and enrollment efforts 
     that are designed to increase the enrollment and 
     participation of eligible children under this title and title 
     XIX; and
       ``(B) promote understanding of the importance of health 
     insurance coverage for prenatal care and children.
       ``(2) Performance bonuses.--The Secretary may reserve a 
     portion of the funds appropriated under subsection (g) for a 
     fiscal year for the purpose of awarding performance bonuses 
     during the succeeding fiscal year to eligible entities that 
     meet enrollment goals or other criteria established by the 
     Secretary.
       ``(b) Priority for Award of Grants.--
       ``(1) In general.--In making grants under subsection 
     (a)(1), the Secretary shall give priority to--
       ``(A) eligible entities that propose to target geographic 
     areas with high rates of--
       ``(i) eligible but unenrolled children, including such 
     children who reside in rural areas; or
       ``(ii) racial and ethnic minorities and health disparity 
     populations, including those proposals that address cultural 
     and linguistic barriers to enrollment; and
       ``(B) eligible entities that plan to engage in outreach 
     efforts with respect to individuals described in subparagraph 
     (A) and that are--
       ``(i) Federal health safety net organizations; or
       ``(ii) faith-based organizations or consortia.
       ``(2) 10 percent set aside for outreach to indian 
     children.--An amount equal to 10 percent of the funds 
     appropriated under subsection (g) for a fiscal year shall be 
     used by the Secretary to award grants to Indian Health 
     Service providers and urban Indian organizations receiving 
     funds under title V of the Indian Health Care Improvement Act 
     (25 U.S.C. 1651 et seq.) for outreach to, and enrollment of, 
     children who are Indians.
       ``(c) Application.--An eligible entity that desires to 
     receive a grant under subsection (a)(1) shall submit an 
     application to the Secretary in such form and manner, and 
     containing such information, as the Secretary may decide. 
     Such application shall include--
       ``(1) quality and outcomes performance measures to evaluate 
     the effectiveness of activities funded by a grant awarded 
     under this section to ensure that the activities are meeting 
     their goals; and
       ``(2) an assurance that the entity shall--
       ``(A) conduct an assessment of the effectiveness of such 
     activities against such performance measures; and
       ``(B) cooperate with the collection and reporting of 
     enrollment data and other information determined as a result 
     of conducting such assessments to the Secretary, in such form 
     and manner as the Secretary shall require.
       ``(d) Dissemination of Enrollment Data and Information 
     Determined From Effectiveness Assessments; Annual Report.--
     The Secretary shall--
       ``(1) disseminate to eligible entities and make publicly 
     available the enrollment data and information collected and 
     reported in accordance with subsection (c)(2)(B); and
       ``(2) submit an annual report to Congress on the outreach 
     activities funded by grants awarded under this section.
       ``(e) Supplement, Not Supplant.--Federal funds awarded 
     under this section shall be used to supplement, not supplant, 
     non-Federal funds that are otherwise available for activities 
     funded under this section.
       ``(f) Definitions.--In this section:
       ``(1) Eligible entity.--The term `eligible entity' means 
     any of the following:
       ``(A) A State or local government.
       ``(B) A Federal health safety net organization.
       ``(C) A national, local, or community-based public or 
     nonprofit private organization, including organizations that 
     use community health workers or community-based doula 
     programs.
       ``(D) A faith-based organization or consortia, to the 
     extent that a grant awarded to such an entity is consistent 
     with the requirements of section 1955 of the Public Health 
     Service Act (42 U.S.C. 300x-65) relating to a grant award to 
     non-governmental entities.
       ``(E) An elementary or secondary school.
       ``(2) Federal health safety net organization.--The term 
     `Federal health safety net organization' means--
       ``(A) an Indian tribe, tribal organization, or an urban 
     Indian organization receiving funds under title V of the 
     Indian Health Care Improvement Act (25 U.S.C. 1651 et seq.), 
     or an Indian Health Service provider;
       ``(B) a Federally-qualified health center (as defined in 
     section 1905(l)(2)(B));
       ``(C) a hospital defined as a disproportionate share 
     hospital for purposes of section 1923;
       ``(D) a covered entity described in section 340B(a)(4) of 
     the Public Health Service Act (42 U.S.C. 256b(a)(4)); and
       ``(E) any other entity or a consortium that serves children 
     under a federally-funded program, including the special 
     supplemental nutrition program for women, infants, and 
     children (WIC) established under section 17 of the Child 
     Nutrition Act of 1966 (42 U.S.C. 1786), the head start and 
     early head start programs under the Head Start Act (42 U.S.C. 
     9801 et seq.), the school lunch program established under the 
     Richard B. Russell National School Lunch Act, and an 
     elementary or secondary school.
       ``(3) Indians; indian tribe; tribal organization; urban 
     indian organization.--The terms `Indian', `Indian tribe', 
     `tribal organization', and `urban Indian organization' have 
     the meanings given such terms in section 4 of the Indian 
     Health Care Improvement Act (25 U.S.C. 1603).
       ``(g) Appropriation.--There is appropriated, out of any 
     money in the Treasury not otherwise appropriated, $50,000,000 
     for each of fiscal years 2008 through 2012 for the purpose of 
     awarding grants under this section. Amounts appropriated and 
     paid under the authority of this section shall be in addition 
     to amounts appropriated under section 2104 and paid to States 
     in accordance with section 2105, including with respect to 
     expenditures for outreach activities in accordance with 
     subsection (a)(1)(D)(iii) of such section.''.

[[Page S5945]]

            TITLE V--IMPROVING THE QUALITY OF PEDIATRIC CARE

     SEC. 501. REQUIRING COVERAGE OF EPSDT SERVICES, INCLUDING 
                   DENTAL SERVICES; STATE OPTION TO PROVIDE 
                   SUPPLEMENTAL COVERAGE OF DENTAL SERVICES.

       (a) Additional Required Services.--
       (1) Required coverage of epsdt services, including dental 
     services.--Section 2103(c) of the Social Security Act (42 
     U.S.C. 1397cc(c)) is amended--
       (A) by redesignating paragraph (5) as paragraph (6); and
       (B) by inserting after paragraph (4), the following:
       ``(5) Other required services.--The child health assistance 
     provided to a targeted low-income child shall include 
     coverage of early and periodic screening, diagnostic, and 
     treatment services described in subsections (a)(4)(B) and (r) 
     of section 1905 and provided in accordance with section 
     1903(a)(43) (including dental services that are necessary to 
     prevent disease and promote oral health, restore oral 
     structures to health and function, and treat emergency 
     conditions).''.
       (2) State child health plan requirement.--Section 
     2102(a)(7)(B) of such Act (42 U.S.C. 1397bb(c)(2)) is amended 
     by inserting ``and services described in section 2103(c)(5)'' 
     after ``emergency services''.
       (3) Conforming amendment.--Section 2103(a) of such Act (42 
     U.S.C. 1397cc(a)) is amended, in the matter preceding 
     paragraph (1), by striking ``subsection (c)(5)'' and 
     inserting ``paragraphs (5) and (6) of subsection (c)''.
       (b) State Option to Provide Supplemental Coverage of Dental 
     Services Under SCHIP to Children With Other Health 
     Coverage.--
       (1) In general.--Section 2110(b) of the Social Security Act 
     (42 U.S.C. 1397jj(b)) is amended--
       (A) in paragraph (1)(C), by inserting ``, subject to 
     paragraph (5),'' after ``under title XIX or''; and
       (B) by adding at the end the following:
       ``(5) State option to provide supplemental coverage of 
     dental services to children with other health coverage.--
       ``(A) In general.--A State may waive the requirement of 
     paragraph (1)(C) that a targeted low-income child may not be 
     covered under a group health plan or under health insurance 
     coverage in order to provide dental services that are not 
     covered, or are only partially covered, under such plan or 
     coverage. Nothing in subsection (c)(5) of section 2103 shall 
     be construed as prohibiting a State from limiting the 
     supplemental coverage of dental services provided in 
     accordance with this paragraph and nothing in paragraph (2) 
     or (3) of subsection (e) of such section shall be construed 
     as prohibiting a State from imposing premiums, deductibles, 
     cost-sharing, or similar charges for such coverage without 
     regard to the requirements of either such paragraph.
       ``(B) Eligibility.--In waiving such requirement, a State 
     may limit the application of the waiver to children whose 
     family income does not exceed a level specified by the State, 
     which may not exceed the maximum income level otherwise 
     established for other children under the State child health 
     plan.
       ``(C) Continued application of duty to prevent substitution 
     of existing coverage.--Nothing in this paragraph shall be 
     construed as modifying the application of section 
     2102(b)(3)(C) to a State.''.
       (2) Application of enhanced match under medicaid.--Section 
     1905 of such Act (42 U.S.C. 1396d) is amended--
       (A) in subsection (b), in the fourth sentence, by striking 
     ``subsection (u)(3)'' and inserting ``(u)(3), or (u)(4)''; 
     and
       (B) in subsection (u), by redesignating paragraph (4) as 
     paragraph (5) and by inserting after paragraph (3) the 
     following:
       ``(4) For purposes of subsection (b), the expenditures 
     described in this paragraph are expenditures for supplemental 
     coverage of dental services for children described in section 
     2110(b)(5).''.
       (3) Application of secondary payor provisions.--Section 
     2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)) is amended--
       (A) by redesignating subparagraphs (B) through (D) as 
     subparagraphs (C) through (E), respectively; and
       (B) by inserting after subparagraph (A) the following new 
     subparagraph:
       ``(B) Section 1902(a)(25) (relating to coordination of 
     benefits and secondary payor provisions) with respect to 
     children provided supplemental coverage of dental services 
     under a waiver described in section 2110(b)(5).''.

     SEC. 502. PEDIATRIC QUALITY AND PERFORMANCE MEASURES PROGRAM.

       Title XIX of the Social Security Act (42 U.S.C. 1396 et 
     seq.) is amended--
       (1) by redesignating section 1939 as section 1941; and
       (2) by inserting after section 1938 the following:


          ``PEDIATRIC QUALITY AND PERFORMANCE MEASURES PROGRAM

       ``Sec. 1939.  (a) Establishment.--The Secretary, acting 
     through the Administrator of the Centers for Medicare & 
     Medicaid Services and in consultation with the Director of 
     the Agency for Healthcare Research and Quality, shall 
     establish a program to encourage and support the development 
     of new and emerging quality and performance measures for 
     providers of pediatric care through the activities described 
     in subsection (c). In establishing the program, gaps in 
     existing evidence-based measures and priority areas for 
     advancement shall be identified.
       ``(b) Purpose.--The purpose of the program is to ensure 
     that--
       ``(1) evidence-based pediatric quality and performance 
     measures are developed; and
       ``(2) such measures are available for States, other 
     purchasers of pediatric health care services, health care 
     providers, and consumers to use.
       ``(c) Program Activities.--
       ``(1) Identifying quality and performance measures for 
     providers of pediatric services and opportunities for new 
     measures.--Not later than 3 months after the date of 
     enactment of this section, the Secretary shall identify 
     quality and performance measures for providers of pediatric 
     services and opportunities for the development of new 
     measures, taking into consideration existing evidence-based 
     measures. In conducting this review, the Secretary shall--
       ``(A) ensure the inclusion of at least 1 measure related to 
     children's dental and oral health; and
       ``(B) convene and consult with representatives of--
       ``(i) States;
       ``(ii) pediatric hospitals, pediatricians, and other 
     pediatric health professionals;
       ``(iii) national organizations representing--

       ``(I) consumers of children's health care; and
       ``(II) purchasers of children's health care;

       ``(iv) experts in pediatric quality and performance 
     measurement; and
       ``(v) a voluntary consensus standards setting organization 
     and other organizations involved in the advancement of 
     consensus on evidence-based measures of health care.
       ``(2) Developing, validating, and testing new measures.--
     The Secretary shall award grants or contracts to eligible 
     entities (as defined in subsection (d)(1)) for the 
     development, validation, and testing of new and emerging 
     quality and performance measures, including at least 1 
     measure related to children's dental and oral health, for 
     providers of pediatric services. Such measures shall--
       ``(A) provide consumers and purchasers (including States 
     and beneficiaries under the program under this title and 
     title XXI) with information about provider performance and 
     quality; and
       ``(B) assist health care providers in improving the quality 
     of the items and services they provide and their performance 
     with respect to the provision of such items and services.
       ``(3) Achieving consensus on evidence-based measures.--The 
     Secretary shall award grants or contracts to eligible 
     consensus entities (as defined in subsection (d)(2)) for the 
     development of consensus on evidence-based measures for 
     pediatric care, including at least 1 measure related to 
     children's dental and oral health, that have broad 
     acceptability in the health care industry.
       ``(d) Eligible Entities.--
       ``(1) Development, validation, and testing.--For purposes 
     of paragraph (2) of subsection (c), the term `eligible 
     entity' means--
       ``(A) organizations with demonstrated expertise and 
     capacity in the development and evaluation of pediatric 
     quality and performance measures;
       ``(B) an organization or association of health care 
     providers with demonstrated experience in working with 
     accrediting organizations in developing pediatric quality and 
     performance measures; and
       ``(C) a collaboration of national pediatric organizations 
     working to improve pediatric quality and performance 
     measures.
       ``(2) Achievement of consensus.--For purposes of paragraph 
     (3) of such subsection, the term `eligible consensus entity' 
     means an organization, including a voluntary consensus 
     standards setting organization involved in the advancement of 
     consensus on evidence-based measures of health care.
       ``(e) Ongoing Authority to Update and Adjust Pediatric 
     Measures.--The Secretary may update and adjust measures 
     developed and advanced under the program under this section 
     in accordance with--
       ``(1) any changes that a voluntary consensus standards 
     setting organization determines should be made with respect 
     to such measures; or
       ``(2) new evidence indicating the need for changes with 
     respect to such measures.
       ``(f) Addition of Pediatric Consumer Assessment Measures to 
     CAHPS Hospital Survey Conducted by AHRQ.--The Director of the 
     Agency for Healthcare Research and Quality shall ensure that 
     consumer assessment measures for hospital services for 
     children are added to the Consumer Assessment of Healthcare 
     Providers and Systems (CAHPS) Hospital survey conducted by 
     such Agency.
       ``(g) Appropriation.--There are authorized to be 
     appropriated and there are appropriated, for the purpose of 
     carrying out this section, $10,000,000, for each of fiscal 
     years 2008 through 2012, to remain available until 
     expended.''.

     SEC. 503. GRANTS TO STATES FOR DEMONSTRATION PROJECTS 
                   TRANSFORMING DELIVERY OF PEDIATRIC CARE.

       Title XIX of the Social Security Act (42 U.S.C. 1396 et 
     seq.), as amended by section 502, is amended by inserting 
     after section 1939 the following:


``GRANTS TO STATES FOR DEMONSTRATION PROJECTS TRANSFORMING DELIVERY OF 
                             PEDIATRIC CARE

       ``Sec. 1940.  (a) Establishment.--The Secretary, acting 
     through the Administrator of the Centers for Medicare & 
     Medicaid Services, shall establish demonstration projects,

[[Page S5946]]

     including demonstration projects in each of the 4 categories 
     described in subsection (d), to award grants to States to 
     improve the delivery of health care services provided to 
     children under this title and title XXI.
       ``(b) Duration.--The demonstration projects shall be 
     conducted for a period of 4 years.
       ``(c) Eligibility.--A State shall not be eligible to 
     receive a grant under this section unless the State has 
     demonstrated experience or commitment to the concept of 
     transformation in the delivery of pediatric care.
       ``(d) Categories of Projects.--The following categories of 
     projects are described in this subsection:
       ``(1) Health information technology systems.--Projects for 
     developing health information technology systems, including 
     technology acquisition, electronic health record development, 
     data standards development, and software development, for 
     pediatric hospital and physician services and other 
     community-based services; implementing model systems; and 
     evaluating their impact on the quality, safety, and costs of 
     care.
       ``(2) Disease management.--Projects for providing provider-
     based care disease management for children with chronic 
     conditions (including physical, developmental, behavioral, 
     and psychological conditions), demonstrating the 
     effectiveness of provider-based management models in 
     promoting better care, reducing adverse health outcomes, and 
     preventing avoidable hospitalizations.
       ``(3) Evidence-based quality improvements.--Projects for 
     implementing evidence-based approaches to improving 
     efficiency, safety, and effectiveness in the delivery of 
     hospital care for children across hospital services, 
     evaluating the translation of successful models of such 
     evidence-based approaches to other institutions, and the 
     impact of such changes on the quality, safety, and costs of 
     care.
       ``(4) Quality and performance measures for providers of 
     children's health care services.--Projects to pilot test 
     evidence-based pediatric quality and performance measures for 
     inpatient hospital services, physician services, or services 
     of other health professionals, determining the reliability, 
     feasibility, and validity of such measures, and evaluating 
     their potential impact on improving the quality and delivery 
     of children's health care. To the extent feasible, such 
     measures shall have been approved by consensus standards 
     setting organizations.
       ``(e) Uniform Metrics.--The Secretary shall establish 
     uniform metrics (adjusted, as appropriate, for patient 
     acuity), collect data, and conduct evaluations with respect 
     to each demonstration project category described in 
     subsection (d). In establishing such metrics, collecting such 
     data, and conducting such evaluations, the Secretary shall 
     consult with--
       ``(1) experts in each such demonstration project category;
       ``(2) participating States;
       ``(3) national pediatric provider organizations;
       ``(4) health care consumers; and
       ``(5) such other entities or individuals with relevant 
     expertise as the Secretary determines appropriate.
       ``(f) Evaluation and Report.--The Secretary shall evaluate 
     the demonstration projects conducted under this section and 
     submit a report to Congress not later than 3 months before 
     the completion of each demonstration project that includes 
     the findings of the evaluation and recommendations with 
     respect to--
       ``(1) expansion of the demonstration project to additional 
     States and sites; and
       ``(2) the broader implementation of approaches identified 
     as being successful in advancing quality and performance in 
     the delivery of medical assistance provided to children under 
     this title and title XXI.
       ``(g) Waiver.--The Secretary may waive the requirements of 
     this title and title XXI to the extent necessary to carry out 
     the demonstration projects under this section.
       ``(h) Amounts Paid to a State.--Amounts paid to a State 
     under this section--
       ``(1) shall be in addition to Federal payments made to the 
     State under section 1903(a);
       ``(2) shall not be used for the State share of any 
     expenditures claimed for payment under such section; and
       ``(3) shall be used only for expenditures of the State for 
     participating in the demonstration projects, or for 
     expenditures of providers in participating in the 
     demonstration projects, including--
       ``(A) administrative costs of States and participating 
     providers (such as costs associated with the design and 
     evaluation of, and data collection under, the demonstration 
     projects); and
       ``(B) such other expenditures that are not otherwise 
     eligible for reimbursement under this title or title XXI as 
     the Secretary may determine appropriate.
       ``(i) Appropriation.--There are authorized to be 
     appropriated and there are appropriated, for the purpose of 
     carrying out this section, to remain available until expended 
     $10,000,000 for each of fiscal years 2008 through 2012.''.

     SEC. 504. REPORT BY THE COMPTROLLER GENERAL ON DESIGN AND 
                   IMPLEMENTATION OF A DEMONSTRATION PROJECT 
                   EVALUATING EXISTING QUALITY AND PERFORMANCE 
                   MEASURES FOR CHILDREN'S INPATIENT HOSPITAL 
                   SERVICES.

       (a) In General.--Not later than 12 months after the date of 
     enactment of this Act, the Comptroller General of the United 
     States (in this section referred to as the ``Comptroller 
     General'') shall submit a report to Congress containing 
     recommendations for the design and implementation of a 
     demonstration project to evaluate the suitability of existing 
     quality and performance measures for children's inpatient 
     hospital services for public reporting, differentiating 
     quality, identifying best practices, and providing a basis 
     for payment rewards.
       (b) Development of Recommendations.--In developing the 
     recommendations submitted under subsection (a), the 
     Comptroller General shall accomplish the following:
       (1) Consider which agency within the Department of Health 
     and Human Services should have primary responsibility and 
     oversight for such a demonstration project.
       (2) Determine a sufficient number of participating 
     hospitals and volume of children's cases, given existing 
     measures that might be chosen for evaluation under such a 
     demonstration project.
       (3) Determine the number of States and variety of 
     geographic locations that may be required to conduct such a 
     demonstration project.
       (4) Describe alternatives for administering and directing 
     funding for such a demonstration project, taking into 
     consideration the potential involvement of multiple States, 
     State plans under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.), and State child health plans under 
     title XXI of such Act (42 U.S.C. 1397aa et seq.). Such 
     description shall be included in the recommendations 
     submitted under subsection (a).
       (5) Determine requirements for consistency in measures, 
     metrics, and risk adjustment for such a demonstration 
     project, across hospitals and across State lines.
       (6) Consider the infrastructure requirements involved in 
     public reporting of quality and performance measures for 
     children's inpatient hospital services at the national and 
     State levels, including the requirements involved with 
     respect to maintaining such measures and data.
       (7) Estimate the cost of undertaking such a demonstration 
     project.
       (c) Suggestion of Existing Measures for Evaluation Under 
     the Demonstration Project.--
       (1) In general.--The report submitted under subsection (a) 
     shall include suggestions for existing measures to be 
     evaluated under the demonstration project recommended in such 
     report, including, to the extent feasible, measures with 
     respect to--
       (A) high volume pediatric inpatient conditions;
       (B) high cost pediatric inpatient services;
       (C) pediatric conditions with predicted high morbidities; 
     and
       (D) pediatric cases at high risk of patient safety 
     failures.
       (2) Suggested measures.--The measures suggested under 
     paragraph (1) shall be measures representing process, 
     structure, patient outcomes, or patient and family 
     experience--
       (A) that are evidence-based;
       (B) that are feasible to collect and report;
       (C) that include a mechanism for risk adjustment when 
     necessary; and
       (D) for which there is a consensus within the pediatric 
     hospital community or a consensus determined by a voluntary 
     consensus standards setting organization involved in the 
     advancement of evidence-based measures of health care.
       (3) Consultation.--In determining the existing measures 
     suggested under paragraph (1), the Comptroller General shall 
     consult with representatives of the following:
       (A) National associations of pediatric hospitals and 
     pediatric health professionals.
       (B) Experts in pediatric quality and performance 
     measurement.
       (C) Voluntary consensus standards setting organizations and 
     other organizations involved in the advancement of consensus 
     on evidence-based measures.
       (D) The Department of Health and Human Services, States, 
     and other purchasers of health care items and services.

     SEC. 505. MEDICAL HOME DEMONSTRATION PROJECT.

       (a) Establishment.--
       (1) In general.--The Secretary of Health and Human Services 
     (in this section referred to as the ``Secretary'') shall 
     establish a medical home demonstration project (in this 
     section referred to as the ``project'') under titles XIX and 
     XXI of the Social Security Act (42 U.S.C. 1396 et seq.; 
     1397aa et seq.) to redesign the health care delivery system 
     by providing targeted, accessible, continuous, coordinated, 
     and family-centered care to eligible individuals.
       (2) Eligible individuals defined.--In this section, the 
     term ``eligible individual'' means an individual who--
       (A) is receiving child health assistance under a State 
     child health plan implemented under title XXI of the Social 
     Security Act (42 U.S.C. 1397aa et seq.), title XIX of such 
     Act (42 U.S.C. 1396 et seq.), or both such titles; and
       (B) is a member of a high need population (as determined by 
     the Secretary).
       (3) Project goals.--The project shall be designed in order 
     to determine whether, and if so, the extent to which, medical 
     homes accomplish the following:
       (A) Increase--
       (i) cost efficiencies of health care delivery;
       (ii) access to appropriate health care services;
       (iii) patient satisfaction;
       (iv) school attendance; and

[[Page S5947]]

       (v) the quality of health care services provided, as 
     determined based on measures of quality the Secretary 
     determines are broadly accepted in the health care community.
       (B) Decrease--
       (i) inappropriate emergency room utilization; and
       (ii) duplication of health care services provided.
       (C) Provide appropriate--
       (i) preventive care; and
       (ii) referrals to multidisciplinary services.
       (b) Project Design.--
       (1) Duration.--The project shall be conducted for a 5 year 
     period.
       (2) Sites.--
       (A) In general.--The project shall be conducted in 8 States 
     on a State-wide basis.
       (B) Application.--A State seeking to participate in the 
     project shall submit an application to the Secretary at such 
     time, in such manner, and containing such information as the 
     Secretary may require.
       (3) Conduct of project.--
       (A) Agreements with academic institutions.--A participating 
     State may enter into an agreement with an academic 
     institution in order to have the institution conduct the 
     project, provide technical assistance and monitoring, and to 
     participate in the evaluation of the project under subsection 
     (e)(1).
       (B) Choice of participating physician practices.--
       (i) In general.--A participating State shall establish 
     procedures for physician practices to participate in the 
     project by providing coordinated care to eligible 
     individuals. Such participation shall be on a voluntary 
     basis.
       (ii) Standards for participating physician practices.--The 
     procedures established under clause (i) shall encourage 
     physician practices participating in the project to 
     demonstrate that they have--

       (I) identified care coordinators, family resource guides, 
     family advisors, and a family advisory committee;
       (II) developed care plans for eligible individuals; and
       (III) taken such other actions as the State determines 
     appropriate in order to provide coordinated care to eligible 
     individuals.

       (c) Project Requirements.--Each participating State shall 
     establish procedures in order to ensure that the following 
     requirements are met:
       (1) Each eligible individual in the State who is enrolled 
     in the project is provided a medical home with access to 
     appropriate medical care.
       (2) Each medical home in the State that is participating in 
     the project--
       (A) provides for physician-directed care coordination;
       (B) uses health information technology (including patient 
     registry systems, clinical decision support tools, remote 
     monitoring, and electronic medical record systems);
       (C) communicates with physician practices participating in 
     the project, eligible individuals receiving health care 
     through the medical home, and other health care providers (as 
     appropriate) with respect to health matters, including 
     through electronic mail and telephone consultations;
       (D) makes arrangements with teams of other health 
     professionals, including care coordinators, and facilitates 
     linkages to community resources to extend access to the full 
     spectrum of health care services that eligible individuals 
     require;
       (E) establishes networks with community practices, 
     hospitals, and community health care providers to facilitate 
     the exchange of ideas and resources in order to improve 
     project outcomes; and
       (F) acts as a facilitator in order to ensure that eligible 
     individuals enrolled in the medical home under the project 
     receive high-quality care at the appropriate time and place 
     in a cost-effective manner.
       (3) The State provides payment (in accordance with 
     subsection (d)) and appropriate support for physician-
     directed care coordination services provided to eligible 
     individuals under the project.
       (d) Payment.--
       (1) In general.--The Secretary shall establish a structure 
     for payments to participating States for the cost of services 
     provided under the project. Such structure shall provide 
     payments based on the performance of medical homes located in 
     the State in achieving quality and efficiency goals (as 
     defined by the Secretary).
       (2) Payments for health information technology.--
       (A) In general.--The Secretary shall establish a 
     prospective, bundled, and risk adjusted structural practice 
     payment to cover health information technology expenses 
     incurred by medical homes under the project.
       (B) In general.--Such payments shall take into account any 
     expenses the medical home incurs in order to acquire and 
     utilize health information technology, such as clinical 
     decision support tools, patient registries, and electronic 
     medical records.
       (3) Payments for physician work outside of office visits.--
     The Secretary shall establish a prospective, bundled, and 
     risk adjusted structural care coordination payment that 
     represents the value of physician work provided to eligible 
     individuals under the project that is done outside of any 
     office visits.
       (e) Evaluation and Report.--
       (1) Evaluation.--The Secretary, in consultation with 
     appropriate pediatric medical associations, shall evaluate 
     the project in order to determine the effectiveness of 
     medical homes in terms of quality improvement, patient and 
     provider satisfaction, and the improvement of health 
     outcomes.
       (2) Report.--Not later than 12 months after completion of 
     the project, the Secretary shall submit to Congress a report 
     on the project containing the results of the evaluation 
     conducted under paragraph (1), together with recommendations 
     for such legislation and administrative action as the 
     Secretary determines to be appropriate.
       (f) Funding.--
       (1) In general.--There are authorized to be appropriated, 
     such sums as may be necessary to carry out this section.
       (2) Prohibition.--Amounts paid to a State under the project 
     shall not be used for purposes of claiming a Federal matching 
     payment under section 1903(a) or 2105(a) of the Social 
     Security Act (42 U.S.C. 1396b(a); 1397ee(a)).
       (g) Waiver.--The Secretary shall waive compliance with such 
     requirements of titles XIX and XXI of the Social Security Act 
     (42 U.S.C. 1396 et seq.; 1397aa et seq.) to the extent and 
     for the period the Secretary finds necessary to conduct the 
     project.

     SEC. 506. DISEASE PREVENTION AND TREATMENT DEMONSTRATION 
                   PROJECTS FOR ETHNIC AND RACIAL MINORITY 
                   CHILDREN.

       (a) Definitions.--In this section:
       (1) Child.--The term ``child'' has the meaning given such 
     term in section 2110(c)(1) of the Social Security Act (42 
     U.S.C. 1397jj(c)(1)).
       (2) Medicaid.--The term ``Medicaid'' means the program 
     established under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.).
       (3) Projects.--The term ``projects'' means the 
     demonstration projects established under subsection (b)(1).
       (4) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (5) SCHIP.--The term ``SCHIP'' means the State Children's 
     Health Insurance Program established under title XXI of the 
     Social Security Act (42 U.S.C. 1397aa et seq.).
       (6) Target individual.--
       (A) In general.--The term ``target individual'' means a 
     child--
       (i) who is a member of a racial and ethnic minority group; 
     and
       (ii) who is enrolled in a State Medicaid program or a State 
     child health plan under SCHIP.
       (B) Racial and ethnic minority group.--The term ``racial 
     and ethnic minority group'' has the meaning given such term 
     in section 1707(g)(1) of the Public Health Service Act (42 
     U.S.C. 300u-6(1)).
       (b) Demonstration Projects.--
       (1) Establishment.--The Secretary shall establish 
     demonstration projects for the purpose of developing models 
     and evaluating methods that--
       (A) improve the quality of medical assistance and child 
     health assistance provided to target individuals under 
     Medicaid and SCHIP in order to reduce disparities in the 
     provision of health care services;
       (B) improve clinical outcomes, satisfaction, quality of 
     life, and the appropriate use of services covered and 
     referral patterns under Medicaid and SCHIP among target 
     individuals;
       (C) eliminate disparities in the rate of preventive 
     measures, such as well child visits and immunizations, among 
     target individuals; and
       (D) promote collaboration with community-based 
     organizations to ensure cultural competency of health care 
     professionals and linguistic access for persons with limited 
     English proficiency.
       (2) Design.--
       (A) Initial design.--Not later than 1 year after the date 
     of enactment of this Act, the Secretary shall--
       (i) evaluate best practices in the private sector, 
     community programs, and academic research with respect to 
     methods for reducing health care disparities among target 
     individuals; and
       (ii) design the projects based on such evaluation.
       (B) Number and project areas.--
       (i) In general.--Not later than 2 years after the date of 
     enactment of this Act, the Secretary shall implement not less 
     than 9 projects, including the following:

       (I) Two projects for each of the 4 following racial and 
     ethnic minority groups:

       (aa) American Indians, including Alaskan Natives, Eskimos, 
     and Aleuts.
       (bb) Asian Americans and Pacific Islanders.
       (cc) Blacks.
       (dd) Hispanics (as defined in section 1707(g)(2) of the 
     Public Health Service Act (42 U.S.C. 300u-6(g)(2)).

       (II) One project within Puerto Rico.

       (ii) Subpopulations.--The 2 projects implemented for the 
     groups described in clause (i)(I) shall each target different 
     ethnic subpopulations within such groups.
       (iii) Rural and inner-city areas.--Not less than 1 of the 
     projects implemented under clause (i)(I) shall be conducted 
     in a rural area and not less than 1 of such projects shall be 
     conducted in an inner-city area.
       (c) Reports to Congress.--
       (1) In general.--Not later than 2 years after the date on 
     which the Secretary initially implements the projects, and 
     biannually thereafter for the duration of the projects, the 
     Secretary shall submit to Congress a report on the projects.
       (2) Contents of report.--Each report submitted under 
     paragraph (1) shall include the following:

[[Page S5948]]

       (A) A description of the projects.
       (B) An evaluation of--
       (i) the cost and benefits of the projects, including 
     whether the projects have reduced expenditures under Medicaid 
     and SCHIP;
       (ii) the quality of the health care services provided to 
     target individuals under the projects, including whether the 
     projects have reduced racial and ethnic health disparities in 
     the quality of health care services provided to such 
     individuals;
       (iii) beneficiary and health care provider satisfaction 
     under the projects; and
       (iv) whether, based on the factors evaluated under clauses 
     (i) through (iii), the projects should be continued or 
     conducted on an expanded basis.
       (C) Any other information with respect to the projects the 
     Secretary determines appropriate.
       (3) Expansion of projects; implementation of results.--If 
     the initial report submitted under paragraph (1) includes an 
     evaluation under paragraph (2)(B)(iv) that the projects 
     initially established under subsection (b)(1) should be 
     continued or conducted on an expanded basis, the Secretary--
       (A) shall continue to conduct such projects; and
       (B) may conduct such additional projects as the Secretary 
     determines appropriate.
       (d) Funding for Projects.--
       (1) In general.--There are authorized to be appropriated, 
     such sums as may be necessary to carry out projects under 
     this section.
       (2) Prohibition.--Amounts paid to a State or territory 
     under the projects shall not be used for purposes of claiming 
     a Federal matching payment under section 1903(a) or 2105(a) 
     of the Social Security Act (42 U.S.C. 1396b(a); 1397ee(a)).
       (e) Waiver.--The Secretary shall waive compliance with such 
     requirements of titles XIX and XXI of the Social Security Act 
     (42 U.S.C. 1396 et seq.; 1397aa et seq.) to the extent and 
     for the period the Secretary finds necessary to conduct the 
     projects.

           TITLE VI--COMMISSION ON CHILDREN'S HEALTH COVERAGE

     SEC. 601. COMMISSION ON CHILDREN'S HEALTH COVERAGE.

       (a) Establishment of Commission.--
       (1) Establishment.--There is established a commission to be 
     known as the ``Commission on Children's Health Coverage'' 
     (referred to in this section as the ``Commission'').
       (2) Membership.--
       (A) In general.--The Committee shall be composed of 10 
     members with academic training and practical experience in--
       (i) the areas of--

       (I) child health and development;
       (II) maternal health and development;
       (III) pediatric care;
       (IV) health care financing;
       (V) community-based participatory research;
       (VI) public health;
       (VII) data collection, analysis, and reporting; and
       (VIII) health and health care disparities; and

       (ii) such other areas as the Secretary of Health and Human 
     Services (in this section referred to as the ``Secretary'') 
     determines appropriate.
       (B) Selection.--The Secretary shall appoint members of the 
     Committee. No candidate for appointment on the Committee 
     shall be asked to provide non-relevant information, such as 
     voting record, political party affiliation, or position on 
     particular policies.
       (3) Term; vacancies.--
       (A) Term.--A member shall be appointed for the life of the 
     Commission.
       (B) Vacancies.--A vacancy on the Commission--
       (i) shall not affect the powers of the Commission; and
       (ii) shall be filled in the same manner as the original 
     appointment was made.
       (4) Meetings.--The Commission shall meet at the call of the 
     Chairperson.
       (5) Quorum.--A majority of the members of the Commission 
     shall constitute a quorum, but a lesser number of members may 
     hold hearings.
       (6) Chairperson and vice chairperson.--The Commission shall 
     select a Chairperson from among the members of the 
     Commission.
       (b) Duties.--
       (1) Study.--The Commission shall conduct a study of all 
     matters relating to children's health coverage.
       (2) Recommendations.--The Commission shall develop 
     recommendations on policy improvements at the State and 
     national levels, and in the private sector, with respect to 
     children's health coverage.
       (3) Report.--
       (A) Annual reports.--During the 2 year period beginning on 
     the date of enactment of this Act, the Commission shall 
     submit to the President and Congress annual reports 
     evaluating the status of children's health coverage, together 
     with recommendations for such legislation and administrative 
     administrative actions as the Commission determines would 
     result in improvements in such health coverage at the State 
     and national levels, and in the private sector.
       (B) Final report.--Not later than 3 years after such date 
     of enactment, the Commission shall submit to the President 
     and Congress a report that contains the recommendations of 
     the Commission for such legislation and administrative 
     actions as the Commission determines would result in 
     comprehensive health coverage of all children in the United 
     States.
       (c) Powers.--.
       (1) Hearings.--The Commission may hold such hearings, meet 
     and act at such times and places, take such testimony, and 
     receive such evidence as the Commission considers advisable 
     to carry out this Act.
       (2) Information from federal agencies.--
       (A) In general.--The Commission may secure directly from a 
     Federal agency such information as the Commission considers 
     necessary to carry out this Act.
       (B) Provision of information.--On request of the 
     Chairperson of the Commission, the head of the agency shall 
     provide the information to the Commission.
       (3) Postal services.--The Commission may use the United 
     States mails in the same manner and under the same conditions 
     as other agencies of the Federal Government.
       (4) Gifts.--The Commission may accept, use, and dispose of 
     gifts or donations of services or property.
       (d) Commission Personnel Matters.--
       (1) Compensation of members.--
       (A) Non-federal employees.--A member of the Commission who 
     is not an officer or employee of the Federal Government shall 
     be compensated at a rate equal to the daily equivalent of the 
     annual rate of basic pay prescribed for level IV of the 
     Executive Schedule under section 5315 of title 5, United 
     States Code, for each day (including travel time) during 
     which the member is engaged in the performance of the duties 
     of the Commission.
       (B) Federal employees.--A member of the Commission who is 
     an officer or employee of the Federal Government shall serve 
     without compensation in addition to the compensation received 
     for the services of the member as an officer or employee of 
     the Federal Government.
       (2) Travel expenses.--A member of the Commission shall be 
     allowed travel expenses, including per diem in lieu of 
     subsistence, at rates authorized for an employee of an agency 
     under subchapter I of chapter 57 of title 5, United States 
     Code, while away from the home or regular place of business 
     of the member in the performance of the duties of the 
     Commission.
       (3) Staff.--
       (A) In general.--The Chairperson of the Commission may, 
     without regard to the civil service laws (including 
     regulations), appoint and terminate an executive director and 
     such other additional personnel as are necessary to enable 
     the Commission to perform the duties of the Commission.
       (B) Confirmation of executive director.--The employment of 
     an executive director shall be subject to confirmation by the 
     Commission.
       (C) Compensation.--
       (i) In general.--Except as provided in subparagraph (B), 
     the Chairperson of the Commission may fix the compensation of 
     the executive director and other personnel without regard to 
     the provisions of chapter 51 and subchapter III of chapter 53 
     of title 5, United States Code, relating to classification of 
     positions and General Schedule pay rates.
       (ii) Maximum rate of pay.--The rate of pay for the 
     executive director and other personnel shall not exceed the 
     rate payable for level V of the Executive Schedule under 
     section 5316 of title 5, United States Code.
       (4) Detail of federal government employees.--
       (A) In general.--An employee of the Federal Government may 
     be detailed to the Commission without reimbursement.
       (B) Civil service status.--The detail of the employee shall 
     be without interruption or loss of civil service status or 
     privilege.
       (5) Procurement of temporary and intermittent services.--
     The Chairperson of the Commission may procure temporary and 
     intermittent services in accordance with section 3109(b) of 
     title 5, United States Code, at rates for individuals that do 
     not exceed the daily equivalent of the annual rate of basic 
     pay prescribed for level V of the Executive Schedule under 
     section 5316 of that title.
       (e) Authorization of Appropriations.--There are authorized 
     to be appropriated such sums as are necessary to carry out 
     this section.
       (f) Termination of Commission.--The Commission shall 
     terminate 90 days after the date on which the Commission 
     submits the final report of the Commission under subsection 
     (b)(3)(B).
                                 ______