[Congressional Record Volume 164, Number 23 (Tuesday, February 6, 2018)]
[House]
[Pages H834-H896]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HONORING HOMETOWN HEROES ACT
General Leave
Mr. FRELINGHUYSEN. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and include extraneous material on the further consideration of
the Senate amendment to H.R. 1892.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New Jersey?
There was no objection.
Mr. FRELINGHUYSEN. Mr. Speaker, pursuant to House Resolution 727, I
call up the bill (H.R. 1892) to amend title 4, United States Code, to
provide for the flying of the flag at half-staff in the event of the
death of a first responder in the line of duty, with the Senate
amendment thereto, and ask for its immediate consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore. The Clerk will designate the Senate
amendment.
Senate amendment:
On page 3, line 6 through 8, strike [``section 1204 of the
Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C.
3796b)''] and insert ``section 1204 of title I of the Omnibus
Crime Control and Safe Streets Act of 1968 (34 U.S.C.
10281)''.
Motion to Concur
Mr. FRELINGHUYSEN. Mr. Speaker, I have a motion at the desk.
The SPEAKER pro tempore. The Clerk will designate the motion.
The text of the motion is as follows:
Mr. Frelinghuysen moves that the House concur in the Senate
amendment to H.R. 1892 with an amendment consisting of the
text of Rules Committee Print 115-58 as modified by the
amendment printed in House Report 115-547.
The text of the House amendment to the Senate amendment to the text
is as follows:
At the end of the matter inserted by the Senate amendment,
insert the following:
DIVISION B--FURTHER EXTENSION OF CONTINUING APPROPRIATIONS ACT, 2018
Sec. 1001. The Continuing Appropriations Act, 2018
(division D of Public Law 115-56) is further amended--
(1) by striking the date specified in section 106(3) and
inserting ``March 23, 2018''; and
(2) by adding after section 155 the following:
``Sec. 156. Notwithstanding section 101, amounts are
provided for `Department of Commerce--Bureau of the Census--
Periodic Censuses and Programs' at a rate for operations of
$1,251,000,000, and such amounts may be apportioned up to the
rate for operations necessary to maintain the schedule and
deliver the required data according to statutory deadlines in
the 2020 Decennial Census Program.
``Sec. 157. Notwithstanding section 101, the matter
preceding the first proviso and the first proviso under the
heading `Power Marketing Administrations--Operation and
Maintenance, Southeastern Power Administration' in division D
of Public Law 115-31 shall be applied by substituting
`$6,379,000' for `$1,000,000' each place it appears.
``Sec. 158. As authorized by section 404 of the Bipartisan
Budget Act of 2015 (Public Law 114-74; 42 U.S.C. 6239 note),
the Secretary of Energy shall draw down and sell not to
exceed $350,000,000 of crude oil from the Strategic Petroleum
Reserve in fiscal year 2018: Provided, That the proceeds from
such drawdown and sale shall be deposited into the `Energy
Security and Infrastructure Modernization Fund' (in this
section referred to as the `Fund') during fiscal year 2018:
Provided further, That in addition to amounts otherwise made
available by section 101, and notwithstanding section 104,
any amounts deposited in the Fund shall be made available and
shall remain available until expended at a rate for
operations of $350,000,000, for necessary expenses in
carrying out the Life Extension II project for the Strategic
Petroleum Reserve.
``Sec. 159. Amounts made available by section 101 for `The
Judiciary--Courts of Appeals, District Courts, and Other
Judicial Services--Fees of Jurors and Commissioners' may be
apportioned up to the rate for operations necessary to
accommodate increased juror usage.
``Sec. 160. (a) In addition to amounts otherwise made
available by section 101, there is appropriated for an
additional amount for the `Small Business Administration--
Disaster Loans Program Account' $225,000,000, to remain
available until expended, for the cost of direct loans
authorized by section 7(b) of the Small Business Act:
Provided, That such amount is designated by the Congress as
an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of
1985.
``(b) The amount designated in subsection (a) by the
Congress as an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit
Control Act of 1985 shall be available only if the President
subsequently so designates such amount and transmits such
designation to the Congress.''.
This division may be cited as the ``Further Extension of
Continuing Appropriations Act, 2018''.
DIVISION C--DEPARTMENT OF DEFENSE APPROPRIATIONS ACT, 2018
That the following sums are appropriated, out of any money
in the Treasury not otherwise appropriated, for the fiscal
year ending September 30, 2018, for military functions
administered by the Department of Defense and for other
purposes, namely:
[[Page H835]]
TITLE I
MILITARY PERSONNEL
Military Personnel, Army
For pay, allowances, individual clothing, subsistence,
interest on deposits, gratuities, permanent change of station
travel (including all expenses thereof for organizational
movements), and expenses of temporary duty travel between
permanent duty stations, for members of the Army on active
duty (except members of reserve components provided for
elsewhere), cadets, and aviation cadets; for members of the
Reserve Officers' Training Corps; and for payments pursuant
to section 156 of Public Law 97-377, as amended (42 U.S.C.
402 note), and to the Department of Defense Military
Retirement Fund, $41,427,054,000.
Military Personnel, Navy
For pay, allowances, individual clothing, subsistence,
interest on deposits, gratuities, permanent change of station
travel (including all expenses thereof for organizational
movements), and expenses of temporary duty travel between
permanent duty stations, for members of the Navy on active
duty (except members of the Reserve provided for elsewhere),
midshipmen, and aviation cadets; for members of the Reserve
Officers' Training Corps; and for payments pursuant to
section 156 of Public Law 97-377, as amended (42 U.S.C. 402
note), and to the Department of Defense Military Retirement
Fund, $28,707,918,000 (reduced by $2,000,000) (increased by
$2,000,000).
Military Personnel, Marine Corps
For pay, allowances, individual clothing, subsistence,
interest on deposits, gratuities, permanent change of station
travel (including all expenses thereof for organizational
movements), and expenses of temporary duty travel between
permanent duty stations, for members of the Marine Corps on
active duty (except members of the Reserve provided for
elsewhere); and for payments pursuant to section 156 of
Public Law 97-377, as amended (42 U.S.C. 402 note), and to
the Department of Defense Military Retirement Fund,
$13,165,714,000.
Military Personnel, Air Force
For pay, allowances, individual clothing, subsistence,
interest on deposits, gratuities, permanent change of station
travel (including all expenses thereof for organizational
movements), and expenses of temporary duty travel between
permanent duty stations, for members of the Air Force on
active duty (except members of reserve components provided
for elsewhere), cadets, and aviation cadets; for members of
the Reserve Officers' Training Corps; and for payments
pursuant to section 156 of Public Law 97-377, as amended (42
U.S.C. 402 note), and to the Department of Defense Military
Retirement Fund, $28,738,320,000.
Reserve Personnel, Army
For pay, allowances, clothing, subsistence, gratuities,
travel, and related expenses for personnel of the Army
Reserve on active duty under sections 10211, 10302, and 3038
of title 10, United States Code, or while serving on active
duty under section 12301(d) of title 10, United States Code,
in connection with performing duty specified in section
12310(a) of title 10, United States Code, or while undergoing
reserve training, or while performing drills or equivalent
duty or other duty, and expenses authorized by section 16131
of title 10, United States Code; and for payments to the
Department of Defense Military Retirement Fund,
$4,721,128,000.
Reserve Personnel, Navy
For pay, allowances, clothing, subsistence, gratuities,
travel, and related expenses for personnel of the Navy
Reserve on active duty under section 10211 of title 10,
United States Code, or while serving on active duty under
section 12301(d) of title 10, United States Code, in
connection with performing duty specified in section 12310(a)
of title 10, United States Code, or while undergoing reserve
training, or while performing drills or equivalent duty, and
expenses authorized by section 16131 of title 10, United
States Code; and for payments to the Department of Defense
Military Retirement Fund, $1,987,662,000.
Reserve Personnel, Marine Corps
For pay, allowances, clothing, subsistence, gratuities,
travel, and related expenses for personnel of the Marine
Corps Reserve on active duty under section 10211 of title 10,
United States Code, or while serving on active duty under
section 12301(d) of title 10, United States Code, in
connection with performing duty specified in section 12310(a)
of title 10, United States Code, or while undergoing reserve
training, or while performing drills or equivalent duty, and
for members of the Marine Corps platoon leaders class, and
expenses authorized by section 16131 of title 10, United
States Code; and for payments to the Department of Defense
Military Retirement Fund, $762,793,000.
Reserve Personnel, Air Force
For pay, allowances, clothing, subsistence, gratuities,
travel, and related expenses for personnel of the Air Force
Reserve on active duty under sections 10211, 10305, and 8038
of title 10, United States Code, or while serving on active
duty under section 12301(d) of title 10, United States Code,
in connection with performing duty specified in section
12310(a) of title 10, United States Code, or while undergoing
reserve training, or while performing drills or equivalent
duty or other duty, and expenses authorized by section 16131
of title 10, United States Code; and for payments to the
Department of Defense Military Retirement Fund,
$1,808,434,000.
National Guard Personnel, Army
For pay, allowances, clothing, subsistence, gratuities,
travel, and related expenses for personnel of the Army
National Guard while on duty under sections 10211, 10302, or
12402 of title 10 or section 708 of title 32, United States
Code, or while serving on duty under section 12301(d) of
title 10 or section 502(f) of title 32, United States Code,
in connection with performing duty specified in section
12310(a) of title 10, United States Code, or while undergoing
training, or while performing drills or equivalent duty or
other duty, and expenses authorized by section 16131 of title
10, United States Code; and for payments to the Department of
Defense Military Retirement Fund, $8,252,426,000.
National Guard Personnel, Air Force
For pay, allowances, clothing, subsistence, gratuities,
travel, and related expenses for personnel of the Air
National Guard on duty under sections 10211, 10305, or 12402
of title 10 or section 708 of title 32, United States Code,
or while serving on duty under section 12301(d) of title 10
or section 502(f) of title 32, United States Code, in
connection with performing duty specified in section 12310(a)
of title 10, United States Code, or while undergoing
training, or while performing drills or equivalent duty or
other duty, and expenses authorized by section 16131 of title
10, United States Code; and for payments to the Department of
Defense Military Retirement Fund, $3,406,137,000.
TITLE II
OPERATION AND MAINTENANCE
Operation and Maintenance, Army
For expenses, not otherwise provided for, necessary for the
operation and maintenance of the Army, as authorized by law,
$38,483,846,000 (reduced by $5,000,000) (reduced by
$5,600,000) (reduced by $6,000,000): Provided, That not to
exceed $12,478,000 can be used for emergencies and
extraordinary expenses, to be expended on the approval or
authority of the Secretary of the Army, and payments may be
made on his certificate of necessity for confidential
military purposes.
Operation and Maintenance, Navy
For expenses, not otherwise provided for, necessary for the
operation and maintenance of the Navy and the Marine Corps,
as authorized by law, $45,980,133,000 (reduced by $598,000)
(reduced by $7,000,000): Provided, That not to exceed
$15,055,000 can be used for emergencies and extraordinary
expenses, to be expended on the approval or authority of the
Secretary of the Navy, and payments may be made on his
certificate of necessity for confidential military purposes.
Operation and Maintenance, Marine Corps
For expenses, not otherwise provided for, necessary for the
operation and maintenance of the Marine Corps, as authorized
by law, $6,885,884,000.
Operation and Maintenance, Air Force
For expenses, not otherwise provided for, necessary for the
operation and maintenance of the Air Force, as authorized by
law, $38,592,745,000: Provided, That not to exceed
$7,699,000 can be used for emergencies and extraordinary
expenses, to be expended on the approval or authority of the
Secretary of the Air Force, and payments may be made on his
certificate of necessity for confidential military purposes.
Operation and Maintenance, Defense-Wide
(including transfer of funds)
For expenses, not otherwise provided for, necessary for the
operation and maintenance of activities and agencies of the
Department of Defense (other than the military departments),
as authorized by law, $33,771,769,000 (increased by
$5,000,000) (reduced by $10,000,000) (reduced by $100,000)
(increased by $100,000) (reduced by $194,897,000) (increased
by $194,897,000) (reduced by $26,200,000) (reduced by
$20,000,000) (reduced by $6,000,000) (reduced by $4,000,000)
(reduced by $20,000,000) (reduced by $1,000,000) (reduced by
$10,000,000) (reduced by $2,500,000) (reduced by $2,000,000)
(reduced by $8,000,000) (reduced by $6,250,000) (reduced by
$10,000,000) (reduced by $10,000,000) (reduced by
$30,000,000) (reduced by $34,734,000) (reduced by
$60,000,000): Provided, That not more than $15,000,000 may
be used for the Combatant Commander Initiative Fund
authorized under section 166a of title 10, United States
Code: Provided further, That not to exceed $36,000,000 can
be used for emergencies and extraordinary expenses, to be
expended on the approval or authority of the Secretary of
Defense, and payments may be made on his certificate of
necessity for confidential military purposes: Provided
further, That of the funds provided under this heading, not
less than $38,458,000 shall be made available for the
Procurement Technical Assistance Cooperative Agreement
Program, of which not less than $3,600,000 shall be available
for centers defined in 10 U.S.C. 2411(1)(D): Provided
further, That none of the funds appropriated or otherwise
made available by this Act may be used to plan or implement
the consolidation of a budget or appropriations liaison
office of the Office of the Secretary of Defense, the office
of the Secretary of a military department, or the service
headquarters of one of the Armed Forces into a legislative
affairs or legislative liaison office: Provided further,
That $9,385,000, to remain available until expended, is
available only for expenses relating to certain classified
activities, and may be transferred as necessary by the
Secretary
[[Page H836]]
of Defense to operation and maintenance appropriations or
research, development, test and evaluation appropriations, to
be merged with and to be available for the same time period
as the appropriations to which transferred: Provided
further, That any ceiling on the investment item unit cost of
items that may be purchased with operation and maintenance
funds shall not apply to the funds described in the preceding
proviso: Provided further, That of the funds provided under
this heading, $415,000,000, of which $100,000,000 to remain
available until September 30, 2019, shall be available to
provide support and assistance to foreign security forces or
other groups or individuals to conduct, support or facilitate
counterterrorism, crisis response, or other Department of
Defense security cooperation programs: Provided further,
That the transfer authority provided under this heading is in
addition to any other transfer authority provided elsewhere
in this Act.
Operation and Maintenance, Army Reserve
For expenses, not otherwise provided for, necessary for the
operation and maintenance, including training, organization,
and administration, of the Army Reserve; repair of facilities
and equipment; hire of passenger motor vehicles; travel and
transportation; care of the dead; recruiting; procurement of
services, supplies, and equipment; and communications,
$2,870,163,000.
Operation and Maintenance, Navy Reserve
For expenses, not otherwise provided for, necessary for the
operation and maintenance, including training, organization,
and administration, of the Navy Reserve; repair of facilities
and equipment; hire of passenger motor vehicles; travel and
transportation; care of the dead; recruiting; procurement of
services, supplies, and equipment; and communications,
$1,038,507,000.
Operation and Maintenance, Marine Corps Reserve
For expenses, not otherwise provided for, necessary for the
operation and maintenance, including training, organization,
and administration, of the Marine Corps Reserve; repair of
facilities and equipment; hire of passenger motor vehicles;
travel and transportation; care of the dead; recruiting;
procurement of services, supplies, and equipment; and
communications, $282,337,000.
Operation and Maintenance, Air Force Reserve
For expenses, not otherwise provided for, necessary for the
operation and maintenance, including training, organization,
and administration, of the Air Force Reserve; repair of
facilities and equipment; hire of passenger motor vehicles;
travel and transportation; care of the dead; recruiting;
procurement of services, supplies, and equipment; and
communications, $3,233,745,000.
Operation and Maintenance, Army National Guard
For expenses of training, organizing, and administering the
Army National Guard, including medical and hospital treatment
and related expenses in non-Federal hospitals; maintenance,
operation, and repairs to structures and facilities; hire of
passenger motor vehicles; personnel services in the National
Guard Bureau; travel expenses (other than mileage), as
authorized by law for Army personnel on active duty, for Army
National Guard division, regimental, and battalion commanders
while inspecting units in compliance with National Guard
Bureau regulations when specifically authorized by the Chief,
National Guard Bureau; supplying and equipping the Army
National Guard as authorized by law; and expenses of repair,
modification, maintenance, and issue of supplies and
equipment (including aircraft), $7,275,820,000.
Operation and Maintenance, Air National Guard
For expenses of training, organizing, and administering the
Air National Guard, including medical and hospital treatment
and related expenses in non-Federal hospitals; maintenance,
operation, and repairs to structures and facilities;
transportation of things, hire of passenger motor vehicles;
supplying and equipping the Air National Guard, as authorized
by law; expenses for repair, modification, maintenance, and
issue of supplies and equipment, including those furnished
from stocks under the control of agencies of the Department
of Defense; travel expenses (other than mileage) on the same
basis as authorized by law for Air National Guard personnel
on active Federal duty, for Air National Guard commanders
while inspecting units in compliance with National Guard
Bureau regulations when specifically authorized by the Chief,
National Guard Bureau, $6,735,930,000.
United States Court of Appeals for the Armed Forces
For salaries and expenses necessary for the United States
Court of Appeals for the Armed Forces, $14,538,000, of which
not to exceed $5,000 may be used for official representation
purposes.
Environmental Restoration, Army
(including transfer of funds)
For the Department of the Army, $215,809,000, to remain
available until transferred: Provided, That the Secretary of
the Army shall, upon determining that such funds are required
for environmental restoration, reduction and recycling of
hazardous waste, removal of unsafe buildings and debris of
the Department of the Army, or for similar purposes, transfer
the funds made available by this appropriation to other
appropriations made available to the Department of the Army,
to be merged with and to be available for the same purposes
and for the same time period as the appropriations to which
transferred: Provided further, That upon a determination
that all or part of the funds transferred from this
appropriation are not necessary for the purposes provided
herein, such amounts may be transferred back to this
appropriation: Provided further, That the transfer authority
provided under this heading is in addition to any other
transfer authority provided elsewhere in this Act.
Environmental Restoration, Navy
(including transfer of funds)
For the Department of the Navy, $288,915,000 (increased by
$34,734,000) (increased by $30,000,000), to remain available
until transferred: Provided, That the Secretary of the Navy
shall, upon determining that such funds are required for
environmental restoration, reduction and recycling of
hazardous waste, removal of unsafe buildings and debris of
the Department of the Navy, or for similar purposes, transfer
the funds made available by this appropriation to other
appropriations made available to the Department of the Navy,
to be merged with and to be available for the same purposes
and for the same time period as the appropriations to which
transferred: Provided further, That upon a determination
that all or part of the funds transferred from this
appropriation are not necessary for the purposes provided
herein, such amounts may be transferred back to this
appropriation: Provided further, That the transfer authority
provided under this heading is in addition to any other
transfer authority provided elsewhere in this Act.
Environmental Restoration, Air Force
(including transfer of funds)
For the Department of the Air Force, $308,749,000
(increased by $30,000,000), to remain available until
transferred: Provided, That the Secretary of the Air Force
shall, upon determining that such funds are required for
environmental restoration, reduction and recycling of
hazardous waste, removal of unsafe buildings and debris of
the Department of the Air Force, or for similar purposes,
transfer the funds made available by this appropriation to
other appropriations made available to the Department of the
Air Force, to be merged with and to be available for the same
purposes and for the same time period as the appropriations
to which transferred: Provided further, That upon a
determination that all or part of the funds transferred from
this appropriation are not necessary for the purposes
provided herein, such amounts may be transferred back to this
appropriation: Provided further, That the transfer authority
provided under this heading is in addition to any other
transfer authority provided elsewhere in this Act.
Environmental Restoration, Defense-Wide
(including transfer of funds)
For the Department of Defense, $9,002,000 (increased by
$10,000,000), to remain available until transferred:
Provided, That the Secretary of Defense shall, upon
determining that such funds are required for environmental
restoration, reduction and recycling of hazardous waste,
removal of unsafe buildings and debris of the Department of
Defense, or for similar purposes, transfer the funds made
available by this appropriation to other appropriations made
available to the Department of Defense, to be merged with and
to be available for the same purposes and for the same time
period as the appropriations to which transferred: Provided
further, That upon a determination that all or part of the
funds transferred from this appropriation are not necessary
for the purposes provided herein, such amounts may be
transferred back to this appropriation: Provided further,
That the transfer authority provided under this heading is in
addition to any other transfer authority provided elsewhere
in this Act.
Environmental Restoration, Formerly Used Defense Sites
(including transfer of funds)
For the Department of the Army, $233,673,000, to remain
available until transferred: Provided, That the Secretary of
the Army shall, upon determining that such funds are required
for environmental restoration, reduction and recycling of
hazardous waste, removal of unsafe buildings and debris at
sites formerly used by the Department of Defense, transfer
the funds made available by this appropriation to other
appropriations made available to the Department of the Army,
to be merged with and to be available for the same purposes
and for the same time period as the appropriations to which
transferred: Provided further, That upon a determination
that all or part of the funds transferred from this
appropriation are not necessary for the purposes provided
herein, such amounts may be transferred back to this
appropriation: Provided further, That the transfer authority
provided under this heading is in addition to any other
transfer authority provided elsewhere in this Act.
Overseas Humanitarian, Disaster, and Civic Aid
For expenses relating to the Overseas Humanitarian,
Disaster, and Civic Aid programs of the Department of Defense
(consisting of the programs provided under sections 401, 402,
404, 407, 2557, and 2561 of title
[[Page H837]]
10, United States Code), $107,900,000, to remain available
until September 30, 2018.
Cooperative Threat Reduction Account
For assistance, including assistance provided by contract
or by grants, under programs and activities of the Department
of Defense Cooperative Threat Reduction Program authorized
under the Department of Defense Cooperative Threat Reduction
Act, $324,600,000, to remain available until September 30,
2019.
Operation and Maintenance, National Defense Restoration Fund
(including transfer of funds)
In addition to amounts provided elsewhere in this Act,
there is appropriated $5,000,000,000, for the ``Operation and
Maintenance, National Defense Restoration Fund'': Provided,
That such funds provided under this heading shall only be
available for programs, projects and activities necessary to
implement the 2018 National Defense Strategy: Provided
further, That such funds shall not be available for transfer
until 30 days after the Secretary has submitted, and the
congressional defense committees have approved, the proposed
allocation plan for the use of such funds to implement such
strategy: Provided further, That such allocation plan shall
include a detailed justification for the use of such funds
and a description of how such investments are necessary to
implement the strategy: Provided further, That the Secretary
of Defense may transfer these funds only to operation and
maintenance accounts: Provided further, That the funds
transferred shall be merged with and shall be available for
the same purposes and for the same time period, as the
appropriation to which transferred: Provided further, That
none of the funds made available under this heading may be
transferred to any program, project, or activity specifically
limited or denied by this Act: Provided further, That the
transfer authority provided under this heading is in addition
to any other transfer authority available to the Department
of Defense.
TITLE III
PROCUREMENT
Aircraft Procurement, Army
For construction, procurement, production, modification,
and modernization of aircraft, equipment, including ordnance,
ground handling equipment, spare parts, and accessories
therefor; specialized equipment and training devices;
expansion of public and private plants, including the land
necessary therefor, for the foregoing purposes, and such
lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
and procurement and installation of equipment, appliances,
and machine tools in public and private plants; reserve plant
and Government and contractor-owned equipment layaway; and
other expenses necessary for the foregoing purposes,
$4,456,533,000, to remain available for obligation until
September 30, 2020.
Missile Procurement, Army
For construction, procurement, production, modification,
and modernization of missiles, equipment, including ordnance,
ground handling equipment, spare parts, and accessories
therefor; specialized equipment and training devices;
expansion of public and private plants, including the land
necessary therefor, for the foregoing purposes, and such
lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
and procurement and installation of equipment, appliances,
and machine tools in public and private plants; reserve plant
and Government and contractor-owned equipment layaway; and
other expenses necessary for the foregoing purposes,
$2,581,600,000, to remain available for obligation until
September 30, 2020.
Procurement of Weapons and Tracked Combat Vehicles, Army
For construction, procurement, production, and modification
of weapons and tracked combat vehicles, equipment, including
ordnance, spare parts, and accessories therefor; specialized
equipment and training devices; expansion of public and
private plants, including the land necessary therefor, for
the foregoing purposes, and such lands and interests therein,
may be acquired, and construction prosecuted thereon prior to
approval of title; and procurement and installation of
equipment, appliances, and machine tools in public and
private plants; reserve plant and Government and contractor-
owned equipment layaway; and other expenses necessary for the
foregoing purposes, $3,556,175,000, to remain available for
obligation until September 30, 2020.
Procurement of Ammunition, Army
For construction, procurement, production, and modification
of ammunition, and accessories therefor; specialized
equipment and training devices; expansion of public and
private plants, including ammunition facilities, authorized
by section 2854 of title 10, United States Code, and the land
necessary therefor, for the foregoing purposes, and such
lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
and procurement and installation of equipment, appliances,
and machine tools in public and private plants; reserve plant
and Government and contractor-owned equipment layaway; and
other expenses necessary for the foregoing purposes,
$1,811,808,000, to remain available for obligation until
September 30, 2020.
Other Procurement, Army
For construction, procurement, production, and modification
of vehicles, including tactical, support, and non-tracked
combat vehicles; the purchase of passenger motor vehicles for
replacement only; communications and electronic equipment;
other support equipment; spare parts, ordnance, and
accessories therefor; specialized equipment and training
devices; expansion of public and private plants, including
the land necessary therefor, for the foregoing purposes, and
such lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
and procurement and installation of equipment, appliances,
and machine tools in public and private plants; reserve plant
and Government and contractor-owned equipment layaway; and
other expenses necessary for the foregoing purposes,
$6,356,044,000 (increased by $30,000,000), to remain
available for obligation until September 30, 2020.
Aircraft Procurement, Navy
For construction, procurement, production, modification,
and modernization of aircraft, equipment, including ordnance,
spare parts, and accessories therefor; specialized equipment;
expansion of public and private plants, including the land
necessary therefor, and such lands and interests therein, may
be acquired, and construction prosecuted thereon prior to
approval of title; and procurement and installation of
equipment, appliances, and machine tools in public and
private plants; reserve plant and Government and contractor-
owned equipment layaway, $17,908,270,000, to remain available
for obligation until September 30, 2020.
Weapons Procurement, Navy
For construction, procurement, production, modification,
and modernization of missiles, torpedoes, other weapons, and
related support equipment including spare parts, and
accessories therefor; expansion of public and private plants,
including the land necessary therefor, and such lands and
interests therein, may be acquired, and construction
prosecuted thereon prior to approval of title; and
procurement and installation of equipment, appliances, and
machine tools in public and private plants; reserve plant and
Government and contractor-owned equipment layaway,
$3,387,826,000 (increased by $26,200,000), to remain
available for obligation until September 30, 2020.
Procurement of Ammunition, Navy and Marine Corps
For construction, procurement, production, and modification
of ammunition, and accessories therefor; specialized
equipment and training devices; expansion of public and
private plants, including ammunition facilities, authorized
by section 2854 of title 10, United States Code, and the land
necessary therefor, for the foregoing purposes, and such
lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
and procurement and installation of equipment, appliances,
and machine tools in public and private plants; reserve plant
and Government and contractor-owned equipment layaway; and
other expenses necessary for the foregoing purposes,
$735,651,000, to remain available for obligation until
September 30, 2020.
Shipbuilding and Conversion, Navy
For expenses necessary for the construction, acquisition,
or conversion of vessels as authorized by law, including
armor and armament thereof, plant equipment, appliances, and
machine tools and installation thereof in public and private
plants; reserve plant and Government and contractor-owned
equipment layaway; procurement of critical, long lead time
components and designs for vessels to be constructed or
converted in the future; and expansion of public and private
plants, including land necessary therefor, and such lands and
interests therein, may be acquired, and construction
prosecuted thereon prior to approval of title, as follows:
Ohio Replacement Submarine (AP), $842,853,000;
Carrier Replacement Program, $1,869,646,000;
Carrier Replacement Program (AP), $2,561,058,000;
Virginia Class Submarine, $3,305,315,000;
Virginia Class Submarine (AP), $1,920,596,000;
CVN Refueling Overhauls, $1,569,669,000;
CVN Refueling Overhauls (AP), $75,897,000;
DDG-1000 Program, $164,976,000;
DDG-51 Destroyer, $3,499,079,000;
DDG-51 Destroyer (AP), $90,336,000;
Littoral Combat Ship, $1,566,971,000;
Expeditionary Sea Base, $635,000,000;
LHA Replacement, $1,695,077,000;
TAO Fleet Oiler, $449,415,000;
TAO Fleet Oiler (AP), $75,068,000;
Ship to Shore Connector, $390,554,000;
Service Craft, $23,994,000;
Towing, Salvage, and Rescue Ship, $76,204,000;
LCU 1700, $31,850,000;
For outfitting, post delivery, conversions, and first
destination transportation, $542,626,000; and
Completion of Prior Year Shipbuilding Programs,
$117,542,000.
In all: $21,503,726,000, to remain available for obligation
until September 30, 2022: Provided, That additional
obligations may be incurred after September 30, 2022, for
engineering services, tests, evaluations, and other such
budgeted work that must be performed in the final stage of
ship construction: Provided further, That none of the funds
provided under this heading for the construction or
[[Page H838]]
conversion of any naval vessel to be constructed in shipyards
in the United States shall be expended in foreign facilities
for the construction of major components of such vessel:
Provided further, That none of the funds provided under this
heading shall be used for the construction of any naval
vessel in foreign shipyards: Provided further, That funds
appropriated or otherwise made available by this Act for
production of the common missile compartment of nuclear-
powered vessels may be available for multiyear procurement of
critical components to support continuous production of such
compartments only in accordance with the provisions of
subsection (i) of section 2218a of title 10, United States
Code (as added by section 1023 of the National Defense
Authorization Act for Fiscal Year 2017 (Public Law 114-328)).
Other Procurement, Navy
For procurement, production, and modernization of support
equipment and materials not otherwise provided for, Navy
ordnance (except ordnance for new aircraft, new ships, and
ships authorized for conversion); the purchase of passenger
motor vehicles for replacement only; expansion of public and
private plants, including the land necessary therefor, and
such lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
and procurement and installation of equipment, appliances,
and machine tools in public and private plants; reserve plant
and Government and contractor-owned equipment layaway,
$7,852,952,000, to remain available for obligation until
September 30, 2020.
Procurement, Marine Corps
For expenses necessary for the procurement, manufacture,
and modification of missiles, armament, military equipment,
spare parts, and accessories therefor; plant equipment,
appliances, and machine tools, and installation thereof in
public and private plants; reserve plant and Government and
contractor-owned equipment layaway; vehicles for the Marine
Corps, including the purchase of passenger motor vehicles for
replacement only; and expansion of public and private plants,
including land necessary therefor, and such lands and
interests therein, may be acquired, and construction
prosecuted thereon prior to approval of title, $1,818,846,000
(increased by $20,000,000), to remain available for
obligation until September 30, 2020.
Aircraft Procurement, Air Force
For construction, procurement, and modification of aircraft
and equipment, including armor and armament, specialized
ground handling equipment, and training devices, spare parts,
and accessories therefor; specialized equipment; expansion of
public and private plants, Government-owned equipment and
installation thereof in such plants, erection of structures,
and acquisition of land, for the foregoing purposes, and such
lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
reserve plant and Government and contractor-owned equipment
layaway; and other expenses necessary for the foregoing
purposes including rents and transportation of things,
$16,553,196,000 (increased by $16,000,000), to remain
available for obligation until September 30, 2020.
Missile Procurement, Air Force
For construction, procurement, and modification of
missiles, rockets, and related equipment, including spare
parts and accessories therefor; ground handling equipment,
and training devices; expansion of public and private plants,
Government-owned equipment and installation thereof in such
plants, erection of structures, and acquisition of land, for
the foregoing purposes, and such lands and interests therein,
may be acquired, and construction prosecuted thereon prior to
approval of title; reserve plant and Government and
contractor-owned equipment layaway; and other expenses
necessary for the foregoing purposes including rents and
transportation of things, $2,203,101,000, to remain available
for obligation until September 30, 2020.
Space Procurement, Air Force
For construction, procurement, and modification of
spacecraft, rockets, and related equipment, including spare
parts and accessories therefor; ground handling equipment,
and training devices; expansion of public and private plants,
Government-owned equipment and installation thereof in such
plants, erection of structures, and acquisition of land, for
the foregoing purposes, and such lands and interests therein,
may be acquired, and construction prosecuted thereon prior to
approval of title; reserve plant and Government and
contractor-owned equipment layaway; and other expenses
necessary for the foregoing purposes including rents and
transportation of things, $3,210,355,000, to remain available
for obligation until September 30, 2020.
Procurement of Ammunition, Air Force
For construction, procurement, production, and modification
of ammunition, and accessories therefor; specialized
equipment and training devices; expansion of public and
private plants, including ammunition facilities, authorized
by section 2854 of title 10, United States Code, and the land
necessary therefor, for the foregoing purposes, and such
lands and interests therein, may be acquired, and
construction prosecuted thereon prior to approval of title;
and procurement and installation of equipment, appliances,
and machine tools in public and private plants; reserve plant
and Government and contractor-owned equipment layaway; and
other expenses necessary for the foregoing purposes,
$1,316,977,000, to remain available for obligation until
September 30, 2020.
Other Procurement, Air Force
For procurement and modification of equipment (including
ground guidance and electronic control equipment, and ground
electronic and communication equipment), and supplies,
materials, and spare parts therefor, not otherwise provided
for; the purchase of passenger motor vehicles for replacement
only; lease of passenger motor vehicles; and expansion of
public and private plants, Government-owned equipment and
installation thereof in such plants, erection of structures,
and acquisition of land, for the foregoing purposes, and such
lands and interests therein, may be acquired, and
construction prosecuted thereon, prior to approval of title;
reserve plant and Government and contractor-owned equipment
layaway, $19,318,814,000, to remain available for obligation
until September 30, 2020.
Procurement, Defense-Wide
For expenses of activities and agencies of the Department
of Defense (other than the military departments) necessary
for procurement, production, and modification of equipment,
supplies, materials, and spare parts therefor, not otherwise
provided for; the purchase of passenger motor vehicles for
replacement only; expansion of public and private plants,
equipment, and installation thereof in such plants, erection
of structures, and acquisition of land for the foregoing
purposes, and such lands and interests therein, may be
acquired, and construction prosecuted thereon prior to
approval of title; reserve plant and Government and
contractor-owned equipment layaway, $5,239,239,000 (reduced
by $10,000,000), to remain available for obligation until
September 30, 2020.
Defense Production Act Purchases
For activities by the Department of Defense pursuant to
sections 108, 301, 302, and 303 of the Defense Production Act
of 1950 (50 U.S.C. 4518, 4531, 4532, and 4533), $67,401,000,
to remain available until expended.
Procurement, National Defense Restoration Fund
(including transfer of funds)
In addition to amounts provided elsewhere in this Act,
there is appropriated $12,622,931,000, for the ``Procurement,
National Defense Restoration Fund'': Provided, That such
funds provided under this heading shall only be available for
programs, projects and activities necessary to implement the
2018 National Defense Strategy: Provided further, That such
funds shall not be available for transfer until 30 days after
the Secretary has submitted, and the congressional defense
committees have approved, the proposed allocation plan for
the use of such funds to implement such strategy: Provided
further, That such allocation plan shall include a detailed
justification for the use of such funds and a description of
how such investments are necessary to implement the strategy:
Provided further, That the Secretary of Defense may transfer
these funds only to procurement accounts: Provided further,
That the funds transferred shall be merged with and shall be
available for the same purposes and for the same time period,
as the appropriation to which transferred: Provided further,
That none of the funds made available under this heading may
be transferred to any program, project, or activity
specifically limited or denied by this Act, except for
missile defense requirements resulting from urgent or
emergent operational needs: Provided further, That the
transfer authority provided under this heading is in addition
to any other transfer authority available to the Department
of Defense.
TITLE IV
RESEARCH, DEVELOPMENT, TEST AND EVALUATION
Research, Development, Test and Evaluation, Army
For expenses necessary for basic and applied scientific
research, development, test and evaluation, including
maintenance, rehabilitation, lease, and operation of
facilities and equipment, $9,674,222,000 (increased by
$6,000,000) (increased by $4,000,000) (increased by
$12,000,000) (increased by $5,000,000), to remain available
for obligation until September 30, 2019.
Research, Development, Test and Evaluation, Navy
For expenses necessary for basic and applied scientific
research, development, test and evaluation, including
maintenance, rehabilitation, lease, and operation of
facilities and equipment, $17,196,521,000 (increased by
$598,000) (increased by $20,000,000) (reduced by $2,500,000)
(increased by $24,000,000), to remain available for
obligation until September 30, 2019: Provided, That funds
appropriated in this paragraph which are available for the V-
22 may be used to meet unique operational requirements of the
Special Operations Forces.
Research, Development, Test and Evaluation, Air Force
For expenses necessary for basic and applied scientific
research, development, test and evaluation, including
maintenance, rehabilitation, lease, and operation of
facilities and equipment, $33,874,980,000 (increased by
$5,000,000) (increased by $6,000,000) (increased by
$10,000,000) (reduced by $30,000,000)
[[Page H839]]
(increased by $30,000,000), to remain available for
obligation until September 30, 2019.
Research, Development, Test and Evaluation, Defense-Wide
(including transfer of funds)
For expenses of activities and agencies of the Department
of Defense (other than the military departments), necessary
for basic and applied scientific research, development, test
and evaluation; advanced research projects as may be
designated and determined by the Secretary of Defense,
pursuant to law; maintenance, rehabilitation, lease, and
operation of facilities and equipment, $20,698,353,000
(reduced by $16,000,000) (reduced by $12,000,000) (reduced by
$2,500,000) (reduced by $12,500,000) (increased by
$20,000,000) (reduced by $20,000,000) (reduced by $4,135,000)
(increased by $4,135,000) (reduced by $27,500,000) (increased
by $10,000,000), to remain available for obligation until
September 30, 2019: Provided, That, of the funds made
available in this paragraph, $250,000,000 for the Defense
Rapid Innovation Program shall only be available for
expenses, not otherwise provided for, to include program
management and oversight, to conduct research, development,
test and evaluation to include proof of concept
demonstration; engineering, testing, and validation; and
transition to full-scale production: Provided further, That
the Secretary of Defense may transfer funds provided herein
for the Defense Rapid Innovation Program to appropriations
for research, development, test and evaluation to accomplish
the purpose provided herein: Provided further, That this
transfer authority is in addition to any other transfer
authority available to the Department of Defense: Provided
further, That the Secretary of Defense shall, not fewer than
30 days prior to making transfers from this appropriation,
notify the congressional defense committees in writing of the
details of any such transfer.
Operational Test and Evaluation, Defense
For expenses, not otherwise provided for, necessary for the
independent activities of the Director, Operational Test and
Evaluation, in the direction and supervision of operational
test and evaluation, including initial operational test and
evaluation which is conducted prior to, and in support of,
production decisions; joint operational testing and
evaluation; and administrative expenses in connection
therewith, $210,900,000, to remain available for obligation
until September 30, 2019.
Research, Development, Test and Evaluation, National Defense
Restoration Fund
(including transfer of funds)
In addition to amounts provided elsewhere in this Act,
there is appropriated $1,000,000,000, for the ``Research,
Development, Test and Evaluation, National Defense
Restoration Fund'': Provided, That such funds provided under
this heading shall only be available for programs, projects
and activities necessary to implement the 2018 National
Defense Strategy: Provided further, That such funds shall not
be available for transfer until 30 days after the Secretary
has submitted, and the congressional defense committees have
approved, the proposed allocation plan for the use of such
funds to implement such strategy: Provided further, That such
allocation plan shall include a detailed justification for
the use of such funds and a description of how such
investments are necessary to implement the strategy: Provided
further, That the Secretary of Defense may transfer these
funds only to research, development, test and evaluation
accounts: Provided further, That the funds transferred shall
be merged with and shall be available for the same purposes
and for the same time period, as the appropriation to which
transferred: Provided further, That none of the funds made
available under this heading may be transferred to any
program, project, or activity specifically limited or denied
by this Act, except for missile defense requirements
resulting from urgent or emergent operational needs: Provided
further, That the transfer authority provided under this
heading is in addition to any other transfer authority
available to the Department of Defense.
TITLE V
REVOLVING AND MANAGEMENT FUNDS
Defense Working Capital Funds
For the Defense Working Capital Funds, $1,586,596,000.
TITLE VI
OTHER DEPARTMENT OF DEFENSE PROGRAMS
Defense Health Program
For expenses, not otherwise provided for, for medical and
health care programs of the Department of Defense as
authorized by law, $33,931,566,000 (increased by $7,000,000)
(increased by $1,000,000) (increased by $10,000,000)
(increased by $2,000,000) (increased by $2,000,000)
(increased by $10,000,000) (increased by $5,000,000)
(increased by $10,000,000); of which $31,735,923,000
(increased by $2,000,000) (increased by $5,000,000) shall be
for operation and maintenance, of which not to exceed one
percent shall remain available for obligation until September
30, 2019, and of which up to $15,349,700,000 may be available
for contracts entered into under the TRICARE program; of
which $895,328,000, to remain available for obligation until
September 30, 2020, shall be for procurement; and of which
$1,300,315,000 (increased by $7,000,000) (increased by
$1,000,000) (increased by $10,000,000) (increased by
$2,000,000) (increased by $10,000,000) (increased by
$10,000,000), to remain available for obligation until
September 30, 2019, shall be for research, development, test
and evaluation: Provided, That, notwithstanding any other
provision of law, of the amount made available under this
heading for research, development, test and evaluation, not
less than $8,000,000 shall be available for HIV prevention
educational activities undertaken in connection with United
States military training, exercises, and humanitarian
assistance activities conducted primarily in African nations:
Provided further, That of the funds provided under this
heading for research, development, test and evaluation, not
less than $627,100,000 shall be made available to the United
States Army Medical Research and Materiel Command to carry
out the congressionally directed medical research programs.
Chemical Agents and Munitions Destruction, Defense
For expenses, not otherwise provided for, necessary for the
destruction of the United States stockpile of lethal chemical
agents and munitions in accordance with the provisions of
section 1412 of the Department of Defense Authorization Act,
1986 (50 U.S.C. 1521), and for the destruction of other
chemical warfare materials that are not in the chemical
weapon stockpile, $961,732,000, of which $104,237,000 shall
be for operation and maintenance, of which no less than
$49,401,000 shall be for the Chemical Stockpile Emergency
Preparedness Program, consisting of $21,045,000 for
activities on military installations and $28,356,000, to
remain available until September 30, 2019, to assist State
and local governments; $18,081,000 shall be for procurement,
to remain available until September 30, 2020, of which
$18,081,000 shall be for the Chemical Stockpile Emergency
Preparedness Program to assist State and local governments;
and $839,414,000, to remain available until September 30,
2019, shall be for research, development, test and
evaluation, of which $750,700,000 shall only be for the
Assembled Chemical Weapons Alternatives program.
Drug Interdiction and Counter-Drug Activities, Defense
(including transfer of funds)
For drug interdiction and counter-drug activities of the
Department of Defense, for transfer to appropriations
available to the Department of Defense for military personnel
of the reserve components serving under the provisions of
title 10 and title 32, United States Code; for operation and
maintenance; for procurement; and for research, development,
test and evaluation, $854,814,000, of which $532,648,000
shall be for counter-narcotics support; $120,813,000 shall be
for the drug demand reduction program; and $201,353,000 shall
be for the National Guard counter-drug program: Provided,
That the funds appropriated under this heading shall be
available for obligation for the same time period and for the
same purpose as the appropriation to which transferred:
Provided further, That upon a determination that all or part
of the funds transferred from this appropriation are not
necessary for the purposes provided herein, such amounts may
be transferred back to this appropriation: Provided further,
That the transfer authority provided under this heading is in
addition to any other transfer authority contained elsewhere
in this Act.
Office of the Inspector General
For expenses and activities of the Office of the Inspector
General in carrying out the provisions of the Inspector
General Act of 1978, as amended, $336,887,000, of which
$334,087,000 shall be for operation and maintenance, of which
not to exceed $700,000 is available for emergencies and
extraordinary expenses to be expended on the approval or
authority of the Inspector General, and payments may be made
on the Inspector General's certificate of necessity for
confidential military purposes; and of which $2,800,000, to
remain available until September 30, 2019, shall be for
research, development, test and evaluation.
TITLE VII
RELATED AGENCIES
Central Intelligence Agency Retirement and Disability System Fund
For payment to the Central Intelligence Agency Retirement
and Disability System Fund, to maintain the proper funding
level for continuing the operation of the Central
Intelligence Agency Retirement and Disability System,
$514,000,000.
Intelligence Community Management Account
For necessary expenses of the Intelligence Community
Management Account, $522,100,000.
TITLE VIII
GENERAL PROVISIONS
Sec. 1101. No part of any appropriation contained in this
Act shall be used for publicity or propaganda purposes not
authorized by the Congress.
Sec. 1102. During the current fiscal year, provisions of
law prohibiting the payment of compensation to, or employment
of, any person not a citizen of the United States shall not
apply to personnel of the Department of Defense: Provided,
That salary increases granted to direct and indirect hire
foreign national employees of the Department of Defense
funded by this Act shall not be at a
[[Page H840]]
rate in excess of the percentage increase authorized by law
for civilian employees of the Department of Defense whose pay
is computed under the provisions of section 5332 of title 5,
United States Code, or at a rate in excess of the percentage
increase provided by the appropriate host nation to its own
employees, whichever is higher: Provided further, That this
section shall not apply to Department of Defense foreign
service national employees serving at United States
diplomatic missions whose pay is set by the Department of
State under the Foreign Service Act of 1980: Provided
further, That the limitations of this provision shall not
apply to foreign national employees of the Department of
Defense in the Republic of Turkey.
Sec. 1103. No part of any appropriation contained in this
Act shall remain available for obligation beyond the current
fiscal year, unless expressly so provided herein.
Sec. 1104. No more than 20 percent of the appropriations
in this Act which are limited for obligation during the
current fiscal year shall be obligated during the last 2
months of the fiscal year: Provided, That this section shall
not apply to obligations for support of active duty training
of reserve components or summer camp training of the Reserve
Officers' Training Corps.
(transfer of funds)
Sec. 1105. Upon determination by the Secretary of Defense
that such action is necessary in the national interest, he
may, with the approval of the Office of Management and
Budget, transfer not to exceed $4,500,000,000 of working
capital funds of the Department of Defense or funds made
available in this Act to the Department of Defense for
military functions (except military construction) between
such appropriations or funds or any subdivision thereof, to
be merged with and to be available for the same purposes, and
for the same time period, as the appropriation or fund to
which transferred: Provided, That such authority to transfer
may not be used unless for higher priority items, based on
unforeseen military requirements, than those for which
originally appropriated and in no case where the item for
which funds are requested has been denied by the Congress:
Provided further, That the Secretary of Defense shall notify
the Congress promptly of all transfers made pursuant to this
authority or any other authority in this Act: Provided
further, That no part of the funds in this Act shall be
available to prepare or present a request to the Committees
on Appropriations for reprogramming of funds, unless for
higher priority items, based on unforeseen military
requirements, than those for which originally appropriated
and in no case where the item for which reprogramming is
requested has been denied by the Congress: Provided further,
That a request for multiple reprogrammings of funds using
authority provided in this section shall be made prior to
June 30, 2017: Provided further, That transfers among
military personnel appropriations shall not be taken into
account for purposes of the limitation on the amount of funds
that may be transferred under this section.
Sec. 1106. (a) With regard to the list of specific
programs, projects, and activities (and the dollar amounts
and adjustments to budget activities corresponding to such
programs, projects, and activities) contained in the tables
titled Explanation of Project Level Adjustments in the
explanatory statement regarding this Act, the obligation and
expenditure of amounts appropriated or otherwise made
available in this Act for those programs, projects, and
activities for which the amounts appropriated exceed the
amounts requested are hereby required by law to be carried
out in the manner provided by such tables to the same extent
as if the tables were included in the text of this Act.
(b) Amounts specified in the referenced tables described in
subsection (a) shall not be treated as subdivisions of
appropriations for purposes of section 8005 of this Act:
Provided, That section 8005 shall apply when transfers of the
amounts described in subsection (a) occur between
appropriation accounts.
Sec. 1107. (a) Not later than 60 days after enactment of
this Act, the Department of Defense shall submit a report to
the congressional defense committees to establish the
baseline for application of reprogramming and transfer
authorities for fiscal year 2018: Provided, That the report
shall include--
(1) a table for each appropriation with a separate column
to display the President's budget request, adjustments made
by Congress, adjustments due to enacted rescissions, if
appropriate, and the fiscal year enacted level;
(2) a delineation in the table for each appropriation both
by budget activity and program, project, and activity as
detailed in the Budget Appendix; and
(3) an identification of items of special congressional
interest.
(b) Notwithstanding section 8005 of this Act, none of the
funds provided in this Act shall be available for
reprogramming or transfer until the report identified in
subsection (a) is submitted to the congressional defense
committees, unless the Secretary of Defense certifies in
writing to the congressional defense committees that such
reprogramming or transfer is necessary as an emergency
requirement: Provided, That this subsection shall not apply
to transfers from the following appropriations accounts:
(1) ``Environmental Restoration, Army'';
(2) ``Environmental Restoration, Navy'' ;
(3) ``Environmental Restoration, Air Force'';
(4) ``Environmental Restoration, Defense-Wide''
(5) ``Environmental Restoration, Formerly Used Defense
Sites''; and
(6) ``Drug Interdiction and Counter-drug Activities,
Defense''.
(transfer of funds)
Sec. 1108. During the current fiscal year, cash balances
in working capital funds of the Department of Defense
established pursuant to section 2208 of title 10, United
States Code, may be maintained in only such amounts as are
necessary at any time for cash disbursements to be made from
such funds: Provided, That transfers may be made between
such funds: Provided further, That transfers may be made
between working capital funds and the ``Foreign Currency
Fluctuations, Defense'' appropriation and the ``Operation and
Maintenance'' appropriation accounts in such amounts as may
be determined by the Secretary of Defense, with the approval
of the Office of Management and Budget, except that such
transfers may not be made unless the Secretary of Defense has
notified the Congress of the proposed transfer: Provided
further, That except in amounts equal to the amounts
appropriated to working capital funds in this Act, no
obligations may be made against a working capital fund to
procure or increase the value of war reserve material
inventory, unless the Secretary of Defense has notified the
Congress prior to any such obligation.
Sec. 1109. Funds appropriated by this Act may not be used
to initiate a special access program without prior
notification 30 calendar days in advance to the congressional
defense committees.
Sec. 1110. None of the funds provided in this Act shall be
available to initiate: (1) a multiyear contract that employs
economic order quantity procurement in excess of $20,000,000
in any one year of the contract or that includes an unfunded
contingent liability in excess of $20,000,000; or (2) a
contract for advance procurement leading to a multiyear
contract that employs economic order quantity procurement in
excess of $20,000,000 in any one year, unless the
congressional defense committees have been notified at least
30 days in advance of the proposed contract award: Provided,
That no part of any appropriation contained in this Act shall
be available to initiate a multiyear contract for which the
economic order quantity advance procurement is not funded at
least to the limits of the Government's liability: Provided
further, That no part of any appropriation contained in this
Act shall be available to initiate multiyear procurement
contracts for any systems or component thereof if the value
of the multiyear contract would exceed $500,000,000 unless
specifically provided in this Act: Provided further, That no
multiyear procurement contract can be terminated without 30-
day prior notification to the congressional defense
committees: Provided further, That the execution of
multiyear authority shall require the use of a present value
analysis to determine lowest cost compared to an annual
procurement: Provided further, That none of the funds
provided in this Act may be used for a multiyear contract
executed after the date of the enactment of this Act unless
in the case of any such contract--
(1) the Secretary of Defense has submitted to Congress a
budget request for full funding of units to be procured
through the contract and, in the case of a contract for
procurement of aircraft, that includes, for any aircraft unit
to be procured through the contract for which procurement
funds are requested in that budget request for production
beyond advance procurement activities in the fiscal year
covered by the budget, full funding of procurement of such
unit in that fiscal year;
(2) cancellation provisions in the contract do not include
consideration of recurring manufacturing costs of the
contractor associated with the production of unfunded units
to be delivered under the contract;
(3) the contract provides that payments to the contractor
under the contract shall not be made in advance of incurred
costs on funded units; and
(4) the contract does not provide for a price adjustment
based on a failure to award a follow-on contract.
Funds appropriated in title III of this Act may be used,
subject to section 2306b of title 10 , United States Code,
for multiyear procurement contracts as follows: V-22 Osprey
aircraft variants; up to 13 SSN Virginia Class Submarines and
Government-furnished equipment; and DDG-51 Arleigh Burke
class Flight III guided missile destroyers, the MK 41
Vertical Launching Systems, and associated Government-
furnished systems and subsystems.
Sec. 1111. Within the funds appropriated for the operation
and maintenance of the Armed Forces, funds are hereby
appropriated pursuant to section 401 of title 10, United
States Code, for humanitarian and civic assistance costs
under chapter 20 of title 10, United States Code. Such funds
may also be obligated for humanitarian and civic assistance
costs incidental to authorized operations and pursuant to
authority granted in section 401 of chapter 20 of title 10,
United States Code, and these obligations shall be reported
as required by section 401(d) of title 10, United States
Code: Provided, That funds available for operation and
maintenance shall be available for providing humanitarian and
similar assistance by using Civic
[[Page H841]]
Action Teams in the Trust Territories of the Pacific Islands
and freely associated states of Micronesia, pursuant to the
Compact of Free Association as authorized by Public Law 99-
239: Provided further, That upon a determination by the
Secretary of the Army that such action is beneficial for
graduate medical education programs conducted at Army medical
facilities located in Hawaii, the Secretary of the Army may
authorize the provision of medical services at such
facilities and transportation to such facilities, on a
nonreimbursable basis, for civilian patients from American
Samoa, the Commonwealth of the Northern Mariana Islands, the
Marshall Islands, the Federated States of Micronesia, Palau,
and Guam.
Sec. 1112. (a) During the current fiscal year, the civilian
personnel of the Department of Defense may not be managed on
the basis of any end-strength, and the management of such
personnel during that fiscal year shall not be subject to any
constraint or limitation (known as an end-strength) on the
number of such personnel who may be employed on the last day
of such fiscal year.
(b) The fiscal year 2019 budget request for the Department
of Defense as well as all justification material and other
documentation supporting the fiscal year 2019 Department of
Defense budget request shall be prepared and submitted to the
Congress as if subsections (a) and (b) of this provision were
effective with regard to fiscal year 2019.
(c) As required by section 1107 of the National Defense
Authorization Act for Fiscal Year 2014 (Public Law 113-66; 10
U.S.C. 2358 note) civilian personnel at the Department of
Army Science and Technology Reinvention Laboratories may not
be managed on the basis of the Table of Distribution and
Allowances, and the management of the workforce strength
shall be done in a manner consistent with the budget
available with respect to such Laboratories.
(d) Nothing in this section shall be construed to apply to
military (civilian) technicians.
Sec. 1113. None of the funds made available by this Act
shall be used in any way, directly or indirectly, to
influence congressional action on any legislation or
appropriation matters pending before the Congress.
Sec. 1114. None of the funds appropriated by this Act
shall be available for the basic pay and allowances of any
member of the Army participating as a full-time student and
receiving benefits paid by the Secretary of Veterans Affairs
from the Department of Defense Education Benefits Fund when
time spent as a full-time student is credited toward
completion of a service commitment: Provided, That this
section shall not apply to those members who have reenlisted
with this option prior to October 1, 1987: Provided further,
That this section applies only to active components of the
Army.
(transfer of funds)
Sec. 1115. Funds appropriated in title III of this Act for
the Department of Defense Pilot Mentor-Protege Program may be
transferred to any other appropriation contained in this Act
solely for the purpose of implementing a Mentor-Protege
Program developmental assistance agreement pursuant to
section 831 of the National Defense Authorization Act for
Fiscal Year 1991 (Public Law 101-510; 10 U.S.C. 2302 note),
as amended, under the authority of this provision or any
other transfer authority contained in this Act.
Sec. 1116. None of the funds in this Act may be available
for the purchase by the Department of Defense (and its
departments and agencies) of welded shipboard anchor and
mooring chain 4 inches in diameter and under unless the
anchor and mooring chain are manufactured in the United
States from components which are substantially manufactured
in the United States: Provided, That for the purpose of this
section, the term ``manufactured'' shall include cutting,
heat treating, quality control, testing of chain and welding
(including the forging and shot blasting process): Provided
further, That for the purpose of this section substantially
all of the components of anchor and mooring chain shall be
considered to be produced or manufactured in the United
States if the aggregate cost of the components produced or
manufactured in the United States exceeds the aggregate cost
of the components produced or manufactured outside the United
States: Provided further, That when adequate domestic
supplies are not available to meet Department of Defense
requirements on a timely basis, the Secretary of the service
responsible for the procurement may waive this restriction on
a case-by-case basis by certifying in writing to the
Committees on Appropriations that such an acquisition must be
made in order to acquire capability for national security
purposes.
Sec. 1117. None of the funds available to the Department
of Defense may be used to demilitarize or dispose of M-1
Carbines, M-1 Garand rifles, M-14 rifles, .22 caliber rifles,
.30 caliber rifles, or M-1911 pistols, or to demilitarize or
destroy small arms ammunition or ammunition components that
are not otherwise prohibited from commercial sale under
Federal law, unless the small arms ammunition or ammunition
components are certified by the Secretary of the Army or
designee as unserviceable or unsafe for further use.
Sec. 1118. No more than $500,000 of the funds appropriated
or made available in this Act shall be used during a single
fiscal year for any single relocation of an organization,
unit, activity or function of the Department of Defense into
or within the National Capital Region: Provided, That the
Secretary of Defense may waive this restriction on a case-by-
case basis by certifying in writing to the congressional
defense committees that such a relocation is required in the
best interest of the Government.
Sec. 1119. Of the funds made available in this Act,
$20,000,000 shall be available for incentive payments
authorized by section 504 of the Indian Financing Act of 1974
(25 U.S.C. 1544): Provided, That a prime contractor or a
subcontractor at any tier that makes a subcontract award to
any subcontractor or supplier as defined in section 1544 of
title 25, United States Code, or a small business owned and
controlled by an individual or individuals defined under
section 4221(9) of title 25, United States Code, shall be
considered a contractor for the purposes of being allowed
additional compensation under section 504 of the Indian
Financing Act of 1974 (25 U.S.C. 1544) whenever the prime
contract or subcontract amount is over $500,000 and involves
the expenditure of funds appropriated by an Act making
appropriations for the Department of Defense with respect to
any fiscal year: Provided further, That notwithstanding
section 1906 of title 41, United States Code, this section
shall be applicable to any Department of Defense acquisition
of supplies or services, including any contract and any
subcontract at any tier for acquisition of commercial items
produced or manufactured, in whole or in part, by any
subcontractor or supplier defined in section 1544 of title
25, United States Code, or a small business owned and
controlled by an individual or individuals defined under
section 4221(9) of title 25, United States Code.
Sec. 1120. Funds appropriated by this Act for the Defense
Media Activity shall not be used for any national or
international political or psychological activities.
Sec. 1121. During the current fiscal year, the Department
of Defense is authorized to incur obligations of not to
exceed $350,000,000 for purposes specified in section
2350j(c) of title 10, United States Code, in anticipation of
receipt of contributions, only from the Government of Kuwait,
under that section: Provided, That, upon receipt, such
contributions from the Government of Kuwait shall be credited
to the appropriations or fund which incurred such
obligations.
Sec. 1122. (a) Of the funds made available in this Act, not
less than $43,100,000 shall be available for the Civil Air
Patrol Corporation, of which--
(1) $30,800,000 shall be available from ``Operation and
Maintenance, Air Force'' to support Civil Air Patrol
Corporation operation and maintenance, readiness, counter-
drug activities, and drug demand reduction activities
involving youth programs;
(2) $10,600,000 shall be available from ``Aircraft
Procurement, Air Force''; and
(3) $1,700,000 shall be available from ``Other Procurement,
Air Force'' for vehicle procurement.
(b) The Secretary of the Air Force should waive
reimbursement for any funds used by the Civil Air Patrol for
counter-drug activities in support of Federal, State, and
local government agencies.
Sec. 1123. (a) None of the funds appropriated in this Act
are available to establish a new Department of Defense
(department) federally funded research and development center
(FFRDC), either as a new entity, or as a separate entity
administrated by an organization managing another FFRDC, or
as a nonprofit membership corporation consisting of a
consortium of other FFRDCs and other nonprofit entities.
(b) No member of a Board of Directors, Trustees, Overseers,
Advisory Group, Special Issues Panel, Visiting Committee, or
any similar entity of a defense FFRDC, and no paid consultant
to any defense FFRDC, except when acting in a technical
advisory capacity, may be compensated for his or her services
as a member of such entity, or as a paid consultant by more
than one FFRDC in a fiscal year: Provided, That a member of
any such entity referred to previously in this subsection
shall be allowed travel expenses and per diem as authorized
under the Federal Joint Travel Regulations, when engaged in
the performance of membership duties.
(c) Notwithstanding any other provision of law, none of the
funds available to the department from any source during the
current fiscal year may be used by a defense FFRDC, through a
fee or other payment mechanism, for construction of new
buildings not located on a military installation, for payment
of cost sharing for projects funded by Government grants, for
absorption of contract overruns, or for certain charitable
contributions, not to include employee participation in
community service and/or development.
(d) Notwithstanding any other provision of law, of the
funds available to the department during fiscal year 2018,
not more than 6,000 staff years of technical effort (staff
years) may be funded for defense FFRDCs: Provided, That, of
the specific amount referred to previously in this
subsection, not more than 1,180 staff years may be funded for
the defense studies and analysis FFRDCs: Provided further,
That this subsection shall not apply to staff years funded in
the National Intelligence Program (NIP) and the Military
Intelligence Program (MIP).
(e) The Secretary of Defense shall, with the submission of
the department's fiscal year 2019 budget request, submit a
report presenting the specific amounts of staff years of
technical effort to be allocated for each defense FFRDC
during that fiscal year and the associated budget estimates.
(f) Notwithstanding any other provision of this Act, the
total amount appropriated in
[[Page H842]]
this Act for FFRDCs is hereby reduced by $210,000,000.
Sec. 1124. None of the funds appropriated or made
available in this Act shall be used to procure carbon, alloy,
or armor steel plate for use in any Government-owned facility
or property under the control of the Department of Defense
which were not melted and rolled in the United States or
Canada: Provided, That these procurement restrictions shall
apply to any and all Federal Supply Class 9515, American
Society of Testing and Materials (ASTM) or American Iron and
Steel Institute (AISI) specifications of carbon, alloy or
armor steel plate: Provided further, That the Secretary of
the military department responsible for the procurement may
waive this restriction on a case-by-case basis by certifying
in writing to the Committees on Appropriations of the House
of Representatives and the Senate that adequate domestic
supplies are not available to meet Department of Defense
requirements on a timely basis and that such an acquisition
must be made in order to acquire capability for national
security purposes: Provided further, That these restrictions
shall not apply to contracts which are in being as of the
date of the enactment of this Act.
Sec. 1125. For the purposes of this Act, the term
``congressional defense committees'' means the Armed Services
Committee of the House of Representatives, the Armed Services
Committee of the Senate, the Subcommittee on Defense of the
Committee on Appropriations of the Senate, and the
Subcommittee on Defense of the Committee on Appropriations of
the House of Representatives.
Sec. 1126. During the current fiscal year, the Department
of Defense may acquire the modification, depot maintenance
and repair of aircraft, vehicles and vessels as well as the
production of components and other Defense-related articles,
through competition between Department of Defense depot
maintenance activities and private firms: Provided, That the
Senior Acquisition Executive of the military department or
Defense Agency concerned, with power of delegation, shall
certify that successful bids include comparable estimates of
all direct and indirect costs for both public and private
bids: Provided further, That Office of Management and Budget
Circular A-76 shall not apply to competitions conducted under
this section.
Sec. 1127. (a)(1) If the Secretary of Defense, after
consultation with the United States Trade Representative,
determines that a foreign country which is party to an
agreement described in paragraph (2) has violated the terms
of the agreement by discriminating against certain types of
products produced in the United States that are covered by
the agreement, the Secretary of Defense shall rescind the
Secretary's blanket waiver of the Buy American Act with
respect to such types of products produced in that foreign
country.
(2) An agreement referred to in paragraph (1) is any
reciprocal defense procurement memorandum of understanding,
between the United States and a foreign country pursuant to
which the Secretary of Defense has prospectively waived the
Buy American Act for certain products in that country.
(b) The Secretary of Defense shall submit to the Congress a
report on the amount of Department of Defense purchases from
foreign entities in fiscal year 2018. Such report shall
separately indicate the dollar value of items for which the
Buy American Act was waived pursuant to any agreement
described in subsection (a)(2), the Trade Agreement Act of
1979 (19 U.S.C. 2501 et seq.), or any international agreement
to which the United States is a party.
(c) For purposes of this section, the term Buy American Act
means chapter 83 of title 41, United States Code.
Sec. 1128. During the current fiscal year, amounts
contained in the Department of Defense Overseas Military
Facility Investment Recovery Account established by section
2921(c)(1) of the National Defense Authorization Act of 1991
(Public Law 101-510; 10 U.S.C. 2687 note) shall be available
until expended for the payments specified by section
2921(c)(2) of that Act.
Sec. 1129. (a) Notwithstanding any other provision of law,
the Secretary of the Air Force may convey at no cost to the
Air Force, without consideration, to Indian tribes located in
the States of Nevada, Idaho, North Dakota, South Dakota,
Montana, Oregon, Minnesota, and Washington relocatable
military housing units located at Grand Forks Air Force Base,
Malmstrom Air Force Base, Mountain Home Air Force Base,
Ellsworth Air Force Base, and Minot Air Force Base that are
excess to the needs of the Air Force.
(b) The Secretary of the Air Force shall convey, at no cost
to the Air Force, military housing units under subsection (a)
in accordance with the request for such units that are
submitted to the Secretary by the Operation Walking Shield
Program on behalf of Indian tribes located in the States of
Nevada, Idaho, North Dakota, South Dakota, Montana, Oregon,
Minnesota, and Washington. Any such conveyance shall be
subject to the condition that the housing units shall be
removed within a reasonable period of time, as determined by
the Secretary.
(c) The Operation Walking Shield Program shall resolve any
conflicts among requests of Indian tribes for housing units
under subsection (a) before submitting requests to the
Secretary of the Air Force under subsection (b).
(d) In this section, the term Indian tribe means any
recognized Indian tribe included on the current list
published by the Secretary of the Interior under section 104
of the Federally Recognized Indian Tribe Act of 1994 (Public
Law 103-454; 108 Stat. 4792; 25 U.S.C. 479a-1).
Sec. 1130. During the current fiscal year, appropriations
which are available to the Department of Defense for
operation and maintenance may be used to purchase items
having an investment item unit cost of not more than
$250,000.
Sec. 1131. None of the funds made available by this Act
may be used to--
(1) disestablish, or prepare to disestablish, a Senior
Reserve Officers' Training Corps program in accordance with
Department of Defense Instruction Number 1215.08, dated June
26, 2006; or
(2) close, downgrade from host to extension center, or
place on probation a Senior Reserve Officers' Training Corps
program in accordance with the information paper of the
Department of the Army titled ``Army Senior Reserve Officers'
Training Corps (SROTC) Program Review and Criteria'', dated
January 27, 2014.
Sec. 1132. The Secretary of Defense shall issue
regulations to prohibit the sale of any tobacco or tobacco-
related products in military resale outlets in the United
States, its territories and possessions at a price below the
most competitive price in the local community: Provided,
That such regulations shall direct that the prices of tobacco
or tobacco-related products in overseas military retail
outlets shall be within the range of prices established for
military retail system stores located in the United States.
Sec. 1133. (a) During the current fiscal year, none of the
appropriations or funds available to the Department of
Defense Working Capital Funds shall be used for the purchase
of an investment item for the purpose of acquiring a new
inventory item for sale or anticipated sale during the
current fiscal year or a subsequent fiscal year to customers
of the Department of Defense Working Capital Funds if such an
item would not have been chargeable to the Department of
Defense Business Operations Fund during fiscal year 1994 and
if the purchase of such an investment item would be
chargeable during the current fiscal year to appropriations
made to the Department of Defense for procurement.
(b) The fiscal year 2019 budget request for the Department
of Defense as well as all justification material and other
documentation supporting the fiscal year 2019 Department of
Defense budget shall be prepared and submitted to the
Congress on the basis that any equipment which was classified
as an end item and funded in a procurement appropriation
contained in this Act shall be budgeted for in a proposed
fiscal year 2019 procurement appropriation and not in the
supply management business area or any other area or category
of the Department of Defense Working Capital Funds.
Sec. 1134. None of the funds appropriated by this Act for
programs of the Central Intelligence Agency shall remain
available for obligation beyond the current fiscal year,
except for funds appropriated for the Reserve for
Contingencies, which shall remain available until September
30, 2019: Provided, That funds appropriated, transferred, or
otherwise credited to the Central Intelligence Agency Central
Services Working Capital Fund during this or any prior or
subsequent fiscal year shall remain available until expended:
Provided further, That any funds appropriated or transferred
to the Central Intelligence Agency for advanced research and
development acquisition, for agent operations, and for covert
action programs authorized by the President under section 503
of the National Security Act of 1947 (50 U.S.C. 3093) shall
remain available until September 30, 2019.
Sec. 1135. Notwithstanding any other provision of law,
funds made available in this Act and hereafter for the
Defense Intelligence Agency may be used for the design,
development, and deployment of General Defense Intelligence
Program intelligence communications and intelligence
information systems for the Services, the Unified and
Specified Commands, and the component commands.
Sec. 1136. Of the funds appropriated to the Department of
Defense under the heading ``Operation and Maintenance,
Defense-Wide'', not less than $12,000,000 shall be made
available only for the mitigation of environmental impacts,
including training and technical assistance to tribes,
related administrative support, the gathering of information,
documenting of environmental damage, and developing a system
for prioritization of mitigation and cost to complete
estimates for mitigation, on Indian lands resulting from
Department of Defense activities.
Sec. 1137. (a) None of the funds appropriated in this Act
may be expended by an entity of the Department of Defense
unless the entity, in expending the funds, complies with the
Buy American Act. For purposes of this subsection, the term
Buy American Act means chapter 83 of title 41, United States
Code.
(b) If the Secretary of Defense determines that a person
has been convicted of intentionally affixing a label bearing
a ``Made in America'' inscription to any product sold in or
shipped to the United States that is not made in America, the
Secretary shall determine, in accordance with section 2410f
of title 10, United States Code, whether the person should be
debarred from contracting with the Department of Defense.
(c) In the case of any equipment or products purchased with
appropriations provided under this Act, it is the sense of
the Congress
[[Page H843]]
that any entity of the Department of Defense, in expending
the appropriation, purchase only American-made equipment and
products, provided that American-made equipment and products
are cost-competitive, quality competitive, and available in a
timely fashion.
Sec. 1138. (a) Except as provided in subsections (b) and
(c), none of the funds made available by this Act may be
used--
(1) to establish a field operating agency; or
(2) to pay the basic pay of a member of the Armed Forces or
civilian employee of the department who is transferred or
reassigned from a headquarters activity if the member or
employee's place of duty remains at the location of that
headquarters.
(b) The Secretary of Defense or Secretary of a military
department may waive the limitations in subsection (a), on a
case-by-case basis, if the Secretary determines, and
certifies to the Committees on Appropriations of the House of
Representatives and the Senate that the granting of the
waiver will reduce the personnel requirements or the
financial requirements of the department.
(c) This section does not apply to--
(1) field operating agencies funded within the National
Intelligence Program;
(2) an Army field operating agency established to
eliminate, mitigate, or counter the effects of improvised
explosive devices, and, as determined by the Secretary of the
Army, other similar threats;
(3) an Army field operating agency established to improve
the effectiveness and efficiencies of biometric activities
and to integrate common biometric technologies throughout the
Department of Defense; or
(4) an Air Force field operating agency established to
administer the Air Force Mortuary Affairs Program and
Mortuary Operations for the Department of Defense and
authorized Federal entities.
Sec. 1139. (a) None of the funds appropriated by this Act
shall be available to convert to contractor performance an
activity or function of the Department of Defense that, on or
after the date of the enactment of this Act, is performed by
Department of Defense civilian employees unless--
(1) the conversion is based on the result of a public-
private competition that includes a most efficient and cost
effective organization plan developed by such activity or
function;
(2) the Competitive Sourcing Official determines that, over
all performance periods stated in the solicitation of offers
for performance of the activity or function, the cost of
performance of the activity or function by a contractor would
be less costly to the Department of Defense by an amount that
equals or exceeds the lesser of--
(A) 10 percent of the most efficient organization's
personnel-related costs for performance of that activity or
function by Federal employees; or
(B) $10,000,000; and
(3) the contractor does not receive an advantage for a
proposal that would reduce costs for the Department of
Defense by--
(A) not making an employer-sponsored health insurance plan
available to the workers who are to be employed in the
performance of that activity or function under the contract;
or
(B) offering to such workers an employer-sponsored health
benefits plan that requires the employer to contribute less
towards the premium or subscription share than the amount
that is paid by the Department of Defense for health benefits
for civilian employees under chapter 89 of title 5, United
States Code.
(b)(1) The Department of Defense, without regard to
subsection (a) of this section or subsection (a), (b), or (c)
of section 2461 of title 10, United States Code, and
notwithstanding any administrative regulation, requirement,
or policy to the contrary shall have full authority to enter
into a contract for the performance of any commercial or
industrial type function of the Department of Defense that--
(A) is included on the procurement list established
pursuant to section 2 of the Javits-Wagner-O'Day Act (section
8503 of title 41, United States Code);
(B) is planned to be converted to performance by a
qualified nonprofit agency for the blind or by a qualified
nonprofit agency for other severely handicapped individuals
in accordance with that Act; or
(C) is planned to be converted to performance by a
qualified firm under at least 51 percent ownership by an
Indian tribe, as defined in section 4(e) of the Indian Self-
Determination and Education Assistance Act (25 U.S.C.
450b(e)), or a Native Hawaiian Organization, as defined in
section 8(a)(15) of the Small Business Act (15 U.S.C.
637(a)(15)).
(2) This section shall not apply to depot contracts or
contracts for depot maintenance as provided in sections 2469
and 2474 of title 10, United States Code.
(c) The conversion of any activity or function of the
Department of Defense under the authority provided by this
section shall be credited toward any competitive or
outsourcing goal, target, or measurement that may be
established by statute, regulation, or policy and is deemed
to be awarded under the authority of, and in compliance with,
subsection (h) of section 2304 of title 10, United States
Code, for the competition or outsourcing of commercial
activities.
(rescissions)
Sec. 1140. Of the funds appropriated in Department of
Defense Appropriations Acts, the following funds are hereby
rescinded from the following accounts and programs in the
specified amounts: Provided, That no amounts may be
rescinded from amounts that were designated by the Congress
for Overseas Contingency Operations/Global War on Terrorism
or as an emergency requirement pursuant to the Concurrent
Resolution on the Budget or the Balanced Budget and Emergency
Deficit Control Act of 1985, as amended:
``Aircraft Procurement, Navy'', 2016/2018, $274,000,000;
``Aircraft Procurement, Air Force'', 2016/2018,
$82,700,000;
``Missile Procurement, Army'', 2017/2019, $19,319,000;
``Procurement of Weapons and Tracked Combat Vehicles,
Army'', 2017/2019, $9,764,000;
``Other Procurement, Army'', 2017/2019, $10,000,000;
``Aircraft Procurement, Navy'', 2017/2019, $105,600,000;
``Weapons Procurement, Navy'', 2017/2019, $54,122,000;
``Shipbuilding and Conversion, Navy'', 2017/2021,
$45,116,000;
``Aircraft Procurement, Air Force'', 2017/2019,
$63,293,000;
``Missile Procurement, Air Force'', 2017/2019, $31,639,000;
``Space Procurement, Air Force'', 2017/2019, $15,000,000;
``Other Procurement, Air Force'', 2017/2019, $105,000,000;
``Research, Development, Test and Evaluation, Navy'', 2017/
2018, $34,128,000;
``Research, Development, Test and Evaluation, Air Force'',
2017/2018, $41,700,000.
Sec. 1141. None of the funds available in this Act may be
used to reduce the authorized positions for military
technicians (dual status) of the Army National Guard, Air
National Guard, Army Reserve and Air Force Reserve for the
purpose of applying any administratively imposed civilian
personnel ceiling, freeze, or reduction on military
technicians (dual status), unless such reductions are a
direct result of a reduction in military force structure.
Sec. 1142. None of the funds appropriated or otherwise
made available in this Act may be obligated or expended for
assistance to the Democratic People's Republic of Korea
unless specifically appropriated for that purpose.
Sec. 1143. Funds appropriated in this Act for operation
and maintenance of the Military Departments, Combatant
Commands and Defense Agencies shall be available for
reimbursement of pay, allowances and other expenses which
would otherwise be incurred against appropriations for the
National Guard and Reserve when members of the National Guard
and Reserve provide intelligence or counterintelligence
support to Combatant Commands, Defense Agencies and Joint
Intelligence Activities, including the activities and
programs included within the National Intelligence Program
and the Military Intelligence Program: Provided, That
nothing in this section authorizes deviation from established
Reserve and National Guard personnel and training procedures.
Sec. 1144. (a) None of the funds available to the
Department of Defense for any fiscal year for drug
interdiction or counter-drug activities may be transferred to
any other department or agency of the United States except as
specifically provided in an appropriations law.
(b) None of the funds available to the Central Intelligence
Agency for any fiscal year for drug interdiction or counter-
drug activities may be transferred to any other department or
agency of the United States except as specifically provided
in an appropriations law.
Sec. 1145. None of the funds appropriated by this Act may
be used for the procurement of ball and roller bearings other
than those produced by a domestic source and of domestic
origin: Provided, That the Secretary of the military
department responsible for such procurement may waive this
restriction on a case-by-case basis by certifying in writing
to the Committees on Appropriations of the House of
Representatives and the Senate, that adequate domestic
supplies are not available to meet Department of Defense
requirements on a timely basis and that such an acquisition
must be made in order to acquire capability for national
security purposes: Provided further, That this restriction
shall not apply to the purchase of ``commercial items'', as
defined by section 103 of title 41, United States Code,
except that the restriction shall apply to ball or roller
bearings purchased as end items.
Sec. 1146. None of the funds made available by this Act
for Evolved Expendable Launch Vehicle service competitive
procurements may be used unless the competitive procurements
are open for award to all certified providers of Evolved
Expendable Launch Vehicle-class systems: Provided, That the
award shall be made to the provider that offers the best
value to the government.
Sec. 1147. In addition to the amounts appropriated or
otherwise made available elsewhere in this Act, $44,000,000
is hereby appropriated to the Department of Defense:
Provided, That upon the determination of the Secretary of
Defense that it shall serve the national interest, the
Secretary shall make grants in the amounts specified as
follows: $20,000,000 to the United Service Organizations and
$24,000,000 to the Red Cross.
Sec. 1148. None of the funds in this Act may be used to
purchase any supercomputer which is not manufactured in the
United States, unless the Secretary of Defense certifies to
the congressional defense committees that such an acquisition
must be made
[[Page H844]]
in order to acquire capability for national security purposes
that is not available from United States manufacturers.
Sec. 1149. Notwithstanding any other provision in this
Act, the Small Business Innovation Research program and the
Small Business Technology Transfer program set-asides shall
be taken proportionally from all programs, projects, or
activities to the extent they contribute to the extramural
budget.
Sec. 1150. None of the funds available to the Department
of Defense under this Act shall be obligated or expended to
pay a contractor under a contract with the Department of
Defense for costs of any amount paid by the contractor to an
employee when--
(1) such costs are for a bonus or otherwise in excess of
the normal salary paid by the contractor to the employee; and
(2) such bonus is part of restructuring costs associated
with a business combination.
(including transfer of funds)
Sec. 1151. During the current fiscal year, no more than
$30,000,000 of appropriations made in this Act under the
heading ``Operation and Maintenance, Defense-Wide'' may be
transferred to appropriations available for the pay of
military personnel, to be merged with, and to be available
for the same time period as the appropriations to which
transferred, to be used in support of such personnel in
connection with support and services for eligible
organizations and activities outside the Department of
Defense pursuant to section 2012 of title 10, United States
Code.
Sec. 1152. During the current fiscal year, in the case of
an appropriation account of the Department of Defense for
which the period of availability for obligation has expired
or which has closed under the provisions of section 1552 of
title 31, United States Code, and which has a negative
unliquidated or unexpended balance, an obligation or an
adjustment of an obligation may be charged to any current
appropriation account for the same purpose as the expired or
closed account if--
(1) the obligation would have been properly chargeable
(except as to amount) to the expired or closed account before
the end of the period of availability or closing of that
account;
(2) the obligation is not otherwise properly chargeable to
any current appropriation account of the Department of
Defense; and
(3) in the case of an expired account, the obligation is
not chargeable to a current appropriation of the Department
of Defense under the provisions of section 1405(b)(8) of the
National Defense Authorization Act for Fiscal Year 1991,
Public Law 101-510, as amended (31 U.S.C. 1551 note):
Provided, That in the case of an expired account, if
subsequent review or investigation discloses that there was
not in fact a negative unliquidated or unexpended balance in
the account, any charge to a current account under the
authority of this section shall be reversed and recorded
against the expired account: Provided further, That the
total amount charged to a current appropriation under this
section may not exceed an amount equal to 1 percent of the
total appropriation for that account.
Sec. 1153. (a) Notwithstanding any other provision of law,
the Chief of the National Guard Bureau may permit the use of
equipment of the National Guard Distance Learning Project by
any person or entity on a space-available, reimbursable
basis. The Chief of the National Guard Bureau shall establish
the amount of reimbursement for such use on a case-by-case
basis.
(b) Amounts collected under subsection (a) shall be
credited to funds available for the National Guard Distance
Learning Project and be available to defray the costs
associated with the use of equipment of the project under
that subsection. Such funds shall be available for such
purposes without fiscal year limitation.
Sec. 1154. None of the funds available to the Department
of Defense may be obligated to modify command and control
relationships to give Fleet Forces Command operational and
administrative control of United States Navy forces assigned
to the Pacific fleet: Provided, That the command and control
relationships which existed on October 1, 2004, shall remain
in force until a written modification has been proposed to
the House and Senate Appropriations Committees: Provided
further, That the proposed modification may be implemented 30
days after the notification unless an objection is received
from either the House or Senate Appropriations Committees:
Provided further, That any proposed modification shall not
preclude the ability of the commander of United States
Pacific Command to meet operational requirements.
(including transfer of funds)
Sec. 1155. Of the funds appropriated in this Act under the
heading ``Operation and Maintenance, Defense-Wide'',
$25,000,000 (increased by $10,000,000) shall be for continued
implementation and expansion of the Sexual Assault Special
Victims' Counsel Program: Provided, That the funds are made
available for transfer to the Department of the Army, the
Department of the Navy, and the Department of the Air Force:
Provided further, That funds transferred shall be merged with
and available for the same purposes and for the same time
period as the appropriations to which the funds are
transferred: Provided further, That this transfer authority
is in addition to any other transfer authority provided in
this Act.
Sec. 1156. None of the funds appropriated in title IV of
this Act may be used to procure end-items for delivery to
military forces for operational training, operational use or
inventory requirements: Provided, That this restriction does
not apply to end-items used in development, prototyping, and
test activities preceding and leading to acceptance for
operational use: Provided further, That this restriction
does not apply to programs funded within the National
Intelligence Program: Provided further, That the Secretary
of Defense may waive this restriction on a case-by-case basis
by certifying in writing to the Committees on Appropriations
of the House of Representatives and the Senate that it is in
the national security interest to do so.
Sec. 1157. (a) The Secretary of Defense may, on a case-by-
case basis, waive with respect to a foreign country each
limitation on the procurement of defense items from foreign
sources provided in law if the Secretary determines that the
application of the limitation with respect to that country
would invalidate cooperative programs entered into between
the Department of Defense and the foreign country, or would
invalidate reciprocal trade agreements for the procurement of
defense items entered into under section 2531 of title 10,
United States Code, and the country does not discriminate
against the same or similar defense items produced in the
United States for that country.
(b) Subsection (a) applies with respect to--
(1) contracts and subcontracts entered into on or after the
date of the enactment of this Act; and
(2) options for the procurement of items that are exercised
after such date under contracts that are entered into before
such date if the option prices are adjusted for any reason
other than the application of a waiver granted under
subsection (a).
(c) Subsection (a) does not apply to a limitation regarding
construction of public vessels, ball and roller bearings,
food, and clothing or textile materials as defined by section
XI (chapters 50-65) of the Harmonized Tariff Schedule of the
United States and products classified under headings 4010,
4202, 4203, 6401 through 6406, 6505, 7019, 7218 through 7229,
7304.41 through 7304.49, 7306.40, 7502 through 7508, 8105,
8108, 8109, 8211, 8215, and 9404.
Sec. 1158. None of the funds appropriated or otherwise
made available by this or other Department of Defense
Appropriations Acts may be obligated or expended for the
purpose of performing repairs or maintenance to military
family housing units of the Department of Defense, including
areas in such military family housing units that may be used
for the purpose of conducting official Department of Defense
business.
Sec. 1159. Notwithstanding any other provision of law,
funds appropriated in this Act under the heading ``Research,
Development, Test and Evaluation, Defense-Wide'' for any new
start advanced concept technology demonstration project or
joint capability demonstration project may only be obligated
45 days after a report, including a description of the
project, the planned acquisition and transition strategy and
its estimated annual and total cost, has been provided in
writing to the congressional defense committees: Provided,
That the Secretary of Defense may waive this restriction on a
case-by-case basis by certifying to the congressional defense
committees that it is in the national interest to do so.
Sec. 1160. The Secretary of Defense shall continue to
provide a classified quarterly report to the House and Senate
Appropriations Committees, Subcommittees on Defense on
certain matters as directed in the classified annex
accompanying this Act.
Sec. 1161. Notwithstanding section 12310(b) of title 10,
United States Code, a Reserve who is a member of the National
Guard serving on full-time National Guard duty under section
502(f) of title 32, United States Code, may perform duties in
support of the ground-based elements of the National
Ballistic Missile Defense System.
Sec. 1162. None of the funds provided in this Act may be
used to transfer to any nongovernmental entity ammunition
held by the Department of Defense that has a center-fire
cartridge and a United States military nomenclature
designation of ``armor penetrator'', ``armor piercing (AP)'',
``armor piercing incendiary (API)'', or ``armor-piercing
incendiary tracer (API-T)'', except to an entity performing
demilitarization services for the Department of Defense under
a contract that requires the entity to demonstrate to the
satisfaction of the Department of Defense that armor piercing
projectiles are either:
(1) rendered incapable of reuse by the demilitarization
process; or
(2) used to manufacture ammunition pursuant to a contract
with the Department of Defense or the manufacture of
ammunition for export pursuant to a License for Permanent
Export of Unclassified Military Articles issued by the
Department of State.
Sec. 1163. Notwithstanding any other provision of law, the
Chief of the National Guard Bureau, or his designee, may
waive payment of all or part of the consideration that
otherwise would be required under section 2667 of title 10,
United States Code, in the case of a lease of personal
property for a period not in excess of 1 year to any
organization specified in section 508(d) of title 32, United
States Code, or any other youth, social, or fraternal
nonprofit organization as may be approved by the Chief of the
National Guard Bureau, or his designee, on a case-by-case
basis.
(including transfer of funds)
Sec. 1164. Of the amounts appropriated in this Act under
the heading ``Operation and
[[Page H845]]
Maintenance, Army'', $66,881,780 shall remain available until
expended: Provided, That, notwithstanding any other
provision of law, the Secretary of Defense is authorized to
transfer such funds to other activities of the Federal
Government: Provided further, That the Secretary of Defense
is authorized to enter into and carry out contracts for the
acquisition of real property, construction, personal
services, and operations related to projects carrying out the
purposes of this section: Provided further, That contracts
entered into under the authority of this section may provide
for such indemnification as the Secretary determines to be
necessary: Provided further, That projects authorized by
this section shall comply with applicable Federal, State, and
local law to the maximum extent consistent with the national
security, as determined by the Secretary of Defense.
Sec. 1165. (a) None of the funds appropriated in this or
any other Act may be used to take any action to modify--
(1) the appropriations account structure for the National
Intelligence Program budget, including through the creation
of a new appropriation or new appropriation account;
(2) how the National Intelligence Program budget request is
presented in the unclassified P-1, R-1, and O-1 documents
supporting the Department of Defense budget request;
(3) the process by which the National Intelligence Program
appropriations are apportioned to the executing agencies; or
(4) the process by which the National Intelligence Program
appropriations are allotted, obligated and disbursed.
(b) Nothing in section (a) shall be construed to prohibit
the merger of programs or changes to the National
Intelligence Program budget at or below the Expenditure
Center level, provided such change is otherwise in accordance
with paragraphs (a)(1)-(3).
(c) The Director of National Intelligence and the Secretary
of Defense may jointly, only for the purposes of achieving
auditable financial statements and improving fiscal
reporting, study and develop detailed proposals for
alternative financial management processes. Such study shall
include a comprehensive counterintelligence risk assessment
to ensure that none of the alternative processes will
adversely affect counterintelligence.
(d) Upon development of the detailed proposals defined
under subsection (c), the Director of National Intelligence
and the Secretary of Defense shall--
(1) provide the proposed alternatives to all affected
agencies;
(2) receive certification from all affected agencies
attesting that the proposed alternatives will help achieve
auditability, improve fiscal reporting, and will not
adversely affect counterintelligence; and
(3) not later than 30 days after receiving all necessary
certifications under paragraph (2), present the proposed
alternatives and certifications to the congressional defense
and intelligence committees.
Sec. 1166. In addition to amounts provided elsewhere in
this Act, $5,000,000 (increased by $5,000,000) is hereby
appropriated to the Department of Defense, to remain
available for obligation until expended: Provided, That
notwithstanding any other provision of law, that upon the
determination of the Secretary of Defense that it shall serve
the national interest, these funds shall be available only
for a grant to the Fisher House Foundation, Inc., only for
the construction and furnishing of additional Fisher Houses
to meet the needs of military family members when confronted
with the illness or hospitalization of an eligible military
beneficiary.
(including transfer of funds)
Sec. 1167. Of the amounts appropriated in this Act under
the headings ``Procurement, Defense-Wide'' and ``Research,
Development, Test and Evaluation, Defense-Wide'',
$705,800,000 shall be for the Israeli Cooperative Programs:
Provided, That of this amount, $92,000,000 shall be for the
Secretary of Defense to provide to the Government of Israel
for the procurement of the Iron Dome defense system to
counter short-range rocket threats, subject to the U.S.-
Israel Iron Dome Procurement Agreement, as amended;
$221,500,000 shall be for the Short Range Ballistic Missile
Defense (SRBMD) program, including cruise missile defense
research and development under the SRBMD program, of which
$120,000,000 shall be for co-production activities of SRBMD
missiles in the United States and in Israel to meet Israel's
defense requirements consistent with each nation's laws,
regulations, and procedures, subject to the U.S.-Israeli co-
production agreement for SRBMD, as amended; $205,000,000
shall be for an upper-tier component to the Israeli Missile
Defense Architecture, of which $120,000,000 shall be for co-
production activities of Arrow 3 Upper Tier missiles in the
United States and in Israel to meet Israel's defense
requirements consistent with each nation's laws, regulations,
and procedures, subject to the U.S.-Israeli co-production
agreement for Arrow 3 Upper Tier, as amended; $105,000,000
shall be for testing of the upper-tier component to the
Israeli Missile Defense Architecture in the United States;
and $82,300,000 shall be for the Arrow System Improvement
Program including development of a long range, ground and
airborne, detection suite: Provided further, That the
transfer authority provided under this provision is in
addition to any other transfer authority contained in this
Act.
(including transfer of funds)
Sec. 1168. Of the amounts appropriated in this Act under
the heading ``Shipbuilding and Conversion, Navy'',
$117,542,000 shall be available until September 30, 2018, to
fund prior year shipbuilding cost increases: Provided, That
upon enactment of this Act, the Secretary of the Navy shall
transfer funds to the following appropriations in the amounts
specified: Provided further, That the amounts transferred
shall be merged with and be available for the same purposes
as the appropriations to which transferred to:
(1) Under the heading ``Shipbuilding and Conversion,
Navy'', 2012/2018: Carrier Replacement Program $20,000,000;
(2) Under the heading ``Shipbuilding and Conversion,
Navy'', 2008/2018: DDG-51 Destroyer $19,436,000;
(3) Under the heading ``Shipbuilding and Conversion,
Navy'', 2012/2018: Littoral Combat Ship $6,394,000;
(4) Under the heading ``Shipbuilding and Conversion,
Navy'', 2012/2018: LHA Replacement $14,200,000;
(5) Under the heading ``Shipbuilding and Conversion,
Navy'', 2013/2018: DDG-51 Destroyer $31,941,000;
(6) Under the heading ``Shipbuilding and Conversion,
Navy'', 2014/2018: Litoral Combat Ship $20,471,000; and
(7) Under the heading ``Shipbuilding and Conversion,
Navy'', 2015/2018: LCAC $5,100,000.
Sec. 1169. Funds appropriated by this Act, or made
available by the transfer of funds in this Act, for
intelligence activities are deemed to be specifically
authorized by the Congress for purposes of section 504 of the
National Security Act of 1947 (50 U.S.C. 3094) during fiscal
year 2018 until the enactment of the Intelligence
Authorization Act for Fiscal Year 2018.
Sec. 1170. None of the funds provided in this Act shall be
available for obligation or expenditure through a
reprogramming of funds that creates or initiates a new
program, project, or activity unless such program, project,
or activity must be undertaken immediately in the interest of
national security and only after written prior notification
to the congressional defense committees.
Sec. 1171. The budget of the President for fiscal year
2018 submitted to the Congress pursuant to section 1105 of
title 31, United States Code, shall include separate budget
justification documents for costs of United States Armed
Forces' participation in contingency operations for the
Military Personnel accounts, the Operation and Maintenance
accounts, the Procurement accounts, and the Research,
Development, Test and Evaluation accounts: Provided, That
these documents shall include a description of the funding
requested for each contingency operation, for each military
service, to include all Active and Reserve components, and
for each appropriations account: Provided further, That
these documents shall include estimated costs for each
element of expense or object class, a reconciliation of
increases and decreases for each contingency operation, and
programmatic data including, but not limited to, troop
strength for each Active and Reserve component, and estimates
of the major weapons systems deployed in support of each
contingency: Provided further, That these documents shall
include budget exhibits OP-5 and OP-32 (as defined in the
Department of Defense Financial Management Regulation) for
all contingency operations for the budget year and the two
preceding fiscal years.
Sec. 1172. None of the funds in this Act may be used for
research, development, test, evaluation, procurement or
deployment of nuclear armed interceptors of a missile defense
system.
Sec. 1173. Notwithstanding any other provision of this
Act, to reflect savings due to favorable foreign exchange
rates, the total amount appropriated in this Act is hereby
reduced by $289,000,000.
Sec. 1174. None of the funds appropriated or made
available in this Act shall be used to reduce or disestablish
the operation of the 53rd Weather Reconnaissance Squadron of
the Air Force Reserve, if such action would reduce the WC-130
Weather Reconnaissance mission below the levels funded in
this Act: Provided, That the Air Force shall allow the 53rd
Weather Reconnaissance Squadron to perform other missions in
support of national defense requirements during the non-
hurricane season.
Sec. 1175. None of the funds provided in this Act shall be
available for integration of foreign intelligence information
unless the information has been lawfully collected and
processed during the conduct of authorized foreign
intelligence activities: Provided, That information
pertaining to United States persons shall only be handled in
accordance with protections provided in the Fourth Amendment
of the United States Constitution as implemented through
Executive Order No. 12333.
Sec. 1176. (a) None of the funds appropriated by this Act
may be used to transfer research and development,
acquisition, or other program authority relating to current
tactical unmanned aerial vehicles (TUAVs) from the Army.
(b) The Army shall retain responsibility for and
operational control of the MQ-1C Gray Eagle Unmanned Aerial
Vehicle (UAV) in order to support the Secretary of Defense in
matters relating to the employment of unmanned aerial
vehicles.
Sec. 1177. None of the funds appropriated by this Act for
programs of the Office of the Director of National
Intelligence shall remain available for obligation beyond the
current fiscal year, except for funds appropriated for
research and technology, which
[[Page H846]]
shall remain available until September 30, 2019.
Sec. 1178. For purposes of section 1553(b) of title 31,
United States Code, any subdivision of appropriations made in
this Act under the heading ``Shipbuilding and Conversion,
Navy'' shall be considered to be for the same purpose as any
subdivision under the heading ``Shipbuilding and Conversion,
Navy'' appropriations in any prior fiscal year, and the 1
percent limitation shall apply to the total amount of the
appropriation.
Sec. 1179. (a) Not later than 60 days after the date of
enactment of this Act, the Director of National Intelligence
shall submit a report to the congressional intelligence
committees to establish the baseline for application of
reprogramming and transfer authorities for fiscal year 2018:
Provided, That the report shall include--
(1) a table for each appropriation with a separate column
to display the President's budget request, adjustments made
by Congress, adjustments due to enacted rescissions, if
appropriate, and the fiscal year enacted level;
(2) a delineation in the table for each appropriation by
Expenditure Center and project; and
(3) an identification of items of special congressional
interest.
(b) None of the funds provided for the National
Intelligence Program in this Act shall be available for
reprogramming or transfer until the report identified in
subsection (a) is submitted to the congressional intelligence
committees, unless the Director of National Intelligence
certifies in writing to the congressional intelligence
committees that such reprogramming or transfer is necessary
as an emergency requirement.
Sec. 1180. None of the funds made available by this Act
may be used to eliminate, restructure, or realign Army
Contracting Command--New Jersey or make disproportionate
personnel reductions at any Army Contracting Command--New
Jersey sites without 30-day prior notification to the
congressional defense committees.
(rescission)
Sec. 1181. Of the unobligated balances available to the
Department of Defense, the following funds are permanently
rescinded from the following accounts and programs in the
specified amounts to reflect excess cash balances in the
Department of Defense Acquisition Workforce Development Fund:
From ``Department of Defense Acquisition Workforce
Development Fund, Defense'', $10,000,000.
Sec. 1182. None of the funds made available by this Act
for excess defense articles, assistance under section 333 of
title 10, United States Code, or peacekeeping operations for
the countries designated annually to be in violation of the
standards of the Child Soldiers Prevention Act of 2008
(Public Law 110-457; 22 U.S.C. 2370c-1) may be used to
support any military training or operation that includes
child soldiers, as defined by the Child Soldiers Prevention
Act of 2008, unless such assistance is otherwise permitted
under section 404 of the Child Soldiers Prevention Act of
2008.
Sec. 1183. (a) None of the funds provided for the National
Intelligence Program in this or any prior appropriations Act
shall be available for obligation or expenditure through a
reprogramming or transfer of funds in accordance with section
102A(d) of the National Security Act of 1947 (50 U.S.C.
3024(d)) that--
(1) creates a new start effort;
(2) terminates a program with appropriated funding of
$10,000,000 or more;
(3) transfers funding into or out of the National
Intelligence Program; or
(4) transfers funding between appropriations, unless the
congressional intelligence committees are notified 30 days in
advance of such reprogramming of funds; this notification
period may be reduced for urgent national security
requirements.
(b) None of the funds provided for the National
Intelligence Program in this or any prior appropriations Act
shall be available for obligation or expenditure through a
reprogramming or transfer of funds in accordance with section
102A(d) of the National Security Act of 1947 (50 U.S.C.
3024(d)) that results in a cumulative increase or decrease of
the levels specified in the classified annex accompanying the
Act unless the congressional intelligence committees are
notified 30 days in advance of such reprogramming of funds;
this notification period may be reduced for urgent national
security requirements.
Sec. 1184. The Director of National Intelligence shall
submit to Congress each year, at or about the time that the
President's budget is submitted to Congress that year under
section 1105(a) of title 31, United States Code, a future-
years intelligence program (including associated annexes)
reflecting the estimated expenditures and proposed
appropriations included in that budget. Any such future-years
intelligence program shall cover the fiscal year with respect
to which the budget is submitted and at least the four
succeeding fiscal years.
Sec. 1185. For the purposes of this Act, the term
``congressional intelligence committees'' means the Permanent
Select Committee on Intelligence of the House of
Representatives, the Select Committee on Intelligence of the
Senate, the Subcommittee on Defense of the Committee on
Appropriations of the House of Representatives, and the
Subcommittee on Defense of the Committee on Appropriations of
the Senate.
(including transfer of funds)
Sec. 1186. During the current fiscal year, not to exceed
$11,000,000 from each of the appropriations made in title II
of this Act for ``Operation and Maintenance, Army'',
``Operation and Maintenance, Navy'', and ``Operation and
Maintenance, Air Force'' may be transferred by the military
department concerned to its central fund established for
Fisher Houses and Suites pursuant to section 2493(d) of title
10, United States Code.
(including transfer of funds)
Sec. 1187. Not to exceed $500,000,000 appropriated by this
Act for operation and maintenance may be available for the
purpose of making remittances and transfer to the Defense
Acquisition Workforce Development Fund in accordance with
section 1705 of title 10, United States Code.
Sec. 1188. (a) Any agency receiving funds made available in
this Act, shall, subject to subsections (b) and (c), post on
the public website of that agency any report required to be
submitted by the Congress in this or any other Act, upon the
determination by the head of the agency that it shall serve
the national interest.
(b) Subsection (a) shall not apply to a report if--
(1) the public posting of the report compromises national
security; or
(2) the report contains proprietary information.
(c) The head of the agency posting such report shall do so
only after such report has been made available to the
requesting Committee or Committees of Congress for no less
than 45 days.
Sec. 1189. (a) None of the funds appropriated or otherwise
made available by this Act may be expended for any Federal
contract for an amount in excess of $1,000,000, unless the
contractor agrees not to--
(1) enter into any agreement with any of its employees or
independent contractors that requires, as a condition of
employment, that the employee or independent contractor agree
to resolve through arbitration any claim under title VII of
the Civil Rights Act of 1964 or any tort related to or
arising out of sexual assault or harassment, including
assault and battery, intentional infliction of emotional
distress, false imprisonment, or negligent hiring,
supervision, or retention; or
(2) take any action to enforce any provision of an existing
agreement with an employee or independent contractor that
mandates that the employee or independent contractor resolve
through arbitration any claim under title VII of the Civil
Rights Act of 1964 or any tort related to or arising out of
sexual assault or harassment, including assault and battery,
intentional infliction of emotional distress, false
imprisonment, or negligent hiring, supervision, or retention.
(b) None of the funds appropriated or otherwise made
available by this Act may be expended for any Federal
contract unless the contractor certifies that it requires
each covered subcontractor to agree not to enter into, and
not to take any action to enforce any provision of, any
agreement as described in paragraphs (1) and (2) of
subsection (a), with respect to any employee or independent
contractor performing work related to such subcontract. For
purposes of this subsection, a ``covered subcontractor'' is
an entity that has a subcontract in excess of $1,000,000 on a
contract subject to subsection (a).
(c) The prohibitions in this section do not apply with
respect to a contractor's or subcontractor's agreements with
employees or independent contractors that may not be enforced
in a court of the United States.
(d) The Secretary of Defense may waive the application of
subsection (a) or (b) to a particular contractor or
subcontractor for the purposes of a particular contract or
subcontract if the Secretary or the Deputy Secretary
personally determines that the waiver is necessary to avoid
harm to national security interests of the United States, and
that the term of the contract or subcontract is not longer
than necessary to avoid such harm. The determination shall
set forth with specificity the grounds for the waiver and for
the contract or subcontract term selected, and shall state
any alternatives considered in lieu of a waiver and the
reasons each such alternative would not avoid harm to
national security interests of the United States. The
Secretary of Defense shall transmit to Congress, and
simultaneously make public, any determination under this
subsection not less than 15 business days before the contract
or subcontract addressed in the determination may be awarded.
(including transfer of funds)
Sec. 1190. From within the funds appropriated for
operation and maintenance for the Defense Health Program in
this Act, up to $115,519,000, shall be available for transfer
to the Joint Department of Defense-Department of Veterans
Affairs Medical Facility Demonstration Fund in accordance
with the provisions of section 1704 of the National Defense
Authorization Act for Fiscal Year 2010, Public Law 111-84:
Provided, That for purposes of section 1704(b), the facility
operations funded are operations of the integrated Captain
James A. Lovell Federal Health Care Center, consisting of the
North Chicago Veterans Affairs Medical Center, the Navy
Ambulatory Care Center, and supporting facilities designated
as a combined Federal medical facility as described by
section 706 of Public Law 110-417: Provided further, That
additional funds may be transferred from funds appropriated
for operation and maintenance for the Defense Health Program
to the Joint Department of Defense-
[[Page H847]]
Department of Veterans Affairs Medical Facility Demonstration
Fund upon written notification by the Secretary of Defense to
the Committees on Appropriations of the House of
Representatives and the Senate.
Sec. 1191. None of the funds appropriated or otherwise
made available by this Act may be used by the Department of
Defense or a component thereof in contravention of the
provisions of section 130h of title 10, United States Code.
Sec. 1192. Appropriations available to the Department of
Defense may be used for the purchase of heavy and light
armored vehicles for the physical security of personnel or
for force protection purposes up to a limit of $450,000 per
vehicle, notwithstanding price or other limitations
applicable to the purchase of passenger carrying vehicles.
(including transfer of funds)
Sec. 1193. Upon a determination by the Director of
National Intelligence that such action is necessary and in
the national interest, the Director may, with the approval of
the Office of Management and Budget, transfer not to exceed
$1,500,000,000 of the funds made available in this Act for
the National Intelligence Program: Provided, That such
authority to transfer may not be used unless for higher
priority items, based on unforeseen intelligence
requirements, than those for which originally appropriated
and in no case where the item for which funds are requested
has been denied by the Congress: Provided further, That a
request for multiple reprogrammings of funds using authority
provided in this section shall be made prior to June 30,
2017.
Sec. 1194. None of the funds appropriated or otherwise
made available in this or any other Act may be used to
transfer, release, or assist in the transfer or release to or
within the United States, its territories, or possessions
Khalid Sheikh Mohammed or any other detainee who--
(1) is not a United States citizen or a member of the Armed
Forces of the United States; and
(2) is or was held on or after June 24, 2009, at United
States Naval Station, Guantanamo Bay, Cuba, by the Department
of Defense.
Sec. 1195. (a) None of the funds appropriated or otherwise
made available in this or any other Act may be used to
construct, acquire, or modify any facility in the United
States, its territories, or possessions to house any
individual described in subsection (c) for the purposes of
detention or imprisonment in the custody or under the
effective control of the Department of Defense.
(b) The prohibition in subsection (a) shall not apply to
any modification of facilities at United States Naval
Station, Guantanamo Bay, Cuba.
(c) An individual described in this subsection is any
individual who, as of June 24, 2009, is located at United
States Naval Station, Guantanamo Bay, Cuba, and who--
(1) is not a citizen of the United States or a member of
the Armed Forces of the United States; and
(2) is--
(A) in the custody or under the effective control of the
Department of Defense; or
(B) otherwise under detention at United States Naval
Station, Guantanamo Bay, Cuba.
Sec. 1196. None of the funds appropriated or otherwise
made available in this Act may be used to transfer any
individual detained at United States Naval Station Guantanamo
Bay, Cuba, to the custody or control of the individual's
country of origin, any other foreign country, or any other
foreign entity except in accordance with section 1034 of the
National Defense Authorization Act for Fiscal Year 2016
(Public Law 114-92) and section 1034 of the National Defense
Authorization Act for Fiscal Year 2017 (Public Law 114-328).
Sec. 1197. None of the funds made available by this Act
may be used in contravention of the War Powers Resolution (50
U.S.C. 1541 et seq.).
Sec. 1198. (a) None of the funds appropriated or otherwise
made available by this or any other Act may be used by the
Secretary of Defense, or any other official or officer of the
Department of Defense, to enter into a contract, memorandum
of understanding, or cooperative agreement with, or make a
grant to, or provide a loan or loan guarantee to
Rosoboronexport or any subsidiary of Rosoboronexport.
(b) The Secretary of Defense may waive the limitation in
subsection (a) if the Secretary, in consultation with the
Secretary of State and the Director of National Intelligence,
determines that it is in the vital national security interest
of the United States to do so, and certifies in writing to
the congressional defense committees that, to the best of the
Secretary's knowledge:
(1) Rosoboronexport has ceased the transfer of lethal
military equipment to, and the maintenance of existing lethal
military equipment for, the Government of the Syrian Arab
Republic;
(2) The armed forces of the Russian Federation have
withdrawn from Crimea, other than armed forces present on
military bases subject to agreements in force between the
Government of the Russian Federation and the Government of
Ukraine; and
(3) Agents of the Russian Federation have ceased taking
active measures to destabilize the control of the Government
of Ukraine over eastern Ukraine.
(c) The Inspector General of the Department of Defense
shall conduct a review of any action involving
Rosoboronexport with respect to a waiver issued by the
Secretary of Defense pursuant to subsection (b), and not
later than 90 days after the date on which such a waiver is
issued by the Secretary of Defense, the Inspector General
shall submit to the congressional defense committees a report
containing the results of the review conducted with respect
to such waiver.
Sec. 1199. None of the funds made available in this Act
may be used for the purchase or manufacture of a flag of the
United States unless such flags are treated as covered items
under section 2533a(b) of title 10, United States Code.
Sec. 1200. (a) Of the funds appropriated in this Act for
the Department of Defense, amounts may be made available,
under such regulations as the Secretary of Defense may
prescribe, to local military commanders appointed by the
Secretary, or by an officer or employee designated by the
Secretary, to provide at their discretion ex gratia payments
in amounts consistent with subsection (d) of this section for
damage, personal injury, or death that is incident to combat
operations of the Armed Forces in a foreign country.
(b) An ex gratia payment under this section may be provided
only if--
(1) the prospective foreign civilian recipient is
determined by the local military commander to be friendly to
the United States;
(2) a claim for damages would not be compensable under
chapter 163 of title 10, United States Code (commonly known
as the ``Foreign Claims Act''); and
(3) the property damage, personal injury, or death was not
caused by action by an enemy.
(c) Nature of Payments.--Any payments provided under a
program under subsection (a) shall not be considered an
admission or acknowledgement of any legal obligation to
compensate for any damage, personal injury, or death.
(d) Amount of Payments.--If the Secretary of Defense
determines a program under subsection (a) to be appropriate
in a particular setting, the amounts of payments, if any, to
be provided to civilians determined to have suffered harm
incident to combat operations of the Armed Forces under the
program should be determined pursuant to regulations
prescribed by the Secretary and based on an assessment, which
should include such factors as cultural appropriateness and
prevailing economic conditions.
(e) Legal Advice.--Local military commanders shall receive
legal advice before making ex gratia payments under this
subsection. The legal advisor, under regulations of the
Department of Defense, shall advise on whether an ex gratia
payment is proper under this section and applicable
Department of Defense regulations.
(f) Written Record.--A written record of any ex gratia
payment offered or denied shall be kept by the local
commander and on a timely basis submitted to the appropriate
office in the Department of Defense as determined by the
Secretary of Defense.
(g) Report.--The Secretary of Defense shall report to the
congressional defense committees on an annual basis the
efficacy of the ex gratia payment program including the
number of types of cases considered, amounts offered, the
response from ex gratia payment recipients, and any
recommended modifications to the program.
Sec. 1201. None of the funds available in this Act to the
Department of Defense, other than appropriations made for
necessary or routine refurbishments, upgrades or maintenance
activities, shall be used to reduce or to prepare to reduce
the number of deployed and non-deployed strategic delivery
vehicles and launchers below the levels set forth in the
report submitted to Congress in accordance with section 1042
of the National Defense Authorization Act for Fiscal Year
2012.
Sec. 1202. The Secretary of Defense shall post grant
awards on a public Website in a searchable format.
Sec. 1203. None of the funds made available by this Act
may be used to fund the performance of a flight demonstration
team at a location outside of the United States: Provided,
That this prohibition applies only if a performance of a
flight demonstration team at a location within the United
States was canceled during the current fiscal year due to
insufficient funding.
Sec. 1204. None of the funds made available by this Act
may be used by the National Security Agency to--
(1) conduct an acquisition pursuant to section 702 of the
Foreign Intelligence Surveillance Act of 1978 for the purpose
of targeting a United States person; or
(2) acquire, monitor, or store the contents (as such term
is defined in section 2510(8) of title 18, United States
Code) of any electronic communication of a United States
person from a provider of electronic communication services
to the public pursuant to section 501 of the Foreign
Intelligence Surveillance Act of 1978.
Sec. 1205. None of the funds made available by this Act
may be obligated or expended to implement the Arms Trade
Treaty until the Senate approves a resolution of ratification
for the Treaty.
Sec. 1206. None of the funds made available in this or any
other Act may be used to pay the salary of any officer or
employee of any agency funded by this Act who approves or
implements the transfer of administrative responsibilities or
budgetary resources of any program, project, or activity
financed by this Act to the jurisdiction of another Federal
agency not financed by this Act unless explicity provided for
in a Defense Appropriations Act: Provided, That this
limitation
[[Page H848]]
shall not apply to transfers of funds expressly provided for
in Defense Appropriations Acts, or provisions of Acts
providing supplemental appropriations for the Department of
Defense.
Sec. 1207. None of the funds made available in this Act
may be obligated for activities authorized under section 1208
of the Ronald W. Reagan National Defense Authorization Act
for Fiscal Year 2005 (Public Law 112-81; 125 Stat. 1621) to
initiate support for, or expand support to, foreign forces,
irregular forces, groups, or individuals unless the
congressional defense committees are notified in accordance
with the direction contained in the classified annex
accompanying this Act, not less than 15 days before
initiating such support: Provided, That none of the funds
made available in this Act may be used under section 1208 for
any activity that is not in support of an ongoing military
operation being conducted by United States Special Operations
Forces to combat terrorism: Provided further, That the
Secretary of Defense may waive the prohibitions in this
section if the Secretary determines that such waiver is
required by extraordinary circumstances and, by not later
than 72 hours after making such waiver, notifies the
congressional defense committees of such waiver.
Sec. 1208. None of the funds made available by this Act
may be used with respect to Iraq in contravention of the War
Powers Resolution (50 U.S.C. 1541 et seq.), including for the
introduction of United States armed forces into hostilities
in Iraq, into situations in Iraq where imminent involvement
in hostilities is clearly indicated by the circumstances, or
into Iraqi territory, airspace, or waters while equipped for
combat, in contravention of the congressional consultation
and reporting requirements of sections 3 and 4 of such
Resolution (50 U.S.C. 1542 and 1543).
Sec. 1209. None of the funds provided in this Act for the
T-AO Fleet Oiler or the Towing, Salvage, and Rescue Ship
programs shall be used to award a new contract that provides
for the acquisition of the following components unless those
components are manufactured in the United States: Auxiliary
equipment (including pumps) for shipboard services;
propulsion equipment (including engines, reduction gears, and
propellers); shipboard cranes; and spreaders for shipboard
cranes.
Sec. 1210. The amount appropriated in title II of this Act
for ``Operation and Maintenance, Army'' is hereby reduced by
$75,000,000 to reflect excess cash balances in Department of
Defense Working Capital Funds.
Sec. 1211. Notwithstanding any other provision of this
Act, to reflect savings due to lower than anticipated fuel
costs, the total amount appropriated in title II of this Act
is hereby reduced by $1,007,267,000.
Sec. 1212. None of the funds made available by this Act
may be used for Government Travel Charge Card expenses by
military or civilian personnel of the Department of Defense
for gaming, or for entertainment that includes topless or
nude entertainers or participants, as prohibited by
Department of Defense FMR, Volume 9, Chapter 3 and Department
of Defense Instruction 1015.10 (enclosure 3, 14a and 14b).
Sec. 1213. None of the funds made available by this Act
may be used to propose, plan for, or execute a new or
additional Base Realignment and Closure (BRAC) round.
Sec. 1214. Of the amounts appropriated in this Act for
``Operation and Maintenance, Navy'', $289,255,000, to remain
available until expended, may be used for any purposes
related to the National Defense Reserve Fleet established
under section 11 of the Merchant Ship Sales Act of 1946 (50
U.S.C. 4405): Provided, That such amounts are available for
reimbursements to the Ready Reserve Force, Maritime
Administration account of the United States Department of
Transportation for programs, projects, activities, and
expenses related to the National Defense Reserve Fleet.
Sec. 1215. None of the funds made available by this Act
for the Joint Surveillance Target Attack Radar System
recapitalization program may be obligated or expended for
pre-milestone B activities after March 31, 2018, except for
source selection and other activities necessary to enter the
engineering and manufacturing development phase.
Sec. 1216. None of the funds made available by this Act
may be used to carry out the closure or realignment of the
United States Naval Station, Guantanamo Bay, Cuba.
(including transfer of funds)
Sec. 1217. Additional readiness funds made available in
title II of this Act for ``Operation and Maintenance, Army'',
``Operation and Maintenance, Navy'', ``Operation and
Maintenance, Marine Corps'', and ``Operation and Maintenance,
Air Force'' may be transferred to and merged with any
appropriation of the Department of Defense for activities
related to the Zika virus in order to provide health support
for the full range of military operations and sustain the
health of the members of the Armed Forces, civilian employees
of the Department of Defense, and their families, to include:
research and development, disease surveillance, vaccine
development, rapid detection, vector controls and
surveillance, training, and outbreak response: Provided,
That the authority provided in this section is subject to the
same terms and conditions as the authority provided in
section 8005 of this Act.
Sec. 1218. (a) None of the funds made available in this Act
may be used to maintain or establish a computer network
unless such network is designed to block access to
pornography websites.
(b) Nothing in subsection (a) shall limit the use of funds
necessary for any Federal, State, tribal, or local law
enforcement agency or any other entity carrying out criminal
investigations, prosecution, or adjudication activities, or
for any activity necessary for the national defense,
including intelligence activities.
Sec. 1219. Notwithstanding any other provision of law, any
transfer of funds appropriated or otherwise made available by
this Act to the Global Engagement Center pursuant to section
1287 of the National Defense Authorization Act for Fiscal
Year 2017 (Public Law 114-328) shall be made in accordance
with section 8005 or 9002 of this Act, as applicable.
Sec. 1220. No amounts credited or otherwise made available
in this or any other Act to the Department of Defense
Acquisition Workforce Development Fund may be transferred to:
(1) the Rapid Prototyping Fund established under section
804(d) of the National Defense Authorization Act for Fiscal
Year 2016 (10 U.S.C. 2302 note); or
(2) credited to a military-department specific fund
established under section 804(d)(2) of the National Defense
Authorization Act for Fiscal Year 2016 (as amended by section
897 of the National Defense Authorization Act for Fiscal Year
2017).
(including transfer fund)
Sec. 1221. In addition to amounts provided elsewhere in
this Act for military personnel pay, including active duty,
reserve and National Guard personnel, $206,400,000 is hereby
appropriated to the Department of Defense and made available
for transfer only to military personnel accounts: Provided,
That the transfer authority provided under this heading is in
addition to any other transfer authority provided elsewhere
in this Act.
Sec. 1222. In addition to amounts provided elsewhere in
this Act, there is appropriated $235,000,000, for an
additional amount for ``Operation and Maintenance, Defense-
Wide'', to remain available until expended: Provided, That
such funds shall only be available to the Secretary of
Defense, acting through the Office of Economic Adjustment of
the Department of Defense, or for transfer to the Secretary
of Education, notwithstanding any other provision of law, to
make grants, conclude cooperative agreements, or supplement
other Federal funds to construct, renovate, repair, or expand
elementary and secondary public schools on military
installations in order to address capacity or facility
condition deficiencies at such schools: Provided further,
That in making such funds available, the Office of Economic
Adjustment or the Secretary of Education shall give priority
consideration to those military installations with schools
having the most serious capacity or facility condition
deficiencies as determined by the Secretary of Defense:
Provided further, That as a condition of receiving funds
under this section a local educational agency or State shall
provide a matching share as described in the notice titled
``Department of Defense Program for Construction, Renovation,
Repair or Expansion of Public Schools Located on Military
Installations'' published by the Department of Defense in the
Federal Register on September 9, 2011 (76 Fed. Reg. 55883 et
seq.): Provided further, That these provisions apply to funds
provided under this section, and to funds previously provided
by Congress to construct, renovate, repair, or expand
elementary and secondary public schools on military
installations in order to address capacity or facility
condition deficiencies at such schools to the extent such
funds remain unobligated on the date of enactment of this
section.
Sec. 1223. None of the funds made available by this Act
may be used to carry out the changes to the Joint Travel
Regulations of the Department of Defense described in the
memorandum of the Per Diem Travel and Transportation
Allowance Committee titled ``UTD/CTD for MAP 118-13/CAP 118-
13 - Flat Rate Per Diem for Long Term TDY'' and dated October
1, 2014.
Sec. 1224. In carrying out the program described in the
memorandum on the subject of ``Policy for Assisted
Reproductive Services for the Benefit of Seriously or
Severely Ill/Injured (Category II or III) Active Duty Service
Members'' issued by the Assistant Secretary of Defense for
Health Affairs on April 3, 2012, and the guidance issued to
implement such memorandum, the Secretary of Defense shall
apply such policy and guidance, except that--
(1) the limitation on periods regarding embryo
cryopreservation and storage set forth in part III(G) and in
part IV(H) of such memorandum shall not apply; and
(2) the term ``assisted reproductive technology'' shall
include embryo cryopreservation and storage without
limitation on the duration of such cryopreservation and
storage.
TITLE IX
OVERSEAS CONTINGENCY OPERATIONS/GLOBAL WAR ON TERRORISM
MILITARY PERSONNEL
Military Personnel, Army
For an additional amount for ``Military Personnel, Army'',
$2,635,317,000: Provided, That such amount is designated by
the Congress for Overseas Contingency Operations/Global War
on Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
[[Page H849]]
Military Personnel, Navy
For an additional amount for ``Military Personnel, Navy'',
$377,857,000: Provided, That such amount is designated by
the Congress for Overseas Contingency Operations/Global War
on Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Military Personnel, Marine Corps
For an additional amount for ``Military Personnel, Marine
Corps'', $103,800,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Military Personnel, Air Force
For an additional amount for ``Military Personnel, Air
Force'', $912,779,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Reserve Personnel, Army
For an additional amount for ``Reserve Personnel, Army'',
$24,942,000: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Reserve Personnel, Navy
For an additional amount for ``Reserve Personnel, Navy'',
$9,091,000: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Reserve Personnel, Marine Corps
For an additional amount for ``Reserve Personnel, Marine
Corps'', $2,328,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Reserve Personnel, Air Force
For an additional amount for ``Reserve Personnel, Air
Force'', $20,569,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
National Guard Personnel, Army
For an additional amount for ``National Guard Personnel,
Army'', $184,589,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
National Guard Personnel, Air Force
For an additional amount for ``National Guard Personnel,
Air Force'', $5,004,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Military Personnel, National Defense Restoration Fund
(including transfer of funds)
In addition to amounts provided elsewhere in this Act,
there is appropriated $1,000,000,000, for the ``Military
Personnel, National Defense Restoration Fund'': Provided,
That such funds provided under this heading shall only be
available for programs, projects and activities necessary to
implement the 2018 National Defense Strategy: Provided
further, That such funds shall not be available for transfer
until 30 days after the Secretary has submitted, and the
congressional defense committees have approved, the proposed
allocation plan for the use of such funds to implement such
strategy: Provided further, That such allocation plan shall
include a detailed justification for the use of such funds
and a description of how such investments are necessary to
implement the strategy: Provided further, That the Secretary
of Defense may transfer these funds only to military
personnel accounts: Provided further, That the funds
transferred shall be merged with and shall be available for
the same purposes and for the same time period, as the
appropriation to which transferred: Provided further, That
none of the funds made available under this heading may be
transferred to any program, project, or activity specifically
limited or denied by this Act: Provided further, That the
transfer authority provided under this heading is in addition
to any other transfer authority available to the Department
of Defense: Provided further, That such amount is designated
by the Congress for Overseas Contingency Operations/Global
War on Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
OPERATION AND MAINTENANCE
Operation and Maintenance, Army
For an additional amount for ``Operation and Maintenance,
Army'', $16,126,403,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, Navy
For an additional amount for ``Operation and Maintenance,
Navy'', $5,875,015,000, of which up to $161,885,000 may be
transferred to the Coast Guard ``Operating Expenses''
account: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Operation and Maintenance, Marine Corps
For an additional amount for ``Operation and Maintenance,
Marine Corps'', $1,116,640,000: Provided, That such amount
is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, Air Force
For an additional amount for ``Operation and Maintenance,
Air Force'', $10,266,295,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, Defense-Wide
For an additional amount for ``Operation and Maintenance,
Defense-Wide'', $6,944,201,000: Provided, That of the funds
provided under this heading, not to exceed $900,000,000, to
remain available until September 30, 2019, shall be for
payments to reimburse key cooperating nations for logistical,
military, and other support, including access, provided to
United States military and stability operations in
Afghanistan and to counter the Islamic State of Iraq and the
Levant: Provided further, That such reimbursement payments
may be made in such amounts as the Secretary of Defense, with
the concurrence of the Secretary of State, and in
consultation with the Director of the Office of Management
and Budget, may determine, based on documentation determined
by the Secretary of Defense to adequately account for the
support provided, and such determination is final and
conclusive upon the accounting officers of the United States,
and 15 days following notification to the appropriate
congressional committees: Provided further, That funds
provided under this heading may be used for the purpose of
providing specialized training and procuring supplies and
specialized equipment and providing such supplies and loaning
such equipment on a non-reimbursable basis to coalition
forces supporting United States military and stability
operations in Afghanistan and to counter the Islamic State of
Iraq and the Levant, and 15 days following notification to
the appropriate congressional committees: Provided further,
That funds provided under this heading may be used to support
the Government of Jordan, in such amounts as the Secretary of
Defense may determine, to enhance the ability of the armed
forces of Jordan to increase or sustain security along its
borders, upon 15 days prior written notification to the
congressional defense committees outlining the amounts
intended to be provided and the nature of the expenses
incurred: Provided further, That of the funds provided under
this heading, not to exceed $750,000,000, to remain available
until September 30, 2019, shall be available to provide
support and assistance to foreign security forces or other
groups or individuals to conduct, support, or facilitate
counterterrorism, crisis response, or other Department of
Defense security cooperation programs: Provided further, That
such amount is designated by the Congress for Overseas
Contingency Operations/Global War on Terrorism pursuant to
section 251(b)(2)(A)(ii) of the Balanced Budget and Emergency
Deficit Control Act of 1985.
Operation and Maintenance, Army Reserve
For an additional amount for ``Operation and Maintenance,
Army Reserve'', $24,699,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, Navy Reserve
For an additional amount for ``Operation and Maintenance,
Navy Reserve'', $23,980,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, Marine Corps Reserve
For an additional amount for ``Operation and Maintenance,
Marine Corps Reserve'', $3,367,000: Provided, That such
amount is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, Air Force Reserve
For an additional amount for ``Operation and Maintenance,
Air Force Reserve'', $58,523,000: Provided, That such amount
is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of
[[Page H850]]
the Balanced Budget and Emergency Deficit Control Act of
1985.
Operation and Maintenance, Army National Guard
For an additional amount for ``Operation and Maintenance,
Army National Guard'', $108,111,000: Provided, That such
amount is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, Air National Guard
For an additional amount for ``Operation and Maintenance,
Air National Guard'', $15,400,000: Provided, That such
amount is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Operation and Maintenance, National Defense Restoration Fund
(including transfer of funds)
In addition to amounts provided elsewhere in this Act,
there is appropriated $2,000,000,000, for the ``Operation and
Maintenance, National Defense Restoration Fund'': Provided,
That such funds provided under this heading shall only be
available for programs, projects and activities necessary to
implement the 2018 National Defense Strategy: Provided
further, That such funds shall not be available for transfer
until 30 days after the Secretary has submitted, and the
congressional defense committees have approved, the proposed
allocation plan for the use of such funds to implement such
strategy: Provided further, That such allocation plan shall
include a detailed justification for the use of such funds
and a description of how such investments are necessary to
implement the strategy: Provided further, That the Secretary
of Defense may transfer these funds only to operation and
maintenance accounts: Provided further, That the funds
transferred shall be merged with and shall be available for
the same purposes and for the same time period, as the
appropriation to which transferred: Provided further, That
none of the funds made available under this heading may be
transferred to any program, project, or activity specifically
limited or denied by this Act: Provided further, That the
transfer authority provided under this heading is in addition
to any other transfer authority available to the Department
of Defense: Provided further, That such amount is designated
by the Congress for Overseas Contingency Operations/Global
War on Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Afghanistan Security Forces Fund
For the ``Afghanistan Security Forces Fund'',
$4,937,515,000 (reduced by $12,000,000), to remain available
until September 30, 2019: Provided, That such funds shall be
available to the Secretary of Defense, notwithstanding any
other provision of law, for the purpose of allowing the
Commander, Combined Security Transition Command--Afghanistan,
or the Secretary's designee, to provide assistance, with the
concurrence of the Secretary of State, to the security forces
of Afghanistan, including the provision of equipment,
supplies, services, training, facility and infrastructure
repair, renovation, construction, and funding: Provided
further, That the Secretary of Defense may obligate and
expend funds made available to the Department of Defense in
this title for additional costs associated with existing
projects previously funded with amounts provided under the
heading ``Afghanistan Infrastructure Fund'' in prior Acts:
Provided further, That such costs shall be limited to
contract changes resulting from inflation, market
fluctuation, rate adjustments, and other necessary contract
actions to complete existing projects, and associated
supervision and administration costs and costs for design
during construction: Provided further, That the Secretary
may not use more than $50,000,000 under the authority
provided in this section: Provided further, That the
Secretary shall notify in advance such contract changes and
adjustments in annual reports to the congressional defense
committees: Provided further, That the authority to provide
assistance under this heading is in addition to any other
authority to provide assistance to foreign nations: Provided
further, That contributions of funds for the purposes
provided herein from any person, foreign government, or
international organization may be credited to this Fund, to
remain available until expended, and used for such purposes:
Provided further, That the Secretary of Defense shall notify
the congressional defense committees in writing upon the
receipt and upon the obligation of any contribution,
delineating the sources and amounts of the funds received and
the specific use of such contributions: Provided further,
That the Secretary of Defense shall, not fewer than 15 days
prior to obligating from this appropriation account, notify
the congressional defense committees in writing of the
details of any such obligation: Provided further, That the
Secretary of Defense shall notify the congressional defense
committees of any proposed new projects or transfer of funds
between budget sub-activity groups in excess of $20,000,000:
Provided further, That the United States may accept equipment
procured using funds provided under this heading in this or
prior Acts that was transferred to the security forces of
Afghanistan and returned by such forces to the United States:
Provided further, That equipment procured using funds
provided under this heading in this or prior Acts, and not
yet transferred to the security forces of Afghanistan or
transferred to the security forces of Afghanistan and
returned by such forces to the United States, may be treated
as stocks of the Department of Defense upon written
notification to the congressional defense committees:
Provided further, That of the funds provided under this
heading, not less than $10,000,000 shall be for recruitment
and retention of women in the Afghanistan National Security
Forces, and the recruitment and training of female security
personnel: Provided further, That such amount is designated
by the Congress for Overseas Contingency Operations/Global
War on Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Counter-ISIL Train and Equip Fund
For the ``Counter-Islamic State of Iraq and the Levant
Train and Equip Fund'', $1,769,000,000, to remain available
until September 30, 2019: Provided, That such funds shall be
available to the Secretary of Defense in coordination with
the Secretary of State, to provide assistance, including
training; equipment; logistics support, supplies, and
services; stipends; infrastructure repair and renovation; and
sustainment, to foreign security forces, irregular forces,
groups, or individuals participating, or preparing to
participate in activities to counter the Islamic State of
Iraq and the Levant, and their affiliated or associated
groups: Provided further, That these funds may be used in
such amounts as the Secretary of Defense may determine to
enhance the border security of nations adjacent to conflict
areas including Jordan, Lebanon, Egypt, and Tunisia resulting
from actions of the Islamic State of Iraq and the Levant:
Provided further, That amounts made available under this
heading shall be available to provide assistance only for
activities in a country designated by the Secretary of
Defense, in coordination with the Secretary of State, as
having a security mission to counter the Islamic State of
Iraq and the Levant, and following written notification to
the congressional defense committees of such designation:
Provided further, That the Secretary of Defense shall ensure
that prior to providing assistance to elements of any forces
or individuals, such elements or individuals are
appropriately vetted, including at a minimum, assessing such
elements for associations with terrorist groups or groups
associated with the Government of Iran; and receiving
commitments from such elements to promote respect for human
rights and the rule of law: Provided further, That the
Secretary of Defense shall, not fewer than 15 days prior to
obligating from this appropriation account, notify the
congressional defense committees in writing of the details of
any such obligation: Provided further, That the Secretary of
Defense may accept and retain contributions, including
assistance in-kind, from foreign governments, including the
Government of Iraq and other entities, to carry out
assistance authorized under this heading: Provided further,
That contributions of funds for the purposes provided herein
from any foreign government or other entity may be credited
to this Fund, to remain available until expended, and used
for such purposes: Provided further, That the Secretary of
Defense may waive a provision of law relating to the
acquisition of items and support services or sections 40 and
40A of the Arms Export Control Act (22 U.S.C. 2780 and 2785)
if the Secretary determines that such provision of law would
prohibit, restrict, delay or otherwise limit the provision of
such assistance and a notice of and justification for such
waiver is submitted to the congressional defense committees,
the Committees on Appropriations and Foreign Relations of the
Senate and the Committees on Appropriations and Foreign
Affairs of the House of Representatives: Provided further,
That the United States may accept equipment procured using
funds provided under this heading, or under the heading,
``Iraq Train and Equip Fund'' in prior Acts, that was
transferred to security forces, irregular forces, or groups
participating, or preparing to participate in activities to
counter the Islamic State of Iraq and the Levant and returned
by such forces or groups to the United States, may be treated
as stocks of the Department of Defense upon written
notification to the congressional defense committees:
Provided further, That equipment procured using funds
provided under this heading, or under the heading, ``Iraq
Train and Equip Fund'' in prior Acts, and not yet transferred
to security forces, irregular forces, or groups
participating, or preparing to participate in activities to
counter the Islamic State of Iraq and the Levant may be
treated as stocks of the Department of Defense when
determined by the Secretary to no longer be required for
transfer to such forces or groups and upon written
notification to the congressional defense committees:
Provided further, That the Secretary of Defense shall provide
quarterly reports to the congressional defense committees on
the use of funds provided under this heading, including, but
not limited to, the number of individuals trained, the nature
and scope of support and sustainment provided to each group
or individual, the area of operations for each group, and the
contributions of other countries, groups, or individuals:
Provided further, That such amount is
[[Page H851]]
designated by the Congress for Overseas Contingency
Operations/ Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
PROCUREMENT
Aircraft Procurement, Army
For an additional amount for ``Aircraft Procurement,
Army'', $424,686,000, to remain available until September 30,
2020: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Missile Procurement, Army
For an additional amount for ``Missile Procurement, Army'',
$557,583,000, to remain available until September 30, 2020:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
Procurement of Weapons and Tracked Combat Vehicles, Army
For an additional amount for ``Procurement of Weapons and
Tracked Combat Vehicles, Army'', $1,191,139,000, to remain
available until September 30, 2020: Provided, That such
amount is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Procurement of Ammunition, Army
For an additional amount for ``Procurement of Ammunition,
Army'', $193,436,000, to remain available until September 30,
2020: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Other Procurement, Army
For an additional amount for ``Other Procurement, Army'',
$405,575,000, to remain available until September 30, 2020:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
Aircraft Procurement, Navy
For an additional amount for ``Aircraft Procurement,
Navy'', $157,300,000, to remain available until September 30,
2020: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Weapons Procurement, Navy
For an additional amount for ``Weapons Procurement, Navy'',
$130,994,000, to remain available until September 30, 2020:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
Procurement of Ammunition, Navy and Marine Corps
For an additional amount for ``Procurement of Ammunition,
Navy and Marine Corps'', $223,843,000, to remain available
until September 30, 2020: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Other Procurement, Navy
For an additional amount for ``Other Procurement, Navy'',
$207,984,000, to remain available until September 30, 2020:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
Procurement, Marine Corps
For an additional amount for ``Procurement, Marine Corps'',
$64,071,000, to remain available until September 30, 2020:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
Aircraft Procurement, Air Force
For an additional amount for ``Aircraft Procurement, Air
Force'', $510,836,000, to remain available until September
30, 2020: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Missile Procurement, Air Force
For an additional amount for ``Missile Procurement, Air
Force'', $381,700,000, to remain available until September
30, 2020: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Space Procurement, Air Force
For an additional amount for ``Space Procurement, Air
Force'', $2,256,000, to remain available until September 30,
2020: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Procurement of Ammunition, Air Force
For an additional amount for ``Procurement of Ammunition,
Air Force'', $501,509,000, to remain available until
September 30, 2020: Provided, That such amount is designated
by the Congress for Overseas Contingency Operations/Global
War on Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Other Procurement, Air Force
For an additional amount for ``Other Procurement, Air
Force'', $3,998,887,000, to remain available until September
30, 2020: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Procurement, Defense-Wide
For an additional amount for ``Procurement, Defense-Wide'',
$510,741,000, to remain available until September 30, 2020:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
National Guard and Reserve Equipment Account
For procurement of rotary-wing aircraft; combat, tactical
and support vehicles; other weapons; and other procurement
items for the reserve components of the Armed Forces,
$1,000,000,000, to remain available for obligation until
September 30, 2020: Provided, That the Chiefs of National
Guard and Reserve components shall, not later than 30 days
after enactment of this Act, individually submit to the
congressional defense committees the modernization priority
assessment for their respective National Guard or Reserve
component: Provided further, That none of the funds made
available by this paragraph may be used to procure manned
fixed wing aircraft, or procure or modify missiles,
munitions, or ammunition: Provided further, That such amount
is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Procurement, National Defense Restoration Fund
(including transfer of funds)
In addition to amounts provided elsewhere in this Act,
there is appropriated $6,000,000,000, for the ``Procurement,
National Defense Restoration Fund'': Provided, That such
funds provided under this heading shall only be available for
programs, projects and activities necessary to implement the
2018 National Defense Strategy: Provided further, That such
funds shall not be available for transfer until 30 days after
the Secretary has submitted, and the congressional defense
committees have approved, the proposed allocation plan for
the use of such funds to implement such strategy: Provided
further, That such allocation plan shall include a detailed
justification for the use of such funds and a description of
how such investments are necessary to implement the strategy:
Provided further, That the Secretary of Defense may transfer
these funds only to procurement accounts: Provided further,
That the funds transferred shall be merged with and shall be
available for the same purposes and for the same time period,
as the appropriation to which transferred: Provided further,
That none of the funds made available under this heading may
be transferred to any program, project, or activity
specifically limited or denied by this Act: Provided further,
That the transfer authority provided under this heading is in
addition to any other transfer authority available to the
Department of Defense: Provided further, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
RESEARCH, DEVELOPMENT, TEST AND EVALUATION
Research, Development, Test and Evaluation, Army
For an additional amount for ``Research, Development, Test
and Evaluation, Army'', $119,368,000 (increased by
$6,000,000), to remain available until September 30, 2019:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
Research, Development, Test and Evaluation, Navy
For an additional amount for ``Research, Development, Test
and Evaluation, Navy'', $124,865,000, to remain available
until September 30, 2019: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Research, Development, Test and Evaluation, Air Force
For an additional amount for ``Research, Development, Test
and Evaluation, Air
[[Page H852]]
Force'', $144,508,000, to remain available until September
30, 2019: Provided, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
Research, Development, Test and Evaluation, Defense-Wide
For an additional amount for ``Research, Development, Test
and Evaluation, Defense-Wide'', $226,096,000, to remain
available until September 30, 2019: Provided, That such
amount is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Research, Development, Test and Evaluation, National Defense
Restoration Fund
(including transfer of funds)
In addition to amounts provided elsewhere in this Act,
there is appropriated $1,000,000,000, for the ``Research,
Development, Test and Evaluation, National Defense
Restoration Fund'': Provided, That such funds provided under
this heading shall only be available for programs, projects
and activities necessary to implement the 2018 National
Defense Strategy: Provided further, That such funds shall not
be available for transfer until 30 days after the Secretary
has submitted, and the congressional defense committees have
approved, the proposed allocation plan for the use of such
funds to implement such strategy: Provided further, That such
allocation plan shall include a detailed justification for
the use of such funds and a description of how such
investments are necessary to implement the strategy: Provided
further, That the Secretary of Defense may transfer these
funds only to research, development, test and evaluation
accounts: Provided further, That the funds transferred shall
be merged with and shall be available for the same purposes
and for the same time period, as the appropriation to which
transferred: Provided further, That none of the funds made
available under this heading may be transferred to any
program, project, or activity specifically limited or denied
by this Act: Provided further, That the transfer authority
provided under this heading is in addition to any other
transfer authority available to the Department of Defense:
Provided further, That such amount is designated by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
REVOLVING AND MANAGEMENT FUNDS
Defense Working Capital Funds
For an additional amount for ``Defense Working Capital
Funds'', $148,956,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
OTHER DEPARTMENT OF DEFENSE PROGRAMS
Defense Health Program
For an additional amount for ``Defense Health Program'',
$395,805,000, which shall be for operation and maintenance:
Provided, That such amount is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
Drug Interdiction and Counter-Drug Activities, Defense
For an additional amount for ``Drug Interdiction and
Counter-Drug Activities, Defense'', $196,300,000: Provided,
That such amount is designated by the Congress for Overseas
Contingency Operations/Global War on Terrorism pursuant to
section 251(b)(2)(A)(ii) of the Balanced Budget and Emergency
Deficit Control Act of 1985.
Joint Improvised-Threat Defeat Fund
(including transfer of funds)
For the ``Joint Improvised-Threat Defeat Fund'',
$483,058,000, to remain available until September 30, 2020:
Provided, That such funds shall be available to the Secretary
of Defense, notwithstanding any other provision of law, for
the purpose of allowing the Director of the Joint Improvised-
Threat Defeat Organization to investigate, develop and
provide equipment, supplies, services, training, facilities,
personnel and funds to assist United States forces in the
defeat of improvised explosive devices: Provided further,
That the Secretary of Defense may transfer funds provided
herein to appropriations for military personnel; operation
and maintenance; procurement; research, development, test and
evaluation; and defense working capital funds to accomplish
the purpose provided herein: Provided further, That this
transfer authority is in addition to any other transfer
authority available to the Department of Defense: Provided
further, That the Secretary of Defense shall, not fewer than
5 days prior to making transfers from this appropriation,
notify the congressional defense committees in writing of the
details of any such transfer: Provided further, That such
amount is designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Office of the Inspector General
For an additional amount for the ``Office of the Inspector
General'', $24,692,000: Provided, That such amount is
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
GENERAL PROVISIONS--THIS TITLE
Sec. 1301. Notwithstanding any other provision of law,
funds made available in this title are in addition to amounts
appropriated or otherwise made available for the Department
of Defense for fiscal year 2018.
(including transfer of funds)
Sec. 1302. Upon the determination of the Secretary of
Defense that such action is necessary in the national
interest, the Secretary may, with the approval of the Office
of Management and Budget, transfer up to $2,500,000,000
between the appropriations or funds made available to the
Department of Defense in this title: Provided, That the
Secretary shall notify the Congress promptly of each transfer
made pursuant to the authority in this section: Provided
further, That the authority provided in this section is in
addition to any other transfer authority available to the
Department of Defense and is subject to the same terms and
conditions as the authority provided in section 8005 of this
Act.
Sec. 1303. Supervision and administration costs and costs
for design during construction associated with a construction
project funded with appropriations available for operation
and maintenance or the ``Afghanistan Security Forces Fund''
provided in this Act and executed in direct support of
overseas contingency operations in Afghanistan, may be
obligated at the time a construction contract is awarded:
Provided, That, for the purpose of this section, supervision
and administration costs and costs for design during
construction include all in-house Government costs.
Sec. 1304. From funds made available in this title, the
Secretary of Defense may purchase for use by military and
civilian employees of the Department of Defense in the United
States Central Command area of responsibility:
(1) passenger motor vehicles up to a limit of $75,000 per
vehicle; and
(2) heavy and light armored vehicles for the physical
security of personnel or for force protection purposes up to
a limit of $450,000 per vehicle, notwithstanding price or
other limitations applicable to the purchase of passenger
carrying vehicles.
Sec. 1305. Not to exceed $5,000,000 of the amounts
appropriated by this title under the heading ``Operation and
Maintenance, Army'' may be used, notwithstanding any other
provision of law, to fund the Commanders' Emergency Response
Program (CERP), for the purpose of enabling military
commanders in Afghanistan to respond to urgent, small-scale,
humanitarian relief and reconstruction requirements within
their areas of responsibility: Provided, That each project
(including any ancillary or related elements in connection
with such project) executed under this authority shall not
exceed $2,000,000: Provided further, That not later than 45
days after the end of each 6 months of the fiscal year, the
Secretary of Defense shall submit to the congressional
defense committees a report regarding the source of funds and
the allocation and use of funds during that 6-month period
that were made available pursuant to the authority provided
in this section or under any other provision of law for the
purposes described herein: Provided further, That, not later
than 30 days after the end of each fiscal year quarter, the
Army shall submit to the congressional defense committees
quarterly commitment, obligation, and expenditure data for
the CERP in Afghanistan: Provided further, That, not less
than 15 days before making funds available pursuant to the
authority provided in this section or under any other
provision of law for the purposes described herein for a
project with a total anticipated cost for completion of
$500,000 or more, the Secretary shall submit to the
congressional defense committees a written notice containing
each of the following:
(1) The location, nature and purpose of the proposed
project, including how the project is intended to advance the
military campaign plan for the country in which it is to be
carried out.
(2) The budget, implementation timeline with milestones,
and completion date for the proposed project, including any
other CERP funding that has been or is anticipated to be
contributed to the completion of the project.
(3) A plan for the sustainment of the proposed project,
including the agreement with either the host nation, a non-
Department of Defense agency of the United States Government
or a third-party contributor to finance the sustainment of
the activities and maintenance of any equipment or facilities
to be provided through the proposed project.
Sec. 1306. Funds available to the Department of Defense
for operation and maintenance may be used, notwithstanding
any other provision of law, to provide supplies, services,
transportation, including airlift and sealift, and other
logistical support to allied forces participating in a
combined operation with the armed forces of the United States
and coalition forces supporting military and stability
operations in Afghanistan and to counter the Islamic State of
Iraq and the Levant: Provided, That the Secretary of Defense
shall provide quarterly reports to the congressional defense
committees regarding support provided under this section.
Sec. 1307. None of the funds appropriated or otherwise
made available by this or any
[[Page H853]]
other Act shall be obligated or expended by the United States
Government for a purpose as follows:
(1) To establish any military installation or base for the
purpose of providing for the permanent stationing of United
States Armed Forces in Iraq.
(2) To exercise United States control over any oil resource
of Iraq.
(3) To establish any military installation or base for the
purpose of providing for the permanent stationing of United
States Armed Forces in Afghanistan.
Sec. 1308. None of the funds made available in this Act
may be used in contravention of the following laws enacted or
regulations promulgated to implement the United Nations
Convention Against Torture and Other Cruel, Inhuman or
Degrading Treatment or Punishment (done at New York on
December 10, 1984):
(1) Section 2340A of title 18, United States Code.
(2) Section 2242 of the Foreign Affairs Reform and
Restructuring Act of 1998 (division G of Public Law 105-277;
112 Stat. 2681-822; 8 U.S.C. 1231 note) and regulations
prescribed thereto, including regulations under part 208 of
title 8, Code of Federal Regulations, and part 95 of title
22, Code of Federal Regulations.
(3) Sections 1002 and 1003 of the Department of Defense,
Emergency Supplemental Appropriations to Address Hurricanes
in the Gulf of Mexico, and Pandemic Influenza Act, 2006
(Public Law 109-148).
Sec. 1309. None of the funds provided for the
``Afghanistan Security Forces Fund'' (ASFF) may be obligated
prior to the approval of a financial and activity plan by the
Afghanistan Resources Oversight Council (AROC) of the
Department of Defense: Provided, That the AROC must approve
the requirement and acquisition plan for any service
requirements in excess of $50,000,000 annually and any non-
standard equipment requirements in excess of $100,000,000
using ASFF: Provided further, That the Department of Defense
must certify to the congressional defense committees that the
AROC has convened and approved a process for ensuring
compliance with the requirements in the preceding proviso and
accompanying report language for the ASFF.
Sec. 1310. Funds made available in this title to the
Department of Defense for operation and maintenance may be
used to purchase items having an investment unit cost of not
more than $250,000: Provided, That, upon determination by
the Secretary of Defense that such action is necessary to
meet the operational requirements of a Commander of a
Combatant Command engaged in contingency operations overseas,
such funds may be used to purchase items having an investment
item unit cost of not more than $500,000.
Sec. 1311. Up to $500,000,000 of funds appropriated by
this Act for the Defense Security Cooperation Agency in
``Operation and Maintenance, Defense-Wide'' may be used to
provide assistance to the Government of Jordan to support the
armed forces of Jordan and to enhance security along its
borders.
Sec. 1312. None of the funds made available by this Act
under the heading ``Counter-ISIL Train and Equip Fund'' may
be used to procure or transfer man-portable air defense
systems.
Sec. 1313. For the ``Ukraine Security Assistance
Initiative'', $150,000,000 is hereby appropriated, to remain
available until September 30, 2018: Provided, That such
funds shall be available to the Secretary of Defense, in
coordination with the Secretary of State, to provide
assistance, including training; equipment; lethal weapons of
a defensive nature; logistics support, supplies and services;
sustainment; and intelligence support to the military and
national security forces of Ukraine, and for replacement of
any weapons or defensive articles provided to the Government
of Ukraine from the inventory of the United States: Provided
further, That the Secretary of Defense shall, not less than
15 days prior to obligating funds provided under this
heading, notify the congressional defense committees in
writing of the details of any such obligation: Provided
further, That the United States may accept equipment procured
using funds provided under this heading in this or prior Acts
that was transferred to the security forces of Ukraine and
returned by such forces to the United States: Provided
further, That equipment procured using funds provided under
this heading in this or prior Acts, and not yet transferred
to the military or National Security Forces of Ukraine or
returned by such forces to the United States, may be treated
as stocks of the Department of Defense upon written
notification to the congressional defense committees:
Provided further, That amounts made available by this section
are designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
Sec. 1314. Funds appropriated in this title shall be
available for replacement of funds for items provided to the
Government of Ukraine from the inventory of the United States
to the extent specifically provided for in section 9013 of
this Act.
Sec. 1315. None of the funds made available by this Act
under section 9013 for ``Assistance and Sustainment to the
Military and National Security Forces of Ukraine'' may be
used to procure or transfer man-portable air defense systems.
Sec. 1316. (a) None of the funds appropriated or otherwise
made available by this Act under the heading ``Operation and
Maintenance, Defense-Wide'' for payments under section 1233
of Public Law 110-181 for reimbursement to the Government of
Pakistan may be made available unless the Secretary of
Defense, in coordination with the Secretary of State,
certifies to the congressional defense committees that the
Government of Pakistan is--
(1) cooperating with the United States in counterterrorism
efforts against the Haqqani Network, the Quetta Shura
Taliban, Lashkar e-Tayyiba, Jaish-e-Mohammed, Al Qaeda, and
other domestic and foreign terrorist organizations, including
taking steps to end support for such groups and prevent them
from basing and operating in Pakistan and carrying out cross
border attacks into neighboring countries;
(2) not supporting terrorist activities against United
States or coalition forces in Afghanistan, and Pakistan's
military and intelligence agencies are not intervening extra-
judicially into political and judicial processes in Pakistan;
(3) dismantling improvised explosive device (IED) networks
and interdicting precursor chemicals used in the manufacture
of IEDs;
(4) preventing the proliferation of nuclear-related
material and expertise;
(5) implementing policies to protect judicial independence
and due process of law;
(6) issuing visas in a timely manner for United States
visitors engaged in counterterrorism efforts and assistance
programs in Pakistan; and
(7) providing humanitarian organizations access to
detainees, internally displaced persons, and other Pakistani
civilians affected by the conflict.
(b) The Secretary of Defense, in coordination with the
Secretary of State, may waive the restriction in subsection
(a) on a case-by-case basis by certifying in writing to the
congressional defense committees that it is in the national
security interest to do so: Provided, That if the Secretary
of Defense, in coordination with the Secretary of State,
exercises such waiver authority, the Secretaries shall report
to the congressional defense committees on both the
justification for the waiver and on the requirements of this
section that the Government of Pakistan was not able to meet:
Provided further, That such report may be submitted in
classified form if necessary.
(including transfer of funds)
Sec. 1317. In addition to amounts otherwise made available
in this Act, $500,000,000 is hereby appropriated to the
Department of Defense and made available for transfer only to
the operation and maintenance, military personnel, and
procurement accounts, to improve the intelligence,
surveillance, and reconnaissance capabilities of the
Department of Defense: Provided, That the transfer authority
provided in this section is in addition to any other transfer
authority provided elsewhere in this Act: Provided further,
That not later than 30 days prior to exercising the transfer
authority provided in this section, the Secretary of Defense
shall submit a report to the congressional defense committees
on the proposed uses of these funds: Provided further, That
the funds provided in this section may not be transferred to
any program, project, or activity specifically limited or
denied by this Act: Provided further, That amounts made
available by this section are designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget
and Emergency Deficit Control Act of 1985: Provided further,
That the authority to provide funding under this section
shall terminate on September 30, 2018.
Sec. 1318. None of the funds made available by this Act
may be used with respect to Syria in contravention of the War
Powers Resolution (50 U.S.C. 1541 et seq.), including for the
introduction of United States armed or military forces into
hostilities in Syria, into situations in Syria where imminent
involvement in hostilities is clearly indicated by the
circumstances, or into Syrian territory, airspace, or waters
while equipped for combat, in contravention of the
congressional consultation and reporting requirements of
sections 3 and 4 of that law (50 U.S.C. 1542 and 1543).
(rescissions)
Sec. 1319. Of the funds appropriated in Department of
Defense Appropriations Acts, the following funds are hereby
rescinded from the following accounts and programs in the
specified amounts: Provided, That such amounts are
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985:
``Other Procurement, Air Force'', 2017/2019, $25,100,000;
``Afghanistan Security Forces Fund'', 2017/2018,
$100,000,000; and
``Counter-ISIL Train and Equip Fund'', 2017/2018,
$112,513,000.
``Operation and Maintenance, Defense-Wide, DSCA Coalition
Support Fund'', 2017/2018, $350,000,000.
Sec. 1320. Each amount designated in this Act by the
Congress for Overseas Contingency Operations/Global War on
Terrorism pursuant to section 251(b)(2)(A)(ii) of the
Balanced Budget and Emergency Deficit Control Act of 1985
shall be available only if the President subsequently so
designates all such amounts and transmits such designations
to the Congress.
[[Page H854]]
Sec. 1321. (a) Not later than 30 days after the date of the
enactment of this Act, the President shall submit to Congress
a report on the United States strategy to defeat Al-Qaeda,
the Taliban, the Islamic State of Iraq and Syria (ISIS), and
their associated forces and co-belligerents.
(b) The report required under subsection (a) shall include
the following:
(1) An analysis of the adequacy of the existing legal
framework to accomplish the strategy described in subsection
(a), particularly with respect to the Authorization for Use
of Military Force (Public Law 107-40; 50 U.S.C. 1541 note)
and the Authorization for Use of Military Force Against Iraq
Resolution of 2002 (Public Law 107-243; 50 U.S.C. 1541 note).
(2) An analysis of the budgetary resources necessary to
accomplish the strategy described in subsection (a).
(c) Not later than 30 days after the date on which the
President submits to the appropriate congressional committees
the report required by subsection (a), the Secretary of State
and the Secretary of Defense shall testify at any hearing
held by any of the appropriate congressional committees on
the report and to which the Secretary is invited.
(d) In this section, the term ``appropriate congressional
committees'' means--
(1) the Committee on Foreign Relations and the Committee on
Armed Services of the Senate; and
(2) the Committee on Foreign Affairs and the Committee on
Armed Services of the House of Representatives.
Sec. 1322. (a) In addition to amounts provided elsewhere in
this Act, there is hereby appropriated $1,184,112,000, for
the following accounts and programs in the specified amounts
for costs associated with Operation Freedom's Sentinel:
(1) ``Military Personnel, Army'', $48,377,000;
(2) ``Military Personnel, Marine Corps'', $179,000;
(3) ``Military Personnel, Air Force'', $1,340,000;
(4) ``Operation and Maintenance, Army'', $872,491,000;
(5) ``Operation and Maintenance, Navy'', $76,274,000;
(6) ``Operation and Maintenance, Marine Corps'',
$24,734,000;
(7) ``Operation and Maintenance, Defense-Wide'',
$81,164,000;
(8) ``Procurement of Ammunition, Navy and Marine Corps'',
$10,853,000, to remain available until September 30, 2020;
(9) ``Other Procurement, Navy'', $31,500,000, to remain
available until September 30, 2020; and
(10) ``Research, Development, Test and Evaluation, Navy'',
$37,200,000, to remain available until September 30, 2019.
(b) Amounts provided pursuant to this section are hereby
designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
TITLE X--ADDITIONAL GENERAL PROVISIONS
references to report
Sec. 1401. Any reference to a ``report accompanying this
Act'' contained in this Act shall be treated as a reference
to House Report 115-219. Such report shall apply for purposes
of determining the allocation of funds provided by, and the
implementation of, this Act.
spending reduction account
Sec. 1402. $0.
Sec. 1403. None of the funds appropriated or otherwise
made available under the heading ``Afghanistan Security
Forces Fund'' may be used to procure uniforms for the Afghan
National Army.
Sec. 1404. None of the funds made available in this Act
may be used for the closure of a biosafety level 4
laboratory.
Sec. 1405. None of the funds made available by this Act
may be used to provide arms, training, or other assistance to
the Azov Battalion.
Sec. 1406. None of the finds made available by this Act
may be used to purchase heavy water from Iran.
Sec. 1407. None of the funds appropriated by this Act may
be used to plan for, begin, continue, complete, process, or
approve a public-private competition under the Office of
Management and Budget Circular A-76.
Sec. 1408. Notwithstanding any other provision of law,
with respect to the revised security category (as that term
is defined in section 250(c)(4)(D) of the Balanced Budget and
Emergency Deficit Control Act of 1985), any sequestration
order issued under such Act for fiscal year 2018 shall have
no force or effect.
This division may be cited as the ``Department of Defense
Appropriations Act, 2018''.
DIVISION D--MISCELLANEOUS
Sec. 1501. (a) Section 1240B of the Food Security Act of
1985 (16 U.S.C. 3839aa-2) is amended by striking subsection
(a) and inserting the following:
``(a) Establishment.--During each of the 2002 through 2019
fiscal years, the Secretary shall provide payments to
producers that enter into contracts with the Secretary under
the program.''.
(b) Section 1241 of the Food Security Act of 1985 (16
U.S.C. 3841) is amended--
(1) in subsection (a)--
(A) in the matter preceding paragraph (1), by striking
``2018'' and inserting ``2018 (and fiscal year 2019 in the
case of the program specified in paragraph (5))''; and
(B) in paragraph (5)(E), by striking ``fiscal year 2018''
and inserting ``each of fiscal years 2018 through 2019''; and
(2) in subsection (b), by striking ``2018'' and inserting
``2018 (and fiscal year 2019 in the case of the program
specified in subsection (a)(5))''.
DIVISION E--TAX MATTERS
SEC. 1601. REPEAL OF SHIFT IN TIME OF PAYMENT OF CORPORATE
ESTIMATED TAXES.
The Trade Preferences Extension Act of 2015 is amended by
striking section 803 (relating to time for payment of
corporate estimated taxes).
DIVISION F--HEALTH PROVISIONS
SEC. 2100. SHORT TITLE.
This division may be cited as the ``Strengthening and
Underpinning the Safety-net to Aid Individuals Needing Care
Act of 2018'' or the ``SUSTAIN Care Act of 2018''.
TITLE I--MEDICARE EXTENDERS AND RELATED POLICIES
Subtitle A--Medicare Part A
SEC. 2101. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL (MDH)
PROGRAM.
(a) In General.--Section 1886(d)(5)(G) of the Social
Security Act (42 U.S.C. 1395ww(d)(5)(G)) is amended--
(1) in clause (i), by striking ``October 1, 2017'' and
inserting ``October 1, 2019'';
(2) in clause (ii)(II), by striking ``October 1, 2017'' and
inserting ``October 1, 2019''; and
(3) in clause (iv)--
(A) by amending subclause (I) to read as follows:
``(I) that--
``(aa) is located in a rural area; or
``(bb) for discharges occurring on or after October 1,
2017, is located in a State with no rural area (as defined in
paragraph (2)(D)) and satisfies any of the criteria in
subclause (I), (II), (III), or (IV) of paragraph
(8)(E)(ii),''; and
(B) by adding at the end, after and below subclause (IV),
the following flush sentence:
``For purposes of applying subclause (II) of paragraph
(8)(E)(ii) under subclause (I)(bb), such subclause (II) shall
be applied by inserting `as of January 1, 2018,' after `such
State' each place it appears.''.
(b) Conforming Amendments.--
(1) Extension of target amount.--Section 1886(b)(3)(D) of
the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is
amended--
(A) in the matter preceding clause (i), by striking
``October 1, 2017'' and inserting ``October 1, 2019''; and
(B) in clause (iv), by striking ``through fiscal year
2017'' and inserting ``through fiscal year 2019''.
(2) Permitting hospitals to decline reclassification.--
Section 13501(e)(2) of the Omnibus Budget Reconciliation Act
of 1993 (42 U.S.C. 1395ww note) is amended by striking
``through fiscal year 2017'' and inserting ``through fiscal
year 2019''.
SEC. 2102. EXTENSION OF INCREASED INPATIENT HOSPITAL PAYMENT
ADJUSTMENT FOR CERTAIN LOW-VOLUME HOSPITALS.
Section 1886(d)(12) of the Social Security Act (42 U.S.C.
1395ww(d)(12)) is amended--
(1) in subparagraph (B), in the matter preceding clause
(i), by striking ``fiscal year 2018'' and inserting ``fiscal
year 2020'';
(2) in subparagraph (C)(i), by striking ``fiscal years 2011
through 2017'' and inserting ``fiscal years 2011 through
2019'' each place it appears; and
(3) in subparagraph (D), by striking ``fiscal years 2011
through 2017'' and inserting ``fiscal years 2011 through
2019''.
SEC. 2103. STUDIES RELATING TO HOSPITAL PROGRAMS PAID OUTSIDE
OF PROSPECTIVE PAYMENT SYSTEMS.
(a) MedPAC Report.--Using data from hospital programs with
respect to which hospitals receive payment outside of the
prospective payment systems under sections 1833 and 1886 of
the Social Security Act (42 U.S.C. 1395l; 42 U.S.C. 1395ww)
(such programs referred to in this subsection as ``PPS carve-
out programs'') or other data, as available, not later than
June 30, 2019, the Medicare Payment Advisory Commission shall
submit to Congress a report that evaluates and recommends
changes to PPS carve-out programs, including with respect to
amendments made by sections 2101 and 2102 of this Act,
sections 1814, 1820, 1886(d)(5)(D)(iii), and 1115(A) of the
Social Security Act, and such other sections of title XVIII
of the Social Security Act deemed appropriate. To the extent
feasible, such report shall make recommendations on a payment
methodology under the Medicare program for hospital payments,
including with respect to PPS carve-out programs, that
differs from the payment methodology applicable to such
programs as of September 30, 2017.
(b) MedPAC Recommendations for Possible Alternative
Payments.--Not later than 2 years after the date by which the
Secretary of Health and Human Services has collected 2 years
of data under sections 1886(d)(5)(G) and 1886(d)(12) of the
Social Security Act (42 U.S.C. 1395ww(d)(5)(G); 42 U.S.C.
1395ww(d)(12)), as extended pursuant to sections 2101 and
2102 of this Act, the Medicare Payment Advisory Commission
shall submit to Congress a report, including--
(1) recommendations on payments, including a technical
prototype for payments for PPS carve-out programs, if
warranted;
[[Page H855]]
(2) recommendations, if any, on which Medicare fee-for-
service regulations for hospital payments under title XVIII
of the Social Security Act should be altered (such as the
critical access hospital 96-hour rule);
(3) an analysis of the impact of the recommended payments
described in paragraph (1) on Medicare beneficiary cost-
sharing, access to care, and choice of setting;
(4) a projection of any potential reduction in expenditures
under title XVIII of the Social Security Act that may be
attributable to the application of the recommended payments
described in paragraph (1);
(5) a review of the value of hospitals participating in PPS
carve-out programs collecting and reporting to the Secretary
standardized patient assessment data with respect to
inpatient hospital services;
(6) the types of rural hospital classifications and payment
methodologies under the Medicare program, including
information on each special payment structure such as
eligibility criteria, and any areas of overlap between such
special payment programs;
(7) Medicare spending on each PPS carve-out program;
(8) the financial aspects of hospitals participating in
such PPS carve-out programs, such as the share of discharges
under the Medicare and Medicaid programs; and
(9) whether such payment programs are empirically justified
to support Medicare beneficiary access to care.
SEC. 2104. EXTENSION OF HOME HEALTH RURAL ADD-ON.
(a) Extension.--
(1) In general.--Section 421 of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law
108-173; 117 Stat. 2283; 42 U.S.C. 1395fff note), as amended
by section 5201(b) of the Deficit Reduction Act of 2005
(Public Law 109-171; 120 Stat. 46), section 3131(c) of the
Patient Protection and Affordable Care Act (Public Law 111-
148; 124 Stat. 428), and section 210 of the Medicare Access
and CHIP Reauthorization Act of 2015 (Public Law 114-10; 129
Stat. 151) is amended--
(A) in subsection (a), by striking ``January 1, 2018'' and
inserting ``January 1, 2019'' each place it appears;
(B) by redesignating subsections (b) and (c) as subsections
(c) and (d), respectively;
(C) in each of subsections (c) and (d), as so redesignated,
by striking ``subsection (a)'' and inserting ``subsection (a)
or (b)''; and
(D) by inserting after subsection (a) the following new
subsection:
``(b) Subsequent Temporary Increase.--
``(1) In general.--The Secretary shall increase the payment
amount otherwise made under such section 1895 for home health
services furnished in a county (or equivalent area) in a
rural area (as defined in such section 1886(d)(2)(D)) that,
as determined by the Secretary--
``(A) is in the highest quartile of all counties (or
equivalent areas) based on the number of Medicare home health
episodes furnished per 100 individuals who are entitled to,
or enrolled for, benefits under part A of title XVIII of the
Social Security Act or enrolled for benefits under part B of
such title (but not enrolled in a plan under part C of such
title)--
``(i) in the case of episodes and visits ending during
2019, by 1.5 percent; and
``(ii) in the case of episodes and visits ending during
2020, by 0.5 percent;
``(B) has a population density of 6 individuals or fewer
per square mile of land area and is not described in
subparagraph (A)--
``(i) in the case of episodes and visits ending during
2019, by 4 percent;
``(ii) in the case of episodes and visits ending during
2020, by 3 percent;
``(iii) in the case of episodes and visits ending during
2021, by 2 percent; and
``(iv) in the case of episodes and visits ending during
2022, by 1 percent; and
``(C) is not described in either subparagraph (A) or (B)--
``(i) in the case of episodes and visits ending during
2019, by 3 percent;
``(ii) in the case of episodes and visits ending during
2020, by 2 percent; and
``(iii) in the case of episodes and visits ending during
2021, by 1 percent.
``(2) Rules for determinations.--
``(A) No switching.--For purposes of this subsection, the
determination by the Secretary as to which subparagraph of
paragraph (1) applies to a county (or equivalent area) shall
be made a single time and shall apply for the duration of the
period to which this subsection applies.
``(B) Utilization.--In determining which counties (or
equivalent areas) are in the highest quartile under paragraph
(1)(A), the following rules shall apply:
``(i) The Secretary shall use data from 2015.
``(ii) The Secretary shall exclude data from the
territories (and the territories shall not be described in
such paragraph).
``(iii) The Secretary may exclude data from counties (or
equivalent areas) in rural areas with a low volume of home
health episodes (and if data is so excluded with respect to a
county (or equivalent area), such county (or equivalent area)
shall not be described in such paragraph).
``(C) Population density.--In determining population
density under paragraph (1)(B), the Secretary shall use data
from the 2010 decennial Census.
``(3) Limitations on review.--There shall be no
administrative or judicial review under section 1869, section
1878, or otherwise of determinations under paragraph (1).''.
(2) Requirement to submit county data on claim form.--
Section 1895(c) of the Social Security Act (42 U.S.C.
1395fff(c)) is amended--
(A) in paragraph (1), by striking ``and'' at the end;
(B) in paragraph (2), by striking the period at the end and
inserting ``; and''; and
(C) by adding at the end the following new paragraph:
``(3) in the case of home health services furnished on or
after January 1, 2019, the claim contains the code for the
county (or equivalent area) in which the home health service
was furnished.''.
(b) OIG Review.--The Office of the Inspector General shall
submit to Congress, not later than January 1, 2020, and
annually thereafter through January 1, 2024, a report
containing--
(1) an analysis of payments made under section 1895 of the
Social Security Act (42 U.S.C. 1395fff) increased under
section 421 of the Medicare Prescription Drug, Improvement,
and Modernization Act of 2003 (Public Law 108-173; 117 Stat.
2283; 42 U.S.C. 1395fff note), as amended by section 5201(b)
of the Deficit Reduction Act of 2005 (Public Law 109-171; 120
Stat. 46), section 3131(c) of the Patient Protection and
Affordable Care Act (Public Law 111-148; 124 Stat. 428),
section 210 of the Medicare Access and CHIP Reauthorization
Act of 2015 (Public Law 114-10; 129 Stat. 151), and
subsection (a); and
(2) a recommendation on whether such payments should
continue to be made based on county data.
Subtitle B--Medicare Part B
SEC. 2111. GROUND AMBULANCE SERVICES COST REPORTING
REQUIREMENT.
(a) In General.--Section 1121 of the Social Security Act
(42 U.S.C. 1320a) is amended--
(1) in subsection (a)--
(A) by striking ``For the purposes of'' and inserting
``Subject to subsection (d), for the purposes of'';
(B) by inserting ``suppliers of ground ambulance
services,'' after ``health maintenance organizations,''; and
(C) in the matter following paragraph (5), by adding the
following new sentence: ``Not later than December 31, 2019,
the Secretary shall modify the uniform reporting systems for
providers of services with respect to ground ambulance
services to ensure that such systems contain information
similar (as determined by the Secretary) to information
required under the uniform reporting system for suppliers of
ground ambulance services.''; and
(2) by adding at the end the following new subsection:
``(d) In the case of a provider or supplier of ground
ambulance services, the Secretary may modify the requirements
for the inclusion of any data element specified in subsection
(a) in reports made in accordance with the uniform reporting
system established under this section with respect to such
services for such provider or supplier.''.
(b) Suspension of Payment for Ground Ambulance Services;
Deeming Certain Payments Overpayments.--Section 1834(l) of
the Social Security Act (42 U.S.C. 1395m(l)) is amended by
adding at the end the following new paragraph:
``(17) Requirement to submit cost report and authority to
suspend payments and deem certain payments overpayments for
ground ambulance services.--
``(A) In general.--With respect to ground ambulance
services furnished by a supplier of such services during cost
reporting periods (as defined in subparagraph (I)) beginning
on or after January 1, 2020, such supplier shall make reports
to the Secretary of information described in section 1121(a)
in accordance with the uniform reporting system established
under such section for such suppliers and, as may be required
by the Secretary, of any of the information described in
subparagraph (B).
``(B) Additional information.--The Secretary may, with
respect to a supplier of ground ambulance services, require
the following information (to be reported to the extent
practicable under the uniform reporting system established
under section 1121(a) for such suppliers):
``(i) Whether the supplier is part of an emergency services
department, a governmental organization, or another type of
entity (as described by the Secretary).
``(ii) The number of hours in a week during which the
supplier is available for furnishing ground ambulance
services.
``(iii) The average number of volunteer hours a week used
by the supplier.
``(C) Suspension of payment.--Subject to subparagraph (E),
in the case that the Secretary determines that a supplier of
ground ambulance services has not made to the Secretary a
timely report described in subparagraph (A) with respect to a
cost reporting period beginning on or after January 1, 2020,
and before January 1, 2022, the Secretary may suspend
payments made under this subsection, in whole or in part, to
such supplier until the Secretary determines that such
supplier has made such a report.
``(D) Deeming certain payments overpayments.--Subject to
subparagraphs (E) and (F), in the case that the Secretary
determines that a supplier of ground ambulance services has
not made to the Secretary a complete, accurate, and timely
report described in subparagraph (A) with respect to a cost
reporting period beginning on or after January 1, 2022, the
Secretary may either--
``(i) deem payments made under this subsection to such
supplier for such period to be
[[Page H856]]
overpayments and recoup such overpayments; or
``(ii) suspend payments made under this subsection to such
supplier for such period.
``(E) Hardship delay.--The Secretary shall establish a
process whereby a supplier of ground ambulance services may
request a delay in making a report described in subparagraph
(A) with respect to a cost reporting period for reason of
significant hardship (as determined by the Secretary).
``(F) Authority to modify cost reporting elements and
enforcement.--Not earlier than January 1, 2024, the Secretary
may provide that subparagraph (D) no longer applies to
suppliers of ground ambulance services or a category of such
suppliers after--
``(i) taking into account the recommendation of the
Medicare Payment Advisory Commission in the most recent
report available to the Secretary submitted under section
2111(g) of the SUSTAIN Care Act of 2018 whether cost reports
made by suppliers or a category of suppliers (as specified
for purposes of the report submitted under such section) of
ground ambulance services should be required or modified; and
``(ii) undertaking notice and comment rulemaking.
``(G) Audit of cost reports.--The Secretary shall audit
reports described in subparagraph (A) made with respect to
cost reporting periods beginning on or after January 1, 2021.
``(H) Appeals.--The Secretary shall establish a process
whereby a supplier of ground ambulance services may appeal a
determination described in subparagraph (C) or (D) made with
respect to a cost report required to be made by such supplier
under subparagraph (A).
``(I) Definition.--In this paragraph, the term `cost
reporting period' means, with respect to a year, the 12-month
period beginning on January 1 of such year.''.
(c) Stakeholder Feedback.--
(1) In general.--The Secretary of Health and Human Services
shall implement the provisions of this section, including the
amendments made by this section, through notice and comment
rulemaking and seek input from stakeholders.
(2) Nonapplication of paperwork reduction act.--Chapter 35
of title 44, United States Code, shall not apply with respect
to--
(A) the development and implementation of the uniform
reporting system required under section 1121(a) of the Social
Security Act (42 U.S.C. 1320a(a)) for suppliers of ground
ambulance services and reports required to be made under
section 1834(l)(17) of such Act (42 U.S.C. 1395m(l)(17)); and
(B) the modification of the uniform reporting systems under
such section 1121(a) of such Act for providers of such
services and reports required to be made under section
1861(v)(1)(F) of such Act (42 U.S.C. 1395x(v)(1)(F)).
(d) Implementation Resources.--In addition to funds
otherwise available, there are appropriated to the Centers
for Medicare & Medicaid Services Program Management Account
from the Federal Hospital Insurance Trust Fund under section
1817 of the Social Security Act (42 U.S.C. 1395i) $8,000,000
and from the Federal Supplementary Medical Insurance Trust
Fund under section 1841 of such Act (42 U.S.C. 1395t)
$137,000,000 (of which not less than $15,000,000 shall be
used to fulfill the auditing requirement under section
1834(l)(17)(G) of such Act, as added by subsection (b) of
this section) to carry out the provisions of this section,
including the amendments made by this section, to remain
available through December 31, 2022. Of the amounts
appropriated under the previous sentence, the Secretary shall
use such sums as may be necessary to hire not less than 2
full-time employees for purposes of carrying out such
provisions, including such amendments.
(e) Extension of Rural Add-on Payments.--Section 1834(l) of
the Social Security Act (42. U.S.C. 1395m(l)) is amended--
(1) in paragraph (12)(A), by striking ``2018'' and
inserting ``2023''; and
(2) in paragraph (13)(A), by striking ``2018'' each place
it appears and inserting ``2023''.
(f) Sense of Congress.--It is the sense of Congress that--
(1) a cost report made by a supplier of ground ambulance
services with respect to a cost reporting period beginning
before January 1, 2022, may not contain complete and accurate
information on ground ambulance services furnished during
such a period by the supplier; and
(2) the Secretary should take into account only the
timeliness of such a report made with respect to such a
period when determining whether to suspend payments to a
supplier under section 1834(l) of the Social Security Act (42
U.S.C. 1395m(l)).
(g) Ground Ambulance Services Cost Reporting Study.--
(1) In general.--Not later than March 15, 2023, and as
determined necessary by the Medicare Payment Advisory
Commission thereafter, such Commission shall assess and
submit to Congress a report on cost reports of suppliers and
providers of ground ambulance services carried out in
accordance with sections 1121(a) and 1834(l) of the Social
Security Act (42 U.S.C. 1320a(a), 1395m(l)), the adequacy of
payments for such services made under section 1834(l) of such
Act, and geographic variations in the cost of providing such
services.
(2) Contents.--The report described in paragraph (1) shall
contain the following:
(A) An analysis of cost report data submitted in accordance
with such sections.
(B) An analysis of any burden on providers and suppliers of
such services associated with reporting such data.
(C) A recommendation on whether or not cost reports of
ground ambulance services made by suppliers or a category of
suppliers (as specified by the Secretary) of such services,
or the ground ambulance portion of cost reports made by
providers of such services, should be required or modified,
taking into account the analyses described in subparagraphs
(A) and (B).
SEC. 2112. EXTENSION OF WORK GPCI FLOOR.
Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C.
1395w-4(e)(1)(E)) is amended by striking ``January 1, 2018''
and inserting ``January 1, 2020''.
SEC. 2113. REPEAL OF MEDICARE PAYMENT CAP FOR THERAPY
SERVICES; REPLACEMENT WITH LIMITATION TO ENSURE
APPROPRIATE THERAPY.
Section 1833(g) of the Social Security Act (42 U.S.C.
1395l(g)) is amended--
(1) in paragraph (1)--
(A) by striking ``Subject to paragraphs (4) and (5)'' and
inserting ``(A) Subject to paragraphs (4) and (5)'';
(B) in the subparagraph (A), as inserted and designated by
subparagraph (A) of this paragraph, by adding at the end the
following new sentence: ``The preceding sentence shall not
apply to expenses incurred with respect to services furnished
after December 31, 2017.''; and
(C) by adding at the end the following new subparagraph:
``(B) With respect to services furnished during 2018 or a
subsequent year, in the case of physical therapy services of
the type described in section 1861(p), speech-language
pathology services of the type described in such section
through the application of section 1861(ll)(2), and physical
therapy services and speech-language pathology services of
such type which are furnished by a physician or as incident
to physicians' services, with respect to expenses incurred in
any calendar year, any amount that is more than the amount
specified in paragraph (2) for the year shall not be
considered as incurred expenses for purposes of subsections
(a) and (b) unless the applicable requirements of paragraph
(7) are met.'';
(2) in paragraph (3)--
(A) by striking ``Subject to paragraphs (4) and (5)'' and
inserting ``(A) Subject to paragraphs (4) and (5)'';
(B) in the subparagraph (A), as inserted and designated by
subparagraph (A) of this paragraph, by adding at the end the
following new sentence: ``The preceding sentence shall not
apply to expenses incurred with respect to services furnished
after December 31, 2017.''; and
(C) by adding at the end the following new subparagraph:.
``(B) With respect to services furnished during 2018 or a
subsequent year, in the case of occupational therapy services
(of the type that are described in section 1861(p) through
the operation of section 1861(g) and of such type which are
furnished by a physician or as incident to physicians'
services), with respect to expenses incurred in any calendar
year, any amount that is more than the amount specified in
paragraph (2) for the year shall not be considered as
incurred expenses for purposes of subsections (a) and (b)
unless the applicable requirements of paragraph (7) are
met.'';
(3) in paragraph (5)--
(A) by redesignating subparagraph (D) as paragraph (8) and
moving such paragraph to immediately follow paragraph (7), as
added by paragraph (4) of this section; and
(B) in subparagraph (E)(iv), by inserting ``, except as
such process is applied under paragraph (7)(B)'' before the
period at the end; and
(4) by adding at the end the following new paragraph:
``(7) For purposes of paragraphs (1)(B) and (3)(B), with
respect to services described in such paragraphs, the
requirements described in this paragraph are as follows:
``(A) Inclusion of appropriate modifier.--The claim for
such services contains an appropriate modifier (such as the
KX modifier described in paragraph (5)(B)) indicating that
such services are medically necessary as justified by
appropriate documentation in the medical record involved.
``(B) Targeted medical review for certain services above
threshold.--
``(i) In general.--In the case where expenses that would be
incurred for such services would exceed the threshold
described in clause (ii) for the year, such services shall be
subject to the process for medical review implemented under
paragraph (5)(E).
``(ii) Threshold.--The threshold under this clause for--
``(I) a year before 2028, is $3,000;
``(II) 2028, is the amount specified in subclause (I)
increased by the percentage increase in the MEI (as defined
in section 1842(i)(3)) for 2028; and
``(III) a subsequent year, is the amount specified in this
clause for the preceding year increased by the percentage
increase in the MEI (as defined in section 1842(i)(3)) for
such subsequent year;
except that if an increase under subclause (II) or (III) for
a year is not a multiple of $10, it shall be rounded to the
nearest multiple of $10.
``(iii) Application.--The threshold under clause (ii) shall
be applied separately--
``(I) for physical therapy services and speech-language
pathology services; and
``(II) for occupational therapy services.
[[Page H857]]
``(iv) Funding.--For purposes of carrying out this
subparagraph, the Secretary shall provide for the transfer,
from the Federal Supplementary Medical Insurance Trust Fund
under section 1841 to the Centers for Medicare & Medicaid
Services Program Management Account, of $5,000,000 for each
fiscal year beginning with fiscal year 2018, to remain
available until expended. Such funds may not be used by a
contractor under section 1893(h) for medical reviews under
this subparagraph.''.
Subtitle C--Miscellaneous
SEC. 2121. PROVIDING CONTINUED ACCESS TO MEDICARE ADVANTAGE
SPECIAL NEEDS PLANS FOR VULNERABLE POPULATIONS.
(a) Extension.--Section 1859(f)(1) of the Social Security
Act (42 U.S.C. 1395w-28(f)(1)) is amended by striking ``and
for periods before January 1, 2019''.
(b) Increased Integration of Dual SNPs.--
(1) In general.--Section 1859(f) of the Social Security Act
(42 U.S.C. 1395w-28(f)) is amended--
(A) in paragraph (3), by adding at the end the following
new subparagraph:
``(F) The plan meets the requirements applicable under
paragraph (8).''; and
(B) by adding at the end the following new paragraph:
``(8) Increased integration of dual snps.--
``(A) Designated contact.--The Secretary, acting through
the Federal Coordinated Health Care Office established under
section 2602 of Public Law 111-148, shall serve as a
dedicated point of contact for States to address
misalignments that arise with the integration of specialized
MA plans for special needs individuals described in
subsection (b)(6)(B)(ii) under this paragraph and, consistent
with such role, shall establish--
``(i) a uniform process for disseminating to State Medicaid
agencies information under this title impacting contracts
between such agencies and such plans under this subsection;
and
``(ii) basic resources for States interested in exploring
such plans as a platform for integration, such as a model
contract or other tools to achieve those goals.
``(B) Unified grievances and appeals process.--
``(i) In general.--Not later than April 1, 2020, the
Secretary shall establish procedures, to the extent feasible
as determined by the Secretary, unifying grievances and
appeals procedures under sections 1852(f), 1852(g),
1902(a)(3), 1902(a)(5), and 1932(b)(4) for items and services
provided by specialized MA plans for special needs
individuals described in subsection (b)(6)(B)(ii) under this
title and title XIX. With respect to items and services
described in the preceding sentence, procedures established
under this clause shall apply in place of otherwise
applicable grievances and appeals procedures. The Secretary
shall solicit comment in developing such procedures from
States, plans, beneficiaries and their representatives, and
other relevant stakeholders.
``(ii) Procedures.--The procedures established under clause
(i) shall be included in the plan contract under paragraph
(3)(D) and shall--
``(I) adopt the provisions for the enrollee that are most
protective for the enrollee and, to the extent feasible as
determined by the Secretary, are compatible with unified
timeframes and consolidated access to external review under
an integrated process;
``(II) take into account differences in State plans under
title XIX to the extent necessary;
``(III) be easily navigable by an enrollee; and
``(IV) include the elements described in clause (iii), as
applicable.
``(iii) Elements described.--Both unified appeals and
unified grievance procedures shall include, as applicable,
the following elements described in this clause:
``(I) Single written notification of all applicable
grievances and appeal rights under this title and title XIX.
For purposes of this subparagraph, the Secretary may waive
the requirements under section 1852(g)(1)(B) when the
specialized MA plan covers items or services under this part
or under title XIX.
``(II) Single pathways for resolution of any grievance or
appeal related to a particular item or service provided by
specialized MA plans for special needs individuals described
in subsection (b)(6)(B)(ii) under this title and title XIX.
``(III) Notices written in plain language and available in
a language and format that is accessible to the enrollee,
including in non-English languages that are prevalent in the
service area of the specialized MA plan.
``(IV) Unified timeframes for grievances and appeals
processes, such as an individual's filing of a grievance or
appeal, a plan's acknowledgment and resolution of a grievance
or appeal, and notification of decisions with respect to a
grievance or appeal.
``(V) Requirements for how the plan must process, track,
and resolve grievances and appeals, to ensure beneficiaries
are notified on a timely basis of decisions that are made
throughout the grievance or appeals process and are able to
easily determine the status of a grievance or appeal.
``(iv) Continuation of benefits pending appeal.--The
unified procedures under clause (i) shall, with respect to
all benefits under parts A and B and title XIX subject to
appeal under such procedures, incorporate provisions under
current law and implementing regulations that provide
continuation of benefits pending appeal under this title and
title XIX.
``(C) Requirement for unified grievances and appeals.--For
2021 and subsequent years, the contract of a specialized MA
plan for special needs individuals described in subsection
(b)(6)(B)(ii) with a State Medicaid agency under paragraph
(3)(D) shall require the use of unified grievances and
appeals procedures as described in subparagraph (B).
``(D) Requirements for integration.--
``(i) In general.--For 2021 and subsequent years, a
specialized MA plan for special needs individuals described
in subsection (b)(6)(B)(ii) shall meet one or more of the
following requirements, to the extent permitted under State
law, for integration of benefits under this title and title
XIX:
``(I) The specialized MA plan must meet the requirements of
contracting with the State Medicaid agency described in
paragraph (3)(D) in addition to coordinating long-term
services and supports or behavioral health services, or both,
by meeting an additional minimum set of requirements
determined by the Secretary through the Federal Coordinated
Health Care Office established under section 2602 of the
Patient Protection and Affordable Care Act based on input
from stakeholders, such as notifying the State in a timely
manner of hospitalizations, emergency room visits, and
hospital or nursing home discharges of enrollees, assigning
one primary care provider for each enrollee, or sharing data
that would benefit the coordination of items and services
under this title and the State plan under title XIX. Such
minimum set of requirements must be included in the contract
of the specialized MA plan with the State Medicaid agency
under such paragraph.
``(II) The specialized MA plan must meet the requirements
of a fully integrated plan described in section
1853(a)(1)(B)(iv)(II) (other than the requirement that the
plan have similar average levels of frailty, as determined by
the Secretary, as the PACE program), or enter into a
capitated contract with the State Medicaid agency to provide
long-term services and supports or behavioral health
services, or both.
``(III) In the case of a specialized MA plan that is
offered by a parent organization that is also the parent
organization of a Medicaid managed care organization
providing long term services and supports or behavioral
services under a contract under section 1903(m), the parent
organization must assume clinical and financial
responsibility for benefits provided under this title and
title XIX with respect to any individual who is enrolled in
both the specialized MA plan and the Medicaid managed care
organization.
``(ii) Suspension of enrollment for failure to meet
requirements during initial period.--During the period of
plan years 2021 through 2025, if the Secretary determines
that a specialized MA plan for special needs individuals
described in subsection (b)(6)(B)(ii) has failed to comply
with clause (i), the Secretary may provide for the
application against the Medicare Advantage organization
offering the plan of the remedy described in section
1857(g)(2)(B) in the same manner as the Secretary may apply
such remedy, and in accordance with the same procedures as
would apply, in the case of an MA organization determined by
the Secretary to have engaged in conduct described in section
1857(g)(1). If the Secretary applies such remedy to a
Medicare Advantage organization under the preceding sentence,
the organization shall submit to the Secretary (at a time,
and in a form and manner, specified by the Secretary)
information describing how the plan will come into compliance
with clause (i).
``(E) Study and report to congress.--
``(i) In general.--Not later than January 1, 2022, and,
subject to clause (iii), biennially thereafter through 2032,
the Medicare Payment Advisory Commission established under
section 1805, in consultation with the Medicaid and CHIP
Payment and Access Commission established under section 1900,
shall conduct (and submit to the Secretary and the Committees
on Ways and Means and Energy and Commerce of the House of
Representatives and the Committee on Finance of the Senate a
report on) a study to determine how specialized MA plans for
special needs individuals described in subsection
(b)(6)(B)(ii) perform among each other based on data from
Healthcare Effectiveness Data and Information Set (HEDIS)
quality measures, reported on the plan level, as required
under section 1852(e)(3) (or such other measures or data
sources that are available and appropriate, such as encounter
data and Consumer Assessment of Healthcare Providers and
Systems data, as specified by such Commissions as enabling an
accurate evaluation under this subparagraph). Such study
shall include, as feasible, the following comparison groups
of specialized MA plans for special needs individuals
described in subsection (b)(6)(B)(ii):
``(I) A comparison group of such plans that are described
in subparagraph (D)(i)(I).
``(II) A comparison group of such plans that are described
in subparagraph (D)(i)(II).
``(III) A comparison group of such plans operating within
the Financial Alignment Initiative demonstration for the
period for which such plan is so operating and the
demonstration is in effect, and, in the case that an
integration option that is not with respect to specialized MA
plans for special needs individuals is established after the
conclusion of the demonstration involved.
[[Page H858]]
``(IV) A comparison group of such plans that are described
in subparagraph (D)(i)(III).
``(V) A comparison group of MA plans, as feasible, not
described in a previous subclause of this clause, with
respect to the performance of such plans for enrollees who
are special needs individuals described in subsection
(b)(6)(B)(ii).
``(ii) Discretionary additional reports.--Beginning with
2033 and every five years thereafter, the Medicare Payment
Advisory Commission, in consultation with the Medicaid and
CHIP Payment and Access Commission shall, at the discretion
of the Secretary, conduct a study described in clause (i).''.
(2) Conforming amendment to responsibilities of federal
coordinated health care office.--Section 2602(d) of Public
Law 111-148 (42 U.S.C. 1315b(d)) is amended by adding at the
end the following new paragraphs:
``(6) To act as a designated contact for States under
subsection (f)(8)(A) of section 1859 of the Social Security
Act (42 U.S.C. 1395w-28) with respect to the integration of
specialized MA plans for special needs individuals described
in subsection (b)(6)(B)(ii) of such section.
``(7) To be responsible, subject to the final approval of
the Secretary, for developing regulations and guidance
related to the implementation of a unified grievance and
appeals process as described in subparagraphs (B) and (C) of
section 1859(f)(8) of the Social Security Act (42 U.S.C.
1395w-28(f)(8)).
``(8) To be responsible, subject to the final approval of
the Secretary, for developing regulations and guidance
related to the integration or alignment of policy and
oversight under the Medicare program under title XVIII of
such Act and the Medicaid program under title XIX of such Act
regarding specialized MA plans for special needs individuals
described in subsection (b)(6)(B)(ii) of such section
1859.''.
(c) Improvements to Severe or Disabling Chronic Condition
SNPs.--
(1) Care management requirements.--Section 1859(f)(5) of
the Social Security Act (42 U.S.C. 1395w-28(f)(5)) is
amended--
(A) by striking ``all snps.--The requirements'' and
inserting ``all snps.--
``(A) In general.--Subject to subparagraph (B), the
requirements'';
(B) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively, and indenting appropriately; and
(C) in clause (ii), as redesignated by subparagraph (B), by
redesignating clauses (i) through (iii) as subclauses (I)
through (III), respectively, and indenting appropriately; and
(D) by adding at the end the following new subparagraph:
``(B) Improvements to care management requirements for
severe or disabling chronic condition snps.--For 2020 and
subsequent years, in the case of a specialized MA plan for
special needs individuals described in subsection
(b)(6)(B)(iii), the requirements described in this paragraph
include the following:
``(i) The interdisciplinary team under subparagraph
(A)(ii)(III) includes a team of providers with demonstrated
expertise, including training in an applicable specialty, in
treating individuals similar to the targeted population of
the plan.
``(ii) Requirements developed by the Secretary to provide
face-to-face encounters with individuals enrolled in the plan
not less frequently than on an annual basis.
``(iii) As part of the model of care under clause (i) of
subparagraph (A), the results of the initial assessment and
annual reassessment under clause (ii)(I) of such subparagraph
of each individual enrolled in the plan are addressed in the
individual's individualized care plan under clause (ii)(II)
of such subparagraph.
``(iv) As part of the annual evaluation and approval of
such model of care, the Secretary shall take into account
whether the plan fulfilled the previous year's goals (as
required under the model of care).
``(v) The Secretary shall establish a minimum benchmark for
each element of the model of care of a plan. The Secretary
shall only approve a plan's model of care under this
paragraph if each element of the model of care meets the
minimum benchmark applicable under the preceding sentence.''.
(2) Revisions to the definition of a severe or disabling
chronic conditions specialized needs individual.--
(A) In general.--Section 1859(b)(6)(B)(iii) of the Social
Security Act (42 U.S.C. 1395w-28(b)(6)(B)(iii)) is amended--
(i) by striking ``who have'' and inserting ``who--
``(I) before January 1, 2022, have'';
(ii) in subclause (I), as added by clause (i), by striking
the period at the end and inserting ``; and''; and
(iii) by adding at the end the following new subclause:
``(II) on or after January 1, 2022, have one or more
comorbid and medically complex chronic conditions that is
life threatening or significantly limits overall health or
function, have a high risk of hospitalization or other
adverse health outcomes, and require intensive care
coordination and that is listed under subsection
(f)(9)(A).''.
(B) Panel of clinical advisors.--Section 1859(f) of the
Social Security Act (42 U.S.C. 1395w-28(f)), as amended by
subsection (b), is amended by adding at the end the following
new paragraph:
``(9) List of conditions for clarification of the
definition of a severe or disabling chronic conditions
specialized needs individual.--
``(A) In general.--Not later than December 31, 2020, and
every 5 years thereafter, subject to subparagraphs (B) and
(C), the Secretary shall convene a panel of clinical advisors
to establish and update a list of conditions that meet each
of the following criteria:
``(i) Conditions that meet the definition of a severe or
disabling chronic condition under subsection (b)(6)(B)(iii)
on or after January 1, 2022.
``(ii) Conditions that require prescription drugs,
providers, and models of care that are unique to the specific
population of enrollees in a specialized MA plan for special
needs individuals described in such subsection on or after
such date and--
``(I) as a result of access to, and enrollment in, such a
specialized MA plan for special needs individuals,
individuals with such condition would have a reasonable
expectation of slowing or halting the progression of the
disease, improving health outcomes and decreasing overall
costs for individuals diagnosed with such condition compared
to available options of care other than through such a
specialized MA plan for special needs individuals; or
``(II) have a low prevalence in the general population of
beneficiaries under this title or a disproportionally high
per-beneficiary cost under this title.
``(B) Inclusion of certain conditions.--The conditions
listed under subparagraph (A) shall include HIV/AIDS, end
stage renal disease, and chronic and disabling mental
illness.
``(C) Requirement.--In establishing and updating the list
under subparagraph (A), the panel shall take into account the
availability of varied benefits, cost-sharing, and
supplemental benefits under the model described in paragraph
(2) of section 1859(h), including the expansion under
paragraph (1) of such section.''.
(d) Quality Measurement at the Plan Level for SNPs and
Determination of Feasability of Quality Measurement at the
Plan Level for All MA Plans.--Section 1853(o) of the Social
Security Act (42 U.S.C. 1395w-23(o)) is amended by adding at
the end the following new paragraphs:
``(6) Quality measurement at the plan level for snps.--
``(A) In general.--Subject to subparagraph (B), the
Secretary may require reporting of data under section 1852(e)
for, and apply under this subsection, quality measures at the
plan level for specialized MA plans for special needs
individuals instead of at the contract level.
``(B) Considerations.--Prior to applying quality
measurement at the plan level under this paragraph, the
Secretary shall--
``(i) take into consideration the minimum number of
enrollees in a specialized MA plan for special needs
individuals in order to determine if a statistically
significant or valid measurement of quality at the plan level
is possible under this paragraph;
``(ii) take into consideration the impact of such
application on plans that serve a disproportionate number of
individuals dually eligible for benefits under this title and
under title XIX;
``(iii) if quality measures are reported at the plan level,
ensure that MA plans are not required to provide duplicative
information; and
``(iv) ensure that such reporting does not interfere with
the collection of encounter data submitted by MA
organizations or the administration of any changes to the
program under this part as a result of the collection of such
data.
``(C) Application.--If the Secretary applies quality
measurement at the plan level under this paragraph--
``(i) such quality measurement may include Medicare Health
Outcomes Survey (HOS), Healthcare Effectiveness Data and
Information Set (HEDIS), Consumer Assessment of Healthcare
Providers and Systems (CAHPS) measures and quality measures
under part D; and
``(ii) the Secretary shall consider applying administrative
actions, such as remedies described in section 1857(g)(2), at
the plan level.
``(7) Determination of feasibility of quality measurement
at the plan level for all ma plans.--
``(A) Determination of feasibility.--The Secretary shall
determine the feasibility of requiring reporting of data
under section 1852(e) for, and applying under this
subsection, quality measures at the plan level for all MA
plans under this part.
``(B) Consideration of change.--After making a
determination under subparagraph (A), the Secretary shall
consider requiring such reporting and applying such quality
measures at the plan level as described in such
subparagraph''.
(e) GAO Study and Report on State-Level Integration Between
Dual SNPs and Medicaid.--
(1) Study.--The Comptroller General of the United States
(in this subsection referred to as the ``Comptroller
General'') shall conduct a study on State-level integration
between specialized MA plans for special needs individuals
described in subsection (b)(6) (B)(ii) of section 1859 of the
Social Security Act (42 U.S.C. 1395w-28) and the Medicaid
program under title XIX of such Act (42 U.S.C. 1396 et seq.).
Such study shall include an analysis of the following:
(A) The characteristics of States in which the State agency
responsible for administering the State plan under such title
XIX
[[Page H859]]
has a contract with such a specialized MA plan and that
delivers long-term services and supports under the State plan
under such title XIX through a managed care program,
including the requirements under such State plan with respect
to long-term services and supports.
(B) The types of such specialized MA plans, which may
include the following:
(i) A plan described in section 1853(a)(1)(B)(iv)(II) of
such Act (42 U.S.C. 1395w-23(a)(1)(B)(iv)(II)).
(ii) A plan that meets the requirements described in
subsection (f)(3)(D) of such section 1859.
(iii) A plan described in clause (ii) that also meets
additional requirements established by the State.
(C) The characteristics of individuals enrolled in such
specialized MA plans.
(D) As practicable, the following with respect to State
programs for the delivery of long-term services and supports
under such title XIX through a managed care program:
(i) Which populations of individuals are eligible to
receive such services and supports.
(ii) Whether all such services and supports are provided on
a capitated basis or if any of such services and supports are
carved out and provided through fee-forservice.
(E) As practicable, how the availability and variation of
integration arrangements of such specialized MA plans offered
in States affects spending, service delivery options, access
to community-based care, and utilization of care.
(F) The efforts of State Medicaid programs to transition
dually-eligible beneficiaries receiving long-term services
and supports (LTSS) from institutional settings to home and
community-based settings and related financial impacts of
such transitions.
(G) Barriers and opportunities for making further progress
on dual integration, as well as recommendations for
legislation or administrative action to expedite or refine
pathways toward fully integrated care.
(2) Report.--Not later than 2 years after the date of the
enactment of this Act, the Comptroller General shall submit
to Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations
for such legislation and administrative action as the
Comptroller General determines appropriate.
SEC. 2122. EXTENSION OF CERTAIN MIPPA FUNDING PROVISIONS;
STATE HEALTH INSURANCE ASSISTANCE PROGRAM
REPORTING REQUIREMENTS.
(a) Funding Extensions.--Section 119 of the Medicare
Improvements for Patients and Providers Act of 2008 (42
U.S.C. 1395b-3 note) is amended--
(1) in subsection (a)(1)(B)--
(A) in clause (vi), by striking ``and'' at the end;
(B) in clause (vii), by striking the period at the end and
inserting ``; and''; and
(C) by inserting after clause (vii) the following new
clause:
``(viii) for each of fiscal years 2018 and 2019, of
$13,000,000.'';
(2) in subsection (b)(1)(B)--
(A) in clause (vi), by striking ``and'' at the end;
(B) in clause (vii), by striking the period at the end and
inserting ``; and''; and
(C) by inserting after clause (vii) the following new
clause:
``(viii) for each of fiscal years 2018 and 2019, of
$7,500,000.'';
(3) in subsection (c)(1)(B)--
(A) in clause (vi), by striking ``and'' at the end;
(B) in clause (vii), by striking the period at the end and
inserting ``; and''; and
(C) by inserting after clause (vii) the following new
clause:
``(viii) for each of fiscal years 2018 and 2019, of
$5,000,000.''; and
(4) in subsection (d)(2)--
(A) in clause (vi), by striking ``and'' at the end;
(B) in clause (vii), by striking the period at the end and
inserting ``; and''; and
(C) by inserting after clause (vii) the following new
clause:
``(viii) for each of fiscal years 2018 and 2019, of
$12,000,000.''.
(b) State Health Insurance Assistance Program Reporting
Requirements.--Beginning not later than April 1, 2019, and
biennially thereafter, the Agency for Community Living shall
electronically post on its website the following information,
with respect to grants to States for State health insurance
assistance programs, (such information to be presented by
State and by entity receiving funds from the State to carry
out such a program funded by such grant):
(1) The amount of Federal funding provided to each such
State for such program for the period involved and the amount
of Federal funding provided by each such State for such
program to each such entity for the period involved.
(2) Information as the Secretary may specify, with respect
to such programs carried out through such grants, consistent
with the terms and conditions for receipt of such grants.
SEC. 2123. EXTENSION OF FUNDING FOR QUALITY MEASURE
ENDORSEMENT, INPUT, AND SELECTION; REPORTING
REQUIREMENTS.
(a) In General.--Section 1890(d) of the Social Security Act
(42 U.S.C. 1395aaa(d)) is amended--
(1) in paragraph (2), by adding at the end the following
new sentence: ``Any of such amounts remaining available as of
the date of the enactment of the SUSTAIN Care Act of 2018
shall be used only for purposes under this section that are
purposes other than funding a contract entered into under
subsection (a).''; and
(2) by adding at the end the following new paragraph:
``(3) For purposes of carrying out this section, the
Secretary shall provide for the transfer, from the Federal
Hospital Insurance Trust Fund under section 1817 and the
Federal Supplemental Medical Insurance Trust Fund under 1841,
in such proportion as Secretary deems appropriate, to the
Centers for Medicare & Medicaid Services Program Management
Account of $7,500,000 for each of fiscal years 2018 and 2019.
Of the amount transferred under the previous sentence for a
fiscal year, there shall be used for the purpose of funding a
contract entered into under subsection (a) with respect to
carrying out section 1890A (other than subsections (e) and
(f)) for such fiscal year an amount that is not less than the
amount used for such purpose for fiscal year 2017.''.
(b) Annual Report by Secretary to Congress.--Section 1890
of the Social Security Act (42 U.S.C. 1395aaa) is amended by
adding at the end the following new subsection:
``(e) Annual Report by Secretary to Congress.--By not later
than March 1 of each year (beginning with 2018), the
Secretary shall submit to Congress a report containing the
following:
``(1) A comprehensive plan that identifies the quality
measurement needs of programs and initiatives of the
Secretary and provides a strategy for using the work
performed by the entity with a contract under subsection (a)
and the work of any other entity the Secretary has contracted
with to perform work associated with this section or section
1890A to help meet those needs, specifically with respect to
the programs under this title and title XIX.
``(2) The amount of mandatory funding provided under
subsection (d) for purposes of carrying out this section and
section 1890A that has been obligated by the Secretary, the
amount of funding provided that has been expended, and the
amount of funding provided that remains unobligated.
``(3) A description of how the funds provided that are
obligated have been allocated, including how much of that
funding has been allocated for work performed by the
Secretary, the entity with a contract under subsection (a),
and any other entity the Secretary has contracted with to
perform work related to this section or section 1890A,
respectively.
``(4) A description of the activities for which the
obligated funds have been or will be used, including any
activities performed by the Secretary, task orders, specific
projects, and activities assigned to the entity with a
contract under subsection (a), and task orders, specific
projects, and activities assigned to any other entity the
Secretary has contracted with to perform work related to
carrying out this section or section 1890A.
``(5) The amount of funding allocated to each of the
activities described in paragraph (4).
``(6) Estimates for, and descriptions of, obligations and
expenditures that the Secretary anticipates will be needed in
the succeeding two year period to carry out each of the
quality measurement activities required under this section
and section 1890A, including any obligations that will
require funds to be expended in a future year.''.
(c) Revisions to Annual Report From Consensus-based Entity
to Congress and the Secretary.--
(1) In general.--Section 1890(b)(5)(A) of the Social
Security Act (42 U.S.C. 1395aaa(b)(5)(A)) is amended--
(A) by redesignating clauses (i) through (vi) as subclauses
(I) through (VI), respectively, and moving the margins
accordingly;
(B) in the matter preceding subclause (I), as redesignated
by clause (i), by striking ``containing a description of--''
and inserting ``containing the following:
``(i) A description of--''; and
(C) by adding at the end the following new clauses:
``(ii) An itemization of financial information for the
fiscal year ending September 30 of the preceding year,
including--
``(I) annual revenues of the entity (including any
government funding, private sector contributions, grants,
membership revenues, and investment revenue);
``(II) annual expenses of the entity (including grants
paid, benefits paid, salaries or other compensation,
fundraising expenses, and overhead costs); and
``(III) a breakdown of the amount awarded per contracted
task order and the specific projects funded in each task
order assigned to the entity.
``(iii) Any updates or modifications of internal policies
and procedures of the entity as they relate to the duties of
the entity under this section, including--
``(I) specifically identifying any modifications to the
disclosure of interests and conflicts of interests for
committees, work groups, task forces, and advisory panels of
the entity; and
``(II) information on external stakeholder participation in
the duties of the entity under this section (including
complete rosters for all committees, work groups, task
forces, and advisory panels funded through government
contracts, descriptions of relevant interests and any
conflicts of interest for members of all committees, work
groups, task forces, and advisory panels, and the total
percentage by health care sector of all
[[Page H860]]
convened committees, work groups, task forces, and advisory
panels.''.
(2) Effective date.--The amendments made by this subsection
shall apply to reports submitted for years beginning with
2018.
(d) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall conduct a study on health care quality measurement
efforts funded under sections 1890 and 1890A of the Social
Security Act (42 U.S.C. 1395aaa; 1395aaa-1). Such study shall
include an examination of the following:
(A) The extent to which the Secretary of Health and Human
Services (in this subsection referred to as the
``Secretary'') has set and prioritized objectives to be
achieved for each of the quality measurement activities
required under such sections 1890 and 1890A.
(B) The efforts that the Secretary has undertaken to meet
quality measurement objectives associated with such sections
1890 and 1890A, including division of responsibilities for
those efforts within the Department of Health and Human
Services and through contracts with a consensus-based entity
under subsection (a) of such section 1890 (in this subsection
referred to as the ``consensus-based entity'') and other
entities, and the extent of any overlap among the work
performed by the Secretary, the consensus-based entity, the
Measure Application Partnership (MAP) convened by such entity
to provide input to the Secretary on the selection of quality
and efficiency measures, and any other entities the Secretary
has contracted with to perform work related to carrying out
such sections 1890 and 1890A.
(C) The total amount of mandatory funding provided to the
Secretary for purposes of carrying out such sections 1890 and
1890A, the amount of such funding that has been obligated by
the Secretary, and the amount of such funding that remains
unobligated.
(D) How the obligated funds have been allocated, including
how much of the obligated funding has been allocated for work
performed by the Secretary, the consensus-based entity, and
any other entity the Secretary has contracted with to perform
work related to carrying out such sections 1890 and 1890A,
respectively, and descriptions of such work.
(E) The extent to which the Secretary has developed a
comprehensive and long-term plan to ensure that it can
achieve quality measurement objectives related to carrying
out such sections 1890 and 1890A in a timely manner and with
efficient use of available resources, including the roles of
the consensus-based entity, the Measure Application
Partnership (MAP), and any other entity the Secretary has
contracted with to perform work related to such sections 1890
and 1890A in helping the Secretary achieve those objectives.
(2) Report.--Not later than 18 months after the date of
enactment of this Act, the Comptroller General of the United
States shall submit to Congress a report containing the
results of the study conducted under paragraph (1), together
with recommendations for such legislation and administrative
action as the Comptroller General determines appropriate.
TITLE II--ADDITIONAL MEDICARE POLICIES RELATING TO EXTENDERS
SEC. 2201. HOME HEALTH PAYMENT REFORM.
(a) Budget Neutral Transition to a 30-day Unit of Payment
for Home Health Services.--Section 1895(b) of the Social
Security Act (42 U.S.C. 1395fff(b)) is amended--
(1) in paragraph (2)--
(A) by striking ``payment.--In defining'' and inserting
``payment.--
``(A) In general.--In defining''; and
(B) by adding at the end the following new subparagraph:
``(B) 30-day unit of service.--For purposes of implementing
the prospective payment system with respect to home health
units of service furnished during a year beginning with 2020,
the Secretary shall apply a 30-day unit of service as the
unit of service applied under this paragraph.'';
(2) in paragraph (3)--
(A) in subparagraph (A), by adding at the end the following
new clause:
``(iv) Budget neutrality for 2020.--With respect to
payments for home health units of service furnished that end
during the 12-month period beginning January 1, 2020, the
Secretary shall calculate a standard prospective payment
amount (or amounts) for 30-day units of service (as described
in paragraph (2)(B)) for the prospective payment system under
this subsection. Such standard prospective payment amount (or
amounts) shall be calculated in a manner such that the
estimated aggregate amount of expenditures under the system
during such period with application of paragraph (2)(B) is
equal to the estimated aggregate amount of expenditures that
otherwise would have been made under the system during such
period if paragraph (2)(B) had not been enacted. The previous
sentence shall be applied before (and not affect the
application of) paragraph (3)(B). In calculating such amount
(or amounts), the Secretary shall make assumptions about
behavior changes that could occur as a result of the
implementation of paragraph (2)(B) and the case-mix
adjustment factors established under paragraph (4)(B) and
shall provide a description of such assumptions in the notice
and comment rulemaking used to implement this clause.''; and
(B) by adding at the end the following new subparagraph:
``(D) Behavior assumptions and adjustments.--
``(i) In general.--The Secretary shall annually determine
the impact of differences between assumed behavior changes
(as described in paragraph (3)(A)(iv)) and actual behavior
changes on estimated aggregate expenditures under this
subsection with respect to years beginning with 2020 and
ending with 2026.
``(ii) Permanent adjustments.--The Secretary shall, at a
time and in a manner determined appropriate, through notice
and comment rulemaking, provide for one or more permanent
increases or decreases to the standard prospective payment
amount (or amounts) for applicable years, on a prospective
basis, to offset for such increases or decreases in estimated
aggregate expenditures (as determined under clause (i)).
``(iii) Temporary adjustments for retrospective behavior.--
The Secretary shall, at a time and in a manner determined
appropriate, through notice and comment rulemaking, provide
for one or more temporary increases or decreases to the
payment amount for a unit of home health services (as
determined under paragraph (4)) for applicable years, on a
prospective basis, to offset for such increases or decreases
in estimated aggregate expenditures (as determined under
clause (i)). Such a temporary increase or decrease shall
apply only with respect to the year for which such temporary
increase or decrease is made, and the Secretary shall not
take into account such a temporary increase or decrease in
computing such amount under this subsection for a subsequent
year.''; and
(3) in paragraph (4)(B)--
(A) by striking ``Factors.--The Secretary'' and inserting
``Factors.--
``(i) In general.--The Secretary''; and
(B) by adding at the end the following new clause:
``(ii) Treatment of therapy thresholds.--For 2020 and
subsequent years, the Secretary shall eliminate the use of
therapy thresholds (established by the Secretary) in case mix
adjustment factors established under clause (i) for
calculating payments under the prospective payment system
under this subsection.''.
(b) Technical Expert Panel.--
(1) In general.--During the period beginning on January 1,
2018, and ending on December 31, 2018, the Secretary of
Health and Human Services shall hold at least one session of
a technical expert panel, the participants of which shall
include home health providers, patient representatives, and
other relevant stakeholders. The technical expert panel shall
identify and prioritize recommendations with respect to the
prospective payment system for home health services under
section 1895(b) of the Social Security Act (42 U.S.C.
1395fff(b)), on the following:
(A) The Home Health Groupings Model, as described in the
proposed rule ``Medicare and Medicaid Programs; CY 2018 Home
Health Prospective Payment System Rate Update and Proposed CY
2019 Case-Mix Adjustment Methodology Refinements; Home Health
Value-Based Purchasing Model; and Home Health Quality
Reporting Requirements'' (82 Fed. Reg. 35294 through 35332
(July 28, 2017)).
(B) Alternative case-mix models to the Home Health
Groupings Model that were submitted during 2017 as comments
in response to proposed rule making, including patient-
focused factors that consider the risks of hospitalization
and readmission to a hospital, improvement or maintenance of
functionality of individuals to increase the capacity for
self-care, quality of care, and resource utilization.
(2) Inapplicability of faca.--The provisions of the Federal
Advisory Committee Act (5 U.S.C. App.) shall not apply to the
technical expert panel under paragraph (1).
(3) Report.--Not later than April 1, 2019, the Secretary of
Health and Human Services shall submit to the Committee on
Ways and Means and the Committee on Energy and Commerce of
the House of Representatives and the Committee on Finance of
the Senate a report on the recommendations of such panel
described in such paragraph.
(4) Notice and comment rulemaking.--Not later than December
31, 2019, the Secretary of Health and Human Services shall
pursue notice and comment rulemaking on a case-mix system
with respect to the prospective payment system for home
health services under section 1895(b) of the Social Security
Act (42 U.S.C. 1395fff(b)).
(c) Reports.--
(1) Interim report.--Not later than March 15, 2022, the
Medicare Payment Advisory Commission shall submit to Congress
an interim report on the application of a 30-day unit of
service as the unit of service applied under section
1895(b)(2) of the Social Security Act (42 U.S.C.
1395fff(b)(2)), as amended by subsection (a), including an
analysis of the level of payments provided to home health
agencies as compared to the cost of delivering home health
services, and any unintended consequences, including with
respect to behavioral changes and quality.
(2) Final report.--Not later than March 15, 2026, such
Commission shall submit to Congress a final report on such
application and any such consequences.
SEC. 2202. INFORMATION TO SATISFY DOCUMENTATION OF MEDICARE
ELIGIBILITY FOR HOME HEALTH SERVICES.
(a) Part A.--Section 1814(a) of the Social Security Act (42
U.S.C. 1395f(a)) is amended
[[Page H861]]
by inserting before ``For purposes of paragraph (2)(C),'' the
following new sentence: ``For purposes of documentation for
physician certification and recertification made under
paragraph (2) on or after January 1, 2019, and made with
respect to home health services furnished by a home health
agency, in addition to using documentation in the medical
record of the physician who so certifies or the medical
record of the acute or post-acute care facility (in the case
that home health services were furnished to an individual who
was directly admitted to the home health agency from such a
facility), the Secretary may use documentation in the medical
record of the home health agency as supporting material, as
appropriate to the case involved.''.
(b) Part B.--Section 1835(a) of the Social Security Act (42
U.S.C. 1395n(a)) is amended by inserting before ``For
purposes of paragraph (2)(A),'' the following new sentence:
``For purposes of documentation for physician certification
and recertification made under paragraph (2) on or after
January 1, 2019, and made with respect to home health
services furnished by a home health agency, in addition to
using documentation in the medical record of the physician
who so certifies or the medical record of the acute or post-
acute care facility (in the case that home health services
were furnished to an individual who was directly admitted to
the home health agency from such a facility), the Secretary
may use documentation in the medical record of the home
health agency as supporting material, as appropriate to the
case involved.''.
SEC. 2203. VOLUNTARY SETTLEMENT OF HOME HEALTH CLAIMS.
(a) Settlement Process for Home Health Claims.--
(1) In general.--Not later than one year after the date of
enactment of this Act, the Secretary of Health and Human
Services shall establish a settlement process under which a
home health agency entitled to an eligible administrative
appeal has the option to enter into a settlement with the
Secretary that is reached in a manner consistent with the
succeeding paragraphs of this subsection.
(2) Process and consideration of home health claims.--A
settlement under paragraph (1) with a home health agency that
is with respect to an eligible administrative appeal may only
be reached in accordance with the following process:
(A) A settlement under such paragraph with the home health
agency shall be with respect to all claims by such agency,
subject to paragraph (4), that, as of the date of such
settlement, are under an eligible administrative appeal.
(B) For the duration of the settlement process with such
agency, an eligible administrative appeal that is with
respect to any such claim by such agency shall be suspended.
(C) Under the settlement process, the Secretary shall
determine an aggregate amount to be paid to the home health
agency with respect to all claims by such agency that are
under an eligible administrative appeal in the following
manner:
(i) The Secretary shall, for purposes of applying clause
(ii) with respect to all settlements under paragraph (1),
select a percentage. In selecting such percentage, the
Secretary shall consider the percentage used under the
Centers for Medicare & Medicaid Services hospital appeals
settlement that began on August 29, 2014.
(ii) The Secretary shall, with respect to each denied claim
for such agency that is under an eligible administrative
appeal, calculate an amount (referred to in this subparagraph
as an ``individual claim amount'') by multiplying the net
payable amount for such claim by the percentage selected
under clause (i).
(iii) Such aggregate amount with respect to such agency
shall be determined by calculating the total sum of all the
individual claim amounts calculated under clause (ii) with
respect to such agency.
(3) Effect of process.--
(A) Effect of settlement.--
(i) Further appeal.--As part of any settlement under
paragraph (1) between a home health agency and the Secretary,
such home health agency shall be required to forego the right
to an administrative appeal under section 1869 of the Social
Security Act (42 U.S.C. 1395ff) or section 1878 of such Act
(42 U.S.C. 1395oo) (including any redetermination,
reconsideration, hearing, or review) with respect to any
claims for home health services that are subject to the
settlement.
(ii) Judicial review.--There shall be no administrative or
judicial review under such section 1869 or otherwise of a
settlement under paragraph (1) and the claims covered by the
settlement.
(B) Effect of no settlement.--In the event that the process
described in paragraph (2) does not, with respect to a home
health agency, result in a settlement under paragraph (1)
with such agency, any appeal under such section 1869 that is
with respect to a claim by such agency that was suspended
pursuant to paragraph (2)(B) shall resume under such section.
(4) Coordination with law enforcement.--The Secretary of
Health and Human Services shall establish a process to
coordinate with appropriate law enforcement agencies in order
to avoid the inadvertent settlement of cases that involve
fraud or other criminal activity.
(b) No Entitlement to Settlement Process.--Nothing in this
section shall be construed as creating an entitlement to
enter into a settlement process established pursuant to
subsection (a).
(c) Eligible Administrative Appeal Defined.--For purposes
of this section, the term ``eligible administrative appeal''
means an appeal under section 1869 of the Social Security Act
(42 U.S.C. 1395ff) (including any redetermination,
reconsideration, hearing, or review)--
(1) that is with respect to one or more claims that--
(A) are for home health services that were furnished on or
after January 1, 2011, and before January 1, 2015; and
(B) were timely filed consistent with section 1814(a)(1) of
such Act (42 U.S.C. 1395f(a)(1)) or sections 1835(a)(1) and
1842(b)(3) of such Act (42 U.S.C. 1395n(a)(1), 1395u(b)(3));
and
(2) either--
(A) was timely filed consistent with section 1869 of such
Act (42 U.S.C. 1395ff) and is pending; or
(B) for which the applicable time frame to file an appeal
has not expired.
(d) Conforming Amendment.--Section 1869 of the Social
Security Act (42 U.S.C. 1395ff) is amended by adding at the
end the following new subsection:
``(j) Application With Respect to Certain Home Health
Claims.--For the application of the provisions of this
section with respect to certain claims for home health
services that were furnished on or after January 1, 2011, and
before January 1, 2015, see section 106 of the Healthcare
Extension, Reauthorization, and Opportunities Act of 2017.''.
SEC. 2204. EXTENSION OF ENFORCEMENT INSTRUCTION ON MEDICARE
SUPERVISION REQUIREMENTS FOR OUTPATIENT
THERAPEUTIC SERVICES IN CRITICAL ACCESS AND
SMALL RURAL HOSPITALS.
Section 1834 of the Social Security Act (42 U.S.C. 1395m)
is amended by adding at the end the following new subsection:
``(v) Extension of Enforcement Instruction on Supervision
Requirements for Outpatient Therapeutic Services in Critical
Access and Small Rural Hospitals.--For calendar year 2017,
the Secretary shall continue to apply the enforcement
instruction described in the notice of the Centers for
Medicare & Medicaid Services entitled `Enforcement
Instruction on Supervision Requirements for Outpatient
Therapeutic Services in Critical Access and Small Rural
Hospitals for CY 2013', dated November 1, 2012 (providing for
an exception to the restatement and clarification under the
final rulemaking changes to the Medicare hospital outpatient
prospective payment system and calendar year 2009 payment
rates (published in the Federal Register on November 18,
2008, 73 Fed. Reg. 68702 through 68704) with respect to
requirements for direct supervision by physicians for
therapeutic hospital outpatient services), as previously
extended under section 1 of Public Law 113-198, as amended by
section 1 of Public Law 114-112 and section 16004(a) of the
21st Century Cures Act (Public Law 114-255).''.
SEC. 2205. TECHNICAL AMENDMENTS TO PUBLIC LAW 114-10.
(a) MIPS Transition.--Section 1848 of the Social Security
Act (42 U.S.C. 1395w-4) is amended--
(1) in subsection (q)--
(A) in paragraph (1)--
(i) in subparagraph (B), by striking ``items and services''
and inserting ``covered professional services (as defined in
subsection (k)(3)(A))''; and
(ii) in subparagraph (C)(iv)--
(I) by amending subclause (I) to read as follows:
``(I) The minimum number (as determined by the Secretary)
of--
``(aa) for performance periods beginning before January 1,
2018, individuals enrolled under this part who are treated by
the eligible professional for the performance period
involved; and
``(bb) for performance periods beginning on or after
January 1, 2018, individuals enrolled under this part who are
furnished covered professional services (as defined in
subsection (k)(3)(A)) by the eligible professional for the
performance period involved.'';
(II) in subclause (II), by striking ``items and services''
and inserting ``covered professional services (as defined in
subsection (k)(3)(A))''; and
(III) by amending subclause (III) to read as follows:
``(III) The minimum amount (as determined by the Secretary)
of--
``(aa) for performance periods beginning before January 1,
2018, allowed charges billed by such professional under this
part for such performance period; and
``(bb) for performance periods beginning on or after
January 1, 2018, allowed charges for covered professional
services (as defined in subsection (k)(3)(A)) billed by such
professional for such performance period.'';
(B) in paragraph (5)(D)--
(i) in clause (i)(I), by inserting ``subject to clause
(iii),'' after ``clauses (i) and (ii) of paragraph (2)(A),'';
and
(ii) by adding at the end the following new clause:
``(iii) Transition years.--For each of the second, third,
fourth, and fifth years for which the MIPS applies to
payments, the
[[Page H862]]
performance score for the performance category described in
paragraph (2)(A)(ii) shall not take into account the
improvement of the professional involved.'';
(C) in paragraph (5)(E)--
(i) in clause (i)(I)(bb)--
(I) in the heading by striking ``First 2 years'' and
inserting ``First 5 years''; and
(II) by striking ``the first and second years'' and
inserting ``each of the first through fifth years'';
(ii) in clause (i)(II)(bb)--
(I) in the heading, by striking ``2 years'' and inserting
``5 years''; and
(II) by striking the second sentence and inserting the
following new sentences: ``For each of the second, third,
fourth, and fifth years for which the MIPS applies to
payments, not less than 10 percent and not more than 30
percent of such score shall be based on performance with
respect to the category described in clause (ii) of paragraph
(2)(A). Nothing in the previous sentence shall be construed,
with respect to a performance period for a year described in
the previous sentence, as preventing the Secretary from
basing 30 percent of such score for such year with respect to
the category described in such clause (ii), if the Secretary
determines, based on information posted under subsection
(r)(2)(I) that sufficient resource use measures are ready for
adoption for use under the performance category under
paragraph (2)(A)(ii) for such performance period.'';
(D) in paragraph (6)(D)--
(i) in clause (i), in the second sentence, by striking
``Such performance threshold'' and inserting ``Subject to
clauses (iii) and (iv), such performance threshold'';
(ii) in clause (ii)--
(I) in the first sentence, by inserting ``(beginning with
2019 and ending with 2024)'' after ``for each year of the
MIPS''; and
(II) in the second sentence, by inserting ``subject to
clause (iii),'' after ``For each such year,'';
(iii) in clause (iii)--
(I) in the heading, by striking ``2'' and inserting ``5'';
and
(II) in the first sentence, by striking ``two years'' and
inserting ``five years''; and
(iv) by adding at the end the following new clause:
``(iv) Additional special rule for third, fourth and fifth
years of mips.--For purposes of determining MIPS adjustment
factors under subparagraph (A), in addition to the
requirements specified in clause (iii), the Secretary shall
increase the performance threshold with respect to each of
the third, fourth, and fifth years to which the MIPS applies
to ensure a gradual and incremental transition to the
performance threshold described in clause (i) (as estimated
by the Secretary) with respect to the sixth year to which the
MIPS applies.'';
(E) in paragraph (6)(E)--
(i) by striking ``In the case of items and services'' and
inserting ``In the case of covered professional services (as
defined in subsection (k)(3)(A))''; and
(ii) by striking ``under this part with respect to such
items and services'' and inserting ``under this part with
respect to such covered professional services''; and
(F) in paragraph (7), in the first sentence, by striking
``items and services'' and inserting ``covered professional
services (as defined in subsection (k)(3)(A))'';
(2) in subsection (r)(2), by adding at the end the
following new subparagraph:
``(I) Information.--The Secretary shall, not later than
December 31st of each year (beginning with 2018), post on the
Internet website of the Centers for Medicare & Medicaid
Services information on resource use measures in use under
subsection (q), resource use measures under development and
the time-frame for such development, potential future
resource use measure topics, a description of stakeholder
engagement, and the percent of expenditures under part A and
this part that are covered by resource use measures.''; and
(3) in subsection (s)(5)(B), by striking ``section
1833(z)(2)(C)'' and inserting ``section 1833(z)(3)(D)''.
(b) Physician-focused Payment Model Technical Advisory
Committee Provision of Initial Proposal Feedback.--Section
1868(c)(2)(C) of the Social Security Act (42 U.S.C.
1395ee(c)(2)(C)) is amended to read as follows:
``(C) Committee review of models submitted.--The Committee,
on a periodic basis--
``(i) shall review models submitted under subparagraph (B);
``(ii) may provide individuals and stakeholder entities who
submitted such models with--
``(I) initial feedback on such models regarding the extent
to which such models meet the criteria described in
subparagraph (A); and
``(II) an explanation of the basis for the feedback
provided under subclause (I); and
``(iii) shall prepare comments and recommendations
regarding whether such models meet the criteria described in
subparagraph (A) and submit such comments and recommendations
to the Secretary.''.
SEC. 2206. REVISED REQUIREMENTS FOR MEDICARE INTENSIVE
CARDIAC REHABILITATION PROGRAMS.
(a) In General.--Section 1861(eee)(4)(B) of the Social
Security Act (42 U.S.C. 1395x(eee)(4)(B)) is amended--
(1) in clause (v), by striking ``or'' at the end;
(2) in clause (vi), by striking the period at the end and
inserting a semicolon; and
(3) by adding at the end the following new clauses:
``(vii) stable, chronic heart failure (defined as patients
with left ventricular ejection fraction of 35 percent or less
and New York Heart Association (NYHA) class II to IV symptoms
despite being on optimal heart failure therapy for at least 6
weeks); or
``(viii) any additional condition for which the Secretary
has determined that a cardiac rehabilitation program shall be
covered, unless the Secretary determines, using the same
process used to determine that the condition is covered for a
cardiac rehabilitation program, that such coverage is not
supported by the clinical evidence.''.
(b) Ensuring Future Supervision Level Parity With Cardiac
Rehabilitation Programs.--Section 1861(eee)(4)(A) of the
Social Security Act (42 U.S.C. 1395x(eee)(4)(A)) is amended,
in the matter preceding clause (i), by striking ``physician-
supervised program (as described in paragraph (2))'' and
inserting ``program (supervised as described in paragraph
(2))''.
TITLE III--CREATING HIGH-QUALITY RESULTS AND OUTCOMES NECESSARY TO
IMPROVE CHRONIC (CHRONIC) CARE
Subtitle A--Receiving High Quality Care in the Home
SEC. 2301. EXTENDING THE INDEPENDENCE AT HOME DEMONSTRATION
PROGRAM.
(a) In General.--Section 1866E of the Social Security Act
(42 U.S.C. 1395cc-5) is amended--
(1) in subsection (e)--
(A) in paragraph (1)--
(i) by striking ``An agreement'' and inserting
``Agreements''; and
(ii) by striking ``5-year'' and inserting ``7-year''; and
(B) in paragraph (5)--
(i) by striking ``10,000'' and inserting ``15,000''; and
(ii) by adding at the end the following new sentence: ``An
applicable beneficiary that participates in the demonstration
program by reason of the increase from 10,000 to 15,000 in
the preceding sentence pursuant to the amendment made by
section 2301(a)(1)(B) of the SUSTAIN Care Act of 2018 shall
be considered in the spending target estimates under
paragraph (1) of subsection (c) and the incentive payment
calculations under paragraph (2) of such subsection for the
sixth and seventh years of such program.'';
(2) in subsection (g), in the first sentence, by inserting
``, including, to the extent practicable, with respect to the
use of electronic health information systems, as described in
subsection (b)(1)(A)(vi)'' after ``under the demonstration
program''; and
(3) in subsection (i)(1)(A), by striking ``will not receive
an incentive payment for the second of 2'' and inserting
``did not achieve savings for the third of 3''.
(b) Effective Date.--The amendment made by subsection
(a)(3) shall take effect as if included in the enactment of
Public Law 111-148.
SEC. 2302. EXPANDING ACCESS TO HOME DIALYSIS THERAPY.
(a) In General.--Section 1881(b)(3) of the Social Security
Act (42 U.S.C. 1395rr(b)(3)) is amended--
(1) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively;
(2) in clause (ii), as redesignated by paragraph (1), by
striking ``on a comprehensive'' and insert ``subject to
subparagraph (B), on a comprehensive'';
(3) by striking ``With respect to'' and inserting ``(A)
With respect to''; and
(4) by adding at the end the following new subparagraph:
``(B)(i) For purposes of subparagraph (A)(ii), subject to
clause (ii), an individual determined to have end stage renal
disease receiving home dialysis may choose to receive monthly
end stage renal disease-related clinical assessments
furnished on or after January 1, 2019, via telehealth.
``(ii) Clause (i) shall apply to an individual only if the
individual receives a face-to-face clinical assessment,
without the use of telehealth--
``(I) in the case of the initial 3 months of home dialysis
of such individual, at least monthly; and
``(II) after such initial 3 months, at least once every 3
consecutive months.''.
(b) Originating Site Requirements.--
(1) In general.--Section 1834(m) of the Social Security Act
(42 U.S.C. 1395m(m)) is amended--
(A) in paragraph (4)(C)(ii), by adding at the end the
following new subclauses:
``(IX) A renal dialysis facility, but only for purposes of
section 1881(b)(3)(B).
``(X) The home of an individual, but only for purposes of
section 1881(b)(3)(B).''; and
(B) by adding at the end the following new paragraph:
``(5) Treatment of home dialysis monthly esrd-related
visit.--The geographic requirements described in paragraph
(4)(C)(i) shall not apply with respect to telehealth services
furnished on or after January 1, 2019, for purposes of
section 1881(b)(3)(B), at an originating site described in
subclause (VI), (IX), or (X) of paragraph (4)(C)(ii).''.
(2) No facility fee if originating site for home dialysis
therapy is the home.--Section 1834(m)(2)(B) of the Social
Security (42 U.S.C. 1395m(m)(2)(B)) is amended--
(A) by redesignating clauses (i) and (ii) as subclauses (I)
and (II), and indenting appropriately;
(B) in subclause (II), as redesignated by subparagraph (A),
by striking ``clause (i) or
[[Page H863]]
this clause'' and inserting ``subclause (I) or this
subclause'';
(C) by striking ``site.--With respect to'' and inserting
``site.--
``(i) In general.--Subject to clause (ii), with respect
to''; and
(D) by adding at the end the following new clause:
``(ii) No facility fee if originating site for home
dialysis therapy is the home.--No facility fee shall be paid
under this subparagraph to an originating site described in
paragraph (4)(C)(ii)(X).''.
(c) Clarification Regarding Telehealth Provided to
Beneficiaries.--Section 1128A(i)(6) of the Social Security
Act (42 U.S.C. 1320a-7a(i)(6)) is amended--
(1) in subparagraph (H), by striking ``or'' at the end;
(2) in subparagraph (I), by striking the period at the end
and inserting ``; or''; and
(3) by adding at the end the following new subparagraph:
``(J) the provision of telehealth technologies (as defined
by the Secretary) on or after January 1, 2019, by a provider
of services or a renal dialysis facility (as such terms are
defined for purposes of title XVIII) to an individual with
end stage renal disease who is receiving home dialysis for
which payment is being made under part B of such title, if--
``(i) the telehealth technologies are not offered as part
of any advertisement or solicitation;
``(ii) the telehealth technologies are provided for the
purpose of furnishing telehealth services related to the
individual's end stage renal disease; and
``(iii) the provision of the telehealth technologies meets
any other requirements set forth in regulations promulgated
by the Secretary.''.
(d) Conforming Amendment.--Section 1881(b)(1) of the Social
Security Act (42 U.S.C. 1395rr(b)(1)) is amended by striking
``paragraph (3)(A)'' and inserting ``paragraph (3)(A)(i)''.
Subtitle B--Expanding Innovation and Technology
SEC. 2311. ADAPTING BENEFITS TO MEET THE NEEDS OF CHRONICALLY
ILL MEDICARE ADVANTAGE ENROLLEES.
Section 1859 of the Social Security Act (42 U.S.C. 1395w-
28) is amended by adding at the end the following new
subsection:
``(h) National Testing of Medicare Advantage Value-Based
Insurance Design Model.--
``(1) In general.--In implementing the Medicare Advantage
Value-Based Insurance Design model that is being tested under
section 1115A(b), the Secretary shall revise the testing of
the model under such section to cover, effective not later
than January 1, 2020, all States.
``(2) Termination and modification provision not applicable
until january 1, 2022.--The provisions of section
1115A(b)(3)(B) shall apply to the Medicare Advantage Value-
Based Insurance Design model, including such model as revised
under paragraph (1), beginning January 1, 2022, but shall not
apply to such model, as so revised, prior to such date.
``(3) Funding.--The Secretary shall allocate funds made
available under section 1115A(f)(1) to design, implement, and
evaluate the Medicare Advantage Value-Based Insurance Design
model, as revised under paragraph (1).''.
SEC. 2312. EXPANDING SUPPLEMENTAL BENEFITS TO MEET THE NEEDS
OF CHRONICALLY ILL MEDICARE ADVANTAGE
ENROLLEES.
(a) In General.--Section 1852(a)(3) of the Social Security
Act (42 U.S.C. 1395w-22(a)(3)) is amended--
(1) in subparagraph (A), by striking ``Each'' and inserting
``Subject to subparagraph (D), each''; and
(2) by adding at the end the following new subparagraph:
``(D) Expanding supplemental benefits to meet the needs of
chronically ill enrollees.--
``(i) In general.--For plan year 2020 and subsequent plan
years, in addition to any supplemental health care benefits
otherwise provided under this paragraph, an MA plan,
including a specialized MA plan for special needs individuals
(as defined in section 1859(b)(6)), may provide supplemental
benefits described in clause (ii) to a chronically ill
enrollee (as defined in clause (iii)).
``(ii) Supplemental benefits described.--
``(I) In general.--Supplemental benefits described in this
clause are supplemental benefits that, with respect to a
chronically ill enrollee, have a reasonable expectation of
improving or maintaining the health or overall function of
the chronically ill enrollee and may not be limited to being
primarily health related benefits.
``(II) Authority to waive uniformity requirements.--The
Secretary may, only with respect to supplemental benefits
provided to a chronically ill enrollee under this
subparagraph, waive the uniformity requirements under this
part, as determined appropriate by the Secretary.
``(iii) Chronically ill enrollee defined.--In this
subparagraph, the term `chronically ill enrollee' means an
enrollee in an MA plan that the Secretary determines--
``(I) has one or more comorbid and medically complex
chronic conditions that is life threatening or significantly
limits the overall health or function of the enrollee;
``(II) has a high risk of hospitalization or other adverse
health outcomes; and
``(III) requires intensive care coordination.''.
(b) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
(in this subsection referred to as the ``Comptroller
General'') shall conduct a study on supplemental benefits
provided to enrollees in Medicare Advantage plans under part
C of title XVIII of the Social Security Act, including
specialized MA plans for special needs individuals (as
defined in section 1859(b)(6) of such Act (42 U.S.C. 1395w-
28(b)(6))). To the extend data are available, such study
shall include an analysis of the following:
(A) The type of supplemental benefits provided to such
enrollees, the total number of enrollees receiving each
supplemental benefit, and whether the supplemental benefit is
covered by the standard benchmark cost of the benefit or with
an additional premium.
(B) The frequency in which supplemental benefits are
utilized by such enrollees.
(C) The impact supplemental benefits have on--
(i) indicators of the quality of care received by such
enrollees, including overall health and function of the
enrollees;
(ii) the utilization of items and services for which
benefits are available under the original Medicare fee-for-
service program option under parts A and B of such title
XVIII by such enrollees; and
(iii) the amount of the bids submitted by Medicare
Advantage Organizations for Medicare Advantage plans under
such part C.
(2) Consultation.--In conducting the study under paragraph
(1), the Comptroller General shall, as necessary, consult
with the Centers for Medicare & Medicaid Services and
Medicare Advantage organizations offering Medicare Advantage
plans.
(3) Report.--Not later than 5 years after the date of the
enactment of this Act, the Comptroller General shall submit
to Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations
for such legislation and administrative action as the
Comptroller General determines appropriate.
SEC. 2313. INCREASING CONVENIENCE FOR MEDICARE ADVANTAGE
ENROLLEES THROUGH TELEHEALTH.
(a) In General.--Section 1852 of the Social Security Act
(42 U.S.C. 1395w-22) is amended--
(1) in subsection (a)(1)(B)(i), by inserting ``, subject to
subsection (m),'' after ``means''; and
(2) by adding at the end the following new subsection:
``(m) Provision of Additional Telehealth Benefits.--
``(1) MA plan option.--For plan year 2020 and subsequent
plan years, subject to the requirements of paragraph (3), an
MA plan may provide additional telehealth benefits (as
defined in paragraph (2)) to individuals enrolled under this
part.
``(2) Additional telehealth benefits defined.--
``(A) In general.--For purposes of this subsection and
section 1854:
``(i) Definition.--The term `additional telehealth
benefits' means services--
``(I) for which benefits are available under part B,
including services for which payment is not made under
section 1834(m) due to the conditions for payment under such
section; and
``(II) that are identified for the year involved by the
Secretary as clinically appropriate to furnish using
electronic information and telecommunications technology when
a physician (as defined in section 1861(r)) or practitioner
(described in section 1842(b)(18)(C)) providing the service
is not at the same location as the plan enrollee.
``(ii) Exclusion of capital and infrastructure costs and
investments.--The term `additional telehealth benefits' does
not include capital and infrastructure costs and investments
relating to such benefits.
``(B) Public comment.--Not later than November 30, 2018,
the Secretary shall solicit comments on--
``(i) what types of items and services (including those
provided through supplemental health care benefits, such as
remote patient monitoring, secure messaging, store and
forward technologies, and other non-face-to-face
communication) should be considered to be additional
telehealth benefits; and
``(ii) the requirements for the provision or furnishing of
such benefits (such as licensure, training, and coordination
requirements).
``(3) Requirements for additional telehealth benefits.--The
Secretary shall specify requirements for the provision or
furnishing of additional telehealth benefits, including with
respect to the following:
``(A) Physician or practitioner qualifications (other than
licensure) and other requirements such as specific training.
``(B) Factors necessary for the coordination of such
benefits with other items and services, including those
furnished in-person.
``(C) Such other areas as determined by the Secretary.
``(4) Enrollee choice.--If an MA plan provides a service as
an additional telehealth benefit (as defined in paragraph
(2))--
``(A) the MA plan shall also provide access to such benefit
through an in-person visit (and not only as an additional
telehealth benefit); and
``(B) an individual enrollee shall have discretion as to
whether to receive such service through the in-person visit
or as an additional telehealth benefit.
[[Page H864]]
``(5) Treatment under ma.--For purposes of this subsection
and section 1854, if a plan provides additional telehealth
benefits, such additional telehealth benefits shall be
treated as if they were benefits under the original Medicare
fee-for-service program option.
``(6) Construction.--Nothing in this subsection shall be
construed as affecting the requirement under subsection
(a)(1) that MA plans provide enrollees with items and
services (other than hospice care) for which benefits are
available under parts A and B, including benefits available
under section 1834(m).''.
(b) Clarification Regarding Inclusion in Bid Amount.--
Section 1854(a)(6)(A)(ii)(I) of the Social Security Act (42
U.S.C. 1395w-24(a)(6)(A)(ii)(I)) is amended by inserting ``,
including, for plan year 2020 and subsequent plan years, the
provision of additional telehealth benefits as described in
section 1852(m)'' before the semicolon at the end.
SEC. 2314. PROVIDING ACCOUNTABLE CARE ORGANIZATIONS THE
ABILITY TO EXPAND THE USE OF TELEHEALTH.
(a) In General.--Section 1899 of the Social Security Act
(42 U.S.C. 1395jjj) is amended by adding at the end the
following new subsection:
``(l) Providing ACOs the Ability To Expand the Use of
Telehealth Services.--
``(1) In general.--In the case of telehealth services for
which payment would otherwise be made under this title
furnished on or after January 1, 2020, for purposes of this
subsection only, the following shall apply with respect to
such services furnished by a physician or practitioner
participating in an applicable ACO (as defined in paragraph
(2)) to a Medicare fee-for-service beneficiary assigned to
the applicable ACO:
``(A) Inclusion of home as originating site.--Subject to
paragraph (3), the home of a beneficiary shall be treated as
an originating site described in section 1834(m)(4)(C)(ii).
``(B) No application of geographic limitation.--The
geographic limitation under section 1834(m)(4)(C)(i) shall
not apply with respect to an originating site described in
section 1834(m)(4)(C)(ii) (including the home of a
beneficiary under subparagraph (A)), subject to State
licensing requirements.
``(2) Definitions.--In this subsection:
``(A) Applicable aco.--The term `applicable ACO' means an
ACO participating in a model tested or expanded under section
1115A or under this section--
``(i) that operates under a two-sided model--
``(I) described in section 425.600(a) of title 42, Code of
Federal Regulations; or
``(II) tested or expanded under section 1115A; and
``(ii) for which Medicare fee-for-service beneficiaries are
assigned to the ACO using a prospective assignment method, as
determined appropriate by the Secretary.
``(B) Home.--The term `home' means, with respect to a
Medicare fee-for-service beneficiary, the place of residence
used as the home of the beneficiary.
``(3) Telehealth services received in the home.--In the
case of telehealth services described in paragraph (1) where
the home of a Medicare fee-for-service beneficiary is the
originating site, the following shall apply:
``(A) No facility fee.--There shall be no facility fee paid
to the originating site under section 1834(m)(2)(B).
``(B) Exclusion of certain services.--No payment may be
made for such services that are inappropriate to furnish in
the home setting such as services that are typically
furnished in inpatient settings such as a hospital.''.
(b) Study and Report.--
(1) Study.--
(A) In general.--The Secretary of Health and Human Services
(in this subsection referred to as the ``Secretary'') shall
conduct a study on the implementation of section 1899(l) of
the Social Security Act, as added by subsection (a). Such
study shall include an analysis of the utilization of, and
expenditures for, telehealth services under such section.
(B) Collection of data.--The Secretary may collect such
data as the Secretary determines necessary to carry out the
study under this paragraph.
(2) Report.--Not later than January 1, 2026, the Secretary
shall submit to Congress a report containing the results of
the study conducted under paragraph (1), together with
recommendations for such legislation and administrative
action as the Secretary determines appropriate.
SEC. 2315. EXPANDING THE USE OF TELEHEALTH FOR INDIVIDUALS
WITH STROKE.
Section 1834(m) of the Social Security Act (42 U.S.C.
1395m(m)), as amended by section 2302(b), is amended--
(1) in paragraph (4)(C)(i), in the matter preceding
subclause (I), by striking ``The term'' and inserting
``Except as provided in paragraph (6), the term''; and
(2) by adding at the end the following new paragraph:
``(6) Treatment of stroke telehealth services.--
``(A) Non-application of originating site requirements.--
The requirements described in paragraph (4)(C) shall not
apply with respect to telehealth services furnished on or
after January 1, 2021, for purposes of diagnosis, evaluation,
or treatment of symptoms of an acute stroke, as determined by
the Secretary.
``(B) Inclusion of certain sites.--With respect to
telehealth services described in subparagraph (A), the term
`originating site' shall include any hospital (as defined in
section 1861(e)) or critical access hospital (as defined in
section 1861(mm)(1)), any mobile stroke unit (as defined by
the Secretary), or any other site determined appropriate by
the Secretary, at which the eligible telehealth individual is
located at the time the service is furnished via a
telecommunications system.
``(C) No originating site facility fee for new sites.--No
facility fee shall be paid under paragraph (2)(B) to an
originating site with respect to a telehealth service
described in subparagraph (A) if the originating site does
not otherwise meet the requirements for an originating site
under paragraph (4)(C).''.
Subtitle C--Identifying the Chronically Ill Population
SEC. 2321. PROVIDING FLEXIBILITY FOR BENEFICIARIES TO BE PART
OF AN ACCOUNTABLE CARE ORGANIZATION.
Section 1899(c) of the Social Security Act (42 U.S.C.
1395jjj(c)) is amended--
(1) by redesignating paragraphs (1) and (2) as
subparagraphs (A) and (B), respectively, and indenting
appropriately;
(2) by striking ``ACOs.--The Secretary'' and inserting
``ACOs.--
``(1) In general.--Subject to paragraph (2), the
Secretary''; and
(3) by adding at the end the following new paragraph:
``(2) Providing flexibility.--
``(A) Choice of prospective assignment.--For each agreement
period (effective for agreements entered into or renewed on
or after January 1, 2020), in the case where an ACO
established under the program is in a Track that provides for
the retrospective assignment of Medicare fee-for-service
beneficiaries to the ACO, the Secretary shall permit the ACO
to choose to have Medicare fee-for-service beneficiaries
assigned prospectively, rather than retrospectively, to the
ACO for an agreement period.
``(B) Assignment based on voluntary identification by
medicare fee-for-service beneficiaries.--
``(i) In general.--For performance year 2018 and each
subsequent performance year, if a system is available for
electronic designation, the Secretary shall permit a Medicare
fee-for-service beneficiary to voluntarily identify an ACO
professional as the primary care provider of the beneficiary
for purposes of assigning such beneficiary to an ACO, as
determined by the Secretary.
``(ii) Notification process.--The Secretary shall establish
a process under which a Medicare fee-for-service beneficiary
is--
``(I) notified of their ability to make an identification
described in clause (i); and
``(II) informed of the process by which they may make and
change such identification.
``(iii) Superseding claims-based assignment.--A voluntary
identification by a Medicare fee-for-service beneficiary
under this subparagraph shall supersede any claims-based
assignment otherwise determined by the Secretary.''.
Subtitle D--Empowering Individuals and Caregivers in Care Delivery
SEC. 2331. ELIMINATING BARRIERS TO CARE COORDINATION UNDER
ACCOUNTABLE CARE ORGANIZATIONS.
(a) In General.--Section 1899 of the Social Security Act
(42 U.S.C. 1395jjj), as amended by section 2314(a), is
amended--
(1) in subsection (b)(2), by adding at the end the
following new subparagraph:
``(I) An ACO that seeks to operate an ACO Beneficiary
Incentive Program pursuant to subsection (m) shall apply to
the Secretary at such time, in such manner, and with such
information as the Secretary may require.'';
(2) by adding at the end the following new subsection:
``(m) Authority To Provide Incentive Payments to
Beneficiaries With Respect to Qualifying Primary Care
Services.--
``(1) Program.--
``(A) In general.--In order to encourage Medicare fee-for-
service beneficiaries to obtain medically necessary primary
care services, an ACO participating under this section under
a payment model described in clause (i) or (ii) of paragraph
(2)(B) may apply to establish an ACO Beneficiary Incentive
Program to provide incentive payments to such beneficiaries
who are furnished qualifying services in accordance with this
subsection. The Secretary shall permit such an ACO to
establish such a program at the Secretary's discretion and
subject to such requirements, including program integrity
requirements, as the Secretary determines necessary.
``(B) Implementation.--The Secretary shall implement this
subsection on a date determined appropriate by the Secretary.
Such date shall be no earlier than January 1, 2019, and no
later than January 1, 2020.
``(2) Conduct of program.--
``(A) Duration.--Subject to subparagraph (H), an ACO
Beneficiary Incentive Program established under this
subsection shall be conducted for such period (of not less
than 1 year) as the Secretary may approve.
``(B) Scope.--An ACO Beneficiary Incentive Program
established under this subsection shall provide incentive
payments to all of the following Medicare fee-for-service
beneficiaries who are furnished qualifying services by the
ACO:
``(i) With respect to the Track 2 and Track 3 payment
models described in section
[[Page H865]]
425.600(a) of title 42, Code of Federal Regulations (or in
any successor regulation), Medicare fee-for-service
beneficiaries who are preliminarily prospectively or
prospectively assigned (or otherwise assigned, as determined
by the Secretary) to the ACO.
``(ii) With respect to any future payment models involving
two-sided risk, Medicare fee-for-service beneficiaries who
are assigned to the ACO, as determined by the Secretary.
``(C) Qualifying service.--For purposes of this subsection,
a qualifying service is a primary care service, as defined in
section 425.20 of title 42, Code of Federal Regulations (or
in any successor regulation), with respect to which
coinsurance applies under part B, furnished through an ACO
by--
``(i) an ACO professional described in subsection (h)(1)(A)
who has a primary care specialty designation included in the
definition of primary care physician under section 425.20 of
title 42, Code of Federal Regulations (or any successor
regulation);
``(ii) an ACO professional described in subsection
(h)(1)(B); or
``(iii) a Federally qualified health center or rural health
clinic (as such terms are defined in section 1861(aa)).
``(D) Incentive payments.--An incentive payment made by an
ACO pursuant to an ACO Beneficiary Incentive Program
established under this subsection shall be--
``(i) in an amount up to $20, with such maximum amount
updated annually by the percentage increase in the consumer
price index for all urban consumers (United States city
average) for the 12-month period ending with June of the
previous year;
``(ii) in the same amount for each Medicare fee-for-service
beneficiary described in clause (i) or (ii) of subparagraph
(B) without regard to enrollment of such a beneficiary in a
medicare supplemental policy (described in section
1882(g)(1)), in a State Medicaid plan under title XIX or a
waiver of such a plan, or in any other health insurance
policy or health benefit plan;
``(iii) made for each qualifying service furnished to such
a beneficiary described in clause (i) or (ii) of subparagraph
(B) during a period specified by the Secretary; and
``(iv) made no later than 30 days after a qualifying
service is furnished to such a beneficiary described in
clause (i) or (ii) of subparagraph (B).
``(E) No separate payments from the secretary.--The
Secretary shall not make any separate payment to an ACO for
the costs, including incentive payments, of carrying out an
ACO Beneficiary Incentive Program established under this
subsection. Nothing in this subparagraph shall be construed
as prohibiting an ACO from using shared savings received
under this section to carry out an ACO Beneficiary Incentive
Program.
``(F) No application to shared savings calculation.--
Incentive payments made by an ACO under this subsection shall
be disregarded for purposes of calculating benchmarks,
estimated average per capita Medicare expenditures, and
shared savings under this section.
``(G) Reporting requirements.--An ACO conducting an ACO
Beneficiary Incentive Program under this subsection shall, at
such times and in such format as the Secretary may require,
report to the Secretary such information and retain such
documentation as the Secretary may require, including the
amount and frequency of incentive payments made and the
number of Medicare fee-for-service beneficiaries receiving
such payments.
``(H) Termination.--The Secretary may terminate an ACO
Beneficiary Incentive Program established under this
subsection at any time for reasons determined appropriate by
the Secretary.
``(3) Exclusion of incentive payments.--Any payment made
under an ACO Beneficiary Incentive Program established under
this subsection shall not be considered income or resources
or otherwise taken into account for purposes of--
``(A) determining eligibility for benefits or assistance
(or the amount or extent of benefits or assistance) under any
Federal program or under any State or local program financed
in whole or in part with Federal funds; or
``(B) any Federal or State laws relating to taxation.'';
(3) in subsection (e), by inserting ``, including an ACO
Beneficiary Incentive Program under subsections (b)(2)(I) and
(m)'' after ``the program''; and
(4) in subsection (g)(6), by inserting ``or of an ACO
Beneficiary Incentive Program under subsections (b)(2)(I) and
(m)'' after ``under subsection (d)(4)''.
(b) Amendment to Section 1128B.--Section 1128B(b)(3) of the
Social Security Act (42 U.S.C. 1320a-7b(b)(3)) is amended--
(1) by striking ``and'' at the end of subparagraph (I);
(2) by striking the period at the end of subparagraph (J)
and inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(K) an incentive payment made to a Medicare fee-for-
service beneficiary by an ACO under an ACO Beneficiary
Incentive Program established under subsection (m) of section
1899, if the payment is made in accordance with the
requirements of such subsection and meets such other
conditions as the Secretary may establish.''.
(c) Evaluation and Report.--
(1) Evaluation.--The Secretary of Health and Human Services
(in this subsection referred to as the ``Secretary'') shall
conduct an evaluation of the ACO Beneficiary Incentive
Program established under subsections (b)(2)(I) and (m) of
section 1899 of the Social Security Act (42 U.S.C. 1395jjj),
as added by subsection (a). The evaluation shall include an
analysis of the impact of the implementation of the Program
on expenditures and beneficiary health outcomes under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
(2) Report.--Not later than October 1, 2023, the Secretary
shall submit to Congress a report containing the results of
the evaluation under paragraph (1), together with
recommendations for such legislation and administrative
action as the Secretary determines appropriate.
SEC. 2332. GAO STUDY AND REPORT ON LONGITUDINAL COMPREHENSIVE
CARE PLANNING SERVICES UNDER MEDICARE PART B.
(a) Study.--The Comptroller General shall conduct a study
on the establishment under part B of the Medicare program
under title XVIII of the Social Security Act of a payment
code for a visit for longitudinal comprehensive care planning
services. Such study shall include an analysis of the
following to the extent such information is available:
(1) The frequency with which services similar to
longitudinal comprehensive care planning services are
furnished to Medicare beneficiaries, which providers of
services and suppliers are furnishing those services, whether
Medicare reimbursement is being received for those services,
and, if so, through which codes those services are being
reimbursed.
(2) Whether, and the extent to which, longitudinal
comprehensive care planning services would overlap, and could
therefore result in duplicative payment, with services
covered under the hospice benefit as well as the chronic care
management code, evaluation and management codes, or other
codes that already exist under part B of the Medicare
program.
(3) Any barriers to hospitals, skilled nursing facilities,
hospice programs, home health agencies, and other applicable
providers working with a Medicare beneficiary to engage in
the care planning process and complete the necessary
documentation to support the treatment and care plan of the
beneficiary and provide such documentation to other providers
and the beneficiary or the beneficiary's representative.
(4) Any barriers to providers, other than the provider
furnishing longitudinal comprehensive care planning services,
accessing the care plan and associated documentation for use
related to the care of the Medicare beneficiary.
(5) Potential options for ensuring that applicable
providers are notified of a patient's existing longitudinal
care plan and that applicable providers consider that plan in
making their treatment decisions, and what the challenges
might be in implementing such options.
(6) Stakeholder's views on the need for the development of
quality metrics with respect to longitudinal comprehensive
care planning services, such as measures related to--
(A) the process of eliciting input from the Medicare
beneficiary or from a legally authorized representative and
documenting in the medical record the patient-directed care
plan;
(B) the effectiveness and patient-centeredness of the care
plan in organizing delivery of services consistent with the
plan;
(C) the availability of the care plan and associated
documentation to other providers that care for the
beneficiary; and
(D) the extent to which the beneficiary received services
and support that is free from discrimination based on
advanced age, disability status, or advanced illness.
(7) Stakeholder's views on how such quality metrics would
provide information on--
(A) the goals, values, and preferences of the beneficiary;
(B) the documentation of the care plan;
(C) services furnished to the beneficiary; and
(D) outcomes of treatment.
(8) Stakeholder's views on--
(A) the type of training and education needed for
applicable providers, individuals, and caregivers in order to
facilitate longitudinal comprehensive care planning services;
(B) the types of providers of services and suppliers that
should be included in the interdisciplinary team of an
applicable provider; and
(C) the characteristics of Medicare beneficiaries that
would be most appropriate to receive longitudinal
comprehensive care planning services, such as individuals
with advanced disease and individuals who need assistance
with multiple activities of daily living.
(9) Stakeholder's views on the frequency with which
longitudinal comprehensive care planning services should be
furnished.
(b) Report.--Not later than 18 months after the date of the
enactment of this Act, the Comptroller General shall submit
to Congress a report containing the results of the study
conducted under subsection (a), together with recommendations
for such legislation and administrative action as the
Comptroller General determines appropriate.
(c) Definitions.--In this section:
(1) Applicable provider.--The term ``applicable provider''
means a hospice program (as defined in subsection (dd)(2) of
section 1861 of the Social Security Act (42 U.S.C. 1395ww))
or other provider of services (as defined in subsection (u)
of such section) or supplier (as defined in subsection (d) of
such section) that--
[[Page H866]]
(A) furnishes longitudinal comprehensive care planning
services through an interdisciplinary team; and
(B) meets such other requirements as the Secretary may
determine to be appropriate.
(2) Comptroller general.--The term ``Comptroller General''
means the Comptroller General of the United States.
(3) Interdisciplinary team.--The term ``interdisciplinary
team'' means a group that--
(A) includes the personnel described in subsection
(dd)(2)(B)(i) of such section 1861;
(B) may include a chaplain, minister, or other clergy; and
(C) may include other direct care personnel.
(4) Longitudinal comprehensive care planning services.--The
term ``longitudinal comprehensive care planning services''
means a voluntary shared decisionmaking process that is
furnished by an applicable provider through an
interdisciplinary team and includes a conversation with
Medicare beneficiaries who have received a diagnosis of a
serious or life-threatening illness. The purpose of such
services is to discuss a longitudinal care plan that
addresses the progression of the disease, treatment options,
the goals, values, and preferences of the beneficiary, and
the availability of other resources and social supports that
may reduce the beneficiary's health risks and promote self-
management and shared decisionmaking.
(5) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
Subtitle E--Other Policies to Improve Care for the Chronically Ill
SEC. 2341. GAO STUDY AND REPORT ON IMPROVING MEDICATION
SYNCHRONIZATION.
(a) Study.--The Comptroller General of the United States
(in this section referred to as the ``Comptroller General'')
shall conduct a study on the extent to which Medicare
prescription drug plans (MA-PD plans and stand alone
prescription drug plans) under part D of title XVIII of the
Social Security Act and private payors use programs that
synchronize pharmacy dispensing so that individuals may
receive multiple prescriptions on the same day to facilitate
comprehensive counseling and promote medication adherence.
The study shall include a analysis of the following:
(1) The extent to which pharmacies have adopted such
programs.
(2) The common characteristics of such programs, including
how pharmacies structure counseling sessions under such
programs and the types of payment and other arrangements that
Medicare prescription drug plans and private payors employ
under such programs to support the efforts of pharmacies.
(3) How such programs compare for Medicare prescription
drug plans and private payors.
(4) What is known about how such programs affect patient
medication adherence and overall patient health outcomes,
including if adherence and outcomes vary by patient
subpopulations, such as disease state and socioeconomic
status.
(5) What is known about overall patient satisfaction with
such programs and satisfaction with such programs, including
within patient subpopulations, such as disease state and
socioeconomic status.
(6) The extent to which laws and regulations of the
Medicare program support such programs.
(7) Barriers to the use of medication synchronization
programs by Medicare prescription drug plans.
(b) Report.--Not later than 18 months after the date of the
enactment of this Act, the Comptroller General shall submit
to Congress a report containing the results of the study
under subsection (a), together with recommendations for such
legislation and administrative action as the Comptroller
General determines appropriate.
SEC. 2342. GAO STUDY AND REPORT ON IMPACT OF OBESITY DRUGS ON
PATIENT HEALTH AND SPENDING.
(a) Study.--The Comptroller General of the United States
(in this section referred to as the ``Comptroller General'')
shall, to the extent data are available, conduct a study on
the use of prescription drugs to manage the weight of obese
patients and the impact of coverage of such drugs on patient
health and on health care spending. Such study shall examine
the use and impact of these obesity drugs in the non-Medicare
population and for Medicare beneficiaries who have such drugs
covered through an MA-PD plan (as defined in section 1860D-
1(a)(3)(C) of the Social Security Act (42 U.S.C. 1395w-
101(a)(3)(C))) as a supplemental health care benefit. The
study shall include an analysis of the following:
(1) The prevalence of obesity in the Medicare and non-
Medicare population.
(2) The utilization of obesity drugs.
(3) The distribution of Body Mass Index by individuals
taking obesity drugs, to the extent practicable.
(4) What is known about the use of obesity drugs in
conjunction with the receipt of other items or services, such
as behavioral counseling, and how these compare to items and
services received by obese individuals who do not take
obesity drugs.
(5) Physician considerations and attitudes related to
prescribing obesity drugs.
(6) The extent to which coverage policies cease or limit
coverage for individuals who fail to receive clinical
benefit.
(7) What is known about the extent to which individuals who
take obesity drugs adhere to the prescribed regimen.
(8) What is known about the extent to which individuals who
take obesity drugs maintain weight loss over time.
(9) What is known about the subsequent impact such drugs
have on medical services that are directly related to
obesity, including with respect to subpopulations determined
based on the extent of obesity.
(10) What is known about the spending associated with the
care of individuals who take obesity drugs, compared to the
spending associated with the care of individuals who do not
take such drugs.
(b) Report.--Not later than 18 months after the date of the
enactment of this Act, the Comptroller General shall submit
to Congress a report containing the results of the study
under subsection (a), together with recommendations for such
legislation and administrative action as the Comptroller
General determines appropriate.
SEC. 2343. HHS STUDY AND REPORT ON LONG-TERM RISK FACTORS FOR
CHRONIC CONDITIONS AMONG MEDICARE
BENEFICIARIES.
(a) Study.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall conduct
a study on long-term cost drivers to the Medicare program,
including obesity, tobacco use, mental health conditions, and
other factors that may contribute to the deterioration of
health conditions among individuals with chronic conditions
in the Medicare population. The study shall include an
analysis of any barriers to collecting and analyzing such
information and how to remove any such barriers (including
through legislation and administrative actions).
(b) Report.--Not later than 18 months after the date of the
enactment of this Act, the Secretary shall submit to Congress
a report containing the results of the study under subsection
(a), together with recommendations for such legislation and
administrative action as the Secretary determines
appropriate. The Secretary shall also post such report on the
Internet website of the Department of Health and Human
Services.
TITLE IV--MEDICARE PART B MISCELLANEOUS POLICIES
Subtitle A--Medicare Part B Improvement Act
SEC. 2401. HOME INFUSION THERAPY SERVICES TEMPORARY
TRANSITIONAL PAYMENT.
(a) In General.--Section 1834(u) of the Social Security Act
(42 U.S.C. 1395m(u)) is amended by adding at the end the
following new paragraph:
``(7) Home infusion therapy services temporary transitional
payment.--
``(A) Temporary transitional payment.--
``(i) In general.--The Secretary shall, in accordance with
the payment methodology described in subparagraph (B) and
subject to the provisions of this paragraph, provide a home
infusion therapy services temporary transitional payment
under this part to an eligible home infusion supplier (as
defined in subparagraph (F)) for items and services described
in subparagraphs (A) and (B) of section 1861(iii)(2))
furnished during the period specified in clause (ii) by such
supplier in coordination with the furnishing of transitional
home infusion drugs (as defined in clause (iii)).
``(ii) Period specified.--For purposes of clause (i), the
period specified in this clause is the period beginning on
January 1, 2019, and ending on the day before the date of the
implementation of the payment system under paragraph (1)(A).
``(iii) Transitional home infusion drug defined.--For
purposes of this paragraph, the term `transitional home
infusion drug' has the meaning given to the term `home
infusion drug' under section 1861(iii)(3)(C)), except that
clause (ii) of such section shall not apply if a drug
described in such clause is identified in clauses (i), (ii),
(iii) or (iv) of subparagraph (C) as of the date of the
enactment of this paragraph.
``(B) Payment methodology.--For purposes of this paragraph,
the Secretary shall establish a payment methodology, with
respect to items and services described in subparagraph
(A)(i). Under such payment methodology the Secretary shall--
``(i) create the three payment categories described in
clauses (i), (ii), and (iii) of subparagraph (C);
``(ii) assign drugs to such categories, in accordance with
such clauses;
``(iii) assign appropriate Healthcare Common Procedure
Coding System (HCPCS) codes to each payment category; and
``(iv) establish a single payment amount for each such
payment category, in accordance with subparagraph (D), for
each infusion drug administration calendar day in the
individual's home for drugs assigned to such category.
``(C) Payment categories.--
``(i) Payment category 1.--The Secretary shall create a
payment category 1 and assign to such category drugs which
are covered under the Local Coverage Determination on
External Infusion Pumps (LCD number L33794) and billed with
the following HCPCS codes (as identified as of January 1,
2018, and as subsequently modified by the Secretary): J0133,
J0285, J0287, J0288, J0289, J0895, J1170, J1250, J1265,
J1325, J1455, J1457, J1570, J2175, J2260, J2270, J2274,
J2278, J3010, or J3285.
``(ii) Payment category 2.--The Secretary shall create a
payment category 2 and assign
[[Page H867]]
to such category drugs which are covered under such local
coverage determination and billed with the following HCPCS
codes (as identified as of January 1, 2018, and as
subsequently modified by the Secretary): J1555 JB, J1559 JB,
J1561 JB, J1562 JB, J1569 JB, or J1575 JB.
``(iii) Payment category 3.--The Secretary shall create a
payment category 3 and assign to such category drugs which
are covered under such local coverage determination and
billed with the following HCPCS codes (as identified as of
January 1, 2018, and as subsequently modified by the
Secretary): J9000, J9039, J9040, J9065, J9100, J9190, J9200,
J9360, or J9370.
``(iv) Infusion drugs not otherwise included.--With respect
to drugs that are not included in payment category 1, 2, or 3
under clause (i), (ii), or (iii), respectively, the Secretary
shall assign to the most appropriate of such categories, as
determined by the Secretary, drugs which are--
``(I) covered under such local coverage determination and
billed under HCPCS codes J7799 or J7999 (as identified as of
July 1, 2017, and as subsequently modified by the Secretary);
or
``(II) billed under any code that is implemented after the
date of the enactment of this paragraph and included in such
local coverage determination or included in subregulatory
guidance as a home infusion drug described in subparagraph
(A)(i).
``(D) Payment amounts.--
``(i) In general.--Under the payment methodology, the
Secretary shall pay eligible home infusion suppliers, with
respect to items and services described in subparagraph
(A)(i) furnished during the period described in subparagraph
(A)(ii) by such supplier to an individual, at amounts equal
to the amounts determined under the physician fee schedule
established under section 1848 for services furnished during
the year for codes and units of such codes described in
clauses (ii), (iii), and (iv) with respect to drugs included
in the payment category under subparagraph (C) specified in
the respective clause, determined without application of the
geographic adjustment under subsection (e) of such section.
``(ii) Payment amount for category 1.--For purposes of
clause (i), the codes and units described in this clause,
with respect to drugs included in payment category 1
described in subparagraph (C)(i), are one unit of HCPCS code
96365 plus three units of HCPCS code 96366 (as identified as
of January 1, 2018, and as subsequently modified by the
Secretary).
``(iii) Payment amount for category 2.--For purposes of
clause (i), the codes and units described in this clause,
with respect to drugs included in payment category 2
described in subparagraph (C)(i), are one unit of HCPCS code
96369 plus three units of HCPCS code 96370 (as identified as
of January 1, 2018, and as subsequently modified by the
Secretary).
``(iv) Payment amount for category 3.--For purposes of
clause (i), the codes and units described in this clause,
with respect to drugs included in payment category 3
described in subparagraph (C)(i), are one unit of HCPCS code
96413 plus three units of HCPCS code 96415 (as identified as
of January 1, 2018, and as subsequently modified by the
Secretary).
``(E) Clarifications.--
``(i) Infusion drug administration day.--For purposes of
this subsection, with respect to the furnishing of
transitional home infusion drugs or home infusion drugs to an
individual by an eligible home infusion supplier or a
qualified home infusion therapy supplier, a reference to
payment to such supplier for an infusion drug administration
calendar day in the individual's home shall refer to payment
only for the date on which professional services (as
described in section 1861(iii)(2)(A)) were furnished to
administer such drugs to such individual. For purposes of the
previous sentence, an infusion drug administration calendar
day shall include all such drugs administered to such
individual on such day.
``(ii) Treatment of multiple drugs administered on same
infusion drug administration day.--In the case that an
eligible home infusion supplier, with respect to an infusion
drug administration calendar day in an individual's home,
furnishes to such individual transitional home infusion drugs
which are not all assigned to the same payment category under
subparagraph (C), payment to such supplier for such infusion
drug administration calendar day in the individual's home
shall be a single payment equal to the amount of payment
under this paragraph for the drug, among all such drugs so
furnished to such individual during such calendar day, for
which the highest payment would be made under this paragraph.
``(F) Eligible home infusion suppliers.--In this paragraph,
the term `eligible home infusion supplier' means a supplier
that is enrolled under this part as a pharmacy that provides
external infusion pumps and external infusion pump supplies
and that maintains all pharmacy licensure requirements in the
State in which the applicable infusion drugs are
administered.
``(G) Implementation.--Notwithstanding any other provision
of law, the Secretary may implement this paragraph by program
instruction or otherwise.''.
(b) Conforming Amendment.--
(1) Section 1842(b)(6)(I) of the Social Security Act (42
U.S.C. 1395u(b)(6)(I)) is amended by inserting ``or, in the
case of items and services described in clause (i) of section
1834(u)(7)(A) furnished to an individual during the period
described in clause (ii) of such section, payment shall be
made to the eligible home infusion therapy supplier'' after
``payment shall be made to the qualified home infusion
therapy supplier''.
(2) Section 5012(d) of the 21st Century Cures Act is
amended by inserting the following before the period at the
end the following: ``, except that the amendments made by
paragraphs (1) and (2) of subsection (c) shall apply to items
and services furnished on or after January 1, 2019''.
SEC. 2402. ORTHOTIST'S AND PROSTHETIST'S CLINICAL NOTES AS
PART OF THE PATIENT'S MEDICAL RECORD.
Section 1834(h) of the Social Security Act (42 U.S.C.
1395m(h)) is amended by adding at the end the following new
paragraph:
``(5) Documentation created by orthotists and
prosthetists.--For purposes of determining the reasonableness
and medical necessity of orthotics and prosthetics,
documentation created by an orthotist or prosthetist shall be
considered part of the individual's medical record to support
documentation created by eligible professionals described in
section 1848(k)(3)(B).''.
SEC. 2403. INDEPENDENT ACCREDITATION FOR DIALYSIS FACILITIES
AND ASSURANCE OF HIGH QUALITY SURVEYS.
(a) Accreditation and Surveys.--
(1) In general.--Section 1865 of the Social Security Act
(42 U.S.C. 1395bb) is amended--
(A) in subsection (a)--
(i) in paragraph (1), in the matter preceding subparagraph
(A), by striking ``or the conditions and requirements under
section 1881(b)''; and
(ii) in paragraph (4), by inserting ``(including a renal
dialysis facility)'' after ``facility''; and
(B) by adding at the end the following new subsection:
``(e) With respect to an accreditation body that has
received approval from the Secretary under subsection
(a)(3)(A) for accreditation of provider entities that are
required to meet the conditions and requirements under
section 1881(b), in addition to review and oversight
authorities otherwise applicable under this title, the
Secretary shall (as the Secretary determines appropriate)
conduct, with respect to such accreditation body and provider
entities, any or all of the following as frequently as is
otherwise required to be conducted under this title with
respect to other accreditation bodies or other provider
entities:
``(1) Validation surveys referred to in subsection (d).
``(2) Accreditation program reviews (as defined in section
488.8(c) of title 42 of the Code of Federal Regulations, or a
successor regulation).
``(3) Performance reviews (as defined in section 488.8(a)
of title 42 of the Code of Federal Regulations, or a
successor regulation).''.
(2) Timing for acceptance of requests from accreditation
organizations.--Not later than 90 days after the date of
enactment of this Act, the Secretary of Health and Human
Services shall begin accepting requests from national
accreditation bodies for a finding described in section
1865(a)(3)(A) of the Social Security Act (42 U.S.C.
1395bb(a)(3)(A)) for purposes of accrediting provider
entities that are required to meet the conditions and
requirements under section 1881(b) of such Act (42 U.S.C.
1395rr(b)).
(b) Requirement for Timing of Surveys of New Dialysis
Facilities.--Section 1881(b)(1) of the Social Security Act
(42 U.S.C. 1395rr(b)(1)) is amended by adding at the end the
following new sentence: ``Beginning 180 days after the date
of the enactment of this sentence, an initial survey of a
provider of services or a renal dialysis facility to
determine if the conditions and requirements under this
paragraph are met shall be initiated not later than 90 days
after such date on which both the provider enrollment form
(without regard to whether such form is submitted prior to or
after such date of enactment) has been determined by the
Secretary to be complete and the provider's enrollment status
indicates approval is pending the results of such survey.''.
SEC. 2404. MODERNIZING THE APPLICATION OF THE STARK RULE
UNDER MEDICARE.
(a) Clarification of the Writing Requirement and Signature
Requirement for Arrangements Pursuant to the Stark Rule.--
(1) Writing requirement.--Section 1877(h)(1) of the Social
Security Act (42 U.S.C. 1395nn(h)(1)) is amended by adding at
the end the following new subparagraph:
``(D) Written requirement clarified.--In the case of any
requirement pursuant to this section for a compensation
arrangement to be in writing, such requirement shall be
satisfied by such means as determined by the Secretary,
including by a collection of documents, including
contemporaneous documents evidencing the course of conduct
between the parties involved.''.
(2) Signature requirement.--Section 1877(h)(1) of the
Social Security Act (42 U.S.C. 1395nn(h)(1)), as amended by
paragraph (1), is further amended by adding at the end the
following new subparagraph:
``(E) Special rule for signature requirements.--In the case
of any requirement pursuant to this section for a
compensation arrangement to be in writing and signed by the
parties, such signature requirement shall be met if--
``(i) not later than 90 consecutive calendar days
immediately following the date on
[[Page H868]]
which the compensation arrangement became noncompliant, the
parties obtain the required signatures; and
``(ii) the compensation arrangement otherwise complies with
all criteria of the applicable exception.''.
(b) Indefinite Holdover for Lease Arrangements and Personal
Services Arrangements Pursuant to the Stark Rule.--Section
1877(e) of the Social Security Act (42 U.S.C. 1395nn(e)) is
amended--
(1) in paragraph (1), by adding at the end the following
new subparagraph:
``(C) Holdover lease arrangements.--In the case of a
holdover lease arrangement for the lease of office space or
equipment, which immediately follows a lease arrangement
described in subparagraph (A) for the use of such office
space or subparagraph (B) for the use of such equipment and
that expired after a term of at least 1 year, payments made
by the lessee to the lessor pursuant to such holdover lease
arrangement, if--
``(i) the lease arrangement met the conditions of
subparagraph (A) for the lease of office space or
subparagraph (B) for the use of equipment when the
arrangement expired;
``(ii) the holdover lease arrangement is on the same terms
and conditions as the immediately preceding arrangement; and
``(iii) the holdover arrangement continues to satisfy the
conditions of subparagraph (A) for the lease of office space
or subparagraph (B) for the use of equipment.''; and
(2) in paragraph (3), by adding at the end the following
new subparagraph:
``(C) Holdover personal service arrangement.--In the case
of a holdover personal service arrangement, which immediately
follows an arrangement described in subparagraph (A) that
expired after a term of at least 1 year, remuneration from an
entity pursuant to such holdover personal service
arrangement, if--
``(i) the personal service arrangement met the conditions
of subparagraph (A) when the arrangement expired;
``(ii) the holdover personal service arrangement is on the
same terms and conditions as the immediately preceding
arrangement; and
``(iii) the holdover arrangement continues to satisfy the
conditions of subparagraph (A).''.
Subtitle B--Additional Provisions
SEC. 2411. MAKING PERMANENT THE REMOVAL OF THE RENTAL CAP FOR
DURABLE MEDICAL EQUIPMENT UNDER MEDICARE WITH
RESPECT TO SPEECH GENERATING DEVICES.
Section 1834(a)(2)(A)(iv) of the Social Security Act (42
U.S.C. 1395m(a)(2)(A)(iv)) is amended by striking ``and
before October 1, 2018,''.
SEC. 2412. INCREASED CIVIL AND CRIMINAL PENALTIES AND
INCREASED SENTENCES FOR FEDERAL HEALTH CARE
PROGRAM FRAUD AND ABUSE.
(a) Increased Civil Money Penalties and Criminal Fines.--
(1) Increased civil money penalties.--Section 1128A of the
Social Security Act (42 U.S.C. 1320a-7a) is amended--
(A) in subsection (a), in the matter following paragraph
(10)--
(i) by striking ``$10,000'' and inserting ``$20,000'' each
place it appears;
(ii) by striking ``$15,000'' and inserting ``$30,000''; and
(iii) by striking ``$50,000'' and inserting ``$100,000''
each place it appears; and
(B) in subsection (b)--
(i) in paragraph (1), in the flush text following
subparagraph (B), by striking ``$2,000'' and inserting
``$5,000'';
(ii) in paragraph (2), by striking ``$2,000'' and inserting
``$5,000''; and
(iii) in paragraph (3)(A)(i), by striking ``$5,000'' and
inserting ``$10,000''.
(2) Increased criminal fines.--Section 1128B of such Act
(42 U.S.C. 1320a-7b) is amended--
(A) in subsection (a), in the matter following paragraph
(6)--
(i) by striking ``$25,000'' and inserting ``$100,000''; and
(ii) by striking ``$10,000'' and inserting ``$20,000'';
(B) in subsection (b)--
(i) in paragraph (1), in the flush text following
subparagraph (B), by striking ``$25,000'' and inserting
``$100,000''; and
(ii) in paragraph (2), in the flush text following
subparagraph (B), by striking ``$25,000'' and inserting
``$100,000'';
(C) in subsection (c), by striking ``$25,000'' and
inserting ``$100,000'';
(D) in subsection (d), in the flush text following
paragraph (2), by striking ``$25,000'' and inserting
``$100,000''; and
(E) in subsection (e), by striking ``$2,000'' and inserting
``$4,000''.
(b) Increased Sentences for Felonies Involving Federal
Health Care Program Fraud and Abuse.--
(1) False statements and representations.--Section 1128B(a)
of the Social Security Act (42 U.S.C. 1320a-7b(a)) is
amended, in the matter following paragraph (6), by striking
``not more than five years or both, or (ii)'' and inserting
``not more than 10 years or both, or (ii)''.
(2) Antikickback.--Section 1128B(b) of such Act (42 U.S.C.
1320a-7b(b)) is amended--
(A) in paragraph (1), in the flush text following
subparagraph (B), by striking ``not more than five years''
and inserting ``not more than 10 years''; and
(B) in paragraph (2), in the flush text following
subparagraph (B), by striking ``not more than five years''
and inserting ``not more than 10 years''.
(3) False statement or representation with respect to
conditions or operations of facilities.--Section 1128B(c) of
such Act (42 U.S.C. 1320a-7b(c)) is amended by striking ``not
more than five years'' and inserting ``not more than 10
years''.
(4) Excess charges.--Section 1128B(d) of such Act (42
U.S.C. 1320a-7b(d)) is amended, in the flush text following
paragraph (2), by striking ``not more than five years'' and
inserting ``not more than 10 years''.
(c) Effective Date.--The amendments made by this section
shall apply to acts committed after the date of the enactment
of this Act.
SEC. 2413. REDUCING THE VOLUME OF FUTURE EHR-RELATED
SIGNIFICANT HARDSHIP REQUESTS.
Section 1848(o)(2)(A) of the Social Security Act (42 U.S.C.
1395w-4(o)(2)(A)) and section 1886(n)(3)(A) of such Act (42
U.S.C. 1395ww(n)(3)(A)) are each amended in the last sentence
by striking ``by requiring'' and all that follows through
``this paragraph''.
SEC. 2414. COVERAGE OF CERTAIN DNA SPECIMEN PROVENANCE ASSAY
TESTS UNDER MEDICARE.
(a) Benefit.--
(1) Coverage.--Section 1861 of the Social Security Act (42
U.S.C. 1395x) is amended--
(A) in subsection (s)(2)--
(i) in subparagraph (FF), by striking ``and'' at the end;
(ii) in subparagraph (GG), by inserting ``and'' at the end;
and
(iii) by adding at the end the following new subparagraph:
``(HH) a prostate cancer DNA Specimen Provenance Assay test
(DSPA test) (as defined in subsection (jjj)); and''; and
(B) by adding at the end the following new subsection:
``(jjj) Prostate Cancer DNA Speciment Provenance Assay
Test.--The term `prostate cancer DNA Specimen Provenance
Assay Test' (DSPA test) means a test that, after a
determination of cancer in one or more prostate biopsy
specimens obtained from an individual, assesses the identity
of the DNA in such specimens by comparing such DNA with the
DNA that was separately taken from such individual at the
time of the biopsy.''.
(2) Exclusion from coverage.--Section 1862(a)(1) of the
Social Security Act (42 U.S.C. 1395y(a)(1)) is amended--
(A) in subparagraph (O), by striking ``and'' at the end;
(B) in subparagraph (P), by striking the semicolon at the
end and inserting ``, and''; and
(C) by adding at the end the following new subparagraph:
``(Q) in the case of a prostate cancer DNA Specimen
Provenance Assay test (DSPA test) (as defined in section
1861(jjj)), unless such test is furnished on or after January
1, 2019, and before January 1, 2024, and such test is ordered
by the physician who furnished the prostate cancer biopsy
that obtained the specimen tested;''.
(b) Payment Amount and Related Requirements.--Section 1834
of the Social Security Act (42 U.S.C. 1395m), as amended by
section 2204, is further amended by adding at the end the
following new subsection:
``(w) Prostate Cancer DNA Specimen Provenance Assay
Tests.--
``(1) Payment for covered tests.--
``(A) In general.--Subject to subparagraph (B), the payment
amount for a prostate cancer DNA Specimen Provenance Assay
test (DSPA test) (as defined in section 1861(jjj)) shall be
$200. Such payment shall be payment for all of the specimens
obtained from the biopsy furnished to an individual that are
tested.
``(B) Limitation.--Payment for a DSPA test under
subparagraph (A) may only be made on an assignment-related
basis.
``(C) Prohibition on separate payment.--No separate payment
shall be made for obtaining DNA that was separately taken
from an individual at the time of a biopsy described in
subparagraph (A).
``(2) HCPCS code and modifier assignment.--
``(A) In general.--The Secretary shall assign one or more
HCPCS codes to a prostate cancer DNA Specimen Provenance
Assay test and may use a modifier to facilitate making
payment under this section for such test.
``(B) Identification of dna match on claim.--The Secretary
shall require an indication on a claim for a prostate cancer
DNA Specimen Provenance Assay test of whether the DNA of the
prostate biopsy specimens match the DNA of the individual
diagnosed with prostate cancer. Such indication may be made
through use of a HCPCS code, a modifier, or other means, as
determined appropriate by the Secretary.
``(3) DNA match review.--
``(A) In general.--The Secretary shall review at least
three years of claims under part B for prostate cancer DNA
Specimen Provenance Assay tests to identify whether the DNA
of the prostate biopsy specimens match the DNA of the
individuals diagnosed with prostate cancer.
``(B) Posting on internet website.--Not later than July 1,
2022, the Secretary shall post on the Internet website of the
Centers for Medicare & Medicaid Services the findings of the
review conducted under subparagraph (A).''.
(c) Cost-sharing.--Section 1833(a)(1) of the Social
Security Act (42 U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (BB)'' and inserting ``(BB)''; and
[[Page H869]]
(2) by inserting before the semicolon at the end the
following: ``, and (CC) with respect to a prostate cancer DNA
Specimen Provenance Assay test (DSPA test) (as defined in
section 1861(jjj)), the amount paid shall be an amount equal
to 80 percent of the lesser of the actual charge for the test
or the amount specified under section 1834(w)''.
SEC. 2415. STRENGTHENING RULES IN CASE OF COMPETITION FOR
DIABETIC TESTING STRIPS.
(a) Special Rule in Case of Competition for Diabetic
Testing Strips.--
(1) In general.--Paragraph (10) of section 1847(b) of the
Social Security Act (42 U.S.C. 1395w-3(b)) is amended--
(A) in subparagraph (A), by striking the second sentence
and inserting the following new sentence: ``With respect to
bids to furnish such types of products on or after January 1,
2019, the volume for such types of products shall be
determined by the Secretary through the use of multiple
sources of data (from mail order and non-mail order Medicare
markets), including market-based data measuring sales of
diabetic testing strip products that are not exclusively sold
by a single retailer from such markets.''; and
(B) by adding at the end the following new subparagraphs:
``(C) Demonstration of ability to furnish types of diabetic
testing strip products.--With respect to bids to furnish
diabetic testing strip products on or after January 1, 2019,
an entity shall attest to the Secretary that the entity has
the ability to obtain an inventory of the types and
quantities of diabetic testing strip products that will allow
the entity to furnish such products in a manner consistent
with its bid and--
``(i) demonstrate to the Secretary, through letters of
intent with manufacturers, wholesalers, or other suppliers,
or other evidence as the Secretary may specify, such ability;
or
``(ii) demonstrate to the Secretary that it made a good
faith attempt to obtain such a letter of intent or such other
evidence.
``(D) Use of unlisted types in calculation of percentage.--
With respect to bids to furnish diabetic testing strip
products on or after January 1, 2019, in determining under
subparagraph (A) whether a bid submitted by an entity under
such subparagraph covers 50 percent (or such higher
percentage as the Secretary may specify) of all types of
diabetic testing strip products, the Secretary may not
attribute a percentage to types of diabetic testing strip
products that the Secretary does not identify by brand,
model, and market share volume.
``(E) Adherence to demonstration.--
``(i) In general.--In the case of an entity that is
furnishing diabetic testing strip products on or after
January 1, 2019, under a contract entered into under the
competition conducted pursuant to paragraph (1), the
Secretary shall establish a process to monitor, on an ongoing
basis, the extent to which such entity continues to cover the
product types included in the entity's bid.
``(ii) Termination.--If the Secretary determines that an
entity described in clause (i) fails to maintain in
inventory, or otherwise maintain ready access to (through
requirements, contracts, or otherwise) a type of product
included in the entity's bid, the Secretary may terminate
such contract unless the Secretary finds that the failure of
the entity to maintain inventory of, or ready access to, the
product is the result of the discontinuation of the product
by the product manufacturer, a market-wide shortage of the
product, or the introduction of a newer model or version of
the product in the market involved.''.
(b) Codifying and Expanding Anti-switching Rule.--Section
1847(b) of the Social Security Act (42 U.S.C. 1395w-3(b)), as
amended by subsection (a)(1), is further amended--
(1) by redesignating paragraph (11) as paragraph (12); and
(2) by inserting after paragraph (10) the following new
paragraph:
``(11) Additional special rules in case of competition for
diabetic testing strips.--
``(A) In general.--With respect to an entity that is
furnishing diabetic testing strip products to individuals
under a contract entered into under the competitive
acquisition program established under this section, the
entity shall furnish to each individual a brand of such
products that is compatible with the home blood glucose
monitor selected by the individual.
``(B) Prohibition on influencing and incentivizing.--An
entity described in subparagraph (A) may not attempt to
influence or incentivize an individual to switch the brand of
glucose monitor or diabetic testing strip product selected by
the individual, including by--
``(i) persuading, pressuring, or advising the individual to
switch; or
``(ii) furnishing information about alternative brands to
the individual where the individual has not requested such
information.
``(C) Provision of information.--
``(i) Standardized information.--Not later than January 1,
2019, the Secretary shall develop and make available to
entities described in subparagraph (A) standardized
information that describes the rights of an individual with
respect to such an entity. The information described in the
preceding sentence shall include information regarding--
``(I) the requirements established under subparagraphs (A)
and (B);
``(II) the right of the individual to purchase diabetic
testing strip products from another mail order supplier of
such products or a retail pharmacy if the entity is not able
to furnish the brand of such product that is compatible with
the home blood glucose monitor selected by the individual;
and
``(III) the right of the individual to return diabetic
testing strip products furnished to the individual by the
entity.
``(ii) Requirement.--With respect to diabetic testing strip
products furnished on or after the date on which the
Secretary develops the standardized information under clause
(i), an entity described in subparagraph (A) may not
communicate directly to an individual until the entity has
verbally provided the individual with such standardized
information.
``(D) Order refills.--With respect to diabetic testing
strip products furnished on or after January 1, 2019, the
Secretary shall require an entity furnishing diabetic testing
strip products to an individual to contact and receive a
request from the individual for such products not more than
14 days prior to dispensing a refill of such products to the
individual.''.
(c) Implementation; Non-application of the Paperwork
Reduction Act.--
(1) Implementation.--Notwithstanding any other provision of
law, the Secretary of Health and Human Services may implement
the provisions of, and amendments made by, this section by
program instruction or otherwise.
(2) Non-application of the paperwork reduction act.--
Chapter 35 of title 44, United States Code (commonly referred
to as the ``Paperwork Reduction Act of 1995''), shall not
apply to this section or the amendments made by this section.
TITLE V--OTHER HEALTH EXTENDERS
SEC. 2501. EXTENSION FOR COMMUNITY HEALTH CENTERS, THE
NATIONAL HEALTH SERVICE CORPS, AND TEACHING
HEALTH CENTERS THAT OPERATE GME PROGRAMS.
(a) Community Health Centers Funding.--Section 10503(b)(1)
of the Patient Protection and Affordable Care Act (42 U.S.C.
254b-2(b)(1)), as amended by section 3101 of Public Law 115-
96, is amended by amending subparagraph (F) to read as
follows:
``(F) $3,600,000,000 for each of fiscal years 2018 and
2019.''.
(b) Other Community Health Centers Provisions.--Section 330
of the Public Health Service Act (42 U.S.C. 254b) is
amended--
(1) in subsection (b)(1)(A)(ii), by striking ``abuse'' and
inserting ``use disorder'';
(2) in subsection (b)(2)(A), by striking ``abuse'' and
inserting ``use disorder'';
(3) in subsection (c)--
(A) in paragraph (1), by striking subparagraphs (B) through
(D);
(B) by striking ``(1) In general'' and all that follows
through ``The Secretary'' and inserting the following:
``(1) Centers.--The Secretary''; and
(C) in paragraph (1), as amended, by redesignating clauses
(i) through (v) as subparagraphs (A) through (E) and moving
the margin of each of such redesignated subparagraph 2 ems to
the left;
(4) by striking subsection (d) and inserting the following:
``(d) Improving Quality of Care.--
``(1) Supplemental awards.--The Secretary may award
supplemental grant funds to health centers funded under this
section to implement evidence-based models for increasing
access to high-quality primary care services, which may
include models related to--
``(A) improving the delivery of care for individuals with
multiple chronic conditions;
``(B) workforce configuration;
``(C) reducing the cost of care;
``(D) enhancing care coordination;
``(E) expanding the use of telehealth and technology-
enabled collaborative learning and capacity building models;
``(F) care integration, including integration of behavioral
health, mental health, or substance use disorder services;
and
``(G) addressing emerging public health or substance use
disorder issues to meet the health needs of the population
served by the health center.
``(2) Sustainability.--In making supplemental awards under
this subsection, the Secretary may consider whether the
health center involved has submitted a plan for continuing
the activities funded under this subsection after
supplemental funding is expended.
``(3) Special consideration.--The Secretary may give
special consideration to applications for supplemental
funding under this subsection that seek to address
significant barriers to access to care in areas with a
greater shortage of health care providers and health services
relative to the national average.'';
(5) in subsection (e)(1)--
(A) in subparagraph (B)--
(i) by striking ``2 years'' and inserting ``1 year''; and
(ii) by adding at the end the following: ``The Secretary
shall not make a grant under this paragraph unless the
applicant provides assurances to the Secretary that within
120 days of receiving grant funding for the operation of the
health center, the applicant will submit, for approval by the
Secretary, an implementation plan to meet the requirements of
subsection (k)(3). The Secretary may extend such 120-day
period for achieving
[[Page H870]]
compliance upon a demonstration of good cause by the health
center.''; and
(B) in subparagraph (C)--
(i) in the subparagraph heading, by striking ``and plans'';
(ii) by striking ``or plan (as described in subparagraphs
(B) and (C) of subsection (c)(1))'';
(iii) by striking ``or plan, including the purchase'' and
inserting the following: ``including--
``(i) the purchase'';
(iv) by inserting ``, which may include data and
information systems'' after ``of equipment'';
(v) by striking the period at the end and inserting a
semicolon; and
(vi) by adding at the end the following:
``(ii) the provision of training and technical assistance;
and
``(iii) other activities that--
``(I) reduce costs associated with the provision of health
services;
``(II) improve access to, and availability of, health
services provided to individuals served by the centers;
``(III) enhance the quality and coordination of health
services; or
``(IV) improve the health status of communities.'';
(6) in subsection (e)(5)(B)--
(A) in the heading of subparagraph (B), by striking ``and
plans''; and
(B) by striking ``and subparagraphs (B) and (C) of
subsection (c)(1) to a health center or to a network or
plan'' and inserting ``to a health center or to a network'';
(7) in subsection (e), by adding at the end the following:
``(6) New access points and expanded services.--
``(A) Approval of new access points.--
``(i) In general.--The Secretary may approve applications
for grants under subparagraph (A) or (B) of paragraph (1) to
establish new delivery sites.
``(ii) Special consideration.--In carrying out clause (i),
the Secretary may give special consideration to applicants
that have demonstrated the new delivery site will be located
within a sparsely populated area, or an area which has a
level of unmet need that is higher relative to other
applicants.
``(iii) Consideration of applications.--In carrying out
clause (i), the Secretary shall approve applications for
grants in such a manner that the ratio of the medically
underserved populations in rural areas which may be expected
to use the services provided by the applicants involved to
the medically underserved populations in urban areas which
may be expected to use the services provided by the
applicants is not less than two to three or greater than
three to two.
``(iv) Service area overlap.--If in carrying out clause (i)
the applicant proposes to serve an area that is currently
served by another health center funded under this section,
the Secretary may consider whether the award of funding to an
additional health center in the area can be justified based
on the unmet need for additional services within the
catchment area.
``(B) Approval of expanded service applications.--
``(i) In general.--The Secretary may approve applications
for grants under subparagraph (A) or (B) of paragraph (1) to
expand the capacity of the applicant to provide required
primary health services described in subsection (b)(1) or
additional health services described in subsection (b)(2).
``(ii) Priority expansion projects.--In carrying out clause
(i), the Secretary may give special consideration to expanded
service applications that seek to address emerging public
health or behavioral health, mental health, or substance
abuse issues through increasing the availability of
additional health services described in subsection (b)(2) in
an area in which there are significant barriers to accessing
care.
``(iii) Consideration of applications.--In carrying out
clause (i), the Secretary shall approve applications for
grants in such a manner that the ratio of the medically
underserved populations in rural areas which may be expected
to use the services provided by the applicants involved to
the medically underserved populations in urban areas which
may be expected to use the services provided by such
applicants is not less than two to three or greater than
three to two.'';
(8) in subsection (h)--
(A) in paragraph (1), by striking ``and children and youth
at risk of homelessness'' and inserting ``, children and
youth at risk of homelessness, homeless veterans, and
veterans at risk of homelessness''; and
(B) in paragraph (5)--
(i) by striking subparagraph (B);
(ii) by redesignating subparagraph (C) as subparagraph (B);
and
(iii) in subparagraph (B) (as so redesignated)--
(I) in the subparagraph heading, by striking ``abuse'' and
inserting ``use disorder''; and
(II) by striking ``abuse'' and inserting ``use disorder'';
(9) in subsection (k)--
(A) in paragraph (2)--
(i) in the paragraph heading, by inserting ``unmet'' before
``need'';
(ii) in the matter preceding subparagraph (A), by inserting
``or subsection (e)(6)'' after ``subsection (e)(1)'';
(iii) in subparagraph (A), by inserting ``unmet'' before
``need for health services'';
(iv) in subparagraph (B), by striking ``and'' at the end;
(v) in subparagraph (C), by striking the period at the end
and inserting ``; and''; and
(vi) by adding after subparagraph (C) the following:
``(D) in the case of an application for a grant pursuant to
subsection (e)(6), a demonstration that the applicant has
consulted with appropriate State and local government
agencies, and health care providers regarding the need for
the health services to be provided at the proposed delivery
site.'';
(B) in paragraph (3)--
(i) in the matter preceding subparagraph (A), by inserting
``or subsection (e)(6)'' after ``subsection (e)(1)(B)'';
(ii) in subparagraph (B), by striking ``in the catchment
area of the center'' and inserting ``, including other health
care providers that provide care within the catchment area,
local hospitals, and specialty providers in the catchment
area of the center, to provide access to services not
available through the health center and to reduce the non-
urgent use of hospital emergency departments'';
(iii) in subparagraph (H)(ii), by inserting ``who shall be
directly employed by the center'' after ``approves the
selection of a director for the center'';
(iv) in subparagraph (L), by striking ``and'' at the end;
(v) in subparagraph (M), by striking the period and
inserting ``; and''; and
(vi) by inserting after subparagraph (M), the following:
``(N) the center has written policies and procedures in
place to ensure the appropriate use of Federal funds in
compliance with applicable Federal statutes, regulations, and
the terms and conditions of the Federal award.''; and
(C) by striking paragraph (4);
(10) in subsection (l), by adding at the end the following:
``Funds expended to carry out activities under this
subsection and operational support activities under
subsection (m) shall not exceed 3 percent of the amount
appropriated for this section for the fiscal year
involved.'';
(11) in subsection (q)(4), by adding at the end the
following: ``A waiver provided by the Secretary under this
paragraph may not remain in effect for more than 1 year and
may not be extended after such period. An entity may not
receive more than one waiver under this paragraph in
consecutive years.'';
(12) in subsection (r)(3)--
(A) by striking ``appropriate committees of Congress a
report concerning the distribution of funds under this
section'' and inserting the following: ``Committee on Health,
Education, Labor, and Pensions of the Senate, and the
Committee on Energy and Commerce of the House of
Representatives, a report including, at a minimum--
``(A) the distribution of funds for carrying out this
section'';
(B) by striking ``populations. Such report shall include an
assessment'' and inserting the following: ``populations;
``(B) an assessment'';
(C) by striking ``and the rationale for any substantial
changes in the distribution of funds.'' and inserting a
semicolon; and
(D) by adding at the end the following:
``(C) the distribution of awards and funding for new or
expanded services in each of rural areas and urban areas;
``(D) the distribution of awards and funding for
establishing new access points, and the number of new access
points created;
``(E) the amount of unexpended funding for loan guarantees
and loan guarantee authority under title XVI;
``(F) the rationale for any substantial changes in the
distribution of funds;
``(G) the rate of closures for health centers and access
points;
``(H) the number and reason for any grants awarded pursuant
to subsection (e)(1)(B); and
``(I) the number and reason for any waivers provided
pursuant to subsection (q)(4).'';
(13) in subsection (r), by adding at the end the following
new paragraph:
``(5) Funding for participation of health centers in all of
us research program.--In addition to any amounts made
available pursuant to paragraph (1) of this subsection,
section 402A of this Act, or section 10503 of the Patient
Protection and Affordable Care Act, there is authorized to be
appropriated, and there is appropriated, out of any monies in
the Treasury not otherwise appropriated, to the Secretary
$25,000,000 for fiscal year 2018 to support the participation
of health centers in the All of Us Research Program under the
Precision Medicine Initiative under section 498E of this
Act.''; and
(14) by striking subsection (s).
(c) National Health Service Corps.--Section 10503(b)(2) of
the Patient Protection and Affordable Care Act (42 U.S.C.
254b-2(b)(2)), as amended by section 3101 of Public Law 115-
96, is amended by amending subparagraph (F) to read as
follows:
``(F) $310,000,000 for each of fiscal years 2018 and
2019.''.
(d) Teaching Health Centers That Operate Graduate Medical
Education Programs.--
(1) Payments.--Subsection (a) of section 340H of the Public
Health Service Act (42 U.S.C. 256h) is amended to read as
follows:
``(a) Payments.--
``(1) In general.--Subject to subsection (h)(2), the
Secretary shall make payments under this section for direct
expenses and indirect expenses to qualified teaching health
centers that are listed as sponsoring institutions by the
relevant accrediting body for, as appropriate--
[[Page H871]]
``(A) maintenance of filled positions at existing approved
graduate medical residency training programs;
``(B) expansion of existing approved graduate medical
residency training programs; and
``(C) establishment of new approved graduate medical
residency training programs.
``(2) Per resident amount.--In making payments under
paragraph (1), the Secretary shall consider the cost of
training residents at teaching health centers and the
implications of the per resident amount on approved graduate
medical residency training programs at teaching health
centers.
``(3) Priority.--In making payments under paragraph (1)(C),
the Secretary shall give priority to qualified teaching
health centers that--
``(A) serve a health professional shortage area with a
designation in effect under section 332 or a medically
underserved community (as defined in section 799B); or
``(B) are located in a rural area (as defined in section
1886(d)(2)(D) of the Social Security Act).''.
(2) Funding.--Paragraph (1) of section 340H(g) of the
Public Health Service Act (42 U.S.C. 256h(g)), as amended by
section 3101 of Public Law 115-96, is amended by striking
``and $30,000,000 for the period of the first and second
quarters of fiscal year 2018'' and inserting ``and
$126,500,000 for each of fiscal years 2018 and 2019''.
(3) Annual reporting.--Subsection (h)(1) of section 340H of
the Public Health Service Act (42 U.S.C. 256h) is amended--
(A) by redesignating subparagraph (D) as subparagraph (H);
and
(B) by inserting after subparagraph (C) the following:
``(D) The number of patients treated by residents described
in paragraph (4).
``(E) The number of visits by patients treated by residents
described in paragraph (4).
``(F) Of the number of residents described in paragraph (4)
who completed their residency training at the end of such
residency academic year, the number and percentage of such
residents entering primary care practice (meaning any of the
areas of practice listed in the definition of a primary care
residency program in section 749A).
``(G) Of the number of residents described in paragraph (4)
who completed their residency training at the end of such
residency academic year, the number and percentage of such
residents who entered practice at a health care facility--
``(i) primarily serving a health professional shortage area
with a designation in effect under section 332 or a medically
underserved community (as defined in section 799B); or
``(ii) located in a rural area (as defined in section
1886(d)(2)(D) of the Social Security Act).''.
(4) Report on training costs.--Not later than March 31,
2019, the Secretary of Health and Human Services shall submit
to the Congress a report on the direct graduate expenses of
approved graduate medical residency training programs, and
the indirect expenses associated with the additional costs of
teaching residents, of qualified teaching health centers (as
such terms are used or defined in section 340H of the Public
Health Service Act (42 U.S.C. 256h)).
(5) Definition.--Subsection (j) of section 340H of the
Public Health Service Act (42 U.S.C. 256h) is amended--
(A) by redesignating paragraphs (2) and (3) as paragraphs
(3) and (4), respectively; and
(B) by inserting after paragraph (1) the following:
``(2) New approved graduate medical residency training
program.--The term `new approved graduate medical residency
training program' means an approved graduate medical
residency training program for which the sponsoring qualified
teaching health center has not received a payment under this
section for a previous fiscal year (other than pursuant to
subsection (a)(1)(C)).''.
(6) Technical correction.--Subsection (f) of section 340H
(42 U.S.C. 256h) is amended by striking ``hospital'' each
place it appears and inserting ``teaching health center''.
(7) Payments for previous fiscal years.--The provisions of
section 340H of the Public Health Service Act (42 U.S.C.
256h), as in effect on the day before the date of enactment
of Public Law 115-96, shall continue to apply with respect to
payments under such section for fiscal years before fiscal
year 2018.
(e) Application.--Amounts appropriated pursuant to this
section for fiscal year 2018 or 2019 are subject to the
requirements contained in Public Law 115-31 for funds for
programs authorized under sections 330 through 340 of the
Public Health Service Act (42 U.S.C. 254b-256).
(f) Conforming Amendment.--Paragraph (4) of section 3014(h)
of title 18, United States Code, as amended by section 3101
of Public Law 115-96, is amended by striking ``and section
3101(d) of the CHIP and Public Health Funding Extension Act''
and inserting ``and section 2501(e) of the SUSTAIN Care Act
of 2018''.
SEC. 2502. EXTENSION FOR SPECIAL DIABETES PROGRAMS.
(a) Special Diabetes Program for Type I Diabetes.--
Subparagraph (D) of section 330B(b)(2) of the Public Health
Service Act (42 U.S.C. 254c-2(b)(2)), as amended by section
3102 of Public Law 115-96, is amended to read as follows:
``(D) $150,000,000 for each of fiscal years 2018 and 2019,
to remain available until expended.''.
(b) Special Diabetes Program for Indians.--Subparagraph (D)
of section 330C(c)(2) of the Public Health Service Act (42
U.S.C. 254c-3(c)(2)), as amended by section 3102 of Public
Law 115-96, is amended to read as follows:
``(D) $150,000,000 for each of fiscal years 2018 and 2019,
to remain available until expended.''.
SEC. 2503. EXTENSION FOR FAMILY-TO-FAMILY HEALTH INFORMATION
CENTERS.
Section 501(c) of the Social Security Act (42 U.S.C.
701(c)) is amended--
(1) in paragraph (1)(A)--
(A) in clause (v), by striking ``and'' at the end;
(B) in clause (vi), by striking the period at the end and
inserting ``; and''; and
(C) by adding at the end the following new clause:
``(vii) $6,000,000 for each of fiscal years 2018 and
2019.'';
(2) in paragraph (3)(C), by inserting before the period the
following: ``, and with respect to fiscal years 2018 and
2019, such centers shall also be developed in all territories
and at least one such center shall be developed for Indian
Tribes''; and
(3) by amending paragraph (5) to read as follows:
``(5) For purposes of this subsection--
``(A) the term `Indian Tribe' has the meaning given to the
term `Indian tribe' in section 4 of the Indian Health Care
Improvement Act (25 U.S.C. 1603);
``(B) the term `State' means each of the 50 States and the
District of Columbia; and
``(C) the term `territory' means Puerto Rico, Guam,
American Samoa, the United States Virgin Islands, and the
Northern Mariana Islands.''.
SEC. 2504. EXTENSION FOR SEXUAL RISK AVOIDANCE EDUCATION.
(a) In General.--Section 510 of the Social Security Act (42
U.S.C. 710) is amended to read as follows:
``SEC. 510. SEXUAL RISK AVOIDANCE EDUCATION.
``(a) In General.--
``(1) Allotments to states.--For the purpose described in
subsection (b), the Secretary shall, for each of fiscal years
2018 and 2019, allot to each State which has transmitted an
application for the fiscal year under section 505(a) an
amount equal to the product of--
``(A) the amount appropriated pursuant to subsection (e)(1)
for the fiscal year, minus the amount reserved under
subsection (e)(2) for the fiscal year; and
``(B) the proportion that the number of low-income children
in the State bears to the total of such numbers of children
for all the States.
``(2) Other allotments.--
``(A) Other entities.--For the purpose described in
subsection (b), the Secretary shall, for each of fiscal years
2018 and 2019, for any State which has not transmitted an
application for the fiscal year under section 505(a), allot
to one or more entities in the State the amount that would
have been allotted to the State under paragraph (1) if the
State had submitted such an application.
``(B) Process.--The Secretary shall select the recipients
of allotments under subparagraph (A) by means of a
competitive grant process under which--
``(i) not later than 30 days after the deadline for the
State involved to submit an application for the fiscal year
under section 505(a), the Secretary publishes a notice
soliciting grant applications; and
``(ii) not later than 120 days after such deadline, all
such applications must be submitted.
``(b) Purpose.--
``(1) In general.--Except for research under paragraph (5)
and information collection and reporting under paragraph (6),
the purpose of an allotment under subsection (a) to a State
(or to another entity in the State pursuant to subsection
(a)(2)) is to enable the State or other entity to implement
education exclusively on sexual risk avoidance (meaning
voluntarily refraining from sexual activity).
``(2) Required components.--Education on sexual risk
avoidance pursuant to an allotment under this section shall--
``(A) ensure that the unambiguous and primary emphasis and
context for each topic described in paragraph (3) is a
message to youth that normalizes the optimal health behavior
of avoiding nonmarital sexual activity;
``(B) be medically accurate and complete;
``(C) be age-appropriate;
``(D) be based on adolescent learning and developmental
theories for the age group receiving the education; and
``(E) be culturally appropriate, recognizing the
experiences of youth from diverse communities, backgrounds,
and experiences.
``(3) Topics.--Education on sexual risk avoidance pursuant
to an allotment under this section shall address each of the
following topics:
``(A) The holistic individual and societal benefits
associated with personal responsibility, self-regulation,
goal setting, healthy decisionmaking, and a focus on the
future.
``(B) The advantage of refraining from nonmarital sexual
activity in order to improve the future prospects and
physical and emotional health of youth.
``(C) The increased likelihood of avoiding poverty when
youth attain self-sufficiency and emotional maturity before
engaging in sexual activity.
[[Page H872]]
``(D) The foundational components of healthy relationships
and their impact on the formation of healthy marriages and
safe and stable families.
``(E) How other youth risk behaviors, such as drug and
alcohol usage, increase the risk for teen sex.
``(F) How to resist and avoid, and receive help regarding,
sexual coercion and dating violence, recognizing that even
with consent teen sex remains a youth risk behavior.
``(4) Contraception.--Education on sexual risk avoidance
pursuant to an allotment under this section shall ensure
that--
``(A) any information provided on contraception is
medically accurate and complete and ensures that students
understand that contraception offers physical risk reduction,
but not risk elimination; and
``(B) the education does not include demonstrations,
simulations, or distribution of contraceptive devices.
``(5) Research.--
``(A) In general.--A State or other entity receiving an
allotment pursuant to subsection (a) may use up to 20 percent
of such allotment to build the evidence base for sexual risk
avoidance education by conducting or supporting research.
``(B) Requirements.--Any research conducted or supported
pursuant to subparagraph (A) shall be--
``(i) rigorous;
``(ii) evidence-based; and
``(iii) designed and conducted by independent researchers
who have experience in conducting and publishing research in
peer-reviewed outlets.
``(6) Information collection and reporting.--A State or
other entity receiving an allotment pursuant to subsection
(a) shall, as specified by the Secretary--
``(A) collect information on the programs and activities
funded through the allotment; and
``(B) submit reports to the Secretary on the data from such
programs and activities.
``(c) National Evaluation.--
``(1) In general.--The Secretary shall--
``(A) in consultation with appropriate State and local
agencies, conduct one or more rigorous evaluations of the
education funded through this section and associated data;
and
``(B) submit a report to the Congress on the results of
such evaluations, together with a summary of the information
collected pursuant to subsection (b)(6).
``(2) Consultation.--In conducting the evaluations required
by paragraph (1), including the establishment of rigorous
evaluation methodologies, the Secretary shall consult with
relevant stakeholders and evaluation experts.
``(d) Applicability of Certain Provisions.--
``(1) Sections 503, 507, and 508 apply to allotments under
subsection (a) to the same extent and in the same manner as
such sections apply to allotments under section 502(c).
``(2) Sections 505 and 506 apply to allotments under
subsection (a) to the extent determined by the Secretary to
be appropriate.
``(e) Definitions.--In this section:
``(1) The term `age-appropriate' means suitable (in terms
of topics, messages, and teaching methods) to the
developmental and social maturity of the particular age or
age group of children or adolescents, based on developing
cognitive, emotional, and behavioral capacity typical for the
age or age group.
``(2) The term `medically accurate and complete' means
verified or supported by the weight of research conducted in
compliance with accepted scientific methods and--
``(A) published in peer-reviewed journals, where
applicable; or
``(B) comprising information that leading professional
organizations and agencies with relevant expertise in the
field recognize as accurate, objective, and complete.
``(3) The term `rigorous', with respect to research or
evaluation, means using--
``(A) established scientific methods for measuring the
impact of an intervention or program model in changing
behavior (specifically sexual activity or other sexual risk
behaviors), or reducing pregnancy, among youth; or
``(B) other evidence-based methodologies established by the
Secretary for purposes of this section.
``(4) The term `youth' refers to one or more individuals
who have attained age 10 but not age 20.
``(f) Funding.--
``(1) In general.--To carry out this section, there is
appropriated, out of any money in the Treasury not otherwise
appropriated, $75,000,000 for each of fiscal years 2018 and
2019.
``(2) Reservation.--The Secretary shall reserve, for each
of fiscal years 2018 and 2019, not more than 20 percent of
the amount appropriated pursuant to paragraph (1) for
administering the program under this section, including the
conducting of national evaluations and the provision of
technical assistance to the recipients of allotments.''.
(b) Effective Date.--The amendment made by this section
takes effect on October 1, 2017.
SEC. 2505. EXTENSION FOR PERSONAL RESPONSIBILITY EDUCATION.
(a) In General.--Section 513 of the Social Security Act (42
U.S.C. 713) is amended--
(1) in subsection (a)(1)(A), by striking ``2017'' and
inserting ``2019''; and
(2) in subsection (a)(4)--
(A) in subparagraph (A), by striking ``2017'' each place it
appears and inserting ``2019''; and
(B) in subparagraph (B)--
(i) in the subparagraph heading, by striking ``3-year
grants'' and inserting ``Competitive prep grants''; and
(ii) in clause (i), by striking ``solicit applications to
award 3-year grants in each of fiscal years 2012 through
2017'' and inserting ``continue through fiscal year 2019
grants awarded for any of fiscal years 2015 through 2017'';
(3) in subsection (c)(1), by inserting after ``youth with
HIV/AIDS,'' the following: ``victims of human trafficking,'';
and
(4) in subsection (f), by striking ``2017'' and inserting
``2019''.
(b) Effective Date.--The amendments made by this section
take effect on October 1, 2017.
TITLE VI--CHILD AND FAMILY SERVICES AND SUPPORT
Subtitle A--Family First Prevention Services Act
SEC. 2601. SHORT TITLE.
This subtitle may be cited as the ``Family First Prevention
Services Act''.
CHAPTER 1--INVESTING IN PREVENTION AND FAMILY SERVICES
SEC. 2611. PURPOSE.
The purpose of this chapter is to enable States to use
Federal funds available under parts B and E of title IV of
the Social Security Act to provide enhanced support to
children and families and prevent foster care placements
through the provision of mental health and substance abuse
prevention and treatment services, in-home parent skill-based
programs, and kinship navigator services.
Subchapter A--Prevention Activities Under Title IV-E
SEC. 2621. FOSTER CARE PREVENTION SERVICES AND PROGRAMS.
(a) State Option.--Section 471 of the Social Security Act
(42 U.S.C. 671) is amended--
(1) in subsection (a)(1), by striking ``and'' and all that
follows through the semicolon and inserting ``, adoption
assistance in accordance with section 473, and, at the option
of the State, services or programs specified in subsection
(e)(1) of this section for children who are candidates for
foster care or who are pregnant or parenting foster youth and
the parents or kin caregivers of the children, in accordance
with the requirements of that subsection;''; and
(2) by adding at the end the following:
``(e) Prevention and Family Services and Programs.--
``(1) In general.--Subject to the succeeding provisions of
this subsection, the Secretary may make a payment to a State
for providing the following services or programs for a child
described in paragraph (2) and the parents or kin caregivers
of the child when the need of the child, such a parent, or
such a caregiver for the services or programs are directly
related to the safety, permanence, or well-being of the child
or to preventing the child from entering foster care:
``(A) Mental health and substance abuse prevention and
treatment services.--Mental health and substance abuse
prevention and treatment services provided by a qualified
clinician for not more than a 12-month period that begins on
any date described in paragraph (3) with respect to the
child.
``(B) In-home parent skill-based programs.--In-home parent
skill-based programs for not more than a 12-month period that
begins on any date described in paragraph (3) with respect to
the child and that include parenting skills training, parent
education, and individual and family counseling.
``(2) Child described.--For purposes of paragraph (1), a
child described in this paragraph is the following:
``(A) A child who is a candidate for foster care (as
defined in section 475(13)) but can remain safely at home or
in a kinship placement with receipt of services or programs
specified in paragraph (1).
``(B) A child in foster care who is a pregnant or parenting
foster youth.
``(3) Date described.--For purposes of paragraph (1), the
dates described in this paragraph are the following:
``(A) The date on which a child is identified in a
prevention plan maintained under paragraph (4) as a child who
is a candidate for foster care (as defined in section
475(13)).
``(B) The date on which a child is identified in a
prevention plan maintained under paragraph (4) as a pregnant
or parenting foster youth in need of services or programs
specified in paragraph (1).
``(4) Requirements related to providing services and
programs.--Services and programs specified in paragraph (1)
may be provided under this subsection only if specified in
advance in the child's prevention plan described in
subparagraph (A) and the requirements in subparagraphs (B)
through (E) are met:
``(A) Prevention plan.--The State maintains a written
prevention plan for the child that meets the following
requirements (as applicable):
``(i) Candidates.--In the case of a child who is a
candidate for foster care described in paragraph (2)(A), the
prevention plan shall--
``(I) identify the foster care prevention strategy for the
child so that the child may remain safely at home, live
temporarily with a kin caregiver until reunification can be
[[Page H873]]
safely achieved, or live permanently with a kin caregiver;
``(II) list the services or programs to be provided to or
on behalf of the child to ensure the success of that
prevention strategy; and
``(III) comply with such other requirements as the
Secretary shall establish.
``(ii) Pregnant or parenting foster youth.--In the case of
a child who is a pregnant or parenting foster youth described
in paragraph (2)(B), the prevention plan shall--
``(I) be included in the child's case plan required under
section 475(1);
``(II) list the services or programs to be provided to or
on behalf of the youth to ensure that the youth is prepared
(in the case of a pregnant foster youth) or able (in the case
of a parenting foster youth) to be a parent;
``(III) describe the foster care prevention strategy for
any child born to the youth; and
``(IV) comply with such other requirements as the Secretary
shall establish.
``(B) Trauma-informed.--The services or programs to be
provided to or on behalf of a child are provided under an
organizational structure and treatment framework that
involves understanding, recognizing, and responding to the
effects of all types of trauma and in accordance with
recognized principles of a trauma-informed approach and
trauma-specific interventions to address trauma's
consequences and facilitate healing.
``(C) Only services and programs provided in accordance
with promising, supported, or well-supported practices
permitted.--
``(i) In general.--Only State expenditures for services or
programs specified in subparagraph (A) or (B) of paragraph
(1) that are provided in accordance with practices that meet
the requirements specified in clause (ii) of this
subparagraph and that meet the requirements specified in
clause (iii), (iv), or (v), respectively, for being a
promising, supported, or well-supported practice, shall be
eligible for a Federal matching payment under section
474(a)(6)(A).
``(ii) General practice requirements.--The general practice
requirements specified in this clause are the following:
``(I) The practice has a book, manual, or other available
writings that specify the components of the practice protocol
and describe how to administer the practice.
``(II) There is no empirical basis suggesting that,
compared to its likely benefits, the practice constitutes a
risk of harm to those receiving it.
``(III) If multiple outcome studies have been conducted,
the overall weight of evidence supports the benefits of the
practice.
``(IV) Outcome measures are reliable and valid, and are
administrated consistently and accurately across all those
receiving the practice.
``(V) There is no case data suggesting a risk of harm that
was probably caused by the treatment and that was severe or
frequent.
``(iii) Promising practice.--A practice shall be considered
to be a `promising practice' if the practice is superior to
an appropriate comparison practice using conventional
standards of statistical significance (in terms of
demonstrated meaningful improvements in validated measures of
important child and parent outcomes, such as mental health,
substance abuse, and child safety and well-being), as
established by the results or outcomes of at least one study
that--
``(I) was rated by an independent systematic review for the
quality of the study design and execution and determined to
be well-designed and well-executed; and
``(II) utilized some form of control (such as an untreated
group, a placebo group, or a wait list study).
``(iv) Supported practice.--A practice shall be considered
to be a `supported practice' if--
``(I) the practice is superior to an appropriate comparison
practice using conventional standards of statistical
significance (in terms of demonstrated meaningful
improvements in validated measures of important child and
parent outcomes, such as mental health, substance abuse, and
child safety and well-being), as established by the results
or outcomes of at least one study that--
``(aa) was rated by an independent systematic review for
the quality of the study design and execution and determined
to be well-designed and well-executed;
``(bb) was a rigorous random-controlled trial (or, if not
available, a study using a rigorous quasi-experimental
research design); and
``(cc) was carried out in a usual care or practice setting;
and
``(II) the study described in subclause (I) established
that the practice has a sustained effect (when compared to a
control group) for at least 6 months beyond the end of the
treatment.
``(v) Well-supported practice.--A practice shall be
considered to be a `well-supported practice' if--
``(I) the practice is superior to an appropriate comparison
practice using conventional standards of statistical
significance (in terms of demonstrated meaningful
improvements in validated measures of important child and
parent outcomes, such as mental health, substance abuse, and
child safety and well-being), as established by the results
or outcomes of at least two studies that--
``(aa) were rated by an independent systematic review for
the quality of the study design and execution and determined
to be well-designed and well-executed;
``(bb) were rigorous random-controlled trials (or, if not
available, studies using a rigorous quasi-experimental
research design); and
``(cc) were carried out in a usual care or practice
setting; and
``(II) at least one of the studies described in subclause
(I) established that the practice has a sustained effect
(when compared to a control group) for at least 1 year beyond
the end of treatment.
``(D) Guidance on practices criteria and pre-approved
services and programs.--
``(i) In general.--Not later than October 1, 2018, the
Secretary shall issue guidance to States regarding the
practices criteria required for services or programs to
satisfy the requirements of subparagraph (C). The guidance
shall include a pre-approved list of services and programs
that satisfy the requirements.
``(ii) Updates.--The Secretary shall issue updates to the
guidance required by clause (i) as often as the Secretary
determines necessary.
``(E) Outcome assessment and reporting.--The State shall
collect and report to the Secretary the following information
with respect to each child for whom, or on whose behalf
mental health and substance abuse prevention and treatment
services or in-home parent skill-based programs are provided
during a 12-month period beginning on the date the child is
determined by the State to be a child described in paragraph
(2):
``(i) The specific services or programs provided and the
total expenditures for each of the services or programs.
``(ii) The duration of the services or programs provided.
``(iii) In the case of a child described in paragraph
(2)(A), the child's placement status at the beginning, and at
the end, of the 1-year period, respectively, and whether the
child entered foster care within 2 years after being
determined a candidate for foster care.
``(5) State plan component.--
``(A) In general.--A State electing to provide services or
programs specified in paragraph (1) shall submit as part of
the State plan required by subsection (a) a prevention
services and programs plan component that meets the
requirements of subparagraph (B).
``(B) Prevention services and programs plan component.--In
order to meet the requirements of this subparagraph, a
prevention services and programs plan component, with respect
to each 5-year period for which the plan component is in
operation in the State, shall include the following:
``(i) How providing services and programs specified in
paragraph (1) is expected to improve specific outcomes for
children and families.
``(ii) How the State will monitor and oversee the safety of
children who receive services and programs specified in
paragraph (1), including through periodic risk assessments
throughout the period in which the services and programs are
provided on behalf of a child and reexamination of the
prevention plan maintained for the child under paragraph (4)
for the provision of the services or programs if the State
determines the risk of the child entering foster care remains
high despite the provision of the services or programs.
``(iii) With respect to the services and programs specified
in subparagraphs (A) and (B) of paragraph (1), information on
the specific promising, supported, or well-supported
practices the State plans to use to provide the services or
programs, including a description of--
``(I) the services or programs and whether the practices
used are promising, supported, or well-supported;
``(II) how the State plans to implement the services or
programs, including how implementation of the services or
programs will be continuously monitored to ensure fidelity to
the practice model and to determine outcomes achieved and how
information learned from the monitoring will be used to
refine and improve practices;
``(III) how the State selected the services or programs;
``(IV) the target population for the services or programs;
and
``(V) how each service or program provided will be
evaluated through a well-designed and rigorous process, which
may consist of an ongoing, cross-site evaluation approved by
the Secretary.
``(iv) A description of the consultation that the State
agencies responsible for administering the State plans under
this part and part B engage in with other State agencies
responsible for administering health programs, including
mental health and substance abuse prevention and treatment
services, and with other public and private agencies with
experience in administering child and family services,
including community-based organizations, in order to foster a
continuum of care for children described in paragraph (2) and
their parents or kin caregivers.
``(v) A description of how the State shall assess children
and their parents or kin caregivers to determine eligibility
for services or programs specified in paragraph (1).
``(vi) A description of how the services or programs
specified in paragraph (1) that are provided for or on behalf
of a child and the parents or kin caregivers of the child
will be coordinated with other child and family
[[Page H874]]
services provided to the child and the parents or kin
caregivers of the child under the State plans in effect under
subparts 1 and 2 of part B.
``(vii) Descriptions of steps the State is taking to
support and enhance a competent, skilled, and professional
child welfare workforce to deliver trauma-informed and
evidence-based services, including--
``(I) ensuring that staff is qualified to provide services
or programs that are consistent with the promising,
supported, or well-supported practice models selected; and
``(II) developing appropriate prevention plans, and
conducting the risk assessments required under clause (iii).
``(viii) A description of how the State will provide
training and support for caseworkers in assessing what
children and their families need, connecting to the families
served, knowing how to access and deliver the needed trauma-
informed and evidence-based services, and overseeing and
evaluating the continuing appropriateness of the services.
``(ix) A description of how caseload size and type for
prevention caseworkers will be determined, managed, and
overseen.
``(x) An assurance that the State will report to the
Secretary such information and data as the Secretary may
require with respect to the provision of services and
programs specified in paragraph (1), including information
and data necessary to determine the performance measures for
the State under paragraph (6) and compliance with paragraph
(7).
``(C) Reimbursement for services under the prevention plan
component.--
``(i) Limitation.--Except as provided in subclause (ii), a
State may not receive a Federal payment under this part for a
given promising, supported, or well-supported practice unless
(in accordance with subparagraph (B)(iii)(V)) the plan
includes a well-designed and rigorous evaluation strategy for
that practice.
``(ii) Waiver of limitation.--The Secretary may waive the
requirement for a well-designed and rigorous evaluation of
any well-supported practice if the Secretary deems the
evidence of the effectiveness of the practice to be
compelling and the State meets the continuous quality
improvement requirements included in subparagraph
(B)(iii)(II) with regard to the practice.
``(6) Prevention services measures.--
``(A) Establishment; annual updates.--Beginning with fiscal
year 2021, and annually thereafter, the Secretary shall
establish the following prevention services measures based on
information and data reported by States that elect to provide
services and programs specified in paragraph (1):
``(i) Percentage of candidates for foster care who do not
enter foster care.--The percentage of candidates for foster
care for whom, or on whose behalf, the services or programs
are provided who do not enter foster care, including those
placed with a kin caregiver outside of foster care, during
the 12-month period in which the services or programs are
provided and through the end of the succeeding 12-month
period.
``(ii) Per-child spending.--The total amount of
expenditures made for mental health and substance abuse
prevention and treatment services or in-home parent skill-
based programs, respectively, for, or on behalf of, each
child described in paragraph (2).
``(B) Data.--The Secretary shall establish and annually
update the prevention services measures--
``(i) based on the median State values of the information
reported under each clause of subparagraph (A) for the 3 then
most recent years; and
``(ii) taking into account State differences in the price
levels of consumption goods and services using the most
recent regional price parities published by the Bureau of
Economic Analysis of the Department of Commerce or such other
data as the Secretary determines appropriate.
``(C) Publication of state prevention services measures.--
The Secretary shall annually make available to the public the
prevention services measures of each State.
``(7) Maintenance of effort for state foster care
prevention expenditures.--
``(A) In general.--If a State elects to provide services
and programs specified in paragraph (1) for a fiscal year,
the State foster care prevention expenditures for the fiscal
year shall not be less than the amount of the expenditures
for fiscal year 2014 (or, at the option of a State described
in subparagraph (E), fiscal year 2015 or fiscal year 2016
(whichever the State elects)).
``(B) State foster care prevention expenditures.--The term
`State foster care prevention expenditures' means the
following:
``(i) TANF; iv-b; ssbg.--State expenditures for foster care
prevention services and activities under the State program
funded under part A (including from amounts made available by
the Federal Government), under the State plan developed under
part B (including any such amounts), or under the Social
Services Block Grant Programs under subtitle A of title XX
(including any such amounts).
``(ii) Other state programs.--State expenditures for foster
care prevention services and activities under any State
program that is not described in clause (i) (other than any
State expenditures for foster care prevention services and
activities under the State program under this part (including
under a waiver of the program)).
``(C) State expenditures.--The term `State expenditures'
means all State or local funds that are expended by the State
or a local agency including State or local funds that are
matched or reimbursed by the Federal Government and State or
local funds that are not matched or reimbursed by the Federal
Government.
``(D) Determination of prevention services and
activities.--The Secretary shall require each State that
elects to provide services and programs specified in
paragraph (1) to report the expenditures specified in
subparagraph (B) for fiscal year 2014 and for such fiscal
years thereafter as are necessary to determine whether the
State is complying with the maintenance of effort requirement
in subparagraph (A). The Secretary shall specify the specific
services and activities under each program referred to in
subparagraph (B) that are `prevention services and
activities' for purposes of the reports.
``(E) State described.--For purposes of subparagraph (A), a
State is described in this subparagraph if the population of
children in the State in 2014 was less than 200,000 (as
determined by the Bureau of the Census).
``(8) Prohibition against use of state foster care
prevention expenditures and federal iv-e prevention funds for
matching or expenditure requirement.--A State that elects to
provide services and programs specified in paragraph (1)
shall not use any State foster care prevention expenditures
for a fiscal year for the State share of expenditures under
section 474(a)(6) for a fiscal year.
``(9) Administrative costs.--Expenditures described in
section 474(a)(6)(B)--
``(A) shall not be eligible for payment under subparagraph
(A), (B), or (E) of section 474(a)(3); and
``(B) shall be eligible for payment under section
474(a)(6)(B) without regard to whether the expenditures are
incurred on behalf of a child who is, or is potentially,
eligible for foster care maintenance payments under this
part.
``(10) Application.--
``(A) In general.--The provision of services or programs
under this subsection to or on behalf of a child described in
paragraph (2) shall not be considered to be receipt of aid or
assistance under the State plan under this part for purposes
of eligibility for any other program established under this
Act.
``(B) Candidates in kinship care.--A child described in
paragraph (2) for whom such services or programs under this
subsection are provided for more than 6 months while in the
home of a kin caregiver, and who would satisfy the AFDC
eligibility requirement of section 472(a)(3)(A)(ii)(II) but
for residing in the home of the caregiver for more than 6
months, is deemed to satisfy that requirement for purposes of
determining whether the child is eligible for foster care
maintenance payments under section 472.''.
(b) Definition.--Section 475 of such Act (42 U.S.C. 675) is
amended by adding at the end the following:
``(13) The term `child who is a candidate for foster care'
means, a child who is identified in a prevention plan under
section 471(e)(4)(A) as being at imminent risk of entering
foster care (without regard to whether the child would be
eligible for foster care maintenance payments under section
472 or is or would be eligible for adoption assistance or
kinship guardianship assistance payments under section 473)
but who can remain safely in the child's home or in a kinship
placement as long as services or programs specified in
section 471(e)(1) that are necessary to prevent the entry of
the child into foster care are provided. The term includes a
child whose adoption or guardianship arrangement is at risk
of a disruption or dissolution that would result in a foster
care placement.''.
(c) Payments Under Title IV-E.--Section 474(a) of such Act
(42 U.S.C. 674(a)) is amended--
(1) in paragraph (5), by striking the period at the end and
inserting ``; plus''; and
(2) by adding at the end the following:
``(6) subject to section 471(e)--
``(A) for each quarter--
``(i) subject to clause (ii)--
``(I) beginning after September 30, 2019, and before
October 1, 2026, an amount equal to 50 percent of the total
amount expended during the quarter for the provision of
services or programs specified in subparagraph (A) or (B) of
section 471(e)(1) that are provided in accordance with
promising, supported, or well-supported practices that meet
the applicable criteria specified for the practices in
section 471(e)(4)(C); and
``(II) beginning after September 30, 2026, an amount equal
to the Federal medical assistance percentage (which shall be
as defined in section 1905(b), in the case of a State other
than the District of Columbia, or 70 percent, in the case of
the District of Columbia) of the total amount expended during
the quarter for the provision of services or programs
specified in subparagraph (A) or (B) of section 471(e)(1)
that are provided in accordance with promising, supported, or
well-supported practices that meet the applicable criteria
specified for the practices in section 471(e)(4)(C) (or, with
respect to the payments made during the quarter under a
cooperative agreement or contract entered into by the State
and an Indian tribe, tribal organization, or tribal
consortium for the administration or payment of funds under
this part, an amount equal to the Federal medical assistance
percentage that would apply under section 479B(d) (in this
paragraph referred to as the `tribal FMAP') if the Indian
tribe, tribal organization, or tribal consortium
[[Page H875]]
made the payments under a program operated under that
section, unless the tribal FMAP is less than the Federal
medical assistance percentage that applies to the State);
except that
``(ii) not less than 50 percent of the total amount
expended by a State under clause (i) for a fiscal year shall
be for the provision of services or programs specified in
subparagraph (A) or (B) of section 471(e)(1) that are
provided in accordance with well-supported practices; plus
``(B) for each quarter specified in subparagraph (A), an
amount equal to the sum of the following proportions of the
total amount expended during the quarter--
``(i) 50 percent of so much of the expenditures as are
found necessary by the Secretary for the proper and efficient
administration of the State plan for the provision of
services or programs specified in section 471(e)(1),
including expenditures for activities approved by the
Secretary that promote the development of necessary processes
and procedures to establish and implement the provision of
the services and programs for individuals who are eligible
for the services and programs and expenditures attributable
to data collection and reporting; and
``(ii) 50 percent of so much of the expenditures with
respect to the provision of services and programs specified
in section 471(e)(1) as are for training of personnel
employed or preparing for employment by the State agency or
by the local agency administering the plan in the political
subdivision and of the members of the staff of State-licensed
or State-approved child welfare agencies providing services
to children described in section 471(e)(2) and their parents
or kin caregivers, including on how to determine who are
individuals eligible for the services or programs, how to
identify and provide appropriate services and programs, and
how to oversee and evaluate the ongoing appropriateness of
the services and programs.''.
(d) Technical Assistance and Best Practices, Clearinghouse,
and Data Collection and Evaluations.--Section 476 of such Act
(42 U.S.C. 676) is amended by adding at the end the
following:
``(d) Technical Assistance and Best Practices,
Clearinghouse, Data Collection, and Evaluations Relating to
Prevention Services and Programs.--
``(1) Technical assistance and best practices.--The
Secretary shall provide to States and, as applicable, to
Indian tribes, tribal organizations, and tribal consortia,
technical assistance regarding the provision of services and
programs described in section 471(e)(1) and shall disseminate
best practices with respect to the provision of the services
and programs, including how to plan and implement a well-
designed and rigorous evaluation of a promising, supported,
or well-supported practice.
``(2) Clearinghouse of promising, supported, and well-
supported practices.--The Secretary shall, directly or
through grants, contracts, or interagency agreements,
evaluate research on the practices specified in clauses
(iii), (iv), and (v), respectively, of section 471(e)(4)(C),
and programs that meet the requirements described in section
427(a)(1), including culturally specific, or location- or
population-based adaptations of the practices, to identify
and establish a public clearinghouse of the practices that
satisfy each category described by such clauses. In addition,
the clearinghouse shall include information on the specific
outcomes associated with each practice, including whether the
practice has been shown to prevent child abuse and neglect
and reduce the likelihood of foster care placement by
supporting birth families and kinship families and improving
targeted supports for pregnant and parenting youth and their
children.
``(3) Data collection and evaluations.--The Secretary,
directly or through grants, contracts, or interagency
agreements, may collect data and conduct evaluations with
respect to the provision of services and programs described
in section 471(e)(1) for purposes of assessing the extent to
which the provision of the services and programs--
``(A) reduces the likelihood of foster care placement;
``(B) increases use of kinship care arrangements; or
``(C) improves child well-being.
``(4) Reports to congress.--
``(A) In general.--The Secretary shall submit to the
Committee on Finance of the Senate and the Committee on Ways
and Means of the House of Representatives periodic reports
based on the provision of services and programs described in
section 471(e)(1) and the activities carried out under this
subsection.
``(B) Public availability.--The Secretary shall make the
reports to the Congress submitted under this paragraph
publicly available.
``(5) Appropriation.--Out of any money in the Treasury of
the United States not otherwise appropriated, there are
appropriated to the Secretary $1,000,000 for fiscal year 2018
and each fiscal year thereafter to carry out this
subsection.''.
(e) Application to Programs Operated by Indian Tribal
Organizations.--
(1) In general.--Section 479B of such Act (42 U.S.C. 679c)
is amended--
(A) in subsection (c)(1)--
(i) in subparagraph (C)(i)--
(I) in subclause (II), by striking ``and'' after the
semicolon;
(II) in subclause (III), by striking the period at the end
and inserting ``; and''; and
(III) by adding at the end the following:
``(IV) at the option of the tribe, organization, or
consortium, services and programs specified in section
471(e)(1) to children described in section 471(e)(2) and
their parents or kin caregivers, in accordance with section
471(e) and subparagraph (E).''; and
(ii) by adding at the end the following:
``(E) Prevention services and programs for children and
their parents and kin caregivers.--
``(i) In general.--In the case of a tribe, organization, or
consortium that elects to provide services and programs
specified in section 471(e)(1) to children described in
section 471(e)(2) and their parents or kin caregivers under
the plan, the Secretary shall specify the requirements
applicable to the provision of the services and programs. The
requirements shall, to the greatest extent practicable, be
consistent with the requirements applicable to States under
section 471(e) and shall permit the provision of the services
and programs in the form of services and programs that are
adapted to the culture and context of the tribal communities
served.
``(ii) Performance measures.--The Secretary shall establish
specific performance measures for each tribe, organization,
or consortium that elects to provide services and programs
specified in section 471(e)(1). The performance measures
shall, to the greatest extent practicable, be consistent with
the prevention services measures required for States under
section 471(e)(6) but shall allow for consideration of
factors unique to the provision of the services by tribes,
organizations, or consortia.''; and
(B) in subsection (d)(1), by striking ``and (5)'' and
inserting ``(5), and (6)(A)''.
(2) Conforming amendment.--The heading for subsection (d)
of section 479B of such Act (42 U.S.C. 679c) is amended by
striking ``for Foster Care Maintenance and Adoption
Assistance Payments''.
(f) Application to Programs Operated by Territories.--
Section 1108(a)(2) of the Social Security Act (42 U.S.C.
1308(a)(2)) is amended by striking ``or 413(f)'' and
inserting ``413(f), or 474(a)(6)''.
SEC. 2622. FOSTER CARE MAINTENANCE PAYMENTS FOR CHILDREN WITH
PARENTS IN A LICENSED RESIDENTIAL FAMILY-BASED
TREATMENT FACILITY FOR SUBSTANCE ABUSE.
(a) In General.--Section 472 of the Social Security Act (42
U.S.C. 672) is amended--
(1) in subsection (a)(2)(C), by striking ``or'' and
inserting ``, with a parent residing in a licensed
residential family-based treatment facility, but only to the
extent permitted under subsection (j), or in a''; and
(2) by adding at the end the following:
``(j) Children Placed With a Parent Residing in a Licensed
Residential Family-based Treatment Facility for Substance
Abuse.--
``(1) In general.--Notwithstanding the preceding provisions
of this section, a child who is eligible for foster care
maintenance payments under this section, or who would be
eligible for the payments if the eligibility were determined
without regard to paragraphs (1)(B) and (3) of subsection
(a), shall be eligible for the payments for a period of not
more than 12 months during which the child is placed with a
parent who is in a licensed residential family-based
treatment facility for substance abuse, but only if--
``(A) the recommendation for the placement is specified in
the child's case plan before the placement;
``(B) the treatment facility provides, as part of the
treatment for substance abuse, parenting skills training,
parent education, and individual and family counseling; and
``(C) the substance abuse treatment, parenting skills
training, parent education, and individual and family
counseling is provided under an organizational structure and
treatment framework that involves understanding, recognizing,
and responding to the effects of all types of trauma and in
accordance with recognized principles of a trauma-informed
approach and trauma-specific interventions to address the
consequences of trauma and facilitate healing.
``(2) Application.--With respect to children for whom
foster care maintenance payments are made under paragraph
(1), only the children who satisfy the requirements of
paragraphs (1)(B) and (3) of subsection (a) shall be
considered to be children with respect to whom foster care
maintenance payments are made under this section for purposes
of subsection (h) or section 473(b)(3)(B).''.
(b) Conforming Amendment.--Section 474(a)(1) of such Act
(42 U.S.C. 674(a)(1)) is amended by inserting ``subject to
section 472(j),'' before ``an amount equal to the Federal''
the first place it appears.
SEC. 2623. TITLE IV-E PAYMENTS FOR EVIDENCE-BASED KINSHIP
NAVIGATOR PROGRAMS.
Section 474(a) of the Social Security Act (42 U.S.C.
674(a)), as amended by section 2621(c) of this Act, is
amended--
(1) in paragraph (6), by striking the period at the end and
inserting ``; plus''; and
(2) by adding at the end the following:
``(7) an amount equal to 50 percent of the amounts expended
by the State during the quarter as the Secretary determines
are for kinship navigator programs that meet the requirements
described in section 427(a)(1) and that the Secretary
determines are operated in accordance with promising,
supported, or well-supported practices that meet the
applicable criteria specified for the practices in section
471(e)(4)(C), without regard
[[Page H876]]
to whether the expenditures are incurred on behalf of
children who are, or are potentially, eligible for foster
care maintenance payments under this part.''.
Subchapter B--Enhanced Support Under Title IV-B
SEC. 2631. ELIMINATION OF TIME LIMIT FOR FAMILY REUNIFICATION
SERVICES WHILE IN FOSTER CARE AND PERMITTING
TIME-LIMITED FAMILY REUNIFICATION SERVICES WHEN
A CHILD RETURNS HOME FROM FOSTER CARE.
(a) In General.--Section 431(a)(7) of the Social Security
Act (42 U.S.C. 629a(a)(7)) is amended--
(1) in the paragraph heading, by striking ``Time-limited
family'' and inserting ``Family''; and
(2) in subparagraph (A)--
(A) by striking ``time-limited family'' and inserting
``family'';
(B) by inserting ``or a child who has been returned home''
after ``child care institution''; and
(C) by striking ``, but only during the 15-month period
that begins on the date that the child, pursuant to section
475(5)(F), is considered to have entered foster care'' and
inserting ``and to ensure the strength and stability of the
reunification. In the case of a child who has been returned
home, the services and activities shall only be provided
during the 15-month period that begins on the date that the
child returns home''.
(b) Conforming Amendments.--
(1) Section 430 of such Act (42 U.S.C. 629) is amended in
the matter preceding paragraph (1), by striking ``time-
limited''.
(2) Subsections (a)(4), (a)(5)(A), and (b)(1) of section
432 of such Act (42 U.S.C. 629b) are amended by striking
``time-limited'' each place it appears.
SEC. 2632. REDUCING BUREAUCRACY AND UNNECESSARY DELAYS WHEN
PLACING CHILDREN IN HOMES ACROSS STATE LINES.
(a) State Plan Requirement.--
(1) In general.--Section 471(a)(25) of the Social Security
Act (42 U.S.C. 671(a)(25)) is amended--
(A) by striking ``provide'' and inserting ``provides''; and
(B) by inserting ``, which, in the case of a State other
than the Commonwealth of Puerto Rico, the United States
Virgin Islands, Guam, and American Samoa, not later than
October 1, 2027, shall include the use of an electronic
interstate case-processing system'' before the first
semicolon.
(2) Exemption of indian tribes.--Section 479B(c) of such
Act (42 U.S.C. 679c(c)) is amended by adding at the end the
following:
``(4) Inapplicability of state plan requirement to have in
effect procedures providing for the use of an electronic
interstate case-processing system.--The requirement in
section 471(a)(25) that a State plan provide that the State
shall have in effect procedures providing for the use of an
electronic interstate case-processing system shall not apply
to an Indian tribe, tribal organization, or tribal consortium
that elects to operate a program under this part.''.
(b) Funding for the Development of an Electronic Interstate
Case-processing System to Expedite the Interstate Placement
of Children in Foster Care or Guardianship, or for
Adoption.--Section 437 of such Act (42 U.S.C. 629g) is
amended by adding at the end the following:
``(g) Funding for the Development of an Electronic
Interstate Case-processing System to Expedite the Interstate
Placement of Children in Foster Care or Guardianship, or for
Adoption.--
``(1) Purpose.--The purpose of this subsection is to
facilitate the development of an electronic interstate case-
processing system for the exchange of data and documents to
expedite the placements of children in foster, guardianship,
or adoptive homes across State lines.
``(2) Requirements.--A State that seeks funding under this
subsection shall submit to the Secretary the following
information:
``(A) A description of the goals and outcomes to be
achieved, which goals and outcomes must result in--
``(i) reducing the time it takes for a child to be provided
with a safe and appropriate permanent living arrangement
across State lines;
``(ii) improving administrative processes and reducing
costs in the foster care system; and
``(iii) the secure exchange of relevant case files and
other necessary materials in real time, and timely
communications and placement decisions regarding interstate
placements of children.
``(B) A description of the activities to be funded in whole
or in part with the funds, including the sequencing of the
activities.
``(C) A description of the strategies for integrating
programs and services for children who are placed across
State lines.
``(D) Such other information as the Secretary may require.
``(3) Funding authority.--The Secretary may provide funds
to a State that complies with paragraph (2). In providing
funds under this subsection, the Secretary shall prioritize
States that are not yet connected with the electronic
interstate case-processing system referred to in paragraph
(1).
``(4) Use of funds.--A State to which funding is provided
under this subsection shall use the funding to support the
State in connecting with, or enhancing or expediting services
provided under, the electronic interstate case-processing
system referred to in paragraph (1).
``(5) Evaluations.--Not later than 1 year after the final
year in which funds are awarded under this subsection, the
Secretary shall submit to the Congress, and make available to
the general public by posting on a website, a report that
contains the following information:
``(A) How using the electronic interstate case-processing
system developed pursuant to paragraph (4) has changed the
time it takes for children to be placed across State lines.
``(B) The number of cases subject to the Interstate Compact
on the Placement of Children that were processed through the
electronic interstate case-processing system, and the number
of interstate child placement cases that were processed
outside the electronic interstate case-processing system, by
each State in each year.
``(C) The progress made by States in implementing the
electronic interstate case-processing system.
``(D) How using the electronic interstate case-processing
system has affected various metrics related to child safety
and well-being, including the time it takes for children to
be placed across State lines.
``(E) How using the electronic interstate case-processing
system has affected administrative costs and caseworker time
spent on placing children across State lines.
``(6) Data integration.--The Secretary, in consultation
with the Secretariat for the Interstate Compact on the
Placement of Children and the States, shall assess how the
electronic interstate case-processing system developed
pursuant to paragraph (4) could be used to better serve and
protect children that come to the attention of the child
welfare system, by--
``(A) connecting the system with other data systems (such
as systems operated by State law enforcement and judicial
agencies, systems operated by the Federal Bureau of
Investigation for the purposes of the Innocence Lost National
Initiative, and other systems);
``(B) simplifying and improving reporting related to
paragraphs (34) and (35) of section 471(a) regarding children
or youth who have been identified as being a sex trafficking
victim or children missing from foster care; and
``(C) improving the ability of States to quickly comply
with background check requirements of section 471(a)(20),
including checks of child abuse and neglect registries as
required by section 471(a)(20)(B).''.
(c) Reservation of Funds to Improve the Interstate
Placement of Children.--Section 437(b) of such Act (42 U.S.C.
629g(b)) is amended by adding at the end the following:
``(4) Improving the interstate placement of children.--The
Secretary shall reserve $5,000,000 of the amount made
available for fiscal year 2018 for grants under subsection
(g), and the amount so reserved shall remain available
through fiscal year 2022.''.
SEC. 2633. ENHANCEMENTS TO GRANTS TO IMPROVE WELL-BEING OF
FAMILIES AFFECTED BY SUBSTANCE ABUSE.
Section 437(f) of the Social Security Act (42 U.S.C.
629g(f)) is amended--
(1) in the subsection heading, by striking ``Increase the
Well-being of, and to Improve the Permanency Outcomes for,
Children Affected by'' and inserting ``Implement IV-E
Prevention Services, and Improve the Well-being of, and
Improve Permanency Outcomes for, Children and Families
Affected by Heroin, Opioids, and Other'';
(2) by striking paragraph (2) and inserting the following:
``(2) Regional partnership defined.--In this subsection,
the term `regional partnership' means a collaborative
agreement (which may be established on an interstate, State,
or intrastate basis) entered into by the following:
``(A) Mandatory partners for all partnership grants.--
``(i) The State child welfare agency that is responsible
for the administration of the State plan under this part and
part E.
``(ii) The State agency responsible for administering the
substance abuse prevention and treatment block grant provided
under subpart II of part B of title XIX of the Public Health
Service Act.
``(B) Mandatory partners for partnership grants proposing
to serve children in out-of-home placements.--If the
partnership proposes to serve children in out-of-home
placements, the Juvenile Court or Administrative Office of
the Court that is most appropriate to oversee the
administration of court programs in the region to address the
population of families who come to the attention of the court
due to child abuse or neglect.
``(C) Optional partners.--At the option of the partnership,
any of the following:
``(i) An Indian tribe or tribal consortium.
``(ii) Nonprofit child welfare service providers.
``(iii) For-profit child welfare service providers.
``(iv) Community health service providers, including
substance abuse treatment providers.
``(v) Community mental health providers.
``(vi) Local law enforcement agencies.
``(vii) School personnel.
``(viii) Tribal child welfare agencies (or a consortia of
the agencies).
``(ix) Any other providers, agencies, personnel, officials,
or entities that are related to the provision of child and
family services under a State plan approved under this
subpart.
[[Page H877]]
``(D) Exception for regional partnerships where the lead
applicant is an indian tribe or tribal consortia.--If an
Indian tribe or tribal consortium enters into a regional
partnership for purposes of this subsection, the Indian tribe
or tribal consortium--
``(i) may (but is not required to) include the State child
welfare agency as a partner in the collaborative agreement;
``(ii) may not enter into a collaborative agreement only
with tribal child welfare agencies (or a consortium of the
agencies); and
``(iii) if the condition described in paragraph (2)(B)
applies, may include tribal court organizations in lieu of
other judicial partners.'';
(3) in paragraph (3)--
(A) in subparagraph (A)--
(i) by striking ``2012 through 2016'' and inserting ``2017
through 2021''; and
(ii) by striking ``$500,000 and not more than $1,000,000''
and inserting ``$250,000 and not more than $1,000,000'';
(B) in subparagraph (B)--
(i) in the subparagraph heading, by inserting ``;
planning'' after ``approval'';
(ii) in clause (i), by striking ``clause (ii)'' and
inserting ``clauses (ii) and (iii)''; and
(iii) by adding at the end the following:
``(iii) Sufficient planning.--A grant awarded under this
subsection shall be disbursed in two phases: a planning phase
(not to exceed 2 years) and an implementation phase. The
total disbursement to a grantee for the planning phase may
not exceed $250,000, and may not exceed the total anticipated
funding for the implementation phase.''; and
(C) by adding at the end the following:
``(D) Limitation on payment for a fiscal year.--No payment
shall be made under subparagraph (A) or (C) for a fiscal year
until the Secretary determines that the eligible partnership
has made sufficient progress in meeting the goals of the
grant and that the members of the eligible partnership are
coordinating to a reasonable degree with the other members of
the eligible partnership.'';
(4) in paragraph (4)--
(A) in subparagraph (B)--
(i) in clause (i), by inserting ``, parents, and families''
after ``children'';
(ii) in clause (ii), by striking ``safety and permanence
for such children; and'' and inserting ``safe, permanent
caregiving relationships for the children;'';
(iii) in clause (iii), by striking ``or'' and inserting
``increase reunification rates for children who have been
placed in out-of-home care, or decrease''; and
(iv) by redesignating clause (iii) as clause (v) and
inserting after clause (ii) the following:
``(iii) improve the substance abuse treatment outcomes for
parents including retention in treatment and successful
completion of treatment;
``(iv) facilitate the implementation, delivery, and
effectiveness of prevention services and programs under
section 471(e); and'';
(B) in subparagraph (D), by striking ``where
appropriate,''; and
(C) by striking subparagraphs (E) and (F) and inserting the
following:
``(E) A description of a plan for sustaining the services
provided by or activities funded under the grant after the
conclusion of the grant period, including through the use of
prevention services and programs under section 471(e) and
other funds provided to the State for child welfare and
substance abuse prevention and treatment services.
``(F) Additional information needed by the Secretary to
determine that the proposed activities and implementation
will be consistent with research or evaluations showing which
practices and approaches are most effective.'';
(5) in paragraph (5)(A), by striking ``abuse treatment''
and inserting ``use disorder treatment including medication
assisted treatment and in-home substance abuse disorder
treatment and recovery'';
(6) in paragraph (7)--
(A) by striking ``and'' at the end of subparagraph (C); and
(B) by redesignating subparagraph (D) as subparagraph (E)
and inserting after subparagraph (C) the following:
``(D) demonstrate a track record of successful
collaboration among child welfare, substance abuse disorder
treatment and mental health agencies; and'';
(7) in paragraph (8)--
(A) in subparagraph (A)--
(i) by striking ``establish indicators that will be'' and
inserting ``review indicators that are''; and
(ii) by striking ``in using funds made available under such
grants to achieve the purpose of this subsection'' and
inserting ``and establish a set of core indicators related to
child safety, parental recovery, parenting capacity, and
family well-being. In developing the core indicators, to the
extent possible, indicators shall be made consistent with the
outcome measures described in section 471(e)(6)''; and
(B) in subparagraph (B)--
(i) in the matter preceding clause (i), by inserting ``base
the performance measures on lessons learned from prior rounds
of regional partnership grants under this subsection, and''
before ``consult''; and
(ii) by striking clauses (iii) and (iv) and inserting the
following:
``(iii) Other stakeholders or constituencies as determined
by the Secretary.'';
(8) in paragraph (9)(A), by striking clause (i) and
inserting the following:
``(i) Semiannual reports.--Not later than September 30 of
each fiscal year in which a recipient of a grant under this
subsection is paid funds under the grant, and every 6 months
thereafter, the grant recipient shall submit to the Secretary
a report on the services provided and activities carried out
during the reporting period, progress made in achieving the
goals of the program, the number of children, adults, and
families receiving services, and such additional information
as the Secretary determines is necessary. The report due not
later than September 30 of the last such fiscal year shall
include, at a minimum, data on each of the performance
indicators included in the evaluation of the regional
partnership.''; and
(9) in paragraph (10), by striking ``2012 through 2016''
and inserting ``2017 through 2021''.
Subchapter C--Miscellaneous
SEC. 2641. REVIEWING AND IMPROVING LICENSING STANDARDS FOR
PLACEMENT IN A RELATIVE FOSTER FAMILY HOME.
(a) Identification of Reputable Model Licensing
Standards.--Not later than October 1, 2018, the Secretary of
Health and Human Services shall identify reputable model
licensing standards with respect to the licensing of foster
family homes (as defined in section 472(c)(1) of the Social
Security Act).
(b) State Plan Requirement.--Section 471(a) of the Social
Security Act (42 U.S.C. 671(a)) is amended--
(1) in paragraph (34)(B), by striking ``and'' after the
semicolon;
(2) in paragraph (35)(B), by striking the period at the end
and inserting a semicolon; and
(3) by adding at the end the following:
``(36) provides that, not later than April 1, 2019, the
State shall submit to the Secretary information addressing--
``(A) whether the State licensing standards are in accord
with model standards identified by the Secretary, and if not,
the reason for the specific deviation and a description as to
why having a standard that is reasonably in accord with the
corresponding national model standards is not appropriate for
the State;
``(B) whether the State has elected to waive standards
established in 471(a)(10)(A) for relative foster family homes
(pursuant to waiver authority provided by 471(a)(10)(D)), a
description of which standards the State most commonly
waives, and if the State has not elected to waive the
standards, the reason for not waiving these standards;
``(C) if the State has elected to waive standards specified
in subparagraph (B), how caseworkers are trained to use the
waiver authority and whether the State has developed a
process or provided tools to assist caseworkers in waiving
nonsafety standards per the authority provided in
471(a)(10)(D) to quickly place children with relatives; and
``(D) a description of the steps the State is taking to
improve caseworker training or the process, if any; and''.
SEC. 2642. DEVELOPMENT OF A STATEWIDE PLAN TO PREVENT CHILD
ABUSE AND NEGLECT FATALITIES.
Section 422(b)(19) of the Social Security Act (42 U.S.C.
622(b)(19)) is amended to read as follows:
``(19) document steps taken to track and prevent child
maltreatment deaths by including--
``(A) a description of the steps the State is taking to
compile complete and accurate information on the deaths
required by Federal law to be reported by the State agency
referred to in paragraph (1), including gathering relevant
information on the deaths from the relevant organizations in
the State including entities such as State vital statistics
department, child death review teams, law enforcement
agencies, offices of medical examiners, or coroners; and
``(B) a description of the steps the State is taking to
develop and implement a comprehensive, statewide plan to
prevent the fatalities that involves and engages relevant
public and private agency partners, including those in public
health, law enforcement, and the courts.''.
SEC. 2643. MODERNIZING THE TITLE AND PURPOSE OF TITLE IV-E.
(a) Part Heading.--The heading for part E of title IV of
the Social Security Act (42 U.S.C. 670 et seq.) is amended to
read as follows:
``PART E--FEDERAL PAYMENTS FOR FOSTER CARE, PREVENTION, AND
PERMANENCY''.
(b) Purpose.--The first sentence of section 470 of such Act
(42 U.S.C. 670) is amended--
(1) by striking ``1995) and'' and inserting ``1995),'';
(2) by inserting ``kinship guardianship assistance, and
prevention services or programs specified in section
471(e)(1),'' after ``needs,''; and
(3) by striking ``(commencing with the fiscal year which
begins October 1, 1980)''.
SEC. 2644. EFFECTIVE DATES.
(a) Effective Dates.--
(1) In general.--Except as provided in paragraph (2),
subject to subsection (b), the amendments made by this
chapter shall take effect on October 1, 2018.
(2) Exceptions.--The amendments made by sections 2621(d),
2641, and 2643 shall take effect on the date of enactment of
this Act.
(b) Transition Rule.--
[[Page H878]]
(1) In general.--In the case of a State plan under part B
or E of title IV of the Social Security Act which the
Secretary of Health and Human Services determines requires
State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional
requirements imposed by the amendments made by this chapter,
the State plan shall not be regarded as failing to comply
with the requirements of such part solely on the basis of the
failure of the plan to meet such 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 deemed to be a separate regular session of
the State legislature.
(2) Application to programs operated by indian tribal
organizations.--In the case of an Indian tribe, tribal
organization, or tribal consortium which the Secretary of
Health and Human Services determines requires time to take
action necessary to comply with the additional requirements
imposed by the amendments made by this chapter (whether the
tribe, organization, or tribal consortium has a plan under
section 479B of the Social Security Act or a cooperative
agreement or contract entered into with a State), the
Secretary shall provide the tribe, organization, or tribal
consortium with such additional time as the Secretary
determines is necessary for the tribe, organization, or
tribal consortium to take the action to comply with the
additional requirements before being regarded as failing to
comply with the requirements.
CHAPTER 2--ENSURING THE NECESSITY OF A PLACEMENT THAT IS NOT IN A
FOSTER FAMILY HOME
SEC. 2651. LIMITATION ON FEDERAL FINANCIAL PARTICIPATION FOR
PLACEMENTS THAT ARE NOT IN FOSTER FAMILY HOMES.
(a) Limitation on Federal Financial Participation.--
(1) In general.--Section 472 of the Social Security Act (42
U.S.C. 672), as amended by section 2622 of this Act, is
amended--
(A) in subsection (a)(2)(C), by inserting ``, but only to
the extent permitted under subsection (k)'' after
``institution''; and
(B) by adding at the end the following:
``(k) Limitation on Federal Financial Participation.--
``(1) In general.--Beginning with the third week for which
foster care maintenance payments are made under this section
on behalf of a child placed in a child-care institution, no
Federal payment shall be made to the State under section
474(a)(1) for amounts expended for foster care maintenance
payments on behalf of the child unless--
``(A) the child is placed in a child-care institution that
is a setting specified in paragraph (2) (or is placed in a
licensed residential family-based treatment facility
consistent with subsection (j)); and
``(B) in the case of a child placed in a qualified
residential treatment program (as defined in paragraph (4)),
the requirements specified in paragraph (3) and section
475A(c) are met.
``(2) Specified settings for placement.--The settings for
placement specified in this paragraph are the following:
``(A) A qualified residential treatment program (as defined
in paragraph (4)).
``(B) A setting specializing in providing prenatal, post-
partum, or parenting supports for youth.
``(C) In the case of a child who has attained 18 years of
age, a supervised setting in which the child is living
independently.
``(D) A setting providing high-quality residential care and
supportive services to children and youth who have been found
to be, or are at risk of becoming, sex trafficking victims,
in accordance with section 471(a)(9)(C).
``(3) Assessment to determine appropriateness of placement
in a qualified residential treatment program.--
``(A) Deadline for assessment.--In the case of a child who
is placed in a qualified residential treatment program, if
the assessment required under section 475A(c)(1) is not
completed within 30 days after the placement is made, no
Federal payment shall be made to the State under section
474(a)(1) for any amounts expended for foster care
maintenance payments on behalf of the child during the
placement.
``(B) Deadline for transition out of placement.--If the
assessment required under section 475A(c)(1) determines that
the placement of a child in a qualified residential treatment
program is not appropriate, a court disapproves such a
placement under section 475A(c)(2), or a child who has been
in an approved placement in a qualified residential treatment
program is going to return home or be placed with a fit and
willing relative, a legal guardian, or an adoptive parent, or
in a foster family home, Federal payments shall be made to
the State under section 474(a)(1) for amounts expended for
foster care maintenance payments on behalf of the child while
the child remains in the qualified residential treatment
program only during the period necessary for the child to
transition home or to such a placement. In no event shall a
State receive Federal payments under section 474(a)(1) for
amounts expended for foster care maintenance payments on
behalf of a child who remains placed in a qualified
residential treatment program after the end of the 30-day
period that begins on the date a determination is made that
the placement is no longer the recommended or approved
placement for the child.
``(4) Qualified residential treatment program.--For
purposes of this part, the term `qualified residential
treatment program' means a program that--
``(A) has a trauma-informed treatment model that is
designed to address the needs, including clinical needs as
appropriate, of children with serious emotional or behavioral
disorders or disturbances and, with respect to a child, is
able to implement the treatment identified for the child by
the assessment of the child required under section 475A(c);
``(B) subject to paragraphs (5) and (6), has registered or
licensed nursing staff and other licensed clinical staff
who--
``(i) provide care within the scope of their practice as
defined by State law;
``(ii) are on-site in accordance with the treatment model
referred to in subparagraph (A); and
``(iii) are available 24 hours a day and 7 days a week;
``(C) to extent appropriate, and in accordance with the
child's best interests, facilitates participation of family
members in the child's treatment program;
``(D) facilitates outreach to the family members of the
child, including siblings, documents how the outreach is made
(including contact information), and maintains contact
information for any known biological family and fictive kin
of the child;
``(E) documents how family members are integrated into the
treatment process for the child, including post-discharge,
and how sibling connections are maintained;
``(F) provides discharge planning and family-based
aftercare support for at least 6 months post-discharge; and
``(G) is licensed in accordance with section 471(a)(10) and
is accredited by any of the following independent, not-for-
profit organizations:
``(i) The Commission on Accreditation of Rehabilitation
Facilities (CARF).
``(ii) The Joint Commission on Accreditation of Healthcare
Organizations (JCAHO).
``(iii) The Council on Accreditation (COA).
``(iv) Any other independent, not-for-profit accrediting
organization approved by the Secretary.
``(5) Administrative costs.--The prohibition in paragraph
(1) on Federal payments under section 474(a)(1) shall not be
construed as prohibiting Federal payments for administrative
expenditures incurred on behalf of a child placed in a child-
care institution and for which payment is available under
section 474(a)(3).
``(6) Rule of construction.--The requirements in paragraph
(4)(B) shall not be construed as requiring a qualified
residential treatment program to acquire nursing and
behavioral health staff solely through means of a direct
employer to employee relationship.''.
(2) Conforming amendment.--Section 474(a)(1) of such Act
(42 U.S.C. 674(a)(1)), as amended by section 2622(b) of this
Act, is amended by striking ``section 472(j)'' and inserting
``subsections (j) and (k) of section 472''.
(b) Definition of Foster Family Home, Child-care
Institution.--Section 472(c) of such Act (42 U.S.C.
672(c)(1)) is amended to read as follows:
``(c) Definitions.--For purposes of this part:
``(1) Foster family home.--
``(A) In general.--The term `foster family home' means the
home of an individual or family--
``(i) that is licensed or approved by the State in which it
is situated as a foster family home that meets the standards
established for the licensing or approval; and
``(ii) in which a child in foster care has been placed in
the care of an individual, who resides with the child and who
has been licensed or approved by the State to be a foster
parent--
``(I) that the State deems capable of adhering to the
reasonable and prudent parent standard;
``(II) that provides 24-hour substitute care for children
placed away from their parents or other caretakers; and
``(III) that provides the care for not more than six
children in foster care.
``(B) State flexibility.--The number of foster children
that may be cared for in a home under subparagraph (A) may
exceed the numerical limitation in subparagraph (A)(ii)(III),
at the option of the State, for any of the following reasons:
``(i) To allow a parenting youth in foster care to remain
with the child of the parenting youth.
``(ii) To allow siblings to remain together.
``(iii) To allow a child with an established meaningful
relationship with the family to remain with the family.
``(iv) To allow a family with special training or skills to
provide care to a child who has a severe disability.
``(C) Rule of construction.--Subparagraph (A) shall not be
construed as prohibiting a foster parent from renting the
home in which the parent cares for a foster child placed in
the parent's care.
``(2) Child-care institution.--
``(A) In general.--The term `child-care institution' means
a private child-care institution, or a public child-care
institution which accommodates no more than 25 children,
which is licensed by the State in which it is situated or has
been approved by the agency
[[Page H879]]
of the State responsible for licensing or approval of
institutions of this type as meeting the standards
established for the licensing.
``(B) Supervised settings.--In the case of a child who has
attained 18 years of age, the term shall include a supervised
setting in which the individual is living independently, in
accordance with such conditions as the Secretary shall
establish in regulations.
``(C) Exclusions.--The term shall not include detention
facilities, forestry camps, training schools, or any other
facility operated primarily for the detention of children who
are determined to be delinquent.''.
(c) Training for State Judges, Attorneys, and Other Legal
Personnel in Child Welfare Cases.--Section 438(b)(1) of such
Act (42 U.S.C. 629h(b)(1)) is amended in the matter preceding
subparagraph (A) by inserting ``shall provide for the
training of judges, attorneys, and other legal personnel in
child welfare cases on Federal child welfare policies and
payment limitations with respect to children in foster care
who are placed in settings that are not a foster family
home,'' after ``with respect to the child,''.
(d) Assurance of Nonimpact on Juvenile Justice System.--
(1) State plan requirement.--Section 471(a) of such Act (42
U.S.C. 671(a)), as amended by section 2641 of this Act, is
further amended by adding at the end the following:
``(37) includes a certification that, in response to the
limitation imposed under section 472(k) with respect to
foster care maintenance payments made on behalf of any child
who is placed in a setting that is not a foster family home,
the State will not enact or advance policies or practices
that would result in a significant increase in the population
of youth in the State's juvenile justice system.''.
(2) GAO study and report.--The Comptroller General of the
United States shall evaluate the impact, if any, on State
juvenile justice systems of the limitation imposed under
section 472(k) of the Social Security Act (as added by
subsection (a)(1) of this section) on foster care maintenance
payments made on behalf of any child who is placed in a
setting that is not a foster family home, in accordance with
the amendments made by subsections (a) and (b) of this
section. In particular, the Comptroller General shall
evaluate the extent to which children in foster care who also
are subject to the juvenile justice system of the State are
placed in a facility under the jurisdiction of the juvenile
justice system and whether the lack of available congregate
care placements under the jurisdiction of the child welfare
systems is a contributing factor to that result. Not later
than December 31, 2024, the Comptroller General shall submit
to Congress a report on the results of the evaluation.
SEC. 2652. ASSESSMENT AND DOCUMENTATION OF THE NEED FOR
PLACEMENT IN A QUALIFIED RESIDENTIAL TREATMENT
PROGRAM.
Section 475A of the Social Security Act (42 U.S.C. 675a) is
amended by adding at the end the following:
``(c) Assessment, Documentation, and Judicial Determination
Requirements for Placement in a Qualified Residential
Treatment Program.--In the case of any child who is placed in
a qualified residential treatment program (as defined in
section 472(k)(4)), the following requirements shall apply
for purposes of approving the case plan for the child and the
case system review procedure for the child:
``(1)(A) Within 30 days of the start of each placement in
such a setting, a qualified individual (as defined in
subparagraph (D)) shall--
``(i) assess the strengths and needs of the child using an
age-appropriate, evidence-based, validated, functional
assessment tool approved by the Secretary;
``(ii) determine whether the needs of the child can be met
with family members or through placement in a foster family
home or, if not, which setting from among the settings
specified in section 472(k)(2) would provide the most
effective and appropriate level of care for the child in the
least restrictive environment and be consistent with the
short- and long-term goals for the child, as specified in the
permanency plan for the child; and
``(iii) develop a list of child-specific short- and long-
term mental and behavioral health goals.
``(B)(i) The State shall assemble a family and permanency
team for the child in accordance with the requirements of
clauses (ii) and (iii). The qualified individual conducting
the assessment required under subparagraph (A) shall work in
conjunction with the family of, and permanency team for, the
child while conducting and making the assessment.
``(ii) The family and permanency team shall consist of all
appropriate biological family members, relative, and fictive
kin of the child, as well as, as appropriate, professionals
who are a resource to the family of the child, such as
teachers, medical or mental health providers who have treated
the child, or clergy. In the case of a child who has attained
age 14, the family and permanency team shall include the
members of the permanency planning team for the child that
are selected by the child in accordance with section
475(5)(C)(iv).
``(iii) The State shall document in the child's case plan--
``(I) the reasonable and good faith effort of the State to
identify and include all such individuals on the family of,
and permanency team for, the child;
``(II) all contact information for members of the family
and permanency team, as well as contact information for other
family members and fictive kin who are not part of the family
and permanency team;
``(III) evidence that meetings of the family and permanency
team, including meetings relating to the assessment required
under subparagraph (A), are held at a time and place
convenient for family;
``(IV) if reunification is the goal, evidence demonstrating
that the parent from whom the child was removed provided
input on the members of the family and permanency team;
``(V) evidence that the assessment required under
subparagraph (A) is determined in conjunction with the family
and permanency team;
``(VI) the placement preferences of the family and
permanency team relative to the assessment that recognizes
children should be placed with their siblings unless there is
a finding by the court that such placement is contrary to
their best interest; and
``(VII) if the placement preferences of the family and
permanency team and child are not the placement setting
recommended by the qualified individual conducting the
assessment under subparagraph (A), the reasons why the
preferences of the team and of the child were not
recommended.
``(C) In the case of a child who the qualified individual
conducting the assessment under subparagraph (A) determines
should not be placed in a foster family home, the qualified
individual shall specify in writing the reasons why the needs
of the child cannot be met by the family of the child or in a
foster family home. A shortage or lack of foster family homes
shall not be an acceptable reason for determining that the
needs of the child cannot be met in a foster family home. The
qualified individual also shall specify in writing why the
recommended placement in a qualified residential treatment
program is the setting that will provide the child with the
most effective and appropriate level of care in the least
restrictive environment and how that placement is consistent
with the short- and long-term goals for the child, as
specified in the permanency plan for the child.
``(D)(i) Subject to clause (ii), in this subsection, the
term `qualified individual' means a trained professional or
licensed clinician who is not an employee of the State agency
and who is not connected to, or affiliated with, any
placement setting in which children are placed by the State.
``(ii) The Secretary may approve a request of a State to
waive any requirement in clause (i) upon a submission by the
State, in accordance with criteria established by the
Secretary, that certifies that the trained professionals or
licensed clinicians with responsibility for performing the
assessments described in subparagraph (A) shall maintain
objectivity with respect to determining the most effective
and appropriate placement for a child.
``(2) Within 60 days of the start of each placement in a
qualified residential treatment program, a family or juvenile
court or another court (including a tribal court) of
competent jurisdiction, or an administrative body appointed
or approved by the court, independently, shall--
``(A) consider the assessment, determination, and
documentation made by the qualified individual conducting the
assessment under paragraph (1);
``(B) determine whether the needs of the child can be met
through placement in a foster family home or, if not, whether
placement of the child in a qualified residential treatment
program provides the most effective and appropriate level of
care for the child in the least restrictive environment and
whether that placement is consistent with the short- and
long-term goals for the child, as specified in the permanency
plan for the child; and
``(C) approve or disapprove the placement.
``(3) The written documentation made under paragraph (1)(C)
and documentation of the determination and approval or
disapproval of the placement in a qualified residential
treatment program by a court or administrative body under
paragraph (2) shall be included in and made part of the case
plan for the child.
``(4) As long as a child remains placed in a qualified
residential treatment program, the State agency shall submit
evidence at each status review and each permanency hearing
held with respect to the child--
``(A) demonstrating that ongoing assessment of the
strengths and needs of the child continues to support the
determination that the needs of the child cannot be met
through placement in a foster family home, that the placement
in a qualified residential treatment program provides the
most effective and appropriate level of care for the child in
the least restrictive environment, and that the placement is
consistent with the short- and long-term goals for the child,
as specified in the permanency plan for the child;
``(B) documenting the specific treatment or service needs
that will be met for the child in the placement and the
length of time the child is expected to need the treatment or
services; and
``(C) documenting the efforts made by the State agency to
prepare the child to return home or to be placed with a fit
and willing relative, a legal guardian, or an adoptive
parent, or in a foster family home.
[[Page H880]]
``(5) In the case of any child who is placed in a qualified
residential treatment program for more than 12 consecutive
months or 18 nonconsecutive months (or, in the case of a
child who has not attained age 13, for more than 6
consecutive or nonconsecutive months), the State agency shall
submit to the Secretary--
``(A) the most recent versions of the evidence and
documentation specified in paragraph (4); and
``(B) the signed approval of the head of the State agency
for the continued placement of the child in that setting.''.
SEC. 2653. PROTOCOLS TO PREVENT INAPPROPRIATE DIAGNOSES.
(a) State Plan Requirement.--Section 422(b)(15)(A) of the
Social Security Act (42 U.S.C. 622(b)(15)(A)) is amended--
(1) in clause (vi), by striking ``and'' after the
semicolon;
(2) by redesignating clause (vii) as clause (viii); and
(3) by inserting after clause (vi) the following:
``(vii) the procedures and protocols the State has
established to ensure that children in foster care placements
are not inappropriately diagnosed with mental illness, other
emotional or behavioral disorders, medically fragile
conditions, or developmental disabilities, and placed in
settings that are not foster family homes as a result of the
inappropriate diagnoses; and''.
(b) Evaluation.--Section 476 of such Act (42 U.S.C. 676),
as amended by section 2621(d) of this Act, is further amended
by adding at the end the following:
``(e) Evaluation of State Procedures and Protocols to
Prevent Inappropriate Diagnoses of Mental Illness or Other
Conditions.--The Secretary shall conduct an evaluation of the
procedures and protocols established by States in accordance
with the requirements of section 422(b)(15)(A)(vii). The
evaluation shall analyze the extent to which States comply
with and enforce the procedures and protocols and the
effectiveness of various State procedures and protocols and
shall identify best practices. Not later than January 1,
2020, the Secretary shall submit a report on the results of
the evaluation to Congress.''.
SEC. 2654. ADDITIONAL DATA AND REPORTS REGARDING CHILDREN
PLACED IN A SETTING THAT IS NOT A FOSTER FAMILY
HOME.
Section 479A(a)(7)(A) of the Social Security Act (42 U.S.C.
679b(a)(7)(A)) is amended by striking clauses (i) through
(vi) and inserting the following:
``(i) with respect to each such placement--
``(I) the type of the placement setting, including whether
the placement is shelter care, a group home and if so, the
range of the child population in the home, a residential
treatment facility, a hospital or institution providing
medical, rehabilitative, or psychiatric care, a setting
specializing in providing prenatal, post-partum, or parenting
supports, or some other kind of child-care institution and if
so, what kind;
``(II) the number of children in the placement setting and
the age, race, ethnicity, and gender of each of the children;
``(III) for each child in the placement setting, the length
of the placement of the child in the setting, whether the
placement of the child in the setting is the first placement
of the child and if not, the number and type of previous
placements of the child, and whether the child has special
needs or another diagnosed mental or physical illness or
condition; and
``(IV) the extent of any specialized education, treatment,
counseling, or other services provided in the setting; and
``(ii) separately, the number and ages of children in the
placements who have a permanency plan of another planned
permanent living arrangement; and''.
SEC. 2655. CRIMINAL RECORDS CHECKS AND CHECKS OF CHILD ABUSE
AND NEGLECT REGISTRIES FOR ADULTS WORKING IN
CHILD-CARE INSTITUTIONS AND OTHER GROUP CARE
SETTINGS.
(a) State Plan Requirement.--Section 471(a)(20) of the
Social Security Act (42 U.S.C. 671(a)(20)) is amended--
(1) in each of subparagraphs (A)(ii) and (B)(iii), by
striking ``and'' after the semicolon;
(2) in subparagraph (C), by adding ``and'' after the
semicolon; and
(3) by inserting after subparagraph (C) the following:
``(D) provides procedures for any child care institution,
including a group home, residential treatment center,
shelter, or other congregate care setting, to conduct
criminal records checks, including fingerprint-based checks
of national crime information databases (as defined in
section 534(f)(3)(A) of title 28, United States Code), and
checks described in subparagraph (B) of this paragraph, on
any adult working in a child-care institution, including a
group home, residential treatment center, shelter, or other
congregate care setting, unless the State reports to the
Secretary the alternative criminal records checks and child
abuse registry checks the State conducts on any adult working
in a child-care institution, including a group home,
residential treatment center, shelter, or other congregate
care setting, and why the checks specified in this
subparagraph are not appropriate for the State;''.
(b) Technical Amendments.--Subparagraphs (A) and (C) of
section 471(a)(20) of the Social Security Act (42 U.S.C.
671(a)(20)) are each amended by striking ``section
534(e)(3)(A)'' and inserting ``section 534(f)(3)(A)''.
SEC. 2656. EFFECTIVE DATES; APPLICATION TO WAIVERS.
(a) Effective Dates.--
(1) In general.--Subject to paragraph (2) and subsections
(b) through (d), the amendments made by this chapter shall
take effect on January 1, 2018.
(2) Transition rule.--In the case of a State plan under
part B or E of title IV of the Social Security Act which the
Secretary of Health and Human Services determines requires
State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional
requirements imposed by the amendments made by this chapter,
the State plan shall not be regarded as failing to comply
with the requirements of such part solely on the basis of the
failure of the plan to meet the 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 deemed to be a separate regular session of
the State legislature.
(b) Limitation on Federal Financial Participation for
Placements That Are Not in Foster Family Homes and Related
Provisions.--
(1) In general.--The amendments made by sections 2651(a),
2651(b), 2651(d), and 2652 shall take effect on October 1,
2019.
(2) State option to delay effective date for not more than
2 years.--If a State requests a delay in the effective date
provided for in paragraph (1), the Secretary of Health and
Human Services shall delay the effective date with respect to
the State for the amount of time requested by the State not
to exceed 2 years. If the effective date is so delayed for a
period with respect to a State under the preceding sentence,
then--
(A) notwithstanding section 2644, the date that the
amendments made by section 2621(c) take effect with respect
to the State shall be delayed for the period; and
(B) in applying section 474(a)(6) of the Social Security
Act with respect to the State, ``on or after the date this
paragraph takes effect with respect to the State'' is deemed
to be substituted for ``after September 30, 2019'' in
subparagraph (A)(i)(I) of such section.
(c) Criminal Records Checks and Checks of Child Abuse and
Neglect Registries for Adults Working in Child-care
Institutions and Other Group Care Settings.--The amendments
made by section 2655 shall take effect on October 1, 2018.
(d) Application to States With Waivers.--In the case of a
State that, on the date of enactment of this Act, has in
effect a waiver approved under section 1130 of the Social
Security Act (42 U.S.C. 1320a-9), the amendments made by this
chapter shall not apply with respect to the State before the
expiration (determined without regard to any extensions) of
the waiver to the extent the amendments are inconsistent with
the terms of the waiver.
CHAPTER 3--CONTINUING SUPPORT FOR CHILD AND FAMILY SERVICES
SEC. 2661. SUPPORTING AND RETAINING FOSTER FAMILIES FOR
CHILDREN.
(a) Supporting and Retaining Foster Parents as a Family
Support Service.--Section 431(a)(2)(B) of the Social Security
Act (42 U.S.C. 631(a)(2)(B)) is amended by redesignating
clauses (iii) through (vi) as clauses (iv) through (vii),
respectively, and inserting after clause (ii) the following:
``(iii) To support and retain foster families so they can
provide quality family-based settings for children in foster
care.''.
(b) Support for Foster Family Homes.--Section 436 of such
Act (42 U.S.C. 629f) is amended by adding at the end the
following:
``(c) Support for Foster Family Homes.--Out of any money in
the Treasury of the United States not otherwise appropriated,
there are appropriated to the Secretary for fiscal year 2018,
$8,000,000 for the Secretary to make competitive grants to
States, Indian tribes, or tribal consortia to support the
recruitment and retention of high-quality foster families to
increase their capacity to place more children in family
settings, focused on States, Indian tribes, or tribal
consortia with the highest percentage of children in non-
family settings. The amount appropriated under this
subparagraph shall remain available through fiscal year
2022.''.
SEC. 2662. EXTENSION OF CHILD AND FAMILY SERVICES PROGRAMS.
(a) Extension of Stephanie Tubbs Jones Child Welfare
Services Program.--Section 425 of the Social Security Act (42
U.S.C. 625) is amended by striking ``2012 through 2016'' and
inserting ``2017 through 2021''.
(b) Extension of Promoting Safe and Stable Families Program
Authorizations.--
(1) In general.--Section 436(a) of such Act (42 U.S.C.
629f(a)) is amended by striking all that follows
``$345,000,000'' and inserting ``for each of fiscal years
2017 through 2021.''.
(2) Discretionary grants.--Section 437(a) of such Act (42
U.S.C. 629g(a)) is amended by striking ``2012 through 2016''
and inserting ``2017 through 2021''.
(c) Extension of Funding Reservations for Monthly
Caseworker Visits and Regional Partnership Grants.--Section
436(b) of such Act (42 U.S.C. 629f(b)) is amended--
(1) in paragraph (4)(A), by striking ``2012 through 2016''
and inserting ``2017 through 2021''; and
(2) in paragraph (5), by striking ``2012 through 2016'' and
inserting ``2017 through 2021''.
[[Page H881]]
(d) Reauthorization of Funding for State Courts.--
(1) Extension of program.--Section 438(c)(1) of such Act
(42 U.S.C. 629h(c)(1)) is amended by striking ``2012 through
2016'' and inserting ``2017 through 2021''.
(2) Extension of federal share.--Section 438(d) of such Act
(42 U.S.C. 629h(d)) is amended by striking ``2012 through
2016'' and inserting ``2017 through 2021''.
(e) Repeal of Expired Provisions.--Section 438(e) of such
Act (42 U.S.C. 629h(e)) is repealed.
SEC. 2663. IMPROVEMENTS TO THE JOHN H. CHAFEE FOSTER CARE
INDEPENDENCE PROGRAM AND RELATED PROVISIONS.
(a) Authority to Serve Former Foster Youth up to Age 23.--
Section 477 of the Social Security Act (42 U.S.C. 677) is
amended--
(1) in subsection (a)(5), by inserting ``(or 23 years of
age, in the case of a State with a certification under
subsection (b)(3)(A)(ii) to provide assistance and services
to youths who have aged out of foster care and have not
attained such age, in accordance with such subsection)''
after ``21 years of age'';
(2) in subsection (b)(3)(A)--
(A) by inserting ``(i)'' before ``A certification'';
(B) by striking ``children who have left foster care'' and
all that follows through the period and inserting ``youths
who have aged out of foster care and have not attained 21
years of age.''; and
(C) by adding at the end the following:
``(ii) If the State has elected under section 475(8)(B) to
extend eligibility for foster care to all children who have
not attained 21 years of age, or if the Secretary determines
that the State agency responsible for administering the State
plans under this part and part B uses State funds or any
other funds not provided under this part to provide services
and assistance for youths who have aged out of foster care
that are comparable to the services and assistance the youths
would receive if the State had made such an election, the
certification required under clause (i) may provide that the
State will provide assistance and services to youths who have
aged out of foster care and have not attained 23 years of
age.''; and
(3) in subsection (b)(3)(B), by striking ``children who
have left foster care'' and all that follows through the
period and inserting ``youths who have aged out of foster
care and have not attained 21 years of age (or 23 years of
age, in the case of a State with a certification under
subparagraph (A)(i) to provide assistance and services to
youths who have aged out of foster care and have not attained
such age, in accordance with subparagraph (A)(ii)).''.
(b) Authority to Redistribute Unspent Funds.--Section
477(d) of such Act (42 U.S.C. 677(d)) is amended--
(1) in paragraph (4), by inserting ``or does not expend
allocated funds within the time period specified under
section 477(d)(3)'' after ``provided by the Secretary''; and
(2) by adding at the end the following:
``(5) Redistribution of unexpended amounts.--
``(A) Availability of amounts.--To the extent that amounts
paid to States under this section in a fiscal year remain
unexpended by the States at the end of the succeeding fiscal
year, the Secretary may make the amounts available for
redistribution in the second succeeding fiscal year among the
States that apply for additional funds under this section for
that second succeeding fiscal year.
``(B) Redistribution.--
``(i) In general.--The Secretary shall redistribute the
amounts made available under subparagraph (A) for a fiscal
year among eligible applicant States. In this subparagraph,
the term `eligible applicant State' means a State that has
applied for additional funds for the fiscal year under
subparagraph (A) if the Secretary determines that the State
will use the funds for the purpose for which originally
allotted under this section.
``(ii) Amount to be redistributed.--The amount to be
redistributed to each eligible applicant State shall be the
amount so made available multiplied by the State foster care
ratio, (as defined in subsection (c)(4), except that, in such
subsection, `all eligible applicant States (as defined in
subsection (d)(5)(B)(i))' shall be substituted for `all
States').
``(iii) Treatment of redistributed amount.--Any amount made
available to a State under this paragraph shall be regarded
as part of the allotment of the State under this section for
the fiscal year in which the redistribution is made.
``(C) Tribes.--For purposes of this paragraph, the term
`State' includes an Indian tribe, tribal organization, or
tribal consortium that receives an allotment under this
section.''.
(c) Expanding and Clarifying the Use of Education and
Training Vouchers.--
(1) In general.--Section 477(i)(3) of such Act (42 U.S.C.
677(i)(3)) is amended--
(A) by striking ``on the date'' and all that follows
through ``23'' and inserting ``to remain eligible until they
attain 26''; and
(B) by inserting ``, but in no event may a youth
participate in the program for more than 5 years (whether or
not consecutive)'' before the period.
(2) Conforming amendment.--Section 477(i)(1) of such Act
(42 U.S.C. 677(i)(1)) is amended by inserting ``who have
attained 14 years of age'' before the period.
(d) Other Improvements.--Section 477 of such Act (42 U.S.C.
677), as amended by subsections (a), (b), and (c) of this
section, is amended--
(1) in the section heading, by striking ``independence
program'' and inserting ``program for successful transition
to adulthood'';
(2) in subsection (a)--
(A) in paragraph (1)--
(i) by striking ``identify children who are likely to
remain in foster care until 18 years of age and to help these
children make the transition to self-sufficiency by providing
services'' and inserting ``support all youth who have
experienced foster care at age 14 or older in their
transition to adulthood through transitional services'';
(ii) by inserting ``and post-secondary education'' after
``high school diploma''; and
(iii) by striking ``training in daily living skills,
training in budgeting and financial management skills'' and
inserting ``training and opportunities to practice daily
living skills (such as financial literacy training and
driving instruction)'';
(B) in paragraph (2), by striking ``who are likely to
remain in foster care until 18 years of age receive the
education, training, and services necessary to obtain
employment'' and inserting ``who have experienced foster care
at age 14 or older achieve meaningful, permanent connections
with a caring adult'';
(C) in paragraph (3), by striking ``who are likely to
remain in foster care until 18 years of age prepare for and
enter postsecondary training and education institutions'' and
inserting ``who have experienced foster care at age 14 or
older engage in age or developmentally appropriate
activities, positive youth development, and experiential
learning that reflects what their peers in intact families
experience''; and
(D) by striking paragraph (4) and redesignating paragraphs
(5) through (8) as paragraphs (4) through (7);
(3) in subsection (b)--
(A) in paragraph (2)(D), by striking ``adolescents'' and
inserting ``youth''; and
(B) in paragraph (3)--
(i) in subparagraph (D)--
(I) by inserting ``including training on youth
development'' after ``to provide training''; and
(II) by striking ``adolescents preparing for independent
living'' and all that follows through the period and
inserting ``youth preparing for a successful transition to
adulthood and making a permanent connection with a caring
adult.'';
(ii) in subparagraph (H), by striking ``adolescents'' each
place it appears and inserting ``youth''; and
(iii) in subparagraph (K)--
(I) by striking ``an adolescent'' and inserting ``a
youth''; and
(II) by striking ``the adolescent'' each place it appears
and inserting ``the youth''; and
(4) in subsection (f), by striking paragraph (2) and
inserting the following:
``(2) Report to congress.--Not later than October 1, 2019,
the Secretary shall submit to the Committee on Ways and Means
of the House of Representatives and the Committee on Finance
of the Senate a report on the National Youth in Transition
Database and any other databases in which States report
outcome measures relating to children in foster care and
children who have aged out of foster care or left foster care
for kinship guardianship or adoption. The report shall
include the following:
``(A) A description of the reasons for entry into foster
care and of the foster care experiences, such as length of
stay, number of placement settings, case goal, and discharge
reason of 17-year-olds who are surveyed by the National Youth
in Transition Database and an analysis of the comparison of
that description with the reasons for entry and foster care
experiences of children of other ages who exit from foster
care before attaining age 17.
``(B) A description of the characteristics of the
individuals who report poor outcomes at ages 19 and 21 to the
National Youth in Transition Database.
``(C) Benchmarks for determining what constitutes a poor
outcome for youth who remain in or have exited from foster
care and plans the executive branch will take to incorporate
these benchmarks in efforts to evaluate child welfare agency
performance in providing services to children transitioning
from foster care.
``(D) An analysis of the association between types of
placement, number of overall placements, time spent in foster
care, and other factors, and outcomes at ages 19 and 21.
``(E) An analysis of the differences in outcomes for
children in and formerly in foster care at age 19 and 21
among States.''.
(e) Clarifying Documentation Provided to Foster Youth
Leaving Foster Care.--Section 475(5)(I) of such Act (42
U.S.C. 675(5)(I)) is amended by inserting after ``REAL ID Act
of 2005'' the following: ``, and any official documentation
necessary to prove that the child was previously in foster
care''.
CHAPTER 4--CONTINUING INCENTIVES TO STATES TO PROMOTE ADOPTION AND
LEGAL GUARDIANSHIP
SEC. 2665. REAUTHORIZING ADOPTION AND LEGAL GUARDIANSHIP
INCENTIVE PROGRAMS.
(a) In General.--Section 473A of the Social Security Act
(42 U.S.C. 673b) is amended--
(1) in subsection (b)(4), by striking ``2013 through 2015''
and inserting ``2016 through 2020'';
[[Page H882]]
(2) in subsection (h)(1)(D), by striking ``2016'' and
inserting ``2021''; and
(3) in subsection (h)(2), by striking ``2016'' and
inserting ``2021''.
(b) Effective Date.--The amendments made by subsection (a)
shall take effect as if enacted on October 1, 2017.
CHAPTER 5--TECHNICAL CORRECTIONS
SEC. 2667. TECHNICAL CORRECTIONS TO DATA EXCHANGE STANDARDS
TO IMPROVE PROGRAM COORDINATION.
(a) In General.--Section 440 of the Social Security Act (42
U.S.C. 629m) is amended to read as follows:
``SEC. 440. DATA EXCHANGE STANDARDS FOR IMPROVED
INTEROPERABILITY.
``(a) Designation.--The Secretary shall, in consultation
with an interagency work group established by the Office of
Management and Budget and considering State government
perspectives, by rule, designate data exchange standards to
govern, under this part and part E--
``(1) necessary categories of information that State
agencies operating programs under State plans approved under
this part are required under applicable Federal law to
electronically exchange with another State agency; and
``(2) Federal reporting and data exchange required under
applicable Federal law.
``(b) Requirements.--The data exchange standards required
by paragraph (1) shall, to the extent practicable--
``(1) incorporate a widely accepted, non-proprietary,
searchable, computer-readable format, such as the Extensible
Markup Language;
``(2) contain interoperable standards developed and
maintained by intergovernmental partnerships, such as the
National Information Exchange Model;
``(3) incorporate interoperable standards developed and
maintained by Federal entities with authority over
contracting and financial assistance;
``(4) be consistent with and implement applicable
accounting principles;
``(5) be implemented in a manner that is cost-effective and
improves program efficiency and effectiveness; and
``(6) be capable of being continually upgraded as
necessary.
``(c) Rule of Construction.--Nothing in this subsection
shall be construed to require a change to existing data
exchange standards found to be effective and efficient.''.
(b) Effective Date.--Not later than the date that is 24
months after the date of the enactment of this section, the
Secretary of Health and Human Services shall issue a proposed
rule that--
(1) identifies federally required data exchanges, include
specification and timing of exchanges to be standardized, and
address the factors used in determining whether and when to
standardize data exchanges; and
(2) specifies State implementation options and describes
future milestones.
SEC. 2668. TECHNICAL CORRECTIONS TO STATE REQUIREMENT TO
ADDRESS THE DEVELOPMENTAL NEEDS OF YOUNG
CHILDREN.
Section 422(b)(18) of the Social Security Act (42 U.S.C.
622(b)(18)) is amended by striking ``such children'' and
inserting ``all vulnerable children under 5 years of age''.
CHAPTER 6--ENSURING STATES REINVEST SAVINGS RESULTING FROM INCREASE IN
ADOPTION ASSISTANCE
SEC. 2669. DELAY OF ADOPTION ASSISTANCE PHASE-IN.
(a) In General.--The table in section 473(e)(1)(B) of the
Social Security Act (42 U.S.C. 673(e)(1)(B)) is amended by
striking the last 2 rows and inserting the following:
----------------------------------------------------------------------------------------------------------------
``2017 through 2023.......................... 2
2024......................................... 2 (or, in the case of a child for whom an adoption assistance
agreement is entered into under this section on or after July 1,
2024, any age)
2025 or thereafter........................... any age.''.
----------------------------------------------------------------------------------------------------------------
(b) Effective Date.--The amendment made by this section
shall take effect on January 1, 2018.
SEC. 2670. GAO STUDY AND REPORT ON STATE REINVESTMENT OF
SAVINGS RESULTING FROM INCREASE IN ADOPTION
ASSISTANCE.
(a) Study.--The Comptroller General of the United States
shall study the extent to which States are complying with the
requirements of section 473(a)(8) of the Social Security Act
relating to the effects of phasing out the AFDC income
eligibility requirements for adoption assistance payments
under section 473 of the Social Security Act, as enacted by
section 402 of the Fostering Connections to Success and
Increasing Adoptions Act of 2008 (Public Law 110-351; 122
Stat. 3975) and amended by section 206 of the Preventing Sex
Trafficking and Strengthening Families Act (Public Law 113-
183; 128 Stat. 1919). In particular, the Comptroller General
shall analyze the extent to which States are complying with
the following requirements under section 473(a)(8)(D) of the
Social Security Act:
(1) The requirement to spend an amount equal to the amount
of the savings (if any) in State expenditures under part E of
title IV of the Social Security Act resulting from phasing
out the AFDC income eligibility requirements for adoption
assistance payments under section 473 of such Act to provide
to children of families any service that may be provided
under part B or E of title IV of such Act.
(2) The requirement that a State shall spend not less than
30 percent of the amount of any savings described in
paragraph (1) on post-adoption services, post-guardianship
services, and services to support and sustain positive
permanent outcomes for children who otherwise might enter
into foster care under the responsibility of the State, with
at least \2/3\ of the spending by the State to comply with
the 30 percent requirement being spent on post-adoption and
post-guardianship services.
(b) Report.--The Comptroller General of the United States
shall submit to the Committee on Finance of the Senate, the
Committee on Ways and Means of the House of Representatives,
and the Secretary of Health and Human Services a report that
contains the results of the study required by subsection (a),
including recommendations to ensure compliance with laws
referred to in subsection (a).
Subtitle B--Supporting Social Impact Partnerships to Pay for Results
SEC. 2681. SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY FOR
RESULTS.
Title XX of the Social Security Act (42 U.S.C. 1397 et
seq.) is amended--
(1) in the title heading, by striking ``TO STATES'' and
inserting ``AND PROGRAMS''; and
(2) by adding at the end the following:
``Subtitle C--Social Impact Demonstration Projects
``purposes
``Sec. 2051. The purposes of this subtitle are the
following:
``(1) To improve the lives of families and individuals in
need in the United States by funding social programs that
achieve real results.
``(2) To redirect funds away from programs that, based on
objective data, are ineffective, and into programs that
achieve demonstrable, measurable results.
``(3) To ensure Federal funds are used effectively on
social services to produce positive outcomes for both service
recipients and taxpayers.
``(4) To establish the use of social impact partnerships to
address some of our Nation's most pressing problems.
``(5) To facilitate the creation of public-private
partnerships that bundle philanthropic or other private
resources with existing public spending to scale up effective
social interventions already being implemented by private
organizations, nonprofits, charitable organizations, and
State and local governments across the country.
``(6) To bring pay-for-performance to the social sector,
allowing the United States to improve the impact and
effectiveness of vital social services programs while
redirecting inefficient or duplicative spending.
``(7) To incorporate outcomes measurement and randomized
controlled trials or other rigorous methodologies for
assessing program impact.
``social impact partnership application
``Sec. 2052. (a) Notice.--Not later than 1 year after the
date of the enactment of this subtitle, the Secretary of the
Treasury, in consultation with the Federal Interagency
Council on Social Impact Partnerships, shall publish in the
Federal Register a request for proposals from States or local
governments for social impact partnership projects in
accordance with this section.
``(b) Required Outcomes for Social Impact Partnership
Project.--To qualify as a social impact partnership project
under this subtitle, a project must produce one or more
measurable, clearly defined outcomes that result in social
benefit and Federal, State, or local savings through any of
the following:
``(1) Increasing work and earnings by individuals in the
United States who are unemployed for more than 6 consecutive
months.
``(2) Increasing employment and earnings of individuals who
have attained 16 years of age but not 25 years of age.
``(3) Increasing employment among individuals receiving
Federal disability benefits.
``(4) Reducing the dependence of low-income families on
Federal means-tested benefits.
``(5) Improving rates of high school graduation.
``(6) Reducing teen and unplanned pregnancies.
``(7) Improving birth outcomes and early childhood health
and development among low-income families and individuals.
``(8) Reducing rates of asthma, diabetes, or other
preventable diseases among low-income families and
individuals to reduce the utilization of emergency and other
high-cost care.
``(9) Increasing the proportion of children living in two-
parent families.
``(10) Reducing incidences and adverse consequences of
child abuse and neglect.
``(11) Reducing the number of youth in foster care by
increasing adoptions, permanent guardianship arrangements,
reunifications,
[[Page H883]]
or placements with a fit and willing relative, or by avoiding
placing children in foster care by ensuring they can be cared
for safely in their own homes.
``(12) Reducing the number of children and youth in foster
care residing in group homes, child care institutions,
agency-operated foster homes, or other non-family foster
homes, unless it is determined that it is in the interest of
the child's long-term health, safety, or psychological well-
being to not be placed in a family foster home.
``(13) Reducing the number of children returning to foster
care.
``(14) Reducing recidivism among juvenile offenders,
individuals released from prison, or other high-risk
populations.
``(15) Reducing the rate of homelessness among our most
vulnerable populations.
``(16) Improving the health and well-being of those with
mental, emotional, and behavioral health needs.
``(17) Improving the educational outcomes of special-needs
or low-income children.
``(18) Improving the employment and well-being of returning
United States military members.
``(19) Increasing the financial stability of low-income
families.
``(20) Increasing the independence and employability of
individuals who are physically or mentally disabled.
``(21) Other measurable outcomes defined by the State or
local government that result in positive social outcomes and
Federal savings.
``(c) Application Required.--The notice described in
subsection (a) shall require a State or local government to
submit an application for the social impact partnership
project that addresses the following:
``(1) The outcome goals of the project.
``(2) A description of each intervention in the project and
anticipated outcomes of the intervention.
``(3) Rigorous evidence demonstrating that the intervention
can be expected to produce the desired outcomes.
``(4) The target population that will be served by the
project.
``(5) The expected social benefits to participants who
receive the intervention and others who may be impacted.
``(6) Projected Federal, State, and local government costs
and other costs to conduct the project.
``(7) Projected Federal, State, and local government
savings and other savings, including an estimate of the
savings to the Federal Government, on a program-by-program
basis and in the aggregate, if the project is implemented and
the outcomes are achieved as a result of the intervention.
``(8) If savings resulting from the successful completion
of the project are estimated to accrue to the State or local
government, the likelihood of the State or local government
to realize those savings.
``(9) A plan for delivering the intervention through a
social impact partnership model.
``(10) A description of the expertise of each service
provider that will administer the intervention, including a
summary of the experience of the service provider in
delivering the proposed intervention or a similar
intervention, or demonstrating that the service provider has
the expertise necessary to deliver the proposed intervention.
``(11) An explanation of the experience of the State or
local government, the intermediary, or the service provider
in raising private and philanthropic capital to fund social
service investments.
``(12) The detailed roles and responsibilities of each
entity involved in the project, including any State or local
government entity, intermediary, service provider,
independent evaluator, investor, or other stakeholder.
``(13) A summary of the experience of the service provider
in delivering the proposed intervention or a similar
intervention, or a summary demonstrating the service provider
has the expertise necessary to deliver the proposed
intervention.
``(14) A summary of the unmet need in the area where the
intervention will be delivered or among the target population
who will receive the intervention.
``(15) The proposed payment terms, the methodology used to
calculate outcome payments, the payment schedule, and
performance thresholds.
``(16) The project budget.
``(17) The project timeline.
``(18) The criteria used to determine the eligibility of an
individual for the project, including how selected
populations will be identified, how they will be referred to
the project, and how they will be enrolled in the project.
``(19) The evaluation design.
``(20) The metrics that will be used in the evaluation to
determine whether the outcomes have been achieved as a result
of the intervention and how the metrics will be measured.
``(21) An explanation of how the metrics used in the
evaluation to determine whether the outcomes achieved as a
result of the intervention are independent, objective
indicators of impact and are not subject to manipulation by
the service provider, intermediary, or investor.
``(22) A summary explaining the independence of the
evaluator from the other entities involved in the project and
the evaluator's experience in conducting rigorous evaluations
of program effectiveness including, where available, well-
implemented randomized controlled trials on the intervention
or similar interventions.
``(23) The capacity of the service provider to deliver the
intervention to the number of participants the State or local
government proposes to serve in the project.
``(24) A description of whether and how the State or local
government and service providers plan to sustain the
intervention, if it is timely and appropriate to do so, to
ensure that successful interventions continue to operate
after the period of the social impact partnership.
``(d) Project Intermediary Information Required.--The
application described in subsection (c) shall also contain
the following information about any intermediary for the
social impact partnership project (whether an intermediary is
a service provider or other entity):
``(1) Experience and capacity for providing or facilitating
the provision of the type of intervention proposed.
``(2) The mission and goals.
``(3) Information on whether the intermediary is already
working with service providers that provide this intervention
or an explanation of the capacity of the intermediary to
begin working with service providers to provide the
intervention.
``(4) Experience working in a collaborative environment
across government and nongovernmental entities.
``(5) Previous experience collaborating with public or
private entities to implement evidence-based programs.
``(6) Ability to raise or provide funding to cover
operating costs (if applicable to the project).
``(7) Capacity and infrastructure to track outcomes and
measure results, including--
``(A) capacity to track and analyze program performance and
assess program impact; and
``(B) experience with performance-based awards or
performance-based contracting and achieving project
milestones and targets.
``(8) Role in delivering the intervention.
``(9) How the intermediary would monitor program success,
including a description of the interim benchmarks and outcome
measures.
``(e) Feasibility Studies Funded Through Other Sources.--
The notice described in subsection (a) shall permit a State
or local government to submit an application for social
impact partnership funding that contains information from a
feasibility study developed for purposes other than applying
for funding under this subtitle.
``awarding social impact partnership agreements
``Sec. 2053. (a) Timeline in Awarding Agreement.--Not
later than 6 months after receiving an application in
accordance with section 2052, the Secretary, in consultation
with the Federal Interagency Council on Social Impact
Partnerships, shall determine whether to enter into an
agreement for a social impact partnership project with a
State or local government.
``(b) Considerations in Awarding Agreement.--In determining
whether to enter into an agreement for a social impact
partnership project (the application for which was submitted
under section 2052) the Secretary, in consultation with the
Federal Interagency Council on Social Impact Partnerships and
the head of any Federal agency administering a similar
intervention or serving a population similar to that served
by the project, shall consider each of the following:
``(1) The recommendations made by the Commission on Social
Impact Partnerships.
``(2) The value to the Federal Government of the outcomes
expected to be achieved if the outcomes specified in the
agreement are achieved as a result of the intervention.
``(3) The likelihood, based on evidence provided in the
application and other evidence, that the State or local
government in collaboration with the intermediary and the
service providers will achieve the outcomes.
``(4) The savings to the Federal Government if the outcomes
specified in the agreement are achieved as a result of the
intervention.
``(5) The savings to the State and local governments if the
outcomes specified in the agreement are achieved as a result
of the intervention.
``(6) The expected quality of the evaluation that would be
conducted with respect to the agreement.
``(7) The capacity and commitment of the State or local
government to sustain the intervention, if appropriate and
timely and if the intervention is successful, beyond the
period of the social impact partnership.
``(c) Agreement Authority.--
``(1) Agreement requirements.--In accordance with this
section, the Secretary, in consultation with the Federal
Interagency Council on Social Impact Partnerships and the
head of any Federal agency administering a similar
intervention or serving a population similar to that served
by the project, may enter into an agreement for a social
impact partnership project with a State or local government
if the Secretary, in consultation with the Federal
Interagency Council on Social Impact Partnerships, determines
that each of the following requirements are met:
``(A) The State or local government agrees to achieve one
or more outcomes as a result of the intervention, as
specified in the agreement and validated by independent
evaluation, in order to receive payment.
``(B) The Federal payment to the State or local government
for each specified outcome
[[Page H884]]
achieved as a result of the intervention is less than or
equal to the value of the outcome to the Federal Government
over a period not to exceed 10 years, as determined by the
Secretary, in consultation with the State or local
government.
``(C) The duration of the project does not exceed 10 years.
``(D) The State or local government has demonstrated,
through the application submitted under section 2052, that,
based on prior rigorous experimental evaluations or rigorous
quasi-experimental studies, the intervention can be expected
to achieve each outcome specified in the agreement.
``(E) The State, local government, intermediary, or service
provider has experience raising private or philanthropic
capital to fund social service investments (if applicable to
the project).
``(F) The State or local government has shown that each
service provider has experience delivering the intervention,
a similar intervention, or has otherwise demonstrated the
expertise necessary to deliver the intervention.
``(2) Payment.--The Secretary shall pay the State or local
government only if the independent evaluator described in
section 2055 determines that the social impact partnership
project has met the requirements specified in the agreement
and achieved an outcome as a result of the intervention, as
specified in the agreement and validated by independent
evaluation.
``(d) Notice of Agreement Award.--Not later than 30 days
after entering into an agreement under this section the
Secretary shall publish a notice in the Federal Register that
includes, with regard to the agreement, the following:
``(1) The outcome goals of the social impact partnership
project.
``(2) A description of each intervention in the project.
``(3) The target population that will be served by the
project.
``(4) The expected social benefits to participants who
receive the intervention and others who may be impacted.
``(5) The detailed roles, responsibilities, and purposes of
each Federal, State, or local government entity,
intermediary, service provider, independent evaluator,
investor, or other stakeholder.
``(6) The payment terms, the methodology used to calculate
outcome payments, the payment schedule, and performance
thresholds.
``(7) The project budget.
``(8) The project timeline.
``(9) The project eligibility criteria.
``(10) The evaluation design.
``(11) The metrics that will be used in the evaluation to
determine whether the outcomes have been achieved as a result
of each intervention and how these metrics will be measured.
``(12) The estimate of the savings to the Federal, State,
and local government, on a program-by-program basis and in
the aggregate, if the agreement is entered into and
implemented and the outcomes are achieved as a result of each
intervention.
``(e) Authority to Transfer Administration of Agreement.--
The Secretary may transfer to the head of another Federal
agency the authority to administer (including making payments
under) an agreement entered into under subsection (c), and
any funds necessary to do so.
``(f) Requirement on Funding Used to Benefit Children.--Not
less than 50 percent of all Federal payments made to carry
out agreements under this section shall be used for
initiatives that directly benefit children.
``feasibility study funding
``Sec. 2054. (a) Requests for Funding for Feasibility
Studies.--The Secretary shall reserve a portion of the amount
made available to carry out this subtitle to assist States or
local governments in developing feasibility studies to apply
for social impact partnership funding under section 2052. To
be eligible to receive funding to assist with completing a
feasibility study, a State or local government shall submit
an application for feasibility study funding addressing the
following:
``(1) A description of the outcome goals of the social
impact partnership project.
``(2) A description of the intervention, including
anticipated program design, target population, an estimate
regarding the number of individuals to be served, and setting
for the intervention.
``(3) Evidence to support the likelihood that the
intervention will produce the desired outcomes.
``(4) A description of the potential metrics to be used.
``(5) The expected social benefits to participants who
receive the intervention and others who may be impacted.
``(6) Estimated costs to conduct the project.
``(7) Estimates of Federal, State, and local government
savings and other savings if the project is implemented and
the outcomes are achieved as a result of each intervention.
``(8) An estimated timeline for implementation and
completion of the project, which shall not exceed 10 years.
``(9) With respect to a project for which the State or
local government selects an intermediary to operate the
project, any partnerships needed to successfully execute the
project and the ability of the intermediary to foster the
partnerships.
``(10) The expected resources needed to complete the
feasibility study for the State or local government to apply
for social impact partnership funding under section 2052.
``(b) Federal Selection of Applications for Feasibility
Study.--Not later than 6 months after receiving an
application for feasibility study funding under subsection
(a), the Secretary, in consultation with the Federal
Interagency Council on Social Impact Partnerships and the
head of any Federal agency administering a similar
intervention or serving a population similar to that served
by the project, shall select State or local government
feasibility study proposals for funding based on the
following:
``(1) The recommendations made by the Commission on Social
Impact Partnerships.
``(2) The likelihood that the proposal will achieve the
desired outcomes.
``(3) The value of the outcomes expected to be achieved as
a result of each intervention.
``(4) The potential savings to the Federal Government if
the social impact partnership project is successful.
``(5) The potential savings to the State and local
governments if the project is successful.
``(c) Public Disclosure.--Not later than 30 days after
selecting a State or local government for feasibility study
funding under this section, the Secretary shall cause to be
published on the website of the Federal Interagency Council
on Social Impact Partnerships information explaining why a
State or local government was granted feasibility study
funding.
``(d) Funding Restriction.--
``(1) Feasibility study restriction.--The Secretary may not
provide feasibility study funding under this section for more
than 50 percent of the estimated total cost of the
feasibility study reported in the State or local government
application submitted under subsection (a).
``(2) Aggregate restriction.--Of the total amount made
available to carry out this subtitle, the Secretary may not
use more than $10,000,000 to provide feasibility study
funding to States or local governments under this section.
``(3) No guarantee of funding.--The Secretary shall have
the option to award no funding under this section.
``(e) Submission of Feasibility Study Required.--Not later
than 9 months after the receipt of feasibility study funding
under this section, a State or local government receiving the
funding shall complete the feasibility study and submit the
study to the Federal Interagency Council on Social Impact
Partnerships.
``(f) Delegation of Authority.--The Secretary may transfer
to the head of another Federal agency the authorities
provided in this section and any funds necessary to exercise
the authorities.
``evaluations
``Sec. 2055. (a) Authority to Enter Into Agreements.--For
each State or local government awarded a social impact
partnership project approved by the Secretary under this
subtitle, the head of the relevant agency, as recommended by
the Federal Interagency Council on Social Impact Partnerships
and determined by the Secretary, shall enter into an
agreement with the State or local government to pay for all
or part of the independent evaluation to determine whether
the State or local government project has achieved a specific
outcome as a result of the intervention in order for the
State or local government to receive outcome payments under
this subtitle.
``(b) Evaluator Qualifications.--The head of the relevant
agency may not enter into an agreement with a State or local
government unless the head determines that the evaluator is
independent of the other parties to the agreement and has
demonstrated substantial experience in conducting rigorous
evaluations of program effectiveness including, where
available and appropriate, well-implemented randomized
controlled trials on the intervention or similar
interventions.
``(c) Methodologies to Be Used.--The evaluation used to
determine whether a State or local government will receive
outcome payments under this subtitle shall use experimental
designs using random assignment or other reliable, evidence-
based research methodologies, as certified by the Federal
Interagency Council on Social Impact Partnerships, that allow
for the strongest possible causal inferences when random
assignment is not feasible.
``(d) Progress Report.--
``(1) Submission of report.--The independent evaluator
shall--
``(A) not later than 2 years after a project has been
approved by the Secretary and biannually thereafter until the
project is concluded, submit to the head of the relevant
agency and the Federal Interagency Council on Social Impact
Partnerships a written report summarizing the progress that
has been made in achieving each outcome specified in the
agreement; and
``(B) before the scheduled time of the first outcome
payment and before the scheduled time of each subsequent
payment, submit to the head of the relevant agency and the
Federal Interagency Council on Social Impact Partnerships a
written report that includes the results of the evaluation
conducted to determine whether an outcome payment should be
made along with information on the unique factors that
contributed to achieving or failing to achieve the outcome,
the challenges faced in attempting to achieve the outcome,
and information on the improved future delivery of this or
similar interventions.
[[Page H885]]
``(2) Submission to the secretary and congress.--Not later
than 30 days after receipt of the written report pursuant to
paragraph (1)(B), the Federal Interagency Council on Social
Impact Partnerships shall submit the report to the Secretary
and each committee of jurisdiction in the House of
Representatives and the Senate.
``(e) Final Report.--
``(1) Submission of report.--Within 6 months after the
social impact partnership project is completed, the
independent evaluator shall--
``(A) evaluate the effects of the activities undertaken
pursuant to the agreement with regard to each outcome
specified in the agreement; and
``(B) submit to the head of the relevant agency and the
Federal Interagency Council on Social Impact Partnerships a
written report that includes the results of the evaluation
and the conclusion of the evaluator as to whether the State
or local government has fulfilled each obligation of the
agreement, along with information on the unique factors that
contributed to the success or failure of the project, the
challenges faced in attempting to achieve the outcome, and
information on the improved future delivery of this or
similar interventions.
``(2) Submission to the secretary and congress.--Not later
than 30 days after receipt of the written report pursuant to
paragraph (1)(B), the Federal Interagency Council on Social
Impact Partnerships shall submit the report to the Secretary
and each committee of jurisdiction in the House of
Representatives and the Senate.
``(f) Limitation on Cost of Evaluations.--Of the amount
made available under this subtitle for social impact
partnership projects, the Secretary may not obligate more
than 15 percent to evaluate the implementation and outcomes
of the projects.
``(g) Delegation of Authority.--The Secretary may transfer
to the head of another Federal agency the authorities
provided in this section and any funds necessary to exercise
the authorities.
``federal interagency council on social impact partnerships
``Sec. 2056. (a) Establishment.--There is established the
Federal Interagency Council on Social Impact Partnerships (in
this section referred to as the `Council') to--
``(1) coordinate with the Secretary on the efforts of
social impact partnership projects funded under this
subtitle;
``(2) advise and assist the Secretary in the development
and implementation of the projects;
``(3) advise the Secretary on specific programmatic and
policy matter related to the projects;
``(4) provide subject-matter expertise to the Secretary
with regard to the projects;
``(5) certify to the Secretary that each State or local
government that has entered into an agreement with the
Secretary for a social impact partnership project under this
subtitle and each evaluator selected by the head of the
relevant agency under section 2055 has access to Federal
administrative data to assist the State or local government
and the evaluator in evaluating the performance and outcomes
of the project;
``(6) address issues that will influence the future of
social impact partnership projects in the United States;
``(7) provide guidance to the executive branch on the
future of social impact partnership projects in the United
States;
``(8) prior to approval by the Secretary, certify that each
State and local government application for a social impact
partnership contains rigorous, independent data and reliable,
evidence-based research methodologies to support the
conclusion that the project will yield savings to the State
or local government or the Federal Government if the project
outcomes are achieved;
``(9) certify to the Secretary, in the case of each
approved social impact partnership that is expected to yield
savings to the Federal Government, that the project will
yield a projected savings to the Federal Government if the
project outcomes are achieved, and coordinate with the
relevant Federal agency to produce an after-action accounting
once the project is complete to determine the actual Federal
savings realized, and the extent to which actual savings
aligned with projected savings; and
``(10) provide periodic reports to the Secretary and make
available reports periodically to Congress and the public on
the implementation of this subtitle.
``(b) Composition of Council.--The Council shall have 11
members, as follows:
``(1) Chair.--The Chair of the Council shall be the
Director of the Office of Management and Budget.
``(2) Other members.--The head of each of the following
entities shall designate one officer or employee of the
entity to be a Council member:
``(A) The Department of Labor.
``(B) The Department of Health and Human Services.
``(C) The Social Security Administration.
``(D) The Department of Agriculture.
``(E) The Department of Justice.
``(F) The Department of Housing and Urban Development.
``(G) The Department of Education.
``(H) The Department of Veterans Affairs.
``(I) The Department of the Treasury.
``(J) The Corporation for National and Community Service.
``commission on social impact partnerships
``Sec. 2057. (a) Establishment.--There is established the
Commission on Social Impact Partnerships (in this section
referred to as the `Commission').
``(b) Duties.--The duties of the Commission shall be to--
``(1) assist the Secretary and the Federal Interagency
Council on Social Impact Partnerships in reviewing
applications for funding under this subtitle;
``(2) make recommendations to the Secretary and the Federal
Interagency Council on Social Impact Partnerships regarding
the funding of social impact partnership agreements and
feasibility studies; and
``(3) provide other assistance and information as requested
by the Secretary or the Federal Interagency Council on Social
Impact Partnerships.
``(c) Composition.--The Commission shall be composed of
nine members, of whom--
``(1) one shall be appointed by the President, who will
serve as the Chair of the Commission;
``(2) one shall be appointed by the Majority Leader of the
Senate;
``(3) one shall be appointed by the Minority Leader of the
Senate;
``(4) one shall be appointed by the Speaker of the House of
Representatives;
``(5) one shall be appointed by the Minority Leader of the
House of Representatives;
``(6) one shall be appointed by the Chairman of the
Committee on Finance of the Senate;
``(7) one shall be appointed by the ranking member of the
Committee on Finance of the Senate;
``(8) one member shall be appointed by the Chairman of the
Committee on Ways and Means of the House of Representatives;
and
``(9) one shall be appointed by the ranking member of the
Committee on Ways and Means of the House of Representatives.
``(d) Qualifications of Commission Members.--The members of
the Commission shall--
``(1) be experienced in finance, economics, pay for
performance, or program evaluation;
``(2) have relevant professional or personal experience in
a field related to one or more of the outcomes listed in this
subtitle; or
``(3) be qualified to review applications for social impact
partnership projects to determine whether the proposed
metrics and evaluation methodologies are appropriately
rigorous and reliant upon independent data and evidence-based
research.
``(e) Timing of Appointments.--The appointments of the
members of the Commission shall be made not later than 120
days after the date of the enactment of this subtitle, or, in
the event of a vacancy, not later than 90 days after the date
the vacancy arises. If a member of Congress fails to appoint
a member by that date, the President may select a member of
the President's choice on behalf of the member of Congress.
Notwithstanding the preceding sentence, if not all
appointments have been made to the Commission as of that
date, the Commission may operate with no fewer than five
members until all appointments have been made.
``(f) Term of Appointments.--
``(1) In general.--The members appointed under subsection
(c) shall serve as follows:
``(A) Three members shall serve for 2 years.
``(B) Three members shall serve for 3 years.
``(C) Three members (one of which shall be Chair of the
Commission appointed by the President) shall serve for 4
years.
``(2) Assignment of terms.--The Commission shall designate
the term length that each member appointed under subsection
(c) shall serve by unanimous agreement. In the event that
unanimous agreement cannot be reached, term lengths shall be
assigned to the members by a random process.
``(g) Vacancies.--Subject to subsection (e), in the event
of a vacancy in the Commission, whether due to the
resignation of a member, the expiration of a member's term,
or any other reason, the vacancy shall be filled in the
manner in which the original appointment was made and shall
not affect the powers of the Commission.
``(h) Appointment Power.--Members of the Commission
appointed under subsection (c) shall not be subject to
confirmation by the Senate.
``limitation on use of funds
``Sec. 2058. Of the amounts made available to carry out
this subtitle, the Secretary may not use more than $2,000,000
in any fiscal year to support the review, approval, and
oversight of social impact partnership projects, including
activities conducted by--
``(1) the Federal Interagency Council on Social Impact
Partnerships; and
``(2) any other agency consulted by the Secretary before
approving a social impact partnership project or a
feasibility study under section 2054.
``no federal funding for credit enhancements
``Sec. 2059. No amount made available to carry out this
subtitle may be used to provide any insurance, guarantee, or
other credit enhancement to a State or local government under
which a Federal payment would be made to a State or local
government as the result of a State or local government
failing to achieve an outcome specified in an agreement.
``availability of funds
``Sec. 2060. Amounts made available to carry out this
subtitle shall remain available until 10 years after the date
of the enactment of this subtitle.
[[Page H886]]
``website
``Sec. 2061. The Federal Interagency Council on Social
Impact Partnerships shall establish and maintain a public
website that shall display the following:
``(1) A copy of, or method of accessing, each notice
published regarding a social impact partnership project
pursuant to this subtitle.
``(2) A copy of each feasibility study funded under this
subtitle.
``(3) For each State or local government that has entered
into an agreement with the Secretary for a social impact
partnership project, the website shall contain the following
information:
``(A) The outcome goals of the project.
``(B) A description of each intervention in the project.
``(C) The target population that will be served by the
project.
``(D) The expected social benefits to participants who
receive the intervention and others who may be impacted.
``(E) The detailed roles, responsibilities, and purposes of
each Federal, State, or local government entity,
intermediary, service provider, independent evaluator,
investor, or other stakeholder.
``(F) The payment terms, methodology used to calculate
outcome payments, the payment schedule, and performance
thresholds.
``(G) The project budget.
``(H) The project timeline.
``(I) The project eligibility criteria.
``(J) The evaluation design.
``(K) The metrics used to determine whether the proposed
outcomes have been achieved and how these metrics are
measured.
``(4) A copy of the progress reports and the final reports
relating to each social impact partnership project.
``(5) An estimate of the savings to the Federal, State, and
local government, on a program-by-program basis and in the
aggregate, resulting from the successful completion of the
social impact partnership project.
``regulations
``Sec. 2062. The Secretary, in consultation with the
Federal Interagency Council on Social Impact Partnerships,
may issue regulations as necessary to carry out this
subtitle.
``definitions
``Sec. 2063. In this subtitle:
``(1) Agency.--The term `agency' has the meaning given that
term in section 551 of title 5, United States Code.
``(2) Intervention.--The term `intervention' means a
specific service delivered to achieve an impact through a
social impact partnership project.
``(3) Secretary.--The term `Secretary' means the Secretary
of the Treasury.
``(4) Social impact partnership project.--The term `social
impact partnership project' means a project that finances
social services using a social impact partnership model.
``(5) Social impact partnership model.--The term `social
impact partnership model' means a method of financing social
services in which--
``(A) Federal funds are awarded to a State or local
government only if a State or local government achieves
certain outcomes agreed on by the State or local government
and the Secretary; and
``(B) the State or local government coordinates with
service providers, investors (if applicable to the project),
and (if necessary) an intermediary to identify--
``(i) an intervention expected to produce the outcome;
``(ii) a service provider to deliver the intervention to
the target population; and
``(iii) investors to fund the delivery of the intervention.
``(6) State.--The term `State' means each State of the
United States, the District of Columbia, each commonwealth,
territory or possession of the United States, and each
federally recognized Indian tribe.
``funding
``Sec. 2064. Out of any money in the Treasury of the United
States not otherwise appropriated, there is hereby
appropriated $92,000,000 for fiscal year 2018 to carry out
this subtitle.''.
Subtitle C--Modernizing Child Support Enforcement Fees
SEC. 2691. MODERNIZING CHILD SUPPORT ENFORCEMENT FEES.
(a) In General.-- Section 454(6)(B)(ii) of the Social
Security Act (42 U.S.C. 654(6)(B)(ii)) is amended--
(1) by striking ``$25'' and inserting ``$35''; and
(2) by striking ``$500'' each place it appears and
inserting ``$550''.
(b) Effective Date.--
(1) In general.--The amendment made by subsection (a) shall
take effect on the 1st day of the 1st fiscal year that begins
on or after the date of the enactment of this Act, and shall
apply to payments under part D of title IV of the Social
Security Act for calendar quarters beginning on or after such
1st day.
(2) Delay permitted if state legislation required.--If the
Secretary of Health and Human Services determines that State
legislation (other than legislation appropriating funds) is
required in order for a State plan developed pursuant to part
D of title IV of the Social Security Act to meet the
requirement imposed by the amendment made by subsection (a),
the plan shall not be regarded as failing to meet the
requirement before the 1st day of the 1st calendar quarter
beginning after the first regular session of the State
legislature that begins after the date of the enactment of
this Act. For purposes of the preceding sentence, if the
State has a 2-year legislative session, each year of the
session is deemed to be a separate regular session of the
State legislature.
Subtitle D--Increasing Efficiency of Prison Data Reporting
SEC. 2699. INCREASING EFFICIENCY OF PRISON DATA REPORTING.
(a) In General.--Section 1611(e)(1)(I)(i)(II) of the Social
Security Act (42 U.S.C. 1382(e)(1)(I)(i)(II)) is amended by
striking ``30 days'' each place it appears and inserting ``15
days''.
(b) Effective Date.--The amendments made by subsection (a)
shall apply with respect to any payment made by the
Commissioner of Social Security pursuant to section
1611(e)(1)(I)(i)(II) of the Social Security Act (as amended
by such subsection) on or after the date that is 6 months
after the date of enactment of this Act.
TITLE VII--OFFSETS
SEC. 2701. PAYMENT FOR EARLY DISCHARGES TO HOSPICE CARE.
(a) In General.--Section 1886(d)(5)(J) of the Social
Security Act (42 U.S.C. 1395ww(d)(5)(J)) is amended--
(1) in clause (ii)--
(A) in subclause (III), by striking ``or'' at the end;
(B) by redesignating subclause (IV) as subclause (V); and
(C) by inserting after subclause (III) the following new
subclause:
``(IV) for discharges occurring on or after October 1,
2022, is provided hospice care by a hospice program; or'';
and
(2) in clause (iv)--
(A) by inserting after the first sentence the following new
sentence: ``The Secretary shall include in the proposed rule
published for fiscal year 2023, a description of the effect
of clause (ii)(IV).''; and
(B) in subclause (I), by striking ``and (III)'' and
inserting ``(III), and, in the case of proposed and final
rules for fiscal year 2023 and subsequent fiscal years,
(IV)''.
(b) MedPAC Evaluation and Report on Hospital to Hospice
Transfers.--
(1) Evaluation.--The Medicare Payment Advisory Commission
(in this subsection referred to as the ``Commission'') shall
conduct an evaluation of the effects of the amendments made
by subsection (a), including the effects on--
(A) the numbers of discharges of patients from an inpatient
hospital setting to a hospice program;
(B) the lengths of stays of patients in an inpatient
hospital setting who are discharged to a hospice program;
(C) spending under the Medicare program under title XVIII
of the Social Security Act; and
(D) other areas determined appropriate by the Commission.
(2) Consideration.--In conducting the evaluation under
paragraph (1), the Commission shall consider factors such as
whether the timely access to hospice care by patients
admitted to a hospital has been affected through changes to
hospital policies or behaviors made as a result of such
amendments.
(3) Preliminary results.--Not later than March 15, 2024,
the Commission shall provide Congress with preliminary
results on the evaluation being conducted under paragraph
(1).
(4) Report.--Not later than March 15, 2025, the Commission
shall submit to Congress a report on the evaluation conducted
under paragraph (1).
SEC. 2702. HOME HEALTH MARKET BASKET REDUCTION.
Section 1895(b)(3)(B) of the Social Security Act (42 U.S.C.
1395fff(b)(3)(B)) is amended--
(1) in clause (iii), in the last sentence, by inserting
before the period at the end the following: ``and for 2020
shall be 1.5 percent''; and
(2) in clause (vi), by inserting ``and 2020'' after
``except 2018''.
SEC. 2703. REDUCTION FOR NON-EMERGENCY ESRD AMBULANCE
TRANSPORTS.
Section 1834(l)(15) of the Social Security Act (42. U.S.C.
1395m(l)(15)) is amended by striking ``on or after October 1,
2013'' and inserting ``during the period beginning on October
1, 2013, and ending on September 30, 2018, and by 23 percent
for such services furnished on or after October 1, 2018''.
SEC. 2704. EXTENSION OF TARGET FOR RELATIVE VALUE ADJUSTMENTS
FOR MISVALUED SERVICES AND TRANSITIONAL PAYMENT
RULES FOR CERTAIN RADIATION THERAPY SERVICES
UNDER THE PHYSICIAN FEE SCHEDULE.
Section 1848 of the Social Security Act (42 U.S.C. 1395w-4)
is amended--
(1) in subsection (b)(11), by striking ``2017 and 2018''
and inserting ``2017, 2018, and 2019''; and
(2) in subsection (c)(2)--
(A) in subparagraph (K)(iv), by striking ``2017 and 2018''
and inserting ``2017, 2018, and 2019''; and
(B) in subparagraph (O), by striking ``2018'' and inserting
``2019''.
SEC. 2705. DELAY IN AUTHORITY TO TERMINATE CONTRACTS FOR
MEDICARE ADVANTAGE PLANS FAILING TO ACHIEVE
MINIMUM QUALITY RATINGS.
Section 1857(h)(3) of the Social Security Act (42 U.S.C.
1395w-27(h)(3)) is amended by striking ``2018'' and inserting
``2027''.
SEC. 2706. MEDICARE IMPROVEMENT FUND.
Section 1898(b)(1) of the Social Security Act (42 U.S.C.
1395iii(b)(1)) is amended by striking ``during and after
fiscal year 2021''
[[Page H887]]
and all that follows through the period at the end and
inserting ``during and after fiscal year 2021, $0.''.
SEC. 2707. PAYMENT FOR OUTPATIENT PHYSICAL THERAPY SERVICES
AND OUTPATIENT OCCUPATIONAL THERAPY SERVICES
FURNISHED BY A THERAPY ASSISTANT.
Section 1834 of the Social Security Act (42 U.S.C. 1395m),
as amended by sections 2204 and 2414, is further amended by
adding at the end the following new subsection:
``(x) Payment for Outpatient Physical Therapy Services and
Outpatient Occupational Therapy Services Furnished by a
Therapy Assistant.--
``(1) In general.--In the case of an outpatient physical
therapy service or outpatient occupational therapy service
furnished on or after January 1, 2022, for which payment is
made under section 1848 or subsection (k), that is furnished
in whole or in part by a therapy assistant (as defined by the
Secretary), the amount of payment for such service shall be
an amount equal to 85 percent of the amount of payment
otherwise applicable for the service under this part. Nothing
in the preceding sentence shall be construed to change
applicable requirements with respect to such services.
``(2) Use of modifier.--
``(A) Establishment.--Not later than January 1, 2019, the
Secretary shall establish a modifier to indicate (in a form
and manner specified by the Secretary), in the case of an
outpatient physical therapy service or outpatient
occupational therapy service furnished in whole or in part by
a therapy assistant (as so defined), that the service was
furnished by a therapy assistant.
``(B) Required use.--Each request for payment, or bill
submitted, for an outpatient physical therapy service or
outpatient occupational therapy service furnished in whole or
in part by a therapy assistant (as so defined) on or after
January 1, 2020, shall include the modifier established under
subparagraph (A) for each such service.
``(3) Implementation.--The Secretary shall implement this
subsection through notice and comment rulemaking.''.
SEC. 2708. CHANGES TO LONG-TERM CARE HOSPITAL PAYMENTS.
(a) Extension.--Section 1886(m)(6)(B)(i) of the Social
Security Act (42 U.S.C. 1395ww(m)(6)(B)(i)) is amended--
(1) in subclause (I), by striking ``fiscal year 2016 or
fiscal year 2017'' and inserting ``fiscal years 2016 through
2019''; and
(2) in subclause (II), by striking ``2018'' and inserting
``2020''.
(b) Temporary Adjustment to Site Neutral Payment Rates.--
Section 1886(m)(6)(B) of the Social Security Act (42 U.S.C.
1395ww(m)(6)(B)) is amended--
(1) in clause (ii), in the matter preceding subclause (I),
by striking ``In this paragraph'' and inserting ``Subject to
clause (iv), in this paragraph''; and
(2) by adding at the end the following new clause:
``(iv) Adjustment.--For each of fiscal years 2018 through
2026, the amount that would otherwise apply under clause
(ii)(I) for the year (determined without regard to this
clause) shall be reduced by 4.6 percent.''.
SEC. 2709. NON-BUDGET NEUTRAL TRANSITIONAL PASS-THROUGH
PAYMENT CHANGE FOR CERTAIN PRODUCTS.
(a) In General.--Subsection 1833(t)(6)(A)(iv) of the Social
Security Act (42 U.S.C. 1395l(t)(6)(A)(iv)) is amended by
inserting ``(except, beginning as of April 1, 2018, a
biosimilar biological product (as defined under section
1847A(c)(6)(H)))'' after ``biological''.
(b) Application.--The amendment made by subsection (a)
shall apply with respect to biosimilar biological products
beginning on April 1, 2018, regardless of whether such
products were receiving pass-through status for an additional
payment under section 1833(t)(6) of the Social Security Act
(42 U.S.C. 1395l(t)(6)) before such date. In the case of a
product that was receiving such an additional payment
pursuant to clause (iv) of subparagraph (A) of such section
as of the day before such date and after application of the
amendment under subsection (a) is not eligible for such an
additional payment as of such date, such product may not be
eligible for such an additional payment pursuant to any other
clause of such subparagraph (A).
SEC. 2710. THIRD PARTY LIABILITY IN MEDICAID AND CHIP.
(a) Modification of Third Party Liability Rules Related to
Special Treatment of Certain Types of Care and Payments.--
(1) In general.--Section 1902(a)(25)(E) of the Social
Security Act (42 U.S.C. 1396a(a)(25)(E)) is amended, in the
matter preceding clause (i), by striking ``prenatal or''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect on the date of enactment of this Act.
(b) Delay in Effective Date and Repeal of Certain
Bipartisan Budget Act of 2013 Amendments.--
(1) Repeal.--Effective as of September 30, 2017, subsection
(b) of section 202 of the Bipartisan Budget Act of 2013
(Public Law 113-67; 127 Stat. 1177; 42 U.S.C. 1396a note)
(including any amendments made by such subsection) is
repealed and the provisions amended by such subsection shall
be applied and administered as if such amendments had never
been enacted.
(2) Delay in effective date.--Subsection (c) of section 202
of the Bipartisan Budget Act of 2013 (Public Law 113-67; 127
Stat. 1177; 42 U.S.C. 1396a note) is amended to read as
follows:
``(c) Effective Date.--The amendments made by subsection
(a) shall take effect on October 1, 2019.''.
(3) Effective date; treatment.--The repeal and amendment
made by this subsection shall take effect as if enacted on
September 30, 2017, and shall apply with respect to any open
claims, including claims pending, generated, or filed, after
such date. The amendments made by subsections (a) and (b) of
section 202 of the Bipartisan Budget Act of 2013 (Public Law
113-67; 127 Stat. 1177; 42 U.S.C. 1396a note) that took
effect on October 1, 2017, are null and void and section
1902(a)(25) of the Social Security Act (42 U.S.C.
1396a(a)(25)) shall be applied and administered as if such
amendments had not taken effect on such date.
(c) GAO Study and Report.--Not later than 18 months after
the date of enactment of this Act, the Comptroller General of
the United States shall submit a report to the Committee on
Energy and Commerce of the House of Representatives and the
Committee on Finance of the Senate on the impacts of the
amendments made by subsections (a)(1) and (b)(2), including--
(1) the impact, or potential effect, of such amendments on
access to prenatal and preventive pediatric care (including
early and periodic screening, diagnostic, and treatment
services) covered under State plans under such title (or
waivers of such plans);
(2) the impact, or potential effect, of such amendments on
access to services covered under such plans or waivers for
individuals on whose behalf child support enforcement is
being carried out by a State agency under part D of title IV
of such Act; and
(3) the impact, or potential effect, on providers of
services under such plans or waivers of delays in payment or
related issues that result from such amendments.
(d) Application to CHIP.--
(1) In general.--Section 2107(e)(1) of the Social Security
Act (42 U.S.C. 1397gg(e)(1)) is amended--
(A) by redesignating subparagraphs (B) through (R) as
subparagraphs (C) through (S), respectively; and
(B) by inserting after subparagraph (A) the following new
subparagraph:
``(B) Section 1902(a)(25) (relating to third party
liability).''.
(2) Mandatory reporting.--Section 1902(a)(25)(I)(i) of the
Social Security Act (42 U.S.C. 1396a(a)(25)(I)(i)) is
amended--
(A) by striking ``medical assistance under the State plan''
and inserting ``medical assistance under a State plan (or
under a waiver of the plan)'';
(B) by striking ``(and, at State option, child'' and
inserting ``and child''; and
(C) by striking ``title XXI)'' and inserting ``title XXI''.
SEC. 2711. TREATMENT OF LOTTERY WINNINGS AND OTHER LUMP-SUM
INCOME FOR PURPOSES OF INCOME ELIGIBILITY UNDER
MEDICAID.
(a) In General.--Section 1902 of the Social Security Act
(42 U.S.C. 1396a) is amended--
(1) in subsection (a)(17), by striking ``(e)(14), (e)(14)''
and inserting ``(e)(14), (e)(15)''; and
(2) in subsection (e)(14), by adding at the end the
following new subparagraph:
``(K) Treatment of certain lottery winnings and income
received as a lump sum.--
``(i) In general.--In the case of an individual who is the
recipient of qualified lottery winnings (pursuant to
lotteries occurring on or after January 1, 2018) or qualified
lump sum income (received on or after such date) and whose
eligibility for medical assistance is determined based on the
application of modified adjusted gross income under
subparagraph (A), a State shall, in determining such
eligibility, include such winnings or income (as applicable)
as income received--
``(I) in the month in which such winnings or income (as
applicable) is received if the amount of such winnings or
income is less than $80,000;
``(II) over a period of 2 months if the amount of such
winnings or income (as applicable) is greater than or equal
to $80,000 but less than $90,000;
``(III) over a period of 3 months if the amount of such
winnings or income (as applicable) is greater than or equal
to $90,000 but less than $100,000; and
``(IV) over a period of 3 months plus 1 additional month
for each increment of $10,000 of such winnings or income (as
applicable) received, not to exceed a period of 120 months
(for winnings or income of $1,260,000 or more), if the amount
of such winnings or income is greater than or equal to
$100,000.
``(ii) Counting in equal installments.--For purposes of
subclauses (II), (III), and (IV) of clause (i), winnings or
income to which such subclause applies shall be counted in
equal monthly installments over the period of months
specified under such subclause.
``(iii) Hardship exemption.--An individual whose income, by
application of clause (i), exceeds the applicable eligibility
threshold established by the State, shall continue to be
eligible for medical assistance to the extent that the State
determines, under procedures established by the State (in
accordance with standards specified by the Secretary), that
the denial of eligibility of the individual would cause an
undue medical or financial hardship as determined on the
basis of criteria established by the Secretary.
``(iv) Notifications and assistance required in case of
loss of eligibility.--A State shall, with respect to an
individual
[[Page H888]]
who loses eligibility for medical assistance under the State
plan (or a waiver of such plan) by reason of clause (i)--
``(I) before the date on which the individual loses such
eligibility, inform the individual--
``(aa) of the individual's opportunity to enroll in a
qualified health plan offered through an Exchange established
under title I of the Patient Protection and Affordable Care
Act during the special enrollment period specified in section
9801(f)(3) of the Internal Revenue Code of 1986 (relating to
loss of Medicaid or CHIP coverage); and
``(bb) of the date on which the individual would no longer
be considered ineligible by reason of clause (i) to receive
medical assistance under the State plan or under any waiver
of such plan and be eligible to reapply to receive such
medical assistance; and
``(II) provide technical assistance to the individual
seeking to enroll in such a qualified health plan.
``(v) Qualified lottery winnings defined.--In this
subparagraph, the term `qualified lottery winnings' means
winnings from a sweepstakes, lottery, or pool described in
paragraph (3) of section 4402 of the Internal Revenue Code of
1986 or a lottery operated by a multistate or
multijurisdictional lottery association, including amounts
awarded as a lump sum payment.
``(vi) Qualified lump sum income defined.--In this
subparagraph, the term `qualified lump sum income' means
income that is received as a lump sum from monetary winnings
from gambling (as defined by the Secretary and including
gambling activities described in section 1955(b)(4) of title
18, United States Code).''.
(b) Rules of Construction.--
(1) Interception of lottery winnings allowed.--Nothing in
the amendment made by subsection (a)(2) shall be construed as
preventing a State from intercepting the State lottery
winnings awarded to an individual in the State to recover
amounts paid by the State under the State Medicaid plan under
title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
for medical assistance furnished to the individual.
(2) Applicability limited to eligibility of recipient of
lottery winnings or lump sum income.--Nothing in the
amendment made by subsection (a)(2) shall be construed, with
respect to a determination of household income for purposes
of a determination of eligibility for medical assistance
under the State plan under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) (or a waiver of such plan) made
by applying modified adjusted gross income under subparagraph
(A) of section 1902(e)(14) of such Act (42 U.S.C.
1396a(e)(14)), as limiting the eligibility for such medical
assistance of any individual that is a member of the
household other than the individual who received qualified
lottery winnings or qualified lump-sum income (as defined in
subparagraph (K) of such section 1902(e)(14), as added by
subsection (a)(2) of this section).
SEC. 2712. MODIFYING REDUCTIONS IN MEDICAID DSH ALLOTMENTS.
Section 1923(f)(7)(A) of the Social Security Act (42 U.S.C.
1396r-4(f)(7)(A)) is amended--
(1) in clause (i), in the matter preceding subclause (I),
by striking ``2018'' and inserting ``2020''; and
(2) in clause (ii), by striking subclauses (I) through
(VIII) and inserting the following:
``(I) $4,000,000,000 for fiscal year 2020; and
``(II) $8,000,000,000 for each of fiscal years 2021 through
2025.''.
SEC. 2713. MEDICAID IMPROVEMENT FUND RESCISSION.
Section 1941(b) of the Social Security Act (42 U.S.C 1396w-
1(b)) is amended--
(1) in paragraph (1), by striking ``$5,000,000'' and
inserting ``$0''; and
(2) in paragraph (3)(A) (as added by section 3006(2)(B) of
the Helping Ensure Access for Little Ones, Toddlers, and
Hopeful Youth by Keeping Insurance Delivery Stable Act
(Public Law 115-120)), by striking ``$980,000,000'' and
inserting ``$0''.
SEC. 2714. SUNSETTING EXCLUSION OF BIOSIMILARS FROM MEDICARE
PART D COVERAGE GAP DISCOUNT PROGRAM.
Section 1860D-14A(g)(2)(A) of the Social Security Act (42
U.S.C. 1395w-114a(g)(2)(A)) is amended by inserting ``, with
respect to a plan year before 2019,'' after ``other than''.
SEC. 2715. PREVENTION AND PUBLIC HEALTH FUND.
Section 4002(b) of the Patient Protection and Affordable
Care Act (42 U.S.C. 300u-11(b)) is amended by striking
paragraphs (1) through (9) and inserting the following new
paragraphs:
``(1) for each of fiscal years 2018 and 2019, $900,000,000;
``(2) for each of fiscal years 2020 and 2021,
$1,000,000,000;
``(3) for each of fiscal years 2022 through 2027,
$1,100,000,000; and
``(4) for fiscal year 2028 and each subsequent fiscal year,
$2,000,000,000.''.
DIVISION G--BUDGETARY EFFECTS
SEC. 3001. BUDGETARY EFFECTS.
(a) In General.--The budgetary effects of division D and
each succeeding division shall not be entered on either PAYGO
scorecard maintained pursuant to section 4(d) of the
Statutory Pay-As-You-Go Act of 2010.
(b) Senate PAYGO Scorecards.--The budgetary effects of
division D and each succeeding division shall not be entered
on any PAYGO scorecard maintained for purposes of section
4106 of H. Con. Res. 71 (115th Congress).
(c) Classification of Budgetary Effects.--Notwithstanding
Rule 3 of the Budget Scorekeeping Guidelines set forth in the
joint explanatory statement of the committee of conference
accompanying Conference Report 105-217 and section 250(c)(8)
of the Balanced Budget and Emergency Deficit Control Act of
1985, the budgetary effects of division D and each succeeding
division shall not be estimated--
(1) for purposes of section 251 of such Act; and
(2) for purposes of paragraph (4)(C) of section 3 of the
Statutory Pay-As-You-Go Act of 2010 as being included in an
appropriation Act.
The SPEAKER pro tempore. Pursuant to House Resolution 727, the motion
shall be debatable for 1 hour equally divided and controlled by the
chair and ranking minority member of the Committee on Appropriations.
The gentleman from New Jersey (Mr. Frelinghuysen) and the gentlewoman
from New York (Mrs. Lowey) each will control 30 minutes.
The Chair recognizes the gentleman from New Jersey.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, for the fifth time since last fall, I rise today to
present another continuing resolution, the House amendment to Senate
amendment to H.R. 1892, to fund the operations of the Federal
Government through March 23, fund the Department of Defense for the
rest of fiscal year 2018, and extend critical healthcare programs,
including funding for community health centers.
Our current continuing resolution expires on Thursday, and without
this legislation, large segments of the Federal Government will shut
down again. Of course, all of us are keenly aware that more time is
needed for our leaders in the House, the Senate, and the White House to
negotiate overall funding levels for the 2018 fiscal year. This bill
should allow that to happen.
Mr. Speaker, this continuing resolution also makes a very limited
number of technical changes in funding levels for only the most
essential needs, including:
To prevent delays in preparation for the 2020 Census;
To ensure that the judicial branch is able to pay jurors;
To provide $225 million in emergency funding for the Small Business
Administration to provide emergency loans to those whose lives and
livelihoods were destroyed by last year's historic natural disasters.
This legislation also includes the full fiscal year 2018 Department
of Defense Appropriations bill, totaling $659 billion for our Armed
Forces.
And I don't have to remind my colleagues that this bill has already
passed this House three times on a bipartisan basis--most recently,
last week.
Mr. Speaker, we ask a great deal of our men and women in uniform, and
we have an obligation to provide them and their families the resources
they need to be safe, to complete their missions successfully at home
and abroad. Governing from CR to CR just creates more unpredictability,
more instability, and has real-life consequences for both our troops
and civilians who support them.
Mr. Speaker, the challenges we face around the world cannot be met
under this Federal CR stop-and-go process. While we delay doing the
Nation's business, our military and economic competitors are
consolidating their gains.
Finally, I would add, this legislation includes necessary funding
extensions for bipartisan health priorities like community health
centers and other public health programs. It also funds important
Medicare extenders and includes commonsense reforms and improvements in
the program.
But let no one doubt our position on continuing resolutions. They are
bad fiscal policy. They do not allow programs to grow, to be reduced or
eliminated, if that is needed. They maintain outdated policies and stop
new, critically important programs from ever starting, including
programs that enhance national security and protect our Armed Forces
from our enemies.
Continuing resolutions are fiscally wasteful and prevent the
executive branch and Congress from planning and preparing, and this is
true for the private sector as well.
Most importantly, they undermine congressional oversight that is
constitutionally mandated for our appropriations.
While I am pleased that we are here to include the Defense
Appropriations
[[Page H889]]
bill in this continuing resolution, we must still pass all 12
appropriations bills for the 2018 fiscal year, as well as our third
emergency disaster supplemental.
As soon as congressional and White House leaders reach a bipartisan
agreement, which could and should happen at any moment, our committee
will get to work immediately to finish negotiations on all 12 year-long
funding bills.
Mr. Speaker, I urge my colleagues to support this legislation, and I
reserve the balance of my time.
Mrs. LOWEY. Mr. Speaker, I yield myself such time as I may consume.
Since President Trump's draconian FY 2018 budget was released last
year, Democrats have warned Republicans that a bipartisan budget
agreement was needed to adequately invest in American families and
communities. Without a budget agreement, programs as diverse as Head
Start, job training, and terrorism prevention grants are in danger of
inadequate funding, at best.
Instead of engaging with Democrats to reach a budget agreement, the
majority is seeking to advance a full year of funding for only the
Department of Defense, busting budget caps, while punting every other
Federal service and investment to an uncertain future.
Mr. Speaker, the most powerful country in the world now being
completely run by a Republican government can't keep the lights on more
than weeks at a time. How did we get here?
Democrats will not go along with any plan that neglects critical
national security and domestic needs. If this bill were to become law,
the majority would have no workable plan to make the investments that
are necessary for priorities, including biomedical research,
infrastructure projects, Pell Grants, homeland security, assistance for
local communities, veterans health, opioid funding, job training, the
FBI, and other Federal law enforcement and more.
This is not a serious bill. We know that it will be quickly rejected
by the Senate. It is the furthest possible cry from regular order that
the majority so frequently discusses yet rarely follows. It is nothing
more than a political ploy that will place us on the brink of another
shutdown.
{time} 1730
It is well past time to increase budget caps and enact responsible
spending bills. The majority displays a lack of urgency regarding
reaching a budget agreement and enacting appropriations law, choosing
instead to advance partisan measures that fail to lift unmanageable
budget caps for both defense and nondefense.
Republicans must abandon these partisan short-term bills and work
with Democrats to fund the entirety of government for the remainder of
the fiscal year to serve the American people.
Mr. Speaker, I reserve the balance of my time.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield 2 minutes to the gentleman
from Alabama (Mr. Aderholt), the chairman of the Subcommittee on
Agriculture, Rural Development, Food and Drug Administration, and
Related Agencies.
Mr. ADERHOLT. Mr. Speaker, today, as the House takes up the fifth
continuing resolution for FY18, it seems all too appropriate to quote
President Reagan where he says: ``Here we go again.''
I rise here on the floor of the House this afternoon to urge my
colleagues to support the CR, which, of course, runs through March 23.
As the chairman of the Committee on Appropriations' Subcommittee on
Agriculture, Rural Development, Food and Drug Administration, and
Related Agencies, our Nation's farmers and ranchers will find it hard
to access credit during the upcoming planting season. And those
recovering from disastrous weather events will not be able to access
essential programs in order to help them if we do not finalize a full-
year funding agreement right away.
These are just a couple of examples of the hardships that are faced
by our citizens here in the U.S. that depend on this legislation.
As I say, this is the fifth CR for this fiscal year. My colleagues on
the other side of the aisle must come to the table willing to negotiate
on these budget caps.
As Members know, the House has passed each of the 12 appropriations
bills. We have done our job. Of course, the other body continues to be
the weakest link in all this, as it needs to seriously reform their
process in order to do the work of the people.
Finally, I appreciate that this bill includes full-year funding for
the Department of Defense. To quote President Reagan once again: ``We
have no choice but to maintain ready defense forces that are second to
none. Yes, the cost is high, but the price of neglect would be
infinitely higher.''
Mrs. LOWEY. Mr. Speaker, I yield 1 minute to the gentlewoman from
California (Ms. Pelosi), the Democratic leader.
Ms. PELOSI. Mr. Speaker, I thank the gentlewoman for yielding to me,
and I commend her for her extraordinary leadership on the
Appropriations Committee, where important decisions are made about how
to allocate the resources of our country to invest in the aspirations
of the American people, to respect the sacrifice of our men and women
in uniform, and to honor the vows of our Founders for a country that is
making the future better for every generation to come.
The distinguished chairman of the committee, Mr. Frelinghuysen,
opened his remarks by saying he came to the floor to introduce the
fifth continuing resolution. And the gentleman who followed him talked
about this being the fifth continuing resolution.
The more is not the merrier. It is like golf: the lower the score,
the better. To have five continuing resolutions is a statement of
incompetence and ineptitude.
The Republicans control the House, the Senate, and the White House;
yet they are pressing forward on their fifth stopgap, short-term
spending bill, demonstrating their failure to govern.
Since President Reagan was mentioned, I will mention our very first
President, our patriarch, George Washington. President Washington, when
he was leaving office, cautioned against political parties who were at
war with their own government.
Does that sound familiar to you?
Here we are again, 2 days from another shutdown, careening toward
another manufactured Republican crisis, demonstrating the Republican
failure to govern.
We don't want to go to that place. As Members of Congress, we take a
solemn oath to support and defend the Constitution of the United States
and to protect the American people.
Democrats support a strong national defense. We, too, want our men
and women in uniform to have the resources they need to keep them safe
and to keep the American people safe as they accomplish their mission.
But we will not allow Republicans to use this continuing resolution,
the fifth time they had to come to the floor because they could not
govern, to hollow out our Nation's commitment to the health, education,
and economic security of America's working families.
We all know that our military might is part of our Nation's strength,
but the health, education, security, and well-being of the American
people is also a source of that strength.
Instead of working constructively with Democrats to meet the needs of
the American people, Republicans are trying to starve the domestic
budget. I just want to remind our colleagues: One-third, 34 percent--
one-third--of the nondefense domestic budget goes to national security.
When you starve the domestic budget, you are not making us stronger.
One-third of the domestic budget is about security; Homeland Security,
Veterans Affairs, the State Department, and antiterrorism activities of
the Justice Department.
But Republicans refuse to give our patriots funded on the domestic
side of the budget the resources they need to do their job, just the
chaos and uncertainty of yet another stopgap extension.
As Defense Secretary Mattis said, stopgap CRs ``just create
unpredictability. It makes us rigid. We cannot deal with new and
revealing threats. We know our enemies are not standing still, so it is
about as unwise as it can be.'' And here are, as unwise as can be for
the fifth time.
And while their continuing resolution seeks to ransack every other
commitment to the health of the American people, Republicans hide
behind a fig leaf of a 2-year extension of community health centers.
[[Page H890]]
We all support community health centers. It was a very important part
of the Affordable Care Act. A very important part. Our colleague,
assistant leader Mr. Clyburn from South Carolina, was one of the great
champions of all time of Congress on expanding funding for programs for
care and for bricks and mortar for our community health centers. This
is a very important piece for us. We should be extending it in a fuller
bill to 5 years, except it is used here to hide from the fact of so
much other domestic investment that we are not making.
Republicans are eliminating the Home Visiting initiative that is
vital for maternal and child care, and cutting off workforce training
for low-income Americans seeking good-paying jobs in healthcare.
The sole purpose of this Republican bill is to destroy our leverage
to achieve parity in the caps, to eliminate any need for bipartisan
compromise, to eliminate any need to invest in working families.
Why?
Because if they get their defense number, then they don't have to
negotiate about the domestic number. And as I said, we support our men
and women in uniform having what they need to be safe and to keep us
safe. But the strength of our country is measured in other ways as
well.
They don't believe that and they can't pass that, so they have to put
the defense bill there. But we cannot support that because, again, it
comes at the expense instead of as a source of strength to our country.
Democrats simply want action on the critical overdue and bipartisan
priorities of the American people so beautifully spelled out by our
ranking member, Congresswoman Lowey.
Again, we need funding for the opioid epidemic. The President talked
about that. Show us the money. The opioid epidemic claims the lives of
115 Americans every day, and it is getting worse every year in every
district in the country. Bipartisan support is there to fight the
opioid epidemic. Let's do it.
We need more funding for veterans, to meet our responsibility and
ensure that no veteran is denied the care they deserve upon returning
from the battlefield.
We need emergency disaster funding for all communities ravaged by
hurricanes and wildfires.
We need to save millions of hardworking Americans' endangered
pensions.
We need to pass the bipartisan Dream Act immediately. This is a moral
priority for us. This is about the character of our Nation, who we are
as a country. A nation, over time, constantly invigorated by people
coming to our country to seek the American Dream; a dream that is
predicated on every generation working to make the future better for
the next; a dream that takes determination, optimism, hope, and
courage. And when these newcomers come to America with that
determination, that courage, that optimism, that hope, they associate
themselves with the values of our Founders to make the future better
for the next generation. These newcomers to America make America more
American.
So we asked to bring the Hurd-Aguilar bill to the floor. It is
bipartisan. It has bipartisan support on the floor. It would pass. Have
the courage to bring a bill that protects the DREAMers to the floor of
the House.
These priorities that I mentioned are all bipartisan. They would pass
if brought to the floor for an up-or-down vote. The GOP squandered all
their time, energy, votes, and enthusiasm on tax breaks for
corporations and the wealthiest, with 83 percent of the tax bill going
to the top 1 percent. And now Republicans need to get serious and get
to work on a budget that funds both the military and the domestic
investments that keep our Nation strong.
I just want to make one point about that tax bill again. Did you see
that the Speaker of the House sang the glory of the tax bill because a
woman was getting $1.50 a week more in her paycheck? Did you see that?
Do you believe that that is a good thing when the top 1 percent were
probably getting $1,500 a week compared to her $1.50 a week in their
paycheck?
Thank God, after millions of people objected, the Speaker withdrew
that tweet. But I don't think he withdrew that sentiment, because it is
the same sentiment that haunts all of these negotiations about
investing in the American people.
Republicans must stop governing from manufactured crisis to crisis,
and work with Democrats to pass many urgent, long-overdue priorities of
the American people. As our distinguished ranking member, Mrs. Lowey,
said earlier in her remarks, ``We must abandon these short-term
bills.'' She spelled out very clearly why. I associate myself with her
remarks.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield 2 minutes to the gentleman
from Texas (Mr. Carter), the chairman of the Committee on
Appropriations' Subcommittee on Homeland Security.
Mr. CARTER of Texas. Mr. Speaker, our fine Secretary of Defense this
morning testified before the Committee on Armed Services. He remarked
that if the military is forced to continue to operate under a
continuing resolution for the rest of the year, it will be unable to
provide pay to our brave men and women in uniform, unable to recruit
personnel we need, unable to maintain our naval ships, unable to
maintain our aircraft, unable to supply our troops in the theater of
combat, and unable to strike contracts critical toward modernizing our
force. Unable, unable, unable.
As Congress, it is our responsibility to make our military force the
most able in the world; able to keep our country safe and able to
promote the ideals of freedom across the globe.
It would be deeply irresponsible for Members of this House to vote
against providing full-year funding to the Defense Department, which
addresses the needs of today and tomorrow, not last year.
The Secretary was on the Hill to discuss something very important:
The Department's National Defense Strategy, which seeks to address the
significant challenges we face with rising adversaries in China and
Russia, along with enduring threats of a nuclear-armed Korea, a
terrorist state in Iran, a terrorist network like ISIS. And he said:
``I regret that, without sustained predictable appropriations, my
presence here today wastes your time because no strategy can survive
without funding necessary to resource it.''
Mr. Speaker, this bill funds our military for the year with funding
that addresses the challenges we face today and separates this critical
funding from the political fights here in Washington, D.C. Our troops
need our support for this bill.
The SPEAKER pro tempore (Mr. Poe of Texas). The time of the gentleman
has expired.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield an additional 30 seconds to
the gentleman from Texas.
Mr. CARTER of Texas. Mr. Speaker, they need what this bill provides.
Because of that, I support the bill and I urge its passage.
{time} 1745
Mrs. LOWEY. Mr. Speaker, I am pleased to yield 5 minutes to the
gentleman from Indiana (Mr. Visclosky), the ranking member of the
Appropriations Committee Subcommittee on Defense.
Mr. VISCLOSKY. Mr. Speaker, the first observation I would make is:
When I was raised by my parents, I was taught not to whine and not to
blame others for problems that arose, but, rather, to work hard to
solve them.
I think it is long past time for people in this body to blame people
in another body for the collective inability of the Congress of the
United States to make a decision about something so important as the
budget of the United States of America.
It is a leadership issue for the Democratic leadership and the
Republican leadership of the House to come to an agreement to overturn
the caps of the Budget Control Act. It is time for the Democratic and
Republican leadership of the Senate to do the same and for those two
bodies to come to an agreement collectively to meet our constitutional
responsibilities.
A few days ago, I was on this floor and said that we were confronted
with a number problem. That is, what is our total spending for this
fiscal year? We are in the 129th day of it for the Department of
Defense. What is the total budget number for all of our domestic
spending so that we can have a strong and vibrant economy and people?
We still have a number problem. For the sake of the country, for the
sake of
[[Page H891]]
this institution, for the sake of our committee and the good work that
Chairman Frelinghuysen, Mrs. Lowey, and the members of our committee
have done repeatedly, please let us have some leadership.
Lewis Carroll wrote ``Through the Looking Glass,'' and there was an
interchange in that story:
`` `Well, in our country,' said Alice, still panting a little, `you'd
generally get to somewhere else--if you ran very fast for a long time,
as we've been doing.' ''
`` `A slow sort of country!' said the Queen. `Now, here, you see, it
takes all the running you can do, to keep in the same place.' ''
In September, we did the first CR to December 8 because it was going
to be different then, but we are in the same place. Then we did a CR
for December 22 because it was going to be different then, but we are
in the same place. Then we did a CR for January 19 because it was going
to be different and a new year, but we are in the same place.
Today, we have February 8 because it was going to be different on
February 8, and now it is going to be the fifth time we have done a
continuing resolution to March 23 because it is going to be different
next month. That is fine.
We did our Defense Appropriations bill. We did it in July; then we
did it in September; then we did it in December; then we did it in
February--four times between CRs, repeatedly doing the same Defense
Appropriations bill. We have done it nine times. If we go through this
sequence one more time, Mr. Speaker, I am not going to be able to keep
track of my numbers anymore.
This is a numbers problem, and I would conclude by noting that I, for
one, did not vote for the Budget Control Act, and I would note that an
independently elected Congress set it aside for 2 years because they
knew a mistake had been made. Then a subsequently elected Congress did
away with the Budget Control Act because they had a 2-year deal because
they knew they had made a mistake.
There are negotiations--apparently taking place as we meet here
today--to set it aside for another 2 years because they know we made a
mistake within our legislation, because Chairman Frelinghuysen, Mrs.
Lowey, my chairwoman, Ms. Granger, and I, everybody has been honest. We
are going to set aside sequestration because we need to spend
additional moneys on defense.
How many times does Congress have to hit its head with a hammer to
not fix this problem permanently? Three different independently elected
Congresses have overturned a really rotten bill, and we are still in
the same place. It is time to stop for the sake of this country.
Give the chairman, give the ranking member, give the committees in
both Houses numbers so we can complete our bills. The last time I
looked, every department of this country has completed their work on
fiscal year 2019, are going to present us with their budgets next week,
and they don't know what we are doing this year.
Mr. Speaker, this is unbecoming of a great nation.
Mr. FRELINGHUYSEN. Mr. Speaker, I am pleased to yield 2 minutes to
the gentleman from Texas (Mr. Brady), the chairman of the Ways and
Means Committee.
Mr. BRADY of Texas. Mr. Speaker, I thank the chairman for his
leadership and hard work on this effort.
For over a year, the Ways and Means Committee has been leading
efforts to advance smart, focused solutions to improve Medicare for the
American people. A number of these solutions are included in the bill
before us today. These policies take action on three primary goals:
First, expanding access to high-quality care;
Second, increasing efficiency in the way we deliver care--a key goal
that will help patients better receive the care they need when they
need it; and
Third, incorporating healthcare technologies that are focused on
patients, such as telehealth, and eliminating barriers to coordinating
care.
This means providing new tools to patients that healthcare providers
can use to better access care and deliver it and, at the same time,
reducing red-tape burdens that now make it harder for our local doctors
to provide the high-quality care our Americans deserve.
So many of these provisions have support from Republicans and
Democrats, and for good reason. These are smart, targeted improvements
that will go a long way in helping Medicare patients in Texas and,
frankly, throughout the country.
Mr. Speaker, I want to thank all of the members of our committee and
throughout the House who have worked on these provisions. Improving and
strengthening Medicare for the long term is a major priority for the
American people. With this bill, we have an opportunity to take
meaningful steps toward this important goal.
Mr. Speaker, I urge all of my colleagues to join me in supporting its
passage.
Mrs. LOWEY. Mr. Speaker, I am pleased to yield 2 minutes to the
gentlewoman from Ohio (Ms. Kaptur), the ranking member of the
Appropriations Committee Subcommittee on Energy and Water Development,
and Related Agencies.
Ms. KAPTUR. Mr. Speaker, I thank Ranking Member Lowey and rise in
opposition to this bill.
Our Nation really needs to be on an even keel to produce steady
economic growth in this country. This bill doesn't help that.
I agree, America must have a strong defense, but a nation has to be
strong at home to be strong abroad. You can't shortchange the home
front. A nation at home must be secure, without wild stock market
swings, to be strong abroad.
A nation at home must be strong, without a massive drug epidemic here
at home, to be strong abroad.
This bill can't produce a steady economy with consistent job growth
because it fails to dedicate sufficient resources here at home: to
education, to healthcare, to employment and retraining, for Head Start,
for energy independence, for law enforcement, and for localities
savaged by the drug epidemic and shortchanged on treatment.
Our ship of state needs to be on an even keel, not the wild
fluctuations in this resolution. This bill tilts in the wind far, far
starboard, and that is not a setting that can assure a steady ship of
state to maintain a steady growth economy.
Mr. Speaker, I rise in opposition to the resolution.
Mr. FRELINGHUYSEN. Mr. Speaker, I am pleased to yield 2 minutes to
the gentleman from Nebraska (Mr. Smith), chairman of the Subcommittee
on Human Resources of the House Ways and Means Committee.
Mr. SMITH of Nebraska. Mr. Speaker, I rise in support of this
continuing resolution package.
While I appreciate this legislation will keep government open, fund
community health centers for 2 years, and fully fund our military while
we continue to work toward a broader budget agreement, I would like to
focus on the various Ways and Means Committee provisions included in
the bill.
This legislation includes numerous Medicare provisions important to
rural health providers and patients, including permanently repealing
therapy caps and extending the floor on geographic payment adjustments
for rural providers and add-ons for rural ambulance providers.
Just as importantly, these health provisions are paid for without
cutting swing bed reimbursements to critical access hospitals,
including the 55 critical access hospitals in Nebraska's Third District
as originally proposed.
I am particularly pleased that two important programs within the
jurisdiction of the Subcommittee on Human Resources--which I chair--are
included today. We have much work to do to lift Americans out of
poverty and into prosperity, and each of these bills will play an
important part in this effort.
The Family First Prevention Services Act reforms our child welfare
system to reinforce the importance of keeping children with their
families whenever possible. We know children who stay with their
families have better long-term outcomes than those who move to
nonfamily settings, and our goal for every program in this space to
demonstrate results through empirical evidence.
I want to thank the sponsor of Family First, Mr. Buchanan, for
working with me to address my concerns about nurse staffing
requirements which would have been costly to implement for entities
like Omaha-based Boys Town, while providing no tangible improvements to
their family driven model of care.
[[Page H892]]
The other H.R. item in this package, the supporting Social Impact
Partnerships to Pay for Results Act, also moves our family support
programs to a more results-driven model by incentivizing States and
local governments to pilot new ideas and reserving Federal funding
until they demonstrate outcomes through rigorous data-driven
evaluation. We still have more work to do in this space, starting with
completing the work begun by this Chamber last September when we passed
a paid-for 5-year MIECHV reauthorization.
But like the rest of this legislation, these provisions are a
downpayment on the work we are committed to completing.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. FRELINGHUYSEN. I yield an additional 30 seconds to the gentleman
from Nebraska.
Mr. SMITH of Nebraska. Mr. Speaker, I thank the gentleman for the
time, and I certainly urge passage of this bill.
Mrs. LOWEY. Mr. Speaker, I am pleased to yield 2 minutes to the
gentlewoman from Connecticut (Ms. DeLauro), the ranking member of the
Labor, Health and Human Services, Education, and Related Agencies
Subcommittee of the Appropriations Committee.
Ms. DeLAURO. Mr. Speaker, I rise to strongly oppose this continuing
resolution. I cannot support a bill that flies in the face of
responsible governing. This is pure incompetence.
How many times are we going to do this? This is our fifth short-term
spending bill since September. How many times will we punt our
priorities, lurching from one self-inflicted wound to another?
That is exactly what the continuing resolution represents: a failure
to govern. It is shameful that, yet again, we neglect our core
obligation as a Congress, which is to fund government programs. We
should be voting on new top-line spending levels for 2018, that
alleviate sequestration from both nondefense and defense spending.
We should have spent the last few months fulfilling our
responsibility as legislators by writing bipartisan bills to fund
programs that help the middle class and the vulnerable, support
evidence-based scientific research, and help working people get the
skills they need to find good jobs and get good wages.
Instead, the majority forced through their tax scam for millionaires
and billionaires. They became the first party to ever control both
Chambers of Congress and the White House, and, yes, they shut down the
government. And today, the President of the United States says that he
supports a government shutdown.
The Republican majority has failed to respond to the needs of the
American people. Instead of working with Democrats to set budget
numbers and ensure parity, equal for defense spending and nondefense
spending, they have put the government on autopilot.
{time} 1800
They put services and investments that are critical to our families
and to our communities at grave risk from apprenticeships to education
for students with disabilities, childcare, after-school programs that
help working families make ends meet, and financial aid for students
who are attending college. Instead, they are forcing through another
continuing resolution, this time cutting almost $3 billion from the
Prevention Fund over the next 10 years on top of the $750 million that
they cut in December.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mrs. LOWEY. Mr. Speaker, I yield the gentlewoman from Connecticut an
additional 1 minute.
Ms. DeLAURO. We are talking about cuts to programs that improve our
public health immunization infrastructure at a time when the flu is
rampant in this country, as well as cuts to lead poisoning prevention
programs that seek to prevent and ultimately eliminate childhood lead
poisoning.
Programs like these and dozens of others in the Prevention Fund save
billions of taxpayer dollars by preventing illness and disease before
they occur.
You cut the Prevention Fund and you cause millions of Americans to
suffer for no reason. You pit community health centers against the
Prevention Fund.
Take the money, the $1\1/2\ trillion that you give to the richest
people in this country: the millionaires, the billionaires, and the
richest corporations; don't take it from children's health, don't take
it from the healthcare centers, and don't take it from the Prevention
Fund. It is unacceptable, because here we are talking about people's
lives.
Mr. Speaker, I urge my colleagues: Reject this continuing resolution.
It fails to meet our obligations to the American people.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield 2 minutes to the gentleman
from Texas (Mr. Barton), who is the vice chairman of the Energy and
Commerce Committee.
Mr. BARTON. Mr. Speaker, I thank the distinguished Appropriations
Committee chairman for yielding me time.
I rise in support of this continuing resolution. Obviously, we would
rather fund the government for the entire year before the start of the
fiscal year, but that is in a perfect world, and one thing that the
Congress has never been accused of is being a perfect world. So we are
here dealing in the real world.
To my good friend from Connecticut who just spoke, and she is my good
friend, I would point out that the bill before us doesn't cut money
from the Prevention Fund. It directs money from the Prevention Fund to
spend on healthcare programs. In other words, it is taking some
discretion from the executive branch and directing that spending that
Congress thinks it should be spent for.
One of the programs that we are going to fund for 2 years is the
community health centers. Twenty-four million people each year get
their healthcare from these community health centers, and one of them
is in my home county, the Hope Clinic. Its main facility is in
Waxahachie, Texas. But in my hometown of Ennis, we have the Nell Barton
Hope Clinic Annex. These two facilities in Ellis County this year are
providing healthcare for over 10,000 Ellis Countians.
This is not exotic care. It is checkups, screenings, mammograms, and
all the odds and ends that you have in your basic healthcare
facilities. If they need more specific treatment, they are referred to
specialists in the Dallas-Fort Worth area.
But for the 10,000 citizens of Ellis County who depend on the Hope
Clinic for their healthcare, this is a big bill. In fact, the executive
director of the Hope Clinic was in my office today, saying: We want to
expand, but we don't know if we are going to have the funds. We really
need to get some certainty.
That is what this bill is all about. So I rise in strong support, and
I urge a ``yes'' vote on the CR later this evening.
Mrs. LOWEY. Mr. Speaker, I yield 2 minutes to the gentlewoman from
California (Ms. Lee), who is a senior member of the Appropriations
Committee.
Ms. LEE. Mr. Speaker, I want to thank the gentlewoman for yielding
and, once again, for her tremendous leadership on so many issues as our
ranking member.
As a member of the Appropriations Committee and the Budget Committee,
I rise in strong opposition to this continuing resolution. This bill
kicks the can down the road for the fifth time--mind you, fifth time--
since October. It also shamelessly includes the stand-alone defense
spending bill of $659 billion to an already out-of-control Pentagon
budget.
This bill breaks the budget caps. It includes $75 billion for wars
that Congress has never debated or voted on. It also includes more than
$1 billion in funds to increase troop levels in Afghanistan by 3,500,
not to mention the millions--the billions, actually--in waste, fraud,
and abuse that taxpayers have already lost by irresponsible Pentagon
spending.
This is outrageous. Republicans control the House, the Senate, and
the White House. The least they could do is keep the government open.
Yet here we stand, once again, with no deal on DREAMers and no
agreement on a long-term spending bill.
Clearly, Republicans have no strategy on funding the government. They
would prefer to pass CR after CR after CR after CR. This is beyond
irresponsible, Mr. Speaker.
[[Page H893]]
How long will Republicans govern from crisis to crisis? Nobody can
manage their household or their business like the Republicans are
managing our government spending.
This short-term resolution once again ignores urgent bipartisan
priorities the Democrats have been fighting for for months with
Republicans, the most urgent of which is passing a clean Dream Act.
DACA recipients are American in every way except on paper, and right
now their lives are hanging in the balance. We have less than 1 month
until DACA expires, a deadline that the President, himself, created.
This continuing resolution is really irresponsible, and it is morally
bankrupt.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mrs. LOWEY. Mr. Speaker, I yield the gentlewoman from California an
additional 1 minute.
Ms. LEE. Mr. Speaker, this continuing resolution fails to honor the
temporary protective status for immigrants.
It fails to raise budget caps for defense and nondefense spending,
and it neglects to provide desperately needed funding for hurricane-
and wildfire-impacted communities, the opioid crisis, and our veterans.
This bill underscores the majority's complete lack of regard for
everyday Americans and struggling families.
Continuing resolutions leave the American people out on a limb with
no confidence in their Federal Government. This resolution makes it
clear that that is just what Republicans want to do.
The American people sent us to Congress to govern in their best
interest. Now we have spent the last 4 months passing short-term
spending bills one after another, and for what? Because Republicans
refuse to do their job.
Instead of wasting more time on this terrible CR, we should deal with
our bipartisan priorities and fund the government for the long term. It
is the right thing to do for our communities and our country.
Mr. Speaker, I urge a ``no'' vote on this bill.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield 1 minute to the gentleman
from Florida (Mr. Bilirakis), who is a member of the House Energy and
Commerce Committee.
Mr. BILIRAKIS. Mr. Speaker, I thank the chairman for doing an
outstanding job this year passing all 12 appropriations bills.
Mr. Speaker, I support passage of this CR which includes three
provisions of mine. It will reauthorize the Community Health Center
program, providing $3.6 billion per year for the next 2 years.
Community health centers have a proven track record of providing
high-quality, cost-efficient healthcare to approximately 25 million
Americans and have long enjoyed bipartisan support because they are a
prime example of what is working in our healthcare system.
The CR updates the civil and criminal penalties in the Medicare and
Medicaid programs. Many haven't been updated in over 20 years.
It also repeals the Medicare therapy cap. This will ensure that
patients who need physical, speech, or occupational therapy services
can receive them without fear of losing their benefits if they hit an
arbitrary cap. This is so important to our seniors, Mr. Speaker.
Mr. Speaker, I encourage my colleagues to support this bill.
Mrs. LOWEY. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Minnesota (Ms. McCollum), who is the ranking member of the Interior,
Environment, and Related Agencies Subcommittee.
Ms. McCOLLUM. Mr. Speaker, I thank our ranking member for yielding me
the time.
Mr. Speaker, I rise in opposition to this legislation, a misguided
bill that ignores the urgent needs of the American people.
The Federal Government's fiscal year started October 1, 2017--128
days ago. Instead of using that time to get their work done,
Republicans have focused solely on partisan politics. When it comes to
the essential responsibility of funding the Federal Government, the
Republicans can't be bothered.
Now we are asked, today, to vote for a bill that funds the Pentagon
for the rest of the year while funding our schools and our hospitals
for just 43 days.
Mr. Speaker, our national security begins at home with investments in
the future that keep our families and our communities safe, strong, and
moving forward. This bill ignores those needs. It provides no certainty
for our law enforcement professionals, no long-term funding for urgent
repairs to our crumbling infrastructure, and no confidence for
investments in lifesaving medical research. It doesn't even provide a
full year of funding for veterans' healthcare.
While it is encouraging that Republicans are finally reauthorizing
vital healthcare programs like our community health centers, paying for
these programs with cuts to the CDC's Prevention and Public Health
Fund, which is currently providing lifesaving vaccines in this severe
flu season, is the height of irresponsibility.
Discord and delay is no way to run a government, but under Republican
control, that is exactly what we are getting.
Mr. Speaker, unlike the President, I do not want a government
shutdown. We need a budget agreement that keeps our government open,
protects our national security, and meets our commitments to
hardworking families. So let's stop playing games, get to our work, and
get to it now.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield 2 minutes to the gentleman
from Georgia (Mr. Carter), who is a member of the House Energy and
Commerce Committee.
Mr. CARTER of Georgia. Mr. Speaker, I rise today in support of this
spending measure under consideration and what it means for our country
and our constituents.
This continuing resolution we are considering includes a number of
extremely important health provisions that are desperately needed.
Under this legislation, we will see a 2-year extension of federally
qualified health centers that employ nearly 190,000 people and serve
over 24 million people across the country.
There is also a 2-year extension of public health programs such as
the National Health Service Corps, the Teaching Health Center Graduate
Medical Education, Family-to-Family Health Information Centers, and the
Sexual Risk Avoidance Education Program.
Additionally, this helps hospitals by eliminating the $5 million in
reductions for Disproportionate Share Hospitals that were included in
the ACA.
Many of the good bills my colleagues on the Energy and Commerce
Committee have worked on are included in this legislation to improve
public health and make reforms to Medicare.
Finally, this legislation pushes through a permanent repeal of the
Medicare payment cap for therapy services, meaning that patients will
have better access to important medical devices.
All of these efforts wouldn't be possible without the work of
Chairman Walden, Chairman Burgess, and my colleagues on both sides of
the aisle in the Energy and Commerce Committee.
Mr. Speaker, now is the time to work together to ensure that these
bills are passed into law, and that is why I urge my colleagues to
support this bill.
Mrs. LOWEY. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman
from Florida (Ms. Wasserman Schultz), who is the ranking member of the
Military Construction, Veterans Affairs, and Related Agencies
Subcommittee.
Ms. WASSERMAN SCHULTZ. Mr. Speaker, I thank the gentlewoman for
yielding and for her leadership.
Mr. Speaker, I rise in strong opposition to this continuing
resolution which, yet again, is a complete and total abdication of our
responsibilities as Members of Congress.
For the fifth time so far this fiscal year, Republicans are asking us
to fund the government for just another flip of the calendar. The last
time Republicans dragged us down this path of budgetary incompetence,
we had the first ever complete government shutdown when one party held
the House, Senate, and the White House. Yet here we are again, left
with this ludicrous approach of funding the U.S. Government month to
month while ignoring so many of the pressing issues Americans want us
to address.
Today we have heard Republicans pay endless lip service to their
devotion to military spending--and that
[[Page H894]]
funding is certainly vital--but what Republicans have not mentioned is
that this latest stopgap gimmick is going to rob from crucial
nondefense budgets that also keep Americans safe. That means veterans,
homeland security, counterterrorism, and State Department programs will
be neglected and ignored.
That is why Democrats are asking for a simple compromise to raise the
spending caps that are unreasonable and uncompromising. That is because
we all want a strong national defense, but we also need equal increases
in our domestic budget so that hardworking families can feel safe and
financially secure.
We also want Republicans to join us in confronting the dire shortfall
at the VA so no veteran is denied care upon returning home.
We want Republicans to work with us to ensure urgently needed
recovery funds go to Texas, Florida, Puerto Rico, the U.S. Virgin
Islands, and all areas impacted by wildfires.
{time} 1815
We want Republicans to truly help us fight this opioid scourge,
protect America's pensions, and do what the vast majority of Americans
want us to do: pass a clean Dream Act.
Don't tell me we don't have the funds to support those needs. This
Congress just gave a huge handout to billionaires and giant
corporations that exploded the deficit by $1.5 trillion.
But this cynically crafted continuing resolution fails to address
those real needs, the needs of the people who actually sent us here to
stand up for them. We must end this cycle of budgetary neglect.
Mr. Speaker, I urge my colleagues to vote ``no.''
Mr. FRELINGHUYSEN. Mr. Speaker, I yield 2 minutes to the gentleman
from Florida (Mr. Dunn).
Mr. DUNN. Mr. Speaker, our troops comprise the most professional,
highly trained, and dedicated military force that the world has ever
seen. They have pledged their lives, the well-being of their families,
and their sacred honor to serve and protect this Nation.
Yet here we are, over a month into 2018, and our military and
national security are being held hostage by our colleagues across the
aisle over unrelated issues.
It is time for the Senate to get its act together. The House has
passed the full defense funding three times this year. Tonight, we will
pass it a fourth time.
It is wrong for us to send our best young men and women into harm's
way without the resources they need, asking them to make up with their
efforts, and their risk, for our shortcomings.
Mr. Speaker, I urge my colleagues to support this funding legislation
and to prove to our troops that we have their backs.
Mrs. LOWEY. Mr. Speaker, I yield 2 minutes to the gentleman from New
Jersey (Mr. Pallone), the ranking member of the Committee on Energy and
Commerce.
Mr. PALLONE. Mr. Speaker, I rise in opposition to H.R. 1892.
Mr. Speaker, I am disappointed that, once again, my Republican
colleagues are playing politics with important health programs.
Rather than bringing a stand-alone, bipartisan health extenders
package to the floor, the Republicans have once again delayed any
action on these extenders so that they could attach them to a CR that
Democrats could not support.
The strategy may hide their inability to pass a final funding bill
for a fiscal year that began on October 1, but it has also created
uncertainty for the millions of Americans who rely on these programs
every day.
I am glad that Republicans have dropped some of the harmful offsets
that have led to months of delay and uncertainty for these health
programs. However, our main concern is that the package excludes
important health priorities, including the Maternal, Infant, and Early
Childhood Home Visiting Program; the Health Profession Opportunity
Grants program; and the increased funding that is desperately needed to
combat the ongoing opioid crisis.
The CR poses a serious threat to public health because it cuts $2.85
billion from the Prevention Fund. These funds are critical to keeping
Americans healthy. The Prevention Fund funds vaccines for children,
lead poisoning prevention, opioid prevention, diabetes, heart disease,
and other prevention programs.
I am also concerned with the Medicaid cuts in this package.
Republicans have included over $10 billion in Medicaid cuts, including
new money from the Medicaid Improvement Fund.
We should also reject the prioritization of funding for the Defense
Department at the expense of all of our domestic needs.
I urge my colleagues to vote ``no.'' It is the only way we are going
to guarantee that, ultimately, these health programs are funded and
that we don't rely so much on the Prevention Fund.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield 2 minutes to the gentlewoman
from Tennessee (Mrs. Blackburn).
Mrs. BLACKBURN. Mr. Speaker, it is so interesting to listen to this
debate. I just want to make three points.
First, on the military funding, I represent Fort Campbell. When you
walk on that post and talk to the men and women in uniform and talk to
them about their readiness training, their redeployment training, do
you know what they tell us?
They say: Give us certainty in funding.
That is exactly what we are doing, is providing that certainty that
they need to defend us, to protect us. They deserve it and they deserve
our best efforts. So I find it so curious that there would be
opposition to funding our military.
The second point is the community health centers. Many of my
colleagues may come from urban areas. I have a rural district.
Community health centers are vitally important to my constituents, to
Tennesseans who want the access to care and seek the education to know
how to take better care of themselves and their families. Let's give
them this funding for the 2 years of certainty that is necessary.
Third, legislation that I have authored and worked on is included in
the Medicare therapy cap provisions.
Have you ever talked to a senior, as I have, who had a stroke, who is
seeking speech therapy or physical therapy from a hip replacement or a
fall?
There is an arbitrary cap that runs out and they can no longer seek
that medical attention that is necessary for a full and complete
recovery and the quality of life that they desire and that they
deserve. This is something that our committee has worked on to provide
for seniors.
The SPEAKER pro tempore. The time of the gentlewoman has expired.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield an additional 1 minute to the
gentlewoman from Tennessee.
Mrs. BLACKBURN. This is something that allows them to have that
quality of life.
Why would you vote against lifting these caps and giving seniors what
they deserve?
They have paid for Medicare through their working life. What they are
seeking is to be able to have a full recovery. It is not only the
appropriate thing to do, this is something that adds to the quality of
life, just as keeping these community health centers funded enriches
our communities. It enriches rural America.
I close with reiterating the point that, out of fairness, out of
respect, out of loyalty to those who put on the uniform to defend us,
let us join together and vote to fund the military and to support their
efforts to defend this Nation.
Mrs. LOWEY. Mr. Speaker, I reserve the balance of my time.
Mr. FRELINGHUYSEN. Mr. Speaker, I yield such time as he may consume
to the gentleman from Oregon (Mr. Walden), the chairman of the Energy
and Commerce Committee.
Mr. WALDEN. Mr. Speaker, I thank the chairman of the House
Appropriations Committee and his great staff who have worked diligently
all year, month after month after month. Five months ago next week,
they approved all 12 appropriations bills, one after another, regular
order, through the House of Representatives. But there they sit over in
the Senate and the Democrats block them.
What brings us here today is really important work. What brings us
here today is that we are taking care of significant public healthcare
issues. We are fully funding for the next 2 years community health
centers.
[[Page H895]]
I have heard from my colleagues about the things that aren't in this
bill that they wish were, so that is why they are going to vote ``no,''
or some other thing that is not even before us and that is why they are
going to vote ``no.''
But let's talk about what is actually before us.
What is before us is taking care of our men and women in uniform and
their needs, especially when they are in harm's way, and fund really,
really important public health programs that used to always be
bipartisan.
Let's talk about those. Valley Family Health Care Outreach Center in
Ontario and Winding Waters Clinic in Wallowa County. I have visited
both of these recently. They are on the front lines of healthcare
prevention. They are on the front lines of saving lives and helping
children and adults. Or La Clinica down in the Medford-Ashland area.
In fact, in my district, we have 12 federally qualified health
centers and 63 delivery sites that give care for 240,000 Oregonians.
Twenty-four million nationwide are served by this.
On November 3, this House had the opportunity to fully fund those
community health centers for 2 years and take care of children's health
insurance and a lot of these other programs. It was a separate bill
brought to the House floor, and a handful of Democrats broke with their
party and voted with us. But, unfortunately, when it got to the Senate,
they couldn't be freed up to support it. So we had to come back in the
last continuing resolution and fully fund the Children's Health
Insurance Program. I am not sure many Democrats voted for that here,
unfortunately.
But here we are today, same process, same situation to fund community
health centers. So we are going to do that. Your choice when you vote
is ``yes'' or ``no,'' you want the community health centers funded or
not, you want to shut the government down or not, you want to take care
of our military or not.
Then there is the disproportionate share hospitals.
What are those?
Those are the hospitals in our districts and States that take care
disproportionately of more poorer people than other hospitals. Under
the Affordable Care Act or ObamaCare, however you want to describe it,
there was prescribed in law automatic cuts to these hospitals that take
care of the poorest of the poor in our communities. Those cuts totaled
$2 billion.
In this legislation, as in the legislation we brought from the Energy
and Commerce Committee on November 3, we turn off those cuts. We say:
Don't do that to our DSH hospitals.
If you are at Saint Alphonsus in Ontario, Oregon, that is the most
affected hospital, I am told, and they will lose money and have to
decide how they cope with that. We solve that here for 2 years at $6.8
million in my State.
Then we extend the special diabetes programs. For heaven's sake, we
should be able to come together in this Chamber and in this Congress to
take care of people with diabetes. My grandfather lost both legs due to
diabetes. They were amputated. I have other relatives and good friends
whose kids have dealt with diabetes and still do to this day.
For our Native Americans and others, we have two separate programs.
We fully fund them and tie them together. That is done in this
legislation. Fifty thousand people in my district have diabetes. My
hunch is all of our districts are not dissimilar from that. We take
care of those people in this legislation.
Then we take care of therapy caps. Since 1997, when this law was put
in place, people who needed physical therapy--my colleague from
Tennessee talked about it--stroke victims, seniors who need therapy,
rather than the physical therapist or the speech therapist saying,
``Here is the program you need to get well, get on your feet, recover
from whatever it is that afflicts you,'' the government put an
arbitrary cap, and that was it. You were done whether you were done or
not.
Everybody is different in terms of recovery. We repeal the therapy
caps in here.
By the way, we have heard about all these things that now won't get
funded because a part of this funding comes out of the Public
Prevention Fund. Mr. Speaker, $2.85 billion is not insignificant, it is
true, but we are applying that money to help prevention and community
health centers, as we did before for the Children's Health Insurance
Program.
We are providing it for diabetes health. We are removing the physical
therapy caps so that people can get well. That seems to me to be pretty
good use of the Prevention Fund.
By the way, during the same period we are spending $2.85 billion out
of that, there will still remain $12 billion left, and the talented
folks at the Appropriations Committee will decide how that money is
spent on vaccines and all these other issues, all these things we care
about. There is still $12 billion left. So we are using discretionary
funds that were set aside for that very purpose here.
Then we heard about some Medicaid cuts. Let me tell you what those
are. We said: If you are a big lottery winner, maybe now that you have
won a big prize, you shouldn't be on government-funded Medicaid
because, by the way, you won a bazillion dollars.
So we are taking lottery winners and saying you have got to treat
that big windfall when you calculate whether that person is poor or not
anymore. So that is in here.
Then, on third-party liability, we said that if insurers actually are
responsible for the cost, insurers should pay the cost rather than the
taxpayer. So we make a little reform here that puts the insurers first
to pay rather than the taxpayer.
Mr. Speaker, I thank the chairman for the marvelous work he has done.
{time} 1830
Mr. FRELINGHUYSEN. Mr. Speaker, I reserve the balance of my time.
Mrs. LOWEY. Mr. Speaker, I yield myself such time as I may consume.
This is the latest example of Republicans being completely incapable
of governing. We must finish our work.
Mr. Speaker, I yield back the balance of my time.
Mr. FRELINGHUYSEN. Mr. Speaker, I am in receipt of the Statement of
Administration Policy, which indicates that the administration supports
this continuing resolution and that the President's advisers would
recommend his signature on the bill.
Mr. Speaker, I include in the Record the Statement of Administration
Policy dated February 6, 2018.
Statement of Administration Policy
House Amendment to H.R. 1892--Further Extension of Continuing
Appropriations Act, 2018--Rep. Frelinghuysen, R-NJ
The Administration supports the House Amendment to the
Senate Amendment to H.R. 1892, the Further Extension of
Continuing Appropriations Act, 2018. This bill funds most
Government programs at current levels through March 23, 2018,
while incorporating the text of the House-passed fiscal year
(FY) 2018 Department of Defense Appropriations Act, which
provides the resources the military needs to keep the Nation
safe. As the Administration has noted previously, the House-
passed Department of DefenseAppropriations Act is consistent
with the President's pledge to undo the looming defense
spending reductions that are harmful to America's national
security and military readiness.
The House-passed Department of Defense Appropriations Act
incorporated in the bill includes a total of $659 billion for
the Department of Defense (DOD), including $584 billion in
base spending and $75 billion for Overseas Contingency
Operations. These amounts are consistent with a total funding
level for DOD similar to that authorized by the National
Defense Authorization Act for Fiscal Year 2018, which was
signed into law by the President. It includes $1.2 billion
requested by the Administration to support increased troop
levels in Afghanistan, special operations forces
capabilities, and other urgent needs.
The United States military's greatest asset is the men and
women who volunteer to serve. This bill keeps faith with
service members by providing a 2.4 percent military pay
raise. It increases end strength across the military services
for active duty, reserve, and National Guard personnel, and
includes funding for training and maintenance to ensure that
United States troops are properly equipped and ready to
fight.
In addition to supporting the defense bill, the
Administration supports language in the House Amendment to
H.R. 1892 that provides for an extension of a variety of
healthcare provisions, including Community Health Centers.
The Administration is also appreciative that the bill
includes language requested by the Administration to ensure
continuity of operations for the 2020 Decennial Census
Program and the Small Business Administration's Disaster
Loans Program.
The Administration supports continuing discussions over a
two-year budget agreement that ensures funding for national
defense and other priorities. As those discussions continue,
however, it is dangerous to
[[Page H896]]
hold defense funding for the current fiscal year hostage to
arbitrary demands for lower-priority domestic programs.
If the Further Extension of Continuing Appropriations Act,
2018, were presented to the President in its current form,
his advisors would recommend that he sign the bill into law.
Mr. FRELINGHUYSEN. Mr. Speaker, I urge all of my colleagues in the
House to support this continuing resolution to keep the government open
for business until March 23 and to support our men and women in the
armed services who do the work of freedom each and every day.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 727, the previous question is ordered.
The question is on the motion by the gentleman from New Jersey (Mr.
Frelinghuysen).
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. FRELINGHUYSEN. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, this 15-
minute vote on the motion to concur will be followed by a 5-minute vote
on the motion to suspend the rules and pass H.R. 219, if ordered.
The vote was taken by electronic device, and there were--yeas 245,
nays 182, not voting 3, as follows:
[Roll No. 60]
YEAS--245
Abraham
Aderholt
Allen
Amodei
Arrington
Babin
Bacon
Banks (IN)
Barletta
Barr
Barton
Bergman
Biggs
Bilirakis
Bishop (GA)
Bishop (MI)
Bishop (UT)
Black
Blackburn
Blum
Bost
Brady (TX)
Brat
Brooks (AL)
Brooks (IN)
Buchanan
Buck
Bucshon
Budd
Burgess
Bustos
Byrne
Calvert
Carbajal
Carter (GA)
Carter (TX)
Chabot
Cheney
Coffman
Cole
Collins (GA)
Collins (NY)
Comer
Comstock
Conaway
Cook
Cooper
Costa
Costello (PA)
Cramer
Crawford
Crist
Culberson
Curtis
Davidson
Davis, Rodney
Denham
Dent
DeSantis
DesJarlais
Diaz-Balart
Donovan
Duffy
Duncan (SC)
Dunn
Emmer
Estes (KS)
Farenthold
Faso
Ferguson
Fitzpatrick
Fleischmann
Flores
Fortenberry
Foxx
Frelinghuysen
Gaetz
Gallagher
Garamendi
Garrett
Gianforte
Gibbs
Gohmert
Goodlatte
Gosar
Gottheimer
Gowdy
Granger
Graves (GA)
Graves (LA)
Graves (MO)
Griffith
Grothman
Guthrie
Handel
Harper
Harris
Hartzler
Hensarling
Herrera Beutler
Hice, Jody B.
Higgins (LA)
Hill
Holding
Hollingsworth
Hudson
Huizenga
Hultgren
Hunter
Hurd
Issa
Jenkins (KS)
Jenkins (WV)
Johnson (LA)
Johnson (OH)
Johnson, Sam
Jordan
Joyce (OH)
Katko
Kelly (MS)
Kelly (PA)
King (IA)
King (NY)
Kinzinger
Knight
Kustoff (TN)
LaHood
LaMalfa
Lamborn
Lance
Latta
Lawson (FL)
Lewis (MN)
LoBiondo
Loebsack
Long
Loudermilk
Love
Lucas
Luetkemeyer
MacArthur
Marchant
Marino
Marshall
Mast
McCarthy
McCaul
McClintock
McHenry
McKinley
McMorris Rodgers
McSally
Meadows
Meehan
Messer
Mitchell
Moolenaar
Mooney (WV)
Mullin
Murphy (FL)
Newhouse
Noem
Norman
Nunes
O'Halleran
Olson
Palazzo
Palmer
Paulsen
Pearce
Perry
Peterson
Pittenger
Poe (TX)
Poliquin
Posey
Ratcliffe
Reed
Reichert
Renacci
Rice (SC)
Roby
Roe (TN)
Rogers (AL)
Rogers (KY)
Rohrabacher
Rokita
Rooney, Francis
Rooney, Thomas J.
Roskam
Ross
Rothfus
Rouzer
Royce (CA)
Ruiz
Russell
Rutherford
Scalise
Schneider
Schweikert
Scott, Austin
Sensenbrenner
Sessions
Shimkus
Shuster
Simpson
Sinema
Smith (MO)
Smith (NE)
Smith (NJ)
Smith (TX)
Smucker
Stefanik
Stewart
Stivers
Taylor
Tenney
Thompson (PA)
Thornberry
Tipton
Trott
Turner
Upton
Valadao
Vela
Wagner
Walberg
Walden
Walker
Walorski
Walters, Mimi
Weber (TX)
Webster (FL)
Wenstrup
Westerman
Williams
Wilson (SC)
Wittman
Womack
Woodall
Yoder
Yoho
Young (AK)
Young (IA)
Zeldin
NAYS--182
Adams
Aguilar
Amash
Barragan
Bass
Beatty
Bera
Beyer
Blumenauer
Blunt Rochester
Bonamici
Boyle, Brendan F.
Brady (PA)
Brown (MD)
Brownley (CA)
Butterfield
Capuano
Cardenas
Carson (IN)
Cartwright
Castor (FL)
Castro (TX)
Chu, Judy
Cicilline
Clark (MA)
Clarke (NY)
Clay
Cleaver
Clyburn
Cohen
Connolly
Correa
Courtney
Crowley
Cuellar
Curbelo (FL)
Davis (CA)
Davis, Danny
DeFazio
DeGette
Delaney
DeLauro
DelBene
Demings
DeSaulnier
Deutch
Dingell
Doggett
Doyle, Michael F.
Duncan (TN)
Ellison
Engel
Eshoo
Espaillat
Esty (CT)
Evans
Foster
Frankel (FL)
Fudge
Gabbard
Gallego
Gomez
Gonzalez (TX)
Green, Al
Green, Gene
Grijalva
Gutierrez
Hanabusa
Hastings
Heck
Higgins (NY)
Himes
Hoyer
Huffman
Jackson Lee
Jayapal
Jeffries
Johnson (GA)
Johnson, E. B.
Jones
Kaptur
Keating
Kelly (IL)
Kennedy
Khanna
Kihuen
Kildee
Kilmer
Kind
Krishnamoorthi
Kuster (NH)
Labrador
Langevin
Larsen (WA)
Larson (CT)
Lawrence
Lee
Levin
Lewis (GA)
Lieu, Ted
Lipinski
Lofgren
Lowenthal
Lowey
Lujan Grisham, M.
Lujan, Ben Ray
Lynch
Maloney, Carolyn B.
Maloney, Sean
Massie
Matsui
McCollum
McEachin
McGovern
McNerney
Meeks
Meng
Moore
Moulton
Nadler
Napolitano
Neal
Nolan
Norcross
O'Rourke
Pallone
Panetta
Pascrell
Payne
Pelosi
Perlmutter
Peters
Pingree
Pocan
Polis
Price (NC)
Quigley
Raskin
Rice (NY)
Richmond
Ros-Lehtinen
Rosen
Roybal-Allard
Ruppersberger
Rush
Ryan (OH)
Sanchez
Sanford
Sarbanes
Schakowsky
Schiff
Schrader
Scott (VA)
Scott, David
Serrano
Sewell (AL)
Shea-Porter
Sherman
Sires
Slaughter
Smith (WA)
Soto
Speier
Suozzi
Swalwell (CA)
Takano
Thompson (CA)
Thompson (MS)
Titus
Tonko
Torres
Tsongas
Vargas
Veasey
Velazquez
Visclosky
Wasserman Schultz
Waters, Maxine
Watson Coleman
Welch
Wilson (FL)
Yarmuth
NOT VOTING--3
Bridenstine
Cummings
Walz
{time} 1855
Mr. GROTHMAN changed his vote from ``nay'' to ``yea.''
So the motion to concur was agreed to.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
____________________