,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #djee  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #ah1 #bjae   
,mr4 ,ellison 7= himself1 ,ms4          
,de,lauro1 ,mr4 ,grijalva1 ,mr4 ,pet]s1 
,mr4 ,crd5as1 ,mr4 ,c>son ( ,indiana1   
,mr4 ,mc,govern1 ,ms4 ,m5g1 ,ms4 ,cl>ke 
( ,new ,york1 ,ms4 ,lee1 ,mr4 ,pocan1   
,ms4 ,kaptur1 ,ms4 ,norton1 ,mr4 ,nadl]1
 ,mr4 ,ha/+s1 ,mr4 ,cony]s1 ,ms4        
,mi*elle ,lujan ,gri%am ( ,new ,mexico1 
,ms4 ,judy ,*u ( ,cali=nia1 ,ms4        
,edw>ds1 & ,mr4 ,van ,holl57 introduc$ !
 foll[+ bill2 :i* 0 ref]r$ to !         
,committee on ,ways & ,means  ,a ,,bill 
,to am5d title ,,iv ( ! ,social         
,security ,act to address ! increas$    
burd5 t ma9ta9+ ! heal? & hygi5e (      
infants & toddl]s places on families 9  
ne$1 ! resultant adv]se heal? effects on
 *ildr5 & families1 & ! limit$ *ild c>e 
options available = infants & toddl]s :o
 lack suffici5t diap]s1 :i* prev5ts _!  
p>5ts & gu>dians f ent]+ ! work=ce4  #a4
 ,%ort title ,?is ,act may be cit$ z !  

,hygi5e ,assi/ance = ,families (        
,infants & ,toddl]s ,act ( #bjae4  #b4  
,f9d+s ,congress f9ds ! foll[+3  7#a7   
,access to a reliable supply ( clean    
diap]s is a m$ical necessity = ! heal? &
 welf>e ( infants & toddl]s1 _!         
families1 & *ild c>e & heal? c>e        
provid]s1 yet 9 a repres5tative survey (
 mo!rs 9 ! ,unit$ ,/ates1 #a 9 #c mo!rs 
report$ hav+ to cut back on ess5tials 9 
ord] to af=d en\gh diap]s = a *ild4     
7#b7 ,9 ! ,unit$ ,/ates1 mo/ *ildr5 beg9
 toilet tra9+ betwe5 #b & #c ye>s ( age1
 & aft] toilet tra9+ is complete1 ! *ild
 w n ne$ diap]s4 ,families ) infants &  
toddl]s are m likely to be economically 
disadvantag$ ?an o!r families4 ,infants 
& toddl]s are m likely to live )        
l[-income & poor families ?an old]      
*ildr51 #be p]c5t ( infants & toddl]s   
live ) families e>n+ less ?an ! ,f$]al  
pov]ty level1 & #dg p]c5t ( infants &   
toddl]s live ) families e>n+ less ?an   
twice ! ,f$]al pov]ty level4 ,!re are   
ov] #ihj1jjj infants & toddl]s :o are   

recipi5ts ( assi/ance "u ! program (    
block grants to ,/ates = tempor>y       
assi/ance = ne$y families 7,,tanf71 ov] 
"o-?ird ( all families enroll$ 9 su* a  
,/ate program include an infant or      
toddl]1 & ! av]age mon?ly diap] bill (  
#gj to #hj repres5ts at lea/ #h p]c5t & 
up to #dj p]c5t ( ! av]age am\nt ( ca%  
assi/ance provid$ to a family ?r\gh su* 
a ,/ate program4  7#c7 ,! av]age mon?ly 
diap] bill ( #gj to #hj repres5ts #f    
p]c5t ( ! pretax income ( a p>5t work+  
full "t = ,f$]al m9imum wage4           
,approximately #df p]c5t ( l[-income    
*ildr5 & #bf p]c5t ( poor infants &     
toddl]s live ) at lea/ #a p>5t :o is    
employ$ full "t & ye> r\nd1 & only #dg  
p]c5t ( l[-income *ildr5 & #ce p]c5t (  
poor infants & toddl]s live ) m>ri$     
p>5ts4  7#d7 ,)\t *ild c>e1 p>5ts &     
gu>dians ( infants & toddl]s _c         
p>ticipate 9 ! work=ce1 b mo/ *ild c>e  
provid]s require p>5ts to provide a     
supply ( clean disposable diap]s = _!   
*ildr54 ,9 a #bjad survey ( #a1abi      

cli5ts ( #h l>ge diap] banks conduct$ by
 ! ,national ,diap] ,bank ,network1     
#ab4d p]c5t ( respond5ts indicat$ t !   
respond5t 0 unable to leave a *ild at a 
*ild c>e provid] at lea/ #a day a mon?  
because ! respond5t's *ild lack$ diap]s1
 & #dg4e p]c5t ( respond5ts said t !    
diap]s receiv$ f ! diap] bank enabl$ !  
respond5t to g to "w4 ,!re=e1 increas+  
availability ( clean diap]s = ne$y      
infants & toddl]s fur!rs ! national goal
 ( enabl+ p>5ts to p>ticipate 9 !       
work=ce to increase _! economic         
self-suffici5cy1 & enables bett]        
implem5tation ( title ,i ( ! ,p]sonal   
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif4  7#e7     
,increas+ ! availability ( clean diap]s 
= ne$y infants & toddl]s fur!rs !       
national goal ( increas+ access to safe 
& quality *ild c>e = all families1 &    
!re=e enables bett] implem5tation ( !   
,*ild ,c>e & ,developm5t ,block ,grant  
,act ( #aiij4  7#f7 ,insuffici5t diap]  
*anges c lead to n only increas$        

irritability & discom=t ( a *ild1 lead+ 
to increas$ p>5tal /ress1 b also to     
diap] d]matitis1 sk9 breakd[n1 op5 sores
 ) a risk ( infection1 & ur9>y tract    
infections = ! *ild1 :i* require m$ical 
att5tion4 ,9 a survey commission$ by    
,fe$+ ,am]ica 9 #bjaa1 #dh p]c5t ( food 
bank cli5ts survey$ said !y w\ld delay  
*ang+ a diap] & #cb p]c5t said !y w\ld  
reuse disposable diap]s 9 ord] to make  
_! diap] supply la/ long]4 ,?is         
increases ! risk ( negative heal?       
outcomes = *ildr5 & _! families4  7#g7  
,a /udy f ! ,yale ,s*ool ( ,m$ic9e f\nd 
a direct correlation betwe5 lack+ en\gh 
clean diap]s to *ange a *ild's diap]s z 
(t5 z requir$--a condition call$ diap]  
ne$--& mat]nal depression1 :i* c        
adv]sely affect mat]nal-*ild bond+1 a   
"m's ability to c>e = h] *ild1 & a "m's 
ability to "w outside ! home4  7#h7     
,diap]s h prov5 to be valuable inc5tives
 9 smok+ cessation programs1 p>5t+ tra9+
 programs1 & o!r programs promot+       
positive & heal?y behaviors4  7#i7      

,increas+ ! availability ( clean diap]s 
= ne$y families fur!rs public heal? by  
provid+ improv$ heal? outcomes = *ildr51
 r$uc+ visits to ! em]g5cy room1 & r$uc+
 p>5tal /ress & depression4  #c4        
,improv+ opportunity diap] demon/ration 
project  7a7 ,9 g5]al ,section #djc ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#fjc7 is am5d$ by add+ at ! end !       
foll[+3  7c7 ,diap] b5efit demon/ration 
project  7#a7 ,9 g5]al ,! ,secret>y %all
 make grants to ,/ates to conduct       
demon/ration projects to implem5t &     
evaluate /rategies to help families )   
eligible *ildr5 address ! diap]+ supply 
ne$s ( su* *ildr54  7#b7 ,application   
requirem5ts ,a ,/ate desir+ a grant "u  
?is subsection %all submit to !         
,secret>y an application t includes !   
foll[+3  7,a7 ,a description ( h[ !     
,/ate w use ! grant funds to develop a  
diap] di/ribution program t w provide   
suffici5t diap]s & diap]+ supplies to   
ea* p>ticipat+ family s t ea* eligible  
*ild 9 ! family receives1 = ea* mon? 9  

:i* ! *ild p>ticipates 9 ! program1 n   
less ?an ! less] (--  7i7 #ej p]c5t ( ! 
diap] *anges requir$ = a mon? = a heal?y
 *ild ( simil> age & size2 or  7ii7 #ajj
 p]c5t ( ! actual diap] *anges requir$ =
 ! *ild = ! mon?4  7,b7 ,a description (
 h[ ! ,/ate w coord9ate ) o!r ,/ate &   
,f$]al assi/ance programs & ag5cies     
7p>ticul>ly o!r programs & ag5cies      
t>get$ at assi/+ infants1 toddl]s1 or ! 
p>5ts or gu>dians ( infants or toddl]s7 
t provide b5efits & s]vices to families 
p>ticipat+ 9 ! diap] di/ribution        
program1 to integrate ! di/ribution (   
diap]s & diap]+ supplies ) ! deliv]y (  
su* o!r b5efits & s]vices1 = ! purpose  
(--  7i7 help+ p>ticipat+ families to   
use effectively ! b5efits !y receive "u 
! diap] di/ribution program2 &  7ii7    
remov+ b>ri]s to ! p>ticipation ( su*   
families 9 activities su* z *ild c>e1   
tra9+1 & "w activities4  7,c7 ,a        
description ( h[ ! ,/ate w evaluate !   
ext5t to :i* ! diap] di/ribution program
 increases ! efficacy1 & affects !      

p>ticipation rates1 ( o!r ,/ate & ,f$]al
 assi/ance programs 9 ! ,/ate4  7,d7 ,a 
description ( h[ ! ,/ate w provide = !  
deliv]y ( b5efits "u ! diap] di/ribution
 program1 :i* may include--  7i7 ca%    
assi/ance to be us$ to pur*ase diap]s & 
diap]+ supplies2  7ii7 v\*]s1 c\pons1   
electronic b5efit transf] sy/ems1 or any
 o!r non-ca% me?od to be us$ to pur*ase 
diap]s & diap]+ supplies1 except t !    
,/ate may n require a /ore to cov] ! co/
 ( any equipm5t1 sy/em1 or process+     
requir$ = any su* me?od z a condition ( 
p>ticipation 9 ! program2  7iii7        
assi/ance 9 di/ribut+ diap]s & diap]+   
supplies f any program or ag5cy ! ,/ate 
consid]s appropriate1 :i* may include-- 
7,i7 ,/ate or ,f$]al *ild c>e programs2 
7,,ii7 "w programs or fa!rhood          
initiative programs1 if ! ,/ate expla9s 
! me?od x int5ds to use to ensure t     
diap]s & diap]+ supplies di/ribut$ ?r\gh
 ^! programs are us$ by ! eligible *ild 
:o is ! int5d$ recipi5t2  7,,iii7 home  
visit+ programs2  7,,iv7 family res\rce 

c5t]s2  7,v7 ,f$]al & ,/ate heal?       
cl9ics2 &  7,,vi7 community s]vice      
c5t]s2  7iv7 ! di/ribution ( diap]s &   
diap]+ supplies at diap] banks or ?r\gh 
o!r nonpr(it organizations describ$ 9   
section #eja7;c77#c7 ( ! ,int]nal       
,rev5ue ,code ( #aihf & exempt f        
taxation "u section #eja7;a7 ( su*      
,code1 includ+ ?r\gh ! assi/ance ( o!r  
,/ate or ,f$]al ag5cies t p>tn] ) su*   
organizations to assi/ ) diap] & diap]+ 
supply di/ribution2 &  7v7 ! di/ribution
 ( diap]s & diap]+ supplies at any o!r  
location or ?r\gh any o!r means t w all[
 ! ,/ate to deliv] diap]s & diap]+      
supplies to p>ticipat+ families )\t     
undue inconv5i5ce4  7,e7 ,a description 
( :e!r ! ,/ate w provide a clo? diap]+  
sy/em1 a disposable diap]+ sy/em1 or    
bo?1 & 9 cases 9 :i* ! ,/ate provides a 
clo? diap]+ sy/em1 an explanation ( h[ !
 ,/ate w provide = diap] clean+ s]vices 
if reque/$ by ! p>5t or gu>dian4  7,f7  
,a description ( h[ ! ,/ate w ensure t !
 diap]+ sy/em or sy/ems provid$ meet !  

requirem5ts ( lic5s$ *ild c>e facilities
 9 ! ,/ate1 su* t ! type ( diap]s &     
diap]+ supplies provid$ d n prev5t      
p>ticipat+ families f enroll+ eligible  
*ildr5 9 su* a facility4  7#c7 ,use (   
funds ,a ,/ate to :i* a grant is made "u
 ?is subsection %all use ! grant funds  
to c>ry out a diap] di/ribution program 
9 accordance ) ! ,/ate grant application
 approv$ by ! ,secret>y1 z provid$ 9    
p>agraph 7#b74  7#d7 ,program           
adm9i/ration  7,a7 ,/ate ,,tanf ag5cy z 
prim>y adm9i/rator ,subject to          
subp>agraph 7,b71 a ,/ate diap]         
di/ribution program c>ri$ out pursuant  
to ?is subsection %all be c>ri$ out by !
 ,/ate ag5cy responsible = adm9i/]+ !   
,/ate program fund$ "u ?is "p4  7,b7    
,au?ority to subgrant & collaborate ,9  
c>ry+ out su* diap] di/ribution program1
 ! ,/ate ag5cy describ$ 9 subp>agraph   
7,a7 may collaborate )1 & ! ,/ate may   
make a subgrant to1 su* public &        
nonpr(it entities z ! ,/ate consid]s    
appropriate1 includ+ ,/ate ag5cies1     

local gov]nm5ts1 community-bas$         
organizations1 ,community ,action       
,ag5cies1 *ild c>e ag5cies1 food        
assi/ance ag5cies1 & o!r nonpr(it       
organizations describ$ 9 section        
#eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code 
( #aihf & exempt f taxation "u section  
#eja7;a7 ( su* ,code4  7#e7             
,c]tification ( b5efit eligibility ,a   
,/ate to :i* a grant is made "u ?is     
subsection may require1 z a condition ( 
receiv+ b5efits "u a ,/ate diap]        
di/ribution program1 t p>ticipat+       
families provide to ! ,/ate su*         
in=mation at su* times z ! ,/ate        
consid]s necess>y to det]m9e :e!r a *ild
 9 ! family is 7or cont9ues to be7 an   
eligible *ild1 z su* t]m is def9$ 9     
p>agraph 7#g77;,d74  7#f7 ,reports ,z a 
condition ( receiv+ a grant "u ?is      
subsection = a fiscal ye>1 ! ,/ate %all 
submit to ! ,secret>y1 n lat] ?an #f    
mon?s aft] ! end ( ! fiscal ye>1 a      
report t--  7,a7 specifies ! numb] (    
*ildr5 & ! numb] ( families receiv+     

assi/ance "u ! ,/ate diap] assi/ance    
program = ea* mon? ( ! fiscal ye>2  7,b7
 specifies ! numb] ( clo? diap]s1 !     
numb] ( disposable diap]s1 & ! numb] (  
ea* type ( diap]+ supply di/ribut$ "u ! 
diap] di/ribution program = ea* mon? ( !
 fiscal ye>2  7,c7 specifies ! me?od or 
me?ods ! ,/ate uses to di/ribute diap]s 
& diap]+ supplies2 &  7,d7 specifies !  
numb] ( *ildr5 & ! numb] ( families     
receiv+ b5efits "u ! diap] di/ribution  
program :o also receive assi/ance dur+ !
 fiscal ye> "u o!r relevant public      
assi/ance programs1 z det]m9$ by !      
,secret>y4  7#g7 ,evaluation  7,a7 ,9   
g5]al ,n lat] ?an ,septemb] #cj1 #bjah1 
! ,secret>y1 9 consultation ) ea* ,/ate 
t receives a grant "u ?is subsection1   
%all conduct a high quality evaluation (
 ! effectiv5ess ( ! ,/ate diap]         
di/ribution programs c>ri$ out pursuant 
to ?is subsection & ( v>y+ approa*es =  
di/ribut+ diap]s & diap]+ supplies us$ 9
 su* ,/ate programs4  7,b7 ,areas (     
evaluation ,! evaluation describ$ 9     

subp>agraph 7,a7 %all include a /udy ( !
 populations s]v$ 9 su* ,/ate programs1 
! diff]5t me?ods us$ by ,/ates to       
di/ribute diap]s & diap]+ supplies1 & ! 
effectiv5ess ( ea* su* me?od4  7,c7     
,evaluator qualifications ,! ,secret>y  
may n ent] into a contract ) an         
evaluator to conduct an evaluation "u   
?is p>agraph unless ! evaluator has     
demon/rat$ exp]i5ce 9 conduct+ rigor\s1 
descriptive evaluations ( program       
effectiv5ess4  7,d7 ,f9al evaluation ,n 
lat] ?an ,septemb] #cj1 #bjbb1 !        
,secret>y1 9 consultation ) ea* ,/ate t 
receives a grant "u ?is subsection1 %all
 update ! evaluation describ$ 9         
subp>agraph 7,a74  7,e7 ,reports &      
public disclosure  7i7 ,initial report  
,n lat] ?an ,septemb] #cj1 #bjah1 !     
,secret>y %all-- 7,i7 submit to !       
relevant congressional committees a     
report on ! results ( ! evaluation      
describ$ 9 subp>agraph 7,a72 &  7,,ii7  
publi% ! results ( ! evaluation on !    
website ( ! ,dep>tm5t ( ,heal? & ,human 

,s]vices 9 a location t is easily       
accessible to ! public4  7ii7 ,f9al     
report ,n lat] ?an #ij days aft]        
completion ( ! f9al evaluation pursuant 
to subp>agraph 7,d71 ! ,secret>y %all-- 
7,i7 submit to ! relevant congressional 
committees a report describ+ ! results (
 ! f9al evaluation2 &  7,,ii7 update !  
website describ$ 9 clause 7i77,,ii7 to  
include ! results ( ! f9al evaluation4  
7#h7 ,applicability ( c]ta9 provisions  
7,a7 ,diap] b5efits n c\nt$ z assi/ance 
,b5efits provid$ "u a ,/ate diap]       
di/ribution program conduct$ pursuant to
 ?is subsection %all n be c\nt$ z       
assi/ance "u a ,/ate program fund$ "u   
?is "p 7or any o!r ,/ate program fund$ )
 qualifi$ ,/ate exp5ditures 7z def9$ 9  
section #dji7;a77#g77;,b77i7774  7,b7   
,rules conc]n+ grants inapplicable      
,sections #djd & #dji7;a77#d7 %all n    
apply ) respect to a grant made "u ?is  
subsection4  7#i7 ,regulations ,!       
,secret>y ( ,heal? & ,human ,s]vices may
 prescribe su* regulations z may be     

necess>y to implem5t ?is subsection4    
7#aj7 ,def9itions ,9 ?is subsection3    
7,a7 ,! t]m diap] means an absorb5t     
g>m5t t is wa%able or disposable t is   
worn by a *ild :o _c control bladd] or  
b[el movem5ts4  7,b7 ,! t]m diap]+      
supplies means items1 includ+ diap]     
wipes & diap] cream1 necess>y to ensure 
t a *ild us+ a diap] is prop]ly clean$ &
 protect$ f diap] ra%1 & t ! surr\nd+   
population is protect$ f h>mful bact]ia 
orig9at+ f dirty diap]s4  7,c7 ,! t]m   
diap]+ sy/em means a me?od ( provid+ an 
adequate supply ( clean1 prop]ly siz$   
diap]s & diap]+ supplies4 ,9 ! case (   
wa%able clo? diap]s1 ?is me?od includes 
! laund]+ ( diap]s to ensure a suffici5t
 supply ( clean diap]s & wat]pro( cov]s4
  7,d7 ,! t]m eligible *ild means a *ild
 :o-- 7i7 is n toilet-tra9$2  7ii7 has n
 atta9$ #c ye>s ( age1 unless ! ,/ate   
det]m9es t ! *ild has a sub/antial      
physical or m5tal impairm5t t requires !
 *ild to we> diap]s2 &  7iii7 is-- 7,i7 
a recipi5t (1 or is eligible to receive1

 assi/ance "u a ,/ate program fund$ "u  
?is "p 7or any o!r ,/ate program fund$ )
 qualifi$ ,/ate exp5ditures 7z def9$ 9  
section #dji7;a77#g77;,b77i7771 or is a 
memb] ( a family t meets ! income       
eligibility requirem5ts ( su* ,/ate     
program2 or  7,,ii7 a memb] ( a family  
^: income is n m ?an #acj p]c5t ( !     
pov]ty l9e 7z def9$ by ! ,(fice (       
,managem5t & ,budget1 & revis$ annually 
9 accordance ) section #fgc7b7 ( !      
,omnibus ,budget ,reconciliation ,act ( 
#aiha7 applicable to a family ( ! size  
involv$4  7,e7 ,! t]m infant means a    
*ild :o has n atta9$ #a ye> ( age4  7,f7
 ,! t]m p>ticipat+ family means a family
 t includes an eligible *ild p>ticipat+ 
9 a ,/ate diap] di/ribution program     
c>ri$ out pursuant to ?is subsection4   
7,g7 ,! t]m ,/ate means ea* ( ! #ej     
,/ates1 ! ,di/rict ( ,columbia1 ,pu]to  
,rico1 ,guam1 ! ,unit$ ,/ates ,virg9    
,isl&s1 ! ,nor!rn ,m>iana ,isl&s1       
,am]ican ,samoa1 & ,indian tribes &     
tribal organizations4  7,h7 ,! t]m      

toddl] means a *ild :o has atta9$ #a ye>
 ( age b has n atta9$ #c ye>s ( age4    
7,i7 ,! t]m toilet-tra9$ means able &   
will+ to use a toilet consi/5tly su* t  
diap]s are n necess>y on a daily basis4 
7#aa7 ,appropriation ,out ( any funds 9 
! ,treasury ( ! ,unit$ ,/ates n o!rwise 
appropriat$1 !re are appropriat$ = ea* (
 fiscal ye>s #bjag ?r\gh #bjba          
#ge1jjj1jjj to c>ry out ?is subsection4 
7#ab7 ,availability ( funds ,funds      
provid$ to a ,/ate "u ?is subsection = a
 fiscal ye> may be exp5d$ only 9 !      
fiscal ye> or ! succe$+ fiscal ye>4  4  
7b7 ,diap] b5efits exempt$ f t]ritorial 
paym5t ceil+ ,section #aajh7;a77#b7 (   
su* ,act 7#db ,u4,s4,c4 #acjh7;a77#b77  
is am5d$ by ins]t+ #djc7;c71 aft]       
#djc7;a77#e714