,i #aaf? ,,congress #b;d ,session ,h4 ,r4 #hbjj ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,septemb] #aa1 #bjbj ,ms4 ,kelly ( ,ill9ois 7= h]self1 ,ms4 ,bass1 ,mr4 ,ca/ro ( ,texas1 ,ms4 ,judy ,*u ( ,cali=nia1 ,mr4 ,g>ca ( ,ill9ois1 ,ms4 ,haal&1 ,ms4 ,lee ( ,cali=nia1 ,mr4 ,soto1 ,ms4 ,sewell ( ,alabama1 ,mr4 ,butt]field1 ,mr4 ,sablan1 ,ms4 ,b>ragn1 ,ms4 ,cl>ke ( ,new ,york1 ,mr4 ,crd5as1 ,mr4 ,s>banes1 ,ms4 ,pressley1 ,mr4 ,?ompson ( ,mississippi1 ,ms4 ,escob>1 ,mr4 ,br5dan ,f4 ,boyle ( ,p5nsylvania1 ,mr4 ,c>son ( ,indiana1 ,mr4 ,clay1 ,mrs4 ,beatty1 ,mr4 ,khanna1 ,ms4 ,g>cia ( ,texas1 ,mr4 ,san ,nicolas1 ,mr4 ,espaillat1 ,ms4 ,jayapal1 ,mrs4 ,dem+s1 ,mr4 ,ha/+s1 ,mrs4 ,watson ,coleman1 ,ms4 ,johnson ( ,texas1 ,mr4 ,grijalva1 ,ms4 ,bonamici1 & ,mr4 ,lyn*7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committees on ,ways & ,means1 ! ,judici>y1 ,transportation & ,infra/ructure1 ,education & ,labor1 ,agriculture1 ,natural ,res\rces1 ,h\se ,adm9i/ration1 ,ov]sight & ,re=m1 ! ,budget1 & ,small ,bus9ess1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to improve ! heal? ( m9ority individuals dur+ ! ,,covid-#ai p&emic1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj or ! ,,ehdc ,act ( #bjbj4 #b4 ,table ( cont5ts ,sec4 #a4 ,%ort title4 ,sec4 #b4 ,table ( cont5ts4 ,title ,i--,racial & ,e?nicity ,data ,collection ,subtitle ,a--,collection & ,report+ ,sec4 #aja4 ,equitable data collection & disclosure on ,,covid-#ai ,act4 ,sec4 #ajb4 ,,covid-#ai report+ portal4 ,sec4 #ajc4 ,regul> ,,cdc report+ on demographic data4 ,sec4 #ajd4 ,am5dm5t to ! ,public ,heal? ,s]vice ,act4 ,sec4 #aje4 ,elim9ation ( pr]equisite ( direct appropriations = data collection & analysis4 ,sec4 #ajf4 ,collection ( data = ! ,m$ic>e program4 ,sec4 #ajg4 ,revision ( ,,hipaa claims /&>ds4 ,sec4 #ajh4 ,disp>ities data collect$ by ! ,f$]al ,gov]nm5t4 ,sec4 #aji4 ,/&>ds = measur+ sexual ori5tation1 g5d] id5tity1 & socioeconomic /atus 9 collection ( heal? data4 ,sec4 #aaj4 ,improv+ heal? data reg>d+ ,native ,hawaiians & o!r ,pacific ,isl&]s4 ,subtitle ,b--,improvem5ts & ,mod]nization ,sec4 #aba4 ,f$]al mod]nization = heal? inequities data4 ,sec4 #abb4 ,mod]nization ( ,/ate & local heal? inequities data4 ,sec4 #abc4 ,additional report+ to ,congress on ! race & e?nicity rates ( ,,covid-#ai te/+1 hospitalizations1 & mortalities4 ,title ,,ii--,equitable ,te/+ & ,trac+ ,subtitle ,a--,free ,te/+ = ,pati5ts ,sec4 #bja4 ,soon] cov]age ( te/+ = ,,covid-#ai4 ,subtitle ,b--,national ,te/+ ,/rategy ,sec4 #baa4 ,,covid-#ai te/+ /rategy4 ,sec4 #bab4 ,coronavirus immigrant families protection4 ,sec4 #bac4 ,,ice det5tion4 ,subtitle ,c--,contact ,trac+ ,sec4 #bba4 ,,covid-#ai ,te/+1 rea*+1 & contact+ ev]yone4 ,sec4 #bbb4 ,national sy/em = ,,covid-#ai te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation4 ,sec4 #bbc4 ,grants4 ,sec4 #bbd4 ,grants to ,/ate & ,tribal work=ce ag5cies4 ,title ,,iii--,free ,treatm5t = ,all ,am]icans ,sec4 #cja4 ,cov]age at no co/ %>+ ( ,,covid-#ai vacc9e & treatm5t4 ,sec4 #cjb4 ,optional cov]age at no co/ %>+ ( ,,covid-#ai treatm5t & vacc9es "u ,m$icaid = un9sur$ individuals4 ,sec4 #cjc4 ,cov]age ( treatm5ts = ,,covid-#ai at no co/ %>+ "u ! ,m$ic>e ,advantage program4 ,sec4 #cjd4 ,requir+ cov]age "u ,m$ic>e ,,pdps & ,,ma-,,pd plans1 )\t ! imposition ( co/ %>+ or utilization managem5t requirem5ts1 ( drugs int5d$ to treat ,,covid-#ai dur+ c]ta9 em]g5cies4 ,sec4 #cje4 ,cov]age ( ,,covid-#ai relat$ treatm5t at no co/ %>+4 ,sec4 #cjf4 ,reimbursem5t = additional heal? s]vices relat+ to coronavirus4 ,title ,,iv--,f$]al ,heal? ,equity ,ov]sight ,sec4 #dja4 ,,covid-#ai ,racial & ,e?nic ,disp>ities ,task ,=ce ,act ( #bjbj4 ,sec4 #djb4 ,protection ( ! ,,hhs ,(fices ( ,m9ority ,heal?4 ,sec4 #djc4 ,e/abli% an int]ag5cy c\nsel & grant programs on social det]m9ants ( heal?4 ,sec4 #djd4 ,acc\ntability & transp>5cy )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 ,title ,v--,exp&$ ,insurance ,access ,sec4 #eja4 ,m$ic>e special enrollm5t p]iod = individuals resid+ 9 ,,covid-#ai em]g5cy areas4 ,sec4 #ejb4 ,special enrollm5t p]iod ?r\gh ex*anges2 ,f$]al ex*ange outrea* & educational activities4 ,sec4 #ejc4 ,,momma's ,act4 ,sec4 #ejd4 ,all[+ = m$ical assi/ance "u ,m$icaid = inmates dur+ #cj-;day p]iod prec$+ release4 ,sec4 #eje4 ,provid+ = imm$iate ,m$icaid eligibility = =m] fo/] y\?4 ,sec4 #ejf4 ,exp&$ cov]age = =m] fo/] y\?4 ,sec4 #ejg4 ,remov+ citiz5%ip & immigration b>ri]s to access to af=dable heal? c>e "u ,,aca4 ,sec4 #ejh4 ,m$icaid 9 ! t]ritories4 ,sec4 #eji4 ,remov+ ,m$ic>e b>ri] to heal? c>e4 ,sec4 #eaj4 ,remov+ b>ri]s to heal? c>e & nutrition assi/ance = *ildr51 pregnant p]sons1 & lawfully pres5t individuals4 ,sec4 #eaa4 ,repeal ( requirem5t = docum5tation evid5c+ citiz5%ip or nationality "u ! ,m$icaid program4 ,title ,,vi--,community ,bas$ ,grants ,sec4 #fja4 ,grants = racial & e?nic approa*es to community heal?4 ,sec4 #fjb4 ,grants to promote heal? = und]s]v$ communities4 ,sec4 #fjc4 ,address+ ,,covid-#ai heal? inequities & improv+ heal? equity4 ,sec4 #fjd4 ,improv+ social det]m9ants ( heal?4 ,sec4 #fje4 ,fund+ to ,/ates1 localities1 & community-bas$ organizations = em]g5cy aid & s]vices4 ,sec4 #fjf4 ,supplem5tal nutrition assi/ance program4 ,title ,,vii--,culturally & ,l+ui/ically ,compet5t ,c>e ,sec4 #gja4 ,ensur+ /&>ds = culturally & l+ui/ically appropriate s]vices 9 heal? c>e4 ,sec4 #gjb4 ,culturally & l+ui/ically appropriate heal? c>e 9 ! ,public ,heal? ,s]vice ,act4 ,sec4 #gjc4 ,tra9+ tomorr['s doctors = culturally & l+ui/ically appropriate c>e3 graduate m$ical education4 ,sec4 #gjd4 ,f$]al reimbursem5t = culturally & l+ui/ically appropriate s]vices "u ! ,m$ic>e1 ,m$icaid1 & ,/ate ,*ildr5's ,heal? ,insurance ,programs4 ,sec4 #gje4 ,requirem5ts = heal? programs or activities receiv+ ,f$]al funds4 ,sec4 #gjf4 ,report on ,f$]al ef=ts to provide culturally & l+ui/ically appropriate heal? c>e s]vices4 ,sec4 #gjg4 ,heal? pr(essions compet5cies to address racial & e?nic m5tal heal? disp>ities4 ,sec4 #gjh4 ,/udy on ! un9sur$4 ,title ,,viii--,aid to ,provid]s ,s]v+ ,m9ority ,communities ,sec4 #hja4 ,tempor>y increase 9 ,m$icaid ,,d% allotm5ts4 ,sec4 #hjb4 ,,covid-#ai-relat$ tempor>y increase ( ,m$icaid ,,fmap4 ,sec4 #hjc4 ,appropriation = prim>y heal? c>e4 ,sec4 #hjd4 ,am5dm5t to ! ,public ,heal? ,s]vice ,act4 ,sec4 #hje4 ,p&emic premium pay = ess5tial work]s4 ,sec4 #hjf4 ,,covid-#ai ,h]oes ,fund grants4 ,sec4 #hjg4 ,en=cem5t & outrea*4 ,title ,,ix--,heal? ,,x & ,bridg+ ! ,digital ,divide 9 ,heal? ,c>e ,sec4 #ija4 ,,hrsa assi/ance to heal? c5t]s = promotion ( ,heal? ,,x4 ,sec4 #ijb4 ,assessm5t ( impact ( ,heal? ,,x on racial & e?nic m9ority communities2 outrea* & adoption ( ,heal? ,,x 9 su* communities4 ,sec4 #ijc4 ,ext5d+ fund+ to /r5g!n ! ,heal? ,,x infra/ructure 9 racial & e?nic m9ority communities4 ,sec4 #ijd4 ,ext5d+ competitive grants = ! developm5t ( loan programs to facilitate adoption ( c]tifi$ ,,ehr te*nology by provid]s s]v+ racial & e?nic m9ority gr\ps4 ,sec4 #ije4 ,au?orization ( appropriations4 ,sec4 #ijf4 ,data collection & assessm5ts conduct$ 9 coord9ation ) m9ority-s]v+ in/itutions4 ,sec4 #ijg4 ,/udy ( heal? in=mation te*nology 9 m$ically und]s]v$ communities4 ,sec4 #ijh4 ,/udy on ! effects ( *anges to teleheal? "u ! ,m$ic>e & ,m$icaid programs dur+ ! ,,covid-#ai em]g5cy4 ,sec4 #iji4 ,,covid-#ai designation ( imm$iate special au?ority ( spectrum = ,tribes' em]g5cy response 9 ,indian ,c\ntry4 ,sec4 #iaj4 ,facilitat+ ! provision ( teleheal? s]vices across ,/ate l9es4 ,title ,x--,public ,aw>5ess ,sec4 #ajja4 ,aw>5ess campaigns4 ,sec4 #ajjb4 ,increas+ und]/&+ ( & improv+ heal? lit]acy4 ,sec4 #ajjc4 ,engli% = speak]s ( o!r languages4 ,sec4 #ajjd4 ,influ5za1 ,,covid-#ai1 & pneumonia vacc9ation campaign4 ,title ,,xi--,rese>* ,sec4 #aaja4 ,rese>* & developm5t4 ,sec4 #aajb4 ,,cdc field /udies p]ta9+ to specific heal? inequities4 ,sec4 #aajc4 ,exp&+ capacity = heal? outcomes4 ,sec4 #aajd4 ,data collection & analysis grants to m9ority-s]v+ in/itutions4 ,sec4 #aaje4 ,safety & effectiv5ess ( drugs ) respect to racial & e?nic backgr\nd4 ,sec4 #aajf4 ,,gao & ,,nih reports4 ,sec4 #aajg4 ,heal? impact assessm5ts4 ,sec4 #aajh4 ,tribal fund+ to rese>* heal? inequities includ+ ,,covid-#ai4 ,sec4 #aaji4 ,rese>* end[m5ts at bo? curr5t & =m] c5t]s ( excell5ce4 ,title ,,xii--,education ,sec4 #abja4 ,grants = s*ools ( m$ic9e 9 div]se & und]s]v$ areas4 ,sec4 #abjb4 ,am5dm5t to ! ,public ,heal? ,s]vice ,act4 ,sec4 #abjc4 ,hispanic-s]v+ in/itutions1 ,hi/orically ,black ,colleges & ,univ]sities1 ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itutions1 ,tribal colleges1 regional community-bas$ organizations1 & national m9ority m$ical associations4 ,sec4 #abjd4 ,loan repaym5t program ( ,c5t]s = ,disease ,control & ,prev5tion4 ,sec4 #abje4 ,/udy & report on /rategies = increas+ div]sity4 ,sec4 #abjf4 ,am5dm5ts to ! ,p&emic ,,ebt ,act4 ,title ,,xiii--,public ,heal? ,assi/ance to ,tribes ,sec4 #acja4 ,appropriations = ! ,indian ,heal? ,s]vice4 ,sec4 #acjb4 ,improv+ ,/ate1 local1 & ,tribal public heal? security4 ,sec4 #acjc4 ,provision ( items to ,indian programs & facilities4 ,sec4 #acjd4 ,heal? c>e access = urban native vet]ans4 ,sec4 #acje4 ,prop] & reimburs$ c>e = native vet]ans4 ,i ,racial & ,e?nicity ,data ,collection ,a ,collection & ,report+ #aja4 ,equitable data collection & disclosure on ,,covid-#ai ,act 7a7 ,f9d+s ,congress makes ! foll[+ f9d+s3 7#a7 ,! ,_w ,heal? ,organization 7,,:o7 decl>$ ,,covid-#ai a ,public ,heal? ,em]g5cy ( ,int]national ,conc]n on ,janu>y #cj1 #bjbj4 ,by late ,m>* #bjbj1 !re h be5 ov] #dgj1jjj confirm$ cases (1 & #bj1jjj dea?s associat$ )1 ,,covid-#ai worldwide4 7#b7 ,9 ! ,unit$ ,/ates1 cases ( ,,covid-#ai h quickly surpass$ ^? across ! _w1 & z ( ,april #ab1 #bjbj1 ov] #ejj1jjj cases & #bj1jjj dea?s h be5 report$ 9 ! ,unit$ ,/ates alone4 7#c7 ,e>ly report+ on racial inequities 9 ,,covid-#ai te/+ & treatm5t h r5ew$ calls = ! ,c5t]s = ,disease ,control & ,prev5tion & o!r relevant subag5cies )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices to publicly release racial & demographic in=mation to bett] in=m ! p&emic response1 specifically 9 communities ( color & 9 ,limit$ ,engli% ,pr(ici5t 7,,lep7 communities4 7#d7 ,! burd5 ( morbidity & mortality 9 ! ,unit$ ,/ates has hi/orically fall5 disproportionately on m>g9aliz$ communities 7^? :o suff] ! mo/ f great public heal? ne$s & are ! mo/ m$ically und]s]v$74 7#e7 ,hi/orically1 /ructures & sy/ems1 su* z racism1 ableism & class oppression1 h r5d]$ affect$ individuals m vuln]able to inequities & h prev5t$ p f a*iev+ _! optimal heal? ev5 :5 !re is n a crisis ( p&emic proportions4 7#f7 ,significant diff]5ces 9 access to heal? c>e1 specifically to prim>y heal? c>e provid]s1 heal? c>e in=mation1 & great] p]ceiv$ discrim9ation 9 heal? c>e place communities ( color1 individuals ) disabilities1 & ,,lep individuals at great] risk ( receiv+ delay$1 & p]haps poor]1 heal? c>e4 7#g7 ,/>k racial inequities across ! ,unit$ ,/ates1 includ+ unequal access to /able h\s+1 quality education1 & dec5t employm5t significantly impact ! ability ( individuals to take c>e ( _! mo/ basic heal? ne$s4 ,communities ( color are m likely to exp]i5ce homelessness & /ruggle ) l[-pay+ jobs or unemploym5t4 ,to date1 exp]ts h cit$ t #b 9 #e ,lat9o resid5ts 9 ,new ,york ,city1 ! curr5t epic5t] ( ! ,,covid-#ai p&emic1 are rec5tly unemploy$ z a direct consequ5ce ( ,,covid-#ai4 ,& at a "t :5 %elt]+ 9 place w save lives1 less ?an #a 9 #e ,black work]s & r\ghly #a 9 #f ,lat9o work]s are able to "w f home4 7#h7 ,communities ( color exp]i5ce high] rates ( *ronic disease & disabilities1 su* z diabetes1 hyp]t5sion1 & a/hma1 ?an non-,hispanic ,:ite communities1 :i* pr$isposes !m to great] risk ( complications & mortality %\ld !y contract ,,covid-#ai4 7#i7 ,su* communities are made ev5 m vuln]able to ! unc]ta9ty ( ! prep>ation1 response1 & ev5ts surr\nd+ ! p&emic public heal? crisis1 ,,covid-#ai4 ,= in/ance1 9 ! rec5t pa/1 multiple epidemiologic /udies & reviews h report$ high] rates ( hospitalization due to ! #bjji ,h#a,n#a p&emic among ! poor1 individuals ) disabilities & preexi/+ conditions1 ^? liv+ 9 impov]i%$ neighborhoods1 & individuals ( color & e?nic backgr\nds 9 ! ,unit$ ,/ates4 ,^! f9d+s highlight ! urg5cy to adapt ! ,,covid-#ai response to monitor & act on ^! inequities via data collection & rese>* by race & e?nicity4 7#aj7 ,rese>* exp]ts recognize t !re are und]ly+ diff]5ces 9 illness & dea? :5 ea* ( ^! factors are exam9$ ?r\gh socioeconomic & racial or e?nic l5ses4 ,^! socially det]m9ant factors ( heal? accel]ate disease & degradation4 7#aa7 ,language b>ri]s are highly correlat$ ) m$ication noncompliance & inconsi/5t engagem5t ) heal? sy/ems4 ,)\t language accessibility data & rese>* ar\nd ,,covid-#ai1 ^! communities are less likely to receive critical te/+ & prev5tive heal? s]vices4 ,yet1 to date1 ! ,c5t]s = ,disease ,control & ,prev5tion d n dissem9ate ,,covid-#ai messag+ 9 critical languages1 includ+ ,m&>9 ,*9ese1 ,spani%1 & ,korean )9 ! same timeframe z in=mation 9 ,engli% despite requirem5ts to ensure limit$ ,engli% pr(ici5t populations are n discrim9at$ aga9/ "u title ,,vi ( ! ,civil ,rights ,act ( #aifd & subsequ5t laws & ,f$]al policies4 7#ab7 ,fur!r1 x is critical to disaggregate data fur!r by ance/ry to address disp>ities among ,asian ,am]ican1 ,native ,hawaiian1 & ,pacific ,isl&] gr\ps4 ,accord+ to ! ,national ,equity ,atlas1 :ile #ac p]c5t ( ! ,asian population ov]all liv$ 9 pov]ty 9 #bjae1 #ci p]c5t ( ,burmese p1 #bi p]c5t ( ,hmong p1 & #ba p]c5t ( ,pacific ,isl&]s liv$ 9 pov]ty4 7#ac7 ,utiliz+ disaggregation ( enrollm5t 9 ,af=dable ,c>e ,act-sponsor$ heal? insurance1 ! ,asian & ,pacific ,isl&] ,am]ican ,heal? ,=um f\nd t prior to ! passage ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh71 ,korean ,am]icans _h a high un9sur$ rate ( #bc p]c5t1 comp>$ to j #ab p]c5t = all ,asian ,am]icans4 ,develop+ t>get$ outrea* ef=ts assi/$ #a1jjj1jjj p & result$ 9 a #ef-p]c5t decrease 9 ! un9sur$ among ! ,asian1 ,native ,hawaiian1 & ,pacific ,isl&] population4 ,su* ef=ts %[ t disaggregat$ data is ess5tial to public heal? mobilizations ef=ts4 7#ad7 ,)\t cle> und]/&+ ( h[ ,,covid-#ai impacts m>g9aliz$ racial & e?nic communities1 !re w be exac]bat$ risk ( endang]+ ! mo/ hi/orically vuln]able ( our ,nation4 7#ae7 ,! consequ5ces ( misund]/&+ ! racial & e?nic impact ( ,,covid-#ai exp\nd beyond communities ( color su* t x w\ld impact all4 7#af7 ,race & e?nicity are valuable rese>* & practice v>iables :5 us$ & int]pret$ appropriately4 ,heal? data collect$ on pati5ts by race & e?nicity w boo/ & m effici5tly direct critical res\rces & in=m risk communication developm5t 9 languages & at appropriate heal? lit]acy levels1 :i* resonate ) hi/orically vuln]able communities ( color4 7#ag7 ,to date1 !re is no public /&>diz$ & compreh5sive race & e?nicity data repository ( ,,covid-#ai te/+1 hospitalizations1 or mortality4 ,! inconsi/5cy ( data collection by ,f$]al1 ,/ate1 & local heal? au?orities1 & ! inability to access data by public rese>* in/itutions & academic organizations1 poses a ?reat to analysis & syn!sis ( ! p&emic impact on communities ( color4 ,h[ev]1 rese>* & m$ical exp]ts ( ,hi/orically ,black ,colleges & ,univ]sities1 academic heal? c>e in/itutions :i* are hi/orically & geographically emb$d$ 9 m9oritiz$ & m>g9aliz$ communities1 g5]ally also possess rapport ) ! communities !y s]ve4 ,!y are well-position$1 z tru/$ ?\ght lead]s & heal? c>e s]vice provid]s1 to collect data & conduct rese>* t[>d creat+ holi/ic solutions to rem$y ! inequitable impact ( ?is & future public heal? crises4 7#ah7 ,well-design$1 e?ically s\nd rese>* aligns ) ! goals ( m$ic9e1 addresses que/ions relevant to ! population among :om ! /udy w be c>ri$ out1 balances ! pot5tial = b5efit aga9/ ! pot5tial = h>m1 employs /udy designs t w yield sci5tifically valid & significant data1 & g5]ates useful k4 7#ai7 ,! de>? ( racially & e?nically disaggregat$ data reflect+ ! heal? ( communities ( color und]lies ! *all5ges ( a fully in=m$ public heal? response4 7#bj7 ,)\t collect+ race & e?nicity data associat$ ) ,,covid-#ai te/+1 hospitalizations1 morbidities1 & mortalities1 z well z publicly disclos+ x1 communities ( color w rema9 at great] risk ( disease & dea?4 7b7 ,em]g5cy fund+ = ,f$]al data collection on ! racial1 e?nic1 & o!r demographic disp>ities ( ,,covid-#ai ,to conduct or support data collection on ! racial1 e?nic1 & o!r demographic implications ( ,,covid-#ai 9 ! ,unit$ ,/ates & its t]ritories1 includ+ support to assi/ 9 ! capacity build+ = ,/ate & local public heal? dep>tm5ts to collect & transmit racial1 e?nic1 & o!r demographic data to ! relevant ,dep>tm5t ( ,heal? & ,human ,s]vices ag5cies1 !re is au?oriz$ to be appropriat$-- 7#a7 to ! ,c5t]s = ,disease ,control & ,prev5tion1 #ab1jjj1jjj2 7#b7 to ,/ate1 t]ritorial1 & ,tribal public heal? ag5cies1 di/ribut$ proportionally bas$ on ! total population ( _! resid5ts :o are enroll$ 9 ,m$icaid or :o h no heal? insurance1 #ae1jjj1jjj2 7#c7 to ! ,indian ,heal? ,s]vice1 ,indian ,tribes & ,tribal organizations 7z def9$ 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act71 & urban ,indian organizations 7z def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act71 #c1jjj1jjj2 7#d7 to ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 #e1jjj1jjj2 7#e7 to ! ,food & ,drug ,adm9i/ration1 #e1jjj1jjj2 7#f7 to ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 #e1jjj1jjj2 & 7#g7 to ! ,(fice ( ! ,national ,coord9ator = ,heal? ,in=mation ,te*nology1 #e1jjj1jjj4 7c7 ,,covid-#ai data collection & disclosure 7#a7 ,data collection ,! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion & ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all make publicly available on ! website ( ! ,c5t]s = ,disease ,control & ,prev5tion data collect$ across all surveillance sy/ems relat+ to ,,covid-#ai1 disaggregat$ by race1 e?nicity1 sex1 age1 prim>y language1 socioeconomic /atus1 disability /atus1 & c\nty1 includ+ ! foll[+3 7,a7 ,data relat$ to all ,,covid-#ai te/+1 includ+ ! numb] ( individuals te/$ & ! numb] ( te/s t 7 positive4 7,b7 ,data relat$ to treatm5t = ,,covid-#ai1 includ+ hospitalizations & int5sive c>e unit admissions4 7,c7 ,data relat$ to ,,covid-#ai outcomes1 includ+ total fatalities & case fatality rates 7express$ z ! proportion ( individuals :o 7 infect$ ) ,,covid-#ai & di$ f ! virus74 7#b7 ,application ( /&>ds ,to ! ext5t practicable1 data collection "u ?is subsection %all foll[ /&>ds develop$ by ! ,dep>tm5t ( ,heal? & ,human ,s]vices ,(fice ( ,m9ority ,heal? & be collect$1 analyz$1 & report$ 9 accordance ) ! /&>ds promulgat$ by ! ,assi/ant ,secret>y = ,plann+ & ,evaluation "u title ,,xxxi ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjjkk et seq474 7#c7 ,timel9e ,! data made available "u ?is subsection %all be updat$ on a daily basis ?r\gh\t ! public heal? em]g5cy4 7#d7 ,privacy ,9 publi%+ data "u ?is subsection1 ! ,secret>y %all take all necess>y /eps to protect ! privacy ( individuals ^: in=mation is includ$ 9 su* data1 includ+-- 7,a7 comply+ ) privacy protections provid$ "u ! regulations promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif2 & 7,b7 protections f all inappropriate int]nal use by an entity t collects1 /ores1 or receives ! data1 includ+ use ( su* data 9 det]m9ations ( eligibility 7or cont9u$ eligibility7 9 heal? plans1 & f inappropriate uses4 7#e7 ,consultation ) ,tribes ,! ,indian ,heal? ,s]vice %all consult ) ,indian ,tribes & conf] ) urban ,indian organizations on data collection & report+4 7#f7 ,report ,n lat] ?an #fj days aft] ! date on :i* ! ,secret>y c]tifies t ! public heal? em]g5cy relat$ to ,,covid-#ai has end$1 ! ,secret>y %all make publicly available a summ>y ( ! f9al /ati/ics relat$ to ,,covid-#ai4 7#g7 ,report ,n lat] ?an #fj days aft] ! date on :i* ! ,secret>y c]tifies t ! public heal? em]g5cy relat$ to ,,covid-#ai has end$1 ! ,dep>tm5t ( ,heal? & ,human ,s]vices %all compile & submit to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions & ! ,committee on ,f9ance ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,ways & ,means ( ! ,h\se ( ,repres5tatives a prelim9>y report-- 7,a7 describ+ ! te/+1 hospitalization1 mortality rates1 & pref]r$ language ( pati5ts associat$ ) ,,covid-#ai by race & e?nicity2 & 7,b7 propos+ evid5c$-bas$ response /rategies to safegu>d ! heal? ( ^! communities 9 future p&emics4 7d7 ,commission on ,ensur+ ,heal? ,equity ,dur+ ! ,,covid-#ai ,public ,heal? ,em]g5cy 7#a7 ,9 g5]al ,n lat] ?an #cj days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y %all e/abli% a commission1 to be kn[n z ! ,commission on ,ensur+ ,heal? ,equity ,dur+ ! ,,covid-#ai ,public ,heal? ,em]g5cy 7ref]r$ to 9 ?is subsection z ! ,commission7 to provide cle> & robu/ guidance on h[ to improve ! collection1 analysis1 & use ( demographic data 9 respond+ to future waves ( ! coronavirus4 7#b7 ,memb]%ip & *airp]son 7,a7 ,memb]%ip ,! ,commission %all be compos$ (-- 7i7 ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion2 7ii7 ! ,director ( ! ,national ,in/itutes ( ,heal?2 7iii7 ! ,commission] ( ,food & ,drugs2 7iv7 ! ,adm9i/rator ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy2 7v7 ! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities2 7vi7 ! ,director ( ! ,indian ,heal? ,s]vice2 7vii7 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices2 7viii7 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality2 7ix7 ! ,surgeon ,g5]al2 7x7 ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration2 7xi7 ! ,director ( ! ,(fice ( ,m9ority ,heal?2 7xii7 ! ,director ( ! ,(fice ( ,wom5's ,heal?2 7xiii7 ! ,*airp]son ( ! ,national ,c\ncil on ,disability2 7xiv7 at lea/ #d ,/ate1 local1 t]ritorial1 & ,tribal public heal? (ficials repres5t+ dep>tm5ts ( public heal?1 :o %all repres5t jurisdictions f diff]5t regions ( ! ,unit$ ,/ates ) relatively high conc5trations ( hi/orically m>g9aliz$ populations1 to be appo9t$ by ! ,secret>y2 & 7xv7 racially & e?nically div]se repres5tation f at lea/ #c indep5d5t exp]ts ) k or field exp]i5ce ) racial & e?nic disp>ities 9 public heal? appo9t$ by ! ,secret>y4 7,b7 ,*airp]son ,! ,presid5t ( ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e1 or designee1 %all s]ve z ! *airp]son ( ! ,commission4 7#c7 ,duties ,! ,commission %all-- 7,a7 exam9e b>ri]s to collect+1 analyz+1 & us+ demographic data2 7,b7 det]m9e h[ to be/ use su* data to promote heal? equity across ! ,unit$ ,/ates & r$uce racial1 ,tribal1 & o!r demographic disp>ities 9 ,,covid-#ai preval5ce & outcomes2 7,c7 ga!r available data relat$ to ,,covid-#ai treatm5t ( individuals ) disabilities1 includ+ d5ial ( treatm5t = pre-exi/+ conditions1 removal or d5ial ( disability relat$ equipm5t 7includ+ v5tilators & ,,cpap71 & data on completion ( ,,dnr ord]s1 & id5tify b>ri]s to obta9+ accurate & timely data relat$ to ,,covid-#ai treatm5t ( su* individuals2 7,d7 solicit input f public heal? (ficials1 community-connect$ organizations1 heal? c>e provid]s1 ,/ate & local ag5cy (ficials1 & o!r exp]ts on b>ri]s to1 & be/ practices =1 collect+ demographic data2 & 7,e7 recomm5d policy *anges t ! data indicates are necess>y to r$uce disp>ities4 7#d7 ,report ,n lat] ?an #fj days aft] ! date ( enactm5t ( ?is ,act1 & e #ahj days !reaft] until ! ,secret>y c]tifies t ! public heal? em]g5cy relat$ to ,,covid-#ai has end$1 ! ,commission %all submit a writt5 report ( its f9d+s & recomm5dations to ,congress & po/ su* report on a website ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 ,su* reports %all conta9 in=mation conc]n+-- 7,a7 h[ to enhance ,/ate1 local1 t]ritorial1 & ,tribal capacity to conduct public heal? rese>* on ,,covid-#ai1 ) a focus on exp&$ capacity to analyze data on disp>ities correlat$ ) race1 e?nicity1 income1 sex1 age1 disability /atus1 specific geographic areas1 & o!r relevant demographic *>act]i/ics1 & an analysis ( :at demographic data is curr5tly be+ collect$ ab\t ,,covid-#ai1 ! accuracy ( t data & any gaps1 h[ ?is data is curr5tly be+ us$ to in=m ef=ts to combat ,,covid-#ai1 & :at res\rces are ne$$ to supplem5t exi/+ public heal? data collection2 7,b7 h[ to collect1 process1 & disclose to ! public ! data describ$ 9 subp>agraph 7,a7 9 a way t ma9ta9s individual privacy :ile help+ direct ! ,/ate & local response to ! virus2 7,c7 h[ to improve demographic data collection relat$ to ,,covid-#ai 9 ! %ort- & long-t]m1 includ+ h[ to cont9ue to gr[ & value ! ,tribal sov]eignty ( data & in=mation conc]n+ ,tribal communities2 7,d7 to ! ext5t possible1 a prelim9>y analysis ( racial & o!r demographic disp>ities 9 ,,covid-#ai mortality1 includ+ an analysis ( comorbidities & case fatality rates2 7,e7 to ! ext5t possible1 a prelim9>y analysis ( sex1 g5d]1 sexual ori5tation1 & g5d] id5tity disp>ities 9 ,,covid-#ai treatm5t & mortality2 7,f7 an analysis ( ,,covid-#ai treatm5t ( individuals ) disabilities1 includ+ equity ( access to treatm5t & equipm5t & int]sections ( disability /atus ) o!r demographic factors1 includ+ race1 & recomm5dations = h[ to improve transp>5cy & equity ( treatm5t = su* individuals dur+ ! ,,covid-#ai public heal? em]g5cy & future em]g5cies2 7,g7 h[ to support ,/ate1 local1 & ,tribal capacity to elim9ate b>ri]s to ,,covid-#ai te/+ & treatm5t2 & 7,h7 to ! ext5t possible1 a prelim9>y analysis ( ,f$]al ,gov]nm5t policies t disp>ately exac]bate ! ,,covid-#ai impact1 & recomm5dations to improve racial & o!r demographic disp>ities 9 heal? outcomes4 7#e7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ su* sums z may be necess>y to c>ry out ?is subsection4 #ajb4 ,,covid-#ai report+ portal 7a7 ,9 g5]al ,n lat] ?an #ae days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y7 %all e/abli% & ma9ta9 an onl9e portal = use by eligible heal? c>e entities to track & transmit data reg>d+ _! p]sonal protective equipm5t & m$ical supply inv5tory & capacity relat$ to ,,covid-#ai4 7b7 ,eligible heal? c>e entities ,9 ?is section1 ! t]m eligible heal? c>e entity means a lic5s$ acute c>e hospital1 hospital sy/em1 or long-t]m c>e facility ) confirm$ cases ( ,,covid-#ai4 7c7 ,submission ,an eligible heal? c>e entity %all report us+ ! portal "u ?is section on a biweekly basis 9 ord] to assi/ ! ,secret>y 9 track+ usage & ne$ ( ,,covid-relat$ supplies & p]sonnel 9 a regul> & real-"t mann]4 7d7 ,includ$ in=mation ,! ,secret>y %all design ! portal "u ?is section to include in=mation on p]sonal protective equipm5t & m$ical supply inv5tory & capacity relat$ to ,,covid-#ai1 includ+ ) respect to ! foll[+3 7#a7 ,p]sonal protective equipm5t ,total p]sonal protective equipm5t inv5tory1 includ+1 9 units1 ! numb]s ( ,n#ie masks & au?oriz$ equival5t respirator masks1 surgical masks1 exam gloves1 face %ields1 isolation g[ns1 & cov]alls4 7#b7 ,m$ical supply 7,a7 ,total v5tilator inv5tory1 includ+1 9 units1 ! numb] ( univ]sal1 adult1 p$iatric1 & infant v5tilators4 7,b7 ,total diagno/ic & s]ological te/ inv5tory1 includ+1 9 units1 ! numb] ( te/ plat=ms1 te/s1 te/ kits1 reag5ts1 transport m$ia1 swabs1 & o!r mat]ials or supplies det]m9$ necess>y by ! ,secret>y4 7#c7 ,capacity 7,a7 ,case c\nt measurem5ts1 includ+ confirm$ positive cases & p]sons "u inve/igation4 7,b7 ,total numb] ( /aff$ b$s1 includ+ m$ical surgical b$s1 int5sive c>e b$s1 & critical c>e b$s4 7,c7 ,available b$s1 includ+ m$ical surgical b$s1 int5sive c>e b$s1 & critical c>e b$s4 7,d7 ,total numb] ( ,,covid-#ai pati5ts curr5tly utiliz+ a v5tilator4 7,e7 ,av]age numb] ( days a ,,covid-#ai pati5t is utiliz+ a v5tilator4 7,f7 ,total numb] ( additionally ne$$ pr(essionals 9 ea* ( ! foll[+ categories3 int5sivi/s1 critical c>e physicians1 respiratory !rapi/s1 regi/]$ nurses1 c]tifi$ regi/]$ nurse ane/heti/s1 & laboratory p]sonnel4 7,g7 ,total numb] ( hospital p]sonnel curr5tly n work+ due to self-isolation foll[+ a kn[n or presum$ ,,covid-#ai exposure4 7e7 ,access to in=mation relat$ to inv5tory & capacity ,! ,secret>y %all ensure t relevant ag5cies & (ficials1 includ+ ! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,assi/ant ,secret>y = ,prep>$ness & ,response1 & ! ,f$]al ,em]g5cy ,managem5t ,ag5cy1 h access to in=mation relat$ to inv5tory & capacity submitt$ "u ?is section4 7f7 ,weekly report to ,congress ,on a weekly basis1 ! ,secret>y %all transmit in=mation relat$ to inv5tory & capacity submitt$ "u ?is section to ! appropriate committees ( ! ,h\se & ,s5ate4 #ajc4 ,regul> ,,cdc report+ on demographic data ,n lat] ?an #ad days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices1 9 coord9ation ) ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all am5d ! report+ "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vice ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci2 #acd ,/at4 #fbj1 #fbf7 on ! demographic *>act]i/ics1 includ+ race1 e?nicity 7includ+ breakd[ns ( major e?nic gr\ps & ,tribal affiliations )9 m9ority populations71 age1 sex1 g5d]1 geographic region1 prim>y writt5 & spok5 language1 disability /atus1 sexual ori5tation1 socioeconomic /atus1 occupation1 & o!r relevant factors ( individuals te/$ = or diagnos$ ) ,,covid-#ai1 to include-- 7#a7 provid+ te*nical assi/ance to ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts to improve ! collection & report+ ( su* demographic data2 7#b7 if su* data is n s collect$ or report$1 ! reason :y ! ,/ate1 local1 ,tribal1 or t]ritorial dep>tm5t ( heal? has n be5 able to collect or provide su* in=mation2 & 7#c7 mak+ a copy ( su* report available publicly on ! website ( ! ,c5t]s = ,disease ,control & ,prev5tion4 #ajd4 ,am5dm5t to ! ,public ,heal? ,s]vice ,act 7a7 ,purpose ,x is ! purpose ( ! am5dm5t made by ?is section to promote data collection1 analysis1 & report+ by race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 disability /atus1 g5d] id5tity1 age1 & socioeconomic /atus among f$]ally support$ heal? programs4 7b7 ,am5dm5t ,! ,public ,heal? ,s]vice ,act is am5d$ by add+ at ! end ! foll[+3 ,,xxxiv ,/r5g!n+ data collection1 improv+ data analysis1 & exp&+ data report+ #cdjj4 ,heal? disp>ity data 7a7 ,requirem5ts 7#a7 ,9 g5]al ,ea* heal?-relat$ program %all-- 7,a7 require ! collection1 by ! ag5cy or program involv$1 ( data on ! race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 disability /atus1 g5d] id5tity1 age1 & socioeconomic /atus ( ea* applicant = & recipi5t ( heal?-relat$ assi/ance "u su* program1 includ+-- 7i7 us+1 at a m9imum1 /&>ds = data collection on race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 g5d] id5tity1 age1 socioeconomic /atus1 & disability /atus z ea* are develop$ "u section #caja2 7ii7 collect+ data = additional population gr\ps if su* gr\ps c be aggregat$ into ! race & e?nicity categories outl9$ by /&>ds develop$ "u section #caja2 7iii7 us+1 :]e practicable1 ! /&>ds develop$ by ! ,heal? & ,m$ic9e ,division ( ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e 7=m]ly kn[n z ! ,in/itute ( ,m$ic9e7 9 ! #bjji publication1 entitl$ ,race1 ,e?nicity1 & ,language ,data3 ,/&>dization = ,heal? ,c>e ,quality ,improvem5t2 & 7iv7 :]e practicable1 collect+ su* data ?r\gh self-report+2 7,b7 ) respect to ! collection ( ! data describ$ 9 subp>agraph 7,a71 = applicants & recipi5ts :o are m9ors1 require communication assi/ance 9 spee* or writ+1 & = applicants & recipi5ts :o are o!rwise legally incapacitat$1 require t-- 7i7 su* data be collect$ f ! p>5t or legal gu>dian ( su* an applicant or recipi5t2 & 7ii7 ! prim>y language ( ! p>5t or legal gu>dian ( su* an applicant or recipi5t be collect$2 7,c7 sy/ematically analyze su* data us+ ! smalle/ appropriate units ( analysis feasible to detect racial & e?nic disp>ities1 z well z disp>ities along ! l9es ( prim>y language1 sex1 disability /atus1 sexual ori5tation1 g5d] id5tity1 age1 & socioeconomic /atus 9 heal? & heal? c>e1 & report ! results ( su* analysis to ! ,secret>y1 ! ,director ( ! ,(fice = ,civil ,rights1 ea* ag5cy li/$ 9 section #caja7;c77#a71 ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions & ! ,committee on ,f9ance ( ! ,s5ate1 & ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,ways & ,means ( ! ,h\se ( ,repres5tatives2 7,d7 provide su* data to ! ,secret>y on at lea/ an annual basis2 & 7,e7 ensure t ! provision ( assi/ance to an applicant or recipi5t ( assi/ance is n d5i$ or o!rwise adv]sely affect$ because ( ! failure ( ! applicant or recipi5t to provide race1 e?nicity1 prim>y language1 sex1 sexual ori5tation1 disability /atus1 g5d] id5tity1 age1 & socioeconomic /atus data4 7#b7 ,rules ( con/ruction ,no?+ 9 ?is subsection %all be con/ru$ to-- 7,a7 p]mit ! use ( in=mation collect$ "u ?is subsection 9 a mann] t w\ld adv]sely affect any individual provid+ any su* in=mation2 or 7,b7 dim9i% any requirem5ts1 includ+ su* requirem5ts 9 effect on or aft] ! date ( enactm5t ( ?is section1 on heal? c>e provid]s to collect data4 7#c7 ,no compell$ disclosure ( data ,?is title does n au?orize any heal? c>e provid]1 ,f$]al (ficial1 or o!r entity to compel ! disclosure ( any data collect$ "u ?is title4 ,! disclosure ( any su* data by an individual pursuant to ?is title %all be /rictly volunt>y4 7b7 ,protection ( data ,! ,secret>y %all ensure 7?r\gh ! promulgation ( regulations or o!rwise7 t all data collect$ pursuant to subsection 7a7 are protect$-- 7#a7 "u ! same privacy protections z ! ,secret>y applies to o!r heal? data "u ! regulations promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif relat+ to ! privacy ( individually id5tifiable heal? in=mation & o!r protections2 & 7#b7 f all inappropriate int]nal use by any entity t collects1 /ores1 or receives ! data1 includ+ use ( su* data 9 det]m9ations ( eligibility 7or cont9u$ eligibility7 9 heal? plans1 & f o!r inappropriate uses1 z def9$ by ! ,secret>y4 7c7 ,national plan ( ! data ,c\ncil ,! ,secret>y %all develop & implem5t a national plan to ensure ! collection ( data 9 a culturally & l+ui/ically appropriate mann]1 to improve ! collection1 analysis1 & report+ ( racial1 e?nic1 sex1 prim>y language1 sexual ori5tation1 disability /atus1 g5d] id5tity1 age1 & socioeconomic /atus data at ! ,f$]al1 ,/ate1 t]ritorial1 ,tribal1 & local levels1 includ+ data to be collect$ "u subsection 7a71 & to ensure t data collection activities c>ri$ out "u ?is section are 9 compliance ) /&>ds develop$ "u section #caja4 ,! ,data ,c\ncil ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 9 consultation ) ! ,national ,committee on ,vital ,heal? ,/ati/ics1 ! ,(fice ( ,m9ority ,heal?1 ,(fice on ,wom5's ,heal?1 & o!r appropriate public & private entities1 %all make recomm5dations to ! ,secret>y conc]n+ ! developm5t1 implem5tation1 & revision ( ! national plan4 ,su* plan %all include recomm5dations on h[ to-- 7#a7 implem5t subsection 7a7 :ile m9imiz+ ! co/ & adm9i/rative burd5s ( data collection & report+2 7#b7 exp& k among ,f$]al ag5cies1 ,/ates1 t]ritories1 ,indian ,tribes1 c\nties1 municipalities1 heal? provid]s1 heal? plans1 & ! g5]al public t data collection1 analysis1 & report+ by race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 g5d] id5tity1 age1 socioeconomic /atus1 & disability /atus is legal & necess>y to assure equity & nondiscrim9ation 9 ! quality ( heal? c>e s]vices2 7#c7 ensure t future pati5t record sy/ems foll[ ,f$]al /&>ds promulgat$ "u ! ,heal? ,in=mation ,te*nology = ,economic & ,cl9ical ,heal? ,act = ! collection & mean+ful use ( electronic heal? data on race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 g5d] id5tity1 age1 socioeconomic /atus1 & disability /atus2 7#d7 improve heal? & heal? c>e data collection & analysis = m population gr\ps if su* gr\ps c be aggregat$ into ! m9imum race & e?nicity categories1 includ+ explor+ ! feasibility ( enhanc+ collection ef=ts 9 ,/ates1 c\nties1 & municipalities = racial & e?nic gr\ps t comprise a significant proportion ( ! population ( ! ,/ate1 c\nty1 or municipality2 7#e7 provide rese>*]s ) great] access to racial1 e?nic1 prim>y language1 sex1 sexual ori5tation1 g5d] id5tity1 age1 socioeconomic /atus data1 & disability /atus data1 subject to all applicable privacy & confid5tiality requirem5ts1 includ+ ,,hipaa privacy & security law z def9$ 9 section #cjji2 & 7#f7 safegu>d & prev5t ! misuse ( data collect$ "u subsection 7a74 7d7 ,compliance ) ,/&>ds ,data collect$ "u subsection 7a7 %all be obta9$1 ma9ta9$1 & pres5t$ 7includ+ = report+ purposes7 9 accordance ) /&>ds develop$ "u section #caja4 7e7 ,analysis ( heal? disp>ity data ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality & 9 coord9ation ) ! ,assi/ant ,secret>y = ,plann+ & ,evaluation1 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 ! ,director ( ! ,national ,c5t] = ,heal? ,/ati/ics1 & ! ,director ( ! ,national ,in/itutes ( ,heal?1 %all provide te*nical assi/ance to ag5cies ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices 9 meet+ ,f$]al /&>ds = heal? disp>ity data collection & = analysis ( racial1 e?nic1 & o!r disp>ities 9 heal? & heal? c>e 9 programs conduct$ or support$ by su* ag5cies by-- 7#a7 id5tify+ appropriate quality assurance me*anisms to monitor = heal? disp>ities2 7#b7 specify+ ! cl9ical1 diagno/ic1 or !rapeutic measures :i* %\ld be monitor$2 7#c7 develop+ new quality measures relat+ to racial & e?nic disp>ities & _! ov]lap ) o!r disp>ity factors 9 heal? & heal? c>e2 7#d7 id5tify+ ! level at :i* data analysis %\ld be conduct$2 & 7#e7 %>+ data ) ext]nal organizations = rese>* & quality improvem5t purposes4 7f7 ,def9itions ,9 ?is section-- 7#a7 ! t]m heal?-relat$ program means a program t is op]at$ by ! ,secret>y1 or t receives fund+ or reimbursem5t1 9 :ole or 9 "p1 ei!r directly or indirectly f ! ,secret>y-- 7,a7 = activities "u ! ,social ,security ,act = heal? c>e s]vices2 or 7,b7 = provid+ ,f$]al f9ancial assi/ance = heal? c>e1 biom$ical rese>*1 or heal? s]vices rese>* or = o!rwise improv+ ! heal? ( ! public2 7#b7 ! t]m prim>y language data includes spok5 & writt5 prim>y language data2 & 7#c7 ! t]m prim>y language data collection activities includes id5tify+1 collect+1 /or+1 track+1 & analyz+ prim>y language data & in=mation on ! me?ods us$ to meet ! language access ne$s ( individuals ) limit$ ,engli% pr(ici5cy4 7g7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdja4 ,e/abli%+ grants = data collection improvem5t activities 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality & 9 consultation ) ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 ! ,director ( ! ,national ,in/itutes ( ,heal?1 ! ,assi/ant ,secret>y = ,plann+ & ,evaluation1 & ! ,director ( ! ,national ,c5t] = ,heal? ,/ati/ics1 %all e/abli% a te*nical assi/ance program "u :i* ! ,secret>y provides grants to eligible entities to assi/ su* entities 9 comply+ ) section #cdca4 7b7 ,types ( assi/ance ,a grant provid$ "u ?is section may be us$ to-- 7#a7 enhance or upgrade comput] te*nology t w facilitate collection1 analysis1 & report+ ( racial1 e?nic1 prim>y language1 sexual ori5tation1 sex1 g5d] id5tity1 socioeconomic /atus1 & disability /atus data2 7#b7 improve me?ods = heal? data collection & analysis1 includ+ additional population gr\ps if su* gr\ps c be aggregat$ into ! race & e?nicity categories outl9$ by /&>ds develop$ "u section #caja2 7#c7 develop me*anisms = submitt+ collect$ data subject to any applicable privacy & confid5tiality regulations2 & 7#d7 develop educational programs to in=m heal? plans1 heal? provid]s1 heal?-relat$ ag5cies1 & ! g5]al public t data collection & report+ by race1 e?nicity1 prim>y language1 sexual ori5tation1 sex1 g5d] id5tity1 disability /atus1 & socioeconomic /atus are legal & ess5tial = elim9at+ heal? & heal? c>e disp>ities4 7c7 ,eligible entity ,to be eligible = grants "u ?is section1 an entity %all be a ,/ate1 t]ritory1 ,indian ,tribe1 municipality1 c\nty1 heal? provid]1 heal? c>e organization1 or heal? plan mak+ a demon/rat$ ef=t to br+ data collections into compliance ) section #cdca4 7d7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdjb4 ,ov]sampl+ ( und]repres5t$ gr\ps 9 ,f$]al heal? surveys 7a7 ,national /rategy 7#a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,national ,c5t] = ,heal? ,/ati/ics ( ! ,c5t]s = ,disease ,control & ,prev5tion1 & o!r ag5cies )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices z ! ,secret>y det]m9es appropriate1 %all develop & implem5t an ongo+ & su/a9able national /rategy = ov]sampl+ und]repres5t$ populations )9 ! categories ( race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 disability /atus1 g5d] id5tity1 & socioeconomic /atus z det]m9$ appropriate by ! ,secret>y 9 ,f$]al heal? surveys & program data collections4 ,su* national /rategy %all include a /rategy = ov]sampl+ ( ,native ,am]icans1 ,asian ,am]icans1 ,native ,hawaiians1 & ,pacific ,isl&]s4 7#b7 ,consultation ,9 develop+ & implem5t+ a national /rategy1 z describ$ 9 p>agraph 7#a71 n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is section1 ! ,secret>y %all-- 7,a7 consult ) repres5tatives ( community gr\ps1 nonpr(it organizations1 nongov]nm5tal organizations1 & gov]nm5t ag5cies work+ ) und]repres5t$ populations2 7,b7 solicit ! p>ticipation ( repres5tatives f o!r ,f$]al dep>tm5ts & ag5cies1 includ+ subag5cies ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices2 & 7,c7 consult on1 & use z models1 ! #bjad ,national ,heal? ,int]view ,survey ov]sample ( ,native ,hawaiian & ,pacific ,isl&] populations & ! #bjag ,behavioral ,risk ,factor ,surveillance ,sy/em ov]sample ( ,am]ican ,indian & ,alaska ,native communities4 7b7 ,progress report ,n lat] ?an #b ye>s aft] ! date ( ! enactm5t ( ?is section1 ! ,secret>y %all submit to ! ,congress a progress report1 :i* %all include ! national /rategy describ$ 9 subsection 7a77#a74 7c7 ,au?orization ( appropriations ,to c>ry out ?is section1 !re are au?oriz$ to be appropriat$ su* sums z may be necess>y = fiscal ye>s #bjba ?r\gh #bjbe4 4 #aje4 ,elim9ation ( pr]equisite ( direct appropriations = data collection & analysis ,section #caja ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjjkk7 is am5d$-- 7#a7 by /rik+ subsection 7h72 & 7#b7 by r$esignat+ subsection 7i7 z subsection 7h74 #ajf4 ,collection ( data = ! ,m$ic>e program ,"p ,a ( title ,,xi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acja et seq47 is am5d$ by add+ at ! end ! foll[+3 #aaej;,c4 ,collection ( data = ! ,m$ic>e program 7a7 ,requirem5t 7#a7 ,9 g5]al ,! ,commission] ( ,social ,security1 9 consultation ) ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all collect data on ! race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 g5d] id5tity1 socioeconomic /atus1 & disability /atus ( all applicants = ,social ,security b5efits "u title ,,ii or ,m$ic>e b5efits "u title ,,xviii4 7#b7 ,data collection /&>ds ,9 collect+ data "u p>agraph 7#a71 ! ,commission] ( ,social ,security %all at lea/ use ! /&>ds = data collection develop$ "u section #caja ( ! ,public ,heal? ,s]vice ,act or ! /&>ds develop$ by ! ,(fice ( ,managem5t & ,budget1 :i*ev] is m disaggregat$4 ,9 ! ev5t !re are no /&>ds = ! demographic gr\ps li/$ "u p>agraph 7#a71 ! ,commission] %all consult ) /akehold] gr\ps repres5t+ ! v>i\s id5tities z well z ) ! ,(fice ( ,m9ority ,heal? )9 ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices to develop appropriate /&>ds4 7#c7 ,data = additional population gr\ps ,:]e practicable1 ! in=mation collect$ by ! ,commission] ( ,social ,security "u p>agraph 7#a7 %all include data = additional population gr\ps if su* gr\ps c be aggregat$ into ! race & e?nicity categories outl9$ by ! data collection /&>ds describ$ 9 p>agraph 7#b74 7#d7 ,collection ( data = m9ors & legally incapacitat$ individuals ,) respect to ! collection ( ! data describ$ 9 p>agraph 7#a7 ( applicants :o are "u #ah ye>s ( age or o!rwise legally incapacitat$1 ! ,commission] ( ,social ,security %all require t-- 7,a7 su* data be collect$ f ! p>5t or legal gu>dian ( su* an applicant2 & 7,b7 ! prim>y language ( ! p>5t or legal gu>dian ( su* an applicant or recipi5t be us$ 9 collect+ ! data4 7#e7 ,quality ( data ,! ,commission] ( ,social ,security %all p]iodically review ! quality & complet5ess ( ! data collect$ "u p>agraph 7#a7 & make adju/m5ts z necess>y to improve bo?4 7#f7 ,transmission ( data ,^u enrollm5t 9 ,m$ic>e b5efits "u title ,,xviii1 ! ,commission] ( ,social ,security %all transmit an individual's demographic data z collect$ "u p>agraph 7#a7 to ! ,c5t]s = ,m$ic>e & ,m$icaid ,s]vices4 7#g7 ,analysis & report+ ( data ,) respect to data transmitt$ "u p>agraph 7#e71 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e & ,m$icaid ,s]vices1 9 consultation ) ! ,commission] ( ,social ,security %all-- 7,a7 require t su* data be uni=mly analyz$ & t su* analysis be report$ at lea/ annually to ,congress2 7,b7 incorporate su* data 9 o!r analysis & report+ on heal? disp>ities z appropriate2 7,c7 make su* data available to rese>*]s1 "u ! protections outl9$ 9 p>agraph 7#g72 7,d7 provide opportunities to individuals enroll$ 9 ,m$ic>e to submit updat$ data2 & 7,e7 ensure t ! provision ( assi/ance or b5efits to an applicant is n d5i$ or o!rwise adv]sely affect$ because ( ! failure ( ! applicant to provide any ( ! data collect$ "u p>agraph 7#a74 7#h7 ,protection ( data ,! ,commission] ( ,social ,security %all ensure 7?r\gh ! promulgation ( regulations or o!rwise7 t all data collect$ pursuant to subsection 7a7 is protect$-- 7,a7 "u ! same privacy protections z ! ,secret>y applies to heal? data "u ! regulations promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7relat+ to ! privacy ( individually id5tifiable heal? in=mation & o!r protections72 & 7,b7 f all inappropriate int]nal use by any entity t collects1 /ores1 or receives ! data1 includ+ use ( su* data 9 det]m9ations ( eligibility 7or cont9u$ eligibility7 9 heal? plans1 & f o!r inappropriate uses1 z def9$ by ! ,secret>y4 7b7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to p]mit ! use ( in=mation collect$ "u ?is section 9 a mann] t w\ld adv]sely affect any individual provid+ any su* in=mation4 7c7 ,te*nical assi/ance ,! ,secret>y may1 ei!r directly or by grant or contract1 provide te*nical assi/ance to enable any entity to comply ) ! requirem5ts ( ?is section or ) regulations implem5t+ ?is section4 7d7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section #ejj million = #bjbj & #ajj million = ea* fiscal ye> !reaft]4 4 #ajg4 ,revision ( ,,hipaa claims /&>ds 7a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all revise ! regulations promulgat$ "u "p ,c ( title ,,xi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;d et seq471 relat+ to ! collection ( data on race1 e?nicity1 & prim>y language 9 a heal?-relat$ transaction1 to require-- 7#a7 ! use1 at a m9imum1 ( /&>ds = data collection on race1 e?nicity1 prim>y language1 disability1 sex1 sexual ori5tation1 g5d] id5tity1 & socioeconomic /atus develop$ "u section #caja ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjjkk72 & 7#b7 9 consultation ) ! ,(fice ( ! ,national ,coord9ator = ,heal? ,in=mation ,te*nology1 ! designation ( ! appropriate racial1 e?nic1 prim>y language1 disability1 sex1 & o!r code sets z requir$ = claims & enrollm5t data4 7b7 ,dissem9ation ,! ,secret>y ( ,heal? & ,human ,s]vices %all dissem9ate ! new /&>ds develop$ "u subsection 7a7 to all entities t are subject to ! regulations describ$ 9 su* subsection & provide te*nical assi/ance ) respect to ! collection ( ! data involv$4 7c7 ,compliance ,! ,secret>y ( ,heal? & ,human ,s]vices %all require t entities comply ) ! new /&>ds develop$ "u subsection 7a7 n lat] ?an #b ye>s aft] ! f9al promulgation ( su* /&>ds4 #ajh4 ,disp>ities data collect$ by ! ,f$]al ,gov]nm5t 7a7 ,repository ( ,gov]nm5t data ,! ,secret>y ( ,heal? & ,human ,s]vices1 9 coord9ation ) ! dep>tm5ts1 ag5cies1 or (fices describ$ 9 subsection 7b71 %all e/abli% a c5traliz$ electronic repository ( ,gov]nm5t data on factors relat$ to ! heal? & well-be+ ( ! population ( ! ,unit$ ,/ates4 7b7 ,collection2 submission ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & ,janu>y #ca ( ea* ye> !reaft]1 ea* dep>tm5t1 ag5cy1 & (fice ( ! ,f$]al ,gov]nm5t t has collect$ data on race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 disability /atus1 g5d] id5tity1 age1 or socioeconomic /atus dur+ ! prec$+ cal5d> ye> %all submit su* data to ! repository ( ,gov]nm5t data e/abli%$ "u subsection 7a74 7c7 ,analysis2 public availability2 report+ ,n lat] ?an ,april #cj1 #bjba1 & ,april #cj ( ea* ye> !reaft]1 ! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,assi/ant ,secret>y = ,plann+ & ,evaluation1 ! ,assi/ant ,secret>y = ,heal?1 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 ! ,director ( ! ,national ,c5t] = ,heal? ,/ati/ics1 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 ! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities1 & ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 %all-- 7#a7 prep>e & make available datasets = public use t relate to disp>ities 9 heal? /atus1 heal? c>e access1 heal? c>e quality1 heal? outcomes1 public heal?1 & o!r areas ( heal? & well-be+ by factors t include race1 e?nicity1 sex1 prim>y language1 sexual ori5tation1 disability /atus1 g5d] id5tity1 & socioeconomic /atus2 7#b7 ensure t ^! datasets are publicly id5tifi$ on ! repository e/abli%$ "u subsection 7a7 z disp>ities data2 & 7#c7 submit a report to ! ,congress on ! availability & use ( su* data by public /akehold]s4 #aji4 ,/&>ds = measur+ sexual ori5tation1 g5d] id5tity1 & socioeconomic /atus 9 collection ( heal? data ,section #caja7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjjkk7a77 is am5d$-- 7#a7 9 p>agraph 7#a77;,a71 by ins]t+ sexual ori5tation1 g5d] id5tity1 socioeconomic /atus1 be=e & disability /atus2 7#b7 9 p>agraph 7#a77;,c71 by ins]t+ sexual ori5tation1 g5d] id5tity1 socioeconomic /atus1 be=e & disability /atus2 & 7#c7 9 p>agraph 7#b77;,b71 by ins]t+ sexual ori5tation1 g5d] id5tity1 socioeconomic /atus1 be=e & disability /atus4 #aaj4 ,improv+ heal? data reg>d+ ,native ,hawaiians & o!r ,pacific ,isl&]s ,"p ,b ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdc et seq47 is am5d$ by ins]t+ aft] section #cag,u ! foll[+3 #cag,v4 ,native ,hawaiian & o!r ,pacific ,isl&] heal? data 7a7 ,def9itions ,9 ?is section3 7#a7 ,community gr\p ,! t]m community gr\p means a gr\p ( ,,nhopi :o are organiz$ at ! community level1 & may include a *ur* gr\p1 social s]vice gr\p1 national advocacy organization1 or cultural gr\p4 7#b7 ,nonpr(it1 nongov]nm5tal organization ,! t]m nonpr(it1 nongov]nm5tal organization means a gr\p ( ,,nhopi ) a demon/rat$ hi/ory ( address+ ,,nhopi issues1 includ+ a ,,nhopi coalition4 7#c7 ,designat$ organization ,! t]m designat$ organization means an entity e/abli%$ to repres5t ,,nhopi populations & :i* has /atutory responsibilities to provide1 or has community support = provid+1 heal? c>e4 7#d7 ,gov]nm5t repres5tatives ( ,,nhopi populations ,! t]m gov]nm5t repres5tatives ( ,,nhopi populations means repres5tatives f ,hawaii1 ,am]ican ,samoa1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,f$]at$ ,/ates ( ,micronesia1 ,guam1 ! ,republic ( ,palau1 & ! ,republic ( ! ,m>%all ,isl&s4 7#e7 ,native ,hawaiians & o!r ,pacific ,isl&]s 7,,nhopi7 ,! t]m ,native ,hawaiians & ,o!r ,pacific ,isl&]s or ,,nhopi means p hav+ orig9s 9 any ( ! orig9al peoples ( ,am]ican ,samoa1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,f$]at$ ,/ates ( ,micronesia1 ,guam1 ,hawaii1 ! ,republic ( ! ,m>%all ,isl&s1 ! ,republic ( ,palau1 or any o!r ,pacific ,isl&4 7#f7 ,insul> area ,! t]m insul> area means ,guam1 ! ,commonweal? ( ,nor!rn ,m>iana ,isl&s1 ,am]ican ,samoa1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ! ,f$]at$ ,/ates ( ,micronesia1 ! ,republic ( ,palau1 or ! ,republic ( ! ,m>%all ,isl&s4 7b7 ,national /rategy 7#a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,national ,c5t] = ,heal? ,/ati/ics 7ref]r$ to 9 ?is section z ,,n*s7 ( ! ,c5t]s = ,disease ,control & ,prev5tion1 & o!r ag5cies )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices z ! ,secret>y det]m9es appropriate1 %all develop & implem5t an ongo+ & su/a9able national /rategy = id5tify+ & evaluat+ ! heal? /atus & heal? c>e ne$s ( ,,nhopi populations liv+ 9 ! cont95tal ,unit$ ,/ates1 ,hawaii1 ,am]ican ,samoa1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,f$]at$ ,/ates ( ,micronesia1 ,guam1 ! ,republic ( ,palau1 & ! ,republic ( ! ,m>%all ,isl&s4 7#b7 ,consultation ,9 develop+ & implem5t+ a national /rategy1 z describ$ 9 p>agraph 7#a71 n lat] ?an #ahj days aft] ! date ( enactm5t ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj1 ! ,secret>y-- 7,a7 %all consult ) repres5tatives ( community gr\ps1 designat$ organizations1 & nonpr(it1 nongov]nm5tal organizations & ) gov]nm5t repres5tatives ( ,,nhopi populations2 & 7,b7 may solicit ! p>ticipation ( repres5tatives f o!r ,f$]al dep>tm5ts4 7c7 ,prelim9>y heal? survey 7#a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ,,n*s1 %all conduct a prelim9>y heal? survey 9 ord] to id5tify ! major areas & regions 9 ! cont95tal ,unit$ ,/ates1 ,hawaii1 ,am]ican ,samoa1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,f$]at$ ,/ates ( ,micronesia1 ,guam1 ! ,republic ( ,palau1 & ! ,republic ( ! ,m>%all ,isl&s 9 :i* ,,nhopi p reside4 7#b7 ,cont5ts ,! heal? survey describ$ 9 p>agraph 7#a7 %all include heal? data & any o!r data ! ,secret>y det]m9es to be-- 7,a7 useful 9 det]m9+ heal? /atus & heal? c>e ne$s2 or 7,b7 requir$ = develop+ or implem5t+ a national /rategy4 7#c7 ,me?odology ,me?odology = ! heal? survey describ$ 9 p>agraph 7#a71 includ+ plans = design+ que/ions1 implem5tation1 sampl+1 & analysis1 %all be develop$ 9 consultation ) community gr\ps1 designat$ organizations1 nonpr(it1 nongov]nm5tal organizations1 & gov]nm5t repres5tatives ( ,,nhopi populations1 z det]m9$ by ! ,secret>y4 7#d7 ,timeframe ,! survey requir$ "u ?is subsection %all be complet$ n lat] ?an #ah mon?s aft] ! date ( enactm5t ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj4 7d7 ,progress report ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj1 ! ,secret>y %all submit to ,congress a progress report1 :i* %all include ! national /rategy describ$ 9 subsection 7b77#a74 7e7 ,/udy & report by ! ,heal? & ,m$ic9e ,division 7#a7 ,9 g5]al ,! ,secret>y %all ent] into an agreem5t ) ! ,heal? & ,m$ic9e ,division ( ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e to conduct a /udy1 ) input f /akehold]s 9 insul> areas1 on ea* ( ! foll[+3 7,a7 ,! /&>ds & def9itions ( heal? c>e appli$ to heal? c>e sy/ems 9 insul> areas & ! appropriat5ess ( su* /&>ds & def9itions4 7,b7 ,! /atus & p]=mance ( heal? c>e sy/ems 9 insul> areas1 evaluat$ bas$ ^u /&>ds & def9itions1 z ! ,secret>y det]m9es appropriate4 7,c7 ,! effectiv5ess ( donor aid 9 address+ heal? c>e ne$s & priorities 9 insul> areas4 7,d7 ,! progress t[>d implem5tation ( recomm5dations ( ! ,committee on ,heal? ,c>e ,s]vices 9 ! ,unit$ ,/ates--,associat$ ,pacific ,bas9 t are set =? 9 ! #aiih report entitl$ ,pacific ,p>tn]%ips = ,heal?3 ,*>t+ a ,new ,c\rse4 7#b7 ,report ,an agreem5t describ$ 9 p>agraph 7#a7 %all require ! ,heal? & ,m$ic9e ,division to submit to ! ,secret>y & to ,congress1 n lat] ?an #b ye>s aft] ! date ( ! enactm5t ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj1 a report conta9+ a description ( ! results ( ! /udy conduct$ "u p>agraph 7#a71 includ+ ! conclusions & recomm5dations ( ! ,heal? & ,m$ic9e ,division = ea* ( ! items describ$ 9 subp>agraphs 7,a7 ?r\gh 7,d7 ( su* p>agraph4 7f7 ,au?orization ( appropriations ,to c>ry out ?is section1 !re are au?oriz$ to be appropriat$ su* sums z may be necess>y = fiscal ye>s #bjba ?r\gh #bjbe4 4 ,b ,improvem5ts & ,mod]nization #aba4 ,f$]al mod]nization = heal? inequities data 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices %all "w ) cov]$ ag5cies to support ! mod]nization ( data collection me?ods & infra/ructure at su* ag5cies = ! purpose ( increas+ data collection relat$ to heal? inequities1 su* z racial1 e?nic 7includ+ breakd[ns ( major e?nic gr\ps & ,tribal affiliations )9 m9ority populations71 socioeconomic1 sex1 g5d]1 age1 geographic region1 prim>y writt5 & spok5 language1 sexual ori5tation1 occupation1 & disability /atus disp>ities4 7b7 ,cov]$ ag5cy def9$ ,9 ?is section1 ! t]m cov]$ ag5cy means ea* ( ! foll[+ ,f$]al ag5cies3 7#a7 ,! ,ag5cy = ,heal?c>e ,rese>* & ,quality4 7#b7 ,! ,c5t]s = ,disease ,control & ,prev5tion4 7#c7 ,! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7#d7 ,! ,food & ,drug ,adm9i/ration4 7#e7 ,! ,(fice ( ! ,national ,coord9ator = ,heal? ,in=mation ,te*nology4 7#f7 ,! ,national ,in/itutes ( ,heal?4 7c7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ea* cov]$ ag5cy to c>ry out ?is section #d1jjj1jjj1 to rema9 available until exp5d$4 #abb4 ,mod]nization ( ,/ate & local heal? inequities data 7a7 ,9 g5]al ,n lat] ?an #f mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all aw>d grants to ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts 9 ord] to support ! mod]nization ( data collection me?ods & infra/ructure = ! purposes ( increas+ data relat$ to heal? inequities1 su* z racial1 e?nic 7includ+ breakd[ns ( major e?nic gr\ps & ,tribal affiliations )9 m9ority populations71 socioeconomic1 sex1 g5d]1 age1 geographic region1 prim>y writt5 & spok5 language1 sexual ori5tation1 occupation1 & disability /atus disp>ities4 ,! ,secret>y %all-- 7#a7 provide guidance1 te*nical assi/ance1 & in=mation to grantees "u ?is section on be/ practices reg>d+ culturally compet5t1 accurate1 & increas$ data collection & transmission2 & 7#b7 track p]=mance ( grantees "u ?is section to help improve _! heal? inequities data collection by id5tify+ gaps & tak+ effective /eps to support ,/ates1 localities1 & t]ritories 9 address+ ! gaps4 7b7 ,report ,n lat] ?an #a ye> aft] ! date on :i* ! fir/ grant is aw>d$ "u ?is section1 ! ,secret>y %all submit to ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate an initial report detail+-- 7#a7 nationwide be/ practices = ensur+ ,/ates & localities collect & transmit heal? inequities data2 7#b7 nationwide tr5ds :i* h9d] ! collection & transmission ( heal? inequities data2 7#c7 ,f$]al be/ practices = work+ ) ,/ates & localities to ensure culturally compet5t1 accurate1 & increas$ data collection & transmission2 & 7#d7 any recomm5d$ *anges to legislative or regulatory au?ority to help improve & increase heal? inequities data collection4 7c7 ,f9al report ,n lat] ?an ,decemb] #ca1 #bjbc1 ! ,secret>y %all-- 7#a7 update & f9alize ! initial report "u subsection 7b72 & 7#b7 submit su* f9al report to ! committees specifi$ 9 su* subsection4 7d7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section #ajj1jjj1jjj1 to rema9 available until exp5d$4 #abc4 ,additional report+ to ,congress on ! race & e?nicity rates ( ,,covid-#ai te/+1 hospitalizations1 & mortalities 7a7 ,9 g5]al ,n lat] ?an ,augu/ #a1 #bjbj1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y7 %all submit to ! ,committee on ,appropriations & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & ! ,committee on ,appropriations & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate an initial report-- 7#a7 describ+ ! te/+1 positive diagnoses1 hospitalization1 int5sive c>e admissions1 & mortality rates associat$ ) ,,covid-#ai1 disaggregat$ by race1 e?nicity 7includ+ breakd[ns ( major e?nic gr\ps & ,tribal affiliations )9 m9ority populations71 age1 sex1 g5d]1 geographic region1 prim>y writt5 & spok5 language1 disability /atus1 sexual ori5tation1 socioeconomic /atus1 occupation1 & o!r relevant factors z det]m9$ by ! ,secret>y2 7#b7 includ+ an analysis ( any v>iances ( te/+1 positive diagnoses1 hospitalizations1 & dea?s by demographic *>act]i/ics2 & 7#c7 includ+ proposals = evid5c$-bas$ response /rategies to r$uce disp>ities relat$ to ,,covid-#ai4 7b7 ,f9al report ,n lat] ?an ,decemb] #ca1 #bjbd1 ! ,secret>y %all-- 7#a7 update & f9alize ! initial report "u subsection 7a72 & 7#b7 submit su* f9al report to ! committees specifi$ 9 su* subsection4 7c7 ,coord9ation ,9 prep>+ ! report submitt$ "u ?is section1 ! ,secret>y %all take into acc\nt & o!rwise coord9ate su* report ) report+ requir$ "u section #ajc & "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vice ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci2 #acd ,/at4 #fbj1 #fbf74 ,,ii ,equitable ,te/+ & ,trac+ ,a ,free ,te/+ = ,pati5ts #bja4 ,soon] cov]age ( te/+ = ,,covid-#ai ,section #fjja7;a7 ( division ,f ( ! ,families ,fir/ ,coronavirus ,response ,act 7#db ,u4,s4,c4 #acbj;b-#e note7 is am5d$ by /rik+ beg9n+ on or aft] & ins]t+ beg9n+ be=e1 on1 or aft]4 ,b ,national ,te/+ ,/rategy #baa4 ,,covid-#ai te/+ /rategy 7a7 ,/rategy ,n lat] ?an ,june #ae1 #bjbj1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y7 %all update ! ,,covid-#ai /rategic te/+ plan "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vice ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci1 #acd ,/at4 #fbj1 #fbf-fbg7 & submit to ! appropriate congressional committees su* updat$ national plan id5tify+-- 7#a7 :at level (1 types (1 & approa*es to te/+ 7includ+ pr$ict$ numb]s ( te/s1 populations to be te/$1 & frequ5cy ( te/+ & ! appropriate sett+ :e!r a heal? c>e sett+ 7su* z hospital-bas$1 high-complexity laboratory1 po9t-(-c>e1 mobile te/+ units1 ph>macies or community heal? c5t]s7 or non-heal? c>e sett+ 7su* z workplaces1 s*ools1 or *ild c>e c5t]s77 are necess>y-- 7,a7 to suffici5tly monitor & contribute to ! control ( ! transmission ( ,,s>s-,co,v-#b 9 ! ,unit$ ,/ates2 7,b7 to ensure t any r$uction 9 social di/anc+ ef=ts1 :5 det]m9$ appropriate by public heal? (ficials1 c be und]tak5 9 a mann] t optimizes ! heal? & safety ( ! p ( ! ,unit$ ,/ates1 & r$uces disp>ities 7includ+ disp>ities relat$ to race1 e?nicity1 sex1 age1 disability /atus1 socioeconomic /atus1 prim>y writt5 & spok5 language1 occupation1 & geographic location7 9 ! preval5ce (1 incid5ce (1 & heal? outcomes ) respect to1 ,,covid-#ai2 & 7,c7 to provide = ongo+ surveillance suffici5t to support contact trac+1 case id5tification1 qu>ant9e1 & isolation to prev5t future outbreaks ( ,,covid-#ai2 7#b7 specific plans & b5*m>ks1 ea* ) cle> timel9es1 to ensure-- 7,a7 su* level (1 types (1 & approa*es to te/+ z are describ$ 9 p>agraph 7#a71 ) respect to optimiz+ heal? & safety2 7,b7 suffici5t availability ( all necess>y te/+ mat]ials & supplies1 includ+ extraction & te/+ kits1 reag5ts1 transport m$ia1 swabs1 in/rum5ts1 analysis equipm5t1 p]sonal protective equipm5t if necess>y = te/+ 7includ+ po9t-(-c>e te/+71 & o!r equipm5t2 7,c7 allocation ( te/+ mat]ials & supplies 9 a mann] t optimizes public heal?1 includ+ by consid]+ ! v>iable impact ( ,,s>s-,co,v-#b on specific ,/ates1 t]ritories1 ,indian ,tribes1 ,tribal organizations1 urban ,indian organizations1 communities1 indu/ries1 & pr(essions2 7,d7 suffici5t evid5ce ( validation = te/s t are deploy$ z a "p ( su* /rategy2 7,e7 suffici5t laboratory & analytical capacity1 includ+ t>get turn>\nd "t = te/ results2 7,f7 suffici5t p]sonnel1 includ+ p]sonnel to collect te/+ samples1 conduct & analyze results1 & conduct te/+ foll[-up1 includ+ contact trac+1 z appropriate2 & 7,g7 en=cem5t ( ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg7 to ensure pati5ts :o are te/$ are n subject to co/ %>+2 7#c7 specific plans to ensure adequate te/+ 9 rural areas1 fronti] areas1 heal? pr(essional %ortage areas1 & m$ically und]s]v$ areas 7z def9$ 9 section #ccj;,i7a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;c-#ad7;a7771 & = und]s]v$ populations1 ,native ,am]icans 7includ+ ,indian ,tribes1 ,tribal organizations1 & urban ,indian organizations71 & populations at increas$ risk relat$ to ,,covid-#ai2 7#d7 specific plans to ensure accessibility ( te/+ to p ) disabilities1 old] individuals1 individuals ) limit$ ,engli% pr(ici5cy1 & individuals ) und]ly+ heal? conditions or weak5$ immune sy/ems2 & 7#e7 specific plans = broadly develop+ & implem5t+ te/+ = pot5tial immunity 9 ! ,unit$ ,/ates1 z appropriate1 9 a mann] suffici5t-- 7,a7 to monitor & contribute to ! control ( ,,s>s-,co,v-#b 9 ! ,unit$ ,/ates2 7,b7 to ensure t any r$uction 9 social di/anc+ ef=ts1 :5 det]m9$ appropriate by public heal? (ficials1 c be und]tak5 9 a mann] t optimizes ! heal? & safety ( ! p ( ! ,unit$ ,/ates2 & 7,c7 to r$uce disp>ities 7includ+ disp>ities relat$ to race1 e?nicity1 sex1 age1 disability /atus1 socioeconomic /atus1 prim>y writt5 & spok5 language1 occupation1 & geographic location7 9 ! preval5ce (1 incid5ce (1 & heal? outcomes ) respect to1 ,,covid-#ai4 7b7 ,coord9ation ,! ,secret>y %all c>ry out ?is section-- 7#a7 9 coord9ation ) ! ,adm9i/rator ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy2 7#b7 9 collaboration ) o!r ag5cies & dep>tm5ts1 z appropriate2 & 7#c7 tak+ into consid]ation ! ,/ate plans = ,,covid-#ai te/+ prep>$ z requir$ "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vice ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci2 #acd ,/at4 #fbj1 #fbd74 7c7 ,updates 7#a7 ,frequ5cy ,! updat$ national plan "u subsection 7a7 %all be updat$ e #cj days until ! end ( ! public heal? em]g5cy fir/ decl>$ by ! ,secret>y "u section #cai ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;d7 on ,janu>y #ca1 #bjbj1 ) respect to ,,covid-#ai4 7#b7 ,relation to o!r law ,p>agraph 7#a7 applies 9 lieu ( ! requirem5t 7= updates e #ij days until funds are exp5d$7 9 ! second to la/ proviso "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vice ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci2 #acd ,/at4 #fbj1 #fbg74 7d7 ,appropriate congressional committees ,9 ?is section1 ! t]m appropriate congressional committees means-- 7#a7 ! ,committee on ,appropriations & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives2 & 7#b7 ! ,committee on ,appropriations & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate4 #bab4 ,coronavirus immigrant families protection 7a7 ,def9itions ,9 ?is section3 7#a7 ,coronavirus public heal? em]g5cy ,! t]m coronavirus public heal? em]g5cy means-- 7,a7 an em]g5cy involv+ ,f$]al prim>y responsibility det]m9$ to exi/ by ! ,presid5t "u section #eja7;b7 ( ! ,rob]t ,t4 ,/af=d ,disa/] ,relief & ,em]g5cy ,assi/ance ,act 7#db ,u4,s4,c4 #eaia7;b77 ) respect to ,,covid-#ai or any o!r coronavirus ) p&emic pot5tial2 7,b7 an em]g5cy decl>$ by a ,f$]al (ficial ) respect to coronavirus 7z def9$ 9 section #ejf ( ! ,coronavirus ,prep>$ness & ,response ,supplem5tal ,appropriations ,act1 #bjbj 7,public ,law #aaf-abc772 7,c7 a national em]g5cy decl>$ by ! ,presid5t "u ! ,national ,em]g5cies ,act 7#ej ,u4,s4,c4 #afja et seq47 ) respect to ,,covid-#ai or any o!r coronavirus ) p&emic pot5tial2 & 7,d7 a public heal? em]g5cy decl>$ by ! ,secret>y ( ,heal? & ,human ,s]vices pursuant to section #cai ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg7;d77 ) respect to ,,covid-#ai or any o!r coronavirus ) p&emic pot5tial4 7#b7 ,coronavirus response law ,! t]m coronavirus response law means-- 7,a7 ! ,coronavirus ,prep>$ness & ,response ,supplem5tal ,appropriations ,act1 #bjbj 7,public ,law #aaf-abc72 7,b7 ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg72 7,c7 ! ,coronavirus ,aid1 ,relief1 & ,economic ,security ,act 7,public ,law #aaf-acf72 & 7,d7 any subsequ5t law enact$ z a response to a coronavirus public heal? em]g5cy4 7#c7 ,,covid-#ai ,! t]m ,,covid-#ai means ! ,coronavirus ,disease #bjai4 7#d7 ,en=cem5t action ,! t]m en=cem5t action means an appreh5sion1 an arre/1 a se>*1 an int]view1 a reque/ = id5tification1 or surveillance = ! purposes ( immigration en=cem5t4 7#e7 ,s5sitive location ,! t]m s5sitive location means all physical space locat$ )9 #a1jjj feet (-- 7,a7 a m$ical treatm5t or heal? c>e facility1 includ+ a hospital1 an (fice ( a heal? c>e practition]1 an accr$it$ heal? cl9ic1 an alcohol or drug treatm5t c5t]1 an em]g5t or urg5t c>e facility1 & a community heal? c5t]2 7,b7 a location at :i* em]g5cy s]vice provid]s di/ribute food or provide %elt]2 7,c7 an organization t provides-- 7i7 disa/] or em]g5cy social s]vices & assi/ance2 7ii7 s]vices = individuals exp]i5c+ homelessness1 includ+ food banks & %elt]s2 or 7iii7 assi/ance = *ildr51 pregnant wom51 victims ( crime or abuse1 or individuals ) significant m5tal or physical disabilities2 7,d7 a public assi/ance (fice1 includ+ any ,f$]al1 ,/ate1 or municipal location at :i* individuals may apply = or receive unemploym5t comp5sation or report violations ( labor & employm5t laws2 7,e7 a ,f$]al1 ,/ate1 or local c\r?\se1 includ+ ! (fice ( ! legal c\nsel or repres5tative ( an individual2 7,f7 a dome/ic viol5ce %elt]1 rape crisis c5t]1 sup]vis$ visitation c5t]1 family ju/ice c5t]1 or victim s]vices provid]2 7,g7 an (fice ( ! ,social ,security ,adm9i/ration2 7,h7 a *ildc>e facility or a s*ool1 includ+ a pres*ool1 prim>y s*ool1 second>y s*ool1 po/-second>y s*ool up to & includ+ a college or univ]sity1 & any o!r in/itution ( le>n+ su* z a vocational or trade s*ool2 7,i7 a *ur*1 synagogue1 mosque or any o!r in/itution ( wor%ip1 su* z a build+ r5t$ = ! purpose ( a religi\s s]vice2 7,j7 ! site ( a fun]al1 w$d+1 or any o!r public religi\s c]emony2 7,k7 9 ! case ( a jurisdiction 9 :i* a %elt]-9-place ord] is 9 effect dur+ a coronavirus public heal? em]g5cy1 any bus9ess location consid]$ to provide an ess5tial s]vice1 su* z a ph>macy or a groc]y /ore2 & 7,l7 any o!r location specifi$ by ! ,secret>y ( ,homel& ,security4 7b7 ,susp5sion ( adv]se immigration actions t det] immigrant communities f seek+ heal? s]vices 9 a public heal? em]g5cy 7#a7 ,9 g5]al ,beg9n+ on ! date on :i* a coronavirus public heal? em]g5cy is decl>$ & end+ on ! date t is #fj days aft] ! date on :i* ! coronavirus public heal? em]g5cy expires-- 7,a7 ! ,secret>y ( ,homel& ,security1 ! ,secret>y ( ,/ate1 & ! ,attorney ,g5]al %all n-- 7i7 implem5t ! f9al rule ( ! ,dep>tm5t ( ,homel& ,security entitl$ ,inadmissibility on ,public ,*>ge ,gr\nds 7#hd ,f$4 ,reg4 #dabib 7,augu/ #ad1 #bjai772 7ii7 implem5t ! int]im f9al rule ( ! ,dep>tm5t ( ,/ate entitl$ ,visas3 ,ineligibility ,bas$ on ,public ,*>ge ,gr\nds 7#hd ,f$4 ,reg4 #ediif 7,octob] #aa1 #bjai772 7iii7 implem5t ! propos$ rule ( ! ,dep>tm5t ( ,ju/ice entitl$ ,inadmissibility on ,public ,*>ge ,gr\nds publi%$ 9 ! ,fall #bjah ,uni=m ,regulatory ,ag5da2 7iv7 conduct any en=cem5t action aga9/ an individual at1 or 9 transit to or f1 a s5sitive location unless ! en=cem5t action is conduct$ pursuant to a valid judicial w>rant2 7v7 deta9 or remove-- 7,i7 a survivor ( dome/ic viol5ce1 sexual assault1 or human traffick+1 or any o!r individual1 :o has a p5d+ application "u section #aja7;a77#ae77,t71 #aja7;a77#ae77,u71 #ajf1 #bdj;,a7b77#b7 ( ! ,immigration & ,nationality ,act 7#h ,u4,s4,c4 #aaja7;a77#ae77,t71 #aaja7;a77#ae77,u71 #aaje;a1 #abbi;b7b77#b77 or section #bdd7;a77#c7 ( t ,act 7z 9 effect on ,m>* #ca1 #aiig72 or 7,,ii7 a ,,vawa self-petition] describ$ 9 section #aja7;a77#ea7 ( t ,act 7#h ,u4,s4,c4 #aaja7;a77#ea77 :o has a p5d+ application = relief "u-- 7aa7 a provision ref]r$ to 9 any ( subp>agraphs 7,a7 ?r\gh 7,g7 ( t section2 or 7bb7 section #aja7;a77#bg77;,j7 ( t ,act 7#h ,u4,s4,c4 #aaja7;a77#bg77;,j772 & 7vi7 require an individual subject to sup]vision by ,u4,s4 ,immigration & ,cu/oms ,en=cem5t to report 9 p]son4 7,b7 ,! ,attorney ,g5]al %all conduct fully telephonic bond he>+s & all[ support+ docum5ts to be fax$ & email$ to ! appropriate cl]k4 7,c7 ,! ,secret>y ( ,homel& ,security1 to ! ext5t practicable1 %all /ipulate to bond det]m9ations on writt5 motions4 7#b7 ,use ( b5efits fund$ by coronavirus response law ,! ,secret>y ( ,homel& ,security1 ! ,secret>y ( ,/ate1 & ! ,attorney ,g5]al %all n consid] 9 any det]m9ation affect+ ! curr5t or future immigration /atus ( any individual ! use ( any b5efit ( any program or activity fund$ 9 :ole or 9 "p by am\nts made available "u a coronavirus response law4 7c7 ,access to ,,covid-#ai te/+ & treatm5t = all communities 7#a7 ,cl>ification reg>d+ em]g5cy s]vices = c]ta9 individuals ,section #aijc7v77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#b77 is am5d$ by add+ at ! end ! foll[+ flu% s5t5ce3 ,= purposes ( subp>agraph 7,a71 c>e & s]vices describ$ 9 su* subp>agraph include any 9 vitro diagno/ic product describ$ 9 section #aije7;a77#c77;,b7 t is adm9i/]$ dur+ any portion ( ! em]g5cy p]iod describ$ 9 su* section beg9n+ on or aft] ! date ( ! enactm5t ( ?is s5t5ce 7& ! adm9i/ration ( su* product71 any ,,covid-#ai vacc9e t is adm9i/]$ dur+ any su* portion 7& ! adm9i/ration ( su* vacc9e71 any item or s]vice t is furni%$ dur+ any su* portion = ! treatm5t ( ,,covid-#ai or a condition t may complicate ! treatm5t ( ,,covid-#ai1 & any s]vices describ$ 9 section #aiaf7;a77#b77;,g74 4 7#b7 ,em]g5cy m$icaid = individuals ) suspect$ ,,covid-#ai infections ,section #aijc7v77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#c77 is am5d$ by /rik+ means a & ins]t+ means any conc]n t ! individual may h contract$ ,,covid-#ai or ano!r44 7#c7 ,treatm5t ( assi/ance & s]vices provid$ ,= any p]iod dur+ :i* a coronavirus public heal? em]g5cy is 9 effect-- 7,a7 ! value ( assi/ance or s]vices provid$ to any p]son "u a program ) respect to :i* a coronavirus response law e/abli%es or exp&s eligibility or b5efits %all n be consid]$ income or res\rces2 & 7,b7 7i7 any m$ical cov]age or s]vices %all be consid]$ treatm5t = an em]g5cy m$ical condition 7z def9$ 9 section #aijc7v77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#c777 = any purpose "u any ,f$]al1 ,/ate1 or local law1 includ+ law relat+ to taxation1 welf>e1 & public assi/ance programs2 7ii7 a p>ticipat+ ,/ate or political subdivision ( a ,/ate %all n decrease any assi/ance o!rwise provid$ to an individual because ( ! receipt ( b5efits "u ! ,social ,security ,act 7#db ,u4,s4,c4 #cja et seq472 & 7iii7 assi/ance & s]vices describ$ 9 ?is subp>agraph %all be consid]$ nonca% disa/] assi/ance1 not)/&+ ! =m 9 :i* ! assi/ance & s]vices are provid$1 except t ca% receiv$ by an individual or a h\sehold may be treat$ z income by any public b5efit program "u ! rules applicable be=e ! date ( ! enactm5t ( ?is ,act4 7#d7 ,nondiscrim9ation ,no p]son %all be1 on ! basis ( actual or p]ceiv$ immigration /atus1 exclud$ f p>ticipation 91 d5i$ ! b5efits (1 or subject to discrim9ation "u1 any program or activity fund$ 9 :ole or 9 "p by am\nts made available "u a coronavirus response law4 7d7 ,language access & public outrea* = public heal? 7#a7 ,grants & coop]ative agreem5ts 7,a7 ,9 g5]al ,! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion 7ref]r$ to 9 ?is subsection z ! ,director7 %all provide grants to1 or ent] into coop]ative agreem5ts )1 community-bas$ organizations = ! purpose ( support+ culturally & l+ui/ically appropriate prep>$ness1 response1 & recov]y activities1 su* z ! developm5t ( educational programs & mat]ials to promote scre5+1 te/+1 treatm5t1 & public heal? practices4 7,b7 ,def9ition ( community-bas$ organization ,9 ?is p>agraph1 ! t]m community-bas$ organization means an entity t has e/abli%$ relation%ips ) h>d-to-rea* populations1 includ+ racial & e?nic m9orities1 individuals ) limit$ ,engli% pr(ici5cy1 & individuals ) disabilities4 7#b7 ,translation 7,a7 ,9 g5]al ,! ,director %all provide = ! translation ( mat]ials on aw>5ess1 scre5+1 te/+1 & treatm5t = ,,covid-#ai into ! languages describ$ 9 ! language access plan ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy dat$ ,octob] #a1 #bjaf1 z ! languages mo/ frequ5tly enc\nt]$4 7,b7 ,public availability ,n lat] ?an #g days aft] ! date on :i* ! mat]ials describ$ 9 subp>agraph 7,a7 are made available to ! public 9 ,engli%1 ! ,director %all ensure t ! translations requir$ by t subp>agraph are made available to ! public4 7#c7 ,hotl9e ,! ,director %all e/abli% an in=mational hotl9e l9e t provides1 9 ! languages ref]r$ to 9 p>agraph 7#b77;,a71 in=mation to ! public directly on ,,covid-#ai4 7#d7 ,int]ag5cy coord9ation ,) respect to individuals ) limit$ ,engli% pr(ici5cy1 ! ,director %all facilitate int]ag5cy coord9ation among ag5cies activat$ ?r\gh ! ,national ,response ,framework bas$ on ! language access /&>ds e/abli%$ "u ! language access plans ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy & ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7#e7 ,au?orization ( appropriations 7,a7 ,9 g5]al ,!re is au?oriz$ to be appropriat$ to c>ry out ?is subsection #ajj1jjj1jjj = fiscal ye> #bjbj1 to be available until exp5d$4 7,b7 ,grants & coop]ative agreem5ts ,( ! am\nt au?oriz$ to be appropriat$ "u subp>agraph 7,a71 n less ?an #ej1jjj1jjj %all be made available to c>ry out p>agraph 7#a74 7e7 ,access ,to support measures = vuln]able communities 7#a7 ,disa/] supplem5tal nutrition assi/ance program b5efits ,! ,rob]t ,t4 ,/af=d ,disa/] ,relief & ,em]g5cy ,assi/ance ,act 7#db ,u4,s4,c4 #eaba et seq47 is am5d$-- 7,a7 9 section #ajb7a7 7#db ,u4,s4,c4 #eabb7a771 by ins]t+ or p&emic aft] cata/rophe2 7,b7 9 section #cja 7#db ,u4,s4,c4 #eada71 by ins]t+ or an em]g5cy due to a p&emic aft] major disa/] ea* place ! t]m appe>s2 7,c7 9 section #dab 7#db ,u4,s4,c4 #eagi7-- 7i7 by ins]t+ or an em]g5cy due to a p&emic aft] major disa/] ea* place ! t]m appe>s2 7ii7 9 subsection 7a71 by ins]t+ )\t reg>d to regul> allotm5ts be=e & to make surplus2 & 7iii7 by add+ at ! end ! foll[+3 7d7 ,assi/ance dur+ a p&emic ,9 ! case ( an em]g5cy due to a p&emic1 = purposes ( provid+ b5efits "u ?is section1 ! ,secret>y ( ,agriculture %all remove or delay ! requirem5t ( an 9-p]son int]view1 & if an int]view occurs1 provide an alt]native to ! 9-p]son int]view requirem5t = all applicants4 ,assi/ance %all be provid$ bas$ on ne$ & n lo/ provisions4 7e7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ su* sums z are necess>y to c>ry out ?is section1 only if su* sums are designat$ by ,congress z be+ = an em]g5cy requirem5t pursuant to section #bea7;b77#b77;,a77i7 ( ! ,balanc$ ,budget & ,em]g5cy ,deficit ,control ,act ( #aihe 7#b ,u4,s4,c4 #ija7;b77#b77;,a77i774 2 & 7,d7 9 section #ejb7;a7 7#db ,u4,s4,c4 #eaib7;a77-- 7i7 9 p>agraph 7#g71 by /rik+ & at ! end2 7ii7 9 p>agraph 7#h77;,b71 by /rik+ ! p]iod at ! end & ins]t+ a semicolon2 & 7iii7 by add+ at ! end ! foll[+3 7#i7 provide assi/ance 9 accordance ) section #dab4 4 7#b7 ,access to b5efits us+ individual taxpay] id5tification numb] ,subsection 7g77#b77;,a7 ( section #fdbh ( ! ,int]nal ,rev5ue ,code ( #aihf1 z add$ by section #bbja ( ! ,coronavirus ,aid1 ,relief1 & ,economic ,security ,act 7,public ,law #aaf-acf71 is am5d$ by ins]t+ be=e ! p]iod at ! end or a taxpay] id5tification numb]4 7#c7 ,ext5sion ( immigration /atus & employm5t au?orization 7,a7 ,9 g5]al ,not)/&+ any o!r provision ( law1 includ+ ! ,immigration & ,nationality ,act 7#h ,u4,s4,c4 #aaja et seq471 ! ,secret>y ( ,homel& ,security %all automatically ext5d ! immigration /atus & employm5t au?orization1 z applicable1 ( an ali5 describ$ 9 subp>agraph 7,b7 = ! same p]iod = :i* ! /atus & employm5t au?orization 0 initially grant$4 7,b7 ,ali5 describ$ ,an ali5 describ$ 9 ?is subp>agraph is an ali5 7z def9$ 9 section #aja7;a7 ( ! ,immigration & ,nationality ,act 7#h ,u4,s4,c4 #aaja7;a777 ^: immigration /atus1 includ+ p]man5t1 tempor>y1 & def]r$ /atus1 or ^: employm5t au?orization-- 7i7 expir$ dur+ ! #cj-;day p]iod prec$+ ! date ( ! enactm5t ( ?is ,act2 or 7ii7 w expire n lat] ?an-- 7,i7 "o ye> aft] su* date ( enactm5t2 or 7,,ii7 #ij days aft] ! date on :i* ! national em]g5cy decl>$ by ! ,presid5t "u ! ,national ,em]g5cies ,act 7#ej ,u4,s4,c4 #afja et seq47 ) respect to ! ,coronavirus ,disease #bjai 7,,covid-#ai7 is resc9d$4 7#d7 ,language access ,any ag5cy receiv+ fund+ "u a coronavirus response law %all ensure t all programs & opportunities made available to ! g5]al public provide translat$ mat]ials describ+ ! programs & opportunities into ! languages describ$ 9 ! language access plan ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy dat$ ,octob] #a1 #bjaf1 z ! languages mo/ frequ5tly enc\nt]$4 #bac4 ,,ice det5tion 7a7 ,review+ ,,ice det5tion ,dur+ ! public heal? em]g5cy decl>$ by ! ,secret>y ( ,heal? & ,human ,s]vices "u section #cai ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;d7 ) respect to ,,covid-#ai1 ! ,secret>y ( ,homel& ,security %all review ! immigration files ( all individuals 9 ! cu/ody ( ,u4,s4 ,immigration & ,cu/oms ,en=cem5t to assess ! ne$ = cont9u$ det5tion4 ,! ,secret>y ( ,homel& ,security %all prioritize = release on recognizance or alt]natives to det5tion individuals :o are n subject to m&atory det5tion laws1 unless ! individual is a ?reat to public safety or national security4 7b7 ,access to electronic communications & hygi5e products ,dur+ ! p]iod describ$ 9 subsection 7c71 ! ,secret>y ( ,homel& ,security %all ensure t-- 7#a7 all individuals 9 ! cu/ody ( ,u4,s4 ,immigration & ,cu/oms ,en=cem5t-- 7,a7 h access to telephonic or video communication at no co/ to ! deta9$ individual2 7,b7 h access to free1 unmonitor$ telephone calls1 at any "t1 to contact attorneys or legal s]vice provid]s 9 a suffici5tly private space to protect confid5tiality2 7,c7 are p]mitt$ to receive legal correspond5ce by fax or email r ?an po/al mail2 & 7,d7 are provid$ suffici5t soap1 h& sanitiz]1 & o!r hygi5e products2 & 7#b7 nonpr(it organizations provid+ legal ori5tation programm+ or "k-y\r-rights programm+ to individuals 9 ! cu/ody ( ,u4,s4 ,immigration & ,cu/oms ,en=cem5t are p]mitt$ broad & flexible access to su* individuals-- 7,a7 to provide gr\p pres5tations us+ remote videoconf]5c+2 & 7,b7 to s*$ule & provide individual ori5tations us+ free telephone calls or remote videoconf]5c+4 7c7 ,p]iod describ$ ,! p]iod describ$ 9 ?is subsection-- 7#a7 beg9s on ! fir/ day ( ! public heal? em]g5cy decl>$ by ! ,secret>y ( ,heal? & ,human ,s]vices "u section #cai ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;d7 ) respect to ,,covid-#ai2 & 7#b7 ends #ij days aft] ! date on :i* su* public heal? em]g5cy t]m9ates4 ,c ,contact ,trac+ #bba4 ,,covid-#ai ,te/+1 rea*+1 & contact+ ev]yone 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 may aw>d grants to eligible entities to conduct diagno/ic te/+ = ,,covid-#ai1 to trace & monitor ! contacts ( infect$ individuals1 & to support ! qu>ant9e ( su* contacts1 ?r\gh-- 7#a7 mobile heal? units2 & 7#b7 z necess>y1 te/+ individuals & provid+ individuals ) s]vices relat$ to te/+ & qu>ant9e at _! resid5ces4 7b7 ,p]missible uses ( funds ,a grant recipi5t "u ?is section may use ! grant funds1 9 support ( ! activities describ$ 9 subsection 7a7-- 7#a7 to hire1 tra91 comp5sate1 & pay ! exp5ses ( individuals2 & 7#b7 to pur*ase p]sonal protective equipm5t & o!r supplies4 7c7 ,priority ,9 select+ grant recipi5ts "u ?is section1 ! ,secret>y %all give priority to-- 7#a7 applicants propos+ to conduct activities fund$ "u ?is section 9 hot spots & m$ically und]s]v$ communities2 & 7#b7 applicants t agree1 9 hir+ individuals to c>ry out activities fund$ "u ?is section1 to hire resid5ts ( ! area or community :]e ! activities w prim>ily occur1 ) high] priority among applicants describ$ 9 ?is p>agraph giv5 bas$ on ! p]c5tage ( individuals to be hir$ f su* area or community4 7d7 ,di/ribution ,9 select+ grant recipi5ts "u ?is section1 ! ,secret>y %all ensure t grants are di/ribut$ across urban & rural areas4 7e7 ,f$]al privacy requirem5ts ,no?+ 9 ?is section %all be con/ru$ to sup]s$e any ,f$]al privacy or confid5tiality requirem5t1 includ+ ! regulations promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7,public ,law #ajd-aia2 #aaj ,/at4 #bjcc7 & section #edc ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bij;dd-#b74 7f7 ,def9itions ,9 ?is section3 7#a7 ,! t]m eligible entity means-- 7,a7 a ,f$]ally qualifi$ heal? c5t] 7z def9$ 9 section #ahfa7;aa7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa7772 7,b7 a s*ool-bas$ heal? cl9ic2 7,c7 a disproportionate %>e hospital 7z def9$ "u ! applicable ,/ate plan "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 pursuant to section #aibc7;a77#a77;,a7 ( su* ,act 7#db ,u4,s4,c4 #acifr-#d772 7,d7 an academic m$ical c5t]2 7,e7 a nonpr(it organization 7includ+ any su* fai?-bas$ organization72 7,f7 an in/itution ( high] education 7z def9$ 9 section #aja ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajja772 7,g7 a high s*ool 7z def9$ 9 section #haja ( ! ,elem5t>y & ,second>y ,education ,act ( #aife 7#bj ,u4,s4,c4 #ghja772 7,h7 any ,tribal organization includ+ ! ,indian ,heal? ,s]vice & ,native ,am]ican s]vic+ facilities2 or 7,i7 any o!r type ( entity t is det]m9$ by ! ,secret>y to be an eligible entity = purposes ( ?is section4 7#b7 ,! t]m em]g5cy p]iod has ! mean+ giv5 to t t]m 9 section #aace7;g77#a77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77#a77;,b774 7#c7 ,! t]m hot spot means a geographic area :]e ! rate ( infection ) ! virus t causes ,,covid-#ai exce$s ! national av]age4 7#d7 ,! t]m m$ically und]s]v$ community has ! mean+ giv5 to t t]m 9 section #gii;,b ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #biep74 7#e7 ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7g7 ,au?orization ( appropriations ,to c>ry out ?is section1 !re are au?oriz$ to be appropriat$-- 7#a7 #ajj1jjj1jjj1jjj = fiscal ye> #bjbj2 & 7#b7 su* sums z may be necess>y = ea* ( fiscal ye> #bjba & any subsequ5t fiscal ye> dur+ :i* ! em]g5cy p]iod cont9ues4 #bbb4 ,national sy/em = ,,covid-#ai te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 & 9 coord9ation ) ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts1 %all e/abli% & implem5t a nationwide evid5ce-bas$ sy/em =-- 7#a7 te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation ) respect to ,,covid-#ai2 7#b7 (f]+ guidance on volunt>y isolation & qu>ant9e ( individuals infect$ )1 or expos$ to individuals infect$ )1 ! virus t causes ,,covid-#ai2 & 7#c7 public report+ on te/+1 contact trac+1 surveillance1 & volunt>y isolation & qu>ant9e activities ) respect to ,,covid-#ai4 7b7 ,coord9ation2 te*nical assi/ance ,9 c>ry+ out ! national sy/em "u ?is section1 ! ,secret>y %all-- 7#a7 coord9ate ,/ate1 local1 ,tribal1 & t]ritorial activities relat$ to te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation ) respect to ,,covid-#ai1 z appropriate2 & 7#b7 provide te*nical assi/ance = su* activities1 z appropriate4 7c7 ,consid]ation ,9 e/abli%+ & implem5t+ ! national sy/em "u ?is section1 ! ,secret>y %all take into consid]ation-- 7#a7 ! ,/ate plans ref]r$ to 9 ! head+ ,public ,heal? & ,social ,s]vices ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci72 & 7#b7 ! te/+ /rategy submitt$ "u section #baa4 7d7 ,report+ ,! ,secret>y %all-- 7#a7 n lat] ?an ,decemb] #ca1 #bjbj1 submit to ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions a prelim9>y report on ! effectiv5ess ( ! activities c>ri$ out pursuant to ?is subtitle2 & 7#b7 n lat] ?an ,decemb] #ba1 #bjba1 submit to su* committees a f9al report on su* effectiv5ess4 #bbc4 ,grants 7a7 ,9 g5]al ,to implem5t ! national sy/em "u section #bbb1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all1 subject to ! availability ( appropriations1 aw>d grants to ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts t seek grants "u ?is section to c>ry out coord9at$ te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation ) respect to ,,covid-#ai1 includ+-- 7#a7 diagno/ic & surveillance te/+ & report+2 7#b7 community-bas$ contact trac+ ef=ts2 & 7#c7 policies relat$ to volunt>y isolation & qu>ant9e ( individuals infect$ )1 or expos$ to individuals infect$ )1 ! virus t causes ,,covid-#ai4 7b7 ,flexibility ,! ,secret>y %all ensure t-- 7#a7 ! grants "u subsection 7a7 provide flexibility = ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts to modify1 e/abli%1 or ma9ta9 evid5ce-bas$ sy/ems2 & 7#b7 local heal? dep>tm5ts receive fund+ f ,/ate heal? dep>tm5ts or directly f ! ,c5t]s = ,disease ,control & ,prev5tion to contribute to su* sy/ems1 z appropriate4 7c7 ,allocations 7#a7 ,=mula ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all allocate am\nts made available pursuant to subsection 7a7 9 accordance ) a =mula to be e/abli%$ by ! ,secret>y t provides a m9imum level ( fund+ to ea* ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5t t seeks a grant "u ?is section & allocates additional fund+ bas$ on ! foll[+ prioritization3 7,a7 ,! ,secret>y %all give highe/ priority to applicants propos+ to s]ve populations 9 "o or m geographic regions ) a high burd5 ( ,,covid-#ai bas$ on data provid$ by ! ,c5t]s = ,disease ,control & ,prev5tion1 or o!r s\rces z det]m9$ by ! ,secret>y4 7,b7 ,! ,secret>y %all give second highe/ priority to applicants prep>+ =1 or curr5tly work+ to mitigate1 a ,,covid-#ai surge 9 a geographic region t does n yet h a high numb] ( report$ cases ( ,,covid-#ai bas$ on data provid$ by ! ,c5t]s = ,disease ,control & ,prev5tion1 or o!r s\rces z det]m9$ by ! ,secret>y4 7,c7 ,! ,secret>y %all give ?ird highe/ priority to applicants propos+ to s]ve high numb]s ( l[-income & un9sur$ populations1 includ+ m$ically und]s]v$ populations 7z def9$ 9 section #ccj7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b77#c7771 heal? pr(essional %ortage areas 7z def9$ "u section #ccb7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7a7771 racial & e?nic m9orities1 or geographically div]se areas1 z det]m9$ by ! ,secret>y4 7#b7 ,notification ,n lat] ?an ! date t is "o week be=e fir/ aw>d+ grants "u ?is section1 ! ,secret>y %all submit to ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate a notification detail+ ! =mula e/abli%$ "u p>agraph 7#a7 = allocat+ am\nts made available pursuant to subsection 7a74 7d7 ,use ( funds ,a ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5t receiv+ a grant "u ?is section %all1 to ! ext5t possible1 use ! grant funds = ! foll[+ activities1 or o!r activities deem$ appropriate by ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion3 7#a7 ,te/+ ,to implem5t a coord9at$ te/+ sy/em t-- 7,a7 lev]ages or mod]nizes exi/+ te/+ infra/ructure & capacity2 7,b7 is consi/5t ) ! updat$ te/+ /rategy requir$ "u section #baa2 7,c7 is coord9at$ ) ! ,/ate plan = ,,covid-#ai te/+ prep>$ z requir$ "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vice ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci2 #acd ,/at4 #fbj1 #fbd72 7,d7 is in=m$ by contact trac+ & surveillance activities "u ?is subtitle2 7,e7 is in=m$ by guidel9es e/abli%$ by ! ,c5t]s = ,disease ,control & ,prev5tion = :i* populations %\ld be te/$2 7,f7 id5tifies h[ diagno/ic & s]ological te/s 9 su* sy/em %all be validat$ prior to use2 7,g7 id5tifies h[ diagno/ic & s]ological te/s & te/+ supplies w be di/ribut$ to implem5t su* sy/em2 7,h7 id5tifies specific /rategies = ensur+ te/+ capabilities & accessibility 9 m$ically und]s]v$ populations 7z def9$ 9 section #ccj7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b77#c7771 heal? pr(essional %ortage areas 7z def9$ "u section #ccb7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7a7771 racial & e?nic m9ority populations1 & geographically div]se areas1 z det]m9$ by ! ,secret>y2 7,i7 id5tifies h[ te/+ may be us$1 & results may be report$1 9 bo? heal? c>e sett+s 7su* z hospitals1 laboratories = mod]ate or high-complexity te/+1 ph>macies1 mobile te/+ units1 & community heal? c5t]s7 & non-heal? c>e sett+s 7su* z workplaces1 s*ools1 *ildc>e c5t]s1 or drive-?r\ghs72 7,j7 all[s = te/+ 9 s5t9el surveillance programs1 z appropriate2 & 7,k7 supports ! procurem5t & di/ribution ( diagno/ic & s]ological te/s & te/+ supplies to meet ! goals ( ! sy/em4 7#b7 ,contact trac+ ,to implem5t a coord9at$ contact trac+ sy/em t-- 7,a7 lev]ages or mod]nizes exi/+ contact trac+ sy/ems & capabilities1 includ+ community heal? work]s1 heal? dep>tm5ts1 & ,f$]ally qualifi$ heal? c5t]s2 7,b7 is able to inve/igate cases ( ,,covid-#ai1 & help to id5tify o!r pot5tial cases ( ,,covid-#ai1 ?r\gh trac+ contacts ( individuals ) positive diagnoses2 7,c7 e/abli%es culturally compet5t & multil+ual /rategies = contact trac+1 :i* may include consultation ) & support = cultural or civic organizations ) e/abli%$ ties to ! community2 7,d7 provides individuals id5tifi$ "u ! contact trac+ program ) in=mation & support = conta9m5t or mitigation2 7,e7 enables ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts to "w ) a nongov]nm5tal1 community p>tn] or p>tn]s & ,/ate & local work=ce developm5t sy/ems 7z def9$ 9 section #c7fg7 ( ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cajb7fg777 receiv+ grants "u section #bbd7;b7 ( ?is ,act to hire & comp5sate a locally s\rc$ contact trac+ work=ce1 if necess>y1 to supplem5t ! public heal? work=ce1 to-- 7i7 id5tify ! numb] ( contact trac]s ne$$ = ! respective ,/ate1 locality1 t]ritorial1 or ,tribal heal? dep>tm5t to id5tify all cases ( ,,covid-#ai curr5tly 9 ! jurisdiction & ^? anticipat$ to em]ge ov] ! next #ah mon?s 9 su* jurisdiction2 7ii7 outl9e qualifications necess>y = contact trac]s2 7iii7 tra9 ! exi/+ & newly hir$ public heal? work=ce on be/ practices relat$ to trac+ close contacts ( individuals diagnos$ ) ,,covid-#ai1 includ+ ! protection ( individual privacy & cyb]security protection2 & 7iv7 equip ! public heal? work=ce ) tools & res\rces to enable a rapid response to new cases2 7,f7 id5tifies ! level ( contact trac+ ne$$ )9 ! ,/ate1 locality1 t]ritory1 or ,tribal area to conta9 & mitigate ! transmission ( ,,covid-#ai2 7,g7 e/abli%es /atewide me*anisms to integrate regul> evaluation to ! ,c5t]s = ,disease ,control & ,prev5tion reg>d+ contact trac+ ef=ts1 makes su* evaluation publicly available1 & to ! ext5t possible provides = su* evaluation at ! c\nty level2 & 7,h7 id5tifies specific /rategies = ensur+ contact trac+ activities 9 m$ically und]s]v$ populations 7z def9$ 9 section #ccj7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b77#c7771 heal? pr(essional %ortage areas 7z def9$ "u section #ccb7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7a7771 racial & e?nic m9ority populations1 & geographically div]se areas1 z det]m9$ by ! ,secret>y4 7#c7 ,surveillance ,to /r5g!n ! exi/+ public heal? surveillance sy/em t-- 7,a7 lev]ages or mod]nizes exi/+ surveillance sy/ems )9 ! respective ,/ate1 local1 ,tribal1 or t]ritorial heal? dep>tm5t & national surveillance sy/ems2 7,b7 detects & id5tifies tr5ds 9 ,,covid-#ai at ! c\nty level2 7,c7 evaluates ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts 9 a*iev+ surveillance capabilities ) respect to ,,covid-#ai2 7,d7 integrates & improves disease surveillance & immunization track+2 & 7,e7 id5tifies specific /rategies = ensur+ disease surveillance 9 m$ically und]s]v$ populations 7z def9$ 9 section #ccj7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b77#c7771 heal? pr(essional %ortage areas 7z def9$ "u section #ccb7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7a7771 racial & e?nic m9ority populations1 & geographically div]se areas1 z det]m9$ by ! ,secret>y4 7#d7 ,conta9m5t & mitigation ,to implem5t a coord9at$ conta9m5t & mitigation sy/em t-- 7,a7 lev]ages or mod]nizes exi/+ conta9m5t & mitigation /rategies )9 ! respective ,/ate1 local1 ,tribal1 or t]ritorial gov]nm5ts & national conta9m5t & mitigation /rategies2 7,b7 may provide =1 connect to1 & lev]age exi/+ social s]vices & support = individuals :o h be5 infect$ ) or expos$ to ,,covid-#ai & :o are isolat$ or qu>ant9$ 9 _! homes1 su* z ?r\gh-- 7i7 food assi/ance programs2 7ii7 guidance = h\sehold infection control2 7iii7 in=mation & assi/ance ) *ildc>e s]vices2 & 7iv7 in=mation & assi/ance p]ta9+ to support available "u ! ,,c>es ,act 7,public ,law #aaf-acf7 & ?is ,act2 7,c7 provides guidance on ! e/abli%m5t ( safe1 high-quality1 facilities = ! volunt>y isolation ( individuals infect$ )1 or qu>ant9e ( ! contacts ( individuals expos$ to ,,covid-#ai1 :]e hospitalization is n requir$1 :i* facilities %\ld-- 7i7 be prohibit$ f mak+ inquiries relat+ to ! citiz5%ip /atus ( an individual isolat$ or qu>ant9$2 & 7ii7 be op]at$ by a non-,f$]al1 community p>tn] or p>tn]s t-- 7,i7 h previ\sly e/abli%$ relation%ips 9 localities2 7,,ii7 "w ) local places ( wor%ip1 community c5t]s1 m$ical facilities1 & s*ools to recruit local /aff = su* facilities2 & 7,,iii7 are fully integrat$ into ,/ate1 local1 ,tribal1 or t]ritorial conta9m5t & mitigation ef=ts2 & 7,d7 id5tifies specific /rategies = ensur+ conta9m5t & mitigation activities 9 m$ically und]s]v$ populations 7z def9$ 9 section #ccj7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b77#c7771 heal? pr(essional %ortage areas 7z def9$ "u section #ccb7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7a7771 racial & e?nic m9ority populations1 & geographically div]se areas1 z det]m9$ by ! ,secret>y4 7e7 ,report+ ,! ,secret>y %all facilitate me*anisms = timely1 /&>diz$ report+ by grantees "u ?is section reg>d+ implem5tation ( ! sy/ems e/abli%$ "u ?is section & coord9at$ processes ) ! report+ z requir$ & "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vice ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci1 #acd ,/at4 #fbj71 includ+-- 7#a7 a summ>y ( c\nty or local heal? dep>tm5t level in=mation f ! ,/ates receiv+ fund+1 & in=mation f directly fund$ localities1 t]ritories1 & ,tribal entities1 ab\t ! activities t w be und]tak5 us+ fund+ aw>d$ "u ?is section1 includ+ subgrants2 7#b7 any anticipat$ %ortages ( requir$ mat]ials = te/+ = ,,covid-#ai "u subsection 7a72 & 7#c7 o!r b>ri]s 9 ! prev5tion1 mitigation1 or treatm5t ( ,,covid-#ai "u ?is section4 7f7 ,public li/+ ( aw>ds ,! ,secret>y %all-- 7#a7 n lat] ?an #g days aft] fir/ aw>d+ grants "u ?is section1 po/ 9 a se>*able1 electronic =mat a li/ ( all aw>ds made by ! ,secret>y "u ?is section1 includ+ ! recipi5ts & am\nts ( su* aw>ds2 & 7#b7 update su* li/ n less ?an e #g days until all funds made available to c>ry out ?is section are exp5d$4 #bbd4 ,grants to ,/ate & ,tribal work=ce ag5cies 7a7 ,def9itions ,9 ?is section3 7#a7 ,9 g5]al ,except z o!rwise provid$1 ! t]ms 9 ?is section h ! mean+s giv5 ! t]ms 9 section #c ( ! ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cajb74 7#b7 ,appr5tice%ip2 appr5tice%ip program ,! t]m appr5tice%ip or appr5tice%ip program means an appr5tice%ip program regi/]$ "u ! ,act ( ,augu/ #af1 #aicg 7commonly kn[n z ! ,national ,appr5tice%ip ,act7 7#ej ,/at4 #ffd1 *apt] #ffc2 #bi ,u4,s4,c4 #ej et seq471 includ+ any requirem5t1 /&>d1 or rule promulgat$ "u su* ,act1 z su* requirem5t1 /&>d1 or rule 0 9 effect on ,decemb] #cj1 #bjai4 7#c7 ,contact trac+ & relat$ positions ,! t]m contact trac+ & relat$ positions means employm5t relat$ to contact trac+1 surveillance1 conta9m5t1 & mitigation activities z describ$ 9 p>agraphs 7#b71 7#c71 & 7#d7 ( section #bbc7;d74 7#d7 ,eligible entity ,! t]m eligible entity means-- 7,a7 a ,/ate or t]ritory1 includ+ ! ,di/rict ( ,columbia & ,pu]to ,rico2 7,b7 an ,indian ,tribe1 ,tribal organization1 ,alaska ,native entity1 ,indian-controll$ organizations s]v+ ,indians1 or ,native ,hawaiian organizations2 7,c7 an outly+ area2 or 7,d7 a local bo>d1 if an eligible entity "u subp>agraphs 7,a7 ?r\gh 7,c7 has n appli$ ) respect to ! area ov] :i* ! local bo>d has jurisdiction z ( ! date on :i* ! local bo>d submits an application "u subsection 7c74 7#e7 ,eligible individual ,not)/&+ section #agj7;b77#b7 ( ! ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cbbe7;b77#b771 ! t]m eligible individual means an individual seek+ or secur+ employm5t 9 contact trac+ & relat$ positions & s]v$ by an eligible entity or community-bas$ organization receiv+ fund+ "u ?is section4 7#f7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,labor4 7b7 ,grants 7#a7 ,9 g5]al ,subject to ! availability ( appropriations "u subsection 7g71 ! ,secret>y %all aw>d national dislocat$ work] grants "u section #agj7;b77#a77;,b7 ( ! ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cbbe7;b77#a77;,b77 to ea* eligible entity t seeks a grant to assi/ local bo>ds & community-bas$ organizations 9 c>ry+ out activities "u subsections 7f7 & 7d71 respectively1 = ! foll[+ purposes3 7,a7 ,to support ! recruitm5t1 placem5t1 & tra9+1 z applicable1 ( eligible individuals seek+ employm5t 9 contact trac+ & relat$ positions 9 accordance ) ! national sy/em = ,,covid-#ai te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation e/abli%$ "u section #bbb4 7,b7 ,to assi/ ) ! employm5t transition to new employm5t or education & tra9+ ( individuals employ$ "u ?is section 9 prep>ation = & ^u t]m9ation ( su* employm5t4 7#b7 ,timel9e ,! ,secret>y ( ,labor %all-- 7,a7 issue application requirem5ts "u subsection 7c7 n lat] ?an #aj days aft] ! date ( enactm5t ( ?is section2 & 7,b7 aw>d grants to an eligible entity "u p>agraph 7#a7 n lat] ?an #aj days aft] ! date on :i* ! ,secret>y receives an application f su* entity4 7c7 ,grant application ,an eligible entity apply+ = a grant "u ?is section %all submit an application to ! ,secret>y1 at su* "t & 9 su* =m & mann] z ! ,secret>y may reasonably require1 :i* %all include a description (-- 7#a7 h[ ! eligible entity w support ! recruitm5t1 placem5t1 & tra9+1 z applicable1 ( eligible individuals seek+ employm5t 9 contact trac+ & relat$ positions by p>tn]+ )-- 7,a7 a ,/ate1 local1 ,tribal1 or t]ritorial heal? dep>tm5t2 or 7,b7 "o or m nonpr(it or community-bas$ organizations p>tn]+ ) su* heal? dep>tm5ts2 7#b7 h[ ! activities describ$ 9 p>agraph 7#a7 w support ,/ate ef=ts to address ! dem& = contact trac+ & relat$ positions ) respect to-- 7,a7 ! ,/ate plans ref]r$ to 9 ! head+ ,public ,heal? & ,social ,s]vices ,em]g5cy ,fund 9 title ,i ( division ,b ( ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci72 7,b7 ! te/+ /rategy submitt$ "u section #baa2 & 7,c7 ! numb] ( eligible individuals t ! ,/ate plans to recruit & tra9 "u ! plans & /rategies describ$ 9 subp>agraphs 7,a7 & 7,b72 7#c7 ! specific /rategies = recruit+ & placem5t ( eligible individuals f or resid+ )9 ! communities 9 :i* !y w "w1 includ+-- 7,a7 plans = ! recruitm5t ( eligible individuals to s]ve z contact trac]s & relat$ positions1 includ+ dislocat$ work]s1 individuals ) b>ri]s to employm5t1 vet]ans1 new entrants 9 ! work=ce1 or und]employ$ or furl\gh$ work]s1 :o are f or reside 9 or ne> ! local area 9 :i* !y w s]ve1 & :o1 to ! ext5t practicable-- 7i7 h exp]i5ce or a backgr\nd 9 indu/ry-sectors & occupations su* z public heal?1 social s]vices1 cu/om] s]vice1 case managem5t1 or occupations t require relat$ qualifications1 skills1 or compet5cies1 su* z /rong int]p]sonal & communication skills1 ne$$ = contact trac+ & relat$ positions1 z describ$ 9 section #bbc7;d77#b77;,e77ii72 or 7ii7 seek to transition to public heal? & public heal? relat$ occupations ^u ! conclusion ( employm5t 9 contact trac+ & relat$ positions2 & 7,b7 h[ su* /rategies w take into acc\nt ! div]sity ( su* community1 includ+ racial1 e?nic1 socioeconomic1 l+ui/ic1 or geographic div]sity2 7#d7 ! am\nt1 tim+1 & me*anisms = di/ribution ( funds provid$ to local bo>ds or ?r\gh subgrants z describ$ 9 subsection 7d72 7#e7 = eligible entities describ$ 9 subp>agraphs 7,a7 ?r\gh 7,c7 ( subsection 7a77#d71 a description ( h[ ! eligible entity w ensure ! equitable di/ribution ( funds ) respect to-- 7,a7 geography 7su* z urban & rural di/ribution72 7,b7 m$ically und]s]v$ populations 7z def9$ 9 section #cc7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b7772 7,c7 heal? pr(essional %ortage areas 7z def9$ "u section #ccb7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7a7772 & 7,d7 ! racial & e?nic div]sity ( ! area2 & 7#f7 = eligible entities :o are local bo>ds1 a description ( h[ a grant to su* eligible entity w\ld s]ve ! equitable di/ribution ( funds z describ$ 9 p>agraph 7#e74 7d7 ,subgrant au?orization & application process 7#a7 ,9 g5]al ,an eligible entity may aw>d a subgrant to "o or m community-bas$ organizations = ! purposes ( p>tn]+ ) a ,/ate or local bo>d to conduct outrea* & education activities to in=m pot5tially eligible individuals ab\t employm5t opportunities 9 contact trac+ & relat$ positions4 7#b7 ,application ,a community-bas$ organization %all submit an application at su* "t & 9 su* mann] z ! eligible entity may reasonably require1 includ+-- 7,a7 a demon/ration ( ! community-bas$ organization's e/abli%$ exp]tise & effectiv5ess 9 community outrea* 9 ! local area t su* organization plans to s]ve2 7,b7 a demon/ration ( ! community-bas$ organization's exp]tise 9 provid+ employm5t or public heal? in=mation to ! local areas 9 :i* su* organization plans to s]ve2 & 7,c7 a description ( ! exp]tise ( ! community-bas$ organization 9 utiliz+ culturally compet5t & multil+ual /rategies 9 ! provision ( s]vices4 7e7 ,grant di/ribution 7#a7 ,f$]al di/ribution 7,a7 ,use ( funds ,! ,secret>y ( ,labor %all use ! funds appropriat$ to c>ry out ?is section z foll[s3 7i7 ,subject to clause 7ii71 ! ,secret>y %all di/ribute funds among eligible entities 9 accordance ) a =mula to be e/abli%$ by ! ,secret>y t provides a m9imum level ( fund+ to ea* eligible entity t seeks a grant "u ?is section & allocates additional fund+ z foll[s3 7,i7 ,! =mula %all give fir/ priority bas$ on ! numb] & proportion ( contact trac+ & relat$ positions t ! ,/ate plans to recruit1 place1 & tra9 individuals z a "p ( ! ,/ate /rategy describ$ 9 subsection 7c77#b77;,a74 7,,ii7 ,subject to subclause 7,i71 ! =mula %all give priority 9 accordance ) section #bbc7;c74 7ii7 ,n m ?an #b p]c5t ( ! fund+ = adm9i/ration ( ! grants & = provid+ te*nical assi/ance to recipi5ts ( funds "u ?is section4 7,b7 ,equitable di/ribution ,if ! geographic region s]v$ by "o or m eligible entities ov]laps1 ! ,secret>y %all di/ribute funds among su* entities 9 su* a mann] t ensures equitable di/ribution ) respect to ! factors "u subsection 7c77#e74 7#b7 ,eligible entity use ( funds ,an eligible entity describ$ 9 subp>agraphs 7,a7 ?r\gh 7,c7 ( subsection 7a77#d7-- 7,a7 %all1 n lat] ?an #cj days aft] ! date on :i* ! entity receives grant funds "u ?is section1 provide n less ?an #gj p]c5t ( grant funds to local bo>ds = ! purpose ( c>ry+ out activities 9 subsection 7f72 7,b7 may use up to #bj p]c5t ( su* funds to make subgrants to community-bas$ organizations 9 ! s]vice area to conduct outrea*1 to pot5tial eligible individuals1 z describ$ 9 subsection 7d72 7,c7 9 provid+ funds to local bo>ds & aw>d+ subgrants "u ?is subsection %all ensure ! equitable di/ribution ) respect to ! factors describ$ 9 subsection 7c77#e72 & 7,d7 may use n m ?an #aj p]c5t ( ! funds aw>d$ "u ?is section = ! adm9i/rative co/s ( c>ry+ out ! grant & = provid+ te*nical assi/ance to local bo>ds & community-bas$ organizations4 7#c7 ,local bo>d use ( funds ,a local bo>d1 or an eligible entity t is a local bo>d1 %all use-- 7,a7 n less ?an #fj p]c5t ( ! funds = recruitm5t & tra9+ = ,,covid-#ai te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation e/abli%$ "u section #bbb2 7,b7 n less ?an #cj p]c5t ( ! funds to support ! transition ( individuals hir$ z contact trac]s & relat$ positions into an education or tra9+ program1 or unsubsidiz$ employm5t ^u completion ( su* positions2 & 7,c7 n m ?an #aj p]c5t ( ! funds = adm9i/rative co/s4 7f7 ,eligible activities ,! ,/ate or local bo>ds %all use funds aw>d$ "u ?is section to support ! recruitm5t & placem5t ( eligible individuals1 tra9+ & employm5t transition z relat$ to contact trac+ & relat$ positions1 & = ! foll[+ activities3 7#a7 ,e/abli%+ or exp&+ p>tn]%ips )-- 7,a7 ,/ate1 local1 ,tribal1 & t]ritorial public heal? dep>tm5ts2 7,b7 community-bas$ heal? provid]s1 includ+ community heal? c5t]s & rural heal? cl9ics2 7,c7 labor organizations or jo9t labor managem5t organizations2 7,d7 two-ye> & f\r-ye> in/itutions ( high] education 7z def9$ 9 section #aja ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajja771 includ+ in/itutions eligible to receive funds "u section #cga7;a7 ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajfgq7a772 & 7,e7 community action ag5cies or o!r community-bas$ organizations s]v+ local areas 9 :i* !re is a dem& = contact trac+ & relat$ positions4 7#b7 ,provid+ tra9+ = contact trac+ & relat$ positions 9 coord9ation ) ,/ate1 local1 ,tribal1 or t]ritorial heal? dep>tm5ts t is consi/5t ) ! ,/ate or t]ritorial te/+ & contact trac+ /rategy1 & ensur+ t eligible individuals receive comp5sation :ile p>ticipat+ 9 su* tra9+4 7#c7 ,provid+ eligible individuals )-- 7,a7 adequate & safe equipm5t1 environm5ts1 & facilities = tra9+ & sup]vision1 z applicable2 7,b7 in=mation reg>d+ ! wages & b5efits relat$ to contact trac+ & relat$ positions1 z comp>$ to ,/ate1 local1 & national av]ages2 7,c7 supplies & equipm5t ne$$ by ! eligible individuals to support placem5t ( an individual 9 contact trac+ & relat$ positions1 z applicable2 7,d7 an individualiz$ employm5t plan = ea* eligible individual1 z applicable-- 7i7 9 coord9ation ) ! entity employ+ ! eligible individual 9 a contact trac+ & relat$ positions2 & 7ii7 :i* %all include provid+ a case manag] to "w ) ea* eligible individual to develop ! plan1 :i* may include-- 7,i7 id5tify+ employm5t & c>e] goals1 & sett+ appropriate a*ievem5t objectives to atta9 su* goals2 & 7,,ii7 explor+ c>e] pa?ways t lead to 9-dem& indu/ries & sectors1 includ+ 9 public heal? & relat$ occupations2 & 7,e7 s]vices = ! p]iod dur+ :i* ! eligible individual is employ$ 9 a contact trac+ & relat$ position to ensure job ret5tion1 :i* may include-- 7i7 supportive s]vices ?r\gh\t ! t]m ( employm5t2 7ii7 a cont9uation ( skills tra9+ z relat$ to employm5t 9 contact trac+ & relat$ positions1 t is conduct$ 9 collaboration ) ! employ]s ( su* individuals2 7iii7 m5tor%ip s]vices & job ret5tion support = eligible individuals2 or 7iv7 t>get$ tra9+ = manag]s & work]s work+ ) eligible individuals 7su* z m5tors71 & human res\rce repres5tatives4 7#d7 ,support+ ! transition & placem5t 9 unsubsidiz$ employm5t = eligible individuals s]v+ 9 contact trac+ & relat$ positions aft] su* positions are no long] necess>y 9 ! ,/ate or local area1 includ+-- 7,a7 any additional tra9+ & employm5t activities z describ$ 9 section #agj7;d77#d7 ( ! ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cbbe7;d77#d772 7,b7 develop+ ! appropriate comb9ation ( s]vices to enable ! eligible individual to a*ieve ! employm5t & c>e] goals id5tifi$ "u p>agraph 7#c77;,d77ii77,i72 & 7,c7 s]vices to assi/ eligible individuals 9 ma9ta9+ employm5t = n less ?an #ab mon?s aft] ! completion ( employm5t 9 contact trac+ & relat$ positions1 z appropriate4 7#e7 ,any o!r activities z describ$ 9 subsections 7a77#c7 & 7b7 ( section #acd ( ! ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cagd74 7g7 ,limitation ,not)/&+ section #agj7;d77#c77;,a7 ( ! ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cbbe7;d77#c77;,a771 a p]son may be employ$ 9 a contact trac+ & relat$ positions us+ funds "u ?is section = a p]iod n great] ?an #b ye>s4 7h7 ,report+ by ! ,dep>tm5t ( ,labor 7#a7 ,9 g5]al ,n lat] ?an #abj days ( ! enactm5t ( ?is ,act1 & once grant funds h be5 exp5d$ "u ?is section1 ! ,secret>y %all report to ! ,committee on ,education & ,labor ( ! ,h\se ( ,repres5tatives & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate1 & make publicly available a report conta9+ a description (-- 7,a7 ! numb] ( eligible individuals recruit$1 hir$1 & tra9$ 9 contact trac+ & relat$ positions2 7,b7 ! numb] ( individuals successfully transition$ to unsubsidiz$ employm5t or tra9+ at ! completion ( employm5t 9 contact trac+ & relat$ positions us+ funds "u ?is subtitle2 7,c7 ! numb] ( su* individuals :o 7 unemploy$ prior to be+ hir$1 tra9$1 or deploy$ z describ$ 9 p>agraph 7#a72 7,d7 ! p]=mance ( ea* program support$ by funds "u ?is subtitle ) respect to ! indicators ( p]=mance "u section #aaf ( ! ,work=ce ,innovation & ,opportunity ,act 7#bi ,u4,s4,c4 #cada71 z applicable2 7,e7 ! numb] ( individuals 9 unsubsidiz$ employm5t )9 six mon?s & #a ye>1 respectively1 ( ! conclusion ( employm5t 9 contact trac+ & relat$ positions &1 ( ^?1 ! numb] ( individuals )9 a ,/ate1 t]ritorial1 or local public heal? dep>tm5t 9 an occupation relat$ to public heal?2 7,f7 any in=mation on h[ eligible entities1 local bo>ds1 or community-bas$ organizations t receiv$ fund+ "u ?is subsection 7 able to support ! goals ( ! national sy/em = ,,covid-#ai te/+1 contact trac+1 surveillance1 conta9m5t1 & mitigation e/abli%$ "u section #bbb ( ?is ,act2 & 7,g7 be/ practices = improv+ & increas+ ! transition ( individuals employ$ 9 contract trac+ & relat$ positions to unsubsidiz$ employm5t4 7#b7 ,disaggregation ,all data report$ "u p>agraph 7#a7 %all be disaggregat$ by race1 e?nicity1 sex1 age1 &1 ) respect to individuals ) b>ri]s to employm5t1 subpopulation ( su* individuals1 except = :5 ! numb] ( p>ticipants 9 a category is insuffici5t to yield /ati/ically reliable in=mation or :5 ! results w\ld reveal p]sonally id5tifiable in=mation ab\t an individual p>ticipant4 7i7 ,special rule ,any funds us$ = programs "u ?is section t are us$ to fund an appr5tice%ip or appr5tice%ip program %all only be us$ =1 or provid$ to1 an appr5tice%ip or appr5tice%ip program t meets ! def9ition ( su* t]m subsection 7a7 ( ?is section1 includ+ any funds aw>d$ = ! purposes ( grants1 contracts1 or coop]ative agreem5ts1 or ! developm5t1 implem5tation1 or adm9i/ration1 ( an appr5tice%ip or an appr5tice%ip program4 7j7 ,in=mation %>+ requirem5t = ,,hhs ,! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all provide ! ,secret>y ( ,labor1 act+ ?r\gh ! ,assi/ant ,secret>y ( ! ,employm5t & ,tra9+ ,adm9i/ration1 ) in=mation on grants "u section #bbc1 includ+-- 7#a7 ! =mula us$ to aw>d su* grants to ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts2 7#b7 ! doll> am\nts ( & scope ( ! "w fund$ "u su* grants2 7#c7 ! geographic areas s]v$ by eligible entities t receive su* grants2 & 7#d7 ! numb] ( contact trac]s & relat$ positions to be hir$ us+ su* grants4 7k7 ,au?orization ( appropriations ,( ! am\nts appropriat$ to c>ry out ?is subtitle1 #ejj1jjj1jjj %all be us$ by ! ,secret>y ( ,labor to c>ry out subsections 7a7 ?r\gh 7h7 ( ?is section4 ,,iii ,free ,treatm5t = ,all ,am]icans #cja4 ,cov]age at no co/ %>+ ( ,,covid-#ai vacc9e & treatm5t 7a7 ,m$icaid 7#a7 ,9 g5]al ,section #aije7;a77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#d77 is am5d$-- 7,a7 by /rik+ & 7,d7 & ins]t+ 7,d72 & 7,b7 by /rik+ ! semicolon at ! end & ins]t+ 2 7,e7 dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ,! ,h]oes ,act1 a ,,covid-#ai vacc9e lic5s$ "u section #cea ( ! ,public ,heal? ,s]vice ,act1 or approv$ or au?oriz$ "u sections #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act1 & adm9i/ration ( ! vacc9e2 & 7,f7 dur+ su* portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g71 items or s]vices = ! prev5tion or treatm5t ( ,,covid-#ai1 includ+ drugs approv$ or au?oriz$ "u su* section #eje or su* section #efd or1 )\t reg>d to ! requirem5ts ( section #aijb7;a77#aj77;,b7 7relat+ to comp>ability71 9 ! case ( an individual :o is diagnos$ ) or presum$ to h ,,covid-#ai1 dur+ su* portion ( su* em]g5cy p]iod dur+ :i* su* individual is infect$ 7or presum$ infect$7 ) ,,covid-#ai1 ! treatm5t ( a condition t may complicate ! treatm5t ( ,,covid-#ai24 7#b7 ,prohibition ( co/ %>+ 7,a7 ,9 g5]al ,subsections 7a77#b7 & 7b77#b7 ( section #aiaf ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifo7 are ea* am5d$-- 7i7 9 subp>agraph 7,f71 by /rik+ or at ! end2 7ii7 9 subp>agraph 7,g71 by /rik+ 2 & & ins]t+ 22 & 7iii7 by add+ at ! end ! foll[+ subp>agraphs3 7,h7 dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ?is subp>agraph1 a ,,covid-#ai vacc9e lic5s$ "u section #cea ( ! ,public ,heal? ,s]vice ,act1 or approv$ or au?oriz$ "u section #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act1 & ! adm9i/ration ( su* vacc9e2 or 7,i7 dur+ su* portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g71 any item or s]vice furni%$ = ! treatm5t ( ,,covid-#ai1 includ+ drugs approv$ or au?oriz$ "u su* section #eje or su* section #efd or1 9 ! case ( an individual :o is diagnos$ ) or presum$ to h ,,covid-#ai1 dur+ ! portion ( su* em]g5cy p]iod dur+ :i* su* individual is infect$ 7or presum$ infect$7 ) ,,covid-#ai1 ! treatm5t ( a condition t may complicate ! treatm5t ( ,,covid-#ai2 & 4 7,b7 ,application to alt]native co/ %>+ ,section #aiaf;,a7b77#c77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is am5d$-- 7i7 9 clause 7xi71 by /rik+ any visit & ins]t+ any s]vice2 & 7ii7 by add+ at ! end ! foll[+ clauses3 7xii7 ,dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ?is clause1 a ,,covid-#ai vacc9e lic5s$ "u section #cea ( ! ,public ,heal? ,s]vice ,act1 or approv$ or au?oriz$ "u section #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act1 & ! adm9i/ration ( su* vacc9e4 7xiii7 ,dur+ su* portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g71 an item or s]vice furni%$ = ! treatm5t ( ,,covid-#ai1 includ+ drugs approv$ or au?oriz$ "u su* section #eje or su* section #efd or1 9 ! case ( an individual :o is diagnos$ ) or presum$ to h ,,covid-#ai1 dur+ su* portion ( su* em]g5cy p]iod dur+ :i* su* individual is infect$ 7or presum$ infect$7 ) ,,covid-#ai1 ! treatm5t ( a condition t may complicate ! treatm5t ( ,,covid-#ai4 4 7,c7 ,cl>ification ,! am5dm5ts made by ?is subsection %all apply ) respect to a ,/ate plan ( a t]ritory 9 ! same mann] z a ,/ate plan ( "o ( ! #ej ,/ates4 7b7 ,/ate p$iatric vacc9e di/ribution program ,section #aibh ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifs7 is am5d$-- 7#a7 9 subsection 7a77#a7-- 7,a7 9 subp>agraph 7,a71 by /rik+ 2 & & ins]t+ a semicolon2 7,b7 9 subp>agraph 7,b71 by /rik+ ! p]iod & ins]t+ 2 &2 & 7,c7 by add+ at ! end ! foll[+ subp>agraph3 7,c7 dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ?is subp>agraph1 ea* vacc9e-eligible *ild 7z def9$ 9 subsection 7b77 is entitl$ to receive a ,,covid-#ai vacc9e f a program-regi/]$ provid] 7z def9$ 9 subsection 7h77#g77 )\t *>ge =-- 7i7 ! co/ ( su* vacc9e2 or 7ii7 ! adm9i/ration ( su* vacc9e4 2 7#b7 9 subsection 7c77#b7-- 7,a7 9 subp>agraph 7,c77ii71 by ins]t+ 1 b1 dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ,! ,h]oes ,act1 may n impose a fee = ! adm9i/ration ( a ,,covid-#ai vacc9e be=e ! p]iod2 & 7,b7 by add+ at ! end ! foll[+ subp>agraph3 7,d7 ,! provid] w provide & adm9i/] an approv$ ,,covid-#ai vacc9e to a vacc9e-eligible *ild 9 accordance ) ! same requirem5ts z apply "u ! prec$+ subp>agraphs to ! provision & adm9i/ration ( a qualifi$ p$iatric vacc9e to su* a *ild4 2 & 7#c7 9 subsection 7d77#a71 9 ! fir/ s5t5ce1 by ins]t+ 1 includ+1 dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ,! ,h]oes ,act1 ) respect to a ,,covid-#ai vacc9e lic5s$ "u section #cea ( ! ,public ,heal? ,s]vice ,act1 or approv$ or au?oriz$ "u section #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act be=e ! p]iod4 7c7 ,,*ip 7#a7 ,9 g5]al ,section #bajc7;c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7c77 is am5d$ by add+ at ! end ! foll[+ p>agraph3 7#aa7 ,cov]age ( ,,covid-#ai vacc9es & treatm5t ,reg>dless ( ! type ( cov]age elect$ by a ,/ate "u subsection 7a71 *ild heal? assi/ance provid$ "u su* cov]age = t>get$ l[-income *ildr5 &1 9 ! case t ! ,/ate elects to provide pregnancy-relat$ assi/ance "u su* cov]age pursuant to section #baab1 su* pregnancy-relat$ assi/ance = t>get$ l[-income pregnant wom5 7z def9$ 9 section #baab7;d77 %all include cov]age1 dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ?is p>agraph1 (-- 7,a7 a ,,covid-#ai vacc9e lic5s$ "u section #cea ( ! ,public ,heal? ,s]vice ,act1 or approv$ or au?oriz$ "u section #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act1 & ! adm9i/ration ( su* vacc9e2 & 7,b7 any item or s]vice furni%$ = ! treatm5t ( ,,covid-#ai1 includ+ drugs approv$ or au?oriz$ "u su* section #eje or su* section #efd1 or1 9 ! case ( an individual :o is diagnos$ ) or presum$ to h ,,covid-#ai1 dur+ ! portion ( su* em]g5cy p]iod dur+ :i* su* individual is infect$ 7or presum$ infect$7 ) ,,covid-#ai1 ! treatm5t ( a condition t may complicate ! treatm5t ( ,,covid-#ai4 4 7#b7 ,prohibition ( co/ %>+ ,section #bajc7;e77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7e77#b771 z am5d$ by section #fjjd7;b77#c7 ( ! ,families ,fir/ ,coronavirus ,response ,act1 is am5d$-- 7,a7 9 ! p>agraph head]1 by ins]t+ a ,,covid-#ai vacc9e1 ,,covid-#ai treatm5t1 be=e or pregnancy-relat$ assi/ance2 & 7,b7 by /rik+ visits describ$ 9 section #aiaf7;a77#b77;,g71 or & ins]t+ s]vices describ$ 9 section #aiaf7;a77#b77;,g71 vacc9es describ$ 9 section #aiaf7;a77#b77;,h7 adm9i/]$ dur+ ! portion ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 beg9n+ on ! date ( ! enactm5t ( ,! ,h]oes ,act1 items or s]vices describ$ 9 section #aiaf7;a77#b77;,i7 furni%$ dur+ su* em]g5cy p]iod1 or4 7d7 ,con=m+ am5dm5ts ,section #aicg ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#g7 is am5d$-- 7#a7 9 subsection 7a77#a77;,b71 by ins]t+ 1 "u subclause 7,,xxiii7 ( section #aijb7;a77#aj77;,a77ii71 aft] section #aijb7;a77#aj77;,a77i72 & 7#b7 9 subsection 7b77#e71 by add+ be=e ! p]iod ! foll[+3 1 &1 effective on ! date ( ! enactm5t ( ,! ,h]oes ,act1 mu/ comply ) subp>agraphs 7,f7 ?r\gh 7,i7 ( subsections 7a77#b7 & 7b77#b7 ( section #aiaf & subsection 7b77#c77;,b7 ( section #aiaf;,a4 7e7 ,effective date ,! am5dm5ts made by ?is section %all take effect on ! date ( enactm5t ( ?is ,act & %all apply ) respect to a ,,covid-#ai vacc9e beg9n+ on ! date t su* vacc9e is lic5s$ "u section #cea ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bfb71 or approv$ or au?oriz$ "u section #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act4 #cjb4 ,optional cov]age at no co/ %>+ ( ,,covid-#ai treatm5t & vacc9es "u ,m$icaid = un9sur$ individuals 7a7 ,9 g5]al ,section #aijb7;a77#aj7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77 is am5d$1 9 ! matt] foll[+ subp>agraph 7,g71 by /rik+ & any visit describ$ 9 section #aiaf7;a77#b77;,g7 & ins]t+ ! foll[+3 1 any ,,covid-#ai vacc9e t is adm9i/]$ dur+ any su* portion 7& ! adm9i/ration ( su* vacc9e71 any item or s]vice t is furni%$ dur+ any su* portion = ! treatm5t ( ,,covid-#ai1 includ+ drugs approv$ or au?oriz$ "u section #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act1 or1 9 ! case ( an individual :o is diagnos$ ) or presum$ to h ,,covid-#ai1 dur+ ! p]iod su* individual is infect$ 7or presum$ infect$7 ) ,,covid-#ai1 ! treatm5t ( a condition t may complicate ! treatm5t ( ,,covid-#ai1 & any s]vices describ$ 9 section #aiaf7;a77#b77;,g74 7b7 ,def9ition ( un9sur$ individual 7#a7 ,9 g5]al ,subsection 7ss7 ( section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$ to read z foll[s3 7ss7 ,un9sur$ individual def9$ ,= purposes ( ?is section1 ! t]m un9sur$ individual means1 not)/&+ any o!r provision ( ?is title1 any individual :o is n cov]$ by m9imum ess5tial cov]age 7z def9$ 9 section #ejjj;,a7f77#a7 ( ! ,int]nal ,rev5ue ,code ( #aihf74 4 7#b7 ,effective date ,! am5dm5t made by p>agraph 7#a7 %all take effect & apply z if includ$ 9 ! enactm5t ( ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg74 7c7 ,cl>ification reg>d+ em]g5cy s]vices = c]ta9 individuals ,section #aijc7v77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#b77 is am5d$ by add+ at ! end ! foll[+ flu% s5t5ce3 ,= purposes ( subp>agraph 7,a71 c>e & s]vices describ$ 9 su* subp>agraph include any 9 vitro diagno/ic product describ$ 9 section #aije7;a77#c77;,b7 7& ! adm9i/ration ( su* product71 any ,,covid-#ai vacc9e 7& ! adm9i/ration ( su* vacc9e71 any item or s]vice t is furni%$ = ! treatm5t ( ,,covid-#ai1 includ+ drugs approv$ or au?oriz$ "u section #eje or #efd ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act1 or a condition t may complicate ! treatm5t ( ,,covid-#ai1 & any s]vices describ$ 9 section #aiaf7;a77#b77;,g74 4 7d7 ,inclusion ( ,,covid-#ai conc]n z an em]g5cy condition ,section #aijc7v77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#c77 is am5d$ by add+ at ! end ! foll[+ flu% s5t5ce3 ,su* t]m includes any indication t an ali5 describ$ 9 p>agraph 7#a7 may h contract$ ,,covid-#ai4 4 #cjc4 ,cov]age ( treatm5ts = ,,covid-#ai at no co/ %>+ "u ! ,m$ic>e ,advantage program 7a7 ,9 g5]al ,section #aheb7;a77#a77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bb7;a77#a77;,b77 is am5d$ by add+ at ! end ! foll[+ new clause3 7vii7 ,special cov]age rules = specifi$ ,,covid-#ai treatm5t s]vices ,not)/&+ clause 7i71 9 ! case ( a specifi$ ,,covid-#ai treatm5t s]vice 7z def9$ 9 section #cjbja7;b7 ( ,! ,h]oes ,act7 t is furni%$ dur+ a plan ye> occurr+ dur+ any portion ( ! em]g5cy p]iod def9$ 9 section #aace7;g77#a77;,b7 beg9n+ on or aft] ! date ( ! enactm5t ( ?is clause1 a ,m$ic>e ,advantage plan may n1 ) respect to su* s]vice1 impose-- 7,i7 any co/-%>+ requirem5t 7includ+ a d$uctible1 copaym5t1 or co9surance requirem5t72 & 7,,ii7 9 ! case su* s]vice is a critical specifi$ ,,covid-#ai treatm5t s]vice 7includ+ v5tilator s]vices & int5sive c>e unit s]vices71 any prior au?orization or o!r utilization managem5t requirem5t4 ,a ,m$ic>e ,advantage plan may n take ! application ( ?is clause into acc\nt = purposes ( a bid am\nt submitt$ by su* plan "u section #ahed7;a77#f74 4 7b7 ,implem5tation ,not)/&+ any o!r provision ( law1 ! ,secret>y ( ,heal? & ,human ,s]vices may implem5t ! am5dm5ts made by ?is section by program in/ruction or o!rwise4 #cjd4 ,requir+ cov]age "u ,m$ic>e ,,pdps & ,,ma-,,pd plans1 )\t ! imposition ( co/ %>+ or utilization managem5t requirem5ts1 ( drugs int5d$ to treat ,,covid-#ai dur+ c]ta9 em]g5cies 7a7 ,cov]age requirem5t ,section #ahfj;,d-#d7;b77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajd7;b77#c77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,i7 ,requir$ inclusion ( drugs int5d$ to treat ,,covid-#ai 7i7 ,9 g5]al ,not)/&+ any o!r provision ( law1 a ,,pdp sponsor (f]+ a prescription drug plan %all1 ) respect to a plan ye>1 any portion ( :i* occurs dur+ ! p]iod describ$ 9 clause 7ii71 be requir$ to-- 7,i7 include 9 any =mul>y-- 7aa7 all cov]$ "p ,d drugs ) a m$ically accept$ indication 7z def9$ 9 section #ahfj;,d-#b7;e77#d77 to treat ,,covid-#ai t are m>ket$ 9 ! ,unit$ ,/ates2 & 7bb7 all drugs au?oriz$ "u section #efd or #efd;,a ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act to treat ,,covid-#ai2 & 7,,ii7 n impose any prior au?orization or o!r utilization managem5t requirem5t ) respect to su* drugs describ$ 9 item 7aa7 or 7bb7 ( subclause 7,i7 7o!r ?an su* a requirem5t t limits ! quantity ( drugs due to safety74 7ii7 ,p]iod describ$ ,= purposes ( clause 7i71 ! p]iod describ$ 9 ?is clause is ! p]iod dur+ :i* !re exi/s ! public heal? em]g5cy decl>$ by ! ,secret>y pursuant to section #cai ( ! ,public ,heal? ,s]vice ,act on ,janu>y #ca1 #bjbj1 entitl$ ,det]m9ation t a ,public ,heal? ,em]g5cy ,exi/s ,nationwide z ! ,result ( ! #bjai ,novel ,coronavirus 7includ+ any r5ewal ( su* decl>ation pursuant to su* section74 4 7b7 ,elim9ation ( co/ %>+ 7#a7 ,elim9ation ( co/ %>+ = drugs int5d$ to treat ,,covid-#ai "u /&>d & alt]native prescription drug cov]age ,section #ahfj;,d-#b ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajb7 is am5d$-- 7,a7 9 subsection 7b7-- 7i7 9 p>agraph 7#a77;,a71 by /rik+ ,! cov]age & ins]t+ ,subject to p>agraph 7#h71 ! cov]age2 7ii7 9 p>agraph 7#b7-- 7,i7 9 subp>agraph 7,a71 by ins]t+ aft] ,subject to subp>agraphs 7,c7 & 7,d7 ! foll[+3 & p>agraph 7#h72 7,,ii7 9 subp>agraph 7,c77i71 by /rik+ p>agraph 7#d7 & ins]t+ p>agraphs 7#d7 & 7#h72 & 7,,iii7 9 subp>agraph 7,d77i71 by /rik+ p>agraph 7#d7 & ins]t+ p>agraphs 7#d7 & 7#h72 7iii7 9 p>agraph 7#d77;,a77i71 by /rik+ ,! cov]age & ins]t+ ,subject to p>agraph 7#h71 ! cov]age2 & 7iv7 by add+ at ! end ! foll[+ new p>agraph3 7#h7 ,elim9ation ( co/ %>+ = drugs int5d$ to treat ,,covid-#ai ,! cov]age does n impose any d$uctible1 copaym5t1 co9surance1 or o!r co/-%>+ requirem5t = drugs describ$ 9 section #ahfj;,d-#d7;b77#c77;,i77i77,i7 ) respect to a plan ye>1 any portion ( :i* occurs dur+ ! p]iod dur+ :i* !re exi/s ! public heal? em]g5cy decl>$ by ! ,secret>y pursuant to section #cai ( ! ,public ,heal? ,s]vice ,act on ,janu>y #ca1 #bjbj1 entitl$ ,det]m9ation t a ,public ,heal? ,em]g5cy ,exi/s ,nationwide z ! ,result ( ! #bjai ,novel ,coronavirus 7includ+ any r5ewal ( su* decl>ation pursuant to su* section74 2 & 7,b7 9 subsection 7c71 by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,same elim9ation ( co/ %>+ = drugs int5d$ to treat ,,covid-#ai ,! cov]age is 9 accordance ) subsection 7b77#h74 4 7#b7 ,elim9ation ( co/ %>+ = drugs int5d$ to treat ,,covid-#ai disp5s$ to individuals :o are subsidy eligible individuals ,section #ahfj;,d-#ad7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7;a77 is am5d$-- 7,a7 9 p>agraph 7#a7-- 7i7 9 subp>agraph 7,d7-- 7,i7 9 clause 7ii71 by /rik+ ,9 ! case ( & ins]t+ ,subject to subp>agraph 7,f71 9 ! case (2 & 7,,ii7 9 clause 7iii71 by /rik+ ,9 ! case ( & ins]t+ ,subject to subp>agraph 7,f71 9 ! case (2 & 7ii7 by add+ at ! end ! foll[+ new subp>agraph3 7,f7 ,elim9ation ( co/ %>+ = drugs int5d$ to treat ,,covid-#ai ,cov]age t is 9 accordance ) section #ahfj;,d-#b7;b77#h74 2 & 7,b7 9 p>agraph 7#b7-- 7i7 9 subp>agraph 7,b71 by /rik+ ,a r$uction & ins]t+ ,subject to subp>agraph 7,f71 a r$uction2 7ii7 9 subp>agraph 7,d71 by /rik+ ,! sub/itution & ins]t+ ,subject to subp>agraph 7,f71 ! sub/itution2 7iii7 9 subp>agraph 7,e71 by ins]t+ aft] ,subject to ! foll[+3 subp>agraph 7,f7 &2 & 7iv7 by add+ at ! end ! foll[+ new subp>agraph3 7,f7 ,elim9ation ( co/ %>+ = drugs int5d$ to treat ,,covid-#ai ,cov]age t is 9 accordance ) section #ahfj;,d-#b7;b77#h74 4 7c7 ,implem5tation ,not)/&+ any o!r provision ( law1 ! ,secret>y ( ,heal? & ,human ,s]vices may implem5t ! am5dm5ts made by ?is section by program in/ruction or o!rwise4 #cje4 ,cov]age ( ,,covid-#ai relat$ treatm5t at no co/ %>+ 7a7 ,9 g5]al ,a gr\p heal? plan & a heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age 7includ+ a gr&fa!r$ heal? plan 7z def9$ 9 section #abea7;e7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act77 %all provide cov]age1 & %all n impose any co/ %>+ 7includ+ d$uctibles1 copaym5ts1 & co9surance7 requirem5ts1 = ! foll[+ items & s]vices furni%$ dur+ any portion ( ! em]g5cy p]iod def9$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77 beg9n+ on or aft] ! date ( ! enactm5t ( ?is ,act3 7#a7 ,m$ically necess>y items & s]vices 7includ+ 9-p]son or teleheal? visits 9 :i* su* items & s]vices are furni%$7 t are furni%$ to an individual :o has be5 diagnos$ ) 7or aft] provision ( ! items & s]vices is diagnos$ )7 ,,covid-#ai to treat or mitigate ! effects ( ,,covid-#ai4 7#b7 ,m$ically necess>y items & s]vices 7includ+ 9-p]son or teleheal? visits 9 :i* su* items & s]vices are furni%$7 t are furni%$ to an individual :o is presum$ to h ,,covid-#ai b is nev] diagnos$ z su*1 if ! foll[+ conditions are met3 7,a7 ,su* items & s]vices are furni%$ to ! individual to treat or mitigate ! effects ( ,,covid-#ai or to mitigate ! impact ( ,,covid-#ai on society4 7,b7 ,heal? c>e provid]s h tak5 appropriate /eps "u ! circum/ances to make a diagnosis1 or confirm :e!r a diagnosis 0 made1 ) respect to su* individual1 = ,,covid-#ai1 if possible4 7b7 ,items & s]vices relat$ to ,,covid-#ai ,= purposes ( ?is section-- 7#a7 n lat] ?an "o week aft] ! date ( ! enactm5t ( ?is section1 ! ,secret>y ( ,heal? & ,human ,s]vices1 ,secret>y ( ,labor1 & ,secret>y ( ! ,treasury %all jo9tly issue guidance specify+ applicable diagnoses & m$ically necess>y items & s]vices relat$ to ,,covid-#ai2 & 7#b7 su* items & s]vices %all include all items or s]vices t are relevant to ! treatm5t or mitigation ( ,,covid-#ai1 reg>dless ( :e!r su* items or s]vices are ord9>ily cov]$ "u ! t]ms ( a gr\p heal? plan or gr\p or individual heal? insurance cov]age (f]$ by a heal? insurance issu]4 7c7 ,en=cem5t 7#a7 ,application ) respect to ,,phsa1 ,,erisa1 & ,,irc ,! provisions ( ?is section %all be appli$ by ! ,secret>y ( ,heal? & ,human ,s]vices1 ,secret>y ( ,labor1 & ,secret>y ( ! ,treasury to gr\p heal? plans & heal? insurance issu]s (f]+ gr\p or individual heal? insurance cov]age z if includ$ 9 ! provisions ( "p ,a ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act1 "p #g ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd1 & sub*apt] ,b ( *apt] #ajj ( ! ,int]nal ,rev5ue ,code ( #aihf1 z applicable4 7#b7 ,private "r ( action ,an individual ) respect to :om an action is tak5 by a gr\p heal? plan or heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age 9 violation ( subsection 7a7 may comm5ce a civil action aga9/ ! plan or issu] = appropriate relief4 ,! previ\s s5t5ce %all n be con/ru$ z limit+ any en=cem5t me*anism o!rwise applicable pursuant to p>agraph 7#a74 7d7 ,implem5tation ,! ,secret>y ( ,heal? & ,human ,s]vices1 ,secret>y ( ,labor1 & ,secret>y ( ! ,treasury may implem5t ! provisions ( ?is section ?r\gh sub-regulatory guidance1 program in/ruction or o!rwise4 7e7 ,t]ms ,! t]ms gr\p heal? plan1 heal? insurance issu]1 gr\p heal? insurance cov]age1 & individual heal? insurance cov]age h ! mean+s giv5 su* t]ms 9 section #bgia ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ia71 section #gcc ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aaia;b71 & section #ihcb ( ! ,int]nal ,rev5ue ,code ( #aihf1 z applicable4 #cjf4 ,reimbursem5t = additional heal? s]vices relat+ to coronavirus ,title ,v ( division ,a ( ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg7 is am5d$ "u ! head+ ,dep>tm5t ( ,heal? & ,human ,s]vices--,(fice ( ! ,secret>y--,public ,heal? & ,social ,s]vices ,em]g5cy ,fund by ins]t+ 1 or treatm5t relat$ to ,,s>s-,co,v-#b or ,,covid-#ai = un9sur$ individuals aft] or visits describ$ 9 p>agraph 7#b7 ( su* section = un9sur$ individuals4 ,,iv ,f$]al ,heal? ,equity ,ov]sight #dja4 ,,covid-#ai ,racial & ,e?nic ,disp>ities ,task ,=ce ,act ( #bjbj 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y7 %all e/abli% an int]ag5cy task =ce1 to be kn[n z ! ,,covid-#ai ,racial & ,e?nic ,disp>ities ,task ,=ce 7ref]r$ to 9 ?is section z ! task =ce71 to ga!r data ab\t disproportionately affect$ communities & provide recomm5dations to combat ! racial & e?nic disp>ities 9 ! ,,covid-#ai response ?r\gh\t ! ,unit$ ,/ates & 9 response to future public heal? crises4 7b7 ,memb]%ip ,! task =ce %all be compos$ ( ! foll[+3 7#a7 ,! ,secret>y ( ,heal? & ,human ,s]vices4 7#b7 ,! ,assi/ant ,secret>y = ,plann+ & ,evaluation ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7#c7 ,! ,assi/ant ,secret>y = ,prep>$ness & ,response ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7#d7 ,! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion4 7#e7 ,! ,director ( ! ,national ,in/itutes ( ,heal?4 7#f7 ,! ,commission] ( ,food & ,drugs4 7#g7 ,! ,adm9i/rator ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy4 7#h7 ,! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities4 7#i7 ,! ,director ( ! ,indian ,heal? ,s]vice4 7#aj7 ,! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7#aa7 ,! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality4 7#ab7 ,! ,surgeon ,g5]al4 7#ac7 ,! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration4 7#ad7 ,! ,director ( ! ,(fice ( ,m9ority ,heal?4 7#ae7 ,! ,secret>y ( ,h\s+ & ,urban ,developm5t4 7#af7 ,! ,secret>y ( ,education4 7#ag7 ,! ,secret>y ( ,labor4 7#ah7 ,! ,secret>y ( ,def5se4 7#ai7 ,! ,secret>y ( ,transportation4 7#bj7 ,! ,secret>y ( ! ,treasury4 7#ba7 ,! ,adm9i/rator ( ! ,small ,bus9ess ,adm9i/ration4 7#bb7 ,! ,adm9i/rator ( ! ,environm5tal ,protection ,ag5cy4 7#bc7 ,five heal? c>e pr(essionals ) exp]tise 9 address+ racial & e?nic disp>ities1 ) at lea/ "o repres5tative f a rural area1 to be appo9t$ by ! ,secret>y4 7#bd7 ,five policy exp]ts specializ+ 9 address+ racial & e?nic disp>ities 9 education or racial & e?nic economic inequality to be appo9t$ by ! ,secret>y4 7#be7 ,six repres5tatives f community-bas$ organizations specializ+ 9 provid+ culturally compet5t c>e or s]vices & address+ racial & e?nic disp>ities1 to be appo9t$ by ! ,secret>y1 ) at lea/ "o repres5tative f an urban ,indian organization & "o repres5tative f a national organization t repres5ts ,tribal gov]nm5ts ) exp]tise 9 ,tribal public heal?4 7#bf7 ,six ,/ate1 local1 t]ritorial1 or ,tribal public heal? (ficials repres5t+ dep>tm5ts ( public heal?1 :o %all repres5t jurisdictions f diff]5t regions ( ! ,unit$ ,/ates ) relatively high conc5trations ( hi/orically m>g9aliz$ populations1 to be appo9t$ by ! ,secret>y1 ) at lea/ "o t]ritorial repres5tative & "o repres5tative ( a ,tribal public heal? dep>tm5t4 7c7 ,adm9i/rative provisions 7#a7 ,appo9tm5t ( non-gov]nm5t memb]s ,not)/&+ any o!r provision ( law1 ! ,secret>y %all appo9t all non-gov]nm5t memb]s ( ! task =ce )9 #cj days ( ! date enactm5t ( ?is section4 7#b7 ,*airp]son ,! ,secret>y %all s]ve z ! *airp]son ( ! task =ce4 ,! ,director ( ! ,(fice ( ,m9ority ,heal? %all s]ve z ! vice *airp]son4 7#c7 ,/aff ,! task =ce %all h #aj full-"t /aff memb]s4 7#d7 ,meet+s ,n lat] ?an #de days aft] ! date ( enactm5t ( ?is section1 ! full task =ce %all h its fir/ meet+4 ,! task =ce %all conv5e at lea/ once a mon? !reaft]4 7#e7 ,subcommittees ,! *airp]son & vice *airp]son ( ! task =ce are au?oriz$ to e/abli% subcommittees to consid] specific issues relat$ to ! broad] mission ( address+ racial & e?nic disp>ities4 7d7 ,f$]al ,em]g5cy ,managem5t ,ag5cy ,res\rce ,allocation ,report+ & ,recomm5dations 7#a7 ,weekly reports ,n lat] ?an #g days aft] ! task =ce fir/ meets1 & weekly !reaft]1 ! task =ce %all submit to ,congress & ! ,f$]al ,em]g5cy ,managem5t ,ag5cy a report t includes-- 7,a7 a description ( ,,covid-#ai pati5t outcomes1 includ+ cases1 hospitalizations1 pati5ts on v5tilation1 & mortality1 disaggregat$ by race & e?nicity 7:]e su* data is miss+1 ! task =ce %all utilize appropriate au?orities to improve data collection72 7,b7 ! id5tification ( communities t lack res\rces to combat ! ,,covid-#ai p&emic1 includ+ p]sonal protective equipm5t1 v5tilators1 hospital b$s1 te/+ kits1 te/+ supplies1 vacc9ations 7:5 available71 res\rces to conduct surveillance & contact trac+1 fund+1 /aff+1 & o!r res\rces ! task =ce deems ess5tial z ne$s arise2 7,c7 ! id5tification ( communities :]e racial & e?nic disp>ities 9 ,,covid-#ai infection1 hospitalization1 & dea? rates are out ( proportion to ! community's population by a c]ta9 ?re%old1 to be det]m9$ by ! task =ce bas$ on available public heal? data2 7,d7 recomm5dations ab\t h[ to be/ allocate critical ,,covid-#ai res\rces to-- 7i7 communities ) disproportionately high ,,covid-#ai infection1 hospitalization1 & dea? rates2 & 7ii7 communities id5tifi$ 9 subp>agraph 7,c72 7,e7 ) respect to communities t are able to r$uce racial & e?nic disp>ities effectively1 a description ( be/ practices involv$2 & 7,f7 an update ) respect to ! response ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy to ! task =ce's previ\s weeks' recomm5dations "u ?is section4 7#b7 ,g5]al consultation ,9 submitt+ weekly reports & recomm5dations "u ?is subsection1 ! task =ce %all consult ) & notify ,/ate1 local1 t]ritorial1 & ,tribal (ficials & community-bas$ organizations f communities id5tifi$ z disproportionately impact$ by ,,covid-#ai4 7#c7 ,consultation ) indian tribes ,9 submitt+ weekly reports & recomm5dations "u ?is subsection1 ! ,director ( ,indian ,heal? ,s]vice %all1 9 coord9ation ) ! task =ce1 consult ) ,indian ,tribes & ,tribal organizations t are disproportionately affect$ by ,,covid-#ai on a gov]nm5t to gov]nm5t basis to id5tify specific ne$s & recomm5dations4 7#d7 ,dissem9ation ,reports "u ?is subsection %all be dissem9at$ to all relevant /akehold]s1 includ+ ,/ate1 local1 t]ritorial1 & ,tribal (ficials1 & public heal? dep>tm5ts4 7#e7 ,tribal data ,! task =ce1 9 consultation ) ,indian ,tribes & ,tribal organizations1 %all ensure t an ,indian ,tribe cons5ts to any public report+ ( heal? data4 7e7 ,,covid-#ai relief ov]sight & implem5tation reports ,n lat] ?an #ad days aft] ! task =ce fir/ meets1 & n lat] ?an e #ad days !reaft]1 ! task =ce %all submit to ,congress & ! relevant ,f$]al ag5cies a report t includes-- 7#a7 an exam9ation ( funds di/ribut$ "u ,,covid-#ai-relat$ relief & /imulus laws 7enact$ prior to & aft] ! date ( enactm5t ( ?is ,act71 includ+ ! ,coronavirus ,prep>$ness & ,response ,em]g5cy ,supplem5tal ,appropriations ,act1 #bjbj 7,public ,law #aaf-abc71 ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg71 ! ,coronavirus ,aid1 ,relief1 & ,economic ,security ,act 7,public ,law #aaf-acf71 & ! ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci71 & h[ t di/ribution impact$ racial & e?nic disp>ities ) respect to ! ,,covid-#ai p&emic2 & 7#b7 recomm5dations to relevant ,f$]al ag5cies ab\t h[ to disburse any undisburs$ fund+ f ,,covid-#ai-relat$ relief & /imulus laws 7enact$ prior to & aft] ! date ( enactm5t ( ?is ,act71 includ+ ^? laws describ$ 9 p>agraph 7#a71 to address racial & e?nic disp>ities ) respect to ! ,,covid-#ai p&emic1 includ+ recomm5dations to-- 7,a7 ! ,dep>tm5t ( ,heal? & ,human ,s]vices ab\t disbursem5t ( funds "u ! ,public ,heal? & ,social ,s]vice ,em]g5cy ,fund2 7,b7 ! ,small ,bus9ess ,adm9i/ration ab\t disbursem5t ( funds "u ! ,pay*eck ,protection ,program & ! ,economic ,injury ,disa/] ,loan ,program2 & 7,c7 ! ,dep>tm5t ( ,education ab\t disbursem5t ( funds "u ! ,education ,/abilization ,fund4 7f7 ,f9al ,,covid-#ai reports ,n lat] ?an #ij days aft] ! date on :i* ! ,presid5t decl>es ! end ( ! ,,covid-#ai public heal? em]g5cy fir/ decl>$ by ! ,secret>y on ,janu>y #ca1 #bjbj1 ! task =ce %all submit to ,congress a report t-- 7#a7 describes inequities )9 ! heal? c>e sy/em1 implicit bias1 /ructural racism1 & social det]m9ants ( heal? 7includ+ h\s+1 nutrition1 education1 economic1 & environm5tal factors7 t contribut$ to racial & e?nic heal? disp>ities ) respect to ! ,,covid-#ai p&emic & h[ ^! factors contribut$ to su* disp>ities2 7#b7 exam9es ! initial ,f$]al response to ! ,,covid-#ai p&emic & its impact on ! racial & e?nic disp>ities 9 ,,covid-#ai infection1 hospitalization1 & dea? rates2 & 7#c7 conta9s recomm5dations to combat racial & e?nic disp>ities 9 future infecti\s disease responses1 includ+ future ,,covid-#ai outbreaks4 7g7 ,sunset & successor task =ce 7#a7 ,sunset ,! task =ce %all t]m9ate on ! date t is #ij days aft] ! date on :i* ! ,presid5t decl>es ! end ( ! ,,covid-#ai public heal? em]g5cy fir/ decl>$ by ! ,secret>y on ,janu>y #ca1 #bjbj4 7#b7 ,successor ,^u ! t]m9ation ( ! task =ce "u p>agraph 7#a71 ! ,secret>y %all e/abli% a p]man5t ,infecti\s ,disease ,racial & ,e?nic ,disp>ities ,task ,=ce bas$ on ! memb]%ip1 conv5+1 & report+ requirem5ts recomm5d$ by ! task =ce 9 reports submitt$ "u ?is section4 7h7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$1 su* sums z may be necess>y to c>ry out ?is section4 #djb4 ,protection ( ! ,,hhs ,(fices ( ,m9ority ,heal? 7a7 ,9 g5]al ,pursuant to section #agjg;,a ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjju-#f;a71 ! ,(fices ( ,m9ority ,heal? e/abli%$ )9 ! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 ! ,sub/ance ,abuse & ,m5tal ,heal? ,s]vices ,adm9i/ration1 ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 ! ,food & ,drug ,adm9i/ration1 & ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 are (fices t1 reg>dless ( *ange 9 ! /ructure ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 %all report to ! ,secret>y ( ,heal? & ,human ,s]vices4 7b7 ,s5se ( ,congress ,x is ! s5se ( ! ,congress t any ef=t to elim9ate or consolidate su* ,(fices ( ,m9ority ,heal? und]m9es ! progress a*iev$ s f>4 #djc4 ,e/abli% an int]ag5cy c\nsel & grant programs on social det]m9ants ( heal? 7a7 ,%ort title ,?is section may be cit$ z ! ,social ,det]m9ants ,accel]ator ,act ( #bjbj4 7b7 ,f9d+s2 purposes 7#a7 ,f9d+s ,congress f9ds ! foll[+3 7,a7 ,!re is a significant body ( evid5ce %[+ t economic & social conditions h a p[]ful impact on individual & population heal? outcomes1 includ+ heal? disp>ities associat$ ) public heal? em]g5cies1 & well-be+1 z well z m$ical co/s4 7,b7 ,/ate1 local1 & ,tribal gov]nm5ts & ! s]vice deliv]y p>tn]s ( su* gov]nm5ts face significant *all5ges 9 coord9at+ b5efits & s]vices deliv]$ ?r\gh ! ,m$icaid program & o!r social s]vices programs because ( ! fragm5t$ & complex nature ( ,f$]al & ,/ate fund+ & adm9i/rative requirem5ts4 7,c7 ,! ,f$]al ,gov]nm5t %\ld prioritize & proactively assi/ ,/ate & local gov]nm5ts to /r5g!n ! capacity ( ,/ate & local gov]nm5ts to improve heal? & social outcomes = individuals1 !reby improv+ co/-effectiv5ess & return on inve/m5t4 7#b7 ,purposes ,! purposes ( ?is ,act are z foll[s3 7,a7 ,to e/abli% effective1 coord9at$ ,f$]al te*nical assi/ance to help ,/ate & local gov]nm5ts to improve outcomes & co/-effectiv5ess (1 & return on inve/m5t f1 heal? & social s]vices programs4 7,b7 ,to build a pipel9e ( ,/ate & locally design$1 cross-sector int]v5tions & /rategies t g5]ate rigor\s evid5ce ab\t h[ to improve heal? & social outcomes1 & increase ! co/-effectiv5ess (1 & return on inve/m5t f1 ,f$]al1 ,/ate1 local1 & ,tribal heal? & social s]vices programs4 7,c7 ,to enli/ ,/ate & local gov]nm5ts & ! s]vice provid]s ( su* gov]nm5ts z p>tn]s 9 id5tify+ ,f$]al /atutory1 regulatory1 & adm9i/rative *all5ges 9 improv+ ! heal? & social outcomes (1 co/-effectiv5ess (1 & return on inve/m5t f1 ,f$]al sp5d+ on individuals enroll$ 9 ,m$icaid4 7,d7 ,to develop /rategies to improve heal? & social outcomes )\t d5y+ s]vices to1 or re/rict+ ! eligibility (1 vuln]able populations4 7c7 ,social det]m9ants accel]ator c\ncil 7#a7 ,e/abli%m5t ,! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is ,act z ! ,secret>y71 9 coord9ation ) ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices 7ref]r$ to 9 ?is ,act z ! ,adm9i/rator71 %all e/abli% an int]ag5cy c\ncil1 to be kn[n z ! ,social ,det]m9ants ,accel]ator ,int]ag5cy ,c\ncil 7ref]r$ to 9 ?is ,act z ! ,c\ncil7 to a*ieve ! purposes li/$ 9 subsection 7b77#a74 7#b7 ,memb]%ip 7,a7 ,f$]al composition ,! ,c\ncil %all be compos$ ( at lea/ "o designee f ea* ( ! foll[+ ,f$]al ag5cies3 7i7 ,! ,(fice ( ,managem5t & ,budget4 7ii7 ,! ,dep>tm5t ( ,agriculture4 7iii7 ,! ,dep>tm5t ( ,education4 7iv7 ,! ,indian ,heal? ,s]vice4 7v7 ,! ,dep>tm5t ( ,h\s+ & ,urban ,developm5t4 7vi7 ,! ,dep>tm5t ( ,labor4 7vii7 ,! ,dep>tm5t ( ,transportation4 7viii7 ,any o!r ,f$]al ag5cy ! ,*air ( ! ,c\ncil det]m9es necess>y4 7,b7 ,designation 7i7 ,9 g5]al ,! head ( ea* ag5cy specifi$ 9 subp>agraph 7,a7 %all designate at lea/ "o employee to s]ve z a memb] ( ! ,c\ncil4 7ii7 ,responsibilities ,an employee describ$ 9 ?is clause %all be a s5ior employee ( ! ag5cy-- 7,i7 ^: responsibilities relate to au?orities1 policies1 & proc$ures ) respect to ! heal? & well-be+ ( individuals receiv+ m$ical assi/ance "u a ,/ate plan 7or a waiv] ( su* plan7 "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq472 or 7,,ii7 :o has au?ority to implem5t & evaluate trans=mative initiatives t h>ness data or conducts rigor\s evaluation to improve ! impact & co/-effectiv5ess ( f$]ally fund$ s]vices & b5efits4 7,c7 ,,hhs repres5tation ,9 addition to ! designees "u subp>agraph 7,a71 ! ,c\ncil %all include designees f at lea/ ?ree ag5cies )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 includ+ ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 at lea/ "o ( :om %all meet ! crit]ia "u ?is section4 7,d7 ,,omb role ,! ,director ( ! ,(fice ( ,managem5t & ,budget %all facilitate ! timely resolution ( ,gov]nm5twide & multiag5cy issues to help ! ,c\ncil a*ieve cons5sus recomm5dations describ$ "u ?is section4 7,e7 ,non-,f$]al composition ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates may designate up to #f ,c\ncil designees-- 7i7 :o h relevant subject matt] exp]tise1 includ+ exp]tise implem5t+ & evaluat+ trans=mative initiatives t h>ness data & conduct evaluations to improve ! impact & co/-effectiv5ess ( ,f$]al ,gov]nm5t s]vices2 & 7ii7 t ea* repres5t-- 7,i7 ,/ate1 local1 & ,tribal heal? & human s]vices ag5cies2 7,,ii7 public h\s+ au?orities or ,/ate h\s+ f9ance ag5cies2 7,,iii7 ,/ate & local gov]nm5t budget (fices2 7,,iv7 ,/ate ,m$icaid ag5cies2 or 7,v7 national consum] advocacy organizations4 7,f7 ,*air 7i7 ,9 g5]al ,! ,secret>y %all select ! ,*air ( ! ,c\ncil f among ! memb]s ( ! ,c\ncil4 7ii7 ,initiat+ guidance ,! ,*air1 on behalf ( ! ,c\ncil1 %all id5tify & invite individuals f div]se entities to provide ! ,c\ncil ) advice & in=mation p]ta9+ to address+ social det]m9ants ( heal?1 includ+-- 7,i7 individuals f ,/ate & local gov]nm5t heal? & human s]vices ag5cies2 7,,ii7 individuals f ,/ate ,m$icaid ag5cies2 7,,iii7 individuals f ,/ate & local gov]nm5t budget (fices2 7,,iv7 individuals f public h\s+ au?orities or ,/ate h\s+ f9ance ag5cies2 7,v7 individuals f nonpr(it organizations1 small bus9esses1 & philan?ropic organizations2 7,,vi7 advocates2 7,,vii7 rese>*]s2 & 7,,viii7 any o!r individuals ! ,*air det]m9es to be appropriate4 7#c7 ,duties ,! duties ( ! ,c\ncil are-- 7,a7 to make recomm5dations to ! ,secret>y & ! ,adm9i/rator reg>d+ ! crit]ia = mak+ aw>ds "u ?is section2 7,b7 to id5tify ,f$]al au?orities & opportunities = use by ,/ates or local gov]nm5ts to improve coord9ation ( fund+ & adm9i/ration ( ,f$]al programs1 ! b5efici>ies ( :om include individuals1 & :i* may be unkn[n or und]utiliz$ & to make in=mation on su* au?orities & opportunities publicly available2 7,c7 to provide t>get$ te*nical assi/ance to ,/ates develop+ a social det]m9ants accel]ator plan "u ?is section1 includ+ id5tify+ pot5tial /atutory or regulatory pa?ways = implem5tation ( ! plan & assi/+ 9 id5tify+ pot5tial s\rces ( fund+ to implem5t ! plan2 7,d7 to report to ,congress annually on ! subjects set =? 9 ?is section2 7,e7 to develop & dissem9ate evaluation guidel9es & /&>ds t c be us$ to reliably assess ! impact ( an int]v5tion or approa* t may be implem5t$ pursuant to ?is ,act on outcomes1 co/-effectiv5ess (1 & return on inve/m5t f ,f$]al1 ,/ate1 local1 & ,tribal gov]nm5ts1 & to facilitate te*nical assi/ance1 :]e ne$$1 to help to improve ,/ate & local evaluation designs & implem5tation2 7,f7 to seek fe$back f ,/ate1 local1 & ,tribal gov]nm5ts1 includ+ ?r\gh an annual survey by an indep5d5t ?ird p>ty1 on h[ to improve ! te*nical assi/ance ! ,c\ncil provides to bett] equip ,/ate1 local1 & ,tribal gov]nm5ts to coord9ate heal? & social s]vice programs2 7,g7 to solicit applications = grants "u ?is section2 & 7,h7 to coord9ate ) o!r cross-ag5cy initiatives focus$ on improv+ ! heal? & well-be+ ( l[-income & at-risk populations 9 ord] to prev5t unnecess>y duplication betwe5 ag5cy initiatives4 7#d7 ,s*$ule ,n lat] ?an #fj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,c\ncil %all conv5e to develop a s*$ule & plan = c>ry+ out ! duties describ$ 9 ?is section1 includ+ solicitation ( applications = ! grants "u ?is section4 7#e7 ,report to ,congress ,! ,c\ncil %all submit an annual report to ,congress1 :i* %all include-- 7,a7 a li/ ( ! ,c\ncil memb]s2 7,b7 activities & exp5ditures ( ! ,c\ncil2 7,c7 summ>ies ( ! int]v5tions & approa*es t w be support$ by ,/ate1 local1 & ,tribal gov]nm5ts t receiv$ a grant "u ?is section1 includ+-- 7i7 ! be/ practices & evid5ce-bas$ approa*es su* gov]nm5ts plan to employ to a*ieve ! purposes li/$ 9 ?is section2 & 7ii7 a description ( h[ ! practices & approa*es w impact ! outcomes1 co/-effectiv5ess (1 & return on inve/m5t f1 ,f$]al1 ,/ate1 local1 & ,tribal gov]nm5ts ) respect to su* purposes2 7,d7 ! fe$back receiv$ f ,/ate & local gov]nm5ts on ways to improve ! te*nical assi/ance ( ! ,c\ncil1 includ+ f9d+s f a ?ird-p>ty survey & actions ! ,c\ncil plans to take 9 response to su* fe$back2 & 7,e7 ! major /atutory1 regulatory1 & adm9i/rative *all5ges id5tifi$ by ,/ate1 local1 & ,tribal gov]nm5ts t receiv$ a grant "u subsection 7d71 & ! actions t ,f$]al ag5cies are tak+ to address su* *all5ges4 7#f7 ,,faca applicability ,! ,f$]al ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 %all n apply to ! ,c\ncil4 7#g7 ,c\ncil proc$ures ,! ,secret>y1 9 consultation ) ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates & ! ,director ( ! ,(fice ( ,managem5t & ,budget1 %all e/abli% proc$ures = ! ,c\ncil to-- 7,a7 ensure t adequate res\rces are available to effectively execute ! responsibilities ( ! ,c\ncil2 7,b7 effectively coord9ate ) o!r relevant advisory bodies & work+ gr\ps to avoid unnecess>y duplication2 7,c7 create transp>5cy to ! public & ,congress ) reg>d to ,c\ncil memb]%ip1 co/s1 & activities1 includ+ ?r\gh use ( mod]n te*nology & social m$ia to dissem9ate in=mation2 & 7,d7 avoid conflicts ( int]e/ t w\ld jeop>dize ! ability ( ! ,c\ncil to make decisions & provide recomm5dations4 7d7 ,social det]m9ants accel]ator grants to ,/ates or local gov]nm5ts 7#a7 ,grants to ,/ates1 local gov]nm5ts1 & tribes ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,adm9i/rator1 9 consultation ) ! ,secret>y & ! ,c\ncil1 %all aw>d on a competitive basis n m ?an #be grants to eligible applicants describ$ 9 ?is section1 = ! developm5t ( social det]m9ants accel]ator plans1 z describ$ 9 ?is section4 7#b7 ,eligible applicant ,an eligible applicant describ$ 9 ?is section is a ,/ate1 local1 or ,tribal heal? or human s]vices ag5cy t-- 7,a7 demon/rates ! support ( relevant p>ties across relevant ,/ate1 local1 or ,tribal jurisdictions2 & 7,b7 9 ! case ( an applicant t is a local gov]nm5t ag5cy1 provides to ! ,secret>y a lett] ( support f ! lead ,/ate heal? or human s]vices ag5cy = ! ,/ate 9 :i* ! local gov]nm5t is locat$4 7#c7 ,am\nt ( grant ,! ,adm9i/rator1 9 coord9ation ) ! ,c\ncil1 %all det]m9e ! total am\nt t ! ,adm9i/rator w make available to ea* grantee "u ?is section4 7#d7 ,application ,an eligible applicant seek+ a grant "u ?is section %all include 9 ! application ! foll[+ in=mation3 7,a7 ,! t>get population 7or populations7 t w\ld b5efit f implem5tation ( ! social det]m9ants accel]ator plan propos$ to be develop$ by ! applicant4 7,b7 ,a description ( ! objective or objectives & outcome goals ( su* propos$ plan1 :i* %all include at lea/ "o heal? outcome & at lea/ "o o!r important social outcome4 7,c7 ,! s\rces & scope ( ineffici5cies t1 if address$ by ! plan1 c\ld result 9 improv$ co/-effectiv5ess ( or return on inve/m5t f ,f$]al1 ,/ate1 local1 & ,tribal gov]nm5ts4 7,d7 ,a description ( pot5tial int]v5tions t c\ld be design$ or enabl$ us+ su* propos$ plan4 7,e7 ,! ,/ate1 local1 ,tribal1 academic1 nonpr(it1 community-bas$ organizations1 & o!r private sector p>tn]s t w\ld p>ticipate 9 ! developm5t ( ! propos$ plan & subsequ5t implem5tation ( programs or initiatives includ$ 9 su* propos$ plan4 7,f7 ,su* o!r in=mation z ! ,adm9i/rator1 9 consultation ) ! ,secret>y & ! ,c\ncil1 det]m9es necess>y to a*ieve ! purposes ( ?is ,act4 7#e7 ,use ( funds ,a recipi5t ( a grant "u ?is section may use funds receiv$ ?r\gh ! grant = ! foll[+ purposes3 7,a7 ,to conv5e & coord9ate ) relevant gov]nm5t entities & o!r /akehold]s across sectors to assi/ 9 ! developm5t ( a social det]m9ant accel]ator plan4 7,b7 ,to id5tify populations ( individuals receiv+ m$ical assi/ance "u a ,/ate plan 7or a waiv] ( su* plan7 "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 :o may b5efit f ! propos$ approa*es to improv+ ! heal? & well-be+ ( su* individuals ?r\gh ! implem5tation ( ! propos$ social det]m9ants accel]ator plan4 7,c7 ,to engage qualifi$ rese>* exp]ts to advise on relevant rese>* & to design a propos$ evaluation plan1 9 accordance ) ! /&>ds & guidel9es issu$ by ! ,adm9i/rator4 7,d7 ,to collaborate ) ! ,c\ncil to support ! developm5t ( social det]m9ants accel]ator plans4 7,e7 ,to prep>e & submit a f9al social det]m9ants accel]ator plan to ! ,c\ncil4 7#f7 ,cont5ts ( plans ,a social det]m9ant accel]ator plan develop$ "u ?is section %all include ! foll[+3 7,a7 ,a description ( ! t>get population 7or populations7 t w\ld b5efit f implem5tation ( ! social det]m9ants accel]ator plan1 includ+ an analysis describ+ ! project$ impact on ! well-be+ ( individuals describ$ 9 p>agraph 7#e77;,b74 7,b7 ,a description ( ! int]v5tions or approa*es design$ "u ! social det]m9ants accel]ator plan & ! evid5ce = select+ su* int]v5tions or approa*es4 7,c7 ,! objectives & outcome goals ( su* int]v5tions or approa*es1 includ+ at lea/ "o heal? outcome & at lea/ "o o!r important social outcome4 7,d7 ,a plan = access+ & l9k+ relevant data to enable coord9at$ b5efits & s]vices = ! jurisdictions describ$ 9 ?is section & an evaluation ( ! propos$ int]v5tions & approa*es4 7,e7 ,a description ( ! ,/ate1 local1 ,tribal1 academic1 nonpr(it1 or community-bas$ organizations1 or any o!r private sector organizations t w\ld p>ticipate 9 implem5t+ ! propos$ int]v5tions or approa*es1 & ! role ea* w\ld play to contribute to ! success ( ! propos$ int]v5tions or approa*es4 7,f7 ,! id5tification ( ! fund+ s\rces t w\ld be us$ to f9ance ! propos$ int]v5tions or approa*es4 7,g7 ,a description ( any f9ancial inc5tives t may be provid$1 includ+ outcome-focus$ contract+ approa*es to enc\rage s]vice provid]s & o!r p>tn]s to improve outcomes (1 co/-effectiv5ess (1 & return on inve/m5t f1 ,f$]al1 ,/ate1 local1 or ,tribal gov]nm5t sp5d+4 7,h7 ,! id5tification ( ! applicable ,f$]al1 ,/ate1 local1 or ,tribal /atutory & regulatory au?orities1 includ+ waiv] au?orities1 to be lev]ag$ to implem5t ! propos$ int]v5tions or approa*es4 7,i7 ,a description ( pot5tial consid]ations t w\ld enhance ! impact1 scalability1 or su/a9ability ( ! propos$ int]v5tions or approa*es & ! actions ! grant aw>dee w\ld take to address su* consid]ations4 7,j7 ,a propos$ evaluation plan1 to be c>ri$ out by an indep5d5t evaluator1 to measure ! impact ( ! propos$ int]v5tions or approa*es on ! outcomes (1 co/-effectiv5ess (1 & return on inve/m5t f1 ,f$]al1 ,/ate1 local1 & ,tribal gov]nm5ts4 7,k7 ,precautions = ensur+ t vuln]able populations w n be d5i$ access to ,m$icaid or o!r ess5tial s]vices z a result ( implem5t+ ! propos$ plan4 7e7 ,fund+ 7#a7 ,9 g5]al ,out ( any money 9 ! ,treasury n o!rwise appropriat$1 !re is appropriat$ to c>ry out ?is ,act #be1jjj1jjj1 ( :i* up to #e1jjj1jjj may be us$ to c>ry out ?is ,act1 to rema9 available = obligation until ! date t is #e ye>s aft] ! date ( enactm5t ( ?is ,act4 7#b7 ,res]vation ( funds 7,a7 ,9 g5]al ,( ! funds made available "u p>agraph 7#a71 ! ,secret>y %all res]ve n less ?an #bj p]c5t to aw>d grants to eligible applicants = ! developm5t ( social det]m9ants accel]ator plans "u ?is section int5d$ to s]ve rural populations4 7,b7 ,exception ,9 ! case ( a fiscal ye> = :i* ! ,secret>y det]m9es t !re are n suffici5t eligible applicants to aw>d up to #be grants "u section #d t are int5d$ to s]ve rural populations & ! ,secret>y _c satisfy ! #bj-p]c5t requirem5t1 ! ,secret>y may res]ve an am\nt t is less ?an #bj p]c5t ( am\nts made available "u p>agraph 7#a7 to aw>d grants = su* purpose4 7#c7 ,rule ( con/ruction ,no?+ 9 ?is ,act %all prev5t ,f$]al ag5cies repres5t$ on ! ,c\ncil f contribut+ additional fund+ f o!r s\rces to support activities to improve ! effectiv5ess ( ! ,c\ncil4 #djd4 ,acc\ntability & transp>5cy )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices ,title ,,xxxiv ( ! ,public ,heal? ,s]vice ,act is am5d$ by ins]t+ aft] subtitle ,c ! foll[+3 ,d ,/r5g!n+ acc\ntability #cdda4 ,elevation ( ! ,(fice ( ,civil ,rights 7a7 ,9 g5]al ,! ,secret>y %all e/abli% )9 ! ,(fice = ,civil ,rights an ,(fice ( ,heal? ,disp>ities1 :i* %all be head$ by a director to be appo9t$ by ! ,secret>y4 7b7 ,purpose ,! ,(fice ( ,heal? ,disp>ities %all ensure t ! heal? programs1 activities1 & op]ations ( heal? entities t receive ,f$]al f9ancial assi/ance are 9 compliance ) title ,,vi ( ! ,civil ,rights ,act1 includ+ ?r\gh ! foll[+ activities3 7#a7 ,! developm5t & implem5tation ( an action plan to address racial & e?nic heal? c>e disp>ities1 :i* %all address conc]ns relat+ to ! ,(fice = ,civil ,rights z releas$ by ! ,unit$ ,/ates ,commission on ,civil ,rights 9 ! report entitl$ ,heal? ,c>e ,*all5ge3 ,ackn[l$g+ ,disp>ity1 ,confront+ ,discrim9ation1 & ,ensur+ ,equity 7,septemb] #aiii7 9 conjunction ) ! reports by ! ,national ,academy ( ,sci5ces 7=m]ly kn[n z ! ,in/itute ( ,m$ic9e7 entitl$ ,unequal ,treatm5t3 ,confront+ ,racial & ,e?nic ,disp>ities 9 ,heal? ,c>e1 ,cross+ ! ,quality ,*asm3 ,a ,new ,heal? ,sy/em = ! #ba/ ,c5tury1 ,9 ! ,nation's ,compell+ ,int]e/3 ,ensur+ ,div]sity 9 ! ,heal? ,c>e ,work=ce1 ,! ,national ,p>tn]%ip = ,action to ,end ,heal? ,disp>ities1 & ,! ,heal? ( ,lesbian1 ,gay1 ,bisexual1 & ,transg5d] ,p1 & o!r relat$ reports by ! ,national ,academy ( ,sci5ces4 ,?is plan %all be publicly disclos$ = review & comm5t & ! f9al plan %all address any comm5ts or conc]ns t are receiv$ by ! ,(fice4 7#b7 ,inve/igative & en=cem5t actions aga9/ int5tional discrim9ation & policies & practices t h a disp>ate impact on m9orities4 7#c7 ,! review ( racial1 e?nic1 g5d] id5tity1 sexual ori5tation1 sex1 disability /atus1 socioeconomic /atus1 & prim>y language heal? data collect$ by ,f$]al heal? ag5cies to assess heal? c>e disp>ities relat$ to int5tional discrim9ation & policies & practices t h a disp>ate impact on m9orities4 ,su* review %all include an assessm5t ( heal? disp>ities 9 communities ) a comb9ation ( ^! classes4 7#d7 ,outrea* & education activities relat+ to compliance ) title ,,vi ( ! ,civil ,rights ,act4 7#e7 ,! provision ( te*nical assi/ance = heal? entities to facilitate compliance ) title ,,vi ( ! ,civil ,rights ,act4 7#f7 ,coord9ation & ov]sight ( activities ( ! civil rights compliance (fices e/abli%$ "u section #cddb4 7#g7 ,ensur+-- 7,a7 at a m9imum1 compliance ) ! mo/ rec5t v]sion ( ! ,(fice ( ,managem5t & ,budget /ati/ical policy directive entitl$ ,/&>ds = ,ma9ta9+1 ,collect+1 & ,pres5t+ ,f$]al ,data on ,race & ,e?nicity2 & 7,b7 consid]ation ( available data & language /&>ds su* z-- 7i7 ! /&>ds = collect+ & report+ data "u section #caja2 & 7ii7 ! ,national ,/&>ds on ,culturally & ,l+ui/ically ,appropriate ,s]vices ( ! ,(fice ( ,m9ority ,heal?4 7c7 ,fund+ & /aff ,! ,secret>y %all ensure ! effectiv5ess ( ! ,(fice ( ,heal? ,disp>ities by ensur+ t ! ,(fice is provid$ )-- 7#a7 adequate fund+ to enable ! ,(fice to c>ry out its duties "u ?is section2 & 7#b7 /aff ) exp]tise 9-- 7,a7 epidemiology2 7,b7 /ati/ics2 7,c7 heal? quality assurance2 7,d7 m9ority heal? & heal? disp>ities2 7,e7 cultural & l+ui/ic compet5cy2 7,f7 civil rights2 & 7,g7 social1 behavioral1 & economic det]m9ants ( heal?4 7d7 ,report ,n lat] ?an ,decemb] #ca1 #bjba1 & annually !reaft]1 ! ,secret>y1 9 collaboration ) ! ,director ( ! ,(fice = ,civil ,rights & ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 %all submit a report to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives t includes-- 7#a7 ! numb] ( cases fil$1 brok5 d[n by category2 7#b7 ! numb] ( cases inve/igat$ & clos$ by ! (fice2 7#c7 ! outcomes ( cases inve/igat$2 7#d7 ! /aff+ levels ( ! (fice includ+ /aff cr$5tials2 7#e7 ! numb] ( o!r l+]+ & em]g+ cases 9 :i* civil rights inequities c be demon/rat$2 & 7#f7 ! numb] ( cases rema9+ op5 & an explanation = _! op5 /atus4 7e7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbf4 #cddb4 ,e/abli%m5t ( ,heal? ,program (fices = ,civil ,rights )9 ,f$]al ,heal? & ,human ,s]vices ag5cies 7a7 ,9 g5]al ,! ,secret>y %all e/abli% civil rights compliance (fices 9 ea* ag5cy )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices t adm9i/]s heal? programs4 7b7 ,purpose ( (fices ,ea* (fice e/abli%$ "u subsection 7a7 %all ensure t recipi5ts ( ,f$]al f9ancial assi/ance "u ,f$]al heal? programs adm9i/] programs1 s]vices1 & activities 9 a mann] t-- 7#a7 does n discrim9ate1 ei!r int5tionally or 9 effect1 on ! basis ( race1 national orig91 language1 e?nicity1 sex1 age1 disability1 sexual ori5tation1 & g5d] id5tity2 & 7#b7 promotes ! r$uction & elim9ation ( disp>ities 9 heal? & heal? c>e bas$ on race1 national orig91 language1 e?nicity1 sex1 age1 disability1 sexual ori5tation1 & g5d] id5tity4 7c7 ,p[]s & duties ,! (fices e/abli%$ 9 subsection 7a7 %all h ! foll[+ p[]s & duties3 7#a7 ,! e/abli%m5t ( compliance & program p>ticipation /&>ds = recipi5ts ( ,f$]al f9ancial assi/ance "u ea* program adm9i/]$ by ! applicable ag5cy1 includ+ ! e/abli%m5t ( disp>ity r$uction /&>ds to encompass disp>ities 9 heal? & heal? c>e relat$ to race1 national orig91 language1 e?nicity1 sex1 age1 disability1 sexual ori5tation1 & g5d] id5tity4 7#b7 ,! developm5t & implem5tation ( program-specific guidel9es t int]pret & apply ,dep>tm5t ( ,heal? & ,human ,s]vices guidance "u title ,,vi ( ! ,civil ,rights ,act ( #aifd & section #aeeg ( ! ,pati5t ,protection & ,af=dable ,c>e ,act to ea* ,f$]al heal? program adm9i/]$ by ! ag5cy4 7#c7 ,! developm5t ( a disp>ity-r$uction impact analysis me?odology t %all be appli$ to e rule issu$ by ! ag5cy & publi%$ z "p ( ! =mal rulemak+ process "u sections #eee1 #eef1 & #eeg ( title #e1 ,unit$ ,/ates ,code4 7#d7 ,ov]sight ( data collection1 analysis1 & publication requirem5ts = all recipi5ts ( ,f$]al f9ancial assi/ance "u ea* ,f$]al heal? program adm9i/]$ by ! ag5cy2 compliance )1 at a m9imum1 ! mo/ rec5t v]sion ( ! ,(fice ( ,managem5t & ,budget /ati/ical policy directive entitl$ ,/&>ds = ,ma9ta9+1 ,collect+1 & ,pres5t+ ,f$]al ,data on ,race & ,e?nicity2 & consid]ation ( available data & language /&>ds su* z-- 7,a7 ! /&>ds = collect+ & report+ data "u section #caja2 & 7,b7 ! ,national ,/&>ds on ,culturally & ,l+ui/ically ,appropriate ,s]vices ( ! ,(fice ( ,m9ority ,heal?4 7#e7 ,! conduct ( publicly available /udies reg>d+ discrim9ation )9 ,f$]al heal? programs adm9i/]$ by ! ag5cy z well z disp>ity r$uction initiatives by recipi5ts ( ,f$]al f9ancial assi/ance "u ,f$]al heal? programs4 7#f7 ,annual reports to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions & ! ,committee on ,f9ance ( ! ,s5ate & ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,ways & ,means ( ! ,h\se ( ,repres5tatives on ! progress 9 r$uc+ disp>ities 9 heal? & heal? c>e ?r\gh ! ,f$]al programs adm9i/]$ by ! ag5cy4 7d7 ,relation%ip to ,(fice = ,civil ,rights 9 ! ,dep>tm5t ( ,ju/ice 7#a7 ,dep>tm5t ( ,heal? & ,human ,s]vices ,! ,(fice = ,civil ,rights ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices %all provide /&>d-sett+ & compliance review inve/igation support s]vices to ! ,civil ,rights ,compliance ,(fice = ea* ag5cy describ$ 9 subsection 7a71 subject to p>agraph 7#b74 7#b7 ,dep>tm5t ( ,ju/ice ,! ,(fice = ,civil ,rights ( ! ,dep>tm5t ( ,ju/ice may1 z appropriate1 in/itute =mal proce$+s :5 a civil rights compliance (fice e/abli%$ "u subsection 7a7 det]m9es t a recipi5t ( ,f$]al f9ancial assi/ance is n 9 compliance ) ! disp>ity r$uction /&>ds ( ! applicable ag5cy4 7e7 ,def9ition ,9 ?is section1 ! t]m ,f$]al heal? programs mean programs-- 7#a7 "u ! ,social ,security ,act 7#db ,u4,s4,c4 #cja et seq47 t pay = heal? c>e & s]vices2 & 7#b7 "u ?is ,act t provide ,f$]al f9ancial assi/ance = heal? c>e1 biom$ical rese>*1 heal? s]vices rese>*1 & programs design$ to improve ! public's heal?1 includ+ heal? s]vice programs4 4 ,v ,exp&$ ,insurance ,access #eja4 ,m$ic>e special enrollm5t p]iod = individuals resid+ 9 ,,covid-#ai em]g5cy areas 7a7 ,9 g5]al ,section #ahcg7;i7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciep7i77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#e7 7,a7 ,9 ! case ( an individual :o-- 7i7 is eligible "u section #ahcf to enroll 9 ! m$ical insurance program e/abli%$ by ?is "p1 7ii7 did n enroll 7or elect$ n to be deem$ enroll$7 "u ?is section dur+ an enrollm5t p]iod1 & 7iii7 dur+ ! em]g5cy p]iod 7z describ$ 9 section #aace7;g77#a77;,b771 resid$ 9 an em]g5cy area 7z describ$ 9 su* section71 !re %all be a special enrollm5t p]iod describ$ 9 subp>agraph 7,b74 7,b7 ,! special enrollm5t p]iod ref]r$ to 9 subp>agraph 7,a7 is ! p]iod t beg9s n lat] ?an ,july #a1 #bjbj1 & ends on ! la/ day ( ! mon? 9 :i* ! em]g5cy p]iod 7z describ$ 9 section #aace7;g77#a77;,b77 ends4 4 7b7 ,cov]age p]iod = individuals transition+ f o!r cov]age ,section #ahch7;e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieq7e77 is am5d$-- 7#a7 by /rik+ pursuant to section #ahcg7;i77#c7 or #ahcg7;i77#d77;,b7-- & ins]t+ ! foll[+3 pursuant to-- 7#a7 section #ahcg7;i77#c7 or #ahcg7;i77#d77;,b7-- 2 7#b7 by r$esignat+ p>agraphs 7#a7 & 7#b7 z subp>agraphs 7,a7 & 7,b71 respectively1 & mov+ ! ind5tation ( ea* su* subp>agraph #b ems to ! "r2 7#c7 by /rik+ ! p]iod at ! end ( ! subp>agraph 7,b71 z s r$esignat$1 & ins]t+ 2 or2 & 7#d7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 section #ahcg7;i77#e71 ! cov]age p]iod %all beg9 on ! fir/ day ( ! mon? foll[+ ! mon? 9 :i* ! individual s enrolls4 4 7c7 ,fund+ ,! ,secret>y ( ,heal? & ,human ,s]vices %all provide = ! transf] f ! ,f$]al ,hospital ,insurance ,tru/ ,fund 7z describ$ 9 section #ahag ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;i77 & ! ,f$]al ,supplem5t>y ,m$ical ,insurance ,tru/ ,fund 7z describ$ 9 section #ahda ( su* ,act 7#db ,u4,s4,c4 #aciet771 9 su* proportions z det]m9$ appropriate by ! ,secret>y1 to ! ,social ,security ,adm9i/ration1 ( #cj1jjj1jjj1 to rema9 available until exp5d$1 = purposes ( c>ry+ out ! am5dm5ts made by ?is section4 7d7 ,implem5tation ,not)/&+ any o!r provision ( law1 ! ,secret>y ( ,heal? & ,human ,s]vices may implem5t ! am5dm5ts made by ?is section by program in/ruction or o!rwise4 #ejb4 ,special enrollm5t p]iod ?r\gh ex*anges2 ,f$]al ex*ange outrea* & educational activities 7a7 ,special enrollm5t p]iod ?r\gh ,ex*anges ,section #acaa7;c7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjca7;c77 is am5d$-- 7#a7 9 p>agraph 7#f7-- 7,a7 9 subp>agraph 7,c71 by /rik+ at ! end &2 7,b7 9 subp>agraph 7,d71 by /rik+ at ! end ! p]iod & ins]t+ 2 &2 & 7,c7 by add+ at ! end ! foll[+ new subp>agraph3 7,e7 subject to subp>agraph 7,b7 ( p>agraph 7#h71 ! special enrollm5t p]iod describ$ 9 subp>agraph 7,a7 ( su* p>agraph4 2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#h7 ,special enrollm5t p]iod = c]ta9 public heal? em]g5cy 7,a7 ,9 g5]al ,! ,secret>y %all1 subject to subp>agraph 7,b71 require an ,ex*ange to provide-- 7i7 = a special enrollm5t p]iod dur+ ! em]g5cy p]iod describ$ 9 section #aace7;g77#a77;,b7 ( ! ,social ,security ,act-- 7,i7 :i* %all beg9 on ! date t is "o week aft] ! date ( ! enactm5t ( ?is p>agraph & :i*1 9 ! case ( an ,ex*ange e/abli%$ or op]at$ by ! ,secret>y )9 a ,/ate pursuant to section #acba7;c71 %all be an #h-week p]iod2 & 7,,ii7 dur+ :i* any individual :o is o!rwise eligible to enroll 9 a qualifi$ heal? plan ?r\gh ! ,ex*ange may enroll 9 su* a qualifi$ heal? plan2 & 7ii7 t1 9 ! case ( an individual :o enrolls 9 a qualifi$ heal? plan ?r\gh ! ,ex*ange dur+ su* enrollm5t p]iod1 ! cov]age p]iod "u su* plan %all beg91 at ! option ( ! individual1 on ,april #a1 #bjbj1 or on ! fir/ day ( ! mon? foll[+ ! day ! individual selects a plan ?r\gh su* special enrollm5t p]iod4 7,b7 ,exception ,! requirem5t ( subp>agraph 7,a7 %all n apply to a ,/ate-op]at$ or ,/ate-e/abli%$ ,ex*ange if su* ,ex*ange1 prior to ! date ( ! enactm5t ( ?is p>agraph1 e/abli%$ or o!rwise provid$ = a special enrollm5t p]iod to address access to cov]age "u qualifi$ heal? plans (f]$ ?r\gh su* ,ex*ange dur+ ! em]g5cy p]iod describ$ 9 section #aace7;g77#a77;,b7 ( ! ,social ,security ,act4 4 7b7 ,f$]al ,ex*ange outrea* & educational activities ,section #acba7;c7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjda7;c77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,outrea* & educational activities 7,a7 ,9 g5]al ,9 ! case ( an ,ex*ange e/abli%$ or op]at$ by ! ,secret>y )9 a ,/ate pursuant to ?is subsection1 ! ,secret>y %all c>ry out outrea* & educational activities = purposes ( in=m+ pot5tial enrollees 9 qualifi$ heal? plans (f]$ ?r\gh ! ,ex*ange ( ! availability ( cov]age "u su* plans & f9ancial assi/ance = cov]age "u su* plans4 ,su* outrea* & educational activities %all be provid$ 9 a mann] t is culturally & l+ui/ically appropriate to ! ne$s ( ! populations be+ s]v$ by ! ,ex*ange 7includ+ h>d-to-rea* populations1 su* z racial & sexual m9orities1 limit$ ,engli% pr(ici5t populations1 & "y adults74 7,b7 ,limitation on use ( funds ,no funds appropriat$ "u ?is p>agraph %all be us$ = exp5ditures = promot+ non-,,aca compliant heal? insurance cov]age4 7,c7 ,non-,,aca compliant heal? insurance cov]age ,= purposes ( subp>agraph 7,b73 7i7 ,! t]m non-,,aca compliant heal? insurance cov]age means heal? insurance cov]age1 or a gr\p heal? plan1 t is n a qualifi$ heal? plan4 7ii7 ,su* t]m includes ! foll[+3 7,i7 ,an association heal? plan4 7,,ii7 ,%ort-t]m limit$ duration insurance4 7,d7 ,fund+ ,!re are appropriat$1 out ( any funds 9 ! ,treasury n o!rwise appropriat$1 #be1jjj1jjj1 to rema9 available until exp5d$-- 7i7 to c>ry out ?is p>agraph2 & 7ii7 at ! discretion ( ! ,secret>y1 to c>ry out section #acaa7;i71 ) respect to an ,ex*ange e/abli%$ or op]at$ by ! ,secret>y )9 a ,/ate pursuant to ?is subsection4 4 7c7 ,implem5tation ,! ,secret>y ( ,heal? & ,human ,s]vices may implem5t ! provisions ( 7includ+ am5dm5ts made by7 ?is section ?r\gh subregulatory guidance1 program in/ruction1 or o!rwise4 #ejc4 ,,momma's ,act 7a7 ,%ort title ,?is section may be cit$ z ! ,mo!rs & ,(fspr+ ,mortality & ,morbidity ,aw>5ess ,act or ! ,,momma's ,act4 7b7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,e ye>1 across ! ,unit$ ,/ates1 #d1jjj1jjj wom5 give bir?1 ab\t #gjj wom5 suff] fatal complications dur+ pregnancy1 :ile giv+ bir? or dur+ ! po/p>tum p]iod1 & #gj1jjj wom5 suff] ne>-fatal1 p>tum-relat$ complications4 7#b7 ,! mat]nal mortality rate is (t5 us$ z a proxy to measure ! ov]all heal? ( a population4 ,:ile ! infant mortality rate 9 ! ,unit$ ,/ates has rea*$ its l[e/ po9t1 ! risk ( dea? = wom5 9 ! ,unit$ ,/ates dur+ pregnancy1 *ildbir?1 or ! po/p>tum p]iod is high] ?an su* risk 9 _m o!r develop$ nations4 ,! e/imat$ mat]nal mortality rate 7p] #ajj1jjj live bir?s7 = ! #dh contigu\s ,/ates & ,wa%+ton1 ,,dc increas$ f #ah4h p]c5t 9 #bjjj to #bc4h p]c5t 9 #bjad to #bf4f p]c5t 9 #bjah4 ,?is e/imat$ rate is on p> ) su* rate = und]develop$ nations su* z ,iraq & ,afghani/an4 7#c7 ,int]national /udies e/imate ! #bjae mat]nal mortality rate 9 ! ,unit$ ,/ates z #bf4d p] #ajj1jjj live bir?s1 :i* is almo/ twice ! #bjae ,_w ,heal? ,organization e/imation ( #ad p] #ajj1jjj live bir?s4 7#d7 ,x is e/imat$ t m ?an #fj p]c5t ( mat]nal dea?s 9 ! ,unit$ ,/ates are prev5table4 7#e7 ,accord+ to ! ,c5t]s = ,disease ,control & ,prev5tion1 ! mat]nal mortality rate v>ies dra/ically = wom5 by race & e?nicity4 ,!re are #ab4g dea?s p] #ajj1jjj live bir?s = ,:ite wom51 #dc4e dea?s p] #ajj1jjj live bir?s = ,african-,am]ican wom51 & #ad4d dea?s p] #ajj1jjj live bir?s = wom5 ( o!r e?nicities4 ,:ile mat]nal mortality disp>ately impacts ,african-,am]ican wom51 ?is urg5t public heal? crisis trav]ses race1 e?nicity1 socioeconomic /atus1 educational backgr\nd1 & geography4 7#f7 ,african-,am]ican wom5 are #c to #d times m likely to die f causes relat$ to pregnancy & *ildbir? comp>$ to non-,hispanic ,:ite wom54 7#g7 ,! f9d+s describ$ 9 p>agraphs 7#a7 ?r\gh 7#f7 are ( major conc]n to rese>*]s1 academics1 memb]s ( ! bus9ess community1 & provid]s across ! ob/etrical cont9uum repres5t$ by organizations su* z ,m>* ( ,dimes2 ! ,preeclampsia ,f\ndation2 ! ,am]ican ,college ( ,ob/etricians & ,gynecologi/s2 ! ,society = ,mat]nal-,fetal ,m$ic9e2 ! ,association ( ,wom5's ,heal?1 ,ob/etric1 & ,neonatal ,nurses2 ! ,cali=nia ,mat]nal ,quality ,c>e ,collaborative2 ,black ,wom5's ,heal? ,imp]ative2 ! ,national ,bir? ,equity ,collaborative2 ,black ,mamas ,matt] ,alliance2 ,ever,thrive ,ill9ois2 ! ,national ,association ( ,c]tifi$ ,pr(essional ,midwives2 ,,pcos ,*all5ge3 ,! ,national ,polycy/ic ,ov>y ,syndrome ,association2 & ! ,am]ican ,college ( ,nurse ,midwives4 7#h7 ,hemorrhage1 c>diovascul> & coron>y conditions1 c>diomyopa?y1 infection1 embolism1 m5tal heal? conditions1 preeclampsia & eclampsia1 polycy/ic ov>y syndrome1 infection & sepsis1 & ane/hesia complications are ! pr$om9ant m$ical causes ( mat]nal-relat$ dea?s & complications4 ,mo/ ( ^! conditions are l>gely prev5table or manageable4 7#i7 ,oral heal? is an important "p ( p]9atal heal?4 ,r$uc+ bact]ia 9 a woman's m\? dur+ pregnancy c significantly r$uce h] risk ( develop+ oral diseases & spread+ decay-caus+ bact]ia to h] baby4 ,moreov]1 "s evid5ce sugge/s t wom5 ) p]iodontal disease dur+ pregnancy c\ld be at great] risk = poor bir? outcomes1 su* z preeclampsia1 pre-t]m bir?1 & l[-bir? weight4 ,fur!rmore1 a woman's oral heal? dur+ pregnancy is a good pr$ictor ( h] newborn's oral heal?1 & s9ce mo!rs c un9t5tionally spread oral bact]ia to _! babies1 putt+ _! *ildr5 at high] risk = too? decay1 prev5tion ef=ts %\ld happ5 ev5 be=e *ildr5 are born1 z a matt] ( pre-pregnancy heal? & pr5atal c>e dur+ pregnancy4 7#aj7 ,! ,unit$ ,/ates has n be5 able to submit a =mal mat]nal mortality rate to int]national data repositories s9ce #bjjg4 ,?us1 no (ficial mat]nal mortality rate exi/s = ! ,unit$ ,/ates4 ,!re c be no mat]nal mortality rate )\t /reaml9+ mat]nal mortality-relat$ data f ! ,/ate level & extrapolat+ su* data to ! ,f$]al level4 7#aa7 ,9 ! ,unit$ ,/ates1 dea? report+ & analysis is a ,/ate function r ?an a ,f$]al process4 ,/ates report all dea?s--includ+ mat]nal dea?s--on a semi-volunt>y basis1 )\t /&>dization across ,/ates4 ,:ile ! ,c5t]s = ,disease ,control & ,prev5tion has ! capacity & sy/em = collect+ dea?-relat$ data bas$ on dea? c]tificates1 ^! data are n suffici5tly report$ by ,/ates 9 an organiz$ & /&>d =mat across ,/ates su* t ! ,c5t]s = ,disease ,control & ,prev5tion is able to id5tify causes ( mat]nal dea? & be/ practices = ! prev5tion ( su* dea?4 7#ab7 ,vital /ati/ics sy/ems (t5 und]e/imate mat]nal mortality & are insuffici5t data s\rces f :i* to d]ive a full scope ( m$ical & social det]m9ant factors contribut+ to mat]nal dea?s4 ,:ile ! addition ( pregnancy *eckboxes on dea? c]tificates s9ce #bjjc h likely improv$ ,/ates' abilities to id5tify pregnancy-relat$ dea?s1 !y are n g5]ally complet$ by ob/etrical provid]s or p]sons tra9$ to recognize pregnancy-relat$ mortality4 ,?us1 ^! vital =ms may be miss+ in=mation or may capture inconsi/5t data4 ,due to v>y+ mat]nal mortality-relat$ analyses1 lack ( reliability1 & granul>ity 9 data1 curr5t mat]nal mortality in=matics d n fully encapsulate ! myriad m$ical & socially det]m9ant factors t contribute to su* high mat]nal mortality rates )9 ! ,unit$ ,/ates comp>$ to o!r develop$ nations4 ,lack ( /&>dization ( data & data %>+ across ,/ates & betwe5 ,f$]al entities1 heal? networks1 & rese>* in/itutions keep ! ,nation 9 ! d>k ab\t ways to prev5t mat]nal dea?s4 7#ac7 ,hav+ reliable & valid ,/ate data aggregat$ at ! ,f$]al level are critical to ! ,nation's ability to quell surges 9 mat]nal dea? & imp]ative = rese>*]s to id5tify long-la/+ int]v5tions4 7#ad7 ,lead]s 9 mat]nal wellness highly recomm5d t mat]nal dea?s be inve/igat$ at ! ,/ate level fir/1 & t /&>diz$1 /reaml9$1 de-id5tifi$ data reg>d+ mat]nal dea?s be s5t annually to ! ,c5t]s = ,disease ,control & ,prev5tion4 ,su* data /&>dization & collection w\ld be simil> 9 op]ation & effect to ! ,national ,program ( ,canc] ,regi/ries ( ! ,c5t]s = ,disease ,control & ,prev5tion & ak9 to ! ,confid5tial ,enquiry 9 ,mat]nal ,dea?s ,programme 9 ! ,unit$ ,k+dom4 ,su* a mat]nal mortalities & morbidities regi/ry & surveillance sy/em w\ld help provid]s1 academicians1 lawmak]s1 & ! public to address que/ions conc]n+ ! types (1 causes (1 & be/ practices to ?w>t1 pregnancy-relat$ or pregnancy-associat$ mortality & morbidity4 7#ae7 ,! ,unit$ ,nations' ,mill5nium ,developm5t ,goal #e;a aim$ to r$uce by #ge p]c5t1 betwe5 #aiij & #bjae1 ! mat]nal mortality rate1 yet ?is metric has n be5 a*iev$4 ,9 fact1 ! mat]nal mortality rate 9 ! ,unit$ ,/ates has be5 e/imat$ to h m ?an d\bl$ betwe5 #bjjj & #bjad4 ,yet1 because national data are n fully available1 ! ,unit$ ,/ates does n h an (ficial mat]nal mortality rate4 7#af7 ,_m ,/ates h /ruggl$ to e/abli% or ma9ta9 ,mat]nal ,mortality ,review ,committees 7ref]r$ to 9 ?is section z ,,mmrc74 ,on ! ,/ate level1 ,m,m,r,cs h lagg$ because ,/ates h n _h ! res\rces to m\nt local reviews4 ,/ate-level reviews are necess>y z only ! ,/ate dep>tm5ts ( heal? h ! au?ority to reque/ m$ical records1 autopsy reports1 & police reports critical to ! function ( ! ,,mmrc4 7#ag7 ,! ,unit$ ,k+dom reg>ds mat]nal dea?s z a heal? sy/ems failure & a national committee ( ob/etrics exp]ts review ea* mat]nal dea? or ne>-fatal *ildbir? complication4 ,su* committee also e/abli%es ! pr$om9ant c\rse ( mat]nal-relat$ dea?s f conditions su* z preeclampsia4 ,consequ5tly1 ! ,unit$ ,k+dom has be5 able to r$uce its incid5ce ( preeclampsia to less ?an "o 9 #aj1jjj wom5--its l[e/ rate s9ce #aieb4 7#ah7 ,! ,unit$ ,/ates has no comp>able1 coord9at$ ,f$]al process by :i* to review cases ( mat]nal mortality1 sy/ems failures1 or be/ practices4 ,_m ,/ates h active ,m,m,r,cs & lev]age _! "w to impact mat]nal wellness4 ,= example1 ! ,/ate ( ,cali=nia has work$ ext5sively ) _! ,/ate heal? dep>tm5ts1 heal? & hospital sy/ems1 & rese>* collaborative organizations1 includ+ ! ,cali=nia ,mat]nal ,quality ,c>e ,collaborative & ! ,alliance = ,innovation on ,mat]nal ,heal?1 to e/abli% ,m,m,r,cs1 :]e9 su* ,/ate has det]m9$ ! mo/ preval5t causes ( mat]nal mortality & record$ & %>$ data ) provid]s & rese>*]s1 :o h develop$ & implem5t$ safety bundles & c>e protocols relat$ to preeclampsia1 mat]nal hemorrhage1 & ! l4 ,9 ?is way1 ! ,/ate ( ,cali=nia has be5 able to lev]age its mat]nal mortality review bo>d sy/em1 g5]ate data1 & apply ^? data to effect *anges 9 mat]nal c>e-relat$ protocol4 ,to date1 ! ,/ate ( ,cali=nia has r$uc$ its mat]nal mortality rate1 :i* is n[ comp>able to ! l[ rates ( ! ,unit$ ,k+dom4 7#ai7 ,hospitals & heal? sy/ems across ! ,unit$ ,/ates lack /&>dization ( em]g5cy ob/etrical protocols be=e1 dur+1 & aft] deliv]y4 ,consequ5tly1 _m provid]s are delay$ 9 recogniz+ critical signs indicat+ mat]nal di/ress t quickly escalate into fatal or ne>-fatal incid5ces4 ,moreov]1 any attempt to address an ob/etrical em]g5cy t does n consid] bo? cl9ical & public heal? approa*es falls woefully "u ! m>k ( excell5t c>e deliv]y4 ,/ate-bas$ mat]nal quality collaborative organizations1 su* z ! ,cali=nia ,mat]nal ,quality ,c>e ,collaborative or entities p>ticipat+ 9 ! ,alliance = ,innovation on ,mat]nal ,heal? 7,,aim71 h =m$ ob/etrical protocols1 tool kits1 & o!r res\rces to improve sy/em c>e & response z !y relate to mat]nal complications & w>n+ signs = su* conditions z mat]nal hemorrhage1 hyp]t5sion1 & preeclampsia4 7#bj7 ,! ,c5t]s = ,disease ,control & ,prev5tion reports t ne>ly half ( all mat]nal dea?s occur 9 ! imm$iate po/p>tum p]iod--! #db days foll[+ a pregnancy--:]eas m ?an "o-?ird ( pregnancy-relat$ or pregnancy-associat$ dea?s occur :ile a p]son is /ill pregnant4 ,yet1 = wom5 eligible = ! ,m$icaid program on ! basis ( pregnancy1 su* ,m$icaid cov]age lapses at ! end ( ! mon? on :i* ! #fj? po/p>tum day l&s4 7#ba7 ,! exp]i5ce ( s]i\s traumatic ev5ts1 su* z be+ expos$ to dome/ic viol5ce1 sub/ance use disord]1 or p]vasive racism1 c ov]-activate ! body's /ress-response sy/em4 ,kn[n z toxic /ress1 ! repetition ( high-doses ( cortisol to ! bra91 c h>m heal?y neurological developm5t1 :i* c h cascad+ physical & m5tal heal? consequ5ces1 z docum5t$ 9 ! ,adv]se ,*ildhood ,exp]i5ces /udy ( ! ,c5t]s = ,disease ,control & ,prev5tion4 7#bb7 ,a gr[+ body ( evid5ce-bas$ rese>* has %[n ! correlation betwe5 ! /ress associat$ ) "o's race--! /ress ( racism--& "o's bir?+ outcomes4 ,! /ress ( sex & race discrim9ation & in/itutional racism has be5 demon/rat$ to contribute to a high] risk ( mat]nal mortality1 irrespective ( "o's ge/ational age1 mat]nal age1 socioeconomic /atus1 or individual-level heal? risk factors1 includ+ pov]ty1 limit$ access to pr5atal c>e1 & poor physical & m5tal heal? 7al?\gh ^! are n nom9al factors74 ,african-,am]ican wom5 rema9 ! mo/ at risk = pregnancy-associat$ or pregnancy-relat$ causes ( dea?4 ,:5 x comes to preeclampsia1 = example1 :i* is relat$ to obesity1 ,african-,am]ican wom5 ( normal weight rema9 ! mo/ at risk ( dy+ dur+ ! p]9atal p]iod comp>$ to non-,african-,am]ican obese wom54 7#bc7 ,! ris+ mat]nal mortality rate 9 ! ,unit$ ,/ates is driv5 pr$om9antly by ! disproportionately high rates ( ,african-,am]ican mat]nal mortality4 7#bd7 ,african-,am]ican wom5 are #c to #d times m likely to die f pregnancy or mat]nal-relat$ di/ress ?an are ,:ite wom51 yield+ "o ( ! greate/ & mo/ disconc]t+ racial disp>ities 9 public heal?4 7#be7 ,comp>$ to wom5 f o!r racial & e?nic demographics1 ,african-,am]ican wom5 across ! socioeconomic spectrum exp]i5ce prolong$1 unrel5t+ /ress relat$ to racial & g5d] discrim9ation1 contribut+ to high] rates ( mat]nal mortality1 giv+ bir? to l[-weight babies1 & exp]i5c+ pre-t]m bir?4 ,racism is a risk-factor = ^! a=em5tion$ exp]i5ces4 ,?is cumulative /ress (t5 ext5ds across ! life c\rse & is situat$ 9 ev]yday spaces :]e ,african-,am]ican wom5 e/abli% livelihood4 ,/ructural b>ri]s1 lack ( access to c>e1 & g5etic pr$ispositions to heal? vuln]abilities exac]bate ,african-,am]ican wom5's likelihood to exp]i5ce poor or fatal bir?+ outcomes1 b d n fully acc\nt = ! great disp>ity4 7#bf7 ,african-,am]ican wom5 are twice z likely to exp]i5ce po/p>tum depression1 & disproportionately high] rates ( preeclampsia comp>$ to ,:ite wom54 7#bg7 ,racism is deeply +ra9$ 9 ,unit$ ,/ates sy/ems1 includ+ 9 heal? c>e deliv]y sy/ems betwe5 pati5ts & provid]s1 (t5 result+ 9 disp>ate treatm5t = pa91 irrev]5ce = cultural norms ) respect to heal?1 & dismissiv5ess4 ,rese>* has demon/rat$ t pati5ts respond m w>mly & adh]e to m$ical treatm5t plans at a high] degree ) provid]s ( ! same race or e?nicity or ) provid]s ) great ability to ex]cise empa?y4 ,h[ev]1 ! provid] pool is n prim$ ) _m p ( color1 nor are provid]s 7:e!r /ud5t-doctors 9 tra9+ or lic5s$ practition]s7 consi/5tly requir$ to und]go implicit bias1 cultural compet5cy1 or empa?y tra9+ on a consi/5t1 on-go+ basis4 7c7 ,improv+ ,f$]al ef=ts ) respect to prev5tion ( mat]nal mortality 7#a7 ,te*nical assi/ance = ,/ates ) respect to report+ mat]nal mortality ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion 7ref]r$ to 9 ?is section z ! ,director71 9 consultation ) ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all provide te*nical assi/ance to ,/ates t elect to report compreh5sive data on mat]nal mortality1 includ+ oral1 m5tal1 & brea/fe$+ heal? in=mation1 = ! purpose ( enc\rag+ uni=mity 9 ! report+ ( su* data & to enc\rage ! %>+ ( su* data among ! respective ,/ates4 7#b7 ,be/ practices relat+ to prev5tion ( mat]nal mortality 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act-- 7i7 ! ,director1 9 consultation ) relevant pati5t & provid] gr\ps1 %all issue be/ practices to ,/ate mat]nal mortality review committees on h[ be/ to id5tify & review mat]nal mortality cases1 tak+ into acc\nt any data made available by ,/ates relat+ to mat]nal mortality1 includ+ data on oral1 m5tal1 & brea/fe$+ heal?1 & utilization ( any em]g5cy s]vices2 & 7ii7 ! ,director1 work+ 9 collaboration ) ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all issue be/ practices to hospitals1 ,/ate pr(essional society gr\ps1 & p]9atal quality collaboratives on h[ be/ to prev5t mat]nal mortality4 7,b7 ,au?orization ( appropriations ,= purposes ( c>ry+ out ?is subsection1 !re is au?oriz$ to be appropriat$ #e1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 7#c7 ,alliance = ,innovation on ,mat]nal ,heal? ,grant ,program 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is subsection z ! ,secret>y71 act+ ?r\gh ! ,associate ,adm9i/rator ( ! ,mat]nal & ,*ild ,heal? ,bureau ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all e/abli% a grant program to be kn[n z ! ,alliance = ,innovation on ,mat]nal ,heal? ,grant ,program 7ref]r$ to 9 ?is subsection z ,,aim7 "u :i* ! ,secret>y %all aw>d grants to eligible entities = ! purpose (-- 7i7 direct+ widespread adoption & implem5tation ( mat]nal safety bundles ?r\gh collaborative ,/ate-bas$ teams2 & 7ii7 collect+ & analyz+ process1 /ructure1 & outcome data to drive cont9u\s improvem5t 9 ! implem5tation ( su* safety bundles by su* ,/ate-bas$ teams ) ! ultimate goal ( elim9at+ prev5table mat]nal mortality & sev]e mat]nal morbidity 9 ! ,unit$ ,/ates4 7,b7 ,eligible entities ,9 ord] to be eligible = a grant "u p>agraph 7#a71 an entity %all-- 7i7 submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require2 & 7ii7 demon/rate 9 su* application t ! entity is an int]discipl9>y1 multi-/akehold]1 national organization ) a national data-driv5 mat]nal safety & quality improvem5t initiative bas$ on implem5tation approa*es t h be5 prov5 to improve mat]nal safety & outcomes 9 ! ,unit$ ,/ates4 7,c7 ,use ( funds ,an eligible entity t receives a grant "u p>agraph 7#a7 %all use su* grant funds-- 7i7 to develop & implem5t1 ?r\gh a robu/1 multi-/akehold] process1 mat]nal safety bundles to assi/ ,/ates & heal? c>e sy/ems 9 align+ national1 ,/ate1 & hospital-level quality improvem5t ef=ts to improve mat]nal heal? outcomes1 specifically ! r$uction ( mat]nal mortality & sev]e mat]nal morbidity2 7ii7 to ensure1 9 develop+ & implem5t+ mat]nal safety bundles "u subp>agraph 7,a71 t su* mat]nal safety bundles-- 7,i7 satisfy ! quality improvem5t ne$s ( a ,/ate or heal? c>e sy/em by factor+ 9 ! results & f9d+s ( relevant data reviews1 su* z reviews conduct$ by a ,/ate mat]nal mortality review committee2 & 7,,ii7 address topics su* z-- 7aa7 ob/etric hemorrhage2 7bb7 mat]nal m5tal heal?2 7cc7 ! mat]nal v5\s sy/em2 7dd7 ob/etric c>e = wom5 ) sub/ance use disord]s1 includ+ opioid use disord]2 7ee7 po/p>tum c>e basics = mat]nal safety2 7ff7 r$uction ( p]ip>tum racial & e?nic disp>ities2 7gg7 r$uction ( prim>y caes>ean bir?2 7hh7 sev]e hyp]t5sion 9 pregnancy2 7ii7 sev]e mat]nal morbidity reviews2 7jj7 support aft] a sev]e mat]nal morbidity ev5t2 7kk7 ?romboembolism2 7ll7 optimization ( support = brea/fe$+2 & 7mm7 mat]nal oral heal?2 & 7iii7 to provide ongo+ te*nical assi/ance at ! national & ,/ate levels to support implem5tation ( mat]nal safety bundles "u subp>agraph 7,a74 7,d7 ,mat]nal safety bundle def9$ ,= purposes ( ?is subsection1 ! t]m mat]nal safety bundle means /&>diz$1 evid5ce-in=m$ processes = mat]nal heal? c>e4 7,e7 ,au?orization ( appropriations ,= purposes ( c>ry+ out ?is subsection1 !re is au?oriz$ to be appropriat$ #aj1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 7#d7 ,fund+ = ,/ate-,bas$ p]9atal quality collaboratives developm5t & su/a9ability 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is subsection z ! ,secret>y71 act+ ?r\gh ! ,division ( ,reproductive ,heal? ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all e/abli% a grant program to be kn[n z ! ,/ate-,bas$ ,p]9atal ,quality ,collaborative grant program "u :i* ! ,secret>y aw>ds grants to eligible entities = ! purpose ( developm5t & su/a9ability ( p]9atal quality collaboratives 9 e ,/ate1 ! ,di/rict ( ,columbia1 & eligible t]ritories1 9 ord] to measurably improve p]9atal c>e & p]9atal heal? outcomes = pregnant & po/p>tum wom5 & _! infants4 7,b7 ,grant am\nts ,grants aw>d$ "u ?is subsection %all be 9 am\nts n to exce$ #bej1jjj p] ye>1 = ! duration ( ! grant p]iod4 7,c7 ,/ate-bas$ p]9atal quality collaborative def9$ ,= purposes ( ?is subsection1 ! t]m ,/ate-bas$ p]9atal quality collaborative means a network ( multidiscipl9>y teams t-- 7i7 "w to improve measurable outcomes = mat]nal & infant heal? by advanc+ evid5ce-in=m$ cl9ical practices us+ quality improvem5t pr9ciples2 7ii7 "w ) hospital-bas$ or outpati5t facility-bas$ cl9ical teams1 exp]ts1 & /akehold]s1 includ+ pati5ts & families1 to spread be/ practices & optimize res\rces to improve p]9atal c>e & outcomes2 7iii7 employ /rategies t include ! use ( ! collaborative le>n+ model to provide opportunities = hospitals & cl9ical teams to collaborate on improvem5t /rategies1 rapid-response data to provide timely fe$back to hospital & o!r cl9ical teams to track progress1 & quality improvem5t sci5ce to provide support & coa*+ to hospital & cl9ical teams2 & 7iv7 h ! goal ( improv+ population-level outcomes 9 mat]nal & infant heal?4 7,d7 ,au?orization ( appropriations ,= purposes ( c>ry+ out ?is subsection1 !re is au?oriz$ to be appropriat$ #ad1jjj1jjj p] ye> = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 7#e7 ,expansion ( ,m$icaid & ,,*ip cov]age = pregnant & po/p>tum wom5 7,a7 ,requir+ cov]age ( oral heal? s]vices = pregnant & po/p>tum wom5 7i7 ,m$icaid ,section #aije ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is am5d$-- 7,i7 9 subsection 7a77#d7-- 7aa7 by /rik+ 2 & 7,d7 & ins]t+ 2 7,d72 & 7bb7 by ins]t+ 2 & 7,e7 oral heal? s]vices = pregnant & po/p>tum wom5 7z def9$ 9 subsection 7ee77 aft] subsection 7bb772 & 7,,ii7 by add+ at ! end ! foll[+ new subsection3 7ee7 ,oral heal? s]vices = pregnant & po/p>tum wom5 7#a7 ,9 g5]al ,= purposes ( ?is title1 ! t]m oral heal? s]vices = pregnant & po/p>tum wom5 means d5tal s]vices necess>y to prev5t disease & promote oral heal?1 re/ore oral /ructures to heal? & function1 & treat em]g5cy conditions t are furni%$ to a woman dur+ pregnancy 7or dur+ ! #a-ye> p]iod beg9n+ on ! la/ day ( ! pregnancy74 7#b7 ,cov]age requirem5ts ,to satisfy ! requirem5t to provide oral heal? s]vices = pregnant & po/p>tum wom51 a ,/ate %all1 at a m9imum1 provide cov]age = prev5tive1 diagno/ic1 p]iodontal1 & re/orative c>e consi/5t ) recomm5dations = p]9atal oral heal? c>e & d5tal c>e dur+ pregnancy f ! ,am]ican ,academy ( ,p$iatric ,d5ti/ry & ! ,am]ican ,college ( ,ob/etricians & ,gynecologi/s4 4 7ii7 ,,*ip ,section #bajc7;c77#e77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7c77#e77;,a77 is am5d$ by ins]t+ or a t>get$ l[-income pregnant woman aft] t>get$ l[-income *ild4 7,b7 ,ext5d+ ,m$icaid cov]age = pregnant & po/p>tum wom5 ,section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$-- 7i7 9 subsection 7e7-- 7,i7 9 p>agraph 7#e7-- 7aa7 by ins]t+ 7includ+ oral heal? s]vices = pregnant & po/p>tum wom5 7z def9$ 9 section #aije7;ee77 aft] po/p>tum m$ical assi/ance "u ! plan2 & 7bb7 by /rik+ #fj-;day & ins]t+ #a-ye>2 & 7,,ii7 9 p>agraph 7#f71 by /rik+ #fj-;day & ins]t+ #a-ye>2 & 7ii7 9 subsection 7l77#a77;,a71 by /rik+ #fj-;day & ins]t+ #a-ye>4 7,c7 ,ext5d+ ,m$icaid cov]age = lawful resid5ts ,section #aijc7v77#d77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#d77;,a77 is am5d$ by /rik+ #fj-;day & ins]t+ #a-ye>4 7,d7 ,ext5d+ ,,*ip cov]age = pregnant & po/p>tum wom5 ,section #baab7;d77#b77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acigll7d77#b77;,a77 is am5d$ by /rik+ #fj-;day & ins]t+ #a-ye>4 7,e7 ,ma9t5ance ( ef=t 7i7 ,m$icaid ,section #aijb7l7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7l77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#e7 ,dur+ ! p]iod t beg9s on ! date ( enactm5t ( ?is p>agraph & ends on ! date t is five ye>s aft] su* date ( enactm5t1 z a condition = receiv+ any ,f$]al paym5ts "u section #aijc7;a7 = cal5d> qu>t]s occurr+ dur+ su* p]iod1 a ,/ate %all n h 9 effect1 ) respect to wom5 :o are eligible = m$ical assi/ance "u ! ,/ate plan or "u a waiv] ( su* plan on ! basis ( be+ pregnant or hav+ be5 pregnant1 eligibility /&>ds1 me?odologies1 or proc$ures "u ! ,/ate plan or waiv] t are m re/rictive ?an ! eligibility /&>ds1 me?odologies1 or proc$ures1 respectively1 "u su* plan or waiv] t are 9 effect on ! date ( enactm5t ( ?is p>agraph4 4 7ii7 ,,*ip ,section #baje7;d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7d77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,9 eligibility /&>ds = t>get$ l[-income pregnant wom5 ,dur+ ! p]iod t beg9s on ! date ( enactm5t ( ?is p>agraph & ends on ! date t is five ye>s aft] su* date ( enactm5t1 z a condition ( receiv+ paym5ts "u subsection 7a7 & section #aijc7;a71 a ,/ate t elects to provide assi/ance to wom5 on ! basis ( be+ pregnant 7includ+ pregnancy-relat$ assi/ance provid$ to t>get$ l[-income pregnant wom5 7z def9$ 9 section #baab7;d771 pregnancy-relat$ assi/ance provid$ to wom5 :o are eligible = su* assi/ance ?r\gh application ( section #aijb7v77#d77;,a77i7 "u section #bajg7;e77#a71 or any o!r assi/ance "u ! ,/ate *ild heal? plan 7or a waiv] ( su* plan7 :i* is provid$ to wom5 on ! basis ( be+ pregnant7 %all n h 9 effect1 ) respect to su* wom51 eligibility /&>ds1 me?odologies1 or proc$ures "u su* plan 7or waiv]7 t are m re/rictive ?an ! eligibility /&>ds1 me?odologies1 or proc$ures1 respectively1 "u su* plan 7or waiv]7 t are 9 effect on ! date ( enactm5t ( ?is p>agraph4 4 7,f7 ,in=mation on b5efits ,! ,secret>y ( ,heal? & ,human ,s]vices %all make publicly available on ! int]net website ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 in=mation reg>d+ b5efits available to pregnant & po/p>tum wom5 & "u ! ,m$icaid program & ! ,*ildr5's ,heal? ,insurance ,program1 includ+ in=mation on-- 7i7 b5efits t ,/ates are requir$ to provide to pregnant & po/p>tum wom5 "u su* programs2 7ii7 optional b5efits t ,/ates may provide to pregnant & po/p>tum wom5 "u su* programs2 & 7iii7 ! availability ( diff]5t k9ds ( b5efits = pregnant & po/p>tum wom51 includ+ oral heal? & m5tal heal? b5efits1 "u su* programs4 7,g7 ,f$]al fund+ = co/ ( ext5d$ ,m$icaid & ,,*ip cov]age = po/p>tum wom5 7i7 ,m$icaid ,section #aije ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d71 z am5d$ by p>agraph 7#a71 is fur!r am5d$-- 7,i7 9 subsection 7b71 by /rik+ & 7aa7 & ins]t+ 7aa71 & 7ff72 & 7,,ii7 by add+ at ! end ! foll[+3 7ff7 ,increas$ ,,fmap = ext5d$ m$ical assi/ance = po/p>tum wom5 ,not)/&+ subsection 7b71 ! ,f$]al m$ical assi/ance p]c5tage = a ,/ate1 ) respect to am\nts exp5d$ by su* ,/ate = m$ical assi/ance = a woman :o is eligible = su* assi/ance on ! basis ( be+ pregnant or hav+ be5 pregnant t is provid$ dur+ ! #cje-;day p]iod t beg9s on ! #fj? day aft] ! la/ day ( h] pregnancy 7includ+ any su* assi/ance provid$ dur+ ! mon? 9 :i* su* p]iod ends71 %all be equal to-- 7#a7 #ajj p]c5t = ! fir/ #bj cal5d> qu>t]s dur+ :i* ?is subsection is 9 effect2 & 7#b7 #ij p]c5t = cal5d> qu>t]s !reaft]4 4 7ii7 ,,*ip ,section #baje7;c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7c77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#ab7 ,enhanc$ paym5t = ext5d$ assi/ance provid$ to pregnant wom5 ,not)/&+ subsection 7b71 ! enhanc$ ,,fmap1 ) respect to paym5ts "u subsection 7a7 = exp5ditures "u ! ,/ate *ild heal? plan 7or a waiv] ( su* plan7 = assi/ance provid$ "u ! plan 7or waiv]7 to a woman :o is eligible = su* assi/ance on ! basis ( be+ pregnant 7includ+ pregnancy-relat$ assi/ance provid$ to a t>get$ l[-income pregnant woman 7z def9$ 9 section #baab7;d771 pregnancy-relat$ assi/ance provid$ to a woman :o is eligible = su* assi/ance ?r\gh application ( section #aijb7v77#d77;,a77i7 "u section #bajg7;e77#a71 or any o!r assi/ance "u ! plan 7or waiv]7 provid$ to a woman :o is eligible = su* assi/ance on ! basis ( be+ pregnant7 dur+ ! #cje-;day p]iod t beg9s on ! #fj? day aft] ! la/ day ( h] pregnancy 7includ+ any su* assi/ance provid$ dur+ ! mon? 9 :i* su* p]iod ends71 %all be equal to-- 7,a7 #ajj p]c5t = ! fir/ #bj cal5d> qu>t]s dur+ :i* ?is p>agraph is 9 effect2 & 7,b7 #ij p]c5t = cal5d> qu>t]s !reaft]4 4 7,h7 ,effective date 7i7 ,9 g5]al ,subject to subp>agraph 7,b71 ! am5dm5ts made by ?is subsection %all take effect on ! fir/ day ( ! fir/ cal5d> qu>t] t beg9s on or aft] ! date t is "o ye> aft] ! date ( enactm5t ( ?is ,act4 7ii7 ,exception = ,/ate legislation ,9 ! case ( a ,/ate plan "u title ,,xix ( ! ,social ,security ,act or a ,/ate *ild heal? plan "u title ,,xxi ( su* ,act t ! ,secret>y ( ,heal? & ,human ,s]vices det]m9es requires ,/ate legislation 9 ord] = ! respective plan to meet any requirem5t impos$ by am5dm5ts made by ?is subsection1 ! respective plan %all n be reg>d$ z fail+ to comply ) ! requirem5ts ( su* title solely on ! basis ( its failure to meet su* an additional requirem5t be=e ! fir/ day ( ! fir/ cal5d> qu>t] beg9n+ aft] ! close ( ! fir/ regul> session ( ! ,/ate legislature t beg9s aft] ! date ( enactm5t ( ?is ,act4 ,= purposes ( ! previ\s s5t5ce1 9 ! case ( a ,/ate t has a #b-ye> legislative session1 ea* ye> ( ! session %all be consid]$ to be a sep>ate regul> session ( ! ,/ate legislature4 7#f7 ,regional c5t]s ( excell5ce ,"p ,p ( title ,,iii ( ! ,public ,heal? ,s]vice ,act is am5d$ by add+ at ! end ! foll[+ new section3 #cii,v-#g4 ,regional c5t]s ( excell5ce address+ implicit bias & cultural compet5cy 9 pati5t-provid] int]actions education 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is section1 ! ,secret>y1 9 consultation ) su* o!r ag5cy heads z ! ,secret>y det]m9es appropriate1 %all aw>d coop]ative agreem5ts = ! e/abli%m5t or support ( regional c5t]s ( excell5ce address+ implicit bias & cultural compet5cy 9 pati5t-provid] int]actions education = ! purpose ( enhanc+ & improv+ h[ heal? c>e pr(essionals are educat$ 9 implicit bias & deliv]+ culturally compet5t heal? c>e4 7b7 ,eligibility ,to be eligible to receive a coop]ative agreem5t "u subsection 7a71 an entity %all-- 7#a7 be a public or o!r nonpr(it entity specifi$ by ! ,secret>y t provides educational & tra9+ opportunities = /ud5ts & heal? c>e pr(essionals1 :i* may be a heal? sy/em1 tea*+ hospital1 community heal? c5t]1 m$ical s*ool1 s*ool ( public heal?1 d5tal s*ool1 social "w s*ool1 s*ool ( pr(essional psy*ology1 or any o!r heal? pr(essional s*ool or program at an in/itution ( high] education 7z def9$ 9 section #aja ( ! ,high] ,education ,act ( #aife7 focus$ on ! prev5tion1 treatm5t1 or recov]y ( heal? conditions t contribute to mat]nal mortality & ! prev5tion ( mat]nal mortality & sev]e mat]nal morbidity2 7#b7 demon/rate community engagem5t & p>ticipation1 su* z ?r\gh p>tn]%ips ) home visit+ & case managem5t programs2 & 7#c7 provide to ! ,secret>y su* in=mation1 at su* "t & 9 su* mann]1 z ! ,secret>y may require4 7c7 ,div]sity ,9 aw>d+ a coop]ative agreem5t "u subsection 7a71 ! ,secret>y %all take into acc\nt any regional diff]5ces among eligible entities & make an ef=t to ensure geographic div]sity among aw>d recipi5ts4 7d7 ,dissem9ation ( in=mation 7#a7 ,public availability ,! ,secret>y %all make publicly available on ! int]net website ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices in=mation submitt$ to ! ,secret>y "u subsection 7b77#c74 7#b7 ,evaluation ,! ,secret>y %all evaluate ea* regional c5t] ( excell5ce e/abli%$ or support$ pursuant to subsection 7a7 & dissem9ate ! f9d+s result+ f ea* su* evaluation to ! appropriate public & private entities4 7#c7 ,di/ribution ,! ,secret>y %all %>e evaluations & ov]all f9d+s ) ,/ate dep>tm5ts ( heal? & o!r relevant ,/ate level (fices to in=m ,/ate & local be/ practices4 7e7 ,mat]nal mortality def9$ ,9 ?is section1 ! t]m mat]nal mortality means dea? ( a woman t occurs dur+ pregnancy or )9 ! "o-ye> p]iod foll[+ ! end ( su* pregnancy4 7f7 ,au?orization ( appropriations ,= purposes ( c>ry+ out ?is section1 !re is au?oriz$ to be appropriat$ #e1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 4 7#g7 ,special supplem5tal nutrition program = wom51 infants1 & *ildr5 ,section #ag7;d77#c77;,a77ii7 ( ! ,*ild ,nutrition ,act ( #aiff 7#db ,u4,s4,c4 #aghf7;d77#c77;,a77ii77 is am5d$-- 7,a7 by /rik+ ! clause designation & head+ & all t foll[s ?r\gh ,a ,/ate & ins]t+ ! foll[+3 7ii7 ,wom5 7,i7 ,brea/fe$+ wom5 ,a ,/ate 2 7,b7 9 subclause 7,i7 7z s designat$71 by /rik+ #a ye> & all t foll[s ?r\gh e>li] & ins]t+ #b ye>s po/p>tum2 & 7,c7 by add+ at ! end ! foll[+3 7,,ii7 ,po/p>tum wom5 ,a ,/ate may elect to c]tify a po/p>tum woman = a p]iod ( #b ye>s4 4 7#h7 ,def9itions ,9 ?is section3 7,a7 ,mat]nal mortality ,! t]m mat]nal mortality means dea? ( a woman t occurs dur+ pregnancy or )9 ! "o-ye> p]iod foll[+ ! end ( su* pregnancy4 7,b7 ,sev]e mat]nal morbidity ,! t]m sev]e mat]nal morbidity includes unexpect$ outcomes ( labor & deliv]y t result 9 significant %ort-t]m or long-t]m consequ5ces to a woman's heal?4 7d7 ,increas+ excise taxes on cig>ettes & e/abli%+ excise tax equity among all tobacco product tax rates 7#a7 ,tax p>ity = roll-,y\r-,own tobacco ,section #egja7;g7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ #bd4gh & ins]t+ #di4ef4 7#b7 ,tax p>ity = pipe tobacco ,section #egja7;f7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ #b4hcaa c5ts & ins]t+ #di4ef4 7#c7 ,tax p>ity = smokeless tobacco 7,a7 ,section #egja7;e7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$-- 7i7 9 p>agraph 7#a71 by /rik+ #a4ea & ins]t+ #bf4hd2 7ii7 9 p>agraph 7#b71 by /rik+ #ej4cc c5ts & ins]t+ #aj4gd2 & 7iii7 by add+ at ! end ! foll[+3 7#c7 ,smokeless tobacco sold 9 discrete s+le-use units ,on discrete s+le-use units1 #ajj4ff p] ?\s&4 4 7,b7 ,section #egjb7m7 ( su* ,code is am5d$-- 7i7 9 p>agraph 7#a71 by /rik+ or *ew+ tobacco & ins]t+ 1 *ew+ tobacco1 or discrete s+le-use unit2 7ii7 9 p>agraphs 7#b7 & 7#c71 by ins]t+ t is n a discrete s+le-use unit be=e ! p]iod 9 ea* su* p>agraph2 & 7iii7 by add+ at ! end ! foll[+3 7#d7 ,discrete s+le-use unit ,! t]m discrete s+le-use unit means any product conta9+ tobacco t-- 7,a7 is n int5d$ to be smok$2 & 7,b7 is 9 ! =m ( a loz5ge1 tablet1 pill1 p\*1 dissolvable /rip1 or o!r discrete s+le-use or s+le-dose unit4 4 7#d7 ,tax p>ity = small cig>s ,p>agraph 7#a7 ( section #egja7;a7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ #ej4cc & ins]t+ #ajj4ff4 7#e7 ,tax p>ity = l>ge cig>s 7,a7 ,9 g5]al ,p>agraph 7#b7 ( section #egja7;a7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ #eb4ge p]c5t & all t foll[s ?r\gh ! p]iod & ins]t+ ! foll[+3 #di4ef p] p\nd & a proportionate tax at ! l rate on all fractional p>ts ( a p\nd b n less ?an #aj4jff c5ts p] cig>44 7,b7 ,guidance ,! ,secret>y ( ! ,treasury1 or ! ,secret>y's delegate1 may issue guidance reg>d+ ! appropriate me?od = det]m9+ ! weight ( l>ge cig>s = purposes ( calculat+ ! applicable tax "u section #egja7;a77#b7 ( ! ,int]nal ,rev5ue ,code ( #aihf4 7#f7 ,tax p>ity = roll-,y\r-,own tobacco & c]ta9 process$ tobacco ,subsection 7o7 ( section #egjb ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by ins]t+ 1 & includes process$ tobacco t is remov$ = deliv]y or deliv]$ to a p]son o!r ?an a p]son ) a p]mit provid$ "u section #egac1 b does n include removals ( process$ tobacco = exportation aft] wrapp]s !re(4 7#g7 ,cl>ify+ tax rate = o!r tobacco products 7,a7 ,9 g5]al ,section #egja ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new subsection3 7i7 ,o!r tobacco products ,any product n o!rwise describ$ "u ?is section t has be5 det]m9$ to be a tobacco product by ! ,food & ,drug ,adm9i/ration ?r\gh its au?orities "u ! ,family ,smok+ ,prev5tion & ,tobacco ,control ,act %all be tax$ at a level ( tax equival5t to ! tax rate = cig>ettes on an e/imat$ p] use basis z det]m9$ by ! ,secret>y4 4 7,b7 ,e/abli%+ p] use basis ,= purposes ( section #egja7;i7 ( ! ,int]nal ,rev5ue ,code ( #aihf1 n lat] ?an #ab mon?s aft] ! lat] ( ! date ( ! enactm5t ( ?is ,act or ! date t a product has be5 det]m9$ to be a tobacco product by ! ,food & ,drug ,adm9i/ration1 ! ,secret>y ( ! ,treasury 7or ! ,secret>y ( ! ,treasury's delegate7 %all issue f9al regulations e/abli%+ ! level ( tax = su* product t is equival5t to ! tax rate = cig>ettes on an e/imat$ p] use basis4 7#h7 ,cl>ify+ def9ition ( tobacco products 7,a7 ,9 g5]al ,subsection 7c7 ( section #egjb ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ to read z foll[s3 7c7 ,tobacco products ,! t]m tobacco products means-- 7#a7 cig>s1 cig>ettes1 smokeless tobacco1 pipe tobacco1 & roll-y\r-own tobacco1 & 7#b7 any o!r product subject to tax pursuant to section #egja7;i74 4 7,b7 ,con=m+ am5dm5ts ,subsection 7d7 ( section #egjb ( su* ,code is am5d$ by /rik+ cig>s1 cig>ettes1 smokeless tobacco1 pipe tobacco1 or roll-y\r-own tobacco ea* place x appe>s & ins]t+ tobacco products4 7#i7 ,increas+ tax on cig>ettes 7,a7 ,small cig>ettes ,section #egja7;b77#a7 ( su* ,code is am5d$ by /rik+ #ej4cc & ins]t+ #ajj4ff4 7,b7 ,l>ge cig>ettes ,section #egja7;b77#b7 ( su* ,code is am5d$ by /rik+ #aje4fi & ins]t+ #baa4ch4 7#aj7 ,tax rates adju/$ = inflation ,section #egja ( su* ,code1 z am5d$ by subsection 7g71 is am5d$ by add+ at ! end ! foll[+ new subsection3 7j7 ,inflation adju/m5t 7#a7 ,9 g5]al ,9 ! case ( any cal5d> ye> beg9n+ aft] #bjba1 ! doll> am\nts provid$ "u ?is *apt] %all ea* be increas$ by an am\nt equal to-- 7,a7 su* doll> am\nt1 multipli$ by 7,b7 ! co/-(-liv+ adju/m5t det]m9$ "u section #a7;f77#c7 = ! cal5d> ye>1 det]m9$ by sub/itut+ #8cal5d> ye> #bjag' = #8cal5d> ye> #bjaf' 9 subp>agraph 7,a77ii7 !re(4 7#b7 ,r\nd+ ,if any am\nt z adju/$ "u p>agraph 7#a7 is n a multiple ( #j4ja1 su* am\nt %all be r\nd$ to ! next highe/ multiple ( #j4ja4 4 7#aa7 ,floor ,/ocks ,taxes 7,a7 ,imposition ( tax ,on tobacco products manufactur$ 9 or import$ into ! ,unit$ ,/ates :i* are remov$ be=e any tax increase date & held on su* date = sale by any p]son1 !re is h]eby impos$ a tax 9 an am\nt equal to ! excess (-- 7i7 ! tax :i* w\ld be impos$ "u section #egja ( ! ,int]nal ,rev5ue ,code ( #aihf on ! article if ! article _h be5 remov$ on su* date1 ov] 7ii7 ! prior tax 7if any7 impos$ "u section #egja ( su* ,code on su* article4 7,b7 ,cr$it aga9/ tax ,ea* p]son %all be all[$ z a cr$it aga9/ ! taxes impos$ by p>agraph 7#a7 an am\nt equal to #ejj4 ,su* cr$it %all n exce$ ! am\nt ( taxes impos$ by p>agraph 7#a7 on su* date = :i* su* p]son is liable4 7,c7 ,liability = tax & me?od ( paym5t 7i7 ,liability = tax ,a p]son hold+ tobacco products on any tax increase date to :i* any tax impos$ by p>agraph 7#a7 applies %all be liable = su* tax4 7ii7 ,me?od ( paym5t ,! tax impos$ by p>agraph 7#a7 %all be paid 9 su* mann] z ! ,secret>y %all prescribe by regulations4 7iii7 ,"t = paym5t ,! tax impos$ by p>agraph 7#a7 %all be paid on or be=e ! date t is #abj days aft] ! effective date ( ! tax rate increase4 7,d7 ,articles 9 =eign trade zones ,not)/&+ ! ,act ( ,june #ah1 #aicd 7commonly kn[n z ! ,=eign ,trade ,zone ,act1 #dh ,/at4 #iih1 #ai ,u4,s4,c4 #ha;a et seq471 or any o!r provision ( law1 any article :i* is locat$ 9 a =eign trade zone on any tax increase date %all be subject to ! tax impos$ by p>agraph 7#a7 if-- 7i7 int]nal rev5ue taxes h be5 det]m9$1 or cu/oms duties liquidat$1 ) respect to su* article be=e su* date pursuant to a reque/ made "u ! #a/ proviso ( section #c7;a7 ( su* ,act2 or 7ii7 su* article is held on su* date "u ! sup]vision ( an (fic] ( ! ,unit$ ,/ates ,cu/oms & ,bord] ,protection ( ! ,dep>tm5t ( ,homel& ,security pursuant to ! #b;d proviso ( su* section #c7;a74 7,e7 ,def9itions ,= purposes ( ?is subsection-- 7i7 ,9 g5]al ,any t]m us$ 9 ?is subsection :i* is also us$ 9 section #egjb ( su* ,code %all h ! same mean+ z su* t]m has 9 su* section4 7ii7 ,tax increase date ,! t]m tax increase date means ! effective date ( any increase 9 any tobacco product excise tax rate pursuant to ! am5dm5ts made by ?is section 7o!r ?an subsection 7j7 !re(74 7iii7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ! ,treasury or ! ,secret>y's delegate4 7,f7 ,controll$ gr\ps ,rules simil> to ! rules ( section #ejfa7;e77#c7 ( su* ,code %all apply = purposes ( ?is subsection4 7,g7 ,o!r laws applicable ,all provisions ( law1 includ+ p5alties1 applicable ) respect to ! taxes impos$ by section #egja ( su* ,code %all1 ins(> z applicable & n inconsi/5t ) ! provisions ( ?is subsection1 apply to ! floor /ocks taxes impos$ by p>agraph 7#a71 to ! same ext5t z if su* taxes 7 impos$ by su* section #egja4 ,! ,secret>y may treat any p]son :o bore ! ultimate burd5 ( ! tax impos$ by p>agraph 7#a7 z ! p]son to :om a cr$it or refund "u su* provisions may be all[$ or made4 7#ab7 ,effective dates 7,a7 ,9 g5]al ,except z provid$ 9 p>agraphs 7#b7 ?r\gh 7#d71 ! am5dm5ts made by ?is section %all apply to articles remov$ 7z def9$ 9 section #egjb7;j7 ( ! ,int]nal ,rev5ue ,code ( #aihf7 aft] ! la/ day ( ! mon? :i* includes ! date ( ! enactm5t ( ?is ,act4 7,b7 ,discrete s+le-use units & process$ tobacco ,! am5dm5ts made by subsections 7c77#a77;,c71 7c77#b71 & 7f7 %all apply to articles remov$ 7z def9$ 9 section #egjb7;j7 ( ! ,int]nal ,rev5ue ,code ( #aihf7 aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ?is ,act4 7,c7 ,l>ge cig>s ,! am5dm5ts made by subsection 7e7 %all apply to articles remov$ aft] ,decemb] #ca1 #bjba4 7,d7 ,o!r tobacco products ,! am5dm5ts made by subsection 7g77#a7 %all apply to products remov$ aft] ! la/ day ( ! mon? :i* includes ! date t ! ,secret>y ( ! ,treasury 7or ! ,secret>y ( ! ,treasury's delegate7 issues f9al regulations e/abli%+ ! level ( tax = su* product4 #ejd4 ,all[+ = m$ical assi/ance "u ,m$icaid = inmates dur+ #cj-;day p]iod prec$+ release 7a7 ,9 g5]al ,! subdivision 7,a7 foll[+ p>agraph 7#cj7 ( section #aije7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is am5d$ by ins]t+ & except dur+ ! #cj-;day p]iod prec$+ ! date ( release ( su* individual f su* public in/itution aft] m$ical in/itution4 7b7 ,report ,n lat] ?an ,june #cj1 #bjbb1 ! ,m$icaid & ,,*ip ,paym5t & ,access ,commission %all submit a report to ,congress on ! ,m$icaid inmate exclusion "u ! subdivision 7,a7 foll[+ p>agraph 7#cj7 ( section #aije7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a774 ,su* report may1 to ! ext5t practicable1 include ! foll[+ in=mation3 7#a7 ,! numb] ( inc>c]at$ individuals :o w\ld o!rwise be eligible to enroll = m$ical assi/ance "u a ,/ate plan approv$ "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7or a waiv] ( su* a plan74 7#b7 ,access to heal? c>e = inc>c]at$ individuals1 includ+ a description ( m$ical s]vices g5]ally available to inc>c]at$ individuals4 7#c7 ,a description ( curr5t practices relat$ to ! dis*>ge ( inc>c]at$ individuals1 includ+ h[ prisons int]act ) ,/ate ,m$icaid ag5cies to ensure t su* individuals :o are eligible to enroll = m$ical assi/ance "u a ,/ate plan or waiv] describ$ 9 p>agraph 7#a7 are s enroll$4 7#d7 ,if det]m9$ appropriate by ! ,commission1 recomm5dations = ,congress1 ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 or ,/ates reg>d+ ! ,m$icaid inmate exclusion4 7#e7 ,any o!r in=mation t ! ,commission det]m9es w\ld be useful to ,congress4 #eje4 ,provid+ = imm$iate ,m$icaid eligibility = =m] fo/] y\? ,section #ajjb7;a77#b7 ( ! ,,support = ,pati5ts & ,communities ,act 7,public ,law #aae-bga7 is am5d$ by /rik+ ,janu>y #a1 #bjbc & ins]t+ ! date ( enactm5t ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj4 #ejf4 ,exp&$ cov]age = =m] fo/] y\? 7a7 ,cov]age cont9uity = =m] fo/] c>e *ildr5 up to age #bf 7#a7 ,9 g5]al ,section #ajjb7;a77#a77;,b7 ( ! ,,support = ,pati5ts & ,communities ,act 7,public ,law #aae-bga7 is am5d$ by /rik+ all t foll[s aft] item 7cc71 & ins]t+ ! foll[+3 by /rik+ responsibility ( ! ,/ate & all t foll[s ?r\gh #dge7h77;,b77iii72 & & ins]t+ responsibility ( a ,/ate on ! date ( atta9+ #ah ye>s ( age 7or su* high] age z su* ,/ate has elect$ "u section #dge7h77;,b77iii771 or :o 7 9 su* c>e at any age b subsequ5tly left su* c>e to ent] into a legal gu>dian%ip ) a k9%ip c>egiv] 7)\t reg>d to :e!r k9%ip gu>dian%ip paym5ts are be+ made on behalf ( ! *ild "u ?is "p7 or 7 emancipat$ f su* c>e prior to atta9+ age #ah24 7#b7 ,am5dm5ts to ,social ,security ,act 7,a7 ,9 g5]al ,section #aijb7;a77#aj77;,a77i77,,ix7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77i77,,ix771 z am5d$ by section #ajjb7;a7 ( ! ,,support = ,pati5ts & ,communities ,act 7,public ,law #aae-bga71 is am5d$-- 7i7 9 item 7bb71 by /rik+ ! semicolon at ! end & ins]t+ 2 &2 & 7ii7 by /rik+ item 7dd74 7,b7 ,effective date ,! am5dm5ts made by ?is p>agraph %all take effect on ,janu>y #a1 #bjbc4 7b7 ,outrea* ef=ts = enrollm5t ( =m] fo/] *ildr5 ,section #aijb7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77 is am5d$-- 7#a7 9 p>agraph 7#he71 by /rik+ 2 & & ins]t+ a semicolon2 7#b7 9 p>agraph 7#hf71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7#c7 by ins]t+ aft] p>agraph 7#hf7 ! foll[+ new p>agraph3 7#hg7 n lat] ?an ,janu>y #a1 #bjbj1 e/abli% an outrea* & enrollm5t program1 9 coord9ation ) ! ,/ate ag5cy responsible = adm9i/]+ ! ,/ate plan "u "p ,e ( title ,,iv & any o!r appropriate or int]e/$ ag5cies1 design$ to increase ! enrollm5t ( individuals :o are eligible = m$ical assi/ance "u ! ,/ate plan "u p>agraph 7#aj77;,a77i77,,ix7 9 accordance ) be/ practices e/abli%$ by ! ,secret>y4 4 #ejg4 ,remov+ citiz5%ip & immigration b>ri]s to access to af=dable heal? c>e "u ,,aca 7a7 ,9 g5]al 7#a7 ,premium tax cr$its ,section #cf;,b ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$-- 7,a7 9 subsection 7c77#a77;,b7-- 7i7 by am5d+ ! head+ to read z foll[s3 ,special rule = c]ta9 individuals ineligible = ,m$icaid due to /atus1 & 7ii7 9 clause 7ii71 by /rik+ lawfully pres5t 9 ! ,unit$ ,/ates1 b & ins]t+ :o1 & 7,b7 by /rik+ subsection 7e74 7#b7 ,co/-%>+ r$uctions ,section #adjb ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjga7 is am5d$ by /rik+ subsection 7e74 7#c7 ,basic heal? program eligibility ,section #acca7;e77#a77;,b7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjea7;e77#a77;,b77 is am5d$ by /rik+ lawfully pres5t 9 ! ,unit$ ,/ates4 7#d7 ,re/rictions on ,f$]al paym5ts ,section #adab ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjhb7 is am5d$ by /rik+ subsection 7d74 7#e7 ,requirem5t to ma9ta9 m9imum ess5tial cov]age ,section #ejjj;,a7d7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by /rik+ p>agraph 7#c7 & by r$esignat+ p>agraph 7#d7 z p>agraph 7#c74 7b7 ,con=m+ am5dm5ts 7#a7 ,section #adaa7;a7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjha7;a77 is am5d$ by /rik+ p>agraph 7#a7 & r$esignat+ p>agraphs 7#b71 7#c71 & 7#d7 z p>agraphs 7#a71 7#b71 & 7#c71 respectively4 7#b7 ,section #acab7;f7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjcb7;f77 is am5d$-- 7,a7 9 ! head+1 by /rik+ 2 access limit$ to citiz5s & lawful resid5ts2 & 7,b7 by /rik+ p>agraph 7#c74 #ejh4 ,m$icaid 9 ! t]ritories 7a7 ,elim9ation ( g5]al ,m$icaid fund+ limitations 7cap7 = t]ritories 7#a7 ,9 g5]al ,section #aajh ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acjh7 is am5d$-- 7,a7 9 subsection 7f71 9 ! matt] prec$+ p>agraph 7#a71 by /rik+ subsection 7g7 & ins]t+ subsections 7g7 & 7h72 7,b7 9 subsection 7g77#b71 9 ! matt] prec$+ subp>agraph 7,a71 by ins]t+ & subsection 7h7 aft] p>agraphs 7#c7 & 7#e72 & 7,c7 by add+ at ! end ! foll[+ new subsection3 7h7 ,sunset ( ,m$icaid fund+ limitations = ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa ,subsections 7f7 & 7g7 %all n apply to ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa beg9n+ ) fiscal ye> #bjbj4 4 7#b7 ,con=m+ am5dm5ts 7,a7 ,section #aijb7;j7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7j77 is am5d$ by /rik+ 1 ! limitation 9 section #aajh7;f714 7,b7 ,section #aijc7u7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7u77 is am5d$ by /rik+ p>agraph 7#d74 7,c7 ,section #acbc7;c77#a7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjdc7;c77#a77 is am5d$ by /rik+ #bjai & ins]t+ #bjah4 7#c7 ,effective date ,! am5dm5ts made by ?is section %all apply beg9n+ ) fiscal ye> #bjba4 7b7 ,elim9ation ( specific ,f$]al m$ical assi/ance p]c5tage 7,,fmap7 limitation = t]ritories ,section #aije7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7b77 is am5d$1 9 clause 7#b71 by ins]t+ = fiscal ye>s be=e fiscal ye> #bjbj aft] ,am]ican ,samoa4 7c7 ,application ( ,m$icaid waiv] au?ority to all ( ! t]ritories 7#a7 ,9 g5]al ,section #aijb7;j7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7j77 is am5d$-- 7,a7 by /rik+ ,am]ican ,samoa & ! ,nor!rn ,m>iana ,isl&s & ins]t+ ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa2 7,b7 by /rik+ ,am]ican ,samoa or ! ,nor!rn ,m>iana ,isl&s & ins]t+ ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1 or ,am]ican ,samoa2 7,c7 by ins]t+ 7#a7 aft] 7j72 7,d7 by ins]t+ except z o!rwise provid$ 9 ?is subsection1 aft] ,not)/&+ any o!r requirem5t ( ?is title2 & 7,e7 by add+ at ! end ! foll[+3 7#b7 ,! ,secret>y may n waive "u ?is subsection ! requirem5t ( subsection 7a77#aj77;,a77i77,,ix7 7relat+ to cov]age ( adults =m]ly "u fo/] c>e7 ) respect to any t]ritory4 4 7#b7 ,effective date ,! am5dm5ts made by ?is section %all apply beg9n+ ,octob] #a1 #bjba4 7d7 ,p]mitt+ ,m$icaid ,,d% allotm5ts = t]ritories ,section #aibc7;f7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7 is am5d$-- 7#a7 9 p>agraph 7#f71 by add+ at ! end ! foll[+ new subp>agraph3 7,c7 ,t]ritories 7i7 ,fiscal ye> #bjbj ,= fiscal ye> #bjbj1 ! ,,d% allotm5t = ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa %all be> ! same ratio to #cjj1jjj1jjj z ! ratio ( ! numb] ( individuals :o are l[-income or un9sur$ & resid+ 9 su* respective t]ritory 7z e/imat$ f "t to "t by ! ,secret>y7 be>s to ! sums ( ! numb] ( su* individuals resid+ 9 all ( ! t]ritories4 7ii7 ,subsequ5t fiscal ye> ,= ea* subsequ5t fiscal ye>1 ! ,,d% allotm5t = ea* su* t]ritory is subject to an increase 9 accordance ) p>agraph 7#b74 2 & 7#b7 9 p>agraph 7#i71 by ins]t+ be=e ! p]iod at ! end ! foll[+3 1 & includes1 beg9n+ ) fiscal ye> #bjba1 ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 ,guam1 ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa4 #eji4 ,remov+ ,m$ic>e b>ri] to heal? c>e 7a7 ,"p ,a ,section #ahah7;a77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#b7;a77#c77 is am5d$ by /rik+ an ali5 & all t foll[s ?r\gh "u ?is section & ins]t+ an individual :o is lawfully pres5t 9 ! ,unit$ ,/ates4 7b7 ,"p ,b ,section #ahcf7b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieo7#b77 is am5d$ by /rik+ an ali5 & all t foll[s ?r\gh "u ?is "p & ins]t+ an individual :o is lawfully pres5t 9 ! ,unit$ ,/ates4 #eaj4 ,remov+ b>ri]s to heal? c>e & nutrition assi/ance = *ildr51 pregnant p]sons1 & lawfully pres5t individuals 7a7 ,m$icaid ,section #aijc7v7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77 is am5d$ by /rik+ p>agraph 7#d7 & ins]t+ ! foll[+ new p>agraph3 7#d7 7,a7 ,not)/&+ sections #dja7;a71 #djb7;b71 #djc1 & #dba ( ! ,p]sonal ,responsibility & ,"w ,opportunity ,reconciliation ,act ( #aiif & p>agraph 7#a71 paym5t %all be made to a ,/ate "u ?is section = m$ical assi/ance furni%$ to an ali5 "u ?is title 7includ+ an ali5 describ$ 9 su* p>agraph7 :o meets any ( ! foll[+ conditions3 7i7 ,! ali5 is o!rwise eligible = su* assi/ance "u ! ,/ate plan approv$ "u ?is title 7o!r ?an ! requirem5t ( ! receipt ( aid or assi/ance "u title ,,iv1 supplem5tal security income b5efits "u title ,,xvi1 or a ,/ate supplem5t>y paym5t7 )9 ei!r or bo? ( ! foll[+ eligibility categories3 7,i7 ,*ildr5 "u #ba ye>s ( age1 includ+ any optional t>get$ l[-income *ild 7z su* t]m is def9$ 9 section #aije7u77#b77;,b774 7,,ii7 ,pregnant p]sons dur+ pregnancy & dur+ ! #ab-mon? p]iod beg9n+ on ! la/ day ( ! pregnancy4 7ii7 ,! ali5 is lawfully pres5t 9 ! ,unit$ ,/ates4 7,b7 ,no debt %all accrue "u an affidavit ( support aga9/ any sponsor ( an ali5 :o meets ! conditions specifi$ 9 subp>agraph 7,a7 on ! basis ( ! provision ( m$ical assi/ance to su* ali5 "u ?is p>agraph & ! co/ ( su* assi/ance %all n be consid]$ z an unreimburs$ co/4 4 7b7 ,,s*ip ,subp>agraph 7,n7 ( section #bajg7;e77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7e77#a77 is am5d$ to read z foll[s3 7,n7 ,p>agraph 7#d7 ( section #aijc7v7 7relat+ to cov]age ( categories ( *ildr51 pregnant p]sons1 & o!r lawfully pres5t individuals74 4 7c7 ,supplem5tal nutrition assi/ance ,not)/&+ sections #dja7;a71 #djb7;a71 & #djc7;a7 ( ! ,p]sonal ,responsibility & ,"w ,opportunity ,reconciliation ,act ( #aiif 7#h ,u4,s4,c4 #afaa7;a72 #afab7;a72 #afac7;a77 & section #f7;f7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjae7;f771 p]sons :o are lawfully pres5t 9 ! ,unit$ ,/ates %all be n be ineligible = b5efits "u ! supplem5tal nutrition assi/ance program on ! basis ( _! immigration /atus or date ( entry into ! ,unit$ ,/ates4 7d7 ,eligibility = families ) *ildr5 ,section #dba7;d77#c7 ( ! ,p]sonal ,responsibility & ,"w ,opportunity ,reconciliation ,act ( #aiif 7#h ,u4,s4,c4 #afca7;d77#c77 is am5d$ by /rik+ to ! ext5t t a qualifi$ ali5 is eligible "u section #djb7;a77#b77;,j7 & ins]t+1 to ! ext5t t a *ild is a memb] ( a h\sehold "u ! supplem5tal nutrition assi/ance program4 7e7 ,ensur+ prop] scre5+ ,section #aa7;e77#b77;,b7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjbj7;e77#b77;,b77 is am5d$-- 7#a7 by r$esignat+ clauses 7vi7 & 7vii7 z clauses 7vii7 & 7viii72 & 7#b7 by ins]t+ aft] clause 7v7 ! foll[+3 7vi7 %all provide a me?od = implem5t+ section #dba ( ! ,p]sonal ,responsibility & ,"w ,opportunity ,reconciliation ,act ( #aiif 7#h ,u4,s4,c4 #afca7 t does n require any unnecess>y in=mation f p]sons :o may be exempt f t provision2 4 #eaa4 ,repeal ( requirem5t = docum5tation evid5c+ citiz5%ip or nationality "u ! ,m$icaid program 7a7 ,repeal ,subsections 7i77#bb7 & 7x7 ( section #aijc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 are ea* repeal$4 7b7 ,con=m+ am5dm5ts 7#a7 ,/ate paym5ts = m$ical assi/ance ,section #aijb ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$-- 7,a7 by am5d+ p>agraph 7#df7 ( subsection 7a7 to read z foll[s3 7#df7 provide t in=mation is reque/$ & ex*ang$ = purposes ( income & eligibility v]ification 9 accordance ) a ,/ate sy/em :i* meets ! requirem5ts ( section #aacg ( ?is ,act2 2 7,b7 9 subsection 7e77#ac77;,a77i7-- 7i7 9 ! matt] prec$+ subclause 7,i71 by /rik+ sections #aijb7;a77#df77;,b7 & #aacg7;d7 & ins]t+ section #aacg7;d72 & 7ii7 9 subclause 7,,iv71 by /rik+ #aijb7;a77#df77;,b7 or2 & 7,c7 by /rik+ subsection 7ee74 7#b7 ,paym5t to /ates ,section #aijc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 is am5d$-- 7,a7 9 subsection 7i71 by r$esignat+ p>agraphs 7#bc7 ?r\gh 7#bf7 z p>agraphs 7#bb7 ?r\gh 7#be71 respectively2 & 7,b7 by r$esignat+ subsections 7y7 & 7z7 z subsections 7x7 & 7y71 respectively4 7#c7 ,repeal ,subsection 7c7 ( section #fjcf ( ! ,deficit ,r$uction ,act ( #bjje 7#db ,u4,s4,c4 #acif;b note7 is repeal$4 7c7 ,effective date ,! am5dm5ts made by ?is section %all take effect z if includ$ 9 ! enactm5t ( ! ,deficit ,r$uction ,act ( #bjje4 ,,vi ,community ,bas$ ,grants #fja4 ,grants = racial & e?nic approa*es to community heal? 7a7 ,purpose ,x is ! purpose ( ?is section to aw>d grants to assi/ communities 9 mobiliz+ & organiz+ res\rces 9 support ( effective & su/a9able programs t w r$uce or elim9ate disp>ities 9 heal? & heal? c>e exp]i5c$ by racial & e?nic m9ority individuals4 7b7 ,au?ority ,to ,aw>d ,grants ,! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration 7ref]r$ to 9 ?is section z ! ,secret>y71 %all aw>d grants to eligible entities to assi/ 9 design+1 implem5t+1 & evaluat+ culturally & l+ui/ically appropriate1 sci5ce-bas$1 & community-driv5 su/a9able /rategies to elim9ate racial & e?nic heal? & heal? c>e disp>ities4 7c7 ,eligible ,entities ,to be eligible to receive a grant "u ?is section1 an entity %all-- 7#a7 repres5t a coalition-- 7,a7 ^: pr9cipal purpose is to develop & implem5t int]v5tions to r$uce or elim9ate a heal? or heal? c>e disp>ity 9 a t>get$ racial or e?nic m9ority gr\p 9 ! community s]v$ by ! coalition2 & 7,b7 t includes-- 7i7 memb]s select$ f among-- 7,i7 public heal? dep>tm5ts2 7,,ii7 community-bas$ organizations2 7,,iii7 univ]sity & rese>* organizations2 7,,iv7 ,indian tribes or tribal organizations 7z su* t]ms are def9$ 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 ! ,indian ,heal? ,s]vice1 or any o!r organization t s]ves ,alaska ,natives2 & 7,v7 int]e/$ public or private heal? c>e provid]s or organizations z det]m9$ appropriate by ! ,secret>y2 & 7ii7 at lea/ #a memb] f a community-bas$ organization t repres5ts ! t>get$ racial or e?nic m9ority gr\p2 & 7#b7 submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require1 :i* %all include-- 7,a7 a description ( ! t>get$ racial or e?nic populations 9 ! community to be s]v$ "u ! grant2 7,b7 a description ( at lea/ #a heal? disp>ity t exi/s 9 ! racial or e?nic t>get$ populations1 includ+ heal? issues su* z infant mortality1 brea/ & c]vical canc] scre5+ & managem5t1 musculoskeletal diseases & obesity1 pro/ate canc] scre5+ & managem5t1 c>diovascul> disease1 diabetes1 *ild & adult immunization levels1 oral disease1 or o!r heal? priority areas z designat$ by ! ,secret>y2 & 7,c7 a demon/ration ( a prov5 record ( accompli%m5t ( ! coalition memb]s 9 s]v+ & work+ ) ! t>get$ community4 7d7 ,su/a9ability ,! ,secret>y %all give priority to an eligible entity "u ?is section if ! entity agrees t1 ) respect to ! co/s to be incurr$ by ! entity 9 c>ry+ out ! activities = :i* ! grant 0 aw>d$1 ! entity 7& ea* ( ! p>ticipat+ p>tn]s 9 ! coalition repres5t$ by ! entity7 w ma9ta9 its exp5ditures ( non-,f$]al funds = su* activities at a level t is n less ?an ! level ( su* exp5ditures dur+ ! fiscal ye> imm$iately prec$+ ! fir/ fiscal ye> = :i* ! grant is aw>d$4 7e7 ,nonduplication ,any funds provid$ to an eligible entity ?r\gh a grant "u ?is section %all-- 7#a7 supplem5t1 n supplant1 any o!r ,f$]al funds made available to ! entity = ! purposes ( ?is section2 & 7#b7 n be us$ to duplicate ! activities ( any o!r heal? disp>ity grant program "u ?is ,act1 includ+ an am5dm5t made by ?is ,act4 7f7 ,te*nical ,assi/ance ,! ,secret>y may1 ei!r directly or by grant or contract1 provide any entity t receives a grant "u ?is section ) te*nical & o!r nonf9ancial assi/ance necess>y to meet ! requirem5ts ( ?is section4 7g7 ,dissem9ation ,! ,secret>y %all enc\rage & enable eligible entities receiv+ grants "u ?is section to %>e be/ practices1 evaluation results1 & reports ) communities n affiliat$ ) su* entities1 by us+ ! ,int]net1 conf]5ces1 & o!r p]t95t in=mation reg>d+ ! projects fund$ by ?is section1 includ+ ?r\gh us+ outrea* ef=ts ( ! ,(fice ( ,m9ority ,heal? & ! ,c5t]s = ,disease ,control & ,prev5tion4 7h7 ,adm9i/rative ,burd5s ,! ,secret>y %all make e ef=t to m9imize duplicative or unnecess>y adm9i/rative burd5s on eligible entities receiv+ grants "u ?is section4 7i7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ su* sums z may be necess>y to c>ry out ?is section4 #fjb4 ,grants to promote heal? = und]s]v$ communities ,"p ,q ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bhj;g et seq47 is am5d$ by add+ at ! end ! foll[+3 #cii,z-#c4 ,grants to promote heal? = und]s]v$ communities 7a7 ,grants ,au?oriz$ ,! ,secret>y1 9 collaboration ) ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration & o!r ,f$]al (ficials det]m9$ appropriate by ! ,secret>y1 is au?oriz$ to aw>d grants to eligible entities-- 7#a7 to promote heal? = und]s]v$ communities1 ) pref]5ce giv5 to projects t b5efit racial & e?nic m9ority wom51 racial & e?nic m9ority *ildr51 adolesc5ts1 & lesbian1 gay1 bisexual1 transg5d]1 que]1 or que/ion+ communities2 & 7#b7 to /r5g!n heal? outrea* initiatives 9 m$ically und]s]v$ communities1 includ+ l+ui/ically isolat$ populations4 7b7 ,use ( ,funds ,grants aw>d$ pursuant to subsection 7a7 may be us$ to support ! activities ( community heal? work]s1 includ+ su* activities-- 7#a7 to educate & provide outrea* reg>d+ enrollm5t 9 heal? insurance includ+ ! ,/ate ,*ildr5's ,heal? ,insurance ,program "u title ,,xxi ( ! ,social ,security ,act1 ,m$ic>e "u title ,,xviii ( su* ,act1 & ,m$icaid "u title ,,xix ( su* ,act2 7#b7 to educate & provide outrea* 9 a community sett+ reg>d+ heal? problems preval5t among und]s]v$ communities1 & especially among racial & e?nic m9ority wom51 racial & e?nic m9ority *ildr51 adolesc5ts1 & lesbian1 gay1 bisexual1 transg5d]1 que]1 or que/ion+ communities2 7#c7 to educate & provide exp]i5tial le>n+ opportunities & t>get risk factors & heal?y behaviors t imp$e or contribute to a*iev+ positive heal? outcomes1 includ+-- 7,a7 heal?y nutrition2 7,b7 physical activity2 7,c7 ov]weight or obesity2 7,d7 tobacco use1 includ+ ! use ( e-cig>ettes & vap+2 7,e7 alcohol & sub/ance use2 7,f7 injury & viol5ce2 7,g7 sexual heal?2 7,h7 m5tal heal?2 7,i7 musculoskeletal heal? & ar?ritis2 7,j7 pr5atal & po/natal c>e2 7,k7 d5tal & oral heal?2 7,l7 und]/&+ in=m$ cons5t2 7,m7 /igma2 & 7,n7 environm5tal haz>ds2 7#d7 to promote community wellness & aw>5ess2 & 7#e7 to educate & ref] t>get populations to appropriate heal? c>e ag5cies & community-bas$ programs & organizations 9 ord] to increase access to quality heal? c>e s]vices1 includ+ prev5tive heal? s]vices4 7c7 ,application 7#a7 ,9 g5]al ,ea* eligible entity t desires to receive a grant "u subsection 7a7 %all submit an application to ! ,secret>y1 at su* "t1 9 su* mann]1 & accompani$ by su* additional in=mation z ! ,secret>y may require4 7#b7 ,cont5ts ,ea* application submitt$ pursuant to p>agraph 7#a7 %all-- 7,a7 describe ! activities = :i* assi/ance "u ?is section is s\ght2 7,b7 conta9 an assurance t1 ) respect to ea* community heal? work] program receiv+ funds "u ! grant aw>d$1 su* program provides 9-language tra9+ & sup]vision to community heal? work]s to enable su* work]s to provide au?oriz$ program activities 9 7at lea/7 ! mo/ commonly us$ languages )9 a p>ticul> geographic region2 7,c7 conta9 an assurance t ! applicant w evaluate ! effectiv5ess ( community heal? work] programs receiv+ funds "u ! grant2 7,d7 conta9 an assurance t ea* community heal? work] program receiv+ funds "u ! grant w provide culturally compet5t s]vices 9 ! l+ui/ic context mo/ appropriate = ! individuals s]v$ by ! program2 7,e7 conta9 a plan to docum5t & dissem9ate project descriptions & results to o!r ,/ates & organizations z id5tifi$ by ! ,secret>y2 & 7,f7 describe plans to enhance ! capacity ( individuals to utilize heal? s]vices & heal?-relat$ social s]vices "u ,f$]al1 ,/ate1 & local programs by-- 7i7 assi/+ individuals 9 e/abli%+ eligibility "u ! programs & 9 receiv+ ! s]vices or o!r b5efits ( ! programs2 & 7ii7 provid+ o!r s]vices1 z ! ,secret>y det]m9es to be appropriate1 :i* may include transportation & translation s]vices4 7d7 ,priority ,9 aw>d+ grants "u subsection 7a71 ! ,secret>y %all give priority to ^? applicants-- 7#a7 :o propose to t>get geographic areas t-- 7,a7 7i7 h a high p]c5tage ( resid5ts :o are un9sur$ or und]9sur$ 7if ! t>get$ geographic area is locat$ 9 a ,/ate t has elect$ to make m$ical assi/ance available "u section #aijb7;a77#aj77;,a77i77,,viii7 ( ! ,social ,security ,act to individuals describ$ 9 su* section72 7ii7 h a high p]c5tage ( und]9sur$ resid5ts 9 a p>ticul> geographic area 7if ! t>get$ geographic area is locat$ 9 a ,/ate t has n s elect$72 or 7iii7 h a high numb] ( h\seholds exp]i5c+ extreme pov]ty2 & 7,b7 h a high p]c5tage ( families = :om ,engli% is n _! prim>y language or includ+ small] limit$ ,engli%-pr(ici5t communities )9 ! region t are n o!rwise rea*$ by l+ui/ically appropriate heal? s]vices2 7#b7 ) exp]i5ce 9 provid+ heal? or heal?-relat$ social s]vices to individuals :o are und]s]v$ ) respect to su* s]vices2 & 7#c7 ) docum5t$ community activity & exp]i5ce ) community heal? work]s4 7e7 ,collaboration ) academic in/itutions ,! ,secret>y %all enc\rage community heal? work] programs receiv+ funds "u ?is section to collaborate ) academic in/itutions1 includ+ m9ority-s]v+ in/itutions4 ,no?+ 9 ?is section %all be con/ru$ to require su* collaboration4 7f7 ,quality assurance & co/ effectiv5ess ,! ,secret>y %all e/abli% guidel9es = ensur+ ! quality ( ! tra9+ & sup]vision ( community heal? work]s "u ! programs fund$ "u ?is section & = ensur+ ! co/ effectiv5ess ( su* programs4 7g7 ,monitor+ ,! ,secret>y %all monitor community heal? work] programs id5tifi$ 9 approv$ applications & %all det]m9e :e!r su* programs are 9 compliance ) ! guidel9es e/abli%$ "u subsection 7f74 7h7 ,te*nical assi/ance ,! ,secret>y may provide te*nical assi/ance to community heal? work] programs id5tifi$ 9 approv$ applications ) respect to plann+1 develop+1 & op]at+ programs "u ! grant4 7i7 ,report to ,congress 7#a7 ,9 g5]al ,n lat] ?an #d ye>s aft] ! date on :i* ! ,secret>y fir/ aw>ds grants "u subsection 7a71 ! ,secret>y %all submit to ,congress a report reg>d+ ! grant project4 7#b7 ,cont5ts ,! report requir$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a description ( ! programs = :i* grant funds 7 us$4 7,b7 ,! numb] ( individuals s]v$4 7,c7 ,an evaluation (-- 7i7 ! effectiv5ess ( ^! programs2 7ii7 ! co/ ( ^! programs2 & 7iii7 ! impact ( ^! programs on ! heal? outcomes ( ! community resid5ts4 7,d7 ,recomm5dations = su/a9+ ! community heal? work] programs develop$ or assi/$ "u ?is section4 7,e7 ,recomm5dations reg>d+ tra9+ to enhance c>e] opportunities = community heal? work]s4 7j7 ,def9itions ,9 ?is section3 7#a7 ,community heal? work] ,! t]m community heal? work] means an individual :o promotes heal? or nutrition )9 ! community 9 :i* ! individual resides-- 7,a7 by s]v+ z a liaison betwe5 communities & heal? c>e ag5cies2 7,b7 by provid+ guidance & social assi/ance to community resid5ts2 7,c7 by enhanc+ community resid5ts' ability to effectively communicate ) heal? c>e provid]s2 7,d7 by provid+ culturally & l+ui/ically appropriate heal? or nutrition education2 7,e7 by advocat+ = individual & community heal?1 includ+ d5tal1 oral1 m5tal1 & environm5tal heal?1 or nutrition ne$s2 7,f7 by tak+ into consid]ation ! ne$s ( ! communities s]v$1 includ+ ! preval5ce rates ( risk factors t imp$e a*iev+ positive heal?y outcomes among wom5 & *ildr51 especially among racial & e?nic m9ority wom5 & *ildr52 & 7,g7 by provid+ ref]ral & foll[up s]vices4 7#b7 ,community sett+ ,! t]m community sett+ means a home or a community organization t s]ves a population4 7#c7 ,eligible entity ,! t]m eligible entity means-- 7,a7 a unit ( ,/ate1 t]ritorial1 local1 or ,tribal gov]nm5t 7includ+ a f$]ally recogniz$ ,tribe or ,alaska ,native village72 or 7,b7 a community-bas$ organization4 7#d7 ,m$ically und]s]v$ community ,! t]m m$ically und]s]v$ community means a community-- 7,a7 t has a sub/antial numb] ( individuals :o are memb]s ( a m$ically und]s]v$ population1 z def9$ by section #ccj7;b77#c72 7,b7 a significant portion ( :i* is a heal? pr(essional %ortage area z designat$ "u section #ccb2 & 7,c7 t includes populations t are l+ui/ically isolat$1 su* z geographic areas ) a %ortage ( heal? pr(essionals able to provide l+ui/ically appropriate s]vices4 7#e7 ,support ,! t]m support means ! provision ( tra9+1 sup]vision1 & mat]ials ne$$ to effectively deliv] ! s]vices describ$ 9 subsection 7b71 reimbursem5t = s]vices1 & o!r b5efits4 7k7 ,au?orization ( ,appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section #ae1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 4 #fjc4 ,address+ ,,covid-#ai heal? inequities & improv+ heal? equity 7a7 ,9 g5]al ,n lat] ?an #fj days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all aw>d grants to eligible entities to e/abli% or exp& programs to improve heal? equity reg>d+ ,,covid-#ai & r$uce or elim9ate inequities1 includ+ racial & e?nic inequities1 9 ! incid5ce1 preval5ce1 & heal? outcomes ( ,,covid-#ai4 7b7 ,eligibility ,to be eligible to receive a grant "u subsection 7a71 an entity %all-- 7#a7 be a nongov]nm5tal entity or consortium ( entities t works to improve heal? & heal? equity 9 populations or communities disproportionately affect$ by adv]se heal? outcomes1 includ+-- 7,a7 racial & e?nic m9ority communities2 7,b7 ,indian ,tribes1 ,tribal organizations1 & urban ,indian organizations2 7,c7 p ) disabilities2 7,d7 ,engli% language le>n]s2 7,e7 old] adults2 7,f7 l[-income communities2 7,g7 ju/ice-involv$ communities2 7,h7 immigrant communities2 & 7,i7 communities on ! basis ( _! sexual ori5tation or g5d] id5tity2 7#b7 h demon/rat$ exp]i5ce 9 successfully work+ 9 & p>tn]+ ) su* communities1 & h an e/abli%$ record ( accompli%m5t 9 improv+ heal? outcomes or prev5t+1 r$uc+ or elim9at+ heal? inequities1 includ+ racial & e?nic inequities1 9 ^? communities2 7#c7 communicate ) ,/ate1 local1 & ,tribal heal? dep>tm5ts to coord9ate grant activities1 z appropriate2 & 7#d7 submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7c7 ,use ( funds ,an entity %all use am\nts receiv$ "u grant "u ?is section to e/abli%1 improve ^u1 or exp& programs to improve heal? equity reg>d+ ,,covid-#ai & r$uce or elim9ate inequities1 includ+ racial & e?nic inequities1 9 ! incid5ce1 preval5ce1 & heal? outcomes ( ,,covid-#ai4 ,su* uses may include-- 7#a7 acquir+ & di/ribut+ m$ical supplies1 su* z p]sonal protective equipm5t1 to communities t are at an increas$ risk ( ,,covid-#ai2 7#b7 help+ p enroll 9 a heal? insurance plan t meets m9imum ess5tial cov]age2 7#c7 increas+ ! availability ( ,,covid-#ai te/+ & any future ,,covid-#ai treatm5ts or vacc9es 9 communities t are at an increas$ risk ( ,,covid-#ai2 7#d7 aid+ communities & individuals 9 foll[+ guidel9es & be/ practices 9 reg>ds to ,,covid-#ai1 includ+ physical di/anc+ guidel9es2 7#e7 help+ communities & ,,covid-#ai survivors recov] & cope ) ! long-t]m heal? impacts ( ,,covid-#ai2 7#f7 address+ social det]m9ants ( heal?1 su* z transportation1 nutrition1 h\s+1 discrim9ation1 heal? c>e access1 includ+ m5tal heal? c>e & sub/ance use disord] prev5tion1 treatm5t1 & recov]y1 heal? lit]acy1 employm5t /atus1 & work+ conditions1 education1 income1 & /ress1 t impact ,,covid-#ai incid5ce1 preval5ce1 & heal? outcomes1 & facilitat+ or provid+ access to ne$$ s]vices2 7#g7 ! provision ( anti-racism & implicit & explicit bias tra9+ = heal? c>e provid]s & o!r relevant pr(essionals2 7#h7 creat+ & dissem9at+ culturally in=m$1 l+ui/ically appropriate1 accessible1 & m$ically accurate outrea* & education reg>d+ ,,covid-#ai2 7#i7 acquir+1 reta9+1 & tra9+ a div]se work=ce2 & 7#aj7 improv+ ! accessibility to heal? c>e1 includ+ accessibility to heal? c>e provid]s1 m5tal heal? c>e1 & ,,covid-#ai te/+ = p ) disabilities4 7d7 ,adm9i/ration 7#a7 ,priority ,9 aw>d+ grants "u ?is section1 ! ,secret>y %all give priority to eligible entities t are a community-bas$ organization or h an e/abli%$ hi/ory ( successfully work+ 9 & p>tn]+ ) ! community or ) populations :i* ! entity int5ds to provide s]vices "u ! grant4 ,! ,secret>y %all also utilize available demographic data to give priority to eligible entities work+ ) populations or communities disproportionately affect$ by ,,covid-#ai4 7#b7 ,geographical div]sity ,! ,secret>y %all seek to ensure geographical div]sity among grant recipi5ts4 7#c7 ,r$uction ( burd5s ,9 adm9i/]+ ! grant program "u ?is section1 ! ,secret>y %all make e ef=t to m9imize unnecess>y adm9i/rative burd5s on eligible entities receiv+ su* grants4 7#d7 ,te*nical assi/ance ,! ,secret>y %all provide te*nical assi/ance to eligible entities on be/ practices = apply+ grants "u ?is section4 7e7 ,duration ,a grant aw>d$ "u ?is section %all be = a p]iod ( #c ye>s4 7f7 ,report+ 7#a7 ,by grantee ,n lat] ?an #ahj days aft] ! end ( a grant p]iod "u ?is section1 ! grantee %all submit to ! ,secret>y a report on ! activities conduct$ "u ! grant1 includ+-- 7,a7 a description ( ! impact ( grant activities1 includ+ on-- 7i7 outrea* & education relat$ to ,,covid-#ai2 & 7ii7 improv+ public heal? activities relat$ to ,,covid-#ai1 includ+ physical di/anc+2 7,b7 ! numb] ( individuals rea*$ by ! activities "u ! grant &1 to ! ext5t kn[n1 ! disaggregat$ demographic data ( su* individuals1 su* z by race1 e?nicity1 sex 7includ+ sexual ori5tation & g5d] id5tity71 income1 disability /atus1 or prim>y language2 & 7,c7 any o!r in=mation ! ,secret>y det]m9es is necess>y4 7#b7 ,by ,secret>y ,n lat] ?an #a ye> aft] ! end ( ! grant program "u ?is section1 ! ,secret>y %all submit to ,congress a report on ! grant program1 includ+ a summ>y ( ! in=mation ga!r$ "u p>agraph 7#a74 7g7 ,supplem5t1 n supplant ,grants aw>d$ "u ?is ,act %all be us$ to supplem5t & n supplant any o!r ,f$]al funds made available to c>ry out ! activities describ$ 9 ?is ,act4 7h7 ,fund+ ,out ( funds 9 ! ,treasury n o!rwise appropriat$1 !re are appropriat$ to c>ry out ?is section1 #ejj1jjj1jjj = ea* ( fiscal ye>s #bjbj ?r\gh #bjbb4 #fjd4 ,improv+ social det]m9ants ( heal? 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,heal?y ,p #bjbj def9es social det]m9ants ( heal? z conditions 9 ! environm5ts 9 :i* p live1 le>n1 "w1 play1 wor%ip1 & age t affect a wide range ( heal?1 function+1 & quality-(-life outcomes & risks4 7#b7 ,"o ( ! ov]>*+ goals ( ,heal?y ,p #bjbj is to create social & physical environm5ts t promote good heal? = all4 7#c7 ,heal?y ,p #bjbj develop$ a place-bas$ organiz+ framework1 reflect+ five key areas ( social det]m9ants ( heal? namely-- 7,a7 economic /ability2 7,b7 education2 7,c7 social & community context2 7,d7 heal? & heal? c>e2 & 7,e7 neighborhood & built environm5t4 7#d7 ,x is e/imat$ t m$ical c>e acc\nts = only #aj to #bj p]c5t ( ! modifiable contributors to heal?y outcomes = a population4 7#e7 ,! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices has indicat$ ! importance ( ! social det]m9ants 9 its "w /at+ t1 ,z we seek to fo/] innovation1 re?9k rural heal?1 f9d solutions to ! opioid epidemic1 & cont9ue to put pati5ts fir/1 we ne$ to take into acc\nt social det]m9ants ( heal? & recognize _! importance44 7#f7 ,! ,dep>tm5t ( ,heal? & ,human ,s]vices' ,public ,heal? #c4j initiative recognizes ! role ( public heal? 9 work+ across sectors on social det]m9ants ( heal?1 z well z ! role ( public heal? z *ief heal? /rategi/ 9 communities4 7#g7 ,?r\gh its ,heal? ,impact 9 #e ,ye>s initiative1 ! ,c5t]s = ,disease ,control & ,prev5tion has highlight$ noncl9ical1 community-wide approa*es t %[ positive heal? impacts1 results )9 five ye>s1 & co/ effectiv5ess or co/ sav+s ov] ! lifetime ( ! population or e>li]4 7#h7 ,heal? dep>tm5ts & ! ,c5t]s = ,disease ,control & ,prev5tion are n fund$ = su* cross-cutt+ "w4 7#i7 ,provid+ grants to public heal? dep>tm5ts & o!r eligible entities to coord9ate cross-sector collaboration w all[ a community-wide1 evid5ce-bas$ approa* to address und]ly+ social det]m9ants ( heal?4 7b7 ,social ,det]m9ants ( ,heal? ,program 7#a7 ,program ,to ! ext5t & 9 ! am\nts made available 9 advance 9 appropriations ,acts1 ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion 79 ?is section ref]r$ to z ! ,director7 %all c>ry out a program1 to be kn[n z ! ,social ,det]m9ants ( ,heal? ,program 79 ?is section ref]r$ to z ! ,program71 to a*ieve ! foll[+ goals3 7,a7 ,improve heal? outcomes & r$uce heal? inequities by coord9at+ social det]m9ants ( heal? activities across ! ,c5t]s = ,disease ,control & ,prev5tion4 7,b7 ,improve ! capacity ( public heal? ag5cies & community organizations to address social det]m9ants ( heal? 9 communities4 7#b7 ,activities ,to a*ieve ! goals li/$ 9 p>agraph 7#a71 ! ,director %all c>ry out activities includ+ ! foll[+3 7,a7 ,coord9at+ across ! ,c5t]s = ,disease ,control & ,prev5tion to ensure t relevant programs consid] & incorporate social det]m9ants ( heal? 9 grant aw>ds & o!r activities4 7,b7 ,aw>d+ grants "u subsection 7c7 to ,/ate1 local1 t]ritorial1 & ,tribal heal? ag5cies & organizations1 & to o!r eligible entities1 to address social det]m9ants ( heal? 9 t>get communities4 7,c7 ,aw>d+ grants "u subsection 7d7 to nonpr(it organizations & public or o!r nonpr(it in/itutions ( high] education-- 7i7 to conduct rese>* on be/ practices to improve social det]m9ants ( heal?2 7ii7 to provide te*nical assi/ance1 tra9+1 & evaluation assi/ance to grantees "u subsection 7c72 & 7iii7 to dissem9ate be/ practices to grantees "u subsection 7c74 7,d7 ,coord9at+1 support+1 & align+ activities ( ! ,c5t]s = ,disease ,control & ,prev5tion relat$ to social det]m9ants ( heal? ) activities ( o!r ,f$]al ag5cies relat$ to social det]m9ants ( heal?1 includ+ su* activities ( ag5cies 9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices su* z ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7,e7 ,collect+ & analyz+ data relat$ to ! social det]m9ants ( heal?4 7c7 ,grants ,to address social det]m9ants ( heal? 7#a7 ,9 g5]al ,! ,director1 z "p ( ! ,program1 %all aw>d grants to eligible entities to address social det]m9ants ( heal? 9 _! communities4 7#b7 ,eligibility ,to be eligible to apply = a grant "u ?is subsection1 an entity %all be-- 7,a7 a ,/ate1 local1 t]ritorial1 or ,tribal heal? ag5cy or organization2 7,b7 a qualifi$ nongov]nm5tal entity1 z def9$ by ! ,director2 or 7,c7 a consortium ( entities t includes a ,/ate1 local1 t]ritorial1 or ,tribal heal? ag5cy or organization4 7#c7 ,use ( funds 7,a7 ,9 g5]al ,a grant "u ?is subsection %all be us$ to address social det]m9ants ( heal? 9 a t>get community by design+ & implem5t+ innovative1 evid5ce-bas$1 cross-sector /rategies4 7,b7 ,t>get community ,= purposes ( ?is subsection1 a t>get community %all be a ,/ate1 c\nty1 city1 or o!r municipality4 7#d7 ,priority ,9 aw>d+ grants "u ?is subsection1 ! ,director %all prioritize applicants propos+ to s]ve t>get communities ) significant unmet heal? & social ne$s1 z def9$ by ! ,director4 7#e7 ,application ,to seek a grant "u ?is subsection1 an eligible entity %all-- 7,a7 submit an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,director may require2 7,b7 propose a set ( activities to address social det]m9ants ( heal? ?r\gh evid5ce-bas$1 cross-sector /rategies1 :i* activities may include-- 7i7 collect+ quantifiable data f heal? c>e1 social s]vices1 & o!r entities reg>d+ ! mo/ significant gaps 9 heal?-promot+ social1 economic1 & environm5tal ne$s2 7ii7 id5tify+ evid5ce-bas$ approa*es to meet+ ! nonm$ical1 social ne$s ( populations id5tifi$ by data collection describ$ 9 clause 7i71 su* z un/able h\s+ or inadequate food2 7iii7 develop+ scalable me?ods to meet pati5ts' social ne$s id5tifi$ 9 cl9ical sett+s or o!r sites2 7iv7 conv5+ entities su* z local & ,/ate gov]nm5tal & nongov]nm5tal organizations1 heal? sy/ems1 payors1 & community-bas$ organizations to review1 plan1 & implem5t community-wide int]v5tions & /rategies to advance heal?-promot+ social conditions2 7v7 monitor+ & evaluat+ ! impact ( activities fund$ ?r\gh ! grant on ! heal? & well-be+ ( ! resid5ts ( ! t>get community & on ! co/ ( heal? c>e2 & 7vi7 su* o!r activities z may be specifi$ by ! ,director2 7,c7 demon/rate h[ ! eligible entity w collaborate )-- 7i7 heal? sy/ems2 7ii7 payors1 includ+1 z appropriate1 m$icaid manag$ c>e organizations 7z def9$ 9 section #aijc7m77#a77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7m77#a77;,a7771 ,m$ic>e ,advantage plans "u "p ,c ( title ,,xviii ( su* ,act 7#db ,u4,s4,c4 #aciew-#ba et seq471 & heal? insurance issu]s & gr\p heal? plans 7z su* t]ms are def9$ 9 section #bgia ( ! ,public ,heal? ,s]vice ,act72 7iii7 o!r relevant /akehold]s & initiatives 9 areas ( ne$1 su* z ! ,acc\ntable ,heal? ,communities ,model ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 heal? homes "u ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 community-bas$ organizations1 & human s]vices organizations2 7iv7 o!r non-heal? c>e sector organizations1 includ+ organizations focus+ on transportation1 h\s+1 or food access2 & 7v7 local employ]s2 & 7,d7 id5tify key heal? inequities 9 ! t>get community & demon/rate h[ ! propos$ ef=ts ( ! eligible entity w\ld address su* inequities4 7#f7 ,monitor+ & evaluation ,z a condition ( receipt ( a grant "u ?is subsection1 a grantee %all agree to submit an annual report to ! ,director describ+ ! activities c>ri$ out ?r\gh ! grant & ! outcomes ( su* activities4 7#g7 ,indep5d5t national evaluation 7,a7 ,9 g5]al ,n lat] ?an #e ye>s aft] ! fir/ grants are aw>d$ "u ?is subsection1 ! ,director %all provide = ! comm5cem5t ( an indep5d5t national evaluation ( ! ,program "u ?is subsection4 7,b7 ,report to ,congress ,n lat] ?an #fj days aft] receiv+ ! results ( su* indep5d5t national evaluation1 ! ,director %all report su* results to ! ,congress4 7d7 ,rese>* & tra9+ ,! ,director1 z "p ( ! ,program-- 7#a7 %all aw>d grants to nonpr(it organizations & public or o!r nonpr(it in/itutions ( high] education-- 7,a7 to conduct rese>* on be/ practices to improve social det]m9ants ( heal?2 7,b7 to provide te*nical assi/ance1 tra9+1 & evaluation assi/ance to grantees "u subsection 7c72 & 7,c7 to dissem9ate be/ practices to grantees "u subsection 7c72 & 7#b7 may require a grantee "u p>agraph 7#a7 to provide te*nical assi/ance & capacity build+ to entities t are eligible entities "u subsection 7c7 b n receiv+ funds ?r\gh su* subsection4 7e7 ,fund+ 7#a7 ,9 g5]al ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section1 #ej1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbf4 7#b7 ,allocation ,( ! am\nt made available to c>ry out ?is section = a fiscal ye>1 n less ?an #ge p]c5t %all be us$ = grants "u subsections 7c7 & 7d74 #fje4 ,fund+ to ,/ates1 localities1 & community-bas$ organizations = em]g5cy aid & s]vices 7a7 ,fund+ = ,/ates 7#a7 ,increase 9 fund+ = ,social ,s]vices ,block ,grant ,program 7,a7 ,appropriation ,out ( any money 9 ! ,treasury ( ! ,unit$ ,/ates n o!rwise appropriat$1 !re are appropriat$ #i1fjj1jjj1jjj1 :i* %all be available = paym5ts "u section #bjjb ( ! ,social ,security ,act4 7,b7 ,deadl9e = di/ribution ( funds ,)9 #de days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all di/ribute ! funds made available by ?is p>agraph1 :i* %all be made available to ,/ates on an em]g5cy basis = imm$iate obligation & exp5diture4 7,c7 ,submission ( ,revis$ ,pre-,exp5diture ,report ,)9 #ij days aft] a ,/ate receives funds made available by ?is p>agraph1 ! ,/ate %all submit to ! ,secret>y a revis$ pre-exp5diture report pursuant to title ,,xx ( ! ,social ,security ,act t describes h[ ! ,/ate plans to adm9i/] ! funds4 7,d7 ,obligation ( funds by ,/ates ,a ,/ate to :i* funds made available by ?is p>agraph are di/ribut$ %all obligate ! funds n lat] ?an ,decemb] #ca1 #bjbj4 7,e7 ,exp5diture ( funds by ,/ates ,a grantee to :i* a ,/ate 7or a subgrantee to :i* a grantee7 provides funds made available by ?is p>agraph %all exp5d ! funds n lat] ?an ,decemb] #ca1 #bjba4 7#b7 ,rules gov]n+ use ( additional funds ,a ,/ate to :i* funds made available by p>agraph 7#a77;,b7 are di/ribut$ %all use ! funds 9 accordance ) ! foll[+3 7,a7 ,purpose 7i7 ,9 g5]al ,! ,/ate %all use ! funds only to support ! provision ( em]g5cy s]vices to disadvantag$ *ildr51 families1 & h\seholds4 7ii7 ,disadvantag$ def9$ ,9 ?is p>agraph1 ! t]m disadvantag$ means1 ) respect to an entity1 t ! entity-- 7,i7 is an individual1 or is locat$ 9 a community1 t is exp]i5c+ mat]ial h>d%ip2 7,,ii7 is a h\sehold 9 :i* !re is a *ild 7z def9$ 9 section #ab7;d7 ( ! ,ri*>d ,b4 ,russell ,national ,s*ool ,lun* ,act7 or a *ild s]v$ "u section #aa7;a77#a7 ( su* ,act1 :o1 if n = ! closure ( ! s*ool att5d$ by ! *ild dur+ a public heal? em]g5cy designation & due to conc]ns ab\t a ,,covid-#ai outbreak1 w\ld receive free or r$uc$ price s*ool meals pursuant to su* ,act2 7,,iii7 is an individual1 or is locat$ 9 a community1 ) b>ri]s to employm5t2 or 7,,iv7 is locat$ 9 a community t1 z ( ! date ( ! enactm5t ( ?is ,act1 is n exp]i5c+ a #ef-;day d[nw>d trajectory (-- 7aa7 influ5za-l illnesses2 7bb7 ,,covid-l syndromic cases2 7cc7 docum5t$ ,,covid-#ai cases2 or 7dd7 positive te/ results z a p]c5tage ( total ,,covid-#ai te/s4 7,b7 ,pass-?r\gh to local entities 7i7 ,9 ! case ( a ,/ate 9 :i* a c\nty adm9i/]s or contributes f9ancially to ! non-,f$]al %>e ( ! am\nts exp5d$ 9 c>ry+ out a ,/ate program fund$ "u title ,,iv ( ! ,social ,security ,act1 ! ,/ate may pass funds s made available ?r\gh to-- 7,i7 ! *ief elect$ (ficial ( ! city or urban c\nty t adm9i/]s ! program2 or 7,,ii7 local gov]nm5t & community-bas$ organizations4 7ii7 ,9 ! case ( any o!r ,/ate1 ! ,/ate %all-- 7,i7 pass ! funds ?r\gh to-- 7aa7 7,,aa7 local gov]nm5ts t w exp5d or di/ribute ! funds 9 consultation ) community-bas$ organizations ) exp]i5ce s]v+ disadvantag$ families or individuals2 or 7,,bb7 community-bas$ organizations ) exp]i5ce s]v+ disadvantag$ families & individuals2 & 7bb7 sub-,/ate areas 9 proportions bas$ on ! population ( disadvantag$ individuals liv+ 9 ! areas2 & 7,,ii7 report to ! ,secret>y on h[ ! ,/ate det]m9$ ! am\nts pass$ ?r\gh pursuant to ?is clause4 7,c7 ,me?ods 7i7 ,9 g5]al ,! ,/ate %all use ! funds only =-- 7,i7 adm9i/]+ em]g5cy s]vices2 7,,ii7 provid+ %ort-t]m ca%1 non-ca%1 or 9-k9d em]g5cy disa/] relief2 7,,iii7 provid+ s]vices ) demon/rat$ ne$ 9 accordance ) objective crit]ia t are made available to ! public2 7,,iv7 op]ational co/s directly relat$ to provid+ s]vices describ$ 9 subclauses 7,i71 7,,ii71 & 7,,iii72 7,v7 local gov]nm5t em]g5cy social s]vice op]ations2 & 7,,vi7 provid+ em]g5cy social s]vices to rural & fronti] communities t may n h access to o!r em]g5cy fund+ /reams4 7ii7 ,adm9i/]+ em]g5cy s]vices def9$ ,9 clause 7i71 ! t]m adm9i/]+ em]g5cy s]vices means-- 7,i7 provid+ basic disa/] relief1 economic1 & well-be+ necessities to ensure communities are able to safely obs]ve %elt]-9-place & social di/anc+ ord]s2 7,,ii7 provid+ necess>y supplies su* z masks1 gloves1 & soap1 to protect ! public aga9/ infecti\s disease2 & 7,,iii7 connect+ individuals1 *ildr51 & families to s]vices or paym5ts = :i* !y may already be eligible4 7,d7 ,prohibitions 7i7 ,no individual eligibility det]m9ations by grantees or subgrantees ,nei!r a grantee to :i* ! ,/ate provides ! funds nor any subgrantee ( su* a grantee may ex]cise individual eligibility det]m9ations = ! purpose ( adm9i/]+ %ort-t]m1 non-ca%1 9-k9d em]g5cy disa/] relief to communities4 7ii7 ,applicability ( c]ta9 social s]vices block grant funds use limitations ,! ,/ate %all use ! funds subject to ! limitations 9 section #bjje ( ! ,social ,security ,act1 except t1 = purposes ( ?is clause1 section #bjje7;a77#b7 & #bjje7;a77#h7 ( su* ,act %all n apply4 7iii7 ,no supplantation ( c]ta9 ,/ate funds ,! ,/ate may use ! funds to supplem5t1 n supplant1 ,/ate g5]al rev5ue funds = social s]vices4 7iv7 ,ban on use = c]ta9 co/s reimbursable by ,,fema ,! ,/ate may n use ! funds = co/s t are reimbursable by ! ,f$]al ,em]g5cy ,managem5t ,ag5cy1 "u a contract = insurance1 or by self-insurance4 7b7 ,fund+ = f$]ally recogniz$ ,indian ,tribes & ,tribal organizations 7#a7 ,grants 7,a7 ,9 g5]al ,)9 #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all make grants to f$]ally recogniz$ ,indian ,tribes & ,tribal organizations4 7,b7 ,am\nt ( grant ,! am\nt ( ! grant = an ,indian ,tribe or ,tribal organization %all be> ! same ratio to ! am\nt appropriat$ by p>agraph 7#c7 z ! total am\nt ( grants aw>d$ to ! ,indian ,tribe or ,tribal organization "u ! ,l[-,income ,home ,en]gy ,assi/ance ,act ( #aiha & ! ,community ,s]vice ,block ,grant = fiscal ye> #bjbj be>s to ! total am\nt ( grants aw>d$ to all ,indian ,tribes & ,tribal organizations "u su* ,act & su* ,grant = ! fiscal ye>4 7#b7 ,rules gov]n+ use ( funds ,an entity to :i* a grant is made "u p>agraph 7#a7 %all obligate ! funds n lat] ?an ,decemb] #ca1 #bjbj1 & ! funds %all be exp5d$ by grantees & subgrantees n lat] ?an ,decemb] #ca1 #bjba1 & us$ 9 accordance ) ! foll[+3 7,a7 ,purpose 7i7 ,9 g5]al ,! grantee %all use ! funds only to support ! provision ( em]g5cy s]vices to disadvantag$ h\seholds4 7ii7 ,disadvantag$ def9$ ,9 clause 7i71 ! t]m disadvantag$ means1 ) respect to an entity1 t ! entity-- 7,i7 is an individual1 or is locat$ 9 a community1 t is exp]i5c+ mat]ial h>d%ip2 7,,ii7 is a h\sehold 9 :i* !re is a *ild 7z def9$ 9 section #ab7;d7 ( ! ,ri*>d ,b4 ,russell ,national ,s*ool ,lun* ,act7 or a *ild s]v$ "u section #aa7;a77#a7 ( su* ,act1 :o1 if n = ! closure ( ! s*ool att5d$ by ! *ild dur+ a public heal? em]g5cy designation & due to conc]ns ab\t a ,,covid-#ai outbreak1 w\ld receive free or r$uc$ price s*ool meals pursuant to su* ,act2 7,,iii7 is an individual1 or is locat$ 9 a community1 ) b>ri]s to employm5t2 or 7,,iv7 is locat$ 9 a community t1 z ( ! date ( ! enactm5t ( ?is ,act1 is n exp]i5c+ a #ef-;day d[nw>d trajectory (-- 7aa7 influ5za-l illnesses2 7bb7 ,,covid-l syndromic cases2 7cc7 docum5t$ ,,covid-#ai cases2 or 7dd7 positive te/ results z a p]c5tage ( total ,,covid-#ai te/s4 7,b7 ,me?ods 7i7 ,9 g5]al ,! grantee %all use ! funds only =-- 7,i7 adm9i/]+ em]g5cy s]vices2 7,,ii7 provid+ %ort-t]m1 non-ca%1 9-k9d em]g5cy disa/] relief2 & 7,,iii7 tribal em]g5cy social s]vice op]ations4 7ii7 ,adm9i/]+ em]g5cy s]vices def9$ ,9 clause 7i71 ! t]m adm9i/]+ em]g5cy s]vices means-- 7,i7 provid+ basic economic & well-be+ necessities to ensure communities are able to safely obs]ve %elt]-9-place & social di/anc+ ord]s2 7,,ii7 provid+ necess>y supplies su* z masks1 gloves1 & soap1 to protect ! public aga9/ infecti\s disease2 & 7,,iii7 connect+ individuals1 *ildr51 & families to s]vices or paym5ts = :i* !y may already be eligible4 7,c7 ,prohibitions 7i7 ,no individual eligibility det]m9ations by grantees or subgrantees ,nei!r ! grantee nor any subgrantee may ex]cise individual eligibility det]m9ations = ! purpose ( adm9i/]+ %ort-t]m1 non-ca%1 9-k9d em]g5cy disa/] relief to communities4 7ii7 ,ban on use = c]ta9 co/s reimbursable by ,,fema ,! grantee may n use ! funds = co/s t are reimbursable by ! ,f$]al ,em]g5cy ,managem5t ,ag5cy1 "u a contract = insurance1 or by self-insurance4 7#c7 ,appropriation ,out ( any money 9 ! ,treasury ( ! ,unit$ ,/ates n o!rwise appropriat$1 !re are appropriat$ to ! ,secret>y ( ,heal? & ,human ,s]vices #djj1jjj1jjj to c>ry out ?is subsection4 #fjf4 ,supplem5tal nutrition assi/ance program 7a7 ,value ( b5efits ,not)/&+ any o!r provision ( law1 beg9n+ on ,june #a1 #bjbj1 & = ea* subsequ5t mon? ?r\gh ,septemb] #cj1 #bjba1 ! value ( b5efits det]m9$ "u section #h7;a7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjag7;a771 & consolidat$ block grants = ,pu]to ,rico & ,am]ican ,samoa det]m9$ "u section #ai7;a7 ( su* ,act 7#g ,u4,s4,c4 #bjbh7;a771 %all be calculat$ us+ #aae p]c5t ( ! ,june #bjai value ( ! ?rifty food plan 7z def9$ 9 section #c ( su* ,act 7#g ,u4,s4,c4 #bjab77 if ! value ( ! b5efits & block grants w\ld be great] "u t calculation ?an 9 ! abs5ce ( ?is subsection4 7b7 ,m9imum am\nt 7#a7 ,9 g5]al ,! m9imum value ( b5efits det]m9$ "u section #h7;a7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjag7;a77 = a h\sehold ( n m ?an #b memb]s %all be #cj4 7#b7 ,effectiv5ess ,p>agraph 7#a7 %all rema9 9 effect until ! date on :i* #h p]c5t ( ! value ( ! ?rifty food plan = a h\sehold conta9+ #a memb]1 r\nd$ to ! ne>e/ :ole doll> increm5t1 is equal to or great] ?an #cj4 7c7 ,requirem5ts = ! ,secret>y ,9 c>ry+ out ?is section1 ! ,secret>y %all-- 7#a7 consid] ! b5efit increases describ$ 9 ea* ( subsections 7a7 & 7b7 to be a mass *ange2 7#b7 require a simple process = ,/ates to notify h\seholds ( ! increase 9 b5efits2 7#c7 consid] section #af7;c77#c77;,a7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjbe7;c77#c77;,a77 to apply to any errors 9 ! implem5tation ( ?is section1 )\t reg>d to ! #abj-;day limit describ$ 9 t section2 7#d7 disreg>d ! additional am\nt ( b5efits t a h\sehold receives z a result ( ?is section 9 det]m9+ ! am\nt ( ov]issuances "u section #ac ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjbb72 & 7#e7 set ! tol]ance level = exclud+ small errors = ! purposes ( section #af7;c7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjbe7;c77 at #ej ?r\gh ,septemb] #cj1 #bjba4 7d7 ,provisions = impact$ work]s ,not)/&+ any o!r provision ( law1 ! requirem5ts "u subsections 7d77#a77;,a77ii7 & 7o7 ( section #f ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjae7 %all n be 9 effect dur+ ! p]iod beg9n+ on ,june #a1 #bjbj1 & end+ #b ye>s aft] ! date ( enactm5t ( ?is ,act4 7e7 ,adm9i/rative exp5ses 7#a7 ,9 g5]al ,= ! co/s ( ,/ate adm9i/rative exp5ses associat$ ) c>ry+ out ?is section & adm9i/]+ ! supplem5tal nutrition assi/ance program e/abli%$ "u ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjaa et seq471 ! ,secret>y %all make available #aej1jjj1jjj = fiscal ye> #bjbj & #aej1jjj1jjj = fiscal ye> #bjba4 7#b7 ,tim+ = fiscal ye> #bjbj ,n lat] ?an #fj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all make available to ,/ates am\nts = fiscal ye> #bjbj "u p>agraph 7#a74 7#c7 ,allocation ( funds ,funds describ$ 9 p>agraph 7#a7 %all be made available z grants to ,/ate ag5cies = ea* fiscal ye> z foll[s3 7,a7 #ge p]c5t ( ! am\nts available = ea* fiscal ye> %all be allocat$ to ,/ates bas$ on ! %>e ( ea* ,/ate ( h\seholds t p>ticipate 9 ! supplem5tal nutrition assi/ance program z report$ to ! ,dep>tm5t ( ,agriculture = ! mo/ rec5t #ab-mon? p]iod = :i* data are available1 adju/$ by ! ,secret>y 7z ( ! date ( ! enactm5t ( ?is ,act7 = p>ticipation 9 disa/] programs "u section #e7;h7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjad7;h772 & 7,b7 #be p]c5t ( ! am\nts available = ea* fiscal ye> %all be allocat$ to ,/ates bas$ on ! increase 9 ! numb] ( h\seholds t p>ticipate 9 ! supplem5tal nutrition assi/ance program z report$ to ! ,dep>tm5t ( ,agriculture ov] ! mo/ rec5t #ab-mon? p]iod = :i* data are available1 adju/$ by ! ,secret>y 7z ( ! date ( ! enactm5t ( ?is ,act7 = p>ticipation 9 disa/] programs "u section #e7;h7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjad7;h774 7f7 ,,snap rules ,no funds 7includ+ fees7 made available "u ?is ,act or any o!r ,act = any fiscal ye> may be us$ to f9alize1 implem5t1 adm9i/]1 en=ce1 c>ry out1 or o!rwise give effect to-- 7#a7 ! f9al rule entitl$ ,supplem5tal ,nutrition ,assi/ance ,program3 ,requirem5ts = ,able-,bodi$ ,adults ,)\t ,dep5d5ts publi%$ 9 ! ,f$]al ,regi/] on ,decemb] #e1 #bjai 7#hd ,f$4 ,reg4 #ffghb72 7#b7 ! propos$ rule entitl$ ,revision ( ,categorical ,eligibility 9 ! ,supplem5tal ,nutrition ,assi/ance ,program 7,,snap7 publi%$ 9 ! ,f$]al ,regi/] on ,july #bd1 #bjai 7#hd ,f$4 ,reg4 #ceegj72 or 7#c7 ! propos$ rule entitl$ ,supplem5tal ,nutrition ,assi/ance ,program3 ,/&>dization ( ,/ate ,heat+ & ,cool+ ,/&>d ,utility ,all[ances publi%$ 9 ! ,f$]al ,regi/] on ,octob] #c1 #bjai 7#hd ,f$4 ,reg4 #ebhji74 7g7 ,c]ta9 exclusions f ,,snap income ,a ,f$]al p&emic unemploym5t comp5sation paym5t made to an individual "u section #bajd ( ! ,,c>es ,act 7,public ,law #aaf-acf7 %all n be reg>d$ z income & %all n be reg>d$ z a res\rce = ! mon? ( receipt & ! foll[+ #i mon?s1 = ! purpose ( det]m9+ eligibility = su* individual or any o!r individual = b5efits or assi/ance1 or ! am\nt ( b5efits or assi/ance1 "u any programs au?oriz$ "u ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjaa et seq474 7h7 ,public availability ,n lat] ?an #aj days aft] ! date ( ! receipt or issuance ( ea* docum5t li/$ bel[1 ! ,secret>y %all make publicly available on ! website ( ! ,dep>tm5t ( ,agriculture ! foll[+ docum5ts3 7#a7 ,any ,/ate ag5cy reque/ to p>ticipate 9 ! supplem5tal nutrition assi/ance program onl9e program "u section #g7k74 7#b7 ,any ,/ate ag5cy reque/ to waive1 adju/1 or modify /atutory or regulatory requirem5ts "u ! ,food & ,nutrition ,act ( #bjjh relat$ to ! ,,covid-#ai outbreak4 7#c7 ,! ,secret>y's approval or d5ial ( ea* su* reque/ "u p>agraphs 7#a7 or 7#b74 7i7 ,fund+ ,!re are h]eby appropriat$ to ! ,secret>y1 out ( any money n o!rwise appropriat$1 su* sums z may be necess>y to c>ry out ?is section4 ,,vii ,culturally & ,l+ui/ically ,compet5t ,c>e #gja4 ,ensur+ /&>ds = culturally & l+ui/ically appropriate s]vices 9 heal? c>e 7a7 ,applicability ,?is section %all apply to any heal? program or activity1 any "p ( :i* is receiv+ ,f$]al f9ancial assi/ance1 includ+ cr$its1 subsidies1 or contracts ( insurance1 or any program or activity t is adm9i/]$ by an executive ag5cy or any entity e/abli%$ "u title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjja et seq47 7or am5dm5ts made !reby74 7b7 ,/&>ds ,ea* program or activity describ$ 9 subsection 7a7-- 7#a7 %all implem5t /rategies to recruit1 reta91 & promote individuals at all levels to ma9ta9 a div]se /aff & lead]%ip t c provide culturally & l+ui/ically appropriate heal? c>e to pati5t populations ( ! s]vice area ( ! program or activity2 7#b7 %all educate & tra9 gov]nance1 lead]%ip1 & work=ce at all levels & across all discipl9es ( ! program or activity 9 culturally & l+ui/ically appropriate policies & practices on an ongo+ basis at lea/ ye>ly2 7#c7 %all (f] & provide language assi/ance1 includ+ tra9$ & compet5t bil+ual /aff & int]pret] s]vices1 to individuals ) limit$ ,engli% pr(ici5cy or :o h o!r communication ne$s1 at no co/ to ! individual at all po9ts ( contact1 & dur+ all h\rs ( op]ation1 to facilitate timely access to heal? c>e s]vices & heal?-c>e-relat$ s]vices2 7#d7 %all = ea* language gr\p consi/+ ( individuals ) limit$ ,engli% pr(ici5cy t con/itutes #e p]c5t or #ejj individuals1 :i*ev] is less1 ( ! population ( p]sons eligible to be s]v$ or likely to be affect$ or enc\nt]$ 9 ! s]vice area ( ! program or activity1 make available at a fif? grade read+ level-- 7,a7 easily und]/ood pati5t-relat$ mat]ials1 includ+ pr9t & multim$ia mat]ials1 9 ! language ( su* language gr\p2 7,b7 in=mation or notices ab\t t]m9ation ( b5efits 9 su* language2 7,c7 signage2 & 7,d7 any o!r docum5ts or types ( docum5ts designat$ by ! ,secret>y2 7#e7 %all develop & implem5t cle> goals1 policies1 op]ational plans1 & managem5t1 acc\ntability1 & ov]sight me*anisms to provide culturally & l+ui/ically appropriate s]vices & infuse !m ?r\gh\t ! plann+ & op]ations ( ! program or activity2 7#f7 %all conduct initial & ongo+ organizational assessm5ts ( culturally & l+ui/ically appropriate s]vices-relat$ activities & integrate valid l+ui/ic1 compet5ce-relat$ ,national ,/&>ds = ,culturally & ,l+ui/ically ,appropriate ,s]vices 7,,clas7 measures into ! int]nal audits1 p]=mance improvem5t programs1 pati5t satisfaction assessm5ts1 cont9u\s quality improvem5t activities1 & outcomes-bas$ evaluations ( ! program or activity & develop ways to /&>dize ! assessm5ts1 & su* assessm5ts mu/ occur at lea/ ye>ly2 7#g7 %all ensure t1 consi/5t ) ! privacy protections provid$ = "u ! regulations promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7#db ,u4,s4,c4 #acbj-b note71 data on an individual requir$ to be collect$ pursuant to section #caja1 includ+ ! individual's alt]native =mat pref]5ces & policy modification ne$s1 are-- 7,a7 collect$ 9 heal? records2 7,b7 integrat$ into ! managem5t in=mation sy/ems ( ! program or activity2 & 7,c7 p]iodically updat$2 7#h7 %all ma9ta9 a curr5t demographic1 cultural1 & epidemiological pr(ile ( ! community1 conduct regul> assessm5ts ( community heal? assets & ne$s1 & use ! results ( su* assessm5ts to accurately plan = & implem5t s]vices t respond to ! cultural & l+ui/ic *>act]i/ics ( ! s]vice area ( ! program or activity2 7#i7 %all develop p>ticipatory1 collaborative p>tn]%ips ) communities & utilize a v>iety ( =mal & in=mal me*anisms to facilitate community & pati5t involvem5t 9 design+1 implem5t+1 & evaluat+ policies & practices to ensure culturally & l+ui/ically appropriate s]vice-relat$ activities2 7#aj7 %all ensure t conflict & grievance resolution processes are culturally & l+ui/ically appropriate & capable ( id5tify+1 prev5t+1 & resolv+ cross-cultural conflicts or compla9ts by pati5ts2 7#aa7 %all regul>ly make available to ! public in=mation ab\t _! progress & successful innovations 9 implem5t+ ! /&>ds "u ?is section & provide public notice 9 _! communities ab\t ! availability ( ?is in=mation2 & 7#ab7 %all1 if reque/$1 regul>ly make available to ! head ( ea* ,f$]al entity f :i* ,f$]al funds are provid$1 in=mation ab\t ! progress & successful innovations ( ! program or activity 9 implem5t+ ! /&>ds "u ?is section z requir$ by ! head ( su* entity4 7c7 ,comm5ts accept$ ?r\gh notice & comm5t rulemak+ ,an ag5cy c>ry+ out a program describ$ 9 subsection 7a7 %all ensure t comm5ts ) respect to su* program t are accept$ ?r\gh notice & comm5t rulemak+ be accept$ 9 all languages1 may n require su* comm5ts to be submitt$ only 9 ,engli%1 & mu/ ensure ^! comm5ts are consid]$ equally z comm5ts submitt$ 9 ,engli% dur+ ! ag5cy's review ( comm5ts submitt$4 #gjb4 ,culturally & l+ui/ically appropriate heal? c>e 9 ! ,public ,heal? ,s]vice ,act ,title ,,xxxiv ( ! ,public ,heal? ,s]vice ,act1 z am5d$ by section #ajd1 is fur!r am5d$ by add+ at ! end ! foll[+3 ,b ,,culturally ,,& ,,l+ui/ically ,,appropriate ,,heal? ,,c>e #cdjc4 ,def9itions 7a7 ,9 g5]al ,9 ?is title3 7#a7 ,bil+ual ,! t]m bil+ual1 ) respect to an individual1 means a p]son :o has suffici5t degree ( pr(ici5cy 9 #b languages4 7#b7 ,cultural ,! t]m cultural means relat+ to integrat$ patt]ns ( human behavior t include ! language1 ?\ghts1 communications1 actions1 cu/oms1 beliefs1 values1 & in/itutions ( racial1 e?nic1 religi\s1 or social gr\ps1 includ+ lesbian1 gay1 bisexual1 transg5d]1 que]1 & que/ion+ individuals1 & individuals ) physical & m5tal disabilities4 7#c7 ,culturally & l+ui/ically appropriate ,! t]m culturally & l+ui/ically appropriate means be+ respectful ( & responsive to ! cultural & l+ui/ic ne$s ( all individuals4 7#d7 ,effective communication ,! t]m effective communication means an ex*ange ( in=mation betwe5 ! provid] ( heal? c>e or heal?-c>e-relat$ s]vices & ! recipi5t ( su* s]vices :o is limit$ 9 ,engli% pr(ici5cy1 or has a communication impairm5t su* z a he>+1 vision1 speak+1 or le>n+ impairm5t1 t enables access to1 und]/&+ (1 & b5efit f heal? c>e or heal?-c>e-relat$ s]vices1 & full p>ticipation 9 ! developm5t ( _! treatm5t plan4 7#e7 ,grievance resolution process ,! t]m grievance resolution process means all aspects ( dispute resolution includ+ fil+ compla9ts1 grievance & appeal proc$ures1 & c\rt action4 7#f7 ,heal? c>e gr\p ,! t]m heal? c>e gr\p means a gr\p ( physicians organiz$1 at lea/ 9 "p1 = ! purposes ( provid+ physician s]vices "u ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act1 ! ,/ate ,*ildr5's ,heal? ,insurance ,program "u title ,,xxi ( su* ,act1 or ! ,m$ic>e program "u title ,,xviii ( su* ,act & may include a hospital & any o!r individual or entity furni%+ s]vices cov]$ "u any su* program t is affiliat$ ) ! heal? c>e gr\p4 7#g7 ,heal? c>e s]vices ,! t]m heal? c>e s]vices means s]vices t address physical z well z m5tal heal? conditions 9 all c>e sett+s4 7#h7 ,heal?-c>e-relat$ s]vices ,! t]m heal?-c>e-relat$ s]vices means human or social s]vices programs or activities t provide access1 ref]rals1 or l9ks to heal? c>e4 7#i7 ,heal? educator ,! t]m heal? educator includes a pr(essional ) a baccalaureate degree :o is responsible = design+1 implem5t+1 & evaluat+ individual & population heal? promotion & *ronic disease prev5tion programs4 7#aj7 ,indian2 indian tribe ,! t]ms ,indian & ,indian ,tribe h ! mean+s giv5 su* t]ms 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act4 7#aa7 ,individual ) a disability ,! t]m individual ) a disability means any individual :o has a disability z def9$ = ! purpose ( section #ejd ( ! ,rehabilitation ,act ( #aigc4 7#ab7 ,individual ) limit$ ,engli% pr(ici5cy ,! t]m individual ) limit$ ,engli% pr(ici5cy means an individual ^: prim>y language = communication is n ,engli% & :o has a limit$ ability to read1 write1 speak1 or und]/& ,engli%4 7#ac7 ,integrat$ heal? c>e deliv]y sy/em ,! t]m integrat$ heal? c>e deliv]y sy/em means an int]discipl9>y sy/em t br+s toge!r provid]s f ! prim>y heal?1 m5tal heal?1 sub/ance use disord]1 & relat$ discipl9es to improve ! heal? outcomes ( an individual4 ,su* provid]s may include hospitals1 heal?1 m5tal heal?1 or sub/ance use disord] cl9ics & provid]s1 home heal? ag5cies1 ambulatory surg]y c5t]s1 skill$ nurs+ facilities1 rehabilitation c5t]s1 & employ$1 indep5d5t1 or contract$ physicians4 7#ad7 ,int]pret+2 int]pretation ,! t]ms int]pret+ & int]pretation mean ! transmission ( a spok51 writt51 or sign$ message f "o language or =mat into ano!r1 fai?fully1 accurately1 & objectively4 7#ae7 ,language access ,! t]m language access means ! provision ( language s]vices to an individual ) limit$ ,engli% pr(ici5cy or an individual ) communication disabilities design$ to enhance t individual's access to1 und]/&+ (1 or b5efit f heal? c>e s]vices or heal?-c>e-relat$ s]vices4 7#af7 ,language assi/ance s]vices ,! t]m language assi/ance s]vices includes-- 7,a7 oral language assi/ance1 includ+ int]pretation 9 non-,engli% languages provid$ 9-p]son or remotely by a qualifi$ int]pret] = an individual ) limit$ ,engli% pr(ici5cy1 & ! use ( qualifi$ bil+ual or multil+ual /aff to communicate directly ) individuals ) limit$ ,engli% pr(ici5cy2 7,b7 writt5 translation1 p]=m$ by a qualifi$ & compet5t translator1 ( writt5 cont5t 9 pap] or electronic =m into languages o!r ?an ,engli%2 & 7,c7 tagl9es4 7#ag7 ,m9ority 7,a7 ,9 g5]al ,! t]ms m9ority & m9orities ref] to individuals f a m9ority gr\p4 7,b7 ,populations ,! t]m m9ority1 ) respect to populations1 ref]s to racial & e?nic m9ority gr\ps1 memb]s ( sexual & g5d] m9ority gr\ps1 & individuals ) a disability4 7#ah7 ,m9ority gr\p ,! t]m m9ority gr\p has ! mean+ giv5 ! t]m racial & e?nic m9ority gr\p4 7#ai7 ,onsite int]pretation ,! t]m onsite int]pretation means a me?od ( int]pret+ or int]pretation = :i* ! int]pret] is 9 ! physical pres5ce ( ! provid] ( heal? c>e s]vices or heal?-c>e-relat$ s]vices & ! recipi5t ( su* s]vices :o is limit$ 9 ,engli% pr(ici5cy or has a communication impairm5t su* z an impairm5t 9 he>+1 vision1 or le>n+4 7#bj7 ,qualifi$ individual ) a disability ,! t]m qualifi$ individual ) a disability means1 ) respect to a heal? program or activity1 an individual ) a disability :o1 ) or )\t reasonable modifications to policies1 practices1 or proc$ures1 ! removal ( ar*itectural1 communication1 or transportation b>ri]s1 or ! provision ( auxili>y aids & s]vices1 meets ! ess5tial eligibility requirem5ts = ! receipt ( aids1 b5efits1 or s]vices (f]$ or provid$ by ! heal? program or activity4 7#ba7 ,qualifi$ int]pret] = an individual ) a disability ,! t]m qualifi$ int]pret] = an individual ) a disability1 = an individual ) a disability-- 7,a7 means an int]pret] :o by means ( a remote int]pret+ s]vice or an on-site appe>ance2 7i7 adh]es to g5]ally accept$ int]pret] e?ics pr9ciples1 includ+ cli5t confid5tiality2 & 7ii7 is able to int]pret effectively1 accurately1 & imp>tially1 bo? receptively & expressively1 us+ any necess>y specializ$ vocabul>y1 t]m9ology1 & phraseology2 & 7,b7 may include sign language int]pret]s1 oral translit]ators 7individuals :o repres5t or spell 9 ! *>act]s ( ano!r alphabet71 & cu$ language translit]ators 7individuals :o repres5t or spell by us+ a small numb] ( h&%apes74 7#bb7 ,qualifi$ int]pret] = an individual ) limit$ ,engli% pr(ici5cy ,! t]m qualifi$ int]pret] = an individual ) limit$ ,engli% pr(ici5cy means an int]pret] :o via a remote int]pret+ s]vice or an on-site appe>ance-- 7,a7 adh]es to g5]ally accept$ int]pret] e?ics pr9ciples1 includ+ cli5t confid5tiality2 7,b7 has demon/rat$ pr(ici5cy 9 speak+ & und]/&+ bo? spok5 ,engli% & "o or m o!r spok5 languages2 & 7,c7 is able to int]pret effectively1 accurately1 & imp>tially1 bo? receptively & expressly1 to & f su* languages & ,engli%1 us+ any necess>y specializ$ vocabul>y1 t]m9ology1 & phraseology4 7#bc7 ,qualifi$ translator ,! t]m qualifi$ translator means a translator :o-- 7,a7 adh]es to g5]ally accept$ translator e?ics pr9ciples1 includ+ cli5t confid5tiality2 7,b7 has demon/rat$ pr(ici5cy 9 writ+ & und]/&+ bo? writt5 ,engli% & "o or m o!r writt5 non-,engli% languages2 & 7,c7 is able to translate effectively1 accurately1 & imp>tially to & f su* languages & ,engli%1 us+ any necess>y specializ$ vocabul>y1 t]m9ology1 & phraseology4 7#bd7 ,racial & e?nic m9ority gr\p ,! t]m racial & e?nic m9ority gr\p means ,indians & ,alaska ,natives1 ,african ,am]icans 7includ+ ,c>ibbean ,blacks1 ,africans1 & o!r ,blacks71 ,asian ,am]icans1 ,hispanics 7includ+ ,lat9os71 & ,native ,hawaiians & o!r ,pacific ,isl&]s4 7#be7 ,sexual & g5d] m9ority gr\p ,! t]m sexual & g5d] m9ority gr\p encompasses lesbian1 gay1 bisexual1 & transg5d] populations1 z well z ^? ^: sexual ori5tation1 g5d] id5tity & expression1 or reproductive developm5t v>ies f traditional1 societal1 cultural1 or physiological norms4 7#bf7 ,sight translation ,! t]m sight translation means ! transmission ( a writt5 message 9 "o language into a spok5 or sign$ message 9 ano!r language1 or an alt]native =mat 9 ,engli% or ano!r language4 7#bg7 ,/ate ,not)/&+ section #b1 ! t]m ,/ate means ea* ( ! sev]al ,/ates1 ! ,di/rict ( ,columbia1 ! ,commonweal? ( ,pu]to ,rico1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,guam1 ,am]ican ,samoa1 & ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s4 7#bh7 ,telephonic int]pretation ,! t]m telephonic int]pretation 7also kn[n z ov] ! phone int]pretation or ,,opi7 means1 ) respect to int]pretation = an individual ) limit$ ,engli% pr(ici5cy1 a me?od ( int]pretation 9 :i* ! int]pret] is n 9 ! physical pres5ce ( ! provid] ( heal? c>e s]vices or heal?-c>e-relat$ s]vices & su* individual receiv+ su* s]vices1 b ! int]pret] is connect$ via telephone4 7#bi7 ,translation ,! t]m translation means ! transmission ( a writt5 message 9 "o language into a writt5 or sign$ message 9 ano!r language1 & includes translation into ano!r language or alt]native =mat1 su* z l>ge pr9t font1 ,braille1 audio record+1 or ,,cd4 7#cj7 ,video remote int]pret+ s]vices ,! t]m video remote int]pret+ s]vices means ! provision1 9 heal? c>e s]vices or heal?-c>e-relat$ s]vices1 ?r\gh a qualifi$ int]pret] = an individual ) limit$ ,engli% pr(ici5cy1 ( video remote int]pret+ s]vices t are-- 7,a7 9 real-"t1 full-motion video1 & audio ov] a d$icat$ high-spe$1 wide-b&wid? video connection or wireless connection t deliv]s high quality video images t d n produce lags1 *oppy1 blurry1 or gra9y images1 or irregul> pauses 9 communication2 & 7,b7 9 a %>ply del9eat$ image t is l>ge en\gh to display4 7#ca7 ,vital docum5t ,! t]m vital docum5t includes applications = gov]nm5t programs t provide heal? c>e s]vices1 m$ical or f9ancial cons5t =ms1 f9ancial assi/ance docum5ts1 lett]s conta9+ important in=mation reg>d+ pati5t in/ructions 7su* z prescriptions1 ref]rals to o!r provid]s1 & dis*>ge plans7 & p>ticipation 9 a program 7su* z a ,m$icaid manag$ c>e program71 notices p]ta9+ to ! r$uction1 d5ial1 or t]m9ation ( s]vices or b5efits1 notices ( ! "r to appeal su* actions1 & notices advis+ individuals ) limit$ ,engli% pr(ici5cy ) communication disabilities ( ! availability ( free language s]vices1 alt]native =mats1 & o!r outrea* mat]ials4 7b7 ,ref]5ce ,9 any ref]5ce 9 ?is title to a regulatory provision applicable to a h&icapp$ individual1 ! t]m h&icapp$ individual 9 su* provision %all h ! same mean+ z ! t]m individual ) a disability z def9$ 9 subsection 7a74 #a ,res\rces & innovation = culturally & l+ui/ically appropriate heal? c>e #cdjd4 ,rob]t ,t4 ,matsui ,c5t] = ,culturally & ,l+ui/ically ,appropriate ,heal? ,c>e 7a7 ,e/abli%m5t ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 %all e/abli% & support a c5t] to be kn[n z ! ,rob]t ,t4 ,matsui ,c5t] = ,culturally & ,l+ui/ically ,appropriate ,heal? ,c>e 7ref]r$ to 9 ?is section z ! ,c5t]7 to c>ry out ea* ( ! foll[+ activities3 7#a7 ,int]pretation s]vices ,! ,c5t] %all provide res\rces via ! int]net to id5tify & l9k heal? c>e provid]s to compet5t int]pret] & translation s]vices4 7#b7 ,translation ( writt5 mat]ial 7,a7 ,vital docum5ts ,! ,c5t] %all provide1 directly or ?r\gh contract1 vital docum5ts f compet5t translation s]vices = provid]s ( heal? c>e s]vices & heal?-c>e-relat$ s]vices at no co/ to su* provid]s4 ,su* docum5ts may be submitt$ by cov]$ entities 7z def9$ 9 section #ib4d ( title #db1 ,code ( ,f$]al ,regulations1 z 9 effect on ,may #af1 #bjaf7 = translation into non-,engli% languages or alt]native =mats at a fif?-grade read+ level4 ,su* translation s]vices %all be provid$ 9 a timely & reasonable mann]4 ,! quality ( su* translation s]vices %all be monitor$ & report$ publicly4 7,b7 ,=ms ,= ea* =m develop$ or revis$ by ! ,secret>y t w be us$ by individuals ) limit$ ,engli% pr(ici5cy 9 heal? c>e or heal?-c>e-relat$ sett+s1 ! ,c5t] %all translate ! =m1 at a m9imum1 into ! top #ae non-,engli% languages 9 ! ,unit$ ,/ates accord+ to ! mo/ rec5t data f ! ,am]ican ,community ,survey or its replacem5t4 ,! translation %all be complet$ )9 #de cal5d> days ( ! ,secret>y receiv+ f9al approval ( ! =m f ! ,(fice ( ,managem5t & ,budget4 ,! ,c5t] %all po/ all translat$ =ms on its website s t o!r entities may use ! same translations4 7#c7 ,toll-free cu/om] s]vice telephone numb] ,! ,c5t] %all provide1 ?r\gh a toll-free numb]1 a cu/om] s]vice l9e = individuals ) limit$ ,engli% pr(ici5cy-- 7,a7 to obta9 in=mation ab\t f$]ally conduct$ or fund$ heal? programs1 includ+ ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act1 ! ,m$icaid program "u title ,,xix ( su* ,act1 & ! ,/ate ,*ildr5's ,heal? ,insurance ,program "u title ,,xxi ( su* ,act1 m>ketplace cov]age available pursuant to title ,,xxvii ( ?is ,act & ! ,pati5t ,protection & ,af=dable ,c>e ,act1 & o!r s\rces ( free or r$uc$ c>e includ+ f$]ally qualifi$ heal? c5t]s1 title ,x cl9ics1 & public heal? dep>tm5ts2 7,b7 to obta9 assi/ance ) apply+ = or access+ ^! programs & und]/&+ ,f$]al notices writt5 9 ,engli%2 & 7,c7 to le>n h[ to access language s]vices4 7#d7 ,heal? in=mation cle>+h\se 7,a7 ,9 g5]al ,! ,c5t] %all develop & ma9ta9 an in=mation cle>+h\se to facilitate ! provision ( language s]vices by provid]s ( heal? c>e s]vices & heal?-c>e-relat$ s]vices to r$uce m$ical errors1 improve m$ical outcomes1 improve cultural compet5ce1 r$uce heal? c>e co/s caus$ by miscommunication ) individuals ) limit$ ,engli% pr(ici5cy1 & r$uce or elim9ate ! duplication ( ef=ts to translate mat]ials4 ,! cle>+h\se %all include ! in=mation describ$ 9 subp>agraphs 7,b7 ?r\gh 7,f7 & make su* in=mation available on ! int]net & 9 pr9t4 7,b7 ,docum5t templates ,! ,c5t] %all collect & evaluate = accuracy1 develop1 & make available templates = /&>d docum5ts t are necess>y = pati5ts & consum]s to access & make educat$ decisions ab\t _! heal? c>e1 includ+ templates = ea* ( ! foll[+3 7i7 ,adm9i/rative & legal docum5ts1 includ+-- 7,i7 intake =ms2 7,,ii7 =ms relat$ to ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act1 ! ,m$icaid program "u title ,,xix ( su* ,act1 & ! ,/ate ,*ildr5's ,heal? ,insurance ,program "u title ,,xxi ( su* ,act1 includ+ eligibility in=mation = su* programs2 7,,iii7 =ms in=m+ pati5ts ( ! compliance & cons5t requirem5ts pursuant to ! regulations "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7#db ,u4,s4,c4 #acbj-b note72 & 7,,iv7 docum5ts conc]n+ in=m$ cons5t1 advanc$ directives1 & waiv]s ( rights4 7ii7 ,cl9ical in=mation1 su* z h[ to take m$ications1 h[ to prev5t transmission ( a contagi\s disease1 & o!r prev5tion & treatm5t in/ructions4 7iii7 ,public heal?1 pati5t education1 & outrea* mat]ials1 su* z immunization notices1 heal? w>n+s1 or scre5+ notices4 7iv7 ,additional heal? or heal?-c>e-relat$ mat]ials z det]m9$ appropriate by ! ,director ( ! ,c5t]4 7,c7 ,/ructure ( =ms ,9 op]at+ ! cle>+h\se1 ! ,c5t] %all-- 7i7 ensure t ! docum5ts po/$ 9 ,engli% & non-,engli% languages are culturally & l+ui/ically appropriate2 7ii7 all[ public review ( ! docum5ts be=e dissem9ation 9 ord] to ensure t ! docum5ts are und]/&able & culturally & l+ui/ically appropriate = ! t>get populations2 7iii7 all[ heal? c>e provid]s to cu/omize ! docum5ts = _! use2 7iv7 facilitate access to ^! docum5ts2 7v7 provide te*nical assi/ance ) respect to ! access & use ( su* in=mation2 & 7vi7 c>ry out any o!r activities ! ,secret>y det]m9es to be useful to fulfill ! purposes ( ! cle>+h\se4 7,d7 ,language assi/ance programs ,! ,c5t] %all provide = ! collection & dissem9ation ( in=mation on curr5t examples ( language assi/ance programs & /rategies to improve language s]vices = individuals ) limit$ ,engli% pr(ici5cy1 includ+ case /udies us+ de-id5tifi$ pati5t in=mation1 program summ>ies1 & program evaluations4 7,e7 ,culturally & l+ui/ically appropriate mat]ials ,! ,c5t] %all provide in=mation relat+ to culturally & l+ui/ically appropriate heal? c>e = m9ority populations resid+ 9 ! ,unit$ ,/ates to all heal? c>e provid]s & heal?-c>e-relat$ s]vices at no co/4 ,su* in=mation %all include-- 7i7 t5ets ( culturally & l+ui/ically appropriate c>e2 7ii7 culturally & l+ui/ically appropriate self-assessm5t tools2 7iii7 culturally & l+ui/ically appropriate tra9+ tools2 7iv7 /rategic plans to increase cultural & l+ui/ic appropriat5ess 9 diff]5t types ( provid]s ( heal? c>e s]vices & heal?-c>e-relat$ s]vices1 includ+ regional collaborations among heal? c>e organizations2 & 7v7 culturally & l+ui/ically appropriate in=mation = educators1 practition]s1 & rese>*]s4 7,f7 ,translation ,gloss>ies ,! ,c5t] %all-- 7i7 develop & publi% on its website translation gloss>ies t provide /&>diz$ translations ( commonly us$ t]ms & phrases utiliz$ 9 docum5ts translat$ by ! ,c5t]2 & 7ii7 make ^! gloss>ies available-- 7,i7 free ( *>ge2 7,,ii7 9 ! #ae languages 9 :i* ! ,c5t] translates mat]ials2 & 7,,iii7 9 alt]native =mats 9 accordance ) ! ,am]icans ) ,disabilities ,act ( #aiij 7#db ,u4,s4,c4 #abaja et seq474 7,g7 ,in=mation ab\t progress ,! ,c5t] %all regul>ly collect & make publicly available in=mation ab\t ! progress ( entities receiv+ grants "u section #cdjb reg>d+ successful innovations 9 implem5t+ ! obligations "u ?is subsection & provide public notice 9 ! entities' communities ab\t ! availability ( ?is in=mation4 7b7 ,director ,! ,c5t] %all be head$ by a ,director :o %all be appo9t$ by1 & :o %all report to1 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality4 7c7 ,availability ( language access ,! ,director %all collaborate ) ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 & ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration to notify heal? c>e provid]s & heal? c>e organizations ab\t ! availability ( language access s]vices by ! ,c5t]4 7d7 ,education ,! ,secret>y1 directly or ?r\gh contract1 %all und]take a national education campaign to in=m provid]s1 individuals ) limit$ ,engli% pr(ici5cy1 individuals ) he>+ or vision impairm5ts1 heal? pr(essionals1 graduate s*ools1 & community heal? c5t]s ab\t-- 7#a7 ,f$]al & ,/ate laws & guidel9es gov]n+ access to language s]vices2 7#b7 ! value ( us+ tra9$ & compet5t int]pret]s & ! risks associat$ ) us+ family memb]s1 fri5ds1 m9ors1 & untra9$ bil+ual /aff2 7#c7 fund+ s\rces = develop+ & implem5t+ language s]vices2 & 7#d7 promis+ practices to effectively provide language s]vices4 7e7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section #e1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdje4 ,innovations 9 culturally & l+ui/ically appropriate heal? c>e grants 7a7 ,9 g5]al 7#a7 ,grants ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 %all aw>d grants to eligible entities to enable su* entities to design1 implem5t1 & evaluate innovative1 co/-effective programs to improve culturally & l+ui/ically appropriate access to heal? c>e s]vices = individuals ) limit$ ,engli% pr(ici5cy4 7#b7 ,coord9ation ,! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality %all coord9ate )1 & ensure ! p>ticipation (1 o!r ag5cies includ+ ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities at ! ,national ,in/itutes ( ,heal?1 & ! ,(fice ( ,m9ority ,heal?1 reg>d+ ! design & evaluation ( ! grants program4 7b7 ,eligibility ,to be eligible to receive a grant "u subsection 7a71 an entity %all-- 7#a7 be-- 7,a7 a city1 c\nty1 ,indian ,tribe1 ,/ate1 or subdivision !re(2 7,b7 an organization describ$ 9 section #eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code ( #aihf & exempt f tax "u section #eja7;a7 ( su* ,code2 7,c7 a community heal?1 m5tal heal?1 or sub/ance use disord] c5t] or cl9ic2 7,d7 a solo or gr\p physician practice2 7,e7 an integrat$ heal? c>e deliv]y sy/em2 7,f7 a public hospital2 7,g7 a heal? c>e gr\p1 univ]sity1 or college2 or 7,h7 any o!r entity designat$ by ! ,secret>y2 & 7#b7 prep>e & submit to ! ,secret>y an application1 at su* "t1 9 su* mann]1 & conta9+ su* additional in=mation z ! ,secret>y may reasonably require4 7c7 ,use ( funds ,an entity %all use funds receiv$ ?r\gh a grant "u ?is section to-- 7#a7 develop1 implem5t1 & evaluate models ( provid+ compet5t int]pretation s]vices ?r\gh onsite int]pretation1 telephonic int]pretation1 or video remote int]pret+ s]vices2 7#b7 implem5t /rategies to recruit1 reta91 & promote individuals at all levels ( ! organization to ma9ta9 a div]se /aff & lead]%ip t c promote & provide language s]vices to pati5t populations ( ! s]vice area ( ! entity2 7#c7 develop & ma9ta9 a ne$s assessm5t t id5tifies ! curr5t demographic1 cultural1 & epidemiological pr(ile ( ! community to accurately plan = & implem5t language s]vices ne$$ 9 ! s]vice area ( ! entity2 7#d7 develop a /rategic plan to implem5t language s]vices2 7#e7 develop p>ticipatory1 collaborative p>tn]%ips ) communities encompass+ ! pati5t populations ( individuals ) limit$ ,engli% pr(ici5cy s]v$ by ! grant to ga9 input 9 design+ & implem5t+ language s]vices2 7#f7 develop & implem5t grievance resolution processes t are culturally & l+ui/ically appropriate & capable ( id5tify+1 prev5t+1 & resolv+ compla9ts by individuals ) limit$ ,engli% pr(ici5cy2 7#g7 develop %ort-t]m m$ical & m5tal heal? int]pretation tra9+ c\rses & inc5tives = bil+ual heal? c>e /aff :o are ask$ to provide int]pretation s]vices 9 ! workplace2 7#h7 develop =mal tra9+ programs1 includ+ cont9u$ pr(essional developm5t & education programs z well z sup]vision1 = individuals int]e/$ 9 becom+ d$icat$ heal? c>e int]pret]s & culturally & l+ui/ically appropriate provid]s2 7#i7 provide /aff language tra9+ in/ruction1 :i* %all include in=mation on ! practical limitations ( su* in/ruction = nonnative speak]s2 7#aj7 develop policies t address comp5sation 9 sal>y = /aff :o receive tra9+ to become ei!r a /aff int]pret] or bil+ual provid]2 7#aa7 develop o!r language assi/ance s]vices z det]m9$ appropriate by ! ,secret>y2 7#ab7 develop1 implem5t1 & evaluate models ( improv+ cultural compet5ce1 includ+ cultural compet5ce programs = community heal? work]s2 & 7#ac7 ensure t1 consi/5t ) ! privacy protections provid$ = "u ! regulations promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif & any applicable ,/ate privacy laws1 data on ! individual pati5t or recipi5t's race1 e?nicity1 & prim>y language are collect$ 7& p]iodically updat$7 9 heal? records & integrat$ into ! organization's in=mation managem5t sy/ems or any simil> sy/em us$ to /ore & retrieve data4 7d7 ,priority ,9 aw>d+ grants "u ?is section1 ! ,secret>y %all give priority to entities t prim>ily engage 9 provid+ direct c>e & t h develop$ p>tn]%ips ) community organizations or ) ag5cies ) exp]i5ce 9 improv+ language access4 7e7 ,evaluation 7#a7 ,by grantees ,an entity t receives a grant "u ?is section %all submit to ! ,secret>y an evaluation t describes1 9 ! mann] & to ! ext5t requir$ by ! ,secret>y1 ! activities c>ri$ out ) funds receiv$ "u ! grant1 & h[ su* activities improv$ access to heal? c>e s]vices & heal?-c>e-relat$ s]vices & ! quality ( heal? c>e = individuals ) limit$ ,engli% pr(ici5cy4 ,su* evaluation %all be collect$ & dissem9at$ ?r\gh ! ,rob]t ,t4 ,matsui ,c5t] = ,culturally & ,l+ui/ically ,appropriate ,heal? ,c>e e/abli%$ "u section #cdja4 ,! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality %all notify grantees ( ! availability ( te*nical assi/ance = ! evaluation & provide su* assi/ance ^u reque/4 7#b7 ,by ,secret>y ,! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality %all evaluate or arrange ) o!r individuals or organizations to evaluate projects fund$ "u ?is section4 7f7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section1 #e1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdjf4 ,rese>* on cultural & language compet5ce 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 %all exp& rese>* conc]n+ language access 9 ! provision ( heal? c>e s]vices4 7b7 ,eligibility ,! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality may conduct ! rese>* describ$ 9 subsection 7a7 or ent] into contracts ) o!r individuals or organizations to conduct su* rese>*4 7c7 ,use ( funds ,rese>* conduct$ "u ?is section %all be design$ to d "o or m ( ! foll[+3 7#a7 ,to id5tify ! b>ri]s to m5tal & behavioral s]vices t are fac$ by individuals ) limit$ ,engli% pr(ici5cy4 7#b7 ,to id5tify heal? c>e provid]s' & heal? adm9i/rators' attitudes1 k1 & aw>5ess ( ! b>ri]s to quality heal? c>e s]vices t are fac$ by individuals ) limit$ ,engli% pr(ici5cy4 7#c7 ,to id5tify optimal approa*es = deliv]+ language access4 7#d7 ,to id5tify be/ practices = data collection1 includ+-- 7,a7 ! collection by provid]s ( heal? c>e s]vices & heal?-c>e-relat$ s]vices ( data on ! race1 e?nicity1 & prim>y language ( recipi5ts ( su* s]vices1 tak+ into acc\nt exi/+ rese>* conduct$ by ! ,gov]nm5t or private sector2 7,b7 ! developm5t & implem5tation ( data collection & report+ sy/ems2 & 7,c7 effective privacy safegu>ds = collect$ data4 7#e7 ,to develop a m9imum data collection set = prim>y language4 7#f7 ,to evaluate ! mo/ effective ways 9 :i* ! ,secret>y c create or coord9ate1 & subsidize or o!rwise fund1 telephonic int]pretation s]vices = heal? c>e provid]s1 tak+ into consid]ation1 among o!r factors1 ! flexibility necess>y = su* a sy/em to accommodate v>iations 9-- 7,a7 provid] type2 7,b7 languages ne$$ & _! frequ5cy ( use2 7,c7 type ( enc\nt]2 7,d7 "t ( enc\nt]1 includ+ regul> bus9ess h\rs & aft] h\rs2 & 7,e7 location ( enc\nt]4 7d7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section #e1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 4 #gjc4 ,tra9+ tomorr['s doctors = culturally & l+ui/ically appropriate c>e3 graduate m$ical education 7a7 ,direct graduate m$ical education ,section #ahhf7;h77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7h77#d77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,l7 ,treatm5t ( culturally & l+ui/ically appropriate tra9+ ,9 det]m9+ a hospital's numb] ( full-"t equival5t resid5ts = purposes ( ?is subsection1 all ! "t t is sp5t by an int]n or resid5t 9 an approv$ m$ical resid5cy tra9+ program = education & tra9+ 9 culturally & l+ui/ically appropriate s]vice deliv]y1 :i* %all include all div]se populations includ+ p ) disabilities & ! ,lesbian1 gay1 bisexual1 transg5d]1 que]1 que/ion+1 que/ion+ & int]sex 7,,lgbtqia7 community1 %all be c\nt$ t[>d ! det]m9ation ( full-"t equival5cy4 4 7b7 ,indirect m$ical education ,section #ahhf7;d77#e77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#e77;,b77 is am5d$-- 7#a7 by r$esignat+ ! clause 7x7 add$ by section #eeje7;b7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act z clause 7xi72 & 7#b7 by add+ at ! end ! foll[+ new clause3 7xii7 ,! provisions ( subp>agraph 7,l7 ( subsection 7h77#d7 %all apply "u ?is subp>agraph 9 ! same mann] z !y apply "u su* subsection4 4 7c7 ,effective date ,! am5dm5ts made by subsections 7a7 & 7b7 %all apply ) respect to paym5ts made to hospitals on or aft] ! date t is "o ye> aft] ! date ( ! enactm5t ( ?is ,act4 #gjd4 ,f$]al reimbursem5t = culturally & l+ui/ically appropriate s]vices "u ! ,m$ic>e1 ,m$icaid1 & ,/ate ,*ildr5's ,heal? ,insurance ,programs 7a7 ,language ,access grants = ,m$ic>e ,provid]s 7#a7 ,e/abli%m5t 7,a7 ,9 g5]al ,n lat] ?an #f mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices & 9 consultation ) ! ,c5t] = ,m$ic>e & ,m$icaid ,innovation 7z ref]r$ to 9 section #aaae;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a771 %all e/abli% a demon/ration program "u :i* ! ,secret>y %all aw>d grants to eligible ,m$ic>e s]vice provid]s to improve communication betwe5 su* provid]s & ,m$ic>e b5efici>ies :o are limit$ ,engli% pr(ici5t1 includ+ b5efici>ies :o live 9 div]se & und]s]v$ communities4 7,b7 ,application ( innovation rules ,! demon/ration project "u subp>agraph 7,a7 %all be conduct$ 9 a mann] t is consi/5t ) ! applicable provisions ( subsections 7b71 7c71 & 7d7 ( section #aaae;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a74 7,c7 ,numb] ( grants ,to ! ext5t practicable1 ! ,secret>y %all aw>d n less ?an #bd grants "u ?is subsection4 7,d7 ,grant p]iod ,except z provid$ "u p>agraph 7#b77;,d71 ea* grant aw>d$ "u ?is subsection %all be = a #c-ye> p]iod4 7#b7 ,eligibility requirem5ts ,to be eligible = a grant "u ?is subsection1 an entity mu/ meet ! foll[+ requirem5ts3 7,a7 ,m$ic>e provid] ,! entity mu/ be-- 7i7 a provid] ( s]vices "u "p ,a ( title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;c et seq472 7ii7 a provid] ( s]vices "u "p ,b ( su* title 7#db ,u4,s4,c4 #acie;j et seq472 7iii7 a ,m$ic>e ,advantage organization (f]+ a ,m$ic>e ,advantage plan "u "p ,c ( su* title 7#db ,u4,s4,c4 #aciew-#ba et seq472 or 7iv7 a ,,pdp sponsor (f]+ a prescription drug plan "u "p ,d ( su* title 7#db ,u4,s4,c4 #aciew-#aja et seq474 7,b7 ,und]s]v$ communities ,! entity mu/ s]ve a community t1 ) respect to necess>y language s]vices = improv+ access & utilization ( heal? c>e among ,engli% le>n]s1 is disproportionally und]s]v$4 7,c7 ,application ,! entity mu/ prep>e & submit to ! ,secret>y an application1 at su* "t1 9 su* mann]1 & accompani$ by su* additional in=mation z ! ,secret>y may require4 7,d7 ,report+ ,9 ! case ( a grantee t receiv$ a grant "u ?is subsection 9 a previ\s ye>1 su* grantee is only eligible = cont9u$ paym5ts "u a grant "u ?is subsection if ! grantee met ! report+ requirem5ts "u p>agraph 7#i7 = su* ye>4 ,if a grantee fails to meet ! requirem5t ( su* p>agraph = ! fir/ ye> ( a grant1 ! ,secret>y may t]m9ate ! grant & solicit applications f new grantees to p>ticipate 9 ! demon/ration program4 7#c7 ,di/ribution ,to ! ext5t feasible1 ! ,secret>y %all aw>d-- 7,a7 at lea/ #f grants to provid]s ( s]vices describ$ 9 p>agraph 7#b77;,a77i72 7,b7 at lea/ #f grants to s]vice provid]s describ$ 9 p>agraph 7#b77;,a77ii72 7,c7 at lea/ #f grants to organizations describ$ 9 p>agraph 7#b77;,a77iii72 & 7,d7 at lea/ #f grants to sponsors describ$ 9 p>agraph 7#b77;,a77iv74 7#d7 ,consid]ations 9 aw>d+ grants 7,a7 ,v>iation 9 grantees ,9 aw>d+ grants "u ?is subsection1 ! ,secret>y %all select grantees to ensure ! foll[+3 7i7 ,! grantees provide _m diff]5t types ( language s]vices4 7ii7 ,! grantees s]ve ,m$ic>e b5efici>ies :o speak diff]5t languages1 & :o1 z a population1 h diff]+ ne$s = language s]vices4 7iii7 ,! grantees s]ve ,m$ic>e b5efici>ies 9 bo? urban & rural sett+s4 7iv7 ,! grantees s]ve ,m$ic>e b5efici>ies 9 at lea/ two geographic regions1 z def9$ by ! ,secret>y4 7v7 ,! grantees s]ve ,m$ic>e b5efici>ies 9 at lea/ two l>ge metropolitan /ati/ical areas ) racial1 e?nic1 sexual1 g5d]1 disability1 & economically div]se populations4 7,b7 ,priority = p>tn]%ips ) community organizations & ag5cies ,9 aw>d+ grants "u ?is subsection1 ! ,secret>y %all give priority to eligible entities t h a p>tn]%ip )-- 7i7 a community organization2 or 7ii7 a consortia ( community organizations1 ,/ate ag5cies1 & local ag5cies1 t has exp]i5ce 9 provid+ language s]vices4 7#e7 ,use ( funds = compet5t language s]vices 7,a7 ,9 g5]al ,subject to subp>agraph 7,e71 a grantee may only use grant funds receiv$ "u ?is subsection to pay = ! provision ( compet5t language s]vices to ,m$ic>e b5efici>ies :o are ,engli% le>n]s4 7,b7 ,compet5t language s]vices def9$ ,= purposes ( ?is subsection1 ! t]m compet5t language s]vices means-- 7i7 int]pret] & translation s]vices t-- 7,i7 subject to ! exceptions "u subp>agraph 7,c7-- 7aa7 if ! grantee op]ates 9 a ,/ate t has /atewide heal? c>e int]pret] /&>ds1 meet ! ,/ate /&>ds curr5tly 9 effect2 or 7bb7 if ! grantee op]ates 9 a ,/ate t does n h /atewide heal? c>e int]pret] /&>ds1 utilizes compet5t int]pret]s :o foll[ ! ,national ,c\ncil on ,int]pret+ 9 ,heal? ,c>e's ,code ( ,e?ics & ,/&>ds ( ,practice & comply ) ! requirem5ts ( section #aeeg ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahaaf7 z publi%$ 9 ! ,f$]al ,regi/] on ,may #ah1 #bjaf2 & 7,,ii7 t1 9 ! case ( int]pret] s]vices1 are provid$ ?r\gh-- 7aa7 onsite int]pretation2 7bb7 telephonic int]pretation2 or 7cc7 video int]pretation2 & 7ii7 ! direct provision ( heal? c>e or heal?-c>e-relat$ s]vices by a compet5t bil+ual heal? c>e provid]4 7,c7 ,exceptions ,! requirem5ts ( subp>agraph 7,b77i77,i7 d n apply1 ) respect to int]pret] & translation s]vices & a grantee-- 7i7 9 ! case ( a ,m$ic>e b5efici>y :o is an ,engli% le>n] if-- 7,i7 su* b5efici>y has be5 in=m$1 9 ! b5efici>y's prim>y language1 ( ! availability ( free int]pret] & translation s]vices & ! b5efici>y in/ead reque/s t a family memb]1 fri5d1 or o!r p]son provide su* s]vices2 & 7,,ii7 ! grantee docum5ts su* reque/ 9 ! b5efici>y's m$ical record2 or 7ii7 9 ! case ( a m$ical em]g5cy :]e ! delay directly associat$ ) obta9+ a compet5t int]pret] or translation s]vices w\ld jeop>dize ! heal? ( ! pati5t4 ,clause 7ii7 %all n be con/ru$ to exempt em]g5cy rooms or simil> entities t regul>ly provide heal? c>e s]vices 9 m$ical em]g5cies to pati5ts :o are ,engli% le>n]s f any applicable legal or regulatory requirem5ts relat$ to provid+ compet5t int]pret] & translation s]vices )\t undue delay4 7,d7 ,m$ic>e advantage organizations & ,,pdp sponsors ,if a grantee is a ,m$ic>e ,advantage organization (f]+ a ,m$ic>e ,advantage plan "u "p ,c ( title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ba et seq47 or a ,,pdp sponsor (f]+ a prescription drug plan "u "p ,d ( su* title 7#db ,u4,s4,c4 #aciew-#aja et seq471 su* entity mu/ provide at lea/ #ej p]c5t ( ! grant funds t ! entity receives "u ?is subsection directly to ! entity's network provid]s 7includ+ all heal? provid]s & ph>maci/s7 = ! purpose ( provid+ support = su* provid]s to provide compet5t language s]vices to ,m$ic>e b5efici>ies :o are ,engli% le>n]s4 7,e7 ,adm9i/rative & report+ co/s ,a grantee may use up to #aj p]c5t ( ! grant funds to pay = adm9i/rative co/s associat$ ) ! provision ( compet5t language s]vices & = report+ requir$ "u p>agraph 7#i74 7#f7 ,det]m9ation ( am\nt ( grant paym5ts 7,a7 ,9 g5]al ,paym5ts to grantees "u ?is subsection %all be calculat$ bas$ on ! e/imat$ numb]s ( ,m$ic>e b5efici>ies :o are ,engli% le>n]s 9 a grantee's s]vice area utiliz+-- 7i7 data on ! numb]s ( ,engli% le>n]s :o speak ,engli% less ?an v well f ! mo/ rec5tly available data f ! ,bureau ( ! ,c5sus or o!r ,/ate-bas$ /udy ! ,secret>y det]m9es likely to yield accurate data reg>d+ ! numb] ( su* individuals 9 su* s]vice area2 or 7ii7 data provid$ by ! grantee1 if ! grantee r\t9ely collects data on ! prim>y language ( ! ,m$ic>e b5efici>ies t ! grantee s]ves & ! ,secret>y det]m9es t ! data is accurate & %[s a great] numb] ( ,engli% le>n]s ?an w\ld be e/imat$ us+ ! data "u clause 7i74 7,b7 ,discretion ( ,secret>y ,subject to subp>agraph 7,c71 ! am\nt ( paym5t made to a grantee "u ?is subsection may be modifi$ annually at ! discretion ( ! ,secret>y1 bas$ on *anges 9 ! data "u subp>agraph 7,a7 ) respect to ! s]vice area ( a grantee = ! ye>4 7,c7 ,limitation on am\nt ,! am\nt ( a grant made "u ?is subsection to a grantee may n exce$ #ejj1jjj = ! p]iod "u p>agraph 7#a77;,d74 7#g7 ,assurances ,grantees "u ?is subsection %all1 z a condition ( receiv+ a grant "u ?is subsection-- 7,a7 ensure t cl9ical & support /aff receive appropriate ongo+ education & tra9+ 9 l+ui/ically appropriate s]vice deliv]y2 7,b7 ensure ! l+ui/ic compet5ce ( bil+ual provid]s2 7,c7 (f] & provide appropriate language s]vices at no additional *>ge to ea* pati5t :o is an ,engli% le>n] = all po9ts ( contact betwe5 ! pati5t & ! grantee1 9 a timely mann] dur+ all h\rs ( op]ation2 7,d7 notify ,m$ic>e b5efici>ies ( _! "r to receive language s]vices 9 _! prim>y language2 7,e7 po/ signage 9 ! prim>y languages commonly us$ by ! pati5t population 9 ! s]vice area ( ! organization2 & 7,f7 ensure t-- 7i7 prim>y language data are collect$ = recipi5ts ( language s]vices & su* data are consi/5t ) /&>ds develop$ "u title ,,xxxiv ( ! ,public ,heal? ,s]vice ,act1 z add$ by section #bjb ( ?is ,act1 to ! ext5t su* /&>ds are available ^u ! initiation ( ! demon/ration program2 & 7ii7 consi/5t ) ! privacy protections provid$ "u ! regulations promulgat$ pursuant to section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7#db ,u4,s4,c4 #acbj;d-#b note71 if ! recipi5t ( language s]vices is a m9or or is incapacitat$1 prim>y language data are collect$ on ! p>5t or legal gu>dian ( su* recipi5t4 7#h7 ,no ,co/ ,%>+ ,m$ic>e b5efici>ies :o are ,engli% le>n]s %all n h to pay co/ %>+ or co-paym5ts = compet5t language s]vices provid$ "u ?is demon/ration program4 7#i7 ,report+ ,requirem5ts = grantees ,n lat] ?an ! end ( ea* cal5d> ye>1 a grantee t receives funds "u ?is subsection 9 su* ye> %all submit to ! ,secret>y a report t includes ! foll[+ in=mation3 7,a7 ,! numb] ( ,m$ic>e b5efici>ies to :om compet5t language s]vices are provid$4 7,b7 ,! prim>y languages ( ^? ,m$ic>e b5efici>ies4 7,c7 ,! types ( language s]vices provid$ to su* b5efici>ies4 7,d7 ,:e!r su* language s]vices 7 provid$ by employees ( ! grantee or ?r\gh a contract ) ext]nal contractors or ag5cies4 7,e7 ,! types ( int]pretation s]vices provid$ to su* b5efici>ies1 & ! approximate l5g? ( "t su* s]vice is provid$ to su* b5efici>ies4 7,f7 ,! co/s ( provid+ compet5t language s]vices4 7,g7 ,an acc\nt ( ! tra9+ or accr$itation ( bil+ual /aff1 int]pret]s1 & translators provid+ s]vices fund$ by ! grant "u ?is subsection4 7#aj7 ,evaluation & report to ,congress ,n lat] ?an #a ye> aft] ! completion ( a #c-ye> grant "u ?is subsection1 ! ,secret>y %all conduct an evaluation ( ! demon/ration program "u ?is subsection & %all submit to ! ,congress a report t includes ! foll[+3 7,a7 ,an analysis ( ! pati5t outcomes & ! co/s ( furni%+ c>e to ! ,m$ic>e b5efici>ies :o are ,engli% le>n]s p>ticipat+ 9 ! project z comp>$ to su* outcomes & co/s = su* ,m$ic>e b5efici>ies n p>ticipat+1 bas$ on ! data provid$ "u p>agraph 7#i7 & any o!r in=mation available to ! ,secret>y4 7,b7 ,! effect ( deliv]+ language s]vices on-- 7i7 ,m$ic>e b5efici>y access to c>e & utilization ( s]vices2 7ii7 ! effici5cy & co/ effectiv5ess ( heal? c>e deliv]y2 7iii7 pati5t satisfaction2 7iv7 heal? outcomes2 & 7v7 ! provision ( culturally appropriate s]vices provid$ to su* b5efici>ies4 7,c7 ,! ext5t to :i* bil+ual /aff1 int]pret]s1 & translators provid+ s]vices "u su* demon/ration 7 tra9$ or accr$it$ & ! nature ( accr$itation or tra9+ ne$$ by type ( provid]1 s]vice1 or o!r category z det]m9$ by ! ,secret>y to ensure ! provision ( high-quality int]pretation1 translation1 or o!r language s]vices to ,m$ic>e b5efici>ies if su* s]vices are exp&$ pursuant to section #aaae;,a7c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7c774 7,d7 ,recomm5dations1 if any1 reg>d+ ! ext5sion ( su* project to ! entire ,m$ic>e ,program1 subject to ! provisions ( su* section #aaae;,a7c74 7#aa7 ,appropriations ,!re is appropriat$ to c>ry out ?is subsection1 9 equal p>ts f ! ,f$]al ,hospital ,insurance ,tru/ ,fund "u section #ahag ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7 & ! ,f$]al ,supplem5t>y ,m$ical ,insurance ,tru/ ,fund "u section #ahda ( su* ,act 7#db ,u4,s4,c4 #aciet71 #af1jjj1jjj = ea* fiscal ye> ( ! demon/ration program4 7#ab7 ,engli% le>n] def9$ ,9 ?is subsection1 ! t]m ,engli% le>n] has ! mean+ giv5 su* t]m 9 section #haja7bj7 ( ! ,elem5t>y & ,second>y ,education ,act ( #aife1 except t subp>agraphs 7,a71 7,b71 & 7,d7 ( su* section %all n apply4 7b7 ,language assi/ance s]vices "u ! ,m$ic>e program 7#a7 ,inclusion z rural heal? cl9ic s]vices ,section #ahfa ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is am5d$-- 7,a7 9 subsection 7aa77#a7-- 7i7 9 subp>agraph 7,b71 by /rik+ & at ! end2 7ii7 by add+ & at ! end ( subp>agraph 7,c72 & 7iii7 by ins]t+ aft] subp>agraph 7,c7 ! foll[+ new subp>agraph3 7,d7 language assi/ance s]vices z def9$ 9 subsection 7jjj77#a71 2 & 7,b7 by add+ at ! end ! foll[+ new subsection3 7kkk7 ,language assi/ance s]vices & relat$ t]ms 7#a7 ,! t]m language assi/ance s]vices means language access or language assi/ance s]vices 7z ^? t]ms are def9$ 9 section #cdjj ( ! ,public ,heal? ,s]vice ,act7 furni%$ by a qualifi$ int]pret] = an individual ) limit$ ,engli% pr(ici5cy or a qualifi$ translator 7z ^? t]ms are def9$ 9 su* section #cdjj7 to an individual ) limit$ ,engli% pr(ici5cy 7z def9$ 9 su* section #cdjj7 or an ,engli% le>n] 7z def9$ 9 p>agraph 7#b774 7#b7 ,! t]m ,engli% le>n] has ! mean+ giv5 t t]m 9 section #haja7bj7 ( ! ,elem5t>y & ,second>y ,education ,act ( #aife1 except t subp>agraphs 7,a71 7,b71 & 7,d7 ( su* section %all n apply4 4 7#b7 ,cov]age ,section #ahcb7;a77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciek7a77#b77 is am5d$-- 7,a7 by /rik+ & at ! end ( subp>agraph 7,i72 7,b7 by /rik+ ! p]iod at ! end ( subp>agraph 7,j7 & ins]t+ 2 &2 & 7,c7 by add+ at ! end ! foll[+ new subp>agraph3 7,k7 language assi/ance s]vices 7z def9$ 9 section #ahfa7;jjj77#a774 4 7#c7 ,paym5t ,section #ahcc7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77 is am5d$-- 7,a7 by /rik+ & at ! end ( p>agraph 7#h72 7,b7 by /rik+ ! p]iod at ! end ( p>agraph 7#i7 & ins]t+ 2 &2 & 7,c7 by ins]t+ aft] p>agraph 7#i7 ! foll[+ new p>agraph3 7#aj7 9 ! case ( language assi/ance s]vices 7z def9$ 9 section #ahfa7;jjj77#a771 #ajj p]c5t ( ! reasonable *>ges = su* s]vices1 z det]m9$ 9 consultation ) ! ,m$ic>e ,paym5t ,advisory ,commission4 4 7#d7 ,waiv] ( budget neutrality ,= ! #c-ye> p]iod beg9n+ on ! date ( enactm5t ( ?is section1 ! budget neutrality provision ( section #ahdh7;c77#b77;,b77ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;c77#b77;,b77ii77 %all n apply ) respect to language assi/ance s]vices 7z def9$ 9 section #ahfa7kkk77#a7 ( su* ,act74 7c7 ,m$ic>e p>ts ,c & ,d 7#a7 ,9 g5]al ,m$ic>e ,advantage plans "u "p ,c ( title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ba et seq47 & prescription drug plans "u "p ,d ( su* title 7#db ,u4,s4,c4 #acieq-#aja7 %all comply ) title ,,vi ( ! ,civil ,rights ,act ( #aifd 7#db ,u4,s4,c4 #bjjj;d et seq47 & section #aeeg ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahaaf7 to provide effective language s]vices to enrollees ( su* plans4 7#b7 ,m$ic>e ,advantage plans & prescription drug plans report+ requirem5t ,section #aheg7;e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bg7;e77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#e7 ,report+ requirem5ts relat+ to effective language s]vices ,a contract "u ?is "p %all require a ,m$ic>e ,advantage organization 7&1 ?r\gh application ( section #ahfj;,d-#ab7;b77#c77;,d71 a contract "u section #ahfj;,d-#ab %all require a ,,pdp sponsor7 to annually submit 7= ea* ye> ( ! contract7 a report t conta9s in=mation on ! int]nal policies & proc$ures ( ! organization 7or sponsor7 relat$ to recruitm5t & ret5tion ef=ts direct$ to work=ce div]sity & l+ui/ically & culturally appropriate provision ( s]vices 9 ea* ( ! foll[+ contexts3 7,a7 ,! collection ( data 9 a mann] t meets ! requirem5ts ( title ,i ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj1 reg>d+ ! enrollee population4 7,b7 ,education ( /aff & contractors :o h r\t9e contact ) enrollees reg>d+ ! v>i\s ne$s ( ! div]se enrollee population4 7,c7 ,evaluation ( ! language s]vices programs & s]vices (f]$ by ! organization 7or sponsor7 ) respect to ! enrollee population1 su* z ?r\gh analysis ( compla9ts or satisfaction survey results4 7,d7 ,me?ods by :i* ! plan provides to ! ,secret>y in=mation reg>d+ ! e?nic div]sity ( ! enrollee population4 7,e7 ,! p]iodic provision ( educational in=mation to plan enrollees on ! language s]vices & programs (f]$ by ! organization 7or sponsor74 4 7d7 ,improv+ language s]vices 9 ,m$icaid & ,,*ip 7#a7 ,paym5ts to ,/ates ,section #aijc7;a77#b77;,e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77#b77;,e771 z am5d$ by section #bjc7;g77#c71 is fur!r am5d$ by-- 7,a7 /rik+ #ge & ins]t+ #ie2 7,b7 /rik+ translation or int]pretation s]vices & ins]t+ language assi/ance s]vices2 & 7,c7 /rik+ *ildr5 ( families & ins]t+ individuals4 7#b7 ,/ate plan requirem5ts ,section #aijb7;a77#aj77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77 is am5d$ by /rik+ & 7#bi7 & ins]t+ 7#bi71 & 7#cj74 7#c7 ,def9ition ( m$ical assi/ance ,section #aije7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is am5d$ by-- 7,a7 9 p>agraph 7#bi71 by /rik+ & at ! end2 7,b7 by r$esignat+ p>agraph 7#cj7 z p>agraph 7#ca72 & 7,c7 by ins]t+ aft] p>agraph 7#bi7 ! foll[+ new p>agraph3 7#cj7 language assi/ance s]vices1 z su* t]m is def9$ 9 section #ahfa7kkk77#a71 provid$ 9 a timely mann] to individuals ) limit$ ,engli% pr(ici5cy z def9$ 9 section #cdjj ( ! ,public ,heal? ,s]vice ,act2 & 4 7#d7 ,use ( d$uctions & co/ %>+ ,section #aiaf7;a77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifo7a77#b77 is am5d$ by-- 7,a7 by /rik+ or at ! end ( subp>agraph 7,d72 7,b7 by /rik+ 2 & at ! end ( subp>agraph 7,e7 & ins]t+ 1 or2 & 7,c7 by add+ at ! end ! foll[+ new subp>agraph3 7,f7 language assi/ance s]vices describ$ 9 section #aije7;a77#bi72 & 4 7#e7 ,,*ip cov]age requirem5ts ,section #bajc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7 is am5d$-- 7,a7 9 subsection 7a71 9 ! matt] be=e p>agraph 7#a71 by /rik+ & 7#g7 & ins]t+ 7#g71 & 7#aj72 & 7,b7 9 subsection 7c71 by add+ at ! end ! foll[+ new p>agraph3 7#aj7 ,language assi/ance s]vices ,! *ild heal? assi/ance provid$ to a t>get$ l[-income *ild %all include cov]age ( language assi/ance s]vices1 z su* t]m is def9$ 9 section #ahfa7;jjj77#a71 provid$ 9 a timely mann] to individuals ) limit$ ,engli% pr(ici5cy 7z def9$ 9 section #cdjj ( ! ,public ,heal? ,s]vice ,act74 2 & 7,c7 9 subsection 7e77#b7-- 7i7 9 ! head+1 by /rik+ prev5tive & ins]t+ c]ta92 & 7ii7 by ins]t+ or subsection 7c77#aj7 aft] subsection 7c77#a77;,d74 7#f7 ,def9ition ( *ild heal? assi/ance ,section #baaj7;a77#bg7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;jj7a77#bg77 is am5d$ by /rik+ translation & ins]t+ language assi/ance s]vices z describ$ 9 section #bajc7;c77#aj74 7#g7 ,/ate data collection ,pursuant to ! report+ requirem5t describ$ 9 section #bajg7;b77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7b77#a771 ! ,secret>y ( ,heal? & ,human ,s]vices %all require t ,/ates collect data on-- 7,a7 ! prim>y language ( individuals receiv+ *ild heal? assi/ance "u title ,,xxi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;aa et seq472 & 7,b7 9 ! case ( su* individuals :o are m9ors or incapacitat$1 ! prim>y language ( ! individual's p>5t or gu>dian4 7#h7 ,,*ip paym5ts to ,/ates ,section #baje ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7 is am5d$-- 7,a7 9 subsection 7a77#a71 by /rik+ #ge & ins]t+ #ij2 & 7,b7 9 subsection 7c77#b77;,a71 by ins]t+ be=e ! p]iod at ! end ! foll[+3 1 except t exp5ditures pursuant to clause 7iv7 ( subp>agraph 7,d7 ( su* p>agraph %all n c\nt t[>ds ?is total4 7e7 ,fund+ language assi/ance s]vices furni%$ by provid]s ( heal? c>e & heal?-,c>e-,relat$ s]vices t s]ve high rates ( un9sur$ ,,lep individuals 7#a7 ,paym5t ( co/s 7,a7 ,9 g5]al ,subject to subp>agraph 7,b71 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is subsection z ! ,secret>y7 %all make paym5ts 7on a qu>t]ly basis7 directly to eligible entities to support ! provision ( language assi/ance s]vices to ,engli% le>n]s 9 an am\nt equal to an eligible entity's eligible co/s = provid+ su* s]vices = ! qu>t]4 7,b7 ,fund+ ,out ( any funds 9 ! ,treasury n o!rwise appropriat$1 !re are appropriat$ to ! ,secret>y ( ,heal? & ,human ,s]vices su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 7,c7 ,relation to ,m$icaid ,,d% ,paym5ts "u ?is subsection %all n (fset or r$uce paym5ts "u section #aibc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d71 nor %all paym5ts "u su* section be consid]$ :5 det]m9+ uncomp5sat$ co/s associat$ ) ! provision ( language assi/ance s]vices = ! purposes ( ?is section4 7#b7 ,me?odology = paym5t ( claims 7,a7 ,9 g5]al ,! ,secret>y %all e/abli% a me?odology to det]m9e ! av]age p] p]son co/ ( language assi/ance s]vices4 7,b7 ,diff]5t entities ,9 e/abli%+ su* me?odology1 ! ,secret>y may e/abli% diff]5t me?odologies = diff]5t types ( eligible entities4 7,c7 ,no individual claims ,! ,secret>y may n require eligible entities to submit individual claims = language assi/ance s]vices = individual pati5ts z a requirem5t = paym5t "u ?is subsection4 7#c7 ,data collection in/rum5t ,= purposes ( ?is subsection1 ! ,secret>y %all create a /&>d data collection in/rum5t t is consi/5t ) any exi/+ report+ requirem5ts by ! ,secret>y or relevant accr$it+ organizations reg>d+ ! numb] ( individuals to :om language access are provid$4 7#d7 ,guidel9es ,n lat] ?an #f mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y %all e/abli% & di/ribute guidel9es conc]n+ ! implem5tation ( ?is subsection4 7#e7 ,report+ requirem5ts 7,a7 ,report to ,secret>y ,entities receiv+ paym5t "u ?is subsection %all provide ! ,secret>y ) a qu>t]ly report on h[ ! entity us$ su* funds4 ,su* report %all conta9 aggregate 7& may n conta9 individualiz$7 data collect$ us+ ! in/rum5t "u p>agraph 7#c7 & %all o!rwise be 9 a =m & mann] det]m9$ by ! ,secret>y4 7,b7 ,report to ,congress ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is ,act1 & e #b ye>s !reaft]1 ! ,secret>y %all submit a report to ,congress conc]n+ ! implem5tation ( ?is subsection4 7#f7 ,def9itions ,9 ?is subsection3 7,a7 ,eligible co/s ,! t]m eligible co/s means1 ) respect to an eligible entity t provides language assi/ance s]vices to ,engli% le>n]s1 ! product (-- 7i7 ! av]age p] p]son co/ ( language assi/ance s]vices1 det]m9$ accord+ to ! me?odology devis$ "u p>agraph 7#b72 & 7ii7 ! numb] ( ,engli% le>n]s :o are provid$ language assi/ance s]vices by ! entity & = :om no reimbursem5t is available = su* s]vices "u ! am5dm5ts made by subsections 7a71 7b71 7c71 or 7d7 or by private heal? insurance4 7,b7 ,eligible entity ,! t]m eligible entity means an entity t-- 7i7 is a ,m$icaid provid] t is-- 7,i7 a physician2 7,,ii7 a hospital ) a l[-income utilization rate 7z def9$ 9 section #aibc7;b77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7;b77#c777 ( great] ?an #be p]c5t2 or 7,,iii7 a ,f$]ally qualifi$ heal? c5t] 7z def9$ 9 section #aije7l77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l77#b77;,b7772 7ii7 n lat] ?an #f mon?s aft] ! date ( ! enactm5t ( ?is ,act1 provides language assi/ance s]vices to n less ?an #h p]c5t ( ! entity's total numb] ( pati5ts2 & 7iii7 prep>es & submits an application to ! ,secret>y1 at su* "t1 9 su* mann]1 & accompani$ by su* in=mation z ! ,secret>y may require1 to asc]ta9 ! entity's eligibility = fund+ "u ?is subsection4 7,c7 ,engli% le>n] ,! t]m ,engli% le>n] has ! mean+ giv5 su* t]m 9 section #haja7bj7 ( ! ,elem5t>y & ,second>y ,education ,act ( #aife 7#bj ,u4,s4,c4 #ghja7bj771 except t subp>agraphs 7,a71 7,b71 & 7,d7 ( su* section %all n apply4 7,d7 ,language assi/ance s]vices ,! t]m language assi/ance s]vices has ! mean+ giv5 su* t]m 9 section #ahfa7kkk77#a7 ( ! ,social ,security ,act1 z add$ by subsection 7b74 7f7 ,application ( ,civil ,rights ,act ( #aifd1 section #aeeg ( ! ,af=dable ,c>e ,act1 & o!r laws ,no?+ 9 ?is section %all be con/ru$ to limit o!rwise exi/+ obligations ( recipi5ts ( ,f$]al f9ancial assi/ance "u title ,,vi ( ! ,civil ,rights ,act ( #aifd 7#db ,u4,s4,c4 #bjjj;d et seq471 section #aeeg ( ! ,af=dable ,c>e ,act1 or o!r laws t protect ! civil rights ( individuals4 7g7 ,effective date 7#a7 ,9 g5]al ,except z o!rwise provid$ & subject to p>agraph 7#b71 ! am5dm5ts made by ?is section %all take effect on ,janu>y #a1 #bjba4 7#b7 ,exception if ,/ate legislation requir$ ,9 ! case ( a ,/ate plan = m$ical assi/ance "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 :i* ! ,secret>y ( ,heal? & ,human ,s]vices det]m9es requires ,/ate legislation 7o!r ?an legislation appropriat+ funds7 9 ord] = ! plan to meet ! additional requirem5t impos$ by ! am5dm5ts made by ?is section1 ! ,/ate plan %all n be reg>d$ z fail+ to comply ) ! requirem5ts ( su* title solely on ! basis ( its failure to meet ?is additional requirem5t be=e ! fir/ day ( ! fir/ cal5d> qu>t] beg9n+ aft] ! close ( ! fir/ regul> session ( ! ,/ate legislature t beg9s aft] ! date ( ! enactm5t ( ?is ,act4 ,= purposes ( ! previ\s s5t5ce1 9 ! case ( a ,/ate t has a #b-ye> legislative session1 ea* ye> ( su* session %all be deem$ to be a sep>ate regul> session ( ! ,/ate legislature4 #gje4 ,requirem5ts = heal? programs or activities receiv+ ,f$]al funds 7a7 ,cov]$ entity2 cov]$ program or activity ,9 ?is section-- 7#a7 ! t]m cov]$ entity has ! mean+ giv5 su* t]m 9 section #ib4d ( title #db1 ,code ( ,f$]al ,regulations1 z 9 effect on ,may #af1 #bjaf2 & 7#b7 ! t]m cov]$ program or activity has ! mean+ giv5 su* t]m 9 section #ib4d ( title #db1 ,code ( ,f$]al ,regulations1 z 9 effect on ,may #af1 #bjaf4 7b7 ,requirem5ts ,a cov]$ entity1 9 ord] to ensure ! "r ( individuals ) limit$ ,engli% pr(ici5cy to receive access to high-quality heal? c>e ?r\gh ! cov]$ program or activity1 %all-- 7#a7 ensure t appropriate cl9ical & support /aff receive ongo+ education & tra9+ 9 culturally & l+ui/ically appropriate s]vice deliv]y2 7#b7 (f] & provide appropriate language assi/ance s]vices at no additional *>ge to ea* pati5t t is an individual ) limit$ ,engli% pr(ici5cy at all po9ts ( contact1 9 a timely mann] dur+ all h\rs ( op]ation2 7#c7 notify pati5ts ( _! "r to receive language s]vices 9 _! prim>y language2 & 7#d7 utilize only qualifi$ int]pret]s = an individual ) limit$ ,engli% pr(ici5cy or qualifi$ translators1 except z provid$ 9 subsection 7c74 7c7 ,exemptions ,! requirem5ts ( subsection 7b77#d7 %all n apply z foll[s3 7#a7 ,:5 a pati5t reque/s ! use ( family1 fri5ds1 or o!r p]sons untra9$ 9 int]pretation or translation if ea* ( ! foll[+ conditions are met3 7,a7 ,! int]pret] reque/$ by ! pati5t is ov] ! age ( #ah4 7,b7 ,! cov]$ entity in=ms ! pati5t 9 ! prim>y language ( ! pati5t t he or %e has ! option ( hav+ ! entity provide to ! pati5t an int]pret] & translation s]vices )\t *>ge4 7,c7 ,! cov]$ entity in=ms ! pati5t t ! entity may n require an individual ) a limit$ ,engli% pr(ici5cy to use a family memb] or fri5d z an int]pret]4 7,d7 ,! cov]$ entity evaluates :e!r ! p]son ! pati5t wi%es to use z an int]pret] is compet5t4 ,if ! cov]$ entity has reason to believe t su* p]son is n compet5t z an int]pret]1 ! entity provides its own int]pret] to protect ! cov]$ entity f liability if ! pati5t's int]pret] is lat] f\nd n compet5t4 7,e7 ,if ! cov]$ entity has reason to believe t !re is a conflict ( int]e/ betwe5 ! int]pret] & pati5t1 ! cov]$ entity may n use ! pati5t's int]pret]4 7,f7 ,! cov]$ entity has ! pati5t sign a waiv]1 witness$ by at lea/ #a individual n relat$ to ! pati5t1 t includes ! in=mation /at$ 9 subp>agraphs 7,a7 ?r\gh 7,e7 & is translat$ into ! pati5t's prim>y language4 7#b7 ,:5 a m$ical em]g5cy exi/s & ! delay directly associat$ ) obta9+ compet5t int]pret] or translation s]vices w\ld jeop>dize ! heal? ( ! pati5t1 b only until a compet5t int]pret] or translation s]vice is available4 7d7 ,rule ( con/ruction ,subsection 7c77#b7 %all n be con/ru$ to mean t em]g5cy rooms or simil> entities t regul>ly provide heal? c>e s]vices 9 m$ical em]g5cies are exempt f legal or regulatory requirem5ts relat$ to compet5t int]pret] s]vices4 #gjf4 ,report on ,f$]al ef=ts to provide culturally & l+ui/ically appropriate heal? c>e s]vices 7a7 ,report ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act & annually !reaft]1 ! ,secret>y ( ,heal? & ,human ,s]vices %all ent] into a contract ) ! ,national ,academy ( ,m$ic9e = ! prep>ation & publication ( a report t describes ,f$]al ef=ts to ensure t all individuals ) limit$ ,engli% pr(ici5cy h mean+ful access to heal? c>e s]vices & heal?-c>e-relat$ s]vices t are culturally & l+ui/ically appropriate4 ,su* report %all include-- 7#a7 a description & evaluation ( ! activities c>ri$ out "u ?is ,act2 7#b7 a description & analysis ( be/ practices1 model programs1 guidel9es1 & o!r effective /rategies = provid+ access to culturally & l+ui/ically appropriate heal? c>e s]vices2 7#c7 recomm5dations on ! developm5t & implem5tation ( policies & practices by provid]s ( heal? c>e s]vices & heal?-c>e-relat$ s]vices = individuals ) limit$ ,engli% pr(ici5cy1 includ+ p ) cognitive1 he>+1 vision1 or pr9t impairm5ts2 7#d7 recomm5d guidel9es or /&>ds = heal? lit]acy & pla9 language1 in=m$ cons5t1 dis*>ge in/ructions1 & writt5 communications1 & = improvem5t ( heal? c>e access2 7#e7 a description ( ! effect ( provid+ language s]vices on quality ( heal? c>e & access to c>e2 & 7#f7 a description ( ! co/s associat$ ) or sav+s relat$ to ! provision ( language s]vices4 7b7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #gjg4 ,heal? pr(essions compet5cies to address racial & e?nic m5tal heal? disp>ities 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,assi/ant ,secret>y = ,m5tal ,heal? & ,sub/ance ,use1 %all aw>d grants to qualifi$ national organizations = ! purposes (-- 7#a7 develop+1 & dissem9at+ to heal? pr(essional educational programs curricula or core compet5cies address+ m5tal heal? inequities among racial & e?nic m9ority gr\ps = use 9 ! tra9+ ( /ud5ts 9 ! pr(essions ( social "w1 psy*ology1 psy*iatry1 m>riage & family !rapy1 m5tal heal? c\nsel+1 pe] support1 & sub/ance abuse c\nsel+2 & 7#b7 c]tify+ community heal? work]s & pe] wellness speciali/s ) respect to su* curricula & core compet5cies & integrat+ & exp&+ ! use ( su* work]s & speciali/s into heal? c>e & community-bas$ sett+s to address m5tal heal? disp>ities among racial & e?nic m9ority gr\ps4 7b7 ,curricula2 core compet5cies ,organizations receiv+ funds "u subsection 7a7 may use ! funds to engage 9 ! foll[+ activities relat$ to ! developm5t & dissem9ation ( curricula or core compet5cies describ$ 9 subsection 7a77#a73 7#a7 ,=mation ( committees or work+ gr\ps compris$ ( exp]ts f accr$it$ heal? pr(essions s*ools to id5tify core compet5cies relat+ to m5tal heal? disp>ities among racial & e?nic m9ority gr\ps4 7#b7 ,plann+ ( work%ops 9 national =a to all[ = public input1 includ+ input f communities ( color ) liv$ exp]i5ce1 into ! educational ne$s associat$ ) m5tal heal? disp>ities among racial & e?nic m9ority gr\ps4 7#c7 ,dissem9ation & promotion ( ! use ( curricula or core compet5cies 9 und]graduate & graduate heal? pr(essions tra9+ programs nationwide4 7#d7 ,e/abli%+ ext]nal /akehold] advisory bo>ds to provide mean+ful input into policy & program developm5t & be/ practices to r$uce m5tal heal? inequities among racial & e?nic gr\ps1 includ+ p>ticipation f communities ( color ) liv$ exp]i5ce ( ! impacts ( m5tal heal? disp>ities4 7c7 ,def9itions ,9 ?is section3 7#a7 ,qualifi$ national organization ,! t]m qualifi$ national organization means a national organization t focuses on ! education ( /ud5ts 9 programs ( social "w1 occupational !rapy1 psy*ology1 psy*iatry1 & m>riage & family !rapy4 7#b7 ,racial & e?nic m9ority gr\p ,! t]m racial & e?nic m9ority gr\p has ! mean+ giv5 to su* t]m 9 section #agjg7;g7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjju-#f7;g774 7d7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #gjh4 ,/udy on ! un9sur$ 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is section ref]r$ to z ! ,secret>y7 %all-- 7#a7 conduct a /udy1 9 accordance ) ! /&>ds "u section #caja ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjjkk71 on ! demographic *>act]i/ics ( ! population ( individuals :o d n h heal? insurance cov]age or oral heal? cov]age2 & 7#b7 pr$ict1 bas$ on su* /udy1 ! demographic *>act]i/ics ( ! population ( individuals :o w\ld rema9 )\t heal? insurance cov]age aft] ! end ( any annual op5 enrollm5t or any special enrollm5t p]iod or ^u enactm5t & implem5tation ( any legislative *anges to ! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh7 t affect ! numb] ( p]sons eligible = cov]age4 7b7 ,report+ requirem5ts 7#a7 ,9 g5]al ,n lat] ?an #ab mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,congress ! results ( ! /udy "u subsection 7a77#a7 & ! pr$iction made "u subsection 7a77#b74 7#b7 ,report+ ( demographic *>act]i/ics ,! ,secret>y %all-- 7,a7 report ! demographic *>act]i/ics "u p>agraphs 7#a7 & 7#b7 ( subsection 7a7 on ! basis ( racial & e?nic gr\p1 & %all /ratify ! report+ on ea* racial & e?nic gr\p by o!r demographic *>act]i/ics t c impact access to heal? insurance cov]age1 su* z sexual ori5tation1 g5d] id5tity1 prim>y language1 disability /atus1 sex1 socioeconomic /atus1 age gr\p1 & citiz5%ip & immigration /atus1 9 a mann] consi/5t ) title ,i ( ?is ,act1 includ+ ! am5dm5ts made by su* title2 & 7,b7 n use su* report to engage 9 or anticipate any deportation or immigration relat$ en=cem5t action by any entity1 includ+ ! ,dep>tm5t ( ,homel& ,security4 ,,viii ,aid to ,provid]s ,s]v+ ,m9ority ,communities #hja4 ,tempor>y increase 9 ,m$icaid ,,d% allotm5ts 7a7 ,9 g5]al ,section #aibc7;f77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7;f77#c77 is am5d$-- 7#a7 9 subp>agraph 7,a71 by /rik+ & subp>agraph 7,e7 & ins]t+ & subp>agraphs 7,e7 & 7,f72 & 7#b7 by add+ at ! end ! foll[+ new subp>agraph3 7,f7 ,tempor>y increase 9 allotm5ts dur+ c]ta9 public heal? em]g5cy ,! ,,d% allotm5t = any ,/ate = ea* ( fiscal ye>s #bjbj & #bjba is equal to #ajb4e p]c5t ( ! ,,d% allotm5t t w\ld be det]m9$ "u ?is p>agraph = ! ,/ate = ea* respective fiscal ye> )\t application ( ?is subp>agraph1 not)/&+ subp>agraphs 7,b7 & 7,c74 ,= ea* fiscal ye> aft] fiscal ye> #bjba1 ! ,,d% allotm5t = a ,/ate = su* fiscal ye> is equal to ! ,,d% allotm5t t w\ld h be5 det]m9$ "u ?is p>agraph = su* fiscal ye> if ?is subp>agraph _h n be5 enact$4 4 7b7 ,,d% allotm5t adju/m5t = ,t5nessee ,section #aibc7;f77#f77;,a77vi7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7;f77#f77;,a77vi77 is am5d$-- 7#a7 by /rik+ ,not)/&+ any o!r provision ( ?is subsection & ins]t+ ! foll[+3 7,i7 ,9 g5]al ,not)/&+ any o!r provision ( ?is subsection 7except z provid$ 9 subclause 7,,ii7 ( ?is clause7 2 & 7#b7 by add+ at ! end ! foll[+3 7,,ii7 ,tempor>y increase 9 allotm5ts ,! ,,d% allotm5t = ,t5nessee = ea* ( fiscal ye>s #bjbj & #bjba %all be equal to #ed1dbg1ejj4 4 7c7 ,s5se ( ,congress ,x is ! s5se ( ,congress t a ,/ate %\ld prioritize mak+ paym5ts "u ! ,/ate plan ( ! ,/ate "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7or a waiv] ( su* plan7 to disproportionate %>e hospitals t h a high] %>e ( ,,covid-#ai pati5ts relative to o!r su* hospitals 9 ! ,/ate4 #hjb4 ,,covid-#ai-relat$ tempor>y increase ( ,m$icaid ,,fmap 7a7 ,9 g5]al ,section #fjjh ( ! ,families ,fir/ ,coronavirus ,response ,act 7#db ,u4,s4,c4 #acif;d note7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 by ins]t+ 7or1 if lat]1 ,june #cj1 #bjba7 aft] la/ day ( su* em]g5cy p]iod occurs2 & 7,b7 by /rik+ #f4b p]c5tage po9ts4 & ins]t+ ! p]c5tage po9ts specifi$ 9 subsection 7e74 ,9 no case may ! application ( ?is section result 9 ! ,f$]al m$ical assi/ance p]c5tage det]m9$ = a ,/ate be+ m ?an #ie p]c5t42 & 7#b7 by add+ at ! end ! foll[+ new subsections3 7e7 ,specifi$ p]c5tage po9ts ,= purposes ( subsection 7a71 ! p]c5tage po9ts specifi$ 9 ?is subsection are-- 7#a7 = ea* cal5d> qu>t] occurr+ dur+ ! p]iod beg9n+ on ! fir/ day ( ! em]g5cy p]iod describ$ 9 p>agraph 7#a77;,b7 ( section #aace7;g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77 & end+ on ,june #cj1 #bjbj1 #f4b p]c5tage po9ts2 7#b7 = ea* cal5d> qu>t] occurr+ dur+ ! p]iod beg9n+ on ,july #a1 #bjbj1 & end+ on ,june #cj1 #bjba1 #ad p]c5tage po9ts2 & 7#c7 = ea* cal5d> qu>t]1 if any1 occurr+ dur+ ! p]iod beg9n+ on ,july #a1 #bjba1 & end+ on ! la/ day ( ! cal5d> qu>t] 9 :i* ! la/ day ( su* em]g5cy p]iod occurs1 #f4b p]c5tage po9ts4 7f7 ,cl>ifications 7#a7 ,9 ! case ( a ,/ate t treats an individual describ$ 9 subsection 7b77#c7 z eligible = ! b5efits describ$ 9 su* subsection1 = ! p]iod describ$ 9 subsection 7a71 exp5ditures = m$ical assi/ance & adm9i/rative co/s attributable to su* individual t w\ld n o!rwise be includ$ z exp5ditures "u section #aijc ( ! ,social ,security ,act %all be reg>d$ z exp5ditures "u ! ,/ate plan approv$ "u title ,,xix ( ! ,social ,security ,act or = adm9i/ration ( su* ,/ate plan4 7#b7 ,! limitations on paym5t "u subsections 7f7 & 7g7 ( section #aajh ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acjh7 %all n apply to ,f$]al paym5ts made "u section #aijc7;a77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77#a77 attributable to ! increase 9 ! ,f$]al m$ical assi/ance p]c5tage "u ?is section4 7#c7 ,exp5ditures attributable to ! increas$ ,f$]al m$ical assi/ance p]c5tage "u ?is section %all n be c\nt$ = purposes ( ! limitations "u section #bajd7;b77#d7 ( su* ,act 7#db ,u4,s4,c4 #acig;dd7b77#d774 7#d7 ,not)/&+ ! fir/ s5t5ce ( section #baje7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7b771 ! application ( ! increase "u ?is section may result 9 ! enhanc$ ,,fmap ( a ,/ate = a fiscal ye> "u su* section exce$+ #he p]c5t1 b 9 no case may ! application ( su* increase be=e application ( ! second s5t5ce ( su* section result 9 ! enhanc$ ,,fmap ( ! ,/ate exce$+ #ie p]c5t4 7g7 ,scope ( application ,an increase 9 ! ,f$]al m$ical assi/ance p]c5tage = a ,/ate "u ?is section %all n be tak5 into acc\nt = purposes ( paym5ts "u "p ,d ( title ,,iv ( ! ,social ,security ,act 7#db ,u4,s4,c4 #fea et seq474 4 7b7 ,effective date ,! am5dm5ts made by subsection 7a7 %all take effect & apply z if includ$ 9 ! enactm5t ( section #fjjh ( ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg74 #hjc4 ,appropriation = prim>y heal? c>e ,= an additional am\nt = ,dep>tm5t ( ,heal? & ,human ,s]vices--,heal? ,res\rces & ,s]vices ,adm9i/ration--,prim>y ,heal? ,c>e1 #g1fjj1jjj1jjj1 to rema9 available until ,septemb] #cj1 #bjbe1 = necess>y exp5ses to prev5t1 prep>e =1 & respond to coronavirus1 = grants & coop]ative agreem5ts "u ! ,heal? ,c5t]s ,program1 z def9$ by section #ccj ( ! ,public ,heal? ,s]vice ,act1 & = grants to ,f$]ally qualifi$ heal? c5t]s1 z def9$ 9 section #ahfa7;aa77#d77;,b7 ( ! ,social ,security ,act1 & = eligible entities "u ! ,native ,hawaiian ,heal? ,c>e ,improvem5t ,act1 includ+ ma9t5ance or expansion ( heal? c5t] & sy/em capacity & /aff+ levels3 ,provid$1 ,t sections #ccj7r77#b77;,b71 #ccj7;e77#f77;,a77iii71 & #ccj7;e77#f77;,b77iii7 %all n apply to funds provid$ "u ?is head+ 9 ?is section3 ,provid$ fur!r1 ,t funds provid$ "u ?is head+ 9 ?is section may be us$ to 7#a7 pur*ase equipm5t & supplies to conduct mobile te/+ = ,,s>s-,co,v-#b or ,,covid-#ai2 7#b7 pur*ase & ma9ta9 mobile vehicles & equipm5t to conduct su* te/+2 & 7#c7 hire & tra9 laboratory p]sonnel & o!r /aff to conduct su* mobile te/+3 ,provid$ fur!r1 ,t su* am\nt is designat$ by ! ,congress z be+ = an em]g5cy requirem5t pursuant to section #bea7;b77#b77;,a77i7 ( ! ,balanc$ ,budget & ,em]g5cy ,deficit ,control ,act ( #aihe4 #hjd4 ,am5dm5t to ! ,public ,heal? ,s]vice ,act ,title ,,xxxiv ( ! ,public ,heal? ,s]vice ,act1 z am5d$ by sections #ajd & #gjb1 is fur!r am5d$ by add+ at ! foll[+3 ,c ,recon/ruction & ,improvem5t ,grants = ,public ,heal? ,c>e ,facilities ,s]v+ ,pacific ,isl&]s & ! ,insul> ,areas #cdjg4 ,grant support = quality improvem5t initiatives 7a7 ,9 g5]al ,! ,secret>y1 9 collaboration ) ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 & ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all aw>d grants to eligible entities = ! conduct ( demon/ration projects to improve ! quality ( & access to heal? c>e4 7b7 ,eligibility ,to be eligible to receive a grant "u subsection 7a71 an entity %all-- 7#a7 be a heal? c5t]1 hospital1 heal? plan1 heal? sy/em1 community cl9ic1 or o!r heal? entity det]m9$ appropriate by ! ,secret>y-- 7,a7 t1 by legal m&ate or explicitly adopt$ mission1 provides pati5ts ) access to s]vices reg>dless ( _! ability to pay2 7,b7 t provides c>e or treatm5t = a sub/antial numb] ( pati5ts :o are un9sur$1 are receiv+ assi/ance "u a ,/ate plan "u title ,,xix ( ! ,social ,security ,act 7or "u a waiv] ( su* plan71 or are memb]s ( vuln]able populations1 z det]m9$ by ! ,secret>y2 & 7,c7 7i7 ) respect to :i*1 n less ?an #ej p]c5t ( ! entity's pati5t population is made up ( racial & e?nic m9ority gr\ps2 or 7ii7 t-- 7,i7 s]ves a disproportionate p]c5tage ( local pati5ts t are f a racial & e?nic m9ority gr\p1 or t has a pati5t population1 at lea/ #ej p]c5t ( :i* is compos$ ( individuals ) limit$ ,engli% pr(ici5cy2 & 7,,ii7 provides an assurance t am\nts receiv$ "u ! grant w be us$ only to support quality improvem5t activities 9 ! racial & e?nic m9ority population s]v$2 & 7#b7 prep>e & submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7c7 ,priority ,9 aw>d+ grants "u subsection 7a71 ! ,secret>y %all give priority to applicants "u subsection 7b77#b7 t-- 7#a7 demon/rate an int5t to op]ate z "p ( a heal? c>e p>tn]%ip1 network1 collaborative1 coalition1 or alliance :]e ea* memb] entity contributes to ! design1 implem5tation1 & evaluation ( ! propos$ int]v5tion2 or 7#b7 int5d to use funds to c>ry out sy/emwide *anges ) respect to heal? c>e quality improvem5t1 includ+-- 7,a7 improv$ sy/ems = data collection & report+2 7,b7 innovative collaborative or simil> processes2 7,c7 gr\p programs ) behavioral or self-managem5t int]v5tions2 7,d7 case managem5t s]vices2 7,e7 physician or pati5t rem9d] sy/ems2 7,f7 educational int]v5tions2 or 7,g7 o!r activities det]m9$ appropriate by ! ,secret>y4 7d7 ,use ( funds ,an entity %all use am\nts receiv$ "u a grant "u subsection 7a7 to support ! implem5tation & evaluation ( heal? c>e quality improvem5t activities or m9ority heal? & heal? c>e disp>ity r$uction activities t include-- 7#a7 ) respect to heal? c>e sy/ems1 activities relat+ to improv+-- 7,a7 pati5t safety2 7,b7 timel9ess ( c>e2 7,c7 effectiv5ess ( c>e2 7,d7 effici5cy ( c>e2 7,e7 pati5t c5t]$ness2 & 7,f7 heal? in=mation te*nology2 & 7#b7 ) respect to pati5ts1 activities relat+ to-- 7,a7 /ay+ heal?y2 7,b7 gett+ well1 m5tally & physically2 7,c7 liv+ effectively ) illness or disability2 7,d7 cop+ ) end-(-life issues2 & 7,e7 %>$ decision mak+4 7e7 ,common data sy/ems ,! ,secret>y %all provide f9ancial & o!r te*nical assi/ance to grantees "u ?is section = ! developm5t ( common data sy/ems4 7f7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbf4 #cdjh4 ,c5t]s ( excell5ce 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all designate c5t]s ( excell5ce at public hospitals1 & o!r heal? sy/ems s]v+ l>ge numb]s ( m9ority pati5ts1 t-- 7#a7 meet ! requirem5ts ( section #cdea7;b77#a72 7#b7 demon/rate excell5ce 9 provid+ c>e to m9ority populations2 & 7#c7 demon/rate excell5ce 9 r$uc+ disp>ities 9 heal? & heal? c>e4 7b7 ,requirem5ts ,a hospital or heal? sy/em t s]ves z a c5t] ( excell5ce "u subsection 7a7 %all-- 7#a7 design1 implem5t1 & evaluate programs & policies relat+ to ! deliv]y ( c>e 9 racially1 e?nically1 & l+ui/ically div]se populations2 7#b7 provide tra9+ & te*nical assi/ance to o!r hospitals & heal? sy/ems relat+ to ! provision ( quality heal? c>e to m9ority populations2 & 7#c7 develop activities = graduate or cont9u+ m$ical education t in/itutionalize a focus on cultural compet5ce tra9+ = heal? c>e provid]s4 7c7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section1 su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbf4 #cdji4 ,recon/ruction & improvem5t grants = public heal? c>e facilities s]v+ pacific isl&]s & ! insul> areas 7a7 ,9 g5]al ,! ,secret>y %all provide direct f9ancial assi/ance to designat$ heal? c>e provid]s & community heal? c5t]s 9 ,am]ican ,samoa1 ,guam1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,pu]to ,rico1 & ,hawaii = ! purposes ( recon/ruct+ & improv+ heal? c>e facilities & s]vices 9 a culturally compet5t & su/a9able mann]4 7b7 ,eligibility ,to be eligible to receive direct f9ancial assi/ance "u subsection 7a71 an entity %all be a public heal? facility or community heal? c5t] locat$ 9 ,am]ican ,samoa1 ,guam1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,pu]to ,rico1 or ,hawaii t-- 7#a7 is own$ or op]at$ by-- 7,a7 ! ,gov]nm5t ( ,am]ican ,samoa1 ,guam1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,pu]to ,rico1 or ,hawaii or a unit ( local gov]nm5t2 or 7,b7 a nonpr(it organization2 & 7#b7 7,a7 provides c>e or treatm5t = a sub/antial numb] ( pati5ts :o are un9sur$1 receiv+ assi/ance "u title ,,xviii ( ! ,social ,security ,act1 or a ,/ate plan "u title ,,xix ( su* ,act 7or "u a waiv] ( su* plan71 or :o are memb]s ( a vuln]able population1 z det]m9$ by ! ,secret>y2 or 7,b7 s]ves a disproportionate p]c5tage ( local pati5ts t are f a racial & e?nic m9ority gr\p4 7c7 ,report ,n lat] ?an #ahj days aft] ! date ( enactm5t ( ?is title & annually !reaft]1 ! ,secret>y %all submit to ! ,congress & ! ,presid5t a report t includes an assessm5t ( heal? res\rces & facilities s]v+ populations 9 ,am]ican ,samoa1 ,guam1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,pu]to ,rico1 & ,hawaii4 ,9 prep>+ su* report1 ! ,secret>y %all-- 7#a7 consult ) & obta9 in=mation on all heal? c>e facilities ne$s f ! entities receiv+ direct f9ancial assi/ance "u subsection 7a72 7#b7 include all am\nts ( ,f$]al assi/ance receiv$ by ea* su* entity 9 ! prec$+ fiscal ye>2 7#c7 review ! total unmet ne$s ( heal? c>e facilities s]v+ ,am]ican ,samoa1 ,guam1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,unit$ ,/ates ,virg9 ,isl&s1 ,pu]to ,rico1 & ,hawaii1 includ+ ne$s = r5ovation & expansion ( exi/+ facilities2 7#d7 include a /rategic plan = address+ ! ne$s ( ea* su* population id5tifi$ 9 ! report2 & 7#e7 evaluate ! effectiv5ess ( ! c>e provid$ by measur+ pati5t outcomes & co/ measures4 7d7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ su* sums z necess>y to c>ry out ?is section4 4 #hje4 ,p&emic premium pay = ess5tial work]s 7a7 ,9 g5]al ,beg9n+ #c days aft] an ess5tial "w employ] receives a grant "u section #hjf f ! ,secret>y ( ! ,treasury1 ! ess5tial "w employ] %all-- 7#a7 be requir$ to comply ) subsections 7b7 ?r\gh 7h72 & 7#b7 be subject to ! en=cem5t requirem5ts ( section #hjg4 7b7 ,p&emic premium pay 7#a7 ,9 g5]al ,an ess5tial "w employ] receiv+ a grant "u section #hjf %all1 9 accordance ) ?is subsection1 provide ea* ess5tial work] ( ! ess5tial "w employ] ) premium pay at a rate equal to #ac = ea* h\r ( "w p]=m$ by ! ess5tial work] = ! employ] f ,janu>y #bg1 #bjbj1 until ! date t is #fj days aft] ! la/ day ( ! ,,covid-#ai ,public ,heal? ,em]g5cy4 7#b7 ,maximum am\nts ,! total am\nt ( all premium pay "u ?is subsection t an ess5tial "w employ] is requir$ to provide to an ess5tial work]1 includ+ ?r\gh any retroactive paym5t "u p>agraph 7#c71 %all n exce$-- 7,a7 = an ess5tial work] :o is n a highly-comp5sat$ ess5tial work]1 #aj1jjj r$uc$ by employ] payroll taxes ) respect to su* premium pay2 or 7,b7 = a highly-comp5sat$ ess5tial work]1 #e1jjj r$uc$ by employ] payroll taxes ) respect to su* premium pay4 7#c7 ,retroactive paym5t ,= all "w p]=m$ by an ess5tial work] dur+ ! p]iod f ,janu>y #bg1 #bjbj1 ?r\gh ! date on :i* ! ess5tial "w employ] ( ! work] receives a grant "u ?is title1 ! ess5tial "w employ] %all use a portion ( ! am\nt ( su* grant to provide su* work] ) premium pay "u ?is subsection = su* "w at ! rate provid$ "u p>agraph 7#a74 ,su* am\nt %all be provid$ to ! ess5tial work] z a lump sum 9 ! next pay*eck 7or o!r paym5t =m7 t imm$iately foll[s ! receipt ( ! grant by ! ess5tial "w employ]4 ,9 any case :]e x is impossible = ! employ] to arrange = paym5t ( ! am\nt due 9 su* pay*eck 7or o!r paym5t =m71 su* am\nts %all be paid z soon z practicable1 b 9 no ev5t lat] ?an ! second pay*eck 7or o!r paym5t =m7 foll[+ ! receipt ( ! grant by ! ess5tial "w employ]4 7#d7 ,no employ] discretion ,an ess5tial "w employ] receiv+ a grant "u section #hjf %all n h any discretion to det]m9e :i* portions ( "w p]=m$ by an ess5tial work] qualify = premium pay "u ?is subsection1 b %all pay su* premium pay = any increm5t ( "t work$ by ! ess5tial work] = ! ess5tial "w employ] up to ! maximum am\nt applicable to ! ess5tial work] "u p>agraph 7#b74 7c7 ,prohibition on r$uc+ comp5sation & displacem5t 7#a7 ,9 g5]al ,any paym5ts made to an ess5tial work] z premium pay "u subsection 7b7 %all be 9 addition to all o!r comp5sation1 includ+ all wages1 remun]ation1 or o!r pay & b5efits1 t ! ess5tial work] o!rwise receives f ! ess5tial "w employ]4 7#b7 ,r$uction ( comp5sation ,an ess5tial "w employ] receiv+ a grant "u section #hjf %all n1 dur+ ! p]iod beg9n+ on ! date ( enactm5t ( ?is ,act & end+ on ! date t is #fj days aft] ! la/ day ( ! ,,covid-#ai ,public ,heal? ,em]g5cy1 r$uce or 9 any o!r way dim9i%1 any o!r comp5sation1 includ+ ! wages1 remun]ation1 or o!r pay or b5efits1 t ! ess5tial "w employ] provid$ to ! ess5tial work] on ! day be=e ! date ( enactm5t ( ?is ,act4 7#c7 ,displacem5t ,an ess5tial "w employ] %all n take any action to displace an ess5tial work] 7includ+ p>tial displacem5t su* z a r$uction 9 h\rs1 wages1 or employm5t b5efits7 = purposes ( hir+ an individual = an equival5t position at a rate ( comp5sation t is less ?an is requir$ to be provid$ to an ess5tial work] "u p>agraph 7#b74 7d7 ,dem>cation f o!r comp5sation ,! am\nt ( any premium pay paid "u subsection 7b7 %all be cle>ly dem>cat$ z a sep>ate l9e item 9 ea* pay/ub or o!r docum5t provid$ to an ess5tial work] t details ! remun]ation ! ess5tial work] receiv$ f ! ess5tial "w employ] = a p>ticul> p]iod ( "t4 ,if any ess5tial work] does n o!rwise regul>ly receive any su* pay/ub or o!r docum5t f ! employ]1 ! ess5tial "w employ] %all provide su* pay/ub or o!r docum5t to ! ess5tial work] = ! duration ( ! p]iod 9 :i* ! ess5tial "w employ] provides premium pay "u subsection 7b74 7e7 ,exclusion f wage-,bas$ calculations ,any premium pay "u subsection 7b7 paid to an ess5tial work] "u ?is section by an ess5tial "w employ] receiv+ a grant "u section #hjf %all be exclud$ f ! am\nt ( remun]ation = "w paid to ! ess5tial work] = purposes (-- 7#a7 calculat+ ! ess5tial work]'s eligibility = any wage-bas$ b5efits (f]$ by ! ess5tial "w employ]2 7#b7 comput+ ! regul> rate at :i* su* ess5tial work] is employ$ "u section #g ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #bjg72 & 7#c7 det]m9+ :e!r su* ess5tial work] is exempt f application ( su* section #g "u section #ac7;a77#a7 ( su* ,act 7#bi ,u4,s4,c4 #bac7;a77#a774 7f7 ,ess5tial work] dea? 7#a7 ,9 g5]al ,9 any case 9 :i* an ess5tial work] ( an ess5tial "w employ] receiv+ a grant "u section #hjf exhibits symptoms ( ,,covid-#ai & dies1 ! ess5tial "w employ] %all pay z a lump sum to ! next ( k9 ( ! ess5tial work] = premium pay "u subsection 7b7-- 7,a7 = an ess5tial work] :o is n a highly-comp5sat$ ess5tial work]1 ! am\nt det]m9$ "u subsection 7b77#b77;,a7 m9us ! total am\nt ( any premium pay ! work] receiv$ "u subsection 7b7 prior to ! dea?2 or 7,b7 = a highly-comp5sat$ ess5tial work]1 ! am\nt det]m9$ "u subsection 7b77#b77;,b7 m9us ! am\nt ( any premium pay ! work] receiv$ "u subsection 7b7 prior to ! dea?4 7#b7 ,treatm5t ( lump sum paym5ts 7,a7 ,treatm5t z premium pay ,= purposes ( ?is title1 any paym5t made "u ?is subsection %all be treat$ z a premium pay "u subsection 7b74 7,b7 ,treatm5t = purposes ( ,int]nal ,rev5ue ,code ( #aihf ,= purposes ( ! ,int]nal ,rev5ue ,code ( #aihf1 any paym5t made "u ?is subsection %all be treat$ z a paym5t = "w p]=m$ by ! ess5tial work]4 7g7 ,application to self-,direct$ c>e work]s fund$ ?r\gh ,m$icaid or ! ,vet]an-,direct$ ,c>e ,program 7#a7 ,m$icaid ,9 ! case ( an ess5tial "w employ] receiv+ a grant "u section #hjf t is a cov]$ employ] describ$ 9 p>agraph 7#d7 :o1 "u a ,/ate ,m$icaid plan "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 or "u a waiv] ( su* plan1 has opt$ to receive items or s]vices us+ a self-direct$ s]vice deliv]y model1 ! prec$+ requirem5ts ( ?is section1 includ+ ! requirem5ts to provide premium pay "u subsection 7b7 7includ+ a lump sum paym5t 9 ! ev5t ( an ess5tial work] dea? "u subsection 7f77 & ! requirem5ts ( sections #hjf & #hjg1 %all apply to ! ,/ate ,m$icaid ag5cy responsible = ! adm9i/ration ( su* plan or waiv] ) respect to self-direct$ c>e work]s employ$ by t employ]4 ,9 adm9i/]+ paym5ts made "u ?is title to su* self-direct$ c>e work]s on behalf ( su* employ]s1 a ,/ate ,m$icaid ag5cy %all-- 7,a7 exclude & disreg>d any paym5ts made "u ?is title to su* self-direct$ work]s f ! individualiz$ budget t applies to ! items or s]vices furni%$ to ! individual cli5t employ] "u ! ,/ate ,m$icaid plan or waiv]2 7,b7 to ! ext5t practicable1 adm9i/] & provide paym5ts "u ?is title directly to su* self-direct$ work]s ?r\gh arrangem5ts ) entities t provide f9ancial managem5t s]vices 9 connection ) ! self-direct$ s]vice deliv]y models us$ "u ! ,/ate ,m$icaid plan or waiv]2 & 7,c7 ensure t individual cli5t employ]s ( su* self-direct$ work]s are provid$ notice (1 & comply )1 ! prohibition "u section #hjg7;b77#a77;,b74 7#b7 ,vet]an-,direct$ ,c>e ,program ,9 ! case ( an ess5tial "w employ] t is a cov]$ employ] describ$ 9 p>agraph 7#d7 :o is a vet]an p>ticipat+ 9 ! ,vet]an ,direct$ ,c>e program adm9i/]$ by ! ,,va ,(fice ( ,g]iatrics ,ext5d$ ,c>e ( ! ,vet]ans ,heal? ,adm9i/ration1 ! prec$+ requirem5ts ( ?is section & sections #hjf & #hjg1 %all apply to su* ,,va ,(fice ( ,g]iatrics ,ext5d$ ,c>e ) respect to self-direct$ c>e work]s employ$ by t employ]4 ,p>agraph 7#a7 ( ?is subsection %all apply to ! adm9i/ration by ! ,,va ,(fice ( ,g]iatrics ,ext5d$ ,c>e ( paym5ts made "u ?is title to su* self-direct$ c>e work]s on behalf ( su* employ]s 9 ! same mann] z su* requirem5ts apply to ,/ate ,m$icaid ag5cies4 7#c7 ,p5alty en=cem5t ,! ,secret>y ( ,labor %all consult ) ! ,secret>y ( ,heal? & ,human ,s]vices & ! ,secret>y ( ,vet]ans ,affairs reg>d+ ! en=cem5t ( p5alties impos$ "u section #hjg7;b77#b7 ) respect to violations ( subp>agraph 7,a7 or 7,b7 ( section #hjg7;b77#a7 t involve self-direct$ work]s = :i* ! requirem5ts ( ?is section & sections #hjf & #hjg are appli$ to a ,/ate ,m$icaid ag5cy "u p>agraph 7#a7 or ! ,,va ,(fice ( ,g]iatrics ,ext5d$ ,c>e "u p>agraph 7#b74 7#d7 ,cov]$ employ] describ$ ,= purposes ( p>agraphs 7#a7 & 7#b71 a cov]$ employ] describ$ 9 ?is p>agraph means-- 7,a7 an entity or p]son t contracts directly ) a ,/ate1 locality1 ,tribal gov]nm5t1 or ! ,f$]al ,gov]nm5t1 to provide c>e 7:i* may include items & s]vices7 ?r\gh employees ( su* entity or p]son to individuals "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 "u a ,/ate ,m$icaid plan "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq47 or "u a waiv] ( su* plan1 or "u any o!r program e/abli%$ or adm9i/]$ by a ,/ate1 locality1 ,tribal gov]nm5t1 or ! ,f$]al ,gov]nm5t2 7,b7 a subcontractor ( an entity or p]son describ$ 9 subp>agraph 7,a72 7,c7 an individual cli5t 7or a repres5tative on behalf ( an individual cli5t71 an entity1 or a p]son1 t employs an individual to provide c>e 7:i* may include items & s]vices7 to ! individual cli5t "u a self-direct$ s]vice deliv]y model ?r\gh a program e/abli%$ or adm9i/]$ by a ,/ate1 locality1 ,tribal gov]nm5t1 or ! ,f$]al ,gov]nm5t2 or 7,d7 an individual cli5t 7or a repres5tative on behalf ( an individual cli5t7 t1 on _! own accord1 employs an individual to provide c>e 7:i* may include items & s]vices7 to ! individual cli5t us+ ! individual cli5t's own f9ances4 7h7 ,int]action ) ,/af=d ,act ,no?+ 9 ?is section %all nullify1 sup]s$e1 or o!rwise *ange a ,/ate's ability to seek reimbursem5t "u section #djc ( ! ,rob]t ,t4 ,/af=d ,disa/] ,relief & ,em]g5cy ,assi/ance ,act 7#db ,u4,s4,c4 #eagj;b7 = ! co/s ( premium pay bas$ on pre-disa/] labor policies = eligible employees4 7i7 ,calculation ( paid leave "u ,,ffcra & ,,fmla 7#a7 ,families ,fir/ ,coronavirus ,response ,act ,section #eaaj7e77;,b7 ( ! ,families ,fir/ ,coronavirus ,response ,act 7#bi ,u4,s4,c4 #bfja note7 is am5d$ by add+ at ! end ! foll[+3 7iii7 ,p&emic premium pay ,comp5sation receiv$ by an employee "u section #hjg7;b7 ( ! ,,ehdc ,act ( #bjbj %all be includ$ z remun]ation = employm5t paid to ! employee = purposes ( comput+ ! regul> rate at :i* su* employee is employ$4 4 7#b7 ,family & ,m$ical ,leave ,act ( #aiic ,section #aaj7;b77#b77;,b7 ( ! ,family & ,m$ical ,leave ,act ( #aiic 7#bi ,u4,s4,c4 #bfbj7;b77#b77;,b77 is am5d$ by add+ at ! end ! foll[+3 7iii7 ,p&emic premium pay ,comp5sation receiv$ by an employee "u section #hjg7;b7 ( ! ,,ehdc ,act ( #bjbj %all be includ$ z remun]ation = employm5t paid to ! employee = purposes ( comput+ ! regul> rate at :i* su* employee is employ$4 4 #hjf4 ,,covid-#ai ,h]oes ,fund grants 7a7 ,grants 7#a7 ,= p&emic premium pay ,! ,secret>y ( ! ,treasury %all1 subject to ! availability ( am\nts provid$ 9 ?is title1 aw>d a grant to ea* ess5tial "w employ] t applies = a grant1 9 accordance ) ?is section1 = ! purpose ( provid+ premium pay to ess5tial work]s "u section #hje7;b71 includ+ am\nts paid "u section #hje7;f74 7#b7 ,eligibility 7,a7 ,eligible employ]s g5]ally ,any ess5tial "w employ] %all be eligible = a grant "u p>agraph 7#a74 7,b7 ,self-direct$ c>e work]s ,a self-direct$ c>e work] employ$ by an ess5tial "w employ] o!r ?an an ess5tial "w employ] describ$ 9 section #hje7;g71 %all be eligible to apply = a grant "u p>agraph 7#a7 9 ! same mann] z an ess5tial "w employ]4 ,su* a work] %all provide premium pay to himself or h]self 9 accordance ) ?is section1 includ+ ! recordkeep+ & refund requirem5ts ( ?is section4 7b7 ,am\nt ( grants 7#a7 ,9 g5]al ,! maximum am\nt available = mak+ a grant "u subsection 7a77#a7 to an ess5tial "w employ] %all be equal to ! sum (-- 7,a7 ! am\nt obta9$ by multiply+ #aj1jjj by ! numb] ( ess5tial work]s ! employ] c]tifies1 9 ! application submitt$ "u subsection 7c77#a71 z employ+1 or provid+ remun]ation to = s]vices or labor1 :o are paid wages or remun]ation by ! employ] at a rate t is less ?an ! equival5t ( #bjj1jjj p] ye>2 & 7,b7 ! am\nt obta9$ by multiply+ #e1jjj by ! numb] ( highly-comp5sat$ ess5tial work]s ! employ] c]tifies1 9 ! application submitt$ "u subsection 7c77#a71 z employ+1 or provid+ remun]ation to = s]vices or labor1 :o are paid wages or remun]ation by ! employ] at a rate t is equal to or great] ?an ! equival5t ( #bjj1jjj p] ye>4 7#b7 ,no p>tial grants ,! ,secret>y ( ! ,treasury %all n aw>d a grant "u ?is section 9 an am\nt less ?an ! maximum describ$ 9 p>agraph 7#a74 7c7 ,grant application & disbursal 7#a7 ,application ,any ess5tial "w employ] seek+ a grant "u subsection 7a77#a7 %all submit an application to ! ,secret>y ( ! ,treasury at su* "t1 9 su* mann]1 & complete ) su* in=mation z ! ,secret>y may require4 7#b7 ,notice & c]tification 7,a7 ,9 g5]al ,! ,secret>y ( ! ,treasury %all1 )9 #ae days aft] receiv+ a complete application f an ess5tial "w employ] eligible = a grant "u ?is section-- 7i7 notify ! employ] ( ! ,secret>y's f9d+s ) respect to ! requirem5ts = ! grant2 & 7ii7 7,i7 if ! ,secret>y f9ds t ! ess5tial "w employ] meets ! requirem5ts "u ?is section = a grant "u subsection 7a71 provide a c]tification to ! employ]-- 7aa7 t ! employ] has met su* requirem5ts2 7bb7 ( ! am\nt ( ! grant paym5t t ! ,secret>y has det]m9$ ! employ] %all receive bas$ on ! requirem5ts "u ?is section2 or 7,,ii7 if ! ,secret>y f9ds t ! ess5tial "w employ] does n meet ! requirem5ts "u ?is section = a grant "u subsection 7a71 provide a notice ( d5ial /at+ ! reasons = ! d5ial & provide an opportunity = adm9i/rative review by n lat] ?an #aj days aft] ! d5ial4 7,b7 ,transf] ,n lat] ?an #g days aft] mak+ a c]tification "u subp>agraph 7,a77ii7 ) respect to an ess5tial "w employ]1 ! ,secret>y ( ! ,treasury %all make ! appropriate transf] to ! employ] ( ! am\nt ( ! grant4 7d7 ,use ( funds 7#a7 ,9 g5]al ,an ess5tial "w employ] receiv+ a grant "u ?is section %all use ! am\nt ( ! grant solely = ! foll[+ purposes3 7,a7 ,provid+ premium pay "u section #hje7;b7 to ess5tial work]s 9 accordance ) ! requirem5ts = su* paym5ts "u su* section1 includ+ provid+ paym5ts describ$ 9 section #hje7;f7 to ! next ( k9 ( ess5tial work]s 9 accordance ) ! requirem5ts = su* paym5ts "u su* section4 7,b7 ,pay+ employ] payroll taxes ) respect to premium pay am\nts describ$ 9 subp>agraph 7,a71 includ+ su* paym5ts describ$ 9 section #hje7;f74 ,ea* doll> ( a grant receiv$ by an ess5tial "w employ] "u ?is title %all be us$ z provid$ 9 subp>agraph 7,a7 or 7,b7 or return$ to ! ,secret>y ( ! ,treasury4 7#b7 ,no o!r uses au?oriz$ ,an ess5tial "w employ] :o uses any am\nt ( a grant = a purpose n requir$ "u p>agraph 7#a7 %all be-- 7,a7 consid]$ to h misus$ funds 9 violation ( section #hje2 & 7,b7 subject to ! en=cem5t & rem$ies provid$ "u section #hjg4 7#c7 ,refund 7,a7 ,9 g5]al ,if an ess5tial "w employ] receives a grant "u ?is section &1 = any reason1 does n provide e doll> ( su* grant to ess5tial work]s 9 accordance ) ! requirem5ts ( ?is title1 !n ! employ] %all refund any su* doll>s to ! ,secret>y ( ! ,treasury n lat] ?an ,june #cj1 #bjba4 ,any am\nts return$ to ! ,secret>y %all be deposit$ into ! ,fund & be available = any additional grants "u ?is section4 7,b7 ,requirem5t = n r$uc+ comp5sation ,an ess5tial "w employ] :o is requir$ to refund any am\nt "u ?is p>agraph %all n r$uce or o!rwise dim9i% an eligible work]'s comp5sation or b5efits 9 response to or o!rwise due to su* refund4 7e7 ,recordkeep+ ,an ess5tial "w employ] t receives a grant "u ?is section %all-- 7#a7 ma9ta9 records1 includ+ payroll records1 demon/rat+ h[ ea* doll> ( funds receiv$ ?r\gh ! grant 7 provid$ to ess5tial work]s2 & 7#b7 provide su* records to ! ,secret>y ( ! ,treasury or ! ,secret>y ( ,labor ^u ! reque/ ( ei!r su* ,secret>y4 7f7 ,rec\pm5t ,9 addition to all o!r en=cem5t & rem$ies available "u ?is title or any o!r law1 ! ,secret>y ( ! ,treasury %all e/abli% a process "u :i* ! ,secret>y %all rec\p ! am\nt ( any grant aw>d$ "u subsection 7a77#a7 if ! ,secret>y det]m9es t ! ess5tial "w employ] receiv+ ! grant-- 7#a7 did n provide all ( ! doll>s ( su* grant to ! ess5tial work]s ( ! employ]2 7#b7 did n1 9 fact1 h ! numb] ( ess5tial work]s c]tifi$ by ! employ] 9 accordance ) subp>agraphs 7,a7 & 7,b7 ( subsection 7b77#a72 7#c7 did n pay ! ess5tial work]s = ! numb] ( h\rs ! employ] claim$ to h paid2 or 7#d7 o!rwise misus$ funds or violat$ ?is title4 7g7 ,special rule = c]ta9 employees ( ,tribal employ]s ,ess5tial work]s ( ,tribal employ]s :o receive funds "u title ,,ii %all n be eligible to receive funds f grants "u ?is section4 7h7 ,tax treatm5t 7#a7 ,exclusion f income ,= purposes ( ! ,int]nal ,rev5ue ,code ( #aihf1 any grant receiv$ by an ess5tial "w employ] "u ?is section %all n be includ$ 9 ! gross income ( su* ess5tial "w employ]4 7#b7 ,d5ial ( d\ble b5efit 7,a7 ,9 g5]al ,9 ! case ( an ess5tial "w employ] t receives a grant "u ?is section-- 7i7 am\nts paid "u subsections 7b7 or 7f7 ( section #hje %all n be tak5 into acc\nt z wages = purposes ( sections #da1 #de;,a1 #ea1 or #acif ( ! ,int]nal ,rev5ue ,code ( #aihf or section #bcja ( ! ,,c>es ,act 7,public ,law #aaf-acf72 & 7ii7 any d$uction o!rwise all[able "u su* ,code = applicable paym5ts dur+ any taxable ye> %all be r$uc$ 7b n bel[ z]o7 by ! excess 7if any7 (-- 7,i7 ! aggregate am\nts ( grants receiv$ "u ?is section2 ov] 7,,ii7 ! sum ( any am\nt refund$ "u subsection 7d7 plus ! aggregate am\nt ( applicable paym5ts made = all prec$+ taxable ye>s4 7,b7 ,applicable paym5ts ,= purposes ( ?is p>agraph1 ! t]m applicable paym5ts means am\nts paid z premium pay "u subsections 7b7 or 7f7 ( section #hje & am\nts paid = employ] payroll taxes ) respect to su* am\nts4 7,c7 ,aggregation rule ,rules simil> to ! rules ( subsections 7a7 & 7b7 ( section #eb ( ! ,int]nal ,rev5ue ,code ( #aihf %all apply = purposes ( ?is section4 7#c7 ,in=mation report+ ,! ,secret>y ( ! ,treasury %all submit to ! ,commission] ( ,int]nal ,rev5ue /atem5ts conta9+-- 7,a7 ! "n & tax id5tification numb] ( ea* ess5tial "w employ] receiv+ a grant "u ?is section2 7,b7 ! am\nt ( su* grant2 & 7,c7 any am\nts refund$ "u subsection 7d77#c74 7i7 ,reports 7#a7 ,9 g5]al ,n lat] ?an #cj days aft] obligat+ ! la/ doll> ( ! funds appropriat$ "u ?is title1 ! ,secret>y ( ! ,treasury %all submit a report1 to ! ,committees ( ,congress describ$ 9 p>agraph 7#b71 t-- 7,a7 c]tifies t all funds appropriat$ "u ?is title h be5 obligat$2 & 7,b7 indicates ! numb] ( p5d+ applications = grants "u ?is section t w be reject$ due to ! lack ( funds4 7#b7 ,committees ( ,congress ,! ,committees ( ,congress describ$ 9 ?is p>agraph are-- 7,a7 ! ,committee on ,ways & ,means ( ! ,h\se ( ,repres5tatives2 7,b7 ! ,committee on ,education & ,labor ( ! ,h\se ( ,repres5tatives2 7,c7 ! ,committee on ,f9ance ( ! ,s5ate2 & 7,d7 ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate4 #hjg4 ,en=cem5t & outrea* 7a7 ,duties ( ,secret>y ( ,labor ,! ,secret>y ( ,labor %all-- 7#a7 h au?ority to en=ce ! requirem5ts ( section #hje1 9 accordance ) subsections 7b7 ?r\gh 7e72 7#b7 conduct outrea* z describ$ 9 subsection 7f72 & 7#c7 coord9ate ) ! ,secret>y ( ! ,treasury z ne$$ to c>ry out ! ,secret>y ( ,labor's responsibilities "u ?is section4 7b7 ,prohibit$ acts1 p5alties1 & en=cem5t 7#a7 ,prohibit$ acts ,x %all be unlawful = a p]son to-- 7,a7 violate any provision ( section #hje applicable to su* p]son2 or 7,b7 dis*>ge or 9 any o!r mann] discrim9ate aga9/ any ess5tial work] because su* ess5tial work] has fil$ any compla9t or in/itut$ or caus$ to be in/itut$ any proce$+ "u or relat$ to ?is title1 or has te/ifi$ or is ab\t to te/ify 9 any su* proce$+4 7#b7 ,en=cem5t & p5alties 7,a7 ,premium pay violations ,a violation describ$ 9 p>agraph 7#a77;,a7 %all be deem$ a violation ( section #g ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #bjg7 & unpaid am\nts requir$ "u ?is section %all be treat$ z unpaid ov]time comp5sation "u su* section #g = ! purposes ( sections #ae & #af ( su* ,act 7#bi ,u4,s4,c4 #bae & #baf74 7,b7 ,dis*>ge or discrim9ation ,a violation ( p>agraph 7#a77;,b7 %all be deem$ a violation ( section #ae7;a77#c7 ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #bae7;a77#c774 7c7 ,inve/igation 7#a7 ,9 g5]al ,to ensure compliance ) ! provisions ( section #hje1 includ+ any regulation or ord] issu$ "u t section1 ! ,secret>y ( ,labor %all h ! inve/igative au?ority provid$ "u section #aa7;a7 ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #baa7;a774 ,= ! purposes ( any inve/igation provid$ = 9 ?is subsection1 ! ,secret>y ( ,labor %all h ! subpo5a au?ority provid$ = "u section #i ( su* ,act 7#bi ,u4,s4,c4 #bji74 7#b7 ,/ate ag5cies ,! ,secret>y ( ,labor may1 = ! purpose ( c>ry+ out ! functions & duties "u ?is section1 utilize ! s]vices ( ,/ate & local ag5cies 9 accordance ) section #aa7;b7 ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #baa7;b774 7d7 ,ess5tial work] en=cem5t 7#a7 ,"r ( action ,an action alleg+ a violation ( p>agraph 7#a7 or 7#b7 ( subsection 7b7 may be ma9ta9$ aga9/ an ess5tial "w employ] receiv+ a grant "u section #hjf 9 any ,f$]al or ,/ate c\rt ( compet5t jurisdiction by "o or m ess5tial work]s or _! repres5tative = & on behalf ( ! ess5tial work]s1 or ! ess5tial work]s & o!rs simil>ly situat$1 9 ! same mann]1 & subject to ! same rem$ies 7includ+ attorney's fees & co/s ( ! action71 z an action br\ght by an employee alleg+ a violation ( section #g or #ae7;a77#c71 respectively1 ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #bjg1 #bae7;a77#c774 7#b7 ,no waiv] ,9 an action alleg+ a violation ( p>agraph 7#a7 or 7#b7 ( subsection 7b7 br\ght by "o or m ess5tial work]s or _! repres5tative = & on behalf ( ! p]sons z describ$ 9 p>agraph 7#a71 to en=ce ! rights 9 section #hje1 no c\rt ( compet5t jurisdiction may grant ! motion ( an ess5tial "w employ] receiv+ a grant "u section #hjf to compel arbitration1 "u *apt] #a ( title #i1 ,unit$ ,/ates ,code1 or any analog\s ,/ate arbitration /atute1 ( ! claims involv$4 ,an ess5tial work]'s "r to br+ an action describ$ 9 p>agraph 7#a7 or subsection 7b77#b77;,a7 on behalf ( simil>ly situat$ ess5tial work]s to en=ce su* rights may n be subject to any private agreem5t t purports to require ! ess5tial work]s to pursue claims on an individual basis4 7e7 ,recordkeep+ ,an ess5tial "w employ] receiv+ a grant "u section #hjf %all make1 keep1 & pres]ve records p]ta9+ to compliance ) section #hje 9 accordance ) section #aa7;c7 ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #baa7;c77 & 9 accordance ) regulations prescrib$ by ! ,secret>y ( ,labor4 7f7 ,outrea* & education ,out ( am\nts appropriat$ to ! ,secret>y ( ! ,treasury "u section #hje = a fiscal ye>1 ! ,secret>y ( ! ,treasury %all transf] to ! ,secret>y ( ,labor1 #c1jjj1jjj1 ( :i* ! ,secret>y ( ,labor %all use-- 7#a7 #b1ejj1jjj = outrea* to ess5tial "w employ]s & ess5tial work]s reg>d+ ! premium pay "u section #hje2 & 7#b7 #ejj1jjj to implem5t an adv]tis+ campaign enc\rag+ l>ge ess5tial "w employ]s to provide ! same premium pay provid$ = by section #hje us+ ! l>ge ess5tial "w employ]s' own funds & )\t utiliz+ grants "u ?is title4 7g7 ,cl>ification ( en=c+ (ficial ,no?+ 9 ! ,gov]nm5t ,employee ,rights ,act ( #aiia 7#db ,u4,s4,c4 #bjjj;e-#af;a et seq47 or section #c7;e77#b77;,c7 ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #bjc7;e77#b77;,c77 %all be con/ru$ to prev5t ! ,secret>y ( ,labor f c>ry+ out ! au?ority ( ! ,secret>y "u ?is section 9 ! case ( ,/ate employees describ$ 9 section #cjd7;a7 ( ! ,gov]nm5t ,employee ,rights ,act ( #aiia 7#db ,u4,s4,c4 #bjjj;e-#af;c7a774 ,,ix ,heal? ,,x & ,bridg+ ! ,digital ,divide 9 ,heal? ,c>e #ija4 ,,hrsa assi/ance to heal? c5t]s = promotion ( ,heal? ,,x ,! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all exp& & int5sify ! programs & activities ( ! ,adm9i/ration 7directly or ?r\gh grants or contracts7 to provide te*nical assi/ance & res\rces to heal? c5t]s 7z def9$ 9 section #ccj7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7a777 to adopt & mean+fully use c]tifi$ ,,ehr te*nology = ! managem5t ( *ronic diseases & heal? conditions & r$uction ( heal? disp>ities4 #ijb4 ,assessm5t ( impact ( ,heal? ,,x on racial & e?nic m9ority communities2 outrea* & adoption ( ,heal? ,,x 9 su* communities 7a7 ,national ,coord9ator = ,heal? ,in=mation ,te*nology ,n lat] ?an #ah mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,national ,coord9ator = ,heal? ,in=mation ,te*nology 7ref]r$ to 9 ?is section z ! ,national ,coord9ator7 %all-- 7#a7 conduct an evaluation ( ! level ( int]op]ability1 access1 use1 & accessibility ( electronic heal? records 9 racial & e?nic m9ority communities1 focus+ on :e!r pati5ts 9 su* communities h provid]s :o use electronic heal? records1 & ! degree to :i* pati5ts 9 su* communities c access1 ex*ange1 & use )\t special ef=t _! heal? in=mation 9 ^? electronic heal? records1 & indicat+ :e!r su* provid]s-- 7,a7 are p>ticipat+ 9 ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 or a ,/ate plan "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq47 7or a waiv] ( su* plan72 7,b7 h receiv$ inc5tive paym5ts or inc5tive paym5t adju/m5ts "u ,m$ic>e & ,m$icaid ,electronic ,heal? ,records ,inc5tive ,programs 7z def9$ 9 subsection 7c77#b772 7,c7 are ,,mips eligible pr(essionals1 z def9$ 9 p>agraph 7#a77;,c7 ( section #ahdh7q7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7q771 = purposes ( ! ,m]it-,bas$ ,inc5tive ,paym5t ,sy/em "u su* section2 or 7,d7 h be5 recruit$ by any ( ! ,heal? ,in=mation ,te*nology ,regional ,ext5sion ,c5t]s e/abli%$ "u section #cjab ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj-#cb72 7#b7 publi% ! results ( su* evaluation includ+ ! race & e?nicity ( su* provid]s & ! populations s]v$ by su* provid]s2 & 7#c7 n lat] ?an #ab mon?s aft] ! enactm5t ( ?is ,act1 %all promulgate a c]tification crit]ion & module ( c]tifi$ ,,ehr te*nology t /ratifies quality measures by disp>ity *>act]i/ics1 includ+ race1 e?nicity1 language1 g5d]1 g5d] id5tity1 sexual ori5tation1 socioeconomic /atus1 & disability /atus1 z ^? *>act]i/ics are def9$ 9 c]tifi$ ,,ehr te*nology2 & reports to ,c5t]s = ,m$ic>e ,m$icaid ,s]vices ! quality measures /ratifi$ by race & at lea/ two o!r disp>ity *>act]i/ics4 ,! t]m quality measures ref]s to ! quality measures specifi$ 9 ,,mips4 7b7 ,national c5t] = heal? /ati/ics ,z soon z practicable aft] ! date ( enactm5t ( ?is ,act1 ! ,director ( ! ,national ,c5t] = ,heal? ,/ati/ics %all provide to ,congress a m detail$ analysis ( ! data pres5t$ 9 ,national ,c5t] = ,heal? ,/ati/ics data brief entitl$ ,adoption ( ,c]tifi$ ,electronic ,heal? ,record ,sy/ems & ,electronic ,in=mation ,%>+ 9 ,physician ,(fices3 ,unit$ ,/ates1 #bjac & #bjad 7,,n*s ,data ,brief ,no4 #bcf74 7c7 ,c5t]s = ,m$ic>e ,m$icaid ,s]vices 7#a7 ,9 g5]al ,z "p ( ! process ( collect+ in=mation1 ) respect to a provid]1 at regi/ration & atte/ation = purposes ( ,m$ic>e & ,m$icaid ,electronic ,heal? ,records ,inc5tive ,programs 7z def9$ 9 p>agraph 7#b77 or ! ,m]it-,bas$ ,inc5tive ,paym5t ,sy/em "u section #ahdh7q7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7q771 ! ,secret>y ( ,heal? & ,human ,s]vices %all collect ! race & e?nicity ( su* provid]4 7#b7 ,m$ic>e & ,m$icaid ,electronic ,heal? ,records ,inc5tive ,programs def9$ ,= purposes ( p>agraph 7#a71 ! t]m ,m$ic>e & ,m$icaid ,electronic ,heal? ,records ,inc5tive ,programs means ! inc5tive programs "u section #ahad7l77#c71 subsections 7a77#g7 & 7o7 ( section #ahdh1 subsections 7l7 & 7m7 ( section #ahec1 subsections 7b77#c77;,b77ix77,i7 & 7n7 ( section #ahhf1 & subsections 7a77#c77;,f7 & 7t7 ( section #aijc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7l77#c71 #aciew-#d1 #aciew-#bc1 #acieww1 & #acif;b74 7d7 ,national ,coord9ator's assessm5t ( impact ( ,,hit ,section #cjja7;c77#f77;,c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj-#aa7;c77#f77;,c77 is am5d$-- 7#a7 9 ! head+ by ins]t+ 1 racial & e?nic m9ority communities1 aft] heal? disp>ities2 7#b7 by ins]t+ 1 9 communities ) a high proportion ( individuals f racial & e?nic m9ority gr\ps 7z def9$ 9 section #agjg7;g771 includ+ p ) disabilities 9 ^! gr\ps1 aft] communities ) heal? disp>ities2 7#c7 by /rik+ ,! ,national ,coord9ator & ins]t+ ! foll[+3 7i7 ,9 g5]al ,! ,national ,coord9ator 2 & 7#d7 by add+ at ! end ! foll[+3 7ii7 ,crit]ia ,9 any publication "u clause 7i71 ! ,national ,coord9ator %all include be/ practices = enc\rag+ p>tn]%ips betwe5 ! ,f$]al ,gov]nm5t1 ,/ates1 & private entities to exp& outrea* = & ! adoption ( c]tifi$ ,,ehr te*nology 9 communities ) a high proportion ( individuals f racial & e?nic m9ority gr\ps 7z s def9$71 :ile also ma9ta9+ ! accessibility requirem5ts ( section #ejh ( ! ,rehabilitation ,act ( #aigc to enc\rage pati5t involvem5t 9 pati5t heal? c>e4 ,! ,national ,coord9ator %all-- 7,i7 n lat] ?an #f mon?s aft] ! submission ( ! report requir$ "u section #hbb ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj1 e/abli% crit]ia = evaluat+ ! impact ( heal? in=mation te*nology on communities ) a high proportion ( individuals f racial & e?nic m9ority gr\ps 7z s def9$7 tak+ into acc\nt ! f9d+s 9 su* report2 & 7,,ii7 n lat] ?an #a ye> aft] ! submission ( su* report1 conduct & publi% ! results ( an evaluation ( su* impact4 4 #ijc4 ,ext5d+ fund+ to /r5g!n ! ,heal? ,,x infra/ructure 9 racial & e?nic m9ority communities ,section #cjaa ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj-#ca7 is am5d$-- 7#a7 9 subsection 7a71 9 ! matt] prec$+ p>agraph 7#a71 by ins]t+ 1 includ+ ) respect to communities ) a high proportion ( individuals f racial & e?nic m9ority gr\ps 7z def9$ 9 section #agjg7;g77 be=e ! colon2 & 7#b7 by add+ at ! end ! foll[+ new subsection3 7e7 ,annual report on exp5ditures ,! ,national ,coord9ator %all report annually to ,congress on activities & exp5ditures "u ?is section4 4 #ijd4 ,ext5d+ competitive grants = ! developm5t ( loan programs to facilitate adoption ( c]tifi$ ,,ehr te*nology by provid]s s]v+ racial & e?nic m9ority gr\ps ,section #cjad7;e7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj-#cd7;e77 is am5d$1 9 ! matt] prec$+ p>agraph 7#a71 by ins]t+ 1 includ+ ) respect to communities ) a high proportion ( individuals f racial & e?nic m9ority gr\ps 7z def9$ 9 section #agjg7;g77 aft] heal? c>e provid] to4 #ije4 ,au?orization ( appropriations ,section #cjah ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj-#ch7 is am5d$ by /rik+ fiscal ye>s #bjji ?r\gh #bjac & ins]t+ fiscal ye>s #bjba ?r\gh #bjbf4 #ijf4 ,data collection & assessm5ts conduct$ 9 coord9ation ) m9ority-s]v+ in/itutions ,section #cjja7;c77#f7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj-#aa7;c77#f77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,f7 ,data collection & assessm5ts conduct$ 9 coord9ation ) m9ority-s]v+ in/itutions 7i7 ,9 g5]al ,9 c>ry+ out subp>agraph 7,c7 ) respect to communities ) a high proportion ( individuals f racial & e?nic m9ority gr\ps 7z def9$ 9 section #agjg7;g771 ! ,national ,coord9ator %all1 to ! greate/ ext5t possible1 coord9ate ) an entity describ$ 9 clause 7ii74 7ii7 ,m9ority-s]v+ in/itutions ,= purposes ( clause 7i71 an entity describ$ 9 ?is clause is a ,hi/orically ,black ,college or ,univ]sity1 a ,hispanic-s]v+ in/itution1 a tribal college or univ]sity1 or an ,asian-,am]ican-1 ,native ,am]ican-1 or ,pacific ,isl&]-s]v+ in/itution ) an accr$it$ public heal?1 heal? policy1 or heal? s]vices rese>* program4 4 #ijg4 ,/udy ( heal? in=mation te*nology 9 m$ically und]s]v$ communities 7a7 ,9 g5]al ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all-- 7#a7 ent] into an agreem5t ) ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e to conduct a /udy on ! developm5t1 implem5tation1 & effectiv5ess ( heal? in=mation te*nology )9 m$ically und]s]v$ areas 7z describ$ 9 subsection 7c772 & 7#b7 submit a report to ,congress describ+ ! results ( su* /udy1 includ+ any recomm5dations = legislative or adm9i/rative action4 7b7 ,/udy ,! /udy describ$ 9 subsection 7a77#a7 %all-- 7#a7 id5tify b>ri]s to successful implem5tation ( heal? in=mation te*nology 9 m$ically und]s]v$ areas2 7#b7 survey a cross-section ( individuals 9 m$ically und]s]v$ areas & report _! op9ions ab\t ! v>i\s topics ( /udy2 7#c7 exam9e ! degree ( int]op]ability among heal? in=mation te*nology & us]s ( heal? in=mation te*nology 9 m$ically und]s]v$ areas1 includ+ pati5ts1 provid]s1 & community s]vices2 7#d7 exam9e ! impact ( heal? in=mation te*nology on provid+ quality c>e & r$uc+ ! co/ ( c>e to individuals 9 su* areas1 includ+ ! impact ( su* te*nology on improv$ heal? outcomes = individuals1 includ+ :i* te*nology work$ = :i* population & h[ x improv$ heal? outcomes = t population2 7#e7 exam9e ! impact ( heal? in=mation te*nology on improv+ heal? c>e-relat$ decisions by bo? pati5ts & provid]s 9 su* areas2 7#f7 id5tify specific be/ practices = us+ heal? in=mation te*nology to fo/] ! consi/5t provision ( physical accessibility & reasonable policy accommodations 9 heal? c>e to individuals ) disabilities 9 su* areas2 7#g7 assess ! feasibility & co/s associat$ ) ! use ( heal? in=mation te*nology 9 su* areas2 7#h7 evaluate :e!r ! adoption & use ( qualifi$ electronic heal? records 7z def9$ 9 section #cjjj ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj77 is effective 9 r$uc+ heal? disp>ities1 includ+ analysis ( cl9ical quality measures report$ by provid]s :o are p>ticipat+ 9 ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 or a ,/ate plan "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq47 7or a waiv] ( su* plan71 pursuant to programs to enc\rage ! adoption & use ( c]tifi$ ,,ehr te*nology2 7#i7 id5tify provid]s 9 m$ically und]s]v$ areas t are n elect+ to adopt & use electronic heal? records & det]m9e :at b>ri]s are prev5t+ ^? provid]s f adopt+ & us+ su* records2 & 7#aj7 exam9e urban & rural community heal? sy/ems & det]m9e ! impact t heal? in=mation te*nology may h on ! capacity ( prim>y heal? provid]s 9 ^? sy/ems4 7c7 ,m$ically und]s]v$ area ,! t]m m$ically und]s]v$ area means-- 7#a7 a population t has be5 designat$ z a m$ically und]s]v$ population "u section #ccj7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b77#c772 7#b7 an area t has be5 designat$ z a heal? pr(essional %ortage area "u section #ccb ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e72 7#c7 an area or population t has be5 designat$ z a m$ically und]s]v$ community "u section #gii;,b ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #biep72 or 7#d7 ano!r area or population t-- 7,a7 exp]i5ces significant b>ri]s to access+ quality heal? s]vices2 & 7,b7 has a high preval5ce ( diseases or conditions describ$ 9 title ,,vii1 ) su* diseases or conditions hav+ a disproportionate impact on racial & e?nic m9ority gr\ps 7z def9$ 9 section #agjg7;g7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjju-#f7;g777 or a subgr\p ( p ) disabilities :o h specific functional impairm5ts4 #ijh4 ,/udy on ! effects ( *anges to teleheal? "u ! ,m$ic>e & ,m$icaid programs dur+ ! ,,covid-#ai em]g5cy 7a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! end ( ! em]g5cy p]iod describ$ 9 section #aace7;g77#a77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77#a77;,b771 ! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is section ref]r$ to z ! ,secret>y7 %all conduct a /udy & submit to ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,ways & ,means ( ! ,h\se ( ,repres5tatives & ! ,committee on ,f9ance ( ! ,s5ate an int]im report on any *anges made to ! provision or availability ( teleheal? s]vices "u "p ,a or ,b ( title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 dur+ su* p]iod4 ,su* report %all include ! foll[+3 7#a7 ,a summ>y ( utilization ( all heal? c>e s]vices furni%$ "u su* "p ,a or ,b dur+ su* p]iod1 includ+ ! numb] (-- 7,a7 9-p]son outpati5t visits1 inpati5t admissions1 & 9-p]son em]g5cy dep>tm5t visits2 & 7,b7 teleheal? visits1 brok5 d[n by-- 7i7 ! numb] ( su* visits furni%$ via audio-visual te*nology comp>$ to ! numb] ( su* visits furni%$ via audio-only te*nology2 7ii7 ! numb] ( su* visits furni%$ by ea* type ( provid] ( s]vices or suppli] 7z def9$ 9 section #ahfa ( su* ,act 7#db ,u4,s4,c4 #aciex7 & includ+ a ,f$]ally qualifi$ heal? c5t] or rural heal? cl9ic 7z s def9$771 includ+ a specification ( ! specialty ( ea* su* provid] or suppli] 7if applicable72 & 7iii7 ! type ( s]vice provid$1 includ+ level ( s]vice & diagnoses associat$ ) ! teleheal? visit4 7#b7 ,a description ( any *anges 9 utilization patt]ns = ! c>e sett+s describ$ 9 p>agraph 7#a7 ov] ! c\rse ( su* p]iod comp>$ to su* patt]ns prior to su* p]iod4 7#c7 ,an analysis ( utilization ( teleheal? s]vices "u su* "p ,a or ,b dur+ su* p]iod1 brok5 d[n by age1 sex 7includ+ sexual ori5tation & g5d] id5tity :]e possible71 race & e?nicity1 disability /atus1 prim>y language1 geographic region 7includ+ by rural heal? areas 7z def9$ by ! ,heal? ,res\rces ,s]vices ,adm9i/ration71 non-rural heal? areas1 heal? pr(essional %ortage areas 7z def9$ 9 section #ccb7;a77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;e7a77#a7771 m$ically und]s]v$ communities 7z def9$ 9 section #gii;,b7#f7 ( su* ,act 7#db ,u4,s4,c4 #biep7#f7771 areas ) m$ically und]s]v$ populations 7z def9$ 9 section #ccj7;b77#c7 ( su* ,act 7#db ,u4,s4,c4 #bed;b7b77#c7771 & by ,/ate71 & income level 7z measur$ directly or indirectly1 su* z by pati5t's zip code tabulation area m$ian income z publicly report$ by ! ,unit$ ,/ates ,c5sus ,bureau71 & ( any tr5ds 9 su* utilization dur+ su* p]iod1 s brok5 d[n4 ,su* analysis %all include ! numb] ( teleheal? visits p]=m$ by provid]s ( s]vices or suppli]s lic5s$ 9 a ,/ate diff]5t f ! ,/ate :]e ! individual receiv+ su* teleheal? s]vices is locat$ at ! "t su* s]vices are furni%$4 ,su* analysis may n include any individually id5tifiable in=mation or protect$ heal? in=mation4 7#d7 ,a description ( exp5ditures & any sav+s "u su* "p ,a or ,b attributable to use ( su* teleheal? s]vices dur+ su* p]iod4 7#e7 ,a description ( any in/ances ( fraud id5tifi$ by ! ,secret>y1 act+ ?r\gh ! ,(fice ( ! ,inspector ,g5]al or o!r relevant ag5cies & dep>tm5ts1 ) respect to su* teleheal? s]vices furni%$ "u su* "p ,a or ,b dur+ su* p]iod & a comp>ison ( ! numb] ( su* in/ances ) ! numb] ( in/ances ( fraud s id5tifi$ ) respect to 9-p]son s]vices s furni%$ dur+ su* p]iod4 7#f7 ,a description ( any privacy conc]ns ) respect to ! furni%+ ( su* teleheal? s]vices 7su* z cyb]security or ransomw>e conc]ns71 includ+ a description ( any actions tak5 by ! ,secret>y1 act+ ?r\gh ! ,heal? ,sector ,cyb]security ,coord9ation ,c5t] or o!r relevant ag5cies & dep>tm5ts1 dur+ su* p]iod to assi/ heal? c>e provid]s secure telecommunications sy/ems4 7#g7 ,an analysis ( heal? c>e quality relat$ to teleheal? 7:i* may include pati5t heal? outcomes 7su* z morbidity1 mortality1 heal?c>e utilization1 & disease-specific managem5t metrics71 safety metrics1 quality measures1 heal? equity focus$ measures1 pati5t satisfaction1 provid] satisfaction1 & o!r inputs & s\rces z det]m9$ by ! ,secret>y74 7#h7 ,an analysis ( any o!r outcomes or metrics relat$ to teleheal?1 z det]m9$ appropriate by ! ,secret>y4 7b7 ,input ,9 conduct+ ! /udy & submitt+ ! report "u subsection 7a71 ! ,secret>y-- 7#a7 7,a7 consult ) relevant /akehold]s 7su* z pati5ts1 c>egiv]s1 pati5t advocacy gr\ps1 m9ority or tribal gr\ps 7includ+ ,urban ,indian ,organization 7,u,i,os771 heal? c>e pr(essionals 7includ+ behavioral heal? pr(essionals71 hospitals1 ,/ate m$ical bo>ds1 ,/ate nurs+ bo>ds1 ! ,f$]ation ( ,/ate ,m$ical ,bo>ds1 ,national ,c\ncil ( ,/ate ,bo>ds ( ,nurs+1 m$ical pr(essional employ]s 7su* z hospitals1 m$ical gr\ps1 /aff+ companies71 teleheal? gr\ps1 heal? pr(essional liability provid]s1 public & private pay]s1 & ,/ate lead]s72 & 7,b7 solicit public comm5ts on su* report be=e ! submission ( su* report2 & 7#b7 %all endeavor to include z _m racially1 e?nically1 geographically1 l+ui/ically1 & pr(essionally div]se p]spectives z possible4 7c7 ,f9al report ,n lat] ?an ,decemb] #ca1 #bjbd1 ! ,secret>y %all-- 7#a7 update & f9alize ! int]im report "u subsection 7a72 & 7#b7 submit su* updat$ & f9aliz$ report to ! committees specifi$ 9 su* subsection4 7d7 ,grants = ,m$icaid reports 7#a7 ,9 g5]al ,n lat] ?an #b ye>s aft] ! end ( ! em]g5cy p]iod describ$ 9 section #aace7;g77#a77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77#a77;,b771 ! ,secret>y %all aw>d grants to ,/ates ) a ,/ate plan 7or waiv] ( su* plan7 9 effect "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr7 t submit an application "u ?is subsection = purposes ( enabl+ su* ,/ates to /udy & submit reports to ! ,secret>y on any *anges made to ! provision or availability ( teleheal? s]vices "u su* plans 7or su* waiv]s7 dur+ su* p]iod4 7#b7 ,eligibility ,to be eligible to receive a grant "u p>agraph 7#a71 a ,/ate %all-- 7,a7 provide b5efits = teleheal? s]vices "u ! ,/ate plan 7or waiv] ( su* plan7 9 effect "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr72 7,b7 be able to diff]5tiate teleheal? f 9-p]son visits )9 claims data submitt$ "u su* plan 7or su* waiv]7 dur+ su* p]iod2 & 7,c7 submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation 7includ+ ! am\nt ( ! grant reque/$7 z ! ,secret>y may require4 7#c7 ,use ( funds ,an ,/ate %all use am\nts receiv$ "u a grant "u ?is subsection to conduct a /udy & report f9d+s reg>d+ ! effects ( *anges to teleheal? s]vices (f]$ "u ! ,/ate plan 7or waiv] ( su* plan7 ( su* ,/ate "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 dur+ su* p]iod 9 accordance ) p>agraph 7#d74 7#d7 ,reports 7,a7 ,int]im report ,n lat] #a ye> aft] ! date a ,/ate receives a grant "u ?is subsection1 ! ,/ate %all submit to ! ,secret>y an int]im report t-- 7i7 details any *anges made to ! provision or availability ( teleheal? b5efits 7su* z eligibility1 cov]age1 or paym5t *anges7 "u ! ,/ate plan 7or waiv] ( su* plan7 ( ! ,/ate "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 dur+ ! em]g5cy p]iod describ$ 9 p>agraph 7#a72 & 7ii7 conta9s-- 7,i7 a summ>y & description ( ! type describ$ 9 p>agraphs 7#a7 & 7#b71 respectively1 ( subsection 7a72 & 7,,ii7 to ! ext5t practicable1 an analysis ( ! type describ$ 9 p>agraph 7#c7 ( subsection 7a71 except t any ref]5ce 9 su* subsection to su* "p ,a or ,b %all1 = purposes ( subclauses 7,i7 & 7,,ii71 be treat$ z a ref]5ce to su* ,/ate plan 7or waiv]74 7,b7 ,f9al report ,n lat] ?an #c ye>s aft] ! date a ,/ate receives a grant "u ?is subsection1 ! ,/ate %all update & f9alize ! int]im report & submit su* f9al report to ! ,secret>y4 7,c7 ,report by ,secret>y ,n lat] ?an ! e>li] ( ! date t is #a ye> aft] ! submission ( all f9al reports "u subp>agraph 7,b7 & ,decemb] #ca1 #bjbh1 ! ,secret>y %all submit to ,congress a report on ! grant program1 includ+ a summ>y ( ! reports receiv$ f ,/ates "u ?is p>agraph4 7#e7 ,modification au?ority ,! ,secret>y may modify any deadl9e describ$ 9 p>agraph 7#d7 or any in=mation requir$ to be includ$ 9 a report made "u ?is subsection to provide flexibility = ,/ates to modify ! scope ( ! /udy & timel9e = su* reports4 7#f7 ,te*nical assi/ance ,! ,secret>y %all provide su* te*nical assi/ance z may be necess>y to a ,/ate receiv+ a grant "u ?is subsection 9 ord] to assi/ su* /ate 9 conduct+ /udies & submitt+ reports "u ?is subsection4 7#g7 ,/ate ,= purposes ( ?is subsection1 ! t]m ,/ate means ea* ( ! sev]al ,/ates1 ! ,di/rict ( ,columbia1 & ea* t]ritory ( ! ,unit$ ,/ates4 7e7 ,au?orization ( appropriations 7#a7 ,m$ic>e ,= ! purpose ( c>ry+ out subsections 7a7 ?r\gh 7c71 !re are au?oriz$ to be appropriat$ su* sums z may be necess>y = ea* ( ! fiscal ye>s #bjbj ?r\gh #bjbd4 7#b7 ,m$icaid ,= ! purpose ( c>ry+ out subsection 7d71 !re are au?oriz$ to be appropriat$ su* sums z may be necess>y = ea* ( ! fiscal ye>s #bjbb ?r\gh #bjbh4 #iji4 ,,covid-#ai designation ( imm$iate special au?ority ( spectrum = ,tribes' em]g5cy response 9 ,indian ,c\ntry 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,! imm$iate grant ( em]g5cy special tempor>y au?ority ( available spectrum t w effici5tly support tempor>y wireless broadb& networks & all[ ,indian ,tribes to provide ,tribal memb]s ) wireless broadb& s]vice ov] ,tribal l&s or ,hawaiian ,home ,l&s dur+ ! ,,covid-#ai crisis due to ! increas$ dem& = telecommunications & disproportionate impacts ( ! ,,covid-#ai p&emic 9 ,indian ,c\ntry is ess5tial4 7#b7 ,res]vations are ! mo/ digitally disconnect$ areas 9 ! ,unit$ ,/ates t lack basic access to broadb& & wireless s]vices at rates comp>able to1 & 9 "s cases l[] ?an1 ?ird-_w c\ntries4 7#c7 ,9 #bjah1 ! ,gov]nm5t ,acc\ntability ,(fice & ! ,f$]al ,communications ,commission report$ t only #fe p]c5t ( ,am]ican ,indian & ,alaska ,natives 7,,ai_/,a,ns7 liv+ on ,tribal l&s _h access to fix$ broadb& s]vices1 & only #fh p]c5t ( ,,ai_/,,an h\seholds on rural ,tribal l&s _h telephone s]vices4 ,?is is a />k comp>ison to only #h p]c5t ( ! national av]age t lacks access to fix$ broadb& s]vices4 7#d7 ,indian ,tribes h previ\sly enc\nt]$ sub/antial b>ri]s to access+ broadb& & o!r communications s]vices on ,tribal l&s to deploy telecommunication s]vices = ! safety & well-be+ ( ,tribal memb]s & to decrease ! al>m+ rates ( unnecess>y loss ( lives t ,,ai_/,a,ns disproportionately exp]i5ce1 especially ?r\gh ! lack ( access to heal? c>e s]vices & em]g5cy res\rces1 z demon/rat$ dur+ ! ,,covid-#ai p&emic t cont9ues to disproportionately impact ,indian ,c\ntry4 7#e7 ,indian ,tribes' lack ( access to broadb& s]vices on ,tribal l&s & ,hawaiian ,home ,l&s dur+ ! ,,covid-#ai p&emic fur!r highlights ! digital divide 9 ,indian ,c\ntry4 7#f7 ,! ,gov]nm5t ,acc\ntability ,(fice f\nd t heal? in=mation te*nology sy/ems at ! ,indian ,heal? ,s]vice rank z ! ,f$]al ,gov]nm5t's ?ird-highe/ ne$ = ag5cy sy/em mod]nization1 s9ce #ej p]c5t ( ,indian ,heal? ,s]vice facilities dep5d on outdat$ circuit connections bas$ on "o or two ,,ti circuit l9es 7#c ,mbps71 creat+ sl[] response times ?an any o!r heal? facility sy/em 9 ! ,unit$ ,/ates4 7#g7 ,a #bjah ,tribal heal? re=m comm5t fil$ ) ! ,f$]al ,communications ,commission has fur!r /at$ t approximately #a4e million p liv+ on ,tribal l&s lack access to broadb& &1 ( ! #ge p]c5t ( rural ,indian ,heal? ,s]vice facilities1 _m /ill lack reliable broadb& networks = ,am]ican ,indians & ,alaska ,natives 7,,ai_/,a,ns7 to access teleheal? or cl9ical heal? c>e s]vices1 :i* is a critical ne$ 9 ! mo/ geographically isolat$ areas ( ! c\ntry ) "s ( ! highe/ pov]ty rates1 & lack ( access to reliable transportation4 7#h7 ,! ,bureau ( ,indian ,education has /at$ t rec5t e/imates f #adb out ( #agd s*ools h indicat$ t approximately #ae to #ie p]c5t ( /ud5ts d n h access to int]net s]vices at home dep5d+ on ,bureau s*ool location & limitations on data caps dur+ ! ,,covid-#ai crisis4 7b7 ,deploym5t ( wireless broadb& s]vice on ,tribal l&s & ,hawaiian ,home ,l&s 7#a7 ,fund+ ( grants = imm$iate deploym5t ( wireless broadb& s]vice on ,tribal l&s & ,hawaiian ,home ,l&s ,9 addition to any o!r am\nts made available1 out ( any money 9 ! ,treasury ( ! ,unit$ ,/ates n o!rwise appropriat$1 !re are appropriat$-- 7,a7 #big1ejj1jjj = grants "u ! community facilities grant program "u section #cjf7;a77#ai7 ( ! ,consolidat$ ,f>m & ,rural ,developm5t ,act to ,indian ,tribes1 qualify+ ,tribal entities1 & ! ,director ( ! ,dep>tm5t ( ,hawaiian ,home ,l&s1 = ! imm$iate deploym5t ( wireless broadb& s]vice on ,tribal l&s & ,hawaiian ,home ,l&s1 respectively1 ?r\gh ! use ( em]g5cy special tempor>y au?ority grant$ "u p>agraph 7#b7 ( ?is subsection1 includ+ backhaul co/s1 repairs to damag$ infra/ructure1 ! co/ ( ! repairs to :i* w\ld be less exp5sive ?an ! co/ ( new infra/ructure & w\ld support ! em]g5cy special tempor>y use1 & ! ,f$]al %>e applicable to grants f su* am\nt %all be #ajj p]c5t1 :i* am\nt %all rema9 available = "o ye> f ! enactm5t ( ?is ,act2 & 7,b7 #c1jjj1jjj = grants "u ! community facilities te*nical assi/ance & tra9+ grant program "u section #cjf7;a77#bf7 ( su* ,act1 )\t reg>d to sections #cjf7;a77#bf77;,b7 & #cjf7;a77#bf77;,c7 ( su* ,act1 to assi/ ,indian ,tribes1 qualify+ ,tribal entities1 & ! ,director ( ! ,dep>tm5t ( ,hawaiian ,home ,l&s 9 prep>+ applications = ! grants ref]r$ to 9 subp>agraph 7,b7 ( ?is p>agraph1 :i* am\nt %all rema9 available = "o ye> f ! enactm5t ( ?is ,act4 ,grants ref]r$ to "u subp>agraph 7,b7 %all be available to ,indian ,tribes1 qualify+ ,tribal entities & %all also be available to int]-,tribal gov]nm5t organizations1 univ]sities1 & colleges ) ,tribal s]v+ in/itutions = ! purposes /at$ h]e94 7#b7 ,em]g5cy special tempor>y au?ority ,to use available & effici5t spectrum on ,tribal l&s & ,hawaiian ,home ,l&s 7,a7 ,grant ( au?ority ,n lat] ?an #aj days aft] receiv+ a reque/ f an ,indian ,tribe1 a qualify+ ,tribal entity1 or ! ,director ( ! ,dep>tm5t ( ,hawaiian ,home ,l&s = em]g5cy special tempor>y au?ority to use electromagnetic spectrum describ$ 9 subp>agraph 7,c7 = ! provision ( wireless broadb& s]vice ov] ! ,tribal l&s ov] :i* ! ,indian ,tribe or qualify+ ,tribal entity has jurisdiction or 79 ! case ( a reque/ f ! ,director ( ! ,dep>tm5t ( ,hawaiian ,home ,l&s7 ov] ! ,hawaiian ,home ,l&s1 all[+ unlic5s$ radio transmitt]s to op]ate = su* provision on su* spectrum at locations on su* ,tribal l&s or ,hawaiian ,home ,l&s :]e su* spectrum is n be+ us$1 ! ,commission %all grant su* reque/ on a second>y non-int]f]5ce basis4 7,b7 ,duration ,a grant ( em]g5cy special tempor>y au?ority "u subp>agraph 7,a7 %all be = a p]iod ( op]ation to beg9 n lat] ?an #f mon?s aft] ! date ( ! enactm5t ( ?is ,act & to rema9 9 op]ation = n long] ?an #f mon?s1 abs5t ext5sions grant$ by ! ,commission pursuant to ! proc$ures ( ! ,commission relat+ to special tempor>y au?ority4 7,c7 ,electromagnetic spectrum describ$ ,! electromagnetic spectrum describ$ 9 ?is subp>agraph = utilization on ! tempor>y basis is any portion ( ! electromagnetic spectrum-- 7i7 t is-- 7,i7 betwe5 ! frequ5cies ( #bdif megah]tz & #bfij megah]tz1 inclusive2 7,,ii7 9 ! :ite spaces ( ! television broadca/ spectrum betwe5 ! frequ5cies ( #dgj megah]tz & #gij megah]tz1 inclusive1 exclud+ ^? frequ5cies utiliz$ = o!r purposes "u subp>t ,h ( "p #ae ( title #dg1 ,code ( ,f$]al ,regulations2 7,,iii7 betwe5 ! frequ5cies ( #eibe megah]tz & #gabe megah]tz1 inclusive2 or 7,,iv7 betwe5 frequ5cies ( #ceej megah]tz & #cgjj megah]tz1 inclusive2 & 7ii7 ) respect to ! ,tribal l&s or ,hawaiian ,home ,l&s ov] :i* au?ority to use su* spectrum is reque/$ "u subp>agraph 7,a71 is n assign$ to any lic5see4 7#c7 ,def9itions ,9 ?is subsection3 7,a7 ,commission ,! t]m ,commission means ! ,f$]al ,communications ,commission4 7,b7 ,hawaiian ,home ,l&s ,! t]m ,hawaiian ,home ,l&s means l&s held 9 tru/ = ,native ,hawaiians by ,hawaii pursuant to ! ,hawaiian ,homes ,commission ,act1 #aibj4 7,c7 ,indian ,tribe ,! t]m ,indian ,tribe means ! gov]n+ body ( any individually id5tifi$ & f$]ally recogniz$ ,indian or ,alaska ,native ,tribe1 b&1 nation1 pueblo1 village1 community1 affiliat$ tribal gr\p1 or compon5t res]vation 9 ! li/ publi%$ pursuant to section #ajd7;a7 ( ! ,f$]ally ,recogniz$ ,indian ,tribe ,li/ ,act ( #aiid 7#be ,u4,s4,c4 #eaca7;a774 7,d7 ,qualify+ ,tribal entity ,! t]m qualify+ ,tribal entity means an entity designat$ by ! ,indian ,tribe ) jurisdiction ov] p>ticul> ,tribal l&s = :i* ! spectrum access is s\ght4 ,! foll[+ may be designat$ z a qualify+ ,tribal entity3 7i7 ,indian ,tribes4 7ii7 ,tribal consortia :i* consi/s ( two or m ,indian ,tribes1 or an ,indian ,tribe & an entity t is m ?an #ej p]c5t own$ & controll$ by "o or m ,indian ,tribes4 7iii7 ,f$]ally *>t]$ ,tribal corporations creat$ "u section #ag ( ! ,indian ,reorganization ,act 7#be ,u4,s4,c4 #eabd71 & creat$ "u section #d ( ! ,oklahoma ,indian ,welf>e ,act 7#be ,u4,s4,c4 #ebjd74 7iv7 ,entities t are m ?an #ej p]c5t own$ & controll$ by an ,indian ,tribe or ,indian ,tribes4 7,e7 ,entity t is m ?an #ej p]c5t own$ & controll$ by "o or m ,indian ,tribes ,! t]m entity t is m ?an #ej p]c5t own$ & controll$ by "o or m ,indian ,tribes means an entity ov] :i* "o or m ,indian ,tribes h bo? de facto & de jure control ( ! entity4 ,de jure control ( ! entity is evid5c$ by own]%ip ( great] ?an #ej p]c5t ( ! vot+ /ock ( a corporation1 or 9 ! case ( a p>tn]%ip1 g5]al p>tn]%ip int]e/s4 ,de facto control ( an entity is det]m9$ on a case-by-case basis4 ,an ,indian ,tribe or ,indian ,tribes mu/ demon/rate indicia ( control to e/abli% t su* ,indian ,tribe or ,indian ,tribes reta9 de facto control ( ! applicant seek+ eligibility z a qualify+ ,tribal entity1 includ+ ! foll[+3 7i7 ,! ,indian ,tribe or ,indian ,tribes con/itute or appo9t m ?an #ej p]c5t ( ! bo>d ( directors or managem5t committee ( ! entity4 7ii7 ,! ,indian ,tribe or ,indian ,tribes h au?ority to appo9t1 promote1 demote1 & fire s5ior executives :o control ! day-to-day activities ( ! entity4 7iii7 ,! ,indian ,tribe or ,indian ,tribes play an integral role 9 ! managem5t decisions ( ! entity4 7iv7 ,! ,indian ,tribe or ,indian ,tribes h ! au?ority to make decisions or o!rwise engage 9 practices or activities t det]m9e or significantly influ5ce-- 7,i7 ! nature or types ( s]vices (f]$ by su* an entity2 7,,ii7 ! t]ms ^u :i* su* s]vices are (f]$2 or 7,,iii7 ! prices *>g$ = su* s]vices4 7,f7 ,tribal l&s ,! t]m ,tribal l&s has ! mean+ giv5 t t]m 9 section #gc4gjjj ( title #dg1 ,code ( ,f$]al ,regulations1 z ( ,april #af1 #bjbj1 & includes ! def9ition ,indian ,c\ntry z def9$ 9 section #aaea ( title #ah1 ,unit$ ,/ates ,code1 & includes fee simple & re/rict$ fee l& held by an ,indian ,tribe4 7,g7 ,wireless broadb& s]vice ,! t]m wireless broadb& s]vice means wireless broadb& int]net access s]vice t is deliv]$-- 7i7 ) a d[nload spe$ ( n less ?an #be megabits p] second & an upload spe$ ( n less ?an #c megabits p] second2 & 7ii7 ?r\gh-- 7,i7 mobile s]vice2 7,,ii7 fix$ po9t-to-po9t multipo9t s]vice2 7,,iii7 fix$ po9t-to-po9t s]vice2 or 7,,iv7 broadca/ s]vice4 #iaj4 ,facilitat+ ! provision ( teleheal? s]vices across ,/ate l9es 7a7 ,9 g5]al ,= purposes ( exp$it+ ! provision ( teleheal? s]vices1 = :i* paym5t is made "u ! ,m$ic>e ,program1 across ,/ate l9es1 ! ,secret>y ( ,heal? & ,human ,s]vices %all1 9 consultation ) repres5tatives ( ,/ates1 physicians1 heal? c>e practition]s1 & pati5t advocates1 enc\rage & facilitate ! adoption ( provisions all[+ = multi/ate practition] practice across ,/ate l9es4 7b7 ,def9itions ,9 subsection 7a73 7#a7 ,teleheal? s]vice ,! t]m teleheal? s]vice has ! mean+ giv5 t t]m 9 subp>agraph 7,f7 ( section #ahcd7m77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d774 7#b7 ,physician1 practition] ,! t]ms physician & practition] h ! mean+ giv5 ^? t]ms 9 subp>agraphs 7,d7 & 7,e71 respectively1 ( su* section4 7#c7 ,m$ic>e program ,! t]m ,m$ic>e ,program means ! program ( heal? insurance adm9i/]$ by ! ,secret>y ( ,heal? & ,human ,s]vices "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 ,x ,public ,aw>5ess #ajja4 ,aw>5ess campaigns ,! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion & 9 coord9ation ) o!r (fices & ag5cies1 z appropriate1 %all aw>d competitive grants or contracts to "o or m public or private entities1 includ+ fai?-bas$ organizations1 to c>ry out multil+ual & culturally appropriate aw>5ess campaigns4 ,su* campaigns %all-- 7#a7 be bas$ on available sci5tific evid5ce2 7#b7 increase aw>5ess & k ( ,,covid-#ai1 includ+ c\nt]+ /igma associat$ ) ,,covid-#ai2 7#c7 improve in=mation on ! availability ( ,,covid-#ai diagno/ic te/+2 & 7#d7 promote coop]ation ) contact trac+ ef=ts4 #ajjb4 ,increas+ und]/&+ ( & improv+ heal? lit]acy 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality ) respect to grants "u subsection 7c77#a7 & ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration ) respect to grants "u subsection 7c77#b71 9 consultation ) ! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities & ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 %all aw>d grants to eligible entities to improve heal? c>e = pati5t populations t h l[ functional heal? lit]acy4 7b7 ,eligibility ,to be eligible to receive a grant "u subsection 7a71 an entity %all-- 7#a7 be a hospital1 heal? c5t] or cl9ic1 heal? plan1 or o!r heal? entity 7includ+ a nonpr(it m9ority heal? organization or association72 & 7#b7 prep>e & submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may reasonably require4 7c7 ,use ( funds 7#a7 ,ag5cy = heal?c>e rese>* & quality ,a grant aw>d$ "u subsection 7a7 ?r\gh ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality %all be us$-- 7,a7 to def9e & increase ! und]/&+ ( heal? lit]acy2 7,b7 to inve/igate ! correlation betwe5 l[ heal? lit]acy & heal? & heal? c>e2 7,c7 to cl>ify :i* aspects ( heal? lit]acy h an effect on heal? outcomes2 & 7,d7 = any o!r activity det]m9$ appropriate by ! ,director4 7#b7 ,heal? res\rces & s]vices adm9i/ration ,a grant aw>d$ "u subsection 7a7 ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration %all be us$ to conduct demon/ration projects = int]v5tions = pati5ts ) l[ heal? lit]acy t may include-- 7,a7 ! developm5t ( new disease managem5t programs = pati5ts ) l[ heal? lit]acy2 7,b7 ! tailor+ ( disease managem5t programs address+ m5tal1 physical1 oral1 & behavioral heal? conditions = pati5ts ) l[ heal? lit]acy2 7,c7 ! translation ( writt5 heal? mat]ials = pati5ts ) l[ heal? lit]acy2 7,d7 ! id5tification1 implem5tation1 & te/+ ( l[ heal? lit]acy scre5+ tools2 7,e7 ! conduct ( educational campaigns = pati5ts & provid]s ab\t l[ heal? lit]acy2 7,f7 ! conduct ( educational campaigns conc]n+ heal? direct$ specifically at pati5ts ) m5tal disabilities1 includ+ ^? ) cognitive & intellectual disabilities1 design$ to r$uce ! incid5ce ( l[ heal? lit]acy among ^! populations1 :i* %all h in/ructional mat]ials 9 ! pla9 language /&>ds promulgat$ "u ! ,pla9 ,writ+ ,act ( #bjaj 7#e ,u4,s4,c4 #cja note7 = ,f$]al ag5cies2 & 7,g7 o!r activities det]m9$ appropriate by ! ,adm9i/rator4 7d7 ,def9itions ,9 ?is section1 ! t]m l[ heal? lit]acy means ! inability ( an individual to obta91 process1 & und]/& basic heal? in=mation & s]vices ne$$ to make appropriate heal? decisions4 7e7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section1 su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #ajjc4 ,engli% = speak]s ( o!r languages 7a7 ,grants au?oriz$ ,! ,secret>y ( ,education is au?oriz$ to provide grants to eligible entities = ! provision ( ,engli% z a second language 79 ?is section ref]r$ to ,,esl7 in/ruction & %all det]m9e1 aft] consultation ) appropriate /akehold]s1 ! me*anism = adm9i/]+ & di/ribut+ su* grants4 7b7 ,eligible entity def9$ ,9 ?is section1 ! t]m eligible entity means a ,/ate or community-bas$ organization t employs & s]ves m9ority populations4 7c7 ,application ,an eligible entity may apply = a grant "u ?is section by submitt+ su* in=mation z ! ,secret>y ( ,education may require & 9 su* =m & mann] z ! ,secret>y may require4 7d7 ,use ( grant ,z a condition ( receiv+ a grant "u ?is section1 an eligible entity %all-- 7#a7 develop & implem5t a plan = assur+ ! availability ( ,,esl in/ruction t effectively integrates in=mation ab\t ! nature ( ! ,unit$ ,/ates heal? c>e sy/em1 h[ to access c>e1 & any special language skills t may be requir$ = individuals to access & regul>ly negotiate ! sy/em effectively2 7#b7 develop a plan1 includ+1 :]e appropriate1 public-private p>tn]%ips1 = mak+ ,,esl in/ruction progressively available to all individuals seek+ in/ruction2 & 7#c7 ma9ta9 curr5t ,,esl in/ruction ef=ts by us+ funds available "u ?is section to supplem5t r ?an supplant any funds exp5d$ = ,,esl in/ruction 9 ! ,/ate z ( ,janu>y #a1 #bjbj4 7e7 ,additional duties ( ! secret>y ,! ,secret>y ( ,education %all-- 7#a7 collect & publicize annual data on h[ mu* ,f$]al1 ,/ate1 & local gov]nm5ts sp5d on ,,esl in/ruction2 7#b7 collect data f ,/ate & local gov]nm5ts to id5tify ! unmet ne$s ( ,engli% language le>n]s = appropriate ,,esl in/ruction1 includ+-- 7,a7 ! pref]r$ writt5 & spok5 language ( su* ,engli% language le>n]s2 7,b7 ! ext5t ( wait+ li/s = ,,esl in/ruction1 includ+ h[ _m programs ma9ta9 wait+ li/s &1 = programs t d n h wait+ li/s1 ! reasons :y n2 7,c7 ! availability ( programs to geographically isolat$ communities2 7,d7 ! impact ( c\rse enrollm5t policies1 includ+ op5 enrollm5t1 on ! availability ( ,,esl in/ruction2 7,e7 ! numb] individuals 9 ! ,/ate & ea* p>ticipat+ locality2 7,f7 ! effectiv5ess ( ! in/ruction 9 meet+ ! ne$s ( individuals receiv+ in/ruction & ^? ne$+ in/ruction2 7,g7 z assessm5t ( ! ne$ = programs t integrate job tra9+ & ,,esl in/ruction1 to assi/ individuals to obta9 bett] jobs2 & 7,h7 ! availability ( ,,esl slots by ,/ate & locality2 7#c7 det]m9e ! co/ & mo/ appropriate me?ods ( mak+ ,,esl in/ruction available to all ,engli% language le>n]s seek+ in/ruction2 & 7#d7 n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act1 issue a report to ,congress t assesses ! in=mation collect$ 9 p>agraphs 7#a71 7#b71 & 7#c7 & makes recomm5dations on /eps t %\ld be tak5 to progressively realize ! goal ( mak+ ,,esl in/ruction available to all ,engli% language le>n]s seek+ in/ruction4 7f7 ,au?orization ( ,appropriations ,!re are au?oriz$ to be appropriat$ to ! ,secret>y ( ,education #bej1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbd to c>ry out ?is section4 #ajjd4 ,influ5za1 ,,covid-#ai1 & pneumonia vacc9ation campaign 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices %all-- 7#a7 enhance ! annual campaign by ! ,dep>tm5t ( ,heal? & ,human ,s]vices to increase ! numb] ( p vacc9at$ ea* ye> = influ5za1 pneumonia1 & ,,covid-#ai2 & 7#b7 include 9 su* campaign ! use ( writt5 educational mat]ials1 public s]vice ann\ncem5ts1 physician education1 & any o!r means :i* ! ,secret>y deems effective4 7b7 ,mat]ials & ann\ncem5ts ,9 c>ry+ out ! annual campaign describ$ 9 subsection 7a71 ! ,secret>y ( ,heal? & ,human ,s]vices %all ensure t-- 7#a7 educational mat]ials & public s]vice ann\ncem5ts are readily & widely available 9 communities exp]i5c+ disp>ities 9 ! incid5ce & mortality rates ( influ5za1 pneumonia1 & ,,covid-#ai2 & 7#b7 ! campaign uses t>get$1 culturally appropriate messages & mess5g]s to rea* und]s]v$ communities4 7c7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 ,,xi ,rese>* #aaja4 ,rese>* & developm5t ,! ,secret>y ( ,heal? & ,human ,s]vices1 9 coord9ation ) ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion & 9 collaboration ) ! ,director ( ! ,national ,in/itutes ( ,heal?1 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 ! ,commission] ( ,food & ,drugs1 & ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all support rese>* & developm5t on m effici5t & effective /rategies-- 7#a7 = ! surveillance ( ,,s>s-,co,v-#b & ,,covid-#ai2 7#b7 = ! te/+ & id5tification ( individuals infect$ ) ,,covid-#ai2 & 7#c7 = ! trac+ ( contacts ( individuals infect$ ) ,,covid-#ai4 #aajb4 ,,cdc field /udies p]ta9+ to specific heal? inequities 7a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,c5t]s = ,disease ,control & ,prev5tion1 9 collaboration ) ,/ate1 local1 ,tribal1 & t]ritorial heal? dep>tm5ts1 %all complete 7by ! report+ deadl9e 9 subsection 7b77 field /udies to bett] und]/& heal? inequities t are n curr5tly track$ by ! ,secret>y4 ,su* /udies %all include an analysis (-- 7#a7 ! impact ( socioeconomic /atus on heal? c>e access & disease outcomes1 includ+ ,,covid-#ai outcomes2 7#b7 ! impact ( disability /atus on heal? c>e access & disease outcomes1 includ+ ,,covid-#ai outcomes2 7#c7 ! impact ( language pref]5ce on heal? c>e access & disease outcomes1 includ+ ,,covid-#ai outcomes2 7#d7 factors contribut+ to disp>ities 9 heal? outcomes = ! ,,covid-#ai p&emic2 & 7#e7 o!r topics relat$ to disp>ities 9 heal? outcomes = ! ,,covid-#ai p&emic1 z det]m9$ by ! ,secret>y4 7b7 ,report ,n lat] ?an ,decemb] #ca1 #bjba1 ! ,secret>y %all submit to ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate an initial report on ! results ( ! field /udies "u ?is section4 7c7 ,f9al report ,n lat] ?an ,decemb] #ca1 #bjbc1 ! ,secret>y %all-- 7#a7 update & f9alize ! initial report "u subsection 7b72 & 7#b7 submit su* f9al report to ! committees specifi$ 9 su* subsection4 7d7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section #be1jjj1jjj1 to rema9 available until exp5d$4 #aajc4 ,exp&+ capacity = heal? outcomes 7a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all aw>d grants to eligible entities to develop & exp& ! use ( te*nology-enabl$ collaborative le>n+ & capacity build+ models to respond to ongo+ & real-"t le>n+1 heal? c>e in=mation %>+1 & capacity build+ ne$s relat$ to ,,covid-#ai4 7b7 ,eligible entities ,to be eligible to receive a grant "u ?is section1 an entity %all h exp]i5ce provid+ te*nology-enabl$ collaborative le>n+ & capacity build+ heal? c>e s]vices-- 7#a7 9 rural areas1 fronti] areas1 heal? pr(essional %ortage areas1 or m$ically und]s]v$ area2 or 7#b7 to m$ically und]s]v$ populations or ,indian ,tribes4 7c7 ,use ( funds ,an eligible entity receiv+ a grant "u ?is section %all use funds receiv$ ?r\gh ! grant-- 7#a7 to advance quality ( c>e 9 response to ,,covid-#ai1 ) p>ticul> emphasis on rural & und]s]v$ areas & populations2 7#b7 to protect m$ical p]sonnel & fir/ respond]s ?r\gh %>+ real-"t le>n+ ?r\gh virtual communities ( practice2 7#c7 to improve pati5t outcomes = conditions affect$ or exac]bat$ by ,,covid-#ai1 includ+ improvem5t ( c>e = pati5ts ) complex *ronic conditions2 & 7#d7 to support rapid uptake by heal? c>e pr(essionals ( em]g+ be/ practices & treatm5t protocols ar\nd ,,covid-#ai4 7d7 ,optional additional uses ( funds ,an eligible entity receiv+ a grant "u ?is section may use funds receiv$ ?r\gh ! grant =-- 7#a7 equipm5t to support ! use & expansion ( te*nology-enabl$ collaborative le>n+ & capacity build+ models1 includ+ h>dw>e & s(tw>e t enables di/ance le>n+1 heal? c>e provid] support1 & ! secure ex*ange ( electronic heal? in=mation2 7#b7 ! p>ticipation ( multidiscipl9>y exp]t team memb]s to facilitate & lead te*nology-enabl$ collaborative le>n+ sessions1 & pr(essionals & /aff assi/+ 9 ! developm5t & execution ( te*nology-enabl$ collaborative le>n+2 7#c7 ! developm5t ( in/ructional programm+ & ! tra9+ ( heal? c>e provid]s & o!r pr(essionals t provide or assi/ 9 ! provision ( s]vices ?r\gh te*nology-enabl$ collaborative le>n+ & capacity build+ models2 & 7#d7 o!r activities consi/5t ) a*iev+ ! objectives ( ! grants aw>d$ "u ?is section4 7e7 ,te*nology-,enabl$ collaborative le>n+ & capacity build+ model def9$ ,9 ?is section1 ! t]m te*nology-enabl$ collaborative le>n+ & capacity build+ model has ! mean+ giv5 t t]m 9 section #b7g7 ( ! ,exp&+ ,capacity = ,heal? ,outcomes ,act 7,public ,law #aad-bgj2 #acj ,/at4 #acie74 7f7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section #bj1jjj1jjj1 to rema9 available until exp5d$4 #aajd4 ,data collection & analysis grants to m9ority-s]v+ in/itutions 7a7 ,au?ority ,! ,secret>y ( ,heal? & ,human ,s]vices1 act+ ?r\gh ! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities & ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 %all aw>d grants to eligible entities to access & analyze racial & e?nic data on disp>ities 9 heal? & heal? c>e1 & :]e possible o!r data on disp>ities 9 heal? & heal? c>e1 to monitor & report on progress to r$uce & elim9ate disp>ities 9 heal? & heal? c>e4 7b7 ,eligible entity ,9 ?is section1 ! t]m eligible entity means an entity t has an accr$it$ public heal?1 heal? policy1 or heal? s]vices rese>* program & is any ( ! foll[+3 7#a7 ,a "p ,b in/itution1 z def9$ 9 section #cbb ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajfa74 7#b7 ,a ,hispanic-s]v+ in/itution1 z def9$ 9 section #ejb ( su* ,act 7#bj ,u4,s4,c4 #aaja;a74 7#c7 ,a ,tribal ,college or ,univ]sity1 z def9$ 9 section #caf ( su* ,act 7#bj ,u4,s4,c4 #ajei;c74 7#d7 ,an ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itution1 z def9$ 9 section #cga7;c7 ( su* ,act 7#bj ,u4,s4,c4 #ajfgq7c774 7c7 ,au?orization ( appropriations ,to c>ry out ?is section1 !re are au?oriz$ to be appropriat$ su* sums z may be necess>y = fiscal ye>s #bjba ?r\gh #bjbe4 #aaje4 ,safety & effectiv5ess ( drugs ) respect to racial & e?nic backgr\nd 7a7 ,9 g5]al ,*apt] ,v ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act 7#ba ,u4,s4,c4 #cea et seq47 is am5d$ by add+ aft] section #eje;,f ! foll[+3 #eje;,g4 ,safety & effectiv5ess ( drugs ) respect to racial & e?nic backgr\nd 7a7 ,preapproval /udies ,if !re is evid5ce t !re may be a disp>ity on ! basis ( racial or e?nic backgr\nd or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]7 z to ! safety or effectiv5ess ( a drug or biological product or if su* product addresses a disease t disproportionately impacts c]ta9 racial or e?nic gr\ps or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]71 !n-- 7#a7 7,a7 9 ! case ( a drug1 ! inve/igations requir$ "u section #eje7;b77#a77;,a7 %all include adequate & well-controll$ inve/igations ( ! disp>ity2 or 7,b7 9 ! case ( a biological product1 ! evid5ce requir$ "u section #cea7;a7 ( ! ,public ,heal? ,s]vice ,act = approval ( a biologics lic5se application = ! biological product %all include adequate & well-controll$ inve/igations ( ! disp>ity2 & 7#b7 if ! inve/igations describ$ 9 subp>agraph 7,a7 or 7,b7 ( p>agraph 7#a7 confirm t !re is su* a disp>ity1 ! label+ ( ! drug or biological product %all include appropriate in=mation ab\t ! disp>ity4 7b7 ,po/m>ket /udies 7#a7 ,9 g5]al ,if !re is evid5ce t !re may be a disp>ity on ! basis ( racial or e?nic backgr\nd or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]7 z to ! safety or effectiv5ess ( a drug = :i* !re is an approv$ application "u section #eje ( ?is ,act or ( a biological product = :i* !re is an approv$ lic5se "u section #cea ( ! ,public ,heal? ,s]vice ,act1 ! ,secret>y may by ord] require ! hold] ( ! approv$ application or lic5se to conduct1 by a date specifi$ by ! ,secret>y1 po/m>ket /udies to inve/igate ! disp>ity4 7#b7 ,label+ ,if ! ,secret>y det]m9es t ! po/m>ket /udies confirm t !re is a disp>ity describ$ 9 p>agraph 7#a71 ! label+ ( ! drug or biological product %all include appropriate in=mation ab\t ! disp>ity4 7#c7 ,/udy design ,! ,secret>y may1 9 an ord] "u p>agraph 7#a71 specify all aspects ( ! design ( ! po/m>ket /udies requir$ "u su* p>agraph = a drug or biological product1 includ+ ! numb] ( /udies & /udy p>ticipants1 & ! o!r demographic *>act]i/ics ( ! /udy p>ticipants4 7#d7 ,modifications ( /udy design ,! ,secret>y may1 by ord] & z necess>y1 modify any aspect ( ! design ( a po/m>ket /udy requir$ 9 an ord] "u p>agraph 7#a7 aft] issu+ su* ord]4 7#e7 ,/udy results ,! results f a /udy requir$ "u p>agraph 7#a7 %all be submitt$ to ! ,secret>y z a supplem5t to ! drug application or biologics lic5se application4 7c7 ,applications "u section #eje7;j7 7#a7 ,9 g5]al ,a drug = :i* an application has be5 submitt$ or approv$ "u section #eje7;j7 %all n be consid]$ ineligible = approval "u t section or misbr&$ "u section #ejb on ! basis t ! label+ ( ! drug omits in=mation relat+ to a disp>ity on ! basis ( racial or e?nic backgr\nd or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]7 z to ! safety or effectiv5ess ( ! drug z to ! safety or effectiv5ess ( ! drug1 :e!r d]iv$ f inve/igations or /udies requir$ "u ?is section or d]iv$ f o!r s\rces1 :5 ! omitt$ in=mation is protect$ by pat5t or by exclusivity "u section #eje7;j77#e77;,f74 7#b7 ,label+ ,not)/&+ p>agraph 7#a71 ! ,secret>y may require t ! label+ ( a drug approv$ "u section #eje7;j7 t omits in=mation relat+ to a disp>ity on ! basis ( racial or e?nic backgr\nd 7su* z age1 sex1 g5d]7 z to ! safety or effectiv5ess ( ! drug include a /atem5t ( any appropriate contra9dications1 w>n+s1 or precautions relat$ to ! disp>ity t ! ,secret>y consid]s necess>y4 7d7 ,def9ition ,! t]m evid5ce t !re may be a disp>ity on ! basis ( racial or e?nic backgr\nd or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]7 z to ! safety or effectiv5ess1 ) respect to a drug or biological product1 includes-- 7#a7 evid5ce t !re is a disp>ity on ! basis ( racial or e?nic backgr\nd or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]7 z to safety or effectiv5ess ( a drug or biological product 9 ! same *emical class z ! drug or biological product2 7#b7 evid5ce t !re is a disp>ity on ! basis ( racial or e?nic backgr\nd or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]7 9 ! way ! drug or biological product is metaboliz$2 7#c7 o!r evid5ce z ! ,secret>y may det]m9e appropriate2 & 7#d7 if su* product addresses a disease_/condition t evid5ce %[s disproportionately impacts c]ta9 racial or e?nic gr\ps or o!r demographic *>act]i/ics 7su* z age1 sex1 g5d]74 4 7b7 ,en=cem5t ,section #ejb ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act 7#ba ,u4,s4,c4 #ceb7 is am5d$ by add+ at ! end ! foll[+3 7ee7 ,if x is a drug & ! hold] ( ! approv$ application "u section #eje or lic5se "u section #cea ( ! ,public ,heal? ,s]vice ,act = ! drug has fail$ to complete ! inve/igations or /udies1 or comply ) any o!r requirem5t1 ( section #eje;,g4 4 7c7 ,drug fees ,section #gcf7;a77#a77;,a77ii7 ( ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;h7a77#a77;,a77ii77 is am5d$ by ins]t+ aft] are n requir$ ! foll[+3 1 includ+ po/m>ket /udies requir$ "u section #eje;,g4 #aajf4 ,,gao & ,,nih reports 7b7 ,,gao report on ,,nih grant racial & e?nic div]sity 7#a7 ,9 g5]al ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a /udy on ! racial & e?nic div]sity among ! foll[+ gr\ps3 7,a7 ,all applicants = grants1 contracts1 & coop]ative agreem5ts aw>d$ by ! ,national ,in/itutes ( ,heal? dur+ ! p]iod beg9n+ on ,janu>y #a1 #bjji1 & end+ ,decemb] #ca1 #bjai4 7,b7 ,all recipi5ts ( su* grants1 contracts1 & coop]ative agreem5ts dur+ su* p]iod4 7,c7 ,all memb]s ( ! pe] review panels ( su* applicants & recipi5ts1 respectively4 7#b7 ,report ,n lat] ?an #f mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al %all complete ! /udy "u p>agraph 7#a7 & submit to ,congress a report conta9+ ! results ( su* /udy4 7c7 ,,gao report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act & bi5nially !reaft] until #bjbd1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a report t id5tifies-- 7#a7 ! racial & e?nic div]sity ( community-bas$ organizations t appli$ = ,f$]al fund+ provid$ pursuant to ,coronavirus ,prep>$ness & ,response ,supplem5tal ,appropriations ,act 7,public ,law #aaf-abc71 ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg71 ,coronavirus ,aid1 ,relief1 & ,economic ,security ,act 7,public ,law #aaf-acf71 & ,pay*eck ,protection ,program & ,heal? ,c>e ,enhancem5t ,act 7,public ,law #aaf-aci72 7#b7 ! p]c5tage ( su* organizations t 7 aw>d$ su* fund+2 & 7#c7 ! impact ( su* community-bas$ organizations' ef=ts on r$uc+ heal? disp>ities )9 racial & e?nic m9ority gr\ps4 7d7 ,annual report on activities ( ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities ,! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities %all prep>e an annual report on ! activities c>ri$ out or to be c>ri$ out by su* in/itute1 & %all submit ea* su* report to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate1 ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives1 ! ,secret>y ( ,heal? & ,human ,s]vices1 & ! ,director ( ! ,national ,in/itutes ( ,heal?4 ,) respect to ! fiscal ye> involv$1 ! report %all-- 7#a7 describe & evaluate ! progress made 9 heal? disp>ities rese>* conduct$ or support$ by in/itutes & c5t]s ( ! ,national ,in/itutes ( ,heal?2 7#b7 summ>ize & analyze exp5ditures made = activities ) respect to heal? disp>ities rese>* conduct$ or support$ by ! ,national ,in/itutes ( ,heal?2 7#c7 include a sep>ate /atem5t apply+ ! requirem5ts ( p>agraphs 7#a7 & 7#b7 specifically to m9ority heal? disp>ities rese>*2 & 7#d7 conta9 su* recomm5dations z ! ,director ( ! ,in/itute consid]s appropriate4 #aajg4 ,heal? impact assessm5ts 7a7 ,f9d+s ,congress makes ! foll[+ f9d+s3 7#a7 ,heal? ,impact ,assessm5t is a tool to help plann]s1 heal? (ficials1 decision mak]s1 & ! public make m in=m$ decisions ab\t ! pot5tial heal? effects ( propos$ plans1 policies1 programs1 & projects 9 ord] to maximize heal? b5efits & m9imize h>ms4 7#b7 ,heal? ,impact ,assessm5ts fo/]s community lead]%ip1 own]%ip & p>ticipation 9 decision-mak+ processes4 7#c7 ,heal? ,impact ,assessm5ts c build community support & r$uce opposition to a project or policy1 !reby facilitat+ economic gr[? by aid+ ! developm5t ( cons5sus reg>d+ new developm5t proposals4 7#d7 ,heal? ,impact ,assessm5ts facilitate collaboration across sectors4 7b7 ,purposes ,x is ! purpose ( ?is section to-- 7#a7 provide m in=mation ab\t ! pot5tial human heal? effects ( policy decisions & ! di/ribution ( ^? effects2 7#b7 improve h[ heal? is consid]$ 9 plann+ & decisionmak+ processes2 & 7#c7 build /rong]1 heal?i] communities ?r\gh ! use ( ,heal? ,impact ,assessm5t4 7c7 ,heal? impact assessm5ts ,"p ,p ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bhj;g et seq471 z am5d$ by section #gif;,a1 is fur!r am5d$ by add+ at ! end ! foll[+3 #cii,v-#ab4 ,heal? impact assessm5ts 7a7 ,def9itions ,9 ?is section3 7#a7 ,adm9i/rator ,! t]m ,adm9i/rator means ! ,adm9i/rator ( ! ,environm5tal ,protection ,ag5cy4 7#b7 ,director ,! t]m ,director means ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion4 7#c7 ,heal? impact assessm5t ,! t]m heal? impact assessm5t means a sy/ematic process t uses an array ( data s\rces & analytic me?ods & consid]s input f /akehold]s to det]m9e ! pot5tial effects ( a propos$ policy1 plan1 program1 or project on ! heal? ( a population & ! di/ribution ( ^? effects )9 ! population4 ,su* t]m includes id5tify+ & recomm5d+ appropriate actions on monitor+ & maximiz+ pot5tial b5efits & m9imiz+ ! pot5tial h>ms4 7#d7 ,heal? disp>ity ,! t]m heal? disp>ity means a p>ticul> type ( heal? diff]5ce t is closely l9k$ ) social1 economic1 or environm5tal disadvantage & t adv]sely affects gr\ps ( p :o h sy/ematically exp]i5c$ great] ob/acles to heal? bas$ on _! racial or e?nic gr\p2 religion2 socioeconomic /atus2 g5d]2 age2 m5tal heal?2 cognitive1 s5sory1 or physical disability2 sexual ori5tation or g5d] id5tity2 geographic location2 citiz5%ip /atus2 or o!r *>act]i/ics hi/orically l9k$ to discrim9ation or exclusion4 7b7 ,e/abli%m5t ,! ,secret>y1 act+ ?r\gh ! ,director & 9 collaboration ) ! ,adm9i/rator1 %all-- 7#a7 9 consultation ) ! ,director ( ! ,national ,c5t] = ,*ronic ,disease ,prev5tion & ,heal? ,promotion & relevant (fices )9 ! ,dep>tm5t ( ,h\s+ & ,urban ,developm5t1 ! ,dep>tm5t ( ,transportation1 & ! ,dep>tm5t ( ,agriculture1 e/abli% a program at ! ,national ,c5t] = ,environm5tal ,heal? at ! ,c5t]s = ,disease ,control & ,prev5tion focus$ on advanc+ ! field ( heal? impact assessm5t t includes-- 7,a7 collect+ & dissem9at+ be/ practices2 7,b7 adm9i/]+ capacity build+ grants to ,/ates to support grantees 9 initiat+ heal? impact assessm5ts1 9 accordance ) subsection 7d72 7,c7 provid+ te*nical assi/ance2 7,d7 develop+ tra9+ tools & provid+ tra9+ on conduct+ heal? impact assessm5t & ! implem5tation ( built environm5t & heal? indicators2 7,e7 mak+ in=mation available1 z appropriate1 reg>d+ ! exi/5ce ( o!r community heal?y liv+ tools1 *eckli/s1 & indices t help connect public heal? to o!r sectors1 & tools to help exam9e ! effect ( ! indoor built environm5t & build+ codes on population heal?2 7,f7 conduct+ rese>* & evaluations ( heal? impact assessm5ts2 & 7,g7 aw>d+ competitive extramural rese>* grants2 7#b7 develop guidance & guidel9es to conduct heal? impact assessm5ts 9 accordance ) subsection 7c72 & 7#c7 e/abli% a grant program to all[ ,/ates to fund eligible entities to conduct heal? impact assessm5ts4 7c7 ,guidance 7#a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ! ,end+ ,heal? ,disp>ities dur+ ,,covid-#ai ,act ( #bjbj1 ! ,secret>y1 act+ ?r\gh ! ,director1 %all issue f9al guidance = conduct+ ! heal? impact assessm5ts4 ,9 develop+ su* guidance ! ,secret>y %all-- 7,a7 consult ) ! ,director ( ! ,national ,c5t] = ,environm5tal ,heal? &1 ! ,director ( ! ,national ,c5t] = ,*ronic ,disease ,prev5tion & ,heal? ,promotion1 & relevant (fices )9 ! ,dep>tm5t ( ,h\s+ & ,urban ,developm5t1 ! ,dep>tm5t ( ,transportation1 & ! ,dep>tm5t ( ,agriculture2 & 7,b7 consid] available int]national heal? impact assessm5t guidance1 ,nor? ,am]ican heal? impact assessm5t practice /&>ds1 & recomm5dations f ! ,national ,academy ( ,sci5ce4 7#b7 ,cont5t ,! guidance "u ?is subsection %all include-- 7,a7 backgr\nd on national & int]national ef=ts to bridge urban plann+1 climate =eca/+1 & public heal? in/itutions & discipl9es1 includ+ a review ( heal? impact assessm5t be/ practices int]nationally2 7,b7 evid5ce-bas$ direct & indirect pa?ways t l9k l&-use plann+1 transportation1 & h\s+ policy & objectives to human heal? outcomes2 7,c7 data res\rces & quantitative & qualitative =eca/+ me?ods to evaluate bo? ! /atus ( heal? det]m9ants & heal? effects1 includ+ id5tification ( exi/+ programs t c dissem9ate ^! res\rces2 7,d7 be/ practices = inclusive public involvem5t 9 conduct+ heal? impact assessm5ts2 & 7,e7 te*nical assi/ance = o!r ag5cies seek+ to develop _! own guidel9es & proc$ures = heal? impact assessm5t4 7d7 ,grant program 7#a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director & 9 collaboration ) ! ,adm9i/rator1 %all-- 7,a7 aw>d grants to ,/ates to fund eligible entities = capacity build+ or to prep>e heal? impact assessm5ts2 & 7,b7 ensure t ,/ates receiv+ a grant "u ?is subsection fur!r support tra9+ & te*nical assi/ance = grantees "u ! program by fund+ & ov]see+ appropriate local1 ,/ate1 ,tribal1 ,f$]al1 in/itution ( high] education1 or nonpr(it heal? impact assessm5t exp]ts to provide su* te*nical assi/ance4 7#b7 ,applications 7,a7 ,9 g5]al ,to be eligible to receive a grant "u ?is section1 an eligible entity %all-- 7i7 be a ,/ate1 ,indian tribe1 or tribal organization t includes individuals or populations ! heal? ( :i* are1 or w be1 affect$ by an activity or a propos$ activity2 & 7ii7 submit to ! ,secret>y an application 9 accordance ) ?is subsection1 at su* "t1 9 su* mann]1 & conta9+ su* additional in=mation z ! ,secret>y may require4 7,b7 ,inclusion ,an application "u ?is subsection %all include a li/ ( propos$ activities t require or w\ld b5efit f conduct+ a heal? impact assessm5t )9 six mon?s ( aw>d+ funds4 ,! li/ %\ld be accompani$ by support+ docum5tation1 includ+ lett]s ( support1 f pot5tial conductors ( heal? impact assessm5ts = ! li/$ propos$ activities4 ,ea* application %\ld also include an assessm5t by ! eligible entity ( ! heal? ( ! population ( its jurisdiction & describe pot5tial adv]se or positive effects on heal? t ! propos$ activities may create4 7,c7 ,pref]5ce ,pref]5ce 9 aw>d+ funds "u ?is section may be giv5 to eligible entities t demon/rate ! pot5tial to significantly improve population heal? or l[] heal? c>e co/s z a result ( pot5tial heal? impact assessm5t "w4 7#c7 ,use ( funds 7,a7 ,9 g5]al ,an entity receiv+ a grant "u ?is section %all use su* grant funds to conduct heal? impact assessm5t capacity build+ or to fund subgrantees 9 conduct+ a heal? impact assessm5t = a propos$ activity 9 accordance ) ?is subsection4 7,b7 ,purposes ,! purposes ( a heal? impact assessm5t "u ?is subsection are-- 7i7 to facilitate ! involvem5t ( tribal1 ,/ate1 & local public heal? (ficials 9 community plann+1 transportation1 h\s+1 & l& use decisions & o!r decisions affect+ ! built environm5t to id5tify any pot5tial heal? conc]n or heal? b5efit relat+ to an activity or propos$ activity2 7ii7 to provide = an inve/igation ( any heal?-relat$ issue ( conc]n rais$ 9 a plann+ process1 an environm5tal impact assessm5t process1 or policy appraisal relat+ to a propos$ activity2 7iii7 to describe & comp>e alt]natives 7includ+ no-action alt]natives7 to a propos$ activity to provide cl>ification ) respect to ! pot5tial heal? outcomes associat$ ) ! propos$ activity &1 :]e appropriate1 to ! relat$ b5efit-co/ or co/-effectiv5ess ( ! propos$ activity & alt]natives2 7iv7 to contribute1 :5 applicable1 to ! f9d+s ( a plann+ process1 policy appraisal1 or an environm5tal impact /atem5t ) respect to ! t]ms & conditions ( implem5t+ a propos$ activity or relat$ mitigation recomm5dations1 z necess>y2 7v7 to ensure t ! disproportionate di/ribution ( negative impacts among vuln]able populations is m9imiz$ z mu* z possible2 7vi7 to engage affect$ community memb]s & ensure adequate opportunity = public comm5t on all /ages ( ! heal? impact assessm5t2 7vii7 :]e appropriate1 to consult ) local & c\nty heal? dep>tm5ts & appropriate organizations1 includ+ plann+1 transportation1 & h\s+ organizations & provid+ !m ) in=mation & tools reg>d+ h[ to conduct & integrate heal? impact assessm5t into _! "w2 & 7viii7 to inspect homes1 wat] sy/ems1 & o!r elem5ts t pose risks to lead exposure1 ) an emphasis on areas t pose a high] risk to *ildr54 7#d7 ,assessm5ts ,heal? impact assessm5ts c>ri$ out us+ grant funds "u ?is section %all-- 7,a7 take appropriate heal? factors into consid]ation z e>ly z practicable dur+ ! plann+1 review1 or decisionmak+ processes2 7,b7 assess ! effect on ! heal? ( individuals & populations ( propos$ policies1 projects1 or plans t result 9 modifications to ! built environm5t2 & 7,c7 assess ! di/ribution ( heal? effects across v>i\s factors1 su* z race1 income1 e?nicity1 age1 disability /atus1 g5d]1 & geography4 7#e7 ,eligible activities 7,a7 ,9 g5]al ,eligible entities fund$ "u ?is subsection %all conduct an evaluation ( any propos$ activity to det]m9e :e!r x w h a significant adv]se or positive effect on ! heal? ( ! affect$ population 9 ! jurisdiction ( ! eligible entity1 bas$ on ! crit]ia describ$ 9 subp>agraph 7,b74 7,b7 ,crit]ia ,! crit]ia describ$ 9 ?is subp>agraph include1 z applicable to ! propos$ activity1 ! foll[+3 7i7 ,any sub/antial adv]se effect or significant heal? b5efit on heal? outcomes or factors kn[n to influ5ce heal?1 includ+ ! foll[+3 7,i7 ,physical activity4 7,,ii7 ,injury4 7,,iii7 ,m5tal heal?4 7,,iv7 ,accessibility to heal?-promot+ goods & s]vices4 7,v7 ,respiratory heal?4 7,,vi7 ,*ronic disease4 7,,vii7 ,nutrition4 7,,viii7 ,l& use *anges t promote local1 su/a9able food s\rces4 7,,ix7 ,infecti\s disease1 includ+ ,,covid-#ai4 7,x7 ,heal? disp>ities4 7,,xi7 ,exi/+ air quality1 gr\nd or surface wat] quality or quantity1 or noise levels4 7,,xii7 ,lead exposure4 7,,xiii7 ,dr9k+ wat] quality & accessibility4 7ii7 ,o!r factors t may be consid]$1 includ+-- 7,i7 ! pot5tial = a propos$ activity to result 9 sy/ems failure t leads to a public heal? em]g5cy1 p&emic1 or o!r infecti\s or bio*emical ag5t2 7,,ii7 ! probability t ! propos$ activity w result 9 a significant increase 9 t\rism1 economic developm5t1 or employm5t 9 ! jurisdiction ( ! eligible entity2 7,,iii7 any o!r significant pot5tial haz>d or enhancem5t to human heal?1 z det]m9$ by ! eligible entity2 or 7,,iv7 :e!r ! evaluation ( a propos$ activity w\ld duplicate ano!r analysis or /udy be+ und]tak5 9 conjunction ) ! propos$ activity4 7,c7 ,factors = consid]ation ,9 evaluat+ a propos$ activity "u subp>agraph 7,a71 an eligible entity may take into consid]ation any reasonable1 direct1 indirect1 or cumulative effect t c be cle>ly relat$ to pot5tial heal? effects & t is relat$ to ! propos$ activity1 includ+ ! effect ( any action t is-- 7i7 includ$ 9 ! long-range plan relat+ to ! propos$ activity2 7ii7 likely to be c>ri$ out 9 coord9ation ) ! propos$ activity2 7iii7 dep5d5t on ! occurr5ce ( ! propos$ activity2 or 7iv7 likely to h a disproportionate impact on high-risk or vuln]able populations4 7#f7 ,requirem5ts ,a heal? impact assessm5t prep>$ ) funds aw>d$ "u ?is subsection %all incorporate ! foll[+1 aft] conduct+ ! scre5+ phase 7id5tify+ projects or policies = :i* a heal? impact assessm5t w\ld be valuable & feasible7 ?r\gh ! application process3 7,a7 ,scop+ ,id5tify+ :i* heal? effects to consid] & ! rese>* me?ods to be utiliz$4 7,b7 ,assess+ risks & b5efits ,assess+ ! basel9e heal? /atus & factors kn[n to influ5ce ! heal? /atus 9 ! affect$ community1 :i* may include aggregat+ & syn!siz+ exi/+ heal? assessm5t evid5ce & data f ! community4 7,c7 ,develop+ recomm5dations ,sugge/+ *anges to proposals to promote positive or mitigate adv]se heal? effects4 7,d7 ,report+ ,syn!siz+ ! assessm5t & recomm5dations & communicat+ ! results to decision mak]s4 7,e7 ,monitor+ & evaluat+ ,track+ ! decision & implem5tation effect on heal? det]m9ants & heal? /atus4 7#g7 ,plan ,an eligible entity t is aw>d$ a grant "u ?is section %all develop & implem5t a plan1 to be approv$ by ! ,director1 = mean+ful & inclusive /akehold] involvem5t 9 all phases ( ! heal? impact assessm5t4 ,/akehold]s may include community lead]s1 community-bas$ organizations1 y\?-s]v+ organizations1 plann]s1 public heal? exp]ts1 ,/ate & local public heal? dep>tm5ts & (ficials1 heal? c>e exp]ts or (ficials1 h\s+ exp]ts or (ficials1 & transportation exp]ts or (ficials4 7#h7 ,submission ( f9d+s ,an eligible entity t is aw>d$ a grant "u ?is section %all submit ! f9d+s ( any fund$ heal? impact assessm5t activities to ! ,secret>y & make ^! f9d+s publicly available4 7#i7 ,assessm5t ( impacts ,an eligible entity t is aw>d$ a grant "u ?is section %all ensure ! assessm5t ( ! di/ribution ( heal? impacts 7relat$ to ! propos$ activity7 across race1 e?nicity1 income1 age1 g5d]1 disability /atus1 & geography4 7#aj7 ,conduct ( assessm5t ,to ! greate/ ext5t feasible1 a heal? impact assessm5t %all be conduct$ "u ?is section 9 a mann] t respects ! ne$s & tim+ ( ! decision-mak+ process x evaluates4 7#aa7 ,me?odology ,9 prep>+ a heal? impact assessm5t "u ?is subsection1 an eligible entity or p>tn] %all foll[ ! guidance publi%$ "u subsection 7c74 7e7 ,heal? impact assessm5t database ,! ,secret>y1 act+ ?r\gh ! ,director & 9 collaboration ) ! ,adm9i/rator1 %all e/abli%1 ma9ta91 & make publicly available a heal? impact assessm5t database1 includ+-- 7#a7 a catalog ( heal? impact assessm5ts receiv$ "u ?is section2 7#b7 an inv5tory ( tools us$ by eligible entities to conduct heal? impact assessm5ts2 & 7#c7 guidance = eligible entities ) respect to ! selection ( appropriate tools describ$ 9 p>agraph 7#b74 7f7 ,evaluation ( grantee activities ,! ,secret>y %all aw>d competitive grants to ,prev5tion ,rese>* ,c5t]s1 or nonpr(it organizations or academic in/itutions ) exp]tise 9 heal? impact assessm5ts to-- 7#a7 assi/ grantees ) ! provision ( tra9+ & te*nical assi/ance 9 ! conduct+ ( heal? impact assessm5ts2 7#b7 evaluate ! activities c>ri$ out ) grants "u subsection 7d72 & 7#c7 assi/ ! ,secret>y 9 dissem9at+ evid5ce1 be/ practices1 & lessons le>n$ f grantees4 7g7 ,report to ,congress ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ! ,end+ ,heal? ,disp>ities ,dur+ ,,covid-#ai ,act ( #bjbj1 ! ,secret>y %all submit to ,congress a report conc]n+ ! evaluation ( ! programs "u ?is section1 includ+ recomm5dations z to h[ lessons le>n$ f su* programs c be incorporat$ into future guidance docum5ts develop$ & provid$ by ! ,secret>y & o!r ,f$]al ag5cies1 z appropriate4 7h7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y4 #cii,v-#ac4 ,implem5tation ( rese>* f9d+s to improve heal? outcomes ?r\gh ! built environm5t 7a7 ,rese>* grant program ,! ,secret>y1 9 collaboration ) ! ,adm9i/rator ( ! ,environm5tal ,protection ,ag5cy 7ref]r$ to 9 ?is section z ! ,adm9i/rator71 %all aw>d grants to public ag5cies or private nonpr(it in/itutions to implem5t evid5ce-bas$ programm+ to improve human heal? ?r\gh improvem5ts to ! built environm5t & subsequ5tly human heal?1 by address+-- 7#a7 levels ( physical activity2 7#b7 consumption ( nutritional foods2 7#c7 rates ( crime2 7#d7 air1 wat]1 & soil quality2 7#e7 risk or rate ( injury2 7#f7 accessibility to heal?-promot+ goods & s]vices2 7#g7 *ronic disease rates2 7#h7 community design2 7#i7 h\s+2 or transportation options2 7#aj7 ability to r$uce ! spread ( infecti\s diseases 7su* z ,,covid-#ai72 & 7#aa7 o!r factors1 z ! ,secret>y det]m9es appropriate4 7b7 ,applications ,a public ag5cy or private nonpr(it in/itution desir+ a grant "u ?is section %all submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* agreem5ts1 assurances1 & in=mation z ! ,secret>y1 9 consultation ) ! ,adm9i/rator1 may require4 7c7 ,rese>* ,! ,secret>y1 9 consultation ) ! ,adm9i/rator1 %all support1 ?r\gh grants aw>d$ "u ?is section1 rese>* t-- 7#a7 uses evid5ce-bas$ rese>* to improve ! built environm5t & human heal?2 7#b7 exam9es-- 7,a7 ! scope & int5sity ( ! impact t ! built environm5t 7includ+ ! v>i\s *>act]i/ics ( ! built environm5t7 has on ! human heal?2 or 7,b7 ! di/ribution ( su* impacts by-- 7i7 location2 & 7ii7 population subgr\p2 7#c7 is us$ to develop-- 7,a7 measures & indicators to address heal? impacts & ! connection ( heal? to ! built environm5t2 7,b7 ef=ts to l9k ! measures to transportation1 l& use1 & heal? databases2 & 7,c7 ef=ts to enhance ! collection ( built environm5t surveillance data2 7#d7 di/+ui%es c>efully betwe5 p]sonal attitudes & *oices & ext]nal influ5ces on behavior to det]m9e h[ mu* ! association betwe5 ! built environm5t & ! heal? ( resid5ts1 v]sus ! life/yle pref]5ces ( ! p t *oose to live 9 ! neighborhood1 reflects ! physical *>act]i/ics ( ! neighborhood2 & 7#e7 7,a7 id5tifies or develops effective int]v5tion /rategies focus+ on enhancem5ts to ! built environm5t t promote increas$ use physical activity1 access to nutriti\s foods1 or o!r heal?-promot+ activities by resid5ts2 & 7,b7 9 develop+ ! int]v5tion /rategies "u subp>agraph 7,a71 ensures t ! int]v5tion /rategies w rea* out to high-risk or vuln]able populations1 includ+ l[-income urban & rural communities & ag+ populations1 9 addition to ! g5]al population4 7d7 ,surveys ,! ,secret>y may all[ recipi5ts ( grants "u ?is section to use su* grant funds to support ! expansion ( national surveys & data track+ sy/ems to provide m detail$ in=mation ab\t ! connection betwe5 ! built environm5t & heal?4 7e7 ,priority ,9 aw>d+ grants "u ?is section1 ! ,secret>y & ! ,adm9i/rator %all give priority to entities ) programm+ t incorporates-- 7#a7 int]discipl9>y approa*es2 or 7#b7 ! exp]tise ( ! public heal?1 physical activity1 urban plann+1 l& use1 & transportation rese>* communities 9 ! ,unit$ ,/ates & abroad4 7f7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ su* sums z may be necess>y to c>ry out ?is section4 ,! ,secret>y may allocate n m ?an #bj p]c5t ( ! am\nt s appropriat$ = a fiscal ye> = purposes ( conduct+ rese>* "u subsection 7c74 4 #aajh4 ,tribal fund+ to rese>* heal? inequities includ+ ,,covid-#ai 7a7 ,9 g5]al ,n lat] ?an #f mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,director ( ! ,indian ,heal? ,s]vice1 9 coord9ation ) ,tribal ,epidemiology ,c5t]s & o!r ,f$]al ag5cies1 z appropriate1 %all conduct or support rese>* & field /udies = ! purposes ( improv$ und]/&+ ( ,tribal heal? inequities among ,am]ican ,indians & ,alaska ,natives1 includ+ ) respect to-- 7#a7 disp>ities relat$ to ,,covid-#ai2 7#b7 public heal? surveillance & infra/ructure reg>d+ unmet ne$s 9 ,indian c\ntry & ,urban ,indian communities2 7#c7 population-bas$ heal? disp>ities2 7#d7 b>ri]s to heal? c>e s]vices2 7#e7 ! impact ( socioeconomic /atus2 & 7#f7 factors contribut+ to ,tribal heal? inequities4 7b7 ,consultation1 conf]1 & coord9ation ,9 c>ry+ out ?is section1 ! ,director ( ! ,indian ,heal? ,s]vice %all-- 7#a7 consult ) ,indian ,tribes & ,tribal organizations2 7#b7 conf] ) ,urban ,indian organizations2 7#c7 coord9ate ) ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion & ! ,director ( ! ,national ,in/itutes ( ,heal?4 7c7 ,process ,n lat] ?an #fj days aft] ! date ( enactm5t ( ?is ,act1 ! ,director ( ! ,indian ,heal? ,s]vice %all e/abli% a nationally repres5tative panel to e/abli% processes & proc$ures = ! rese>* & field /udies conduct$ or support$ "u subsection 7a74 ,! ,director %all ensure t1 at a m9imum1 ! panel consi/s ( ! foll[+ individuals3 7#a7 ,elect$ ,tribal lead]s or _! designees4 7#b7 ,tribal public heal? practition]s & exp]ts f ! national & regional levels4 7d7 ,duties ,! panel e/abli%$ "u subsection 7c7 %all1 at a m9imum-- 7#a7 advise ! ,director ( ! ,indian ,heal? ,s]vice on ! processes & proc$ures reg>d+ ! design1 implem5tation1 & evaluation (1 & report+ on1 rese>* & field /udies conduct$ or support$ "u ?is section2 7#b7 develop & %>e res\rces on ,tribal public heal? data surveillance & report+1 includ+ be/ practices2 & 7#c7 c>ry out su* o!r activities z may be appropriate to e/abli% processes & proc$ures = ! rese>* & field /udies conduct$ or support$ "u subsection 7a74 7e7 ,report ,n lat] ?an #a ye> aft] exp5d+ all funds made available to c>ry out ?is section1 ! ,director ( ! ,indian ,heal? ,s]vice1 9 coord9ation ) ! panel e/abli%$ "u subsection 7c71 %all submit an initial report on ! results ( ! rese>* & field /udies "u ?is section to-- 7#a7 ! ,committee on ,en]gy & ,comm]ce & ! ,committee on ,natural ,res\rces ( ! ,h\se ( ,repres5tatives2 & 7#b7 ! ,committee on ,indian ,affairs & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate4 7f7 ,tribal data sov]eignty ,! ,director ( ! ,indian ,heal? ,s]vice %all ensure t all rese>* & field /udies conduct$ or support$ "u ?is section are tribally-direct$ & c>ri$ out 9 a mann] :i* ensures ,tribal-direction ( all data collect$ "u ?is section-- 7#a7 accord+ to ,tribal be/ practices reg>d+ rese>* design & implem5tation1 includ+ by ensur+ ! cons5t ( ! ,tribes involv$ to public report+ ( ,tribal data2 7#b7 accord+ to all relevant & applicable ,tribal1 pr(essional1 in/itutional1 & ,f$]al /&>ds = conduct+ rese>* & gov]n+ rese>* e?ics2 7#c7 ) ! prior & in=m$ cons5t ( any ,indian ,tribe p>ticipat+ 9 ! rese>* or %>+ data = use "u ?is section2 & 7#d7 9 a mann] t respects ! inh]5t sov]eignty ( ,indian ,tribes1 includ+ ,tribal gov]nance ( data & rese>*4 7g7 ,f9al report ,n lat] ?an ,decemb] #ca1 #bjbc1 ! ,director ( ! ,indian ,heal? ,s]vice %all-- 7#a7 update & f9alize ! initial report "u subsection 7e72 & 7#b7 submit su* f9al report to ! committees specifi$ 9 su* subsection4 7h7 ,def9itions ,9 ?is section3 7#a7 ,! t]ms ,indian ,tribe & ,tribal organization h ! mean+s giv5 to su* t]ms 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd74 7#b7 ,! t]m ,urban ,indian organization has ! mean+ giv5 to su* t]m 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afjc74 7i7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section #be1jjj1jjj1 to rema9 available until exp5d$4 #aaji4 ,rese>* end[m5ts at bo? curr5t & =m] c5t]s ( excell5ce ,p>agraph 7#a7 ( section #dfdz-#c7;h7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bhet7h77 is am5d$ to read z foll[s3 7#a7 ,9 g5]al ,! ,director ( ! ,in/itute may c>ry out a program to facilitate m9ority heal? disp>ities rese>* & o!r heal? disp>ities rese>* by provid+ = rese>* end[m5ts-- 7,a7 at curr5t or =m] c5t]s ( excell5ce "u section #gcf2 & 7,b7 at curr5t or =m] c5t]s ( excell5ce "u section #dfdz-#d4 4 ,,xii ,education #abja4 ,grants = s*ools ( m$ic9e 9 div]se & und]s]v$ areas ,subp>t ,,ii ( "p ,c ( title ,,vii ( ! ,public ,heal? ,s]vice ,act is am5d$ by ins]t+ aft] section #gdi;,b ( su* ,act 7#db ,u4,s4,c4 #bicm7 ! foll[+3 #gdi;,c4 ,s*ools ( m$ic9e 9 und]s]v$ areas 7a7 ,grants ,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 may aw>d grants to in/itutions ( high] education 7includ+ multiple in/itutions ( high] education apply+ jo9tly7 = ! e/abli%m5t1 improvem5t1 & expansion ( an allopa?ic or o/eopa?ic s*ool ( m$ic9e1 or a bran* campus ( an allopa?ic or o/eopa?ic s*ool ( m$ic9e4 7b7 ,priority ,9 select+ grant recipi5ts "u ?is section1 ! ,secret>y %all give priority to in/itutions ( high] education t-- 7#a7 propose to use ! grant = an allopa?ic or o/eopa?ic s*ool ( m$ic9e1 or a bran* campus ( an allopa?ic or o/eopa?ic s*ool ( m$ic9e1 9 a comb9$ /ati/ical area ) few] ?an #bjj actively practic+ physicians p] #ajj1jjj resid5ts accord+ to ! m$ical bo>d 7or bo>ds7 ( ! ,/ate 7or ,/ates7 involv$2 7#b7 h a curriculum t emphasizes c>e = div]se & und]s]v$ populations2 or 7#c7 are m9ority-s]v+ in/itutions describ$ 9 ! li/ 9 section #cga7;a7 ( ! ,high] ,education ,act ( #aife4 7c7 ,use ( funds ,! activities = :i* a grant "u ?is section may be us$ include-- 7#a7 plann+ & con/ruct+-- 7,a7 a new allopa?ic or o/eopa?ic s*ool ( m$ic9e 9 an area 9 :i* no o!r s*ool is bas$2 or 7,b7 a bran* campus ( an allopa?ic or o/eopa?ic s*ool ( m$ic9e 9 an area 9 :i* no su* s*ool is bas$2 7#b7 accr$itation & plann+ activities = an allopa?ic or o/eopa?ic s*ool ( m$ic9e or bran* campus2 7#c7 hir+ faculty & o!r /aff to s]ve at an allopa?ic or o/eopa?ic s*ool ( m$ic9e or bran* campus2 7#d7 recruitm5t & enrollm5t ( /ud5ts at an allopa?ic or o/eopa?ic s*ool ( m$ic9e or bran* campus2 7#e7 support+ educational programs at an allopa?ic or o/eopa?ic s*ool ( m$ic9e or bran* campus2 7#f7 mod]niz+ infra/ructure or curriculum at an exi/+ allopa?ic or o/eopa?ic s*ool ( m$ic9e or bran* campus !re(2 7#g7 exp&+ infra/ructure or curriculum at exi/+ an allopa?ic or o/eopa?ic s*ool ( m$ic9e or bran* campus2 & 7#h7 o!r activities t ! ,secret>y det]m9es fur!r ! developm5t1 improvem5t1 & expansion ( an allopa?ic or o/eopa?ic s*ool ( m$ic9e or bran* campus !re(4 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]m bran* campus means a geographically sep>ate site at lea/ #ajj miles f ! ma9 campus ( a s*ool ( m$ic9e :]e at lea/ "o /ud5t completes at lea/ #fj p]c5t ( ! /ud5t's tra9+ lead+ to a degree ( doctor ( m$ic9e4 7#b7 ,! t]m in/itution ( high] education has ! mean+ giv5 to su* t]m 9 section #aja7;a7 ( ! ,high] ,education ,act ( #aife4 7e7 ,au?orization ( appropriations ,to c>ry out ?is section1 !re is au?oriz$ to be appropriat$ #a1jjj1jjj1jjj1 to rema9 available until exp5d$4 4 #abjb4 ,am5dm5t to ! ,public ,heal? ,s]vice ,act ,title ,,xxxiv ( ! ,public ,heal? ,s]vice ,act1 z am5d$ by z am5d$ by sections #ajd1 #gjb1 & #hjf1 is am5d$ by add+ at ! end ! foll[+3 ,d ,div]sify+ ! ,heal? ,c>e ,workplace #cdaj4 ,national ,work+ ,gr\p on ,work=ce ,div]sity 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,bureau ( ,heal? ,work=ce ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all aw>d a grant to an entity det]m9$ appropriate by ! ,secret>y = ! e/abli%m5t ( a national work+ gr\p on work=ce div]sity4 7b7 ,repres5tation ,9 e/abli%+ ! national work+ gr\p "u subsection 7a73 7#a7 ,! grantee %all ensure t ! gr\p has repres5tatives ( ea* ( ! foll[+3 7,a7 ,! ,heal? ,res\rces & ,s]vices ,adm9i/ration4 7,b7 ,! ,dep>tm5t ( ,heal? & ,human ,s]vices ,data ,c\ncil4 7,c7 ,! ,(fice ( ,m9ority ,heal? ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7,d7 ,! ,sub/ance ,abuse & ,m5tal ,heal? ,s]vices ,adm9i/ration4 7,e7 ,! ,bureau ( ,labor ,/ati/ics ( ! ,dep>tm5t ( ,labor4 7,f7 ,! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities4 7,g7 ,! ,ag5cy = ,heal?c>e ,rese>* & ,quality4 7,h7 ,! ,in/itute ( ,m$ic9e ,/udy ,committee = ! #bjjd work=ce div]sity report4 7,i7 ,! ,indian ,heal? ,s]vice4 7,j7 ,! ,dep>tm5t ( ,education4 7,k7 ,m9ority-s]v+ academic in/itutions4 7,l7 ,consum] organizations4 7,m7 ,heal? pr(essional associations1 includ+ ^? t repres5t und]repres5t$ m9ority populations4 7,n7 ,rese>*]s 9 ! area ( heal? work=ce4 7,o7 ,heal? work=ce accr$itation entities4 7,p7 ,private 7includ+ nonpr(it7 f\ndations t h sponsor$ work=ce div]sity initiatives4 7,q7 ,local & ,/ate heal? dep>tm5ts4 7,r7 ,repres5tatives ( community memb]s to be includ$ on admissions committees = heal? pr(ession s*ools pursuant to subsection 7c77#i74 7,s7 ,national community-bas$ organizations t s]ve z a national int]m$i>y to _! urban affiliate memb]s & h demon/rat$ capacity to tra9 heal? c>e pr(essionals4 7,t7 ,! ,vet]ans ,heal? ,adm9i/ration4 7,u7 ,o!r entities det]m9$ appropriate by ! ,secret>y4 7#b7 ,! grantee %all ensure t1 9 addition to ! repres5tatives "u p>agraph 7#a71 ! work+ gr\p has n less ?an #e heal? pr(essions /ud5ts repres5t+ v>i\s heal? pr(ession fields & levels ( tra9+4 7c7 ,activities ,! work+ gr\p e/abli%$ "u subsection 7a7 %all conv5e at lea/ twice ea* ye> to complete ! foll[+ activities3 7#a7 ,review public & private heal? work=ce div]sity initiatives4 7#b7 ,id5tify successful heal? work=ce div]sity programs & practices4 7#c7 ,exam9e *all5ges relat+ to ! developm5t & implem5tation ( heal? work=ce div]sity initiatives4 7#d7 ,draft a national /rategic "w plan = heal? work=ce div]sity1 includ+ recomm5dations = public & private sector initiatives4 7#e7 ,develop a framework & me?ods = ! evaluation ( curr5t & future heal? work=ce div]sity initiatives4 7#f7 ,develop recomm5d$ /&>ds = work=ce div]sity t c\ld be applicable to all heal? pr(essions programs & programs fund$ "u ?is ,act4 7#g7 ,develop guidel9es to tra9 heal? pr(essionals to c>e = a div]se population4 7#h7 ,develop a work=ce data collection or track+ sy/em to id5tify :]e racial & e?nic m9ority heal? pr(essionals practice4 7#i7 ,develop a /rategy = ! inclusion ( community memb]s on admissions committees = heal? pr(ession s*ools4 7#aj7 ,help ) monitor+ & implem5tation ( /&>ds = div]sity1 equity1 & inclusion4 7#aa7 ,o!r activities det]m9$ appropriate by ! ,secret>y4 7d7 ,annual report ,n lat] ?an #a ye> aft] ! e/abli%m5t ( ! work+ gr\p "u subsection 7a71 & annually !reaft]1 ! work+ gr\p %all prep>e & make available to ! g5]al public = comm5t1 an annual report on ! activities ( ! work+ gr\p4 ,su* report %all include ! recomm5dations ( ! work+ gr\p = improv+ heal? work=ce div]sity4 7e7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdab4 ,te*nical ,cle>+h\se = ,heal? work=ce ,div]sity 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 & 9 collaboration ) ! ,bureau ( ,heal? ,work=ce )9 ! ,heal? ,res\rces & ,s]vices ,adm9i/ration & ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities1 %all e/abli% a te*nical cle>+h\se on heal? work=ce div]sity )9 ! ,(fice ( ,m9ority ,heal? & coord9ate curr5t & future cle>+h\ses relat$ to heal? work=ce div]sity4 7b7 ,in=mation & s]vices ,! cle>+h\se e/abli%$ "u subsection 7a7 %all (f] ! foll[+ in=mation & s]vices3 7#a7 ,in=mation on ! importance ( heal? work=ce div]sity4 7#b7 ,/ati/ical in=mation relat+ to und]repres5t$ m9ority repres5tation 9 heal? & alli$ heal? pr(essions & occupations4 7#c7 ,model heal? work=ce div]sity practices & programs1 includ+ integrat$ models ( c>e4 7#d7 ,admissions policies t promote heal? work=ce div]sity & are 9 compliance ) ,f$]al & ,/ate laws4 7#e7 ,reta9m5t policies t promote completion ( heal? pr(ession degrees = und]s]v$ populations4 7#f7 ,li/s ( s*ol>%ip1 loan repaym5t1 & loan cancellation grants z well z fell[%ip in=mation = und]s]v$ populations = heal? pr(essions s*ools4 7#g7 ,f\ndation & o!r l>ge organizational initiatives relat+ to heal? work=ce div]sity4 7c7 ,consultation ,9 c>ry+ out ?is section1 ! ,secret>y %all consult ) non-,f$]al entities :i* may include m9ority heal? pr(essional associations & m9ority sections ( major heal? pr(essional associations to ensure ! adequacy & accuracy ( in=mation4 7d7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdac4 ,support = ,in/itutions committ$ to work=ce div]sity1 equity1 & inclusion 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration & ! ,c5t]s = ,disease ,control & ,prev5tion1 %all aw>d grants to eligible entities t demon/rate a commitm5t to heal? work=ce div]sity4 7b7 ,eligibility ,to be eligible to receive a grant "u subsection 7a71 an entity %all-- 7#a7 be an educational in/itution or entity t hi/orically produces or tra9s mean+ful numb]s ( und]repres5t$ m9ority heal? pr(essionals1 includ+-- 7,a7 "p ,b in/itutions1 z def9$ 9 section #cbb ( ! ,high] ,education ,act ( #aife2 7,b7 ,hispanic-s]v+ heal? pr(essions s*ools2 7,c7 ,hispanic-s]v+ in/itutions1 z def9$ 9 section #ejb ( su* ,act2 7,d7 ,tribal colleges or univ]sities1 z def9$ 9 section #caf ( su* ,act2 7,e7 ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itutions1 z def9$ 9 section #cga7;c7 ( su* ,act2 7,f7 in/itutions t h programs to recruit & reta9 und]repres5t$ m9ority heal? pr(essionals1 9 :i* a significant numb] ( ! enroll$ p>ticipants are und]repres5t$ m9orities2 7,g7 heal? pr(essional associations1 :i* may include und]repres5t$ m9ority heal? pr(essional associations2 & 7,h7 in/itutions1 includ+ national & regional community-bas$ organizations ) demon/rat$ commitm5t to a div]sifi$ work=ce-- 7i7 locat$ 9 communities ) pr$om9antly und]repres5t$ m9ority populations2 7ii7 ) :om p>tn]%ips h be5 =m$ = ! purpose ( increas+ work=ce div]sity2 & 7iii7 9 :i* at lea/ #bj p]c5t ( ! enroll$ p>ticipants are und]repres5t$ m9orities2 & 7#b7 submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7c7 ,use ( funds ,am\nts receiv$ "u a grant "u subsection 7a7 %all be us$ to exp& exi/+ work=ce div]sity programs1 implem5t new work=ce div]sity programs1 or evaluate exi/+ or new work=ce div]sity programs1 includ+ ) respect to m5tal heal? c>e pr(essions4 ,su* programs %all enhance div]sity by consid]+ m9ority /atus z "p ( an individualiz$ consid]ation ( qualifications4 ,possible activities may include-- 7#a7 educational outrea* programs relat+ to opportunities 9 ! heal? pr(essions2 7#b7 s*ol>%ip1 fell[%ip1 grant1 loan repaym5t1 & loan cancellation programs2 7#c7 po/baccalaureate programs2 7#d7 academic enri*m5t programs1 p>ticul>ly t>get+ ^? :o w\ld n be competitive = heal? pr(essions s*ools2 7#e7 support+ work=ce div]sity 9 k9d]g>t5 ?r\gh #ab? grade & o!r heal? pipel9e programs2 7#f7 m5tor+ programs2 7#g7 int]n%ip or rotation programs involv+ hospitals1 heal? sy/ems1 heal? plans1 & o!r heal? entities2 7#h7 community p>tn]%ip developm5t = purposes relat+ to work=ce div]sity2 or 7#i7 lead]%ip tra9+4 7d7 ,reports ,n lat] ?an #a ye> aft] receiv+ a grant "u ?is section1 & annually = ! t]m ( ! grant1 a grantee %all submit to ! ,secret>y a report t summ>izes & evaluates all activities conduct$ "u ! grant4 7e7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section1 su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdad4 ,c>e] developm5t = sci5ti/s & rese>*]s 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,national ,in/itutes ( ,heal?1 ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,commission] ( ,food & ,drugs1 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 & ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all aw>d grants t exp& exi/+ opportunities = sci5ti/s & rese>*]s & promote ! inclusion ( und]repres5t$ m9orities 9 ! heal? pr(essions4 7b7 ,rese>* fund+ ,! head ( ea* ag5cy li/$ 9 subsection 7a7 %all e/abli% or exp& exi/+ programs to provide rese>* fund+ to sci5ti/s & rese>*]s 9 tra9+4 ,"u su* programs1 ! head ( ea* su* entity %all give priority 9 allocat+ rese>* fund+ to support heal? rese>* 9 traditionally und]s]v$ communities1 includ+ und]repres5t$ m9ority communities1 & rese>* classifi$ z community or p>ticipatory4 7c7 ,data collection ,! head ( ea* ag5cy li/$ 9 subsection 7a7 %all collect data on ! numb] 7express$ z an absolute numb] & a p]c5tage7 ( und]repres5t$ m9ority & nonm9ority applicants :o receive & are d5i$ ag5cy fund+ at e /age ( review4 ,su* data %all be report$ annually to ! ,secret>y & ! appropriate committees ( ,congress4 7d7 ,/ud5t loan reimbursem5t ,! ,secret>y %all e/abli% a /ud5t loan reimbursem5t program to provide /ud5t loan reimbursem5t assi/ance to rese>*]s :o focus on racial & e?nic disp>ities 9 heal?4 ,! ,secret>y %all promulgate regulations to def9e ! scope & proc$ures = ! program "u ?is subsection4 7e7 ,/ud5t loan cancellation ,! ,secret>y %all e/abli% a /ud5t loan cancellation program to provide /ud5t loan cancellation assi/ance to rese>*]s :o focus on racial & e?nic disp>ities 9 heal?4 ,/ud5ts p>ticipat+ 9 ! program %all make a m9imum #e-ye> commitm5t to "w at an accr$it$ heal? pr(ession s*ool4 ,! ,secret>y %all promulgate additional regulations to def9e ! scope & proc$ures = ! program "u ?is subsection4 7f7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section1 su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdae4 ,c>e] support = nonrese>* ,heal? pr(essionals 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,assi/ant ,secret>y = ,m5tal ,heal? & ,sub/ance ,use1 ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 & ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 %all e/abli% a program to aw>d grants to eligible individuals = c>e] support 9 nonrese>*-relat$ heal? & wellness pr(essions4 7b7 ,eligibility ,to be eligible to receive a grant "u subsection 7a71 an individual %all-- 7#a7 be a /ud5t 9 a heal? pr(essions s*ool1 a graduate ( su* a s*ool :o is work+ 9 a heal? pr(ession1 an individual work+ 9 a heal? or wellness pr(ession 7includ+ m5tal & behavioral heal?71 or a faculty memb] ( su* a s*ool2 & 7#b7 submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7c7 ,use ( funds ,an individual %all use am\nts receiv$ "u a grant "u ?is section to-- 7#a7 support ! individual's heal? activities or projects t involve und]s]v$ communities1 includ+ racial & e?nic m9ority communities2 7#b7 support heal?-relat$ c>e] advancem5t activities2 7#c7 to pay1 or z reimbursem5t = paym5ts (1 /ud5t loans or tra9+ or cr$5tial+ co/s = individuals :o are heal? pr(essionals & are focus$ on heal? issues affect+ und]s]v$ communities1 includ+ racial & e?nic m9ority communities2 & 7#d7 to e/abli% & promote lead]%ip tra9+ programs to decrease heal? disp>ities & to increase cultural compet5ce ) ! goal ( increas+ div]sity 9 lead]%ip positions4 7d7 ,def9ition ,9 ?is section1 ! t]m c>e] 9 nonrese>*-relat$ heal? & wellness pr(essions means employm5t or int5d$ employm5t 9 ! field ( public heal?1 heal? policy1 heal? managem5t1 heal? adm9i/ration1 m$ic9e1 nurs+1 ph>macy1 psy*ology1 social "w1 psy*iatry1 o!r m5tal & behavioral heal?1 alli$ heal?1 community heal?1 social "w1 or o!r fields det]m9$ appropriate by ! ,secret>y1 o!r ?an 9 a position t involves rese>*4 7e7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdaf4 ,rese>* on ! effect ( work=ce ,div]sity on quality 7a7 ,9 g5]al ,! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 9 collaboration ) ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal? & ! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities1 %all aw>d grants to eligible entities to exp& rese>* on ! l9k betwe5 heal? work=ce div]sity & quality heal? c>e4 7b7 ,eligibility ,to be eligible to receive a grant "u subsection 7a71 an entity %all-- 7#a7 be a cl9ical1 public heal?1 or heal? s]vices rese>* entity or o!r entity det]m9$ appropriate by ! ,director2 & 7#b7 submit to ! ,secret>y an application at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require4 7c7 ,use ( funds ,am\nts receiv$ "u a grant aw>d$ "u subsection 7a7 %all be us$ to support rese>* t inve/igates ! effect ( heal? work=ce div]sity on-- 7#a7 language access2 7#b7 cultural compet5ce2 7#c7 pati5t satisfaction2 7#d7 timel9ess ( c>e2 7#e7 safety ( c>e2 7#f7 effectiv5ess ( c>e2 7#g7 effici5cy ( c>e2 7#h7 pati5t outcomes2 7#i7 community engagem5t2 7#aj7 res\rce allocation2 7#aa7 organizational /ructure2 7#ab7 compliance ( c>e2 or 7#ac7 o!r topics det]m9$ appropriate by ! ,director4 7d7 ,priority ,9 aw>d+ grants "u subsection 7a71 ! ,director %all give individualiz$ consid]ation to all relevant aspects ( ! applicant's backgr\nd4 ,consid]ation ( prior rese>* exp]i5ce involv+ ! heal? ( und]s]v$ communities %all be su* a factor4 7e7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 #cdag4 ,heal? disp>ities education program 7a7 ,e/abli%m5t ,! ,secret>y1 act+ ?r\gh ! ,(fice ( ,m9ority ,heal?1 9 collaboration ) ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities1 ! ,(fice = ,civil ,rights1 ! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 & o!r appropriate public & private entities1 %all e/abli% & coord9ate a heal? & heal? c>e disp>ities education program to support1 develop1 & implem5t educational initiatives & outrea* /rategies t in=m heal? c>e pr(essionals & ! public ab\t ! exi/5ce ( & me?ods to r$uce racial & e?nic disp>ities 9 heal? & heal? c>e4 7b7 ,activities ,! ,secret>y1 ?r\gh ! education program e/abli%$ "u subsection 7a71 %all1 ?r\gh ! use ( public aw>5ess & outrea* campaigns t>get+ ! g5]al public & ! m$ical community at l>ge-- 7#a7 dissem9ate sci5tific evid5ce = ! exi/5ce & ext5t ( racial & e?nic disp>ities 9 heal? c>e1 includ+ disp>ities t are n o!rwise attributable to kn[n factors su* z access to c>e1 pati5t pref]5ces1 or appropriat5ess ( int]v5tion1 z describ$ 9 ! #bjjb ,in/itute ( ,m$ic9e ,report entitl$ ,unequal ,treatm5t3 ,confront+ ,racial & ,e?nic ,disp>ities 9 ,heal? ,c>e1 z well z ! impact ( disp>ities relat$ to age1 disability /atus1 socioeconomic /atus1 sex1 g5d] id5tity1 & sexual ori5tation on racial & e?nic m9orities2 7#b7 dissem9ate new rese>* f9d+s to heal? c>e provid]s & pati5ts to assi/ !m 9 und]/&+1 r$uc+1 & elim9at+ heal? & heal? c>e disp>ities2 7#c7 dissem9ate in=mation ab\t ! impact ( l+ui/ic & cultural b>ri]s on heal? c>e quality & ! obligation ( heal? provid]s :o receive ,f$]al f9ancial assi/ance to ensure t individuals ) limit$ ,engli% pr(ici5cy h access to language access s]vices2 7#d7 dissem9ate in=mation ab\t ! importance & legality ( racial1 e?nic1 disability /atus1 socioeconomic /atus1 sex1 g5d] id5tity1 & sexual ori5tation1 & prim>y language data collection1 analysis1 & report+2 7#e7 design & implem5t specific educational initiatives to heal? c>e provid]s relat+ to heal? & heal? c>e disp>ities2 7#f7 assess ! impact ( ! programs e/abli%$ "u ?is section 9 rais+ aw>5ess ( heal? & heal? c>e disp>ities & provid+ in=mation on available res\rces2 & 7#g7 design & implem5t specific educational initiatives to educate ! heal? c>e work=ce relat+ to unconsci\s bias4 7c7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbe4 4 #abjc4 ,hispanic-s]v+ in/itutions1 ,hi/orically ,black ,colleges & ,univ]sities1 ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itutions1 ,tribal colleges1 regional community-bas$ organizations1 & national m9ority m$ical associations ,"p ,b ( title ,,vii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bic et seq47 is am5d$ by add+ at ! end ! foll[+3 #gdb4 ,hispanic-s]v+ in/itutions1 ,hi/orically ,black ,colleges & ,univ]sities1 ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itutions1 & ,tribal colleges 7a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration & 9 consultation ) ! ,secret>y ( ,education1 %all aw>d grants to ,hispanic-s]v+ in/itutions1 ,hi/orically ,black ,colleges & ,univ]sities1 ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itutions1 ,tribal ,colleges or ,univ]sities1 regional community-bas$ organizations1 & national m9ority m$ical associations1 = c\nsel+1 m5tor+ & provid+ in=mation on f9ancial assi/ance to prep>e und]repres5t$ m9ority individuals to enroll 9 & graduate f heal? pr(essional s*ools & to increase s]vices = und]repres5t$ m9ority /ud5ts includ+-- 7#a7 m5tor+ ) und]repres5t$ heal? pr(essionals2 & 7#b7 provid+ f9ancial assi/ance in=mation = cont9u$ education & applications to heal? pr(essional s*ools4 7b7 ,def9itions ,9 ?is section3 7#a7 ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itution ,! t]m ,asian ,am]ican & ,native ,am]ican ,pacific ,isl&]-s]v+ in/itution has ! mean+ giv5 su* t]m 9 section #cbj7;b7 ( ! ,high] ,education ,act ( #aife4 7#b7 ,hispanic-s]v+ in/itution ,! t]m ,hispanic-s]v+ in/itution means an entity t-- 7,a7 is a s*ool or program = :i* !re is a def9ition "u #gii;,b2 7,b7 has an enrollm5t ( full-"t equival5t /ud5ts t is made up ( at lea/ #i p]c5t ,hispanic /ud5ts2 7,c7 has be5 effective 9 c>ry+ out programs to recruit ,hispanic individuals to enroll 9 & graduate f ! s*ool2 7,d7 has be5 effective 9 recruit+ & reta9+ ,hispanic faculty memb]s2 7,e7 has a significant numb] ( graduates :o are provid+ heal? s]vices to m$ically und]s]v$ populations or to individuals 9 heal? pr(essional %ortage areas2 & 7,f7 is a ,hispanic ,c5t] ( ,excell5ce 9 ,heal? ,pr(essions ,education designat$ "u section #gcf7;d77#b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bic7;d77#b774 7#c7 ,hi/orically black colleges & univ]sity ,! t]m hi/orically black college & univ]sity has ! mean+ giv5 ! t]m "p ,b in/itution z def9$ 9 section #cbb ( ! ,high] ,education ,act ( #aife4 7#d7 ,tribal college or univ]sity ,! t]m ,tribal ,college or ,univ]sity has ! mean+ giv5 su* t]m 9 section #caf7;b7 ( ! ,high] ,education ,act ( #aife4 7c7 ,c]ta9 loan repaym5t programs ,9 c>ry+ out ! ,national ,heal? ,s]vice ,corps ,loan ,repaym5t ,program e/abli%$ "u subp>t ,,iii ( "p ,d ( title ,,iii & ! loan repaym5t program "u section #cag;,f1 ! ,secret>y %all ensure1 not)/&+ su* subp>t or section1 t loan repaym5ts ( n less ?an #ej1jjj p] ye> p] p]son are aw>d$ = repaym5t ( loans incurr$ = enrollm5t or p>ticipation ( und]repres5t$ m9ority individuals 9 heal? pr(essional s*ools & o!r heal? programs describ$ 9 ?is section4 7d7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section su* sums z may be necess>y = ea* ( fiscal ye>s #bjba ?r\gh #bjbf4 4 #abjd4 ,loan repaym5t program ( ,c5t]s = ,disease ,control & ,prev5tion ,section #cag;,f7c77#a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#g7;c77#a77 is am5d$-- 7#a7 by /rik+ & aft] #aiid12 & 7#b7 by ins]t+ be=e ! p]iod at ! end ! foll[+3 1 #gej1jjj = fiscal ye> #bjbj1 & su* sums z may be necess>y = ea* ( ! fiscal ye>s #bjba ?r\gh #bjbe4 #abje4 ,/udy & report on /rategies = increas+ div]sity 7a7 ,/udy ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a /udy on /rategies = increas+ ! div]sity ( ! heal? pr(essional work=ce4 ,su* /udy %all include an analysis ( /rategies = increas+ ! numb] ( heal? pr(essionals f rural1 l[] income1 & und]repres5t$ m9ority communities1 includ+ :i* /rategies are mo/ effective = a*iev+ su* goal4 7b7 ,report ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al %all submit to ,congress a report on ! /udy conduct$ "u subsection 7a71 toge!r ) recomm5dations = su* legislation & adm9i/rative action z ! ,comptroll] ,g5]al det]m9es appropriate4 #abjf4 ,am5dm5ts to ! ,p&emic ,,ebt ,act ,section #aaja ( ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 by /rik+ fiscal ye> #bjbj & ins]t+ fiscal ye>s #bjbj & #bjba2 7,b7 by /rik+ dur+ :i* ! s*ool w\ld o!rwise be 9 session2 & 7,c7 by ins]t+ until ! s*ool reop5s aft] assi/ance2 7#b7 9 subsection 7b7-- 7,a7 by ins]t+ & ,/ate ag5cy plans = *ild c>e cov]$ *ildr5 9 accordance ) subsection 7i7 aft] ) eligible *ildr52 7,b7 by ins]t+ 1 a plan to enroll *ildr5 :o become eligible *ildr5 dur+ a public heal? em]g5cy designation be=e 1 & issuances2 7,c7 by /rik+ 9 an am\nt n less ?an ! value ( meals at ! free rate ov] ! c\rse ( #e s*ool days & ins]t+ 9 accordance ) subsection 7h77#a72 & 7,d7 by ins]t+ & = ea* *ild c>e cov]$ *ild 9 ! h\sehold be=e ! p]iod at ! end2 7#c7 9 subsection 7c71 by ins]t+ or *ild c>e c5t] aft] s*ool2 7#d7 by am5d+ subsection 7e7 to read z foll[s3 7e7 ,release ( in=mation ,not)/&+ any o!r provision ( law1 ! ,secret>y ( ,agriculture may au?orize-- 7#a7 ,/ate educational ag5cies & s*ool food au?orities adm9i/]+ a s*ool lun* program "u ! ,ri*>d ,b4 ,russell ,national ,s*ool ,lun* ,act 7#db ,u4,s4,c4 #agea et seq47 to release to appropriate (ficials adm9i/]+ ! supplem5tal nutrition assi/ance program su* in=mation z may be necess>y to c>ry out ?is section ) respect to eligible *ildr52 & 7#b7 ,/ate ag5cies adm9i/]+ a *ild & adult c>e food program "u section #ag ( ! ,ri*>d ,b4 ,russell ,national ,s*ool ,lun* ,act 7#db ,u4,s4,c4 #agff7 to release to appropriate (ficials adm9i/]+ ! supplem5tal nutrition assi/ance program su* in=mation z may be necess>y to c>ry out ?is section ) respect to *ild c>e cov]$ *ildr54 2 7#e7 by am5d+ subsection 7g7 to read z foll[s3 7g7 ,availability ( commodities 7#a7 ,9 g5]al ,subject to p>agraph 7#b71 dur+ fiscal ye> #bjbj1 ! ,secret>y ( ,agriculture may pur*ase commodities = em]g5cy di/ribution 9 any area ( ! ,unit$ ,/ates dur+ a public heal? em]g5cy designation4 7#b7 ,pur*ases ,funds made available to c>ry out ?is subsection on or aft] ! date ( ! enactm5t ( ! ,*ild ,nutrition & ,relat$ ,programs ,recov]y ,act may only be us$ to pur*ase commodities = em]g5cy di/ribution-- 7,a7 "u commodity di/ribution programs & *ild nutrition programs t 7 e/abli%$ & adm9i/]$ by ! ,food & ,nutrition ,s]vice on or be=e ! day be=e ! date ( ! enactm5t ( ! ,families ,fir/ ,coronavirus ,response ,act 7,public ,law #aaf-abg72 7,b7 to ,tribal organizations 7z def9$ 9 section #c ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjab771 t are n adm9i/]+ ! food di/ribution program e/abli%$ "u section #d7;b7 ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjac7;b772 or 7,c7 to em]g5cy fe$+ organizations t are eligible recipi5t ag5cies 7z su* t]ms are def9$ 9 section #bja;,a ( ! ,em]g5cy ,food ,assi/ance ,act ( #aihc 7#g ,u4,s4,c4 #geja774 2 7#f7 by r$esignat+ subsections 7h7 & 7i7 z subsections 7l7 & 7m72 7#g7 by ins]t+ aft] subsection 7g7 ! foll[+3 7h7 ,am\nt ( b5efits 7#a7 ,9 g5]al ,a h\sehold %all receive b5efits "u ?is section 9 an am\nt equal to #a breakfa/ & #a lun* at ! free rate = ea* eligible *ild or *ild c>e cov]$ *ild 9 su* h\sehold = ea* day4 7#b7 ,treatm5t ( newly eligible *ildr5 ,9 ! case ( a *ild :o becomes an eligible *ild dur+ a public heal? em]g5cy designation1 ! ,secret>y & ,/ate ag5cy %all-- 7,a7 if su* *ild becomes an eligible *ild dur+ s*ool ye> #bjai-bjbj1 treat su* *ild z if su* *ild 0 an eligible *ild z ( ! date ! s*ool 9 :i* ! *ild is enroll$ clos$2 & 7,b7 if su* *ild becomes an eligible *ild aft] s*ool ye> #bjai-bjbj1 treat su* *ild z an eligible *ild z ( ! fir/ day ( ! mon? 9 :i* su* *ild becomes s eligible4 7i7 ,*ild c>e cov]$ *ild assi/ance 7#a7 ,9 g5]al ,dur+ fiscal ye>s #bjbj & #bjba1 9 any case 9 :i* a *ild c>e c5t] is clos$ = at lea/ #e consecutive days dur+ a public heal? em]g5cy designation1 ea* h\sehold conta9+ at lea/ #a memb] :o is a *ild c>e cov]$ *ild att5d+ ! *ild c>e c5t] %all be eligible until ! s*ools 9 ! ,/ate 9 :i* su* *ild c>e c5t] is locat$ reop51 z det]m9$ by ! ,secret>y1 to receive assi/ance pursuant to-- 7,a7 a ,/ate ag5cy plan approv$ "u subsection 7b7 t includes-- 7i7 an application by ! ,/ate ag5cy seek+ to p>ticipate 9 ! program "u ?is subsection2 & 7ii7 a ,/ate ag5cy plan = tempor>y em]g5cy /&>ds ( eligibility & levels ( b5efits "u ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjaa et seq47 = h\seholds ) *ild c>e cov]$ *ildr52 or 7,b7 an add5dum application describ$ 9 p>agraph 7#b74 7#b7 ,add5dum application ,9 ! case ( a ,/ate ag5cy t submits a plan to ! ,secret>y ( ,agriculture "u subsection 7b7 t does n include an application or plan describ$ 9 clauses 7i7 & 7ii7 ( p>agraph 7#a77;,a71 su* ,/ate ag5cy may apply to p>ticipate 9 ! program "u ?is subsection by submitt+ to ! ,secret>y ( ,agriculture an add5dum application = approval t includes a ,/ate ag5cy plan describ$ 9 su* clause 7ii74 7#c7 ,requirem5ts = p>ticipation ,a ,/ate ag5cy may n p>ticipate 9 ! program "u ?is subsection if-- 7,a7 ! ,/ate ag5cy plan submitt$ by su* ,/ate ag5cy "u subsection 7b7 ) respect to eligible *ildr5 is n approv$ by ! ,secret>y "u su* subsection2 or 7,b7 ! ,/ate ag5cy plan submitt$ by su* ,/ate ag5cy "u subsection 7b7 or ?is subsection ) respect to *ild c>e cov]$ *ildr5 is n approv$ by ! ,secret>y "u ei!r su* subsection4 7#d7 ,automatic enrollm5t 7,a7 ,9 g5]al ,subject to subp>agraph 7,b71 ! ,secret>y %all deem a *ild :o is less ?an #f ye>s ( age to be a *ild c>e cov]$ *ild eligible to receive assi/ance "u ?is subsection if-- 7i7 ! h\sehold ) su* *ild atte/s t su* *ild is a *ild c>e cov]$ *ild2 7ii7 su* *ild resides 9 a h\sehold t includes an eligible *ild2 7iii7 su* *ild receives ca% assi/ance b5efits "u ! tempor>y assi/ance = ne$y families program "u "p ,a ( title ,,iv ( ! ,social ,security ,act 7#db ,u4,s4,c4 #fja et seq472 7iv7 su* *ild receives assi/ance "u ! ,*ild ,c>e & ,developm5t ,block ,grant ,act ( #aiij 7#db ,u4,s4,c4 #iheg et seq472 7v7 su* *ild is-- 7,i7 enroll$ z a p>ticipant 9 a ,head ,/>t program au?oriz$ "u ! ,head ,/>t ,act 7#db ,u4,s4,c4 #ihca et seq472 7,,ii7 a fo/] *ild ^: c>e & placem5t is ! responsibility ( an ag5cy t adm9i/]s a ,/ate plan "u "p ,b or ,e ( title ,,iv ( ! ,social ,security ,act 7#db ,u4,s4,c4 #fba et seq472 7,,iii7 a fo/] *ild :o a c\rt has plac$ ) a c>etak] h\sehold2 or 7,,iv7 a homeless *ild or y\? 7z def9$ 9 section #gbe7b7 ( ! ,mc,kinney-,v5to ,homeless ,assi/ance ,act 7#db ,u4,s4,c4 #aadcd;a7#b7772 7vi7 su* *ild p>ticipates 9 ! special supplem5tal nutrition program = wom51 infants1 & *ildr5 "u section #ag ( ! ,*ild ,nutrition ,act ( #aiff 7#db ,u4,s4,c4 #aghf72 7vii7 ?r\gh ! use ( in=mation obta9$ by ! ,/ate ag5cy = ! purpose ( p>ticipat+ 9 ! supplem5tal nutrition assi/ance program "u ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjaa et seq471 ! ,/ate ag5cy elects to treat z a *ild c>e cov]$ *ild ea* *ild less ?an #f ye>s ( age :o is a memb] ( a h\sehold t receives supplem5tal nutrition assi/ance program b5efits "u su* ,act2 or 7viii7 ! ,/ate 9 :i* su* *ild resides det]m9es t su* *ild is a *ild c>e cov]$ *ild1 us+ ,/ate data approv$ by ! ,secret>y4 7,b7 ,acceptance ( any =m ( automatic enrollm5t 7i7 ,"o category ,= purposes ( deem+ a *ild to be a *ild c>e cov]$ *ild "u subp>agraph 7,a71 a ,/ate ag5cy may n be requir$ to %[ t a *ild meets m ?an "o requirem5t specifi$ 9 clauses 7i7 ?r\gh 7viii7 ( su* subp>agraph4 7ii7 ,deem+ requirem5t ,if a ,/ate ag5cy submits to ! ,secret>y in=mation t a *ild meets any "o ( ! requirem5ts specifi$ 9 clauses 7i7 ?r\gh 7viii7 ( subp>agraph 7,a71 ! ,secret>y %all deem su* *ild a *ild c>e cov]$ *ild "u su* subp>agraph4 7j7 ,exclusions ,! provisions ( section #af ( ! ,food & ,nutrition ,act ( #bjjh 7#g ,u4,s4,c4 #bjbe7 relat+ to quality control %all n apply ) respect to assi/ance provid$ "u ?is section4 7k7 ,feasibility analysis 7#a7 ,9 g5]al ,n lat] ?an #cj days aft] ! date ( ! enactm5t ( ! ,*ild ,nutrition & ,relat$ ,programs ,recov]y ,act1 ! ,secret>y %all submit to ! ,education & ,labor ,committee & ! ,agriculture ,committee ( ! ,h\se ( ,repres5tatives & ! ,committee on ,agriculture1 ,nutrition1 & ,=e/ry ( ! ,s5ate a report on-- 7,a7 ! feasibility ( implem5t+ ! program = eligible *ildr5 "u ?is section us+ an ,,ebt sy/em 9 ,pu]to ,rico1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa simil> to ! mann] 9 :i* ! supplem5tal nutrition assi/ance program "u ! ,food & ,nutrition ,act ( #bjjh is op]at$ 9 ! ,/ates1 includ+ an analysis (-- 7i7 ! curr5t nutrition assi/ance program issuance infra/ructure2 7ii7 ! availability (-- 7,i7 an ,,ebt sy/em1 includ+ ! ability = au?oriz$ retail]s to accept ,,ebt c>ds2 & 7,,ii7 ,,ebt c>ds2 7iii7 ! ability to limit pur*ases us+ nutrition assi/ance program b5efits to food = home consumption2 & 7iv7 ! availability ( reliable data necess>y = ! implem5tation ( su* program "u ?is section = eligible *ildr5 & *ild c>e cov]$ *ildr51 includ+ ! names ( su* *ildr5 & ! mail+ addresses ( _! h\seholds2 & 7,b7 ! feasibility ( implem5t+ ! program = *ild c>e cov]$ *ildr5 "u subsection 7i7 9 ,pu]to ,rico1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa1 includ+ ) respect to su* program ea* analysis specifi$ 9 clauses 7i7 ?r\gh 7iv7 ( subp>agraph 7,a74 7#b7 ,cont+5t availability ( p>ticipation ,beg9n+ #cj days aft] ! date ( ! enactm5t ( ! ,*ild ,nutrition & ,relat$ ,programs ,recov]y ,act1 ,pu]to ,rico1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 & ,am]ican ,samoa may ea*-- 7,a7 submit a plan "u subsection 7b71 unless ! ,secret>y makes a f9d+1 bas$ on ! analysis provid$ "u p>agraph 7#a77;,a71 t ! implem5tation ( ! program = eligible *ildr5 "u ?is section is n feasible 9 su* t]ritories2 & 7,b7 submit a plan "u subsection 7i71 unless ! ,secret>y makes a f9d+1 bas$ on ! analysis provid$ "u p>agraph 7#a77;,b71 t ! implem5tation ( ! program = *ild c>e cov]$ *ildr5 "u subsection 7i7 is n feasible 9 su* t]ritories4 7#c7 ,treatm5t ( plans submitt$ by t]ritories ,not)/&+ any o!r provision ( law1 ) respect to a plan submitt$ pursuant to ?is subsection by ,pu]to ,rico1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 or ,am]ican ,samoa "u subsection 7b7 or subsection 7i71 ! ,secret>y %all treat su* plan 9 ! same mann] z a plan submitt$ by a ,/ate ag5cy "u su* subsection1 includ+ ) respect to ! t]ms ( fund+ provid$ "u subsection 7m74 2 7#h7 9 subsection 7l71 z r$esign$ by p>agraph 7#g7-- 7,a7 by r$esignat+ p>agraph 7#a7 z p>agraph 7#c72 7,b7 by r$esignat+ p>agraphs 7#b7 & 7#c7 z p>agraphs 7#e7 & 7#f71 respectively2 7,c7 by ins]t+ be=e p>agraph 7#c7 7z s r$esignat$7 ! foll[+3 7#a7 ,! t]m *ild c>e c5t] means an organization describ$ 9 subp>agraph 7,a7 or 7,b7 ( section #ag7;a77#b7 ( ! ,ri*>d ,b4 ,russell ,national ,s*ool ,lun* ,act 7#db ,u4,s4,c4 #agff7;a77#b77 & a family or gr\p day c>e home4 7#b7 ,! t]m *ild c>e cov]$ *ild means a *ild s]v$ "u section #ag ( ! ,ri*>d ,b4 ,russell ,national ,s*ool ,lun* ,act 7#db ,u4,s4,c4 #agff7 :o1 if n = ! closure ( ! *ild c>e c5t] att5d$ by ! *ild dur+ a public heal? em]g5cy designation & due to conc]ns ab\t a ,,covid-#ai outbreak1 w\ld receive meals "u su* section at ! *ild c>e c5t]4 2 & 7,d7 by ins]t+ aft] p>agraph 7#c7 7z s r$esignat$7 ! foll[+3 7#d7 ,! t]m free rate means-- 7,a7 ) respect to a breakfa/1 ! rate ( a free breakfa/ "u ! s*ool breakfa/ program "u section #d ( ! ,*ild ,nutrition ,act ( #aiff 7#db ,u4,s4,c4 #aggc72 & 7,b7 ) respect to a lun*1 ! rate ( a free lun* "u ! s*ool lun* program "u ! ,ri*>d ,b4 ,russell ,national ,s*ool ,lun* ,act 7#db ,u4,s4,c4 #agga et seq474 2 & 7#i7 9 subsection 7m71 z r$esignat$ by p>agraph 7#g71 by ins]t+ 7includ+ all adm9i/rative exp5ses7 aft] ?is section4 ,,xiii ,public ,heal? ,assi/ance to ,tribes #acja4 ,appropriations = ! ,indian ,heal? ,s]vice ,,h]oes ,act ,division ,a1 ,title ,v--,dep>tm5t ( ,heal? ,human ,s]vices--,indian ,heal? ,s]vice--,! #b4a billion 9 ,,covid-#ai response fund+ = ! ,indian ,heal? ,s]vice4 #acjb4 ,improv+ ,/ate1 local1 & ,tribal public heal? security ,section #cai;,c-#a ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;d-#c;a7 is am5d$-- 7#a7 9 ! section head+1 by /rik+ & local & ins]t+ 1 local1 & ,tribal2 7#b7 9 subsection 7b7-- 7,a7 9 p>agraph 7#a7-- 7i7 9 subp>agraph 7,b71 by /rik+ or at ! end2 7ii7 9 subp>agraph 7,c71 by /rik+ & at ! end & ins]t+ or2 & 7iii7 by add+ at ! end ! foll[+3 7,d7 be an ,indian ,tribe1 ,tribal organization1 or a consortium ( ,indian ,tribes or ,tribal organizations2 & 2 & 7,b7 9 p>agraph 7#b7-- 7i7 9 ! matt] prec$+ subp>agraph 7,a71 by ins]t+ 1 z applicable aft] includ+2 7ii7 9 subp>agraph 7,a77viii7-- 7,i7 by ins]t+ & ,tribal aft] ) ,/ate2 7,,ii7 by /rik+ 7z def9$ 9 section #haja ( ! ,elem5t>y & ,second>y ,education ,act ( #aife7 & ins]t+ & ,tribal educational ag5cies 7z def9$ 9 sections #haja & #facb1 respectively1 ( ! ,elem5t>y & ,second>y ,education ,act ( #aife72 & 7,,iii7 by ins]t+ & ,tribal aft] & ,/ate2 7iii7 9 subp>agraph 7,g71 by /rik+ & tribal & ins]t+ ,tribal1 & urban ,indian organization2 & 7iv7 9 subp>agraph 7,h71 by ins]t+ 1 ,indian ,tribes1 & urban ,indian organizations aft] public heal?2 7#c7 9 subsection 7e71 by ins]t+ ,indian ,tribes1 ,tribal organizations1 urban ,indian organizations1 aft] local em]g5cy plans12 7#d7 9 subsection 7g77#a71 by /rik+ tribal (ficials & ins]t+ ,tribal (ficials2 7#e7 9 subsection 7h7-- 7,a7 9 p>agraph 7#a77;,a7-- 7i7 by /rik+ ?r\gh #bjbc & ins]t+ & #bjbj2 & 7ii7 by ins]t+ be=e ! p]iod 2 & #fij1jjj1jjj = ea* ( fiscal ye>s #bjba ?r\gh #bjbc = aw>ds pursuant to p>agraph 7#c7 7subject to ! au?ority ( ! ,secret>y to make aw>ds pursuant to p>agraphs 7#d7 & 7#e77 & p>agraph 7#h71 ( :i* n less ?an #e1jjj1jjj %all be res]v$ ea* fiscal ye> = aw>ds "u p>agraph 7#h72 7,b7 9 subsection 7h77#b77;,b71 by /rik+ tribal public & ins]t+ ,tribal public2 7,c7 9 ! head+ ( p>agraph 7#c71 by ins]t+ = ,/ates aft] am\nt2 & 7,d7 by add+ at ! end ! foll[+3 7#h7 ,tribal eligible entities 7,a7 ,det]m9ation ( fund+ am\nt 7i7 ,9 g5]al ,! ,secret>y %all aw>d at lea/ #aj coop]ative agreem5ts "u ?is section1 9 am\nts n less ?an ! m9imum am\nt det]m9$ "u clause 7ii71 to eligible entities describ$ 9 subsection 7b77#a77;,d7 t submits to ! ,secret>y an application t meets ! crit]ia ( ! ,secret>y = ! receipt ( su* an aw>d & t meets o!r reasonable implem5tation conditions e/abli%$ by ! ,secret>y1 9 consultation ) ,indian ,tribes1 = su* aw>ds4 ,if ! ,secret>y receives m ?an #aj applications "u ?is section f eligible entities describ$ 9 subsection 7b77#a77;,d7 t meet ! crit]ia & conditions describ$ 9 ! previ\s s5t5ce1 ! ,secret>y1 9 consultation ) ,indian ,tribes1 may make additional aw>ds "u ?is section to su* entities4 7ii7 ,m9imum am\nt ,9 det]m9+ ! m9imum am\nt ( an aw>d pursuant to clause 7i71 ! ,secret>y1 9 consultation ) ,indian ,tribes1 %all fir/ det]m9e an am\nt ! ,secret>y consid]s appropriate = ! eligible entity4 7,b7 ,available until exp5d$ ,am\nts provid$ to a ,tribal eligible entity "u a coop]ative agreem5t "u ?is section = a fiscal ye> & rema9+ unobligat$ at ! end ( su* ye> %all rema9 available to su* entity dur+ ! entirety ( ! p]=mance p]iod1 = ! purposes = :i* said funds 7 provid$4 7,c7 ,no mat*+ requirem5t ,subp>agraphs 7,b71 7,c71 & 7,d7 ( p>agraph 7#a7 %all n apply ) respect to coop]ative agreem5ts aw>d$ "u ?is section to eligible entities describ$ 9 subsection 7b77#a77;,d74 2 & 7#f7 by add+ at ! end ! foll[+3 7l7 ,special rules relat$ to ,tribal eligible entities 7#a7 ,modifications ,aft] consultation ) ,indian ,tribes1 ! ,secret>y may make necess>y & appropriate modifications to ! program "u ?is section to facilitate ! use ( ! coop]ative agreem5t program by eligible entities describ$ 9 subsection 7b77#a77;,d74 7#b7 ,waiv]s 7,a7 ,9 g5]al ,except z provid$ 9 subp>agraph 7,b71 ! ,secret>y may waive or specify alt]native requirem5ts = any provision ( ?is section 7includ+ regulations7 t ! ,secret>y adm9i/]s 9 connection ) ?is section if ! ,secret>y f9ds t ! waiv] or alt]native requirem5t is necess>y = ! effective deliv]y & adm9i/ration ( ?is program ) respect to eligible entities describ$ 9 subsection 7b77#a77;,d74 7,b7 ,exception ,! ,secret>y may n waive or specify alt]native requirem5ts "u subp>agraph 7,a7 relat+ to labor /&>ds or ! environm5t4 7#c7 ,consultation ,! ,secret>y %all consult ) ,indian ,tribes & ,tribal organizations on ! design ( ?is program ) respect to su* ,tribes & organizations to ensure ! effectiv5ess ( ! program 9 enhanc+ ! security ( ,indian ,tribes ) respect to public heal? em]g5cies4 7#d7 ,report+ 7,a7 ,9 g5]al ,n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is subsection1 & z an add5dum to ! bi5nial evaluations requir$ "u subsection 7k71 ! ,secret>y1 9 coord9ation ) ! ,director ( ! ,indian ,heal? ,s]vice1 %all-- 7i7 conduct a review ( ! implem5tation ( ?is section ) respect to eligible entities describ$ 9 subsection 7b77#a77;,d71 includ+ any factors t may h limit$ its success2 & 7ii7 submit a report describ+ ! results ( ! review describ$ 9 clause 7i7 to-- 7,i7 ! ,committee on ,indian ,affairs1 ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions1 & ! ,committee on ,appropriations ( ! ,s5ate2 & 7,,ii7 ! ,subcommittee = ,indig5\s ,peoples ( ! ,unit$ ,/ates ( ! ,committee on ,natural ,res\rces1 ! ,committee on ,en]gy & ,comm]ce1 & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7,b7 ,analysis ( ,tribal public heal? em]g5cy infra/ructure limitation ,! ,secret>y %all include 9 ! initial report submitt$ "u subp>agraph 7,a7 a description ( any public heal? em]g5cy infra/ructure limitation enc\nt]$ by eligible entities describ$ 9 subsection 7b77#a77;,d74 4 #acjc4 ,provision ( items to ,indian programs & facilities 7a7 ,/rategic ,national ,/ockpile ,section #cai;,f-#b7;a77#c77;,g7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bdg;d-#f;b7a77#c77;,g77 is am5d$ by ins]t+ 1 &1 9 ! case t ! ,secret>y deploys ! /ockpile "u ?is subp>agraph1 ensure1 9 coord9ation ) ! applicable ,/ates & programs & facilities1 t appropriate drugs1 vacc9es & o!r biological products1 m$ical devices1 & o!r supplies are deploy$ by ! ,secret>y directly to heal? programs or facilities op]at$ by ! ,indian ,heal? ,s]vice1 an ,indian ,tribe1 a ,tribal organization 7z ^? t]ms are def9$ 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 or an int]-,tribal consortium 7z def9$ 9 section #eja ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #echa77 or ?r\gh an urban ,indian organization 7z def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act71 :ile avoid+ duplicative di/ributions to su* programs or facilities be=e ! semicolon4 7b7 ,di/ribution ( qualifi$ p&emic or epidemic products to ,,ihs facilities ,title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bda et seq47 is am5d$ by ins]t+ aft] section #cai;,f-#d ! foll[+3 #cai;,f-#e4 ,di/ribution ( qualifi$ p&emic or epidemic products to ,indian programs & facilities ,9 ! case t ! ,secret>y di/ributes qualifi$ p&emic or epidemic products 7z def9$ 9 section #cai;,f-#c7;i77#g77 to ,/ates or o!r entities1 ! ,secret>y %all ensure1 9 coord9ation ) ! applicable ,/ates & programs & facilities1 t1 z appropriate1 su* products are di/ribut$ directly to heal? programs or facilities op]at$ by ! ,indian ,heal? ,s]vice1 an ,indian ,tribe1 a ,tribal organization 7z ^? t]ms are def9$ 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 or an int]-,tribal consortium 7z def9$ 9 section #eja ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #echa77 or ?r\gh an urban ,indian organization 7z def9$ 9 section #d ( ! ,indian ,heal? ,c>e ,improvem5t ,act71 :ile avoid+ duplicative di/ributions to su* programs or facilities4 4 #acjd4 ,heal? c>e access = urban native vet]ans ,section #dje ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afde7 is am5d$-- 7#a7 9 subsection 7a77#a71 by ins]t+ urban ,indian organizations1 be=e & tribal organizations2 & 7#b7 9 subsection 7c7-- 7,a7 by ins]t+ urban ,indian organization1 be=e or tribal organization2 & 7,b7 by ins]t+ an urban ,indian organization1 be=e or a tribal organization4 #acje4 ,prop] & reimburs$ c>e = native vet]ans ,section #dje7;c7 ( ! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afde7;c77 is am5d$ by ins]t+ be=e ! p]iod at ! end ! foll[+3 1 reg>dless ( :e!r su* s]vices are provid$ directly by ! ,s]vice1 an ,indian tribe1 or tribal organization1 ?r\gh contract heal? s]vices1 or ?r\gh a contract = travel describ$ 9 section #bac7;b74