,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #bei  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #aa1 #bjba,ms4
 ,lee ( ,cali=nia 7= h]self1 ,mrs4      
,c>olyn ,b4 ,maloney ( ,new ,york1 ,mrs4
 ,watson ,coleman1 ,mr4 ,pocan1 ,ms4    
,m5g1 ,mr4 ,ru%1 ,ms4 ,s*ak[sky1 ,mr4   
,grijalva1 ,mr4 ,coh51 ,mr4 ,pet]s1     
,mrs4 ,hayes1 ,mr4 ,sires1 ,ms4 ,norton1
 & ,ms4 ,*u7 introduc$ ! foll[+ bill2   
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = 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 am5d ! ,public  
,heal? ,s]vice ,act to address !        
increas$ burd5 t ma9ta9+ ! heal? &      
hygi5e ( infants & toddl]s places on    
families 9 ne$1 ! resultant adv]se heal?
 effects on *ildr5 & families1 & !      
limit$ *ild c>e options available =     
infants & toddl]s :o lack suffici5t     
diap]s1 & = o!r purposes4  #a4 ,%ort    

title ,?is ,act may be cit$ z ! ,end    
,diap] ,ne$ ,act ( #bjba4  #b4 ,diap]   
di/ribution demon/ration project ,"p ,p 
( 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,v-#g4 ,diap] di/ribution           
demon/ration program  7a7 ,e/abli%m5t ,!
 ,secret>y %all make grants to assi/    
eligible entities to conduct            
demon/ration projects t implem5t &      
evaluate /rategies to help l[-income    
families to address ! diap] ne$s (      
infants & toddl]s4  7b7 ,design (       
program ,9 c>ry+ out ! grant program "u 
subsection 7a71 ! ,secret>y %all-- 7#a7 
consult ) relevant /akehold]s1 includ+  
ag5cies1 pr(essional associations1 &    
nonpr(it organizations1 on ! design ( ! 
program2 &  7#b7 design ! program 9 su* 
a way t ! program-- 7,a7 decreases diap]
 ne$ 9 l[-income families & meets !     
unmet diap] ne$s ( infants & toddl]s 9  
su* families ?r\gh-- 7i7 ! di/ribution (
 free diap]s & diap]+ supplies2  7ii7   

community outrea* to assi/ 9            
p>ticipation 9 exi/+ diap] di/ribution  
programs2 or  7iii7 improv+ access to   
diap]s & diap]+ supplies z "p ( a       
compreh5sive s]vice2 &  7,b7 increases !
 abilities ( communities & l[-income    
families 9 ^? communities to provide = !
 diap] ne$s ( infants & toddl]s 9 ^?    
communities4  7c7 ,eligible entities ,to
 be eligible = a grant "u ?is section1  
an entity %all-- 7#a7 be a ,/ate or     
local gov]nm5tal entity1 an ,indian     
,tribe or tribal organization 7z def9$ 9
 section #d ( ! ,indian                 
,self-,det]m9ation & ,education         
,assi/ance ,act71 or a nonpr(it         
organization describ$ 9 section         
#eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code 
( #aihf & exempt f taxation "u section  
#eja7;a7 ( su* ,code2  7#b7 h exp]i5ce 9
 ! area (-- 7,a7 community di/ributions 
( basic ne$ s]vices1 includ+ exp]i5ce   
collect+1 w>eh\s+1 & di/ribut+ basic    
necessities su* z diap]s1 food1 or      
m5/rual products2  7,b7 *ild c>e2  7,c7 

*ild developm5t activities 9 l[-income  
communities2 or  7,d7 mo!rhood1         
fa!rhood1 or p>5t-education ef=ts s]v+  
l[-income p>5ts ( "y *ildr52  7#c7      
demon/rate compet5cy to implem5t a      
project1 provide fiscal acc\ntability1  
collect data1 & prep>e reports & o!r    
necess>y docum5tation2  7#d7 demon/rate 
a will+ness to %>e in=mation ) rese>*]s1
 practition]s1 & o!r int]e/$ p>ties2 &  
7#e7 submit to ! ,secret>y a description
 ( ! design ( ! evaluation to be c>ri$  
out "u subsection 7d77#b7 & receive !   
,secret>y's approval ( su* design bas$  
on a det]m9ation t su* design is rigor\s
 & is likely to yield in=mation t is    
cr$ible & w be useful to o!r ,/ates4    
7d7 ,use ( ,funds ,am\nts provid$ ?r\gh 
a grant "u ?is section %all be us$ to   
conduct a demon/ration project to       
implem5t & evaluate /rategies to help   
l[-income families to address ! diap]   
ne$s ( infants & toddl]s1 :i* use may   
include any ( ! foll[+3 7#a7 ,to pay = !
 pur*ase ( diap]s & diap]+ supplies &   

fund diap] di/ribution demon/ration     
projects t s]ve l[-income families ) "o 
or m *ildr5 #c ye>s ( age or y\ng]4     
7#b7 ,us+ n m ?an #be p]c5t ( ! funds   
receiv$ by ! grantee "u ?is section1 to 
evaluate ! effect ( activities "u       
p>agraph 7#a7 on mitigat+ ! heal? &     
developm5tal risks ( unmet diap] ne$    
among infants1 toddl]s1 & o!r family    
memb]s 9 l[-income families1 includ+ !  
risks ( diap] d]matitis1 ur9>y tract    
infections1 & p>5tal & *ild depression &
 anxiety4  7#c7 ,to integrate activities
 "u p>agraph 7#a7 ) o!r basic ne$s      
assi/ance programs s]v+ eligible *ildr5 
& _! families1 includ+ ! foll[+3 7,a7   
,programs fund$ by ! ,tempor>y          
,assi/ance = ,ne$y ,families program1   
includ+ its ,/ate ma9t5ance ( ef=t      
provisions4  7,b7 ,programs design$ to  
support ! heal? ( eligible *ildr51 su* z
 ! ,*ildr5's ,heal? ,insurance ,program 
"u title ,,xxi ( ! ,social ,security    
,act1 ! ,m$icaid program "u title ,,xix 
( su* ,act1 or ,/ate-fund$ heal? c>e    

programs4  7,c7 ,programs fund$ ?r\gh ! 
,special ,supplem5tal ,nutrition        
,program = ,wom51 ,infants1 & ,*ildr54  
7,d7 ,programs t (f] e>ly home visit+   
s]vices1 includ+ ! ,nurse-,family       
,p>tn]%ip & ! ,mat]nal1 ,infant1 & ,e>ly
 ,*ildhood ,home ,visit+ 7,,mie*v7      
,program 7includ+ ! ,tribal ,home       
,visit+ ,program74  7,e7 ,programs to   
provide improv$ & af=dable access to    
*ild c>e1 includ+ programs fund$ ?r\gh !
 ,*ild ,c>e & ,developm5t ,fund1 !      
,tempor>y ,assi/ance = ,ne$y ,families  
program1 or a ,/ate-fund$ program4  7e7 
,no effect on o!r programs ,any         
assi/ance or b5efits receiv$ by a family
 z a result ( a project e/abli%$        
pursuant to ?is section %all be         
disreg>d$ = purposes ( det]m9+ !        
family's eligibility =1 or am\nt (1     
b5efits "u any o!r ,f$]al ne$s-bas$     
programs4  7f7 ,reports ,z a condition (
 receiv+ a grant "u ?is section = a     
fiscal ye>1 ! grantee %all submit to !  
,secret>y1 n lat] ?an #f mon?s aft] !   

end ( ! fiscal ye>1 a report t          
specifies1 by mon? & fiscal ye>1 !      
foll[+3 7#a7 ,! numb] ( infants &       
toddl]s & ! age ( ! infant & toddl]s :o 
receiv$ assi/ance f ! grantee's diap]   
di/ribution project4  7#b7 ,! numb] (   
families t h receiv$ assi/ance f !      
grantee's diap] di/ribution project4    
7#c7 ,! numb] ( diap]s1 & ! numb] ( ea* 
type ( diap]+ supply1 di/ribut$ "u !    
grantee's diap] di/ribution project4    
7#d7 ,! ,,zip ,code or ,,zip ,codes :]e 
! grantee di/ribut$ diap]s & diap]      
supplies4  7#e7 ,! me?od or me?ods !    
grantee uses to di/ribute diap]s &      
diap]+ supplies4  7#f7 ,su* o!r         
in=mation z ! ,secret>y may specify4    
7g7 ,evaluation ,! ,secret>y1 9         
consultation ) ea* grantee "u ?is       
section1 %all-- 7#a7 n lat] ?an #b ye>s 
aft] ! date ( enactm5t ( ! ,end ,diap]  
,ne$ ,act ( #bjba-- 7,a7 complete an    
evaluation ( ! effectiv5ess ( ! program 
c>ri$ out pursuant to ?is section2  7,b7
 submit to ! relevant congressional     

committees a report on ! results ( su*  
evaluation2 &  7,c7 publi% ! results ( !
 evaluation on ! int]net website ( !    
,dep>tm5t ( ,heal? & ,human ,s]vices2 & 
7#b7 7,a7 n lat] ?an #c ye>s aft] ! date
 ( enactm5t ( ! ,end ,diap] ,ne$ ,act ( 
#bjba1 update ! evaluation requir$ by   
p>agraph 7#a77;,a72 &  7,b7 n lat] ?an  
#ij days aft] completion ( ! updat$     
evaluation "u subp>agraph 7,a7-- 7i7    
submit to ! relevant congressional      
committees a report describ+ ! results (
 su* updat$ evaluation2 &  7ii7 publi% !
 results ( su* evaluation on ! int]net  
website ( ! ,dep>tm5t ( ,heal? & ,human 
,s]vices4  7h7 ,def9itions ,9 ?is       
section3 7#a7 ,diap] ,! t]m diap] means 
an absorb5t g>m5t t-- 7,a7 is wa%able or
 disposable t may be worn by an infant  
or toddl] :o is n toilet-tra9$2 &  7,b7 
if disposable-- 7i7 does n use any latex
 or common all]g5s2 &  7ii7 meets or    
exce$s ! quality /&>ds = diap]s         
comm]cially available ?r\gh retail sale 
9 ! foll[+ categories3 7,i7 ,absorb5cy  

7) acceptable rates = fir/ & second     
wett+74  7,,ii7 ,wat]pro( out] cov]4    
7,,iii7 ,flexible leg op5+s4  7,,iv7    
,refa/5+ closures4  7#b7 ,diap]+        
supplies ,! t]m diap]+ supplies means   
items1 includ+ diap] wipes & diap]      
cream1 necess>y to ensure t a *ild us+ a
 diap] is prop]ly clean$ & protect$ f   
diap] ra%4  7#c7 ,eligible *ild ,! t]m  
eligible *ild means a *ild :o-- 7,a7 has
 n atta9$ #d ye>s ( age2 &  7,b7 is a   
memb] ( a family ^: self-c]tifi$ income 
is n m ?an #bjj p]c5t ( ! ,f$]al pov]ty 
l9e4  7#d7 ,f$]al pov]ty l9e ,! t]m     
,f$]al pov]ty l9e means ! ,f$]al pov]ty 
l9e z def9$ by ! ,(fice ( ,managem5t &  
,budget & revis$ annually 9 accordance )
 section #fgc7b7 ( ! ,omnibus ,budget   
,reconciliation ,act ( #aiha applicable 
to a family ( ! size involv$4  7#e7     
,l[-income ,! t]m l[-income1 ) respect  
to a family1 means a family ^:          
self-c]tifi$ income is n m ?an #bjj     
p]c5t ( ! ,f$]al pov]ty l9e4  7i7       
,au?orization ( appropriations  7#a7 ,9 

g5]al ,to c>ry out ?is section1 !re is  
au?oriz$ to be appropriat$ #ajj1jjj1jjj 
= ea* ( fiscal ye>s #bjbb ?r\gh #bjbe4  
7#b7 ,availability ( funds ,funds       
provid$ to a grantee "u ?is section = a 
fiscal ye> may be exp5d$ by ! grantee   
only 9 su* fiscal ye> or ! succe$+      
fiscal ye>4  4  #c4 ,improv+ access to  
diap]s = m$ically complex *ildr5        
,section #aiae7;c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acifn7c77 is am5d$
 by add+ at ! end ! foll[+ new p>agraph3
  7#aa7 7,a7 ,9 ! case ( any waiv] "u   
?is subsection t provides m$ical        
assi/ance to a m$ically complex *ild :o 
has be5 diagnos$ ) b[el or bladd]       
incont95ce1 a b[el or bladd] condition t
 causes excess ur9e or /ool 7su* z %ort 
gut syndrome or diabetes insipidus71 or 
a sev]e sk9 condition t causes sk9      
erosions 7su* z epid]molysis bullosa71  
su* m$ical assi/ance %all include1 = !  
duration ( ! waiv]1 ! provision ( #bjj  
m$ically necess>y diap]s p] mon? &      
diap]+ supplies4 ,su* m$ical assi/ance  

may include ! provision ( m$ically      
necess>y diap]s 9 am\nts great] ?an #bjj
 if a lic5s$ heal? c>e provid] 7su* z a 
physician1 nurse practition]1 or        
physician assi/ant7 specifies t su*     
great] am\nts are necess>y = su*        
m$ically complex *ild4  7,b7 ,= purposes
 ( ?is p>agraph-- 7i7 ! t]m m$ically    
complex *ild means an individual :o is  
at lea/ ?ree ye>s ( age & = :om a lic5s$
 heal? c>e provid] has provid$ a        
diagnosis ( "o or m significant *ronic  
conditions2  7ii7 ! t]m m$ically        
necess>y diap] means an absorb5t g>m5t t
 is-- 7,i7 wa%able or disposable2 &     
7,,ii7 worn by a m$ically complex *ild  
:o has be5 diagnos$ ) a condition       
describ$ 9 subp>agraph 7,a7 & ne$s su*  
g>m5t to correct or ameliorate su*      
condition2 &  7iii7 ! t]m diap]+        
supplies means items1 includ+ diap]     
wipes & diap] creams1 necess>y to ensure
 t a m$ically complex *ild :o has be5   
diagnos$ ) a condition describ$ 9       
subp>agraph 7,a7 & uses a m$ically      

necess>y diap] is prop]ly clean$ &      
protect$ f diap] ra%4  4  #d4 ,inclusion
 ( diap]s & diap]+ supplies z qualifi$  
m$ical exp5ses  7a7 ,heal? sav+s acc\nts
 ,section #bbc7;d77#b7 ( ! ,int]nal     
,rev5ue ,code ( #aihf is am5d$-- 7#a7 by
 add+ at ! end ( subp>agraph 7,a7 !     
foll[+3 ,= purposes ( ?is subp>agraph1  
am\nts paid = m$ically necess>y diap]s &
 diap]+ supplies %all be treat$ z paid =
 m$ical c>e42 &  7#b7 by add+ at ! end !
 foll[+ new subp>agraph3  7,e7 ,m$ically
 necess>y diap]s & diap]+ supplies ,=   
purposes ( ?is p>agraph-- 7i7 ,m$ically 
necess>y diap]s ,! t]m m$ically necess>y
 diap] means an absorb5t g>m5t t is     
wa%able or disposable worn by an        
individual ne$s diap]s because !y are   
m$ically necess>y1 s]ve a prev5tative   
m$ical purpose1 or are ne$$ to correct  
or ameliorate defects or physical or    
m5tal illnesses or conditions :i* are   
diagnos$ by a lic5c$ heal? c>e provid]4 
7ii7 ,diap]+ supplies ,! t]m diap]+     
supplies means items1 includ+ diap]     

wipes & diap] creams necess>y to ensure 
t a *ild us+ a m$ically necess>y diap]  
is prop]ly clean$ & protect$ f diap]    
ra%4  4  7b7 ,ar*] ,m,s,as ,section     
#bbj7;d77#b77;,a7 ( su* ,code is am5d$  
by add+ at ! end ! foll[+3 ,= purposes (
 ?is subp>agraph1 am\nts paid = m$ically
 necess>y diap]s & diap]+ supplies 7z   
def9$ 9 section #bbc7;d77#b77;,d77 %all 
be treat$ z paid = m$ical c>e44  7c7    
,heal? flexible sp5d+ arrangem5ts &     
heal? reimbursem5t arrangem5ts ,section 
#ajf ( su* ,code is am5d$ by add+ at !  
end ! foll[+ new subsection3  7h7       
,reimbursem5ts = m$ically necess>y      
diap]s & diap]+ supplies ,= purposes (  
?is section & section #aje1 exp5ses     
incurr$ = m$ically necess>y diap]s &    
diap]+ supplies 7z def9$ 9 section      
#bbc7;d77#b77;,d77 %all be treat$ z     
incurr$ = m$ical c>e4  4  7d7 ,effective
 dates  7#a7 ,di/ributions f heal? sav+s
 acc\nts ,! am5dm5ts made by subsections
 7a7 & 7b7 %all apply to am\nts paid    
aft] ,decemb] #ca1 #bjba4  7#b7         

,reimbursem5ts ,! am5dm5t made by       
subsection 7c7 %all apply to exp5ses    
incurr$ aft] ,decemb] #ca1 #bjba4