,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #ifca  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #ag1        
#bjbd,ms4 ,lee ( ,cali=nia introduc$ !  
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committee on             
,agriculture1 = 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 provide = !     
e/abli%m5t or expansion ( ,food z       
,m$ic9e programs1 & = o!r purposes4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,national ,food z ,m$ic9e ,program ,act 
( #bjbd4  #b4 ,food z ,m$ic9e ,m$icaid  
waiv] grant program  7a7 ,9 g5]al ,!    
,secret>y ( ,heal? & ,human ,s]vices 79 
?is section ref]r$ to z ! ,secret>y7    
%all e/abli% a program "u :i* !         
,secret>y %all aw>d grants to ,/ates to 
plan1 implem5t1 exp&1 or evaluate ,food 
z ,m$ic9e programs4  7b7 ,application ,a
 ,/ate seek+ a grant "u ?is section %all

 submit an application to ! ,secret>y at
 su* "t1 9 su* mann]1 & conta9+ su*     
in=mation z ! ,secret>y may require4    
7c7 ,priority ,9 aw>d+ grants "u ?is    
section1 ! ,secret>y %all give priority 
to ,/ates t h1 z ( ! date ( submission (
 ! application = a grant "u ?is section1
 a p>tn]%ip )-- 7#a7 a network ( heal?  
c>e provid]s t includes public1         
nonpr(it1 & community-bas$ organizations
 or entities1 & community heal? cl9ics1 
includ+ ,f$]ally qualifi$ heal? c5t]s 7z
 def9$ 9 section #ahfa ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #aciex772 
or  7#b7 public1 nonpr(it1 socially     
disadvantag$1 & community-bas$          
organizations or entities t provide     
locally-s\rc$ 7or regionally-s\rc$1 if  
locally-s\rc$ produce is n available7   
agricultural products 7z def9$ 9 section
 #bjg ( ! ,agricultural ,m>ket+ ,act (  
#aidf 7#g ,u4,s4,c4 #afbf77 gr[n1 or    
work+ to transition to1 a cov]$ me?od ( 
production4  7d7 ,use ( funds ,a ,/ate t
 receives a grant "u ?is section %all   

use funds receiv$ ?r\gh ! grant to      
e/abli%1 implem5t1 & exp& ,food z       
,m$ic9e int]v5tions to r$uce            
nutrition-relat$ *ronic conditions1     
address food & nutrition insecurity1 &  
improve heal? ?r\gh provid+             
locally-s\rc$ 7or regionally-s\rc$1 if  
locally-s\rc$ produce is n available7   
agricultural products gr[n1 or work+ to 
transition to1 a cov]$ me?od (          
production4  7e7 ,report to ! ,secret>y 
,n less ?an #c ye>s aft] ! date on :i* a
 ,/ate receives a grant "u ?is section1 
su* ,/ate %all provide to ! ,secret>y a 
report t conta9s-- 7#a7 an evaluation ( 
! impact ( ! ,food z ,m$ic9e program    
e/abli%$ or exp&$ 9 su* ,/ate1 includ+  
relevant data collect$ "u ! ,m$icaid    
program "u title ,,xix ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acif et  
seq472  7#b7 ! impact ( ! ,food z       
,m$ic9e program on1 ) respect to        
individuals p>ticipat+ 9 su* program1 ! 
appropriate heal?1 nutrition1 &         
associat$ behavioral outcome basel9e    

in=mation = su* individuals t is        
relevant to ! /at$ goals & desir$       
outcomes ( ! pilot project2  7#c7 to !  
ext5t possible1 ! ,food z ,m$ic9e       
,program's impact on hospital admissions
 & readmissions1 admissions into        
long-t]m c>e facilities1 m$ication      
utilization1 em]g5cy room utilization   
rates1 prim>y c>e1 specialty c>e1 prim>y
 c>e m$ical home engagem5t1 pati5t      
exp]i5ce1 & heal? c>e team engagem5t2   
7#d7 o!r relevant f9d+s1 includ+        
recomm5dations on /r5g!n+ ! adm9i/ration
 ( ! program & res\rces ne$$ to support 
& /r5g!n ! ,food z ,m$ic9e program4  7f7
 ,def9itions ,9 ?is section3 7#a7 ,! t]m
 cov]$ me?od ( production means1 )      
respect to an agricultural product1 t ! 
product is-- 7,a7 reg5]atively produc$2 
7,b7 organically produc$2 or  7,c7      
reg5]atively & organically produc$4     
7#b7 ,! t]m ,food z ,m$ic9e program     
means a program "u :i* a ,/ate pursuant 
to a waiv] "u section #aaae ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #acae7    

provides to individuals eligible to     
receive m$ical assi/ance "u su* waiv]   
m$ically supportive food & nutrition    
int]v5tions4  7#c7 ,! t]m food hub means
 a bus9ess or organization t actively   
manages ! aggregation1 di/ribution1 &   
m>ket+ ( s\rce-id5tifi$ food products   
prim>ily f local & regional produc]s to 
/r5g!n _! ability to satisfy :olesale1  
retail1 & in/itutional dem&4  7#d7 7,a7 
,! t]m m$ically supportive food &       
nutrition int]v5tions means int]v5tions 
t provide culturally-appropriate1       
nutri5t-ri* :ole food 7includ+ any fre% 
vegetables & fruit1 legume1 nut1 se$1   
:ole gra91 l[-m]cury & high-omega-#c    
fatty acid seafood1 or lean animal      
prote97 prescrib$ by a heal? c>e        
pr(essional = ! prev5tion1 rev]sal1 or  
treatm5t ( c]ta9 heal? conditions4  7,b7
 ,su* t]m includes ! foll[+ int]v5tions3
 7i7 ,meals t are-- 7,i7 tailor$ to a   
recipi5t's heal? conditions by a regi/]$
 dietitian nutritioni/ & adh]e to /&>ds 
in=m$ by available diet>y recomm5dations

 = specific heal? conditions or diet>y  
!rapies4 bas$ on evid5ce-bas$           
nutritional practice guidel9es2 &       
7,,ii7 consi/5t ) ! ,diet>y ,guidel9es =
 ,am]icans e/abli%$ "u section #cja ( ! 
,national ,nutrition ,monitor+ & ,relat$
 ,rese>* ,act ( #aiij 7#g ,u4,s4,c4     
#ecda74  7ii7 ,produce 7vegetables &    
fruit7 prescriptions1 deliv]$ or procur$
 f 9 a groc]y /ore1 f>m1 f>m]s' m>ket1  
or food hub1 t are consi/5t ) ! ,diet>y 
,guidel9es = ,am]icans e/abli%$ "u      
section #cja ( ! ,national ,nutrition   
,monitor+ & ,relat$ ,rese>* ,act ( #aiij
 7#g ,u4,s4,c4 #ecda74  7iii7 ,nutrition
 coa*+ or c\nsel+1 gr\p m$ical visits1  
cook+ education & tools1 heal? coa*+1 & 
o!r behavioral supports bas$ on a       
recipi5t's m$ical conditions1 :5 pair$ )
 ! int]v5tions describ$ 9 subp>agraphs  
7,a7 & 7,b74  7#e7 ,! t]m organically   
produc$ means1 ) respect to an          
agricultural product1 t ! product is--  
7,a7 c]tifi$ "u ! ,organic ,foods       
,production ,act ( #aiij 7#g ,u4,s4,c4  

#feja et seq47 z organically produc$2 or
  7,b7 v]ifi$ ?r\gh a community-bas$1   
culturally-appropriate v]ification      
program "u ! ,organic ,foods ,production
 ,act ( #aiij z organically produc$4    
7#f7 ,! t]m reg5]atively produc$ means1 
) respect to an agricultural product1 t 
! product is produc$-- 7,a7 us+ an      
integrat$ approa* to f>m+ & ran*+ root$ 
9 ! pr9ciples ( soil heal? lead+ to     
improv$ t>get outcomes1 includ+-- 7i7   
build+ soil heal?2  7ii7 re/or+ &       
ma9ta9+ wat] res\rces2  7iii7 protect+  
air quality2  7iv7 seque/]+ gre5h\se gas
 emissions2  7v7 us+ su/a9able &        
integrat$ pe/ managem5t to elim9ate     
reliance on pe/icides2  7vi7 improv+    
nutri5t cycl+ to r$uce use ( ext]nal    
f]tiliz]s2  7vii7 support+ ,native-l$   
/ew>d%ip practices 7z describ$ 9 ,ord]  
,no4 #cdjc entitl$ ,jo9t ,secret>ial    
,ord] on ,fulfill+ ! ,tru/              
,responsibility to ,indian ,tribes 9 !  
,/ew>d%ip ( ,f$]al ,l&s & ,wat]s publi%$
 jo9tly by ! ,secret>y ( ,agriculture & 

! ,secret>y ( ! ,int]ior on ,novemb]    
#ae1 #bjba72 &  7viii7 fo/]+ wildlife & 
animal welf>e2 &  7,b7 9 a mann] t fo/]s
 community & social wellness1 includ+-- 
7i7 improv+ human heal? 9 rural & urban 
communities2  7ii7 creat+ supportive    
livelihoods 7work] conditions1 safety7 &
 durable solutions = a heal?y food &    
agriculture work=ce2  7iii7 creat+      
economic vitality = f>m]s1 ran*]s1 & a  
heal?y food & agriculture work=ce2 &    
7iv7 optimiz+ ! above t>get outcomes to 
ensure t !re is m9imal negative impact  
on o!r t>get outcomes4  7#g7 ,! t]m     
reg5]atively-organically produc$ means1 
) respect to an agricultural product1 t 
! product is produc$-- 7,a7 us+ "s      
organic me?ods1 z describ$ 9 ! ,organic 
,foods ,production ,act ( #aiij 7#g     
,u4,s4,c4 #feja et seq472 &  7,b7 us+ "s
 me?ods includ$ 9 ! integrat$ approa*   
describ$ 9 p>agraph 7#e74  7#h7 ,! t]m  
,/ate ea* ( ! sev]al ,/ates & ea*       
t]ritory & possession ( ! ,unit$ ,/ates4
  #c4 ,dep>tm5t ( ,agriculture ,food z  

,m$ic9e te*nical assi/ance program  7a7 
,9 g5]al ,! ,secret>y ( ,agriculture    
7ref]r$ to 9 ?is section z ! ,secret>y7 
%all ent] into coop]ative agreem5ts )   
eligible entities to provide te*nical   
assi/ance & infra/ructure support to    
produc]s to enable su* produc]s to      
connect ) local heal? c>e provid]s =    
purposes ( provid+ nutriti\s food "u a  
,food is ,m$ic9e program e/abli%$ or    
exp&$ pursuant to section #b4 ,an       
eligible entity may "w 9 collaboration )
 a ,regional ,food ,bus9ess ,c5t] ( !   
,dep>tm5t ( ,agriculture to provide su* 
te*nical assi/ance "u a coop]ative      
agreem5t4  7b7 ,application ,an eligible
 entity seek+ to ent] into a coop]ative 
agreem5t "u ?is section %all 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
 select+ eligible entities ) :i* to ent]
 into coop]ative agreem5ts "u ?is       
section1 ! ,secret>y %all give priority 
to applications conta9+ proposals-- 7#a7

 to provide te*nical assi/ance &        
infra/ructure support to beg9n+ f>m]s & 
ran*]s 7z def9$ 9 section #cdc7;a7 ( !  
,consolidat$ ,f>m & ,rural ,developm5t  
,act 7#g ,u4,s4,c4 #aiia7;a777 &        
socially disadvantag$ f>m]s & ran*]s 7z 
def9$ 9 section #cee7;e7 ( !            
,consolidat$ ,f>m & ,rural ,developm5t  
,act 7#g ,u4,s4,c4 #bjjc7;e7772 &  7#b7 
to provide te*nical assi/ance &         
infra/ructure support to produc]s t     
produce agricultural products 7z def9$ 9
 section #bjg ( ! ,agricultural ,m>ket+ 
,act ( #aidf 7#g ,u4,s4,c4 #afbf77 t are
 produc$ us+ a cov]$ me?od ( production 
7z def9$ 9 section #b7 or v]ifi$ ?r\gh  
community-bas$1 culturally appropriate  
v]ification programs4  7d7 ,def9itions  
,9 ?is section3 7#a7 ,! t]m ,food is    
,m$ic9e program has ! mean+ giv5 su* t]m
 9 section #b4  7#b7 ,! t]m eligible    
entity means-- 7,a7 a l&-grant college  
or univ]sity2  7,b7 a food hub 7z def9$ 
9 section #b72 or  7,c7 a ,regional     
,food ,bus9ess ,c5t] support$ by !      

,dep>tm5t ( ,agriculture4  7#c7 ,! t]m  
l&-grant college or univ]sity has !     
mean+ giv5 ! t]m l&-grant colleges &    
univ]sities 9 section #adjd ( !         
,national ,agricultural ,rese>*1        
,ext5sion1 & ,tea*+ ,policy ,act ( #aigg
 7#g ,u4,s4,c4 #cajc74  #d4 ,report to  
,congress ,n lat] ?an "o ye> aft] ! date
 on :i* ! fir/ grant is aw>d$ "u section
 #b1 ! ,secret>y ( ,heal? & ,human      
,s]vices1 9 consultation ) ! ,secret>y (
 ,agriculture1 %all submit to ,congress 
a report t includes ! in=mation receiv$ 
f ! ,/ates "u section #b & ! ,secret>y's
 recomm5dations ) respect to be/        
practices = c>ry+ out a ,food is ,m$ic9e
 program4  #e4 ,food z ,m$ic9e ,guidance
  7a7 ,9 g5]al ,n lat] ?an "o ye> aft] !
 date ( ! enactm5t ( ?is ,act1 !        
,secret>y ( ,heal? & ,human ,s]vices1 9 
consultation ) ! (ficials & /akehold]s  
describ$ 9 subsection 7c71 %all develop 
& issue-- 7#a7 recomm5dations = ,/ates &
 c\nties to implem5t or exp& a ,food z  
,m$ic9e program 7z def9$ 9 section #b71 

cl9ical nutrition tra9+ = heal? c>e     
provid]s1 & nutritional & behavioral    
support = pati5ts to integrate food     
int]v5tions into daily habits2 &  7#b7  
guidance relat$ to-- 7,a7 h[ a ,/ate may
 include food insecurity & or nutrition 
insecurity z conditions mak+ an         
individual eligible to p>ticipate 9     
,food z ,m$ic9e programs1 9 addition to 
eligible populations ) *ronic           
conditions2  7,b7 eligible populations t
 address food insecurity1 nutrition     
insecurity1 & *ronic conditions2  7,c7 !
 duration & dosage ( m$ically supportive
 food & nutrition int]v5tion plans2     
7,d7 ! value-bas$ procurem5t ( food     
?r\gh a manag$ c>e rate sett+ process t 
includes m9imum p]c5tages & ti]-bas$    
inc5tives to increase ! procurem5t (    
products gr[n us+ cov]$ me?ods (        
production 7z def9$ 9 section #b7 by    
socially disadvantag$ f>m]s & ran*]s 7z 
def9$ 9 section #beja ( ! ,food1        
,agriculture1 ,cons]vation1 & ,trade    
,act ( #aiij 7#g ,u4,s4,c4 #bbgi772     

7,e7 det]m9ation ( provid]s p]mitt$ to  
provide m$ically supportive food &      
nutrition int]v5tions 7z def9$ 9 section
 #b72 &  7,f7 cont9u+ education = heal? 
c>e provid]s prescrib+ m$ically         
supportive food & nutrition int]v5tions4
  7b7 ,public comm5t p]iod ,! ,secret>y 
%all provide = #cj-;day public comm5t   
p]iod ) respect to any propos$ guidance 
issu$ "u ?is section4 ,su* guidance %all
 n be f9aliz$ until ! date t is #fj days
 aft] ! close ( su* public comm5t p]iod4
  7c7 ,(ficials & /akehold]s describ$ ,!
 (ficials & /akehold]s describ$ 9 ?is   
subsection include ! foll[+3 7#a7 ,!    
heads ( appropriate ,f$]al ag5cies )9 ! 
,dep>tm5t ( ,heal? & ,human ,s]vices4   
7#b7 ,! ,secret>y ( ,agriculture4  7#c7 
,div]se /akehold]s f community-bas$     
organizations1 small- to m$ium-siz$ f>ms
 op]at$ by socially disadvantag$ f>m]s &
 ran*]s1 food hubs1 heal? c>e provid]s1 
& ,m$icaid manag$ c>e organizations :o h
 help$ to implem5t ,food z ,m$ic9e      
programs4