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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9631 Introduced in House (IH)]
<DOC>
118th CONGRESS
2d Session
H. R. 9631
To provide for the establishment or expansion of Food as Medicine
programs, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 17, 2024
Ms. Lee of California introduced the following bill; which was referred
to the Committee on Energy and Commerce, and in addition to the
Committee on Agriculture, for a period to be subsequently determined by
the Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To provide for the establishment or expansion of Food as Medicine
programs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``National Food as Medicine Program
Act of 2024''.
SEC. 2. FOOD AS MEDICINE MEDICAID WAIVER GRANT PROGRAM.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall establish a
program under which the Secretary shall award grants to States to plan,
implement, expand, or evaluate Food as Medicine programs.
(b) Application.--A State seeking a grant under this section shall
submit an application to the Secretary at such time, in such manner,
and containing such information as the Secretary may require.
(c) Priority.--In awarding grants under this section, the Secretary
shall give priority to States that have, as of the date of submission
of the application for a grant under this section, a partnership with--
(1) a network of health care providers that includes
public, nonprofit, and community-based organizations or
entities, and community health clinics, including Federally
qualified health centers (as defined in section 1861 of the
Social Security Act (42 U.S.C. 1395x)); or
(2) public, nonprofit, socially disadvantaged, and
community-based organizations or entities that provide locally-
sourced (or regionally-sourced, if locally-sourced produce is
not available) agricultural products (as defined in section 207
of the Agricultural Marketing Act of 1946 (7 U.S.C. 1626))
grown, or working to transition to, a covered method of
production.
(d) Use of Funds.--A State that receives a grant under this
section shall use funds received through the grant to establish,
implement, and expand Food as Medicine interventions to reduce
nutrition-related chronic conditions, address food and nutrition
insecurity, and improve health through providing locally-sourced (or
regionally-sourced, if locally-sourced produce is not available)
agricultural products grown, or working to transition to, a covered
method of production.
(e) Report to the Secretary.--Not less than 3 years after the date
on which a State receives a grant under this section, such State shall
provide to the Secretary a report that contains--
(1) an evaluation of the impact of the Food as Medicine
program established or expanded in such State, including
relevant data collected under the Medicaid program under title
XIX of the Social Security Act (42 U.S.C. 1396 et seq.);
(2) the impact of the Food as Medicine program on, with
respect to individuals participating in such program, the
appropriate health, nutrition, and associated behavioral
outcome baseline information for such individuals that is
relevant to the stated goals and desired outcomes of the pilot
project;
(3) to the extent possible, the Food as Medicine Program's
impact on hospital admissions and readmissions, admissions into
long-term care facilities, medication utilization, emergency
room utilization rates, primary care, specialty care, primary
care medical home engagement, patient experience, and health
care team engagement;
(4) other relevant findings, including recommendations on
strengthening the administration of the program and resources
needed to support and strengthen the Food as Medicine program.
(f) Definitions.--In this section:
(1) The term ``covered method of production'' means, with
respect to an agricultural product, that the product is--
(A) regeneratively produced;
(B) organically produced; or
(C) regeneratively and organically produced.
(2) The term ``Food as Medicine program'' means a program
under which a State pursuant to a waiver under section 1115 of
the Social Security Act (42 U.S.C. 1315) provides to
individuals eligible to receive medical assistance under such
waiver medically supportive food and nutrition interventions.
(3) The term ``food hub'' means a business or organization
that actively manages the aggregation, distribution, and
marketing of source-identified food products primarily from
local and regional producers to strengthen their ability to
satisfy wholesale, retail, and institutional demand.
(4)(A) The term ``medically supportive food and nutrition
interventions'' means interventions that provide culturally-
appropriate, nutrient-rich whole food (including any fresh
vegetables and fruit, legume, nut, seed, whole grain, low-
mercury and high-omega-3 fatty acid seafood, or lean animal
protein) prescribed by a health care professional for the
prevention, reversal, or treatment of certain health
conditions.
(B) Such term includes the following interventions:
(i) Meals that are--
(I) tailored to a recipient's health
conditions by a registered dietitian
nutritionist and adhere to standards informed
by available dietary recommendations for
specific health conditions or dietary
therapies. based on evidence-based nutritional
practice guidelines; and
(II) consistent with the Dietary Guidelines
for Americans established under section 301 of
the National Nutrition Monitoring and Related
Research Act of 1990 (7 U.S.C. 5341).
(ii) Produce (vegetables and fruit) prescriptions,
delivered or procured from in a grocery store, farm,
farmers' market, or food hub, that are consistent with
the Dietary Guidelines for Americans established under
section 301 of the National Nutrition Monitoring and
Related Research Act of 1990 (7 U.S.C. 5341).
(iii) Nutrition coaching or counseling, group
medical visits, cooking education and tools, health
coaching, and other behavioral supports based on a
recipient's medical conditions, when paired with the
interventions described in subparagraphs (A) and (B).
(5) The term ``organically produced'' means, with respect
to an agricultural product, that the product is--
(A) certified under the Organic Foods Production
Act of 1990 (7 U.S.C. 6501 et seq.) as organically
produced; or
(B) verified through a community-based, culturally-
appropriate verification program under the Organic
Foods Production Act of 1990 as organically produced.
(6) The term ``regeneratively produced'' means, with
respect to an agricultural product, that the product is
produced--
(A) using an integrated approach to farming and
ranching rooted in the principles of soil health
leading to improved target outcomes, including--
(i) building soil health;
(ii) restoring and maintaining water
resources;
(iii) protecting air quality;
(iv) sequestering greenhouse gas emissions;
(v) using sustainable and integrated pest
management to eliminate reliance on pesticides;
(vi) improving nutrient cycling to reduce
use of external fertilizers;
(vii) supporting Native-led stewardship
practices (as described in Order No. 3403
entitled ``Joint Secretarial Order on
Fulfilling the Trust Responsibility to Indian
Tribes in the Stewardship of Federal Lands and
Waters'' published jointly by the Secretary of
Agriculture and the Secretary of the Interior
on November 15, 2021); and
(viii) fostering wildlife and animal
welfare; and
(B) in a manner that fosters community and social
wellness, including--
(i) improving human health in rural and
urban communities;
(ii) creating supportive livelihoods
(worker conditions, safety) and durable
solutions for a healthy food and agriculture
workforce;
(iii) creating economic vitality for
farmers, ranchers, and a healthy food and
agriculture workforce; and
(iv) optimizing the above target outcomes
to ensure that there is minimal negative impact
on other target outcomes.
(7) The term ``regeneratively-organically produced'' means,
with respect to an agricultural product, that the product is
produced--
(A) using some organic methods, as described in the
Organic Foods Production Act of 1990 (7 U.S.C. 6501 et
seq.); and
(B) using some methods included in the integrated
approach described in paragraph (5).
(8) The term ``State'' each of the several States and each
territory and possession of the United States.
SEC. 3. DEPARTMENT OF AGRICULTURE FOOD AS MEDICINE TECHNICAL ASSISTANCE
PROGRAM.
(a) In General.--The Secretary of Agriculture (referred to in this
section as the ``Secretary'') shall enter into cooperative agreements
with eligible entities to provide technical assistance and
infrastructure support to producers to enable such producers to connect
with local health care providers for purposes of providing nutritious
food under a Food is Medicine program established or expanded pursuant
to section 2. An eligible entity may work in collaboration with a
Regional Food Business Center of the Department of Agriculture to
provide such technical assistance under a cooperative agreement.
(b) Application.--An eligible entity seeking to enter into a
cooperative agreement under this section shall submit to the Secretary
an application at such time, in such manner, and containing such
information as the Secretary may require.
(c) Priority.--In selecting eligible entities with which to enter
into cooperative agreements under this section, the Secretary shall
give priority to applications containing proposals--
(1) to provide technical assistance and infrastructure
support to beginning farmers and ranchers (as defined in
section 343(a) of the Consolidated Farm and Rural Development
Act (7 U.S.C. 1991(a))) and socially disadvantaged farmers and
ranchers (as defined in section 355(e) of the Consolidated Farm
and Rural Development Act (7 U.S.C. 2003(e))); and
(2) to provide technical assistance and infrastructure
support to producers that produce agricultural products (as
defined in section 207 of the Agricultural Marketing Act of
1946 (7 U.S.C. 1626)) that are produced using a covered method
of production (as defined in section 2) or verified through
community-based, culturally appropriate verification programs.
(d) Definitions.--In this section:
(1) The term ``Food is Medicine program'' has the meaning
given such term in section 2.
(2) The term ``eligible entity'' means--
(A) a land-grant college or university;
(B) a food hub (as defined in section 2); or
(C) a Regional Food Business Center supported by
the Department of Agriculture.
(3) The term ``land-grant college or university'' has the
meaning given the term ``land-grant colleges and universities''
in section 1404 of the National Agricultural Research,
Extension, and Teaching Policy Act of 1977 (7 U.S.C. 3103).
SEC. 4. REPORT TO CONGRESS.
Not later than one year after the date on which the first grant is
awarded under section 2, the Secretary of Health and Human Services, in
consultation with the Secretary of Agriculture, shall submit to
Congress a report that includes the information received from the
States under section 2 and the Secretary's recommendations with respect
to best practices for carrying out a Food is Medicine program.
SEC. 5. FOOD AS MEDICINE GUIDANCE.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Health and Human Services, in
consultation with the officials and stakeholders described in
subsection (c), shall develop and issue--
(1) recommendations for States and counties to implement or
expand a Food as Medicine program (as defined in section 2),
clinical nutrition training for health care providers, and
nutritional and behavioral support for patients to integrate
food interventions into daily habits; and
(2) guidance related to--
(A) how a State may include food insecurity and or
nutrition insecurity as conditions making an individual
eligible to participate in Food as Medicine programs,
in addition to eligible populations with chronic
conditions;
(B) eligible populations that address food
insecurity, nutrition insecurity, and chronic
conditions;
(C) the duration and dosage of medically supportive
food and nutrition intervention plans;
(D) the value-based procurement of food through a
managed care rate setting process that includes minimum
percentages and tier-based incentives to increase the
procurement of products grown using covered methods of
production (as defined in section 2) by socially
disadvantaged farmers and ranchers (as defined in
section 2501 of the Food, Agriculture, Conservation,
and Trade Act of 1990 (7 U.S.C. 2279));
(E) determination of providers permitted to provide
medically supportive food and nutrition interventions
(as defined in section 2); and
(F) continuing education for health care providers
prescribing medically supportive food and nutrition
interventions.
(b) Public Comment Period.--The Secretary shall provide for 30-day
public comment period with respect to any proposed guidance issued
under this section. Such guidance shall not be finalized until the date
that is 60 days after the close of such public comment period.
(c) Officials and Stakeholders Described.--The officials and
stakeholders described in this subsection include the following:
(1) The heads of appropriate Federal agencies within the
Department of Health and Human Services.
(2) The Secretary of Agriculture.
(3) Diverse stakeholders from community-based
organizations, small- to medium-sized farms operated by
socially disadvantaged farmers and ranchers, food hubs, health
care providers, and Medicaid managed care organizations who
have helped to implement Food as Medicine programs.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Agriculture, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Agriculture, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Nutrition, Foreign Agriculture, and Horticulture.
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