Health Equity and Accountability Act of 2026

In this title:

(1) Administrator.— The term Administrator means the Administrator of the Environmental Protection Agency.

(2) Agency.— The term Agency means the Environmental Protection Agency.

(3) Built environment.— The term built environment means the components of the environment, and the location of those components in a geographically defined space, that are created or modified by individuals to form the physical and social characteristics of a community or enhance quality of human life, including—

(A) homes, schools, and places of work and worship;

(B) parks, recreation areas, and greenways;

(C) transportation systems;

(D) business, industry, and agriculture; and

(E) land-use plans, projects, and policies that impact the physical or social characteristics of a community, including access to services and amenities.

(4) Determinants of health.— The term determinants of health—

(A) means the range of nonclinical factors inclusive of personal, social, economic, and environmental factors that directly influence health status; and

(B) includes social determinants of health.

(5) Economic determinants of health.— The term economic determinants of health means income and social status.

(6) Environmental determinants of health.— The term environmental determinants of health means the broad physical (including manmade and natural), psychological, social, spiritual, cultural, and aesthetic environment.

(7) Personal determinants of health.— The term personal determinants of health means an individual’s behavior, biology, and genetics.

(8) Secretary.— The term Secretary means the Secretary of Health and Human Services.

(9) Social determinants of health.— The term social determinants of health—

(A) means a subset of determinants of the health of individuals and environments (such as communities, neighborhoods, and societies) that describe an individual’s or group of people’s social identity, describe the social and economic resources to which such individual or group has access, and describe the conditions in which an individual or group of people works, lives, and plays; and

(B) are sometimes referred to as “social and economic determinants of health”, “socioeconomic determinants of health”, “environmental determinants of health”, “social drivers of inequality”, or “personal determinants of health”.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.), as amended by section 7901C–1(a), is further amended by adding at the end the following:

“399V–15. Health impact assessments.—

(a) Definitions.— In this section:

(1) Administrator.— The term Administrator means the Administrator of the Environmental Protection Agency.

(2) Director.— The term Director means the Director of the Centers for Disease Control and Prevention.

(3) Health impact assessment.— The term health impact assessment means a systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. Such term includes identifying and recommending appropriate actions on monitoring and maximizing potential benefits and minimizing potential harms.

(4) Health inequity.— The term health inequity means a particular type of health difference that is closely linked with social, economic, or environmental disadvantage and that adversely affects groups of people who have systematically experienced greater obstacles to health based on their—

(A) racial or ethnic group;

(B) religion;

(C) socioeconomic status;

(D) gender;

(E) age;

(F) mental health;

(G) cognitive, sensory, or physical disability;

(H) sexual orientation or gender identity;

(I) geographic location;

(J) citizenship status; or

(K) other characteristics historically linked to discrimination or exclusion.

(b) Establishment.— The Secretary, acting through the Director and in collaboration with the Administrator, shall—

(1) in consultation with the Director of the National Center for Chronic Disease Prevention and Health Promotion and the heads of relevant offices within the Department of Housing and Urban Development, the Department of Transportation, and the Department of Agriculture, establish a program at the National Center for Environmental Health of the Centers for Disease Control and Prevention focused on advancing the field of health impact assessment that includes—

(A) collecting and disseminating best practices;

(B) administering capacity building grants to States, Indian Tribes, and Tribal organizations to support subgrantees in initiating health impact assessments, in accordance with subsection (d);

(C) providing technical assistance;

(D) developing training tools and providing training on conducting a health impact assessment and the implementation of built environment and health indicators;

(E) making information available, as appropriate, regarding the existence of other community healthy living tools, checklists, and indices that help connect public health to other sectors, and tools to help examine the effect of the indoor built environment and building codes on population health;

(F) conducting research and evaluations of health impact assessments; and

(G) awarding competitive extramural research grants;

(2) develop guidance and guidelines to conduct health impact assessments in accordance with subsection (c); and

(3) establish a grant program to allow States, Indian Tribes, and Tribal organizations to award subgrants to eligible entities to conduct health impact assessments.

(c) Guidance.—

(1) In general.— Not later than 1 year after the date of enactment of the Health Equity and Accountability Act of 2026, the Secretary, acting through the Director, shall issue final guidance for conducting health impact assessments. In developing such guidance, the Secretary shall—

(A) consult with the Director of the National Center for Environmental Health, the Director of the National Center for Chronic Disease Prevention and Health Promotion, and the heads of relevant offices within the Department of Housing and Urban Development, the Department of Transportation, and the Department of Agriculture; and

(B) consider available international health impact assessment guidance, North American health impact assessment practice standards, and recommendations from the National Academy of Sciences.

(2) Content.— The guidance under this subsection shall include—

(A) background on national and international efforts to bridge urban planning, climate forecasting, and public health institutions and disciplines, including a review of health impact assessment best practices internationally;

(B) evidence-based direct and indirect pathways that link land-use planning, transportation, and housing policy and objectives to human health outcomes;

(C) data resources and quantitative and qualitative forecasting methods to evaluate both the status of health determinants and health effects, including identification of existing programs that can disseminate these resources;

(D) best practices for inclusive public involvement in conducting health impact assessments; and

(E) technical assistance for other agencies seeking to develop their own guidelines and procedures for health impact assessment.

(d) Grant program.—

(1) In general.— The Secretary, acting through the Director and in collaboration with the Administrator, shall—

(A) award grants to States, Indian Tribes, and Tribal organizations to award subgrants to eligible entities for capacity building or to prepare health impact assessments; and

(B) ensure that States, Indian Tribes, and Tribal organizations receiving a grant under this subsection further support training and technical assistance for subgrantees under subparagraph (A) by funding and overseeing appropriate experts on health impact assessments from local, State, and Tribal governments, the Federal Government, institutions of higher education, and nonprofit organizations to provide such training and technical assistance.

(2) Applications for subgrants.—

(A) In general.— To be eligible to receive a subgrant under this subsection, an eligible entity shall—

(i) be a community-based organization serving individuals or populations, the health of which are, or will be, affected by an activity or a proposed activity; and

(ii) submit to the grantee an application in accordance with this subsection, at such time, in such manner, and containing such additional information as the Secretary (acting through the Director and in collaboration with the Administrator) and the grantee may require.

(B) Inclusion.— An application for a subgrant under this subsection shall include—

(i) a list of proposed activities that require or would benefit from conducting a health impact assessment by not later than 180 days after receiving the subgrant;

(ii) supporting documentation, including letters of support, from potential conductors of health impact assessments for the listed proposed activities;

(iii) an assessment by the applicant of the health of the population to be served through the subgrant; and

(iv) a description of potential adverse or positive effects on health that the proposed activities may create.

(C) Preference.— In awarding subgrants under this subsection, a State may give preference to eligible entities that demonstrate the potential to significantly improve population health or lower health care costs as a result of potential health impact assessment work.

(3) Use of funds.—

(A) In general.— A State, Indian Tribe, or Tribal organization receiving a grant under this subsection shall use such grant to conduct health impact assessment capacity building in support of a subgrantee conducting a health impact assessment for a proposed activity in accordance with this subsection.

(B) Purposes.— The purposes of a health impact assessment under this subsection are—

(i) to facilitate the involvement of Tribal, State, and local public health officials in community planning, transportation, housing, and land use decisions and other decisions affecting the built environment to identify any potential health concern or health benefit relating to an activity or proposed activity;

(ii) to provide for an investigation of any health-related issue of concern raised in a planning process, an environmental impact assessment process, or policy appraisal relating to a proposed activity;

(iii) to describe and compare alternatives (including no-action alternatives) to a proposed activity to provide clarification with respect to the potential health outcomes associated with the proposed activity and, where appropriate, to the related benefit-cost or cost-effectiveness of the proposed activity and alternatives;

(iv) to contribute, when applicable, to the findings of a planning process, policy appraisal, or an environmental impact statement with respect to the terms and conditions of implementing a proposed activity or related mitigation recommendations, as necessary;

(v) to ensure that the disproportionate distribution of negative impacts among vulnerable populations is minimized as much as possible;

(vi) to engage affected community members and ensure adequate opportunity for public comment on all stages of the health impact assessment;

(vii) where appropriate, to consult with local and county health departments and appropriate organizations, including planning, transportation, and housing organizations, and provide them information and tools regarding how to conduct and integrate health impact assessment into their work; and

(viii) to inspect homes, water systems, and other elements that pose risks to lead exposure, with an emphasis on areas that pose a higher risk to children.

(4) Assessments.— Health impact assessments carried out using funds under this section shall—

(A) take appropriate health factors into consideration as early as practicable during the planning, review, or decision-making processes;

(B) assess the effect on the health of individuals and populations of proposed policies, projects, or plans that result in modifications to the built environment; and

(C) assess the distribution of health effects across various factors, such as race, income, ethnicity, age, disability status, gender, and geography.

(5) Eligible activities.—

(A) In general.— A State, Indian Tribe, or Tribal organization receiving a grant under this section shall conduct an evaluation of any activity proposed to be funded through the grant, including through a subgrant, to determine whether such activity will have a significant adverse or positive effect on the health of the affected population to be served, based on the criteria described in subparagraph (B).

(B) Criteria.— The criteria described in this subparagraph include, as applicable to the proposed activity, the following:

(i) Any substantial adverse effect or significant health benefit on health outcomes or factors known to influence health, including the following:

(I) Physical activity.

(II) Injury.

(III) Mental health.

(IV) Accessibility to health-promoting goods and services.

(V) Respiratory health.

(VI) Chronic disease.

(VII) Nutrition.

(VIII) Land use changes that promote local, sustainable food sources.

(IX) Infectious disease.

(X) Health inequities.

(XI) Existing air quality, ground or surface water quality or quantity, or noise levels.

(XII) Lead exposure.

(XIII) Drinking water quality and accessibility.

(ii) Other factors that may be considered, including—

(I) the potential for a proposed activity to result in systems failure that leads to a public health emergency;

(II) the probability that the proposed activity will result in a significant increase in tourism, economic development, or employment in the population to be served;

(III) any other significant potential hazard or enhancement to human health, as determined by the grantee; or

(IV) whether the evaluation of a proposed activity would duplicate another analysis or study being undertaken in conjunction with the proposed activity.

(C) Factors for consideration.— In evaluating a proposed activity under subparagraph (A), a grantee may take into consideration any reasonable, direct, indirect, or cumulative effect that can be clearly related to potential health effects and that is related to the proposed activity, including the effect of any action that is—

(i) included in the long-range plan relating to the proposed activity;

(ii) likely to be carried out in coordination with the proposed activity;

(iii) dependent on the occurrence of the proposed activity; or

(iv) likely to have a disproportionate impact on high-risk or vulnerable populations.

(6) Requirements.— A health impact assessment prepared with funds awarded under this subsection shall incorporate the following, after conducting the screening phase (identifying projects or policies for which a health impact assessment would be valuable and feasible) through the application process:

(A) Scoping.— Identifying which health effects to consider and the research methods to be utilized.

(B) Assessing risks and benefits.— Assessing the baseline health status and factors known to influence the health status in the affected community, which may include aggregating and synthesizing existing health assessment evidence and data from the community.

(C) Developing recommendations.— Suggesting changes to proposals to promote positive or mitigate adverse health effects.

(D) Reporting.— Synthesizing the assessment and recommendations and communicating the results to decision makers.

(E) Monitoring and evaluating.— Tracking the decision and implementation effect on health determinants and health status.

(7) Plan.— A subgrantee under this subsection shall develop and implement a plan, to be approved by the Secretary (acting through the Director and in collaboration with the Administrator) and the grantee, for meaningful and inclusive stakeholder involvement in all phases of the health impact assessment. Stakeholders may include community leaders, community-based organizations, youth-serving organizations, planners, public health experts, State and local public health departments and officials, health care experts or officials, housing experts or officials, and transportation experts or officials.

(8) Submission of findings.— A grantee under this subsection shall submit the findings of any funded health impact assessment activities to the Secretary and make these findings publicly available.

(9) Assessment of impacts.— A subgrantee under this subsection shall ensure the assessment of the distribution of health impacts (related to the proposed activity) across race, ethnicity, income, age, gender, disability status, and geography.

(10) Conduct of assessment.— To the greatest extent feasible, a health impact assessment shall be conducted under this section in a manner that respects the needs and timing of the decision-making process such assessment evaluates.

(11) Methodology.— In preparing a health impact assessment funded under this subsection, a subgrantee under this subsection shall follow the guidance published under subsection (c).

(e) Health impact assessment database.— The Secretary, acting through the Director and in collaboration with the Administrator, shall establish, maintain, and make publicly available a health impact assessment database, including—

(1) a catalog of health impact assessments received under this section;

(2) an inventory of tools used by subgrantees to conduct health impact assessments; and

(3) guidance for subgrantees with respect to the selection of appropriate tools described in paragraph (2).

(f) Evaluation of grantee activities.— The Secretary shall award competitive grants to Prevention Research Centers, or nonprofit organizations or academic institutions with expertise in health impact assessments, to—

(1) assist grantees and subgrantees with the provision of training and technical assistance in the conducting of health impact assessments;

(2) evaluate the activities carried out with grants and subgrants under subsection (d); and

(3) assist the Secretary in disseminating evidence, best practices, and lessons learned from grantees and subgrantees.

(g) Report to Congress.— Not later than 1 year after the date of enactment of the Health Equity and Accountability Act of 2026, the Secretary shall submit to Congress a report concerning the evaluation of the programs under this section, including recommendations as to how lessons learned from such programs can be incorporated into future guidance documents developed and provided by the Secretary and other Federal agencies, as appropriate.

(h) Authorization of appropriations.— There are authorized to be appropriated to carry out this section such sums as may be necessary.

399V–16. Implementation of research findings to improve health outcomes through the built environment.—

(a) Research grant program.— The Secretary, in collaboration with the Administrator of the Environmental Protection Agency (referred to in this section as the “Administrator”), shall award grants to public agencies or private nonprofit institutions to implement evidence-based programming to improve human health through improvements to the built environment and subsequently human health, by addressing—

(1) levels of physical activity;

(2) consumption of nutritional foods;

(3) rates of crime;

(4) air, water, and soil quality;

(5) risk or rate of injury;

(6) accessibility to health-promoting goods and services;

(7) chronic disease rates;

(8) community design;

(9) housing;

(10) transportation options; and

(11) other factors as the Secretary determines appropriate.

(b) Applications.— A public agency or private nonprofit institution desiring a grant under this section shall submit to the Secretary an application at such time, in such manner, and containing such agreements, assurances, and information as the Secretary, in consultation with the Administrator, may require.

(c) Research.— The Secretary, in consultation with the Administrator, shall support, through grants awarded under this section, research that—

(1) uses evidence-based research to improve the built environment and human health;

(2) examines—

(A) the scope and intensity of the impacts that the built environment (including the various characteristics of the built environment) has on human health; or

(B) the distribution of such impacts by—

(i) location; and

(ii) population subgroup;

(3) is used to develop—

(A) measures and indicators to address health impacts and the connection of health to the built environment;

(B) efforts to link the measures to transportation, land use, and health databases; and

(C) efforts to enhance the collection of built environment surveillance data;

(4) distinguishes carefully between personal attitudes and choices and external influences on behavior to determine how much the association between the built environment and the health of residents, versus the lifestyle preferences of the people that choose to live in the neighborhood, reflects the physical characteristics of the neighborhood; and

(5)

(A) identifies or develops effective intervention strategies focusing on enhancements to the built environment that promote increased use, physical activity, access to nutritious foods, or other health-promoting activities by residents; and

(B) in developing the intervention strategies under subparagraph (A), ensures that the intervention strategies will reach out to high-risk or vulnerable populations, including low-income urban and rural communities and aging populations, in addition to the general population.

(d) Surveys.— The Secretary may allow recipients of grants under this section to use such grant funds to support the expansion of national surveys and data tracking systems to provide more detailed information about the connection between the built environment and health.

(e) Priority.— In awarding grants under this section, the Secretary and the Administrator shall give priority to entities with programming that incorporates—

(1) interdisciplinary approaches; or

(2) the expertise of the public health, physical activity, urban planning, land use, and transportation research communities in the United States and abroad.

(f) Authorization of appropriations.— There are authorized to be appropriated such sums as may be necessary to carry out this section. The Secretary may allocate not more than 20 percent of the amount so appropriated for a fiscal year for purposes of conducting research under subsection (c).”.

(a) Definitions.— In this section:

(1) Director.— The term Director means the Director of the Centers for Disease Control and Prevention, acting in collaboration with the Administrator and the Director of the National Institute of Environmental Health Sciences.

(2) Eligible entity.— The term eligible entity means a State, Indian Tribe, Tribal organization, or local community that—

(A) bears a disproportionate burden of exposure to environmental health hazards;

(B) bears a disproportionate burden of exposure to unhealthy living conditions, low standard housing conditions, low socioeconomic status, poor nutrition, less opportunity for educational attainment, disproportionately high unemployment rates, or lower literacy levels and access to information;

(C) has established a coalition—

(i) with not less than 1 community-based organization or demonstration program; and

(ii) with not less than 1—

(I) public health entity;

(II) health care provider organization;

(III) academic institution, including any minority-serving institution described in section 371(a) of the Higher Education Act of 1965 (20 U.S.C. 1067q(a));

(IV) child-serving institution; or

(V) landlord or housing provider working on lead remediation;

(D) ensures planned activities and funding streams are coordinated to improve community health; and

(E) submits an application in accordance with subsection (c).

(b) Establishment.— The Director shall establish a grant program under which eligible entities shall receive grants to conduct environmental health improvement activities and to improve social determinants of health.

(c) Application.— To receive a grant under this section, an eligible entity shall submit an application to the Director at such time, in such manner, and accompanied by such information as the Director may require.

(d) Use of grant funds.— An eligible entity may use a grant under this section—

(1) to promote environmental health;

(2) to address environmental health inequities among all populations, including children; and

(3) to address racial and ethnic inequities in social determinants of health.

(e) Amount of grants.— The Director shall award grants to eligible entities at the following 3 funding levels:

(1) Level 1 grants.—

(A) In general.— An eligible entity awarded a grant under this paragraph shall use the funds to identify environmental health problems and solutions by—

(i) establishing a planning and prioritizing council in accordance with subparagraph (B); and

(ii) conducting an environmental health assessment in accordance with subparagraph (C).

(B) Planning and prioritizing council.—

(i) In general.— A planning and prioritizing council established under subparagraph (A)(i) (referred to in this paragraph as a PPC) shall assist the environmental health assessment process and environmental health promotion activities of the eligible entity.

(ii) Membership.— Membership of a PPC shall consist of representatives from various organizations within public health, planning, development, and environmental services and shall include stakeholders from vulnerable groups such as children, the elderly, disabled, and minority ethnic groups that are often not actively involved in democratic or decision-making processes.

(iii) Duties.— A PPC shall—

(I) identify key stakeholders and engage and coordinate potential partners in the planning process;

(II) establish a formal advisory group to plan for the establishment of services;

(III) conduct an in-depth review of the nature and extent of the need for an environmental health assessment, including a local epidemiological profile, an evaluation of the service provider capacity of the community, and a profile of any target populations; and

(IV) define the components of care and form essential programmatic linkages with related providers in the community.

(C) Environmental health assessment.—

(i) In general.— A PPC shall carry out an environmental health assessment to identify environmental health concerns.

(ii) Assessment process.— The PPC shall—

(I) define the goals of the assessment;

(II) generate the environmental health issue list;

(III) analyze issues with a systems framework;

(IV) develop appropriate community environmental health indicators;

(V) rank the environmental health issues;

(VI) set priorities for action;

(VII) develop an action plan;

(VIII) implement the plan; and

(IX) evaluate progress and planning for the future.

(D) Evaluation.— Each eligible entity that receives a grant under this paragraph shall evaluate, report, and disseminate program findings and outcomes.

(E) Technical assistance.— The Director may provide such technical and other non-financial assistance to eligible entities as the Director determines to be necessary.

(2) Level 2 grants.—

(A) Eligibility.—

(i) In general.— The Director shall award grants under this paragraph to eligible entities that have already—

(I) established broad-based collaborative partnerships; and

(II) completed environmental assessments.

(ii) No level 1 requirement.— To be eligible to receive a grant under this paragraph, an eligible entity is not required to have successfully completed a Level 1 grant (as described in paragraph (1)).

(B) Use of grant funds.— An eligible entity awarded a grant under this paragraph shall use the funds to further activities to carry out environmental health improvement activities, including—

(i) addressing community environmental health priorities in accordance with paragraph (1)(C)(ii), including—

(I) geography;

(II) the built environment;

(III) air quality;

(IV) water quality;

(V) land use;

(VI) solid waste;

(VII) housing;

(VIII) violence;

(IX) socioeconomic status;

(X) ethnicity, social construct, and language preference;

(XI) educational attainment;

(XII) employment;

(XIII) food safety, accessibility, and affordability;

(XIV) nutrition;

(XV) health care services; and

(XVI) injuries;

(ii) building partnerships between planning, public health, and other sectors, including child-serving institutions, to address how the built environment impacts food availability and access and physical activity to promote healthy behaviors and lifestyles and reduce overweight and obesity, musculoskeletal diseases, respiratory conditions, infectious diseases, dental, oral, and mental health conditions, poverty, and related co-morbidities;

(iii) establishing programs to address—

(I) how environmental and social conditions of work and living choices influence physical activity and dietary intake; or

(II) how the conditions described in subclause (I) influence the concerns and needs of people who have impaired mobility and use assistance devices, including wheelchairs, lower limb prostheses, and hip, knee, and other joint replacements; and

(iv) convening intervention and demonstration programs that examine the role of the social environment in connection with the physical and chemical environment in—

(I) determining access to nutritional food;

(II) improving physical activity to reduce overweight, obesity, and co-morbidities and increase quality of life; and

(III) location and access to medical facilities.

(3) Level 3 grants.—

(A) In general.— An eligible entity awarded a grant under this paragraph shall use the funds to identify and address racial and ethnic inequities in social determinants of health by creating demonstration programs that assess the feasibility of establishing a federally funded comprehensive program and describe key outcomes that address racial and ethnic inequities in social determinants of health.

(B) Program Design.—

(i) Evaluation.— Not later than 1 year after the date of enactment of this Act, the Director shall evaluate the best practices of existing programs from the private, public, community-based, and academically supported initiatives focused on reducing inequities in the social determinants of health for racial and ethnic populations.

(ii) Demonstration projects.— Not later than 2 years after the date of enactment of this Act, the Director shall implement at least 12 demonstration projects, including at least one project for each major racial and ethnic minority group, each of which is unique to the cultural and linguistic needs of each of the following groups:

(I) Native Americans and Alaska Natives.

(II) Asian Americans.

(III) African Americans/Blacks.

(IV) Hispanic/Latino-Americans.

(V) Native Hawaiians and Pacific Islanders.

(VI) Middle Eastern and Northern African communities.

(iii) Report to Congress.— No later than 2 years after the implementation of the initial demonstration projects under this paragraph, the Director shall submit to Congress a report that includes—

(I) a description of each demonstration project and design;

(II) an evaluation of the cost-effectiveness of each project’s prevention and treatment efforts;

(III) an evaluation of the cultural and linguistic appropriateness of each project by racial and ethnic group; and

(IV) an evaluation of the beneficiary’s health status improvement under the demonstration project.

(iv) Any other information determined appropriate by the Director.— The Director shall require eligible entities awarded a grant under this paragraph to report any other information the Director determines appropriate to be shared by or developed by such entity, including the following:

(I) Developing models and evaluating methods that improve the cultural and linguistically appropriate services provided through the Centers for Disease Control and Prevention to target individuals impacted by health inequities based on their race, ethnicity, gender, or sexual orientation.

(II) Promoting the collaboration between primary and specialty care health care providers and patients, to ensure patients impacted by health inequities based on race, ethnicity, gender, or sexual orientation are receiving comprehensive and organized treatment and care.

(III) Educating health care professionals on the causes and effects of inequities in the social determinants of health in relation to minority and racial and ethnic communities and the need for culturally and linguistically appropriate care in the prevention and treatment of high-impact diseases.

(IV) Encouraging collaboration among community- and patient-based organizations that work to address inequities in the social determinants of health in relation to high-impact diseases in minority and racial and ethnic populations.

(f) Authorization of appropriations.— There are authorized to be appropriated to carry out this section—

(1) $25,000,000 for fiscal year 2027; and

(2) such sums as may be necessary for fiscal years 2028 through 2030.

(a) Definition of eligible institution.— In this section, the term eligible institution means a public or private nonprofit institution that submits to the Secretary and the Administrator an application for a grant under the grant program authorized under subsection (b)(2) at such time, in such manner, and containing such agreements, assurances, and information as the Secretary and Administrator may require.

(b) Research grant program.—

(1) Definition of health.— In this section, the term health includes—

(A) levels of physical activity;

(B) degree of mobility due to factors such as musculoskeletal diseases, arthritis, and obesity;

(C) consumption of nutritional foods;

(D) rates of crime;

(E) air, water, and soil quality;

(F) risk of injury;

(G) accessibility to health care services;

(H) levels of educational attainment; and

(I) other indicators as determined appropriate by the Secretary.

(2) Grants.— The Secretary, in collaboration with the Administrator, shall provide grants to eligible institutions to conduct and coordinate research on the built environment and its influence on individual and population-based health.

(3) Research.— The Secretary shall support research that—

(A) investigates and defines the causal links between all aspects of the built environment and the health of residents;

(B) examines—

(i) the extent of the impact of the built environment (including the various characteristics of the built environment) on the health of residents;

(ii) the variation in the health of residents by—

(I) location (such as inner cities, inner suburbs, outer suburbs, reservations, and rural areas); and

(II) population subgroup (including children, young adults, the elderly, the disadvantaged); or

(iii) the importance of the built environment to the total health of residents, which is the primary variable of interest from a public health perspective;

(C) is used to develop—

(i) measures to address health and the connection of health to the built environment; and

(ii) efforts to link the measures to travel and health databases;

(D) distinguishes carefully between personal attitudes and choices and external influences on observed behavior to determine how much an observed association between the built environment and the health of residents, versus the lifestyle preferences of the people that choose to live in the neighborhood, reflects the physical characteristics of the neighborhood; and

(E)

(i) identifies or develops effective intervention strategies to promote better health among residents with a focus on behavioral interventions and enhancements of the built environment that promote increased use by residents; and

(ii) in developing the intervention strategies under clause (i), ensures that the intervention strategies will reach out to high-risk populations, including racial and ethnic minorities, low-income urban and rural communities, and children.

(4) Priority.— In providing assistance under the grant program authorized under paragraph (2), the Secretary and the Administrator shall give priority to research that incorporates—

(A) minority-serving institutions as grantees;

(B) interdisciplinary approaches; or

(C) the expertise of the public health, physical activity, nutrition and health care (including child health), urban planning, and transportation research communities in the United States and abroad.

(a) Statement of policy.— It is the policy of the Federal Government to work in conjunction with States, territories, Tribal governments, international organizations, and foreign governments as a steward of the environment for the benefit of public health, to maintain air quality and water quality, to sustain the diversity of plant and animal species, to combat global climate change, and to protect the environment for future generations.

(b) Study and report on public health or environmental impact of revised rules, regulations, laws, or other agency decisions.—

(1) Study.— Not later than 30 days after the date of enactment of this Act, the President shall seek to enter into an arrangement under which the National Academy of Sciences shall conduct a study to determine the effects on public health, air quality, water quality, wildlife, and the environment of the following regulations, laws, and other agency decisions:

(A) Clean water.—

(i) The final rule of the Environmental Protection Agency and the Corps of Engineers entitled “Final Revisions to the Clean Water Act Regulatory Definitions of Fill Material and Discharge of Fill Material” and published in the Federal Register on May 9, 2002 (67 Fed. Reg. 31129).

(ii) The final rule of the Environmental Protection Agency entitled “National Pollutant Discharge Elimination System Permit Regulation for Concentrated Animal Feeding Operations: Removal of Vacated Elements in Response to 2011 Court Decision” and published in the Federal Register on July 30, 2012 (77 Fed. Reg. 44494).

(iii) The final rule of the Environmental Protection Agency entitled “Withdrawal of Revisions to the Water Quality Planning and Management Regulation and Revisions to the National Pollutant Discharge Elimination System Program in Support of Revisions to the Water Quality Planning and Management Regulation” and published in the Federal Register on March 19, 2003 (68 Fed. Reg. 13608).

(iv) The final rule of the Environmental Protection Agency entitled “Consolidated Permit Regulations: RCRA Hazardous Waste; SDWA Underground Injection Control; CWA National Pollutant Discharge Elimination System; CWA Section 404 Dredge or Fill Programs; and CAA Prevention of Significant Deterioration” and published in the Federal Register on May 19, 1980 (45 Fed. Reg. 33290), with respect to the definition of the “waters of the United States”.

(v) The final rule of the Corps of Engineers and the Environmental Protection Agency entitled “Definition of “Waters of the United States”—Recodification of Pre-Existing Rules” and published in the Federal Register on October 22, 2019 (84 Fed. Reg. 56626).

(vi) The final rule of the Corps of Engineers and the Environmental Protection Agency entitled “The Navigable Waters Protection Rule: Definition of “Waters of the United States”” and published in the Federal Register on April 21, 2020 (85 Fed. Reg. 22250).

(B) Forests and land management.—

(i) The Healthy Forests Restoration Act of 2003 (16 U.S.C. 6501 et seq.).

(ii) The application of section 553(e) of title 5, United States Code, such that a State may petition for a special rule for the inventoried roadless areas within National Forest System land within the State.

(iii) The final rules of the Forest Service entitled “National Forest System Land Management Planning” (77 Fed. Reg. 21162), “National Forest System Land Management Planning; Correction” (78 Fed. Reg. 23491), and “National Forest System Land Management Planning” (81 Fed. Reg. 90723), published on April 9, 2012, April 19, 2013, and December 15, 2016, respectively.

(iv) The final rule of the Bureau of Land Management entitled “Oil Shale Management—General” and published on November 18, 2008 (73 Fed. Reg. 69414).

(v) The record of decision described in the notice of availability of the Bureau of Land Management entitled “Notice of Availability of Approved Land Use Plan Amendments/Record of Decision for Allocation of Oil Shale and Tar Sands Resources on Lands Administered by the Bureau of Land Management in Colorado, Utah, and Wyoming and Final Programmatic Environmental Impact Statement” and published on April 1, 2013 (78 Fed. Reg. 19518).

(C) Scientific review.— The final rule of the United States Fish and Wildlife Service and the National Oceanic and Atmospheric Administration entitled “Interagency Cooperation Under the Endangered Species Act” and published on December 16, 2008 (73 Fed. Reg. 76272), as amended by the final rule of the United States Fish and Wildlife Service and the National Oceanic and Atmospheric Administration entitled “Endangered and Threatened Wildlife and Plants; Regulations for Interagency Cooperation” and published on August 27, 2019 (84 Fed. Reg. 44976).

(2) Method.— In conducting the study under paragraph (1), the National Academy of Sciences may use and compare existing scientific studies regarding the regulations, laws, and other agency decisions described in paragraph (1).

(3) Report.— Not later than 270 days after the date on which the President enters into the arrangement under paragraph (1), the National Academy of Sciences shall make publicly available and shall submit to Congress and to the head of each department and agency of the Federal Government that issued, implements, or would implement a regulation, law, or other agency decision described in paragraph (1), a report that includes—

(A) a description of the effects of each regulation, law, or other agency decision described in paragraph (1) on public health, air quality, water quality, wildlife, and the environment, compared to the impact of preexisting regulations, laws, or other agency decisions in effect, as applicable, including—

(i) any negative impacts to air quality or water quality;

(ii) any negative impacts to wildlife;

(iii) any delays in hazardous waste cleanup that are projected to be hazardous to public health; and

(iv) any other negative impact on public health or the environment; and

(B) any recommendations that the National Academy of Sciences considers appropriate to maintain, restore, or improve in whole or in part protections for public health, air quality, water quality, wildlife, and the environment for each of the regulations, laws, and other agency decisions described in paragraph (1), which may include recommendations for the adoption of any regulation or law in place or proposed prior to January 1, 2001.

(c) Department and agency revision of existing rules, regulations, or laws.— Not later than 180 days after the date on which the report is submitted pursuant to subsection (b)(3), the head of each department or agency that has issued or implemented a regulation, law, or other agency decision described in subsection (b)(1) shall submit to Congress a plan describing the steps the department or agency will take, or has taken, to restore or improve protections for public health and the environment in whole or in part that were in existence prior to the issuance of the applicable regulation, law, or other agency decision.

(a) Study.— The Comptroller General of the United States shall conduct a study on the type and scope of health care services administered through the Department of Health and Human Services addressing the provision of health care to racial and ethnic minorities, including residents, cleanup workers, and volunteers, affected by the blowout and explosion of the mobile offshore drilling unit Deepwater Horizon that occurred on April 20, 2010, and resulting hydrocarbon releases into the environment.

(b) Specific components.— In carrying out subsection (a), the Comptroller General of the United States shall—

(1) assess the type, size, and scope of programs administered by the Secretary that focus on the provision of health care to communities on the Gulf Coast;

(2) identify the merits and disadvantages associated with each of the programs;

(3) perform an analysis of the costs and benefits of the programs; and

(4) determine whether there is any duplication of programs.

(c) Report.— Not later than 180 days after the date of enactment of this Act, the Comptroller General of the United States shall submit to Congress a report that includes—

(1) the findings of the study conducted under subsection (a); and

(2) recommendations for improving access to health care for racial and ethnic minorities.

(a) Purposes.— The purposes of this section are as follows:

(1) To establish effective, coordinated Federal technical assistance to help State and local governments to improve outcomes and cost-effectiveness of, and return on investment from, health and social services programs.

(2) To build a pipeline of State and locally designed, cross-sector interventions and strategies that generate rigorous evidence about how to improve health and social outcomes, and increase the cost-effectiveness of, and return on investment from, Federal, State, local, and Tribal health and social services programs.

(3) To enlist State and local governments and the service providers of such governments as partners in identifying Federal statutory, regulatory, and administrative challenges in improving the health and social outcomes of, cost-effectiveness of, and return on investment from, Federal spending on individuals enrolled in Medicaid.

(4) To develop strategies to improve health and social outcomes without denying services to, or restricting the eligibility of, vulnerable populations.

(b) Social determinants accelerator council.—

(1) Establishment.— The Secretary, in coordination with the Administrator of the Centers for Medicare & Medicaid Services (referred to in this section as the “Administrator”), shall establish an interagency council, to be known as the Social Determinants Accelerator Interagency Council (referred to in this section as the “Council”) to achieve the purposes listed in subsection (a).

(2) Membership.—

(A) Federal composition.— The Council shall be composed of at least one designee from each of the following Federal agencies:

(i) The Office of Management and Budget.

(ii) The Department of Agriculture.

(iii) The Department of Education.

(iv) The Indian Health Service.

(v) The Department of Housing and Urban Development.

(vi) The Department of Labor.

(vii) The Department of Transportation.

(viii) Any other Federal agency the Chair of the Council determines necessary.

(B) Designation.—

(i) In general.— The head of each agency specified in subparagraph (A) shall designate at least one employee described in clause (ii) to serve as a member of the Council.

(ii) Responsibilities.— An employee described in this clause shall be a senior employee of the agency—

(I) whose responsibilities relate to authorities, policies, and procedures with respect to the health and well-being of individuals receiving medical assistance under a State plan (or a waiver of such plan) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); or

(II) who has authority to implement and evaluate transformative initiatives that harness data or conduct rigorous evaluation to improve the impact and cost-effectiveness of federally funded services and benefits.

(C) HHS representation.— In addition to the designees under subparagraph (A), the Council shall include designees from at least 3 agencies within the Department of Health and Human Services, including the Centers for Medicare & Medicaid Services, at least one of whom shall meet the criteria under subparagraph (B)(ii).

(D) OMB role.— The Director of the Office of Management and Budget shall facilitate the timely resolution of Federal Government-wide and multiagency issues to help the Council achieve consensus recommendations described under this section.

(E) Non-Federal composition.— The Comptroller General of the United States may designate up to 6 Council designees—

(i) who have relevant subject matter expertise, including expertise implementing and evaluating transformative initiatives that harness data and conduct evaluations to improve the impact and cost-effectiveness of Federal Government services; and

(ii) that each represent—

(I) State, local, and Tribal health and human services agencies;

(II) public housing authorities or State housing finance agencies;

(III) State and local government budget offices;

(IV) State Medicaid agencies; or

(V) national consumer advocacy organizations.

(F) Chair.—

(i) In general.— The Secretary shall select the Chair of the Council from among the members of the Council.

(ii) Initiating guidance.— The Chair, on behalf of the Council, shall identify and invite individuals from diverse entities to provide the Council with advice and information pertaining to addressing social determinants of health, including—

(I) individuals from State and local government health and human services agencies;

(II) individuals from State Medicaid agencies;

(III) individuals from State and local government budget offices;

(IV) individuals from public housing authorities or State housing finance agencies;

(V) individuals from nonprofit organizations, small businesses, and philanthropic organizations;

(VI) advocates;

(VII) researchers; and

(VIII) any other individuals the Chair determines to be appropriate.

(3) Duties.— The duties of the Council are—

(A) to make recommendations to the Secretary and the Administrator regarding the criteria for making awards under this section;

(B) to identify Federal authorities and opportunities for use by States or local governments to improve coordination of funding and administration of Federal programs, the beneficiaries of whom include individuals, and which may be unknown or underutilized, and to make information on such authorities and opportunities publicly available;

(C) to provide targeted technical assistance to States developing a social determinants accelerator plan under this section, including identifying potential statutory or regulatory pathways for implementation of the plan and assisting in identifying potential sources of funding to implement the plan;

(D) to report to Congress annually on the subjects set forth in this section;

(E) to develop and disseminate evaluation guidelines and standards that can be used to reliably assess the impact of an intervention or approach that may be implemented pursuant to this section on outcomes and cost-effectiveness of, and return on investment from, Federal, State, local, and Tribal governments, and to facilitate technical assistance, where needed, to help to improve State and local evaluation designs and implementation;

(F) to seek feedback from State, local, and Tribal governments, including through an annual survey by an independent third party, on how to improve the technical assistance the Council provides to better equip State, local, and Tribal governments to coordinate health and social service programs;

(G) to solicit applications for grants under subsection (c); and

(H) to coordinate with other cross-agency initiatives focused on improving the health and well-being of low-income and at-risk populations in order to prevent unnecessary duplication between agency initiatives.

(4) Schedule.— Not later than 60 days after the date of enactment of this Act, the Council shall convene to develop a schedule and plan for carrying out the duties described in this section, including solicitation of applications for the grants under this section.

(5) Report to Congress.— The Council shall submit an annual report to Congress, which shall include—

(A) a list of the Council members;

(B) activities and expenditures of the Council;

(C) summaries of the interventions and approaches that will be supported by State, local, and Tribal governments that received a grant under this section, including—

(i) the best practices and evidence-based approaches such governments plan to employ to achieve the purposes listed in this section; and

(ii) a description of how the practices and approaches will impact the outcomes and cost-effectiveness of, and return on investment from, Federal, State, local, and Tribal governments with respect to such purposes;

(D) the feedback received from State and local governments on ways to improve the technical assistance of the Council, including findings from a third-party survey and actions the Council plans to take in response to such feedback; and

(E) the major statutory, regulatory, and administrative challenges identified by State, local, and Tribal governments that received a grant under subsection (c), and the actions that Federal agencies are taking to address such challenges.

(6) FACA inapplicability.— Chapter 10 of title 5, United States Code, shall not apply to the Council.

(7) Council procedures.— The Secretary, in consultation with the Comptroller General of the United States and the Director of the Office of Management and Budget, shall establish procedures for the Council to—

(A) ensure that adequate resources are available to effectively execute the responsibilities of the Council;

(B) effectively coordinate with other relevant advisory bodies and working groups to avoid unnecessary duplication;

(C) create transparency to the public and Congress with regard to Council membership, costs, and activities, including through use of modern technology and social media to disseminate information; and

(D) avoid conflicts of interest that would jeopardize the ability of the Council to make decisions and provide recommendations.

(c) Social determinants accelerator grants to States or local governments.—

(1) Grants to States, local governments, and Tribes.— Not later than 180 days after the date of enactment of this Act, the Administrator, in consultation with the Secretary and the Council, shall award on a competitive basis not more than 25 grants to eligible applicants described in this subsection, for the development of social determinants accelerator plans, as described in this subsection.

(2) Eligible applicant.— An eligible applicant described in this subsection is a State, local, or Tribal health or human services agency that—

(A) demonstrates the support of relevant parties across relevant State, local, or Tribal jurisdictions; and

(B) in the case of an applicant that is a local government agency, provides to the Secretary a letter of support from the lead State health or human services agency for the State in which the local government is located.

(3) Amount of grant.— The Administrator, in coordination with the Council, shall determine the total amount that the Administrator will make available to each grantee under this subsection.

(4) Application.— An eligible applicant seeking a grant under this subsection shall include in the application the following information:

(A) The target population (or populations) that would benefit from implementation of the social determinants accelerator plan proposed to be developed by the applicant.

(B) A description of the objective or objectives and outcome goals of such proposed plan, which shall include at least one health outcome and at least one other important social outcome.

(C) The sources and scope of inefficiencies that, if addressed by the plan, could result in improved cost-effectiveness of or return on investment from Federal, State, local, and Tribal governments.

(D) A description of potential interventions that could be designed or enabled using such proposed plan.

(E) The State, local, and Tribal governments, academic institutions, nonprofit organizations, community-based organizations, and other public and private sector partners that would participate in the development of the proposed plan and subsequent implementation of programs or initiatives included in such proposed plan.

(F) Such other information as the Administrator, in consultation with the Secretary and the Council, determines necessary to achieve the purposes of this section.

(5) Use of funds.— A recipient of a grant under this subsection may use funds received through the grant for the following purposes:

(A) To convene and coordinate with relevant government entities and other stakeholders across sectors to assist in the development of a social determinant accelerator plan.

(B) To identify populations of individuals receiving medical assistance under a State plan (or a waiver of such plan) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) who may benefit from the proposed approaches to improving the health and well-being of such individuals through the implementation of the proposed social determinants accelerator plan.

(C) To engage qualified research experts to advise on relevant research and to design a proposed evaluation plan, in accordance with the standards and guidelines issued by the Administrator.

(D) To collaborate with the Council to support the development of social determinants accelerator plans.

(E) To prepare and submit a final social determinants accelerator plan to the Council.

(6) Contents of plans.— A social determinant accelerator plan developed under this subsection shall include the following:

(A) A description of the target population (or populations) that would benefit from implementation of the social determinants accelerator plan, including an analysis describing the projected impact on the well-being of individuals described in paragraph (5)(B).

(B) A description of the interventions or approaches designed under the social determinants accelerator plan and the evidence for selecting such interventions or approaches.

(C) The objectives and outcome goals of such interventions or approaches, including at least one health outcome and at least one other important social outcome.

(D) A plan for accessing and linking relevant data to enable coordinated benefits and services for the jurisdictions described in this section and an evaluation of the proposed interventions and approaches.

(E) A description of the State, local, and Tribal governments, academic institutions, nonprofit organizations, or any other public or private sector organizations that would participate in implementing the proposed interventions or approaches, and the role each would play to contribute to the success of the proposed interventions or approaches.

(F) The identification of the funding sources that would be used to finance the proposed interventions or approaches.

(G) A description of any financial incentives that may be provided, including outcome-focused contracting approaches to encourage service providers and other partners to improve outcomes of, cost-effectiveness of, and return on investment from, Federal, State, local, or Tribal government spending.

(H) The identification of the applicable Federal, State, local, or Tribal statutory and regulatory authorities, including waiver authorities, to be leveraged to implement the proposed interventions or approaches.

(I) A description of potential considerations that would enhance the impact, scalability, or sustainability of the proposed interventions or approaches and the actions the grant awardee would take to address such considerations.

(J) A proposed evaluation plan, to be carried out by an independent evaluator, to measure the impact of the proposed interventions or approaches on the outcomes of, cost-effectiveness of, and return on investment from, Federal, State, local, and Tribal governments.

(K) Precautions for ensuring that vulnerable populations will not be denied access to Medicaid or other essential services as a result of implementing the proposed plan.

(d) Funding.—

(1) In general.— Out of any money in the Treasury not otherwise appropriated, there is appropriated to carry out this section $25,000,000, to remain available for obligation until the date that is 5 years after the date of enactment of this section.

(2) Reservation of funds.—

(A) In general.— Of the funds made available under paragraph (1), the Secretary shall reserve not less than 20 percent to award grants to eligible applicants for the development of social determinants accelerator plans under this section intended to serve rural populations.

(B) Exception.— In the case of a fiscal year for which the Secretary determines that there are not sufficient eligible applicants to award up to 25 grants under subsection (c) that are intended to serve rural populations and the Secretary cannot satisfy the 20-percent requirement, the Secretary may reserve an amount that is less than 20 percent of amounts made available under paragraph (1) to award grants for such purpose.

(3) Rule of construction.— Nothing in this section shall prevent Federal agencies represented on the Council from contributing additional funding from other sources to support activities to improve the effectiveness of the Council.

(a) Short title.— This section may be cited as the “Correcting Hurtful and Alienating Names in Government Expression Act” or the “CHANGE Act”.

(b) Definitions.— In this section:

(1) Employee.— The term employee has the meaning given the term in section 2105 of title 5, United States Code.

(2) Executive agency.— The term Executive agency has the meaning given the term in section 105 of title 5, United States Code.

(3) Officer.— The term officer has the meaning given the term in section 2104 of title 5, United States Code.

(4) Prohibited term.— The term prohibited term means—

(A) the term alien, when used to refer to an individual who is not a citizen or national of the United States; and

(B) the term illegal alien, when used to refer to an individual who—

(i) is unlawfully present in the United States; or

(ii) lacks a lawful immigration status in the United States.

(c) Modernization of language referring to individuals who are not citizens or nationals of the United States.—

(1) In general.— Except as provided in paragraph (2), on and after the date of enactment of this Act, an Executive agency may not use a prohibited term in any proposed or final rule, regulation, interpretation, publication, other document, display, or sign issued by the Executive agency.

(2) Exception.— An Executive agency may use a prohibited term under paragraph (1) if the Executive agency uses the prohibited term while quoting or reproducing text written by a source that is not an officer or employee of the Executive agency.

(d) Uniform definition.—

(1) In general.— Chapter 1 of title 1, United States Code, is amended by adding at the end the following:

“9. Definition of foreign national.— In determining the meaning of any Act of Congress or any ruling, regulation, or interpretation of an administrative bureau or agency of the United States, the term foreign national means any individual who is not an individual who—

(1) is a citizen of the United States; or

(2) though not a citizen of the United States, owes permanent allegiance to the United States.”.

(2) Technical amendment.— The table of sections for chapter 1 of title 1, United States Code, is amended by adding at the end the following:

(e) References.— Any reference in any Federal statute, rule, regulation, Executive order, publication, or other document of the United States—

(1) to the term alien, when used to refer to an individual who is not a citizen or national of the United States, is deemed to refer to the term foreign national; and

(2) to the term illegal alien is deemed to refer to the term undocumented foreign national, when used to refer to an individual who—

(A) is unlawfully present in the United States; or

(B) lacks a lawful immigration status in the United States.

(a) In general.— Chapter 13 of title 18, United States Code, is amended by adding at the end the following:

“251. Medical attention for individuals in Federal custody displaying medical distress.—

(a) Definitions.— In this section—

(1) the term appropriate Inspector General, with respect to a covered official, means—

(A) the Inspector General of the Federal agency that employs the covered official; or

(B) in the case of a covered official employed by a Federal agency that does not have an Inspector General, the Inspector General of the Department of Justice;

(2) the term covered official means—

(A) a Federal law enforcement officer (as defined in section 115);

(B) an officer or employee of the Bureau of Prisons; or

(C) an officer or employee of the United States Marshals Service; and

(3) the term medical distress includes breathing difficulties.

(b) Requirement.—

(1) Offense.— It shall be unlawful for a covered official to negligently fail to obtain or provide immediate medical attention to an individual in Federal custody who displays medical distress in the presence of the covered official if the individual suffers unnecessary pain, injury, or death as a result of that failure.

(2) Penalty.— A covered official who violates paragraph (1) shall be fined under this title, imprisoned for not more than 1 year, or both.

(3) State civil enforcement.— Whenever an attorney general of a State has reasonable cause to believe that a resident of the State has been aggrieved by a violation of paragraph (1) by a covered official, the attorney general, or another official, agency, or entity designated by the State, may bring a civil action in any appropriate district court of the United States to obtain appropriate equitable and declaratory relief.

(c) Inspector General investigation.—

(1) In general.— The appropriate Inspector General shall investigate any instance in which—

(A) a covered official fails to obtain or provide immediate medical attention to an individual in Federal custody who displays medical distress in the presence of the covered official; and

(B) the individual suffers unnecessary pain, injury, or death as a result of the failure to obtain or provide immediate medical attention.

(2) Referral for prosecution.— If an appropriate Inspector General, in conducting an investigation under paragraph (1), concludes that the covered official acted negligently in failing to obtain or provide immediate medical attention to the individual in Federal custody, the appropriate Inspector General shall refer the case to the Attorney General for prosecution under this section.

(3) Confidential complaint process.— The Inspector General of a Federal agency that employs covered officials shall establish a process under which an individual may confidentially submit a complaint to the Inspector General regarding an incident described in paragraph (1) involving a covered official employed by the Federal agency (or, in the case of the Inspector General of the Department of Justice, involving a covered official employed by a Federal agency that does not have an Inspector General).

(d) Training.— The head of an agency that employs covered officials shall provide training to each such covered official on obtaining or providing medical assistance to individuals in medical distress.”.

(b) Technical and conforming amendment.— The table of sections for chapter 13 of title 18, United States Code, is amended by adding at the end the following:

(a) Sense of Congress.— It is the sense of Congress that it is imperative that a comprehensive public health approach to addressing trauma and mental health care be focused on care delivery that is culturally sensitive and competent.

(b) Research on adverse health effects associated with interactions with law enforcement.—

(1) In general.— The Secretary, acting through the Director of the Office of Minority Health of the Centers for Disease Control and Prevention (established pursuant to section 1707A of the Public Health Service Act (42 U.S.C. 300u–6a)), shall conduct research on the adverse health effects associated with interactions with law enforcement.

(2) Effects among racial and ethnic minorities.— The research under paragraph (1) shall include research on—

(A) the health consequences, both individual and community-wide, of trauma related to violence committed by law enforcement among racial and ethnic minorities; and

(B) the disproportionate burden of morbidity and mortality associated with such trauma.

(3) Report.— Not later than 1 year after the date of enactment of this Act, the Secretary shall—

(A) complete the research under this subsection; and

(B) submit to Congress a report on the findings, conclusions, and recommendations resulting from such research.

(c) Grants for increasing racial and ethnic minority access to high-Quality trauma support services and mental health care.—

(1) In general.— The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall award grants to eligible entities to establish or expand programs for the purpose of increasing racial and ethnic minority access to high-quality trauma support services and mental health care.

(2) Eligible entities.— To seek a grant under this subsection, an entity shall be a community-based program or organization that—

(A) provides culturally competent programs and resources that are aligned with evidence-based practices for trauma-informed care; and

(B) has demonstrated expertise in serving communities of color or can partner with a program that has such demonstrated expertise.

(3) Use of funds.— As a condition on receipt of a grant under this subsection, a grantee shall agree to use the grant to increase racial and ethnic minority access to high-quality trauma support services and mental health care, such as by—

(A) establishing and maintaining community-based programs providing evidence-based services in trauma-informed care and culturally specific services and other resources;

(B) developing innovative culturally specific strategies and projects to enhance access to trauma-informed care and resources for racial and ethnic minorities who face obstacles to using more traditional services and resources (such as obstacles in geographic access to providers, insurance coverage, and access to audio and video technologies);

(C) working with State and local governments and social service agencies to develop and enhance effective strategies to provide culturally specific services to racial and ethnic minorities;

(D) increasing communities’ capacity to provide culturally specific resources and support for communities of color;

(E) working in cooperation with the community to develop education and prevention strategies highlighting culturally specific issues and resources regarding racial and ethnic minorities;

(F) providing culturally specific programs for racial and ethnic minorities exposed to law enforcement violence; and

(G) examining the dynamics of culture and its impact on victimization and healing.

(4) Priority.— In awarding grants under this subsection, the Secretary shall give priority to eligible entities proposing to serve communities that have faced high rates of community trauma, including from exposure to law enforcement violence, intergenerational poverty, civil unrest, discrimination, or oppression.

(5) Grant period.— The period of a grant under this subsection shall be 4 years.

(6) Evaluation.— Not later than 6 months after the end of the period of all grants under this subsection, the Secretary shall—

(A) conduct an evaluation of the programs funded by a grant under this subsection;

(B) include in such evaluation an assessment of the outcomes of each such program; and

(C) submit a report on the results of such evaluation to Congress.

(7) Authorization of appropriations.— To carry out this subsection, there is authorized to be appropriated $20,000,000 for each of fiscal years 2027 through 2031.

(d) Behavioral and mental health outreach education strategy.—

(1) In general.— The Secretary, in coordination with advocacy and behavioral and mental health organizations serving racial and ethnic minority groups, shall develop and implement an outreach and education strategy to promote behavioral and mental health, and reduce stigma associated with mental health conditions, among racial and ethnic minorities.

(2) Design.— The strategy under this subsection shall be designed to—

(A) meet the diverse cultural and language needs of racial and ethnic minority groups;

(B) provide information on evidence-based, culturally and linguistically appropriate and adapted interventions and treatments;

(C) increase awareness of symptoms of mental illness among racial and ethnic minority groups; and

(D) ensure full participation of, and engage, both consumers and community members in the development and implementation of materials.

(3) Report.— Not later than 1 year after the date of enactment of this Act, the Secretary shall submit to Congress, and make publicly available, a report detailing the outreach and education strategy that is developed and implemented under this subsection and the results of such implementation.

(a) Definitions.— In this section:

(1) Advisory council.— The term advisory council means the advisory council established under subsection (b)(4)(B)(i).

(2) Committee.— The term Committee means the Environmental Justice Mapping Committee established by subsection (b)(1).

(3) Environmental justice.— The term environmental justice means the fair treatment and meaningful involvement of all people regardless of race, color, culture, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies to ensure that each person enjoys—

(A) the same degree of protection from environmental and health hazards; and

(B) equal access to any Federal agency action relating to the development, implementation, and enforcement of environmental laws, regulations, and policies for the purpose of having a healthy environment in which to live, learn, work, and recreate.

(4) Environmental justice community.— The term environmental justice community means a community with significant representation of communities of color, low-income communities, or Tribal and indigenous communities, that experiences, or is at risk of experiencing, higher or more adverse human health or environmental effects, as compared to other communities.

(5) Ground-truthing.— The term ground-truthing means a community fact-finding process by which residents of a community supplement technical information with local knowledge for the purpose of better informing policy and project decisions.

(6) Relevant stakeholder.— The term relevant stakeholder means—

(A) a representative of a regional, State, Tribal, or local government agency;

(B) a representative of a nongovernmental organization with experience in areas that may include Tribal relations, environmental conservation, city and regional planning, and public health;

(C) a representative of a labor union;

(D) a representative or member of—

(i) an environmental justice community; or

(ii) a community-based organization for an environmental justice community;

(E) an individual with expertise in cumulative impacts, geospatial data, and environmental justice, particularly such an individual from an academic or research institution; and

(F) an advocate with experience in environmental justice who represents an environmental justice community.

(b) Establishment of Committee.—

(1) In general.— There is established a committee, to be known as the “Environmental Justice Mapping Committee”.

(2) Membership.—

(A) In general.— The Committee shall be composed of not fewer than 1 representative of each of the following:

(i) Of the Environmental Protection Agency—

(I) the Office of Air and Radiation;

(II) the Office of Chemical Safety and Pollution Prevention;

(III) the Office of International and Tribal Affairs;

(IV) the Office of Land and Emergency Management;

(V) the Office of Water;

(VI) the Office of Environmental Justice and External Civil Rights;

(VII) the Office of Research and Development; and

(VIII) the Office of Public Engagement and Environmental Education.

(ii) The Council on Environmental Quality.

(iii) Of the Department of Commerce—

(I) the Office of Oceanic and Atmospheric Research of the National Oceanic and Atmospheric Administration, including not fewer than 1 representative of the Climate Program Office;

(II) the Bureau of Economic Analysis; and

(III) the National Institute of Standards and Technology.

(iv) Of the Department of Health and Human Services—

(I) the Centers for Disease Control and Prevention, not including the Agency for Toxic Substances and Disease Registry;

(II) the Agency for Toxic Substances and Disease Registry;

(III) the Administration for Children and Families;

(IV) of the National Institutes of Health—

(aa) the National Institute of Environmental Health Sciences;

(bb) the National Institute of Mental Health; and

(cc) the National Institute on Minority Health and Health Disparities; and

(V) the Office for Civil Rights.

(v) Of the Department of the Interior—

(I) the Bureau of Indian Affairs;

(II) the Office of Diversity, Inclusion, and Civil Rights; and

(III) the United States Geological Survey.

(vi) The Forest Service.

(vii) The Department of Housing and Urban Development.

(viii) The Department of Energy.

(ix) The Department of Transportation.

(x) The Department of Justice.

(xi) The Federal Energy Regulatory Commission.

(xii) The Department of the Treasury.

(xiii) Such other Federal departments, agencies, and offices as the Administrator determines to be appropriate, particularly offices relating to public engagement.

(B) Selection of representatives.— The head of a department or agency described in subparagraph (A) shall, in appointing to the Committee a representative of the department or agency, select a representative—

(i) of a component of the department or agency that is among the components that are the most relevant to the responsibilities of the Committee; or

(ii) who has expertise in areas relevant to those responsibilities, such as demographic indicators relating to socioeconomic hardship, environmental justice, public engagement, public health, exposure to pollution, future climate and extreme weather mapping, affordable energy, sustainable transportation, and access to water, food, and green space.

(C) Co-chairs.—

(i) In general.— The members of the Committee shall select 3 members to serve as co-chairs of the Committee—

(I) 1 of whom shall be a representative of the Environmental Protection Agency;

(II) 1 of whom shall be a representative of the Council on Environmental Quality; and

(III) 1 of whom shall have substantial experience in public engagement.

(ii) Terms.— Each co-chair shall serve for a term of not more than 3 years.

(iii) Responsibilities of co-chairs.— The co-chairs of the Committee shall—

(I) determine the agenda of the Committee, in consultation with other members of the Committee;

(II) direct the work of the Committee, including the oversight of a meaningful public engagement process; and

(III) convene meetings of the Committee not less frequently than once each fiscal quarter.

(3) Administrative support.—

(A) In general.— The Administrator shall provide technical and administrative support to the Committee.

(B) Funding.— The Administrator may carry out subparagraph (A) using, in addition to any amounts made available under subsection (e), amounts authorized to be appropriated to the Administrator before the date of enactment of this Act and available for obligation as of that date of enactment.

(4) Consultation.—

(A) In general.— In carrying out the duties of the Committee, the Committee shall consult with relevant stakeholders.

(B) Advisory council.—

(i) In general.— The Committee shall establish an advisory council composed of a balanced proportion of relevant stakeholders, at least ½ of whom shall represent environmental justice communities.

(ii) Chair.— The advisory council shall be chaired by an environmental justice advocate or other relevant stakeholder with substantial experience in environmental justice.

(iii) Requirements.— Consultation described in subparagraph (A) shall include—

(I) early and regular engagement with the advisory council, including in carrying out public engagement under subparagraph (C); and

(II) consideration of the recommendations of the advisory council.

(iv) Recommendations not used.— If the Committee does not use a recommendation of the advisory council, not later than 60 days after the date on which the Committee receives notice of the recommendation, the Committee shall—

(I) make available to the public on an internet website of the Environmental Protection Agency a written report describing the rationale of the Committee for not using the recommendation; and

(II) submit the report described in subclause (I) to the Committee on Environment and Public Works of the Senate and the Committee on Energy and Commerce of the House of Representatives.

(v) Outreach.— The advisory council may carry out public outreach activities using amounts made available under subsection (e) to supplement public engagement carried out by the Committee under subparagraph (C).

(C) Public engagement.—

(i) In general.— The Committee shall, throughout the process of carrying out the duties of the Committee described in subsection (c)—

(I) meaningfully engage with relevant stakeholders, particularly—

(aa) members and representatives of environmental justice communities;

(bb) environmental justice advocates; and

(cc) individuals with expertise in cumulative impacts and geospatial data; and

(II) ensure that the input of the stakeholders described in subclause (I) is central to the activities of the Committee.

(ii) Plan.—

(I) In general.— In carrying out clause (i), the Committee shall develop a plan, in consultation with the advisory council, for comprehensive public engagement with, and incorporation of feedback from, environmental justice advocates and members of environmental justice communities.

(II) Strategies to overcome barriers to public engagement.— The plan developed under subclause (I) shall include strategies to overcome barriers to public engagement, including—

(aa) language barriers;

(bb) transportation barriers;

(cc) economic barriers; and

(dd) lack of internet access.

(III) Consideration.— In developing the plan under subclause (I), the Committee shall consider the diverse and varied experiences of environmental justice communities relating to the scope and types of environmental hazards and socioeconomic injustices.

(iii) Consultation and solicitation of public comment.—

(I) In general.— In carrying out clause (i), not less frequently than once each fiscal quarter, the Committee shall consult with the advisory council and solicit meaningful public comment, particularly from relevant stakeholders, on the activities of the Committee.

(II) Requirements.— The Committee shall carry out subclause (I) through means including—

(aa) public notice of a meeting of the Committee occurring during the applicable fiscal quarter, which shall include—

(AA) notice in publications relevant to environmental justice communities;

(BB) notification to environmental justice communities through direct means, such as community centers and schools; and

(CC) direct outreach to known environmental justice groups;

(bb) public broadcast of that meeting, including soliciting and receiving comments by virtual means; and

(cc) public availability of a transcript of that meeting through publication on an accessible website.

(III) Languages.— The Committee shall provide each notice, notification, direct outreach, broadcast, and transcript described in subclause (II) in each language commonly used in the applicable environmental justice community, including through oral interpretation, if applicable.

(iv) Funding.— Of amounts made available under subsection (e), the Administrator shall make available to the Committee such sums as are necessary for participation by relevant stakeholders in public engagement under this paragraph, as determined by the Administrator, in consultation with the advisory council.

(c) Duties of Committee.—

(1) In general.— The Committee shall—

(A) establish a tool described in paragraph (2) to identify environmental justice communities, including the identification of—

(i) criteria to be used in the tool; and

(ii) a methodology to determine the cumulative impacts of those criteria;

(B) assess and address data gaps in accordance with paragraph (4); and

(C) collect data for the environmental justice data repository established under subsection (d).

(2) Establishment of tool.—

(A) In general.— The Committee, in consultation with relevant stakeholders and the advisory council, shall establish an interactive, transparent, integrated, and Federal Government-wide tool for assessing and mapping environmental justice communities based on the cumulative impacts of all indicators selected by the Committee to be integrated into the tool.

(B) Requirements.— In establishing the tool under subparagraph (A), the Committee shall—

(i) integrate into the tool multiple data layers of indicators that fall into categories including—

(I) demographics, particularly relating to socioeconomic hardship and social stressors, such as—

(aa) race and ethnicity;

(bb) low income;

(cc) high unemployment;

(dd) low levels of home ownership;

(ee) high rent burden;

(ff) high transportation burden;

(gg) low levels of educational attainment;

(hh) linguistic isolation;

(ii) energy insecurity or high utility rate burden;

(jj) food insecurity;

(kk) health insurance status and access to health care; and

(ll) membership in an Indian Tribe;

(II) public health, particularly data that are indicative of sensitive populations, such as—

(aa) rates of asthma;

(bb) rates of cardiovascular disease;

(cc) childhood leukemia or other cancers that correlate with environmental hazards;

(dd) low birth weight;

(ee) maternal mortality;

(ff) rates of lead poisoning; and

(gg) rates of diabetes;

(III) pollution burdens, such as pollution burdens created by—

(aa) toxic chemicals;

(bb) air pollutants;

(cc) water pollutants;

(dd) soil contaminants; and

(ee) perfluoroalkyl and polyfluoroalkyl substances; and

(IV) environmental effects, such as effects created by proximity to—

(aa) risk management plan sites;

(bb) hazardous waste facilities;

(cc) sites on the National Priorities List developed by the President in accordance with section 105(a)(8)(B) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9605(a)(8)(B)); and

(dd) fossil fuel infrastructure;

(ii) investigate how further indicators of vulnerability to the impacts of climate change (including proximity and exposure to sea level rise, wildfire smoke, flooding, drought, rising average temperatures, extreme storms, and extreme heat, and financial burdens from flood and fire insurance) should be incorporated into the tool as an additional set of layers;

(iii) identify and consider the effects of other indicators relating to environmental justice for integration into the tool as layers, including—

(I) safe, sufficient, and affordable drinking water, sanitation, and stormwater services;

(II) access to and the quality of—

(aa) green space and tree canopy cover;

(bb) healthy food;

(cc) affordable energy and water;

(dd) transportation;

(ee) reliable communication systems, such as broadband internet;

(ff) child care;

(gg) high-quality public schools, early childhood education, and child care; and

(hh) health care facilities;

(III) length of commute;

(IV) indoor air quality in multiunit dwellings;

(V) mental health;

(VI) labor market categories, particularly relating to essential workers; and

(VII) each type of utility expense;

(iv) consider the implementation of specific regional indicators, with the potential—

(I) to create regionally and locally downscaled maps in addition to a national map;

(II) to provide incentives for States to collect data and conduct additional analyses to capture conditions specific to their localities;

(III) to provide resources for and engage in ground-truthing to identify and verify important data with community members; and

(IV) to develop companion resources for, and provide technical support to, regional, State, local, or Tribal governments to create their own maps and environmental justice scores with relevant regional, State, local, and Tribal data;

(v) identify a methodology to account for the cumulative impacts of all indicators selected by the Committee under clause (i), in addition to other indicators as the Committee determines to be necessary, to provide relative environmental justice scores for regions that are—

(I) as small as practicable to identify communities; and

(II) not larger than a census tract;

(vi) ensure that the tool is capable of providing maps of environmental justice communities based on environmental justice scores described in clause (v);

(vii) ensure that users of the tool are able to map available layers together or independently as desired;

(viii) implement a method for users of the tool to generate a map and environmental justice score based on a subset of indicators, particularly for the purpose of using the tool in addressing various policy needs, permitting processes, and investment goals;

(ix) make the tool customizable to address specific policy needs, permitting processes, and investment goals;

(x) account for conditions that are not captured by the quantitative data used to develop the 1 or more maps and environmental justice scores comprising the tool, by—

(I) developing and executing a plan to perform outreach to relevant communities; and

(II) establishing a mechanism by which communities can self-identify as environmental justice communities to be included in the tool, which may include citing qualitative data on conditions for which quantitative data are lacking, such as cultural loss in Tribal communities;

(xi) consider that the tool—

(I) will be used across the Federal Government in screening Federal policies, permitting processes, and investments for environmental and climate justice impacts; and

(II) may be used to assess communities for pollution reduction programs; and

(xii) carry out such other activities as the Committee determines to be appropriate.

(3) Transparency and updates.—

(A) In general.—

(i) Notice and comment.— The Committee shall establish the tool described in paragraph (2) after providing notice and an opportunity for public comment.

(ii) Hearings.— In carrying out clause (i), the Committee shall hold hearings, which shall be time and language appropriate, in communities affected by environmental justice issues in geographically disparate States and Tribal areas.

(B) Updates.—

(i) Annual updates.— The Committee shall update the tool described in paragraph (2) not less frequently than annually to account for data sets that are updated annually.

(ii) Other updates.— Not less frequently than once every 3 years, the Committee shall—

(I) update the indicators, methodology, or both for the tool described in paragraph (2); and

(II) reevaluate data submitted by Federal departments and agencies that is used for the tool.

(iii) Reports.— After the initial establishment of the tool described in paragraph (2) and each update under clause (i) or (ii), the Committee shall publish a report describing—

(I) the process for identifying indicators relating to environmental justice in the development of the tool;

(II) the methodology described in paragraph (2)(B)(v); and

(III) the use of public input and community engagement in that process.

(C) Training tutorials and sessions.—

(i) In general.— The Committee shall—

(I) develop virtual training tutorials and sessions for environmental justice communities for the use of the tool described in paragraph (2); and

(II) where practicable, provide in-person training sessions for environmental justice communities for the use of that tool.

(ii) Languages.— The tutorials and sessions under clause (i) shall be made available in each language commonly used in the applicable environmental justice community.

(D) Public availability.—

(i) In general.— The Committee shall make available to the public on an internet website of the Environmental Protection Agency—

(I) the tool described in paragraph (2);

(II) each update under clauses (i) and (ii) of subparagraph (B);

(III) each report under subparagraph (B)(iii); and

(IV) the training tutorials and sessions developed under subparagraph (C)(i)(I).

(ii) Accessibility.— The Committee shall make the tool, updates, and reports described in clause (i) accessible to the public by publication in relevant languages and with accessibility functions, as appropriate.

(iii) Requirement.— In carrying out clause (i)(I), the Committee shall take measures to prevent the tool from being misused to discriminate against environmental justice communities, such as by providing safeguards against the use of downscaled data that may enable the identification of individuals.

(4) Data gap audit.—

(A) In general.— In establishing the tool described in paragraph (2), the Committee shall direct relevant Federal departments and agencies to conduct an audit of data collected by the department or agency to identify any data that are relevant to environmental justice concerns, including data relating to—

(i) public health metrics;

(ii) toxic chemicals;

(iii) socioeconomic demographics;

(iv) air quality;

(v) water quality; and

(vi) killings of individuals by law enforcement officers.

(B) Requirements.— An audit described in subparagraph (A) shall—

(i) examine the granularity and accessibility of the data;

(ii) address the need for improved air quality monitoring; and

(iii) include recommendations to other Federal departments and agencies on means to improve the quality, granularity, and transparency of, and public involvement in, data collection and dissemination.

(C) Improvements.— The Committee shall direct a Federal department or agency, in conducting an audit under subparagraph (A), to address gaps in existing data collection that will assist the Committee in establishing and operating the tool described in paragraph (2), including by providing to the department or agency—

(i) benchmarks to meet in addressing the gaps;

(ii) instructions for consistency in data formatting that will allow for inclusion of data in the environmental justice data repository described in subsection (d); and

(iii) best practices for collecting data in collaboration with local organizations and partners, such as engaging in ground-truthing.

(D) Reports.— Not later than 180 days after a Federal department or agency has conducted an audit under subparagraph (A), the Committee shall—

(i) make available to the public on an internet website of the Environmental Protection Agency a report describing the findings and conclusions of the audit, including the progress made by the Federal department or agency in addressing environmental justice data gaps; and

(ii) submit the report described in clause (i) to—

(I) the Committee on Environment and Public Works of the Senate;

(II) the Committee on Health, Education, Labor, and Pensions of the Senate;

(III) the Committee on Energy and Commerce of the House of Representatives; and

(IV) the Committee on Education and Workforce of the House of Representatives.

(d) Environmental justice data repository.—

(1) In general.— The Administrator shall establish an environmental justice data repository to maintain—

(A) the data collected by the Committee through the establishment of the tool described in subsection (c)(2) and the audits conducted under subsection (c)(4)(A); and

(B) any subnational data collected under paragraph (3)(B).

(2) Updates.— The Administrator shall update the data in the data repository described in paragraph (1) as frequently as practicable, including every year if practicable, but not less frequently than once every 3 years.

(3) Availability; inclusion of subnational data.— The Administrator—

(A) shall make the data repository described in paragraph (1) available to regional, State, local, and Tribal governments; and

(B) may collaborate with the governments described in subparagraph (A) to include within that data repository subnational data in existence before the establishment of the tool described in subsection (c)(2) and the completion of the audits under subsection (c)(4)(A).

(4) Requirement.— The Administrator shall take measures to prevent the data in the data repository described in paragraph (1) from being misused to discriminate against environmental justice communities, such as by providing safeguards against the use of downscaled data that may enable the identification of individuals.

(e) Authorization of appropriations.— There are authorized to be appropriated to the Administrator to carry out this section, including any necessary administrative costs of the Committee—

(1) $20,000,000 for each of fiscal years 2027 and 2028; and

(2) $18,000,000 for each of fiscal years 2029 through 2031.

(f) Effect.— Nothing in any provision of this section relating to the tool described in subsection (c)(2) prohibits a State from developing a map relating to environmental justice or pollution burden that relies on different data, or analyzes data differently, than that tool.

(a) Public health research and investment in dismantling structural racism.— Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.), as amended by section 5201(d), is further amended by adding at the end the following:

“320D. National Center on Antiracism and Health.—

(a) In general.—

(1) National center.— There is established within the Centers for Disease Control and Prevention a center to be known as the “National Center on Antiracism and Health” (referred to in this section as the “Center”). The Director of the Centers for Disease Control and Prevention shall appoint a director to head the Center who has experience living in and working with racial and ethnic minority communities. The Center shall promote public health by—

(A) declaring racism a public health crisis and naming racism as an historical and present threat to the physical and mental health and well-being of the United States and world;

(B) aiming to develop new knowledge in the science and practice of antiracism, including by identifying the mechanisms by which racism operates in the provision of health care and in systems that impact health and well-being;

(C) transferring that knowledge into practice, including by developing interventions that dismantle the mechanisms of racism and replace such mechanisms with equitable structures, policies, practices, norms, and values so that a healthy society can be realized; and

(D) contributing to a national and global conversation regarding the impacts of racism on the health and well-being of the United States and world.

(2) General duties.— The Secretary, acting through the Center, shall undertake activities to carry out the mission of the Center as described in paragraph (1), such as the following:

(A) Conduct research into, collect, analyze and make publicly available data on, and provide leadership and coordination for the science and practice of antiracism, the public health impacts of structural racism, and the effectiveness of intervention strategies to address these impacts. Topics of research and data collection under this subparagraph may include identifying and understanding—

(i) policies and practices that have a disparate impact on the health and well-being of communities of color;

(ii) the public health impacts of implicit racial bias, White supremacy, weathering, xenophobia, discrimination, and prejudice;

(iii) the social determinants of health resulting from structural racism, including poverty, housing, employment, political participation, and environmental factors; and

(iv) the intersection of racism and other systems of oppression, including as related to age, sexual orientation, gender identity, and disability status.

(B) Award noncompetitive grants and cooperative agreements to eligible public and nonprofit private entities, including State, local, territorial, and Tribal health agencies and organizations, for the research and collection, analysis, and reporting of data on the topics described in subparagraph (A).

(C) Establish, through grants or cooperative agreements, at least 3 regional centers of excellence, located in racial and ethnic minority communities, in antiracism for the purpose of developing new knowledge in the science and practice of antiracism in health by researching, understanding, and identifying the mechanisms by which racism operates in the health space, racial and ethnic inequities in health care access and outcomes, the history of successful antiracist movements in health, and other antiracist public health work.

(D) Establish a clearinghouse within the Centers for Disease Control and Prevention for the collection and storage of data generated under the programs implemented under this section for which there is not an otherwise existing surveillance system at the Centers for Disease Control and Prevention. Such data shall—

(i) be comprehensive and disaggregated, to the extent practicable, by including racial, ethnic, primary language, sex, gender identity, sexual orientation, age, socioeconomic status, and disability disparities;

(ii) be made publicly available;

(iii) protect the privacy of individuals whose information is included in such data; and

(iv) comply with privacy protections under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996.

(E) Provide information and education to the public on the public health impacts of structural racism and on antiracist public health interventions.

(F) Consult with other Centers and National Institutes within the Centers for Disease Control and Prevention, including the Office of Health Equity, the Office of Tribal Affairs and Strategic Alliances, the Office of Rural Health, and the Office of Island Affairs, to ensure that scientific and programmatic activities initiated by the agency consider structural racism in their designs, conceptualizations, and executions, which shall include—

(i) putting measures of racism in population-based surveys;

(ii) establishing a Federal Advisory Committee on racism and health for the Centers for Disease Control and Prevention;

(iii) developing training programs, curricula, and seminars for the purposes of training public health professionals and researchers around issues of race, racism, and antiracism;

(iv) providing standards and best practices for programming and grant recipient compliance with Federal data collection standards, including section 3101 of the Public Health Service Act; and

(v) establishing leadership and stakeholder councils with experts and leaders in racism and public health disparities.

(G) Coordinate with the Indian Health Service and with the Tribal Advisory Committee of the Centers for Disease Control and Prevention to ensure meaningful Tribal consultation, the gathering of information from Tribal authorities, and respect for Tribal data sovereignty.

(H) Engage in government to government consultation with Indian Tribes and Tribal organizations.

(I) At least every 2 years, produce and publicly post on the Centers for Disease Control and Prevention’s website a report on antiracist activities completed by the Center, which may include newly identified antiracist public health practices.

(b) Definitions.— In this section:

(1) Antiracism.— The term antiracism is a collection of antiracist policies that lead to racial equity, and are substantiated by antiracist ideas.

(2) Antiracist.— The term antiracist is any measure that produces or sustains racial equity between racial groups.

(c) Authorization of appropriations.— There is authorized to be appropriated such sums as may be necessary to carry out this section.”.

(b) Public health research and investment in police violence.—

(1) In general.— The Secretary shall establish within the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention (referred to in this subsection as the “Center”) a law enforcement violence prevention program.

(2) General duties.— In implementing the program under paragraph (1), the Center shall conduct research into, and provide leadership and coordination for—

(A) the understanding and promotion of knowledge about the public health impacts of uses of force by law enforcement, including police brutality and violence;

(B) developing public health interventions and perspectives for eliminating deaths, injury, trauma, and negative mental health effects from police presence and interactions, including police brutality and violence; and

(C) ensuring comprehensive data collection, analysis, and reporting regarding police violence and misconduct, in consultation with the Department of Justice and independent researchers.

(3) Functions.— Under the program under paragraph (1), the Center shall—

(A) summarize and enhance the knowledge of the distribution, status, and characteristics of law enforcement-related death, trauma, and injury;

(B) conduct research and prepare, with the assistance of State public health departments—

(i) statistics on law enforcement-related death, injury, and brutality;

(ii) studies of the factors, including legal, socioeconomic, discrimination, and other factors that correlate with or influence police brutality;

(iii) public information about uses of force by law enforcement, including police brutality and violence, for the practical use of the public health community, including publications that synthesize information relevant to the national goal of understanding police violence and methods for its control;

(iv) information to identify socioeconomic groups, communities, and geographic areas in need of study, and a strategic plan for research necessary to comprehend the extent and nature of police uses of force by law enforcement, including police brutality and violence, and determine what options exist to reduce or eradicate death and injury that result; and

(v) best practices in police violence prevention in other countries;

(C) award grants, contracts, and cooperative agreements to provide for the conduct of epidemiologic research on uses of force by law enforcement, including police brutality and violence, by Federal, State, local, and private agencies, institutions, organizations, and individuals;

(D) award grants, contracts, and cooperative agreements to community groups, independent research organizations, academic institutions, and other entities to support, execute, or conduct research on interventions to reduce or eliminate uses of force by law enforcement, including police brutality and violence;

(E) coordinate with the Department of Justice and other Federal, State, and local agencies on the standardization of data collection, storage, and retrieval necessary to collect, evaluate, analyze, and disseminate information about the extent and nature of uses of force by law enforcement, including police brutality and violence, as well as options for the eradication of such practices;

(F) submit an annual report to Congress on research findings with recommendations to improve data collection and standardization and to disrupt processes in policing that preserve and reinforce racism and racial disparities in public health;

(G) conduct primary research and explore uses of force by law enforcement, including police brutality and violence, and options for its control; and

(H) study alternatives to law enforcement response as a method of reducing police violence.

(4) Authorization of appropriations.— There is authorized to be appropriated such sums as may be necessary to carry out this subsection.

(a) Improving data collection on the sexual orientation and gender identity of deceased individuals through the National Violent Death Reporting System.—

(1) Collection of sexual orientation and gender identity data.—

(A) In general.— Not later than 120 days after the date of enactment of this Act, the Director of the Centers for Disease Control and Prevention shall take measures to improve the incidence of the collection of information on the sexual orientation and gender identity of deceased individuals through the National Violent Death Reporting System or any successor programs.

(B) Confidentiality.— Any information collected relating to the sexual orientation or gender identity of a decedent shall be maintained in accordance with the confidentiality and privacy standards and policies for the protection of individuals applicable to all other data collected for purposes of the National Violent Death Reporting System.

(2) Definitions.— In this subsection:

(A) Gender identity.— The term gender identity means an individual’s sense of being male, female, transgender, or another gender, as distinct from the individual’s sex assigned at birth.

(B) Sexual orientation.— The term sexual orientation means how a person identifies in terms of their emotional, romantic, or sexual attractions, and includes identification as straight, heterosexual, gay, lesbian, or bisexual, among other terms.

(3) Authorization.— There is authorized to be appropriated $25,000,000 for fiscal year 2027 to carry out this subsection.

(b) Sense of Congress.— It is the sense of Congress that—

(1) the Centers for Disease Control and Prevention has made significant efforts to encourage States and other jurisdictions to collect data on sexual orientation and gender identity through the National Violent Death Reporting System; and

(2) jurisdictions that participate in the collection of such data through the National Violent Death Reporting System should be commended for their participation.

(a) Purposes.— The purposes of this section are as follows:

(1) To establish effective, coordinated Federal technical assistance to help State and local governments to improve outcomes and cost-effectiveness of, and return on investment from, health and social services programs.

(2) To build a pipeline of State and locally designed, cross-sector interventions and strategies that generate rigorous evidence about how to improve health and social outcomes, and increase the cost-effectiveness of, and return on investment from, Federal, State, local, and Tribal health and social services programs.

(3) To enlist State and local governments and the service providers of such governments as partners in identifying Federal statutory, regulatory, and administrative challenges in improving the health and social outcomes of, cost-effectiveness of, and return on investment from, Federal spending on individuals enrolled in the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).

(4) To develop strategies to improve health and social outcomes without denying services to, or restricting the eligibility of, vulnerable populations.

(b) Social determinants accelerator council.—

(1) Establishment.— The Secretary, in coordination with the Administrator of the Centers for Medicare & Medicaid Services (referred to in this section as the “Administrator”), shall establish an interagency council, to be known as the Social Determinants Accelerator Interagency Council (referred to in this section as the “Council”), to achieve the purposes listed in subsection (a).

(2) Membership.—

(A) Federal composition.— The Council shall be composed of at least one designee from each of the following Federal agencies:

(i) The Office of Management and Budget.

(ii) The Department of Agriculture.

(iii) The Department of Education.

(iv) The Indian Health Service.

(v) The Department of Housing and Urban Development.

(vi) The Department of Labor.

(vii) The Department of Transportation.

(viii) Any other Federal agency the Chair of the Council determines necessary.

(B) Designation.—

(i) In general.— The head of each agency specified in subparagraph (A) shall designate at least one employee described in clause (ii) to serve as a member of the Council.

(ii) Responsibilities.— An employee described in this clause shall be a senior employee of the agency—

(I) whose responsibilities relate to authorities, policies, and procedures with respect to the health and well-being of individuals receiving medical assistance under a State plan (or a waiver of such plan) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); or

(II) who has authority to implement and evaluate transformative initiatives that harness data or conducts rigorous evaluation to improve the impact and cost-effectiveness of federally funded services and benefits.

(C) HHS representation.— In addition to the designees under subparagraph (A), the Council shall include designees from at least three agencies within the Department of Health and Human Services, including the Centers for Medicare & Medicaid Services, at least one of whom shall meet the criteria under subparagraph (B)(ii).

(D) OMB role.— The Director of the Office of Management and Budget shall facilitate the timely resolution of Government-wide and multiagency issues to help the Council achieve consensus recommendations described under paragraph (3)(A).

(E) Non-Federal composition.— The Comptroller General of the United States may designate up to 6 Council designees—

(i) who have relevant subject matter expertise, including expertise implementing and evaluating transformative initiatives that harness data and conduct evaluations to improve the impact and cost-effectiveness of Federal Government services; and

(ii) that each represent—

(I) State, local, and Tribal health and human services agencies;

(II) public housing authorities or State housing finance agencies;

(III) State and local government budget offices;

(IV) State Medicaid agencies; or

(V) national consumer advocacy organizations.

(F) Chair.—

(i) In general.— The Secretary shall select the Chair of the Council from among the members of the Council.

(ii) Initiating guidance.— The Chair, on behalf of the Council, shall identify and invite individuals from diverse entities to provide the Council with advice and information pertaining to addressing social determinants of health, including—

(I) individuals from State and local government health and human services agencies;

(II) individuals from State Medicaid agencies;

(III) individuals from State and local government budget offices;

(IV) individuals from public housing authorities or State housing finance agencies;

(V) individuals from nonprofit organizations, small businesses, and philanthropic organizations;

(VI) advocates;

(VII) researchers; and

(VIII) any other individuals the Chair determines to be appropriate.

(3) Duties.— The duties of the Council are—

(A) to make recommendations to the Secretary and the Administrator regarding the criteria for making awards under subsection (b);

(B) to identify Federal authorities and opportunities for use by States or local governments to improve coordination of funding and administration of Federal programs, the beneficiaries of whom include individuals described in subsection (a), and which may be unknown or underutilized and to make information on such authorities and opportunities publicly available;

(C) to provide targeted technical assistance to States developing a social determinants accelerator plan under subsection (c), including identifying potential statutory or regulatory pathways for implementation of the plan and assisting in identifying potential sources of funding to implement the plan;

(D) to report to Congress annually on the subjects set forth in paragraph (5);

(E) to develop and disseminate evaluation guidelines and standards that can be used to reliably assess the impact of an intervention or approach that may be implemented pursuant to this section on outcomes, cost-effectiveness of, and return on investment from Federal, State, local, and Tribal governments, and to facilitate technical assistance, where needed, to help to improve State and local evaluation designs and implementation;

(F) to seek feedback from State, local, and Tribal governments, including through an annual survey by an independent third party, on how to improve the technical assistance the Council provides to better equip State, local, and Tribal governments to coordinate health and social service programs;

(G) to solicit applications for grants under subsection (c); and

(H) to coordinate with other cross-agency initiatives focused on improving the health and well-being of low-income and at-risk populations in order to prevent unnecessary duplication between agency initiatives.

(4) Schedule.— Not later than 60 days after the date of enactment of this Act, the Council shall convene to develop a schedule and plan for carrying out the duties described in paragraph (3), including solicitation of applications for the grants under subsection (c).

(5) Report to Congress.— The Council shall submit an annual report to Congress, which shall include—

(A) a list of the Council members;

(B) a description of the activities and expenditures of the Council;

(C) summaries of the interventions and approaches that will be supported by State, local, and Tribal governments that received a grant under subsection (c), including—

(i) the best practices and evidence-based approaches such governments plan to employ to achieve the purposes listed in subsection (a); and

(ii) a description of how the practices and approaches will impact the outcomes, cost-effectiveness of, and return on investment from, Federal, State, local, and Tribal governments with respect to such purposes;

(D) the feedback received from State and local governments on ways to improve the technical assistance of the Council, including findings from a third-party survey and actions the Council plans to take in response to such feedback; and

(E) the major statutory, regulatory, and administrative challenges identified by State, local, and Tribal governments that received a grant under subsection (c), and the actions that Federal agencies are taking to address such challenges.

(6) FACA applicability.— Chapter 10 of title 5, United States Code, shall not apply to the Council.

(7) Council procedures.— The Secretary, in consultation with the Comptroller General of the United States and the Director of the Office of Management and Budget, shall establish procedures for the Council to—

(A) ensure that adequate resources are available to effectively execute the responsibilities of the Council;

(B) effectively coordinate with other relevant advisory bodies and working groups to avoid unnecessary duplication;

(C) create transparency to the public and Congress with regard to Council membership, costs, and activities, including through use of modern technology and social media to disseminate information; and

(D) avoid conflicts of interest that would jeopardize the ability of the Council to make decisions and provide recommendations.

(c) Social determinants accelerator grants to States or local governments.—

(1) Grants to States, local governments, and tribes.— Not later than 180 days after the date of enactment of this Act, the Administrator, in consultation with the Secretary and the Council, shall award on a competitive basis not more than 25 grants to eligible applicants described in paragraph (2), for the development of social determinants accelerator plans, as described in paragraph (6).

(2) Eligible applicant.— An eligible applicant described in this subsection is a State, local, or Tribal health or human services agency that—

(A) demonstrates the support of relevant parties across relevant State, local, or Tribal jurisdictions; and

(B) in the case of an applicant that is a local government agency, provides to the Secretary a letter of support from the lead State health or human services agency for the State in which the local government is located.

(3) Amount of grant.— The Administrator, in coordination with the Council, shall determine the total amount that the Administrator will make available to each grantee under this subsection.

(4) Application.— An eligible applicant seeking a grant under this subsection shall include in the application the following information:

(A) The target population (or populations) that would benefit from implementation of the social determinants accelerator plan proposed to be developed by the applicant.

(B) A description of the objective or objectives and outcome goals of such proposed plan, which shall include at least one health outcome and at least one other important social outcome.

(C) The sources and scope of inefficiencies that, if addressed by the plan, could result in improved cost-effectiveness of or return on investment from Federal, State, local, and Tribal governments.

(D) A description of potential interventions that could be designed or enabled using such proposed plan.

(E) The State, local, Tribal, academic, nonprofit, community-based organizations, and other private sector partners that would participate in the development of the proposed plan and subsequent implementation of programs or initiatives included in such proposed plan.

(F) Such other information as the Administrator, in consultation with the Secretary and the Council, determines necessary to achieve the purposes of this section.

(5) Use of funds.— A recipient of a grant under this subsection may use funds received through the grant for the following purposes:

(A) To convene and coordinate with relevant government entities and other stakeholders across sectors to assist in the development of a social determinants accelerator plan.

(B) To identify populations of individuals receiving medical assistance under a State plan (or a waiver of such plan) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) who may benefit from the proposed approaches to improving the health and well-being of such individuals through the implementation of the proposed social determinants accelerator plan.

(C) To engage qualified research experts to advise on relevant research and to design a proposed evaluation plan, in accordance with the standards and guidelines issued by the Administrator.

(D) To collaborate with the Council to support the development of social determinants accelerator plans.

(E) To prepare and submit a final social determinants accelerator plan to the Council.

(6) Contents of plans.— A social determinants accelerator plan developed under this subsection shall include the following:

(A) A description of the target population (or populations) that would benefit from implementation of the social determinants accelerator plan, including an analysis describing the projected impact on the well-being of individuals described in paragraph (5)(B).

(B) A description of the interventions or approaches designed under the social determinants accelerator plan and the evidence for selecting such interventions or approaches.

(C) The objectives and outcome goals of such interventions or approaches, including at least one health outcome and at least one other important social outcome.

(D) A plan for accessing and linking relevant data to enable coordinated benefits and services for the jurisdictions described in paragraph (2)(A) and an evaluation of the proposed interventions and approaches.

(E) A description of the State, local, Tribal, academic, nonprofit, or community-based organizations, or any other private sector organizations that would participate in implementing the proposed interventions or approaches, and the role each would play to contribute to the success of the proposed interventions or approaches.

(F) The identification of the funding sources that would be used to finance the proposed interventions or approaches.

(G) A description of any financial incentives that may be provided, including outcome-focused contracting approaches to encourage service providers and other partners to improve outcomes of, cost-effectiveness of, and return on investment from, Federal, State, local, or Tribal government spending.

(H) The identification of the applicable Federal, State, local, or Tribal statutory and regulatory authorities, including waiver authorities, to be leveraged to implement the proposed interventions or approaches.

(I) A description of potential considerations that would enhance the impact, scalability, or sustainability of the proposed interventions or approaches and the actions the grant awardee would take to address such considerations.

(J) A proposed evaluation plan, to be carried out by an independent evaluator, to measure the impact of the proposed interventions or approaches on the outcomes of, cost-effectiveness of, and return on investment from, Federal, State, local, and Tribal governments.

(K) Precautions for ensuring that vulnerable populations will not be denied access to Medicaid or other essential services as a result of implementing the proposed plan.

(d) Funding.—

(1) In general.— Out of any money in the Treasury not otherwise appropriated, there is appropriated to carry out this section $25,000,000 for the period of fiscal years 2027 through 2031, of which up to $5,000,000 may be used to carry out this section, to remain available for obligation until the date that is 5 years after the date of enactment of this Act.

(2) Reservation of funds.—

(A) In general.— Of the funds made available under paragraph (1), the Secretary shall reserve not less than 20 percent to award grants to eligible applicants for the development of social determinants accelerator plans under subsection (c) intended to serve rural populations.

(B) Exception.— In the case of a fiscal year for which the Secretary determines that there are not sufficient eligible applicants for grants under subsection (c) that are intended to serve rural populations and the Secretary cannot satisfy the 20-percent requirement, the Secretary may reserve an amount that is less than 20 percent of amounts made available under paragraph (1) to award grants for such purpose.

(3) Rule of construction.— Nothing in this section shall prevent Federal agencies represented on the Council from contributing additional funding from other sources to support activities to improve the effectiveness of the Council.

(a) Social Determinants of Health Program.—

(1) Program.— To the extent and in the amounts made available in advance in appropriations Acts, the Director of the Centers for Disease Control and Prevention (in this section referred to as the “Director”) shall carry out a program, to be known as the Social Determinants of Health Program (in this section referred to as the “Program”), to achieve the following goals:

(A) Improve health outcomes and reduce health inequities by coordinating social determinants of health activities across the Centers for Disease Control and Prevention.

(B) Improve the capacity of public health agencies and community organizations to address social determinants of health in communities.

(2) Activities.— To achieve the goals listed in paragraph (1), the Director shall carry out activities including the following:

(A) Coordinating across the Centers for Disease Control and Prevention to ensure that relevant programs consider and incorporate social determinants of health in grant awards and other activities.

(B) Awarding grants under subsection (b) to State, local, territorial, and Tribal health agencies and organizations, and to other eligible entities, to address social determinants of health in target communities.

(C) Awarding grants under subsection (c) to nonprofit organizations and public or other nonprofit institutions of higher education—

(i) to conduct research on best practices to improve social determinants of health;

(ii) to provide technical assistance, training, and evaluation assistance to grantees under subsection (b); and

(iii) to disseminate best practices to grantees under subsection (b).

(D) Coordinating, supporting, and aligning activities of the Centers for Disease Control and Prevention related to social determinants of health with activities of other Federal agencies related to social determinants of health, including such activities of agencies in the Department of Health and Human Services such as the Centers for Medicare & Medicaid Services.

(E) Collecting and analyzing data related to the social determinants of health.

(b) Grants To address social determinants of health.—

(1) In general.— The Director, as part of the Program, shall award grants to eligible entities to address social determinants of health in their communities.

(2) Eligibility.— To be eligible to apply for a grant under this subsection, an entity shall be—

(A) a State, local, territorial, or Tribal health agency or organization;

(B) a qualified nongovernmental entity, as defined by the Director; or

(C) a consortium of entities that includes a State, local, territorial, or Tribal health agency or organization.

(3) Use of funds.—

(A) In general.— A grant under this subsection shall be used to address social determinants of health in a target community by designing and implementing innovative, evidence-based, cross-sector strategies.

(B) Target community.— For purposes of this subsection, a target community shall be a State, county, city, or other municipality.

(4) Priority.— In awarding grants under this subsection, the Director shall prioritize applicants proposing to serve target communities with significant unmet health and social needs, as defined by the Director.

(5) Application.— To seek a grant under this subsection, an eligible entity shall—

(A) submit an application at such time, in such manner, and containing such information as the Director may require;

(B) propose a set of activities to address social determinants of health through evidence-based, cross-sector strategies, which activities may include—

(i) collecting quantifiable data from health care, social services, and other entities regarding the most significant gaps in health-promoting social, economic, and environmental needs;

(ii) identifying evidence-based approaches to meeting the nonmedical, social needs of populations identified by data collection described in clause (i), such as unstable housing or food insecurity;

(iii) developing scalable methods to meet patients’ social needs identified in clinical settings or other sites;

(iv) convening entities such as local and State governmental and nongovernmental organizations, health systems, payors, and community-based organizations to review, plan, and implement community-wide interventions and strategies to advance health-promoting social conditions;

(v) monitoring and evaluating the impact of activities funded through the grant on the health and well-being of the residents of the target community and on the cost of health care; and

(vi) such other activities as may be specified by the Director;

(C) demonstrate how the eligible entity will collaborate with—

(i) health systems;

(ii) payors, including, as appropriate, Medicaid managed care organizations (as defined in section 1903(m)(1)(A) of the Social Security Act (42 U.S.C. 1396b(m)(1)(A))), Medicare Advantage plans under part C of title XVIII of such Act (42 U.S.C. 1395w–21 et seq.), and health insurance issuers and group health plans (as such terms are defined in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91));

(iii) other relevant stakeholders and initiatives in areas of need, such as the Accountable Health Communities Model of the Centers for Medicare & Medicaid Services, health homes under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), community-based organizations, and human services organizations;

(iv) other non-health care sector organizations, including organizations focusing on transportation, housing, or food access; and

(v) local employers; and

(D) identify key health inequities in the target community and demonstrate how the proposed efforts of the eligible entity would address such inequities.

(6) Monitoring and evaluation.— As a condition of receipt of a grant under this subsection, a grantee shall agree to submit an annual report to the Director describing the activities carried out through the grant and the outcomes of such activities.

(7) Independent national evaluation.—

(A) In general.— Not later than 5 years after the first grants are awarded under this subsection, the Director shall provide for the commencement of an independent national evaluation of the program under this subsection.

(B) Report to Congress.— Not later than 60 days after receiving the results of such independent national evaluation, the Director shall report such results to Congress.

(c) Research and training.— The Director, as part of the Program—

(1) shall award grants to nonprofit organizations and public or other nonprofit institutions of higher education—

(A) to conduct research on best practices to improve social determinants of health;

(B) to provide technical assistance, training, and evaluation assistance to grantees under subsection (b); and

(C) to disseminate best practices to grantees under subsection (b); and

(2) may require a grantee under paragraph (1) to provide technical assistance and capacity building to entities that are eligible entities under subsection (b) but not receiving funds through such subsection.

(d) Funding.—

(1) In general.— There is authorized to be appropriated to carry out this section, $50,000,000 for each of fiscal years 2027 through 2032.

(2) Allocation.— Of the amount made available to carry out this section for a fiscal year, not less than 75 percent shall be used for grants under subsections (b) and (c).

Section 443 of the Higher Education Act of 1965 (20 U.S.C. 1087–53) is amended by adding at the end the following:

“(f) Notification regarding SNAP.—

(1) In general.— An institution receiving a grant under this part shall send a notification (by email or other electronic means) to each eligible student informing the student of their potential eligibility for participation in SNAP and the process for obtaining more information, confirming eligibility, and accessing benefits under that program. The notification shall be developed by the Secretary of Education in consultation with the Secretary of Agriculture, and shall include details on eligibility requirements for participation in SNAP that a student must satisfy. The notification shall be, to the extent practicable, specific to the student’s State of residence and shall provide contact information for the local office where an application for SNAP may be made.

(2) Evidence of participation in federally financed work-study program.— The notification under paragraph (1) shall include an official document confirming that the recipient is an eligible student sufficient for purposes of demonstrating that the exclusion from ineligibility for participation in SNAP under section 6(e)(4) of the Food and Nutrition Act of 2008 (7 U.S.C. 2015(e)(4)) applies to the student.

(3) Guidance.— The Secretary of Education, in consultation with the Secretary of Agriculture, shall provide guidance to States and institutions of higher education on how to identify and communicate with students who are likely to be eligible for SNAP, including those eligible for a State or federally financed work-study program.

(4) Definitions.— For purposes of this subsection:

(A) The term “eligible student” means a student receiving work-study assistance under this part.

(B) The term “SNAP” means the supplemental nutrition assistance program (as defined in section 3(t) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(t))).”.

(a) In general.— Section 391 of the Public Health Service Act (42 U.S.C. 280b) is amended—

(1) in subsection (a)(1), by striking “research relating to the causes, mechanisms, prevention, diagnosis, treatment of injuries, and rehabilitation from injuries;” and inserting the following:

“(A) the causes, mechanisms, prevention, diagnosis, and treatment of injuries, including with respect to gun violence; and

(B) rehabilitation from such injuries;”; and

(2) by adding at the end the following:

“(c) No advocacy or promotion of gun control.— Nothing in this section shall be construed to—

(1) authorize the Secretary to give assistance, make grants, or enter into cooperative agreements or contracts for the purpose of advocating or promoting gun control; or

(2) permit a recipient of any assistance, grant, cooperative agreement, or contract under this section to use such assistance, grant, agreement, or contract for the purpose of advocating or promoting gun control.”.

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall improve the National Violent Death Reporting System (as authorized by sections 301(a) and 391(a) of the Public Service Health Act (42 U.S.C. 241(a), 280b(a))), particularly through the inclusion of additional States and activities to increase the quality, type, and timeliness of reported data. Participation in the System by the States shall be voluntary.

Not later than one year after the date of enactment of this Act, and annually thereafter, the Surgeon General shall submit to Congress a report on the effects on public health, including mental health, of gun violence in the United States during the preceding year, and the status of actions taken to address such effects.

Not later than one year after the date of enactment of this Act, the Deputy Assistant Secretary for Minority Health shall submit to Congress a report on the effects of gun violence on public health, including mental health, in minority communities in the United States, and the status of actions taken to address such effects.

This chapter may be cited as the “Senior Hunger Prevention Act”.

(a) Certification period.— Section 3(f) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(f)) is amended, in the second sentence, by striking “24” and inserting “36”.

(b) Standard medical expense deduction.— Section 5(e)(5) of the Food and Nutrition Act of 2008 (7 U.S.C. 2014(e)(5)) is amended—

(1) in the paragraph heading, by striking “Excess medical” and inserting “Medical”;

(2) in subparagraph (A), by striking “an excess medical” and all that follows through the period at the end and inserting “a standard medical deduction or a medical expense deduction of actual costs for the allowable medical expenses incurred by the elderly or disabled member, exclusive of special diets.”;

(3) in subparagraph (B)(i), by striking “excess”; and

(4) by adding at the end the following:

“(D) Standard medical expense deduction amount.—

(i) In general.— Except as provided in clause (ii), the standard medical expense deduction shall be equal to—

(I) for fiscal year 2027, $155; and

(II) for each subsequent fiscal year, the applicable amount for the immediately preceding fiscal year, as adjusted to reflect changes for the 12-month period ending the preceding June 30 in the Consumer Price Index for All Urban Consumers: Medical Care published by the Bureau of Labor Statistics of the Department of Labor.

(ii) Exception.— For any fiscal year, a State agency may establish a greater standard medical expense deduction than the deduction described in clause (i) if the greater deduction satisfies the applicable cost-neutrality standards established by the Secretary for that fiscal year.”.

(c) Value of allotment.— Section 8(a) of the Food and Nutrition Act of 2008 (7 U.S.C. 2017(a)) is amended, in the proviso, by striking “8 percent” and inserting “1/3”.

(a) Definition of elderly and disabled.— Section 3(j) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(j)) is amended—

(1) in the matter preceding paragraph (1), by striking the subsection designation and all that follows through “who” and inserting the following:

“(j) Elderly or disabled.— The term elderly or disabled, with respect to an individual or member of a household, means that the individual or member of the household”; and

(2) in paragraph (2)(B), by inserting “(which includes medical assistance provided to an individual described in section 1902(e)(14)(D)(i)(III) of that Act (42 U.S.C. 1396a(e)(14)(D)(i)(III)))” after “(42 U.S.C. 1396 et seq.)”.

(b) Elderly simplified application program.— The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) is amended by adding at the end the following:

“31. Elderly simplified application program.—

(a) In general.— Not later than 180 days after the date of enactment of this section, the Secretary shall establish a program, to be known as the “elderly simplified application program” (referred to in this section as ESAP), under which a State, in carrying out the supplemental nutrition assistance program, may elect to implement a streamlined application and certification process for households in which all adult members—

(1) are elderly or disabled members; and

(2) have no earned income.

(b) Certification period.— The certification period for participants in ESAP shall be 36 months.

(c) Income and other data verification.—

(1) In general.— A State agency determining the eligibility for an applicant household under ESAP shall, notwithstanding section 11(e)(3)—

(A) to the maximum extent practicable, use data matching for income verification and household size; and

(B)

(i) allow self-declaration by the applicant of the information required under section 273.2(f) of title 7, Code of Federal Regulations (or a successor regulation); but

(ii) verify, prior to certification of the household, factors of eligibility provided by the applicant that the State agency determines are questionable.

(2) Accountability and fraud prevention.— In carrying out paragraph (1), a State agency shall establish accountability and fraud protection measures to deter fraud and ensure the integrity of ESAP and the supplemental nutrition assistance program.

(d) Interviews.—

(1) In general.— Notwithstanding section 11(e)(6)(A), for recertification of a household under ESAP, a State agency shall not require an interview unless requested by the household.

(2) Virtual interviews.— An interview under paragraph (1) may be conducted virtually.

(e) Guidance.— Prior to the establishment of ESAP under subsection (a), the Administrator of the Food and Nutrition Service shall develop guidance for States, including by consulting with States, to carry out ESAP, which shall include—

(1) general implementation guidelines;

(2) reporting requirements;

(3) quality control requirements; and

(4) best practices.”.

(c) Combined application program.— The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) (as amended by subsection (b)) is amended by adding at the end the following:

“32. Combined application program.—

(a) In general.— Not later than 180 days after the date of enactment of this section, the Secretary, in coordination with the Commissioner of Social Security, shall establish a program, to be known as the “combined application program” (referred to in this section as CAP), under which a State, in carrying out the supplemental nutrition assistance program, may elect to implement a streamlined application process for households in which all adult members are applicants for or recipients of benefits under title II of the Social Security Act (42 U.S.C. 401 et seq.) on the basis of a disability or supplemental security income under title XVI of that Act (42 U.S.C. 1381 et seq.).

(b) Purposes.— The purposes of CAP are—

(1) to reduce the need for households described in subsection (a) to have in-person interviews with State offices administering the supplemental nutrition assistance program; and

(2) to increase participation in the supplemental nutrition assistance program by simplifying the application process for the supplemental nutrition assistance program through increased automation and simplified calculation of benefits.

(c) CAP models.— The Secretary, in coordination with the Commissioner of the Social Security Administration, shall offer, at a minimum, each of the following models for States to implement CAP:

(1) Standard model.—

(A) In general.— Under the standard model, the Commissioner of the Social Security Administration and the State agency administering the supplemental nutrition assistance program shall coordinate—

(i) to develop a simplified joint application process for the supplemental nutrition assistance program that uses standardized benefit amounts or standardized shelter expenses, in accordance with this paragraph; and

(ii) to conduct outreach to adult members receiving supplemental security income under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.) that are not receiving benefits under the supplemental nutrition assistance program.

(B) Standardized benefit amounts.—

(i) In general.— Under the standardized model described in subparagraph (A), applicants shall receive a standardized or automated benefit level under the supplemental nutrition assistance program based on the shelter expenses and other income of the applicants.

(ii) Minimum standardized benefit levels.— At a minimum, there shall be in effect 2 standardized benefit levels under clause (i), including, as determined by the State—

(I) a level for participants with low shelter expenses; and

(II) a level for participants with high shelter expenses.

(iii) Comparable amount.— A State shall ensure that the amount provided under a standardized benefit level under clause (i) is comparable to an amount that a participant would otherwise receive under the supplemental nutrition assistance program.

(iv) Referral.— A State shall refer a household described in subsection (a) to the supplemental nutrition assistance program instead of enrolling that household in CAP if the standardized amount that the household would receive under CAP would be significantly less than the amount of benefits that the household would receive under the supplemental nutrition assistance program.

(C) Standardized shelter expenses.— In computing an excess shelter expense deduction under section 5(e)(6), a State agency may use a standard utility allowance in accordance with regulations promulgated by the Secretary.

(2) Modified model.— Under the modified model, a State agency administering the supplemental nutrition assistance program shall—

(A) conduct outreach to prospective participants in the supplemental nutrition assistance program using information from the Social Security Administration to identify households described in subsection (a) that are not participants in the supplemental nutrition assistance program; and

(B) send to those households simplified application forms for the supplemental nutrition assistance program.”.

The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) (as amended by section 10203(c)) is amended by adding at the end the following:

“33. Enrollment and outreach pilot program for older adults, kinship families, and adults with disabilities.—

(a) Definitions.— In this section:

(1) Disability.— The term disability has the meaning given the term in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102).

(2) Eligible entity.— The term eligible entity means—

(A) a State or local government agency;

(B) an Indian tribe or Tribal organization;

(C) a nonprofit organization, including a public or nonprofit provider of services;

(D) a community-based organization; and

(E) an educational provider.

(3) Kinship family.— The term kinship family means a family in which a child resides with, and is being raised by, a grandparent, another extended family member, or an adult with whom the child has a close family-like relationship, such as a godparent or a close family friend.

(4) Older adult.— The term older adult has the meaning given the term older individual in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002).

(5) Pilot program.— The term pilot program means the Enrollment and Outreach Pilot Program for Older Adults, Kinship Families, and Adults with Disabilities established under subsection (b).

(b) Establishment.— Not later than 180 days after the date of enactment of this section, the Secretary shall establish a pilot program, to be known as the “Enrollment and Outreach Pilot Program for Older Adults, Kinship Families, and Adults with Disabilities”, under which the Secretary shall award grants to eligible entities—

(1) to raise awareness among older adults, kinship families, and adults with disabilities of the availability, eligibility requirements, application procedures, and benefits of the supplemental nutrition assistance program; and

(2) to support older adults, kinship families, and adults with disabilities in enrolling in the supplemental nutrition assistance program.

(c) Priority.— In awarding grants under the pilot program, the Secretary shall give priority to—

(1) eligible entities that—

(A) provide services to older adults or adults with disabilities;

(B) provide services to kinship families, including kinship navigator programs;

(C) have experience implementing programs that receive funding under the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.);

(D) have experience implementing programs administered by the Food and Nutrition Service; or

(E) receive, plan to receive, or demonstrate an ability to partner with a program that receives, funding under—

(i) the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.);

(ii) the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.); or

(iii) 1 or more nutrition programs administered by the Secretary; and

(2) projects that will—

(A) serve communities with—

(i) high rates of food insecurity or malnutrition; or

(ii) low food access;

(B) serve rural communities, indigenous communities, or communities of color;

(C) serve members of the lesbian, gay, bisexual, transgender, and queer community;

(D) serve adults with limited English proficiency;

(E) serve veterans;

(F) serve residents in federally subsidized housing, including federally subsidized housing units for older adults and adults with disabilities;

(G) serve residents living in housing serving kinship families; and

(H) incorporate nutrition education activities that promote healthy eating and active lifestyles.

(d) Eligible activities.— An eligible entity receiving a grant under the pilot program shall use the grant to carry out 1 or more of the following activities:

(1) Application assistance, including—

(A) eligibility prescreening;

(B) assistance in completing an application for the supplemental nutrition assistance program;

(C) assistance in obtaining application verification documents;

(D) medical expense deduction counseling; and

(E) translation of materials and bilingual accommodation.

(2) Tailored dissemination of information relating to the supplemental nutrition assistance program, including through—

(A) community-based outreach workshops and events;

(B) a toll-free hotline to provide information relating to Federal, State, and local food resources;

(C) informational websites and other social media sites; and

(D) printed or digital informational content.

(3) Transportation, including—

(A) transportation to or from a local office of the supplemental nutrition assistance program; and

(B) administration of vouchers or similar items for the transportation described in subparagraph (A).

(4) Identification, implementation, analysis, and dissemination of replicable and scalable models for increasing enrollment in the supplemental nutrition assistance program among older adults, kinship families, and adults with disabilities.

(e) Grants.—

(1) Maximum amount.— A grant awarded under the pilot program to an eligible entity for a fiscal year shall be—

(A) not less than $50,000; and

(B) not more than $250,000.

(2) Duration.— An eligible entity may be awarded a grant under the pilot program for not more than 5 years.

(f) Evaluation.— Not later than 2 years after the date of establishment of the pilot program, the Secretary shall conduct an evaluation of the pilot program.

(g) Funding.—

(1) In general.— In addition to amounts otherwise available, there is appropriated, out of any funds in the Treasury not otherwise appropriated, $12,250,000, to remain available until expended, to carry out the pilot program, of which not more than $250,000 shall be used to carry out the evaluation under subsection (f).

(2) Administrative costs.— Of the amounts made available under paragraph (1) (excluding the amount made available to carry out subsection (f)), not more than 3 percent may be used by the Secretary for administrative costs.”.

The Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) (as amended by section 10204) is amended by adding at the end the following:

“34. Food delivery.—

(a) Definitions.— In this section:

(1) Covered retail food store.— The term covered retail food store means a retail food store, a public or private nonprofit meal delivery service, or a public or nonprofit meal delivery provider participating in the supplemental nutrition assistance program that is unable to cover the cost of food delivery for participants of the supplemental nutrition assistance program.

(2) Employee.— The term employee has the meaning given the term in section 3 of the Fair Labor Standards Act of 1938 (29 U.S.C. 203).

(b) Program modifications.—

(1) In general.— In carrying out the supplemental nutrition assistance program, the Secretary shall—

(A) notify retail food stores participating in the supplemental nutrition assistance program of existing opportunities through which the retail food stores can deliver food to program participants, including by—

(i) allowing an EBT card to be swiped with a mobile device on delivery of food to the home; and

(ii) preparing food for pickup;

(B) authorize public-private partnerships between the Department of Agriculture, retail food stores participating in the supplemental nutrition assistance program, and community-based organizations to provide free or low-cost food delivery, including through the use of private funds;

(C) in the case of a covered retail food store, use funds made available under subparagraph (E) of paragraph (3) to provide, in accordance with that paragraph, free grocery delivery for participants in the supplemental nutrition assistance program who are older adults or adults with disabilities (as those terms are defined in section 33(a)) who are unable to shop for food or lack safe and accessible transportation options to the covered retail food store; and

(D) require each State to submit to the Secretary a plan that describes the methods by which the State will—

(i) work with retail food stores participating in the supplemental nutrition assistance program and other community-based partners to establish a process for food delivery for program participants;

(ii) administer the reimbursements described in paragraph (3), including timing, eligibility, and distribution processes; and

(iii) ensure that retail food stores participating in the supplemental nutrition assistance program that are reimbursed for delivery costs under paragraph (3) adhere to the requirements described in subparagraph (B) of that paragraph.

(2) State plans.— Not later than 10 days after the date on which the Secretary receives a State plan under paragraph (1)(D), the Secretary shall—

(A) determine whether to approve or disapprove the State plan; and

(B) make publicly available on the website of the Department of Agriculture—

(i) the State plan;

(ii) the determination made under subparagraph (A) with respect to that plan; and

(iii) any guidance issued to the State with respect to that plan.

(3) Reimbursement of covered retail food stores.—

(A) In general.— Notwithstanding any other provision of law (including sections 274.7(f) and 278.2(b) of title 7, Code of Federal Regulations (or successor regulations), and any other regulations), subject to the availability of funds, a State agency shall reimburse a covered retail food store for the cost of food delivery to participants described in paragraph (1)(C) if—

(i) the covered retail food store meets the requirements under subparagraph (B); and

(ii) the majority of the number of food items delivered by the covered retail food store are eligible for redemption using benefits under the supplemental nutrition assistance program, regardless of whether the delivery includes nonfood items, subject to the condition that those nonfood items shall be of de minimis value.

(B) Requirements.— A covered retail food store may receive reimbursement for the cost of food delivery to participants described in paragraph (1)(C) if the following requirements are met:

(i) Food delivery is performed by employees of the covered retail food store or employees of an entity contracted by the covered retail food store to perform deliveries.

(ii) Before any employee described in clause (i) begins making food deliveries, that employee receives employer-provided health and safety training that reflects the most recent guidelines of the Centers for Disease Control and Prevention.

(iii) All employees described in clause (i) performing deliveries are paid at a rate that is not less than the greater of—

(I) the minimum wage rate established under section 6(a)(1) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(a)(1)); and

(II) the minimum wage rate established by the applicable State or locality in which the employee works.

(iv) The covered retail food store meets the size standard determined by the Small Business Administration for a supermarket or other grocery retailer or a convenience retailer under section 121.201 of title 13, Code of Federal Regulations (or a successor regulation).

(v) The covered retail food store does not—

(I) charge the supplemental nutrition assistance program participant for delivery costs for which the covered retail food store will be reimbursed;

(II) require minimum purchase thresholds in order to provide free delivery;

(III) restrict delivery times to least-favorable windows for those participants; or

(IV) charge surge pricing.

(C) Reimbursable costs.— Reimbursable costs under subparagraph (A) include costs associated with purchasing point-of-sale devices or receiving technical assistance relating to point-of-sale devices.

(D) Maximum reimbursement per delivery.— The maximum amount of reimbursement under subparagraph (A) for a food delivery fee shall be $10 per delivery, which may be adjusted by the Secretary for inflation.

(E) Authorization of appropriations.— There is authorized to be appropriated to the Secretary $500,000,000 for fiscal year 2027, and each fiscal year thereafter, to remain available until expended, to cover the cost of food delivery described in paragraph (1)(C), to be distributed among States to fund reimbursements by States under subparagraph (A).

(4) Report.— Not later than April 30, 2027, and April 30 of each year thereafter, the Secretary shall submit to the Committee on Agriculture, Nutrition, and Forestry of the Senate and the Committee on Agriculture of the House of Representatives a report that describes, for the period covered by the report, as applicable—

(A) the number of supplemental nutrition assistance program participants using food delivery services, including the percentage of those participants that are older adults and adults with disabilities (as those terms are defined in section 33(a));

(B) the covered retail food stores that were reimbursed under paragraph (3), including the amount of each reimbursement;

(C) any complications or difficulties experienced by States in administering reimbursements under paragraph (3); and

(D) recommendations or best practices to assist States in implementing food delivery programs similar to the program under this section.”.

(a) Funds.— Section 4 of the Agriculture and Consumer Protection Act of 1973 (7 U.S.C. 612c note; Public Law 93–86) is amended—

(1) in subsection (a), in the first sentence, by striking “2023” and inserting “2031”; and

(2) by adding at the end the following:

“(d) Funds.— In addition to amounts otherwise available, there is appropriated, out of any funds in the Treasury not otherwise appropriated, to carry out the program under this section $10,000,000 for each of fiscal years 2027 through 2031.”.

(b) Adults with disabilities.— Section 5 of the Agriculture and Consumer Protection Act of 1973 (7 U.S.C. 612c note; Public Law 93–86) is amended—

(1) by striking “2023” each place it appears and inserting “2031”;

(2) in subsection (g)—

(A) in paragraph (1), by striking “to low-income persons aged 60 and older.” and inserting the following:

“(A) low-income persons aged 60 and older; and

(B) low-income adults with disabilities (as defined in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102)).”;

(B) by redesignating paragraph (2) as paragraph (3);

(C) by inserting after paragraph (1) the following:

“(2) Income eligibility.— For purposes of paragraph (1), a low-income individual described in subparagraph (A) or (B) of that paragraph shall have a gross income level that is less than 185 percent of the Federal poverty line.”; and

(D) in subparagraph (B) of paragraph (3) (as so redesignated), in the matter preceding clause (i), by striking “of—” and all that follows through the period at the end of clause (ii) and inserting “of 36 months.”; and

(3) in subsection (i), in the matter preceding paragraph (1)—

(A) by inserting “or low-income adults with disabilities described in subsection (g)(1)(B)” after “elderly persons”; and

(B) by striking “to each elderly participant in, or applicant for, the commodity supplemental food program for the elderly” and inserting “to each participant in, or applicant for, such a program”.

(a) In general.— Section 4402 of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 3007) is amended—

(1) in subsection (a)—

(A) by striking “Of the funds” and inserting the following:

“(1) Mandatory funding.— Of the funds”;

(B) in paragraph (1) (as so designated), by inserting “(referred to in this section as the Secretary)” after “Agriculture”; and

(C) by adding at the end the following:

“(2) Authorization of appropriations.— There are authorized to be appropriated to the Secretary to carry out and expand the seniors farmers' market nutrition program—

(A) not less than $60,000,000 for fiscal year 2027;

(B) not less than $70,000,000 for fiscal year 2028; and

(C) not less than $100,000,000 for each of fiscal years 2029 through 2031.”;

(2) in subsection (b)(1), by inserting “and adults with disabilities (as defined in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102))” before the semicolon at the end;

(3) by redesignating subsections (c) through (f) as subsections (f) through (i), respectively; and

(4) by inserting after subsection (b) the following:

“(c) Benefit amounts.— Under the seniors farmers' market nutrition program—

(1) the minimum individual benefit shall be $35; and

(2) the maximum individual benefit shall be $80.

(d) Certification period.— The certification period for participants in the seniors farmers' market nutrition program shall be 36 months.

(e) Modernization grants.—