SPECIAL SUPPLEMENTAL NUTRITION PROGRAM.

SEC. 204. SPECIAL SUPPLEMENTAL NUTRITION PROGRAM. (a) Definition of Nutritional Risk.— Section 17(b)(8) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)(8)) is amended— (1) by redesignating subparagraph (D) as subparagraph (E); (2) by inserting after “health,” at the end of subparagraph (C) the following new subparagraph: “(D) conditions that directly affect the nutritional health of a person, such as alcoholism or drug abuse,”; and (3) in subparagraph (E) (as redesignated by paragraph (1)), by striking “alcoholism and drug addiction, homelessness, and” and inserting “homelessness and”. (b) Promotion of Program.— Section 17(c) of such Act (42 U.S.C. 1786(c)) is amended by adding at the end the following new paragraph: “(5) The Secretary shall promote the special supplemental nutrition program by producing and distributing materials, including television and radio public service announcements in English and other appropriate languages, that inform potentially eligible individuals of the benefits and services under the program.”. (c) Eligibility for Certain Pregnant Women.— Section 17(d) of such Act (42 U.S.C. 1786(d)) is amended— 108 STAT. 4739 (1) in paragraph (2), by adding at the end the following new subparagraph: “(C) In the case of a pregnant woman who is otherwise ineligible for participation in the program because the family of the woman is of insufficient size to meet the income eligibility standards of the program, the pregnant woman shall be considered to have satisfied the income eligibility standards if, by increasing the number of individuals in the family of the woman by 1 individual, the income eligibility standards would be met.”; and (2) in paragraph (3)— (A) by inserting “(A)” after “(3)”; and (B) by adding at the end the following new subparagraph: “(B) A State may consider pregnant women who meet the income eligibility standards to be presumptively eligible to participate in the program and may certify the women for participation immediately, without delaying certification until an evaluation is made concerning nutritional risk. A nutritional risk evaluation of such a woman shall be completed not later than 60 days after the woman is certified for participation. If it is subsequently determined that the woman does not meet nutritional risk criteria, the certification of the woman shall terminate on the date of the determination.”. (d) Technical Corrections.— Section 17(e) of such Act (42 U.S.C. 1786(e)) is amended by redesignating paragraph (3) (as added by section 123(a)(3)(D) of the Child Nutrition and WIC Reauthorization Act of 1989 (Public Law 101–147; 103 Stat. 895)) and paragraphs (4) and (5) as paragraphs (4), (5), and (6), respectively. (e) Coordination of WIC and Medicaid Programs Using Coordinated Care Providers.— Section 17(f)(l)(C)(iii) of such Act (42 U.S.C. 1786(0(1)(C)(iii)) is amended by inserting before the semicolon at the end the following: “, including medicaid programs that use coordinated care providers under a contract entered into under section 1903(m), or a waiver granted under section 1915(b), of the Social Security Act (42 U.S.C. 1396b(m) or 1396n(b)) (including coordination through the referral of potentially eligible women, infants, and children between the program authorized under this section and the medicaid program)”. (f) Priority Consideration for Certain Migrant Populations.— The first sentence of section 17(f)(3) of such Act (42 U.S.C. 1786(f)(3)) is amended by inserting before the period at the end the following: “and shall ensure that local programs provide priority consideration to serving migrant participants who are residing in the State for a limited period of time”. (g) Income Eligibility Guidelines.— Paragraph (18) of section 17(f) of such Act (42 U.S.C. 1786(0(18)) is amended to read as follows: “(18) Notwithstanding subsection (d)(2)(A)(i), not later than July 1 of each year, a State agency may implement income eligibility guidelines under this section concurrently with the implementation of income eligibility guidelines under the medicaid program established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).”. (h) Use of Recovered Program Funds in Year Collected.— Section 17(0 of such Act (42 U.S.C. 1786(0) is amended by adding at the end the following new paragraph: 108 STAT. 4740 “(23) A State agency may use funds recovered as a result of violations in the food delivery system of the program in the year in which the funds are collected for the purpose of carrying out the program.”. (i) Coordination Initiative for WIC and Medicaid Programs.— Section 17(f) of such Act (42 U.S.C. 1786(f)) (as amended by subsection (h)) is further amended by adding at the end the following new paragraph: “(24) The Secretary and the Secretary of Health and Human Services shall carry out an initiative to assure that, in a case in which a State medicaid program uses coordinated care providers under a contract entered into under section 1903(m), or a waiver granted under section 1915(b), of the Social Security Act (42 U.S.C. 1396b(m) or 1396n(b)), coordination between the program authorized by this section and the medicaid program is continued, including— “(A) the referral of potentially eligible women, infants, and children between the 2 programs; and “(B) the timely provision of medical information related to the program authorized by this section to agencies carrying out the program.”. (j) Extension of Program.— Section 17 of such Act (42 U.S.C. 1786) is amended— (1) in the first sentence of subsection (g)(1), by striking “1991, 1992, 1993, and 1994” and inserting “1995 through 1998”; and (2) in the first sentence of subsection (h)(2)(A), by striking “1990, 1991, 1992, 1993 and 1994” and inserting “1995 through 1998”. (k) Use of Funds for Technical Assistance and Research Evaluation Projects.— Section 17(g)(5) of such Act (42 U.S.C. 1786(g)(5)) is amended— (1) by striking “and administration of pilot projects” and inserting “administration of pilot projects”; and (2) by inserting before the period at the end the following: “, and carrying out technical assistance and research evaluation projects of the programs under this section”. (l) Breastfeeding Promotion and Support Activities.— Section 17(h)(3) of such Act (42 U.S.C. 1786(h)(3)) is amended— (1) in subparagraph (A)(i)(II)— (A) by striking “an amount” and inserting “except as otherwise provided in subparagraphs (F) and (G), an amount”; and (B) by striking “$8,000,000,” and inserting “the national minimum breastfeeding promotion expenditure, as described in subparagraph (E),”; and (2) by adding at the end the following new subparagraphs: “(E) In the case of fiscal year 1996 (except as provided in subparagraph (G)) and each subsequent fiscal year, the national minimum breastfeeding promotion expenditure means an amount that is— “(i) equal to $21 multiplied by the number of pregnant women and breastfeeding women participating in the program nationwide, based on the average number of pregnant women and breastfeeding women so participating during the last 3 months for which the Secretary has final data; and 108 STAT. 4741 “(ii) adjusted for inflation on October 1, 1996, and each October 1 thereafter, in accordance with paragraph (1)(B)(ii). “(F) In the case of fiscal year 1995, a State shall pay, in lieu of the expenditure required under subparagraph (A)(i)(II), an amount that is equal to the lesser of— “(i) an amount that is more than the expenditure of the State for fiscal year 1994 on the activities described in subparagraph (A)(i); or “(ii) an amount that is equal to $21 multiplied by the number of pregnant women and breastfeeding women participating in the program in the State, based on the average number of pregnant women and breastfeeding women so participating during the last 3 months for which the Secretary has final data. “(G) (i) If the Secretary determines that a State agency is unable, for reasons the Secretary considers to be appropriate, to make the expenditure required under subparagraph (A)(i)(II) for fiscal year 1996, the Secretary may permit the State to make the required level of expenditure not later than October 1, 1996. “(ii) In the case of fiscal year 1996, if the Secretary makes a determination described in clause (i), a State shall pay, in lieu of the expenditure required under subparagraph (A)(i)(II), an amount that is equal to the lesser of— “(I) an amount that is more than the expenditure of the State for fiscal year 1995 on the activities described in subparagraph (A)(i); and “(II) an amount that is equal to $21 multiplied by the number of pregnant women and breastfeeding women participating in the program in the State, based on the average number of pregnant women and breastfeeding women so participating during the last 3 months for which the Secretary has data.”. (m) Development of Standards for the Collection of Breastfeeding Data.— Section 17(h)(4) of such Act (42 U.S.C. 1786(h)(4)) is amended— (1) by striking “and” at the end of subparagraph (C); (2) by striking the period at the end of subparagraph (D) and inserting “; and”; and (3) by adding at the end the following new subparagraph: “(E) not later than 1 year after the date of enactment of this subparagraph, develop uniform requirements for the collection of data regarding the incidence and duration of breastfeeding among participants in the program and, on development of the uniform requirements, require each State agency to report the data for inclusion in the report to Congress described in subsection (d)(4).”. (n) Submission of Information to Congress on Waivers With Respect to Procurement of Infant Formula.— Section 17(h)(8)(D)(iii) of such Act (42 U.S.C. 1786(h)(8)(D)(iii)) is amended by striking “at 6-month intervals” and inserting “on a timely basis”. (o) Cost Containment.— (1) In general.— Section 17(h)(8)(G) of such Act (42 U.S.C. 1786(h)(8)(G)) is amended by adding at the end the following new clause: “(ix) Not later than September 30, 1996, the Secretary shall offer to solicit bids on behalf of State agencies regarding cost containment contracts to be entered into by infant cereal manufac-108 STAT. 4742 turers and State agencies. In carrying out this clause, the Secretary shall, to the maximum extent feasible, follow the procedures prescribed in this subparagraph regarding offers made by the Secretary with regard to soliciting bids regarding infant formula cost containment contracts. The Secretary may carry out this clause without issuing regulations.”. (2) Repeal of termination of authority.— Section 209 of the WIC Infant Formula Procurement Act of 1992 (Public Law 102–512; 42 U.S.C. 1786 note) is repealed. (p) Prohibition on Interest Liability to Federal Government on Rebate Funds.— Section 17(h)(8) of such Act (42 U.S.C. 1786(h)(8)) is amended by adding at the end the following new subparagraph: “(L) A State shall not incur any interest liability to the Federal Government on rebate funds for infant formula and other foods if all interest earned by the State on the funds is used for program purposes.”. (q) Use of Universal Product Codes.— Section 17(h)(8) of such Act (42 U.S.C. 1786(h)(8)) (as amended by subsection (p)) is further amended by adding at the end the following new subparagraph: “(M) (i) The Secretary shall establish pilot projects in at least 1 State, with the consent of the State, to determine the feasibility and cost of requiring States to carry out a system for using universal product codes to assist retail food stores that are vendors under the program in providing the type of infant formula that the participants in the program are authorized to obtain. In carrying out the projects, the Secretary shall determine whether the system reduces the incidence of incorrect redemptions of low-iron formula or brands of infant formula not authorized to be redeemed through the program, or both. “(ii) The Secretary shall provide a notification to the Committee on Education and Labor of the House of Representatives and the Committee on Agriculture, Nutrition, and Forestry of the Senate regarding whether the system is feasible, is cost-effective, reduces the incidence of incorrect redemptions described in clause (i), and results in any additional costs to States. “(iii) The system shall not require a vendor under the program to obtain special equipment and shall not be applicable to a vendor that does not have equipment that can use universal product codes.”. (r) Use of Unspent Nutrition Services and Administration Funds.— Section 17(h) of such Act (42 U.S.C. 1786(h)) is amended by adding at the end the following new paragraph: “(10) (A) For each of fiscal years 1995 through 1998, the Secretary shall use for the purposes specified in subparagraph (B), $10,000,000 or the amount of nutrition services and administration funds for the prior fiscal year that has not been obligated, whichever is less. “(B) Funds under subparagraph (A) shall be used for— “(i) development of infrastructure for the program under this section, including management information systems; “(ii) special State projects of regional or national significance to improve the services of the program under this section; and “(iii) special breastfeeding support and promotion projects, including projects to assess the effectiveness of particular108 STAT. 4743 breastfeeding promotion strategies and to develop State or local agency capacity or facilities to provide quality breastfeeding services.”. (s) Spendback Funds.— Section 17(i)(3) of such Act (42 U.S.C. 1786(i)(3)) is amended— (1) in subparagraph (A)(i), by inserting “(except as provided in subparagraph (H))” after “1 percent”; and (2) by adding at the end the following new subparagraph: “(H) The Secretary may authorize a State agency to expend not more than 3 percent of the amount of funds allocated to a State under this section for supplemental foods for a fiscal year for expenses incurred under this section for supplemental foods during the preceding fiscal year, if the Secretary determines that there has been a significant reduction in infant formula cost containment savings provided to the State agency that would affect the ability of the State agency to at least maintain the level of participation by eligible participants served by the State agency”. (t) Elimination of Duplicative Migrant Reports.— Section 17 of such Act (42 U.S.C. 1786) is amended— (1) in subsection (d)(4), by inserting after “Congress” the following: “and the National Advisory Council on Maternal, Infant, and Fetal Nutrition established under subsection (k)”; and (2) by striking subsection (j). (u) Initiative To Provide Program Services at Community and Migrant Health Centers.— Section 17 of such Act (42 U.S.C. 1786) (as amended by subsection (t)(2)) is further amended by inserting after subsection (i) the following new subsection: “(j) (1) The Secretary and the Secretary of Health and Human Services (referred to in this subsection as the ‘Secretaries’) shall jointly establish and carry out an initiative for the purpose of providing both supplemental foods and nutrition education under the special supplemental nutrition program and health care services to low-income pregnant, postpartum, and breastfeeding women, infants, and children at substantially more community health centers and migrant health centers. “(2) The initiative shall also include— “(A) activities to improve the coordination of the provision of supplemental foods and nutrition education under the special supplemental nutrition program and health care services at facilities funded by the Indian Health Service; and “(B) the development and implementation of strategies to ensure that, to the maximum extent feasible, new community health centers, migrant health centers, and other federally supported health care facilities established in medically underserved areas provide supplemental foods and nutrition education under the special supplemental nutrition program. “(3) The initiative may include— “(A) outreach and technical assistance for State and local agencies and the facilities described in paragraph (2)(A) and the health centers and facilities described in paragraph (2)(B); “(B) demonstration projects in selected State or local areas; and “(C) such other activities as the Secretaries find are appropriate. 108 STAT. 4744 “(4) (A) Not later than April 1, 1995, the Secretaries shall provide to Congress a notification concerning the actions the Secretaries intend to take to carry out the initiative. “(B) Not later than July 1, 1996, the Secretaries shall provide to Congress a notification concerning the actions the Secretaries are taking under the initiative or actions the Secretaries intend to take under the initiative as a result of their experience in implementing the initiative. “(C) On completion of the initiative, the Secretaries shall provide to Congress a notification concerning an evaluation of the initiative by the Secretaries and a plan of the Secretaries to further the goals of the initiative. “(5) As used in this subsection: “(A) The term ‘community health center’ has the meaning given the term in section 330(a) of the Public Health Service Act (42 U.S.C. 254c(a)). “(B) The term ‘migrant health center’ has the meaning given the term in section 329(a)(1) of such Act (42 U.S.C. 254b(a)(1))”. (v) Expansion of Farmers’ Market Nutrition Program.— (1) Matching requirement for Indian state agencies.— Section 17(m)(3) of such Act (42 U.S.C. 1786(m)(3)) is amended by adding at the end the following new sentence: “The Secretary may negotiate with an Indian State agency a lower percentage of matching funds than is required under the preceding sentence, but not lower than 10 percent of the total cost of the program, if the Indian State agency demonstrates to the Secretary financial hardship for the affected Indian tribe, band, group, or council.”. (2) Expansion.— Section 17(m)(5)(F) of such Act (42 U.S.C. 1786(m)(5)(F)) is amended— (A) in clause (i), by striking “15 percent” and inserting “17 percent”; (B) by striking clause (ii) and inserting the following new clause: “(ii) During any fiscal year for which a State receives assistance under this subsection, the Secretary shall permit the State to use not more than 2 percent of total program funds for market development or technical assistance to farmers’ markets if the Secretary determines that the State intends to promote the development of farmers’ markets in socially or economically disadvantaged areas, or remote rural areas, where individuals eligible for participation in the program have limited access to locally grown fruits and vegetables.”; and (C) in clause (iii), strike “for the administration of the program”. (3) Continued funding for certain states under farmers’ market nutrition program.— Subparagraph (A) of section 17(m)(6) of such Act (42 U.S.C. 1786(m)(6)(A)) is amended to read as follows: “(A) The Secretary shall give the same preference for funding under this subsection to eligible States that participated in the program under this subsection in a prior fiscal year as to States that participated in the program in the most recent fiscal year. The Secretary shall inform each State of the award of funds as prescribed by subparagraph (G) by February 15 of each year.”. 108 STAT. 4745 (4) Funding reduction floor.— Section 17(m)(6)(B)(ii) of such Act (42 U.S.C. 1786(m)(6)(B)(ii)) is amended by striking “$50,000” each place it appears and inserting “$75,000”. (5) State plan submission date.— Section 17(m)(6)(D)(i) of such Act (42 U.S.C. 1786(m)(6)(D)(i)) is amended by striking “at such time and in such manner as the Secretary may reasonably require” and inserting “by November 15 of each year”. (6) Percentage of annual appropriations available to states under farmers’ market nutrition program.— Section 17(m)(6)(G) of such Act (42 U.S.C. 1786(m)(6)(G)) is amended— (A) in the first sentence of clause (i), by striking “45 to 55 percent” and inserting “75 percent”; and (B) in the first sentence of clause (ii), by striking “45 to 55 percent” and inserting “25 percent”. (7) Data collection requirements.— Section 17(m)(8) of such Act (42 U.S.C. 1786(m)(8)) is amended by striking subparagraphs (D) and (E) and inserting the following new subparagraphs: “(D) the change in consumption of fresh fruits and vegetables by recipients, if the information is available; “(E) the effects of the program on farmers’ markets, if the information is available; and”. (8) Extension of coupon program.— Section 17(m)(10)(A) of such Act (42 U.S.C. 1786(m)(10)(A)) is amended— (A) by striking “$3,000,000 for fiscal year 1992, $6,500,000 for fiscal year 1993, and”; and (B) by inserting before the period at the end “, $10,500,000 for fiscal year 1995, and such sums as may be necessary for each of fiscal years 1996 through 1998”. (9) Elimination of funding carryover provision under farmers’ market nutrition program.— Section 17(m)(10)(B)(i) of such Act (42 U.S.C. 1786(m)(10)(B)(i)) is amended— (A) in subclause (I), by striking “Except as provided in subclause (II), each” and inserting “Each”; and (B) in subclause (II), by striking “or may be retained” and all that follows and inserting a period. (10) Elimination of reallocation of unexpended funds with respect to demonstration projects under farmers’ market nutrition program.— Section 17(m)(10)(B)(ii) of such Act (42 U.S.C. 1786(m)(10)(B)(ii)) is amended by striking the second sentence (11) Definition.— Section 17(m)(11)(D) of such Act (42 U.S.C. 1786(m)(11)(D)) is amended by inserting before the period at the end the following: “and any other agency approved by the chief executive officer of the State”. (12) Promotion by the secretary.— The Secretary of Agriculture shall promote the use of farmers’ markets by recipients of Federal nutrition programs administered by the Secretary. (w) Change in Name of Program.— (1) In general.— Section 17 of such Act (42 U.S.C. 1786) is amended— (A) by striking the section heading and inserting the following new section heading: 108 STAT. 4746 “SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN”; (B) in the first sentence of subsection (c)(1), by striking “special supplemental food program” and inserting “special supplemental nutrition program”; (C) in the second sentence of subsection (k)(1), by striking “special supplemental food program” each place it appears and inserting “special supplemental nutrition program”; and (D) in subsection (o)(1)(B), by striking “special supplemental food program” and inserting “special supplemental nutrition program”. (2) Conforming amendments.— (A) The second sentence of section 9(c) of the Food Stamp Act of 1977 (7 U.S.C. 2018(c)) is amended by striking “special supplemental food program” and inserting “special supplemental nutrition program”. (B) Section 685(b)(8) of the Individuals with Disabilities Education Act (20 U.S.C. 1484a(b)(8)) is amended by striking “Special Supplemental Food Program for Women, Infants and Children” and inserting “special supplemental nutrition program for women, infants, and children”. (C) Section 3803(c)(2)(C)(x) of title 31, United States Code, is amended by striking “special supplemental food program” and inserting “special supplemental nutrition program”. (D) Section 399(b)(6) of the Public Health Service Act (42 U.S.C. 280c–6(b)(6)) is amended by striking “special supplemental food program” and inserting “special supplemental nutrition program”. (E) Paragraphs (11)(C) and (53)(A) of section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) are each amended by striking “special supplemental food program” and inserting “special supplemental nutrition program”. (F) Section 202(b) of the WIC Infant Formula Procurement Act of 1992 (Public Law 102–512; 42 U.S.C. 1786 note) is amended by striking “special supplemental food program” and inserting “special supplemental nutrition program”. (3) References.— Any reference to the special supplemental food program established under section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786) in any provision of law, regulation, document, record, or other paper of the United States shall be considered to be a reference to the special supplemental nutrition program established under such section.