S.Amdt. 2966

SA 2966. Mr. SANDERS submitted an amendment intended to be proposed
to amendment SA 2910 proposed by Mr. Shelby to the bill H.R. 5895,
making appropriations for energy and water development and related
agencies for the fiscal year ending September 30, 2019, and for other
purposes; which was ordered to lie on the table; as follows:

At the end of title II of division C, add the following:

SEC. 2__. PILOT PROGRAM ON PROVISION OF MEDICALLY-TAILORED
MEALS TO VETERANS.

(a) In General.--The Secretary of Veterans Affairs shall
conduct a pilot program to assess the feasibility and
advisability of providing medically-tailored meals for
veterans living with one or more chronic conditions that may
be improved as follows by access to a healthy diet:
(1) Improvement in the health of the veteran, as measured
by--
(A) a health outcome measure associated with the identified
chronic condition or the overall health of the veteran;
(B) a reduction on the reliance of the veteran on
medication to control the identified chronic condition;
(C) the perception by the veteran of their overall health
and wellness; and

[[Page S4050]]

(D) such other measures as determined by the Secretary to
be clinically significant in coordination with the Secretary
of Health and Human Services.
(2) The reduction of individual and household food
insecurity.
(3) The increased consumption of domestic fruits and
vegetables.
(b) Grants.--
(1) In general.--In carrying out the pilot program, the
Secretary may award grants to programs receiving Federal
funding and serving veterans, including the following:
(A) An emergency feeding organization (as defined in
section 201A of the Emergency Food Assistance Act of 1983 (7
U.S.C. 7501)).
(B) A federally-qualified health center (as defined in
section 1905(l)(2)(B) of the Social Security Act (42 U.S.C.
1396d(l)(2)(B))).
(C) A facility operated by the Indian Health Service or the
governing body of an Indian tribe (as defined in section 4 of
the Indian Self-Determination and Education Assistance Act
(25 U.S.C. 5304)).
(D) An institution of higher education (as defined in
section 101 of the Higher Education Act of 1965 (20 U.S.C.
1001)).
(2) Grant duration.--The period covered by a grant awarded
under paragraph (1) may not be less than two years.
(c) Duration of Program.--
(1) In general.--The Secretary shall carry out the pilot
program for a period of five years beginning on the date that
is one year after the date of the enactment of this Act.
(2) Individual participation.--Veterans participating in
the pilot program shall participate in the pilot program for
a period of not less than one year.
(d) Location.--The pilot program shall be carried out at
not fewer than 10 locations in 10 different States.
(e) Program Requirements.--In carrying out the pilot
program, the Secretary shall include the following program
requirements:
(1) A methodology for how the pilot program would be
targeted to low-income veterans and households with
individuals with one or more chronic conditions.
(2) A plan for screening and enrolling veterans in the
pilot program.
(3) A methodology for the evaluation of participants in the
pilot program at the time of enrollment, after six months,
and after one year of participation focused on the purposes
of the pilot program under subsection (a), including--
(A) a comprehensive health assessment of each participant;
(B) an evaluation of each participant's perception of their
wellness;
(C) an assessment of the eligibility of the participant and
the participation of the participant in programs of the
Federal Government designed to reduce food insecurity,
including the supplemental nutrition assistance program
established under the Food and Nutrition Act of 2008 (7
U.S.C. 2011 et seq.) and the Meals on Wheels program; and
(D) an assessment of the eligibility of the participant and
the participation of the participant in programs of the
Federal Government designed to provide access to health care,
including the Medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.), the Medicaid
program under title XIX of such Act (42 U.S.C. 1396 et seq.),
and health insurance purchased through a health insurance
exchange under title I of the Patient Protection and
Affordable Care Act (Public Law 111-148).
(4) The inclusion of nutrition education opportunities for
participants.
(5) A methodology for the collection and aggregation of
data for purposes of analyzing the benefit of medically-
tailored meals on participants.
(f) Report to Congress.--Not later than 180 days after the
completion of the pilot program, the Secretary shall submit
to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report detailing the recommendations of the
Secretary as to the feasibility and advisability of
continuing or expanding the pilot program, based on the
following:
(1) The improvement of health outcomes of participants in
the pilot program.
(2) The reduction in the reliance of such participants on
medications to control identified chronic conditions.
(3) The reduction of health care costs for Federal agencies
resulting from the pilot program.
(4) The overall impact of the pilot program on spending in
other programs of the Federal Government that are utilized by
such participants.
(g) Funding.--There is authorized to be appropriated to
carry out this section $10,000,000 for each of fiscal years
2019 through 2023.
(h) Definitions.--In this section:
(1) Medically-tailored meals.--The term ``medically-
tailored meals'' means meals or food packages designed by a
registered dietitian or other nutrition professional to be
beneficial for someone with one or more chronic conditions.
(2) Wellness.--The term ``wellness'' has the meaning given
that term by the Secretary of Health and Human Services and
incorporates the eight dimensions of wellness set forth by
the Substance Abuse and Mental Health Service Administration
of the Department of Health and Human Services.
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