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PRINTER'S NO. 610
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
667
Session of
2023
INTRODUCED BY BULLOCK, HARRIS, KENYATTA, KINSEY, SANCHEZ, HILL-
EVANS, MADDEN, VENKAT, HOHENSTEIN, BURGOS, PROBST, PARKER,
KINKEAD, N. NELSON, INNAMORATO, OTTEN AND KHAN,
MARCH 23, 2023
REFERRED TO COMMITTEE ON HUMAN SERVICES, MARCH 23, 2023
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," in general powers and
duties of the Department of Public Welfare, providing for
Medically Tailored Meals Pilot Program and imposing duties on
the Department of Human Services.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of June 13, 1967 (P.L.31, No.21), known
as the Human Services Code, is amended by adding a section to
read:
Section 217. Medically Tailored Meals Pilot Program.--(a)
The Medically Tailored Meals Pilot Program is established within
the department.
(b) The department shall conduct the program for a three-
year period, beginning no later than one year after the
effective date of this subsection, to assess the effects of a
covered hospital providing medically tailored meals to qualified
individuals.
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(c) In accordance with this section, the department shall:
(1) Select hospitals to participate in the program.
(2) Establish procedures for covered hospitals to carry out
the requirements of the program.
(3) Make payments to covered hospitals for items and
services provided to qualified individuals.
(4) Submit reports on the program in accordance with
subsection (h).
(d) The department shall select at least twenty covered
hospitals located in at least ten different counties to carry
out the requirements of the program.
(e) The following apply to program requirements:
(1) A covered hospital shall maintain on staff a physician,
a licensed dietitian-nutritionist or a clinical social worker
to:
(i) Screen an individual that is an inpatient of the covered
hospital with validated screening tools to determine whether the
individual is a qualified individual.
(ii) Re-screen each individual receiving medically tailored
meals with validated screening tools every twelve weeks to
determine whether the individual is qualified to continue
receiving medically tailored meals.
(iii) If an individual is determined to be a qualified
individual under subparagraph (i) or (ii), ensure that the
individual receives medically tailored meals pursuant to a
contract described in paragraph (2).
(iv) Provide to an individual determined to be a qualified
individual under subparagraph (i) or (ii) medical nutrition
therapy, furnished by a licensed dietitian-nutritionist, or
ensure that the organization described in paragraph (2) that
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delivers meals to the individual provides to the individual
medical nutrition therapy as appropriate.
(v) Monitor the clinical health outcomes, based on measures
developed by the department consistent with State law, of each
individual who receives medically tailored meals.
(2) The following apply to a contract to deliver medically
tailored meals:
(i) A covered hospital shall enter into a contract, in
accordance with criteria established by the department, with at
least one nonprofit organization that has at least three years
of experience preparing and delivering medically tailored meals
or similar meals and providing individual nutrition counseling
or medical nutrition therapy in connection with delivering
meals.
(ii) A contract under this paragraph shall provide for the
following:
(A) At least two medically tailored meals, or a portioned
equivalent, each day that meet at least two-thirds of the daily
nutritional needs of a qualified individual.
(B) At least twelve weeks of medically tailored meals.
(iii) If an individual is determined to be a qualified
individual under paragraph (1)(i) or (ii), the covered hospital
may contract with the organization described in subparagraph (i)
to provide to the primary caregiver of the individual or a
dependent under eighteen years of age that resides in the
household of the individual a meal that the organization
determines appropriate.
(f) Not later than one year after the date that the covered
hospital begins to participate in the program, and annually
thereafter for the duration of the program, a hospital selected
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to participate in the program shall submit to the department a
report on the following:
(1) The impact of medically tailored meals on clinical
health outcomes described in subsection (e)(1)(v).
(2) The impact of medically tailored meals on hospital
utilization, including readmission.
(3) Any other information necessary to evaluate the program.
(g) Within six months of the effective date of this
subsection, the secretary shall apply to the Centers for
Medicare and Medicaid Services of the United States Department
of Health and Human Services for approval of a demonstration
project under 42 U.S.C. § 1315 (relating to demonstration
projects) for the purpose of providing medically tailored meals
as a covered service for medical assistance enrollees. The
application for the demonstration project shall take into
account other assistance programs that provide coverage for
medically tailored meals to reduce monitoring and other
administrative costs of the department.
(h) Not later than three years after the effective date of
this subsection, and six years after that date, the department
shall prepare a report on the program. The following apply:
(1) The report shall be submitted to:
(i) The Health and Human Services Committee of the Senate.
(ii) The Health Committee of the House of Representatives.
(iii) The Human Services Committee of the House of
Representatives.
(2) The report shall include a summary of, evaluation of,
and recommendations on whether to cover medically tailored meals
as a benefit under this act.
(i) Not later than ninety days after the date that the
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department submits a report under subsection (h), the committees
listed under subsection (h)(1) shall hold a hearing on the
recommendations submitted by the department in the report.
(j) To determine decisions for the program, the program may
consult with stakeholders, including:
(1) Food access organizations.
(2) Human service organizations.
(3) Social service organizations.
(4) Any other organization that the program deems necessary
for the implementation of this subsection.
(k) As used in this section, the following words and phrases
shall have the following meanings:
"Covered hospital" means a hospital that:
(1) submits to the department an application in the time and
manner, and containing the information, prescribed by the
department;
(2) is selected by the department to carry out the
requirements of the program for not more than a three-year
period; and
(3) is a subsection (d) hospital.
"Licensed dietitian-nutritionist" means the same as the term
"licensed dietitian-nutritionist" under section 2(9) of the act
of May 22, 1951 (P.L.317, No.69), known as "The Professional
Nursing Law."
"Medical nutrition therapy" means, for the purpose of disease
management, nutrition, diagnostics and counseling, services that
are furnished by a licensed dietitian-nutritionist.
"Medically tailored meal" means a meal that is designed by a
licensed dietitian-nutritionist:
(1) for the treatment plan of a qualified individual; and
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(2) to improve health outcomes, lower the cost of care and
increase the patient satisfaction of the qualified individual.
"Nonprofit organization" means an organization that:
(1) is tax exempt under 26 U.S.C. § 501(c)(3) (relating to
exemption from tax on corporations, certain trusts, etc.);
(2) works at a local level to improve life for residents;
(3) focuses on building equality across society, including
access to social services; and
(4) addresses the social determinants of health.
"Program" means the Medically Tailored Meals Pilot Program
established under this section.
"Qualified individual" means an individual who:
(1) is entitled to benefits under this part;
(2) has a diet-impacted disease, such as kidney disease,
congestive heart failure, diabetes, chronic obstructive
pulmonary disease or any other disease that the department
determines appropriate, which is likely to cause the individual
to require care at a hospital; and
(3) has at least one activity of daily living limitation.
"Readmission" means the same as the term "readmission" in 42
U.S.C. § 1395ww(q)(5)(E) (relating to payments to hospitals for
inpatient hospital services).
"Social determinants of health" means the conditions in the
environments where people are born, live, learn, work, play,
worship and age that affect a wide range of health, functioning
and quality of life outcomes and risks. The conditions may be
grouped in the following categories:
(1) Economic stability.
(2) Education access and quality.
(3) Health care access and quality.
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(4) Neighborhood and built environment.
(5) Social and community context.
"Subsection (d) hospital" means the same as the term
"subsection (d) hospital" in 42 U.S.C. § 1395ww(d)(1)(B).
"Validated screening tool" means a questionnaire that has
been psychometrically tested for reliability and validity in
assessing the presence of a condition in the individual who is
screened by the questionnaire.
Section 2. This act shall take effect immediately.
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