[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1815 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 1815
To provide targeted funding for States and other eligible entities
through the Social Services Block Grant program to address the
increased burden that maintaining the health and hygiene of infants and
toddlers, medically complex children, and low-income adults or adults
with disabilities who rely on adult incontinence materials and supplies
place on families in need, the resultant adverse health effects on
children and families, and the limited child care options available for
infants and toddlers who lack sufficient diapers and diapering
supplies, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 20, 2025
Ms. Duckworth (for herself, Mr. Cramer, and Mr. Kelly) introduced the
following bill; which was read twice and referred to the Committee on
Finance
_______________________________________________________________________
A BILL
To provide targeted funding for States and other eligible entities
through the Social Services Block Grant program to address the
increased burden that maintaining the health and hygiene of infants and
toddlers, medically complex children, and low-income adults or adults
with disabilities who rely on adult incontinence materials and supplies
place on families in need, the resultant adverse health effects on
children and families, and the limited child care options available for
infants and toddlers who lack sufficient diapers and diapering
supplies, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``End Diaper Need Act of 2025''.
SEC. 2. TARGETED FUNDING FOR DIAPER ASSISTANCE (INCLUDING DIAPERING
SUPPLIES AND ADULT INCONTINENCE MATERIALS AND SUPPLIES)
THROUGH THE SOCIAL SERVICES BLOCK GRANT PROGRAM.
(a) Increase in Funding for Social Services Block Grant Program.--
(1) In general.--The amount specified in subsection (c) of
section 2003 of the Social Security Act (42 U.S.C. 1397b) for
purposes of subsections (a) and (b) of such section is deemed
to be $1,900,000,000 for each of fiscal years 2026 through
2029. Each State shall use the increase in funding the State
receives as a result of this section in accordance with
subsection (b) of this section.
(2) Appropriation.--
(A) In general.--Out of any money in the Treasury
of the United States not otherwise appropriated, there
is appropriated $200,000,000 for each of fiscal years
2026 through 2029, to carry out this section.
(B) Reservations.--
(i) Purposes.--The Secretary shall reserve,
from the amount appropriated under subparagraph
(A) to carry out this section--
(I) for each of fiscal years 2026
through 2029, not more than 2 percent
of the amount appropriated for the
fiscal year for purposes of entering
into an agreement with a national
entity described in subparagraph (C) to
assist in providing technical
assistance and training, to support
effective policy, practice, research,
and cross-system collaboration among
grantees and subgrantees, and to assist
in the administration of the program
described in this section; and
(II) for fiscal year 2026, an
amount, not to exceed $3,000,000, for
purposes of conducting an evaluation
under subsection (d).
(ii) No state entitlement to reserved
funds.--The State entitlement under section
2002(a) of the Social Security Act (42 U.S.C.
1397a(a)) shall not apply to the amounts
reserved under clause (i).
(C) National entity described.--A national entity
described in this subparagraph is a nonprofit
organization described in section 501(c)(3) of the
Internal Revenue Code of 1986 and exempt from taxation
under section 501(a) of such Code, that--
(i) has experience in more than 1 State in
the area of--
(I) community distributions of
basic need services, including
experience collecting, warehousing, and
distributing basic necessities such as
diapers, food, or menstrual products;
(II) child care;
(III) child development activities
in low-income communities; or
(IV) motherhood, fatherhood, or
parent education efforts serving low-
income parents of young children;
(ii) demonstrates competency to implement a
project, provide fiscal accountability, collect
data, and prepare reports and other necessary
documentation; and
(iii) demonstrates a willingness to share
information with researchers, practitioners,
and other interested parties.
(b) Rules Governing Use of Additional Funds.--
(1) In general.--Funds are used in accordance with this
subsection if--
(A) the State, in consultation with relevant
stakeholders, including agencies, professional
associations, and nonprofit organizations, distributes
the funds to eligible entities to--
(i) decrease the need for diapers and
diapering supplies and adult incontinence
materials and supplies in low-income families
and meet such unmet needs of infants and
toddlers, medically complex children, and low-
income adults and adults with disabilities in
such families through--
(I) the distribution of free
diapers and diapering supplies,
medically necessary diapers, and adult
incontinence materials and supplies;
and
(II) improving access to diapers
and diapering supplies, medically
necessary diapers, and adult
incontinence materials and supplies;
(ii) carry out community outreach to assist
in participation in diaper distribution
programs or programs that distribute medically
necessary diapers or adult incontinence
materials and supplies; and
(iii) increase the ability of communities
and low-income families in such communities to
provide for the need for diapers and diapering
supplies, medically necessary diapers, and
adult continence materials and supplies, of
infants and toddlers, medically complex
children, and low-income adults and adults with
disabilities;
(B) the funds are used subject to the limitations
in section 2005 of the Social Security Act (42 U.S.C.
1397d); and
(C) the funds are used to supplement, not supplant,
State general revenue funds provided for the purposes
described in subparagraph (A).
(2) Administrative costs.--A State receiving funds made
available under subsection (a) may use not more than 5 percent
of the funds for State administrative costs, which may include
costs of contracting, monitoring, and reporting.
(3) Allowable uses by eligible entities.--An eligible
entity receiving funds made available under subsection (a)
shall use the funds for any of the following:
(A) To pay for the purchase and distribution of
diapers and diapering supplies, medically necessary
diapers, and funding diaper (including medically
necessary diapers) distribution that serves low-income
families with--
(i) 1 or more children 3 years of age or
younger; or
(ii) 1 or more medically complex children.
(B) To pay for the purchase and distribution of
adult incontinence materials and supplies and funding
distribution of the materials and supplies for low-
income families with 1 or more low-income adults,
adults with disabilities, or children with a disability
who have attained 3 years of age and have not attained
19 years of age, who rely on adult incontinence
materials and supplies.
(C) To integrate activities carried out under
subparagraph (A) with other basic needs assistance
programs serving eligible children and their families,
including the following:
(i) Programs funded by the temporary
assistance for needy families program under
part A of title IV of the Social Security Act
(42 U.S.C. 601 et seq.), including the State
maintenance of effort provisions of such
program.
(ii) Programs designed to support the
health of eligible children, such as the
Children's Health Insurance Program under title
XXI of the Social Security Act, the Medicaid
program under title XIX of such Act, or State
funded health care programs.
(iii) Programs funded through the special
supplemental nutrition program for women,
infants, and children under section 17 of the
Child Nutrition Act of 1966.
(iv) Programs that offer early home
visiting services, including the maternal,
infant, and early childhood home visiting
program (including the Tribal home visiting
program) under section 511 of the Social
Security Act (42 U.S.C. 711).
(v) Programs to provide improved and
affordable access to child care, including
programs funded through the Child Care and
Development Fund, the temporary assistance for
needy families program under part A of title IV
of the Social Security Act (42 U.S.C. 601 et
seq.), or a State-funded program.
(vi) Programs funded under part C of the
Individuals with Disabilities Education Act (20
U.S.C. 1431 et seq.).
(4) Availability of funds.--
(A) Funds distributed to eligible entities.--Funds
made available under subsection (a) that are
distributed to an eligible entity by a State for a
fiscal year may be expended by the eligible entity only
in such fiscal year or the succeeding fiscal year.
(B) Evaluation.--Funds reserved under subsection
(a)(2)(B)(i)(II) to carry out the evaluation under
subsection (d) shall be available for expenditure
during the 3-year period that begins on the date of
enactment of this Act.
(5) No effect on other programs.--Any assistance or
benefits received by a family through funds made available
under subsection (a) shall be disregarded for purposes of
determining the family's eligibility for, or amount of,
benefits under any other Federal needs-based programs.
(c) Annual Reports.--A State shall include in the annual report
required under section 2006 of the Social Security Act (42 U.S.C.
1397e) covering each of fiscal years 2026 through 2029, information
detailing how eligible entities, including subgrantees, used funds made
available under subsection (a) to distribute diapers and diapering
supplies and adult incontinence materials and supplies to families in
need. Each such report shall include the following:
(1) The number and age of infants, toddlers, medically
complex children, and low-income adults and adults with
disabilities who received assistance or benefits through such
funds.
(2) The number of families that have received assistance or
benefits through such funds.
(3) The number of diapers, medically necessary diapers, or
adult incontinence materials and supplies (such as adult
diapers, briefs, protective underwear, pull-ons, pull-ups,
liners, shields, guards, pads, undergarments), and the number
of each type of diapering or adult incontinence supply,
distributed through the use of such funds.
(4) The ZIP Code or ZIP Codes where the eligible entity (or
subgrantee) distributed diapers and diapering supplies and
adult incontinence materials and supplies.
(5) The method or methods the eligible entity (or
subgrantee) uses to distribute diapers and diapering supplies
and, adult incontinence materials and supplies.
(6) Such other information as the Secretary may specify.
(d) Evaluation.--The Secretary, in consultation with States, the
national entity described in subsection (a)(2)(C), and eligible
entities receiving funds made available under this section, shall--
(1) not later than 2 years after the date of enactment of
this Act--
(A) complete an evaluation of the effectiveness of
the assistance program carried out pursuant to this
section, such as the effect of activities carried out
under this Act on mitigating the health and
developmental risks of unmet diaper need among infants,
toddlers, medically complex children, and other family
members in low-income families, including the risks of
diaper dermatitis, urinary tract infections, and
parental and child depression and anxiety;
(B) submit to the relevant congressional committees
a report on the results of such evaluation; and
(C) publish the results of the evaluation on the
internet website of the Department of Health and Human
Services;
(2) not later than 3 years after the date of enactment of
this Act, update the evaluation required by paragraph (1)(A);
and
(3) not later than 120 days after completion of the updated
evaluation under paragraph (2)--
(A) submit to the relevant congressional committees
a report describing the results of such updated
evaluation; and
(B) publish the results of such evaluation on the
internet website of the Department of Health and Human
Services.
(e) Guidance.--Not later than 180 days after enactment of this Act,
the Secretary shall issue guidance regarding how the provisions of this
section should be carried out, including information regarding eligible
entities, allowable use of funds, and reporting requirements.
(f) Definitions.--In this section:
(1) Adult incontinence materials and supplies.--The term
``adult incontinence materials and supplies'' means those
supplies that are used to assist adults or adults with
disabilities and includes adult diapers, briefs, protective
underwear, pull-ons, pull-ups, liners, shields, guards, pads,
undergarments, disposable wipes, over-the-counter adult diaper
rash cream products, intermittent catheterization, indwelling
catheters, condom catheters, urinary drainage bags, external
collection devices, wearable urinals, and penile clamps.
(2) Adults with disabilities.--The term ``adults with
disabilities'' means individuals who--
(A) have attained 18 years of age; and
(B) have a disability (as such term is defined,
with respect to an individual, in section 3 of the
Americans with Disabilities Act of 1990 (42 U.S.C.
12102)).
(3) Diaper.--The term ``diaper'' means an absorbent garment
that--
(A) is washable or disposable that may be worn by
an infant or toddler who is not toilet-trained; and
(B) if disposable--
(i) does not use any latex or common
allergens; and
(ii) meets or exceeds the quality standards
for diapers commercially available through
retail sale in the following categories:
(I) Absorbency (with acceptable
rates for first and second wetting).
(II) Waterproof outer cover.
(III) Flexible leg openings.
(IV) Refastening closures.
(4) Diaper bank.--- The term ``diaper bank'' means a
nonprofit organization that--
(A) is described in section 501(c)(3) of the
Internal Revenue Code of 1986 and exempt from taxation
under section 501(a) of such Code;
(B) is established and operating primarily for the
purpose of collecting or purchasing diapers and
diapering supplies; and
(C) distributes diapers and diapering supplies
either directly or through partnerships for eventual
distribution to individuals free of charge.
(5) Diapering supplies.--The term ``diapering supplies''
means items, including diaper wipes and diaper cream, necessary
to ensure that--
(A) an eligible child using a diaper is properly
cleaned and protected from diaper rash; or
(B) a medically complex child who uses a medically
necessary diaper is properly cleaned and protected from
diaper rash.
(6) Eligible child.--The term ``eligible child'' means a
child who--
(A) has not attained 4 years of age; and
(B) is a member of a low-income family.
(7) Eligible entities.--The term ``eligible entity'' means
a State or local governmental entity, an Indian tribe or tribal
organization (as defined in section 4 of the Indian Self-
Determination and Education Assistance Act), or a diaper bank
or other nonprofit organization described in section 501(c)(3)
of the Internal Revenue Code of 1986 and exempt from taxation
under section 501(a) of such Code that--
(A) has at least 1 year of demonstrated experience
in the area of--
(i) community distributions of diapers and
diapering supplies and other basic need
services, such as food or menstrual products;
(ii) child care;
(iii) child development activities in low-
income communities; or
(iv) motherhood, fatherhood, or parent
education efforts serving low-income parents of
young children;
(B) demonstrates competency to implement a project,
provide fiscal accountability, collect data, and
prepare reports and other necessary documentation; and
(C) demonstrates a willingness to share information
with researchers, practitioners, and other interested
parties.
(8) Federal poverty line.--The term ``Federal poverty
line'' means the Federal poverty line as defined by the Office
of Management and Budget and revised annually in accordance
with section 673(2) of the Omnibus Budget Reconciliation Act of
1981 (42 U.S.C. 9902(2)) applicable to a family of the size
involved.
(9) Low-income.--The term ``low-income'', with respect to a
family, means a family whose self-certified income is not more
than 200 percent of the Federal poverty line.
(10) Medically complex child.--The term ``medically complex
child'' means an individual who has attained 3 years of age and
for whom a licensed health care provider has provided a
diagnosis of 1 or more significant chronic conditions.
(11) Medically necessary diaper.--The term ``medically
necessary diaper'' means an absorbent garment that is--
(A) washable or disposable;
(B) worn by a medically complex child who has been
diagnosed with bowel or bladder incontinence, a bowel
or bladder condition that causes excess urine or stool
(such as short gut syndrome or diabetes insipidus), or
a severe skin condition that causes skin erosions (such
as epidermolysis bullosa) and needs such garment to
correct or ameliorate such condition; and
(C) if disposable--
(i) does not use any latex or common
allergens; and
(ii) meets or exceeds the quality standards
for diapers commercially available through
retail sale in the following categories:
(I) Absorbency (with acceptable
rates for first and second wetting).
(II) Waterproof outer cover.
(III) Flexible leg openings.
(IV) Refastening closures.
(12) State.--The term ``State'' means the 50 States, the
District of Columbia, the Commonwealth of Puerto Rico the
United States Virgin Islands, Guam, the Commonwealth of the
Northern Mariana Islands, American Samoa, the Republic of the
Marshall Islands, the Federated States of Micronesia, and the
Republic of Palau.
(g) Exemption of Program From Sequestration.--
(1) In general.--Section 255(h) of the Balanced Budget and
Emergency Deficit Control Act of 1985 (2 U.S.C. 905(h)) is
amended by inserting after ``Supplemental Security Income
Program (28-0406-0-1-609).'' the following:
``Targeted funding for States for diaper assistance
(including diapering supplies and adult incontinence materials
and supplies) through the Social Services Block Grant
Program.''.
(2) Applicability.--The amendment made by this subsection
shall apply to any sequestration order issued under the
Balanced Budget and Emergency Deficit Control Act of 1985 (2
U.S.C. 900 et seq.) on or after the date of enactment of this
Act.
SEC. 3. INCLUSION OF DIAPERS AND DIAPERING SUPPLIES AS QUALIFIED
MEDICAL EXPENSES.
(a) Health Savings Accounts.--Section 223(d)(2) of the Internal
Revenue Code of 1986 is amended--
(1) by inserting ``, medically necessary diapers, and
diapering supplies'' after ``menstrual care products'' in the
last sentence of subparagraph (A); and
(2) by adding at the end the following new subparagraph:
``(E) Medically necessary diapers and diapering
supplies.--For purposes of this paragraph--
``(i) Medically necessary diapers.--The
term `medically necessary diaper' means an
absorbent garment which is washable or
disposable and which is worn by an individual
who has attained 3 years of age because of
medical necessity, such as someone who has been
diagnosed with bowel or bladder incontinence, a
bowel or bladder condition that causes excess
urine or stool (such as short gut syndrome or
diabetes insipidus), or a severe skin condition
that causes skin erosions (such as
epidermolysis bullosa) and needs such garment
to correct or ameliorate such condition, to
serve a preventative medical purpose, or to
correct or ameliorate defects or physical or
mental illnesses or conditions diagnosed by a
licensed health care provider, and, if
disposable--
``(I) does not use any latex or
common allergens; and
``(II) meets or exceeds the quality
standards for diapers commercially
available through retail sale in the
following categories:
``(aa) Absorbency (with
acceptable rates for first and
second wetting).
``(bb) Waterproof outer
cover.
``(cc) Flexible leg
openings.
``(dd) Refastening
closures.
``(ii) Diapering supplies.--The term
`diapering supplies' means items, including
diaper wipes and diaper creams, necessary to
ensure that an individual wearing medically
necessary diapers is properly cleaned and
protected from diaper rash.''.
(b) Archer MSAs.--The last sentence of section 220(d)(2)(A) of such
Code is amended by inserting ``, medically necessary diapers (as
defined in section 223(d)(2)(E)), and diapering supplies (as defined in
section 223(d)(2)(E))'' after ``menstrual care products (as defined in
section 223(d)(2)(D))''.
(c) Health Flexible Spending Arrangements and Health Reimbursement
Arrangements.--Section 106(f) of such Code is amended--
(1) by inserting ``, medically necessary diapers (as
defined in section 223(d)(2)(E)), and diapering supplies (as
defined in section 223(d)(2)(E))'' after ``menstrual care
products (as defined in section 223(d)(2)(D))''; and
(2) in the heading, by inserting ``, Medically Necessary
Diapers, and Diapering Supplies'' after ``Menstrual Care
Products''.
(d) Effective Dates.--
(1) Distributions from certain accounts.--The amendments
made by subsections (a) and (b) shall apply to amounts paid
after December 31, 2025.
(2) Reimbursements.--The amendment made by subsection (c)
shall apply to expenses incurred after December 31, 2025.
<all>