In this section:

(1) Eligible entity The term “eligible entity” means a governmental agency or nonprofit organization.

(2) Emergency feeding organization The term “emergency feeding organization” has the meaning given the term in section 7501 of this title.

The term “supplemental nutrition assistance program” means—

(A) the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.); and

(B) the programs for nutrition assistance under section 19 of such Act (7 U.S.C. 2028).

The term “healthcare partner” means a healthcare provider, including—

(A) a hospital;

(B) a Federally-qualified health center (as defined in section 1905(l) of the Social Security Act (42 U.S.C. 1396d(l)));

(C) a hospital or clinic operated by the Secretary of Veterans Affairs; or

(D) a healthcare provider group.

The term “member” means, as determined by the applicable eligible entity or healthcare partner carrying out a project under subsection (c) in accordance with procedures established by the Secretary—

(A) an individual eligible for— (i) benefits under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.); or (ii) medical assistance under a State plan or a waiver of such a plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) and enrolled under such plan or waiver; and

(B) a member of a low-income household that suffers from, or is at risk of developing, a diet-related health condition.

An eligible entity that receives a grant under this subsection may partner with, or make subgrants to, public, private, nonprofit, or for-profit entities, including—

An eligible entity that receives a grant under this subsection may partner with, or make subgrants to, public, private, nonprofit, or for-profit entities, including—

(A) In general In each of the years specified in subsection (c), the Secretary shall make grants to eligible entities in accordance with paragraph (2).

(B) Partners and collaboratorsAn eligible entity that receives a grant under this subsection may partner with, or make subgrants to, public, private, nonprofit, or for-profit entities, including— (i) an emergency feeding organization; (ii) an agricultural cooperative; (iii) a producer network or association; (iv) a community health organization; (v) a public benefit corporation; (vi) an economic development corporation; (vii) a farmers’ market; (viii) a community-supported agriculture program; (ix) a buying club; (x) a retail food store participating in the supplemental nutrition assistance program; (xi) a State, local, or tribal agency; (xii) another eligible entity that receives a grant under this subsection; and (xiii) any other entity the Secretary designates.

(C) Federal share Except as provided in subparagraph (D)(iii), the Federal share of the cost of carrying out an activity under this subsection shall not exceed 50 percent of the total cost of the activity.

(D) Non-Federal share (i) In generalThe non-Federal share of the cost of an activity under this subsection may be provided— (I) in cash or in-kind contributions as determined by the Secretary, including facilities, equipment, or services; and (II) by a State or local government or a private source. (ii) Limitation In the case of a for-profit entity, the non-Federal share described in clause (i) shall not include services of an employee, including salaries paid or expenses covered by the employer. (iii) Tribal agencies The Secretary may allow a Tribal agency to use funds provided to the Indian Tribe of the Tribal agency through a Federal agency (including the Indian Health Service) or other Federal benefit to satisfy all or part of the non-Federal share described in clause (i) if such use is otherwise consistent with the purpose of such funds.

To receive a grant under this subsection, an eligible entity shall—

(A) In generalTo receive a grant under this subsection, an eligible entity shall— (i) meet the application criteria set forth by the Secretary; and (ii) propose a project that, at a minimum— (I) has the support of the State agency administering the supplemental nutrition assistance program; (II) would increase the purchase of fruits and vegetables by low-income households participating in the supplemental nutrition assistance program by providing an incentive for the purchase of fruits and vegetables at the point of purchase to a household purchasing food with supplemental nutrition assistance program benefits; (III) except in the case of projects receiving $100,000 or less over 1 year, would measure the purchase of fruits and vegetables by low-income households participating in the supplemental nutrition assistance program; (IV) ensures that the same terms and conditions apply to purchases made by individuals with benefits issued under the Food and Nutrition Act of 2008 [7 U.S.C. 2011 et seq.] and incentives provided for in this subsection as apply to purchases made by individuals who are not members of households receiving benefits, such as provided for in section 278.2(b) of title 7, Code of Federal Regulations (or a successor regulation); (V) has adequate plans to collect data for reporting and agrees to provide that information for the report described in subsection (e)(2)(B)(iii); and (VI) would share information with the Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information Centers established under subsection (e).

(B) PriorityIn awarding grants under this section, the Secretary shall give priority to projects that— (i) maximize the share of funds used for direct incentives to participants; (ii) use direct-to-consumer sales marketing; (iii) demonstrate a track record of designing and implementing successful nutrition incentive programs that connect low-income consumers and agricultural producers; (iv) provide locally or regionally produced fruits and vegetables; (v) include a project design— (I) that provides incentives when fruits or vegetables are purchased using supplemental nutrition assistance program benefits; and (II) in which the incentives earned may be used only to purchase fruits or vegetables; (vi) have demonstrated the ability to provide services to underserved communities; (vii) include coordination with multiple stakeholders, such as farm organizations, nutrition education programs, cooperative extension services, public health departments, health providers, private and public health insurance agencies, cooperative grocers, grocery associations, and community-based and nongovernmental organizations; (viii) offer supplemental services in high-need communities, including online ordering, transportation between home and store, and delivery services; (ix) include food retailers that are open— (I) for extended hours; and (II) most or all days of the year; or (x) address other criteria as established by the Secretary.

The Secretary shall establish a grant program under which the Secretary shall award grants to eligible entities to conduct projects that demonstrate and evaluate the impact of the projects on—

The Secretary shall establish a grant program under which the Secretary shall award grants to eligible entities to conduct projects that demonstrate and evaluate the impact of the projects on—

(A) the improvement of dietary health through increased consumption of fruits and vegetables;

(B) the reduction of individual and household food insecurity; and

(C) the reduction in healthcare use and associated costs.

(2) Healthcare partners In carrying out a project using a grant received under paragraph (1), an eligible entity shall partner with 1 or more healthcare partners.

To be eligible to receive a grant under paragraph (1), an eligible entity—

(A) In generalTo be eligible to receive a grant under paragraph (1), an eligible entity— (i) shall— (I) prescribe fresh fruits and vegetables to members; (II) submit to the Secretary an application containing such information as the Secretary may require, including the information described in subparagraph (B); and (ii) may— (I) provide financial or non-financial incentives for members to purchase or procure fresh fruits and vegetables; (II) provide educational resources on nutrition to members; and (III) establish additional accessible locations for members to procure fresh fruits and vegetables.

(B) ApplicationAn application shall— (i) identify the 1 or more healthcare partners with which the eligible entity is partnering under paragraph (2); and (ii) include— (I) a description of the methods by which an eligible entity shall— (aa) screen and verify eligibility for members for participation in a produce prescription project, in accordance with procedures established under subsection (a)(5); (bb) implement an effective produce prescription project, including the role of each healthcare partner in implementing the produce prescription project; (cc) evaluate members participating in a produce prescription project with respect to the matters described in subparagraphs (A) through (C) of paragraph (1); (dd) provide educational opportunities relating to nutrition to members participating in a produce prescription project; and (ee) inform members of the availability of the produce prescription project, including locations at which produce prescriptions may be redeemed; (II) a description of any additional nonprofit or emergency feeding organizations that shall be involved in the project and the role of each additional nonprofit or emergency feeding organization in implementing and evaluating an effective produce prescription project; (III) documentation of a partnership agreement with a relevant State Medicaid agency or other appropriate entity, as determined by the Secretary, to evaluate the effectiveness of the produce prescription project in reducing healthcare use and associated costs; (IV) adequate plans to collect data for reporting and agreement to provide that information for the report described in subsection (e)(2)(B)(iii); and (V) agreement to share information with the Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information Centers established under subsection (e).

(4) Coordination In carrying out the grant program established under paragraph (1), the Secretary shall coordinate with the Secretary of Health and Human Services and the heads of other appropriate Federal agencies that carry out activities relating to healthcare partners.

A memorandum of understanding entered into under subparagraph (A) shall include—

(A) In general In carrying out the grant program under paragraph (1), the Secretary may enter into 1 or more memoranda of understanding with a Federal agency, a State, or a private entity to ensure the effective implementation and evaluation of each project.

(B) Memorandum of understandingA memorandum of understanding entered into under subparagraph (A) shall include— (i) a description of a plan to provide educational opportunities relating to nutrition to members participating in produce prescription projects; (ii) a description of the role of the Federal agency, State, or private entity, as applicable, in implementing and evaluating an effective produce prescription project; and (iii) documentation of a partnership agreement with a relevant State Medicaid agency or other appropriate entity, as determined by the Secretary.

Assistance provided under subsections (b) and (c) to households receiving benefits under the supplemental nutrition assistance program shall not—

(1) In general The value of any benefit provided to a participant in any activity funded under subsections (b) or (c) shall be treated as supplemental nutrition benefits under section 8(b) of the Food and Nutrition Act of 2008 (7 U.S.C. 2017(b)).

(2) Prohibition on collection of sales taxes Each State shall ensure that no State or local tax is collected on a purchase of food with assistance provided under subsections (b) and (c).

(3) No limitation on benefits Grants made available under subsections (b) and (c) shall not be used to carry out any project that limits the use of benefits under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.) or any other Federal nutrition law.

Assistance provided under subsections (b) and (c) to households receiving benefits under the supplemental nutrition assistance program shall not—

(A) be considered part of the supplemental nutrition assistance program benefits of the household; or

(B) be used in the collection or disposition of claims under section 13 of the Food and Nutrition Act of 2008 (7 U.S.C. 2022).

The Secretary shall—

The Secretary shall—

(A) establish 1 or more Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information Centers, in consultation with the Director of the National Institute of Food and Agriculture; and

(B) to the extent practicable, consult on the design and scope of such Centers with grocers, farmers, health professionals, researchers, incentive program managers, and employees of the Department of Agriculture with direct experience with implementation of existing incentive programs or projects.

The Centers shall be capable of providing services related to grants under subsections (b) and (c), including—

(A) offering incentive program training and technical assistance to applicants and grantees to the extent practicable, including— (i) collecting and providing information on best practices that may include communications, signage, record-keeping, incentive instruments, development and integration of point of sale systems, and reporting; (ii) disseminating information and assisting with collaboration among grantee projects, applicable State agencies, and nutrition education programs; (iii) facilitating communication between grantees and the Department of Agriculture and applicable State agencies; and (iv) providing support for the development of best practices for produce prescription projects and the sharing of information among eligible entities and healthcare providers that participate in a produce prescription project under subsection (c); and (v) other services identified by the Secretary; and

(B) creating a system to collect and compile core data sets from eligible entities that— (i) uses standard metrics with consideration of outcome measures for existing projects; (ii) includes to the extent practicable grocers, farmers, health professionals, researchers, incentive program managers, and employees of the Department of Agriculture with direct experience with implementation of existing incentive programs in the design of the instrument through which data will be collected and the mechanism for reporting; (iii) compiles project data from grantees, and beginning in fiscal year 2020 generates an annual report to Congress on grant outcomes, including— (I) the results of the project; and (II) the amount of grant funds used for the project; and (iv) creates and maintains a publicly accessible online site that makes annual reports and incentive program information available in an anonymized format that protects confidential, personal, or other sensitive data.

The organizations referred to in subparagraph (A) may include—

(A) In general To carry out paragraph (1), the Secretary may, on a competitive basis, enter into 1 or more cooperative agreements with 1 or more organizations with expertise in developing outcome-based reporting, at least 1 of which has expertise in the food insecurity nutrition incentive program and at least 1 of which has expertise in produce prescription projects.

(B) InclusionThe organizations referred to in subparagraph (A) may include— (i) nongovernmental organizations; (ii) State cooperative extension services; (iii) regional food system centers; (iv) Federal, State, or Tribal agencies; (v) institutions of higher education (as defined in section 1001(a) of title 20); or (vi) other appropriate entities as determined by the Secretary.

Of the funds of the Commodity Credit Corporation, the Secretary shall use to carry out this section—

(1) Authorization of appropriations There is authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2014 through 2023.

Of the funds of the Commodity Credit Corporation, the Secretary shall use to carry out this section—

(A) $35,000,000 for the period of fiscal years 2014 and 2015;

(B) $20,000,000 for each of fiscal years 2016 and 2017;

(C)  [1] $25,000,000 for fiscal year 2018;

(C)  1 $45,000,000 for fiscal year 2019;

(D) $48,000,000 for fiscal year 2020;

(E) $48,000,000 for fiscal year 2021;

(F) $53,000,000 for fiscal year 2022; and

(G) $56,000,000 for fiscal year 2023 and each fiscal year thereafter.

With respect to funds made available under this section for fiscal years 2019 through 2023—

(A) for each fiscal year the Secretary shall use not more than 10 percent of such funds available for such fiscal year for the produce prescription program described in subsection (c);

(B) for each fiscal year not more than 8 percent of such funds available for such fiscal year shall be used by the National Institute of Food and Agriculture and the Food and Nutrition Service for administration; and

(C) the Secretary shall use for the Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information Centers established under subsection (e) not more than— (i) $17,000,000 in the aggregate for fiscal years 2019 and 2020; and (ii) $7,000,000 for each of the fiscal years 2021 through 2023.

(Pub. L. 110–234, title IV, § 4405, May 22, 2008, 122 Stat. 1138; Pub. L. 110–246, § 4(a), title IV, § 4405, June 18, 2008, 122 Stat. 1664, 1899; Pub. L. 113–79, title IV, § 4208, Feb. 7, 2014, 128 Stat. 826; Pub. L. 115–334, title IV, § 4205(a), Dec. 20, 2018, 132 Stat. 4656.)