Rep. Madeleine Dean

Maddy summaryThe Latonya Reeves Freedom Act of 2023 strengthens the Americans with Disabilities Act's requirement that individuals with disabilities receive long-term services and supports in community settings rather than institutions. It defines "community-based" services to include specific housing options where individuals with disabilities can live independently with maximum control over their lives, including access to integrated housing, employment, and community participation. The bill requires states to develop transition plans to move people from institutional settings to community-based services within 12 years, with measurable annual targets for reducing institutionalization. It establishes enforcement mechanisms through the Department of Justice and Department of Health and Human Services to ensure compliance with these requirements.

Maddy summaryThe Puppy Protection Act of 2023 sets new standards for businesses that sell dogs (dealers), directly affecting pet stores and breeders operating under the Animal Welfare Act. It requires specific housing with space allowances based on dog size (e.g., 12-30 square feet per dog), temperature control (45-85°F), clean food twice daily, and daily exercise or socialization with humans/dogs for at least 30 minutes. The bill also mandates annual veterinary exams including dental care, strict breeding limits (e.g., age restrictions, maximum 2 litters in 18 months), and efforts to place retired breeding dogs in homes instead of selling them to other breeders. Regulations must be finalized within 18 months of enactment.

Maddy summaryThis bill allows the Department of Veterans Affairs (VA) to use existing funds more flexibly to assist homeless veterans and veterans in HUD housing programs. It authorizes the VA to provide immediate needs like food, shelter, transportation for appointments, and communication devices (e.g., phones, tablets) to support veterans' stability and health. The law expands how VA funds can be applied beyond traditional housing assistance, focusing on urgent, practical support. It directly affects homeless veterans and those in HUD's housing assistance program by enabling faster, more adaptable aid. The bill amends existing VA law to improve responsiveness to veterans' immediate survival and health needs.

Maddy summaryHR 2584, the SAVE Act, creates a new federal criminal offense for assaulting or intimidating hospital employees while they're performing their duties, punishable by up to 10 years in prison, with enhanced penalties for using weapons, causing injury, or during public emergencies. The bill authorizes $25 million annually in federal grants to hospitals for violence prevention programs, including staff training, security technologies like panic buttons and video surveillance, and coordination with law enforcement. It defines "hospital" broadly to include various medical facilities such as long-term care hospitals, rehabilitation facilities, and critical access hospitals. The legislation directly affects hospital workers and medical facilities by establishing federal criminal penalties for violence against employees and providing funding to improve workplace safety. The law aims to address the rising problem of workplace violence against healthcare workers, which the bill states has increased since 2011.

Maddy summaryHR 2630, the Safe Step Act, requires group health plans and health insurance issuers to establish a clear, transparent process for patients or their doctors to request exceptions to medication step therapy protocols. These protocols typically force patients to try cheaper drugs first before covering more expensive alternatives. The bill mandates that plans must approve exceptions when prior treatments failed, delay would cause serious harm, a treatment is unsafe, or a patient is stable on a previously approved drug, with strict 72-hour (or 24-hour in emergencies) decision timelines. It also requires plans to publish the exception process online and limit documentation requests to only necessary medical information. This law directly affects health insurers, employers offering health plans, and patients using step therapy for prescription drugs.

Maddy summaryThe School Meals Expansion Act (HR 2567) amends the National School Lunch Act to make it easier for schools to provide free meals to all students. It lowers the income threshold to 25% (from a higher previous rate) and increases the eligibility multiplier to 2.5 for school years starting July 1, 2023. This means school districts with 25% or more students from low-income families can now qualify for full federal funding to offer free meals to all students without requiring individual applications. The bill directly affects local school districts that choose to participate in the community eligibility program under the National School Lunch Act.

Maddy summaryThis bill allows Medicaid coverage for incarcerated individuals during the 30 days preceding their release from public institutions. It directly affects people transitioning from prisons or jails back into communities by extending health coverage during this critical period. The key mechanism amends the Social Security Act to remove a Medicaid exclusion for this 30-day window. Additionally, it requires an 18-month report analyzing correctional healthcare standards, current discharge practices, and the potential impact of this coverage extension on post-release health access.

Maddy summaryThis bill creates a 2-year pilot program to establish or improve state-based nursing workforce centers. It provides $1.5 million annually (2024-2025) for up to six state or regional centers, requiring non-Federal matching funds (1:4 ratio). These centers will analyze nursing workforce data - including education, retention, and shortages - and develop strategies to recruit, retain, and diversify nurses, especially in rural and underserved areas. The program mandates annual reports to Congress on outcomes and best practices for addressing nursing shortages. It directly affects states, nursing schools, healthcare employers, and nursing workforce centers through federal grants and data-driven planning.

Maddy summaryThis bill authorizes $50 million annually from 2024 through 2029 for the Centers for Disease Control and Prevention (CDC) to conduct or support research on firearms safety and gun violence prevention. The funding is specifically for studies under the Public Health Service Act, adding to existing research budgets rather than replacing them. It directly affects CDC researchers and public health agencies by providing dedicated resources to study gun violence causes and prevention strategies. The bill creates no new regulations or requirements, only enabling research to inform future policy decisions.

Resident Physician Shortage Reduction Act of 2023 This bill increases the number of residency positions eligible for graduate medical education payments under Medicare for qualifying hospitals, including hospitals in rural areas and health professional shortage areas. Current law provides for an increase of up to 200 positions per fiscal year beginning in FY2023, with a total increase of 1,000 positions; each hospital may receive up to 25 additional positions. Current law also provides for an additional increase of up to 200 positions for FY2026, with at least 100 of these positions for psychiatry or related specialties; each hospital may receive up to 10 additional positions. The bill provides for an additional increase of 2,000 positions per fiscal year from FY2025-FY2031; during this period, each hospital may receive up to 75 additional positions in total under the bill and current law. Additionally, one-third of the positions that are made available under the bill must be allocated to hospitals that are already operating above applicable resident limits. The bill also requires the Government Accountability Office to report on strategies to increase the diversity of the health professional workforce, including with respect to representation from rural, low-income, and minority communities.