United States · United States Congress · 31 October 2019
Safeguarding Medicare Access to Respiratory Therapy Act of 2019 This bill establishes certain requirements relating to Medicare coverage of ventilators. Specifically, the bill (1) excludes ventilators and other covered respiratory items, as specified, from Medicare's competitive acquisition program (in which rates are set through a competitive bidding program rather than by an established fee schedule); and (2) requires the Centers for Medicare & Medicaid Services to establish a technical expert panel to review, and make recommendations regarding, national coverage determinations with respect to Medicare coverage of ventilators and other specified respiratory devices.
United States · United States Congress · 31 October 2019
Basic Assistance for Students In College Act or the BASIC Act This bill directs the Department of Education (ED) to award planning and implementation grants to institutions of higher education in order to identify and meet the basic needs of students, including food, housing, transportation, and health care. ED must also implement an agreement to (1) share data with other federal agencies in order to identify students who may be eligible for certain federal benefits; and (2) coordinate efforts to enroll those students in federal benefits programs, including Medicaid and the Supplemental Nutrition Assistance Program.
United States · United States Congress · 31 October 2019
Leveraging Effective Apprenticeships to Rebuild National Skills Act or the LEARNS Act This bill establishes, in the Employment and Training Administration of the Department of Labor, an Office of Apprenticeship to determine whether an apprenticeship program meets requirements for registration and maintains the standards necessary to remain registered, manage the national apprenticeship system (the collective group of registered apprenticeship programs and pre-apprenticeship programs in the nation), and make grants on a competitive basis to eligible entities to carry out projects that support development of pre-apprenticeship programs. The bill also establishes in Labor a National Advisory Committee on Apprenticeships. Labor and the Department of Education shall establish a voluntary Registered Apprenticeship-College Collaborative consisting of the sponsors carrying out registered apprenticeship programs, two- or four-year postsecondary educational institutions, and organizations that represent such programs or institutions, that agree to meet certain criteria in order to promote stronger connections between the registered apprenticeship programs involved and participating two- and four-year postsecondary educational institutions. Labor shall make assistance payments to eligible sponsors of new registered apprenticeship programs or of existing programs that add employers as new partners.
United States · United States Congress · 31 October 2019
Bridge to End Homelessness Act of 2019 This bill requires the Department of Housing and Urban Development to award grants to local or regional government entities to provide interim housing for individuals experiencing homelessness.
United States · United States Congress · 30 October 2019
Smoke Planning and Research Act of 2019 This bill requires the Environmental Protection Agency (EPA) to research and mitigate the impacts of smoke emissions from wildland fires. Specifically, the EPA must establish (1) four Centers of Excellence for Wildfire Smoke at institutions of higher education, and (2) a grant program to support community mitigation efforts.
United States · United States Congress · 30 October 2019
Prevent Family Fire Act of 2019 This bill allows a new business-related tax credit for 10% of the amount of the first retail sale of a safe firearm storage device. The amount upon which the credit is based may not exceed $400. A "safe firearm storage device" is a device that (1) is designed and marketed to deny unauthorized access to, or rendering inoperable, a firearm or ammunition; and (2) is secured by a combination lock, key lock, or lock based on biometric information. This credit terminates after December 31, 2026.
United States · United States Congress · 30 October 2019
Too Long; Didn't Read Act of 2019 or the TL; DR Act of 2019 This bill requires a federal agency to provide a clearly-marked section at the top of a communication (both hard copy and electronic) that the agency sends to an individual if such communication requires or authorizes such individual to act. The clearly-marked section shall include the authorized or required action; if a response by the individual is required, optional, or not permitted; all deadlines to complete the authorized or required action; how to complete the authorized or required action; and the contact information for the agency, department, or office that can assist or answer questions relating to the authorized or required action.
United States · United States Congress · 29 October 2019
Native American Veteran Parity in Access to Care Today Act or the Native American PACT Act This bill prohibits the Department of Veterans Affairs from collecting copayments from American Indian or Alaska Native veterans for hospital care or medical services.
United States · United States Congress · 29 October 2019
Time to Rescue United States Trusts Act or the TRUST Act This bill establishes congressional rescue committees to develop recommendations and legislation to improve critical social contract programs. A critical social contract program is a federal program for which a federal trust fund is established (e.g., Social Security, Medicare, and federal highway programs), with outlays of at least $20 billion during the year preceding the year in which this bill is enacted, and for which the amount of dedicated federal funds and federal trust fund balances will be inadequate to meet the total amount of outlays of the program that would otherwise be made. Each rescue committee may develop recommendations and legislation to improve the program for which it was established, including by (1) increasing the duration of positive balances of the federal trust fund established for the program, and (2) providing for the solvency of the federal trust fund established for the program during a 75-year period. Congress must use specified expedited legislative procedures to consider legislation that is approved and submitted by the rescue committees.
United States · United States Congress · 29 October 2019
Puerto Rico Statehood Admission Act This bill (1) declares that Congress commits to deeming Puerto Rico to be a state of the United States if it chooses statehood; and (2) requires Puerto Rico to conduct a plebiscite, a vote of the people, on statehood in conjunction with the November 2020 election.
United States · United States Congress · 28 October 2019
Global Child Thrive Act of 2019 This bill reauthorizes for FY2020-FY2025 programs to provide assistance to orphans and other vulnerable children in developing countries. The bill also requires the U.S. Agency for International Development to direct relevant executive branch agencies to incorporate early childhood development into current programs and promote inclusive early childhood development in partner countries. Such actions to promote early childhood development shall build on existing U.S. plans and strategies and aim to (1) prevent unnecessary family-child separation, (2) assist families with children with disabilities, and (3) help countries transition from child care protection systems that rely on residential care (such as orphanages and children's homes) to ones focused on family-based care.
United States · United States Congress · 28 October 2019
Veteran Deportation Prevention and Reform Act This bill modifies immigration and naturalization procedures for noncitizens who are members or veterans of the Armed Forces. Specifically, the bill requires interagency coordination to (1) identify such individuals who are the subject of immigration removal proceedings or who have already been removed; and (2) naturalize them as citizens or otherwise change their status, as appropriate.
United States · United States Congress · 28 October 2019
Threat Information Protocol for Sharing Act of 2019 This bill establishes several new reporting requirements related to information received by the Federal Bureau of Investigation (FBI) through the national tip line relating to an individual or threat. Specifically, the FBI must submit the following: monthly reports to state law enforcement agencies and fusion centers on all information received by the national tip line relating to an individual or threat in the state during the preceding month, annual reports to Congress on total reports received by the tip line and the total number submitted to state law enforcement agencies and fusion centers, and annual reports to Congress on criminal events involving an individual or threat that had been the subject of a report received through the tip line prior to the criminal event. Additionally, the Government Accountability Office must review and report on the operating processes and procedures of the tip line.
United States · United States Congress · 28 October 2019
Syrian Partner Protection Act This bill authorizes the Department of Homeland Security (DHS) to provide special immigrant status to qualified aliens who assisted U.S. efforts in Syria against the Islamic State. (A special immigrant is qualified to become a permanent resident) A qualifying alien is a Syrian national (or stateless person who habitually resided in Syria) who (1) partnered with or worked for the United States in Syria in a sensitive and trusted capacity (such as an interpreter) on or after January 1, 2014, for at least one year, and (2) provided documented service to U.S. efforts against the Islamic State. The spouse or child of such an alien shall also qualify for special immigrant status. DHS may admit up to 4,000 principal aliens under this bill each fiscal year for the five fiscal years after this bill's enactment. Unused visas at the end of a fiscal year shall carry forward and be available the next year. Aliens admitted under this bill shall not be subject to other numerical limitations. If a qualifying alien applying for special immigrant status under this bill is in imminent danger, the Department of State shall provide protection to that alien. An alien who has received special immigrant status under this bill shall be eligible for benefits generally available to admitted refugees, such as resettlement assistance.
United States · United States Congress · 23 October 2019
Citizenship for Children of Military Members and Civil Servants Act This bill establishes that a foreign-born child of a U.S. citizen member of the Armed Forces or government employee may automatically acquire U.S. citizenship even if the child is not residing in the United States. Currently, a foreign-born child automatically acquires U.S. citizenship if the child (1) has at least one parent who is a citizen, (2) is less than 18 years old, and (3) is residing in the United States in the citizen parent's legal and physical custody pursuant to a lawful admission for permanent residence. Under this bill, the third requirement is fulfilled if a foreign-born child is (1) living in the legal and physical custody of the citizen Armed Services member or government employee who has been stationed abroad (or the accompanying spouse of such a citizen), and (2) lawfully admitted for permanent residence in the United States.
United States · United States Congress · 23 October 2019
SOS: Sustaining Outpatient Services Act This bill allows for payment under the Medicare prospective payment system for hospital outpatient department services of certain items and services that are furnished at off-campus outpatient departments. Specifically, the bill allows for payment of items and services for which payments to physician specialists (under the Medicare physician fee schedule) did not exceed $2 million during the previous year.
United States · United States Congress · 23 October 2019
White House Accountability for Language Diversity Act This bill requires the White House and each federal agency to establish official websites in the five most commonly used languages in the United States other than English to increase accessibility. The websites must be of a similar scope and content as the English version. The President and each agency shall maintain and update the websites on a regular basis.
United States · United States Congress · 18 October 2019
Justice for ALS Veterans Act of 2019 This bill extends increased dependency and indemnity compensation to the surviving spouse of a veteran who dies from amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease) regardless of how long the veteran had such disease prior to death. Under current law, such compensation is paid for a service-connected disability that was rated totally disabling for a continuous period of at least eight years immediately preceding death.
United States · United States Congress · 18 October 2019
This resolution rejects the Supreme Court's decisions in the Insular Cases (a series of cases regarding the application of constitutional rights in U.S. territories) and recognizes the importance of supporting equal rights of Americans living in the U.S. territories.
United States · United States Congress · 17 October 2019
Courtney Wild Crime Victims' Rights Reform Act of 2019 This bill expands the rights of crime victims, including by allowing victims to make motions to annul or rescind prosecutorial agreements, providing for attorneys' fees for victims who prevail against the United States in enforcement actions, and permitting victims to bring civil actions to enforce restitution orders. It also requires the Department of Justice to take specified actions to ensure the rights of victims.
United States · United States Congress · 17 October 2019
Polling Access Safety Act of 2019 This bill limits immigration enforcement in relation to polling places and establishes various requirements related to the Department of Homeland Security (DHS). Absent exigent circumstances, the following are prohibited on a voting day: (1) immigration enforcement actions within one mile of a polling place; (2) identification checks at a polling place by a federal officer or employee; and (3) DHS-conducted temporary vehicle checkpoints, public transportation searches, and public training exercises. State election administrations shall post notice of such prohibitions at each polling place on a voting day. Information acquired in violation of such prohibitions may not be used to initiate deportation proceedings. DHS shall establish a training program for certain officers and employees on compliance with federal laws limiting certain political activities of federal employees and officers (e.g., the Hatch Act). The bill establishes three positions to monitor and ensure compliance with the bill. These positions shall be within the DHS Office of Inspector General, the DHS Office for Civil Rights and Civil Liberties, and the Office of Special Counsel.
United States · United States Congress · 17 October 2019
Youth Tax Fairness Act of 2019 This bill amends the Internal Revenue Code to treat certain income as earned income for purposes of the taxation of the unearned income of certain children (i.e., the kiddie tax). Such income includes (1) distributions from qualified disability trusts, (2) certain military survivor benefits, (3) certain first responder survivor benefits, (4) certain Indian tribal payments, (5) certain scholarships or fellowship grants, (6) Alaska permanent fund dividends, and (7) Social Security benefits. Treating such income as earned income allows it to be taxed at lower rates.
United States · United States Congress · 17 October 2019
Support UNFPA Funding Act This bill authorizes annual contributions to support the core functions and programs of the United Nations Population Fund for the five fiscal years following the bill's enactment.
United States · United States Congress · 16 October 2019
Take Unsafe Limos Off the Road Act This bill directs the Department of Transportation to award grants to states that have enacted and are enforcing laws that require the impoundment or immobilization of stretch limousines if such limousines are found to have certain defects upon inspection.
United States · United States Congress · 16 October 2019
Safety, Accountability, and Federal Enforcement of Limos Act of 2019 or the SAFE Limos Act This bill establishes safety standards for stretch limousines. Among other requirements, the bill requires safety belts to be installed in stretch limousines with a gross vehicle weight rating greater than 8,500 pounds at each designated seating position, including on side-facing seats; the Department of Transportation (DOT) to develop and issue guidelines, best practices, and recommendations to assist stretch limousine alterers develop and administer a vehicle modifier plan; DOT to complete research into side impact protection, roof crush resistance, and air bag systems for the protection of occupants in stretch limousines given alternative seating positions or interior configurations, including perimeter seating arrangements; stretch limousine operators to disclose (1) the date of the most recent inspection of the limousine required under state or federal law, (2) the results of the inspection, and (3) any corrective actions taken to ensure the limousine passes inspection; and the use of event data recorders in stretch limousines.
United States · United States Congress · 16 October 2019
Protect Against Conflict by Turkey Act or the PACT Act This bill imposes sanctions and various restrictions related to Turkey's military invasion of northern Syria. The President shall impose visa- and asset-blocking sanctions on specific Turkish officials connected to the invasion, including Turkey's Minister of National Defense. The Department of State shall report to the President and Congress as to (1) other Turkish officials involved with the invasion; and (2) foreign persons that knowingly provided defense articles, services, or technology to Turkey that could be used in the invasion of northern Syria. Such foreign persons shall also be subject to visa- and asset-blocking sanctions. The President shall impose financial sanctions on the large Turkish state-owned bank known as Halk Bankasi or Halkbank and on any financial institutions that the State Department determines to have knowingly facilitated significant transactions for the Turkish Armed Forces or Turkey's defense industry related to the invasion. The President shall impose sanctions on Turkey's government pursuant to the Countering America's Adversaries Through Sanctions Act. A U.S. defense article, service, or technology may not be transferred to Turkey's government if it (1) is covered under the Arms Export Control Act, and (2) may be used by Turkey in military operations in northern Syria. The President may not exercise certain emergency waiver authority related to the Arms Export Control Act in relation to this prohibition. The bill calls for reports on (1) the national security impact of the invasion and, (2) the net worth of Turkish President Tayyip Erdogan and his family.
United States · United States Congress · 16 October 2019
End the Limo Loophole Act This bill revises the definition of commercial motor vehicle to include vehicles that are designed to transport 9 or more passengers including the driver (currently, at least 16 passengers including the driver) and requires the Federal Motor Carrier Safety Administration to finalize a rulemaking to require states to implement an annual inspection program for commercial passenger-carrying vehicles.
United States · United States Congress · 15 October 2019
College Affordability Act This bill reauthorizes and revises the Higher Education Act of 1965, including to revise federal student financial aid programs, consolidate federal student loans and expand loan forgiveness , increase college access and success for certain students, and revise accountability measures. Specifically, the bill revises financial aid programs, including to (1) increase the maximum federal Pell Grant award, (2) provide incentives for states to fund public institutions of higher education (IHEs), and (3) increase and make permanent funding for minority-serving IHEs. The bill also revises federal student loan programs, including to (1) replace existing student loan repayment plans with one income-based repayment plan and one fixed repayment plan, (2) allow existing borrowers to lower their payments by switching to the new plans, and (3) expand public service loan forgiveness programs (e.g., TEACH grants) and create appeal processes for denied applications. In addition, the bill increases college access and success for certain students (e.g., students with low-income, children, or the disabled) through investments and practices, such as student support services and accelerated learning opportunities. Finally, the bill revises accountability measures for IHEs (including for-profit IHEs), job training programs, college accrediting agencies, and lenders. In particular, the bill updates the performance goals of the Office of Federal Student Aid and requires the Department of Education to be responsible for the oversight of the office.
United States · United States Congress · 15 October 2019
Designates the facility of the United States Postal Service located at 21701 Stevens Creek Boulevard in Cupertino, California, as the "Petty Officer 2nd Class (SEAL) Matthew G. Axelson Post Office Building."
United States · United States Congress · 15 October 2019
This resolution expresses Congress's opposition to the decision to end U.S. efforts to prevent Turkey's military operations against Kurdish forces in northeast Syria. It also calls on (1) Turkey to immediately cease unilateral military action in northeast Syria and respect existing agreements, (2) the United States to continue supporting Syrian Kurdish communities through military and humanitarian support and ensure that the Turkish military acts with restraint, and (3) the White House to present a clear and specific plan for the enduring defeat of the Islamic State of Iraq and Syria (ISIS).
United States · United States Congress · 11 October 2019
Capping Drug Costs for Seniors Act of 2019 This bill reduces the annual out-of-pocket spending threshold, and eliminates beneficiary cost-sharing above this threshold, under the Medicare prescription drug benefit.
United States · United States Congress · 11 October 2019
Biomedical Innovation Expansion Act of 2019 This bill expands and reauthorizes through FY2030 the National Institutes of Health innovation projects, which include the (1) All of Us Research Programs, (2) Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, (3) Cancer Moonshot research, and (4) Regenerative Medicine Innovation Project. The bill also provides new funding for antimicrobial resistance research and for the research of rare diseases or conditions.
United States · United States Congress · 8 October 2019
Stopping Harmful Interference in Elections for a Lasting Democracy Act or the SHIELD Act This bill establishes a duty to report election interference from foreign entities, applies existing campaign advertising requirements to online advertisements, and generally limits political spending and election interference by foreign entities. Specifically, a political committee must report certain foreign contacts involving an offer of unlawful election assistance to the Federal Bureau of Investigation and the Federal Election Commission. The bill establishes criminal penalties for violations of these requirements. Existing requirements for political advertisements and electioneering communications apply to internet and digital advertisements, including requirements related to disclosures and contributions. Additionally, large online platforms must maintain a public database of certain political advertisements. The bill places limitations on political spending by foreign entities. Specifically, foreign entities may not (1) contribute to campaigns related to ballot initiatives and referenda, or (2) make disbursements for certain internet activity referring to a candidate or a political issue. A candidate is prohibited from offering to share nonpublic campaign information with certain foreign entities. The bill also prohibits (1) the dissemination of false statements regarding federal elections or public endorsement, or (2) the intentional hindering of voting or registering to vote. The bill establishes criminal penalties and a private right of action with respect to these prohibitions.
United States · United States Congress · 4 October 2019
VA Reporting Transparency Act This bill requires the Department of Veterans Affairs (VA) to establish and maintain a website that allows the public to obtain electronic copies of all legislatively requested reports. Information, records, and reports that are exempt from public disclosure are not required to be included on the website. The VA must submit a report to Congress recommending which recurring legislatively requested reports should be discontinued.
United States · United States Congress · 27 September 2019
Minority Diabetes Initiative Act This bill allows the Department of Health and Human Services (HHS) to make grants to public and nonprofit private health care providers to provide treatment for diabetes in minority communities. HHS must ensure that these grants cover a variety of diabetes-related health care services, including routine care for diabetic patients, public education on diabetes prevention and control, eye care, foot care, and treatment for kidney disease and other complications of diabetes.
United States · United States Congress · 27 September 2019
Stop Mental Health Stigma in Our Communities Act This bill requires the Substance Abuse and Mental Health Services Administration to develop and implement an outreach and education strategy regarding behavioral health issues among the Hispanic and Latino populations. The strategy must be designed to promote behavioral and mental health and reduce stigma associated with mental health conditions and substance abuse among such populations.
United States · United States Congress · 27 September 2019
Prevent Trafficking in Our Schools Act This bill directs (1) the Department of Homeland Security (DHS) and the Department of Education (ED) to jointly carry out a pilot program under which qualified DHS personnel provide annual human trafficking awareness training to ED personnel and to teachers, school leaders, and other personnel of elementary schools and secondary schools; and (2) ED to develop and implement a public awareness program on the threat of human trafficking in the education system.
United States · United States Congress · 27 September 2019
Public Servants Protection and Fairness Act This bill establishes an alternative formula to calculate Old-Age, Survivors, and Disability Insurance benefits for those who receive pensions for certain non-covered employment. (The existing formula is known as the windfall elimination provision.) The alternative formula adjusts an individual's total lifetime earnings based on the proportion of covered earnings (i.e., earnings subject to Social Security payroll taxes). It applies to individuals who (1) first become eligible for benefits after 2021, (2) have earnings from non-covered service performed after 1977 and (3) have less than 30 years of coverage (i.e., years in which a beneficiary is considered to have contributed a substantial amount into the Social Security trust funds). Beneficiaries receive the higher benefit amount as calculated under the alternative method or the existing formula. In addition, the bill provides rebates for certain beneficiaries currently impacted by the existing formula. The Social Security Administration must include non-covered earnings in Social Security account statements, and the Government Accountability Office must study the availability of certain information related to retirement plans maintained by state and local governments.
United States · United States Congress · 26 September 2019
This joint resolution nullifies a rule issued by the Department of Education (ED) on September 23, 2019. The rule revised the process for a student loan borrower to obtain a discharge from a student loan if an institution of higher education misrepresented a material fact. Among other requirements, the 2019 rule requires each borrower to apply to ED for a defense to repayment. However, under the previous 2016 rule, an application could be submitted on behalf of an entire group (e.g., veterans).
United States · United States Congress · 26 September 2019
Expanding Health Care Options for Early Retirees Act This bill establishes a Medicare buy-in option for certain qualifying first responders. Specifically, the bill allows first responders aged 50 to 64 to enroll in Medicare if they are retired or otherwise separated from service due to a disability. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations for outreach and enrollment activities relating to the buy-in option.
United States · United States Congress · 24 September 2019
This resolution expresses the sense of the House of Representatives that the U.S. Postal Service should issue a commemorative stamp series honoring women veterans.
United States · United States Congress · 19 September 2019
Eric Garner Excessive Use of Force Prevention Act of 2019 This bill modifies the criminal civil rights statute that prohibits the deprivation of rights under color of law. Currently, the second prong of the prohibition bars the application of different punishments, pains, or penalties based on an individual's alien status, color, or race. This bill specifies that the application of any pressure to a person's throat or windpipe which may prevent or hinder breathing or reduce intake of air (e.g., a chokehold) constitutes a punishment, pain, or penalty.
United States · United States Congress · 19 September 2019
This concurrent resolution supports existing regulations with the goals of (1) reducing greenhouse gas emissions and oil usage, and (2) protecting national security and human health and welfare. The concurrent resolution also supports policies that will help meet these goals, such as policies that achieve maximum feasible reductions in oil use.
United States · United States Congress · 18 September 2019
Aircraft Maintenance Outsourcing Disclosure Act of 2019 This bill requires air carriers that provide scheduled passenger or cargo air transportation to publicly disclose their aircraft maintenance practices, including the location and date that an aircraft underwent heavy maintenance.
United States · United States Congress · 18 September 2019
Public Service Loan Forgiveness Modernization Act or the PSLF Modernization Act This bill revises provisions related to the public service loan forgiveness program. Specifically, the bill requires the Department of Education (ED) to establish a comprehensive database identifying each qualified public service employer and each position offered by such employer that is a public service job. ED must also establish a process whereby an employer may submit a certification that it is a qualified public service employer. In addition, the bill prohibits ED from requiring a borrower to apply for and be denied loan cancellation pursuant to the public service loan forgiveness program as a condition of eligibility for loan forgiveness under the Temporary Expanded Public Service Loan Forgiveness program. ED must also develop and make publicly available an online tool where borrowers may learn more about the expanded program, determine their eligibility for forgiveness, and identify any requirements for participation.
United States · United States Congress · 18 September 2019
This resolution recognizes (1) the celebration of Hispanic Heritage Month; and (2) the integral role of Latinos and their manifold heritage in the economy, culture, and identity of the United States.
United States · United States Congress · 17 September 2019
Yes In My Backyard Act This bill requires certain Community Development Block Grant program recipients to submit to the Department of Housing and Community Development information regarding their implementation of certain land-use policies (e.g., policies for reducing minimum lot size).
United States · United States Congress · 12 September 2019
Puppies Assisting Wounded Servicemembers for Veterans Therapy Act or the PAWS for Veterans Therapy Act This bill requires the Department of Veterans Affairs to implement a pilot program to assess the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder through a method where veterans train service dogs for veterans with disabilities.
United States · United States Congress · 12 September 2019
Homeless Assistance Act of 2019 This bill authorizes public housing agencies to disclose to certain entities information regarding individuals and families who are homeless or at risk of homelessness. Such disclosure is limited to the confidential use of the information to facilitate, identify, assess, and link housing and supportive services to ensure continuity of care for such individuals and their families.