Requires NJ FamilyCare coverage for healthy food prescriptions for certain enrollees.

S4189

SENATE, No. 4189

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED MAY 11, 2026

Sponsored by:

Senator� ANGELA V. MCKNIGHT

District 31 (Hudson)

SYNOPSIS

���� Requires NJ FamilyCare coverage for healthy food
prescriptions for certain enrollees.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act

concerning healthy foods, amending the title and
body of P.L.2019, c.15, and supplementing P.L.1968, c.413 (C.30:4D-1 et seq.).

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.��� The title of P.L.2019,
c.15 is amended to read as follows:

����
An Act
concerning food
retailers
and retail pharmacies
, and supplementing Title 24 of the
Revised Statutes.

(cf: P.L.2019, c.15, title)

���� 2.��� Section 1 of P.L.2019,
c.15 (C.24:4A-6) is amended to read as follows:

���� 1.��� This act shall be known
and may be cited as the "Healthy Small Food Retailer
and Retail Pharmacy

Act."

(cf: P.L.2019, c.15, s.1)

���� 3.��� Section 2 of P.L.2019,
c.15 (C.24:4A-7) is amended to read as follows:

���� 2.��� The Legislature finds
and declares:

���� a.���� Overweight children and
adults are at greater risk for numerous adverse health consequences, including
type 2 diabetes, heart disease, stroke, high blood pressure, high cholesterol,
certain cancers, asthma, low self-esteem, depression, and other debilitating
diseases;

���� b.��� In the United States,
the medical costs of obesity are rising rapidly with Medicare and Medicaid
paying roughly half of these obesity-related costs, estimated to be over $100
billion per year;

���� c.���� Many Americans,
particularly those in low income neighborhoods, rural areas, and communities of
color, live in communities that lack adequate access to full-service grocery
stores, and low income areas have more than twice as many convenience stores
and four times as many small grocery stores as high income areas;

���� d.��� Small food stores, which
tend to charge higher prices for food compared to grocery stores and
supermarkets, have limited supplies of fresh produce, whole grains, and low-fat
dairy products and frequently sell highly processed foods that are high in fat
and low in nutrients;

���� e.���� Providing assistance to
existing small food retailers
and retail pharmacies
to stock fresh
produce and other healthy foods that promote good nutrition will better provide
people with access to healthier foods, and community programs that work with
these small food retailers have shown promise in increasing healthy food sales,
improving the quality of store offerings, and promoting good nutrition; and

���� f.���� It is therefore the
intent of the Legislature to provide support to small food retailers
and retail
pharmacies
operating in New Jersey, in both urban and rural areas, to sell
more fresh fruits and vegetables and other healthy foods at affordable prices
to neighborhood residents in an effort to improve the health and wellness of
all New Jerseyans.

(cf: P.L.2019, c.15, s.2)

���� 4.��� Section 3 of P.L.2019,
c.15 (C.24:4A-8) is amended to read as follows:

���� 3.��� As used P.L.2019, c.15
(C.24:4A-6 et seq.):

���� "Department" means
the Department of Health.

����
�Division� means the
Division of Medical Assistance and Health Services in the Department of Human
Services.

����
�Food prescription� means a
prescription, written by a health care provider, for certain foods as a
treatment for diet-related health conditions.

���� "Fund" means the
"Healthy Small Food Retailer
and Retail Pharmacy
Fund"
established pursuant to section 5 of
[
this
act
]

�
P.L.2019,
c.15 (C.24:4A-10) and section 6 of P.L.��� , c.��� (pending before the
Legislature as this bill)
.

���� "Healthy Corner Store
and
Retail Pharmacy
Program" means the program established pursuant to section
4 of
[
this
act
]

P.L.2019,
c.15 (C.24:4A-9) and section 5 of P.L.��� , c.���� (pending before the
Legislature as this bill)
.

���� "Low income area"
means a census tract, as reported in the most recently completed decennial
census published by the United States Census Bureau, that has a poverty rate of
at least 20 percent or in which the median family income does not exceed 80
percent of the Statewide or metropolitan median family income, whichever is
greater.

���� "Moderate income
area" means a census tract, as reported in the most recently completed
decennial census published by the United States Census Bureau, in which the
median family income is between 81 and 95 percent of the median family income
for the area.

����
�NJ FamilyCare� means the
program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), which
includes the State�s Medicaid Program and the Children�s Health Insurance
Program.

����
�Retail pharmacy� means any
establishment, including a community pharmacy, licensed by the State to
dispense prescription medications directly to patients.

���� "Small food
retailer" means a small retail outlet, with less than 2,500 square feet,
which sells a limited selection of foods and other

products, such as a bodega,
convenience store, corner store, neighborhood store, small grocery, or
small-scale store.

(cf: P.L.2019, c.15, s.3)

���� 5.��� Section 4 of P.L.2019,
c.15 (C.24:4A-9) is amended to read as follows:

���� 4.��� a.� The department
,
in collaboration with the division,
shall develop and implement a
"Healthy Corner Store
and Retail Pharmacy
Program" to
:

����
(1)
�� increase the
availability and sales of fresh produce and nutritious, healthy food by small
food retailers
and retail pharmacies
in rural and urban low income and
moderate income areas
; and

����
(2)�� enable a NJ
FamilyCare enrollee, for whom a licensed health care provider has written a
food prescription, to fill the prescription at a retail pharmacy pursuant to subsection
a. of section 9 of P.L. , c.���� (C.�������
) (pending before the Legislature as this bill)
. �

���� The department
in
collaboration with the division
shall select at least one grantee in each
community participating in the program to administer the program and distribute
program funding to small food retailers
and retail pharmacies
in the
community.

���� b.��� To support the program,
the department shall promote the availability of program funding Statewide,
establish eligibility guidelines for funding, evaluate applicants, raise
matching funds, and disburse funding through the "Healthy Small Food
Retailer
and Retail Pharmacy
Fund," established pursuant to section
5 of
[
this
act
]

P.L.2019,
c.15 (C.24:4A-10)
.

���� c.���� The department shall
develop an application and applicant selection process and create eligibility
guidelines for any organization applying to be selected as a grantee.� To
qualify for funding, an applicant shall:

���� (1)�� provide proof
satisfactory to the department that it is a nonprofit entity;

���� (2)�� have a well-defined
public health goal with standards based on the best available science;

���� (3)�� agree to provide
assistance to small food retailers
and retail pharmacies
located in low
income or moderate income areas that:

���� (a)�� accept, or agree to
accept as a condition of receiving assistance, Supplemental Nutrition
Assistance Program benefits;

���� (b)�� agree to apply to accept
Special Supplemental Nutrition Program for Women, Infants, and Children
benefits, and accept those benefits if eligible;
[
and
]

���� (c)��
in the case of a
retail pharmacy, are or agree to apply to become an approved NJ FamilyCare
provider as a condition of receiving assistance; and;

����
(d)
�� agree to abide by
the
[
department's
]
conditions
,
established by the department and the division,
for receiving assistance;

���� (4)�� collect and provide data
and other information required by the department
and the division
for
program monitoring, accountability, and evaluation purposes;
[
and
]

���� (5)�� establish defined goals,
standards, and accountability mechanisms to ensure that expenditures from the
fund are appropriate and consistent with the purpose of
[
this act
]

P.L.2019,
c.115 (C.24:4A-6 et seq.)
, including:

���� (a)�� identifying the basis
for selecting each particular small food retailer
, retail pharmacy,
or
geographic area for assistance;

���� (b)�� submitting and
implementing a plan which includes specific targets and goals for increasing
the sales of produce and other healthy foods by a small food retailer
or
retail pharmacy
in the designated area, engaging the community to support
the participating small food retailers
and retail pharmacies
, and
establishing standards to assess performance and whether goals within the plan
are met;
[
and
]

���� (c)�� engaging an advisory
group of members of county or municipal agencies, such as planning or economic
development entities, private or public universities, cooperative extensions,
community-based organizations, and community members, to provide expertise and
support and to coordinate other efforts to support the program and
participating small food retailers
and retail pharmacies; and

����
(d)�� ensure that small
food retailers and retail pharmacies selected for assistance are accessible for
community members; and

����
(6)�� present a plan to
engage in public awareness and community outreach concerning the availability
of healthy foods at participating small food retailers and retail pharmacies
.

���� d.��� The department
, in
collaboration with the division,
shall develop specific standards for
selecting a small food retailer
or a retail pharmacy
to participate as a
designated healthy corner store
or retail pharmacy
.� In determining
whether a small food retailer
or a retail pharmacy
is qualified,
consideration shall be given to the level of need in the area served. �As a
condition of participation, a small food retailer
or a retail pharmacy
shall
sign a written agreement prior to receiving assistance.� A grantee shall be authorized
to monitor the participating small food retailers
and retail pharmacies
,
and enforce the agreements if necessary.� A grantee shall establish monitoring
and accountability mechanisms for participating small food retailers
and
retail pharmacies
.

(cf: P.L.2019, c.15, s.4)

���� 6.��� Section 5 of P.L.2019,
c.15 (C.24:4A-10) is amended to read as follows:

���� 5.��� a. There is established
in the Department of Health the "Healthy Small Food Retailer
and Retail
Pharmacy
Fund," to support the "Healthy Corner Store
and
Retail Pharmacy
Program" created pursuant to section 4 of
[
this act
]

P.L.2019,
c.15
(
C.24:4A-9) and section 5 of P.L.��� , c.��� (pending before the
Legislature as this bill)
.� All monies received in the fund shall be
expended by the Commissioner of Health and distributed through grantees to
provide assistance to participating small food retailers
and retail
pharmacies
in rural and urban low income and moderate income areas.

���� b.��� The fund shall be
credited annually with any monies made available to it from the General Fund or
any public
,
or private source other than the State.� The commissioner
shall include with the annual budget request for the department a request for
funds sufficient to carry out the purposes and intent of
[
this act
]

P.L.2019,
c.15 (C.24:4A-6 et seq.) and P.L.��� , c.���� (C.������� ) (pending before the
Legislature as this bill
.

���� c.���� Monies from the fund
shall be used only for the following purposes:

���� (1)�� salary and associated
administrative costs incurred to provide education, advice, or other assistance
to small food retailers
and retail pharmacists or pharmacy staff
on food
safety and handling, nutrition education, business operations, and promotion;

���� (2)�� refrigeration, display
shelving,
storage, transportation,
or other equipment necessary for a
small food retailer
or a retail pharmacy
to
[
keep
]
stock
[
of
]

or distribute perishable

healthy foods and fresh produce, up to
[
$5,000
]

$6,000

per retailer
or retail pharmacy
;

���� (3)�� materials and supplies
for nutrition education and healthy food promotion; and

���� (4)�� mini-grants to small
food retailers
and retail pharmacies
, of up to $100 per retailer
or
pharmacy
, to meet initial expenses incurred with participation in the
program.

���� d.��� At least 10 percent, but
not more than 25 percent of the fund shall be reserved for each grantee's
administrative and operational costs to allocate funds to small food retailers
and
retail pharmacies
and evaluate and report on the program, unless those
costs are provided for from other funding sources or in-kind resources.

(cf: P.L.2019, c.15, s.5)

���� 7.��� Section 6 of P.L.2019,
c.15 (C.24:4A-11) is amended to read as follows:

���� 6. a. Each grantee shall
submit a report to the department
and the division
on or before March 1
of each year, which includes information concerning the overall geographic
distribution of the funding, the amount of funding allocated to each small food
retailer
and retail pharmacy
, the health impact associated with the
program and its funding,
the number and amount of any Medicaid claims for
food prescriptions filled pursuant to section 4 of P.L.����� , c.���� (C. )
(pending before the Legislature as this bill),
and any other data or
information required by the department
or the division
for program
monitoring, accountability, and evaluation pursuant to subsection c. of section
4 of
[
this
act
]

P.L.2019,
c.15 (C.24:4A-9) and section 5

of P.L.��� , c.����
.� The report
shall also evaluate any data collected from participating small food retailers
and
retail pharmacies
and assess other effects and outcomes of the program.

���� b.��� Pursuant to section 2 of
P.L.1991, c.164 (C.52:14-19.1), the department
, in collaboration with the division,

shall prepare and submit to the Legislature and to the Governor an annual
report summarizing the expenditures of the fund, assessing the program and the
performance of any grantee, and including all reports submitted by a grantee
pursuant to subsection a. of this section.� The department
, in collaboration
with the division,
shall provide recommendations about the program as
necessary.

(cf: P.L.2019, c.15, s.6)

���� 8.��� Section 7 of P.L.2019,
c.15 (C.24:4A-12) is amended to read as follows:

���� 7.��� The Department of
Agriculture shall expand the "Jersey Fresh" website to provide
opportunities for the establishment of purchasing networks between farmers,
distributors, grantees, and small food retailers
and retail pharmacies
participating
in the "Healthy Corner Store
and Retail Pharmacy
Program."�
The department shall post, in a prominent location on the homepage of its
Internet website, a hyperlink that provides visitors with direct access to the
"Healthy Corner Store
and Retail Pharmacy
Program" on the
expanded website.

(cf: P.L.2019, c.15, s.7)

���� 9.��� (New section)� a.� (1)� Conditional
upon the receipt of all necessary federal approvals and the securing of federal
financial participation for NJ FamilyCare expenditures under the federal
Medicaid program, the Commissioner of Human Services, in collaboration with the
Commissioner of Health, shall establish a three-year pilot program to provide
NJ FamilyCare coverage for food prescriptions written by licensed health care
providers for NJ FamilyCare enrollees who are diagnosed with a diet-related medical
condition.� The pilot program shall be designed to reduce overall Medicaid
expenditures through improved management of diet-related conditions.�

���� (2)�� Food prescriptions
written pursuant to P.L.��� , c.���� (C.������� ) (pending before the
Legislature as this bill) may be filled at a Medicaid-approved retail pharmacy
that participates in the �Healthy Corner Store and Retail Pharmacy Program,"
as amended by section 4 of P.L.���� c.���� (C.������� ) (pending before the
Legislature as this bill).

���� b.� (1)� Foods that may be
prescribed to NJ FamilyCare enrollees, pursuant to the pilot program established
in subsection a. of this section, shall include:

���� (a)�� fresh fruits;

���� (b)�� fresh vegetables;

���� (c)�� culturally-appropriate
staple foods; and

���� (d)�� other
medically-appropriate grocery items as identified by the Commissioner of Human
Services in consultation with the Commissioner of Health.

���� (2)�� In implementing the
pilot program established in subsection a. of this section, the Department of
Human Services shall, to the extent practicable, prioritize partnerships with
local farmers and food suppliers in filling food prescriptions for pilot
program participants.

���� c.���� (1)� The Department of
Human Services, in consultation with the Department of Health, shall engage
with stakeholders, including health care providers, Medicaid managed care
organizations, food retailers, retail pharmacies, and community based
organizations in the implementation of the pilot program established in
subsection a. of this section.�

���� (2)�� Where practicable and
permissible under federal and State law, the Department of Human Services shall
engage with community-based organizations and community health workers to
provide program participants with educational resources, encourage compliance,
and facilitate participants� access to prescribed foods.

���� d.��� The Department of Human
Services shall monitor:

���� (1)�� the number of food
prescriptions written for, and filled by, NJ FamilyCare enrollees who have a
diet-related medical condition and who elect to participate in the pilot
program established pursuant to subsection a. of this section;

���� (2)�� any improvements in
access to healthy foods for NJ FamilyCare enrollees who participate in the
pilot program; and

���� (3)�� health outcomes for NJ
FamilyCare enrollees who participate in the pilot program.

���� e.���� In implementing the
pilot program established in subsection a. of this section, the Department of
Human Services shall incorporate program integrity safeguards, including:

���� (1)�� a process to verify
participant eligibility for the program;

���� (2)�� utilization review; and

���� (3)�� periodic audits to
prevent program fraud, waste, and abuse.

���� f.���� As used in this
section:

���� �Diet-related medical
condition� means Type II diabetes, hypertension, or obesity.

���� �Food prescription� means a
prescription, written by a licensed health care provider, for certain foods as
a treatment for diet-related health conditions.

���� �Retail pharmacy� means any
establishment, including a community pharmacy, licensed by the State to
dispense prescription medications directly to patients.

���� g.��� The Department of Human
Services shall report annually to the Governor, and to the Legislature pursuant
to section 2 of P.L.1991, c.164 (C.52:14-19.1), concerning:

���� (1)�� pilot program participation
rates;

���� (2)�� participants� health
outcomes;

���� (3)�� State costs for the
pilot program;

���� (4)�� any reduction in overall
Medicaid expenditures associated with participation in the program including,
but not limited to, reductions in emergency department visits,
hospitalizations, and prescription drug utilization; and

���� (5)�� any recommendations for
program expansion.�

���� h.��� Following submission of
the final annual report pursuant to subsection g. of this section, the
Department of Human Services may, upon Legislative authorization and the
receipt of any necessary federal approvals, expand the scope of the pilot
program established in subsection a. of this section.

���� i.���� The Commissioner of
Human Services shall apply for such Medicaid waivers or state plan amendments
as may be necessary to ensure continued federal reimbursements for State
expenditures under the federal Medicaid program.

���� 10.� There is appropriated
from the General Fund to the Department of Human Services $500,000 to implement
the provisions of this act.

���� 11.� The Commissioner of Human
Services and the Commissioner of Health shall, in accordance with the
"Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.),
adopt rules and regulations as necessary to implement this act.

���� 12.� The provisions of P.L.���
, c.���� (C.������� ) (pending before the Legislature as this bill) shall take
effect on the first day of the fourth month next following the date of
enactment, and section 9 shall expire three years thereafter.

STATEMENT

���� This bill requires the NJ
FamilyCare program to establish a three year pilot program to cover food
prescriptions for healthy foods when written by a licensed health care provider
for a NJ FamilyCare enrollee who has been diagnosed with a diet-related medical
condition.� The pilot program will be designed to reduce overall Medicaid
expenditures through improved management of diet-related conditions.�

���� The bill defines �diet-related
medical condition� to mean Type II diabetes, hypertension, or obesity.� Under
the bill, a food prescription includes: �fresh fruits, fresh vegetables,
culturally-appropriate staple foods, and other medically-appropriate grocery
items as identified by the Commissioner of Human Services in consultation with
the Commissioner of Health. �The bill provides that, in implementing the pilot
program, the Department of Human Services (department) will prioritize
partnerships with local farmers and food suppliers, to the extent practicable.

���� Where practicable and
permissible under federal and State law, the department will engage
community-based organizations and community health workers to provide
educational resources for program participants, encourage compliance, and
facilitate access to prescribed foods.

���� The Commissioner of Human
Services will monitor the number of food prescriptions written for, and filled
by, NJ FamilyCare enrollees who participate in the pilot program, health
outcomes for pilot program participants, and any improvements in access to healthy
foods for NJ FamilyCare enrollees who participate in the pilot program.

���� In implementing the pilot program,
the department will incorporate program integrity safeguards, including
eligibility verification, utilization review, and periodic audits to prevent
waste, fraud, and abuse.

���� The bill additionally amends
the "Healthy Small Food Retailer Act" (the act) to allow retail
pharmacies to participate in the program to market and sell healthy foods in
rural and urban low income and moderate income areas, and permit NJ FamilyCare
enrollees to fill food prescriptions, written by licensed health care
providers, at small food retailers and retail pharmacies.� Retail pharmacies
must become authorized Medicaid providers in order to fill food prescriptions
for NJ FamilyCare enrollees who enroll in the pilot program.�

���� The bill further amends the
act to provide that retail pharmacies may receive financial assistance from the
Healthy Small Food Retailers Fund for refrigeration, display shelving, or other
equipment necessary to stock healthy foods and fresh produce, and increases the
amount that each participating small food retailer or retail pharmacy may
receive from $5,000 to $6,000.� Retail pharmacies will also be eligible to
receive mini-grants of up to $100 to cover the up-front costs to participate in
the program.�

���� The bill appropriates $500,000
from the General Fund to the Department of Human Services to implement the
provisions therein.