The bill establishes the Ohio River Basin Restoration Program to enhance the ecological health of the Ohio River and its tributaries. It includes the establishment of an advisory council and a national program office within the Environmental Protection Agency, with a Program Director overseeing the program's implementation. The program aims to carry out projects to improve water quality, increase community resilience to natural disasters, protect wildlife habitat, and more. Funding of $350 million annually for the next five years is authorized, with provisions for interagency agreements and public engagement. The bill emphasizes consultation with stakeholders, including Tribal Governments and public input.