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[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 1342 Introduced in Senate (IS)]

  1st Session
                                S. 1342

  To improve the health of Americans and reduce health care costs by 
    reorienting the Nation's health care system toward prevention, 
                        wellness, and self care.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              May 9, 2007

  Mr. Harkin introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL

 
  To improve the health of Americans and reduce health care costs by 
    reorienting the Nation's health care system toward prevention, 
                        wellness, and self care.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Healthy Lifestyles 
and Prevention America Act'' or the ``HeLP America Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
                       TITLE I--CHILDHOOD OBESITY

Sec. 101. Federal Task Force on Childhood Obesity.
                  TITLE II--HEALTHIER KIDS AND SCHOOLS

Sec. 201. Fresh fruit and vegetable program.
Sec. 202. Food of minimal nutritional value.
Sec. 203. School nutrition environment enhancement grants.
Sec. 204. Baby friendly hospital-center for breastfeeding excellence.
Sec. 205. Intervention to strengthen families and build children's 
                            resilience.
Sec. 206. Grants for the integration of schools and mental health 
                            systems.
Sec. 207. Grants for the promotion of university-community partnerships 
                            to increase youth competencies and reduce 
                            youth problem behaviors in communities.
Sec. 208. Reservations for Early Head Start programs.
            TITLE III--HEALTHIER COMMUNITIES AND WORKPLACES

             Subtitle A--Incentives for a Healthy Workforce

Sec. 301. Short title.
Sec. 302. Tax credit to employers for costs of implementing wellness 
                            programs.
Sec. 303. CDC and employer-based wellness programs.
Sec. 304. Employer-provided off-premises health club services.
                    Subtitle B--Healthy Communities

       Chapter 1--Provisions To Improve the Health of Communities

Sec. 311. Healthy community grants.
Sec. 312. Promoting the health and wellness of individuals with 
                            disabilities through community sports 
                            programs.
Sec. 313. Safe and complete streets.
Sec. 314. National assessment of mental health needs.
Sec. 315. Preventive medicine and public health training grant program.
Sec. 316. Task force for the Promotion of Breastfeeding in the 
                            Workplace.
Sec. 317. Lactation accommodation and breastfeeding promotion at work.
            Chapter 2--Promoting Lifelong Active Communities

Sec. 321. Short title.
Sec. 322. Purpose.
Sesubchapter a--national program promoting lifelong active communities
Sec. 331. Development of community play index.
Sec. subchapter b--model communities of play implementation grants
Sec. 341. Model communities of play implementation grants.
         TITLE IV--RESPONSIBLE MARKETING AND CONSUMER AWARENESS

                     Subtitle A--General Provisions

Sec. 401. Nutrition labeling of restaurant foods.
Sec. 402. Rulemaking authority for advertising to children.
Sec. 403. Food advertising in schools.
Sec. 404. Disallowance of deductions for advertising and marketing 
                            expenses relating to tobacco product use.
Sec. 405. Federal-state tobacco counter-advertising programs.
        Subtitle B--Penalties for Failure to Reduce Teen Smoking

Sec. 411. Child cigarette use surveys.
Sec. 412. Cigarette use reduction goal and noncompliance.
Sec. 413. Enforcement.
                       Subtitle C--Food Guidance

Sec. 421. Front-label food guidance systems.
       TITLE V--REIMBURSEMENT AND COVERAGE OF PREVENTIVE SERVICES

Sec. 501. Coverage of substance use (other than tobacco), diet, 
                            exercise, injury prevention, and dental 
                            health counseling.
Sec. 502. Medicare coverage of medical nutrition therapy services for 
                            people with pre-diabetes.
Sec. 503. Preventive mental health screenings.
Sec. 504. Encouragement of cessation of tobacco use.
Sec. 505. Recognition of school-based health centers as model for 
                            delivery of primary care for children under 
                            the medicaid and State children's health 
                            insurance programs.
Sec. 506. Preventive health care demonstration program.
Sec. 507. Preventive health services for women.
Sec. 508. Promoting cessation of tobacco use by pregnant women under 
                            the medicaid program.
 TITLE VI--HELP (HEALTHY LIFESTYLES AND PREVENTION) AMERICA TRUST FUND

Sec. 601. HELP (Healthy Lifestyles and Prevention) America Trust Fund.
                          TITLE VII--RESEARCH

Sec. 701. Expansion of research regarding obesity.
Sec. 702. Incorporation of physical activity into Federal programs.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Health care costs in the United States are rising 
        rapidly. Per capita health spending in the United States is 56 
        percent higher than the median country that is a member of the 
        Organization for Economic Cooperation and Development.
            (2) According to the Centers for Medicare and Medicaid 
        Services, total health care spending in the United States in 
        2004 was $1,800,000,000,000 and is expected to rise to 
        $3,600,000,000,000 by 2014. Furthermore, chronic disease 
        accounts for approximately 75 percent of health care costs 
        annually.
            (3) The United States spends less than 2 percent of annual 
        health care expenditures on prevention
            (4) Reducing and preventing the incidence of chronic 
        disease is one means by which to reduce health care costs in 
        the United States.
            (5) More than 1,700,000 Americans die of a chronic disease 
        each year, accounting for nearly 70 percent of all deaths in 
        the United States.
            (6) The economic impact of chronic disease can be seen in 
        the annual costs associated with cardiovascular disease and 
        stroke ($352,000,000,000), obesity ($117,000,000,000), cancer 
        ($171,600,000,000), and diabetes ($132,000,000,000).
            (7) Obesity related health conditions cost employers nearly 
        $13,000,000,000 in health care and other indirect costs.
            (8) Health promotion investments by employers on average 
        yield a return of $3 for every $1 invested in a program.
            (9) Being overweight or obese increase the risk of 
        diabetes, heart disease, stroke, several types of cancer and 
        other health problems.
            (10) An estimated 65 percent of adults and 15 percent of 
        children and adolescents in the United States are overweight or 
        obese.
            (11) The rates of obesity have doubled in children and 
        tripled in teens since the 1980's.
            (12) Almost 40 percent of Americans are sedentary. More 
        than \1/3\ of young people in grades 9 through 12 do not 
        regularly engage in vigorous-intensity physical activity.
            (13) Only 1 in 5 young people eat the recommended 5 daily 
        servings of fruits and vegetables.
            (14) Food and beverage advertisers collectively spend 
        $10,000,000,000 to $12,000,000,000 a year to reach children and 
        youth.
            (15) Between 1977 and 1995, trips made by walking declined 
        by 40 percent for adults while driving trips increased to 
        almost 90 percent of the total.
            (16) Virtually all-new users of tobacco products are under 
        the minimum legal age to purchase such products. Every day in 
        America, more than 4,000 kids try their first cigarette. 
        Another 2,000 children become new daily smokers.
            (17) In 2002, nearly a quarter of American adults, 
        46,000,000 people, smoked cigarettes, including almost 40 
        percent of college-aged students.
            (18) Research consistently shows that smoking cessation 
        services offered as a combination of tobacco medication therapy 
        and counseling can be one of the most cost-effective health 
        interventions and can reduce smoking-related health care costs.
            (19) Physical and mental health are interconnected. 
        Physical conditions often result in mental health complications 
        and depression can manifest itself through physical symptoms.
            (20) The Surgeon General reported that mental disorders 
        collectively account for over 15 percent of the overall burden 
        of disease from all causes, slightly more than the burden 
        associated with all forms of cancer.
            (21) One of every 2 people who need mental health treatment 
        in the United States does not receive it. Of children and 
        adolescents 6 to 17 years old who need mental health services, 
        nearly 80 percent do not receive it.
            (22) Early screening and prevention programs in the schools 
        can detect high risk children that are vulnerable to developing 
        mental illness and assist in accessing appropriate services.
            (23) Children are at greater risk for mental health 
        problems when they experience stressful family circumstances 
        such as social or economic disadvantage, severe marital 
        discord, divorce, family violence, parental substance abuse or 
        other mental disorder or physical illness, and parental absence 
        due to military service, imprisonment, or death.
            (24) The 2003 President's New Freedom Commission on Mental 
        Health urged a transformation of the approach to mental health 
        in the United States, including improving the mental health of 
        children and promoting resilience and prevention.
            (25) People with disabilities report substantial 
        disparities in health compared with people without 
        disabilities. These disparities are caused by a number of 
        factors, including less access to health care than individuals 
        without disabilities. People with disabilities report more days 
        of pain, depression, and anxiety and they have higher rates of 
        obesity.
            (26) Evidence shows that health promotion programs with 
        exercise, nutrition, and wellness components targeting people 
        with disabilities can significantly reduce the incidence of 
        these conditions and lead to healthy outcomes for people with 
        disabilities, as well as save money by reducing the frequency 
        of medical visits.

                       TITLE I--CHILDHOOD OBESITY

SEC. 101. FEDERAL TASK FORCE ON CHILDHOOD OBESITY.

    Part Q of title III of the Public Health Service Act (42 U.S.C. 
280h et seq.) is amended by adding at the end the following:

``SEC. 399Z-1. FEDERAL TASK FORCE ON CHILDHOOD OBESITY.

    ``(a) Establishment.--The Secretary shall convene a Task Force on 
Childhood Obesity (referred to in this section as the `Task Force') 
to--
            ``(1) establish a government-wide strategy for preventing 
        and reducing childhood overweight and obesity;
            ``(2) coordinate effective inter-agency coordination and 
        priorities for action among Federal agencies;
            ``(3) implement and evaluate the effectiveness of such 
        strategy; and
            ``(4) direct the Secretary to designate a responsible 
        agency to formally monitor and report, not later than January 
        1, 2008, to Congress on the progress of the various entities 
        and activities related to the recommendations included in the 
        report of Institute of Medicine entitled ``Food Marketing to 
        Children and Youth''.
    ``(b) Membership.--
            ``(1) In general.--The Task Force shall be composed of 
        employees of--
                    ``(A) the Department of Health and Human Services;
                    ``(B) the Department of Agriculture;
                    ``(C) the Department of Education;
                    ``(D) the Federal Trade Commission;
                    ``(E) the Department of Transportation; and
                    ``(F) any other Federal agency that the Secretary 
                determines appropriate.
            ``(2) Chairperson.--The chairperson of the Task Force shall 
        be--
                    ``(A) an individual appointed by the President; and
                    ``(B) until the date that an individual is 
                appointed under subparagraph (A), the Secretary.
    ``(c) Meetings.--The Task Force shall meet at the call of the 
chairperson.
    ``(d) Report.--Not later than January 1, 2008, and on annual basis 
thereafter through January 1, 2013, the Task Force shall submit to the 
President and to the relevant committees of Congress, a report that--
            ``(1) describes the activities and efforts to prevent and 
        reduce childhood overweight and obesity conducted by the Task 
        Force during the year to which the report relates; and
            ``(2) evaluates the effectiveness of such activities and 
        efforts to prevent and reduce childhood overweight and 
        obesity.''.

                  TITLE II--HEALTHIER KIDS AND SCHOOLS

SEC. 201. FRESH FRUIT AND VEGETABLE PROGRAM.

    Section 18(g)(6)(B) of the Richard B. Russell National School Lunch 
Act (42 U.S.C. 1769(g)(6)(B)) is amended--
            (1) by redesignating clause (ii) as clause (iv); and
            (2) by inserting after clause (i) the following:
                            ``(ii) Additional mandatory funding.--Out 
                        of any funds in the Treasury not otherwise 
                        appropriated, the Secretary of the Treasury 
                        shall transfer to the Secretary of Agriculture 
                        to carry out and expand the program under this 
                        subsection, to remain available until 
                        expended--
                                    ``(I) on October 1, 2007, 
                                $1,000,000,000; and
                                    ``(II) on October 1, 2007, and on 
                                each October 1 thereafter, the amount 
                                made available for the previous fiscal 
                                year, as adjusted under clause (iii).
                            ``(iii) Adjustment.--On October 1, 2007, 
                        and on each October 1 thereafter of a fiscal 
                        year the amount made available under subclause 
                        (I) of clause (ii) shall be calculated by 
                        adjusting the amount made available for the 
                        previous fiscal year to reflect changes in the 
                        Consumer Price Index of the Bureau of Labor 
                        Statistics for fresh fruits and vegetables, 
                        with the adjustment--
                                    ``(I) rounded down to the nearest 
                                dollar increment; and
                                    ``(II) based on the unrounded 
                                amounts for the preceding 12-month 
                                period.''.

SEC. 202. FOOD OF MINIMAL NUTRITIONAL VALUE.

    Section 10 of the Child Nutrition Act of 1966 (42 U.S.C. 1779) is 
amended--
            (1) by striking the section heading and all that follows 
        through ``(a) The Secretary'' and inserting the following:

``SEC. 10. REGULATIONS.

    ``(a) In General.--The Secretary''; and
            (2) by striking subsections (b) and (c) and inserting the 
        following:
    ``(b) Food of Minimal Nutritional Value.--
            ``(1) Proposed regulations.--
                    ``(A) In general.--Not later than 180 days after 
                the date of enactment of this paragraph, the Secretary 
                shall promulgate proposed regulations to revise the 
                definition of `food of minimal nutritional value' that 
                is used to carry out this Act and the Richard B. 
                Russell National School Lunch Act (42 U.S.C. 1751 et 
                seq.).
                    ``(B) Application.--The revised definition of `food 
                of minimal nutritional value' shall apply to all foods 
                sold--
                            ``(i) outside the school meal programs;
                            ``(ii) on the school campus; and
                            ``(iii) at any time during the school day.
                    ``(C) Requirements.--In revising the definition, 
                the Secretary shall consider--
                            ``(i) both the positive and negative 
                        contributions of nutrients, ingredients, and 
                        foods (including calories, portion size, 
                        saturated fat, trans fat, sodium, and added 
                        sugars) to the diets of children;
                            ``(ii) evidence concerning the relationship 
                        between consumption of certain nutrients, 
                        ingredients, and foods to both preventing and 
                        promoting the development of overweight, 
                        obesity, and other chronic illnesses;
                            ``(iii) recommendations made by 
                        authoritative scientific organizations 
                        concerning appropriate nutritional standards 
                        for foods sold outside of the reimbursable meal 
                        programs in schools; and
                            ``(iv) special exemptions for school-
                        sponsored fundraisers (other than fundraising 
                        through vending machines, school stores, snack 
                        bars, a la carte sales, and any other 
                        exclusions determined by the Secretary), if the 
                        fundraisers are approved by the school and are 
                        infrequent within the school.
            ``(2) Implementation.--
                    ``(A) Effective date.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), the proposed regulations shall 
                        take effect at the beginning of the school year 
                        following the date on which the regulations are 
                        finalized.
                            ``(ii) Exception.--If the regulations are 
                        finalized on a date that is not more than 60 
                        days before the beginning of the school year, 
                        the proposed regulations shall take effect at 
                        the beginning of the following school year.
                    ``(B) Failure to promulgate.--If, on the date that 
                is 1 year after the date of enactment of this 
                paragraph, the Secretary has not promulgated final 
                regulations, the proposed regulations shall be 
                considered to be final regulations.''.

SEC. 203. SCHOOL NUTRITION ENVIRONMENT ENHANCEMENT GRANTS.

    Section 18 of the Richard B. Russell National School Lunch Act (42 
U.S.C. 1769) is amended by adding at the end the following:
    ``(l) Healthy School Nutrition Environment Incentive Grants.--
            ``(1) In general.--The Secretary may implement a grant 
        program to follow the recommendations made by the Institute of 
        Medicine report entitled ``Nutrition Standards for Foods in 
        Schools-Leading the Way Toward Healthier Youth'' to--
                    ``(A) provide schools with technical assistance in 
                implementing the recommendations of the Institute of 
                Medicine regarding appropriate school nutrition 
                standards; and
                    ``(B) assess the impact of implementing the 
                recommendations on the health and well-being of 
                children enrolled in the schools.
            ``(2) Selection of schools.--In selecting schools to 
        receive incentive grants under this subsection, the Secretary 
        shall--
                    ``(A) ensure that not less than 75 percent of 
                schools selected to participate in the program 
                established under this subsection are schools in which 
                not less than 50 percent of the students enrolled in 
                each school are eligible for free or reduced price 
                meals under this Act;
                    ``(B) ensure that, of the schools selected to 
                participate in the program, there is appropriate 
                representation of rural, urban, and suburban schools, 
                as determined by the Secretary;
                    ``(C) ensure that, of the schools selected to 
                participate in the program, there is appropriate 
                representation of elementary, middle, and secondary 
                schools, as determined by the Secretary;
                    ``(D) ensure that schools selected to receive a 
                grant under this subsection meet the requirements of 
                paragraph (3);
                    ``(E) give priority to schools that develop 
                comprehensive plans that include the involvement of a 
                broad range of community stakeholders in achieving 
                healthy school nutrition environments; and
                    ``(F) give priority to schools that develop 
                comprehensive plans that include a strategy for 
                maintaining healthy school nutrition environments in 
                the years following the fiscal years for which the 
                schools receive grants under this subsection.
            ``(3) Requirements.--
                    ``(A) Criteria for healthy school environments.--
                The Secretary shall establish criteria, based upon the 
                recommendations of the Institute of Medicine described 
                in paragraph (1), under which schools may receive 
                grants under this section.
                    ``(B) Plan.--To be eligible to receive a grant 
                under this subsection, a school shall--
                            ``(i) submit to the Secretary a healthy 
                        school nutrition environment plan that 
                        describes the actions the school will take to 
                        meet the criteria established under 
                        subparagraph (A); and
                            ``(ii) take the actions described in the 
                        plan.
            ``(4) Grants.--For each of 5-fiscal years following the 
        establishment of criteria by the Secretary under paragraph (3), 
        the Secretary shall award a grant to each school selected under 
        paragraph (2).
            ``(5) Evaluations.--
                    ``(A) In general.--The Secretary, acting through 
                the Administrator of the Food and Nutrition Service, 
                shall conduct an evaluation of a representative sample 
                of schools that receive grants under this subsection.
                    ``(B) Content.--The evaluation shall measure, at a 
                minimum, the effects of a healthy school nutrition 
                environment on--
                            ``(i) overweight children and obesity;
                            ``(ii) dietary intake;
                            ``(iii) nutrition education and behavior;
                            ``(iv) parental and student attitudes and 
                        participation; and
                            ``(v) related funding issues, including the 
                        cost of maintaining a healthy school nutrition 
                        environment.
                    ``(C) Reports.--The Secretary shall submit to the 
                Committee on Education and the Workforce of the House 
                of Representatives and the Committee on Agriculture, 
                Nutrition, and Forestry of the Senate--
                            ``(i) an interim report on the activities 
                        of schools evaluated under this subsection; and
                            ``(ii) a final report on the activities of 
                        schools evaluated under this subsection.
            ``(6) Authorization of appropriations.--
                    ``(A) In general.--There are authorized to be 
                appropriated such sums as are necessary to carry out 
                this subsection for the 5-fiscal year following the 
                establishment of criteria by the Secretary under 
                paragraph (3), to remain available until expended.
                    ``(B) Evaluations.--The Secretary may use not more 
                than 10 percent of the total funds made available for a 
                fiscal year under subparagraph (A) to carry out 
                paragraph (5).''.

SEC. 204. BABY FRIENDLY HOSPITAL-CENTER FOR BREASTFEEDING EXCELLENCE.

    (a) Establishment of Program.--The Director of the Office on 
Women's Health of the Department of Health and Human Services (referred 
to in this section as the ``Director'') shall establish a program to be 
known as the ``Baby-Friendly Hospital Initiative'' (referred to in this 
section as the ``Initiative'').
    (b) Certification Process.--Under the Initiative, the Director 
shall establish a certification process under which a hospital can 
apply for a certification as a ``baby friendly hospital/center for 
breastfeeding excellence''. Such certification process shall be based 
upon the international guidelines of the Baby-Friendly Hospital 
Initiative established by the World Health Organization and United 
Nations Children's Fund.
    (c) Requirements.--
            (1) In general.--To be certified as a baby friendly 
        hospital/center for breastfeeding excellence, a hospital (as 
        defined for purposes of this section by the Director, and which 
        may include birth centers) shall carry out the following:
                    (A) The hospital shall maintain a written 
                breastfeeding policy that is routinely communicated to 
                all of the healthcare staff of the hospital.
                    (B) The hospital shall provide training for all 
                healthcare staff in the skills necessary to implement 
                the policy described in subparagraph (A).
                    (C) The hospital shall ensure that all pregnant 
                women who are patients at the hospital are informed 
                about the benefits and management of breastfeeding.
                    (D) The hospital shall help mothers initiate 
                breastfeeding within one hour of birth.
                    (E) The hospital shall demonstrate to mothers how 
                to breastfeed and how to maintain lactation, even if 
                the mother is separated from her infant.
                    (F) The hospital shall give infants no food or 
                drink other than breastmilk, unless medically 
                indicated.
                    (G) The hospital shall implement a ``rooming in'' 
                policy by allowing mothers and infants to remain 
                together 24 hours a day in the same hospital room.
                    (H) The hospital shall encourage unrestricted 
                breastfeeding.
                    (I) The hospital shall provide no pacifiers or 
                artificial nipples to breastfeeding infants.
                    (J) The hospital shall foster the establishment of 
                breastfeeding support groups and refer mothers to such 
                groups on discharge from the hospital.
            (2) Inspection.--A hospital shall be certified as a baby 
        friendly hospital/center for breastfeeding excellence only upon 
        the completion of an on-site assessment by the Director through 
        which the Director has determined that the hospital is in 
        compliance with the guidelines used for certification under 
        subsection (b).
            (3) Verification.--Upon being certified as a baby friendly 
        hospital/center for breastfeeding excellence, a hospital shall 
        agree to permit the Director to conduct on-site assessments to 
        verify the continued compliance of the hospital with the 
        requirements of paragraph (1).
    (d) Authority for Automatic Certification.--The Director may 
automatically certify a hospital as a baby friendly hospital/center of 
breastfeeding excellence if such hospital has been designated as a 
baby-friendly hospital under the Baby-Friendly USA program.
    (e) Limitation.--A hospital shall not make any claim that such 
hospital is a baby friendly hospital/center of breastfeeding excellence 
unless such hospital has been certified by the Director in accordance 
with this section.
    (f) Technical Assistance.--The Director shall provide, at the 
request of a hospital seeking a certification as a baby friendly 
hospital/center of breastfeeding excellence, such technical assistance 
as appropriate to assist the requesting hospital to achieve such 
certification.
    (g) Certification Costs.--Subject to the availability of 
appropriations, the Director may provide to a hospital that has 
successfully been certified as a baby friendly hospital/center of 
breastfeeding excellence under this Act, a one time award of up to 
$20,000 to offset the cost to such hospital of being certified as a 
baby friendly hospital/center of breastfeeding excellence.
    (h) Recommendations for Accrediting Entities.--Not later than 12 
months after certifying the first baby friendly hospital/center for 
breastfeeding excellence under this section, the Director shall provide 
to the appropriate organizations or entities that are engaged in the 
accreditation of healthcare organizations, recommendations concerning 
steps that such accrediting entities may take to integrate the baby 
friendly hospital requirements used in the Baby Friendly Hospital 
Initiative into healthcare organization accreditation procedures and 
requirements.
    (i) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section.

SEC. 205. INTERVENTION TO STRENGTHEN FAMILIES AND BUILD CHILDREN'S 
              RESILIENCE.

    Part B of title V of the Public Health Service Act (42 3 U.S.C. 
290bb et seq.) is amended by adding at the end the following:

``SEC. 520K. INTERVENTIONS TO STRENGTHEN FAMILIES AND BUILD CHILDREN'S 
              RESILIENCE.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities for the purpose of implementing programs that strengthen 
families of children at risk for emotional or behavioral problems due 
to family distress.
    ``(b) Eligible Entity.--Entities eligible to receive funds under 
this section may include--
            ``(1) a local public entity, including a health department 
        or local education agency;
            ``(2) an Indian tribal organization or agency;
            ``(3) a federally qualified health center;
            ``(4) a community-based organization; or
            ``(5) any other entity determined appropriate by the 
        Secretary, including a consortia or partnership of entities 
        eligible to receive funds under this section.
    ``(c) Use of Funds.--
            ``(1) In general.--An eligible entity that receives a grant 
        under this section shall use the funds made available through 
        the grant to carry out home-based, school-based, and community-
        based activities that--
                    ``(A) promote strong, supportive families and child 
                resilience through parenting skills training and 
                supports, or skill-building services with children, as 
                well as provide other consultative services and support 
                for family and other caregivers, such as child care 
                providers, educators, and after-school program staff;
                    ``(B) enhance mental health promotion activities in 
                domains where children live, play, and learn; and
                    ``(C) enhance community wellness, and reduce the 
                incidence of preventable mental health problems among 
                children.
            ``(2) Intervention activities.--Intervention activities 
        funded under this section shall--
                    ``(A) be consumer and family driven, and use 
                strengths-based approaches;
                    ``(B) be designed to promote social and emotional 
                competencies and increase children's ability to 
                successfully cope with stressful life circumstances;
                    ``(C) be designed to strengthen children and their 
                families by enhancing the knowledge, social, emotional, 
                and other life or work skills, and support of, parents 
                or other significant caregivers;
                    ``(D) emphasize and model a positive, supportive 
                approach to working with children;
                    ``(E) be evidence-based and provide in-depth and 
                ongoing training and consultation in the adoption and 
                use of evidence-based interventions by schools, 
                communities, and families;
                    ``(F) include a rigorous evaluation component, 
                including outcome measures suited to the intervention 
                and the overall goals of the grant, as well as use of 
                comparison groups and moderating and meditating process 
                variables whenever possible;
                    ``(G) involve partnerships between communities or 
                schools and universities where possible to support 
                effective implementation and evaluation of the 
                intervention activities;
                    ``(H) provide facilitated referrals for parents and 
                other family members who need mental health, substance 
                abuse, or social work services, and coordinate a 
                referral network of professionals with affordable fees; 
                and
                    ``(I) emphasize local capacity-building to use 
                evidence-based intervention, promote linkages among 
                individuals and groups that serve children and 
                families, and develop community outreach to support 
                coalition-building.
            ``(3) Target populations.--Families targeted by these 
        activities shall include those with children at risk for 
        increased mental health problems due to stressful family 
        circumstances, including--
                    ``(A) social or economic disadvantage;
                    ``(B) severe marital discord;
                    ``(C) divorce;
                    ``(D) family violence;
                    ``(E) parental substance abuse or other mental 
                disorder or physical illness;
                    ``(F) parental death;
                    ``(G) parental absence due to military service;
                    ``(H) parental absence due to imprisonment; and
                    ``(I) other family disruption determined 
                appropriate by the Secretary.
    ``(d) Priority Funding.--In awarding grants under subsection (a), 
the Secretary shall give priority to the following:
            ``(1) Entities that provide non-Federal contributions, 
        either in cash or in kind.
            ``(2) Entities with demonstrated experience with community-
        based partnerships.
            ``(3) Entities with demonstrated experience and success 
        with such interventions.
            ``(4) Entities with demonstrated experience working with 
        families.
            ``(5) Entities that develop comprehensive plans that 
        include a strategy for extending program activities developed 
        under this section in the years following the fiscal years for 
        which they receive grants under this section.
            ``(6) Entities that submit plans that exhibit cooperative 
        plans that include the involvement of a broad range of 
        stakeholders, including the following:
                    ``(A) Community-based organizations.
                    ``(B) Local governments.
                    ``(C) Local educational agencies.
                    ``(D) Local business and community associations.
                    ``(E) Accredited colleges, universities, and 
                community colleges.
                    ``(F) Other entities determined appropriate by the 
                Secretary.
    ``(e) Evaluation.--Of the funds appropriated to carry out this 
section, the Secretary may reserve up to 5 percent for each fiscal year 
for the purpose of carrying out evaluations of the activities carried 
out under this section, including a national cross-site evaluation. 
Within 90 days of the completion of any evaluations, they shall be 
provided to the relevant authorizing committees and to the Committees 
on Appropriations of the Senate and the House of Representatives.
    ``(f) Duration.--The Secretary shall award grants under this 
section for a period of not more than 5 years.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $25,000,000 for fiscal year 
2008, and such sums as may be necessary for each of fiscal years 2008 
to 2012.''.

SEC. 206. GRANTS FOR THE INTEGRATION OF SCHOOLS AND MENTAL HEALTH 
              SYSTEMS.

    Section 5541 of the Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7269) is amended--
            (1) in subsection (c), by adding at the end the following:
            ``(7) To support schools that work with families and 
        appropriate community partners to implement school-wide 
        prevention strategies, based on mental health research, that 
        will support early and intensive interventions.
            ``(8) To provide necessary training and support to school 
        personnel on how to recognize and seek needed support for 
        children exhibiting early warning signs of behavioral and 
        academic problems.''; and
            (2) in subsection (d)--
                    (A) in paragraph (4)--
                            (i) in subparagraph (C), by striking 
                        ``and'' after the semicolon;
                            (ii) in subparagraph (D), by striking the 
                        period and inserting ``; and''; and
                            (iii) by adding at the end the following:
                    ``(E) mental health services provided under this 
                section by schools will be evidence-based or promising 
                early interventions.''; and
                    (B) by adding at the end the following:
            ``(7) An explanation of how the applicant will carry out 
        public education programs in support of mental health promotion 
        and prevention by collaborating with--
                    ``(A) an institution of higher education (including 
                a graduate program in psychology, social work, or 
                education at an institution of higher education); and
                    ``(B) private nonprofit community-based 
                organizations that have experience in public education 
                programs relating to mental health promotion and 
                prevention.''.

SEC. 207. GRANTS FOR THE PROMOTION OF UNIVERSITY-COMMUNITY PARTNERSHIPS 
              TO INCREASE YOUTH COMPETENCIES AND REDUCE YOUTH PROBLEM 
              BEHAVIORS IN OUR COMMUNITIES.

    (a) In General.--The Secretary of Health and Human Services shall 
award grants to eligible entities for the implementation of programs 
that promote university-community partnerships to implement community-
based prevention strategies that will support youth competencies and 
prevent youth problem behaviors.
    (b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall be a partnership between--
            (1) an institution of higher education (including a 
        graduate program in psychology, social work, or education at an 
        institution of higher education); and
            (2) a private nonprofit community-based organization that 
        has experience in prevention and interventions relating to 
        mental health promotion and prevention.
    (c) Use of Funds.--An entity shall use amounts received under a 
grant under this section to carry out community-based activities that--
            (1) are comprehensive and utilize evidence-based or 
        promising early interventions; and
             (2) include an evaluation component that includes outcomes 
        measures related to prevention efforts as well as the overall 
        goals of the grant.
    (d) Authorization of Appropriations.--There is to be authorized to 
be appropriated to carry out this section, $10,000,000 for fiscal year 
2008, and such sums as may be necessary for each of fiscal years 2009 
and 2010.

SEC. 208. RESERVATIONS FOR EARLY HEAD START PROGRAMS.

    Section 640(a)(6)(A) of the Head Start Act (42 U.S.C. 
9835(a)(6)(A)) is amended by striking ``7.5 percent'' and all that 
follows and inserting ``12 percent for fiscal year 2008, 14 percent for 
fiscal year 2009, 16 percent for fiscal year 2010, 18 percent for 
fiscal year 2011, and 20 percent for fiscal year 2012, of the amount 
appropriated pursuant to section 639(a).''.

            TITLE III--HEALTHIER COMMUNITIES AND WORKPLACES

             Subtitle A--Incentives for a Healthy Workforce

SEC. 301. SHORT TITLE.

    This subtitle may be cited as the ``Healthy Workforce Act of 
2007''.

SEC. 302. TAX CREDIT TO EMPLOYERS FOR COSTS OF IMPLEMENTING WELLNESS 
              PROGRAMS.

    (a) In General.--Subpart D of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 (relating to business related 
credits) is amended by adding at the end the following:

``SEC. 45O. WELLNESS PROGRAM CREDIT.

    ``(a) Allowance of Credit.--
            ``(1) In general.--For purposes of section 38, the wellness 
        program credit determined under this section for any taxable 
        year during the credit period with respect to an employer is an 
        amount equal to 50 percent of the costs paid or incurred by the 
        employer in connection with a qualified wellness program during 
        the taxable year.
            ``(2) Limitation.--The amount of credit allowed under 
        paragraph (1) for any taxable year shall not exceed the sum 
        of--
                    ``(A) the product of $200 and the number of 
                employees of the employer not in excess of 200 
                employees, plus
                    ``(B) the product of $100 and the number of 
                employees of the employer in excess of 200 employees.
    ``(b) Qualified Wellness Program.--For purposes of this section--
            ``(1) Qualified wellness program.--The term `qualified 
        wellness program' means a program which--
                    ``(A) consists of any 3 of the wellness program 
                components described in subsection (c), and
                    ``(B) which is certified by the Secretary of Health 
                and Human Services, in coordination with the Director 
                of the Center for Disease Control and Prevention, as a 
                qualified wellness program under this section.
            ``(2) Programs must be consistent with research and best 
        practices.--
                    ``(A) In general.--The Secretary of Health and 
                Human Services shall not certify a program as a 
                qualified wellness program unless the program--
                            ``(i) is consistent with evidence-based 
                        research and best practices, as identified by 
                        persons with expertise in employer health 
                        promotion and wellness programs,
                            ``(ii) includes multiple, evidence-based 
                        strategies which are based on the existing and 
                        emerging research and careful scientific 
                        reviews, including the Guide to Community 
                        Preventive Services, the Guide to Clinical 
                        Preventive Services, and the National Registry 
                        for Effective Programs, and
                            ``(iii) includes strategies which focus on 
                        employee populations with a disproportionate 
                        burden of health problems.
                    ``(B) Periodic updating and review.--The Secretary 
                of Health and Human Services shall establish procedures 
                for periodic review and recertifications of programs 
                under this subsection. Such procedures shall require 
                revisions of programs if necessary to ensure compliance 
                with the requirements of this section and require 
                updating of the programs to the extent the Secretary, 
                in coordination with the Director of the Centers for 
                Disease Control and Prevention, determines necessary to 
                reflect new scientific findings.
            ``(3) Health literacy.--The Secretary of Health and Human 
        Services shall, as part of the certification process, encourage 
        employees to make the programs culturally competent and to meet 
        the health literacy needs of the employees covered by the 
        programs.
    ``(c) Wellness Program Components.--For purposes of this section, 
the wellness program components described in this subsection are the 
following:
            ``(1) Health awareness component.--A health awareness 
        component which provides for the following:
                    ``(A) Health education.--The dissemination of 
                health information which addresses the specific needs 
                and health risks of employees.
                    ``(B) Health screenings.--The opportunity for 
                periodic screenings for health problems and referrals 
                for appropriate follow up measures.
            ``(2) Employee engagement component.--An employee 
        engagement component which provides for--
                    ``(A) the establishment of a committee to actively 
                engage employees in worksite wellness programs through 
                worksite assessments and program planning, delivery, 
                evaluation, and improvement efforts, and
                    ``(B) the tracking of employee participation.
            ``(3) Behavioral change component.--A behavioral change 
        component which provides for altering employee lifestyles to 
        encourage healthy living through counseling, seminars, on-line 
        programs, or self-help materials which provide technical 
        assistance and problem solving skills. Such component may 
        include programs relating to--
                    ``(A) tobacco use,
                    ``(B) obesity,
                    ``(C) stress management,
                    ``(D) physical fitness,
                    ``(E) nutrition,
                    ``(F) substance abuse,
                    ``(G) depression, and
                    ``(H) mental health promotion (including anxiety).
            ``(4) Supportive environment component.--A supportive 
        environment component which includes the following:
                    ``(A) On-site policies.--Policies and services at 
                the worksite which promote a healthy lifestyle, 
                including policies relating to--
                            ``(i) tobacco use at the worksite,
                            ``(ii) the nutrition of food available at 
                        the worksite through cafeterias and vending 
                        options,
                            ``(iii) minimizing stress and promoting 
                        positive mental health in the workplace,
                            ``(iv) where applicable, accessible and 
                        attractive stairs, and
                            ``(v) the encouragement of physical 
                        activity before, during, and after work hours.
                    ``(B) Participation incentives.--
                            ``(i) In general.--Qualified incentive 
                        benefits for each employee who participates in 
                        the health screenings described in paragraph 
                        (1)(B) or the behavioral change programs 
                        described in paragraph (3).
                            ``(ii) Qualified incentive benefit.--For 
                        purposes of clause (i), the term `qualified 
                        incentive benefit' means any benefit which is 
                        approved by the Secretary of Health and Human 
                        Services, in coordination with the Director of 
                        the Centers for Disease Control and Prevention. 
                        Such benefit may include an adjustment in 
                        health insurance premiums or co-pays.
                    ``(C) Employee input.--The opportunity for 
                employees to participate in the management of any 
                qualified wellness program to which this section 
                applies.
    ``(d) Participation Requirement.--
            ``(1) In general.--No credit shall be allowed under 
        subsection (a) unless the Secretary of Health and Human 
        Services, in coordination with the Director of the Centers for 
        Disease Control and Prevention, certifies, as a part of any 
        certification described in subsection (b), that each wellness 
        program component of the qualified wellness program applies to 
        all qualified employees of the employer. The Secretary of 
        Health and Human Services shall prescribe rules under which an 
        employer shall not be treated as failing to meet the 
        requirements of this subsection merely because the employer 
        provides specialized programs for employees with specific 
        health needs or unusual employment requirements or provides a 
        pilot program to test new wellness strategies.
            ``(2) Qualified employee.--For purposes of paragraph (1), 
        the term `qualified employee' means an employee who works an 
        average of not less than 25 hours per week during the taxable 
        year.
    ``(e) Other Definitions and Special Rules.--For purposes of this 
section--
            ``(1) Employee and employer.--
                    ``(A) Partners and partnerships.--The term 
                `employee' includes a partner and the term `employer' 
                includes a partnership.
                    ``(B) Certain rules to apply.--Rules similar to the 
                rules of section 52 shall apply.
            ``(2) Certain costs not included.--Costs paid or incurred 
        by an employer for food or health insurance shall not be taken 
        into account under subsection (a).
            ``(3) No credit where grant awarded.--No credit shall be 
        allowable under subsection (a) with respect to any qualified 
        wellness program of any taxpayer (other than an eligible 
        employer described in subsection (f)(2)(A)) who receives a 
        grant provided by the United States, a State, or a political 
        subdivision of a State for use in connection with such program. 
        The Secretary shall prescribe rules providing for the waiver of 
        this paragraph with respect to any grant which does not 
        constitute a significant portion of the funding for the 
        qualified wellness program.
            ``(4) Credit period.--
                    ``(A) In general.--The term `credit period' means 
                the period of 10 consecutive taxable years beginning 
                with the taxable year in which the qualified wellness 
                program is first certified under this section.
                    ``(B) Special rule for existing programs.--In the 
                case of an employer (or predecessor) which operates a 
                wellness program for its employees on the date of the 
                enactment of this section, subparagraph (A) shall be 
                applied by substituting `3 consecutive taxable years' 
                for `10 consecutive taxable years'. The Secretary shall 
                prescribe rules under which this subsection shall not 
                apply if an employer is required to make substantial 
                modifications in the existing wellness program in order 
                to qualify such program for certification as a 
                qualified wellness program.
                    ``(C) Controlled groups.--For purposes of this 
                paragraph, all persons treated as a single employer 
                under subsection (b), (c), (m), or (o) of section 414 
                shall be treated as a single employer.
    ``(f) Portion of Credit Made Refundable.--
            ``(1) In general.--In the case of an eligible employer of 
        an employee, the aggregate credits allowed to a taxpayer under 
        subpart C shall be increased by the lesser of--
                    ``(A) the credit which would be allowed under this 
                section without regard to this subsection and the 
                limitation under section 38(c), or
                    ``(B) the amount by which the aggregate amount of 
                credits allowed by this subpart (determined without 
                regard to this subsection) would increase if the 
                limitation imposed by section 38(c) for any taxable 
                year were increased by the amount of employer payroll 
                taxes imposed on the taxpayer during the calendar year 
                in which the taxable year begins.
        The amount of the credit allowed under this subsection shall 
        not be treated as a credit allowed under this subpart and shall 
        reduce the amount of the credit otherwise allowable under 
        subsection (a) without regard to section 38(c).
            ``(2) Eligible employer.--For purposes of this subsection, 
        the term `eligible employer' means an employer which is--
                    ``(A) a State or political subdivision thereof, the 
                District of Columbia, a possession of the United 
                States, or an agency or instrumentality of any of the 
                foregoing, or
                    ``(B) any organization described in section 501(c) 
                of the Internal Revenue Code of 1986 which is exempt 
                from taxation under section 501(a) of such Code.
            ``(3) Employer payroll taxes.--For purposes of this 
        subsection--
                    ``(A) In general.--The term `employer payroll 
                taxes' means the taxes imposed by--
                            ``(i) section 3111(b), and
                            ``(ii) sections 3211(a) and 3221(a) 
                        (determined at a rate equal to the rate under 
                        section 3111(b)).
                    ``(B) Special rule.--A rule similar to the rule of 
                section 24(d)(2)(C) shall apply for purposes of 
                subparagraph (A).
    ``(g) Termination.--This section shall not apply to any amount paid 
or incurred after December 31, 2017.''.
    (b) Treatment as General Business Credit.--Subsection (b) of 
section 38 of the Internal Revenue Code of 1986 (relating to general 
business credit) is amended by striking ``plus'' at the end of 
paragraph (30), by striking the period at the end of paragraph (31) and 
inserting ``, plus'', and by adding at the end the following:
            ``(32) the wellness program credit determined under section 
        45O.''.
    (c) Denial of Double Benefit.--Section 280C of the Internal Revenue 
Code of 1986 (relating to certain expenses for which credits are 
allowable) is amended by adding at the end the following new 
subsection:
    ``(f) Wellness Program Credit.--
            ``(1) In general.--No deduction shall be allowed for that 
        portion of the costs paid or incurred for a qualified wellness 
        program (within the meaning of section 45O) allowable as a 
        deduction for the taxable year which is equal to the amount of 
        the credit allowable for the taxable year under section 45O.
            ``(2) Similar rule where taxpayer capitalizes rather than 
        deducts expenses.--If--
                    ``(A) the amount of the credit determined for the 
                taxable year under section 45O, exceeds
                    ``(B) the amount allowable as a deduction for such 
                taxable year for a qualified wellness program,
        the amount chargeable to capital account for the taxable year 
        for such expenses shall be reduced by the amount of such 
        excess.
            ``(3) Controlled groups.--In the case of a corporation 
        which is a member of a controlled group of corporations (within 
        the meaning of section 41(f)(5)) or a trade or business which 
        is treated as being under common control with other trades or 
        business (within the meaning of section 41(f)(1)(B)), this 
        subsection shall be applied under rules prescribed by the 
        Secretary similar to the rules applicable under subparagraphs 
        (A) and (B) of section 41(f)(1).''.
    (d) Clerical Amendment.--The table of sections for subpart D of 
part IV of subchapter A of chapter 1 of the Internal Revenue Code of 
1986 is amended by adding at the end the following:

``Sec. 45O. Wellness program credit.''.
    (e) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2007.
    (f) Outreach.--
            (1) In general.--The Secretary of the Treasury, in 
        conjunction with the Director of the Centers for Disease 
        Control and members of the business community, shall institute 
        an outreach program to inform businesses about the availability 
        of the wellness program credit under section 45O of the 
        Internal Revenue Code of 1986 as well as to educate businesses 
        on how to develop programs according to recognized and 
        promising practices and on how to measure the success of 
        implemented programs.
            (2) Authorization of appropriations.--There are authorized 
        to be appropriated such sums as are necessary to carry out the 
        outreach program described in paragraph (1).

SEC. 303. CDC AND EMPLOYER-BASED WELLNESS PROGRAMS.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following:

           ``PART R--CDC AND EMPLOYER-BASED WELLNESS PROGRAMS

``SEC. 399Z-1. MOTIVATING EMPLOYERS TO IMPLEMENT WORKPLACE WELLNESS 
              PROGRAMS.

    ``(a) Workplace Wellness Marketing Campaign for Employers.--The 
Director of the Centers for Disease Control and Prevention, in 
coordination with relevant worksite health promotion organizations, 
shall conduct an educational campaign to make employers, employer 
groups, and other interested parties aware of the benefits of employer-
based wellness programs.
    ``(b) Employer Award Program.--The Director of the Centers for 
Disease Control and Prevention shall develop an annual awards program 
for employers to encourage the development of creative and effective 
solutions to help employees maintain or improve their health. The 
awards program shall provide that small, medium, and large employers 
that are public or private shall be eligible for the awards

``SEC. 399Z-2. EVALUATION OF EMPLOYER-BASED WELLNESS PROGRAMS.

    ``The Director of the Centers for Disease Control and Prevention 
shall enter into contracts with entities to--
            ``(1) provide employers (including small, medium, and large 
        employers, as determined by the Director) with technical 
        assistance in evaluating such employers' employer-based 
        wellness programs, including--
                    ``(A) measuring the participation of employees in 
                such programs; and
                    ``(B) evaluating such programs as they relate to 
                changes in the health status of employees, the 
                absenteeism of employees, the productivity of 
                employees, and the medical costs incurred by employees; 
                and
            ``(2) train employers on how to evaluate such employers' 
        employer-based wellness programs.

``SEC. 399Z-3. NATIONAL WORKSITE HEALTH POLICIES AND PROGRAMS STUDY.

    ``(a) In General.--Not later than 1 year after the date of 
enactment of this section, and annually thereafter, the Director of the 
Centers for Disease Control and Prevention shall conduct a national 
worksite health policies and programs study to assess employer-based 
health policies and programs.
    ``(b) Report.--After completing each study under subsection (a), 
the Director of the Centers for Disease Control and Prevention shall 
submit to Congress a report that includes the recommendations of the 
Director for the implementation of effective employer-based health 
policies and programs.

``SEC. 399Z-4. MISCELLANEOUS PROVISIONS.

    ``(a) Behavioral Risk Factor Surveillance System.--The Secretary 
shall expand the Behavioral Risk Factor Surveillance System to include 
a workforce component to enable employers, researchers, and health 
officials to assess employee health risks, identify emerging problems 
associated with general employee health, prevent disease within the 
employee population, and improve employer-based health programs and 
policies.
    ``(b) Demonstration Projects.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall award grants to entities to enable such entities to carry 
        out research demonstration projects to study the effect of the 
        application of new worksite-based health interventions and 
        models.
            ``(2) Eligibility.--To be eligible to receive a grant under 
        paragraph (1), an entity shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require.
            ``(3) Broad participation.--In awarding grants under 
        paragraph (1), the Secretary shall ensure that demonstration 
        projects are conducted in both the public and private sectors 
        and in small and large employer settings.
            ``(4) Submission of findings.--An entity shall submit to 
        the Secretary a report on the results of the research conducted 
        under the grant within such period as the Secretary may 
        prescribe. Such report shall include any guidelines or 
        recommendations developed by the entity based on such research.
    ``(c) Implementation of Research Results.--The Secretary shall 
carry out activities to implement the guidelines or recommendations 
received by the Secretary under subsection (b)(4) if the Secretary 
determines that such guidelines of recommendations would result in 
improved employee health through worksite-based health programs or 
policies.''.

SEC. 304. EMPLOYER-PROVIDED OFF-PREMISES HEALTH CLUB SERVICES.

    (a) Treatment as Fringe Benefit.--Subparagraph (A) of section 
132(j)(4) of the Internal Revenue Code of 1986 (relating to on-premises 
gyms and other athletic facilities) is amended to read as follows:
                    ``(A) In general.--Gross income shall not include--
                            ``(i) the value of any on-premises athletic 
                        facility provided by an employer to its 
                        employees, and
                            ``(ii) so much of the fees, dues, or 
                        membership expenses paid by an employer to an 
                        athletic or fitness facility described in 
                        subparagraph (C) on behalf of its employees as 
                        does not exceed $900 per employee per year.''.
    (b) Athletic Facilities Described.--Paragraph (4) of section 132(j) 
of the Internal Revenue Code of 1986 (relating to special rules) is 
amended by adding at the end the following new subparagraph:
                    ``(C) Certain athletic or fitness facilities 
                described.--For purposes of subparagraph (A)(ii), an 
                athletic or fitness facility described in this 
                subparagraph is a facility--
                            ``(i) which provides instruction in a 
                        program of physical exercise, offers facilities 
                        for the preservation, maintenance, 
                        encouragement, or development of physical 
                        fitness, or is the site of such a program of a 
                        State or local government,
                            ``(ii) which is not a private club owned 
                        and operated by its members,
                            ``(iii) which does not offer golf, hunting, 
                        sailing, or riding facilities,
                            ``(iv) whose health or fitness facility is 
                        not incidental to its overall function and 
                        purpose, and
                            ``(v) which is fully compliant with the 
                        State of jurisdiction and Federal anti-
                        discrimination laws.''.
    (c) Exclusion Applies to Highly Compensated Employees Only if No 
Discrimination.--Section 132(j)(1) of the Internal Revenue Code of 1986 
is amended--
            (1) by striking ``Paragraphs (1) and (2) of subsection 
        (a)'' and inserting ``Subsections (a)(1), (a)(2), and (j)(4)'', 
        and
            (2) by striking the heading thereof through ``apply'' and 
        inserting ``Certain exclusions apply''.
    (d) Employer Deduction for Dues to Certain Athletic Facilities.--
            (1) In general.--Paragraph (3) of section 274(a) of the 
        Internal Revenue Code of 1986 (relating to denial of deduction 
        for club dues) is amended by adding at the end the following 
        new sentence: ``The preceding sentence shall not apply to so 
        much of the fees, dues, or membership expenses paid to athletic 
        or fitness facilities (within the meaning of section 
        132(j)(4)(C)) as does not exceed $900 per employee per year.''.
            (2) Conforming amendment.--The last sentence of section 
        274(e)(4) of such Code is amended by inserting ``the first 
        sentence of'' before ``subsection (a)(3)''.
    (e) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

                    Subtitle B--Healthy Communities

       CHAPTER 1--PROVISIONS TO IMPROVE THE HEALTH OF COMMUNITIES

SEC. 311. HEALTHY COMMUNITY GRANTS.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399P. HEALTHY COMMUNITY GRANTS.

    ``(a) Establishment.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention and in coordination with 
the Directors of other appropriate Federal agencies, shall award 
competitive grants to eligible entities for the purpose of planning and 
implementing programs that seek to promote individual and community 
health and to prevent the incidence of chronic disease.
    ``(b) Eligibility.--
            ``(1) In general.--To be eligible to receive a grant under 
        this section an entity shall--
                    ``(A) be--
                            ``(i) a city, county, or Indian tribe;
                            ``(ii) a local or tribal educational 
                        agency;
                            ``(iii) an accredited university, college, 
                        or community college;
                            ``(iv) a federally qualified health center;
                            ``(v) a local health department;
                            ``(vi) a health care provider;
                            ``(vii) a community-based organization; or
                            ``(viii) any other entity determined 
                        appropriate by the Secretary, including a 
                        consortia or partnership of entities described 
                        in any of clauses (i) through (vii);
                    ``(B) prepare and submit an application in 
                accordance with paragraph (2); and
                    ``(C) provide assurances that the entity will 
                contribute the non-Federal share as required under 
                paragraph (3) to the cost of the activities carried out 
                under the grant.
            ``(2) Application.--
                    ``(A) In general.--An entity desiring a grant under 
                this section shall submit an application to the 
                Secretary at such time, in such manner, and containing 
                such information as the Secretary may require, 
                including a plan that meets the requirements of 
                subparagraph (B).
                    ``(B) Plan.--A plan meets the requirements of this 
                subparagraph if such plan, at a minimum, includes 
                information regarding--
                            ``(i)(I) programs or community-based 
                        activities that the applicant proposes to carry 
                        out with funds received under this section and 
                        which seek to prevent and reduce the incidence 
                        of--
                                    ``(aa) overweight and obesity, or 
                                chronic diseases associated with 
                                overweight and obesity;
                                    ``(bb) tobacco use; or
                                    ``(cc) mental illness; or
                            ``(II) other such activities, as determined 
                        appropriate by the Secretary, that are 
                        consistent with the goals of promoting 
                        individual and community health and preventing 
                        chronic disease; and
                            ``(ii) the manner in which the applicant 
                        will evaluate the effectiveness of the program 
                        or activities carried out under this section.
            ``(3) Non-federal share.--To be eligible to receive a grant 
        under this section, an entity shall provide a non-Federal 
        contribution, in cash or in kind, to the costs of activities 
        under the grant in an amount that is equal to not less than 25 
        percent of the costs of such activities.
    ``(c) Use of Funds.--An entity that receives a grant under this 
section shall use the amount made available under the grant to carry 
out community-based activities, including--
            ``(1) activities that seek to promote individual health and 
        community wellness and to prevent and reduce the incidence of 
        health problems and chronic diseases associated with--
                    ``(A) being overweight or obese;
                    ``(B) tobacco use; or
                    ``(C) mental illness; or
            ``(2) other activities undertaken with the goals of health 
        promotion and chronic disease prevention, as determined 
        appropriate by the Secretary.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to--
            ``(1) entities that demonstrate that they have previously 
        applied successfully for funds to carry out activities that 
        seek to promote individual and community health and to prevent 
        the incidence of chronic disease and that can cite published 
        and peer-reviewed research demonstrating that the activities 
        that the entity proposes to carry out under this subsection are 
        effective;
            ``(2) entities that will carry out programs or activities 
        that seek to accomplish a goal or goals set by the State in the 
        Healthy People 2010 plan of the State;
            ``(3) entities that provide non-Federal contributions, 
        either in cash or in kind, to the costs of funding activities 
        under the grant;
            ``(4) entities that develop comprehensive plans that 
        include a strategy for extending program activities developed 
        under this section in the years following the fiscal years for 
        which they receive grants under this section;
            ``(5) entities located in communities that are medically 
        underserved, as determined by the Secretary;
            ``(6) entities located in areas where the average poverty 
        rate is 150 or higher than the average poverty rate in the 
        State involved, as determined by the Secretary; and
            ``(7) entities that submit plans that exhibit 
        multisectoral, cooperative conduct that includes the 
        involvement of a broad range of stakeholders, including--
                    ``(A) community-based organizations;
                    ``(B) local governments;
                    ``(C) local educational agencies;
                    ``(D) the private sector;
                    ``(E) State or local departments of health;
                    ``(F) accredited colleges, universities, and 
                community colleges;
                    ``(G) health care providers;
                    ``(H) State and local departments of transportation 
                and city planning; and
                    ``(I) other entities determined appropriate by the 
                Secretary.
    ``(e) Technical Assistance.--From amounts appropriated to carry out 
this section, the Secretary may reserve not more than 10 percent for 
each fiscal year to provide entities receiving grants under this 
section with technical assistance in the implementation of the plans 
required under subsection (b)(2)(B).
    ``(f) Evaluation.--From amounts appropriated to carry out this 
section, the Secretary may reserve not to exceed 5 percent for each 
fiscal year for the purpose of carrying out evaluations of the 
activities carried out under this section. Not later than 90 days after 
the completion of any such evaluation, the results of such evaluation 
shall be submitted to the relevant authorizing committees of Congress 
and to the Committee on Appropriations of the Senate and the Committee 
on Appropriations of the House of Representatives.
    ``(g) Limitation on Administrative Costs.--An entity may not use 
more than 10 percent of amounts received under a grant under this 
section for administrative expenses.
    ``(h) Supplement Not Supplant.--Amounts provided under a grant 
under this section shall be used to supplement, and not supplant, other 
amounts provided for activities of the type to be carried out under 
this section.
    ``(i) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this 
section.''.

SEC. 312. PROMOTING THE HEALTH AND WELLNESS OF INDIVIDUALS WITH 
              DISABILITIES THROUGH COMMUNITY SPORTS PROGRAMS.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399R. COMMUNITY SPORTS PROGRAMS FOR INDIVIDUALS WITH 
              DISABILITIES.

    ``(a) In General.--
            ``(1) Individual with a disability defined.--For purposes 
        of this section, the term `individual with a disability' has 
        the meaning given such term in section 7(20) of the 
        Rehabilitation Act of 1973 (29 U.S.C. 705(20), for the purpose 
        of title V of such Act (29 U.S.C. 791 et seq.).
            ``(2) Community sports grants program.--The Secretary, in 
        collaboration with the National Advisory Committee on Community 
        Sports Programs for Individuals with Disabilities, may award 
        grants on a competitive basis to public and nonprofit private 
        entities to implement community-based, sports and athletic 
        programs for individuals with disabilities, including youth 
        with disabilities.
    ``(b) Application.--To be eligible to receive a grant under 
subsection (a)(2), a public or nonprofit private entity shall submit to 
the Secretary an application at such time, in such manner, and 
containing such agreements, assurances, and information as the 
Secretary determines to be necessary to carry out this section.
    ``(c) Authorized Activities.--Amounts awarded under a grant under 
subsection (a) shall be used for--
            ``(1) community-based sports programs, leagues, or 
        competitions in individual or team sports for individuals with 
        physical disabilities;
            ``(2) regional sports programs or competitions in 
        individual or team sports for individuals with physical 
        disabilities;
            ``(3) the development of competitive team and individual 
        sports programs for individuals with disabilities at the high 
        school and collegiate level; or
            ``(4) the development of mentoring programs to encourage 
        participation in sports programs for individuals who are newly 
        disabled or with newly acquired physical limitations.
    ``(d) Priorities.--
            ``(1) Advisory committee.--The Secretary shall establish a 
        National Advisory Committee on Community Sports Programs for 
        Individuals with Disabilities that shall--
                    ``(A) establish priorities for the implementation 
                of this section, review grant proposals;
                    ``(B) make recommendations for funding under this 
                section; and
                    ``(C) annually evaluate the progress of programs 
                carried out under this section in implementing such 
                priorities.
            ``(2) Representation.--The Advisory Committee established 
        under paragraph (1) shall include representatives of--
                    ``(A) the Department of Health and Human Services 
                Office on Disability;
                    ``(B) the United States Surgeon General;
                    ``(C) the Centers for Disease Control and 
                Prevention;
                    ``(D) the Paralympic division of the United States 
                Olympic Committee;
                    ``(E) disabled sports organizations;
                    ``(F) organizations that represent the interests of 
                individuals with disabilities; and
                    ``(G) individuals with disabilities (including 
                athletes with physical disabilities) or their family 
                members.
    ``(e) Dissemination of Information.--The Secretary shall 
disseminate information about the availability of grants under this 
section in a manner that is designed to reach public entities and 
nonprofit private organizations that are dedicated to providing 
outreach, advocacy, or independent living services to individuals with 
disabilities.
    ``(f) Technical Assistance.--The Secretary, in conjunction with the 
United States Olympic Committee and disabled sports organizations, 
shall establish a technical assistance center to provide training, 
support, and information to grantees under this section on establishing 
and operating community sports programs for individuals with 
disabilities.
    ``(g) Report to Congress.--Not later than 180 days after the date 
of the enactment of this section, and annually thereafter, the 
Secretary shall submit to Congress a report summarizing activities, 
findings, outcomes, and recommendations resulting from the grant 
projects funded under this section during the year for which the report 
is being prepared.
    ``(h) Authorization of Appropriations.--
            ``(1) In general.--To carry out this section, there are 
        authorized to be appropriated such sums as may be necessary.
            ``(2) Limitation.--Not to exceed 10 percent of the amount 
        appropriated in each fiscal year shall be used to carry out 
        activities under subsection (c)(4).''.

SEC. 313. SAFE AND COMPLETE STREETS.

    Section 133 of title 23, United States Code, is amended by adding 
at the end the following:
    ``(g) Withholding of Funding.--
            ``(1) In general.--Beginning with the fiscal year that 
        begins 2 years after the date of enactment of this subsection, 
        the Secretary of Transportation shall withhold 2 percent of the 
        amounts allocated in such fiscal year to the highway and 
        planning funds allotted to a Metropolitan Planning Organization 
        or State Transportation Improvement Program under the Safe, 
        Accountable, Flexible, Efficient Transportation Equity Act 
        unless the State or Metropolitan Planning Organization provides 
        the Secretary with documentation--
                    ``(A) of the existence of an explicit statement of 
                policy (that meets the requirements of subsection (b)) 
                that the safety and convenience of all users of the 
                transportation system shall be accommodated; and
                    ``(B) that such policy has been applied to the 
                projects contained in the Transportation Improvement 
                Plan.
            ``(2) Purpose.--The purpose of the policy statement 
        required under paragraph (1)(A) is to ensure that all users of 
        the transportation system, including pedestrians, bicyclists, 
        and transit users as well as children, older individuals, and 
        individuals with disabilities, are able to travel safely and 
        conveniently on streets and highways within the public right of 
        way.
    ``(h) Policy Statement Requirements.--A policy statement under 
subsection (g)(1)(A) shall include the following:
            ``(1) An assurance that all users of the transportation 
        system will include pedestrians (including individuals of all 
        ages, and individuals with disabilities (including mobility, 
        sensory, neurological or hidden disabilities)), bicyclists, 
        transit vehicles and users, and motorists.
            ``(2) An assurance that the statement will apply to both 
        new road construction and transportation improvement projects.
            ``(3) A clear procedure that requires approval by a senior 
        manager of any specified exceptions from implementing the 
        policy statement, including documentation with supporting data 
        that indicates the basis for the exemption.
            ``(4) A statement directing the use of the current design 
        standards, including those standards applying to access for 
        individuals with disabilities.
            ``(5) A statement requiring that complete streets solutions 
        be developed to fit in with the context of the community and 
        that those solutions be flexible.
            ``(6) A description of the performance standards with 
        measurable outcomes that will be developed.
            ``(7) A statement that accommodation shall be made for all 
        users in all construction and improvement projects unless one 
        or more of the following apply:
                    ``(A) The project involved a roadway on which non-
                motorized users are prohibited by law from using. In 
                such case, a greater effort shall be made to 
                accommodate bicyclists and pedestrians elsewhere.
                    ``(B) The cost of establishing complete facilities 
                would be excessively disproportionate to the need or 
                probable use.
                    ``(C) With respect to a project area with a low 
                population, a lack of transit service, or other 
                documented factors indicate an absence of need now and 
                in the future.
                    ``(D) The policy statement may be achieved through 
                a State or local law or ordinance, or through an agency 
                policy directive.
    ``(i) Certifications.--The Metropolitan Planning Organization and 
State Transportation Improvement Plan shall certify that each road 
project included in such plan has been reviewed for its compliance with 
any applicable policy statement under this section and that each 
project under such plan enhances the safety, convenience, and 
accessibility of the transportation system for all users to the extent 
that it is reasonably possible and that the project applicant addressed 
these concerns in the material prepared for public input with respect 
to such plan.
    ``(j) Accessibility Standards.--Not later than 12 months after the 
date of enactment of this subsection, the United States Access Board 
shall issue final standards for accessibility of new construction and 
alterations of pedestrian facilities in the public right-of-way. Until 
such time as the Access Board completes a final Public Right of Way 
Accessibility rule, Department of Transportation Standards for 
Accessible Transportation Facilities (49 C.F.R. 37.9, as amended on 10/
30/2006 (71 FR 63263)) shall serve as the minimum standard. If the 
Department Of Transportation standards are silent or inapplicable with 
respect to any issue, the 2005 draft Public Right Of Way Accessibility 
Guidelines provisions shall be consulted. A Metropolitan Planning 
Organization or State department of transportation that is adopting 
complete streets policies may consult existing Federal guidance, 
including the 2000 USDOT Guidance document, ``Accommodating Bicycle and 
Pedestrian Travel''.
    ``(k) Inclusion of All Users.--Metropolitan planning organizations 
shall strongly encourage local jurisdictions that are served by such 
organizations to maximize their efforts to include all users in their 
transportation planning.
    ``(l) Additional Provisions.--
            ``(1) Research.--
                    ``(A) In general.--The Secretary of Transportation 
                shall require the Federal Highway Administration to 
                conduct complete streets research to assist States and 
                Metropolitan Planning Organizations in developing, 
                adopting, and implementing plans, projects, procedures, 
                policies, and training that comply with the applicable 
                statement of policy under subsection (g)(1)(A).
                    ``(B) Participation.--Research under subparagraph 
                (A) shall be conducted with the participation of the 
                American Association of State Highway Transportation 
                Officials, the Institute of Transportation Engineers, 
                the American Public Transit Association, the American 
                Planning Association, the National Association of 
                Regional Councils, the Association of Metropolitan 
                Planning Organizations, and representatives of the 
                disability, motoring, bicycling, walking, transit user, 
                aging, and other affected communities.
                    ``(C) Existing needs.--Research under subparagraph 
                (A) shall be based on the existing statement of 
                complete streets research needs as outlined by the 
                Transportation Research Board in TR Circular E110, and 
                shall also develop new areas of inquiry.
            ``(2) Benchmarks and guidance.--The research project 
        conducted under paragraph (1) shall be designed to result in 
        the establishment of benchmarks and the provision of practical 
        guidance on how to effectively implement street procedures and 
        designs that will accommodate all types of users along the same 
        facility or corridor including, vehicles, pedestrians, 
        bicycles, and transit use. Such benchmarks and guidance shall 
        focus on changing scoping, design, and construction procedures 
        to more effectively fit the individual modes together into 
        integrated facilities that meet the needs of each in an 
        appropriate balance. Such benchmarks and guidance shall 
        indicate the expected operational and safety performance of 
        alternative approaches to facility design.
            ``(3) Best practices report.--Not later than 2 years after 
        the date of enactment of this subsection, the Federal Highway 
        Administration shall publish a best practices report showing 
        how transportation agencies have changed their procedures to 
        routinely design safe, effective multi-modal facilities. In 
        establishing such best practices, consideration shall be given 
        to the following areas:
                    ``(A) Procedures for identifying the needs of the 
                mix of users, including primary and secondary users 
                that need to be served on various highway functional 
                classes.
                    ``(B) The identification of the types and designs 
                of facilities needed to serve each of those types of 
                users.
                    ``(C) The identification of barriers to 
                implementation and identification of costs associated 
                with implementing complete streets policies.
            ``(4) Data collection.--In addition to preparing the report 
        under paragraph (3), the Federal Highway Administration shall 
        work with the Bureau of Transportation Statistics and the 
        Federal Transit Association and appropriate Transportation 
        Research Board committees on data collection, including a 
        baseline non-motorized and transit use survey that will be 
        integrated into the National Highway Traffic Safety 
        Administration and the development of a survey tool for use by 
        State transportation departments in identifying the multi-modal 
        capacity of State and local road networks.''.

SEC. 314. NATIONAL ASSESSMENT OF MENTAL HEALTH NEEDS.

    Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) 
is amended by inserting after section 506B (42 U.S.C. 290aa-5b) the 
following:

``SEC. 506C. NATIONAL ASSESSMENT OF MENTAL HEALTH NEEDS.

    ``(a) In General.--The Secretary, acting through the Administrator, 
and in consultation with the Centers for Disease Control and Prevention 
and the Director of the National Institutes of Health, shall establish 
and implement public health monitoring measures to address the mental 
and behavioral health needs of the population of the United States and 
other populations served by the Administration, that include--
            ``(1) monitoring the mental health status of the 
        population, including incidence and prevalence rates of mental 
        and behavioral health problems throughout the lifespan;
            ``(2) monitoring mental and behavioral health risks;
            ``(3) enhancing existing public health monitoring systems 
        to include data on mental and behavioral health status and 
        risks; and
            ``(4) monitoring the immediate and long-term impact of 
        environmental factors to collect data on the prevalence of 
        mental and behavioral health problems throughout the lifespan 
        with the aim of encouraging early intervention and treatment.
    ``(b) Distinguishing Among Age Groups.--In designing and 
implementing the measures described in subsection (a) the Secretary 
shall ensure that methods of monitoring and reporting data distinguish 
among different age groups, including when identifying groups of 
children, and very young children under age 3, together with their 
parents.
    ``(c) Report.--Not later than 1 year after the date of enactment of 
this section, the Secretary shall submit a report to Congress that 
describes the progress on the implementation of the monitoring measures 
described in subsection (a).
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for fiscal year 2008 
and such sums as may be necessary for each of the following fiscal 
years.''.

SEC. 315. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT PROGRAM.

    Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.) is amended by adding at the end the following:

               ``Subpart XI--Preventive Medicine Training

``SEC. 340H. PREVENTIVE MEDICINE AND PUBLIC HEALTH TRAINING GRANT 
              PROGRAM.

    ``(a) Grants.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, may award grants to, or 
enter into contracts with, eligible entities to provide training to 
graduate medical residents in preventive medicine specialties.
    ``(b) Eligibility.--To be eligible to receive a grant or contract 
under subsection (a), an entity shall--
            ``(1) be a school of public health, public health 
        department, school of medicine or osteopathic medicine, public 
        or private hospital, or public or private non-profit entity;
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require; and
            ``(3) maintain and adhere to a Letter of Agreement with a 
        local community health center (if available in the local area 
        involved) that supports practicum training of preventive 
        medicine residents, if practicable.
    ``(c) Use of Funds.--Amounts received under a grant or contract 
under this section shall be used to--
            ``(1) to plan, develop, and operate residency programs for 
        preventive medicine or public health;
            ``(2) provide financial assistance, including tuition and 
        stipends, to resident physicians (MD or DO) who plan to 
        specialize in preventive medicine or public health;
            ``(3) defray the costs associated with the planning, 
        development, and operation of preventive medicine or public 
        health programs, including the development of curriculum to be 
        used in such program; and
            ``(4) provide for the improvement of academic 
        administrative units.
    ``(d) Duration of Award.--A grant or contract under this section 
shall be for a term of not to exceed 5 years.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $43,000,000 for fiscal year 
2008, and such sums as may be necessary for each succeeding fiscal 
year.''.

SEC. 316. TASK FORCE FOR THE PROMOTION OF BREASTFEEDING IN THE 
              WORKPLACE.

    (a) Establishment.--The Secretary of Health and Human Services and 
the Secretary of Labor, or their designees, shall convene a task force 
for the purpose of promoting breastfeeding among working mothers 
(referred to in this section as the ``Task Force'').
    (b) Membership.--The Task Force shall be composed of members who 
are--
            (1) expert staff from the Department of Labor with 
        expertise in workforce issues;
            (2) expert staff from the Department of Health and Human 
        Services with expertise in the areas of breastfeeding and 
        breastfeeding promotion;
            (3) members of the United States Breastfeeding Committee;
            (4) expert staff from the Department of Agriculture; and
            (5) appointed by the Secretary of Health and Human Services 
        and the Secretary of Labor, including--
                    (A) working mothers who have experience in working 
                and breastfeeding; and
                    (B) representatives of the human resource 
                departments of both large and small employers that have 
                successfully promoted breastfeeding and breastmilk 
                pumping support at work.
    (c) Period of Appointment; Vacancies.--Members shall be appointed 
for the life of the Task Force. Any vacancy in the Task Force shall not 
affects its powers, but shall be filled in the same manner as the 
original appointment.
    (d) Chair.--The Task Force shall be chaired jointly by the 
Secretary of Health and Human Services and the Secretary of Labor, or 
their designees.
    (e) Duties of the Task Force.--
            (1) Examination.--Consistent with the Department of Health 
        and Human Services Blueprint for Action on Breastfeeding 
        (2000), the Task Force shall examine the following issues:
                    (A) The challenges that mothers face with 
                continuing breastfeeding when the mothers return to 
                work after giving birth.
                    (B) The challenges that employers face in 
                accommodating mothers who seek to continue to 
                breastfeed or to express milk when the mothers re-enter 
                the workforce, including different challenges that 
                mothers of varying socio-economic status and in 
                different professions may face.
                    (C) The benefits that accrue to mothers, babies, 
                and to employers when mothers are able to continue to 
                breastfeed or to express breastmilk at work after the 
                mothers have re-entered the workforce.
                    (D) Federal and State statutes that may have the 
                effect of reducing breastfeeding and breastfeeding 
                retention rates among working mothers.
            (2) Reports.--
                    (A) In general.--Not later than 1 year after the 
                date of enactment of this section, the Task Force shall 
                issue a public report with recommendations on the 
                following:
                            (i) Steps that can be taken to promote 
                        breastfeeding among working mothers and to 
                        remove barriers to breastfeeding among working 
                        mothers.
                            (ii) Potential ways in which the Federal 
                        Government can work with employers to promote 
                        breastfeeding among working mothers.
                            (iii) Areas in which changes to existing 
                        Federal, State, or local laws would likely have 
                        the effect of making it easier for working 
                        mothers to breastfeed or would remove 
                        impediments to breastfeeding that currently 
                        exist in such laws.
                            (iv) Whether or not increased rates of 
                        breastfeeding among working mothers would 
                        likely have the result of reducing health care 
                        costs among such mothers and their children, 
                        and, in particular, whether increased rates of 
                        breastfeeding would be likely to result in 
                        lower Federal expenditures on health care for 
                        such mothers and their children.
                            (v) Areas in which the Federal Government, 
                        through additional appropriations, increased 
                        efforts by Federal agencies, or changes to 
                        existing Federal law, can and should increase 
                        the Federal Government's efforts to promote 
                        breastfeeding among working mothers.
                    (B) Copy to congress.--Upon completion of the 
                report described in subparagraph (A), the Task Force 
                shall submit a copy of the report to the Committee on 
                Health, Education, Labor, and Pensions of the Senate, 
                the Committee on Appropriations of the Senate, the 
                Committee on Education and the Workforce of the House 
                of Representatives, and the Committee on Appropriations 
                of the House of Representatives.
    (f) Powers of the Task Force.--
            (1) Hearings.--The Task Force may hold such hearings, sit 
        and act at such times and places, take such testimony, and 
        receive such evidence as the Task Force considers advisable to 
        carry out this section.
            (2) Information from federal agencies.--The Task Force may 
        secure directly from any Federal department or agency such 
        information as the Task Force considers necessary to carry out 
        this section. Upon request of the Chair of the Task Force, the 
        head of such department or agency shall furnish such 
        information to the task Force.
            (3) Postal services.--The Task Force may use the United 
        States mails in the same manner and under the same conditions 
        as other departments and agencies of the Federal Government.
            (4) Gifts.--The Task Force may accept, use, and dispose of 
        gifts or donations of services or property.
    (g) Operating Expenses.--The operating expenses of the Task Force, 
including travel expenses for members of the Task Force, shall be paid 
for from the general operating expenses funds of the Secretary of 
Health and Human Services and the Secretary of Labor.

SEC. 317. LACTATION ACCOMMODATION AND BREASTFEEDING PROMOTION AT WORK.

    (a) Breastfeeding at Work General Requirements.--The Family and 
Medical Leave Act of 1993 (29 U.S.C. 2611 et seq.) is amended by 
inserting after title IV the following:

              ``TITLE V--LACTATION PERIODS AND FACILITIES

``SEC. 501. DEFINITIONS.

    ``In this title:
            ``(1) Eligible child.--The term `eligible child', used with 
        respect to an eligible employee, means a son or daughter (as 
        defined in section 101) who is a child of the employee.
            ``(2) Eligible employee.--The term `eligible employee' has 
        the meaning given the term in section 101, except that the 
        limitations established in clauses (i) and (ii) of section 
        101(2)(A) shall not apply. The term `eligible employee' does 
        not include any Federal officer or employee covered under 
        subchapter VII of chapter 63 of title 5, United States Code, 
        but does include a State employee described in section 304(a) 
        of the Government Employee Rights Act of 1991 (42 U.S.C. 2000e-
        16c(a)).
            ``(3) Employer.--The term `employer' has the meaning given 
        the term in section 101, and includes an entity employing a 
        State employee described in section 304(a) of the Government 
        Employee Rights Act of 1991.
            ``(4) Undue hardship.--The term `undue hardship' means an 
        action requiring significant difficulty or expense.

``SEC. 502. LACTATION PERIODS.

    ``(a) In General.--An employer shall provide an appropriate number 
of lactation periods, of reasonable length, for an eligible employee 
during each workday, to permit the employee to express milk for, or 
breastfeed, an eligible child.
    ``(b) Break Time.--
            ``(1) Unpaid break periods.--Except as provided in 
        paragraph (2), the lactation periods may consist of unpaid 
        break periods.
            ``(2) Combined break periods.--To the extent practicable, 
        an employer shall combine break periods by providing the 
        lactation periods for an eligible employee at the same time as 
        the employer provides other break periods for the employee. If 
        the employer combines the break periods, the employee shall 
        receive the same compensation for a combined break period as 
        the employee would have received for an original break period.
    ``(c) Limitation.--
            ``(1) Undue hardship.--An employer shall not be required to 
        provide a lactation period under this section if the employer 
        demonstrates that providing the period would impose an undue 
        hardship on the employer, subject to paragraph (2).
            ``(2) Reasonable efforts.--An employer who maintains that 
        an undue hardship would result from providing a lactation 
        period to an eligible employee shall demonstrate that the 
        employer made reasonable efforts to comply with subsections (a) 
        and (b).

``SEC. 503. LACTATION FACILITIES.

    ``(a) In General.--An employer shall provide an appropriate 
lactation facility for an eligible employee, within a reasonable 
distance from the employee's usual work location, to permit the 
employee to express milk for, or breastfeed, an eligible child.
    ``(b) Limitation.--
            ``(1) Undue hardship.--An employer shall not be required to 
        provide a lactation facility under this section if the employer 
        demonstrates that providing the facility would impose an undue 
        hardship on the employer, subject to paragraph (2).
            ``(2) Reasonable efforts.--An employer who maintains that 
        an undue hardship would result from providing a lactation 
        facility to an eligible employee shall demonstrate that the 
        employer made reasonable efforts to comply with subsection (a).

``SEC. 504. ENFORCEMENT AND REMEDIES.

    ``(a) Enforcement Process.--The Secretary of Labor shall establish 
or designate a process through which--
            ``(1) an individual may file a complaint regarding a 
        violation of this title; and
            ``(2) an office designated by the Secretary in the 
        Department of Labor shall receive, investigate, make 
        determinations regarding, and administer remedies with respect 
        to such complaints.
    ``(b) Remedies.--The Secretary of Labor shall establish remedies 
for violations of this title.
    ``(c) Government Accountability Office and Library of Congress.--In 
the case of the Government Accountability Office and the Library of 
Congress, the authority of the Secretary of Labor under this title 
shall be exercised respectively by the Comptroller General of the 
United States and the Librarian of Congress.

``SEC. 505. REGULATIONS.

    ``The Secretary of Labor shall issue regulations to carry out this 
title, including provisions prescribing--
            ``(1) an appropriate number and reasonable length of 
        lactation periods, for purposes of section 502;
            ``(2) an appropriate lactation facility (which shall not be 
        a restroom or a portion of a restroom) and a reasonable 
        distance from a usual work location, for purposes of section 
        503; and
            ``(3) the process and remedies described in section 504.''.
    (b) Breastfeeding at Work for Civil Service Employees.--Chapter 63 
of title 5, United States Code, is amended by adding at the end:

           ``SUBCHAPTER VII--LACTATION PERIODS AND FACILITIES

``Sec. 6392. Definitions
    ``For the purpose of this subchapter--
            ``(1) the term `eligible child', used with respect to an 
        employee, means a son or daughter (as defined in section 6381) 
        who is a child of the employee;
            ``(2) the term `employee' means any individual who is an 
        `employee', as defined by section 6301(2), including any 
        individual employed in a position referred to in clause (v) or 
        (ix) of section 6301(2), but excluding any individual employed 
        by the government of the District of Columbia, any individual 
        employed on a temporary or intermittent basis, and any employee 
        of the General Accounting Office or the Library of Congress; 
        and
            ``(3) the term `undue hardship' means an action requiring 
        significant difficulty or expense.
``Sec. 6392A. Lactation periods
    ``(a) An employing agency shall provide an appropriate number of 
lactation periods, of reasonable length, for an employee during each 
workday, to permit the employee to express milk for, or breastfeed, an 
eligible child.
    ``(b)(1) Except as provided in paragraph (2), the lactation periods 
may consist of unpaid break periods.
    ``(2) To the extent practicable, an employing agency shall combine 
break periods by providing the lactation periods for an employee at the 
same time as the employing agency provides other break periods for the 
employee. If the employing agency combines the break periods, the 
employee shall receive the same compensation for a combined break 
period as the employee would have received for an original break 
period.
    ``(c)(1) An employing agency shall not be required to provide a 
lactation period under this section if the employing agency 
demonstrates that providing the period would impose an undue hardship 
on the employing agency, subject to paragraph (2).
    ``(2) An employing agency who maintains that an undue hardship 
would result from providing a lactation period to an employee shall 
demonstrate that the employing agency made reasonable efforts to comply 
with subsections (a) and (b).
``Sec. 6392B. Lactation facilities
    ``(a) An employing agency shall provide an appropriate lactation 
facility for an employee, within a reasonable distance from the 
employee's usual work location, to permit the employee to express milk 
for, or breastfeed, an eligible child.
    ``(b)(1) An employing agency shall not be required to provide a 
lactation facility under this section if the employing agency 
demonstrates that providing the facility would impose an undue hardship 
on the employing agency, subject to paragraph (2).
    ``(2) An employing agency who maintains that an undue hardship 
would result from providing a lactation facility to an employee shall 
demonstrate that the employing agency made reasonable efforts to comply 
with subsection (a).
``Sec. 6392C. Remedies
    ``(a) The Office of Personnel Management shall establish or 
designate a process through which--
            ``(1) an individual may file a complaint regarding a 
        violation of this subchapter; and
            ``(2) an office designated by the Director of the Office of 
        Personnel Management shall receive, investigate, make 
        determinations regarding, and administer remedies with respect 
        to such complaints.
    ``(b) The Office of Personnel Management shall establish remedies 
for violations of this subchapter.
``Sec. 6392D. Regulations
    ``(a) The Office of Personnel Management shall issue regulations to 
carry out this subchapter, including provisions prescribing--
            ``(1) an appropriate number and reasonable length of 
        lactation periods, for purposes of section 6392A;
            ``(2) an appropriate lactation facility (which shall not be 
        a restroom or a portion of a restroom) and a reasonable 
        distance from a usual work location, for purposes of section 
        6392B; and
            ``(3) the process and remedies described in section 6392C.
    ``(b) The regulations prescribed under this subchapter shall, to 
the extent appropriate, be consistent with the regulations prescribed 
by the Secretary of Labor to carry out title V of the Family and 
Medical Leave Act of 1993.''.
    (c) Breastfeeding at Work for Congressional Employees.--
            (1) Application of laws.--Section 102(a) of the 
        Congressional Accountability Act of 1995 (2 U.S.C. 1302(a)) is 
        amended--
                    (A) in paragraph (5), by striking ``The'' and 
                inserting ``Title I of the''; and
                    (B) by adding at the end the following:
            ``(12) Title V of the Family and Medical Leave Act of 
        1993.''.
            (2) Extension of rights and protections.--Part A of title 
        II of the Congressional Accountability Act of 1995 (2 U.S.C. 
        1311 et seq.) is amended--
                    (A) in section 202 (2 U.S.C. 1312), by striking the 
                title and inserting the following:

``SEC. 202. RIGHTS AND PROTECTIONS UNDER TITLE I OF THE FAMILY AND 
              MEDICAL LEAVE ACT OF 1993.'';

                    (B) by redesignating section 207 as section 208; 
                and
                    (C) by inserting after section 206 the following:

``SEC. 207. RIGHTS AND PROTECTIONS UNDER TITLE V OF THE FAMILY AND 
              MEDICAL LEAVE ACT OF 1993.

    ``(a) Breastfeeding Rights and Protections Provided.--
            ``(1) In general.--The rights and protections established 
        by sections 501 through 503 of the Family and Medical Leave Act 
        of 1993 shall apply to covered employees.
            ``(2) Definition.--For purposes of the application 
        described in paragraph (1)--
                    ``(A) the term `employer' as used in the Family and 
                Medical Leave Act of 1993 means any employing office; 
                and
                    ``(B) the term `eligible employee' as used in the 
                Family and Medical Leave Act of 1993 means a covered 
                employee who has been employed in any employing office.
    ``(b) Remedy.--The remedy for a violation of subsection (a) shall 
be such remedy as would be appropriate if awarded under section 504 of 
the Family and Medical Leave Act of 1993.
    ``(c) Regulations.--
            ``(1) In general.--The Board shall, pursuant to section 
        304, issue regulations to implement the rights and protections 
        under this section.
            ``(2) Agency regulations.--The regulations issued under 
        paragraph (1) shall be the same as substantive regulations 
        promulgated by the Secretary of Labor to implement the 
        statutory provisions referred to in subsections (a) and (b), 
        except insofar as the Board may determine, for good cause shown 
        and stated together with the issued regulations, that a 
        modification of such promulgated regulations would be more 
        effective for the implementation of the rights and protections 
        under this section.''.
            (3) Table of contents.--The table of contents for the 
        Congressional Accountability Act of 1995 is amended by striking 
        the item relating to section 207 and inserting the following:

``Sec. 207. Rights and protections under title V of the Family and 
                            Medical Leave Act of 1993.
``Sec. 208. Prohibition of intimidation or reprisal.''.
    (d) Breastfeeding at Work for Employees in Presidential Offices.--
            (1) Application of laws.--Section 402 of title 3, United 
        States Code, is amended--
                    (A) in paragraph (5), by striking ``The'' and 
                inserting ``Title I of the''; and
                    (B) by adding at the end the following:
            ``(12) Title V of the Family and Medical Leave Act of 
        1993.''.
            (2) Extension of rights and protections.--Subchapter II of 
        chapter 5 of title 3, United States Code, is amended--
                    (A) in section 412, by striking the title and 
                inserting the following:

``SEC. 412. RIGHTS AND PROTECTIONS UNDER TITLE I OF THE FAMILY AND 
              MEDICAL LEAVE ACT OF 1993.'';

                    (B) by redesignating section 417 as section 418; 
                and
                    (C) by inserting after section 416 the following:

``SEC. 417. RIGHTS AND PROTECTIONS UNDER TITLE V OF THE FAMILY AND 
              MEDICAL LEAVE ACT OF 1993.

    ``(a) Breastfeeding Rights and Protections Provided.--
            ``(1) In general.--The rights and protections established 
        by sections 501 through 503 of the Family and Medical Leave Act 
        of 1993 shall apply to covered employees.
            ``(2) Definition.--For purposes of the application 
        described in paragraph (1)--
                    ``(A) the term `employer' as used in the Family and 
                Medical Leave Act of 1993 means any employing office; 
                and
                    ``(B) the term `eligible employee' as used in the 
                Family and Medical Leave Act of 1993 means a covered 
                employee.
    ``(b) Remedy.--The remedy for a violation of subsection (a) shall 
be such remedy as would be appropriate if awarded under section 504 of 
the Family and Medical Leave Act of 1993.
    ``(c) Regulations.--
            ``(1) In general.--The President, or the designee of the 
        President, shall issue regulations to implement this section.
            ``(2) Agency regulations.--The regulations issued under 
        paragraph (1) shall be the same as substantive regulations 
        promulgated by the Secretary of Labor to implement the 
        statutory provisions referred to in subsections (a) and (b)--
                    ``(A) except to the extent that the President or 
                designee may determine, for good cause shown and stated 
                together with the issued regulations, that a 
                modification of such promulgated regulations would be 
                more effective for the implementation of the rights and 
                protections under this section; and
                    ``(B) except that the President or designee may, at 
                the discretion of the President or designee, issue 
                regulations to implement a provision of subchapter VII 
                of chapter 63 of title 5, United States Code, that 
                applies to employees in the executive branch of the 
                Federal Government in lieu of an analogous statutory 
                provision referred to in subsection (a) or (b), if the 
                issuance of such regulations--
                            ``(i) would be equally effective for the 
                        implementation of the rights and protections 
                        under this section; and
                            ``(ii) would promote uniformity in the 
                        application of Federal law to employees in the 
                        executive branch of the Federal Government.''.
            (3) Conforming amendment.--Section 411(e) of title 3, 
        United States Code, is amended by striking ``417'' and 
        inserting ``418''.
            (4) Table of contents.--The table of contents for chapter 5 
        of title 3, United States Code, is amended by striking the item 
        relating to section 417 and inserting the following:

``417. Rights and protections under title V of the Family and Medical 
                            Leave Act of 1993.
``418. Prohibition of intimidation or reprisal.''.
    (e) Effective Dates.--
            (1) In general.--Except as provided in paragraph (2), this 
        section and the amendments made by this section take effect 18 
        months after the date of enactment of this Act.
            (2) Regulations.--Section 505 of the Family and Medical 
        Leave Act of 1993 (as added by subsection (a)), section 6392D 
        of title 5, United States Code (as added by subsection (b)), 
        section 207(c) of the Congressional Accountability Act of 1995 
        (as added by subsection (c)), and section 417(c) of title 3, 
        United States Code (as added by subsection (d)) take effect on 
        the date of enactment of this Act.

            CHAPTER 2--PROMOTING LIFELONG ACTIVE COMMUNITIES

SEC. 321. SHORT TITLE.

    This chapter may be cited as the ``Promoting Lifelong Active 
Communities Every Day Act'' or the ``PLAY Every Day Act''.

SEC. 322. PURPOSE.

    The purpose of this chapter is to help children, families and 
communities achieve the national recommendation of 60 minutes of 
physical activity every day.

SEC. 323. DEFINITION OF SECRETARY.

    In this chapter, the term ``Secretary'' means the Secretary of 
Health and Human Services.

  Subchapter A--National Program Promoting Lifelong Active Communities

SEC. 331. DEVELOPMENT OF COMMUNITY PLAY INDEX.

    (a) Community Play Index.--The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, shall 
develop a well-validated community measurement tool, which shall be 
known as the ``Community Play Index'', that can measure the policy, 
program, or environmental barriers in communities to participating in 
physical activity. The Community Play Index shall include--
            (1) cross-cutting measurements that--
                    (A) examine barriers to physical activities across 
                multiple settings, including homes, after school and 
                child care sites, schools, the community at-large, and 
                worksites; and
                    (B) focus on the--
                            (i) availability of adequate spaces and 
                        places for physical activity;
                            (ii) availability of, and access to, 
                        quality physical activity and physical 
                        education programs; and
                            (iii) the availability of programs, 
                        activities, and leaders to educate about the 
                        importance of physical activity for the 
                        community; and
            (2) additional measurements to assist economically and 
        culturally diverse communities in examining the social 
        determinants of health.
    (b) Guidance and Training.--The Secretary shall provide guidance 
and develop training on utilizing the Community Play Index.

SEC. 332. SENSE OF THE SENATE REGARDING FUNDING.

    It is the sense of the Senate that the Secretary, acting through 
the Director of the Centers for Disease Control and Prevention, shall 
carry out this subchapter using any additional and available funds 
provided to the Secretary for the steps to a healthier United States 
program carried out by the Centers for Disease Control and Prevention.

     Subchapter B--Model Communities of Play Implementation Grants

SEC. 341. MODEL COMMUNITIES OF PLAY IMPLEMENTATION GRANTS.

    (a) Program Authorized.--
            (1) In general.--The Secretary, acting through the Director 
        of the Centers for Disease Control and Prevention, shall award 
        3 grants to State health departments to enable the State health 
        departments to work in partnership with eligible community-
        based coalitions to plan and implement model communities of 
        play that--
                    (A) increase the physical spaces and places 
                available for physical activity;
                    (B) increase the opportunities for children and 
                families to participate in quality play, and the number 
                of children and families participating in quality play; 
                and
                    (C) increase knowledge and awareness about the 
                importance of individuals achieving 60 minutes of 
                recommended physical activity every day.
            (2) Amount of grants.--A grant awarded under this 
        subsection shall be in the amount of $250,000. If the amounts 
        appropriated under this title for a fiscal year are not 
        sufficient to support 3 grants at such level, the Secretary 
        shall ratably reduce the amount of all grants.
    (b) Application.--A State health department desiring a grant under 
subsection (a) shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may require.
    (c) Coordination.--In awarding grants under subsection (a), the 
Secretary shall ensure that the proposed programs assisted under each 
grant are coordinated in substance and format with programs currently 
funded through other Federal departments and agencies, including--
            (1) State-based nutrition and physical activity programs, 
        comprehensive school health education programs, and community-
        based health and wellness programs of the Centers for Disease 
        Control and Prevention;
            (2) the physical education programs under subpart 10 of 
        part D of title V of the Elementary and Secondary Education Act 
        of 1965 (20 U.S.C. 7261 et seq.;
            (3) the safe routes to schools program under section 1404 
        of the Safe, Accountable, Flexible, Efficient Transportation 
        Equity Act: A Legacy for Users (23 U.S.C. 402 note; 119 Stat. 
        1228); and
            (4) other health and wellness programs operating within the 
        community.
    (d) Partnership With Community Coalitions.--A State health 
department receiving a grant under subsection (a) shall use grant funds 
to carry out the activities described in subsection (e) in partnership 
with 1 or more community coalitions that meet all of the following 
requirements:
            (1) The community coalition is comprised of a 
        representative sampling of community partners, including not 
        less than half of the different types of individuals or 
        entities described in subparagraphs (A) through (O):
                    (A) A community-based organization that focuses on 
                children and youth, preventive health, physical 
                activity, or physical education.
                    (B) A local parks and recreation department.
                    (C) A local health department.
                    (D) A local educational agency, as defined in 
                section 9101 of the Elementary and Secondary Education 
                Act of 1965 (20 U.S.C. 7801).
                    (E) A local city planning agency.
                    (F) A local health care provider.
                    (G) A 4-year institution of higher education, as 
                defined in section 101 of the Higher Education Act of 
                1965 (20 U.S.C. 1001).
                    (H) A tribal health facility, where applicable.
                    (I) A tribal educational agency, where applicable.
                    (J) A Federally qualified health center or rural 
                health clinic, where applicable.
                    (K) A hospital.
                    (L) A faith-based organization.
                    (M) A policymaker or elected official.
                    (N) A community planning organization.
                    (O) A business.
            (2) The community coalition completed and submitted to the 
        State health department--
                    (A) a Community Play Index developed under section 
                101 for the community that identifies the gaps and 
                barriers to physical activity in the community to 
                children and youth; and
                    (B) a community action plan describing the 
                programs, policy, and environmental change strategies 
                that will be implemented with grant funds to help 
                children and youth in the community reach the 
                recommended 60 minutes of physical activity every day.
            (3) The community coalition provided--
                    (A) documentation to the State health department on 
                the manner in which the coalition will coordinate with 
                appropriate State and local authorities, including--
                            (i) State or local health departments;
                            (ii) State educational agencies or local 
                        educational agencies, as defined in section 
                        9101 of the Elementary and Secondary Education 
                        Act of 1965 (20 U.S.C. 7801);
                            (iii) State or local parks and recreation 
                        departments or associations;
                            (iv) State or local departments of 
                        transportation or city planning;
                            (v) community foundations; and
                            (vi) any other entities determined to be 
                        appropriate by the Secretary; and
                    (B) a description of the manner in which the 
                coalition will evaluate the effectiveness of the 
                programs carried out with grant funds.
    (e) Authorized Activities.--A State health department that receives 
a grant under subsection (a) shall use funds available through the 
grant to carry out the following activities:
            (1) Train community-based coalitions on how to utilize the 
        Community Play Index to measure the program, policy, and 
        environmental barriers to promoting lifelong physical activity 
        for youth.
            (2) Work in partnership with community coalitions described 
        in subsection (d) to enable the community coalitions to carry 
        out the coalition's community action plan and promote a model 
        community of play, which may include the following:
                    (A) Enabling the maximum use of, or the creation of 
                spaces and places for, physical activity for children, 
                families, and communities before, during, and after 
                school or work, which may include increasing the number 
                of--
                            (i) programs that increase the number of 
                        safe streets and sidewalks in the community to 
                        walk and bike to school, work, or other 
                        community destinations, such as recreation 
                        sites, parks, or community centers;
                            (ii) schools, faith-based organizations, 
                        and recreational facilities serving the 
                        community that provide programming on physical 
                        activity and physical education before, during, 
                        or after school;
                            (iii) schools serving the community that 
                        provide recess, physical education, and 
                        physical activity for children and youth;
                            (iv) day care, child care, and after school 
                        care sites in the community that provide 
                        physical activity for children and youth;
                            (v) venues in the community that provide 
                        co-curricular physical activity programs, 
                        including sports fields and courts, especially 
                        venues for all-inclusive intramural programs 
                        and physical activity clubs;
                            (vi) playgrounds and activity sites in the 
                        community for young children, including sites 
                        that offer programs that provide physical 
                        activity instruction that meet the various 
                        needs and interests of all students, including 
                        those with illness, injury, and physical and 
                        developmental disabilities, as well as those 
                        that live sedentary lifestyles or with a 
                        disinterest in traditional team sports;
                            (vii) capital improvement projects that 
                        increase opportunities for physical activity in 
                        the community; and
                            (viii) networks of walking and cycling 
                        trails where trails do not exist in the 
                        community, that offer both a functional 
                        alternative to automobile travel and an 
                        opportunity for exercise, recreation, and 
                        community connectedness.
                    (B) Enhancing opportunities and access for children 
                and youth in the community to participate in quality 
                physical activity and physical education programs 
                before, during, and after school, which may include 
                increasing the number of--
                            (i) school and after school care sites in 
                        the community that implement proven health 
                        curricula, physical education (including 
                        developing innovative approaches to teaching 
                        and staffing, physical education), and physical 
                        activity programming;
                            (ii) children and youth in the community 
                        that are able to participate in physical 
                        education or activity during and after school, 
                        by ensuring that adequate equipment is 
                        available to such children and youth;
                            (iii) scholarships to low-income children 
                        and youth for physical activity programs;
                            (iv) education and training programs for 
                        education, recreation, leisure, child care, and 
                        coaching professionals regarding quality 
                        physical education and physical activity 
                        programs and policies;
                            (v) training programs to assist physicians 
                        in--
                                    (I) carefully communicating the 
                                results of body mass index (BMI) tests 
                                to parents and, in an age-appropriate 
                                manner, to the children and youth 
                                themselves;
                                    (II) providing information to 
                                families so they may make informed 
                                decisions about physical activity and 
                                nutrition; and
                                    (III) explaining the benefits 
                                associated with physical activity and 
                                the risks associated with childhood 
                                overweight and obesity;
                            (vi) assessment tools used to measure the 
                        quality of physical activity, sports, and 
                        intramural sports programs;
                            (vii) guidelines and informational 
                        materials used by teachers, parents, 
                        caregivers, and health-care professionals who 
                        are interested in promoting physical activity 
                        for infants, toddlers, and preschoolers; and
                            (viii) guidelines and informational 
                        materials used to promote physical activity 
                        with the intent of improving the current 
                        health, fitness, and wellness of preadolescent 
                        children (ages 6 through 12) as well as to 
                        promote lifelong physical activity.
                    (C) Identifying, engaging and mobilizing community 
                leaders, decision-makers, experts, and the media to 
                raise awareness and educate the public about the 
                importance of securing 60 minutes of physical activity 
                every day, which may include increasing the number of--
                            (i) school and after school care faculty 
                        and staff, including coaches, that serve as 
                        positive role models for students regarding 
                        regular physical activity;
                            (ii) businesses that serve as role models 
                        by providing physical space and incentives for 
                        employees to participate in physical activity;
                            (iii) businesses that serve as role models 
                        to communities by--
                                    (I) providing support to intramural 
                                teams, clubs, sports leagues, 
                                playgrounds, trails, biking and walking 
                                paths, and fields and venues for 
                                sports, play, and physical activity;
                                    (II) incorporating built 
                                environment strategies into new 
                                construction of facilities;
                                    (III) adopting safe routes to 
                                school programs;
                                    (IV) providing bike racks at the 
                                office; and
                                    (V) encouraging the use of the 
                                stairs;
                            (iv) insurers that provide incentives for 
                        maintaining healthy body weight, including 
                        offering screening and obesity prevention 
                        services in routine clinical practice;
                            (v) groups representing low-income 
                        individuals or individuals with disabilities, 
                        that can promote and secure safer and more 
                        accessible sites for activity;
                            (vi) consumer research-driven marketing 
                        strategies for ongoing initiatives and 
                        interventions that enhance physical activity 
                        for children and youth;
                            (vii) products and opportunities provided 
                        or offered by leisure, entertainment, and 
                        recreation industries that promote regular 
                        physical activity and reduce sedentary 
                        behaviors;
                            (viii) media advocacy training programs for 
                        public health and exercise scientists so as to 
                        empower the scientists to disseminate their 
                        knowledge to a broad audience; and
                            (ix) campaigns to foster awareness about 
                        the health benefits of regular physical 
                        activity of not less than 60 minutes a day for 
                        all children and youth.
            (3) To support the evaluation of the community action plans 
        of the community coalitions and the activities carried out 
        under this title.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this subtitle $750,000 for fiscal year 2008.

         TITLE IV--RESPONSIBLE MARKETING AND CONSUMER AWARENESS

                     Subtitle A--General Provisions

SEC. 401. NUTRITION LABELING OF RESTAURANT FOODS.

    Section 403(q)(5) of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 343(q)(5)(A)(i)) is amended--
            (1) in clause (A)--
                    (A) in subclause (i), by inserting ``except as 
                provided in clauses (H) and (I),'' before ``which'' the 
                first place it appears; and
                    (B) in subclause (ii), by inserting ``except as 
                provided in clauses (H) and (I),'' before ``which'' the 
                first place it appears; and
            (2) by adding at the end the following:
    ``(H) Restaurants and Retail Food Establishments.--
            ``(i) In general.--Except for food described in subclause 
        (iii), in the case of food that is served, processed, or 
        prepared in a restaurant or similar retail food establishment 
        that is part of a chain with 20 or more locations doing 
        business under the same trade name (regardless of the type of 
        ownership of the locations), the restaurant or establishment 
        shall disclose the information described in subclause (ii).
            ``(ii) Information required to be disclosed.--Except as 
        provided in subclause (iii), the establishment shall disclose--
                    ``(I)(aa) in a statement adjacent to the name of 
                the food on any menu listing the food for sale, or by 
                any other means deemed equivalent by the Secretary, the 
                number of calories, grams of saturated fat plus trans 
                fat, and milligrams of sodium contained in a standard 
                serving of the food, as usually offered for sale, in a 
                clear and conspicuous manner; and
                    ``(bb) information, specified by the Secretary by 
                regulation, designed to enable the public to 
                understand, in the context of a total daily diet, the 
                significance of the nutrition information that is 
                provided; and
                    ``(II) in a statement adjacent to the name of the 
                food on any menu board or other sign listing the food 
                for sale, or by any other means deemed equivalent by 
                the Secretary--
                            ``(aa) the number of calories contained in 
                        a serving of the food, as usually offered for 
                        sale, in a clear and conspicuous manner; and
                            ``(bb) notification that the information 
                        required by subitems (aa) and (bb) of item (I) 
                        shall be provided in writing at the request of 
                        a prospective purchaser.
            ``(iii) Nonapplicability to certain food.--This clause does 
        not apply to--
                    ``(I) items that are not listed on a menu or menu 
                board (such as condiments and other items placed on the 
                table or counter for general use); or
                    ``(II) daily specials, temporary menu items, or 
                other irregular menu items, as specified by the 
                Secretary by regulation.
            ``(iv) Self-service facilities.--In the case of food sold 
        at a salad bar, buffet line, cafeteria line, or similar self-
        service facility, a restaurant or other establishment shall 
        place a sign that lists calories per standard serving adjacent 
        to each food offered.
            ``(v) Voluntary provision of nutrition information; state 
        regulation of nutrition information for restaurant food.--
                    ``(I) Retail food establishments.--Nothing in this 
                clause precludes a restaurant or similar retail food 
                establishment from providing additional nutrition 
                information, voluntarily, if the information complies 
                with the nutrition labeling requirements contained in 
                this subparagraph.
                    ``(II) State or local requirements.--Nothing in 
                this clause precludes a State or political subdivision 
                of a State from requiring that a restaurant or similar 
                food establishment provide nutrition information in 
                addition to that required under this clause.
            ``(vi) Regulations.--
                    ``(I) Proposed regulation.--Not later than 1 year 
                after the date of enactment of this clause, the 
                Secretary shall promulgate proposed regulations to 
                carry out this clause.
                    ``(II) Contents.--The regulations shall allow for 
                the variations in serving sizes and in food preparation 
                that can reasonably be expected to result from 
                inadvertent human error, training of food service 
                workers, and other factors.
                    ``(III) Final regulations.--Not later than 2 years 
                after the date of enactment of this clause, the 
                Secretary shall promulgate final regulations to 
                implement this clause.
                    ``(IV) Failure to promulgate final regulations by 
                required date.--If the Secretary does not promulgate 
                final regulations under item (III) by the date that is 
                2 years after the date of enactment of this clause--
                            ``(aa) the proposed regulations issued in 
                        accordance with item (I) shall become effective 
                        as the final regulations on the day after that 
                        date; and
                            ``(bb) the Secretary shall publish in the 
                        Federal Register notice of the final 
                        regulations.
    ``(I) Vending Machines.--
            ``(i) In general.--In the case of an article of food sold 
        from a vending machine that--
                    ``(I) does not permit a prospective purchaser to 
                examine the article so as to be able to read a 
                statement affixed to the article before purchasing the 
                article; and
                    ``(II) is operated by a person that is engaged in 
                the business of owning and operating 20 or more vending 
                machines;
        the vending machine operator shall provide a conspicuous sign 
        in close proximity to the article that includes a statement 
        disclosing the number of calories contained in the article.
            ``(ii) Voluntary provision of nutrition information; state 
        regulation of nutrition information for vending machines.--
                    ``(I) Vending machine operators.--Nothing in this 
                clause precludes a vending machine operator from 
                providing additional nutrition information, 
                voluntarily, if the information complies with the 
                nutrition labeling requirements contained in this 
                subparagraph.
                    ``(II) State or local requirements.--Nothing in 
                this title precludes a State or political subdivision 
                of a State from requiring that a vending machine 
                operator provide nutrition information in addition to 
                that required under this clause.
            ``(iii) Regulations.--
                    ``(I) Proposed regulations.--Not later than 1 year 
                after the date of enactment of this clause, the 
                Secretary shall promulgate proposed regulations to 
                carry out this clause.
                    ``(II) Final regulations.--Not later than 2 years 
                after the date of enactment of this clause, the 
                Secretary shall promulgate final regulations to 
                implement this clause.
                    ``(III) Failure to promulgate final regulations by 
                required date.--If the Secretary does not promulgate 
                final regulations under item (II) by the date that is 2 
                years after the date of enactment of this clause--
                            ``(aa) the proposed regulations issued in 
                        accordance with item (I) shall become effective 
                        as the final regulations on the day after that 
                        date; and
                            ``(bb) the Secretary shall publish in the 
                        Federal Register notice of the final 
                        regulations.''.

SEC. 402. RULEMAKING AUTHORITY FOR ADVERTISING TO CHILDREN.

    (a) Purpose.--The purpose of this section is to restore the 
authority of the Federal Trade Commission to issue regulations that 
restrict the marketing or advertising of foods and beverages to 
children under the age of 18 years if the Federal Trade Commission 
determines that there is evidence that consumption of certain foods and 
beverages is detrimental to the health of children.
    (b) Authority.--Section 18 of the Federal Trade Commission Act (15 
U.S.C. 57a) is amended by striking subsection (h).

SEC. 403. FOOD ADVERTISING IN SCHOOLS.

    Section 10 of the Child Nutrition Act of 1966 (42 U.S.C. 1779) is 
amended by adding at the end the following:
    ``(d) Food Advertising.--The Secretary may prohibit the advertising 
of food in participating schools if the Secretary determines that 
consumption of the advertised food has a detrimental effect on the 
diets or health of children.''.

SEC. 404. DISALLOWANCE OF DEDUCTIONS FOR ADVERTISING AND MARKETING 
              EXPENSES RELATING TO TOBACCO PRODUCT USE.

    (a) In General.--Part IX of subchapter B of chapter 1 of subtitle A 
of the Internal Revenue Code of 1986 (relating to items not deductible) 
is amended by adding at the end the following new section:

``SEC. 280I. DISALLOWANCE OF DEDUCTION FOR TOBACCO ADVERTISING AND 
              MARKETING EXPENSES.

    ``No deduction shall be allowed under this chapter for expenses 
relating to advertising or marketing cigars, cigarettes, smokeless 
tobacco, pipe tobacco, or any similar tobacco product. For purposes of 
this section, any term used in this section which is also used in 
section 5702 shall have the same meaning given such term by section 
5702.''.
    (b) Conforming Amendment.--The table of sections for such part IX 
is amended by adding after the item relating to section 280H the 
following new item:

                                  ``Sec. 280I. Disallowance of 
                                        deduction for tobacco 
                                        advertising and marketing 
                                        expenses.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 405. FEDERAL-STATE TOBACCO COUNTER-ADVERTISING PROGRAMS.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.), as amended in section 312, is further amended by adding 
at the end the following:

``SEC. 399S. FEDERAL-STATE TOBACCO COUNTER-ADVERTISING PROGRAMS.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, shall award grants to 
and enter into contracts with eligible entities for the implementation 
of national and local media (such as counter-advertising) and non-media 
campaigns designed to reduce the use of tobacco products.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall be--
            ``(1) a public entity, including a State public health 
        department; or
            ``(2) a private, nonprofit entity that--
                    ``(A) is not affiliated with a manufacturer or 
                importer of a tobacco product;
                    ``(B) has demonstrated a record of conducting a 
                national antitobacco public education campaign to 
                effectively reduce the use of tobacco products;
                    ``(C) has expertise in conducting a multi-media 
                communications campaign; and
                    ``(D) has expertise in developing strategies that 
                affect behavior changes in children and other targeted 
                populations.
    ``(c) Application.--An eligible entity shall submit an application 
to the Secretary for a grant under this section at such time, in such 
manner, and accompanied by such information as the Secretary may 
require.
    ``(d) Use of Funds.--An eligible entity shall use amounts received 
under a grant under this section to--
            ``(1) design and implement multimedia public education and 
        social marketing campaigns that--
                    ``(A) discourage the use of tobacco products;
                    ``(B) encourage the use of products designed to 
                enable tobacco use cessation; and
                    ``(C) educate the public about the hazards of 
                environmental tobacco smoke exposure; or
            ``(2) conduct research related to the effectiveness of the 
        campaigns described in paragraph (1).
    ``(e) Allocation of Grants.--Of the amounts awarded under this 
section, the Secretary shall award--
            ``(1) 50 percent of such amounts to eligible public 
        entities; and
            ``(2) 50 percent of such amounts to eligible private, 
        nonprofit entities.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated $200,000,000 to carry out this section.''.

        Subtitle B--Penalties for Failure to Reduce Teen Smoking

SEC. 411. CHILD CIGARETTE USE SURVEYS.

    (a) Annual Performance Survey.--
            (1) In general.--Not later than August 31, 2007, and 
        annually thereafter, the Secretary of Health and Human Services 
        (referred to in this section as the ``Secretary'') shall 
        publish the results of an annual cigarette survey, to be 
        carried out after the date of enactment of this Act and 
        completed prior to August 21, 2007, and prior to August 21 of 
        each year thereafter, to determine--
                    (A) the percentage of all young individuals who 
                used a type of cigarette within the 30-day period prior 
                to the conduct of the survey involved; and
                    (B) the percentage of young individuals who 
                identify each brand of each type of cigarette as the 
                usual brand smoked within such 30-day period.
            (2) Young individuals.--For the purposes of this subtitle, 
        the term ``young individuals'' means individuals who are under 
        18 years of age.
    (b) Size and Methodology.--
            (1) In general.--The survey referred to in subsection (a) 
        shall be comparable in size and methodology to the Monitoring 
        the Future survey that was completed in 1999 to measure the use 
        of cigarettes (by brand) by youths under 18 years of age within 
        the 30-day period prior to the conduct of the study.
            (2) Conclusive accurateness.--A survey using the 
        methodology described in paragraph (1) shall be deemed 
        conclusively proper, correct, and accurate for purposes of this 
        section.
            (3) Definition.--In this subtitle, the term ``Monitoring 
        the Future survey'' means the combined survey of 8th, 10th, and 
        12th grade students that was conducted at the Institute for 
        Social Research at the University of Michigan.
    (c) Reduction.--The Secretary, based on a comparison of the results 
of the first annual cigarette survey referred to in subsection (a) and 
the Monitoring the Future survey referred to in subsection (b)(1), 
shall determine the percentage reduction (if any) in youth cigarette 
use for each manufacturer of cigarettes.
    (d) Participation in Survey.--Notwithstanding any other provision 
of law, the Secretary may conduct a survey under this section involving 
minors if the results of such survey with respect to such minors are 
kept confidential and not disclosed.
    (e) Nonapplicability.--Chapter 35 of title 44, United States Code, 
shall not apply to information required for the purposes of carrying 
out this section.
    (f) Definition.--In this subtitle the term ``cigarette'' has the 
meaning given such term in section 3(1) of the Federal Cigarette 
Labeling and Advertising Act (15 U.S.C. 1332(1)).

SEC. 412. CIGARETTE USE REDUCTION GOAL AND NONCOMPLIANCE.

    (a) Goal.--It shall be the cigarette use reduction goal that each 
manufacturer reduce youth cigarette use by at least 15 percent during 
the period between the Monitoring the Future survey referred to in 
section 411(b)(1) and the completion of the first annual cigarette 
survey (and such subsequent surveys as compared to the previous year's 
survey) referred to in section 411(a).
    (b) Noncompliance.--
            (1) Industry-wide penalty.--If the Secretary determines 
        that the cigarette use reduction goal under subsection (a) has 
        not been achieved, the Secretary shall, not later than 
        September 10, 2007, and September 10 of each year thereafter, 
        impose an industry-wide penalty on the manufacturers of 
        cigarettes in an amount that is in the aggregate equal to--
                    (A) if youth cigarette use has been reduced by 5 
                percent or less, $6,000,000,000;
                    (B) if youth cigarette use has been reduced by at 
                least 6 percent but less than 10 percent, 
                $4,000,000,000; and
                    (C) if youth cigarette use has been reduced by at 
                least 11 percent but less than 15 percent, 
                $2,000,000,000.
            (2) Payment.--The industry-wide penalty imposed under this 
        subsection shall be paid by each manufacturer based on the 
        percentage of cigarettes of each such manufacturer that are 
        used by youth (as determined under the Monitoring the Future 
        survey and compared to the cigarettes manufactured by all 
        manufacturers) as such percentage relates to the total amount 
        to be paid by all manufacturers.
            (3) Final determination.--The determination of the 
        Secretary as to the amount and allocation of a surcharge under 
        this subtitle shall be final and the manufacturer shall pay 
        such surcharge within 10 days of the date on which the 
        manufacturer is assessed. Such payment shall be retained by the 
        Secretary pending final judicial review of what, if any, change 
        in the surcharge is appropriate.
            (4) Compliance by certain manufacturers.--A manufacturer 
        that individually complies with the goal under subsection (a) 
        shall not be liable for the payment of any portion of the 
        penalty under this subsection.
            (5) Limitation.--With respect to cigarettes, a manufacturer 
        with a market share of 1 percent or less of youth cigarette use 
        shall not be liable for the payment of a surcharge under this 
        section.
    (c) Penalties Nondeductible.--The payment of penalties under this 
subtitle shall not be considered to be an ordinary and necessary 
expense in carrying on a trade or business for purposes of the Internal 
Revenue Code of 1986 and shall not be deductible.
    (d) Judicial Review.--
            (1) After payment.--A manufacturer of cigarettes may seek 
        judicial review of any action under this subtitle only after 
        the assessment involved has been paid by the manufacturer to 
        the Department of the Treasury and only in the United States 
        District Court for the District of Columbia.
            (2) Review by attorney general.--Prior to the filing of an 
        action by a manufacturer seeking judicial review of an action 
        under this subtitle, the manufacturer shall notify the Attorney 
        General of such intent to file and the Attorney General shall 
        have 30 days in which to respond to the action.
            (3) Review.--The amount of any surcharge paid under this 
        subtitle shall be subject to judicial review by the United 
        States Court of Appeals for the District of Columbia Circuit, 
        based on the arbitrary and capricious standard of section 706 
        of title 5, United States Code. Notwithstanding any other 
        provision of law, no court shall have the authority to stay any 
        surcharge payment due to the Secretary under this subtitle 
        pending judicial review until the Secretary has made or failed 
        to make a compliance determination, as described under this 
        subtitle, that has adversely affected the person seeking the 
        review.

SEC. 413. ENFORCEMENT.

    (a) Initial Penalty.--There is hereby imposed an initial penalty on 
the failure of any manufacturer to make any payment required under this 
subtitle within 10 days after the date on which such payment is due.
    (b) Amount of Penalty.--The amount of the penalty imposed by 
subsection (a) on any failure with respect to a manufacturer shall be 
an amount equal to 2 percent of the penalty owed under section 412 for 
each day during the noncompliance period.
    (c) Noncompliance Period.--For purposes of this section, the term 
``noncompliance period'' means, with respect to any failure to make the 
surcharge payment required under this subtitle, the period--
            (1) beginning on the due date for such payment; and
            (2) ending on the date on which such payment is paid in 
        fall.
    (d) Limitations.--No penalty shall be imposed by subsection (a) 
on--
            (1) any failure to make a surcharge payment under this 
        subtitle during any period for which it is established to the 
        satisfaction of the Secretary that none of the persons 
        responsible for such failure knew or, exercising reasonable 
        diligence, would have known, that such failure existed; or
            (2) any manufacturer that produces less than 1 percent of 
        cigarettes used by youth in that year (as determined by the 
        annual survey).

                       Subtitle C--Food Guidance

SEC. 421. FRONT-LABEL FOOD GUIDANCE SYSTEMS.

    (a) In General.--Not later than March 1, 2008, the Secretary of 
Health and Human Services (referred to in this section as the 
``Secretary'') shall begin solicitation of public comments regarding--
            (1) the use of retail front-label food guidance systems to 
        convey nutrition information to the public using logos, 
        symbols, signs, emblems, insignia, or other graphic 
        representations on the labeling of food intended for human 
        consumption that are intended to provide simple, standardized, 
        and understandable nutrition information to the public in 
        graphic form;
            (2) appropriate nutrition standards by which a retail 
        front-label food guidance system may convey the relative 
        nutritional value of different foods in simple graphic form; 
        and
            (3) whether American consumers would be better served by 
        establishing a single, standardized retail front-label food 
        guidance system regulated by the Food and Drug Administration, 
        or by allowing individual food companies, trade associations, 
        nonprofit organizations, and others to continue to develop 
        their own retail front-label food guidance systems.
    (b) Effect on Nutrition Facts Panel.--In soliciting public comments 
under subsection (a), the Secretary shall inform the public that any 
retail front-label food guidance system is intended to supplement, not 
replace, the Nutrition Facts Panel that appears on food labels pursuant 
to section 403(q) of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 343(q)).
    (c) Proposed Regulation.--Not later than 12 months following the 
closure of the public comment solicitation period under subsection (a), 
the Secretary shall--
            (1) publish a notice in the Federal Register that 
        summarizes the public comments and describes the suggested 
        retail front-label food guidance systems received through such 
        solicitation; and
            (2) publish proposed regulations that--
                    (A) establish a single, standardized retail front-
                label food guidance system; or
                    (B) establish the conditions under which individual 
                food companies, trade associations, nonprofit 
                organizations, and other persons may continue to 
                develop their own retail front-label food guidance 
                systems.

       TITLE V--REIMBURSEMENT AND COVERAGE OF PREVENTIVE SERVICES

SEC. 501. COVERAGE OF SUBSTANCE USE (OTHER THAN TOBACCO), DIET, 
              EXERCISE, INJURY PREVENTION, AND DENTAL HEALTH 
              COUNSELING.

    (a) Coverage.--
            (1) In general.--Section 1861(s)(2) of the Social Security 
        Act (42 U.S.C. 1395x(s)(2)), as amended by section 642(a) of 
        the Medicare Prescription Drug, Improvement, and Modernization 
        Act of 2003 (Public Law 108-173; 117 Stat. 2322), is amended--
                    (A) in subparagraph (Y), by striking ``and'' after 
                the semicolon at the end;
                    (B) in subparagraph (Z), by adding ``and'' after 
                the semicolon at the end; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(AA) substance use (other than tobacco), diet, exercise, 
        injury prevention, and dental health counseling (as defined in 
        subsection (bbb)(1));''.
            (2) Conforming amendments.--(A) Section 1862(a)(12) of the 
        Social Security Act (42 U.S.C. 1395y(a)(12)) is amended by 
        inserting ``(except as otherwise allowed under subsection 
        1861(s)(2)(AA))'' after ``directly supporting teeth''.
            (B) Clauses (i) and (ii) of section 1861(s)(2)(K) of the 
        Social Security Act (42 U.S.C. 1395x(s)(2)(K)), as amended by 
        section 611(d)(2) of the Medicare Prescription Drug, 
        Improvement, and Modernization Act of 2003 (Public Law 108-173; 
        117 Stat. 2304), are each amended by striking ``subsection 
        (ww)(1)'' and inserting ``subsections (ww)(1) and (bbb)''.
    (b) Services Described.--Section 1861 of the Social Security Act 
(42 U.S.C. 1395x), as amended by section 706(b) of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (Public 
Law 108-173; 117 Stat. 2339), is amended by adding at the end the 
following new subsection:

     ``Substance Use (Other Than Tobacco), Diet, Exercise, Injury 
                Prevention, and Dental Health Counseling

    ``(bbb) The term `substance use (other than tobacco), diet, 
exercise, injury prevention, and dental health counseling' means 
therapy and counseling relating to substance use (other than tobacco), 
diet, exercise, injury prevention, and dental health counseling that is 
furnished--
            ``(1) by or under the supervision of a physician; or
            ``(2) by any other health care professional who--
                    ``(A) is legally authorized to furnish such 
                services under State law (or the State regulatory 
                mechanism provided by State law) of the State in which 
                the services are furnished; and
                    ``(B) is authorized to receive payment for other 
                services under this title or is designated by the 
                Secretary for this purpose.''.
    (c) Payment and Elimination of Cost-Sharing.--
            (1) Payment and elimination of coinsurance.--Section 
        1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)), 
        as amended by section 302(b)(2) of the Medicare Prescription 
        Drug, Improvement, and Modernization Act of 2003 (Public Law 
        108-173; 117 Stat. 2229), is amended--
                    (A) in subparagraph (N), by inserting ``or 
                substance use (other than tobacco), diet, exercise, 
                injury prevention, and dental health counseling (as 
                defined in section 1861(bbb))'' after ``(as defined in 
                section 1848(j)(3))'';
                    (B) by striking ``and'' before ``(V)''; and
                    (C) by inserting before the semicolon at the end 
                the following: ``and (W) with respect to substance use 
                (other than tobacco), diet, exercise, injury 
                prevention, and dental health counseling (as defined in 
                section 1861(bbb) the amount paid shall be the lesser 
                of the actual charge for the services or the amount 
                determined under the payment basis determined under 
                section 1848''.
            (2) Payment under physician fee schedule.--Section 
        1848(j)(3) of the Social Security Act (42 U.S.C. 1395w-
        4(j)(3)), as amended by section 611(c) of the Medicare 
        Prescription Drug, Improvement, and Modernization Act of 2003 
        (Public Law 108-173; 117 Stat. 2304), is amended by inserting 
        ``(2)(AA),'' after ``(2)(W),''.
            (3) Elimination of coinsurance in outpatient hospital 
        settings.--
                    (A) Exclusion from opd fee schedule.--Section 
                1833(t)(1)(B)(iv) of the Social Security Act (42 U.S.C. 
                1395l(t)(1)(B)(iv)), as amended by section 614(a) of 
                the Medicare Prescription Drug, Improvement, and 
                Modernization Act of 2003 (Public Law 108-173; 117 
                Stat. 2306), is amended by striking ``and diagnostic 
                mammography'' and inserting ``, diagnostic mammography, 
                or substance use (other than tobacco), diet, exercise, 
                injury prevention, and dental health counseling (as 
                defined in section 1861(bbb))''.
                    (B) Conforming amendments.--Section 1833(a)(2) of 
                the Social Security Act (42 U.S.C. 1395l(a)(2)) is 
                amended--
                            (i) in subparagraph (F), by striking 
                        ``and'' after the semicolon at the end;
                            (ii) in subparagraph (G)(ii), by striking 
                        the comma at the end and inserting
                        ``; and''; and
                            (iii) by inserting after subparagraph 
                        (G)(ii) the following new subparagraph:
                    ``(H) with respect to substance use (other than 
                tobacco), diet, exercise, injury prevention, and dental 
                health counseling (as defined in section 1861(bbb)) 
                furnished by an outpatient department of a hospital, 
                the amount determined under paragraph (1)(W),''.
            (4) Elimination of deductible.--The first sentence of 
        section 1833(b) of the Social Security Act (42 U.S.C. 1395l(b)) 
        is amended--
                    (A) by striking ``and'' before ``(6)''; and
                    (B) by inserting before the period at the end the 
                following: ``, and (7) such deductible shall not apply 
                with respect to substance use (other than tobacco), 
                diet, exercise, injury prevention, and dental health 
                counseling (as defined in section 1861(bbb))''.
    (d) Application of Limits on Billing.--Section 1842(b)(18)(C) of 
the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by 
adding at the end the following new clause:
            ``(vii) Any health care professional designated under 
        section 1861(bbb)(2)(B) to perform substance use (other than 
        tobacco), diet, exercise, injury prevention, and dental health 
        counseling that is not otherwise described in this 
        subparagraph.''.
    (e) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 
117 Stat. 2066) and shall apply to services furnished on and after 
January 1, 2008.

SEC. 502. MEDICARE COVERAGE OF MEDICAL NUTRITION THERAPY SERVICES FOR 
              PEOPLE WITH PRE-DIABETES.

    (a) Coverage of Medical Nutrition Therapy Services.--Section 
1861(s)(2)(V) of the Social Security Act (42 U.S.C. 1395x(s)(2)(V)) is 
amended by inserting after ``beneficiary with diabetes'' the following 
``, pre-diabetes or its risk factors, including hypertension, 
dyslipidemia, or obesity''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to services furnished on or after the date of the 
enactment of this Act.

SEC. 503. PREVENTIVE MENTAL HEALTH SCREENINGS.

    (a) Coverage.--
            (1) In general.--Section 1861(s)(2) of the Social Security 
        Act (42 U.S.C. 1395x(s)(2)), as amended by section 501(a)(1), 
        is amended--
                    (A) in subparagraph (Z), by striking ``and'' after 
                the semicolon at the end;
                    (B) in subparagraph (AA), by adding ``and'' after 
                the semicolon at the end; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(BB) screenings for clinical depression, anxiety, and 
        impaired cognitive functioning (as defined in subsection 
        (ccc)(1));''.
            (2) Conforming amendments.--Clauses (i) and (ii) of section 
        1861(s)(2)(K) of the Social Security Act (42 U.S.C. 
        1395x(s)(2)(K)), as amended by section 501(a)(2)(B), are each 
        amended by striking ``and (bbb)'' and inserting ``(bbb), and 
        (ccc)''.
    (b) Services Described.--Section 1861 of the Social Security Act 
(42 U.S.C. 1395x), as amended by section 501(b), is amended by adding 
at the end the following new subsection:

 ``Screenings for Clinical Depression, Anxiety, and Impaired Cognitive 
                              Functioning

    ``(ccc)(1) The term `screening for clinical depression, anxiety, 
and impaired cognitive functioning' means a consultation for the 
purpose of detecting clinical depression, anxiety, and impaired 
cognitive functioning during which a qualified health professional (as 
defined in paragraph (2))--
            ``(A) uses a screening on the list established or 
        identified under paragraph (3);
            ``(B) assesses the individual's risk of clinical 
        depression, anxiety, and impaired cognitive functioning; and
            ``(C) if the qualified health professional determines that 
        the individual is at high risk for clinical depression, 
        anxiety, or impaired cognitive functioning, refers the 
        individual for a full diagnostic evaluation and such additional 
        treatment as may be required.
Nothing in subparagraph (C) shall be construed as prohibiting a 
qualified health professional performing the screening for clinical 
depression, anxiety, and impaired cognitive functioning with respect to 
an individual from directly providing the diagnostic evaluation and 
additional treatment described in such clause to such individual if 
such professional is legally authorized to provide such an evaluation 
and additional treatment under State law (or the State regulatory 
mechanism provided by State law) of the State in which the screening is 
performed.
    ``(2) For purposes of this subsection, the term `qualified health 
professional' means an individual who--
            ``(A) is--
                    ``(i) a physician (as defined in subsection 
                (r)(1));
                    ``(ii) a nurse practitioner (as defined in 
                subsection (aa)(5)); or
                    ``(iii) a mental health care professional 
                (including clinical psychologists (as defined by the 
                Secretary for purposes of section 1861(ii)) and 
                clinical social workers (as defined in subsection 
                1861(hh))) that is licensed or certified to perform 
                mental health services by the State in which the 
                screenings are performed; and
            ``(B) has an agreement in effect with the Secretary to 
        accept--
                    ``(i) the amount determined under section 
                1833(a)(1)(W) as full payment for screenings for 
                clinical depression, anxiety, and impaired cognitive 
                functioning; and
                    ``(ii) an assignment described in section 
                1842(b)(3)(B)(ii) with respect to payment for each 
                screening furnished by the professional to an 
                individual enrolled under part B.
    ``(3) The Secretary shall, in consultation with mental health 
professionals and other stakeholders with experience in screening for 
clinical depression, anxiety, and impaired cognitive functioning, shall 
establish or identify a list of approved screenings to be used under 
this paragraph. The Secretary, in consultation with such professionals 
and stakeholders, shall review and update such list not less frequently 
than once every 5 years.''.
    (c) Payment and Elimination of Cost-Sharing.--
            (1) Payment and elimination of coinsurance.--Section 
        1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)), 
        as amended by section 501(c)(1), is amended--
                    (A) in subparagraph (N), by striking ``or substance 
                use (other than tobacco), diet, exercise, injury 
                prevention, and dental health counseling (as defined in 
                section 1861(bbb))'' and inserting ``substance use 
                (other than tobacco), diet, exercise, injury 
                prevention, and dental health counseling (as defined in 
                section 1861(bbb)), or screenings for clinical 
                depression, anxiety, and impaired cognitive functioning 
                (as defined in section 1861(ccc))''; and
                    (B) in subparagraph (W), by inserting ``and 
                screenings for clinical depression, anxiety, and 
                impaired cognitive functioning (as defined in section 
                1861(ccc))'' after ``(as defined in section 
                1861(bbb))''.
            (2) Payment under physician fee schedule.--Section 
        1848(j)(3) of the Social Security Act (42 U.S.C. 1395w-
        4(j)(3)), as amended by section 501(c)(2), is amended by 
        inserting ``(2)(BB),'' after ``(2)(AA),''.
            (3) Elimination of coinsurance in outpatient hospital 
        settings.--
                    (A) Exclusion from opd fee schedule.--Section 
                1833(t)(1)(B)(iv) of the Social Security Act (42 U.S.C. 
                1395l(t)(1)(B)(iv)), as amended by section 
                501(c)(3)(A), is amended by striking ``or substance use 
                (other than tobacco), diet, exercise, injury 
                prevention, and dental health counseling (as defined in 
                section 1861(bbb))'' and inserting ``substance use 
                (other than tobacco), diet, exercise, injury 
                prevention, and dental health counseling (as defined in 
                section 1861(bbb)), or screenings for clinical 
                depression, anxiety, and impaired cognitive functioning 
                (as defined in section 1861(ccc))''.
                    (B) Conforming amendment.--Section 1833(a)(2)(H) of 
                the Social Security Act (42 U.S.C. 1395l(a)(2)(H)), as 
                added by section 501(c)(3)(B)(iii), is amended by 
                inserting ``and screenings for clinical depression, 
                anxiety, and impaired cognitive functioning (as defined 
                in section 1861(ccc))'' after ``(as defined in section 
                1861(bbb))''.
            (4) Elimination of deductible.--Section 1833(b)(7) of the 
        Social Security Act (42 U.S.C. 1395l(b)(7)), as amended by 
        section 501(c)(4), is amended by inserting ``or screenings for 
        clinical depression, anxiety, and impaired cognitive 
        functioning (as defined in section 1861(ccc))'' before the 
        period at the end.
    (d) Application of Limits on Billing.--Section 1842(b)(18)(C) of 
the Social Security Act (42 U.S.C. 1395u(b)(18)(C)), as amended by 
section 501(d), is amended by adding at the end the following new 
clause:
            ``(viii) A mental health care professional described in 
        section 1861(ccc)(2) that is authorized to perform screenings 
        for clinical depression, anxiety, and impaired cognitive 
        functioning (as defined in section 1861(ccc)(1)) that is not 
        otherwise described in this subparagraph.''.
    (e) Frequency.--Section 1862(a)(1) of the Social Security Act (42 
U.S.C. 1395y(a)(1)), as amended by section 613(c) of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (Public 
Law 108-173; 117 Stat. 2306), is amended--
            (1) in subparagraph (L), by striking ``and'' after the 
        comma at the end;
            (2) in subparagraph (M), by striking the semicolon at the 
        end and inserting ``, and''; and
            (3) by adding at the end the following new subparagraph:
            ``(N) in the case of screenings for clinical depression, 
        anxiety, and impaired cognitive functioning (as defined in 
        section 1861(ccc)(1)), which is performed more frequently than 
        is covered under such section;''.
    (f) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 
117 Stat. 2066) and shall apply to services furnished on and after 
January 1, 2008.

SEC. 504. ENCOURAGEMENT OF CESSATION OF TOBACCO USE.

    (a) Medicare Coverage of Counseling and Pharmacotherapy for 
Cessation of Tobacco Use.--
            (1) Coverage.--
                    (A) In general.--Section 1861(s)(2) of the Social 
                Security Act (42 U.S.C. 1395x(s)(2)), as amended by 
                section 502(a)(1), is amended--
                            (i) in subparagraph (AA), by striking 
                        ``and'' after the semicolon at the end;
                            (ii) in subparagraph (BB), by adding 
                        ``and'' after the semicolon at the end; and
                            (iii) by adding at the end the following 
                        new subparagraph:
            ``(CC) counseling and pharmacotherapy for cessation of 
        tobacco use (as defined in subsection (ddd)(1));''.
                    (B) Conforming amendments.--Clauses (i) and (ii) of 
                section 1861(s)(2)(K) of the Social Security Act (42 
                U.S.C. 1395x(s)(2)(K)), as amended by section 
                502(a)(2), are each amended by striking ``and (ccc)'' 
                and inserting ``(ccc), and (ddd)''.
            (2) Services described.--Section 1861 of the Social 
        Security Act (42 U.S.C. 1395x), as amended by section 502(b), 
        is amended by adding at the end the following new subsection:

     ``Counseling and Pharmacotherapy for Cessation of Tobacco Use

    ``(ddd)(1) Subject to paragraphs (2) and (3), the term `counseling 
and pharmacotherapy for cessation of tobacco use' means diagnostic, 
therapy, and counseling services and pharmacotherapy (including the 
coverage of prescription and nonprescription tobacco cessation agents 
approved by the Food and Drug Administration) for cessation of tobacco 
use for individuals who use tobacco products or who are being treated 
for tobacco use which are furnished--
            ``(A) by or under the supervision of a physician; or
            ``(B) by any other health care professional who--
                    ``(i) is legally authorized to furnish such 
                services under State law (or the State regulatory 
                mechanism provided by State law) of the State in which 
                the services are furnished; and
                    ``(ii) is authorized to receive payment for other 
                services under this title or is designated by the 
                Secretary for this purpose.
    ``(2) Such term is limited to--
            ``(A) services recommended in `Treating Tobacco Use and 
        Dependence: A Clinical Practice Guideline', published by the 
        Public Health Service in June 2000, or any subsequent 
        modification of such Guideline; and
            ``(B) such other services that the Secretary recognizes to 
        be effective.
    ``(3) Each individual who is described in paragraph (1) and 
enrolled under part B shall be eligible for the services described in 
this subsection for up to 3 attempts to cease the use of tobacco.''.
            (3) Payment and elimination of cost-sharing.--
                    (A) Payment and elimination of coinsurance.--
                Section 1833(a)(1) of the Social Security Act (42 
                U.S.C. 1395l(a)(1)), as amended by section 502(c)(1), 
                is amended--
                            (i) in subparagraph (N) by striking ``or 
                        screenings for clinical depression, anxiety, 
                        and impaired cognitive functioning (as defined 
                        in section 1861(ccc))'' and inserting ``, 
                        screenings for clinical depression, anxiety, 
                        and impaired cognitive functioning (as defined 
                        in section 1861(ccc)), or counseling and 
                        pharmacotherapy for cessation of tobacco use 
                        (as defined in section 1861(ddd))''; and
                            (ii) in subparagraph (W), by striking ``and 
                        screenings for clinical depression, anxiety, 
                        and impaired cognitive functioning (as defined 
                        in section 1861(ccc))'' and inserting 
                        ``screenings for clinical depression, anxiety, 
                        and impaired cognitive functioning (as defined 
                        in section 1861(ccc)), and counseling and 
                        pharmacotherapy for cessation of tobacco use 
                        (as defined in section 1861(ddd))''.
                    (B) Payment under physician fee schedule.--Section 
                1848(j)(3) of the Social Security Act (42 U.S.C. 1395w-
                4(j)(3)), as amended by section 502(c)(2), is amended 
                by inserting ``(2)(CC) (with separate payment amounts 
                for pharmacotherapy, including prescription and 
                nonprescription tobacco cessation agents approved by 
                the Food and Drug Administration),'' after 
                ``(2)(BB),''.
                    (C) Elimination of coinsurance in outpatient 
                hospital settings.--
                            (i) Exclusion from opd fee schedule.--
                        Section 1833(t)(1)(B)(iv) of the Social 
                        Security Act (42 U.S.C. 1395l(t)(1)(B)(iv)), as 
                        amended by section 502(c)(3)(A), is amended by 
                        striking ``or screenings for clinical 
                        depression, anxiety, and impaired cognitive 
                        functioning (as defined in section 1861(ccc))'' 
                        and inserting ``screenings for clinical 
                        depression, anxiety, and impaired cognitive 
                        functioning (as defined in section 1861(ccc)), 
                        or counseling and pharmacotherapy for cessation 
                        of tobacco use (as defined in section 
                        1861(ddd))''.
                            (ii) Conforming amendment.--Section 
                        1833(a)(2)(H) of the Social Security Act (42 
                        U.S.C. 1395l(a)(2)(H)), as added by section 
                        502(c)(3)(B), is amended by striking ``and 
                        screenings for clinical depression, anxiety, 
                        and impaired cognitive functioning (as defined 
                        in section 1861(ccc))'' and inserting 
                        ``screenings for clinical depression, anxiety, 
                        and impaired cognitive functioning (as defined 
                        in section 1861(ccc)), and counseling and 
                        pharmacotherapy for cessation of tobacco use 
                        (as defined in section 1861(ddd))''.
                    (D) Elimination of deductible.--Section 1833(b)(7) 
                of the Social Security Act (42 U.S.C. 1395l(b)(7)), as 
                added by section 502(c)(4), is amended by striking ``or 
                screenings for clinical depression, anxiety, and 
                impaired cognitive functioning (as defined in section 
                1861(ccc))'' and inserting ``screenings for clinical 
                depression, anxiety, and impaired cognitive functioning 
                (as defined in section 1861(ccc)), or counseling and 
                pharmacotherapy for cessation of tobacco use (as 
                defined in section 1861(ddd))''.
            (4) Application of limits on billing.--Section 
        1842(b)(18)(C) of the Social Security Act (42 U.S.C. 
        1395u(b)(18)(C)), as amended by section 502(d), is amended by 
        adding at the end the following new clause:
            ``(ix) Any individual designated by the Secretary under 
        section 1861(ddd)(1)(B)(ii).''.
            (5) Frequency.--Section 1862(a)(1) of the Social Security 
        Act (42 U.S.C. 1395y(a)(1)), as amended by section 502(e), is 
        amended--
                    (A) in subparagraph (M), by striking ``and'' after 
                the comma at the end;
                    (B) in subparagraph (N), by striking the semicolon 
                at the end and inserting ``, and''; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(O) in the case of counseling and pharmacotherapy for 
        cessation of tobacco use (as defined in section 1861(ddd)), 
        which is performed with respect to more attempts to cease 
        tobacco use than is covered under such section;''.
    (b) Promoting Cessation of Tobacco Use Under the Medicaid 
Program.--
            (1) Dropping exception from medicaid prescription drug 
        coverage for tobacco cessation medications.--Section 1927(d)(2) 
        of the Social Security Act (42 U.S.C. 1396r-8(d)(2)) is 
        amended--
                    (A) by striking subparagraph (E);
                    (B) by redesignating subparagraphs (F) through (J) 
                as subparagraphs (E) through (I), respectively; and
                    (C) in subparagraph (F) (as redesignated by 
                paragraph (2)), by inserting before the period at the 
                end the following: ``, except agents approved by the 
                Food and Drug Administration for purposes of promoting, 
                and when used to promote, tobacco cessation''.
            (2) Requiring coverage of tobacco cessation counseling and 
        pharmacotherapy services for pregnant women.--Section 
        1905(a)(4) of the Social Security Act (42 U.S.C. 1396d(a)(4)) 
        is amended--
                    (A) by striking ``and'' before ``(C)''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``; and (D) counseling and 
                pharmacotherapy for cessation of tobacco use (as 
                defined in section 1861(ddd)) for pregnant women''.
            (3) Removal of cost-sharing for tobacco cessation 
        counseling and pharmacotherapy services for pregnant women.--
        Section 1916 of the Social Security Act (42 U.S.C. 1396o) is 
        amended in each of subsections (a)(2)(B) and (b)(2)(B), by 
        inserting ``, and counseling for cessation of tobacco use (as 
        defined in section 1861(ddd))'' after ``complicate the 
        pregnancy''.
    (c) Coverage Under FEHBP.--The last sentence of section 8904(a) of 
title 5, United States Code, is amended by striking ``both for costs 
associated with care in a general hospital and for other health 
services of a catastrophic nature'' and inserting ``for costs 
associated with care in a general hospital, for other health services 
of a catastrophic nature, and for counseling and pharmacotherapy for 
cessation of tobacco use (as defined in section 1861(ddd)(1) of the 
Social Security Act)''.
    (d) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 
117 Stat. 2066) and shall apply to services furnished on and after 
January 1, 2008.

SEC. 505. RECOGNITION OF SCHOOL-BASED HEALTH CENTERS AS MODEL FOR 
              DELIVERY OF PRIMARY CARE FOR CHILDREN UNDER THE MEDICAID 
              AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS.

    (a) In General.--Title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) is amended by inserting after section 1911 the following:

                     ``school-based health centers

    ``Sec. 1911A. Not later than 12 months after the date of enactment 
of this section, the Secretary shall establish procedures to encourage 
a State program established under this title, title XXI, or both, to 
recognize school-based health centers as a model of delivery for 
primary care for children who are eligible for medical assistance under 
this title or child health assistance under title XXI. Such procedures 
shall include the following:
            ``(1) Recognition of, and reimbursement for, services 
        provided through school-based health centers.--Procedures that 
        encourage a State to recognize as primary care providers under 
        this title and title XXI, providers who furnish physical or 
        mental health services that are available as medical assistance 
        under this title or child health assistance under title XXI to 
        children who are eligible for such assistance through school-
        based health centers, and to reimburse such providers or 
        centers (as appropriate) for furnishing such services to such 
        children.
            ``(2) Exceptions to the `free care' rule.--Procedures that 
        allow a State the option to permit school-based health centers 
        to bill the State for physical or mental health services that 
        are available as medical assistance under this title or child 
        health assistance under title XXI and that are furnished to 
        children who are eligible for such assistance through such 
        centers without billing all children who are provided such 
        services.
            ``(3) Exceptions to the `third party liability' cost 
        avoidance policy.--Procedures that encourage a State to include 
        physical or mental health services that are available as 
        medical assistance under this title and that are provided 
        through school-based health centers in the list of diagnosis 
        billing codes for preventive pediatric care services that the 
        State will pay for under this title and then seek reimbursement 
        from any liable third party in accordance with the requirements 
        of section 1902(a)(25).
            ``(4) Assurance of payment for services covered by a 
        contract with a managed care entity.--Procedures that encourage 
        a State to include in any contract entered into with a managed 
        care entity (as defined in section 1932(a)(1)(B)) under this 
        title or title XXI provisions which ensure that the entity will 
        make prompt payment to a school-based health center for 
        furnishing physical or mental health services to a child who is 
        eligible for medical assistance under this title or child 
        health assistance under title XXI that are within the scope of 
        items and services for which benefits are available with 
        respect to the child under the contract between the entity and 
        the State (or to a provider who furnishes such services to such 
        a child through a school-based health center), regardless of 
        whether the center (or provider) is a participating provider 
        with respect to such entity, at a rate established by the 
        entity for such services that is not less than the level and 
        amount of payment which the entity would make for the services 
        if the services were furnished by a participating provider.''.
    (b) Report to Congress.--Not later than 36 months after the date of 
enactment of this section, the Secretary of Health and Human Services 
shall submit a report to Congress on the effectiveness of the 
procedures established in accordance with section 1911A of the Social 
Security Act (as added by subsection (a)) in encouraging the use of 
school-based health centers for the delivery of primary care physical 
and mental health services to children who are eligible for medical 
assistance under title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) or child health assistance under title XXI of such Act (42 
U.S.C. 1397aa et seq.), together with such recommendations for 
administrative or legislative action as the Secretary determines to be 
appropriate.

SEC. 506. PREVENTIVE HEALTH CARE DEMONSTRATION PROGRAM.

    (a) Establishment.--
            (1) In general.--Not later than 18 months after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services (in this section referred to as the ``Secretary'') 
        shall conduct a 5-year demonstration program under part B of 
        title XVIII of the Social Security Act under which the 
        Secretary establishes demonstration projects to contract with 
        appropriate entities to provide preventive health care to 
        eligible beneficiaries through the development and 
        implementation of a disease prevention plan (as described in 
        subsection (b)).
            (2) Sites.--The Secretary shall designate at least 2 sites 
        at which to conduct the demonstration program under this 
        section, of which--
                    (A) 1 shall be in an urban area; and
                    (B) 1 shall be in a rural area.
            (3) Number of eligible beneficiaries.--Each demonstration 
        project site under this section shall consist of at least 1,000 
        eligible beneficiaries representative of the population of 
        individuals entitled to benefits under part A of title XVIII of 
        the Social Security Act, and enrolled under part B of such 
        title. The Secretary may expand the population as needed to 
        measure statistical significance.
            (4) Identifying eligible beneficiaries.--The Secretary 
        shall develop a method for identifying eligible beneficiaries 
        who may benefit from the demonstration program and communicate 
        with them regarding their eligibility.
            (5) Voluntary participation.--Participation of health care 
        providers, and individual beneficiaries, in the demonstration 
        program shall be voluntary.
    (b) Disease Prevention Plan.--
            (1) In general.--The disease prevention plan described in 
        this subsection is a plan, developed in consultation with an 
        eligible beneficiary participating in the demonstration 
        program, to mitigate the risk factors associated with a 
        particular disease.
            (2) Plan contents.--The disease prevention plan should 
        include the following:
                    (A) Point of contact.--The disease prevention plan 
                shall provide for a point of contact responsible for 
                communicating with the participating beneficiary and 
                with other health care providers on behalf of such 
                beneficiary.
                    (B) Personal health care.--The disease prevention 
                plan shall provide for instruction on personal health 
                care.
                    (C) Physician and health care provider training.--
                The disease prevention plan shall provide for the 
                training of physicians or other health care providers 
                in the communication of relevant clinical information.
                    (D) Monitoring technology.--The disease prevention 
                plan may provide for necessary monitoring technology to 
                facilitate the exchange of information, including 
                information such as vital signs, symptoms, and health 
                self assessments.
    (c) Program Standards and Criteria.--The Secretary shall establish 
performance standards for the demonstration program under this section, 
including best practices for the prevention of chronic diseases. Such 
practices shall be standardized to the greatest extent possible. The 
eligibility of entities or individuals to enter into a contract to 
provide preventive health care under the demonstration program shall be 
conditioned, at a minimum, on performance that meets or exceeds such 
standards.
    (d) Payment.--The Secretary shall develop a method and level of 
payment for entities that participate in the program under this section 
based on best practices, as determined by the Secretary.
    (e) Waiver Authority.--The Secretary may waive such requirements of 
titles XI and XVIII of the Social Security Act as may be necessary to 
carry out the purposes of the demonstration program under this section.
    (f) Evaluation and Report.--
            (1) Evaluation.--The Secretary shall conduct evaluations 
        of--
                    (A) the benefits due to a reduction, if any, in 
                disease incidence for participants in the demonstration 
                projects compared to the medicare population as a 
                whole, as determined by the use of appropriate 
                statistical techniques;
                    (B) the long term cost effectiveness of the 
                demonstration projects to the medicare program in terms 
                of acute care costs avoided due to disease prevention; 
                and
                    (C) patient satisfaction under the demonstration 
                projects.
            (2) Report.--Not later than 6 months after the date on 
        which the demonstration program under this section ends, the 
        Secretary shall prepare and submit to Congress a report on the 
        demonstration program together with--
                    (A) recommendations on whether the demonstration 
                program should be expanded in terms of its success in 
                disease prevention and the cost effectiveness of the 
                demonstration program; and
                    (B) such recommendations for legislation or 
                administrative action as the Secretary determines 
                appropriate.
    (g) Funding.--The Secretary shall provide for the transfer from the 
Federal Supplementary Medical Insurance Trust Fund under section 1841 
of the Social Security Act (42 U.S.C. 1395t) of such funds, not to 
exceed $50,000,000, as are necessary for the costs of carrying out the 
demonstration program under this Act.
    (h) Definitions.--In this section:
            (1) Appropriate entity.--The term ``appropriate entity'' 
        means--
                    (A) a chronic care improvement program;
                    (B) a hospital; and
                    (C) any other entity that the Secretary determines 
                appropriate based on clinical, financial, or other 
                requirements appropriate to carry out the purposes of 
                the demonstration program under this section.
            (2) Eligible beneficiary.--The term ``eligible 
        beneficiary'' means an individual who--
                    (A) is entitled to benefits under part A of title 
                XVIII of the Social Security Act or enrolled under part 
                B of such title; and
                    (B) has 2 or more risk factors associated with--
                            (i) chronic obstructive pulmonary disease;
                            (ii) diabetes; or
                            (iii) any other chronic condition that the 
                        Secretary determines would be appropriate for 
                        the purpose of providing significant potential 
                        cost benefits to the medicare program through 
                        the prevention of such condition.

SEC. 507. PREVENTIVE HEALTH SERVICES FOR WOMEN.

    Section 1509 of the Public Health Service Act (42 U.S.C. 300n-4a) 
is amended to read as follows:

``SEC. 1509. ESTABLISHMENT OF PROGRAM FOR ADDITIONAL PREVENTIVE HEALTH 
              SERVICES.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, may, through a 
competitive review process, award grants to States that have received 
grants under section 1501 for a fiscal year, to enable such State to 
carry out programs--
            ``(1) to provide preventive health services, in addition to 
        the services authorized in such section 1501, for diseases such 
        as cardiovascular diseases, osteoporosis, and obesity;
            ``(2) to provide screenings, such as screening for blood 
        pressure, cholesterol, and osteoporosis, and other services 
        that the Secretary, acting through the Director of the Centers 
        for Disease Control and Prevention, determines to be 
        appropriate and feasible;
            ``(3) for health education, counseling, and interventions 
        for behavioral risk factors, such as physical inactivity and 
        poor nutrition, and diseases referred to in paragraph (1);
            ``(4) to provide appropriate referrals for medical 
        treatment of women receiving services pursuant to paragraph (1) 
        through (3), and ensuring, to the extent practicable, the 
        provision of appropriate follow-up services; and
            ``(5) to evaluate the activities conducted under paragraphs 
        (1) through (4) through appropriate surveillance, research, or 
        program monitoring activities.
    ``(b) Status as Participant in Program Regarding Breast and 
Cervical Cancer.--The Secretary may not make a grant to a State under 
subsection (a) unless the State involved agrees that services under the 
grant will be provided in conjunction with entities that are screening 
women for breast or cervical cancer pursuant to a grant under section 
1501.
    ``(c) Applicability of Provisions.--The provisions of this title 
shall apply to a grant under subsection (a) to the same extent and in 
the same manner as such provisions apply to a grant under section 1501.
    ``(d) Funding.--
            ``(1) In general.--There is authorized to be appropriated 
        such sums as may be necessary to carry out this section for 
        fiscal year 2008 and for each subsequent fiscal year.
            ``(2) Limitation regarding funding with respect to breast 
        and cervical cancer.--No additional resources shall be 
        appropriated for a fiscal year under paragraph (1) unless the 
        amount appropriated under section 1510(a) for such fiscal year 
        is at least $173,920,000.''.

SEC. 508. PROMOTING CESSATION OF TOBACCO USE BY PREGNANT WOMEN UNDER 
              THE MEDICAID PROGRAM.

    (a) Requiring Coverage of Counseling and Pharmacotherapy for 
Cessation of Tobacco Use by Pregnant Women.--Section 1905 of the Social 
Security Act (42 U.S.C. 1396d(a)(4)) is amended--
            (1) in subsection (a)(4)--
                    (A) by striking ``and'' before ``(C)''; and
                    (B) by inserting before the semicolon at the end 
                the following new subparagraph: ``; and (D) counseling 
                and pharmacotherapy for cessation of tobacco use by 
                pregnant women (as defined in subsection (y))''; and
            (2) by adding at the end the following:
    ``(y)(1) For purposes of this title, the term `counseling and 
pharmacotherapy for cessation of tobacco use by pregnant women' means 
diagnostic, therapy, and counseling services and pharmacotherapy 
(including the coverage of prescription and nonprescription tobacco 
cessation agents approved by the Food and Drug Administration) for 
cessation of tobacco use by pregnant women who use tobacco products or 
who are being treated for tobacco use that is furnished--
            ``(A) by or under the supervision of a physician; or
            ``(B) by any other health care professional who--
                    ``(i) is legally authorized to furnish such 
                services under State law (or the State regulatory 
                mechanism provided by State law) of the State in which 
                the services are furnished; and
                    ``(ii) is authorized to receive payment for other 
                services under this title or is designated by the 
                Secretary for this purpose.
    ``(2) Subject to paragraph (3), such term is limited to--
            ``(A) services recommended with respect to pregnant women 
        in `Treating Tobacco Use and Dependence: A Clinical Practice 
        Guideline', published by the Public Health Service in June 
        2000, or any subsequent modification of such Guideline; and
            ``(B) such other services that the Secretary recognizes to 
        be effective for cessation of tobacco use by pregnant women.
    ``(3) Such term shall not include coverage for drugs or biologicals 
that are not otherwise covered under this title.''.
    (b) Exception From Optional Restriction Under Medicaid Prescription 
Drug Coverage.--Section 1927(d)(2) of the Social Security Act (42 
U.S.C. 1396r-8(d)(2)) is amended--
            (1) in subparagraph (E), by inserting before the period at 
        the end the following: ``, except in the case of pregnant women 
        when recommended in accordance with the Guideline referred to 
        in section 1905(y)(2)(A)''; and
            (2) in subparagraph (G), by inserting before the period at 
        the end the following: ``, except, in the case of pregnant 
        women when recommended in accordance with the Guideline 
        referred to in section 1905(y)(2)(A), agents approved by the 
        Food and Drug Administration for purposes of promoting, and 
        when used to promote, tobacco cessation''.
    (c) Removal of Cost-Sharing for Counseling and Pharmacotherapy for 
Cessation of Tobacco Use by Pregnant Women.--
            (1) General cost sharing limitations.--Section 1916 of the 
        Social Security Act (42 U.S.C. 1396o) is amended in each of 
        subsections (a)(2)(B) and (b)(2)(B) by inserting ``, and 
        counseling and pharmacotherapy for cessation of tobacco use by 
        pregnant women (as defined in section 1905(y)) and covered 
        outpatient drugs (as defined in subsection (k)(2) of section 
        1927 and including nonprescription drugs described in 
        subsection (d)(2) of such section) that are prescribed for 
        purposes of promoting, and when used to promote, tobacco 
        cessation by pregnant women in accordance with the Guideline 
        referred to in section 1905(y)(2)(A)'' after ``complicate the 
        pregnancy''.
            (2) Application to alternative cost sharing.--Section 
        1916A(b)(3)(B)(iii) of such Act (42 U.S.C. 1396o-
        1(b)(3)(B)(iii)) is amended by inserting ``, and counseling and 
        pharmacotherapy for cessation of tobacco use by pregnant women 
        (as defined in section 1905(y))'' after ``complicate the 
        pregnancy''.
    (d) Increased FMAP for Tobacco Cessation Counseling Services and 
Medications.--The first sentence of section 1905(b) of the Social 
Security Act (42 U.S.C. 1396d(b)) is amended by inserting the following 
before the period: ``, and medical assistance provided for counseling 
and pharmacotherapy for cessation of tobacco use by pregnant women (as 
defined in subsection (y)) and for covered outpatient drugs (as defined 
in subsection (k)(2) of section 1927 and including nonprescription 
drugs described in subsection (d)(2) of such section) that are 
prescribed for purposes of promoting, and when used to promote, tobacco 
cessation by pregnant women in accordance with the Guideline referred 
to in subsection (y)(2)(A)''.
    (e) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after the first fiscal year quarter 
that begins after the date of enactment of this Act.

 TITLE VI--HELP (HEALTHY LIFESTYLES AND PREVENTION) AMERICA TRUST FUND

SEC. 601. HELP (HEALTHY LIFESTYLES AND PREVENTION) AMERICA TRUST FUND.

    (a) Creation of Trust Fund.--There is established in the Treasury 
of the United States a trust fund to be known as the `HeLP (Healthy 
Lifestyles and Prevention) America Trust Fund' (referred to in this 
section as the `Trust Fund'), consisting of such amounts as may be 
appropriated or credited to the Trust Fund as provided in this section.
    (b) Transfers to Trust Fund.--There is hereby appropriated to the 
Trust Fund an amount equivalent to--
            (1) the increase in revenues received in the Treasury as 
        the result of the amendment made by section 405 of this Act,
            (2) the increase in revenues received in the Treasury as 
        the result of the amendments made by title II of this Act, and
            (3) the receipts paid by tobacco companies under subtitle B 
        of title III of this Act.
    (c) Distribution of Amounts in Trust Fund.--
            (1) Mandatory expenditures.--On a fiscal year basis 
        (beginning with fiscal year 2008) and without further 
        appropriation the Secretary of the Treasury shall distribute 
        from amounts in the Trust Fund such amounts as are necessary to 
        provide for the Federal expenditures attributable to the 
        following:
                    (A) The amendments made to the Fruit and Vegetable 
                Program by section 201 of this Act.
                    (B) Smoking cessation drugs under title XIX of the 
                Social Security Act as identified by the Secretary of 
                Health and Human Services.
                    (C) Coverage of smoking cessation under the Federal 
                Employee Health Benefits Program under chapter 89 of 
                title 5, United States Code (as amended by section 
                503).
                    (D) The amendments made to the medicare program 
                under title XVIII of the Social Security Act by 
                sections 501 and 502 of this Act.
                    (E) The preventive health care demonstration 
                program carried out under section 505 of this Act.
        Such amounts shall be in addition to any other amounts 
        appropriated for such purposes.
            (2) Discretionary expenditures.--Amounts in the Trust Fund 
        not to exceed $2,050,000,000 shall be available, as provided in 
        appropriation Acts, for each fiscal year (beginning with fiscal 
        year 2008) only for purposes of making expenditures to carry 
        out the following:
                    (A) School nutrition environment enhancement grants 
                under section 18(l) of the Richard B. Russell National 
                School Lunch Act (as added by section 203).
                    (B) Mental health services in schools under 
                paragraphs (7) and (8) of section 5541(c) of the 
                Elementary and Secondary Education Act of 1965 (as 
                added by section 204).
                    (C) The Baby-Friendly Hospital Initiative carried 
                out under section 205 of this Act.
                    (D) The grant program to strengthen families and 
                build children's resilience carried out under section 
                520K of the Public Health Service Act (as added by 
                section 206).
                    (E) The reservation for early Head Start programs 
                under section 640(a)(6)(A) of the Head Start Act (as 
                amended by section 207).
                    (F) Community grants to prevent and reduce the 
                incidence of chronic disease under section 399P of the 
                Public Health Service Act (as added by section 313).
                    (G) Living well with a disability and working well 
                with a disability programs under sections 399Q and 399R 
                of the Public Health Service Act (as added by section 
                312).
                    (H) The amendments made to title 23, United States 
                Code, by section 313 of this Act and the nonmotorized 
                transportation pilot program carried out under section 
                313(d).
                    (I) The national assessment of mental health needs 
                program carried out under section 506C of the Public 
                Health Service Act (as added by section 314).
                    (J) The preventive medicine and public health 
                training grant program carried out under section 747A 
                of the Public Health Service Act (as added by section 
                315).
                    (K) Federal-State tobacco counter-advertising 
                programs under section 399S of the Public Health 
                Service Act (as added by section 406).
                    (L) Preventive health services for women, including 
                well-integrated screening and evaluation for women 
                across the Nation, under section 1509 of the Public 
                Health Service Act (as added by section 506).
                    (M) Carol M. White Physical Education Program under 
                subpart 10 of part D of title V of the Elementary and 
                Secondary Education Act of 1965.
                    (N) Research regarding obesity under section 101 of 
                this Act.
                    (O) Expanded Food and Nutrition Education Program 
                under section 3175 of title 23, United States Code.
                    (P) The following programs under the authority of 
                the Secretary of Health and Human Services through the 
                Centers for Disease Control and Prevention:
                            (i) Nutrition and physical activity grants.
                            (ii) Division of Adolescent and School 
                        Health.
                            (iii) Verb Campaign.
                            (iv) Prevention research centers.
                            (v) 5-a-day programs.
                            (vi) Steps to a healthier United States.
                    (Q) Access to local foods and school gardens, as 
                authorized by section 122 of the Child Nutrition and 
                WIC Reauthorization Act of 2004 (Public Law 108-265).
    (d) Application of Certain Rules.--For purposes of this section, 
rules similar to the rules of sections 9601 and 9602 of the Internal 
Revenue Code of 1986 shall apply.

                          TITLE VII--RESEARCH

SEC. 701. EXPANSION OF RESEARCH REGARDING OBESITY.

    The Secretary of Health and Human Services shall, based on the 
conclusions of the United States Preventive Services Task Force on 
Obesity, conduct research on obesity prevention, treatment, and control 
with regard to the following:
            (1) The effectiveness of physical activity and dietary 
        counseling with children and adolescents in the primary care 
        setting to prevent, treat, and control obesity.
            (2) The cost-effectiveness of intensive dietary and 
        physical activity counseling to prevent, treat, and control 
        obesity in a variety of populations.
            (3) The effectiveness of dietary and physical activity 
        counseling among children and adolescents, low income 
        populations, and minority groups in the primary care setting to 
prevent, treat, and control obesity.
            (4) The effectiveness of the assessment of obesity by a 
        primary care physician and subsequent referral for obesity 
        counseling to a nonaffiliated obesity expert or specialist.

SEC. 702. INCORPORATION OF PHYSICAL ACTIVITY INTO FEDERAL PROGRAMS.

    (a) Study.--The Secretary of Health and Human Services, in 
collaborate with the Secretary of Education the Director of the Centers 
for Disease Control and Prevention, shall enter into a contract with 
the Institute of Medicine of the National Academy of Sciences for the 
conduct of a study to examine and make recommendations concerning the 
various means that could be employed to incorporate physical activity 
into Head Start and childcare settings, elementary, middle and high 
school settings, and before- and after-school programs. The Institute 
of Medicine shall submit to Congress a report concerning the results of 
such study.
    (b) Classification.--The Commissioner of Food and Drugs shall 
conduct a review of the classification of sodium and partially 
hydrogenated oil as a Generally Recognized as Safe (GRAS) ingredient 
based on new scientific developments.
    (c) Reducing Sodium Intake.--The Secretary of Health and Human 
Services shall enter into a contract with the Institute of Medicine of 
the National Academy of Sciences for the conduct of a study and the 
development of recommendations on various means that could be employed 
to reduce dietary sodium intake to recommended levels and food 
reformulation approaches.
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