II 

110TH CONGRESS 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Healthy Lifestyles and Prevention America Act’’ or the 

6 ‘‘HeLP America Act’’. 

7 (b) TABLE OF CONTENTS.—The table of contents of 

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 


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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. 

Sec. 323. Definition of Secretary. 

SUBCHAPTER A—NATIONAL PROGRAM PROMOTING LIFELONG ACTIVE

COMMUNITIES

Sec. 331. Development of community play index. 

Sec. 332. Sense of the Senate regarding funding. 

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 


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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. 

1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Health care costs in the United States are 

4 rising rapidly. Per capita health spending in the 

5 United States is 56 percent higher than the median 


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1 country that is a member of the Organization for 

2 Economic Cooperation and Development. 

3 (2) According to the Centers for Medicare and 

4 Medicaid Services, total health care spending in the 

5 United States in 2004 was $1,800,000,000,000 and 

6 is expected to rise to $3,600,000,000,000 by 2014. 

7 Furthermore, chronic disease accounts for approxi8 mately 75 percent of health care costs annually. 

9 (3) The United States spends less than 2 per10 cent of annual health care expenditures on preven11 tion 

12 (4) Reducing and preventing the incidence of 

13 chronic disease is one means by which to reduce 

14 health care costs in the United States. 

15 (5) More than 1,700,000 Americans die of a 

16 chronic disease each year, accounting for nearly 70 

17 percent of all deaths in the United States. 

18 (6) The economic impact of chronic disease can 

19 be seen in the annual costs associated with cardio20 vascular disease and stroke ($352,000,000,000), 

21 obesity ($117,000,000,000), cancer 

22 ($171,600,000,000), and diabetes 

23 ($132,000,000,000). 


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1 (7) Obesity related health conditions cost em2 ployers nearly $13,000,000,000 in health care and 

3 other indirect costs. 

4 (8) Health promotion investments by employers 

5 on average yield a return of $3 for every $1 invested 

6 in a program. 

7 (9) Being overweight or obese increase the risk 

8 of diabetes, heart disease, stroke, several types of 

9 cancer and other health problems. 

10 (10) An estimated 65 percent of adults and 15 

11 percent of children and adolescents in the United 

12 States are overweight or obese. 

13 (11) The rates of obesity have doubled in chil14 dren and tripled in teens since the 1980’s. 

15 (12) Almost 40 percent of Americans are sedentary. More than 1 16 ⁄3 of young people in grades 9 

17 through 12 do not regularly engage in vigorous-in18 tensity physical activity. 

19 (13) Only 1 in 5 young people eat the rec20 ommended 5 daily servings of fruits and vegetables. 

21 (14) Food and beverage advertisers collectively 

22 spend $10,000,000,000 to $12,000,000,000 a year 

23 to reach children and youth. 


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1 (15) Between 1977 and 1995, trips made by 

2 walking declined by 40 percent for adults while driv3 ing trips increased to almost 90 percent of the total. 

4 (16) Virtually all-new users of tobacco products 

5 are under the minimum legal age to purchase such 

6 products. Every day in America, more than 4,000 

7 kids try their first cigarette. Another 2,000 children 

8 become new daily smokers. 

9 (17) In 2002, nearly a quarter of American 

10 adults, 46,000,000 people, smoked cigarettes, includ11 ing almost 40 percent of college-aged students. 

12 (18) Research consistently shows that smoking 

13 cessation services offered as a combination of to14 bacco medication therapy and counseling can be one 

15 of the most cost-effective health interventions and 

16 can reduce smoking-related health care costs. 

17 (19) Physical and mental health are inter18 connected. Physical conditions often result in mental 

19 health complications and depression can manifest 

20 itself through physical symptoms. 

21 (20) The Surgeon General reported that mental 

22 disorders collectively account for over 15 percent of 

23 the overall burden of disease from all causes, slightly 

24 more than the burden associated with all forms of 

25 cancer. 


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1 (21) One of every 2 people who need mental 

2 health treatment in the United States does not re3 ceive it. Of children and adolescents 6 to 17 years 

4 old who need mental health services, nearly 80 per5 cent do not receive it. 

6 (22) Early screening and prevention programs 

7 in the schools can detect high risk children that are 

8 vulnerable to developing mental illness and assist in 

9 accessing appropriate services. 

10 (23) Children are at greater risk for mental 

11 health problems when they experience stressful fam12 ily circumstances such as social or economic dis13 advantage, severe marital discord, divorce, family vi14 olence, parental substance abuse or other mental dis15 order or physical illness, and parental absence due 

16 to military service, imprisonment, or death. 

17 (24) The 2003 President’s New Freedom Com18 mission on Mental Health urged a transformation of 

19 the approach to mental health in the United States, 

20 including improving the mental health of children 

21 and promoting resilience and prevention. 

22 (25) People with disabilities report substantial 

23 disparities in health compared with people without 

24 disabilities. These disparities are caused by a num25 ber of factors, including less access to health care 


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1 than individuals without disabilities. People with dis2 abilities report more days of pain, depression, and 

3 anxiety and they have higher rates of obesity. 

4 (26) Evidence shows that health promotion pro5 grams with exercise, nutrition, and wellness compo6 nents targeting people with disabilities can signifi7 cantly reduce the incidence of these conditions and 

8 lead to healthy outcomes for people with disabilities, 

9 as well as save money by reducing the frequency of 

10 medical visits. 

11 TITLE I—CHILDHOOD OBESITY 

12 SEC. 101. FEDERAL TASK FORCE ON CHILDHOOD OBESITY. 

13 Part Q of title III of the Public Health Service Act 

14 (42 U.S.C. 280h et seq.) is amended by adding at the end 

15 the following: 

16 ‘‘SEC. 399Z–1. FEDERAL TASK FORCE ON CHILDHOOD OBE17 SITY. 

18 ‘‘(a) ESTABLISHMENT.—The Secretary shall convene 

19 a Task Force on Childhood Obesity (referred to in this 

20 section as the ‘Task Force’) to— 

21 ‘‘(1) establish a government-wide strategy for 

22 preventing and reducing childhood overweight and 

23 obesity; 


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1 ‘‘(2) coordinate effective inter-agency coordina2 tion and priorities for action among Federal agen3 cies; 

4 ‘‘(3) implement and evaluate the effectiveness 

5 of such strategy; and 

6 ‘‘(4) direct the Secretary to designate a respon7 sible agency to formally monitor and report, not 

8 later than January 1, 2008, to Congress on the 

9 progress of the various entities and activities related 

10 to the recommendations included in the report of In11 stitute of Medicine entitled ‘‘Food Marketing to 

12 Children and Youth’’. 

13 ‘‘(b) MEMBERSHIP.— 

14 ‘‘(1) IN GENERAL.—The Task Force shall be 

15 composed of employees of— 

16 ‘‘(A) the Department of Health and 

17 Human Services; 

18 ‘‘(B) the Department of Agriculture; 

19 ‘‘(C) the Department of Education; 

20 ‘‘(D) the Federal Trade Commission; 

21 ‘‘(E) the Department of Transportation; 

22 and 

23 ‘‘(F) any other Federal agency that the 

24 Secretary determines appropriate. 


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1 ‘‘(2) CHAIRPERSON.—The chairperson of the 

2 Task Force shall be— 

3 ‘‘(A) an individual appointed by the Presi4 dent; and 

5 ‘‘(B) until the date that an individual is 

6 appointed under subparagraph (A), the Sec7 retary. 

8 ‘‘(c) MEETINGS.—The Task Force shall meet at the 

9 call of the chairperson. 

10 ‘‘(d) REPORT.—Not later than January 1, 2008, and 

11 on annual basis thereafter through January 1, 2013, the 

12 Task Force shall submit to the President and to the rel13 evant committees of Congress, a report that— 

14 ‘‘(1) describes the activities and efforts to pre15 vent and reduce childhood overweight and obesity 

16 conducted by the Task Force during the year to 

17 which the report relates; and 

18 ‘‘(2) evaluates the effectiveness of such activi19 ties and efforts to prevent and reduce childhood 

20 overweight and obesity.’’. 


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1 TITLE II—HEALTHIER KIDS AND 

2 SCHOOLS 

3 SEC. 201. FRESH FRUIT AND VEGETABLE PROGRAM. 

4 Section 18(g)(6)(B) of the Richard B. Russell Na5 tional School Lunch Act (42 U.S.C. 1769(g)(6)(B)) is 

6 amended— 

7 (1) by redesignating clause (ii) as clause (iv); 

8 and 

9 (2) by inserting after clause (i) the following: 

10 ‘‘(ii) ADDITIONAL MANDATORY FUND11 ING.—Out of any funds in the Treasury 

12 not otherwise appropriated, the Secretary 

13 of the Treasury shall transfer to the Sec14 retary of Agriculture to carry out and ex15 pand the program under this subsection, to 

16 remain available until expended— 

17 ‘‘(I) on October 1, 2007, 

18 $1,000,000,000; and 

19 ‘‘(II) on October 1, 2007, and on 

20 each October 1 thereafter, the amount 

21 made available for the previous fiscal 

22 year, as adjusted under clause (iii). 

23 ‘‘(iii) ADJUSTMENT.—On October 1, 

24 2007, and on each October 1 thereafter of 

25 a fiscal year the amount made available 


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1 under subclause (I) of clause (ii) shall be 

2 calculated by adjusting the amount made 

3 available for the previous fiscal year to re4 flect changes in the Consumer Price Index 

5 of the Bureau of Labor Statistics for fresh 

6 fruits and vegetables, with the adjust7 ment— 

8 ‘‘(I) rounded down to the nearest 

9 dollar increment; and 

10 ‘‘(II) based on the unrounded 

11 amounts for the preceding 12-month 

12 period.’’. 

13 SEC. 202. FOOD OF MINIMAL NUTRITIONAL VALUE. 

14 Section 10 of the Child Nutrition Act of 1966 (42 

15 U.S.C. 1779) is amended— 

16 (1) by striking the section heading and all that 

17 follows through ‘‘(a) The Secretary’’ and inserting 

18 the following: 

19 ‘‘SEC. 10. REGULATIONS. 

20 ‘‘(a) IN GENERAL.—The Secretary’’; and 

21 (2) by striking subsections (b) and (c) and in22 serting the following: 

23 ‘‘(b) FOOD OF MINIMAL NUTRITIONAL VALUE.— 

24 ‘‘(1) PROPOSED REGULATIONS.— 


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1 ‘‘(A) IN GENERAL.—Not later than 180 

2 days after the date of enactment of this para3 graph, the Secretary shall promulgate proposed 

4 regulations to revise the definition of ‘food of 

5 minimal nutritional value’ that is used to carry 

6 out this Act and the Richard B. Russell Na7 tional School Lunch Act (42 U.S.C. 1751 et 

8 seq.). 

9 ‘‘(B) APPLICATION.—The revised defini10 tion of ‘food of minimal nutritional value’ shall 

11 apply to all foods sold— 

12 ‘‘(i) outside the school meal programs; 

13 ‘‘(ii) on the school campus; and 

14 ‘‘(iii) at any time during the school 

15 day. 

16 ‘‘(C) REQUIREMENTS.—In revising the 

17 definition, the Secretary shall consider— 

18 ‘‘(i) both the positive and negative 

19 contributions of nutrients, ingredients, and 

20 foods (including calories, portion size, satu21 rated fat, trans fat, sodium, and added 

22 sugars) to the diets of children; 

23 ‘‘(ii) evidence concerning the relation24 ship between consumption of certain nutri25 ents, ingredients, and foods to both preVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 venting and promoting the development of 

2 overweight, obesity, and other chronic ill3 nesses; 

4 ‘‘(iii) recommendations made by au5 thoritative scientific organizations con6 cerning appropriate nutritional standards 

7 for foods sold outside of the reimbursable 

8 meal programs in schools; and 

9 ‘‘(iv) special exemptions for school10 sponsored fundraisers (other than fund11 raising through vending machines, school 

12 stores, snack bars, a la carte sales, and 

13 any other exclusions determined by the 

14 Secretary), if the fundraisers are approved 

15 by the school and are infrequent within the 

16 school. 

17 ‘‘(2) IMPLEMENTATION.— 

18 ‘‘(A) EFFECTIVE DATE.— 

19 ‘‘(i) IN GENERAL.—Except as pro20 vided in clause (ii), the proposed regula21 tions shall take effect at the beginning of 

22 the school year following the date on which 

23 the regulations are finalized. 

24 ‘‘(ii) EXCEPTION.—If the regulations 

25 are finalized on a date that is not more 


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1 than 60 days before the beginning of the 

2 school year, the proposed regulations shall 

3 take effect at the beginning of the fol4 lowing school year. 

5 ‘‘(B) FAILURE TO PROMULGATE.—If, on 

6 the date that is 1 year after the date of enact7 ment of this paragraph, the Secretary has not 

8 promulgated final regulations, the proposed reg9 ulations shall be considered to be final regula10 tions.’’. 

11 SEC. 203. SCHOOL NUTRITION ENVIRONMENT ENHANCE12 MENT GRANTS. 

13 Section 18 of the Richard B. Russell National School 

14 Lunch Act (42 U.S.C. 1769) is amended by adding at the 

15 end the following: 

16 ‘‘(l) HEALTHY SCHOOL NUTRITION ENVIRONMENT

17 INCENTIVE GRANTS.— 

18 ‘‘(1) IN GENERAL.—The Secretary may imple19 ment a grant program to follow the recommenda20 tions made by the Institute of Medicine report enti21 tled ‘‘Nutrition Standards for Foods in Schools22 Leading the Way Toward Healthier Youth’’ to— 

23 ‘‘(A) provide schools with technical assist24 ance in implementing the recommendations of 


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1 the Institute of Medicine regarding appropriate 

2 school nutrition standards; and 

3 ‘‘(B) assess the impact of implementing 

4 the recommendations on the health and well5 being of children enrolled in the schools. 

6 ‘‘(2) SELECTION OF SCHOOLS.—In selecting 

7 schools to receive incentive grants under this sub8 section, the Secretary shall— 

9 ‘‘(A) ensure that not less than 75 percent 

10 of schools selected to participate in the program 

11 established under this subsection are schools in 

12 which not less than 50 percent of the students 

13 enrolled in each school are eligible for free or 

14 reduced price meals under this Act; 

15 ‘‘(B) ensure that, of the schools selected to 

16 participate in the program, there is appropriate 

17 representation of rural, urban, and suburban 

18 schools, as determined by the Secretary; 

19 ‘‘(C) ensure that, of the schools selected to 

20 participate in the program, there is appropriate 

21 representation of elementary, middle, and sec22 ondary schools, as determined by the Secretary; 

23 ‘‘(D) ensure that schools selected to receive 

24 a grant under this subsection meet the require25 ments of paragraph (3); 


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1 ‘‘(E) give priority to schools that develop 

2 comprehensive plans that include the involve3 ment of a broad range of community stake4 holders in achieving healthy school nutrition en5 vironments; and 

6 ‘‘(F) give priority to schools that develop 

7 comprehensive plans that include a strategy for 

8 maintaining healthy school nutrition environ9 ments in the years following the fiscal years for 

10 which the schools receive grants under this sub11 section. 

12 ‘‘(3) REQUIREMENTS.— 

13 ‘‘(A) CRITERIA FOR HEALTHY SCHOOL EN14 VIRONMENTS.—The Secretary shall establish 

15 criteria, based upon the recommendations of the 

16 Institute of Medicine described in paragraph 

17 (1), under which schools may receive grants 

18 under this section. 

19 ‘‘(B) PLAN.—To be eligible to receive a 

20 grant under this subsection, a school shall— 

21 ‘‘(i) submit to the Secretary a healthy 

22 school nutrition environment plan that de23 scribes the actions the school will take to 

24 meet the criteria established under sub25 paragraph (A); and 


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1 ‘‘(ii) take the actions described in the 

2 plan. 

3 ‘‘(4) GRANTS.—For each of 5-fiscal years fol4 lowing the establishment of criteria by the Secretary 

5 under paragraph (3), the Secretary shall award a 

6 grant to each school selected under paragraph (2). 

7 ‘‘(5) EVALUATIONS.— 

8 ‘‘(A) IN GENERAL.—The Secretary, acting 

9 through the Administrator of the Food and Nu10 trition Service, shall conduct an evaluation of a 

11 representative sample of schools that receive 

12 grants under this subsection. 

13 ‘‘(B) CONTENT.—The evaluation shall 

14 measure, at a minimum, the effects of a healthy 

15 school nutrition environment on— 

16 ‘‘(i) overweight children and obesity; 

17 ‘‘(ii) dietary intake; 

18 ‘‘(iii) nutrition education and behav19 ior; 

20 ‘‘(iv) parental and student attitudes 

21 and participation; and 

22 ‘‘(v) related funding issues, including 

23 the cost of maintaining a healthy school 

24 nutrition environment. 


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1 ‘‘(C) REPORTS.—The Secretary shall sub2 mit to the Committee on Education and the 

3 Workforce of the House of Representatives and 

4 the Committee on Agriculture, Nutrition, and 

5 Forestry of the Senate— 

6 ‘‘(i) an interim report on the activities 

7 of schools evaluated under this subsection; 

8 and 

9 ‘‘(ii) a final report on the activities of 

10 schools evaluated under this subsection. 

11 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

12 ‘‘(A) IN GENERAL.—There are authorized 

13 to be appropriated such sums as are necessary 

14 to carry out this subsection for the 5-fiscal year 

15 following the establishment of criteria by the 

16 Secretary under paragraph (3), to remain avail17 able until expended. 

18 ‘‘(B) EVALUATIONS.—The Secretary may 

19 use not more than 10 percent of the total funds 

20 made available for a fiscal year under subpara21 graph (A) to carry out paragraph (5).’’. 

22 SEC. 204. BABY FRIENDLY HOSPITAL-CENTER FOR 

23 BREASTFEEDING EXCELLENCE. 

24 (a) ESTABLISHMENT OF PROGRAM.—The Director of 

25 the Office on Women’s Health of the Department of 


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1 Health and Human Services (referred to in this section 

2 as the ‘‘Director’’) shall establish a program to be known 

3 as the ‘‘Baby-Friendly Hospital Initiative’’ (referred to in 

4 this section as the ‘‘Initiative’’). 

5 (b) CERTIFICATION PROCESS.—Under the Initiative, 

6 the Director shall establish a certification process under 

7 which a hospital can apply for a certification as a ‘‘baby 

8 friendly hospital/center for breastfeeding excellence’’. Such 

9 certification process shall be based upon the international 

10 guidelines of the Baby-Friendly Hospital Initiative estab11 lished by the World Health Organization and United Na12 tions Children’s Fund. 

13 (c) REQUIREMENTS.— 

14 (1) IN GENERAL.—To be certified as a baby 

15 friendly hospital/center for breastfeeding excellence, 

16 a hospital (as defined for purposes of this section by 

17 the Director, and which may include birth centers) 

18 shall carry out the following: 

19 (A) The hospital shall maintain a written 

20 breastfeeding policy that is routinely commu21 nicated to all of the healthcare staff of the hos22 pital. 

23 (B) The hospital shall provide training for 

24 all healthcare staff in the skills necessary to imVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 plement the policy described in subparagraph 

2 (A). 

3 (C) The hospital shall ensure that all preg4 nant women who are patients at the hospital 

5 are informed about the benefits and manage6 ment of breastfeeding. 

7 (D) The hospital shall help mothers ini8 tiate breastfeeding within one hour of birth. 

9 (E) The hospital shall demonstrate to 

10 mothers how to breastfeed and how to maintain 

11 lactation, even if the mother is separated from 

12 her infant. 

13 (F) The hospital shall give infants no food 

14 or drink other than breastmilk, unless medically 

15 indicated. 

16 (G) The hospital shall implement a ‘‘room17 ing in’’ policy by allowing mothers and infants 

18 to remain together 24 hours a day in the same 

19 hospital room. 

20 (H) The hospital shall encourage unre21 stricted breastfeeding. 

22 (I) The hospital shall provide no pacifiers 

23 or artificial nipples to breastfeeding infants. 

24 (J) The hospital shall foster the establish25 ment of breastfeeding support groups and refer 


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1 mothers to such groups on discharge from the 

2 hospital. 

3 (2) INSPECTION.—A hospital shall be certified 

4 as a baby friendly hospital/center for breastfeeding 

5 excellence only upon the completion of an on-site as6 sessment by the Director through which the Director 

7 has determined that the hospital is in compliance 

8 with the guidelines used for certification under sub9 section (b). 

10 (3) VERIFICATION.—Upon being certified as a 

11 baby friendly hospital/center for breastfeeding excel12 lence, a hospital shall agree to permit the Director 

13 to conduct on-site assessments to verify the contin14 ued compliance of the hospital with the requirements 

15 of paragraph (1). 

16 (d) AUTHORITY FOR AUTOMATIC CERTIFICATION.— 

17 The Director may automatically certify a hospital as a 

18 baby friendly hospital/center of breastfeeding excellence if 

19 such hospital has been designated as a baby-friendly hos20 pital under the Baby-Friendly USA program. 

21 (e) LIMITATION.—A hospital shall not make any 

22 claim that such hospital is a baby friendly hospital/center 

23 of breastfeeding excellence unless such hospital has been 

24 certified by the Director in accordance with this section. 


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1 (f) TECHNICAL ASSISTANCE.—The Director shall 

2 provide, at the request of a hospital seeking a certification 

3 as a baby friendly hospital/center of breastfeeding excel4 lence, such technical assistance as appropriate to assist 

5 the requesting hospital to achieve such certification. 

6 (g) CERTIFICATION COSTS.—Subject to the avail7 ability of appropriations, the Director may provide to a 

8 hospital that has successfully been certified as a baby 

9 friendly hospital/center of breastfeeding excellence under 

10 this Act, a one time award of up to $20,000 to offset the 

11 cost to such hospital of being certified as a baby friendly 

12 hospital/center of breastfeeding excellence. 

13 (h) RECOMMENDATIONS FOR ACCREDITING ENTI14 TIES.—Not later than 12 months after certifying the first 

15 baby friendly hospital/center for breastfeeding excellence 

16 under this section, the Director shall provide to the appro17 priate organizations or entities that are engaged in the 

18 accreditation of healthcare organizations, recommenda19 tions concerning steps that such accrediting entities may 

20 take to integrate the baby friendly hospital requirements 

21 used in the Baby Friendly Hospital Initiative into 

22 healthcare organization accreditation procedures and re23 quirements. 


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1 (i) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated such sums as may be 

3 necessary to carry out this section. 

4 SEC. 205. INTERVENTION TO STRENGTHEN FAMILIES AND 

5 BUILD CHILDREN’S RESILIENCE. 

6 Part B of title V of the Public Health Service Act 

7 (42 3 U.S.C. 290bb et seq.) is amended by adding at the 

8 end the following: 

9 ‘‘SEC. 520K. INTERVENTIONS TO STRENGTHEN FAMILIES 

10 AND BUILD CHILDREN’S RESILIENCE. 

11 ‘‘(a) IN GENERAL.—The Secretary shall award 

12 grants to eligible entities for the purpose of implementing 

13 programs that strengthen families of children at risk for 

14 emotional or behavioral problems due to family distress. 

15 ‘‘(b) ELIGIBLE ENTITY.—Entities eligible to receive 

16 funds under this section may include— 

17 ‘‘(1) a local public entity, including a health de18 partment or local education agency; 

19 ‘‘(2) an Indian tribal organization or agency; 

20 ‘‘(3) a federally qualified health center; 

21 ‘‘(4) a community-based organization; or 

22 ‘‘(5) any other entity determined appropriate by 

23 the Secretary, including a consortia or partnership 

24 of entities eligible to receive funds under this sec25 tion. 


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1 ‘‘(c) USE OF FUNDS.— 

2 ‘‘(1) IN GENERAL.—An eligible entity that re3 ceives a grant under this section shall use the funds 

4 made available through the grant to carry out home5 based, school-based, and community-based activities 

6 that— 

7 ‘‘(A) promote strong, supportive families 

8 and child resilience through parenting skills 

9 training and supports, or skill-building services 

10 with children, as well as provide other consult11 ative services and support for family and other 

12 caregivers, such as child care providers, edu13 cators, and after-school program staff; 

14 ‘‘(B) enhance mental health promotion ac15 tivities in domains where children live, play, and 

16 learn; and 

17 ‘‘(C) enhance community wellness, and re18 duce the incidence of preventable mental health 

19 problems among children. 

20 ‘‘(2) INTERVENTION ACTIVITIES.—Intervention 

21 activities funded under this section shall— 

22 ‘‘(A) be consumer and family driven, and 

23 use strengths-based approaches; 

24 ‘‘(B) be designed to promote social and 

25 emotional competencies and increase children’s 


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1 ability to successfully cope with stressful life 

2 circumstances; 

3 ‘‘(C) be designed to strengthen children 

4 and their families by enhancing the knowledge, 

5 social, emotional, and other life or work skills, 

6 and support of, parents or other significant 

7 caregivers; 

8 ‘‘(D) emphasize and model a positive, sup9 portive approach to working with children; 

10 ‘‘(E) be evidence-based and provide in11 depth and ongoing training and consultation in 

12 the adoption and use of evidence-based inter13 ventions by schools, communities, and families; 

14 ‘‘(F) include a rigorous evaluation compo15 nent, including outcome measures suited to the 

16 intervention and the overall goals of the grant, 

17 as well as use of comparison groups and moder18 ating and meditating process variables when19 ever possible; 

20 ‘‘(G) involve partnerships between commu21 nities or schools and universities where possible 

22 to support effective implementation and evalua23 tion of the intervention activities; 

24 ‘‘(H) provide facilitated referrals for par25 ents and other family members who need menVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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•S 1342 IS 

1 tal health, substance abuse, or social work serv2 ices, and coordinate a referral network of pro3 fessionals with affordable fees; and 

4 ‘‘(I) emphasize local capacity-building to 

5 use evidence-based intervention, promote link6 ages among individuals and groups that serve 

7 children and families, and develop community 

8 outreach to support coalition-building. 

9 ‘‘(3) TARGET POPULATIONS.—Families targeted 

10 by these activities shall include those with children 

11 at risk for increased mental health problems due to 

12 stressful family circumstances, including— 

13 ‘‘(A) social or economic disadvantage; 

14 ‘‘(B) severe marital discord; 

15 ‘‘(C) divorce; 

16 ‘‘(D) family violence; 

17 ‘‘(E) parental substance abuse or other 

18 mental disorder or physical illness; 

19 ‘‘(F) parental death; 

20 ‘‘(G) parental absence due to military serv21 ice; 

22 ‘‘(H) parental absence due to imprison23 ment; and 

24 ‘‘(I) other family disruption determined ap25 propriate by the Secretary. 


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1 ‘‘(d) PRIORITY FUNDING.—In awarding grants under 

2 subsection (a), the Secretary shall give priority to the fol3 lowing: 

4 ‘‘(1) Entities that provide non-Federal contribu5 tions, either in cash or in kind. 

6 ‘‘(2) Entities with demonstrated experience with 

7 community-based partnerships. 

8 ‘‘(3) Entities with demonstrated experience and 

9 success with such interventions. 

10 ‘‘(4) Entities with demonstrated experience 

11 working with families. 

12 ‘‘(5) Entities that develop comprehensive plans 

13 that include a strategy for extending program activi14 ties developed under this section in the years fol15 lowing the fiscal years for which they receive grants 

16 under this section. 

17 ‘‘(6) Entities that submit plans that exhibit co18 operative plans that include the involvement of a 

19 broad range of stakeholders, including the following: 

20 ‘‘(A) Community-based organizations. 

21 ‘‘(B) Local governments. 

22 ‘‘(C) Local educational agencies. 

23 ‘‘(D) Local business and community asso24 ciations. 


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•S 1342 IS 

1 ‘‘(E) Accredited colleges, universities, and 

2 community colleges. 

3 ‘‘(F) Other entities determined appropriate 

4 by the Secretary. 

5 ‘‘(e) EVALUATION.—Of the funds appropriated to 

6 carry out this section, the Secretary may reserve up to 

7 5 percent for each fiscal year for the purpose of carrying 

8 out evaluations of the activities carried out under this sec9 tion, including a national cross-site evaluation. Within 90 

10 days of the completion of any evaluations, they shall be 

11 provided to the relevant authorizing committees and to the 

12 Committees on Appropriations of the Senate and the 

13 House of Representatives. 

14 ‘‘(f) DURATION.—The Secretary shall award grants 

15 under this section for a period of not more than 5 years. 

16 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

17 is authorized to be appropriated to carry out this section, 

18 $25,000,000 for fiscal year 2008, and such sums as may 

19 be necessary for each of fiscal years 2008 to 2012.’’. 

20 SEC. 206. GRANTS FOR THE INTEGRATION OF SCHOOLS 

21 AND MENTAL HEALTH SYSTEMS. 

22 Section 5541 of the Elementary and Secondary Edu23 cation Act of 1965 (20 U.S.C. 7269) is amended— 

24 (1) in subsection (c), by adding at the end the 

25 following: 


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1 ‘‘(7) To support schools that work with families 

2 and appropriate community partners to implement 

3 school-wide prevention strategies, based on mental 

4 health research, that will support early and intensive 

5 interventions. 

6 ‘‘(8) To provide necessary training and support 

7 to school personnel on how to recognize and seek 

8 needed support for children exhibiting early warning 

9 signs of behavioral and academic problems.’’; and 

10 (2) in subsection (d)— 

11 (A) in paragraph (4)— 

12 (i) in subparagraph (C), by striking 

13 ‘‘and’’ after the semicolon; 

14 (ii) in subparagraph (D), by striking 

15 the period and inserting ‘‘; and’’; and 

16 (iii) by adding at the end the fol17 lowing: 

18 ‘‘(E) mental health services provided under 

19 this section by schools will be evidence-based or 

20 promising early interventions.’’; and 

21 (B) by adding at the end the following: 

22 ‘‘(7) An explanation of how the applicant will 

23 carry out public education programs in support of 

24 mental health promotion and prevention by collabo25 rating with— 


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1 ‘‘(A) an institution of higher education (in2 cluding a graduate program in psychology, so3 cial work, or education at an institution of 

4 higher education); and 

5 ‘‘(B) private nonprofit community-based 

6 organizations that have experience in public 

7 education programs relating to mental health 

8 promotion and prevention.’’. 

9 SEC. 207. GRANTS FOR THE PROMOTION OF UNIVERSITY10 COMMUNITY PARTNERSHIPS TO INCREASE 

11 YOUTH COMPETENCIES AND REDUCE YOUTH 

12 PROBLEM BEHAVIORS IN OUR COMMUNITIES. 

13 (a) IN GENERAL.—The Secretary of Health and 

14 Human Services shall award grants to eligible entities for 

15 the implementation of programs that promote university16 community partnerships to implement community-based 

17 prevention strategies that will support youth competencies 

18 and prevent youth problem behaviors. 

19 (b) ELIGIBILITY.—To be eligible to receive a grant 

20 under subsection (a), an entity shall be a partnership be21 tween— 

22 (1) an institution of higher education (including 

23 a graduate program in psychology, social work, or 

24 education at an institution of higher education); and 


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•S 1342 IS 

1 (2) a private nonprofit community-based orga2 nization that has experience in prevention and inter3 ventions relating to mental health promotion and 

4 prevention. 

5 (c) USE OF FUNDS.—An entity shall use amounts re6 ceived under a grant under this section to carry out com7 munity-based activities that— 

8 (1) are comprehensive and utilize evidence9 based or promising early interventions; and 

10 (2) include an evaluation component that in11 cludes outcomes measures related to prevention ef12 forts as well as the overall goals of the grant. 

13 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

14 to be authorized to be appropriated to carry out this sec15 tion, $10,000,000 for fiscal year 2008, and such sums as 

16 may be necessary for each of fiscal years 2009 and 2010. 

17 SEC. 208. RESERVATIONS FOR EARLY HEAD START PRO18 GRAMS. 

19 Section 640(a)(6)(A) of the Head Start Act (42 

20 U.S.C. 9835(a)(6)(A)) is amended by striking ‘‘7.5 per21 cent’’ and all that follows and inserting ‘‘12 percent for 

22 fiscal year 2008, 14 percent for fiscal year 2009, 16 per23 cent for fiscal year 2010, 18 percent for fiscal year 2011, 

24 and 20 percent for fiscal year 2012, of the amount appro25 priated pursuant to section 639(a).’’. 


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1 TITLE III—HEALTHIER COMMU2 NITIES AND WORKPLACES 

3 Subtitle A—Incentives for a 

4 Healthy Workforce 

5 SEC. 301. SHORT TITLE. 

6 This subtitle may be cited as the ‘‘Healthy Workforce 

7 Act of 2007’’. 

8 SEC. 302. TAX CREDIT TO EMPLOYERS FOR COSTS OF IM9 PLEMENTING WELLNESS PROGRAMS. 

10 (a) IN GENERAL.—Subpart D of part IV of sub11 chapter A of chapter 1 of the Internal Revenue Code of 

12 1986 (relating to business related credits) is amended by 

13 adding at the end the following: 

14 ‘‘SEC. 45O. WELLNESS PROGRAM CREDIT. 

15 ‘‘(a) ALLOWANCE OF CREDIT.— 

16 ‘‘(1) IN GENERAL.—For purposes of section 38, 

17 the wellness program credit determined under this 

18 section for any taxable year during the credit period 

19 with respect to an employer is an amount equal to 

20 50 percent of the costs paid or incurred by the em21 ployer in connection with a qualified wellness pro22 gram during the taxable year. 

23 ‘‘(2) LIMITATION.—The amount of credit al24 lowed under paragraph (1) for any taxable year shall 

25 not exceed the sum of— 


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1 ‘‘(A) the product of $200 and the number 

2 of employees of the employer not in excess of 

3 200 employees, plus 

4 ‘‘(B) the product of $100 and the number 

5 of employees of the employer in excess of 200 

6 employees. 

7 ‘‘(b) QUALIFIED WELLNESS PROGRAM.—For pur8 poses of this section— 

9 ‘‘(1) QUALIFIED WELLNESS PROGRAM.—The 

10 term ‘qualified wellness program’ means a program 

11 which— 

12 ‘‘(A) consists of any 3 of the wellness pro13 gram components described in subsection (c), 

14 and 

15 ‘‘(B) which is certified by the Secretary of 

16 Health and Human Services, in coordination 

17 with the Director of the Center for Disease 

18 Control and Prevention, as a qualified wellness 

19 program under this section. 

20 ‘‘(2) PROGRAMS MUST BE CONSISTENT WITH

21 RESEARCH AND BEST PRACTICES.— 

22 ‘‘(A) IN GENERAL.—The Secretary of 

23 Health and Human Services shall not certify a 

24 program as a qualified wellness program unless 

25 the program— 


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1 ‘‘(i) is consistent with evidence-based 

2 research and best practices, as identified 

3 by persons with expertise in employer 

4 health promotion and wellness programs, 

5 ‘‘(ii) includes multiple, evidence-based 

6 strategies which are based on the existing 

7 and emerging research and careful sci8 entific reviews, including the Guide to 

9 Community Preventive Services, the Guide 

10 to Clinical Preventive Services, and the 

11 National Registry for Effective Programs, 

12 and 

13 ‘‘(iii) includes strategies which focus 

14 on employee populations with a dispropor15 tionate burden of health problems. 

16 ‘‘(B) PERIODIC UPDATING AND REVIEW.— 

17 The Secretary of Health and Human Services 

18 shall establish procedures for periodic review 

19 and recertifications of programs under this sub20 section. Such procedures shall require revisions 

21 of programs if necessary to ensure compliance 

22 with the requirements of this section and re23 quire updating of the programs to the extent 

24 the Secretary, in coordination with the Director 

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1 tion, determines necessary to reflect new sci2 entific findings. 

3 ‘‘(3) HEALTH LITERACY.—The Secretary of 

4 Health and Human Services shall, as part of the 

5 certification process, encourage employees to make 

6 the programs culturally competent and to meet the 

7 health literacy needs of the employees covered by the 

8 programs. 

9 ‘‘(c) WELLNESS PROGRAM COMPONENTS.—For pur10 poses of this section, the wellness program components de11 scribed in this subsection are the following: 

12 ‘‘(1) HEALTH AWARENESS COMPONENT.—A 

13 health awareness component which provides for the 

14 following: 

15 ‘‘(A) HEALTH EDUCATION.—The dissemi16 nation of health information which addresses 

17 the specific needs and health risks of employees. 

18 ‘‘(B) HEALTH SCREENINGS.—The oppor19 tunity for periodic screenings for health prob20 lems and referrals for appropriate follow up 

21 measures. 

22 ‘‘(2) EMPLOYEE ENGAGEMENT COMPONENT.— 

23 An employee engagement component which provides 

24 for— 


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•S 1342 IS 

1 ‘‘(A) the establishment of a committee to 

2 actively engage employees in worksite wellness 

3 programs through worksite assessments and 

4 program planning, delivery, evaluation, and im5 provement efforts, and 

6 ‘‘(B) the tracking of employee participa7 tion. 

8 ‘‘(3) BEHAVIORAL CHANGE COMPONENT.—A 

9 behavioral change component which provides for al10 tering employee lifestyles to encourage healthy living 

11 through counseling, seminars, on-line programs, or 

12 self-help materials which provide technical assistance 

13 and problem solving skills. Such component may in14 clude programs relating to— 

15 ‘‘(A) tobacco use, 

16 ‘‘(B) obesity, 

17 ‘‘(C) stress management, 

18 ‘‘(D) physical fitness, 

19 ‘‘(E) nutrition, 

20 ‘‘(F) substance abuse, 

21 ‘‘(G) depression, and 

22 ‘‘(H) mental health promotion (including 

23 anxiety). 


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1 ‘‘(4) SUPPORTIVE ENVIRONMENT COMPO2 NENT.—A supportive environment component which 

3 includes the following: 

4 ‘‘(A) ON-SITE POLICIES.—Policies and 

5 services at the worksite which promote a 

6 healthy lifestyle, including policies relating to— 

7 ‘‘(i) tobacco use at the worksite, 

8 ‘‘(ii) the nutrition of food available at 

9 the worksite through cafeterias and vend10 ing options, 

11 ‘‘(iii) minimizing stress and promoting 

12 positive mental health in the workplace, 

13 ‘‘(iv) where applicable, accessible and 

14 attractive stairs, and 

15 ‘‘(v) the encouragement of physical 

16 activity before, during, and after work 

17 hours. 

18 ‘‘(B) PARTICIPATION INCENTIVES.— 

19 ‘‘(i) IN GENERAL.—Qualified incentive 

20 benefits for each employee who participates 

21 in the health screenings described in para22 graph (1)(B) or the behavioral change pro23 grams described in paragraph (3). 

24 ‘‘(ii) QUALIFIED INCENTIVE BEN25 EFIT.—For purposes of clause (i), the 


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•S 1342 IS 

1 term ‘qualified incentive benefit’ means 

2 any benefit which is approved by the Sec3 retary of Health and Human Services, in 

4 coordination with the Director of the Cen5 ters for Disease Control and Prevention. 

6 Such benefit may include an adjustment in 

7 health insurance premiums or co-pays. 

8 ‘‘(C) EMPLOYEE INPUT.—The opportunity 

9 for employees to participate in the management 

10 of any qualified wellness program to which this 

11 section applies. 

12 ‘‘(d) PARTICIPATION REQUIREMENT.— 

13 ‘‘(1) IN GENERAL.—No credit shall be allowed 

14 under subsection (a) unless the Secretary of Health 

15 and Human Services, in coordination with the Direc16 tor of the Centers for Disease Control and Preven17 tion, certifies, as a part of any certification described 

18 in subsection (b), that each wellness program compo19 nent of the qualified wellness program applies to all 

20 qualified employees of the employer. The Secretary 

21 of Health and Human Services shall prescribe rules 

22 under which an employer shall not be treated as fail23 ing to meet the requirements of this subsection 

24 merely because the employer provides specialized 

25 programs for employees with specific health needs or 


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•S 1342 IS 

1 unusual employment requirements or provides a 

2 pilot program to test new wellness strategies. 

3 ‘‘(2) QUALIFIED EMPLOYEE.—For purposes of 

4 paragraph (1), the term ‘qualified employee’ means 

5 an employee who works an average of not less than 

6 25 hours per week during the taxable year. 

7 ‘‘(e) OTHER DEFINITIONS AND SPECIAL RULES.— 

8 For purposes of this section— 

9 ‘‘(1) EMPLOYEE AND EMPLOYER.— 

10 ‘‘(A) PARTNERS AND PARTNERSHIPS.— 

11 The term ‘employee’ includes a partner and the 

12 term ‘employer’ includes a partnership. 

13 ‘‘(B) CERTAIN RULES TO APPLY.—Rules 

14 similar to the rules of section 52 shall apply. 

15 ‘‘(2) CERTAIN COSTS NOT INCLUDED.—Costs 

16 paid or incurred by an employer for food or health 

17 insurance shall not be taken into account under sub18 section (a). 

19 ‘‘(3) NO CREDIT WHERE GRANT AWARDED.— 

20 No credit shall be allowable under subsection (a) 

21 with respect to any qualified wellness program of 

22 any taxpayer (other than an eligible employer de23 scribed in subsection (f)(2)(A)) who receives a grant 

24 provided by the United States, a State, or a political 

25 subdivision of a State for use in connection with 


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•S 1342 IS 

1 such program. The Secretary shall prescribe rules 

2 providing for the waiver of this paragraph with re3 spect to any grant which does not constitute a sig4 nificant portion of the funding for the qualified 

5 wellness program. 

6 ‘‘(4) CREDIT PERIOD.— 

7 ‘‘(A) IN GENERAL.—The term ‘credit pe8 riod’ means the period of 10 consecutive taxable 

9 years beginning with the taxable year in which 

10 the qualified wellness program is first certified 

11 under this section. 

12 ‘‘(B) SPECIAL RULE FOR EXISTING PRO13 GRAMS.—In the case of an employer (or prede14 cessor) which operates a wellness program for 

15 its employees on the date of the enactment of 

16 this section, subparagraph (A) shall be applied 

17 by substituting ‘3 consecutive taxable years’ for 

18 ‘10 consecutive taxable years’. The Secretary 

19 shall prescribe rules under which this sub20 section shall not apply if an employer is re21 quired to make substantial modifications in the 

22 existing wellness program in order to qualify 

23 such program for certification as a qualified 

24 wellness program. 


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1 ‘‘(C) CONTROLLED GROUPS.—For pur2 poses of this paragraph, all persons treated as 

3 a single employer under subsection (b), (c), 

4 (m), or (o) of section 414 shall be treated as a 

5 single employer. 

6 ‘‘(f) PORTION OF CREDIT MADE REFUNDABLE.— 

7 ‘‘(1) IN GENERAL.—In the case of an eligible 

8 employer of an employee, the aggregate credits al9 lowed to a taxpayer under subpart C shall be in10 creased by the lesser of— 

11 ‘‘(A) the credit which would be allowed 

12 under this section without regard to this sub13 section and the limitation under section 38(c), 

14 or 

15 ‘‘(B) the amount by which the aggregate 

16 amount of credits allowed by this subpart (de17 termined without regard to this subsection) 

18 would increase if the limitation imposed by sec19 tion 38(c) for any taxable year were increased 

20 by the amount of employer payroll taxes im21 posed on the taxpayer during the calendar year 

22 in which the taxable year begins. 

23 The amount of the credit allowed under this sub24 section shall not be treated as a credit allowed under 

25 this subpart and shall reduce the amount of the 


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•S 1342 IS 

1 credit otherwise allowable under subsection (a) with2 out regard to section 38(c). 

3 ‘‘(2) ELIGIBLE EMPLOYER.—For purposes of 

4 this subsection, the term ‘eligible employer’ means 

5 an employer which is— 

6 ‘‘(A) a State or political subdivision there7 of, the District of Columbia, a possession of the 

8 United States, or an agency or instrumentality 

9 of any of the foregoing, or 

10 ‘‘(B) any organization described in section 

11 501(c) of the Internal Revenue Code of 1986 

12 which is exempt from taxation under section 

13 501(a) of such Code. 

14 ‘‘(3) EMPLOYER PAYROLL TAXES.—For pur15 poses of this subsection— 

16 ‘‘(A) IN GENERAL.—The term ‘employer 

17 payroll taxes’ means the taxes imposed by— 

18 ‘‘(i) section 3111(b), and 

19 ‘‘(ii) sections 3211(a) and 3221(a) 

20 (determined at a rate equal to the rate 

21 under section 3111(b)). 

22 ‘‘(B) SPECIAL RULE.—A rule similar to 

23 the rule of section 24(d)(2)(C) shall apply for 

24 purposes of subparagraph (A). 


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•S 1342 IS 

1 ‘‘(g) TERMINATION.—This section shall not apply to 

2 any amount paid or incurred after December 31, 2017.’’. 

3 (b) TREATMENT AS GENERAL BUSINESS CREDIT.— 

4 Subsection (b) of section 38 of the Internal Revenue Code 

5 of 1986 (relating to general business credit) is amended 

6 by striking ‘‘plus’’ at the end of paragraph (30), by strik7 ing the period at the end of paragraph (31) and inserting 

8 ‘‘, plus’’, and by adding at the end the following: 

9 ‘‘(32) the wellness program credit determined 

10 under section 45O.’’. 

11 (c) DENIAL OF DOUBLE BENEFIT.—Section 280C of 

12 the Internal Revenue Code of 1986 (relating to certain 

13 expenses for which credits are allowable) is amended by 

14 adding at the end the following new subsection: 

15 ‘‘(f) WELLNESS PROGRAM CREDIT.— 

16 ‘‘(1) IN GENERAL.—No deduction shall be al17 lowed for that portion of the costs paid or incurred 

18 for a qualified wellness program (within the meaning 

19 of section 45O) allowable as a deduction for the tax20 able year which is equal to the amount of the credit 

21 allowable for the taxable year under section 45O. 

22 ‘‘(2) SIMILAR RULE WHERE TAXPAYER CAP23 ITALIZES RATHER THAN DEDUCTS EXPENSES.—If— 

24 ‘‘(A) the amount of the credit determined 

25 for the taxable year under section 45O, exceeds 


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•S 1342 IS 

1 ‘‘(B) the amount allowable as a deduction 

2 for such taxable year for a qualified wellness 

3 program, 

4 the amount chargeable to capital account for the 

5 taxable year for such expenses shall be reduced by 

6 the amount of such excess. 

7 ‘‘(3) CONTROLLED GROUPS.—In the case of a 

8 corporation which is a member of a controlled group 

9 of corporations (within the meaning of section 

10 41(f)(5)) or a trade or business which is treated as 

11 being under common control with other trades or 

12 business (within the meaning of section 

13 41(f)(1)(B)), this subsection shall be applied under 

14 rules prescribed by the Secretary similar to the rules 

15 applicable under subparagraphs (A) and (B) of sec16 tion 41(f)(1).’’. 

17 (d) CLERICAL AMENDMENT.—The table of sections 

18 for subpart D of part IV of subchapter A of chapter 1 

19 of the Internal Revenue Code of 1986 is amended by add20 ing at the end the following: 

‘‘Sec. 45O. Wellness program credit.’’. 

21 (e) EFFECTIVE DATE.—The amendments made by 

22 this section shall apply to taxable years beginning after 

23 December 31, 2007. 

24 (f) OUTREACH.— 


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•S 1342 IS 

1 (1) IN GENERAL.—The Secretary of the Treas2 ury, in conjunction with the Director of the Centers 

3 for Disease Control and members of the business 

4 community, shall institute an outreach program to 

5 inform businesses about the availability of the 

6 wellness program credit under section 45O of the In7 ternal Revenue Code of 1986 as well as to educate 

8 businesses on how to develop programs according to 

9 recognized and promising practices and on how to 

10 measure the success of implemented programs. 

11 (2) AUTHORIZATION OF APPROPRIATIONS.— 

12 There are authorized to be appropriated such sums 

13 as are necessary to carry out the outreach program 

14 described in paragraph (1). 

15 SEC. 303. CDC AND EMPLOYER-BASED WELLNESS PRO16 GRAMS. 

17 Title III of the Public Health Service Act (42 U.S.C. 

18 241 et seq.) is amended by adding at the end the fol19 lowing: 

20 ‘‘PART R—CDC AND EMPLOYER-BASED 

21 WELLNESS PROGRAMS 

22 ‘‘SEC. 399Z–1. MOTIVATING EMPLOYERS TO IMPLEMENT 

23 WORKPLACE WELLNESS PROGRAMS. 

24 ‘‘(a) WORKPLACE WELLNESS MARKETING CAMPAIGN

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1 ease Control and Prevention, in coordination with relevant 

2 worksite health promotion organizations, shall conduct an 

3 educational campaign to make employers, employer 

4 groups, and other interested parties aware of the benefits 

5 of employer-based wellness programs. 

6 ‘‘(b) EMPLOYER AWARD PROGRAM.—The Director of 

7 the Centers for Disease Control and Prevention shall de8 velop an annual awards program for employers to encour9 age the development of creative and effective solutions to 

10 help employees maintain or improve their health. The 

11 awards program shall provide that small, medium, and 

12 large employers that are public or private shall be eligible 

13 for the awards 

14 ‘‘SEC. 399Z–2. EVALUATION OF EMPLOYER-BASED 

15 WELLNESS PROGRAMS. 

16 ‘‘The Director of the Centers for Disease Control and 

17 Prevention shall enter into contracts with entities to— 

18 ‘‘(1) provide employers (including small, me19 dium, and large employers, as determined by the Di20 rector) with technical assistance in evaluating such 

21 employers’ employer-based wellness programs, in22 cluding— 

23 ‘‘(A) measuring the participation of em24 ployees in such programs; and 


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•S 1342 IS 

1 ‘‘(B) evaluating such programs as they re2 late to changes in the health status of employ3 ees, the absenteeism of employees, the produc4 tivity of employees, and the medical costs in5 curred by employees; and 

6 ‘‘(2) train employers on how to evaluate such 

7 employers’ employer-based wellness programs. 

8 ‘‘SEC. 399Z–3. NATIONAL WORKSITE HEALTH POLICIES AND 

9 PROGRAMS STUDY. 

10 ‘‘(a) IN GENERAL.—Not later than 1 year after the 

11 date of enactment of this section, and annually thereafter, 

12 the Director of the Centers for Disease Control and Pre13 vention shall conduct a national worksite health policies 

14 and programs study to assess employer-based health poli15 cies and programs. 

16 ‘‘(b) REPORT.—After completing each study under 

17 subsection (a), the Director of the Centers for Disease 

18 Control and Prevention shall submit to Congress a report 

19 that includes the recommendations of the Director for the 

20 implementation of effective employer-based health policies 

21 and programs. 

22 ‘‘SEC. 399Z–4. MISCELLANEOUS PROVISIONS. 

23 ‘‘(a) BEHAVIORAL RISK FACTOR SURVEILLANCE

24 SYSTEM.—The Secretary shall expand the Behavioral 

25 Risk Factor Surveillance System to include a workforce 


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•S 1342 IS 

1 component to enable employers, researchers, and health 

2 officials to assess employee health risks, identify emerging 

3 problems associated with general employee health, prevent 

4 disease within the employee population, and improve em5 ployer-based health programs and policies. 

6 ‘‘(b) DEMONSTRATION PROJECTS.— 

7 ‘‘(1) IN GENERAL.—The Secretary, acting 

8 through the Director of the Centers for Disease 

9 Control and Prevention, shall award grants to enti10 ties to enable such entities to carry out research 

11 demonstration projects to study the effect of the ap12 plication of new worksite-based health interventions 

13 and models. 

14 ‘‘(2) ELIGIBILITY.—To be eligible to receive a 

15 grant under paragraph (1), an entity shall submit to 

16 the Secretary an application at such time, in such 

17 manner, and containing such information as the Sec18 retary may require. 

19 ‘‘(3) BROAD PARTICIPATION.—In awarding 

20 grants under paragraph (1), the Secretary shall en21 sure that demonstration projects are conducted in 

22 both the public and private sectors and in small and 

23 large employer settings. 

24 ‘‘(4) SUBMISSION OF FINDINGS.—An entity 

25 shall submit to the Secretary a report on the results 


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1 of the research conducted under the grant within 

2 such period as the Secretary may prescribe. Such re3 port shall include any guidelines or recommendations 

4 developed by the entity based on such research. 

5 ‘‘(c) IMPLEMENTATION OF RESEARCH RESULTS.— 

6 The Secretary shall carry out activities to implement the 

7 guidelines or recommendations received by the Secretary 

8 under subsection (b)(4) if the Secretary determines that 

9 such guidelines of recommendations would result in im10 proved employee health through worksite-based health 

11 programs or policies.’’. 

12 SEC. 304. EMPLOYER-PROVIDED OFF-PREMISES HEALTH 

13 CLUB SERVICES. 

14 (a) TREATMENT AS FRINGE BENEFIT.—Subpara15 graph (A) of section 132(j)(4) of the Internal Revenue 

16 Code of 1986 (relating to on-premises gyms and other ath17 letic facilities) is amended to read as follows: 

18 ‘‘(A) IN GENERAL.—Gross income shall 

19 not include— 

20 ‘‘(i) the value of any on-premises ath21 letic facility provided by an employer to its 

22 employees, and 

23 ‘‘(ii) so much of the fees, dues, or 

24 membership expenses paid by an employer 

25 to an athletic or fitness facility described 


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1 in subparagraph (C) on behalf of its em2 ployees as does not exceed $900 per em3 ployee per year.’’. 

4 (b) ATHLETIC FACILITIES DESCRIBED.—Paragraph 

5 (4) of section 132(j) of the Internal Revenue Code of 1986 

6 (relating to special rules) is amended by adding at the end 

7 the following new subparagraph: 

8 ‘‘(C) CERTAIN ATHLETIC OR FITNESS FA9 CILITIES DESCRIBED.—For purposes of sub10 paragraph (A)(ii), an athletic or fitness facility 

11 described in this subparagraph is a facility— 

12 ‘‘(i) which provides instruction in a 

13 program of physical exercise, offers facili14 ties for the preservation, maintenance, en15 couragement, or development of physical 

16 fitness, or is the site of such a program of 

17 a State or local government, 

18 ‘‘(ii) which is not a private club owned 

19 and operated by its members, 

20 ‘‘(iii) which does not offer golf, hunt21 ing, sailing, or riding facilities, 

22 ‘‘(iv) whose health or fitness facility is 

23 not incidental to its overall function and 

24 purpose, and 


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1 ‘‘(v) which is fully compliant with the 

2 State of jurisdiction and Federal anti-dis3 crimination laws.’’. 

4 (c) EXCLUSION APPLIES TO HIGHLY COMPENSATED

5 EMPLOYEES ONLY IF NO DISCRIMINATION.—Section 

6 132(j)(1) of the Internal Revenue Code of 1986 is amend7 ed— 

8 (1) by striking ‘‘Paragraphs (1) and (2) of sub9 section (a)’’ and inserting ‘‘Subsections (a)(1), 

10 (a)(2), and (j)(4)’’, and 

11 (2) by striking the heading thereof through 

12 ‘‘APPLY’’ and inserting ‘‘CERTAIN EXCLUSIONS

13 APPLY’’. 

14 (d) EMPLOYER DEDUCTION FOR DUES TO CERTAIN

15 ATHLETIC FACILITIES.— 

16 (1) IN GENERAL.—Paragraph (3) of section 

17 274(a) of the Internal Revenue Code of 1986 (relat18 ing to denial of deduction for club dues) is amended 

19 by adding at the end the following new sentence: 

20 ‘‘The preceding sentence shall not apply to so much 

21 of the fees, dues, or membership expenses paid to 

22 athletic or fitness facilities (within the meaning of 

23 section 132(j)(4)(C)) as does not exceed $900 per 

24 employee per year.’’. 


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1 (2) CONFORMING AMENDMENT.—The last sen2 tence of section 274(e)(4) of such Code is amended 

3 by inserting ‘‘the first sentence of’’ before ‘‘sub4 section (a)(3)’’. 

5 (e) EFFECTIVE DATE.—The amendments made by 

6 this section shall apply to taxable years beginning after 

7 the date of the enactment of this Act. 

8 Subtitle B—Healthy Communities 

9 CHAPTER 1—PROVISIONS TO IMPROVE 

10 THE HEALTH OF COMMUNITIES 

11 SEC. 311. HEALTHY COMMUNITY GRANTS. 

12 Part P of title III of the Public Health Service Act 

13 (42 U.S.C. 280g et seq.) is amended by adding at the end 

14 the following: 

15 ‘‘SEC. 399P. HEALTHY COMMUNITY GRANTS. 

16 ‘‘(a) ESTABLISHMENT.—The Secretary, acting 

17 through the Director of the Centers for Disease Control 

18 and Prevention and in coordination with the Directors of 

19 other appropriate Federal agencies, shall award competi20 tive grants to eligible entities for the purpose of planning 

21 and implementing programs that seek to promote indi22 vidual and community health and to prevent the incidence 

23 of chronic disease. 

24 ‘‘(b) ELIGIBILITY.— 


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1 ‘‘(1) IN GENERAL.—To be eligible to receive a 

2 grant under this section an entity shall— 

3 ‘‘(A) be— 

4 ‘‘(i) a city, county, or Indian tribe; 

5 ‘‘(ii) a local or tribal educational 

6 agency; 

7 ‘‘(iii) an accredited university, college, 

8 or community college; 

9 ‘‘(iv) a federally qualified health cen10 ter; 

11 ‘‘(v) a local health department; 

12 ‘‘(vi) a health care provider; 

13 ‘‘(vii) a community-based organiza14 tion; or 

15 ‘‘(viii) any other entity determined ap16 propriate by the Secretary, including a 

17 consortia or partnership of entities de18 scribed in any of clauses (i) through (vii); 

19 ‘‘(B) prepare and submit an application in 

20 accordance with paragraph (2); and 

21 ‘‘(C) provide assurances that the entity will 

22 contribute the non-Federal share as required 

23 under paragraph (3) to the cost of the activities 

24 carried out under the grant. 

25 ‘‘(2) APPLICATION.— 


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1 ‘‘(A) IN GENERAL.—An entity desiring a 

2 grant under this section shall submit an appli3 cation to the Secretary at such time, in such 

4 manner, and containing such information as the 

5 Secretary may require, including a plan that 

6 meets the requirements of subparagraph (B). 

7 ‘‘(B) PLAN.—A plan meets the require8 ments of this subparagraph if such plan, at a 

9 minimum, includes information regarding— 

10 ‘‘(i)(I) programs or community-based 

11 activities that the applicant proposes to 

12 carry out with funds received under this 

13 section and which seek to prevent and re14 duce the incidence of— 

15 ‘‘(aa) overweight and obesity, or 

16 chronic diseases associated with over17 weight and obesity; 

18 ‘‘(bb) tobacco use; or 

19 ‘‘(cc) mental illness; or 

20 ‘‘(II) other such activities, as deter21 mined appropriate by the Secretary, that 

22 are consistent with the goals of promoting 

23 individual and community health and pre24 venting chronic disease; and 


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1 ‘‘(ii) the manner in which the appli2 cant will evaluate the effectiveness of the 

3 program or activities carried out under this 

4 section. 

5 ‘‘(3) NON-FEDERAL SHARE.—To be eligible to 

6 receive a grant under this section, an entity shall 

7 provide a non-Federal contribution, in cash or in 

8 kind, to the costs of activities under the grant in an 

9 amount that is equal to not less than 25 percent of 

10 the costs of such activities. 

11 ‘‘(c) USE OF FUNDS.—An entity that receives a grant 

12 under this section shall use the amount made available 

13 under the grant to carry out community-based activities, 

14 including— 

15 ‘‘(1) activities that seek to promote individual 

16 health and community wellness and to prevent and 

17 reduce the incidence of health problems and chronic 

18 diseases associated with— 

19 ‘‘(A) being overweight or obese; 

20 ‘‘(B) tobacco use; or 

21 ‘‘(C) mental illness; or 

22 ‘‘(2) other activities undertaken with the goals 

23 of health promotion and chronic disease prevention, 

24 as determined appropriate by the Secretary. 


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1 ‘‘(d) PRIORITY.—In awarding grants under sub2 section (a), the Secretary shall give priority to— 

3 ‘‘(1) entities that demonstrate that they have 

4 previously applied successfully for funds to carry out 

5 activities that seek to promote individual and com6 munity health and to prevent the incidence of chron7 ic disease and that can cite published and peer-re8 viewed research demonstrating that the activities 

9 that the entity proposes to carry out under this sub10 section are effective; 

11 ‘‘(2) entities that will carry out programs or ac12 tivities that seek to accomplish a goal or goals set 

13 by the State in the Healthy People 2010 plan of the 

14 State; 

15 ‘‘(3) entities that provide non-Federal contribu16 tions, either in cash or in kind, to the costs of fund17 ing activities under the grant; 

18 ‘‘(4) entities that develop comprehensive plans 

19 that include a strategy for extending program activi20 ties developed under this section in the years fol21 lowing the fiscal years for which they receive grants 

22 under this section; 

23 ‘‘(5) entities located in communities that are 

24 medically underserved, as determined by the Sec25 retary; 


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1 ‘‘(6) entities located in areas where the average 

2 poverty rate is 150 or higher than the average pov3 erty rate in the State involved, as determined by the 

4 Secretary; and 

5 ‘‘(7) entities that submit plans that exhibit 

6 multisectoral, cooperative conduct that includes the 

7 involvement of a broad range of stakeholders, includ8 ing— 

9 ‘‘(A) community-based organizations; 

10 ‘‘(B) local governments; 

11 ‘‘(C) local educational agencies; 

12 ‘‘(D) the private sector; 

13 ‘‘(E) State or local departments of health; 

14 ‘‘(F) accredited colleges, universities, and 

15 community colleges; 

16 ‘‘(G) health care providers; 

17 ‘‘(H) State and local departments of trans18 portation and city planning; and 

19 ‘‘(I) other entities determined appropriate 

20 by the Secretary. 

21 ‘‘(e) TECHNICAL ASSISTANCE.—From amounts ap22 propriated to carry out this section, the Secretary may re23 serve not more than 10 percent for each fiscal year to pro24 vide entities receiving grants under this section with techVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00058 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 nical assistance in the implementation of the plans re2 quired under subsection (b)(2)(B). 

3 ‘‘(f) EVALUATION.—From amounts appropriated to 

4 carry out this section, the Secretary may reserve not to 

5 exceed 5 percent for each fiscal year for the purpose of 

6 carrying out evaluations of the activities carried out under 

7 this section. Not later than 90 days after the completion 

8 of any such evaluation, the results of such evaluation shall 

9 be submitted to the relevant authorizing committees of 

10 Congress and to the Committee on Appropriations of the 

11 Senate and the Committee on Appropriations of the House 

12 of Representatives. 

13 ‘‘(g) LIMITATION ON ADMINISTRATIVE COSTS.—An 

14 entity may not use more than 10 percent of amounts re15 ceived under a grant under this section for administrative 

16 expenses. 

17 ‘‘(h) SUPPLEMENT NOT SUPPLANT.—Amounts pro18 vided under a grant under this section shall be used to 

19 supplement, and not supplant, other amounts provided for 

20 activities of the type to be carried out under this section. 

21 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 

22 authorized to be appropriated such sums as may be nec23 essary to carry out this section.’’. 


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1 SEC. 312. PROMOTING THE HEALTH AND WELLNESS OF IN2 DIVIDUALS WITH DISABILITIES THROUGH 

3 COMMUNITY SPORTS PROGRAMS. 

4 Part P of title III of the Public Health Service Act 

5 (42 U.S.C. 280g et seq.) is amended by adding at the end 

6 the following: 

7 ‘‘SEC. 399R. COMMUNITY SPORTS PROGRAMS FOR INDIVID8 UALS WITH DISABILITIES. 

9 ‘‘(a) IN GENERAL.— 

10 ‘‘(1) INDIVIDUAL WITH A DISABILITY DE11 FINED.—For purposes of this section, the term ‘in12 dividual with a disability’ has the meaning given 

13 such term in section 7(20) of the Rehabilitation Act 

14 of 1973 (29 U.S.C. 705(20), for the purpose of title 

15 V of such Act (29 U.S.C. 791 et seq.). 

16 ‘‘(2) COMMUNITY SPORTS GRANTS PROGRAM.— 

17 The Secretary, in collaboration with the National 

18 Advisory Committee on Community Sports Pro19 grams for Individuals with Disabilities, may award 

20 grants on a competitive basis to public and nonprofit 

21 private entities to implement community-based, 

22 sports and athletic programs for individuals with 

23 disabilities, including youth with disabilities. 

24 ‘‘(b) APPLICATION.—To be eligible to receive a grant 

25 under subsection (a)(2), a public or nonprofit private enti26 ty shall submit to the Secretary an application at such 


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1 time, in such manner, and containing such agreements, 

2 assurances, and information as the Secretary determines 

3 to be necessary to carry out this section. 

4 ‘‘(c) AUTHORIZED ACTIVITIES.—Amounts awarded 

5 under a grant under subsection (a) shall be used for— 

6 ‘‘(1) community-based sports programs, 

7 leagues, or competitions in individual or team sports 

8 for individuals with physical disabilities; 

9 ‘‘(2) regional sports programs or competitions 

10 in individual or team sports for individuals with 

11 physical disabilities; 

12 ‘‘(3) the development of competitive team and 

13 individual sports programs for individuals with dis14 abilities at the high school and collegiate level; or 

15 ‘‘(4) the development of mentoring programs to 

16 encourage participation in sports programs for indi17 viduals who are newly disabled or with newly ac18 quired physical limitations. 

19 ‘‘(d) PRIORITIES.— 

20 ‘‘(1) ADVISORY COMMITTEE.—The Secretary 

21 shall establish a National Advisory Committee on 

22 Community Sports Programs for Individuals with 

23 Disabilities that shall— 

24 ‘‘(A) establish priorities for the implemen25 tation of this section, review grant proposals; 


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1 ‘‘(B) make recommendations for funding 

2 under this section; and 

3 ‘‘(C) annually evaluate the progress of pro4 grams carried out under this section in imple5 menting such priorities. 

6 ‘‘(2) REPRESENTATION.—The Advisory Com7 mittee established under paragraph (1) shall include 

8 representatives of— 

9 ‘‘(A) the Department of Health and 

10 Human Services Office on Disability; 

11 ‘‘(B) the United States Surgeon General; 

12 ‘‘(C) the Centers for Disease Control and 

13 Prevention; 

14 ‘‘(D) the Paralympic division of the United 

15 States Olympic Committee; 

16 ‘‘(E) disabled sports organizations; 

17 ‘‘(F) organizations that represent the in18 terests of individuals with disabilities; and 

19 ‘‘(G) individuals with disabilities (including 

20 athletes with physical disabilities) or their fam21 ily members. 

22 ‘‘(e) DISSEMINATION OF INFORMATION.—The Sec23 retary shall disseminate information about the availability 

24 of grants under this section in a manner that is designed 

25 to reach public entities and nonprofit private organizations 


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1 that are dedicated to providing outreach, advocacy, or 

2 independent living services to individuals with disabilities. 

3 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary, in 

4 conjunction with the United States Olympic Committee 

5 and disabled sports organizations, shall establish a tech6 nical assistance center to provide training, support, and 

7 information to grantees under this section on establishing 

8 and operating community sports programs for individuals 

9 with disabilities. 

10 ‘‘(g) REPORT TO CONGRESS.—Not later than 180 

11 days after the date of the enactment of this section, and 

12 annually thereafter, the Secretary shall submit to Con13 gress a report summarizing activities, findings, outcomes, 

14 and recommendations resulting from the grant projects 

15 funded under this section during the year for which the 

16 report is being prepared. 

17 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

18 ‘‘(1) IN GENERAL.—To carry out this section, 

19 there are authorized to be appropriated such sums 

20 as may be necessary. 

21 ‘‘(2) LIMITATION.—Not to exceed 10 percent of 

22 the amount appropriated in each fiscal year shall be 

23 used to carry out activities under subsection 

24 (c)(4).’’. 


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1 SEC. 313. SAFE AND COMPLETE STREETS. 

2 Section 133 of title 23, United States Code, is 

3 amended by adding at the end the following: 

4 ‘‘(g) WITHHOLDING OF FUNDING.— 

5 ‘‘(1) IN GENERAL.—Beginning with the fiscal 

6 year that begins 2 years after the date of enactment 

7 of this subsection, the Secretary of Transportation 

8 shall withhold 2 percent of the amounts allocated in 

9 such fiscal year to the highway and planning funds 

10 allotted to a Metropolitan Planning Organization or 

11 State Transportation Improvement Program under 

12 the Safe, Accountable, Flexible, Efficient Transpor13 tation Equity Act unless the State or Metropolitan 

14 Planning Organization provides the Secretary with 

15 documentation— 

16 ‘‘(A) of the existence of an explicit state17 ment of policy (that meets the requirements of 

18 subsection (b)) that the safety and convenience 

19 of all users of the transportation system shall 

20 be accommodated; and 

21 ‘‘(B) that such policy has been applied to 

22 the projects contained in the Transportation 

23 Improvement Plan. 

24 ‘‘(2) PURPOSE.—The purpose of the policy 

25 statement required under paragraph (1)(A) is to en26 sure that all users of the transportation system, inVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00064 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 cluding pedestrians, bicyclists, and transit users as 

2 well as children, older individuals, and individuals 

3 with disabilities, are able to travel safely and conven4 iently on streets and highways within the public 

5 right of way. 

6 ‘‘(h) POLICY STATEMENT REQUIREMENTS.—A policy 

7 statement under subsection (g)(1)(A) shall include the fol8 lowing: 

9 ‘‘(1) An assurance that all users of the trans10 portation system will include pedestrians (including 

11 individuals of all ages, and individuals with disabil12 ities (including mobility, sensory, neurological or hid13 den disabilities)), bicyclists, transit vehicles and 

14 users, and motorists. 

15 ‘‘(2) An assurance that the statement will apply 

16 to both new road construction and transportation 

17 improvement projects. 

18 ‘‘(3) A clear procedure that requires approval 

19 by a senior manager of any specified exceptions from 

20 implementing the policy statement, including docu21 mentation with supporting data that indicates the 

22 basis for the exemption. 

23 ‘‘(4) A statement directing the use of the cur24 rent design standards, including those standards ap25 plying to access for individuals with disabilities. 


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1 ‘‘(5) A statement requiring that complete 

2 streets solutions be developed to fit in with the con3 text of the community and that those solutions be 

4 flexible. 

5 ‘‘(6) A description of the performance stand6 ards with measurable outcomes that will be devel7 oped. 

8 ‘‘(7) A statement that accommodation shall be 

9 made for all users in all construction and improve10 ment projects unless one or more of the following 

11 apply: 

12 ‘‘(A) The project involved a roadway on 

13 which non-motorized users are prohibited by 

14 law from using. In such case, a greater effort 

15 shall be made to accommodate bicyclists and 

16 pedestrians elsewhere. 

17 ‘‘(B) The cost of establishing complete fa18 cilities would be excessively disproportionate to 

19 the need or probable use. 

20 ‘‘(C) With respect to a project area with a 

21 low population, a lack of transit service, or 

22 other documented factors indicate an absence of 

23 need now and in the future. 


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1 ‘‘(D) The policy statement may be 

2 achieved through a State or local law or ordi3 nance, or through an agency policy directive. 

4 ‘‘(i) CERTIFICATIONS.—The Metropolitan Planning 

5 Organization and State Transportation Improvement Plan 

6 shall certify that each road project included in such plan 

7 has been reviewed for its compliance with any applicable 

8 policy statement under this section and that each project 

9 under such plan enhances the safety, convenience, and ac10 cessibility of the transportation system for all users to the 

11 extent that it is reasonably possible and that the project 

12 applicant addressed these concerns in the material pre13 pared for public input with respect to such plan. 

14 ‘‘(j) ACCESSIBILITY STANDARDS.—Not later than 12 

15 months after the date of enactment of this subsection, the 

16 United States Access Board shall issue final standards for 

17 accessibility of new construction and alterations of pedes18 trian facilities in the public right-of-way. Until such time 

19 as the Access Board completes a final Public Right of Way 

20 Accessibility rule, Department of Transportation Stand21 ards for Accessible Transportation Facilities (49 C.F.R. 

22 37.9, as amended on 10/30/2006 (71 FR 63263)) shall 

23 serve as the minimum standard. If the Department Of 

24 Transportation standards are silent or inapplicable with 

25 respect to any issue, the 2005 draft Public Right Of Way 


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1 Accessibility Guidelines provisions shall be consulted. A 

2 Metropolitan Planning Organization or State department 

3 of transportation that is adopting complete streets policies 

4 may consult existing Federal guidance, including the 2000 

5 USDOT Guidance document, ‘‘Accommodating Bicycle 

6 and Pedestrian Travel’’. 

7 ‘‘(k) INCLUSION OF ALL USERS.—Metropolitan plan8 ning organizations shall strongly encourage local jurisdic9 tions that are served by such organizations to maximize 

10 their efforts to include all users in their transportation 

11 planning. 

12 ‘‘(l) ADDITIONAL PROVISIONS.— 

13 ‘‘(1) RESEARCH.— 

14 ‘‘(A) IN GENERAL.—The Secretary of 

15 Transportation shall require the Federal High16 way Administration to conduct complete streets 

17 research to assist States and Metropolitan 

18 Planning Organizations in developing, adopting, 

19 and implementing plans, projects, procedures, 

20 policies, and training that comply with the ap21 plicable statement of policy under subsection 

22 (g)(1)(A). 

23 ‘‘(B) PARTICIPATION.—Research under 

24 subparagraph (A) shall be conducted with the 

25 participation of the American Association of 


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1 State Highway Transportation Officials, the In2 stitute of Transportation Engineers, the Amer3 ican Public Transit Association, the American 

4 Planning Association, the National Association 

5 of Regional Councils, the Association of Metro6 politan Planning Organizations, and representa7 tives of the disability, motoring, bicycling, walk8 ing, transit user, aging, and other affected com9 munities. 

10 ‘‘(C) EXISTING NEEDS.—Research under 

11 subparagraph (A) shall be based on the existing 

12 statement of complete streets research needs as 

13 outlined by the Transportation Research Board 

14 in TR Circular E110, and shall also develop 

15 new areas of inquiry. 

16 ‘‘(2) BENCHMARKS AND GUIDANCE.—The re17 search project conducted under paragraph (1) shall 

18 be designed to result in the establishment of bench19 marks and the provision of practical guidance on 

20 how to effectively implement street procedures and 

21 designs that will accommodate all types of users 

22 along the same facility or corridor including, vehi23 cles, pedestrians, bicycles, and transit use. Such 

24 benchmarks and guidance shall focus on changing 

25 scoping, design, and construction procedures to more 


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1 effectively fit the individual modes together into inte2 grated facilities that meet the needs of each in an 

3 appropriate balance. Such benchmarks and guidance 

4 shall indicate the expected operational and safety 

5 performance of alternative approaches to facility de6 sign. 

7 ‘‘(3) BEST PRACTICES REPORT.—Not later than 

8 2 years after the date of enactment of this sub9 section, the Federal Highway Administration shall 

10 publish a best practices report showing how trans11 portation agencies have changed their procedures to 

12 routinely design safe, effective multi-modal facilities. 

13 In establishing such best practices, consideration 

14 shall be given to the following areas: 

15 ‘‘(A) Procedures for identifying the needs 

16 of the mix of users, including primary and sec17 ondary users that need to be served on various 

18 highway functional classes. 

19 ‘‘(B) The identification of the types and 

20 designs of facilities needed to serve each of 

21 those types of users. 

22 ‘‘(C) The identification of barriers to im23 plementation and identification of costs associ24 ated with implementing complete streets poli25 cies. 


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1 ‘‘(4) DATA COLLECTION.—In addition to pre2 paring the report under paragraph (3), the Federal 

3 Highway Administration shall work with the Bureau 

4 of Transportation Statistics and the Federal Transit 

5 Association and appropriate Transportation Re6 search Board committees on data collection, includ7 ing a baseline non-motorized and transit use survey 

8 that will be integrated into the National Highway 

9 Traffic Safety Administration and the development 

10 of a survey tool for use by State transportation de11 partments in identifying the multi-modal capacity of 

12 State and local road networks.’’. 

13 SEC. 314. NATIONAL ASSESSMENT OF MENTAL HEALTH 

14 NEEDS. 

15 Title V of the Public Health Service Act (42 U.S.C. 

16 290aa et seq.) is amended by inserting after section 506B 

17 (42 U.S.C. 290aa–5b) the following: 

18 ‘‘SEC. 506C. NATIONAL ASSESSMENT OF MENTAL HEALTH 

19 NEEDS. 

20 ‘‘(a) IN GENERAL.—The Secretary, acting through 

21 the Administrator, and in consultation with the Centers 

22 for Disease Control and Prevention and the Director of 

23 the National Institutes of Health, shall establish and im24 plement public health monitoring measures to address the 

25 mental and behavioral health needs of the population of 


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•S 1342 IS 

1 the United States and other populations served by the Ad2 ministration, that include— 

3 ‘‘(1) monitoring the mental health status of the 

4 population, including incidence and prevalence rates 

5 of mental and behavioral health problems through6 out the lifespan; 

7 ‘‘(2) monitoring mental and behavioral health 

8 risks; 

9 ‘‘(3) enhancing existing public health moni10 toring systems to include data on mental and behav11 ioral health status and risks; and 

12 ‘‘(4) monitoring the immediate and long-term 

13 impact of environmental factors to collect data on 

14 the prevalence of mental and behavioral health prob15 lems throughout the lifespan with the aim of encour16 aging early intervention and treatment. 

17 ‘‘(b) DISTINGUISHING AMONG AGE GROUPS.—In de18 signing and implementing the measures described in sub19 section (a) the Secretary shall ensure that methods of 

20 monitoring and reporting data distinguish among different 

21 age groups, including when identifying groups of children, 

22 and very young children under age 3, together with their 

23 parents. 

24 ‘‘(c) REPORT.—Not later than 1 year after the date 

25 of enactment of this section, the Secretary shall submit 


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1 a report to Congress that describes the progress on the 

2 implementation of the monitoring measures described in 

3 subsection (a). 

4 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

5 is authorized to be appropriated to carry out this section 

6 $5,000,000 for fiscal year 2008 and such sums as may 

7 be necessary for each of the following fiscal years.’’. 

8 SEC. 315. PREVENTIVE MEDICINE AND PUBLIC HEALTH 

9 TRAINING GRANT PROGRAM. 

10 Part D of title III of the Public Health Service Act 

11 (42 U.S.C. 254b et seq.) is amended by adding at the end 

12 the following: 

13 ‘‘Subpart XI—Preventive Medicine Training 

14 ‘‘SEC. 340H. PREVENTIVE MEDICINE AND PUBLIC HEALTH 

15 TRAINING GRANT PROGRAM. 

16 ‘‘(a) GRANTS.—The Secretary, acting through the 

17 Director of the Centers for Disease Control and Preven18 tion, may award grants to, or enter into contracts with, 

19 eligible entities to provide training to graduate medical 

20 residents in preventive medicine specialties. 

21 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

22 or contract under subsection (a), an entity shall— 

23 ‘‘(1) be a school of public health, public health 

24 department, school of medicine or osteopathic mediVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00073 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 cine, public or private hospital, or public or private 

2 non-profit entity; 

3 ‘‘(2) submit to the Secretary an application at 

4 such time, in such manner, and containing such in5 formation as the Secretary may require; and 

6 ‘‘(3) maintain and adhere to a Letter of Agree7 ment with a local community health center (if avail8 able in the local area involved) that supports 

9 practicum training of preventive medicine residents, 

10 if practicable. 

11 ‘‘(c) USE OF FUNDS.—Amounts received under a 

12 grant or contract under this section shall be used to— 

13 ‘‘(1) to plan, develop, and operate residency 

14 programs for preventive medicine or public health; 

15 ‘‘(2) provide financial assistance, including tui16 tion and stipends, to resident physicians (MD or 

17 DO) who plan to specialize in preventive medicine or 

18 public health; 

19 ‘‘(3) defray the costs associated with the plan20 ning, development, and operation of preventive medi21 cine or public health programs, including the devel22 opment of curriculum to be used in such program; 

23 and 

24 ‘‘(4) provide for the improvement of academic 

25 administrative units. 


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1 ‘‘(d) DURATION OF AWARD.—A grant or contract 

2 under this section shall be for a term of not to exceed 

3 5 years. 

4 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

5 is authorized to be appropriated to carry out this section, 

6 $43,000,000 for fiscal year 2008, and such sums as may 

7 be necessary for each succeeding fiscal year.’’. 

8 SEC. 316. TASK FORCE FOR THE PROMOTION OF 

9 BREASTFEEDING IN THE WORKPLACE. 

10 (a) ESTABLISHMENT.—The Secretary of Health and 

11 Human Services and the Secretary of Labor, or their des12 ignees, shall convene a task force for the purpose of pro13 moting breastfeeding among working mothers (referred to 

14 in this section as the ‘‘Task Force’’). 

15 (b) MEMBERSHIP.—The Task Force shall be com16 posed of members who are— 

17 (1) expert staff from the Department of Labor 

18 with expertise in workforce issues; 

19 (2) expert staff from the Department of Health 

20 and Human Services with expertise in the areas of 

21 breastfeeding and breastfeeding promotion; 

22 (3) members of the United States Breastfeeding 

23 Committee; 

24 (4) expert staff from the Department of Agri25 culture; and 


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1 (5) appointed by the Secretary of Health and 

2 Human Services and the Secretary of Labor, includ3 ing— 

4 (A) working mothers who have experience 

5 in working and breastfeeding; and 

6 (B) representatives of the human resource 

7 departments of both large and small employers 

8 that have successfully promoted breastfeeding 

9 and breastmilk pumping support at work. 

10 (c) PERIOD OF APPOINTMENT; VACANCIES.—Mem11 bers shall be appointed for the life of the Task Force. Any 

12 vacancy in the Task Force shall not affects its powers, 

13 but shall be filled in the same manner as the original ap14 pointment. 

15 (d) CHAIR.—The Task Force shall be chaired jointly 

16 by the Secretary of Health and Human Services and the 

17 Secretary of Labor, or their designees. 

18 (e) DUTIES OF THE TASK FORCE.— 

19 (1) EXAMINATION.—Consistent with the De20 partment of Health and Human Services Blueprint 

21 for Action on Breastfeeding (2000), the Task Force 

22 shall examine the following issues: 

23 (A) The challenges that mothers face with 

24 continuing breastfeeding when the mothers re25 turn to work after giving birth. 


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1 (B) The challenges that employers face in 

2 accommodating mothers who seek to continue 

3 to breastfeed or to express milk when the moth4 ers re-enter the workforce, including different 

5 challenges that mothers of varying socio-eco6 nomic status and in different professions may 

7 face. 

8 (C) The benefits that accrue to mothers, 

9 babies, and to employers when mothers are able 

10 to continue to breastfeed or to express 

11 breastmilk at work after the mothers have re12 entered the workforce. 

13 (D) Federal and State statutes that may 

14 have the effect of reducing breastfeeding and 

15 breastfeeding retention rates among working 

16 mothers. 

17 (2) REPORTS.— 

18 (A) IN GENERAL.—Not later than 1 year 

19 after the date of enactment of this section, the 

20 Task Force shall issue a public report with rec21 ommendations on the following: 

22 (i) Steps that can be taken to promote 

23 breastfeeding among working mothers and 

24 to remove barriers to breastfeeding among 

25 working mothers. 


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1 (ii) Potential ways in which the Fed2 eral Government can work with employers 

3 to promote breastfeeding among working 

4 mothers. 

5 (iii) Areas in which changes to exist6 ing Federal, State, or local laws would 

7 likely have the effect of making it easier 

8 for working mothers to breastfeed or would 

9 remove impediments to breastfeeding that 

10 currently exist in such laws. 

11 (iv) Whether or not increased rates of 

12 breastfeeding among working mothers 

13 would likely have the result of reducing 

14 health care costs among such mothers and 

15 their children, and, in particular, whether 

16 increased rates of breastfeeding would be 

17 likely to result in lower Federal expendi18 tures on health care for such mothers and 

19 their children. 

20 (v) Areas in which the Federal Gov21 ernment, through additional appropria22 tions, increased efforts by Federal agen23 cies, or changes to existing Federal law, 

24 can and should increase the Federal GovVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00078 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 ernment’s efforts to promote breastfeeding 

2 among working mothers. 

3 (B) COPY TO CONGRESS.—Upon comple4 tion of the report described in subparagraph 

5 (A), the Task Force shall submit a copy of the 

6 report to the Committee on Health, Education, 

7 Labor, and Pensions of the Senate, the Com8 mittee on Appropriations of the Senate, the 

9 Committee on Education and the Workforce of 

10 the House of Representatives, and the Com11 mittee on Appropriations of the House of Rep12 resentatives. 

13 (f) POWERS OF THE TASK FORCE.— 

14 (1) HEARINGS.—The Task Force may hold 

15 such hearings, sit and act at such times and places, 

16 take such testimony, and receive such evidence as 

17 the Task Force considers advisable to carry out this 

18 section. 

19 (2) INFORMATION FROM FEDERAL AGENCIES.— 

20 The Task Force may secure directly from any Fed21 eral department or agency such information as the 

22 Task Force considers necessary to carry out this 

23 section. Upon request of the Chair of the Task 

24 Force, the head of such department or agency shall 

25 furnish such information to the task Force. 


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1 (3) POSTAL SERVICES.—The Task Force may 

2 use the United States mails in the same manner and 

3 under the same conditions as other departments and 

4 agencies of the Federal Government. 

5 (4) GIFTS.—The Task Force may accept, use, 

6 and dispose of gifts or donations of services or prop7 erty. 

8 (g) OPERATING EXPENSES.—The operating expenses 

9 of the Task Force, including travel expenses for members 

10 of the Task Force, shall be paid for from the general oper11 ating expenses funds of the Secretary of Health and 

12 Human Services and the Secretary of Labor. 

13 SEC. 317. LACTATION ACCOMMODATION AND 

14 BREASTFEEDING PROMOTION AT WORK. 

15 (a) BREASTFEEDING AT WORK GENERAL REQUIRE16 MENTS.—The Family and Medical Leave Act of 1993 (29 

17 U.S.C. 2611 et seq.) is amended by inserting after title 

18 IV the following: 

19 ‘‘TITLE V—LACTATION PERIODS 

20 AND FACILITIES 

21 ‘‘SEC. 501. DEFINITIONS. 

22 ‘‘In this title: 

23 ‘‘(1) ELIGIBLE CHILD.—The term ‘eligible 

24 child’, used with respect to an eligible employee, 


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1 means a son or daughter (as defined in section 101) 

2 who is a child of the employee. 

3 ‘‘(2) ELIGIBLE EMPLOYEE.—The term ‘eligible 

4 employee’ has the meaning given the term in section 

5 101, except that the limitations established in 

6 clauses (i) and (ii) of section 101(2)(A) shall not 

7 apply. The term ‘eligible employee’ does not include 

8 any Federal officer or employee covered under sub9 chapter VII of chapter 63 of title 5, United States 

10 Code, but does include a State employee described in 

11 section 304(a) of the Government Employee Rights 

12 Act of 1991 (42 U.S.C. 2000e–16c(a)). 

13 ‘‘(3) EMPLOYER.—The term ‘employer’ has the 

14 meaning given the term in section 101, and includes 

15 an entity employing a State employee described in 

16 section 304(a) of the Government Employee Rights 

17 Act of 1991. 

18 ‘‘(4) UNDUE HARDSHIP.—The term ‘undue 

19 hardship’ means an action requiring significant dif20 ficulty or expense. 

21 ‘‘SEC. 502. LACTATION PERIODS. 

22 ‘‘(a) IN GENERAL.—An employer shall provide an ap23 propriate number of lactation periods, of reasonable 

24 length, for an eligible employee during each workday, to 


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1 permit the employee to express milk for, or breastfeed, an 

2 eligible child. 

3 ‘‘(b) BREAK TIME.— 

4 ‘‘(1) UNPAID BREAK PERIODS.—Except as pro5 vided in paragraph (2), the lactation periods may 

6 consist of unpaid break periods. 

7 ‘‘(2) COMBINED BREAK PERIODS.—To the ex8 tent practicable, an employer shall combine break 

9 periods by providing the lactation periods for an eli10 gible employee at the same time as the employer 

11 provides other break periods for the employee. If the 

12 employer combines the break periods, the employee 

13 shall receive the same compensation for a combined 

14 break period as the employee would have received for 

15 an original break period. 

16 ‘‘(c) LIMITATION.— 

17 ‘‘(1) UNDUE HARDSHIP.—An employer shall 

18 not be required to provide a lactation period under 

19 this section if the employer demonstrates that pro20 viding the period would impose an undue hardship 

21 on the employer, subject to paragraph (2). 

22 ‘‘(2) REASONABLE EFFORTS.—An employer 

23 who maintains that an undue hardship would result 

24 from providing a lactation period to an eligible em25 ployee shall demonstrate that the employer made 


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1 reasonable efforts to comply with subsections (a) 

2 and (b). 

3 ‘‘SEC. 503. LACTATION FACILITIES. 

4 ‘‘(a) IN GENERAL.—An employer shall provide an ap5 propriate lactation facility for an eligible employee, within 

6 a reasonable distance from the employee’s usual work loca7 tion, to permit the employee to express milk for, or 

8 breastfeed, an eligible child. 

9 ‘‘(b) LIMITATION.— 

10 ‘‘(1) UNDUE HARDSHIP.—An employer shall 

11 not be required to provide a lactation facility under 

12 this section if the employer demonstrates that pro13 viding the facility would impose an undue hardship 

14 on the employer, subject to paragraph (2). 

15 ‘‘(2) REASONABLE EFFORTS.—An employer 

16 who maintains that an undue hardship would result 

17 from providing a lactation facility to an eligible em18 ployee shall demonstrate that the employer made 

19 reasonable efforts to comply with subsection (a). 

20 ‘‘SEC. 504. ENFORCEMENT AND REMEDIES. 

21 ‘‘(a) ENFORCEMENT PROCESS.—The Secretary of 

22 Labor shall establish or designate a process through 

23 which— 

24 ‘‘(1) an individual may file a complaint regard25 ing a violation of this title; and 


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1 ‘‘(2) an office designated by the Secretary in 

2 the Department of Labor shall receive, investigate, 

3 make determinations regarding, and administer rem4 edies with respect to such complaints. 

5 ‘‘(b) REMEDIES.—The Secretary of Labor shall es6 tablish remedies for violations of this title. 

7 ‘‘(c) GOVERNMENT ACCOUNTABILITY OFFICE AND

8 LIBRARY OF CONGRESS.—In the case of the Government 

9 Accountability Office and the Library of Congress, the au10 thority of the Secretary of Labor under this title shall be 

11 exercised respectively by the Comptroller General of the 

12 United States and the Librarian of Congress. 

13 ‘‘SEC. 505. REGULATIONS. 

14 ‘‘The Secretary of Labor shall issue regulations to 

15 carry out this title, including provisions prescribing— 

16 ‘‘(1) an appropriate number and reasonable 

17 length of lactation periods, for purposes of section 

18 502; 

19 ‘‘(2) an appropriate lactation facility (which 

20 shall not be a restroom or a portion of a restroom) 

21 and a reasonable distance from a usual work loca22 tion, for purposes of section 503; and 

23 ‘‘(3) the process and remedies described in sec24 tion 504.’’. 


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1 (b) BREASTFEEDING AT WORK FOR CIVIL SERVICE

2 EMPLOYEES.—Chapter 63 of title 5, United States Code, 

3 is amended by adding at the end: 

4 ‘‘SUBCHAPTER VII—LACTATION PERIODS AND 

5 FACILITIES 

6 ‘‘§ 6392. Definitions 

7 ‘‘For the purpose of this subchapter— 

8 ‘‘(1) the term ‘eligible child’, used with respect 

9 to an employee, means a son or daughter (as defined 

10 in section 6381) who is a child of the employee; 

11 ‘‘(2) the term ‘employee’ means any individual 

12 who is an ‘employee’, as defined by section 6301(2), 

13 including any individual employed in a position re14 ferred to in clause (v) or (ix) of section 6301(2), but 

15 excluding any individual employed by the govern16 ment of the District of Columbia, any individual em17 ployed on a temporary or intermittent basis, and any 

18 employee of the General Accounting Office or the Li19 brary of Congress; and 

20 ‘‘(3) the term ‘undue hardship’ means an action 

21 requiring significant difficulty or expense. 

22 ‘‘§ 6392A. Lactation periods 

23 ‘‘(a) An employing agency shall provide an appro24 priate number of lactation periods, of reasonable length, 


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1 for an employee during each workday, to permit the em2 ployee to express milk for, or breastfeed, an eligible child. 

3 ‘‘(b)(1) Except as provided in paragraph (2), the lac4 tation periods may consist of unpaid break periods. 

5 ‘‘(2) To the extent practicable, an employing agency 

6 shall combine break periods by providing the lactation pe7 riods for an employee at the same time as the employing 

8 agency provides other break periods for the employee. If 

9 the employing agency combines the break periods, the em10 ployee shall receive the same compensation for a combined 

11 break period as the employee would have received for an 

12 original break period. 

13 ‘‘(c)(1) An employing agency shall not be required to 

14 provide a lactation period under this section if the employ15 ing agency demonstrates that providing the period would 

16 impose an undue hardship on the employing agency, sub17 ject to paragraph (2). 

18 ‘‘(2) An employing agency who maintains that an 

19 undue hardship would result from providing a lactation 

20 period to an employee shall demonstrate that the employ21 ing agency made reasonable efforts to comply with sub22 sections (a) and (b). 

23 ‘‘§ 6392B. Lactation facilities 

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1 able distance from the employee’s usual work location, to 

2 permit the employee to express milk for, or breastfeed, an 

3 eligible child. 

4 ‘‘(b)(1) An employing agency shall not be required 

5 to provide a lactation facility under this section if the em6 ploying agency demonstrates that providing the facility 

7 would impose an undue hardship on the employing agency, 

8 subject to paragraph (2). 

9 ‘‘(2) An employing agency who maintains that an 

10 undue hardship would result from providing a lactation 

11 facility to an employee shall demonstrate that the employ12 ing agency made reasonable efforts to comply with sub13 section (a). 

14 ‘‘§ 6392C. Remedies 

15 ‘‘(a) The Office of Personnel Management shall es16 tablish or designate a process through which— 

17 ‘‘(1) an individual may file a complaint regard18 ing a violation of this subchapter; and 

19 ‘‘(2) an office designated by the Director of the 

20 Office of Personnel Management shall receive, inves21 tigate, make determinations regarding, and admin22 ister remedies with respect to such complaints. 

23 ‘‘(b) The Office of Personnel Management shall es24 tablish remedies for violations of this subchapter. 


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1 ‘‘§ 6392D. Regulations 

2 ‘‘(a) The Office of Personnel Management shall issue 

3 regulations to carry out this subchapter, including provi4 sions prescribing— 

5 ‘‘(1) an appropriate number and reasonable 

6 length of lactation periods, for purposes of section 

7 6392A; 

8 ‘‘(2) an appropriate lactation facility (which 

9 shall not be a restroom or a portion of a restroom) 

10 and a reasonable distance from a usual work loca11 tion, for purposes of section 6392B; and 

12 ‘‘(3) the process and remedies described in sec13 tion 6392C. 

14 ‘‘(b) The regulations prescribed under this sub15 chapter shall, to the extent appropriate, be consistent with 

16 the regulations prescribed by the Secretary of Labor to 

17 carry out title V of the Family and Medical Leave Act 

18 of 1993.’’. 

19 (c) BREASTFEEDING AT WORK FOR CONGRESSIONAL

20 EMPLOYEES.— 

21 (1) APPLICATION OF LAWS.—Section 102(a) of 

22 the Congressional Accountability Act of 1995 (2 

23 U.S.C. 1302(a)) is amended— 

24 (A) in paragraph (5), by striking ‘‘The’’ 

25 and inserting ‘‘Title I of the’’; and 

26 (B) by adding at the end the following: 


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1 ‘‘(12) Title V of the Family and Medical Leave 

2 Act of 1993.’’. 

3 (2) EXTENSION OF RIGHTS AND PROTEC4 TIONS.—Part A of title II of the Congressional Ac5 countability Act of 1995 (2 U.S.C. 1311 et seq.) is 

6 amended— 

7 (A) in section 202 (2 U.S.C. 1312), by 

8 striking the title and inserting the following: 

9 ‘‘SEC. 202. RIGHTS AND PROTECTIONS UNDER TITLE I OF 

10 THE FAMILY AND MEDICAL LEAVE ACT OF 

11 1993.’’; 

12 (B) by redesignating section 207 as section 

13 208; and 

14 (C) by inserting after section 206 the fol15 lowing: 

16 ‘‘SEC. 207. RIGHTS AND PROTECTIONS UNDER TITLE V OF 

17 THE FAMILY AND MEDICAL LEAVE ACT OF 

18 1993. 

19 ‘‘(a) BREASTFEEDING RIGHTS AND PROTECTIONS

20 PROVIDED.— 

21 ‘‘(1) IN GENERAL.—The rights and protections 

22 established by sections 501 through 503 of the Fam23 ily and Medical Leave Act of 1993 shall apply to 

24 covered employees. 


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1 ‘‘(2) DEFINITION.—For purposes of the appli2 cation described in paragraph (1)— 

3 ‘‘(A) the term ‘employer’ as used in the 

4 Family and Medical Leave Act of 1993 means 

5 any employing office; and 

6 ‘‘(B) the term ‘eligible employee’ as used 

7 in the Family and Medical Leave Act of 1993 

8 means a covered employee who has been em9 ployed in any employing office. 

10 ‘‘(b) REMEDY.—The remedy for a violation of sub11 section (a) shall be such remedy as would be appropriate 

12 if awarded under section 504 of the Family and Medical 

13 Leave Act of 1993. 

14 ‘‘(c) REGULATIONS.— 

15 ‘‘(1) IN GENERAL.—The Board shall, pursuant 

16 to section 304, issue regulations to implement the 

17 rights and protections under this section. 

18 ‘‘(2) AGENCY REGULATIONS.—The regulations 

19 issued under paragraph (1) shall be the same as 

20 substantive regulations promulgated by the Sec21 retary of Labor to implement the statutory provi22 sions referred to in subsections (a) and (b), except 

23 insofar as the Board may determine, for good cause 

24 shown and stated together with the issued regula25 tions, that a modification of such promulgated reguVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00090 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 lations would be more effective for the implementa2 tion of the rights and protections under this sec3 tion.’’. 

4 (3) TABLE OF CONTENTS.—The table of con5 tents for the Congressional Accountability Act of 

6 1995 is amended by striking the item relating to 

7 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.’’. 

8 (d) BREASTFEEDING AT WORK FOR EMPLOYEES IN

9 PRESIDENTIAL OFFICES.— 

10 (1) APPLICATION OF LAWS.—Section 402 of 

11 title 3, United States Code, is amended— 

12 (A) in paragraph (5), by striking ‘‘The’’ 

13 and inserting ‘‘Title I of the’’; and 

14 (B) by adding at the end the following: 

15 ‘‘(12) Title V of the Family and Medical Leave 

16 Act of 1993.’’. 

17 (2) EXTENSION OF RIGHTS AND PROTEC18 TIONS.—Subchapter II of chapter 5 of title 3, 

19 United States Code, is amended— 

20 (A) in section 412, by striking the title and 

21 inserting the following: 


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1 ‘‘SEC. 412. RIGHTS AND PROTECTIONS UNDER TITLE I OF 

2 THE FAMILY AND MEDICAL LEAVE ACT OF 

3 1993.’’; 

4 (B) by redesignating section 417 as section 

5 418; and 

6 (C) by inserting after section 416 the fol7 lowing: 

8 ‘‘SEC. 417. RIGHTS AND PROTECTIONS UNDER TITLE V OF 

9 THE FAMILY AND MEDICAL LEAVE ACT OF 

10 1993. 

11 ‘‘(a) BREASTFEEDING RIGHTS AND PROTECTIONS

12 PROVIDED.— 

13 ‘‘(1) IN GENERAL.—The rights and protections 

14 established by sections 501 through 503 of the Fam15 ily and Medical Leave Act of 1993 shall apply to 

16 covered employees. 

17 ‘‘(2) DEFINITION.—For purposes of the appli18 cation described in paragraph (1)— 

19 ‘‘(A) the term ‘employer’ as used in the 

20 Family and Medical Leave Act of 1993 means 

21 any employing office; and 

22 ‘‘(B) the term ‘eligible employee’ as used 

23 in the Family and Medical Leave Act of 1993 

24 means a covered employee. 

25 ‘‘(b) REMEDY.—The remedy for a violation of sub26 section (a) shall be such remedy as would be appropriate 


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•S 1342 IS 

1 if awarded under section 504 of the Family and Medical 

2 Leave Act of 1993. 

3 ‘‘(c) REGULATIONS.— 

4 ‘‘(1) IN GENERAL.—The President, or the des5 ignee of the President, shall issue regulations to im6 plement this section. 

7 ‘‘(2) AGENCY REGULATIONS.—The regulations 

8 issued under paragraph (1) shall be the same as 

9 substantive regulations promulgated by the Sec10 retary of Labor to implement the statutory provi11 sions referred to in subsections (a) and (b)— 

12 ‘‘(A) except to the extent that the Presi13 dent or designee may determine, for good cause 

14 shown and stated together with the issued regu15 lations, that a modification of such promulgated 

16 regulations would be more effective for the im17 plementation of the rights and protections 

18 under this section; and 

19 ‘‘(B) except that the President or designee 

20 may, at the discretion of the President or des21 ignee, issue regulations to implement a provi22 sion of subchapter VII of chapter 63 of title 5, 

23 United States Code, that applies to employees 

24 in the executive branch of the Federal Govern25 ment in lieu of an analogous statutory provision 


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•S 1342 IS 

1 referred to in subsection (a) or (b), if the 

2 issuance of such regulations— 

3 ‘‘(i) would be equally effective for the 

4 implementation of the rights and protec5 tions under this section; and 

6 ‘‘(ii) would promote uniformity in the 

7 application of Federal law to employees in 

8 the executive branch of the Federal Gov9 ernment.’’. 

10 (3) CONFORMING AMENDMENT.—Section 

11 411(e) of title 3, United States Code, is amended by 

12 striking ‘‘417’’ and inserting ‘‘418’’. 

13 (4) TABLE OF CONTENTS.—The table of con14 tents for chapter 5 of title 3, United States Code, 

15 is amended by striking the item relating to section 

16 417 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.’’. 

17 (e) EFFECTIVE DATES.— 

18 (1) IN GENERAL.—Except as provided in para19 graph (2), this section and the amendments made by 

20 this section take effect 18 months after the date of 

21 enactment of this Act. 

22 (2) REGULATIONS.—Section 505 of the Family 

23 and Medical Leave Act of 1993 (as added by sub24 section (a)), section 6392D of title 5, United States 


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•S 1342 IS 

1 Code (as added by subsection (b)), section 207(c) of 

2 the Congressional Accountability Act of 1995 (as 

3 added by subsection (c)), and section 417(c) of title 

4 3, United States Code (as added by subsection (d)) 

5 take effect on the date of enactment of this Act. 

6 CHAPTER 2—PROMOTING LIFELONG 

7 ACTIVE COMMUNITIES 

8 SEC. 321. SHORT TITLE. 

9 This chapter may be cited as the ‘‘Promoting Life10 long Active Communities Every Day Act’’ or the ‘‘PLAY 

11 Every Day Act’’. 

12 SEC. 322. PURPOSE. 

13 The purpose of this chapter is to help children, fami14 lies and communities achieve the national recommendation 

15 of 60 minutes of physical activity every day. 

16 SEC. 323. DEFINITION OF SECRETARY. 

17 In this chapter, the term ‘‘Secretary’’ means the Sec18 retary of Health and Human Services. 

19 Subchapter A—National Program Promoting 

20 Lifelong Active Communities 

21 SEC. 331. DEVELOPMENT OF COMMUNITY PLAY INDEX. 

22 (a) COMMUNITY PLAY INDEX.—The Secretary, act23 ing through the Director of the Centers for Disease Con24 trol and Prevention, shall develop a well-validated commu25 nity measurement tool, which shall be known as the ‘‘ComVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00095 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 munity Play Index’’, that can measure the policy, pro2 gram, or environmental barriers in communities to partici3 pating in physical activity. The Community Play Index 

4 shall include— 

5 (1) cross-cutting measurements that— 

6 (A) examine barriers to physical activities 

7 across multiple settings, including homes, after 

8 school and child care sites, schools, the commu9 nity at-large, and worksites; and 

10 (B) focus on the— 

11 (i) availability of adequate spaces and 

12 places for physical activity; 

13 (ii) availability of, and access to, qual14 ity physical activity and physical education 

15 programs; and 

16 (iii) the availability of programs, ac17 tivities, and leaders to educate about the 

18 importance of physical activity for the com19 munity; and 

20 (2) additional measurements to assist economi21 cally and culturally diverse communities in exam22 ining the social determinants of health. 

23 (b) GUIDANCE AND TRAINING.—The Secretary shall 

24 provide guidance and develop training on utilizing the 

25 Community Play Index. 


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1 SEC. 332. SENSE OF THE SENATE REGARDING FUNDING. 

2 It is the sense of the Senate that the Secretary, act3 ing through the Director of the Centers for Disease Con4 trol and Prevention, shall carry out this subchapter using 

5 any additional and available funds provided to the Sec6 retary for the steps to a healthier United States program 

7 carried out by the Centers for Disease Control and Pre8 vention. 

9 Subchapter B—Model Communities of Play 

10 Implementation Grants 

11 SEC. 341. MODEL COMMUNITIES OF PLAY IMPLEMENTA12 TION GRANTS. 

13 (a) PROGRAM AUTHORIZED.— 

14 (1) IN GENERAL.—The Secretary, acting 

15 through the Director of the Centers for Disease 

16 Control and Prevention, shall award 3 grants to 

17 State health departments to enable the State health 

18 departments to work in partnership with eligible 

19 community-based coalitions to plan and implement 

20 model communities of play that— 

21 (A) increase the physical spaces and places 

22 available for physical activity; 

23 (B) increase the opportunities for children 

24 and families to participate in quality play, and 

25 the number of children and families partici26 pating in quality play; and 


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•S 1342 IS 

1 (C) increase knowledge and awareness 

2 about the importance of individuals achieving 

3 60 minutes of recommended physical activity 

4 every day. 

5 (2) AMOUNT OF GRANTS.—A grant awarded 

6 under this subsection shall be in the amount of 

7 $250,000. If the amounts appropriated under this 

8 title for a fiscal year are not sufficient to support 3 

9 grants at such level, the Secretary shall ratably re10 duce the amount of all grants. 

11 (b) APPLICATION.—A State health department desir12 ing a grant under subsection (a) shall submit an applica13 tion to the Secretary at such time, in such manner, and 

14 containing such information as the Secretary may require. 

15 (c) COORDINATION.—In awarding grants under sub16 section (a), the Secretary shall ensure that the proposed 

17 programs assisted under each grant are coordinated in 

18 substance and format with programs currently funded 

19 through other Federal departments and agencies, includ20 ing— 

21 (1) State-based nutrition and physical activity 

22 programs, comprehensive school health education 

23 programs, and community-based health and wellness 

24 programs of the Centers for Disease Control and 

25 Prevention; 


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1 (2) the physical education programs under sub2 part 10 of part D of title V of the Elementary and 

3 Secondary Education Act of 1965 (20 U.S.C. 7261 

4 et seq.; 

5 (3) the safe routes to schools program under 

6 section 1404 of the Safe, Accountable, Flexible, Effi7 cient Transportation Equity Act: A Legacy for 

8 Users (23 U.S.C. 402 note; 119 Stat. 1228); and 

9 (4) other health and wellness programs oper10 ating within the community. 

11 (d) PARTNERSHIP WITH COMMUNITY COALITIONS.— 

12 A State health department receiving a grant under sub13 section (a) shall use grant funds to carry out the activities 

14 described in subsection (e) in partnership with 1 or more 

15 community coalitions that meet all of the following re16 quirements: 

17 (1) The community coalition is comprised of a 

18 representative sampling of community partners, in19 cluding not less than half of the different types of 

20 individuals or entities described in subparagraphs 

21 (A) through (O): 

22 (A) A community-based organization that 

23 focuses on children and youth, preventive 

24 health, physical activity, or physical education. 


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1 (B) A local parks and recreation depart2 ment. 

3 (C) A local health department. 

4 (D) A local educational agency, as defined 

5 in section 9101 of the Elementary and Sec6 ondary Education Act of 1965 (20 U.S.C. 

7 7801). 

8 (E) A local city planning agency. 

9 (F) A local health care provider. 

10 (G) A 4-year institution of higher edu11 cation, as defined in section 101 of the Higher 

12 Education Act of 1965 (20 U.S.C. 1001). 

13 (H) A tribal health facility, where applica14 ble. 

15 (I) A tribal educational agency, where ap16 plicable. 

17 (J) A Federally qualified health center or 

18 rural health clinic, where applicable. 

19 (K) A hospital. 

20 (L) A faith-based organization. 

21 (M) A policymaker or elected official. 

22 (N) A community planning organization. 

23 (O) A business. 

24 (2) The community coalition completed and 

25 submitted to the State health department— 


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1 (A) a Community Play Index developed 

2 under section 101 for the community that iden3 tifies the gaps and barriers to physical activity 

4 in the community to children and youth; and 

5 (B) a community action plan describing 

6 the programs, policy, and environmental change 

7 strategies that will be implemented with grant 

8 funds to help children and youth in the commu9 nity reach the recommended 60 minutes of 

10 physical activity every day. 

11 (3) The community coalition provided— 

12 (A) documentation to the State health de13 partment on the manner in which the coalition 

14 will coordinate with appropriate State and local 

15 authorities, including— 

16 (i) State or local health departments; 

17 (ii) State educational agencies or local 

18 educational agencies, as defined in section 

19 9101 of the Elementary and Secondary 

20 Education Act of 1965 (20 U.S.C. 7801); 

21 (iii) State or local parks and recre22 ation departments or associations; 

23 (iv) State or local departments of 

24 transportation or city planning; 

25 (v) community foundations; and 


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1 (vi) any other entities determined to 

2 be appropriate by the Secretary; and 

3 (B) a description of the manner in which 

4 the coalition will evaluate the effectiveness of 

5 the programs carried out with grant funds. 

6 (e) AUTHORIZED ACTIVITIES.—A State health de7 partment that receives a grant under subsection (a) shall 

8 use funds available through the grant to carry out the fol9 lowing activities: 

10 (1) Train community-based coalitions on how to 

11 utilize the Community Play Index to measure the 

12 program, policy, and environmental barriers to pro13 moting lifelong physical activity for youth. 

14 (2) Work in partnership with community coali15 tions described in subsection (d) to enable the com16 munity coalitions to carry out the coalition’s commu17 nity action plan and promote a model community of 

18 play, which may include the following: 

19 (A) Enabling the maximum use of, or the 

20 creation of spaces and places for, physical activ21 ity for children, families, and communities be22 fore, during, and after school or work, which 

23 may include increasing the number of— 

24 (i) programs that increase the number 

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1 munity to walk and bike to school, work, 

2 or other community destinations, such as 

3 recreation sites, parks, or community cen4 ters; 

5 (ii) schools, faith-based organizations, 

6 and recreational facilities serving the com7 munity that provide programming on phys8 ical activity and physical education before, 

9 during, or after school; 

10 (iii) schools serving the community 

11 that provide recess, physical education, and 

12 physical activity for children and youth; 

13 (iv) day care, child care, and after 

14 school care sites in the community that 

15 provide physical activity for children and 

16 youth; 

17 (v) venues in the community that pro18 vide co-curricular physical activity pro19 grams, including sports fields and courts, 

20 especially venues for all-inclusive intra21 mural programs and physical activity 

22 clubs; 

23 (vi) playgrounds and activity sites in 

24 the community for young children, includ25 ing sites that offer programs that provide 


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1 physical activity instruction that meet the 

2 various needs and interests of all students, 

3 including those with illness, injury, and 

4 physical and developmental disabilities, as 

5 well as those that live sedentary lifestyles 

6 or with a disinterest in traditional team 

7 sports; 

8 (vii) capital improvement projects that 

9 increase opportunities for physical activity 

10 in the community; and 

11 (viii) networks of walking and cycling 

12 trails where trails do not exist in the com13 munity, that offer both a functional alter14 native to automobile travel and an oppor15 tunity for exercise, recreation, and commu16 nity connectedness. 

17 (B) Enhancing opportunities and access 

18 for children and youth in the community to par19 ticipate in quality physical activity and physical 

20 education programs before, during, and after 

21 school, which may include increasing the num22 ber of— 

23 (i) school and after school care sites 

24 in the community that implement proven 

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1 cluding developing innovative approaches 

2 to teaching and staffing, physical edu3 cation), and physical activity programming; 

4 (ii) children and youth in the commu5 nity that are able to participate in physical 

6 education or activity during and after 

7 school, by ensuring that adequate equip8 ment is available to such children and 

9 youth; 

10 (iii) scholarships to low-income chil11 dren and youth for physical activity pro12 grams; 

13 (iv) education and training programs 

14 for education, recreation, leisure, child 

15 care, and coaching professionals regarding 

16 quality physical education and physical ac17 tivity programs and policies; 

18 (v) training programs to assist physi19 cians in— 

20 (I) carefully communicating the 

21 results of body mass index (BMI) 

22 tests to parents and, in an age-appro23 priate manner, to the children and 

24 youth themselves; 


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1 (II) providing information to 

2 families so they may make informed 

3 decisions about physical activity and 

4 nutrition; and 

5 (III) explaining the benefits asso6 ciated with physical activity and the 

7 risks associated with childhood over8 weight and obesity; 

9 (vi) assessment tools used to measure 

10 the quality of physical activity, sports, and 

11 intramural sports programs; 

12 (vii) guidelines and informational ma13 terials used by teachers, parents, care14 givers, and health-care professionals who 

15 are interested in promoting physical activ16 ity for infants, toddlers, and preschoolers; 

17 and 

18 (viii) guidelines and informational ma19 terials used to promote physical activity 

20 with the intent of improving the current 

21 health, fitness, and wellness of preadoles22 cent children (ages 6 through 12) as well 

23 as to promote lifelong physical activity. 

24 (C) Identifying, engaging and mobilizing 

25 community leaders, decision-makers, experts, 


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1 and the media to raise awareness and educate 

2 the public about the importance of securing 60 

3 minutes of physical activity every day, which 

4 may include increasing the number of— 

5 (i) school and after school care faculty 

6 and staff, including coaches, that serve as 

7 positive role models for students regarding 

8 regular physical activity; 

9 (ii) businesses that serve as role mod10 els by providing physical space and incen11 tives for employees to participate in phys12 ical activity; 

13 (iii) businesses that serve as role mod14 els to communities by— 

15 (I) providing support to intra16 mural teams, clubs, sports leagues, 

17 playgrounds, trails, biking and walk18 ing paths, and fields and venues for 

19 sports, play, and physical activity; 

20 (II) incorporating built environ21 ment strategies into new construction 

22 of facilities; 

23 (III) adopting safe routes to 

24 school programs; 


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1 (IV) providing bike racks at the 

2 office; and 

3 (V) encouraging the use of the 

4 stairs; 

5 (iv) insurers that provide incentives 

6 for maintaining healthy body weight, in7 cluding offering screening and obesity pre8 vention services in routine clinical practice; 

9 (v) groups representing low-income in10 dividuals or individuals with disabilities, 

11 that can promote and secure safer and 

12 more accessible sites for activity; 

13 (vi) consumer research-driven mar14 keting strategies for ongoing initiatives 

15 and interventions that enhance physical ac16 tivity for children and youth; 

17 (vii) products and opportunities pro18 vided or offered by leisure, entertainment, 

19 and recreation industries that promote reg20 ular physical activity and reduce sedentary 

21 behaviors; 

22 (viii) media advocacy training pro23 grams for public health and exercise sci24 entists so as to empower the scientists to 


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1 disseminate their knowledge to a broad au2 dience; and 

3 (ix) campaigns to foster awareness 

4 about the health benefits of regular phys5 ical activity of not less than 60 minutes a 

6 day for all children and youth. 

7 (3) To support the evaluation of the community 

8 action plans of the community coalitions and the ac9 tivities carried out under this title. 

10 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

11 are authorized to be appropriated to carry out this subtitle 

12 $750,000 for fiscal year 2008. 

13 TITLE IV—RESPONSIBLE MAR14 KETING AND CONSUMER 

15 AWARENESS 

16 Subtitle A—General Provisions 

17 SEC. 401. NUTRITION LABELING OF RESTAURANT FOODS. 

18 Section 403(q)(5) of the Federal Food, Drug, and 

19 Cosmetic Act (21 U.S.C. 343(q)(5)(A)(i)) is amended— 

20 (1) in clause (A)— 

21 (A) in subclause (i), by inserting ‘‘except 

22 as provided in clauses (H) and (I),’’ before 

23 ‘‘which’’ the first place it appears; and 


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1 (B) in subclause (ii), by inserting ‘‘except 

2 as provided in clauses (H) and (I),’’ before 

3 ‘‘which’’ the first place it appears; and 

4 (2) by adding at the end the following: 

5 ‘‘(H) RESTAURANTS AND RETAIL FOOD ESTABLISH6 MENTS.— 

7 ‘‘(i) IN GENERAL.—Except for food described in 

8 subclause (iii), in the case of food that is served, 

9 processed, or prepared in a restaurant or similar re10 tail food establishment that is part of a chain with 

11 20 or more locations doing business under the same 

12 trade name (regardless of the type of ownership of 

13 the locations), the restaurant or establishment shall 

14 disclose the information described in subclause (ii). 

15 ‘‘(ii) INFORMATION REQUIRED TO BE DIS16 CLOSED.—Except as provided in subclause (iii), the 

17 establishment shall disclose— 

18 ‘‘(I)(aa) in a statement adjacent to the 

19 name of the food on any menu listing the food 

20 for sale, or by any other means deemed equiva21 lent by the Secretary, the number of calories, 

22 grams of saturated fat plus trans fat, and milli23 grams of sodium contained in a standard serv24 ing of the food, as usually offered for sale, in 

25 a clear and conspicuous manner; and 


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1 ‘‘(bb) information, specified by the Sec2 retary by regulation, designed to enable the 

3 public to understand, in the context of a total 

4 daily diet, the significance of the nutrition in5 formation that is provided; and 

6 ‘‘(II) in a statement adjacent to the name 

7 of the food on any menu board or other sign 

8 listing the food for sale, or by any other means 

9 deemed equivalent by the Secretary— 

10 ‘‘(aa) the number of calories con11 tained in a serving of the food, as usually 

12 offered for sale, in a clear and conspicuous 

13 manner; and 

14 ‘‘(bb) notification that the information 

15 required by subitems (aa) and (bb) of item 

16 (I) shall be provided in writing at the re17 quest of a prospective purchaser. 

18 ‘‘(iii) NONAPPLICABILITY TO CERTAIN FOOD.— 

19 This clause does not apply to— 

20 ‘‘(I) items that are not listed on a menu or 

21 menu board (such as condiments and other 

22 items placed on the table or counter for general 

23 use); or 


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1 ‘‘(II) daily specials, temporary menu items, 

2 or other irregular menu items, as specified by 

3 the Secretary by regulation. 

4 ‘‘(iv) SELF-SERVICE FACILITIES.—In the case 

5 of food sold at a salad bar, buffet line, cafeteria line, 

6 or similar self-service facility, a restaurant or other 

7 establishment shall place a sign that lists calories 

8 per standard serving adjacent to each food offered. 

9 ‘‘(v) VOLUNTARY PROVISION OF NUTRITION IN10 FORMATION; STATE REGULATION OF NUTRITION IN11 FORMATION FOR RESTAURANT FOOD.— 

12 ‘‘(I) RETAIL FOOD ESTABLISHMENTS.— 

13 Nothing in this clause precludes a restaurant or 

14 similar retail food establishment from providing 

15 additional nutrition information, voluntarily, if 

16 the information complies with the nutrition la17 beling requirements contained in this subpara18 graph. 

19 ‘‘(II) STATE OR LOCAL REQUIREMENTS.— 

20 Nothing in this clause precludes a State or po21 litical subdivision of a State from requiring that 

22 a restaurant or similar food establishment pro23 vide nutrition information in addition to that 

24 required under this clause. 

25 ‘‘(vi) REGULATIONS.— 


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1 ‘‘(I) PROPOSED REGULATION.—Not later 

2 than 1 year after the date of enactment of this 

3 clause, the Secretary shall promulgate proposed 

4 regulations to carry out this clause. 

5 ‘‘(II) CONTENTS.—The regulations shall 

6 allow for the variations in serving sizes and in 

7 food preparation that can reasonably be ex8 pected to result from inadvertent human error, 

9 training of food service workers, and other fac10 tors. 

11 ‘‘(III) FINAL REGULATIONS.—Not later 

12 than 2 years after the date of enactment of this 

13 clause, the Secretary shall promulgate final reg14 ulations to implement this clause. 

15 ‘‘(IV) FAILURE TO PROMULGATE FINAL

16 REGULATIONS BY REQUIRED DATE.—If the Sec17 retary does not promulgate final regulations 

18 under item (III) by the date that is 2 years 

19 after the date of enactment of this clause— 

20 ‘‘(aa) the proposed regulations issued 

21 in accordance with item (I) shall become 

22 effective as the final regulations on the day 

23 after that date; and 


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1 ‘‘(bb) the Secretary shall publish in 

2 the Federal Register notice of the final 

3 regulations. 

4 ‘‘(I) VENDING MACHINES.— 

5 ‘‘(i) IN GENERAL.—In the case of an article of 

6 food sold from a vending machine that— 

7 ‘‘(I) does not permit a prospective pur8 chaser to examine the article so as to be able 

9 to read a statement affixed to the article before 

10 purchasing the article; and 

11 ‘‘(II) is operated by a person that is en12 gaged in the business of owning and operating 

13 20 or more vending machines; 

14 the vending machine operator shall provide a con15 spicuous sign in close proximity to the article that 

16 includes a statement disclosing the number of cal17 ories contained in the article. 

18 ‘‘(ii) VOLUNTARY PROVISION OF NUTRITION IN19 FORMATION; STATE REGULATION OF NUTRITION IN20 FORMATION FOR VENDING MACHINES.— 

21 ‘‘(I) VENDING MACHINE OPERATORS.— 

22 Nothing in this clause precludes a vending ma23 chine operator from providing additional nutri24 tion information, voluntarily, if the information 


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1 complies with the nutrition labeling require2 ments contained in this subparagraph. 

3 ‘‘(II) STATE OR LOCAL REQUIREMENTS.— 

4 Nothing in this title precludes a State or polit5 ical subdivision of a State from requiring that 

6 a vending machine operator provide nutrition 

7 information in addition to that required under 

8 this clause. 

9 ‘‘(iii) REGULATIONS.— 

10 ‘‘(I) PROPOSED REGULATIONS.—Not later 

11 than 1 year after the date of enactment of this 

12 clause, the Secretary shall promulgate proposed 

13 regulations to carry out this clause. 

14 ‘‘(II) FINAL REGULATIONS.—Not later 

15 than 2 years after the date of enactment of this 

16 clause, the Secretary shall promulgate final reg17 ulations to implement this clause. 

18 ‘‘(III) FAILURE TO PROMULGATE FINAL

19 REGULATIONS BY REQUIRED DATE.—If the Sec20 retary does not promulgate final regulations 

21 under item (II) by the date that is 2 years after 

22 the date of enactment of this clause— 

23 ‘‘(aa) the proposed regulations issued 

24 in accordance with item (I) shall become 


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1 effective as the final regulations on the day 

2 after that date; and 

3 ‘‘(bb) the Secretary shall publish in 

4 the Federal Register notice of the final 

5 regulations.’’. 

6 SEC. 402. RULEMAKING AUTHORITY FOR ADVERTISING TO 

7 CHILDREN. 

8 (a) PURPOSE.—The purpose of this section is to re9 store the authority of the Federal Trade Commission to 

10 issue regulations that restrict the marketing or advertising 

11 of foods and beverages to children under the age of 18 

12 years if the Federal Trade Commission determines that 

13 there is evidence that consumption of certain foods and 

14 beverages is detrimental to the health of children. 

15 (b) AUTHORITY.—Section 18 of the Federal Trade 

16 Commission Act (15 U.S.C. 57a) is amended by striking 

17 subsection (h). 

18 SEC. 403. FOOD ADVERTISING IN SCHOOLS. 

19 Section 10 of the Child Nutrition Act of 1966 (42 

20 U.S.C. 1779) is amended by adding at the end the fol21 lowing: 

22 ‘‘(d) FOOD ADVERTISING.—The Secretary may pro23 hibit the advertising of food in participating schools if the 

24 Secretary determines that consumption of the advertised 


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1 food has a detrimental effect on the diets or health of chil2 dren.’’. 

3 SEC. 404. DISALLOWANCE OF DEDUCTIONS FOR ADVER4 TISING AND MARKETING EXPENSES RELAT5 ING TO TOBACCO PRODUCT USE. 

6 (a) IN GENERAL.—Part IX of subchapter B of chap7 ter 1 of subtitle A of the Internal Revenue Code of 1986 

8 (relating to items not deductible) is amended by adding 

9 at the end the following new section: 

10 ‘‘SEC. 280I. DISALLOWANCE OF DEDUCTION FOR TOBACCO 

11 ADVERTISING AND MARKETING EXPENSES. 

12 ‘‘No deduction shall be allowed under this chapter for 

13 expenses relating to advertising or marketing cigars, ciga14 rettes, smokeless tobacco, pipe tobacco, or any similar to15 bacco product. For purposes of this section, any term used 

16 in this section which is also used in section 5702 shall 

17 have the same meaning given such term by section 5702.’’. 

18 (b) CONFORMING AMENDMENT.—The table of sec19 tions for such part IX is amended by adding after the 

20 item relating to section 280H the following new item: 

‘‘Sec. 280I. Disallowance of deduction for tobacco advertising 

and marketing expenses.’’. 

21 (c) EFFECTIVE DATE.—The amendments made by 

22 this section shall apply to taxable years beginning after 

23 the date of the enactment of this Act. 


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1 SEC. 405. FEDERAL-STATE TOBACCO COUNTER-ADVER2 TISING PROGRAMS. 

3 Part P of title III of the Public Health Service Act 

4 (42 U.S.C. 280g et seq.), as amended in section 312, is 

5 further amended by adding at the end the following: 

6 ‘‘SEC. 399S. FEDERAL-STATE TOBACCO COUNTER-ADVER7 TISING PROGRAMS. 

8 ‘‘(a) IN GENERAL.—The Secretary, acting through 

9 the Director of the Centers for Disease Control and Pre10 vention, shall award grants to and enter into contracts 

11 with eligible entities for the implementation of national 

12 and local media (such as counter-advertising) and non13 media campaigns designed to reduce the use of tobacco 

14 products. 

15 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

16 under subsection (a), an entity shall be— 

17 ‘‘(1) a public entity, including a State public 

18 health department; or 

19 ‘‘(2) a private, nonprofit entity that— 

20 ‘‘(A) is not affiliated with a manufacturer 

21 or importer of a tobacco product; 

22 ‘‘(B) has demonstrated a record of con23 ducting a national antitobacco public education 

24 campaign to effectively reduce the use of to25 bacco products; 


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1 ‘‘(C) has expertise in conducting a multi2 media communications campaign; and 

3 ‘‘(D) has expertise in developing strategies 

4 that affect behavior changes in children and 

5 other targeted populations. 

6 ‘‘(c) APPLICATION.—An eligible entity shall submit 

7 an application to the Secretary for a grant under this sec8 tion at such time, in such manner, and accompanied by 

9 such information as the Secretary may require. 

10 ‘‘(d) USE OF FUNDS.—An eligible entity shall use 

11 amounts received under a grant under this section to— 

12 ‘‘(1) design and implement multimedia public 

13 education and social marketing campaigns that— 

14 ‘‘(A) discourage the use of tobacco prod15 ucts; 

16 ‘‘(B) encourage the use of products de17 signed to enable tobacco use cessation; and 

18 ‘‘(C) educate the public about the hazards 

19 of environmental tobacco smoke exposure; or 

20 ‘‘(2) conduct research related to the effective21 ness of the campaigns described in paragraph (1). 

22 ‘‘(e) ALLOCATION OF GRANTS.—Of the amounts 

23 awarded under this section, the Secretary shall award— 

24 ‘‘(1) 50 percent of such amounts to eligible 

25 public entities; and 


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1 ‘‘(2) 50 percent of such amounts to eligible pri2 vate, nonprofit entities. 

3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated $200,000,000 to carry 

5 out this section.’’. 

6 Subtitle B—Penalties for Failure to 

7 Reduce Teen Smoking 

8 SEC. 411. CHILD CIGARETTE USE SURVEYS. 

9 (a) ANNUAL PERFORMANCE SURVEY.— 

10 (1) IN GENERAL.—Not later than August 31, 

11 2007, and annually thereafter, the Secretary of 

12 Health and Human Services (referred to in this sec13 tion as the ‘‘Secretary’’) shall publish the results of 

14 an annual cigarette survey, to be carried out after 

15 the date of enactment of this Act and completed 

16 prior to August 21, 2007, and prior to August 21 

17 of each year thereafter, to determine— 

18 (A) the percentage of all young individuals 

19 who used a type of cigarette within the 30-day 

20 period prior to the conduct of the survey in21 volved; and 

22 (B) the percentage of young individuals 

23 who identify each brand of each type of ciga24 rette as the usual brand smoked within such 

25 30-day period. 


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1 (2) YOUNG INDIVIDUALS.—For the purposes of 

2 this subtitle, the term ‘‘young individuals’’ means in3 dividuals who are under 18 years of age. 

4 (b) SIZE AND METHODOLOGY.— 

5 (1) IN GENERAL.—The survey referred to in 

6 subsection (a) shall be comparable in size and meth7 odology to the Monitoring the Future survey that 

8 was completed in 1999 to measure the use of ciga9 rettes (by brand) by youths under 18 years of age 

10 within the 30-day period prior to the conduct of the 

11 study. 

12 (2) CONCLUSIVE ACCURATENESS.—A survey 

13 using the methodology described in paragraph (1) 

14 shall be deemed conclusively proper, correct, and ac15 curate for purposes of this section. 

16 (3) DEFINITION.—In this subtitle, the term 

17 ‘‘Monitoring the Future survey’’ means the com18 bined survey of 8th, 10th, and 12th grade students 

19 that was conducted at the Institute for Social Re20 search at the University of Michigan. 

21 (c) REDUCTION.—The Secretary, based on a com22 parison of the results of the first annual cigarette survey 

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1 mine the percentage reduction (if any) in youth cigarette 

2 use for each manufacturer of cigarettes. 

3 (d) PARTICIPATION IN SURVEY.—Notwithstanding 

4 any other provision of law, the Secretary may conduct a 

5 survey under this section involving minors if the results 

6 of such survey with respect to such minors are kept con7 fidential and not disclosed. 

8 (e) NONAPPLICABILITY.—Chapter 35 of title 44, 

9 United States Code, shall not apply to information re10 quired for the purposes of carrying out this section. 

11 (f) DEFINITION.—In this subtitle the term ‘‘ciga12 rette’’ has the meaning given such term in section 3(1) 

13 of the Federal Cigarette Labeling and Advertising Act (15 

14 U.S.C. 1332(1)). 

15 SEC. 412. CIGARETTE USE REDUCTION GOAL AND NON16 COMPLIANCE. 

17 (a) GOAL.—It shall be the cigarette use reduction 

18 goal that each manufacturer reduce youth cigarette use 

19 by at least 15 percent during the period between the Moni20 toring the Future survey referred to in section 411(b)(1) 

21 and the completion of the first annual cigarette survey 

22 (and such subsequent surveys as compared to the previous 

23 year’s survey) referred to in section 411(a). 

24 (b) NONCOMPLIANCE.— 


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1 (1) INDUSTRY-WIDE PENALTY.—If the Sec2 retary determines that the cigarette use reduction 

3 goal under subsection (a) has not been achieved, the 

4 Secretary shall, not later than September 10, 2007, 

5 and September 10 of each year thereafter, impose 

6 an industry-wide penalty on the manufacturers of 

7 cigarettes in an amount that is in the aggregate 

8 equal to— 

9 (A) if youth cigarette use has been reduced 

10 by 5 percent or less, $6,000,000,000; 

11 (B) if youth cigarette use has been reduced 

12 by at least 6 percent but less than 10 percent, 

13 $4,000,000,000; and 

14 (C) if youth cigarette use has been reduced 

15 by at least 11 percent but less than 15 percent, 

16 $2,000,000,000. 

17 (2) PAYMENT.—The industry-wide penalty im18 posed under this subsection shall be paid by each 

19 manufacturer based on the percentage of cigarettes 

20 of each such manufacturer that are used by youth 

21 (as determined under the Monitoring the Future 

22 survey and compared to the cigarettes manufactured 

23 by all manufacturers) as such percentage relates to 

24 the total amount to be paid by all manufacturers. 


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1 (3) FINAL DETERMINATION.—The determina2 tion of the Secretary as to the amount and allocation 

3 of a surcharge under this subtitle shall be final and 

4 the manufacturer shall pay such surcharge within 10 

5 days of the date on which the manufacturer is as6 sessed. Such payment shall be retained by the Sec7 retary pending final judicial review of what, if any, 

8 change in the surcharge is appropriate. 

9 (4) COMPLIANCE BY CERTAIN MANUFACTUR10 ERS.—A manufacturer that individually complies 

11 with the goal under subsection (a) shall not be liable 

12 for the payment of any portion of the penalty under 

13 this subsection. 

14 (5) LIMITATION.—With respect to cigarettes, a 

15 manufacturer with a market share of 1 percent or 

16 less of youth cigarette use shall not be liable for the 

17 payment of a surcharge under this section. 

18 (c) PENALTIES NONDEDUCTIBLE.—The payment of 

19 penalties under this subtitle shall not be considered to be 

20 an ordinary and necessary expense in carrying on a trade 

21 or business for purposes of the Internal Revenue Code of 

22 1986 and shall not be deductible. 

23 (d) JUDICIAL REVIEW.— 

24 (1) AFTER PAYMENT.—A manufacturer of ciga25 rettes may seek judicial review of any action under 


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•S 1342 IS 

1 this subtitle only after the assessment involved has 

2 been paid by the manufacturer to the Department of 

3 the Treasury and only in the United States District 

4 Court for the District of Columbia. 

5 (2) REVIEW BY ATTORNEY GENERAL.—Prior to 

6 the filing of an action by a manufacturer seeking ju7 dicial review of an action under this subtitle, the 

8 manufacturer shall notify the Attorney General of 

9 such intent to file and the Attorney General shall 

10 have 30 days in which to respond to the action. 

11 (3) REVIEW.—The amount of any surcharge 

12 paid under this subtitle shall be subject to judicial 

13 review by the United States Court of Appeals for the 

14 District of Columbia Circuit, based on the arbitrary 

15 and capricious standard of section 706 of title 5, 

16 United States Code. Notwithstanding any other pro17 vision of law, no court shall have the authority to 

18 stay any surcharge payment due to the Secretary 

19 under this subtitle pending judicial review until the 

20 Secretary has made or failed to make a compliance 

21 determination, as described under this subtitle, that 

22 has adversely affected the person seeking the review. 

23 SEC. 413. ENFORCEMENT. 

24 (a) INITIAL PENALTY.—There is hereby imposed an 

25 initial penalty on the failure of any manufacturer to make 


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•S 1342 IS 

1 any payment required under this subtitle within 10 days 

2 after the date on which such payment is due. 

3 (b) AMOUNT OF PENALTY.—The amount of the pen4 alty imposed by subsection (a) on any failure with respect 

5 to a manufacturer shall be an amount equal to 2 percent 

6 of the penalty owed under section 412 for each day during 

7 the noncompliance period. 

8 (c) NONCOMPLIANCE PERIOD.—For purposes of this 

9 section, the term ‘‘noncompliance period’’ means, with re10 spect to any failure to make the surcharge payment re11 quired under this subtitle, the period— 

12 (1) beginning on the due date for such pay13 ment; and 

14 (2) ending on the date on which such payment 

15 is paid in fall. 

16 (d) LIMITATIONS.—No penalty shall be imposed by 

17 subsection (a) on— 

18 (1) any failure to make a surcharge payment 

19 under this subtitle during any period for which it is 

20 established to the satisfaction of the Secretary that 

21 none of the persons responsible for such failure 

22 knew or, exercising reasonable diligence, would have 

23 known, that such failure existed; or 


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•S 1342 IS 

1 (2) any manufacturer that produces less than 1 

2 percent of cigarettes used by youth in that year (as 

3 determined by the annual survey). 

4 Subtitle C—Food Guidance 

5 SEC. 421. FRONT-LABEL FOOD GUIDANCE SYSTEMS. 

6 (a) IN GENERAL.—Not later than March 1, 2008, the 

7 Secretary of Health and Human Services (referred to in 

8 this section as the ‘‘Secretary’’) shall begin solicitation of 

9 public comments regarding— 

10 (1) the use of retail front-label food guidance 

11 systems to convey nutrition information to the public 

12 using logos, symbols, signs, emblems, insignia, or 

13 other graphic representations on the labeling of food 

14 intended for human consumption that are intended 

15 to provide simple, standardized, and understandable 

16 nutrition information to the public in graphic form; 

17 (2) appropriate nutrition standards by which a 

18 retail front-label food guidance system may convey 

19 the relative nutritional value of different foods in 

20 simple graphic form; and 

21 (3) whether American consumers would be bet22 ter served by establishing a single, standardized re23 tail front-label food guidance system regulated by 

24 the Food and Drug Administration, or by allowing 

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1 profit organizations, and others to continue to de2 velop their own retail front-label food guidance sys3 tems. 

4 (b) EFFECT ON NUTRITION FACTS PANEL.—In solic5 iting public comments under subsection (a), the Secretary 

6 shall inform the public that any retail front-label food 

7 guidance system is intended to supplement, not replace, 

8 the Nutrition Facts Panel that appears on food labels pur9 suant to section 403(q) of the Federal Food, Drug, and 

10 Cosmetic Act (21 U.S.C. 343(q)). 

11 (c) PROPOSED REGULATION.—Not later than 12 

12 months following the closure of the public comment solici13 tation period under subsection (a), the Secretary shall— 

14 (1) publish a notice in the Federal Register 

15 that summarizes the public comments and describes 

16 the suggested retail front-label food guidance sys17 tems received through such solicitation; and 

18 (2) publish proposed regulations that— 

19 (A) establish a single, standardized retail 

20 front-label food guidance system; or 

21 (B) establish the conditions under which 

22 individual food companies, trade associations, 

23 nonprofit organizations, and other persons may 

24 continue to develop their own retail front-label 

25 food guidance systems. 


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1 TITLE V—REIMBURSEMENT AND 

2 COVERAGE OF PREVENTIVE 

3 SERVICES 

4 SEC. 501. COVERAGE OF SUBSTANCE USE (OTHER THAN TO5 BACCO), DIET, EXERCISE, INJURY PREVEN6 TION, AND DENTAL HEALTH COUNSELING. 

7 (a) COVERAGE.— 

8 (1) IN GENERAL.—Section 1861(s)(2) of the 

9 Social Security Act (42 U.S.C. 1395x(s)(2)), as 

10 amended by section 642(a) of the Medicare Prescrip11 tion Drug, Improvement, and Modernization Act of 

12 2003 (Public Law 108–173; 117 Stat. 2322), is 

13 amended— 

14 (A) in subparagraph (Y), by striking 

15 ‘‘and’’ after the semicolon at the end; 

16 (B) in subparagraph (Z), by adding ‘‘and’’ 

17 after the semicolon at the end; and 

18 (C) by adding at the end the following new 

19 subparagraph: 

20 ‘‘(AA) substance use (other than tobacco), diet, 

21 exercise, injury prevention, and dental health coun22 seling (as defined in subsection (bbb)(1));’’. 

23 (2) CONFORMING AMENDMENTS.—(A) Section 

24 1862(a)(12) of the Social Security Act (42 U.S.C. 

25 1395y(a)(12)) is amended by inserting ‘‘(except as 


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•S 1342 IS 

1 otherwise allowed under subsection 

2 1861(s)(2)(AA))’’ after ‘‘directly supporting teeth’’. 

3 (B) Clauses (i) and (ii) of section 

4 1861(s)(2)(K) of the Social Security Act (42 U.S.C. 

5 1395x(s)(2)(K)), as amended by section 611(d)(2) of 

6 the Medicare Prescription Drug, Improvement, and 

7 Modernization Act of 2003 (Public Law 108–173; 

8 117 Stat. 2304), are each amended by striking 

9 ‘‘subsection (ww)(1)’’ and inserting ‘‘subsections 

10 (ww)(1) and (bbb)’’. 

11 (b) SERVICES DESCRIBED.—Section 1861 of the So12 cial Security Act (42 U.S.C. 1395x), as amended by sec13 tion 706(b) of the Medicare Prescription Drug, Improve14 ment, and Modernization Act of 2003 (Public Law 108– 

15 173; 117 Stat. 2339), is amended by adding at the end 

16 the following new subsection: 

17 ‘‘Substance Use (Other Than Tobacco), Diet, Exercise, 

18 Injury Prevention, and Dental Health Counseling 

19 ‘‘(bbb) The term ‘substance use (other than tobacco), 

20 diet, exercise, injury prevention, and dental health coun21 seling’ means therapy and counseling relating to substance 

22 use (other than tobacco), diet, exercise, injury prevention, 

23 and dental health counseling that is furnished— 

24 ‘‘(1) by or under the supervision of a physician; 

25 or 


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•S 1342 IS 

1 ‘‘(2) by any other health care professional 

2 who— 

3 ‘‘(A) is legally authorized to furnish such 

4 services under State law (or the State regu5 latory mechanism provided by State law) of the 

6 State in which the services are furnished; and 

7 ‘‘(B) is authorized to receive payment for 

8 other services under this title or is designated 

9 by the Secretary for this purpose.’’. 

10 (c) PAYMENT AND ELIMINATION OF COST-SHAR11 ING.— 

12 (1) PAYMENT AND ELIMINATION OF COINSUR13 ANCE.—Section 1833(a)(1) of the Social Security 

14 Act (42 U.S.C. 1395l(a)(1)), as amended by section 

15 302(b)(2) of the Medicare Prescription Drug, Im16 provement, and Modernization Act of 2003 (Public 

17 Law 108–173; 117 Stat. 2229), is amended— 

18 (A) in subparagraph (N), by inserting ‘‘or 

19 substance use (other than tobacco), diet, exer20 cise, injury prevention, and dental health coun21 seling (as defined in section 1861(bbb))’’ after 

22 ‘‘(as defined in section 1848(j)(3))’’; 

23 (B) by striking ‘‘and’’ before ‘‘(V)’’; and 

24 (C) by inserting before the semicolon at 

25 the end the following: ‘‘and (W) with respect to 


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1 substance use (other than tobacco), diet, exer2 cise, injury prevention, and dental health coun3 seling (as defined in section 1861(bbb) the 

4 amount paid shall be the lesser of the actual 

5 charge for the services or the amount deter6 mined under the payment basis determined 

7 under section 1848’’. 

8 (2) PAYMENT UNDER PHYSICIAN FEE SCHED9 ULE.—Section 1848(j)(3) of the Social Security Act 

10 (42 U.S.C. 1395w–4(j)(3)), as amended by section 

11 611(c) of the Medicare Prescription Drug, Improve12 ment, and Modernization Act of 2003 (Public Law 

13 108–173; 117 Stat. 2304), is amended by inserting 

14 ‘‘(2)(AA),’’ after ‘‘(2)(W),’’. 

15 (3) ELIMINATION OF COINSURANCE IN OUT16 PATIENT HOSPITAL SETTINGS.— 

17 (A) EXCLUSION FROM OPD FEE SCHED18 ULE.—Section 1833(t)(1)(B)(iv) of the Social 

19 Security Act (42 U.S.C. 1395l(t)(1)(B)(iv)), as 

20 amended by section 614(a) of the Medicare 

21 Prescription Drug, Improvement, and Mod22 ernization Act of 2003 (Public Law 108–173; 

23 117 Stat. 2306), is amended by striking ‘‘and 

24 diagnostic mammography’’ and inserting ‘‘, di25 agnostic mammography, or substance use 


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•S 1342 IS 

1 (other than tobacco), diet, exercise, injury pre2 vention, and dental health counseling (as de3 fined in section 1861(bbb))’’. 

4 (B) CONFORMING AMENDMENTS.—Section 

5 1833(a)(2) of the Social Security Act (42 

6 U.S.C. 1395l(a)(2)) is amended— 

7 (i) in subparagraph (F), by striking 

8 ‘‘and’’ after the semicolon at the end; 

9 (ii) in subparagraph (G)(ii), by strik10 ing the comma at the end and inserting 

11 ‘‘; and’’; and 

12 (iii) by inserting after subparagraph 

13 (G)(ii) the following new subparagraph: 

14 ‘‘(H) with respect to substance use (other 

15 than tobacco), diet, exercise, injury prevention, 

16 and dental health counseling (as defined in sec17 tion 1861(bbb)) furnished by an outpatient de18 partment of a hospital, the amount determined 

19 under paragraph (1)(W),’’. 

20 (4) ELIMINATION OF DEDUCTIBLE.—The first 

21 sentence of section 1833(b) of the Social Security 

22 Act (42 U.S.C. 1395l(b)) is amended— 

23 (A) by striking ‘‘and’’ before ‘‘(6)’’; and 

24 (B) by inserting before the period at the 

25 end the following: ‘‘, and (7) such deductible 


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1 shall not apply with respect to substance use 

2 (other than tobacco), diet, exercise, injury pre3 vention, and dental health counseling (as de4 fined in section 1861(bbb))’’. 

5 (d) APPLICATION OF LIMITS ON BILLING.—Section 

6 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 

7 1395u(b)(18)(C)) is amended by adding at the end the 

8 following new clause: 

9 ‘‘(vii) Any health care professional designated 

10 under section 1861(bbb)(2)(B) to perform substance 

11 use (other than tobacco), diet, exercise, injury pre12 vention, and dental health counseling that is not oth13 erwise described in this subparagraph.’’. 

14 (e) EFFECTIVE DATE.—The amendments made by 

15 this section shall take effect as if included in the enact16 ment of the Medicare Prescription Drug, Improvement, 

17 and Modernization Act of 2003 (Public Law 108–173; 117 

18 Stat. 2066) and shall apply to services furnished on and 

19 after January 1, 2008. 

20 SEC. 502. MEDICARE COVERAGE OF MEDICAL NUTRITION 

21 THERAPY SERVICES FOR PEOPLE WITH PRE22 DIABETES. 

23 (a) COVERAGE OF MEDICAL NUTRITION THERAPY

24 SERVICES.—Section 1861(s)(2)(V) of the Social Security 

25 Act (42 U.S.C. 1395x(s)(2)(V)) is amended by inserting 


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•S 1342 IS 

1 after ‘‘beneficiary with diabetes’’ the following ‘‘, pre-dia2 betes or its risk factors, including hypertension, 

3 dyslipidemia, or obesity’’. 

4 (b) EFFECTIVE DATE.—The amendment made by 

5 subsection (a) shall apply with respect to services fur6 nished on or after the date of the enactment of this Act. 

7 SEC. 503. PREVENTIVE MENTAL HEALTH SCREENINGS. 

8 (a) COVERAGE.— 

9 (1) IN GENERAL.—Section 1861(s)(2) of the 

10 Social Security Act (42 U.S.C. 1395x(s)(2)), as 

11 amended by section 501(a)(1), is amended— 

12 (A) in subparagraph (Z), by striking 

13 ‘‘and’’ after the semicolon at the end; 

14 (B) in subparagraph (AA), by adding 

15 ‘‘and’’ after the semicolon at the end; and 

16 (C) by adding at the end the following new 

17 subparagraph: 

18 ‘‘(BB) screenings for clinical depression, anx19 iety, and impaired cognitive functioning (as defined 

20 in subsection (ccc)(1));’’. 

21 (2) CONFORMING AMENDMENTS.—Clauses (i) 

22 and (ii) of section 1861(s)(2)(K) of the Social Secu23 rity Act (42 U.S.C. 1395x(s)(2)(K)), as amended by 

24 section 501(a)(2)(B), are each amended by striking 

25 ‘‘and (bbb)’’ and inserting ‘‘(bbb), and (ccc)’’. 


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1 (b) SERVICES DESCRIBED.—Section 1861 of the So2 cial Security Act (42 U.S.C. 1395x), as amended by sec3 tion 501(b), is amended by adding at the end the following 

4 new subsection: 

5 ‘‘Screenings for Clinical Depression, Anxiety, and 

6 Impaired Cognitive Functioning 

7 ‘‘(ccc)(1) The term ‘screening for clinical depression, 

8 anxiety, and impaired cognitive functioning’ means a con9 sultation for the purpose of detecting clinical depression, 

10 anxiety, and impaired cognitive functioning during which 

11 a qualified health professional (as defined in paragraph 

12 (2))— 

13 ‘‘(A) uses a screening on the list established or 

14 identified under paragraph (3); 

15 ‘‘(B) assesses the individual’s risk of clinical de16 pression, anxiety, and impaired cognitive func17 tioning; and 

18 ‘‘(C) if the qualified health professional deter19 mines that the individual is at high risk for clinical 

20 depression, anxiety, or impaired cognitive func21 tioning, refers the individual for a full diagnostic 

22 evaluation and such additional treatment as may be 

23 required. 

24 Nothing in subparagraph (C) shall be construed as prohib25 iting a qualified health professional performing the screenVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00136 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 ing for clinical depression, anxiety, and impaired cognitive 

2 functioning with respect to an individual from directly pro3 viding the diagnostic evaluation and additional treatment 

4 described in such clause to such individual if such profes5 sional is legally authorized to provide such an evaluation 

6 and additional treatment under State law (or the State 

7 regulatory mechanism provided by State law) of the State 

8 in which the screening is performed. 

9 ‘‘(2) For purposes of this subsection, the term ‘quali10 fied health professional’ means an individual who— 

11 ‘‘(A) is— 

12 ‘‘(i) a physician (as defined in subsection 

13 (r)(1)); 

14 ‘‘(ii) a nurse practitioner (as defined in 

15 subsection (aa)(5)); or 

16 ‘‘(iii) a mental health care professional (in17 cluding clinical psychologists (as defined by the 

18 Secretary for purposes of section 1861(ii)) and 

19 clinical social workers (as defined in subsection 

20 1861(hh))) that is licensed or certified to per21 form mental health services by the State in 

22 which the screenings are performed; and 

23 ‘‘(B) has an agreement in effect with the Sec24 retary to accept— 


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•S 1342 IS 

1 ‘‘(i) the amount determined under section 

2 1833(a)(1)(W) as full payment for screenings 

3 for clinical depression, anxiety, and impaired 

4 cognitive functioning; and 

5 ‘‘(ii) an assignment described in section 

6 1842(b)(3)(B)(ii) with respect to payment for 

7 each screening furnished by the professional to 

8 an individual enrolled under part B. 

9 ‘‘(3) The Secretary shall, in consultation with mental 

10 health professionals and other stakeholders with experi11 ence in screening for clinical depression, anxiety, and im12 paired cognitive functioning, shall establish or identify a 

13 list of approved screenings to be used under this para14 graph. The Secretary, in consultation with such profes15 sionals and stakeholders, shall review and update such list 

16 not less frequently than once every 5 years.’’. 

17 (c) PAYMENT AND ELIMINATION OF COST-SHAR18 ING.— 

19 (1) PAYMENT AND ELIMINATION OF COINSUR20 ANCE.—Section 1833(a)(1) of the Social Security 

21 Act (42 U.S.C. 1395l(a)(1)), as amended by section 

22 501(c)(1), is amended— 

23 (A) in subparagraph (N), by striking ‘‘or 

24 substance use (other than tobacco), diet, exer25 cise, injury prevention, and dental health counVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00138 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 seling (as defined in section 1861(bbb))’’ and 

2 inserting ‘‘substance use (other than tobacco), 

3 diet, exercise, injury prevention, and dental 

4 health counseling (as defined in section 

5 1861(bbb)), or screenings for clinical depres6 sion, anxiety, and impaired cognitive func7 tioning (as defined in section 1861(ccc))’’; and 

8 (B) in subparagraph (W), by inserting 

9 ‘‘and screenings for clinical depression, anxiety, 

10 and impaired cognitive functioning (as defined 

11 in section 1861(ccc))’’ after ‘‘(as defined in sec12 tion 1861(bbb))’’. 

13 (2) PAYMENT UNDER PHYSICIAN FEE SCHED14 ULE.—Section 1848(j)(3) of the Social Security Act 

15 (42 U.S.C. 1395w–4(j)(3)), as amended by section 

16 501(c)(2), is amended by inserting ‘‘(2)(BB),’’ after 

17 ‘‘(2)(AA),’’. 

18 (3) ELIMINATION OF COINSURANCE IN OUT19 PATIENT HOSPITAL SETTINGS.— 

20 (A) EXCLUSION FROM OPD FEE SCHED21 ULE.—Section 1833(t)(1)(B)(iv) of the Social 

22 Security Act (42 U.S.C. 1395l(t)(1)(B)(iv)), as 

23 amended by section 501(c)(3)(A), is amended 

24 by striking ‘‘or substance use (other than to25 bacco), diet, exercise, injury prevention, and 


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•S 1342 IS 

1 dental health counseling (as defined in section 

2 1861(bbb))’’ and inserting ‘‘substance use 

3 (other than tobacco), diet, exercise, injury pre4 vention, and dental health counseling (as de5 fined in section 1861(bbb)), or screenings for 

6 clinical depression, anxiety, and impaired cog7 nitive functioning (as defined in section 

8 1861(ccc))’’. 

9 (B) CONFORMING AMENDMENT.—Section 

10 1833(a)(2)(H) of the Social Security Act (42 

11 U.S.C. 1395l(a)(2)(H)), as added by section 

12 501(c)(3)(B)(iii), is amended by inserting ‘‘and 

13 screenings for clinical depression, anxiety, and 

14 impaired cognitive functioning (as defined in 

15 section 1861(ccc))’’ after ‘‘(as defined in section 

16 1861(bbb))’’. 

17 (4) ELIMINATION OF DEDUCTIBLE.—Section 

18 1833(b)(7) of the Social Security Act (42 U.S.C. 

19 1395l(b)(7)), as amended by section 501(c)(4), is 

20 amended by inserting ‘‘or screenings for clinical de21 pression, anxiety, and impaired cognitive functioning 

22 (as defined in section 1861(ccc))’’ before the period 

23 at the end. 

24 (d) APPLICATION OF LIMITS ON BILLING.—Section 

25 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 


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1 1395u(b)(18)(C)), as amended by section 501(d), is 

2 amended by adding at the end the following new clause: 

3 ‘‘(viii) A mental health care professional de4 scribed in section 1861(ccc)(2) that is authorized to 

5 perform screenings for clinical depression, anxiety, 

6 and impaired cognitive functioning (as defined in 

7 section 1861(ccc)(1)) that is not otherwise described 

8 in this subparagraph.’’. 

9 (e) FREQUENCY.—Section 1862(a)(1) of the Social 

10 Security Act (42 U.S.C. 1395y(a)(1)), as amended by sec11 tion 613(c) of the Medicare Prescription Drug, Improve12 ment, and Modernization Act of 2003 (Public Law 108– 

13 173; 117 Stat. 2306), is amended— 

14 (1) in subparagraph (L), by striking ‘‘and’’ 

15 after the comma at the end; 

16 (2) in subparagraph (M), by striking the semi17 colon at the end and inserting ‘‘, and’’; and 

18 (3) by adding at the end the following new sub19 paragraph: 

20 ‘‘(N) in the case of screenings for clinical de21 pression, anxiety, and impaired cognitive functioning 

22 (as defined in section 1861(ccc)(1)), which is per23 formed more frequently than is covered under such 

24 section;’’. 


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1 (f) EFFECTIVE DATE.—The amendments made by 

2 this section shall take effect as if included in the enact3 ment of the Medicare Prescription Drug, Improvement, 

4 and Modernization Act of 2003 (Public Law 108–173; 117 

5 Stat. 2066) and shall apply to services furnished on and 

6 after January 1, 2008. 

7 SEC. 504. ENCOURAGEMENT OF CESSATION OF TOBACCO 

8 USE. 

9 (a) MEDICARE COVERAGE OF COUNSELING AND

10 PHARMACOTHERAPY FOR CESSATION OF TOBACCO

11 USE.— 

12 (1) COVERAGE.— 

13 (A) IN GENERAL.—Section 1861(s)(2) of 

14 the Social Security Act (42 U.S.C. 

15 1395x(s)(2)), as amended by section 502(a)(1), 

16 is amended— 

17 (i) in subparagraph (AA), by striking 

18 ‘‘and’’ after the semicolon at the end; 

19 (ii) in subparagraph (BB), by adding 

20 ‘‘and’’ after the semicolon at the end; and 

21 (iii) by adding at the end the fol22 lowing new subparagraph: 

23 ‘‘(CC) counseling and pharmacotherapy for ces24 sation of tobacco use (as defined in subsection 

25 (ddd)(1));’’. 


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•S 1342 IS 

1 (B) CONFORMING AMENDMENTS.—Clauses 

2 (i) and (ii) of section 1861(s)(2)(K) of the So3 cial Security Act (42 U.S.C. 1395x(s)(2)(K)), 

4 as amended by section 502(a)(2), are each 

5 amended by striking ‘‘and (ccc)’’ and inserting 

6 ‘‘(ccc), and (ddd)’’. 

7 (2) SERVICES DESCRIBED.—Section 1861 of 

8 the Social Security Act (42 U.S.C. 1395x), as 

9 amended by section 502(b), is amended by adding at 

10 the end the following new subsection: 

11 ‘‘Counseling and Pharmacotherapy for Cessation of 

12 Tobacco Use 

13 ‘‘(ddd)(1) Subject to paragraphs (2) and (3), the 

14 term ‘counseling and pharmacotherapy for cessation of to15 bacco use’ means diagnostic, therapy, and counseling serv16 ices and pharmacotherapy (including the coverage of pre17 scription and nonprescription tobacco cessation agents ap18 proved by the Food and Drug Administration) for ces19 sation of tobacco use for individuals who use tobacco prod20 ucts or who are being treated for tobacco use which are 

21 furnished— 

22 ‘‘(A) by or under the supervision of a physician; 

23 or 

24 ‘‘(B) by any other health care professional 

25 who— 


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•S 1342 IS 

1 ‘‘(i) is legally authorized to furnish such 

2 services under State law (or the State regu3 latory mechanism provided by State law) of the 

4 State in which the services are furnished; and 

5 ‘‘(ii) is authorized to receive payment for 

6 other services under this title or is designated 

7 by the Secretary for this purpose. 

8 ‘‘(2) Such term is limited to— 

9 ‘‘(A) services recommended in ‘Treating To10 bacco Use and Dependence: A Clinical Practice 

11 Guideline’, published by the Public Health Service in 

12 June 2000, or any subsequent modification of such 

13 Guideline; and 

14 ‘‘(B) such other services that the Secretary rec15 ognizes to be effective. 

16 ‘‘(3) Each individual who is described in paragraph 

17 (1) and enrolled under part B shall be eligible for the serv18 ices described in this subsection for up to 3 attempts to 

19 cease the use of tobacco.’’. 

20 (3) PAYMENT AND ELIMINATION OF COST21 SHARING.— 

22 (A) PAYMENT AND ELIMINATION OF COIN23 SURANCE.—Section 1833(a)(1) of the Social 

24 Security Act (42 U.S.C. 1395l(a)(1)), as 

25 amended by section 502(c)(1), is amended— 


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•S 1342 IS 

1 (i) in subparagraph (N) by striking 

2 ‘‘or screenings for clinical depression, anx3 iety, and impaired cognitive functioning (as 

4 defined in section 1861(ccc))’’ and insert5 ing ‘‘, screenings for clinical depression, 

6 anxiety, and impaired cognitive functioning 

7 (as defined in section 1861(ccc)), or coun8 seling and pharmacotherapy for cessation 

9 of tobacco use (as defined in section 

10 1861(ddd))’’; and 

11 (ii) in subparagraph (W), by striking 

12 ‘‘and screenings for clinical depression, 

13 anxiety, and impaired cognitive functioning 

14 (as defined in section 1861(ccc))’’ and in15 serting ‘‘screenings for clinical depression, 

16 anxiety, and impaired cognitive functioning 

17 (as defined in section 1861(ccc)), and 

18 counseling and pharmacotherapy for ces19 sation of tobacco use (as defined in section 

20 1861(ddd))’’. 

21 (B) PAYMENT UNDER PHYSICIAN FEE

22 SCHEDULE.—Section 1848(j)(3) of the Social 

23 Security Act (42 U.S.C. 1395w–4(j)(3)), as 

24 amended by section 502(c)(2), is amended by 

25 inserting ‘‘(2)(CC) (with separate payment 


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•S 1342 IS 

1 amounts for pharmacotherapy, including pre2 scription and nonprescription tobacco cessation 

3 agents approved by the Food and Drug Admin4 istration),’’ after ‘‘(2)(BB),’’. 

5 (C) ELIMINATION OF COINSURANCE IN

6 OUTPATIENT HOSPITAL SETTINGS.— 

7 (i) EXCLUSION FROM OPD FEE

8 SCHEDULE.—Section 1833(t)(1)(B)(iv) of 

9 the Social Security Act (42 U.S.C. 

10 1395l(t)(1)(B)(iv)), as amended by section 

11 502(c)(3)(A), is amended by striking ‘‘or 

12 screenings for clinical depression, anxiety, 

13 and impaired cognitive functioning (as de14 fined in section 1861(ccc))’’ and inserting 

15 ‘‘screenings for clinical depression, anxiety, 

16 and impaired cognitive functioning (as de17 fined in section 1861(ccc)), or counseling 

18 and pharmacotherapy for cessation of to19 bacco use (as defined in section 

20 1861(ddd))’’. 

21 (ii) CONFORMING AMENDMENT.—Sec22 tion 1833(a)(2)(H) of the Social Security 

23 Act (42 U.S.C. 1395l(a)(2)(H)), as added 

24 by section 502(c)(3)(B), is amended by 

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1 pression, anxiety, and impaired cognitive 

2 functioning (as defined in section 

3 1861(ccc))’’ and inserting ‘‘screenings for 

4 clinical depression, anxiety, and impaired 

5 cognitive functioning (as defined in section 

6 1861(ccc)), and counseling and 

7 pharmacotherapy for cessation of tobacco 

8 use (as defined in section 1861(ddd))’’. 

9 (D) ELIMINATION OF DEDUCTIBLE.—Sec10 tion 1833(b)(7) of the Social Security Act (42 

11 U.S.C. 1395l(b)(7)), as added by section 

12 502(c)(4), is amended by striking ‘‘or 

13 screenings for clinical depression, anxiety, and 

14 impaired cognitive functioning (as defined in 

15 section 1861(ccc))’’ and inserting ‘‘screenings 

16 for clinical depression, anxiety, and impaired 

17 cognitive functioning (as defined in section 

18 1861(ccc)), or counseling and pharmacotherapy 

19 for cessation of tobacco use (as defined in sec20 tion 1861(ddd))’’. 

21 (4) APPLICATION OF LIMITS ON BILLING.—Sec22 tion 1842(b)(18)(C) of the Social Security Act (42 

23 U.S.C. 1395u(b)(18)(C)), as amended by section 

24 502(d), is amended by adding at the end the fol25 lowing new clause: 


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•S 1342 IS 

1 ‘‘(ix) Any individual designated by the Sec2 retary under section 1861(ddd)(1)(B)(ii).’’. 

3 (5) FREQUENCY.—Section 1862(a)(1) of the 

4 Social Security Act (42 U.S.C. 1395y(a)(1)), as 

5 amended by section 502(e), is amended— 

6 (A) in subparagraph (M), by striking 

7 ‘‘and’’ after the comma at the end; 

8 (B) in subparagraph (N), by striking the 

9 semicolon at the end and inserting ‘‘, and’’; and 

10 (C) by adding at the end the following new 

11 subparagraph: 

12 ‘‘(O) in the case of counseling and 

13 pharmacotherapy for cessation of tobacco use (as de14 fined in section 1861(ddd)), which is performed with 

15 respect to more attempts to cease tobacco use than 

16 is covered under such section;’’. 

17 (b) PROMOTING CESSATION OF TOBACCO USE

18 UNDER THE MEDICAID PROGRAM.— 

19 (1) DROPPING EXCEPTION FROM MEDICAID

20 PRESCRIPTION DRUG COVERAGE FOR TOBACCO CES21 SATION MEDICATIONS.—Section 1927(d)(2) of the 

22 Social Security Act (42 U.S.C. 1396r–8(d)(2)) is 

23 amended— 

24 (A) by striking subparagraph (E); 


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•S 1342 IS 

1 (B) by redesignating subparagraphs (F) 

2 through (J) as subparagraphs (E) through (I), 

3 respectively; and 

4 (C) in subparagraph (F) (as redesignated 

5 by paragraph (2)), by inserting before the pe6 riod at the end the following: ‘‘, except agents 

7 approved by the Food and Drug Administration 

8 for purposes of promoting, and when used to 

9 promote, tobacco cessation’’. 

10 (2) REQUIRING COVERAGE OF TOBACCO CES11 SATION COUNSELING AND PHARMACOTHERAPY

12 SERVICES FOR PREGNANT WOMEN.—Section 

13 1905(a)(4) of the Social Security Act (42 U.S.C. 

14 1396d(a)(4)) is amended— 

15 (A) by striking ‘‘and’’ before ‘‘(C)’’; and 

16 (B) by inserting before the semicolon at 

17 the end the following: ‘‘; and (D) counseling 

18 and pharmacotherapy for cessation of tobacco 

19 use (as defined in section 1861(ddd)) for preg20 nant women’’. 

21 (3) REMOVAL OF COST-SHARING FOR TOBACCO

22 CESSATION COUNSELING AND PHARMACOTHERAPY

23 SERVICES FOR PREGNANT WOMEN.—Section 1916 of 

24 the Social Security Act (42 U.S.C. 1396o) is amend25 ed in each of subsections (a)(2)(B) and (b)(2)(B), 


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1 by inserting ‘‘, and counseling for cessation of to2 bacco use (as defined in section 1861(ddd))’’ after 

3 ‘‘complicate the pregnancy’’. 

4 (c) COVERAGE UNDER FEHBP.—The last sentence 

5 of section 8904(a) of title 5, United States Code, is 

6 amended by striking ‘‘both for costs associated with care 

7 in a general hospital and for other health services of a 

8 catastrophic nature’’ and inserting ‘‘for costs associated 

9 with care in a general hospital, for other health services 

10 of a catastrophic nature, and for counseling and 

11 pharmacotherapy for cessation of tobacco use (as defined 

12 in section 1861(ddd)(1) of the Social Security Act)’’. 

13 (d) EFFECTIVE DATE.—The amendments made by 

14 this section shall take effect as if included in the enact15 ment of the Medicare Prescription Drug, Improvement, 

16 and Modernization Act of 2003 (Public Law 108–173; 117 

17 Stat. 2066) and shall apply to services furnished on and 

18 after January 1, 2008. 


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1 SEC. 505. RECOGNITION OF SCHOOL-BASED HEALTH CEN2 TERS AS MODEL FOR DELIVERY OF PRIMARY 

3 CARE FOR CHILDREN UNDER THE MEDICAID 

4 AND STATE CHILDREN’S HEALTH INSURANCE 

5 PROGRAMS. 

6 (a) IN GENERAL.—Title XIX of the Social Security 

7 Act (42 U.S.C. 1396 et seq.) is amended by inserting after 

8 section 1911 the following: 

9 ‘‘SCHOOL-BASED HEALTH CENTERS

10 ‘‘SEC. 1911A. Not later than 12 months after the 

11 date of enactment of this section, the Secretary shall es12 tablish procedures to encourage a State program estab13 lished under this title, title XXI, or both, to recognize 

14 school-based health centers as a model of delivery for pri15 mary care for children who are eligible for medical assist16 ance under this title or child health assistance under title 

17 XXI. Such procedures shall include the following: 

18 ‘‘(1) RECOGNITION OF, AND REIMBURSEMENT

19 FOR, SERVICES PROVIDED THROUGH SCHOOL-BASED

20 HEALTH CENTERS.—Procedures that encourage a 

21 State to recognize as primary care providers under 

22 this title and title XXI, providers who furnish phys23 ical or mental health services that are available as 

24 medical assistance under this title or child health as25 sistance under title XXI to children who are eligible 

26 for such assistance through school-based health cenVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00151 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 ters, and to reimburse such providers or centers (as 

2 appropriate) for furnishing such services to such 

3 children. 

4 ‘‘(2) EXCEPTIONS TO THE ‘FREE CARE’ 

5 RULE.—Procedures that allow a State the option to 

6 permit school-based health centers to bill the State 

7 for physical or mental health services that are avail8 able as medical assistance under this title or child 

9 health assistance under title XXI and that are fur10 nished to children who are eligible for such assist11 ance through such centers without billing all chil12 dren who are provided such services. 

13 ‘‘(3) EXCEPTIONS TO THE ‘THIRD PARTY LI14 ABILITY’ COST AVOIDANCE POLICY.—Procedures 

15 that encourage a State to include physical or mental 

16 health services that are available as medical assist17 ance under this title and that are provided through 

18 school-based health centers in the list of diagnosis 

19 billing codes for preventive pediatric care services 

20 that the State will pay for under this title and then 

21 seek reimbursement from any liable third party in 

22 accordance with the requirements of section 

23 1902(a)(25). 

24 ‘‘(4) ASSURANCE OF PAYMENT FOR SERVICES

25 COVERED BY A CONTRACT WITH A MANAGED CARE


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1 ENTITY.—Procedures that encourage a State to in2 clude in any contract entered into with a managed 

3 care entity (as defined in section 1932(a)(1)(B)) 

4 under this title or title XXI provisions which ensure 

5 that the entity will make prompt payment to a 

6 school-based health center for furnishing physical or 

7 mental health services to a child who is eligible for 

8 medical assistance under this title or child health as9 sistance under title XXI that are within the scope of 

10 items and services for which benefits are available 

11 with respect to the child under the contract between 

12 the entity and the State (or to a provider who fur13 nishes such services to such a child through a 

14 school-based health center), regardless of whether 

15 the center (or provider) is a participating provider 

16 with respect to such entity, at a rate established by 

17 the entity for such services that is not less than the 

18 level and amount of payment which the entity would 

19 make for the services if the services were furnished 

20 by a participating provider.’’. 

21 (b) REPORT TO CONGRESS.—Not later than 36 

22 months after the date of enactment of this section, the 

23 Secretary of Health and Human Services shall submit a 

24 report to Congress on the effectiveness of the procedures 

25 established in accordance with section 1911A of the Social 


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1 Security Act (as added by subsection (a)) in encouraging 

2 the use of school-based health centers for the delivery of 

3 primary care physical and mental health services to chil4 dren who are eligible for medical assistance under title 

5 XIX of the Social Security Act (42 U.S.C. 1396 et seq.) 

6 or child health assistance under title XXI of such Act (42 

7 U.S.C. 1397aa et seq.), together with such recommenda8 tions for administrative or legislative action as the Sec9 retary determines to be appropriate. 

10 SEC. 506. PREVENTIVE HEALTH CARE DEMONSTRATION 

11 PROGRAM. 

12 (a) ESTABLISHMENT.— 

13 (1) IN GENERAL.—Not later than 18 months 

14 after the date of enactment of this Act, the Sec15 retary of Health and Human Services (in this sec16 tion referred to as the ‘‘Secretary’’) shall conduct a 

17 5-year demonstration program under part B of title 

18 XVIII of the Social Security Act under which the 

19 Secretary establishes demonstration projects to con20 tract with appropriate entities to provide preventive 

21 health care to eligible beneficiaries through the de22 velopment and implementation of a disease preven23 tion plan (as described in subsection (b)). 


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1 (2) SITES.—The Secretary shall designate at 

2 least 2 sites at which to conduct the demonstration 

3 program under this section, of which— 

4 (A) 1 shall be in an urban area; and 

5 (B) 1 shall be in a rural area. 

6 (3) NUMBER OF ELIGIBLE BENEFICIARIES.— 

7 Each demonstration project site under this section 

8 shall consist of at least 1,000 eligible beneficiaries 

9 representative of the population of individuals enti10 tled to benefits under part A of title XVIII of the 

11 Social Security Act, and enrolled under part B of 

12 such title. The Secretary may expand the population 

13 as needed to measure statistical significance. 

14 (4) IDENTIFYING ELIGIBLE BENEFICIARIES.— 

15 The Secretary shall develop a method for identifying 

16 eligible beneficiaries who may benefit from the dem17 onstration program and communicate with them re18 garding their eligibility. 

19 (5) VOLUNTARY PARTICIPATION.—Participation 

20 of health care providers, and individual beneficiaries, 

21 in the demonstration program shall be voluntary. 

22 (b) DISEASE PREVENTION PLAN.— 

23 (1) IN GENERAL.—The disease prevention plan 

24 described in this subsection is a plan, developed in 

25 consultation with an eligible beneficiary participating 


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•S 1342 IS 

1 in the demonstration program, to mitigate the risk 

2 factors associated with a particular disease. 

3 (2) PLAN CONTENTS.—The disease prevention 

4 plan should include the following: 

5 (A) POINT OF CONTACT.—The disease pre6 vention plan shall provide for a point of contact 

7 responsible for communicating with the partici8 pating beneficiary and with other health care 

9 providers on behalf of such beneficiary. 

10 (B) PERSONAL HEALTH CARE.—The dis11 ease prevention plan shall provide for instruc12 tion on personal health care. 

13 (C) PHYSICIAN AND HEALTH CARE PRO14 VIDER TRAINING.—The disease prevention plan 

15 shall provide for the training of physicians or 

16 other health care providers in the communica17 tion of relevant clinical information. 

18 (D) MONITORING TECHNOLOGY.—The dis19 ease prevention plan may provide for necessary 

20 monitoring technology to facilitate the exchange 

21 of information, including information such as 

22 vital signs, symptoms, and health self assess23 ments. 

24 (c) PROGRAM STANDARDS AND CRITERIA.—The Sec25 retary shall establish performance standards for the demVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00156 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 onstration program under this section, including best 

2 practices for the prevention of chronic diseases. Such prac3 tices shall be standardized to the greatest extent possible. 

4 The eligibility of entities or individuals to enter into a con5 tract to provide preventive health care under the dem6 onstration program shall be conditioned, at a minimum, 

7 on performance that meets or exceeds such standards. 

8 (d) PAYMENT.—The Secretary shall develop a meth9 od and level of payment for entities that participate in 

10 the program under this section based on best practices, 

11 as determined by the Secretary. 

12 (e) WAIVER AUTHORITY.—The Secretary may waive 

13 such requirements of titles XI and XVIII of the Social 

14 Security Act as may be necessary to carry out the pur15 poses of the demonstration program under this section. 

16 (f) EVALUATION AND REPORT.— 

17 (1) EVALUATION.—The Secretary shall conduct 

18 evaluations of— 

19 (A) the benefits due to a reduction, if any, 

20 in disease incidence for participants in the dem21 onstration projects compared to the medicare 

22 population as a whole, as determined by the use 

23 of appropriate statistical techniques; 

24 (B) the long term cost effectiveness of the 

25 demonstration projects to the medicare program 


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1 in terms of acute care costs avoided due to dis2 ease prevention; and 

3 (C) patient satisfaction under the dem4 onstration projects. 

5 (2) REPORT.—Not later than 6 months after 

6 the date on which the demonstration program under 

7 this section ends, the Secretary shall prepare and 

8 submit to Congress a report on the demonstration 

9 program together with— 

10 (A) recommendations on whether the dem11 onstration program should be expanded in 

12 terms of its success in disease prevention and 

13 the cost effectiveness of the demonstration pro14 gram; and 

15 (B) such recommendations for legislation 

16 or administrative action as the Secretary deter17 mines appropriate. 

18 (g) FUNDING.—The Secretary shall provide for the 

19 transfer from the Federal Supplementary Medical Insur20 ance Trust Fund under section 1841 of the Social Secu21 rity Act (42 U.S.C. 1395t) of such funds, not to exceed 

22 $50,000,000, as are necessary for the costs of carrying 

23 out the demonstration program under this Act. 

24 (h) DEFINITIONS.—In this section: 


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1 (1) APPROPRIATE ENTITY.—The term ‘‘appro2 priate entity’’ means— 

3 (A) a chronic care improvement program; 

4 (B) a hospital; and 

5 (C) any other entity that the Secretary de6 termines appropriate based on clinical, finan7 cial, or other requirements appropriate to carry 

8 out the purposes of the demonstration program 

9 under this section. 

10 (2) ELIGIBLE BENEFICIARY.—The term ‘‘eligi11 ble beneficiary’’ means an individual who— 

12 (A) is entitled to benefits under part A of 

13 title XVIII of the Social Security Act or en14 rolled under part B of such title; and 

15 (B) has 2 or more risk factors associated 

16 with— 

17 (i) chronic obstructive pulmonary dis18 ease; 

19 (ii) diabetes; or 

20 (iii) any other chronic condition that 

21 the Secretary determines would be appro22 priate for the purpose of providing signifi23 cant potential cost benefits to the medicare 

24 program through the prevention of such 

25 condition. 


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1 SEC. 507. PREVENTIVE HEALTH SERVICES FOR WOMEN. 

2 Section 1509 of the Public Health Service Act (42 

3 U.S.C. 300n–4a) is amended to read as follows: 

4 ‘‘SEC. 1509. ESTABLISHMENT OF PROGRAM FOR ADDI5 TIONAL PREVENTIVE HEALTH SERVICES. 

6 ‘‘(a) IN GENERAL.—The Secretary, acting through 

7 the Director of the Centers for Disease Control and Pre8 vention, may, through a competitive review process, award 

9 grants to States that have received grants under section 

10 1501 for a fiscal year, to enable such State to carry out 

11 programs— 

12 ‘‘(1) to provide preventive health services, in ad13 dition to the services authorized in such section 

14 1501, for diseases such as cardiovascular diseases, 

15 osteoporosis, and obesity; 

16 ‘‘(2) to provide screenings, such as screening 

17 for blood pressure, cholesterol, and osteoporosis, and 

18 other services that the Secretary, acting through the 

19 Director of the Centers for Disease Control and Pre20 vention, determines to be appropriate and feasible; 

21 ‘‘(3) for health education, counseling, and inter22 ventions for behavioral risk factors, such as physical 

23 inactivity and poor nutrition, and diseases referred 

24 to in paragraph (1); 

25 ‘‘(4) to provide appropriate referrals for medical 

26 treatment of women receiving services pursuant to 


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1 paragraph (1) through (3), and ensuring, to the ex2 tent practicable, the provision of appropriate follow3 up services; and 

4 ‘‘(5) to evaluate the activities conducted under 

5 paragraphs (1) through (4) through appropriate sur6 veillance, research, or program monitoring activities. 

7 ‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD8 ING BREAST AND CERVICAL CANCER.—The Secretary 

9 may not make a grant to a State under subsection (a) 

10 unless the State involved agrees that services under the 

11 grant will be provided in conjunction with entities that are 

12 screening women for breast or cervical cancer pursuant 

13 to a grant under section 1501. 

14 ‘‘(c) APPLICABILITY OF PROVISIONS.—The provi15 sions of this title shall apply to a grant under subsection 

16 (a) to the same extent and in the same manner as such 

17 provisions apply to a grant under section 1501. 

18 ‘‘(d) FUNDING.— 

19 ‘‘(1) IN GENERAL.—There is authorized to be 

20 appropriated such sums as may be necessary to 

21 carry out this section for fiscal year 2008 and for 

22 each subsequent fiscal year. 

23 ‘‘(2) LIMITATION REGARDING FUNDING WITH

24 RESPECT TO BREAST AND CERVICAL CANCER.—No 

25 additional resources shall be appropriated for a fisVerDate Aug 31 2005 22:42 May 10, 2007 Jkt 059200 PO 00000 Frm 00161 Fmt 6652 Sfmt 6201 E:\BILLS\S1342.IS S1342

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1 cal year under paragraph (1) unless the amount ap2 propriated under section 1510(a) for such fiscal year 

3 is at least $173,920,000.’’. 

4 SEC. 508. PROMOTING CESSATION OF TOBACCO USE BY 

5 PREGNANT WOMEN UNDER THE MEDICAID 

6 PROGRAM. 

7 (a) REQUIRING COVERAGE OF COUNSELING AND

8 PHARMACOTHERAPY FOR CESSATION OF TOBACCO USE

9 BY PREGNANT WOMEN.—Section 1905 of the Social Secu10 rity Act (42 U.S.C. 1396d(a)(4)) is amended— 

11 (1) in subsection (a)(4)— 

12 (A) by striking ‘‘and’’ before ‘‘(C)’’; and 

13 (B) by inserting before the semicolon at 

14 the end the following new subparagraph: ‘‘; and 

15 (D) counseling and pharmacotherapy for ces16 sation of tobacco use by pregnant women (as 

17 defined in subsection (y))’’; and 

18 (2) by adding at the end the following: 

19 ‘‘(y)(1) For purposes of this title, the term ‘coun20 seling and pharmacotherapy for cessation of tobacco use 

21 by pregnant women’ means diagnostic, therapy, and coun22 seling services and pharmacotherapy (including the cov23 erage of prescription and nonprescription tobacco ces24 sation agents approved by the Food and Drug Administra25 tion) for cessation of tobacco use by pregnant women who 


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1 use tobacco products or who are being treated for tobacco 

2 use that is furnished— 

3 ‘‘(A) by or under the supervision of a physician; 

4 or 

5 ‘‘(B) by any other health care professional 

6 who— 

7 ‘‘(i) is legally authorized to furnish such 

8 services under State law (or the State regu9 latory mechanism provided by State law) of the 

10 State in which the services are furnished; and 

11 ‘‘(ii) is authorized to receive payment for 

12 other services under this title or is designated 

13 by the Secretary for this purpose. 

14 ‘‘(2) Subject to paragraph (3), such term is limited 

15 to— 

16 ‘‘(A) services recommended with respect to 

17 pregnant women in ‘Treating Tobacco Use and De18 pendence: A Clinical Practice Guideline’, published 

19 by the Public Health Service in June 2000, or any 

20 subsequent modification of such Guideline; and 

21 ‘‘(B) such other services that the Secretary rec22 ognizes to be effective for cessation of tobacco use 

23 by pregnant women. 


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1 ‘‘(3) Such term shall not include coverage for drugs 

2 or biologicals that are not otherwise covered under this 

3 title.’’. 

4 (b) EXCEPTION FROM OPTIONAL RESTRICTION

5 UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 

6 Section 1927(d)(2) of the Social Security Act (42 U.S.C. 

7 1396r–8(d)(2)) is amended— 

8 (1) in subparagraph (E), by inserting before the 

9 period at the end the following: ‘‘, except in the case 

10 of pregnant women when recommended in accord11 ance with the Guideline referred to in section 

12 1905(y)(2)(A)’’; and 

13 (2) in subparagraph (G), by inserting before the 

14 period at the end the following: ‘‘, except, in the case 

15 of pregnant women when recommended in accord16 ance with the Guideline referred to in section 

17 1905(y)(2)(A), agents approved by the Food and 

18 Drug Administration for purposes of promoting, and 

19 when used to promote, tobacco cessation’’. 

20 (c) REMOVAL OF COST-SHARING FOR COUNSELING

21 AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO

22 USE BY PREGNANT WOMEN.— 

23 (1) GENERAL COST SHARING LIMITATIONS.— 

24 Section 1916 of the Social Security Act (42 U.S.C. 

25 1396o) is amended in each of subsections (a)(2)(B) 


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1 and (b)(2)(B) by inserting ‘‘, and counseling and 

2 pharmacotherapy for cessation of tobacco use by 

3 pregnant women (as defined in section 1905(y)) and 

4 covered outpatient drugs (as defined in subsection 

5 (k)(2) of section 1927 and including nonprescription 

6 drugs described in subsection (d)(2) of such section) 

7 that are prescribed for purposes of promoting, and 

8 when used to promote, tobacco cessation by preg9 nant women in accordance with the Guideline re10 ferred to in section 1905(y)(2)(A)’’ after ‘‘com11 plicate the pregnancy’’. 

12 (2) APPLICATION TO ALTERNATIVE COST SHAR13 ING.—Section 1916A(b)(3)(B)(iii) of such Act (42 

14 U.S.C. 1396o–1(b)(3)(B)(iii)) is amended by insert15 ing ‘‘, and counseling and pharmacotherapy for ces16 sation of tobacco use by pregnant women (as defined 

17 in section 1905(y))’’ after ‘‘complicate the preg18 nancy’’. 

19 (d) INCREASED FMAP FOR TOBACCO CESSATION

20 COUNSELING SERVICES AND MEDICATIONS.—The first 

21 sentence of section 1905(b) of the Social Security Act (42 

22 U.S.C. 1396d(b)) is amended by inserting the following 

23 before the period: ‘‘, and medical assistance provided for 

24 counseling and pharmacotherapy for cessation of tobacco 

25 use by pregnant women (as defined in subsection (y)) and 


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•S 1342 IS 

1 for covered outpatient drugs (as defined in subsection 

2 (k)(2) of section 1927 and including nonprescription 

3 drugs described in subsection (d)(2) of such section) that 

4 are prescribed for purposes of promoting, and when used 

5 to promote, tobacco cessation by pregnant women in ac6 cordance with the Guideline referred to in subsection 

7 (y)(2)(A)’’. 

8 (e) EFFECTIVE DATE.—The amendments made by 

9 this section shall apply to services furnished on or after 

10 the first fiscal year quarter that begins after the date of 

11 enactment of this Act. 

12 TITLE VI—HELP (HEALTHY LIFE13 STYLES AND PREVENTION) 

14 AMERICA TRUST FUND 

15 SEC. 601. HELP (HEALTHY LIFESTYLES AND PREVENTION) 

16 AMERICA TRUST FUND. 

17 (a) CREATION OF TRUST FUND.—There is estab18 lished in the Treasury of the United States a trust fund 

19 to be known as the ‘HeLP (Healthy Lifestyles and Preven20 tion) America Trust Fund’ (referred to in this section as 

21 the ‘Trust Fund’), consisting of such amounts as may be 

22 appropriated or credited to the Trust Fund as provided 

23 in this section. 


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1 (b) TRANSFERS TO TRUST FUND.—There is hereby 

2 appropriated to the Trust Fund an amount equivalent 

3 to— 

4 (1) the increase in revenues received in the 

5 Treasury as the result of the amendment made by 

6 section 405 of this Act, 

7 (2) the increase in revenues received in the 

8 Treasury as the result of the amendments made by 

9 title II of this Act, and 

10 (3) the receipts paid by tobacco companies 

11 under subtitle B of title III of this Act. 

12 (c) DISTRIBUTION OF AMOUNTS IN TRUST FUND.— 

13 (1) MANDATORY EXPENDITURES.—On a fiscal 

14 year basis (beginning with fiscal year 2008) and 

15 without further appropriation the Secretary of the 

16 Treasury shall distribute from amounts in the Trust 

17 Fund such amounts as are necessary to provide for 

18 the Federal expenditures attributable to the fol19 lowing: 

20 (A) The amendments made to the Fruit 

21 and Vegetable Program by section 201 of this 

22 Act. 

23 (B) Smoking cessation drugs under title 

24 XIX of the Social Security Act as identified by 

25 the Secretary of Health and Human Services. 


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•S 1342 IS 

1 (C) Coverage of smoking cessation under 

2 the Federal Employee Health Benefits Program 

3 under chapter 89 of title 5, United States Code 

4 (as amended by section 503). 

5 (D) The amendments made to the medi6 care program under title XVIII of the Social 

7 Security Act by sections 501 and 502 of this 

8 Act. 

9 (E) The preventive health care demonstra10 tion program carried out under section 505 of 

11 this Act. 

12 Such amounts shall be in addition to any other 

13 amounts appropriated for such purposes. 

14 (2) DISCRETIONARY EXPENDITURES.—Amounts 

15 in the Trust Fund not to exceed $2,050,000,000 

16 shall be available, as provided in appropriation Acts, 

17 for each fiscal year (beginning with fiscal year 2008) 

18 only for purposes of making expenditures to carry 

19 out the following: 

20 (A) School nutrition environment enhance21 ment grants under section 18(l) of the Richard 

22 B. Russell National School Lunch Act (as 

23 added by section 203). 

24 (B) Mental health services in schools under 

25 paragraphs (7) and (8) of section 5541(c) of 


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1 the Elementary and Secondary Education Act 

2 of 1965 (as added by section 204). 

3 (C) The Baby-Friendly Hospital Initiative 

4 carried out under section 205 of this Act. 

5 (D) The grant program to strengthen fam6 ilies and build children’s resilience carried out 

7 under section 520K of the Public Health Serv8 ice Act (as added by section 206). 

9 (E) The reservation for early Head Start 

10 programs under section 640(a)(6)(A) of the 

11 Head Start Act (as amended by section 207). 

12 (F) Community grants to prevent and re13 duce the incidence of chronic disease under sec14 tion 399P of the Public Health Service Act (as 

15 added by section 313). 

16 (G) Living well with a disability and work17 ing well with a disability programs under sec18 tions 399Q and 399R of the Public Health 

19 Service Act (as added by section 312). 

20 (H) The amendments made to title 23, 

21 United States Code, by section 313 of this Act 

22 and the nonmotorized transportation pilot pro23 gram carried out under section 313(d). 

24 (I) The national assessment of mental 

25 health needs program carried out under section 


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1 506C of the Public Health Service Act (as 

2 added by section 314). 

3 (J) The preventive medicine and public 

4 health training grant program carried out 

5 under section 747A of the Public Health Serv6 ice Act (as added by section 315). 

7 (K) Federal-State tobacco counter-adver8 tising programs under section 399S of the Pub9 lic Health Service Act (as added by section 

10 406). 

11 (L) Preventive health services for women, 

12 including well-integrated screening and evalua13 tion for women across the Nation, under section 

14 1509 of the Public Health Service Act (as 

15 added by section 506). 

16 (M) Carol M. White Physical Education 

17 Program under subpart 10 of part D of title V 

18 of the Elementary and Secondary Education 

19 Act of 1965. 

20 (N) Research regarding obesity under sec21 tion 101 of this Act. 

22 (O) Expanded Food and Nutrition Edu23 cation Program under section 3175 of title 23, 

24 United States Code. 


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1 (P) The following programs under the au2 thority of the Secretary of Health and Human 

3 Services through the Centers for Disease Con4 trol and Prevention: 

5 (i) Nutrition and physical activity 

6 grants. 

7 (ii) Division of Adolescent and School 

8 Health. 

9 (iii) Verb Campaign. 

10 (iv) Prevention research centers. 

11 (v) 5-a-day programs. 

12 (vi) Steps to a healthier United 

13 States. 

14 (Q) Access to local foods and school gar15 dens, as authorized by section 122 of the Child 

16 Nutrition and WIC Reauthorization Act of 

17 2004 (Public Law 108–265). 

18 (d) APPLICATION OF CERTAIN RULES.—For pur19 poses of this section, rules similar to the rules of sections 

20 9601 and 9602 of the Internal Revenue Code of 1986 shall 

21 apply. 

22 TITLE VII—RESEARCH 

23 SEC. 701. EXPANSION OF RESEARCH REGARDING OBESITY. 

24 The Secretary of Health and Human Services shall, 

25 based on the conclusions of the United States Preventive 


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1 Services Task Force on Obesity, conduct research on obe2 sity prevention, treatment, and control with regard to the 

3 following: 

4 (1) The effectiveness of physical activity and di5 etary counseling with children and adolescents in the 

6 primary care setting to prevent, treat, and control 

7 obesity. 

8 (2) The cost-effectiveness of intensive dietary 

9 and physical activity counseling to prevent, treat, 

10 and control obesity in a variety of populations. 

11 (3) The effectiveness of dietary and physical ac12 tivity counseling among children and adolescents, 

13 low income populations, and minority groups in the 

14 primary care setting to prevent, treat, and control 

15 obesity. 

16 (4) The effectiveness of the assessment of obe17 sity by a primary care physician and subsequent re18 ferral for obesity counseling to a nonaffiliated obe19 sity expert or specialist. 

20 SEC. 702. INCORPORATION OF PHYSICAL ACTIVITY INTO 

21 FEDERAL PROGRAMS. 

22 (a) STUDY.—The Secretary of Health and Human 

23 Services, in collaborate with the Secretary of Education 

24 the Director of the Centers for Disease Control and Pre25 vention, shall enter into a contract with the Institute of 


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1 Medicine of the National Academy of Sciences for the con2 duct of a study to examine and make recommendations 

3 concerning the various means that could be employed to 

4 incorporate physical activity into Head Start and childcare 

5 settings, elementary, middle and high school settings, and 

6 before- and after-school programs. The Institute of Medi7 cine shall submit to Congress a report concerning the re8 sults of such study. 

9 (b) CLASSIFICATION.—The Commissioner of Food 

10 and Drugs shall conduct a review of the classification of 

11 sodium and partially hydrogenated oil as a Generally Rec12 ognized as Safe (GRAS) ingredient based on new scientific 

13 developments. 

14 (c) REDUCING SODIUM INTAKE.—The Secretary of 

15 Health and Human Services shall enter into a contract 

16 with the Institute of Medicine of the National Academy 

17 of Sciences for the conduct of a study and the development 

18 of recommendations on various means that could be em19 ployed to reduce dietary sodium intake to recommended 

20 levels and food reformulation approaches. 

Æ 


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