II 

113TH CONGRESS 

1ST SESSION S. 39 

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

health promotion. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 22 (legislative day, JANUARY 3), 2013 

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 health promotion. 

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. 


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TITLE I—HEALTHIER KIDS AND SCHOOLS 

Sec. 101. Nutrition and physical activity in child care quality improvement. 

Sec. 102. Access to local foods and school gardens at preschools and child care. 

Sec. 103. Fresh fruit and vegetable program. 

Sec. 104. Equal physical activity opportunities for students with disabilities. 

Sec. 105. Physical activity in school settings. 

TITLE II—HEALTHIER COMMUNITIES AND WORKPLACES 

Subtitle A—Creating Healthier Communities 

Sec. 201. Technical assistance for the development of joint/shared use agreements. 

Sec. 202. Community sports programs for individuals with disabilities. 

Sec. 203. Community gardens. 

Sec. 204. Physical activity guidelines for Americans. 

Sec. 205. Tobacco tax increase and parity. 

Sec. 206. Leveraging and coordinating federal resources for improved health. 

Sec. 207. Healthier national parks. 

Subtitle B—Incentives for a Healthier Workforce 

Sec. 211. Tax credit to employers for costs of implementing wellness programs. 

Sec. 212. Employer-provided off-premises athletic facilities. 

Sec. 213. Task force for the promotion of breastfeeding in the workplace. 

Sec. 214. Improving healthy eating and active living options in Federal workplaces. 

TITLE III—RESPONSIBLE MARKETING AND CONSUMER 

AWARENESS 

Sec. 301. Guidelines for reduction in sodium content in certain foods. 

Sec. 302. Nutrition labeling for food products sold principally for use in restaurants or other retail food establishments. 

Sec. 303. Front-label food guidance systems. 

Sec. 304. Rulemaking authority for advertising to children. 

Sec. 305. Health literacy: research, coordination and dissemination. 

Sec. 306. Disallowance of deductions for advertising and marketing expenses 

relating to tobacco product use. 

Sec. 307. Incentives to reduce tobacco use. 

Sec. 308. Voluntary standards on food marketing to children. 

TITLE IV—EXPANDED COVERAGE OF PREVENTIVE SERVICES 

Sec. 401. Required coverage of preventive services under the Medicaid program. 

Sec. 402. Coverage for comprehensive workplace wellness program and preventive services. 

Sec. 403. Health professional education and training in healthy eating. 

Sec. 404. Integrative medicine training program. 

TITLE V—RESEARCH 

Sec. 501. National consortium on breastfeeding research. 

Sec. 502. National assessment of mental health needs. 


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1 TITLE I—HEALTHIER KIDS AND 

2 SCHOOLS 

3 SEC. 101. NUTRITION AND PHYSICAL ACTIVITY IN CHILD 

4 CARE QUALITY IMPROVEMENT. 

5 (a) STATE PLAN.—Section 658E(c)(2)(F) of the 

6 Child Care and Development Block Grant Act of 1990 (42 

7 U.S.C. 9858c(c)(2)(F)) is amended in the second sen8 tence— 

9 (1) by redesignating clauses (i), (ii), and (iii) as 

10 subclauses (I), (II), and (III) and indenting the 

11 margins so as to match the margins of subclause (I) 

12 of section 658E(c)(2)(A)(i); 

13 (2) by striking ‘‘requirements shall include—’’ 

14 and inserting ‘‘requirements— 

15 ‘‘(i) shall include—’’; 

16 (3) by striking the period and inserting ‘‘; 

17 and’’; and 

18 (4) by adding at the end the following: 

19 ‘‘(ii) may include requirements relat20 ing to standards for nutrition and access 

21 to physical activity.’’. 

22 (b) ACTIVITIES TO IMPROVE THE QUALITY OF

23 CHILD CARE.—Section 658G of that Act (42 U.S.C. 

24 9858e) is amended by adding at the end the following: 

25 ‘‘Funds reserved under this section may be used to supVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 port State or local efforts to develop or adopt high-quality 

2 program standards relating to health, mental health, nu3 trition, physical activity, and physical development or to 

4 provide resources to enable eligible child care providers to 

5 meet, exceed, or sustain success in meeting or exceeding 

6 such standards. Such standards shall take into account 

7 existing empirical studies and research and existing stand8 ards that have been approved by accrediting bodies.’’. 

9 SEC. 102. ACCESS TO LOCAL FOODS AND SCHOOL GARDENS 

10 AT PRESCHOOLS AND CHILD CARE. 

11 Section 18(g) of the Richard B. Russell National 

12 School Lunch Act (42 U.S.C. 1769(g)) is amended— 

13 (1) by striking paragraph (1) and inserting the 

14 following: 

15 ‘‘(1) DEFINITIONS.—In this subsection: 

16 ‘‘(A) CHILD CARE CENTER.—The term 

17 ‘child care center’ means a child care center 

18 participating in the program under section 17 

19 (other than a child care center that solely par20 ticipates in the program under subsection (r) of 

21 that section). 

22 ‘‘(B) ELIGIBLE SCHOOL.—The term ‘eligi23 ble school’ means a school or institution that 

24 participates in a program under this Act or the 

25 school breakfast program established under secVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 tion 4 of the Child Nutrition Act of 1966 (42 

2 U.S.C. 1773). 

3 ‘‘(C) SPONSORING ORGANIZATION.—The 

4 term ‘sponsoring organization’ means an insti5 tution described in subparagraphs (C), (D), or 

6 (E) of section 17(a)(2).’’; 

7 (2) in paragraph (2)— 

8 (A) by inserting ‘‘child care centers, spon9 soring organizations for home-based care,’’ 

10 after ‘‘eligible schools,’’; and 

11 (B) by inserting ‘‘, child care centers, and 

12 sponsoring organizations for home-based care’’ 

13 before the period at the end; 

14 (3) in paragraph (5)— 

15 (A) in subparagraph (A), by inserting ‘‘, 

16 child care center, or sponsoring organization for 

17 home-based care’’ after ‘‘eligible school’’; and 

18 (B) in subparagraph (D), by inserting 

19 ‘‘child care centers, sponsoring organizations 

20 for home-based care,’’ after ‘‘eligible schools,’’; 

21 and 

22 (4) in paragraph (7), in the matter preceding 

23 subparagraph (A), by inserting ‘‘child care centers, 

24 sponsoring organizations for home-based care,’’ after 

25 ‘‘eligible schools,’’. 


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1 SEC. 103. FRESH FRUIT AND VEGETABLE PROGRAM. 

2 Section 19 of the Richard B. Russell National School 

3 Lunch Act (42 U.S.C. 1769a) is amended— 

4 (1) by striking subsections (c) and (d) and in5 serting the following: 

6 ‘‘(c) SCHOOL PARTICIPATION.— 

7 ‘‘(1) IN GENERAL.—Each State shall carry out 

8 the program in each elementary school (as defined 

9 in section 9101 of the Elementary and Secondary 

10 Education Act of 1965 (20 U.S.C. 7801)) in the 

11 State— 

12 ‘‘(A) in which not less than 50 percent of 

13 the students are eligible for free or reduced 

14 price meals under this Act; and 

15 ‘‘(B) that submits an application in ac16 cordance with paragraph (2). 

17 ‘‘(2) APPLICATION.— 

18 ‘‘(A) IN GENERAL.—An interested elemen19 tary school shall submit to the State an applica20 tion containing— 

21 ‘‘(i) information pertaining to the per22 centage of students enrolled in the school 

23 who are eligible for free or reduced price 

24 school lunches under this Act; 

25 ‘‘(ii) a certification of support for par26 ticipation in the program signed by the 


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1 school food manager, the school principal, 

2 and the district superintendent (or equiva3 lent positions, as determined by the 

4 school); 

5 ‘‘(iii) a plan for implementation of the 

6 program, including efforts to integrate ac7 tivities carried out under this section with 

8 other efforts to promote sound health and 

9 nutrition, reduce overweight and obesity, 

10 or promote physical activity; and 

11 ‘‘(iv) such other information as may 

12 be requested by the Secretary. 

13 ‘‘(B) PARTNERSHIPS.—Each State shall 

14 encourage interested elementary schools to sub15 mit a plan for implementation of the program 

16 that includes a partnership with 1 or more enti17 ties that will provide non-Federal resources (in18 cluding entities representing the fruit and vege19 table industry).’’; 

20 (2) by striking subsection (i) and inserting the 

21 following: 

22 ‘‘(i) FUNDING.— 

23 ‘‘(1) IN GENERAL.—Out of any funds in the 

24 Treasury not otherwise appropriated, the Secretary 

25 of the Treasury shall transfer to the Secretary to 


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1 carry out this section such sums as are necessary, 

2 to remain available until expended. 

3 ‘‘(2) RECEIPT AND ACCEPTANCE.—The Sec4 retary shall be entitled to receive, shall accept, and 

5 shall use to carry out this section the funds trans6 ferred under paragraph (1), without further appro7 priation.’’; and 

8 (3) by redesignating subsections (e) through (i) 

9 as subsections (d) through (h), respectively. 

10 SEC. 104. EQUAL PHYSICAL ACTIVITY OPPORTUNITIES FOR 

11 STUDENTS WITH DISABILITIES. 

12 (a) IN GENERAL.—Title V of the Rehabilitation Act 

13 of 1973 (29 U.S.C. 791 et seq.) is amended by adding 

14 at the end the following: 

15 ‘‘SEC. 511. EQUAL PHYSICAL ACTIVITY OPPORTUNITIES 

16 FOR STUDENTS WITH DISABILITIES. 

17 ‘‘(a) IN GENERAL.—The Secretary shall promote 

18 equal opportunities for students with disabilities to be in19 cluded and to participate in physical education and extra20 curricular athletics implemented in, or in conjunction 

21 with, elementary schools, secondary schools, and institu22 tions of higher education, by ensuring the provision of ap23 propriate technical assistance and guidance for schools 

24 and institutions described in this subsection and their per25 sonnel. 


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1 ‘‘(b) TECHNICAL ASSISTANCE AND GUIDANCE.—The 

2 provision of technical assistance and guidance described 

3 in subsection (a) shall include— 

4 ‘‘(1) providing technical assistance to elemen5 tary schools, secondary schools, local educational 

6 agencies, State educational agencies, and institutions 

7 of higher education, regarding— 

8 ‘‘(A) inclusion and participation of stu9 dents with disabilities, in a manner equal to 

10 that of the other students, in physical education 

11 opportunities (including classes), and extra12 curricular athletics opportunities, including 

13 technical assistance on providing reasonable 

14 modifications to policies, practices, and proce15 dures, and providing supports to ensure such 

16 inclusion and participation; 

17 ‘‘(B) provision of adaptive sports pro18 grams, in the physical education and extra19 curricular athletics opportunities, including pro20 grams with competitive sports leagues or com21 petitions, for students with disabilities; and 

22 ‘‘(C) responsibilities of the schools, institu23 tions, and agencies involved under section 504, 

24 the Americans with Disabilities Act of 1990 (42 

25 U.S.C. 12101 et seq.), and any other applicable 


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1 Federal law to provide students with disabilities 

2 equal access to extracurricular athletics; 

3 ‘‘(2) facilitating information sharing among the 

4 schools, institutions, and agencies, and students with 

5 disabilities, on ways to provide inclusive opportuni6 ties in physical education and extracurricular ath7 letics for students with disabilities; and 

8 ‘‘(3) monitoring the extent to which physical 

9 education and extracurricular athletics opportunities 

10 for students with disabilities are implemented in, or 

11 in conjunction with, elementary schools, secondary 

12 schools, and institutions of higher education. 

13 ‘‘(c) DEFINITIONS.—In this section: 

14 ‘‘(1) AGENCIES.—The terms ‘local educational 

15 agency’ and ‘State educational agency’ have the 

16 meanings given the terms in section 9101 of the Ele17 mentary and Secondary Education Act of 1965 (20 

18 U.S.C. 7801). 

19 ‘‘(2) SCHOOLS.—The terms ‘elementary school’, 

20 ‘secondary school’, and ‘institution of higher edu21 cation’ mean an elementary school, secondary school, 

22 or institution of higher education, respectively (as 

23 defined in section 9101 of the Elementary and Sec24 ondary Education Act of 1965), that receives or has 


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1 1 or more students who receive, Federal financial as2 sistance. 

3 ‘‘(3) STUDENT WITH A DISABILITY.— 

4 ‘‘(A) IN GENERAL.—The term ‘student 

5 with a disability’ means an individual who— 

6 ‘‘(i) attends an elementary school, sec7 ondary school, or institution of higher edu8 cation; and 

9 ‘‘(ii) who— 

10 ‘‘(I) is eligible for, and receiving, 

11 special education or related services 

12 under part B of the Individuals with 

13 Disabilities Education Act (20 U.S.C. 

14 1411 et seq.); or 

15 ‘‘(II) is an individual with a dis16 ability, for purposes of section 504 or 

17 the Americans with Disabilities Act of 

18 1990. 

19 ‘‘(B) STUDENTS WITH DISABILITIES.—The 

20 term ‘students with disabilities’ means more 

21 than 1 student with a disability.’’. 

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

23 section 1(b) of the Rehabilitation Act of 1973 is amended 

24 by inserting after the item relating to section 509 the fol25 lowing: 


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‘‘Sec. 510. Establishment of standards for accessible medical diagnostic equipment. 

‘‘Sec. 511. Equal physical activity opportunities for students with disabilities.’’. 

1 SEC. 105. PHYSICAL ACTIVITY IN SCHOOL SETTINGS. 

2 (a) ANNUAL STATE REPORT CARD.—Section 

3 1111(h)(1)(C) of the Elementary and Secondary Edu4 cation Act of 1965 (20 U.S.C. 6311(h)(1)(C)) is amend5 ed— 

6 (1) in clause (vii), by striking ‘‘and’’ after the 

7 semicolon; 

8 (2) in clause (viii), by striking the period at the 

9 end and inserting a semicolon; and 

10 (3) by adding at the end the following: 

11 ‘‘(ix) the average number of minutes 

12 during the school day that all students 

13 spend in required physical education, and 

14 the average number of minutes that such 

15 students engage in moderate to vigorous 

16 physical activity during the school day, as 

17 measured against the most recent estab18 lished and recommended guidelines of the 

19 Centers for Disease Control and Preven20 tion and the Secretary of Health and 

21 Human Services; 

22 ‘‘(x) the percentage of local edu23 cational agencies that have a required, age24 appropriate, physical education curriculum 


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1 that adheres to the most recent guidelines 

2 developed by the Centers for Disease Con3 trol and Prevention and State standards; 

4 ‘‘(xi) the percentage of elementary 

5 school and secondary school physical edu6 cation teachers who are licensed or cer7 tified to teach physical education in the 

8 State; 

9 ‘‘(xii) the percentage of elementary 

10 schools and secondary schools that have a 

11 physical education teacher who is certified 

12 or licensed to teach in the State and who 

13 also is certified or licensed in adapted 

14 physical education; 

15 ‘‘(xiii) the number of indoor square 

16 feet and the number of outdoor square feet 

17 used primarily for physical education or 

18 physical activity by elementary schools and 

19 secondary schools; and 

20 ‘‘(xiv) the percentage of local edu21 cational agencies that have a school 

22 wellness council that— 

23 ‘‘(I) includes members appointed 

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1 ents, students, representatives of the 

2 school food authority, representatives 

3 of the school board, school administra4 tors, and members of the public; and 

5 ‘‘(II) meets regularly to promote 

6 a healthy school environment.’’. 

7 (b) PHYSICAL EDUCATION AS A CORE SUBJECT.— 

8 Section 9101(11) of the Elementary and Secondary Edu9 cation Act of 1965 (20 U.S.C. 7801(11)) is amended by 

10 inserting ‘‘physical education,’’ after ‘‘economics, arts,’’. 

11 (c) 21ST CENTURY LEARNING COMMUNITIES.— 

12 (1) PURPOSE; DEFINITIONS.—Section 4201 of 

13 the Elementary and Secondary Education Act of 

14 1965 (20 U.S.C. 7171) is amended— 

15 (A) in subsection (a)(2), by inserting ‘‘nu16 trition education programs, structured physical 

17 activity programs,’’ after ‘‘recreation pro18 grams,’’; and 

19 (B) in subsection (b)(1)(A), by inserting 

20 ‘‘nutrition education, structured physical activ21 ity,’’ after ‘‘recreation,’’. 

22 (2) LOCAL ACTIVITIES.—Section 4205(a) of the 

23 Elementary and Secondary Education Act of 1965 

24 (20 U.S.C. 7175(a)) is amended— 


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1 (A) in paragraph (11), by striking ‘‘and’’ 

2 after the semicolon; 

3 (B) in paragraph (12), by striking the pe4 riod at the end and inserting ‘‘; and’’; and 

5 (C) by adding at the end the following: 

6 ‘‘(13) programs that support a healthy, active 

7 lifestyle, including nutritional education and regular, 

8 structured physical activity programs.’’. 

9 (d) PARENTAL INVOLVEMENT.—Section 1118(d)(1) 

10 of the Elementary and Secondary Education Act of 1965 

11 (20 U.S.C. 6318(d)(1)) is amended— 

12 (1) by inserting ‘‘, healthy,’’ after ‘‘supportive’’; 

13 (2) by striking ‘‘; and participating’’ and insert14 ing ‘‘; participating’’; and 

15 (3) by inserting after ‘‘extracurricular time;’’ 

16 the following: ‘‘and supporting their children in lead17 ing a healthy and active life, such as by providing 

18 healthy meals and snacks, encouraging participation 

19 in physical education, and sharing in physical activ20 ity outside the school day to support successful aca21 demic achievement;’’. 

22 (e) LOCAL APPLICATION AND NEEDS ASSESS23 MENT.—Section 2122(b)(9) of the Elementary and Sec24 ondary Education Act of 1965 (20 U.S.C. 6622) is amend25 ed— 


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1 (1) in subparagraph (C), by striking ‘‘and’’ 

2 after the semicolon; 

3 (2) in subparagraph (D), by striking a period 

4 and inserting ‘‘; and’’; and 

5 (3) by adding at the end the following: 

6 ‘‘(E) encourage healthy eating habits and 

7 increased physical activity among students to 

8 support successful academic achievement.’’. 

9 TITLE II—HEALTHIER COMMU10 NITIES AND WORKPLACES 

11 Subtitle A—Creating Healthier 

12 Communities 

13 SEC. 201. TECHNICAL ASSISTANCE FOR THE DEVELOP14 MENT OF JOINT/SHARED USE AGREEMENTS. 

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

16 Human Services, in coordination with the Secretary of 

17 Education and in consultation with leading national ex18 perts and organizations advancing healthy living in the 

19 school environment, shall develop and disseminate guide20 lines and best practices, including model documents, and 

21 provide technical assistance to elementary and secondary 

22 schools to assist such schools with the development of 

23 joint/shared use agreements so as to address liability, 

24 operational and management, and cost issues that may 

25 otherwise impede the ability of community members to use 


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1 school facilities for recreational and nutritional purposes 

2 during nonschool hours. 

3 (b) DEFINITION.—In this section, the term ‘‘joint/ 

4 shared use agreement’’ means a formal agreement be5 tween an elementary or secondary school and another enti6 ty relating to the use of the school’s facilities, equipment, 

7 or property, including recreational and food services facili8 ties, equipment, and property, by individuals other than 

9 the school’s students or staff. 

10 SEC. 202. COMMUNITY SPORTS PROGRAMS FOR INDIVID11 UALS WITH DISABILITIES. 

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. 399V–6. COMMUNITY SPORTS PROGRAMS FOR INDI16 VIDUALS WITH DISABILITIES. 

17 ‘‘(a) IN GENERAL.— 

18 ‘‘(1) INDIVIDUAL WITH A DISABILITY DE19 FINED.—For purposes of this section, the term ‘in20 dividual with a disability’ means any person who has 

21 a disability as defined in section 3 of the Americans 

22 with Disabilities Act of 1990 (42 U.S.C. 12102). 

23 ‘‘(2) INDIVIDUAL WITH A PHYSICAL DIS24 ABILITY.—The term ‘individual with a physical disVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 ability’ means an individual with a disability that 

2 has a physical or visual disability. 

3 ‘‘(3) COMMUNITY SPORTS GRANTS PROGRAM.— 

4 The Secretary, in collaboration with the National 

5 Advisory Committee on Community Sports Pro6 grams for Individuals with Disabilities, may award 

7 grants on a competitive basis to public and nonprofit 

8 private entities to implement community-based, 

9 sports and athletic programs for individuals with 

10 disabilities, including youth with disabilities. 

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

12 under this section, a public or nonprofit private entity 

13 shall submit to the Secretary an application at such time, 

14 in such manner, and containing such agreements, assur15 ances, and information as the Secretary determines to be 

16 necessary to carry out this section. 

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

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

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

20 leagues, or competitions in individual or team sports 

21 for individuals with physical disabilities; 

22 ‘‘(2) regional sports programs or competitions 

23 in individual or team sports for individuals with 

24 physical disabilities; 


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

2 individual sports programs for individuals with dis3 abilities at the high school and collegiate level; or 

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

5 encourage participation in sports programs for indi6 viduals with disabilities, including individuals with 

7 recently acquired disabilities. 

8 ‘‘(d) PRIORITIES.— 

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

10 shall establish a National Advisory Committee on 

11 Community Sports Programs for Individuals with 

12 Disabilities that shall— 

13 ‘‘(A) establish priorities for the implemen14 tation of this section; 

15 ‘‘(B) review grant proposals; 

16 ‘‘(C) make recommendations for distribu17 tion of the available appropriated funds to spe18 cific applicants; and 

19 ‘‘(D) annually evaluate the progress of pro20 grams carried out under this section in imple21 menting such priorities. 

22 ‘‘(2) REPRESENTATION.—The Advisory Com23 mittee established under paragraph (1) shall include 

24 representatives of— 


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1 ‘‘(A) the Department of Health and 

2 Human Services Administration for Community 

3 Living; 

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

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

6 Prevention; 

7 ‘‘(D) disabled sports organizations; 

8 ‘‘(E) organizations that represent the in9 terests of individuals with disabilities; and 

10 ‘‘(F) individuals with disabilities (including 

11 athletes with physical disabilities) or their fam12 ily members. 

13 ‘‘(e) DISSEMINATION OF INFORMATION.—The Sec14 retary shall disseminate information about the availability 

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

16 to reach public entities and nonprofit private organizations 

17 that are dedicated to providing outreach, advocacy, or 

18 independent living services to individuals with disabilities. 

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

20 conjunction with the United States Olympic Committee 

21 and disabled sports organizations, shall establish a tech22 nical assistance center to provide training, support, and 

23 information to grantees under this section on establishing 

24 and operating community sports programs for individuals 

25 with disabilities. 


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

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

3 annually thereafter, the Secretary shall submit to Con4 gress a report summarizing activities, findings, outcomes, 

5 and recommendations resulting from the grant projects 

6 funded under this section during the year for which the 

7 report is being prepared. 

8 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

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

10 there are authorized to be appropriated such sums 

11 as may be necessary. 

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

13 the amount appropriated in each fiscal year shall be 

14 used to carry out activities under subsection 

15 (c)(4).’’. 

16 SEC. 203. COMMUNITY GARDENS. 

17 Subtitle D of title X of the Food, Conservation, and 

18 Energy Act of 2008 (Public Law 110–246; 122 Stat. 

19 2109) is amended by adding at the end the following: 

20 ‘‘SEC. 10405. COMMUNITY GARDEN GRANT PROGRAM. 

21 ‘‘(a) DEFINITIONS.—In this section: 

22 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en23 tity’ means— 

24 ‘‘(A) a nonprofit organization; or 


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1 ‘‘(B) a unit of general local government, or 

2 tribal government, located on tribal land or in 

3 a low-income community. 

4 ‘‘(2) LOW-INCOME COMMUNITY.—The term 

5 ‘low-income community’ means— 

6 ‘‘(A) a community in which not less than 

7 50 percent of children are eligible for free or re8 duced priced meals under the Richard B. Rus9 sell National School Lunch Act (42 U.S.C. 

10 1751 et seq.); or 

11 ‘‘(B) any other community determined by 

12 the Secretary to be low-income for purposes of 

13 this section. 

14 ‘‘(3) UNIT OF GENERAL LOCAL GOVERN15 MENT.—The term ‘unit of general local government’ 

16 has the meaning given the term in section 102 of the 

17 Housing and Community Development Act of 1974 

18 (42 U.S.C. 5302). 

19 ‘‘(b) PROGRAM ESTABLISHED.—Using such amounts 

20 as are appropriated to carry out this section, the Secretary 

21 shall award grants to eligible entities to expand, establish, 

22 or maintain community gardens. 

23 ‘‘(c) APPLICATION.—To be considered for a grant 

24 under this section, an eligible entity shall submit to the 

25 Secretary an application at such time, in such manner, 


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1 and containing such information as the Secretary may re2 quire, including— 

3 ‘‘(1) an assurance that priority for hiring for 

4 jobs created by the expansion, establishment, or 

5 maintenance of a community garden funded with a 

6 grant received under this section will be given to in7 dividuals who reside in the community in which the 

8 garden is located; and 

9 ‘‘(2) a demonstration that the eligible entity is 

10 committed to providing non-Federal financial or in11 kind support (such as providing a water supply) for 

12 the community garden for which the entity receives 

13 funds under this section.’’. 

14 SEC. 204. PHYSICAL ACTIVITY GUIDELINES FOR AMERI15 CANS. 

16 (a) REPORT.— 

17 (1) IN GENERAL.—At least every 10 years, the 

18 Secretary of Health and Human Services (in this 

19 section referred to as the ‘‘Secretary’’) shall publish 

20 a report entitled ‘‘Physical Activity Guidelines for 

21 Americans’’. Each such report shall contain physical 

22 activity information and guidelines for the general 

23 public, and shall be promoted by each Federal agen24 cy in carrying out any Federal health program. Not 

25 later than 5 years after the publication of the first 


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1 such report, and every 10 years thereafter, the Sec2 retary shall publish a report highlighting the best 

3 practices and continuing issues in the physical activ4 ity arena, which may focus on a particular group, 

5 subsection, or other division of the general public or 

6 a particular issue relating to the physical activity of 

7 Americans. 

8 (2) BASIS OF GUIDELINES.—The information 

9 and guidelines contained in each report required 

10 under paragraph (1) shall be based on the prepon11 derance of the scientific and medical knowledge 

12 which is current at the time the report is prepared, 

13 and shall include guidelines for identified population 

14 subgroups, including children, if the preponderance 

15 of scientific and medical knowledge indicates those 

16 subgroups require different levels of physical activ17 ity. 

18 (b) APPROVAL BY SECRETARY.— 

19 (1) REVIEW.—Any Federal agency that pro20 poses to issue any physical activity guidance for the 

21 general population or identified population sub22 groups shall submit the text of such guidance to the 

23 Secretary for a 60-day review period. 

24 (2) BASIS OF REVIEW.— 


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1 (A) IN GENERAL.—During the 60-day re2 view period established in paragraph (1), the 

3 Secretary shall review and approve or dis4 approve such guidance to assure that the guid5 ance either is consistent with the ‘‘Physical Ac6 tivity Guidelines for Americans’’ or that the 

7 guidance is based on medical or new scientific 

8 knowledge which is determined to be valid by 

9 the Secretary. If after such 60-day review pe10 riod the Secretary has not notified the pro11 posing agency that such guidance has been dis12 approved, then such guidance may be issued by 

13 the agency. If the Secretary disapproves such 

14 guidance, it shall be returned to the agency. If 

15 the Secretary finds that such guidance is incon16 sistent with the ‘‘Physical Activity Guidelines 

17 for Americans’’ and so notifies the proposing 

18 agency, such agency shall follow the procedures 

19 set forth in this subsection before disseminating 

20 such proposal to the public in final form. If 

21 after such 60-day period, the Secretary dis22 approves such guidance as inconsistent with the 

23 ‘‘Physical Activity Guidelines for Americans’’ 

24 the proposing agency shall— 


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1 (i) publish a notice in the Federal 

2 Register of the availability of the full text 

3 of the proposal and the preamble of such 

4 proposal which shall explain the basis and 

5 purpose for the proposed physical activity 

6 guidance; 

7 (ii) provide in such notice for a public 

8 comment period of 30 days; and 

9 (iii) make available for public inspec10 tion and copying during normal business 

11 hours any comment received by the agency 

12 during such comment period. 

13 (B) REVIEW OF COMMENTS.—After review 

14 of comments received during the comment pe15 riod, the Secretary may approve for dissemina16 tion by the proposing agency a final version of 

17 such physical activity guidance along with an 

18 explanation of the basis and purpose for the 

19 final guidance which addresses significant and 

20 substantive comments as determined by the 

21 proposing agency. 

22 (C) ANNOUNCEMENT.—Any such final 

23 physical activity guidance to be disseminated 

24 under subparagraph (B) shall be announced in 

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1 fore public dissemination along with an address 

2 where copies may be obtained. 

3 (D) NOTIFICATION OF DISAPPROVAL.—If 

4 after the 30-day period for comment as pro5 vided under subparagraph (A)(ii), the Secretary 

6 disapproves a proposed physical activity guid7 ance, the Secretary shall notify the Federal 

8 agency submitting such guidance of such dis9 approval, and such guidance may not be issued, 

10 except as provided in subparagraph (E). 

11 (E) REVIEW OF DISAPPROVAL.—If a pro12 posed physical activity guidance is disapproved 

13 by the Secretary under subparagraph (D), the 

14 Federal agency proposing such guidance may, 

15 within 15 days after receiving notification of 

16 such disapproval under subparagraph (D), re17 quest the Secretary to review such disapproval. 

18 Within 15 days after receiving a request for 

19 such a review, the Secretary shall conduct such 

20 review. If, pursuant to such review, the Sec21 retary approves such proposed physical activity 

22 guidance, such guidance may be issued by the 

23 Federal agency. 

24 (3) DEFINITIONS.—In this subsection: 


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1 (A) The term ‘‘physical activity guidance 

2 for the general population’’ does not include 

3 any rule or regulation issued by a Federal agen4 cy. 

5 (B) The term ‘‘identified population sub6 groups’’ shall include, but not be limited to, 

7 groups based on factors such as age, sex, race, 

8 or physical disability. 

9 (c) EXISTING AUTHORITY NOT AFFECTED.—This 

10 section does not place any limitations on— 

11 (1) the conduct or support of any scientific or 

12 medical research by any Federal agency; or 

13 (2) the presentation of any scientific or medical 

14 findings or the exchange or review of scientific or 

15 medical information by any Federal agency. 

16 SEC. 205. TOBACCO TAX INCREASE AND PARITY. 

17 (a) SHORT TITLE.—This section may be cited as the 

18 ‘‘Saving Lives by Lowering Tobacco Use Act’’. 

19 (b) INCREASE IN EXCISE TAX ON SMALL CIGARS

20 AND CIGARETTES.— 

21 (1) SMALL CIGARS.—Section 5701(a)(1) of the 

22 Internal Revenue Code of 1986 is amended by strik23 ing ‘‘$50.33’’ and inserting ‘‘$100.50’’. 

24 (2) CIGARETTES.—Section 5701(b) of such 

25 Code is amended— 


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1 (A) by striking ‘‘$50.33’’ in paragraph (1) 

2 and inserting ‘‘$100.50’’, and 

3 (B) by striking ‘‘$105.69’’ in paragraph 

4 (2) and inserting ‘‘$211.04’’. 

5 (c) TAX PARITY FOR PIPE TOBACCO AND ROLL6 YOUR-OWN TOBACCO.— 

7 (1) PIPE TOBACCO.—Section 5701(f) of the In8 ternal Revenue Code of 1986 is amended by striking 

9 ‘‘$2.8311 cents’’ and inserting ‘‘$49.55’’. 

10 (2) ROLL-YOUR-OWN TOBACCO.—Section 

11 5701(g) of such Code is amended by striking 

12 ‘‘$24.78’’ and inserting ‘‘$49.55’’. 

13 (d) CLARIFICATION OF DEFINITION OF SMALL CI14 GARS.—Paragraphs (1) and (2) of section 5701(a) of the 

15 Internal Revenue Code of 1986 are each amended by 

16 striking ‘‘three pounds per thousand’’ and inserting ‘‘four 

17 and one-half pounds per thousand’’. 

18 (e) CLARIFICATION OF DEFINITION OF CIGA19 RETTE.—Paragraph (2) of section 5702(b) of the Internal 

20 Revenue Code of 1986 is amended by inserting before the 

21 final period the following: ‘‘, which includes any roll for 

22 smoking containing tobacco that weighs no more than four 

23 and a half pounds per thousand, unless it is wrapped in 

24 whole tobacco leaf and does not have a cellulose acetate 

25 or other cigarette-style filter’’. 


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1 (f) TAX PARITY FOR SMOKELESS TOBACCO.— 

2 (1) IN GENERAL.—Section 5701(e) of the Inter3 nal Revenue Code of 1986 is amended— 

4 (A) in paragraph (1), by striking ‘‘$1.51’’ 

5 and inserting ‘‘$26.79’’; 

6 (B) in paragraph (2), by striking ‘‘50.33 

7 cents’’ and inserting ‘‘$10.72’’; and 

8 (C) by adding at the end the following: 

9 ‘‘(3) SMOKELESS TOBACCO SOLD IN DISCRETE

10 SINGLE-USE UNITS.—On discrete single-use units, 

11 $100.50 per each 1,000 single-use units.’’. 

12 (2) DISCRETE SINGLE-USE UNIT.—Section 

13 5702(m) of such Code is amended— 

14 (A) in paragraph (1), by striking ‘‘or chew15 ing tobacco’’ and inserting ‘‘chewing tobacco, 

16 discrete single-use unit’’; 

17 (B) in paragraphs (2) and (3), by inserting 

18 ‘‘that is not a discrete single-use unit’’ before 

19 the period in each such paragraph; and 

20 (C) by adding at the end the following: 

21 ‘‘(4) DISCRETE SINGLE-USE UNIT.—The term 

22 ‘discrete single-use unit’ means any product con23 taining tobacco that— 

24 ‘‘(A) is intended or expected to be con25 sumed without being combusted; and 


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1 ‘‘(B) is in the form of a lozenge, tablet, 

2 pill, pouch, dissolvable strip, or other discrete 

3 single-use or single-dose unit.’’. 

4 (3) OTHER TOBACCO PRODUCTS.—Section 5701 

5 of such Code is amended by adding at the end the 

6 following new subsection: 

7 ‘‘(i) OTHER TOBACCO PRODUCTS.—Any product not 

8 otherwise described under this section that has been deter9 mined to be a tobacco product by the Food and Drug Ad10 ministration through its authorities under the Family 

11 Smoking Prevention and Control Act shall be taxed at a 

12 level of tax equivalent to the tax rate for cigarettes on 

13 an estimated per use basis as determined by the Sec14 retary.’’. 

15 (g) CLARIFYING OTHER TOBACCO TAX DEFINI16 TIONS.— 

17 (1) TOBACCO PRODUCT DEFINITION.—Section 

18 5702(c) of the Internal Revenue Code of 1986 is 

19 amended by inserting before the period the fol20 lowing: ‘‘, and any other product containing tobacco 

21 that is intended or expected to be consumed’’. 

22 (2) CIGARETTE TUBE DEFINITION.—Section 

23 5702(f) of such Code is amended by inserting before 

24 the period ‘‘or cigars’’. 


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1 (3) IMPORTER DEFINITION.—Section 5702(k) 

2 of such Code is amended by inserting ‘‘or any other 

3 tobacco product’’ after ‘‘cigars or cigarettes’’. 

4 (4) PIPE TOBACCO DEFINITION.—Section 

5 5702(n) of such Code is amended— 

6 (A) by striking ‘‘The term’’ and inserting 

7 the following: 

8 ‘‘(1) IN GENERAL.—The term’’; and 

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

10 ‘‘(2) ROLL-YOUR-OWN TOBACCO.—Any tobacco 

11 that meets the definition under both this subsection 

12 and section 5702(o) shall be treated as roll-your-own 

13 tobacco under section 5702(o). 

14 ‘‘(3) EXCEPTION.—Paragraph (2) shall not 

15 apply to a product that, as of January 1, 2009, was 

16 either commercially marketed in the United States 

17 in packaging that bore, pursuant to part 40 or 41 

18 of title 27, Code of Federal Regulations, a designa19 tion as ‘pipe tobacco’ or ‘Tax Class L’, or is sub20 stantially equivalent to such product, provided that 

21 such product is widely used as pipe tobacco.’’. 

22 (h) INFLATION ADJUSTMENT.—Section 5701 of the 

23 Internal Revenue Code of 1986, as amended by subsection 

24 (f)(3), is amended by adding at the end the following new 

25 subsection: 


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1 ‘‘(j) INFLATION ADJUSTMENT.—In the case of any 

2 calendar year after 2013, each amount set forth in this 

3 section shall be increased by an amount equal to— 

4 ‘‘(1) such amount, multiplied by 

5 ‘‘(2) the cost-of-living adjustment determined 

6 under section 1(f)(3) for such calendar year by sub7 stituting ‘calendar year 2012’ for ‘calendar year 

8 1992’ in subparagraph (B) thereof.’’. 

9 (i) FLOOR STOCKS TAXES.— 

10 (1) IMPOSITION OF TAX.—On tobacco products 

11 manufactured in or imported into the United States 

12 which are removed before any tax increase date and 

13 held on such date for sale by any person, there is 

14 hereby imposed a tax in an amount equal to the ex15 cess of— 

16 (A) the tax which would be imposed under 

17 section 5701 of the Internal Revenue Code of 

18 1986 on the article if the article had been re19 moved on such date, over 

20 (B) the prior tax (if any) imposed under 

21 section 5701 of such Code on such article. 

22 (2) CREDIT AGAINST TAX.—Each person shall 

23 be allowed as a credit against the taxes imposed by 

24 paragraph (1) an amount equal to $500. Such credit 

25 shall not exceed the amount of taxes imposed by 


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1 paragraph (1) on such date for which such person 

2 is liable. 

3 (3) LIABILITY FOR TAX AND METHOD OF PAY4 MENT.— 

5 (A) LIABILITY FOR TAX.—A person hold6 ing tobacco products on any tax increase date 

7 to which any tax imposed by paragraph (1) ap8 plies shall be liable for such tax. 

9 (B) METHOD OF PAYMENT.—The tax im10 posed by paragraph (1) shall be paid in such 

11 manner as the Secretary shall prescribe by reg12 ulations. 

13 (C) TIME FOR PAYMENT.—The tax im14 posed by paragraph (1) shall be paid on or be15 fore the date that is 120 days after the effective 

16 date of the tax rate increase. 

17 (4) ARTICLES IN FOREIGN TRADE ZONES.— 

18 Notwithstanding the Act of June 18, 1934 (com19 monly known as the Foreign Trade Zone Act, 48 

20 Stat. 998, 19 U.S.C. 81a et seq.), or any other pro21 vision of law, any article which is located in a for22 eign trade zone on any tax increase date shall be 

23 subject to the tax imposed by paragraph (1) if— 

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1 spect to such article before such date pursuant 

2 to a request made under the 1st proviso of sec3 tion 3(a) of such Act, or 

4 (B) such article is held on such date under 

5 the supervision of an officer of the United 

6 States Customs and Border Protection of the 

7 Department of Homeland Security pursuant to 

8 the 2d proviso of such section 3(a). 

9 (5) DEFINITIONS.—For purposes of this sub10 section— 

11 (A) IN GENERAL.—Any term used in this 

12 subsection which is also used in section 5702 of 

13 such Code shall have the same meaning as such 

14 term has in such section. 

15 (B) TAX INCREASE DATE.—The term ‘‘tax 

16 increase date’’ means the effective date of any 

17 increase in any tobacco product excise tax rate 

18 pursuant to the amendments made by this sec19 tion (other than subsection (g) thereof). 

20 (C) SECRETARY.—The term ‘‘Secretary’’ 

21 means the Secretary of the Treasury or the 

22 Secretary’s delegate. 

23 (6) CONTROLLED GROUPS.—Rules similar to 

24 the rules of section 5061(e)(3) of such Code shall 

25 apply for purposes of this subsection. 


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1 (7) OTHER LAWS APPLICABLE.—All provisions 

2 of law, including penalties, applicable with respect to 

3 the taxes imposed by section 5701 of such Code 

4 shall, insofar as applicable and not inconsistent with 

5 the provisions of this subsection, apply to the floor 

6 stocks taxes imposed by paragraph (1), to the same 

7 extent as if such taxes were imposed by such section 

8 5701. The Secretary may treat any person who bore 

9 the ultimate burden of the tax imposed by para10 graph (1) as the person to whom a credit or refund 

11 under such provisions may be allowed or made. 

12 (j) EFFECTIVE DATE.—The amendments made by 

13 this section shall apply to articles removed (as defined in 

14 section 5702(j) of the Internal Revenue Code of 1986) 

15 after December 31, 2013. 

16 SEC. 206. LEVERAGING AND COORDINATING FEDERAL RE17 SOURCES FOR IMPROVED HEALTH. 

18 (a) HEALTH IMPACTS OF NON-HEALTH LEGISLA19 TION.— 

20 (1) IN GENERAL.—Not later than 6 months 

21 after the date of enactment of this Act, the National 

22 Prevention, Health Promotion and Public Health 

23 Council, shall enter into a contract with the Institute 

24 of Medicine of the National Academy of Sciences for 

25 the conduct of a study to assess the potential health 


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1 impacts of major non-health related legislation that 

2 is likely to be considered by Congress within a year 

3 of completion of the study. Such study shall identify 

4 the ways in which such legislation involved is likely 

5 to impact the health of Americans and shall contain 

6 recommendations to Congress on ways to maximize 

7 the positive health impacts and minimize the nega8 tive health impacts. 

9 (2) TIMING.—The timing of the study under 

10 paragraph (1) shall be determined in a manner that 

11 ensures that the results of the study will be available 

12 at least 3 months prior to the consideration of the 

13 legislation involved by Congress. 

14 (3) GUIDELINES.—To the extent practicable, 

15 the Council under paragraph (1) shall ensure that 

16 the study conducted under this subsection complies 

17 with the consensus guidelines on how to carry out a 

18 health impact assessment, including stakeholder en19 gagement guidelines, such as the HIA of the Amer20 icas Practice Guidelines and guidelines promulgated 

21 by the World Health Organization and other con22 sensus bodies. 

23 (4) REPORT.—Upon completion of the study 

24 under this subsection, the Institute of Medicine shall 


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1 submit to the Council under paragraph (1), and 

2 make available to the general public, a report that— 

3 (A) summarizes the direct, indirect, and 

4 cumulative health impacts identified in the as5 sessment; and 

6 (B) contains recommendations for how to 

7 maximize positive health impacts and minimize 

8 negative health impacts of the legislation in9 volved. 

10 (5) TYPE OF LEGISLATION.—For purposes of 

11 this subsection, the term ‘‘non-health related legisla12 tion’’ shall have the meaning given such term by the 

13 Council under paragraph (1), and shall include legis14 lation that is likely to have impacts on the health of 

15 Americans where such impacts are not likely to be 

16 considered by Congress to the extent required by 

17 their scope without the conduct of an assessment 

18 under this subsection. Examples of major non-health 

19 related legislation that could be the subject of the 

20 study include reauthorizations of the Moving Ahead 

21 for Progress in the 21st Century Act (Public Law 

22 112–141), the Food, Conservation, and Energy Act 

23 of 2008 (Public Law 110–246), and the Elementary 

24 and Secondary Education Act of 1965 (20 U.S.C. 

25 6301 et seq.). 


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1 (b) IMPROVING HEALTH IMPACTS OF FEDERAL

2 AGENCY ACTIVITIES.— 

3 (1) IN GENERAL.—The Secretary, in coordina4 tion with the National Prevention, Health Promotion 

5 and Public Health Council, shall detail employees of 

6 the Department of Health and Human Services to 

7 policy and program planning offices of other Federal 

8 departments and agencies, including the Department 

9 of Transportation, the Department of Housing and 

10 Urban Development, the Department of Agriculture, 

11 the Department of Education, and the Department 

12 of the Interior, in order to assist those departments 

13 and agencies to consider the impacts of their activi14 ties on the health of the populations served and to 

15 assist with the integration of health goals into the 

16 activities of the departments and agencies, as appro17 priate. 

18 (2) DUTIES.—Employees detailed under para19 graph (1) shall assist with assessments of the poten20 tial impacts of the programs and activities of the de21 partment or agency involved on the health and well22 being of the populations served, the development of 

23 metrics and performance standards that can be in24 corporated, as appropriate, into the activities, per25 formance measurements, and grant and contract 


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1 standards of the department or agency, and the de2 velopment of the report detailed in paragraph (3). 

3 (3) REPORTS.—Not later than 1 year after the 

4 date of enactment of this Act, and annually there5 after, each department and agency with a detailee 

6 under this section shall submit to the National Pre7 vention, Health Promotion and Public Health Coun8 cil, the Committee on Health, Education, Labor, and 

9 Pensions of the Senate and the Committee on En10 ergy and Commerce of the House of Representatives 

11 a report detailing the health impacts of the depart12 ment or agency’s activities and any plans to improve 

13 those impacts. 

14 SEC. 207. HEALTHIER NATIONAL PARKS. 

15 (a) CONCESSIONS CONTRACTS.—Section 403 of the 

16 National Park Service Concessions Management Improve17 ment Act of 1998 (16 U.S.C. 5952) is amended— 

18 (1) in paragraph (4)(A), by adding at the end 

19 the following: 

20 ‘‘(iv) Measures necessary to ensure 

21 the easy and plentiful availability of 

22 healthy snacks, beverages, and meals (in23 cluding meals for children) that reflect the 

24 most recent Dietary Guidelines for Ameri25 cans published under section 301 of the 


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1 National Nutrition Monitoring and Related 

2 Research Act of 1990 (7 U.S.C. 5341).’’; 

3 and 

4 (2) in paragraph (5)(A), by adding at the end 

5 the following: 

6 ‘‘(v) The responsiveness of the pro7 posal to the objective of supporting the ef8 forts of visitors to the unit of the National 

9 Park System to make healthy dietary 

10 choices through the easy and plentiful 

11 availability of healthy snacks, beverages, 

12 and meals (including meals for children) 

13 that reflect the most recent Dietary Guide14 lines for Americans published under sec15 tion 301 of the National Nutrition Moni16 toring and Related Research Act of 1990 

17 (7 U.S.C. 5341).’’. 

18 (b) REPORT.— 

19 (1) IN GENERAL.—Not later than 180 days 

20 after the date of enactment of this Act, the Sec21 retary of the Interior (acting through the Director of 

22 the National Park Service) (referred to in this sec23 tion as the ‘‘Secretary’’) shall submit to Congress a 

24 report that describes the state of food and beverage 

25 offerings in units of the National Park System. 


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1 (2) COMPONENTS.—The report submitted 

2 under paragraph (1) shall include— 

3 (A) an assessment of the nutritional qual4 ity of foods offered in units of the National 

5 Park System, including the approximate per6 centage of food and beverage offerings that re7 flect the most recent Dietary Guidelines for 

8 Americans published under section 301 of the 

9 National Nutrition Monitoring and Related Re10 search Act of 1990 (7 U.S.C. 5341); 

11 (B) guidelines for concessioners to ensure 

12 the easy and plentiful availability of healthy 

13 snacks, beverages, and meals (including meals 

14 for children) from National Park Service res15 taurants, retail food outlets, and other food 

16 concessioners that take into account— 

17 (i) the most recent Dietary Guidelines 

18 for Americans published under section 301 

19 of the National Nutrition Monitoring and 

20 Related Research Act of 1990 (7 U.S.C. 

21 5341); and 

22 (ii) the most recent Sustainability 

23 Guidelines for Federal Concessions and 

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1 retary of Health and Human Services and 

2 the Administrator of General Services; and 

3 (C) a plan to ensure that, not later than 

4 August 25, 2016, there are adequate offerings 

5 of healthy food items from all food conces6 sioners in units of the National Park System. 

7 (c) PROMOTING HEALTH, RECREATION, AND OUT8 DOORS.— 

9 (1) IN GENERAL.—The Secretary of Health and 

10 Human Services (acting through the Director of the 

11 Centers for Disease Control and Prevention) shall 

12 coordinate with the Secretary (acting through the 

13 Director of the National Park Service), in consulta14 tion with the Program Manager of the Rivers, 

15 Trails, and Conservation Assistance Program, to ad16 vance efforts for the National Park System to en17 hance opportunities for people to engage in physical 

18 activity. 

19 (2) ACTION PLAN.—Not later than 1 year after 

20 the date of enactment of this Act, the Secretary of 

21 Health and Human Services (acting through the Di22 rector of the Centers for Disease Control and Pre23 vention), the Secretary (acting through the Director 

24 of the National Park Service), and the Program 

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1 sistance Program shall establish a long-range action 

2 plan— 

3 (A) that identifies and coordinates mecha4 nisms to advance— 

5 (i) public education on the health im6 portance of physical activity and recreation 

7 outdoors in nature, including in units of 

8 the National Park System; and 

9 (ii) health, physical activity, and 

10 recreation programs that increase the 

11 amount of time and the quality of opportu12 nities spent outdoors in nature, including 

13 in units of the National Park System; and 

14 (B) that considers accessibility to units of 

15 the National Park System and barriers to par16 ticipation in outdoor physical activity and recre17 ation opportunities, with an emphasis on access 

18 by and barriers for disadvantaged populations, 

19 including individuals with disabilities. 


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1 Subtitle B—Incentives for a 

2 Healthier Workforce 

3 SEC. 211. TAX CREDIT TO EMPLOYERS FOR COSTS OF IM4 PLEMENTING WELLNESS PROGRAMS. 

5 (a) IN GENERAL.—Subpart D of part IV of sub6 chapter A of chapter 1 of the Internal Revenue Code of 

7 1986 is amended by adding at the end the following: 

8 ‘‘SEC. 45S. WELLNESS PROGRAM CREDIT. 

9 ‘‘(a) ALLOWANCE OF CREDIT.— 

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

11 the wellness program credit determined under this 

12 section for any taxable year during the credit period 

13 with respect to an employer is an amount equal to 

14 50 percent of the costs paid or incurred by the em15 ployer in connection with a qualified wellness pro16 gram during the taxable year. 

17 ‘‘(2) LIMITATION.—The amount of credit al18 lowed under paragraph (1) for any taxable year shall 

19 not exceed the sum of— 

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

21 of employees of the employer not in excess of 

22 200 employees, plus 

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

24 of employees of the employer in excess of 200 

25 employees. 


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1 ‘‘(b) QUALIFIED WELLNESS PROGRAM.—For pur2 poses of this section— 

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

4 term ‘qualified wellness program’ means a program 

5 which— 

6 ‘‘(A) consists of any 3 of the wellness pro7 gram components described in subsection (c), 

8 and 

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

10 Health and Human Services, in consultation 

11 with the Secretary of the Treasury and the Sec12 retary of Labor, as a qualified wellness program 

13 under this section. 

14 ‘‘(2) PROGRAMS MUST BE CONSISTENT WITH

15 RESEARCH AND BEST PRACTICES.— 

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

17 Health and Human Services shall not certify a 

18 program as a qualified wellness program unless 

19 the program— 

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

21 research and best practices, as identified 

22 by persons with expertise in employer 

23 health promotion and wellness programs, 

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

25 strategies which are based on the existing 


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1 and emerging research and careful sci2 entific reviews, including the Guide to 

3 Community Preventive Services, the Guide 

4 to Clinical Preventive Services, and the 

5 National Registry of Evidence-based Pro6 grams and Practices, and 

7 ‘‘(iii) includes strategies which focus 

8 on employee populations with a dispropor9 tionate burden of health problems. 

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

11 The Secretary of Health and Human Services 

12 shall establish procedures for periodic review 

13 and recertifications of programs under this sub14 section. Such procedures shall require revisions 

15 of programs if necessary to ensure compliance 

16 with the requirements of this section and re17 quire updating of the programs to the extent 

18 the Secretary, in consultation with the Sec19 retary of the Treasury and the Secretary of 

20 Labor, determines necessary to reflect new sci21 entific findings. 

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

23 Health and Human Services shall, as part of the 

24 certification process, encourage employers to make 

25 the programs culturally competent and to meet the 


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1 health literacy needs of the employees covered by the 

2 programs. 

3 ‘‘(c) WELLNESS PROGRAM COMPONENTS.—For pur4 poses of this section, the wellness program components de5 scribed in this subsection are the following: 

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

7 health awareness component which provides for the 

8 following: 

9 ‘‘(A) HEALTH EDUCATION.—The dissemi10 nation of health information which addresses 

11 the specific needs and health risks of employees. 

12 ‘‘(B) HEALTH SCREENINGS.—The oppor13 tunity for periodic screenings for health prob14 lems and referrals for appropriate follow up 

15 measures. 

16 ‘‘(2) EMPLOYEE ENGAGEMENT COMPONENT.— 

17 An employee engagement component which provides 

18 for— 

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

20 actively engage employees in worksite wellness 

21 programs through worksite assessments and 

22 program planning, delivery, evaluation, and im23 provement efforts, and 

24 ‘‘(B) the tracking of employee participa25 tion. 


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

2 behavioral change component which provides for al3 tering employee lifestyles to encourage healthy living 

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

5 self-help materials which provide technical assistance 

6 and problem solving skills. Such component may in7 clude programs relating to— 

8 ‘‘(A) tobacco use, 

9 ‘‘(B) overweight and obesity, 

10 ‘‘(C) stress management, 

11 ‘‘(D) physical activity, 

12 ‘‘(E) nutrition, 

13 ‘‘(F) substance abuse, 

14 ‘‘(G) depression, and 

15 ‘‘(H) mental health promotion (including 

16 anxiety). 

17 ‘‘(4) SUPPORTIVE ENVIRONMENT COMPO18 NENT.—A supportive environment component which 

19 includes the following: 

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

21 services at the worksite which promote a 

22 healthy lifestyle, including policies relating to— 

23 ‘‘(i) tobacco use at the worksite, 


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

2 the worksite through cafeterias and vend3 ing options, 

4 ‘‘(iii) minimizing stress and promoting 

5 positive mental health in the workplace, 

6 ‘‘(iv) where applicable, accessible and 

7 attractive stairs, 

8 ‘‘(v) alternative transportation and 

9 commuting options and facilities, and 

10 ‘‘(vi) the encouragement of physical 

11 activity before, during, and after work 

12 hours. 

13 ‘‘(B) PARTICIPATION INCENTIVES.— 

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

15 benefits for each employee who participates 

16 in the health screenings described in para17 graph (1)(B) or the behavioral change pro18 grams described in paragraph (3). 

19 ‘‘(ii) QUALIFIED INCENTIVE BEN20 EFIT.—For purposes of clause (i), the 

21 term ‘qualified incentive benefit’ means 

22 any benefit which is approved by the Sec23 retary of Health and Human Services, in 

24 consultation with the Secretary of the 

25 Treasury and the Secretary of Labor. Such 


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1 benefit may include an adjustment in 

2 health insurance premiums or co-pays. 

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

4 for employees to participate in the management 

5 of any qualified wellness program to which this 

6 section applies. 

7 ‘‘(d) PARTICIPATION REQUIREMENT.— 

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

9 under subsection (a) unless the Secretary of Health 

10 and Human Services, in consultation with the Sec11 retary of the Treasury and the Secretary of Labor, 

12 as a part of any certification described in subsection 

13 (b), determine that each wellness program compo14 nent of the qualified wellness program applies to all 

15 qualified employees of the employer. The Secretary 

16 of Health and Human Services shall prescribe rules 

17 under which an employer shall not be treated as fail18 ing to meet the requirements of this subsection 

19 merely because the employer provides specialized 

20 programs for employees with specific health needs or 

21 unusual employment requirements or provides a 

22 pilot program to test new wellness strategies. 

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

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


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1 an employee who works an average of not less than 

2 25 hours per week during the taxable year. 

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

4 For purposes of this section— 

5 ‘‘(1) EMPLOYEE AND EMPLOYER.— 

6 ‘‘(A) PARTNERS AND PARTNERSHIPS.— 

7 The term ‘employee’ includes a partner and the 

8 term ‘employer’ includes a partnership. 

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

10 similar to the rules of section 52 shall apply. 

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

12 paid or incurred by an employer for food or health 

13 insurance shall not be taken into account under sub14 section (a). 

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

16 No credit shall be allowable under subsection (a) 

17 with respect to any qualified wellness program of 

18 any taxpayer (other than an eligible employer de19 scribed in subsection (f)(2)(A)) who receives a grant 

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

21 subdivision of a State for use in connection with 

22 such program. The Secretary shall prescribe rules 

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1 nificant portion of the funding for the qualified 

2 wellness program. 

3 ‘‘(4) CREDIT PERIOD.— 

4 ‘‘(A) IN GENERAL.—The term ‘credit pe5 riod’ means the period of 10 consecutive taxable 

6 years beginning with the taxable year in which 

7 the qualified wellness program is first certified 

8 under this section. 

9 ‘‘(B) SPECIAL RULE FOR EXISTING PRO10 GRAMS.—In the case of an employer (or prede11 cessor) which operates a wellness program for 

12 its employees on the date of the enactment of 

13 this section, subparagraph (A) shall be applied 

14 by substituting ‘3 consecutive taxable years’ for 

15 ‘10 consecutive taxable years’. The Secretary 

16 shall prescribe rules under which this sub17 section shall not apply if an employer is re18 quired to make substantial modifications in the 

19 existing wellness program in order to qualify 

20 such program for certification as a qualified 

21 wellness program. 

22 ‘‘(C) CONTROLLED GROUPS.—For pur23 poses of this paragraph, all persons treated as 

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


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

2 single employer. 

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

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

5 employer of an employee, the aggregate credits al6 lowed to a taxpayer under subpart C shall be in7 creased by the lesser of— 

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

9 under this section without regard to this sub10 section and the limitation under section 38(c), 

11 or 

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

13 amount of credits allowed by this subpart (de14 termined without regard to this subsection) 

15 would increase if the limitation imposed by sec16 tion 38(c) for any taxable year were increased 

17 by the amount of employer payroll taxes im18 posed on the taxpayer during the calendar year 

19 in which the taxable year begins. 

20 The amount of the credit allowed under this sub21 section shall not be treated as a credit allowed under 

22 this subpart and shall reduce the amount of the 

23 credit otherwise allowable under subsection (a) with24 out regard to section 38(c). 


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

2 this subsection, the term ‘eligible employer’ means 

3 an employer which is— 

4 ‘‘(A) a State or political subdivision there5 of, the District of Columbia, a possession of the 

6 United States, or an agency or instrumentality 

7 of any of the foregoing, or 

8 ‘‘(B) any organization described in section 

9 501(c) of the Internal Revenue Code of 1986 

10 which is exempt from taxation under section 

11 501(a) of such Code. 

12 ‘‘(3) EMPLOYER PAYROLL TAXES.—For pur13 poses of this subsection— 

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

15 payroll taxes’ means the taxes imposed by— 

16 ‘‘(i) section 3111(b), and 

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

18 (determined at a rate equal to the rate 

19 under section 3111(b)). 

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

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

22 purposes of subparagraph (A). 

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

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


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1 (b) TREATMENT AS GENERAL BUSINESS CREDIT.— 

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

3 of 1986 is amended by striking ‘‘plus’’ at the end of para4 graph (35), by striking the period at the end of paragraph 

5 (36) and inserting ‘‘, plus’’, and by adding at the end the 

6 following: 

7 ‘‘(37) the wellness program credit determined 

8 under section 45S.’’. 

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

10 the Internal Revenue Code of 1986 is amended by adding 

11 at the end the following new subsection: 

12 ‘‘(j) WELLNESS PROGRAM CREDIT.— 

13 ‘‘(1) IN GENERAL.—No deduction shall be al14 lowed for that portion of the costs paid or incurred 

15 for a qualified wellness program (within the meaning 

16 of section 45S) allowable as a deduction for the tax17 able year which is equal to the amount of the credit 

18 allowable for the taxable year under section 45S. 

19 ‘‘(2) SIMILAR RULE WHERE TAXPAYER CAP20 ITALIZES RATHER THAN DEDUCTS EXPENSES.—If— 

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

22 for the taxable year under section 45S, exceeds 

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

24 for such taxable year for a qualified wellness 

25 program, 


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1 the amount chargeable to capital account for the 

2 taxable year for such expenses shall be reduced by 

3 the amount of such excess. 

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

5 corporation which is a member of a controlled group 

6 of corporations (within the meaning of section 

7 41(f)(5)) or a trade or business which is treated as 

8 being under common control with other trades or 

9 business (within the meaning of section 

10 41(f)(1)(B)), this subsection shall be applied under 

11 rules prescribed by the Secretary similar to the rules 

12 applicable under subparagraphs (A) and (B) of sec13 tion 41(f)(1).’’. 

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

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

16 of the Internal Revenue Code of 1986 is amended by add17 ing at the end the following: 

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

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

19 this section shall apply to taxable years beginning after 

20 the date of enactment of this Act. 

21 (f) OUTREACH.— 

22 (1) IN GENERAL.—The Secretary of the Treas23 ury, in conjunction with the Director of the Centers 

24 for Disease Control and members of the business 

25 community, shall institute an outreach program to 


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1 inform businesses about the availability of the 

2 wellness program credit under section 45S of the In3 ternal Revenue Code of 1986 as well as to educate 

4 businesses on how to develop programs according to 

5 recognized and promising practices and on how to 

6 measure the success of implemented programs. 

7 (2) AUTHORIZATION OF APPROPRIATIONS.— 

8 There are authorized to be appropriated such sums 

9 as are necessary to carry out the outreach program 

10 described in paragraph (1). 

11 SEC. 212. EMPLOYER-PROVIDED OFF-PREMISES ATHLETIC 

12 FACILITIES. 

13 (a) TREATMENT AS FRINGE BENEFIT.—Subpara14 graph (A) of section 132(j)(4) of the Internal Revenue 

15 Code of 1986 is amended to read as follows: 

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

17 not include— 

18 ‘‘(i) the value of any on-premises ath19 letic facility provided by an employer to its 

20 employees, and 

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

22 membership expenses paid by an employer 

23 to an athletic or fitness facility described 

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1 ployees as does not exceed $900 per em2 ployee per year.’’. 

3 (b) ATHLETIC FACILITIES DESCRIBED.—Paragraph 

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

5 is amended by adding at the end the following new sub6 paragraph: 

7 ‘‘(C) CERTAIN ATHLETIC OR FITNESS FA8 CILITIES DESCRIBED.—For purposes of sub9 paragraph (A)(ii), an athletic or fitness facility 

10 described in this subparagraph is a facility— 

11 ‘‘(i) which provides instruction in a 

12 program of physical exercise, offers facili13 ties for the preservation, maintenance, en14 couragement, or development of physical 

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

16 a State or local government, 

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

18 and operated by its members, 

19 ‘‘(iii) which does not offer golf, hunt20 ing, sailing, or riding facilities, 

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

22 not incidental to its overall function and 

23 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 is 

18 amended by adding at the end the following new 

19 sentence: ‘‘The preceding sentence shall not apply to 

20 so much of the fees, dues, or membership expenses 

21 paid to athletic or fitness facilities (within the mean22 ing of section 132(j)(4)(C)) as does not exceed $900 

23 per employee per year.’’. 

24 (2) CONFORMING AMENDMENT.—The last sen25 tence of section 274(e)(4) of such Code is amended 


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1 by inserting ‘‘the first sentence of’’ before ‘‘sub2 section (a)(3)’’. 

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

4 this section shall apply to taxable years beginning after 

5 the date of the enactment of this Act. 

6 SEC. 213. TASK FORCE FOR THE PROMOTION OF 

7 BREASTFEEDING IN THE WORKPLACE. 

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

9 Human Services and the Secretary of Labor, or their des10 ignees, shall convene a task force for the purpose of pro11 moting breastfeeding among working mothers (referred to 

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

13 (b) MEMBERSHIP.—The Task Force shall be com14 posed of members who are— 

15 (1) expert staff from the Department of Labor 

16 with expertise in workforce issues; 

17 (2) expert staff from the Department of Health 

18 and Human Services with expertise in the areas of 

19 breastfeeding and breastfeeding promotion; 

20 (3) members of the United States Breastfeeding 

21 Committee; 

22 (4) expert staff from the Department of Agri23 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 affect its powers, but 

13 shall be filled in the same manner as the original appoint14 ment. 

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 Sur20 geon General’s Call to Action to Support 

21 Breastfeeding (2011), the Task Force shall examine 

22 the following issues: 

23 (A) The challenges that mothers face with 

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1 ferent challenges that mothers of varying socio2 economic status and in different professions 

3 may face. 

4 (B) The challenges that employers face in 

5 accommodating mothers who seek to continue 

6 to breastfeed or to express milk when the moth7 ers re-enter the workforce. 

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 breast 

11 milk at work after the mothers have re-entered 

12 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 (E) The implementation of the reasonable 

18 break time for nursing mothers requirements 

19 under section 7(r) of the Fair Labor Standards 

20 Act of 1938 (29 U.S.C. 207(r)). 

21 (2) REPORTS.— 

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

23 after the date of enactment of this section, the 

24 Task Force shall issue a public report with rec25 ommendations on the following: 


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1 (i) Steps that can be taken to promote 

2 breastfeeding among working mothers and 

3 to remove barriers to breastfeeding among 

4 working mothers. 

5 (ii) Potential ways in which the Fed6 eral Government can work with employers 

7 to promote breastfeeding among working 

8 mothers. 

9 (iii) Areas in which changes to exist10 ing Federal, State, or local laws would 

11 likely have the effect of making it easier 

12 for working mothers to breastfeed or would 

13 remove impediments to breastfeeding that 

14 currently exist in such laws. 

15 (iv) Whether or not increased rates of 

16 breastfeeding among working mothers 

17 would likely have the result of reducing 

18 health care costs among such mothers and 

19 their children, and, in particular, whether 

20 increased rates of breastfeeding would be 

21 likely to result in lower Federal expendi22 tures on health care for such mothers and 

23 their children. 

24 (v) Areas in which the Federal Gov25 ernment, through increased efforts by FedVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00064 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 eral agencies, or changes to existing Fed2 eral law, can and should increase the Fed3 eral Government’s efforts to promote 

4 breastfeeding among working mothers. 

5 (B) COPY TO CONGRESS.—Upon comple6 tion of the report described in subparagraph 

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

8 report to the Committee on Health, Education, 

9 Labor, and Pensions of the Senate, the Com10 mittee on Appropriations of the Senate, the 

11 Committee on Education and the Workforce of 

12 the House of Representatives, and the Com13 mittee on Appropriations of the House of Rep14 resentatives. 

15 (f) POWERS OF THE TASK FORCE.— 

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

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

18 take such testimony, and receive such evidence as 

19 the Task Force considers advisable to carry out this 

20 section. 

21 (2) INFORMATION FROM FEDERAL AGENCIES.— 

22 The Task Force may secure directly from any Fed23 eral department or agency such information as the 

24 Task Force considers necessary to carry out this 

25 section. Upon request of the Chair of the Task 


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1 Force, the head of such department or agency shall 

2 furnish such information to the Task Force. 

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

4 use the United States mails in the same manner and 

5 under the same conditions as other departments and 

6 agencies of the Federal Government. 

7 (4) DONATIONS.—The Task Force may accept, 

8 use, and dispose of donations of services or property. 

9 (g) OPERATING EXPENSES.—The operating expenses 

10 of the Task Force, including travel expenses for members 

11 of the Task Force, shall be paid for from the general oper12 ating expenses funds of the Secretary of Health and 

13 Human Services and the Secretary of Labor. 

14 SEC. 214. IMPROVING HEALTHY EATING AND ACTIVE LIV15 ING OPTIONS IN FEDERAL WORKPLACES. 

16 (a) MENU LABELING IN FEDERAL FOOD ESTAB17 LISHMENTS.— 

18 (1) IN GENERAL.— 

19 (A) EXECUTIVE AND JUDICIAL BUILD20 INGS.—Section 403(q) of the Federal Food, 

21 Drug, and Cosmetic Act (21 U.S.C. 343(q)) is 

22 amended by adding at the end the following: 

23 ‘‘(6)(A) The requirements of subparagraph (5)(H) 

24 shall apply— 


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1 ‘‘(i) to a restaurant or similar retail food estab2 lishment located in a Federal building in the same 

3 manner as such subparagraph applies to a res4 taurant or similar retail food establishment that is 

5 part of a chain with 20 or more locations, as de6 scribed in subparagraph (5)(H)(i); and 

7 ‘‘(ii) to a person that operates a vending ma8 chine located in a Federal building in the same man9 ner as such subparagraph applies to a person who 

10 is engaged in the business of owning or operating 20 

11 or more vending machines, as described in subpara12 graph (5)(H)(viii). 

13 ‘‘(B) In this subparagraph, the term ‘Federal build14 ing’ means a building that is— 

15 ‘‘(i) under the control of the Federal agency (as 

16 defined in section 102 of title 40, United States 

17 Code); 

18 ‘‘(ii) owned by the Federal Government; and 

19 ‘‘(iii) located in a State, the District of Colum20 bia, Puerto Rico, or a territory or possession of the 

21 United States.’’. 

22 (B) APPLICABILITY.—The requirement in 

23 the amendment made by paragraph (1) shall 

24 apply to restaurants or similar retail food es25 tablishments and vending machines located in a 


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1 Federal building beginning 12 months after the 

2 date of enactment of this Act. 

3 (2) CONGRESSIONAL BUILDINGS.—The Archi4 tect of the Capitol, in coordination with the Com5 mittee on Rules and Administration of the Senate 

6 and the Committee on House Administration of the 

7 House of Representatives, shall establish a program 

8 to apply the requirements of section 403(q)(5)(H) of 

9 the Federal Food, Drug, and Cosmetic Act (21 

10 U.S.C. 343(q)(5)(H)) (as amended by paragraph 

11 (1)) to— 

12 (A) food that is served in restaurants or 

13 other similar retail food establishments that are 

14 located in Congressional buildings and installa15 tions; 

16 (B) food that is sold through vending ma17 chines that are operated in Congressional build18 ings and installations; and 

19 (C) food that is served to individuals with20 in Congressional buildings and installations 

21 pursuant to a contract with a private entity. 

22 (b) NUTRITIONAL STANDARDS FOR FOOD IN FED23 ERAL BUILDINGS.— 

24 (1) EXECUTIVE AND JUDICIAL BUILDINGS.— 

25 Subchapter V of chapter 5 of subtitle I of title 40, 


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1 United States Code, is amended by adding at the 

2 end the following: 

3 ‘‘SEC. 594. NUTRITIONAL STANDARDS FOR FOOD IN FED4 ERAL BUILDINGS. 

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

6 date of enactment of this section, the Administrator of 

7 General Services, in consultation with the Secretary of 

8 Health and Human Services, shall establish, by regulation, 

9 nutritional standards for foods and beverages purchased, 

10 served, and sold through Federal buildings and on Federal 

11 property (including food products provided by contractors 

12 or vending machines). Such standards shall reflect the 

13 most recent Dietary Guidelines for Americans. 

14 ‘‘(b) CONSIDERATIONS.—In developing the nutri15 tional standards under subsection (a), the Administrator 

16 shall consider the following: 

17 ‘‘(1) Recommendations for nutrition standards 

18 for foods, beverages, or meals made by authoritative 

19 scientific organizations. 

20 ‘‘(2) Both positive and negative contributions of 

21 nutrients, ingredients, and foods to diets (including 

22 calories or portion size, saturated fat, trans fat, so23 dium, added sugars, and the presence of fruits, vege24 tables, whole grains, and nutrients of concern in 

25 Americans’ diets). 


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1 ‘‘(3) Adaptations of the standards for different 

2 venues, such as childcare, correctional facilities, gov3 ernment meetings, or other settings with unique 

4 populations or circumstances. 

5 ‘‘(c) PERIODIC REVIEW.—Not later than 5 years 

6 after the date of enactment of this section, and every 5 

7 years thereafter, the Secretary, shall review, and if nec8 essary, revise and update the nutrition standards devel9 oped under subsection (a) to reflect advancements in nu10 trition science, dietary data, and new product availability. 

11 ‘‘(d) USE OF AMOUNTS.—Amounts appropriated to 

12 an executive agency for installation, repair, and mainte13 nance, generally, may be used to achieve compliance with 

14 the regulations promulgated pursuant to this section. 

15 ‘‘(e) LIABILITY.—Nothing in this section increases or 

16 enlarges the tort liability of the Federal Government for 

17 any injury to an individual or damage to property.’’. 

18 (2) CONGRESSIONAL BUILDINGS.— 

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

20 after the date of enactment of this Act, the Ar21 chitect of the Capitol, in coordination with the 

22 Committee on Rules and Administration of the 

23 Senate and the Committee on House Adminis24 tration of the House of Representatives shall 

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1 erage products purchased, served, or sold 

2 through Congressional buildings and properties 

3 (including food products provided by contrac4 tors and vending machines). Such standards 

5 shall reflect the most recent Dietary Guidelines 

6 for Americans. 

7 (B) CONSIDERATIONS.—In developing the 

8 nutritional standards under subparagraph (A), 

9 the Architect shall consider the following: 

10 (i) Recommendations for nutrition 

11 standards for foods, beverages, or meals 

12 made by authoritative scientific organiza13 tions. 

14 (ii) Both positive and negative con15 tributions of nutrients, ingredients, and 

16 foods to diets (including calories or portion 

17 size, saturated fat, trans fat, sodium, 

18 added sugars, and the presence of fruits, 

19 vegetables, whole grains, and nutrients of 

20 concern in Americans’ diets). 

21 (C) PERIODIC REVIEW.—Not later than 5 

22 years after the date of enactment of this Act, 

23 and every 5 years thereafter, the Architect, 

24 shall review, and if necessary, revise and update 

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1 paragraph (A) to reflect advancements in nutri2 tion science, dietary data, and new product 

3 availability. 

4 (c) ENCOURAGEMENT OF USE OF STAIRS.— 

5 (1) EXECUTIVE AND JUDICIAL BUILDINGS.— 

6 Subchapter V of chapter 5 of subtitle I of title 40, 

7 United States Code, as amended by subsection (b), 

8 is further amended by adding at the end the fol9 lowing: 

10 ‘‘SEC. 595. ENCOURAGEMENT OF USE OF STAIRS. 

11 ‘‘(a) IN GENERAL.—In the design of new or sub12 stantively remodeled Federal buildings, each Federal 

13 agency shall consider including building features that en14 sure stairs are accessible and attractive. In new and exist15 ing buildings, each Federal agency shall install point-of16 decision prompts encouraging individuals to use stairs 

17 wherever practicable at each relevant building and instal18 lation that is— 

19 ‘‘(1) under the control of the Federal agency; 

20 ‘‘(2) owned by the Federal Government; and 

21 ‘‘(3) located in a State, the District of Colum22 bia, Puerto Rico, or a territory or possession of the 

23 United States. 

24 ‘‘(b) REIMBURSEMENT.—Subsection (a) may be car25 ried out by— 


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1 ‘‘(1) reimbursement to a State or political sub2 division of a State, the District of Columbia, Puerto 

3 Rico, or a territory or possession of the United 

4 States; or 

5 ‘‘(2) grants or contracts. 

6 ‘‘(c) REGULATIONS.—Subsection (a) shall be carried 

7 out in accordance with such regulations as the Adminis8 trator of General Services may promulgate, with the ap9 proval of the Director of the Office of Management and 

10 Budget. 

11 ‘‘(d) USE OF AMOUNTS.—Amounts appropriated to 

12 a Federal agency for installation, repair, and maintenance, 

13 generally, shall be available to carry out this section. 

14 ‘‘(e) LIABILITY.—Nothing in this section increases or 

15 enlarges the tort liability of the Federal Government for 

16 any injury to an individual or damage to property.’’. 

17 (2) CONGRESSIONAL BUILDINGS.—The Archi18 tect of the Capitol shall implement a program to in19 stall point-of-decision prompts encouraging individ20 uals to use stairs wherever practicable in Congres21 sional buildings and installations in the same man22 ner as established under section 595 of title 40, 

23 United States Code (as added by paragraph (1)). 

24 (d) ACCOMMODATIONS FOR BICYCLE COMMUTERS.— 


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1 (1) EXECUTIVE AND JUDICIAL FEDERAL

2 BUILDINGS.—Subchapter V of chapter 5 of subtitle 

3 I of title 40, United States Code, as amended by 

4 subsection (c), is further amended by adding at the 

5 end the following: 

6 ‘‘SEC. 596. ACCOMMODATIONS FOR BICYCLE COMMUTERS. 

7 ‘‘(a) IN GENERAL.—Each Federal agency shall in8 stall and maintain a bicycle storage area and equipment 

9 (such as a bicycle rack) and a shower for bicycle com10 muters at each relevant parking structure that is— 

11 ‘‘(1) under the control of the Federal agency; 

12 ‘‘(2) owned by the Federal Government; and 

13 ‘‘(3) located in a State, the District of Colum14 bia, Puerto Rico, or a territory or possession of the 

15 United States. 

16 ‘‘(b) REIMBURSEMENT.—Subsection (a) may be car17 ried out by— 

18 ‘‘(1) reimbursement to a State or political sub19 division of a State, the District of Columbia, Puerto 

20 Rico, or a territory or possession of the United 

21 States; or 

22 ‘‘(2) grants or contracts. 

23 ‘‘(c) REGULATIONS.—Subsection (a) shall be carried 

24 out in accordance with such regulations as the Adminis25 trator of General Services may promulgate, with the apVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00074 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 proval of the Director of the Office of Management and 

2 Budget. 

3 ‘‘(d) USE OF AMOUNTS.—Amounts appropriated to 

4 a Federal agency for installation, repair, and maintenance, 

5 generally, shall be available to carry out this section. 

6 ‘‘(e) LIABILITY.—Nothing in this section increases or 

7 enlarges the tort liability of the Federal Government for 

8 any injury to an individual or damage to property.’’. 

9 (2) CONGRESSIONAL BUILDINGS.—The Archi10 tect of the Capitol, in coordination with the Sergeant 

11 at Arms and Doorkeeper of the Senate, the Sergeant 

12 at Arms of the House of Representatives, and the 

13 United States Capitol Police, shall implement, within 

14 their respective jurisdictions, a program to make ac15 commodations for bicycle commuters on the United 

16 States Capitol complex in the same manner as estab17 lished under section 596 of title 40, United States 

18 Code (as added by paragraph (1)). 

19 TITLE III—RESPONSIBLE MAR20 KETING AND CONSUMER 

21 AWARENESS 

22 SEC. 301. GUIDELINES FOR REDUCTION IN SODIUM CON23 TENT IN CERTAIN FOODS. 

24 (a) IN GENERAL.—Not later than 180 days after the 

25 date of enactment of this Act, the Secretary of Health and 


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1 Human Services shall promulgate regulations establishing 

2 guidelines for the mandatory reduction, over a 2-year pe3 riod, in the sodium content of processed food and res4 taurant food following, as appropriate, the recommenda5 tions made by the Institute of Medicine report entitled 

6 ‘‘Strategies to Reduce Sodium Intake in the United 

7 States’’. 

8 (b) DEFINITIONS.—For purposes of this section— 

9 (1) the term ‘‘processed food’’ has the meaning 

10 given such term in section 201(gg) of the Federal 

11 Food, Drug, and Cosmetic Act (21 U.S.C. 321(gg)); 

12 and 

13 (2) the term ‘‘restaurant food’’ means food sub14 ject to the requirements of section 403(q)(5)(H) of 

15 the Federal Food, Drug, and Cosmetic Act (21 

16 U.S.C. 343(q)(5)(H)). 

17 SEC. 302. NUTRITION LABELING FOR FOOD PRODUCTS 

18 SOLD PRINCIPALLY FOR USE IN RES19 TAURANTS OR OTHER RETAIL FOOD ESTAB20 LISHMENTS. 

21 Section 403(q)(5) of the Federal Food, Drug, and 

22 Cosmetic Act (21 U.S.C. 343(q)(5)) is amended by strik23 ing clause (G). 


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1 SEC. 303. FRONT-LABEL FOOD GUIDANCE SYSTEMS. 

2 (a) IN GENERAL.—Not later than 6 months after the 

3 date of enactment of this Act, the Secretary of Health and 

4 Human Services (referred to in this section as the ‘‘Sec5 retary’’) shall begin soliciting public comments regard6 ing— 

7 (1) the use of retail front-label food guidance 

8 systems to convey nutrition information to the public 

9 using logos, symbols, signs, emblems, insignia, or 

10 other graphic representations on the labeling of food 

11 intended for human consumption that are intended 

12 to provide simple, standardized, and understandable 

13 nutrition information to the public in graphic form; 

14 (2) appropriate nutrition standards by which a 

15 retail front-label food guidance system may convey 

16 the relative nutritional value of different foods in 

17 simple graphic form; and 

18 (3) whether American consumers would be bet19 ter served by establishing a single, standardized re20 tail front-label food guidance system regulated by 

21 the Food and Drug Administration, or by allowing 

22 individual food companies, trade associations, non23 profit organizations, and others to continue to de24 velop their own retail front-label food guidance sys25 tems. 


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1 (b) EFFECT ON NUTRITION FACTS PANEL.—In solic2 iting public comments under subsection (a), the Secretary 

3 shall inform the public that any retail front-label food 

4 guidance system is intended to supplement, not replace, 

5 the Nutrition Facts Panel that appears on food labels pur6 suant to section 403(q) of the Federal Food, Drug, and 

7 Cosmetic Act (21 U.S.C. 343(q)). 

8 (c) PROPOSED REGULATION.—Not later than 12 

9 months following the closure of the public comment solici10 tation period under subsection (a), the Secretary shall— 

11 (1) publish a notice in the Federal Register 

12 that summarizes the public comments and describes 

13 the suggested retail front-label food guidance sys14 tems received through such solicitation; and 

15 (2) publish proposed regulations that— 

16 (A) establish a single, standardized retail 

17 front-label food guidance system; or 

18 (B) establish the conditions under which 

19 individual food companies, trade associations, 

20 nonprofit organizations, and other entities may 

21 continue to develop their own retail front-label 

22 food guidance systems. 


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1 SEC. 304. RULEMAKING AUTHORITY FOR ADVERTISING TO 

2 CHILDREN. 

3 (a) PURPOSE.—The purpose of this section is to re4 store the authority of the Federal Trade Commission to 

5 issue regulations that restrict the marketing or advertising 

6 of foods and beverages to children under the age of 18 

7 years if the Federal Trade Commission determines that 

8 there is evidence that consumption of certain foods and 

9 beverages is detrimental to the health of children. 

10 (b) AUTHORITY.—Section 18 of the Federal Trade 

11 Commission Act (15 U.S.C. 57a) is amended— 

12 (1) in subsection (a), by striking ‘‘Except as 

13 provided in subsection (h), the’’ and inserting 

14 ‘‘The’’; 

15 (2) by amending subsection (b) to read as fol16 lows: 

17 ‘‘(b) PROCEDURE APPLICABLE.—When prescribing a 

18 rule under subsection (a)(1)(B) of this section, the Com19 mission shall proceed in accordance with section 553 of 

20 title 5 (without regard to any reference in such section 

21 to sections 556 and 557 of such title).’’; 

22 (3) by striking subsections (c), (f), (h), (i), and 

23 (j); 

24 (4) by striking subsection (d) and inserting the 

25 following: 


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1 ‘‘(c) When any rule under subsection (a)(1)(B) takes 

2 effect a subsequent violation thereof shall constitute an 

3 unfair or deceptive act or practice in violation of section 

4 5(a)(1) of this Act, unless the Commission otherwise ex5 pressly provides in such rule.’’; 

6 (5) by redesignating subsections (e) and (g) as 

7 subsections (d) and (e), respectively; and 

8 (6) in subsection (d), as redesignated— 

9 (A) in paragraph (1)(B), by striking ‘‘the 

10 transcript required by subsection (c)(5),’’; 

11 (B) in paragraph (3), by striking ‘‘error)’’ 

12 and all that follows through the period at the 

13 end and inserting ‘‘error).’’; and 

14 (C) in paragraph (5), by striking subpara15 graph (C). 

16 SEC. 305. HEALTH LITERACY: RESEARCH, COORDINATION 

17 AND DISSEMINATION. 

18 (a) IN GENERAL.—Part A of title IX of the Public 

19 Health Service Act (42 U.S.C. 299 et seq.) is amended 

20 by adding at the end the following: 

21 ‘‘SEC. 904. HEALTH LITERACY: RESEARCH, COORDINATION 

22 AND DISSEMINATION. 

23 ‘‘(a) DEFINITION.—In this section, the term ‘health 

24 literacy’ means a consumer’s ability to obtain, process, 

25 and understand basic health information and services 


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1 needed to make appropriate health care decisions and the 

2 adaptation of services to enhance a consumer’s under3 standing and navigation of applicable health care services. 

4 ‘‘(b) HEALTH LITERACY PROGRAM.— 

5 ‘‘(1) ESTABLISHMENT.—The Director shall es6 tablish within the Agency a program (referred to in 

7 this section as the ‘program’) to strengthen health 

8 literacy by improving measurement, research, devel9 opment, and information dissemination. 

10 ‘‘(2) DUTIES.—In carrying out the program, 

11 the Director shall— 

12 ‘‘(A) gather health literacy resources from 

13 public and private sources and make such re14 sources available to researchers, health care 

15 providers, and the general public; 

16 ‘‘(B) identify and fill research gaps relat17 ing to health literacy that have direct applica18 bility to— 

19 ‘‘(i) prevention; 

20 ‘‘(ii) self-management of chronic dis21 ease; 

22 ‘‘(iii) quality improvement; 

23 ‘‘(iv) the barriers to health literacy; 

24 ‘‘(v) relationships between health lit25 eracy and health disparities, particularly 


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1 with respect to language and cultural com2 petency; and 

3 ‘‘(vi) the utilization of information on 

4 comparative effectiveness of health treat5 ments; 

6 ‘‘(C) sponsor demonstration and evaluation 

7 projects with respect to interventions and tools 

8 designed to strengthen health literacy, including 

9 projects focused on— 

10 ‘‘(i) the provision of simplified, pa11 tient-centered written materials; 

12 ‘‘(ii) technology-based communication 

13 techniques; 

14 ‘‘(iii) consumer navigation services; 

15 and 

16 ‘‘(iv) the training of health profes17 sional providers; 

18 ‘‘(D) give preference to health literacy ini19 tiatives that— 

20 ‘‘(i) focus on the particular needs of 

21 vulnerable populations such as the elderly, 

22 racial and ethnic minorities, children, indi23 viduals with limited English proficiency, 

24 and individuals with disabilities; and 


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1 ‘‘(ii) partner with institutions in the 

2 community such as schools, libraries, sen3 ior centers, literacy groups, recreation cen4 ters, early childhood education centers, 

5 area health education centers, and public 

6 assistance programs; 

7 ‘‘(E) assist appropriate Federal agencies in 

8 establishing specific objectives and strategies 

9 for carrying out the program, in monitoring the 

10 programs of such agencies, and incorporating 

11 health literacy into research design, human sub12 jects protections, and informed consent in clin13 ical research; 

14 ‘‘(F) seek to enter into implementation 

15 partnerships with organizations and agencies, 

16 including other agencies within the Department 

17 of Health and Human Services, such as the 

18 Centers for Medicare & Medicaid Services and 

19 the Health Resources and Services Administra20 tion, the Office of the Surgeon General, the 

21 Joint Commission on the Accreditation of 

22 Healthcare Organizations, the Office of the Na23 tional Coordinator for Health Information 

24 Technology, and the National Committee for 

25 Quality Assurance, to promote the adoption of 


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1 interventions and tools developed under this 

2 section, particularly in the training of health 

3 professionals; and 

4 ‘‘(G) coordinate with other agencies within 

5 the Department of Health and Human Services 

6 to collect data that monitors national trends in 

7 health literacy by including relevant items in 

8 surveys such as the Medical Expenditure Panel 

9 Survey, the National Health Interview Survey, 

10 and the National Hospital Discharge Survey. 

11 ‘‘(3) REPORT.—The Agency for Healthcare Re12 search and Quality shall annually submit to Con13 gress a report that includes— 

14 ‘‘(A) a comprehensive and detailed descrip15 tion of the operations, activities, financial condi16 tion, and accomplishments of the Agency in the 

17 field of health literacy; and 

18 ‘‘(B) a description of how plans for the op19 eration of the program for the succeeding fiscal 

20 year will facilitate achievement of the goals of 

21 the program. 

22 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

23 There are authorized to be appropriated to carry out 

24 this subsection such sums as may be necessary for 

25 each of fiscal years 2014 through 2018. 


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1 ‘‘(c) STATE HEALTH LITERACY GRANTS.— 

2 ‘‘(1) GRANTS.—The Director of the Agency 

3 shall award grants to eligible entities to facilitate 

4 State and community efforts to strengthen health 

5 literacy. 

6 ‘‘(2) USE OF FUNDS.—An entity receiving a 

7 grant under this subsection shall use amounts re8 ceived under such grant to— 

9 ‘‘(A) support efforts to monitor and 

10 strengthen health literacy within a State or 

11 community; 

12 ‘‘(B) assist public and private efforts in 

13 the State or community in coordinating and de14 livering health literacy services; 

15 ‘‘(C) encourage partnerships among State 

16 and local governments, community organiza17 tions, non-profit entities, academic institutions, 

18 and businesses to coordinate efforts to strength19 en health literacy; 

20 ‘‘(D) provide technical and policy assist21 ance to State and local governments and service 

22 providers; and 

23 ‘‘(E) monitor and evaluate programs con24 ducted under this grant. 


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1 ‘‘(3) REPORT.—Not later than September 30 of 

2 each fiscal year for which a grant is received by an 

3 entity under this section, the entity shall submit to 

4 the Director a report that describes the programs 

5 supported by the grant and the results of monitoring 

6 and evaluation of those programs. 

7 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

8 There are authorized to be appropriated such sums 

9 as may be necessary to carry out this subsection for 

10 each of fiscal years 2014 through 2018.’’. 

11 (b) INSTITUTE OF MEDICINE STUDY AND REPORT.— 

12 (1) STUDY.—The Secretary of Health and 

13 Human Services shall seek to enter into a contract 

14 with the Institute of Medicine to conduct a study 

15 identifying opportunities within the Department of 

16 Health and Human Services to strengthen the 

17 health literacy of health care providers and health 

18 care consumers in accordance with the Patient Pro19 tection and Affordable Care Act (Public Law 111– 

20 148). 

21 (2) REPORT.—A contract entered into under 

22 paragraph (1) shall include a provision requiring the 

23 Institute of Medicine, not later than 1 year after the 

24 date of enactment of this Act, to submit a report 

25 concerning the results of the study conducted under 


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1 paragraph (1) to the Secretary of Health and 

2 Human Services and the appropriate committees of 

3 Congress.’’. 

4 SEC. 306. DISALLOWANCE OF DEDUCTIONS FOR ADVER5 TISING AND MARKETING EXPENSES RELAT6 ING TO TOBACCO PRODUCT USE. 

7 (a) IN GENERAL.—Part IX of subchapter B of chap8 ter 1 of subtitle A of the Internal Revenue Code of 1986 

9 (relating to items not deductible) is amended by adding 

10 at the end the following new section: 

11 ‘‘SEC. 280I. DISALLOWANCE OF DEDUCTION FOR ADVER12 TISING AND MARKETING EXPENSES RELAT13 ING TO TOBACCO PRODUCT USE. 

14 ‘‘No deduction shall be allowed under this chapter for 

15 expenses relating to advertising or marketing cigars, ciga16 rettes, smokeless tobacco, pipe tobacco, or any other to17 bacco product. For purposes of this section, any term used 

18 in this section which is also used in section 5702 shall 

19 have the same meaning given such term by section 5702.’’. 

20 (b) CONFORMING AMENDMENT.—The table of sec21 tions for such part IX is amended by adding after the 

22 item relating to section 280H the following new item: 

‘‘Sec. 280I. Disallowance of deduction for tobacco advertising and marketing 

expenses.’’. 


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1 (c) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply to taxable years beginning after 

3 the date of the enactment of this Act. 

4 SEC. 307. INCENTIVES TO REDUCE TOBACCO USE. 

5 (a) CHILD TOBACCO USE SURVEYS.— 

6 (1) ANNUAL PERFORMANCE SURVEY.— 

7 (A) IN GENERAL.—Not later than August 

8 31, 2014, and annually thereafter, the Sec9 retary of Health and Human Services (referred 

10 to in this section as the ‘‘Secretary’’) shall pub11 lish the results of an annual tobacco use survey, 

12 to be carried out not later than 18 months after 

13 the date of enactment of this Act and completed 

14 on an annual basis thereafter, to determine— 

15 (i) the percentage of all young individ16 uals who used tobacco products within the 

17 30-day period prior to the conduct of the 

18 survey involved; and 

19 (ii) the percentage of young individ20 uals who identify each brand of each type 

21 of tobacco product as the usual brand used 

22 within such 30-day period. 

23 (B) YOUNG INDIVIDUALS.—For the pur24 poses of this section, the term ‘‘young individVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00088 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 uals’’ means individuals who are under 18 years 

2 of age. 

3 (2) SIZE AND METHODOLOGY.— 

4 (A) IN GENERAL.—The survey referred to 

5 in paragraph (1) may be the National Survey 

6 on Drug Use and Health or shall at least be 

7 comparable in size and methodology to the 

8 NSDUH that was completed in 2009 to meas9 ure the use of cigarettes (by brand) by youths 

10 under 18 years of age within the 30-day period 

11 prior to the conduct of the study. Such survey 

12 may be conducted as a component of the Na13 tional Health and Nutrition Examination Sur14 vey or the National Health Interview Survey, if 

15 all other requirements provided for in this sec16 tion are complied with. 

17 (B) CONCLUSIVE ACCURATENESS.—A sur18 vey using the methodology described in sub19 paragraph (A) shall be deemed conclusively 

20 proper, correct, and accurate for purposes of 

21 this section. 

22 (C) DEFINITION.—In this section, the 

23 term ‘‘National Survey on Drug Use and 

24 Health’’ or ‘‘NSDUH’’ means the annual na25 tionwide survey of randomly selected individVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00089 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 uals, aged 12 and older, conducted by the Sub2 stance Abuse and Mental Health Services Ad3 ministration. 

4 (3) REDUCTION.—The Secretary, based on a 

5 comparison of the results of the first annual tobacco 

6 product survey referred to in paragraph (1) and the 

7 most recent survey data referred to in paragraph 

8 (2)(A) completed prior to the date of enactment of 

9 this Act, shall determine the percentage reduction (if 

10 any) in youth tobacco use for each manufacturer of 

11 tobacco products. 

12 (4) PARTICIPATION IN SURVEY.—Notwith13 standing any other provision of law, the Secretary 

14 may conduct a survey under this subsection involv15 ing minors if the results of such survey with respect 

16 to such minors are kept confidential and not dis17 closed. 

18 (5) NONAPPLICABILITY.—Chapter 35 of title 

19 44, United States Code, shall not apply to informa20 tion required for the purposes of carrying out this 

21 section. 

22 (b) TOBACCO USE REDUCTION GOAL AND NON23 COMPLIANCE.— 

24 (1) GOAL.—It shall be the tobacco use reduc25 tion goal that youth tobacco use be reduced by at 


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1 least 5 percent or a level determined significantly 

2 sufficient by the Secretary between the most recent 

3 NSDUH referred to in subsection (a)(2)(A) and the 

4 completion of the first annual cigarette survey (and 

5 such subsequent surveys as compared to the pre6 vious year’s survey) referred to in subsection (a)(1). 

7 (2) NONCOMPLIANCE.— 

8 (A) INDUSTRY-WIDE PENALTY.—If the 

9 Secretary determines that the tobacco use re10 duction goal under paragraph (1) has not been 

11 achieved, the Secretary shall, not later than 

12 September 10, 2014, and September 10 of each 

13 year thereafter, impose an industry-wide pen14 alty on the manufacturers of cigarettes in an 

15 amount that is in the aggregate equal to 

16 $3,000,000,000. 

17 (B) PAYMENT.—The industry-wide penalty 

18 imposed under this subsection shall be paid by 

19 each manufacturer based on the brand share 

20 among youth ages 12–17 (as determined by the 

21 survey described in subsection (a)(1)) as such 

22 percentage relates to the total amount to be 

23 paid by all manufacturers. 

24 (C) FINAL DETERMINATION.—The deter25 mination of the Secretary as to the amount and 


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1 allocation of a surcharge under this section 

2 shall be final and the manufacturer shall pay 

3 such surcharge within 10 days of the date on 

4 which the manufacturer is assessed. Such pay5 ment shall be retained by the Secretary pending 

6 final judicial review of what, if any, change in 

7 the surcharge is appropriate. 

8 (D) LIMITATION.—With respect to ciga9 rettes, a manufacturer with a market share of 

10 1 percent or less of youth tobacco use shall not 

11 be liable for the payment of a surcharge under 

12 this paragraph. 

13 (E) USE OF AMOUNTS.—Amounts collected 

14 under subparagraph (A) shall be deposited into 

15 the Prevention and Public Health Fund estab16 lished under section 4002 of the Patient Protec17 tion and Affordable Care Act (42 U.S.C. 300u– 

18 11). Such funds shall remain available for 

19 transfer through September 30th of the fifth 

20 fiscal year following their collection, subject to 

21 the terms and conditions of such section 4002. 

22 (3) PENALTIES NONDEDUCTIBLE.—The pay23 ment of penalties under this section shall not be con24 sidered to be an ordinary and necessary expense in 

25 carrying on a trade or business for purposes of the 


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1 Internal Revenue Code of 1986 and shall not be de2 ductible. 

3 (4) JUDICIAL REVIEW.— 

4 (A) AFTER PAYMENT.—A manufacturer of 

5 cigarettes may seek judicial review of any action 

6 under this section only after the assessment in7 volved has been paid by the manufacturer to 

8 the Department of the Treasury and only in the 

9 United States District Court for the District of 

10 Columbia. 

11 (B) REVIEW BY ATTORNEY GENERAL.— 

12 Prior to the filing of an action by a manufac13 turer seeking judicial review of an action under 

14 this section, the manufacturer shall notify the 

15 Attorney General of such intent to file and the 

16 Attorney General shall have 30 days in which to 

17 respond to the action. 

18 (C) REVIEW.—The amount of any sur19 charge paid under this section shall be subject 

20 to judicial review by the United States Court of 

21 Appeals for the District of Columbia Circuit, 

22 based on the arbitrary and capricious standard 

23 of section 706 of title 5, United States Code. 

24 Notwithstanding any other provision of law, no 

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1 charge payment due to the Secretary under this 

2 section pending judicial review until the Sec3 retary has made or failed to make a compliance 

4 determination, as described under this section, 

5 that has adversely affected the person seeking 

6 the review. 

7 (c) ENFORCEMENT.— 

8 (1) INITIAL PENALTY.—There is hereby im9 posed an initial penalty on the failure of any manu10 facturer to make any payment required under this 

11 section not later than a period determined sufficient 

12 by the Secretary after the date on which such pay13 ment is due. 

14 (2) AMOUNT OF PENALTY.—The amount of the 

15 penalty imposed by paragraph (1) on any failure 

16 with respect to a manufacturer shall be an amount 

17 equal to 2 percent of the penalty owed under sub18 section (b) for each day during the noncompliance 

19 period. 

20 (3) NONCOMPLIANCE PERIOD.—For purposes of 

21 this subsection, the term ‘‘noncompliance period’’ 

22 means, with respect to any failure to make the sur23 charge payment required under this section, the pe24 riod— 


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1 (A) beginning on the due date for such 

2 payment; and 

3 (B) ending on the date on which such pay4 ment is paid in full. 

5 (4) LIMITATIONS.—No penalty shall be imposed 

6 by paragraph (1) on— 

7 (A) any failure to make a surcharge pay8 ment under this section during any period for 

9 which it is established to the satisfaction of the 

10 Secretary that none of the persons responsible 

11 for such failure knew or, exercising reasonable 

12 diligence, would have known, that such failure 

13 existed; or 

14 (B) any manufacturer that produces less 

15 than 1 percent of cigarettes used by youth in 

16 that year (as determined by the annual survey). 

17 SEC. 308. VOLUNTARY STANDARDS ON FOOD MARKETING 

18 TO CHILDREN. 

19 (a) IN GENERAL.—The Interagency Working Group 

20 on Food Marketed to Children (as established by the Om21 nibus Appropriations Act, 2009 (Public Law 109–8)) and 

22 constituted by the Commisioner of the Federal Trade 

23 Commission, together with the Commissioner of the Food 

24 and Drug Administration, the Director of the Centers for 

25 Disease Control and Prevention, and the Secretary of AgVerDate Mar 15 2010 04:15 Jan 26, 2013 Jkt 029200 PO 00000 Frm 00095 Fmt 6652 Sfmt 6201 E:\BILLS\S39.IS S39

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1 riculture, shall develop recommendations for standards for 

2 the marketing of food when such marketing targets chil3 dren who are 17 years of age or younger or when such 

4 food represents a significant component of the diets of 

5 children. 

6 (b) CONSIDERATIONS.—In developing standards 

7 under subsection (a), the Working Group shall consider— 

8 (1) positive and negative contributions of nutri9 ents, ingredients, and food (including calories, por10 tion size, saturated fat, trans fat, sodium, added 

11 sugars, and the presence of nutrients, fruits, vegeta12 bles, and whole grains) to the diets of such children; 

13 and 

14 (2) evidence concerning the role of the con15 sumption of nutrients, ingredients, and foods in pre16 venting or promoting the development of obesity 

17 among such children. 

18 (c) SCOPE.—The Working Group shall determine the 

19 scope of the media to which the standards developed under 

20 subsection (a) should apply. 

21 (d) SUBMISSION TO CONGRESS.—Not later than July 

22 15, 2014, the Working Group shall submit to the relevant 

23 Committees of Congress a report containing the findings 

24 and recommendations of the Working Group under this 

25 section. 


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1 TITLE IV—EXPANDED COV2 ERAGE OF PREVENTIVE 

3 SERVICES 

4 SEC. 401. REQUIRED COVERAGE OF PREVENTIVE SERVICES 

5 UNDER THE MEDICAID PROGRAM. 

6 (a) MANDATORY COVERAGE.—Section 1905 of the 

7 Social Security Act (42 U.S.C. 1396d), as amended by 

8 section 4107(a)(1) of the Patient Protection and Afford9 able Care Act (Public Law 111–148), is amended— 

10 (1) in subsection (a)(4)— 

11 (A) by striking ‘‘and’’ before ‘‘(D)’’; and 

12 (B) by inserting before the semicolon at 

13 the end the following new subparagraph: ‘‘; and 

14 (E) preventive services described in subsection 

15 (ee);’’; and 

16 (2) by adding at the end the following new sub17 section: 

18 ‘‘(ee) PREVENTIVE SERVICES.—For purposes of sub19 section (a)(4)(E), the preventive services described in this 

20 subsection are diagnostic, screening, preventive, and reha21 bilitative services not otherwise described in subsection (a) 

22 or (r) that the Secretary determines are appropriate for 

23 individuals entitled to medical assistance under this title, 

24 including— 


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1 ‘‘(1) evidence-based services that are assigned a 

2 grade of A or B by the United States Preventive 

3 Services Task Force; and 

4 ‘‘(2) with respect to an adult individual, ap5 proved vaccines recommended for routine use by the 

6 Advisory Committee on Immunization Practices of 

7 the Centers for Disease Control and Prevention.’’. 

8 (b) ELIMINATION OF COST-SHARING.— 

9 (1) Subsections (a)(2)(D) and (b)(2)(D) of sec10 tion 1916 of the Social Security Act (42 U.S.C. 

11 1396o) are each amended by inserting ‘‘preventive 

12 services described in section 1905(ee),’’ after ‘‘emer13 gency services (as defined by the Secretary),’’. 

14 (2) Section 1916A(a)(1) of such Act (42 U.S.C. 

15 1396o–1(a)(1)) is amended by inserting ‘‘, preven16 tive services described in section 1905(ee),’’ after 

17 ‘‘subsection (c)’’. 

18 (c) CONFORMING AMENDMENT.—Effective as if in19 cluded in the enactment of the Patient Protection and Af20 fordable Care Act (Public Law 111–148), the provisions 

21 of, and amendments made by, section 4106 of such Act 

22 are repealed. 

23 (d) INTERVAL PERIOD FOR INCLUSION OF NEW REC24 OMMENDATIONS IN STATE PLANS.—With respect to a rec25 ommendation issued on or after the date of enactment of 


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1 this Act by an organization described in subsection (ee) 

2 of section 1905 of the Social Security Act for a preventive 

3 service included under such subsection, the Secretary of 

4 Health and Human Services shall establish a minimum 

5 interval period, which shall be not less than 12 months, 

6 between the date on which the recommendation is issued 

7 and the plan year for which a State plan for medical as8 sistance under title XIX of the Social Security Act shall 

9 be required to include such preventive service. 

10 (e) EFFECTIVE DATE.— 

11 (1) IN GENERAL.—Except as provided in para12 graph (2), the amendments made by subsections (a) 

13 and (b) take effect on the date of enactment of this 

14 Act. 

15 (2) EXTENSION OF EFFECTIVE DATE FOR

16 STATE LAW AMENDMENT.—In the case of a State 

17 plan under title XIX of the Social Security Act (42 

18 U.S.C. 1396 et seq.) which the Secretary of Health 

19 and Human Services determines requires State legis20 lation or State regulation in order for the plan to 

21 meet the additional requirements imposed by the 

22 amendments made by subsections (a) and (b), the 

23 State plan shall not be regarded as failing to comply 

24 with the requirements of such title solely on the 

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1 ments before the first day of the first calendar quar2 ter beginning after the close of the first regular ses3 sion of the State legislature that begins after the 

4 date of enactment of this Act. For purposes of the 

5 previous sentence, in the case of a State that has a 

6 2-year legislative session, each year of the session is 

7 considered to be a separate regular session of the 

8 State legislature. 

9 SEC. 402. COVERAGE FOR COMPREHENSIVE WORKPLACE 

10 WELLNESS PROGRAM AND PREVENTIVE 

11 SERVICES. 

12 Section 8904(a) of title 5, United States Code, is 

13 amended— 

14 (1) in paragraph (1), by adding at the end the 

15 following: 

16 ‘‘(G) Comprehensive workplace wellness 

17 program benefits that meet the requirements of 

18 section 10408 of the Patient Protection and Af19 fordable Care Act (Public Law 111–148). 

20 ‘‘(H) Preventive services benefits deemed 

21 an ‘A’ or ‘B’ service by the United States Pre22 ventive Services Taskforce. 

23 ‘‘(I) Immunizations that have in effect a 

24 recommendation from the Advisory Committee 

25 on Immunization Practices of the Centers for 


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1 Disease Control and Prevention with respect to 

2 the individuals involved. 

3 ‘‘(J) With respect to infants, children, and 

4 adolescents, evidence-informed preventive care 

5 and screenings provided for in the comprehen6 sive guidelines supported by the Health Re7 sources and Services Administration of the De8 partment of Health and Human Services.’’; and 

9 (2) in paragraph (2), by adding at the end the 

10 following: 

11 ‘‘(G) Comprehensive workplace wellness 

12 program benefits that meet the requirements of 

13 section 10408 of the Patient Protection and Af14 fordable Care Act (Public Law 111–148). 

15 ‘‘(H) Preventive services benefits deemed 

16 an ‘A’ or ‘B’ service by the United States Pre17 ventive Services Taskforce. 

18 ‘‘(I) Immunizations that have in effect a 

19 recommendation from the Advisory Committee 

20 on Immunization Practices of the Centers for 

21 Disease Control and Prevention with respect to 

22 the individuals involved. 

23 ‘‘(J) With respect to infants, children, and 

24 adolescents, evidence-informed preventive care 

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1 sive guidelines supported by the Health Re2 sources and Services Administration of the De3 partment of Health and Human Services.’’. 

4 SEC. 403. HEALTH PROFESSIONAL EDUCATION AND TRAIN5 ING IN HEALTHY EATING. 

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

7 (42 U.S.C. 280h et seq.) is amended by striking section 

8 399Z and inserting the following: 

9 ‘‘SEC. 399Z. HEALTH PROFESSIONAL EDUCATION AND 

10 TRAINING IN HEALTHY EATING. 

11 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 

12 with the Director of the Centers for Disease Control and 

13 Prevention, the Administrator of the Health Resources 

14 and Services Administration, and the heads of other agen15 cies, and in consultation with appropriate health profes16 sional associations, shall develop and carry out a program 

17 to educate and train health professionals in effective strat18 egies to— 

19 ‘‘(1) better identify patients at-risk of becoming 

20 overweight or obese or developing an eating disorder; 

21 ‘‘(2) detect overweight or obesity or eating dis22 orders among a diverse patient population; 

23 ‘‘(3) counsel, refer, or treat patients with over24 weight or obesity or an eating disorder; 


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1 ‘‘(4) educate patients and the families of pa2 tients about effective strategies to establish healthy 

3 eating habits and appropriate levels of physical ac4 tivity; and 

5 ‘‘(5) assist in the creation and administration of 

6 community-based overweight and obesity and eating 

7 disorder prevention efforts. 

8 ‘‘(b) EATING DISORDER.—In this section, the term 

9 ‘eating disorder’ includes anorexia nervosa, bulimia 

10 nervosa, binge eating disorder, and eating disorders not 

11 otherwise specified, as defined in the fourth edition of the 

12 Diagnostic and Statistical Manual of Mental Disorders or 

13 any subsequent edition. 

14 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated to carry out this section 

16 such sums as may be necessary for each of the fiscal years 

17 2014 through 2018.’’. 

18 SEC. 404. INTEGRATIVE MEDICINE TRAINING PROGRAM. 

19 Title VII of the Public Health Service Act is amended 

20 by inserting after section 768 (42 U.S.C. 295c) the fol21 lowing: 

22 ‘‘SEC. 768A. INTEGRATIVE MEDICINE TRAINING PROGRAM. 

23 ‘‘(a) NATIONAL COORDINATING CENTER FOR TRAIN24 ING IN INTEGRATIVE MEDICINE.— 


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1 ‘‘(1) IN GENERAL.—the Secretary, acting 

2 through the Administrator, shall award a single 

3 grant to an eligible entity that shall serve as the Na4 tional Coordinating Center for Training in Integra5 tive Medicine. 

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

7 grant under paragraph (1), an entity shall— 

8 ‘‘(A) be— 

9 ‘‘(i) an accredited school of medicine 

10 or osteopathic medicine; 

11 ‘‘(ii) an accredited public or private 

12 nonprofit hospital; 

13 ‘‘(iii) a State, local, or tribal health 

14 department; or 

15 ‘‘(iv) a consortium of 2 or more of the 

16 entities described in clause (i) or (ii); 

17 ‘‘(B) submit an application to the Sec18 retary at such time, in such manner, and con19 taining such information as the Secretary may 

20 require; and 

21 ‘‘(C) demonstrate a capacity to perform 

22 the duties described in paragraph (3). 

23 ‘‘(3) DUTIES.—An entity that receives a grant 

24 under paragraph (2) shall— 


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1 ‘‘(A) plan, develop, or design an integrative 

2 medicine curriculum that can be incorporated 

3 into an accredited residency training program 

4 in specialties, including family medicine, inter5 nal medicine, pediatrics, and obstetrics and 

6 gynecology, physical medicine and rehabilitation 

7 and psychiatry; 

8 ‘‘(B) provide technical assistance to the 

9 network of grantees under subsection (b); 

10 ‘‘(C) develop, administer, and coordinate 

11 the network of grantees under such subsection; 

12 ‘‘(D) conduct an evaluation and oversee 

13 data collection of integrative medicine training 

14 programs; and 

15 ‘‘(E) develop, distribute, and provide edu16 cational and faculty development materials and 

17 programs to train medical professionals in inte18 grative medicine. 

19 ‘‘(b) GRANTS TO INCORPORATE INTEGRATIVE MEDI20 CINE INTO RESIDENCY TRAINING PROGRAMS.— 

21 ‘‘(1) IN GENERAL.—The Secretary shall award 

22 grants to, or enter into contracts with, eligible enti23 ties to develop graduate medical education training 

24 programs in integrative medicine. 


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

2 grant or contract under paragraph (1) an entity 

3 shall— 

4 ‘‘(A) operate an accredited medical resi5 dency program; and 

6 ‘‘(B) submit an application to the Sec7 retary at such time, in such manner, and con8 taining such information as the Secretary may 

9 require. 

10 ‘‘(3) USE OF FUNDS.—Amounts received under 

11 a grant or contract under this subsection shall be 

12 used to incorporate curriculum in integrative medi13 cine into residency programs to enhance teaching in 

14 prevention and wellness and to work collaboratively 

15 with other grantees and the national coordinating 

16 center to evaluate outcomes and best practices in 

17 teaching Integrative Medicine. 

18 ‘‘(c) DEFINITION.—In this section, the term ‘integra19 tive medicine’ means the integration of alternative treat20 ment, diagnostic and prevention systems, modalities, and 

21 disciplines with the practice of conventional medicine as 

22 a complement to such medicine and into health care deliv23 ery systems in the United States. 

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

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


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1 such sums as may be necessary for each of fiscal years 

2 2014 through 2018.’’. 

3 TITLE V—RESEARCH 

4 SEC. 501. NATIONAL CONSORTIUM ON BREASTFEEDING RE5 SEARCH. 

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

7 Human Services, acting through the Director of the Na8 tional Institutes of Health, shall establish a national con9 sortium on breastfeeding research (referred to in this sec10 tion as the ‘‘consortium’’), to be composed of researchers 

11 determined appropriate by the Secretary, in consultation 

12 with the Director, to— 

13 (1) assist in overcoming the limitations faced by 

14 researchers in designing breastfeeding studies; 

15 (2) increase the generalizability of research on 

16 breastfeeding; 

17 (3) assist in prioritizing key breastfeeding re18 search areas; 

19 (4) enable the performance of expanded and ad20 vanced breastfeeding research; and 

21 (5) foster the timely translation of such re22 search into practice. 

23 (b) REQUIREMENTS.—The consortium shall seek 

24 to— 


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1 (1) standardize definitions of specific terms and 

2 measures used to classify the variables used in re3 search on breastfeeding; 

4 (2) promote the use of the definitions standard5 ized under paragraph (1); 

6 (3) identify ethical study designs that would ex7 pand the knowledge that has been generated from 

8 observational breastfeeding studies; 

9 (4) develop and update national agendas for 

10 surveillance and research on topics related to 

11 breastfeeding and infant nutrition; 

12 (5) spearhead funding strategies to help accom13 plish the agenda developed by the consortium; 

14 (6) facilitate communication among researchers; 

15 and 

16 (7) promote the dissemination of research find17 ings and monitor the translation of research into 

18 best practices. 

19 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

20 are authorized to be appropriated to carry out this section, 

21 such sums as may be necessary for each of the fiscal years 

22 2014 through 2018. 


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1 SEC. 502. NATIONAL ASSESSMENT OF MENTAL HEALTH 

2 NEEDS. 

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

4 290aa et seq.) is amended by inserting after section 506B 

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

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

7 NEEDS. 

8 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

9 with the Administrator, the Director of the Centers for 

10 Disease Control and Prevention and the Director of the 

11 National Institutes of Health, shall establish and imple12 ment public health monitoring measures to address the 

13 mental health and substance use disorder status of the 

14 population of the United States and other populations 

15 served by the Administration, that include— 

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

17 population, including the incidence and prevalence of 

18 mental health conditions and substance use dis19 orders across the lifespan; 

20 ‘‘(2) monitoring access to appropriate diag21 nostic and treatment services for mental health con22 ditions and substance use disorders, including trends 

23 in unmet need for services; 

24 ‘‘(3) monitoring mental health conditions as 

25 risk factors for obesity and chronic diseases to the 

26 extent practicable; 


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1 ‘‘(4) enhancing existing public health moni2 toring systems by including measures assessing men3 tal health and substance use disorders and associ4 ated risk factors; and 

5 ‘‘(5) to the extent practicable, monitoring the 

6 immediate and long-term impact of disasters or cat7 astrophic events, whether natural or man-made on 

8 the mental health of affected populations. 

9 ‘‘(b) DISTINGUISHING AMONG AGE GROUPS.—In de10 signing and implementing the measures described in sub11 section (a) the Secretary shall ensure that data collection 

12 and reporting standards stratify data by age groups, in 

13 particular, to the extent practicable, children under the 

14 age of 5 years. 

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

16 of enactment of this section, the Secretary shall submit 

17 a report to Congress that describes the progress on the 

18 implementation of the monitoring measures described in 

19 subsection (a). 

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

21 is authorized to be appropriated to carry out this section 

22 such sums as may be necessary to carry out this section 

23 for each of fiscal years 2014 through 2018.’’. 

Æ 


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