II 

111TH CONGRESS 

2D SESSION S. 3260 

To enhance and further research into the prevention and treatment of eating 

disorders, to improve access to treatment of eating disorders, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 26, 2010 

Mr. HARKIN (for himself, Ms. KLOBUCHAR, and Mr. FRANKEN) introduced 

the following bill; which was read twice and referred to the Committee 

on Health, Education, Labor, and Pensions 

A BILL 

To enhance and further research into the prevention and 

treatment of eating disorders, to improve access to treatment of eating disorders, and for other purposes. 

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. 

4 This Act may be cited as the ‘‘Federal Response to 

5 Eliminate Eating Disorders Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) Estimates, based on current research, indi9 cate that at least 5,000,000 people in the United 


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1 States suffer from eating disorders including ano2 rexia nervosa, bulimia nervosa, binge eating dis3 order, and eating disorders not otherwise specified 

4 (referred to in this Act as ‘‘EDNOS’’). 

5 (2) Anecdotal evidence suggests that as many 

6 as 11,000,000 people in the United States, including 

7 1,000,000 males, may suffer from eating disorders. 

8 (3) Eating disorders occur in all nations and in 

9 all populations, and among people of all ages and 

10 races and of both genders. 

11 (4) Eating disorders are diseases with grave 

12 health consequences and high rates of mortality. 

13 (5) Health consequences associated with eating 

14 disorders include heart failure and other serious car15 diac conditions, electrolyte imbalance, kidney failure, 

16 osteoporosis, debilitating tooth decay, and gastro17 intestinal disorders, including esophageal inflamma18 tion and rupture, gastric rupture, peptic ulcers, and 

19 pancreatitis. 

20 (6) Anorexia nervosa has one of the highest 

21 overall mortality rates of any mental illness. Accord22 ing to the National Institute of Mental Health, 1 in 

23 10 people with anorexia nervosa will die of starva24 tion, cardiac arrest, or another medical complication. 


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1 (7) The risk of death among adolescents with 

2 anorexia nervosa is 11 times greater than in disease3 free adolescents. 

4 (8) Anorexia nervosa has the highest suicide 

5 rate of all mental illnesses. 

6 (9) New research suggests that bulimia nervosa 

7 has a much higher rate of mortality than is reflected 

8 in current statistics, because of the failure to iden9 tify the underlying eating disorder. 

10 (10) Binge eating disorder is the most common 

11 eating disorder, with an estimated 3.5 percent of 

12 American women and 2 percent of American men 

13 expected to suffer from this disorder in their life14 time. Binge eating disorder is characterized by fre15 quent episodes of uncontrolled overeating and is as16 sociated with obesity, heart disease, gall bladder dis17 ease, and diabetes. 

18 (11) Research demonstrates that there is a sig19 nificant genetic component to the development of 

20 eating disorders. 

21 (12) Certain populations, including adolescent 

22 females and athletes of both genders, are at higher 

23 risk of developing an eating disorder. 

24 (13) Different types of eating disorders may af25 fect certain races and genders disproportionately. 


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1 (14) Despite the serious health consequences 

2 and the high risk of death, Federal research funding 

3 for eating disorders has lagged behind research con4 cerning other diseases, when compared by the num5 ber of individuals affected by, and the relative health 

6 consequences of, the diseases. 

7 (15) The ability of individuals suffering from 

8 eating disorders, particularly bulimia nervosa, binge 

9 eating disorder, and EDNOS to access appropriate 

10 treatment is unacceptably low. 

11 (16) The development of an eating disorder is 

12 frequently preceded by unhealthy weight control be13 haviors commonly identified as disordered eating, in14 cluding skipping meals, using diet pills, taking lax15 atives, self-induced vomiting, and fasting. Such dis16 ordered eating behaviors should be included in en17 hanced research prevention and training efforts. 

18 SEC. 3. PURPOSES. 

19 The purposes of this Act are— 

20 (1) to expand research into the prevention of 

21 eating disorders; 

22 (2) to expand research on effective treatment 

23 and intervention of eating disorders and to support 

24 evidence-based programs designed to prevent eating 

25 disorders; 


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1 (3) to expand research on the causes, courses, 

2 and outcomes of eating disorders; 

3 (4) to increase the number of people properly 

4 screened and diagnosed with an eating disorder; 

5 (5) to improve training and education of health 

6 care and behavioral care providers and of school per7 sonnel at all levels of elementary and secondary edu8 cation; 

9 (6) to improve surveillance and data systems 

10 for tracking the prevalence, severity, and economic 

11 costs of eating disorders; and 

12 (7) to enhance access to comprehensive treat13 ment for eating disorders. 

14 TITLE I—EATING DISORDER 

15 DETECTION AND RESEARCH 

16 SEC. 101. EXPANSION AND COORDINATION OF THE ACTIVI17 TIES OF THE NATIONAL INSTITUTE OF 

18 HEALTH AND THE NATIONAL INSTITUTE OF 

19 MENTAL HEALTH WITH RESPECT TO RE20 SEARCH ON EATING DISORDERS. 

21 Part B of title IV of the Public Health Service Act 

22 (42 U.S.C. 284 et seq.), as amended by section 4305(b) 

23 of the Patient Protection and Affordable Care Act (Public 

24 Law 111–148), is further amended by adding at the end 

25 the following: 


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1 ‘‘SEC. 409K. EXPANSION AND COORDINATION OF ACTIVI2 TIES WITH RESPECT TO RESEARCH ON EAT3 ING DISORDERS. 

4 ‘‘(a) IN GENERAL.—The Director of NIH, pursuant 

5 to the general authority of such director, shall expand, in6 tensify, and coordinate the activities of the National Insti7 tutes of Health with respect to research on eating dis8 orders. 

9 ‘‘(b) GRANTS.—The Director of NIH may award 

10 grants to public or private entities to pay all or part of 

11 the cost of planning, establishing, improving, and pro12 viding basic operating support for such entities to estab13 lish consortia in eating disorder research and to carry out 

14 the activities described in subsection (e). 

15 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

16 a grant under this section, an entity shall— 

17 ‘‘(1) be public or nonprofit private entity (in18 cluding a health department of a State, a political 

19 subdivision of a State, or an institution of higher 

20 education); and 

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

22 such time, in such manner, and containing such in23 formation as the Secretary may require. 

24 ‘‘(d) REQUIREMENTS OF CONSORTIA.— 

25 ‘‘(1) IN GENERAL.—Each consortium estab26 lished as described in subsection (b) may use the faVerDate Nov 24 2008 02:19 Apr 27, 2010 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3260.IS S3260

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1 cilities of a single lead institution, or may be formed 

2 from several cooperating institutions, meeting such 

3 requirements as may be prescribed by the Director 

4 of NIH. 

5 ‘‘(2) COORDINATION OF CONSORTIA.—The Di6 rector of NIH— 

7 ‘‘(A) may, as appropriate, provide for the 

8 coordination of information among consortia es9 tablished under subsection (b); and 

10 ‘‘(B) shall ensure regular communication 

11 between members of the various consortia es12 tablished using grants awarded under this sec13 tion. 

14 ‘‘(3) REPORTS.—The Director of NIH shall re15 quire each consortium to periodically prepare and 

16 submit to such director reports on the activities of 

17 such consortium. 

18 ‘‘(e) ACTIVITIES.—Each consortium receiving a grant 

19 under subsection (b) shall conduct basic, clinical, epide20 miological, population-based, or translational research re21 garding eating disorders, which may include research re22 lated to— 

23 ‘‘(1) the identification and classification of eat24 ing disorders and disordered eating; 


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1 ‘‘(2) the causes, diagnosis, and early detection 

2 of eating disorders; 

3 ‘‘(3) the treatment of eating disorders, includ4 ing the development and evaluation of new treat5 ments and best practices; 

6 ‘‘(4) the conditions or diseases related to, or 

7 arising from, an eating disorder; and 

8 ‘‘(5) the evaluation of existing prevention pro9 grams and the development of reliable prevention 

10 and screening programs. 

11 ‘‘(f) COLLABORATION.—The Secretary, acting 

12 through the Director of NIH and the Director of the Na13 tional Institute of Mental Health, shall identify relevant 

14 Federal agencies (including the other institutes and cen15 ters of the National Institutes of Health, the Centers for 

16 Medicare & Medicaid Services, the Centers for Disease 

17 Control and Prevention, the Agency for Healthcare Re18 search and Quality, the Substance Abuse and Mental 

19 Health Services Administration, the Health Resources and 

20 Services Administration, and the Office on Women’s 

21 Health) that shall collaborate with respect to activities 

22 conducted under subsection (d). 

23 ‘‘(g) PUBLIC INPUT.—The Director of NIH shall pro24 vide for a mechanism— 


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1 ‘‘(1) to educate and disseminate information on 

2 the existing and planned programs and research ac3 tivities of the National Institutes of Health with re4 spect to eating disorders; and 

5 ‘‘(2) through which the Director of NIH may 

6 receive comments from the public regarding such 

7 programs and activities. 

8 ‘‘(h) DISSEMINATION OF INFORMATION.—The Direc9 tor of NIH shall provide for a mechanism for making the 

10 results and information generated by the consortia pub11 licly available, such as through the Internet. 

12 ‘‘(i) DEFINITION.—For purposes of this section, the 

13 term ‘eating disorder’ has the meaning given such term 

14 in section 399OO(e). 

15 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 

16 carry out this section, there are authorized to be appro17 priated such sums as may be necessary for each of fiscal 

18 years 2011 through 2015.’’. 

19 SEC. 102. INTERAGENCY COORDINATING COUNCIL; SUR20 VEILLANCE AND RESEARCH PROGRAM; 

21 STUDY ON ECONOMIC COST. 

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

23 241 et seq.), as amended by section 4303 of the Patient 

24 Protection and Affordable Care Act (Public Law 111– 


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1 148), is further amended by adding at the end the fol2 lowing: 

3 ‘‘PART W—PROGRAMS RELATING TO EATING 

4 DISORDERS 

5 ‘‘SEC. 399OO. INTERAGENCY EATING DISORDERS COORDI6 NATING COUNCIL. 

7 ‘‘(a) ESTABLISHMENT.—There is established within 

8 the Department of Health and Human Services the Inter9 agency Eating Disorders Coordinating Council (referred 

10 to in this section as the ‘Coordinating Council’). 

11 ‘‘(b) RESPONSIBILITIES.—The Coordinating Council 

12 shall— 

13 ‘‘(1) develop and annually update a summary of 

14 advances in eating disorder research concerning 

15 causes of, prevention of, early screening for, treat16 ment and access to services related to, and supports 

17 for individuals affected by, eating disorders; 

18 ‘‘(2) monitor Federal activities with respect to 

19 eating disorders; 

20 ‘‘(3) make recommendations to the Secretary 

21 regarding any appropriate changes to such activities, 

22 and to the Director of NIH, with respect to the stra23 tegic plan developed under paragraph (4); 

24 ‘‘(4) develop and annually update a strategic 

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1 order research, including proposed budgetary rec2 ommendations; and 

3 ‘‘(5) submit to Congress the strategic plan de4 veloped under paragraph (4) and all updates to such 

5 plan. 

6 ‘‘(c) MEMBERSHIP.— 

7 ‘‘(1) CHAIRPERSON.—The Director of NIH 

8 shall serve as the chairperson of the Coordinating 

9 Council and shall be responsible for the leadership 

10 and oversight of the activities of the Coordinating 

11 Council. 

12 ‘‘(2) MEMBERS IN GENERAL.—The Coordi13 nating Council shall be composed of— 

14 ‘‘(A) representatives of— 

15 ‘‘(i) the Agency for Healthcare Re16 search and Quality; 

17 ‘‘(ii) the Substance Abuse and Mental 

18 Health Administration; 

19 ‘‘(iii) the research institutes at the 

20 National Institutes of Health, as the Di21 rector of NIH determines appropriate; 

22 ‘‘(iv) the Health Resources and Serv23 ices Administration; 

24 ‘‘(v) the Centers for Medicare & Med25 icaid Services; 


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1 ‘‘(vi) the Office of Women’s Health; 

2 ‘‘(vii) the Centers for Disease Control 

3 and Prevention; and 

4 ‘‘(viii) the Department of Education; 

5 and 

6 ‘‘(B) the additional members appointed 

7 under paragraph (3). 

8 ‘‘(3) ADDITIONAL MEMBERS.—Not fewer than 

1 9 ⁄3 of the total membership of the Coordinating 

10 Council shall be composed of non-Federal public 

11 members to be appointed by the Secretary, including 

12 representatives of— 

13 ‘‘(A) academic medical centers or schools 

14 of medicine, nursing, or other health profes15 sions; 

16 ‘‘(B) health care professionals who are ac17 tively involved in the treatment of eating dis18 orders; 

19 ‘‘(C) researchers with expertise in eating 

20 disorders; and 

21 ‘‘(D) at least 2 individuals with a past or 

22 present diagnosis of an eating disorder or par23 ents of individuals with a past or present diag24 nosis of an eating disorder. 


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1 ‘‘(d) ADMINISTRATIVE SUPPORT; TERMS OF SERV2 ICE; OTHER PROVISIONS.— 

3 ‘‘(1) ADMINISTRATIVE SUPPORT.—The Coordi4 nating Council shall receive necessary and appro5 priate administrative support from the Secretary. 

6 ‘‘(2) TERMS OF SERVICE.—Members of the Co7 ordinating Council appointed under subsection (c)(2) 

8 shall serve for a term of 4 years, and may be re9 appointed for one or more additional 4 year-terms. 

10 Any member appointed to fill a vacancy for an unex11 pired term shall be appointed for the remainder of 

12 such term. A member may serve after the expiration 

13 of the member’s term until a successor has taken of14 fice. 

15 ‘‘(3) MEETINGS.— 

16 ‘‘(A) IN GENERAL.—The Coordinating 

17 Council shall meet at the call of the chairperson 

18 or upon the request of the Secretary. The Co19 ordinating Council shall meet not fewer than 2 

20 times each year. 

21 ‘‘(B) NOTICE.—Notice of any upcoming 

22 meeting of the Coordinating Council shall be 

23 published in the Federal Register. 

24 ‘‘(C) PUBLIC ACCESS.—Each meeting of 

25 the Coordinating Council shall be open to the 


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1 public and shall include appropriate periods of 

2 time for questions by the public. 

3 ‘‘(4) SUBCOMMITTEES.—In carrying out its 

4 functions the Coordinating Council may establish 

5 subcommittees and convene workshops and con6 ferences. 

7 ‘‘(e) EATING DISORDER.—In this part, the term ‘eat8 ing disorder’ includes anorexia nervosa, bulimia nervosa, 

9 binge eating disorder, and eating disorders not otherwise 

10 specified, as defined in the fourth edition of the Diagnostic 

11 and Statistical Manual of Mental Disorders or any subse12 quent edition. 

13 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

14 carry out this section, there are authorized to be appro15 priated such sums as may be necessary for each of fiscal 

16 years 2011 through 2015. 

17 ‘‘SEC. 399OO–1. EATING DISORDER SURVEILLANCE AND RE18 SEARCH PROGRAM. 

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

20 the Director of the Centers for Disease Control and Pre21 vention, shall award grants or cooperative agreements to 

22 eligible entities for the purpose of improving the collection, 

23 analysis and reporting of State epidemiological data on 

24 eating disorders. 


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1 ‘‘(b) ACTIVITIES.—An eligible entity shall assist with 

2 the development and coordination of eating disorder sur3 veillance efforts within a region and may— 

4 ‘‘(1) provide for the collection, analysis, and re5 porting of epidemiological data on eating disorders 

6 through the existing surveillance programs; 

7 ‘‘(2) develop recommendations to enhance exist8 ing surveillance programs to more accurately collect 

9 epidemiological data on disordered eating and eating 

10 disorders, including the number, incidence, trends, 

11 correlates, mortality, and causes of eating disorders 

12 and the effects of eating disorders on quality of life; 

13 ‘‘(3) develop recommendations to improve re14 quirements for ensuring that eating disorders are ac15 curately recorded as underlying and contributing 

16 causes of death; and 

17 ‘‘(4) assist with the development and coordina18 tion of surveillance efforts within a region. 

19 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

20 an award under this section, an entity shall— 

21 ‘‘(1) be a public or nonprofit private entity (in22 cluding a health department of a State, a political 

23 subdivision of a State, or an institution of higher 

24 education); and 


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

2 such time, in such manner, and containing such in3 formation as the Secretary may require. 

4 ‘‘(d) TECHNICAL ASSISTANCE.—In making awards 

5 under this section, the Secretary may provide direct tech6 nical assistance in lieu of cash. 

7 ‘‘(e) REPORTS.—Each entity awarded a grant or co8 operative agreement under this section shall submit to the 

9 Secretary a report describing the activities conducted 

10 using grant funds and providing recommendations for im11 proving the collection, analysis, and reporting of epidemio12 logical data on eating disorders. 

13 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

14 carry out this section, there are authorized to be appro15 priated such sums as may be necessary for each of fiscal 

16 years 2011 through 2015. 

17 ‘‘SEC. 399OO–2. STUDY REGARDING ECONOMIC COSTS OF 

18 EATING DISORDERS. 

19 ‘‘The Secretary, acting through the Director of the 

20 Centers for Disease Control and Prevention, shall conduct 

21 a study evaluating the economic costs of eating disorders. 

22 Such study may examine years of productive life lost, 

23 missed days of work, reduced work productivity, costs of 

24 medical and mental health treatment, costs to family, and 

25 costs to society as a result of eating disorders.’’. 


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1 TITLE II—EATING DISORDER 

2 EDUCATION AND PREVEN3 TION; STUDIES ON EATING 

4 DISORDERS AND BODY MASS 

5 INDEX; PUBLIC SERVICE AN6 NOUNCEMENTS 

7 SEC. 201. GRANTS TO PREVENT EATING DISORDERS. 

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

9 241 et seq.), as amended by section 102, is further amend10 ed by adding at the end the following: 

11 ‘‘SEC. 399OO–3. GRANTS TO PREVENT EATING DISORDERS. 

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

13 the Director of the Centers for Disease Control and Pre14 vention and in coordination with the Administrator of the 

15 Health Resources and Services Administration, shall 

16 award grants to eligible entities to plan, implement, and 

17 evaluate programs to prevent eating disorders and obesity 

18 and the acute and chronic medical conditions that accom19 pany such conditions, and to promote healthy body image 

20 and appropriate nutrition-based eating behaviors. 

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

22 under this section, an entity shall— 

23 ‘‘(1) be a State, local or tribal educational 

24 agency, an accredited institution of higher education, 


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1 a State or local health department, or a community 

2 based organization; and 

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

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

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

7 under this section shall fund development and testing of 

8 school-, clinic-, community-, or health department-based 

9 programs designed to promote healthy eating behaviors 

10 and to prevent eating disorders including— 

11 ‘‘(1) developing evidence-based interventions to 

12 prevent eating disorders, including educational or 

13 intervention programs regarding nutritional content, 

14 understanding and responding to hunger and sati15 ety, positive body image development, positive self16 esteem development, and life skills, that take into 

17 account cultural and developmental issues and the 

18 role of family, school, and community; 

19 ‘‘(2) planning and implementing a healthy life20 style curriculum or program with an emphasis on 

21 healthy eating behaviors, physical activity, and emo22 tional wellness, the connection between emotional 

23 and physical health, and the prevention of bullying 

24 based on body size, shape, and weight; 


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1 ‘‘(3) forming partnerships with parents and 

2 caregivers to educate adults about identifying 

3 unhealthy eating behaviors and promoting healthy 

4 eating behaviors, physical activity, and emotional 

5 wellness; and 

6 ‘‘(4) integrating eating disorder prevention and 

7 awareness in physical education, health, education, 

8 athletic training programs, and after-school rec9 reational sports programs, to the extent possible. 

10 ‘‘(d) REQUIREMENTS OF GRANT RECIPIENTS.— 

11 ‘‘(1) LIMITATION ON ADMINISTRATIVE EX12 PENSES.—A recipient of a grant under this section 

13 shall not use more than 10 percent of the amounts 

14 received under a grant under this section for admin15 istrative expenses. 

16 ‘‘(2) CONTRIBUTION OF FUNDS.—A recipient of 

17 a grant under this section, and any entity receiving 

18 assistance under the grant for training and edu19 cation, shall contribute non-Federal funds, either di20 rectly or through in-kind contributions, to the costs 

21 of the activities to be funded under the grant in an 

22 amount that is not less than 10 percent of the total 

23 cost of such activities. 

24 ‘‘(3) EVALUATION.—Each recipient of a grant 

25 under this section shall provide to the Secretary, in 


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1 such form and manner as the Secretary shall speci2 fy, relevant data and an evaluation of the activities 

3 of the grant recipient in promoting healthy eating 

4 behaviors and preventing eating disorders. Evalua5 tion reports shall be made publicly available, such as 

6 through the Internet. 

7 ‘‘(e) TECHNICAL ASSISTANCE.—The Secretary may 

8 set aside an amount not to exceed 1 percent of the total 

9 amount appropriated for a fiscal year to provide grantees 

10 with technical support in the development, implementa11 tion, and evaluation of programs under this section and 

12 to disseminate information about preventing and treating 

13 eating disorders and obesity. 

14 ‘‘SEC. 399OO–4. STUDY OF EATING DISORDERS IN ELEMEN15 TARY SCHOOLS, SECONDARY SCHOOLS, AND 

16 INSTITUTIONS OF HIGHER EDUCATION. 

17 ‘‘Not later than 18 months after the date of enact18 ment of the Federal Response to Eliminate Eating Dis19 orders Act, the National Center for Health Statistics of 

20 the Centers for Disease Control and Prevention and the 

21 National Center for Education Statistics of the Depart22 ment of Education shall conduct a joint study, or enter 

23 into a contract to have a study conducted, on the impact 

24 eating disorders have on educational advancement and 

25 achievement. The study shall— 


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1 ‘‘(1) determine the incidence of eating disorders 

2 and disordered eating among students, and the mor3 bidity and mortality rates associated with eating dis4 orders; 

5 ‘‘(2) evaluate the extent to which students with 

6 eating disorders are more likely to miss school, have 

7 delayed rates of development, or have reduced cog8 nitive skills; 

9 ‘‘(3) report on current State and local programs 

10 to increase awareness about the dangers of eating 

11 disorders among youth and to prevent eating dis12 orders and the risk factors for eating disorders, and 

13 evaluate the value of such programs; and 

14 ‘‘(4) make recommendations on measures that 

15 could be undertaken by Congress, the Department of 

16 Education, States, and local educational agencies to 

17 strengthen eating disorder prevention and awareness 

18 programs including development of best practices. 

19 ‘‘SEC. 399OO–5. STUDY OF THE SUITABILITY OF MANDATING 

20 BODY MASS INDEX REPORTING IN ELEMEN21 TARY SCHOOLS AND SECONDARY SCHOOLS. 

22 ‘‘Not later than 18 months after the date of enact23 ment of the Federal Response to Eliminate Eating Dis24 orders Act, the Director of the Centers for Disease Control 

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1 cation, shall conduct a study on mandatory reporting of 

2 body mass index, including— 

3 ‘‘(1) how many schools are currently conducting 

4 such measuring; and 

5 ‘‘(2) the impacts on students of such measures, 

6 which may include student and parent reactions to 

7 such reports, including changes in physical activity, 

8 a focus on nutrition, a focus on body image, the use 

9 of weight control behaviors, eating disorder symp10 toms, and the incidence of teasing or bullying based 

11 on body size. 

12 ‘‘SEC. 399OO–6. PUBLIC SERVICE ADVERTISEMENTS. 

13 ‘‘The Secretary, in consultation with the Director of 

14 the National Institutes of Health and the Secretary of 

15 Education, shall carry out a program to develop, dis16 tribute, and promote the broadcasting of public service an17 nouncements to improve public awareness of, and to pro18 mote the identification and prevention, of eating disorders. 

19 ‘‘SEC. 399OO–7. AUTHORIZATION OF APPROPRIATIONS. 

20 ‘‘To carry out sections 399OO–3, 399OO–4, 399OO– 

21 5, and 399OO–6, there are authorized to be appropriated 

22 such sums as may be necessary for each of fiscal years 

23 2011 through 2015.’’. 


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1 SEC. 202. SENSE OF THE SENATE. 

2 It is the sense of the Senate that critically necessary 

3 programs to reduce obesity in children may also uninten4 tionally increase the unhealthy weight control behaviors 

5 that can lead to development of eating disorders, and that 

6 federally funded programs to combat obesity should take 

7 this connection into consideration. 

8 TITLE III—IMPROVING TRAIN9 ING IN HEALTH PROFES10 SIONS, EDUCATION, AND RE11 LATED FIELDS 

12 SEC. 301. GRANTS FOR HEALTH PROFESSIONALS. 

13 Part D of title VII of the Public Health Service Act 

14 (42 U.S.C. 294 et seq.), as amended by section 4305(c) 

15 of the Patient Protection and Affordable Care Act (Public 

16 Law 111–148), is further amended by adding at the end 

17 the following: 

18 ‘‘SEC. 760. GRANTS FOR HEALTH PROFESSIONALS. 

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

20 Director of the Health Resources and Services Adminis21 tration, shall award grants under this section to develop 

22 interdisciplinary training and education programs that 

23 provide undergraduate, graduate, post-graduate medical, 

24 nursing (including advanced practice nursing students), 

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1 standing of, and clinical skills pertinent to identifying and 

2 treating, eating disorders. 

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

4 under this section an entity shall— 

5 ‘‘(1) be an accredited school of allopathic or os6 teopathic medicine, or an accredited school of nurs7 ing, public health, social work, dentistry, behavioral 

8 and mental health, or pharmacy, or an accredited 

9 medical, dental, or nursing residency program; 

10 ‘‘(2) prepare and submit to the Secretary an 

11 application at such time, in such manner, and con12 taining such information as the Secretary may re13 quire, including— 

14 ‘‘(A) information to demonstrate that the 

15 applicant will employ an evidence-based ap16 proach for training health professionals on eat17 ing disorders; 

18 ‘‘(B) strategies for the dissemination and 

19 sharing of curricula and other educational ma20 terials developed under the grant to other inter21 ested health professions schools, national re22 source repositories for materials on eating dis23 orders, and health services continuing education 

24 providers; 


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1 ‘‘(C) a plan for consulting with commu2 nity-based coalitions, treatment centers, or eat3 ing disorder research experts who have experi4 ence and expertise in issues related to eating 

5 disorders, for services provided under the pro6 gram carried out under the grant; and 

7 ‘‘(D) a plan for making the information 

8 and curricula publicly available to health profes9 sionals, such as through the Internet. 

10 ‘‘(c) USE OF FUNDS.— 

11 ‘‘(1) REQUIRED USES.—Amounts provided 

12 under a grant awarded under this section shall be 

13 used to fund interdisciplinary training and education 

14 projects that are designed to train medical, nursing, 

15 and other health professions students and residents 

16 to identify and provide appropriate health care serv17 ices (including mental or behavioral health care serv18 ices and referrals to appropriate community serv19 ices) to individuals who have eating disorders. 

20 ‘‘(2) PERMISSIVE USE.—Amounts provided 

21 under a grant under this section may be used to 

22 offer community-based training opportunities in 

23 rural areas for medical, nursing, and other health 

24 professions students and residents on eating dis25 orders, which may include the use of distance learnVerDate Nov 24 2008 02:19 Apr 27, 2010 Jkt 089200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S3260.IS S3260

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1 ing networks and other available technologies needed 

2 to reach isolated rural areas. 

3 ‘‘(d) REQUIREMENTS OF GRANTEES.— 

4 ‘‘(1) LIMITATION ON ADMINISTRATIVE EX5 PENSES.—A grantee shall not use more than 10 per6 cent of the amounts received under a grant under 

7 this section for administrative expenses. 

8 ‘‘(2) CONTRIBUTION OF FUNDS.—A grantee 

9 under this section, and any entity receiving assist10 ance under the grant for training and education, 

11 shall contribute non-Federal funds, either directly or 

12 through in-kind contributions, to the costs of the ac13 tivities to be funded under the grant in an amount 

14 that is not less than 10 percent of the total cost of 

15 such activities. 

16 ‘‘(e) EATING DISORDER.—In this section, the term 

17 ‘eating disorder’ has the meaning given such term in sec18 tion 399OO(e). 

19 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

20 are authorized to be appropriated to carry out this section 

21 such sums as may be necessary for fiscal years 2011 

22 through 2015.’’. 


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1 SEC. 302. TRAINING IN ELEMENTARY AND SECONDARY 

2 SCHOOLS. 

3 Section 5131(a) of the Elementary and Secondary 

4 Education Act of 1965 (20 U.S.C. 7215(a)) is amended 

5 by adding at the end the following: 

6 ‘‘(28) Programs to improve the identification of 

7 students with eating disorders (as defined in section 

8 399OO of the Public Health Service Act), increase 

9 awareness of such disorders among parents and stu10 dents, and train educators (including teachers, 

11 school nurses, school social workers, coaches, school 

12 counselors, and administrators) on effective eating 

13 disorder prevention, screening, detection and assist14 ance methods.’’. 

15 TITLE IV—IMPROVING AVAIL16 ABILITY AND ACCESS TO 

17 TREATMENT 

18 SEC. 401. MEDICAID COVERAGE FOR EATING DISORDER 

19 TREATMENT SERVICES. 

20 (a) IN GENERAL.—Section 1905 of the Social Secu21 rity Act (42 U.S.C. 1396d(a)), as amended by section 

22 2301(a)(1) of the Patient Protection and Affordable Care 

23 Act (Public Law 111–148) and section 1202(b) of the 

24 Health Care and Education Reconciliation Act of 2010 

25 (Public Law 111–152), is amended— 

26 (1) in subsection (a)— 


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1 (A) in paragraph (28), by striking ‘‘and’’ 

2 at the end; 

3 (B) by redesignating paragraph (29) as 

4 paragraph (30); and 

5 (C) by inserting after paragraph (28) the 

6 following new paragraph: 

7 ‘‘(29) eating disorder treatment services (as de8 fined in subsection (ee)(1)); and’’; and 

9 (2) by adding at the end the following new sub10 section: 

11 ‘‘(ee) EATING DISORDER TREATMENT SERVICES.— 

12 ‘‘(1) DEFINITION.—The term ‘eating disorder 

13 treatment services’ means services relating to diag14 nosis and treatment of an eating disorder (as de15 fined in section 399OO of the Public Health Service 

16 Act), including screening, counseling, 

17 pharmacotherapy (including coverage of drugs de18 scribed in paragraph (2)), and other necessary 

19 health care services. 

20 ‘‘(2) COVERAGE FOR PHARMACOLOGICAL

21 TREATMENT OF EATING DISORDERS.—For purposes 

22 of paragraph (1), eating disorder treatment services 

23 shall include drugs provided as part of care in an in24 patient setting, covered outpatient drugs (as defined 

25 in section 1927(k)(2)), and non-prescription drugs 


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1 described in section 1927(d)(2)(A) that are pre2 scribed, in accordance with generally accepted med3 ical guidelines, for treatment of an eating disorder.’’. 

4 (b) INCREASED FMAP FOR EATING DISORDER

5 TREATMENT SERVICES.—Section 1905(b) of the Social 

6 Security Act (42 U.S.C. 1396d(b)), as amended by section 

7 4106(b) of the Patient Protection and Affordable Care 

8 Act, is amended— 

9 (1) by striking ‘‘and’’ before ‘‘(5)’’; and 

10 (2) by inserting before the period at the end the 

11 following: ‘‘, and (6) the Federal medical assistance 

12 percentage shall be equal to the enhanced FMAP de13 scribed in section 2105(b) with respect to medical 

14 assistance for eating disorder treatment services (as 

15 defined in subsection (ee)(1)) provided to an indi16 vidual who is eligible for such assistance and has an 

17 eating disorder (as defined in section 399OO of the 

18 Public Health Service Act)’’. 

19 (c) INCLUSION IN EPSDT SERVICES.—Section 

20 1905(r)(1)(B) of such Act (42 U.S.C. 1396d(r)(1)(B)) is 

21 amended— 

22 (1) in clause (iv), by striking ‘‘and’’ at the end; 

23 (2) in clause (v), by striking the period at the 

24 end and inserting ‘‘; and’’; and 


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1 (3) by inserting after clause (v) the following 

2 new clause: 

3 ‘‘(vi) appropriate diagnostic services 

4 relating to eating disorders (as defined in 

5 section 399OO of the Public Health Serv6 ice Act).’’. 

7 (d) EXCEPTION FROM OPTIONAL RESTRICTION

8 UNDER MEDICAID DRUG COVERAGE.—Section 

9 1927(d)(2)(A) of such Act (42 U.S.C. 1396r–8(d)(2)(A)) 

10 is amended by inserting before the period at the end the 

11 following: ‘‘, except for drugs that are prescribed, in ac12 cordance with generally accepted medical guidelines, for 

13 the purpose of treatment of an individual who is eligible 

14 for medical assistance under the State plan and has an 

15 eating disorder (as defined in section 399OO of the Public 

16 Health Service Act)’’. 

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

18 this section shall apply to drugs and services furnished 

19 on or after October 1, 2010. 

20 SEC. 402. GRANTS TO SUPPORT PATIENT ADVOCACY. 

21 Subpart II of part D of title IX of the Public Health 

22 Service Act, as amended by section 6301(b) of the Patient 

23 Protection and Affordable Care Act (Public Law 111– 

24 148), is further amended by adding at the end the fol25 lowing: 


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1 ‘‘SEC. 938. GRANTS TO SUPPORT PATIENT ADVOCACY. 

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

3 Director, shall award grants under this section to develop 

4 and support patient advocacy work to help individuals with 

5 eating disorders obtain adequate health care services and 

6 insurance coverage. 

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

8 under this section, an entity shall— 

9 ‘‘(1) be a public or nonprofit private entity (in10 cluding a health department of a State or tribal 

11 agency, a community-based organization, or an insti12 tution of higher education); 

13 ‘‘(2) prepare and submit to the Secretary an 

14 application at such time, in such manner, and con15 taining such information as the Secretary may re16 quire, including— 

17 ‘‘(A) comprehensive strategies for advo18 cating on behalf of, and working with, individ19 uals with eating disorders or at risk for devel20 oping eating disorders; 

21 ‘‘(B) a plan for consulting with commu22 nity-based coalitions, treatment centers, or eat23 ing disorder research experts who have experi24 ence and expertise in issues related to eating 

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1 ices under a grant awarded under this section; 

2 and 

3 ‘‘(C) a plan for financial sustainability in4 volving State, local, and private contributions. 

5 ‘‘(c) USE OF FUNDS.—Amounts provided under a 

6 grant awarded under this section shall be used to support 

7 patient advocacy work, including— 

8 ‘‘(1) providing education and outreach in com9 munity settings regarding eating disorders and asso10 ciated health problems, especially among low-income, 

11 minority, and medically underserved populations; 

12 ‘‘(2) facilitating access to appropriate, ade13 quate, and timely health care for individuals with 

14 eating disorders and associated health problems; 

15 ‘‘(3) assisting in communication and coopera16 tion between patients and providers; 

17 ‘‘(4) representing the interests of patients in 

18 managing health insurance claims and plans; 

19 ‘‘(5) providing education and outreach regard20 ing enrollment in health insurance, including enroll21 ment in the Medicare program under title XVIII of 

22 the Social Security Act, the Medicaid program under 

23 title XIX of such Act, and the Children’s Health In24 surance Program under title XXI of such Act; 


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1 ‘‘(6) identifying, referring, and enrolling under2 served populations in appropriate health care agen3 cies and community-based programs and organiza4 tions in order to increase access to high-quality 

5 health care services; 

6 ‘‘(7) providing technical assistance, training, 

7 and organizational support for patient advocates; 

8 and 

9 ‘‘(8) creating, operating, and participating in 

10 State or regional networks of patient advocates. 

11 ‘‘(d) REQUIREMENTS OF GRANTEES.— 

12 ‘‘(1) LIMITATION ON ADMINISTRATIVE EX13 PENSES.—A grantee shall not use more than 5 per14 cent of the amounts received under a grant under 

15 this section for administrative expenses. 

16 ‘‘(2) CONTRIBUTION OF FUNDS.—A grantee 

17 under this section, and any entity receiving assist18 ance under the grant for training and education, 

19 shall contribute non-Federal funds, either directly or 

20 through in-kind contributions, to the costs of the ac21 tivities to be funded under the grant in an amount 

22 that is not less than 75 percent of the total cost of 

23 such activities. 

24 ‘‘(3) REPORTING TO SECRETARY.—A grantee 

25 under this section shall submit to the Secretary a reVerDate Nov 24 2008 02:19 Apr 27, 2010 Jkt 089200 PO 00000 Frm 00033 Fmt 6652 Sfmt 6201 E:\BILLS\S3260.IS S3260

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1 port, at such time, in such manner, and containing 

2 such information as the Secretary may require, in3 cluding a description and evaluation of the activities 

4 described in subsection (c) carried out by such enti5 ty. 

6 ‘‘(e) EATING DISORDER.—In this section, the term 

7 ‘eating disorder’ has the meaning given such term in sec8 tion 399OO(e). 

9 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

10 carry out this section, there are authorized to be appro11 priated such sums as may be necessary for fiscal years 

12 2011 through 2015.’’. 

Æ 


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