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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 3260 Introduced in Senate (IS)]

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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Federal Response to Eliminate Eating 
Disorders Act''.

SEC. 2. FINDINGS.

    Congress finds as follows:
            (1) Estimates, based on current research, indicate that at 
        least 5,000,000 people in the United States suffer from eating 
        disorders including anorexia nervosa, bulimia nervosa, binge 
        eating disorder, and eating disorders not otherwise specified 
        (referred to in this Act as ``EDNOS'').
            (2) Anecdotal evidence suggests that as many as 11,000,000 
        people in the United States, including 1,000,000 males, may 
        suffer from eating disorders.
            (3) Eating disorders occur in all nations and in all 
        populations, and among people of all ages and races and of both 
        genders.
            (4) Eating disorders are diseases with grave health 
        consequences and high rates of mortality.
            (5) Health consequences associated with eating disorders 
        include heart failure and other serious cardiac conditions, 
        electrolyte imbalance, kidney failure, osteoporosis, 
        debilitating tooth decay, and gastrointestinal disorders, 
        including esophageal inflammation and rupture, gastric rupture, 
        peptic ulcers, and pancreatitis.
            (6) Anorexia nervosa has one of the highest overall 
        mortality rates of any mental illness. According to the 
        National Institute of Mental Health, 1 in 10 people with 
        anorexia nervosa will die of starvation, cardiac arrest, or 
        another medical complication.
            (7) The risk of death among adolescents with anorexia 
        nervosa is 11 times greater than in disease-free adolescents.
            (8) Anorexia nervosa has the highest suicide rate of all 
        mental illnesses.
            (9) New research suggests that bulimia nervosa has a much 
        higher rate of mortality than is reflected in current 
        statistics, because of the failure to identify the underlying 
        eating disorder.
            (10) Binge eating disorder is the most common eating 
        disorder, with an estimated 3.5 percent of American women and 2 
        percent of American men expected to suffer from this disorder 
        in their lifetime. Binge eating disorder is characterized by 
        frequent episodes of uncontrolled overeating and is associated 
        with obesity, heart disease, gall bladder disease, and 
        diabetes.
            (11) Research demonstrates that there is a significant 
        genetic component to the development of eating disorders.
            (12) Certain populations, including adolescent females and 
        athletes of both genders, are at higher risk of developing an 
        eating disorder.
            (13) Different types of eating disorders may affect certain 
        races and genders disproportionately.
            (14) Despite the serious health consequences and the high 
        risk of death, Federal research funding for eating disorders 
        has lagged behind research concerning other diseases, when 
        compared by the number of individuals affected by, and the 
        relative health consequences of, the diseases.
            (15) The ability of individuals suffering from eating 
        disorders, particularly bulimia nervosa, binge eating disorder, 
        and EDNOS to access appropriate treatment is unacceptably low.
            (16) The development of an eating disorder is frequently 
        preceded by unhealthy weight control behaviors commonly 
        identified as disordered eating, including skipping meals, 
        using diet pills, taking laxatives, self-induced vomiting, and 
        fasting. Such disordered eating behaviors should be included in 
        enhanced research prevention and training efforts.

SEC. 3. PURPOSES.

    The purposes of this Act are--
            (1) to expand research into the prevention of eating 
        disorders;
            (2) to expand research on effective treatment and 
        intervention of eating disorders and to support evidence-based 
        programs designed to prevent eating disorders;
            (3) to expand research on the causes, courses, and outcomes 
        of eating disorders;
            (4) to increase the number of people properly screened and 
        diagnosed with an eating disorder;
            (5) to improve training and education of health care and 
        behavioral care providers and of school personnel at all levels 
        of elementary and secondary education;
            (6) to improve surveillance and data systems for tracking 
        the prevalence, severity, and economic costs of eating 
        disorders; and
            (7) to enhance access to comprehensive treatment for eating 
        disorders.

            TITLE I--EATING DISORDER DETECTION AND RESEARCH

SEC. 101. EXPANSION AND COORDINATION OF THE ACTIVITIES OF THE NATIONAL 
              INSTITUTE OF HEALTH AND THE NATIONAL INSTITUTE OF MENTAL 
              HEALTH WITH RESPECT TO RESEARCH ON EATING DISORDERS.

    Part B of title IV of the Public Health Service Act (42 U.S.C. 284 
et seq.), as amended by section 4305(b) of the Patient Protection and 
Affordable Care Act (Public Law 111-148), is further amended by adding 
at the end the following:

``SEC. 409K. EXPANSION AND COORDINATION OF ACTIVITIES WITH RESPECT TO 
              RESEARCH ON EATING DISORDERS.

    ``(a) In General.--The Director of NIH, pursuant to the general 
authority of such director, shall expand, intensify, and coordinate the 
activities of the National Institutes of Health with respect to 
research on eating disorders.
    ``(b) Grants.--The Director of NIH may award grants to public or 
private entities to pay all or part of the cost of planning, 
establishing, improving, and providing basic operating support for such 
entities to establish consortia in eating disorder research and to 
carry out the activities described in subsection (e).
    ``(c) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall--
            ``(1) be public or nonprofit private entity (including a 
        health department of a State, a political subdivision of a 
        State, or an institution of higher education); and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(d) Requirements of Consortia.--
            ``(1) In general.--Each consortium established as described 
        in subsection (b) may use the facilities of a single lead 
        institution, or may be formed from several cooperating 
        institutions, meeting such requirements as may be prescribed by 
        the Director of NIH.
            ``(2) Coordination of consortia.--The Director of NIH--
                    ``(A) may, as appropriate, provide for the 
                coordination of information among consortia established 
                under subsection (b); and
                    ``(B) shall ensure regular communication between 
                members of the various consortia established using 
                grants awarded under this section.
            ``(3) Reports.--The Director of NIH shall require each 
        consortium to periodically prepare and submit to such director 
        reports on the activities of such consortium.
    ``(e) Activities.--Each consortium receiving a grant under 
subsection (b) shall conduct basic, clinical, epidemiological, 
population-based, or translational research regarding eating disorders, 
which may include research related to--
            ``(1) the identification and classification of eating 
        disorders and disordered eating;
            ``(2) the causes, diagnosis, and early detection of eating 
        disorders;
            ``(3) the treatment of eating disorders, including the 
        development and evaluation of new treatments and best 
        practices;
            ``(4) the conditions or diseases related to, or arising 
        from, an eating disorder; and
            ``(5) the evaluation of existing prevention programs and 
        the development of reliable prevention and screening programs.
    ``(f) Collaboration.--The Secretary, acting through the Director of 
NIH and the Director of the National Institute of Mental Health, shall 
identify relevant Federal agencies (including the other institutes and 
centers of the National Institutes of Health, the Centers for Medicare 
& Medicaid Services, the Centers for Disease Control and Prevention, 
the Agency for Healthcare Research and Quality, the Substance Abuse and 
Mental Health Services Administration, the Health Resources and 
Services Administration, and the Office on Women's Health) that shall 
collaborate with respect to activities conducted under subsection (d).
    ``(g) Public Input.--The Director of NIH shall provide for a 
mechanism--
            ``(1) to educate and disseminate information on the 
        existing and planned programs and research activities of the 
        National Institutes of Health with respect to eating disorders; 
        and
            ``(2) through which the Director of NIH may receive 
        comments from the public regarding such programs and 
        activities.
    ``(h) Dissemination of Information.--The Director of NIH shall 
provide for a mechanism for making the results and information 
generated by the consortia publicly available, such as through the 
Internet.
    ``(i) Definition.--For purposes of this section, the term `eating 
disorder' has the meaning given such term in section 399OO(e).
    ``(j) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2011 through 2015.''.

SEC. 102. INTERAGENCY COORDINATING COUNCIL; SURVEILLANCE AND RESEARCH 
              PROGRAM; STUDY ON ECONOMIC COST.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.), 
as amended by section 4303 of the Patient Protection and Affordable 
Care Act (Public Law 111-148), is further amended by adding at the end 
the following:

            ``PART W--PROGRAMS RELATING TO EATING DISORDERS

``SEC. 399OO. INTERAGENCY EATING DISORDERS COORDINATING COUNCIL.

    ``(a) Establishment.--There is established within the Department of 
Health and Human Services the Interagency Eating Disorders Coordinating 
Council (referred to in this section as the `Coordinating Council').
    ``(b) Responsibilities.--The Coordinating Council shall--
            ``(1) develop and annually update a summary of advances in 
        eating disorder research concerning causes of, prevention of, 
        early screening for, treatment and access to services related 
        to, and supports for individuals affected by, eating disorders;
            ``(2) monitor Federal activities with respect to eating 
        disorders;
            ``(3) make recommendations to the Secretary regarding any 
        appropriate changes to such activities, and to the Director of 
        NIH, with respect to the strategic plan developed under 
        paragraph (4);
            ``(4) develop and annually update a strategic plan for the 
        conduct of, and support for, eating disorder research, 
        including proposed budgetary recommendations; and
            ``(5) submit to Congress the strategic plan developed under 
        paragraph (4) and all updates to such plan.
    ``(c) Membership.--
            ``(1) Chairperson.--The Director of NIH shall serve as the 
        chairperson of the Coordinating Council and shall be 
        responsible for the leadership and oversight of the activities 
        of the Coordinating Council.
            ``(2) Members in general.--The Coordinating Council shall 
        be composed of--
                    ``(A) representatives of--
                            ``(i) the Agency for Healthcare Research 
                        and Quality;
                            ``(ii) the Substance Abuse and Mental 
                        Health Administration;
                            ``(iii) the research institutes at the 
                        National Institutes of Health, as the Director 
                        of NIH determines appropriate;
                            ``(iv) the Health Resources and Services 
                        Administration;
                            ``(v) the Centers for Medicare & Medicaid 
                        Services;
                            ``(vi) the Office of Women's Health;
                            ``(vii) the Centers for Disease Control and 
                        Prevention; and
                            ``(viii) the Department of Education; and
                    ``(B) the additional members appointed under 
                paragraph (3).
            ``(3) Additional members.--Not fewer than \1/3\ of the 
        total membership of the Coordinating Council shall be composed 
        of non-Federal public members to be appointed by the Secretary, 
        including representatives of--
                    ``(A) academic medical centers or schools of 
                medicine, nursing, or other health professions;
                    ``(B) health care professionals who are actively 
                involved in the treatment of eating disorders;
                    ``(C) researchers with expertise in eating 
                disorders; and
                    ``(D) at least 2 individuals with a past or present 
                diagnosis of an eating disorder or parents of 
                individuals with a past or present diagnosis of an 
                eating disorder.
    ``(d) Administrative Support; Terms of Service; Other Provisions.--
            ``(1) Administrative support.--The Coordinating Council 
        shall receive necessary and appropriate administrative support 
        from the Secretary.
            ``(2) Terms of service.--Members of the Coordinating 
        Council appointed under subsection (c)(2) shall serve for a 
        term of 4 years, and may be reappointed for one or more 
        additional 4 year-terms. Any member appointed to fill a vacancy 
        for an unexpired term shall be appointed for the remainder of 
        such term. A member may serve after the expiration of the 
        member's term until a successor has taken office.
            ``(3) Meetings.--
                    ``(A) In general.--The Coordinating Council shall 
                meet at the call of the chairperson or upon the request 
                of the Secretary. The Coordinating Council shall meet 
                not fewer than 2 times each year.
                    ``(B) Notice.--Notice of any upcoming meeting of 
                the Coordinating Council shall be published in the 
                Federal Register.
                    ``(C) Public access.--Each meeting of the 
                Coordinating Council shall be open to the public and 
                shall include appropriate periods of time for questions 
                by the public.
            ``(4) Subcommittees.--In carrying out its functions the 
        Coordinating Council may establish subcommittees and convene 
        workshops and conferences.
    ``(e) Eating Disorder.--In this part, the term `eating disorder' 
includes anorexia nervosa, bulimia nervosa, binge eating disorder, and 
eating disorders not otherwise specified, as defined in the fourth 
edition of the Diagnostic and Statistical Manual of Mental Disorders or 
any subsequent edition.
    ``(f) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2011 through 2015.

``SEC. 399OO-1. EATING DISORDER SURVEILLANCE AND RESEARCH PROGRAM.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, shall award grants or 
cooperative agreements to eligible entities for the purpose of 
improving the collection, analysis and reporting of State 
epidemiological data on eating disorders.
    ``(b) Activities.--An eligible entity shall assist with the 
development and coordination of eating disorder surveillance efforts 
within a region and may--
            ``(1) provide for the collection, analysis, and reporting 
        of epidemiological data on eating disorders through the 
        existing surveillance programs;
            ``(2) develop recommendations to enhance existing 
        surveillance programs to more accurately collect 
        epidemiological data on disordered eating and eating disorders, 
        including the number, incidence, trends, correlates, mortality, 
        and causes of eating disorders and the effects of eating 
        disorders on quality of life;
            ``(3) develop recommendations to improve requirements for 
        ensuring that eating disorders are accurately recorded as 
        underlying and contributing causes of death; and
            ``(4) assist with the development and coordination of 
        surveillance efforts within a region.
    ``(c) Eligible Entities.--To be eligible to receive an award under 
this section, an entity shall--
            ``(1) be a public or nonprofit private entity (including a 
        health department of a State, a political subdivision of a 
        State, or an institution of higher education); and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(d) Technical Assistance.--In making awards under this section, 
the Secretary may provide direct technical assistance in lieu of cash.
    ``(e) Reports.--Each entity awarded a grant or cooperative 
agreement under this section shall submit to the Secretary a report 
describing the activities conducted using grant funds and providing 
recommendations for improving the collection, analysis, and reporting 
of epidemiological data on eating disorders.
    ``(f) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2011 through 2015.

``SEC. 399OO-2. STUDY REGARDING ECONOMIC COSTS OF EATING DISORDERS.

    ``The Secretary, acting through the Director of the Centers for 
Disease Control and Prevention, shall conduct a study evaluating the 
economic costs of eating disorders. Such study may examine years of 
productive life lost, missed days of work, reduced work productivity, 
costs of medical and mental health treatment, costs to family, and 
costs to society as a result of eating disorders.''.

 TITLE II--EATING DISORDER EDUCATION AND PREVENTION; STUDIES ON EATING 
      DISORDERS AND BODY MASS INDEX; PUBLIC SERVICE ANNOUNCEMENTS

SEC. 201. GRANTS TO PREVENT EATING DISORDERS.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.), 
as amended by section 102, is further amended by adding at the end the 
following:

``SEC. 399OO-3. GRANTS TO PREVENT EATING DISORDERS.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention and in coordination with 
the Administrator of the Health Resources and Services Administration, 
shall award grants to eligible entities to plan, implement, and 
evaluate programs to prevent eating disorders and obesity and the acute 
and chronic medical conditions that accompany such conditions, and to 
promote healthy body image and appropriate nutrition-based eating 
behaviors.
    ``(b) Eligibility.--To be eligible to receive a grant under this 
section, an entity shall--
            ``(1) be a State, local or tribal educational agency, an 
        accredited institution of higher education, a State or local 
        health department, or a community based organization; and
            ``(2) submit an application to the Secretary at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--An entity receiving a grant under this section 
shall fund development and testing of school-, clinic-, community-, or 
health department-based programs designed to promote healthy eating 
behaviors and to prevent eating disorders including--
            ``(1) developing evidence-based interventions to prevent 
        eating disorders, including educational or intervention 
        programs regarding nutritional content, understanding and 
        responding to hunger and satiety, positive body image 
        development, positive self-esteem development, and life skills, 
        that take into account cultural and developmental issues and 
        the role of family, school, and community;
            ``(2) planning and implementing a healthy lifestyle 
        curriculum or program with an emphasis on healthy eating 
        behaviors, physical activity, and emotional wellness, the 
        connection between emotional and physical health, and the 
        prevention of bullying based on body size, shape, and weight;
            ``(3) forming partnerships with parents and caregivers to 
        educate adults about identifying unhealthy eating behaviors and 
        promoting healthy eating behaviors, physical activity, and 
        emotional wellness; and
            ``(4) integrating eating disorder prevention and awareness 
        in physical education, health, education, athletic training 
        programs, and after-school recreational sports programs, to the 
        extent possible.
    ``(d) Requirements of Grant Recipients.--
            ``(1) Limitation on administrative expenses.--A recipient 
        of a grant under this section shall not use more than 10 
        percent of the amounts received under a grant under this 
        section for administrative expenses.
            ``(2) Contribution of funds.--A recipient of a grant under 
        this section, and any entity receiving assistance under the 
        grant for training and education, shall contribute non-Federal 
        funds, either directly or through in-kind contributions, to the 
        costs of the activities to be funded under the grant in an 
        amount that is not less than 10 percent of the total cost of 
        such activities.
            ``(3) Evaluation.--Each recipient of a grant under this 
        section shall provide to the Secretary, in such form and manner 
        as the Secretary shall specify, relevant data and an evaluation 
        of the activities of the grant recipient in promoting healthy 
        eating behaviors and preventing eating disorders. Evaluation 
        reports shall be made publicly available, such as through the 
        Internet.
    ``(e) Technical Assistance.--The Secretary may set aside an amount 
not to exceed 1 percent of the total amount appropriated for a fiscal 
year to provide grantees with technical support in the development, 
implementation, and evaluation of programs under this section and to 
disseminate information about preventing and treating eating disorders 
and obesity.

``SEC. 399OO-4. STUDY OF EATING DISORDERS IN ELEMENTARY SCHOOLS, 
              SECONDARY SCHOOLS, AND INSTITUTIONS OF HIGHER EDUCATION.

    ``Not later than 18 months after the date of enactment of the 
Federal Response to Eliminate Eating Disorders Act, the National Center 
for Health Statistics of the Centers for Disease Control and Prevention 
and the National Center for Education Statistics of the Department of 
Education shall conduct a joint study, or enter into a contract to have 
a study conducted, on the impact eating disorders have on educational 
advancement and achievement. The study shall--
            ``(1) determine the incidence of eating disorders and 
        disordered eating among students, and the morbidity and 
        mortality rates associated with eating disorders;
            ``(2) evaluate the extent to which students with eating 
        disorders are more likely to miss school, have delayed rates of 
        development, or have reduced cognitive skills;
            ``(3) report on current State and local programs to 
        increase awareness about the dangers of eating disorders among 
        youth and to prevent eating disorders and the risk factors for 
        eating disorders, and evaluate the value of such programs; and
            ``(4) make recommendations on measures that could be 
        undertaken by Congress, the Department of Education, States, 
        and local educational agencies to strengthen eating disorder 
        prevention and awareness programs including development of best 
        practices.

``SEC. 399OO-5. STUDY OF THE SUITABILITY OF MANDATING BODY MASS INDEX 
              REPORTING IN ELEMENTARY SCHOOLS AND SECONDARY SCHOOLS.

    ``Not later than 18 months after the date of enactment of the 
Federal Response to Eliminate Eating Disorders Act, the Director of the 
Centers for Disease Control and Prevention, in consultation with the 
Secretary of Education, shall conduct a study on mandatory reporting of 
body mass index, including--
            ``(1) how many schools are currently conducting such 
        measuring; and
            ``(2) the impacts on students of such measures, which may 
        include student and parent reactions to such reports, including 
        changes in physical activity, a focus on nutrition, a focus on 
        body image, the use of weight control behaviors, eating 
        disorder symptoms, and the incidence of teasing or bullying 
        based on body size.

``SEC. 399OO-6. PUBLIC SERVICE ADVERTISEMENTS.

    ``The Secretary, in consultation with the Director of the National 
Institutes of Health and the Secretary of Education, shall carry out a 
program to develop, distribute, and promote the broadcasting of public 
service announcements to improve public awareness of, and to promote 
the identification and prevention, of eating disorders.

``SEC. 399OO-7. AUTHORIZATION OF APPROPRIATIONS.

    ``To carry out sections 399OO-3, 399OO-4, 399OO-5, and 399OO-6, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2011 through 2015.''.

SEC. 202. SENSE OF THE SENATE.

    It is the sense of the Senate that critically necessary programs to 
reduce obesity in children may also unintentionally increase the 
unhealthy weight control behaviors that can lead to development of 
eating disorders, and that federally funded programs to combat obesity 
should take this connection into consideration.

  TITLE III--IMPROVING TRAINING IN HEALTH PROFESSIONS, EDUCATION, AND 
                             RELATED FIELDS

SEC. 301. GRANTS FOR HEALTH PROFESSIONALS.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.), as amended by section 4305(c) of the Patient Protection and 
Affordable Care Act (Public Law 111-148), is further amended by adding 
at the end the following:

``SEC. 760. GRANTS FOR HEALTH PROFESSIONALS.

    ``(a) Grants.--The Secretary, acting through the Director of the 
Health Resources and Services Administration, shall award grants under 
this section to develop interdisciplinary training and education 
programs that provide undergraduate, graduate, post-graduate medical, 
nursing (including advanced practice nursing students), dental, mental 
and behavioral health, pharmacy, and other health professions students 
or residents with an understanding of, and clinical skills pertinent to 
identifying and treating, eating disorders.
    ``(b) Eligibility.--To be eligible to receive a grant under this 
section an entity shall--
            ``(1) be an accredited school of allopathic or osteopathic 
        medicine, or an accredited school of nursing, public health, 
        social work, dentistry, behavioral and mental health, or 
        pharmacy, or an accredited medical, dental, or nursing 
        residency program;
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require, including--
                    ``(A) information to demonstrate that the applicant 
                will employ an evidence-based approach for training 
                health professionals on eating disorders;
                    ``(B) strategies for the dissemination and sharing 
                of curricula and other educational materials developed 
                under the grant to other interested health professions 
                schools, national resource repositories for materials 
                on eating disorders, and health services continuing 
                education providers;
                    ``(C) a plan for consulting with community-based 
                coalitions, treatment centers, or eating disorder 
                research experts who have experience and expertise in 
                issues related to eating disorders, for services 
                provided under the program carried out under the grant; 
                and
                    ``(D) a plan for making the information and 
                curricula publicly available to health professionals, 
                such as through the Internet.
    ``(c) Use of Funds.--
            ``(1) Required uses.--Amounts provided under a grant 
        awarded under this section shall be used to fund 
        interdisciplinary training and education projects that are 
        designed to train medical, nursing, and other health 
        professions students and residents to identify and provide 
        appropriate health care services (including mental or 
        behavioral health care services and referrals to appropriate 
        community services) to individuals who have eating disorders.
            ``(2) Permissive use.--Amounts provided under a grant under 
        this section may be used to offer community-based training 
        opportunities in rural areas for medical, nursing, and other 
        health professions students and residents on eating disorders, 
        which may include the use of distance learning networks and 
        other available technologies needed to reach isolated rural 
        areas.
    ``(d) Requirements of Grantees.--
            ``(1) Limitation on administrative expenses.--A grantee 
        shall not use more than 10 percent of the amounts received 
        under a grant under this section for administrative expenses.
            ``(2) Contribution of funds.--A grantee under this section, 
        and any entity receiving assistance under the grant for 
        training and education, shall contribute non-Federal funds, 
        either directly or through in-kind contributions, to the costs 
        of the activities to be funded under the grant in an amount 
        that is not less than 10 percent of the total cost of such 
        activities.
    ``(e) Eating Disorder.--In this section, the term `eating disorder' 
has the meaning given such term in section 399OO(e).
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for fiscal years 2011 through 2015.''.

SEC. 302. TRAINING IN ELEMENTARY AND SECONDARY SCHOOLS.

    Section 5131(a) of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7215(a)) is amended by adding at the end the following:
            ``(28) Programs to improve the identification of students 
        with eating disorders (as defined in section 399OO of the 
        Public Health Service Act), increase awareness of such 
        disorders among parents and students, and train educators 
        (including teachers, school nurses, school social workers, 
        coaches, school counselors, and administrators) on effective 
        eating disorder prevention, screening, detection and assistance 
        methods.''.

        TITLE IV--IMPROVING AVAILABILITY AND ACCESS TO TREATMENT

SEC. 401. MEDICAID COVERAGE FOR EATING DISORDER TREATMENT SERVICES.

    (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d(a)), as amended by section 2301(a)(1) of the Patient Protection 
and Affordable Care Act (Public Law 111-148) and section 1202(b) of the 
Health Care and Education Reconciliation Act of 2010 (Public Law 111-
152), is amended--
            (1) in subsection (a)--
                    (A) in paragraph (28), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (29) as paragraph 
                (30); and
                    (C) by inserting after paragraph (28) the following 
                new paragraph:
            ``(29) eating disorder treatment services (as defined in 
        subsection (ee)(1)); and''; and
            (2) by adding at the end the following new subsection:
    ``(ee) Eating Disorder Treatment Services.--
            ``(1) Definition.--The term `eating disorder treatment 
        services' means services relating to diagnosis and treatment of 
        an eating disorder (as defined in section 399OO of the Public 
        Health Service Act), including screening, counseling, 
        pharmacotherapy (including coverage of drugs described in 
        paragraph (2)), and other necessary health care services.
            ``(2) Coverage for pharmacological treatment of eating 
        disorders.--For purposes of paragraph (1), eating disorder 
        treatment services shall include drugs provided as part of care 
        in an inpatient setting, covered outpatient drugs (as defined 
        in section 1927(k)(2)), and non-prescription drugs described in 
        section 1927(d)(2)(A) that are prescribed, in accordance with 
        generally accepted medical guidelines, for treatment of an 
        eating disorder.''.
    (b) Increased FMAP for Eating Disorder Treatment Services.--Section 
1905(b) of the Social Security Act (42 U.S.C. 1396d(b)), as amended by 
section 4106(b) of the Patient Protection and Affordable Care Act, is 
amended--
            (1) by striking ``and'' before ``(5)''; and
            (2) by inserting before the period at the end the 
        following: ``, and (6) the Federal medical assistance 
        percentage shall be equal to the enhanced FMAP described in 
        section 2105(b) with respect to medical assistance for eating 
        disorder treatment services (as defined in subsection (ee)(1)) 
        provided to an individual who is eligible for such assistance 
        and has an eating disorder (as defined in section 399OO of the 
        Public Health Service Act)''.
    (c) Inclusion in EPSDT Services.--Section 1905(r)(1)(B) of such Act 
(42 U.S.C. 1396d(r)(1)(B)) is amended--
            (1) in clause (iv), by striking ``and'' at the end;
            (2) in clause (v), by striking the period at the end and 
        inserting ``; and''; and
            (3) by inserting after clause (v) the following new clause:
                            ``(vi) appropriate diagnostic services 
                        relating to eating disorders (as defined in 
                        section 399OO of the Public Health Service 
                        Act).''.
    (d) Exception From Optional Restriction Under Medicaid Drug 
Coverage.--Section 1927(d)(2)(A) of such Act (42 U.S.C. 1396r-
8(d)(2)(A)) is amended by inserting before the period at the end the 
following: ``, except for drugs that are prescribed, in accordance with 
generally accepted medical guidelines, for the purpose of treatment of 
an individual who is eligible for medical assistance under the State 
plan and has an eating disorder (as defined in section 399OO of the 
Public Health Service Act)''.
    (e) Effective Date.--The amendments made by this section shall 
apply to drugs and services furnished on or after October 1, 2010.

SEC. 402. GRANTS TO SUPPORT PATIENT ADVOCACY.

    Subpart II of part D of title IX of the Public Health Service Act, 
as amended by section 6301(b) of the Patient Protection and Affordable 
Care Act (Public Law 111-148), is further amended by adding at the end 
the following:

``SEC. 938. GRANTS TO SUPPORT PATIENT ADVOCACY.

    ``(a) Grants.--The Secretary, acting through the Director, shall 
award grants under this section to develop and support patient advocacy 
work to help individuals with eating disorders obtain adequate health 
care services and insurance coverage.
    ``(b) Eligibility.--To be eligible to receive a grant under this 
section, an entity shall--
            ``(1) be a public or nonprofit private entity (including a 
        health department of a State or tribal agency, a community-
        based organization, or an institution of higher education);
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require, including--
                    ``(A) comprehensive strategies for advocating on 
                behalf of, and working with, individuals with eating 
                disorders or at risk for developing eating disorders;
                    ``(B) a plan for consulting with community-based 
                coalitions, treatment centers, or eating disorder 
                research experts who have experience and expertise in 
                issues related to eating disorders or patient advocacy 
                in providing services under a grant awarded under this 
                section; and
                    ``(C) a plan for financial sustainability involving 
                State, local, and private contributions.
    ``(c) Use of Funds.--Amounts provided under a grant awarded under 
this section shall be used to support patient advocacy work, 
including--
            ``(1) providing education and outreach in community 
        settings regarding eating disorders and associated health 
        problems, especially among low-income, minority, and medically 
        underserved populations;
            ``(2) facilitating access to appropriate, adequate, and 
        timely health care for individuals with eating disorders and 
        associated health problems;
            ``(3) assisting in communication and cooperation between 
        patients and providers;
            ``(4) representing the interests of patients in managing 
        health insurance claims and plans;
            ``(5) providing education and outreach regarding enrollment 
        in health insurance, including enrollment in the Medicare 
        program under title XVIII of the Social Security Act, the 
        Medicaid program under title XIX of such Act, and the 
        Children's Health Insurance Program under title XXI of such 
        Act;
            ``(6) identifying, referring, and enrolling underserved 
        populations in appropriate health care agencies and community-
        based programs and organizations in order to increase access to 
        high-quality health care services;
            ``(7) providing technical assistance, training, and 
        organizational support for patient advocates; and
            ``(8) creating, operating, and participating in State or 
        regional networks of patient advocates.
    ``(d) Requirements of Grantees.--
            ``(1) Limitation on administrative expenses.--A grantee 
        shall not use more than 5 percent of the amounts received under 
        a grant under this section for administrative expenses.
            ``(2) Contribution of funds.--A grantee under this section, 
        and any entity receiving assistance under the grant for 
        training and education, shall contribute non-Federal funds, 
        either directly or through in-kind contributions, to the costs 
        of the activities to be funded under the grant in an amount 
        that is not less than 75 percent of the total cost of such 
        activities.
            ``(3) Reporting to secretary.--A grantee under this section 
        shall submit to the Secretary a report, at such time, in such 
        manner, and containing such information as the Secretary may 
        require, including a description and evaluation of the 
        activities described in subsection (c) carried out by such 
        entity.
    ``(e) Eating Disorder.--In this section, the term `eating disorder' 
has the meaning given such term in section 399OO(e).
    ``(f) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2011 through 2015.''.
                                 <all>
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