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(4) an assessment of the number of education 
days gained by students as a result of seasonal vac-
cinations based on absenteeism rates; 
(5) a determination of whether the program 
under this section— 
(A) increased vaccination rates in the par-
ticipating localities; and 
(B) was implemented for sufficient time 
for gathering enough valid data; and 
(6) a recommendation on whether the program 
should be continued, expanded, or terminated. 
(k) DEFINITIONS.—In this section: 
(1) ELIGIBLE PARTNERSHIP.—The term ‘‘eligi-
ble partnership’’ means a local public health depart-
ment, or another health organization defined by the 
Secretary as eligible to submit an application, and 
one or more elementary and secondary schools. 
(2) ELEMENTARY
SCHOOL.—The terms ‘‘ele-
mentary school’’ and ‘‘secondary school’’ have the 
meanings given such terms in section 9101 of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(3) LOW-INCOME.—The term ‘‘low-income’’ 
means a student, age 5 through 19, eligible for free 
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or reduced-price lunch under the National School 
Lunch Act (42 U.S.C. 1751 et seq.). 
(4) RURAL
LOCAL
EDUCATIONAL
AGENCY.— 
The term ‘‘rural local educational agency’’ means an 
eligible local educational agency described in section 
6211(b)(1) of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 7345(b)(1)). 
(5) SECRETARY.—Except as otherwise speci-
fied, the term ‘‘Secretary’’ means the Secretary of 
Health and Human Services. 
(l) 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. 2525. EXTENSION OF WISEWOMAN PROGRAM. 
Section 1509 of the Public Health Service Act (42 
U.S.C. 300n–4a) is amended— 
(1) in subsection (a)— 
(A) by striking the heading and inserting 
‘‘IN GENERAL.—’’; and 
(B) in the matter preceding paragraph (1), 
by striking ‘‘may make grants’’ and all that fol-
lows through ‘‘purpose’’ and inserting the fol-
lowing: ‘‘may make grants to such States for 
the purpose’’; and 
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(2) in subsection (d)(1), by striking ‘‘there are 
authorized’’ and all that follows through the period 
and inserting ‘‘there are authorized to be appro-
priated 
$70,000,000 
for 
fiscal 
year 
2011, 
$73,500,000 for fiscal year 2012, $77,000,000 for 
fiscal year 2013, $81,000,000 for fiscal year 2014, 
and $85,000,000 for fiscal year 2015.’’. 
SEC. 2526. HEALTHY TEEN INITIATIVE TO PREVENT TEEN 
PREGNANCY. 
Part B of title III (42 U.S.C. 243 et seq.) is amended 
by inserting after section 317T the following: 
‘‘SEC. 317U. HEALTHY TEEN INITIATIVE TO PREVENT TEEN 
PREGNANCY. 
‘‘(a) PROGRAM.—To the extent and in the amount 
of appropriations made in advance in appropriations Acts, 
the Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, shall establish a pro-
gram consisting of making grants, in amounts determined 
under subsection (c), to each State that submits an appli-
cation in accordance with subsection (d) for an evidence- 
based education program described in subsection (b). 
‘‘(b) USE OF FUNDS.—Amounts received by a State 
under this section shall be used to conduct or support evi-
dence-based education programs (directly or through 
grants or contracts to public or private nonprofit entities, 
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including schools and community-based and faith-based 
organizations) to reduce teen pregnancy or sexually trans-
mitted diseases. 
‘‘(c) DISTRIBUTION OF FUNDS.—The Director shall, 
for fiscal year 2011 and each subsequent fiscal year, make 
a grant to each State described in subsection (a) in an 
amount equal to the product of— 
‘‘(1) the amount appropriated to carry out this 
section for the fiscal year; and 
‘‘(2) the percentage determined for the State 
under section 502(c)(1)(B)(ii) of the Social Security 
Act. 
‘‘(d) APPLICATION.—To seek a grant under this sec-
tion, a State shall submit an application at such time, in 
such manner, and containing such information and assur-
ance of compliance with this section as the Secretary may 
require. At a minimum, an application shall to the satis-
faction of the Secretary— 
‘‘(1) describe how the State’s proposal will ad-
dress the needs of at-risk teens in the State; 
‘‘(2) identify the evidence-based education pro-
gram or programs selected from the registry devel-
oped under subsection (g) that will be used to ad-
dress risks in priority populations; 
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‘‘(3) describe how the program or programs will 
be implemented and any adaptations to the evidence- 
based model that will be made; 
‘‘(4) list any private and public entities with 
whom the State proposes to work, including schools 
and community-based and faith-based organizations, 
and demonstrate their capacity to implement the 
proposed program or programs; and 
‘‘(5) identify an independent entity that will 
evaluate the impact of the program or programs. 
‘‘(e) EVALUATION.— 
‘‘(1) REQUIREMENT.—As a condition on receipt 
of a grant under this section, a State shall agree— 
‘‘(A) to arrange for an independent evalua-
tion of the impact of the programs to be con-
ducted or supported through the grant; and 
‘‘(B) submit reports to the Secretary on 
such programs and the results of evaluation of 
such programs. 
‘‘(2) FUNDING LIMITATION.—Of the amounts 
made available to a State through a grant under this 
section for any fiscal year, not more than 10 percent 
may be used for such evaluation. 
‘‘(f) RULE OF CONSTRUCTION.—This section shall 
not be construed to preempt or limit any State law regard-
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ing parental involvement and decisionmaking in children’s 
education. 
‘‘(g) REGISTRY OF ELIGIBLE PROGRAMS.—The Sec-
retary shall develop not later than 180 days after the date 
of the enactment of the Affordable Health Care for Amer-
ica Act, and periodically update thereafter, a publicly 
available registry of programs described in subsection (b) 
that, as determined by the Secretary— 
‘‘(1) meet the definition of the term ‘evidence- 
based’ in subsection (i); 
‘‘(2) are medically and scientifically accurate; 
and 
‘‘(3) provide age-appropriate information. 
‘‘(h) MATCHING FUNDS.—The Secretary may award 
a grant to a State under this section for a fiscal year only 
if the State agrees to provide, from non-Federal sources, 
an amount equal to $1 (in cash or in kind) for each $4 
provided through the grant to carry out the activities sup-
ported by the grant. 
‘‘(i) DEFINITION.—In this section, the term ‘evi-
dence-based’ means based on a model that has been found, 
in methodologically sound research— 
‘‘(1) to delay initiation of sex; 
‘‘(2) to decrease number of partners; 
‘‘(3) to reduce teen pregnancy; 
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‘‘(4) to reduce sexually transmitted infection 
rates; or 
‘‘(5) to improve rates of contraceptive use. 
‘‘(j) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $50,000,000 for each of fiscal years 2011 through 
2015.’’. 
SEC. 2527. NATIONAL TRAINING INITIATIVES ON AUTISM 
SPECTRUM DISORDERS. 
Title I of the Developmental Disabilities Assistance 
and Bill of Rights Act of 2000 (42 U.S.C. 15001 et seq.) 
is amended by adding at the end the following: 
‘‘Subtitle F—National Training Ini-
tiative on Autism Spectrum Dis-
orders 
‘‘SEC. 171. NATIONAL TRAINING INITIATIVE. 
‘‘(a) GRANTS AND TECHNICAL ASSISTANCE.— 
‘‘(1) GRANTS.— 
‘‘(A) IN GENERAL.—The Secretary, in con-
sultation with the Interagency Autism Coordi-
nating Committee, shall award multiyear grants 
to eligible entities to provide individuals (includ-
ing parents and health, allied health, vocational, 
and educational professionals) with interdiscipli-
nary training, continuing education, technical 
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assistance, and information for the purpose of 
improving services rendered to children and 
adults with autism, and their families, to ad-
dress unmet needs related to autism. 
‘‘(B) ELIGIBLE ENTITY.—To be eligible to 
receive a grant under this subsection, an entity 
shall be— 
‘‘(i) a University Center for Excel-
lence in Developmental Disabilities Edu-
cation, Research, and Service; or 
‘‘(ii) a comparable interdisciplinary 
education, research, and service entity. 
‘‘(C) APPLICATION
REQUIREMENTS.—An 
entity that desires to receive a grant for a pro-
gram under this paragraph shall submit to the 
Secretary an application— 
‘‘(i) demonstrating that the entity has 
capacity to— 
‘‘(I) provide training and tech-
nical assistance in evidence-based 
practices to evaluate, and provide ef-
fective interventions, services, treat-
ments, and supports to, children and 
adults with autism and their families; 
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‘‘(II) include individuals with au-
tism and their families as part of the 
program to ensure that an individual- 
and family-centered approach is used; 
‘‘(III) share and disseminate ma-
terials and practices that are devel-
oped for, and evaluated to be effective 
in, the provision of training and tech-
nical assistance; and 
‘‘(IV) provide training, technical 
assistance, 
interventions, 
services, 
treatments, and supports under this 
subsection statewide. 
‘‘(ii) providing assurances that the en-
tity will— 
‘‘(I) provide trainees under this 
subsection with an appropriate bal-
ance of interdisciplinary academic and 
community-based experiences; and 
‘‘(II) provide to the Secretary, in 
the manner prescribed by the Sec-
retary, data regarding the number of 
individuals who have benefitted from, 
and outcomes of, the provision of 
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training 
and 
technical 
assistance 
under this subsection; 
‘‘(iii) providing assurances that train-
ing, technical assistance, dissemination of 
information, and services under this sub-
section will be— 
‘‘(I) consistent with the goals of 
this Act, the Americans with Disabil-
ities Act of 1990, the Individuals with 
Disabilities Education Act, and the 
Elementary and Secondary Education 
Act of 1965; and 
‘‘(II) conducted in coordination 
with relevant State agencies, institu-
tions of higher education, and service 
providers; and 
‘‘(iv) containing such other informa-
tion and assurances as the Secretary may 
require. 
‘‘(D) USE OF FUNDS.—A grant received 
under this subsection shall be used to provide 
individuals (including parents and health, allied 
health, vocational, and educational profes-
sionals) with interdisciplinary training, con-
tinuing education, technical assistance, and in-
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formation for the purpose of improving services 
rendered to children and adults with autism, 
and their families, to address unmet needs re-
lated to autism. Such training, education, as-
sistance, and information shall include each of 
the following: 
‘‘(i) Training health, allied health, vo-
cational, and educational professionals to 
identify, evaluate the needs of, and develop 
interventions, services, treatments, and 
supports for, children and adults with au-
tism. 
‘‘(ii) Developing model services and 
supports that demonstrate evidence-based 
practices. 
‘‘(iii) Developing systems and prod-
ucts that allow for the interventions, serv-
ices, treatments, and supports to be evalu-
ated for fidelity of implementation. 
‘‘(iv) Working to expand the avail-
ability of evidence-based, lifelong interven-
tions; educational, employment, and transi-
tion services; and community supports. 
‘‘(v) Providing statewide technical as-
sistance in collaboration with relevant 
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State agencies, institutions of higher edu-
cation, autism advocacy groups, and com-
munity-based service providers. 
‘‘(vi) Working to develop comprehen-
sive systems of supports and services for 
individuals with autism and their families, 
including seamless transitions between 
education and health systems across the 
lifespan. 
‘‘(vii) Promoting training, technical 
assistance, dissemination of information, 
supports, and services. 
‘‘(viii) Developing mechanisms to pro-
vide training and technical assistance, in-
cluding for-credit courses, intensive sum-
mer institutes, continuing education pro-
grams, distance based programs, and Web- 
based information dissemination strategies. 
‘‘(ix) Promoting activities that sup-
port community-based family and indi-
vidual services and enable individuals with 
autism and related developmental disabil-
ities to fully participate in society and 
achieve good quality-of-life outcomes. 
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‘‘(x) Collecting data on the outcomes 
of training and technical assistance pro-
grams to meet statewide needs for the ex-
pansion of services to children and adults 
with autism. 
‘‘(E) AMOUNT OF GRANTS.—The amount 
of a grant to any entity for a fiscal year under 
this section shall be not less than $250,000. 
‘‘(2) TECHNICAL ASSISTANCE.—The Secretary 
shall reserve 2 percent of the amount appropriated 
to carry out this subsection for a fiscal year to make 
a grant to a national organization with dem-
onstrated capacity for providing training and tech-
nical assistance to— 
‘‘(A) assist in national dissemination of 
specific information, including evidence-based 
best practices, from interdisciplinary training 
programs, and when appropriate, other entities 
whose findings would inform the work per-
formed by entities awarded grants; 
‘‘(B) compile and disseminate strategies 
and materials that prove to be effective in the 
provision of training and technical assistance so 
that the entire network can benefit from the 
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models, materials, and practices developed in 
individual centers; 
‘‘(C) assist in the coordination of activities 
of grantees under this subsection; 
‘‘(D) develop a Web portal that will pro-
vide linkages to each of the individual training 
initiatives and provide access to training mod-
ules, promising training, and technical assist-
ance practices and other materials developed by 
grantees; 
‘‘(E) serve as a research-based resource for 
Federal and State policymakers on information 
concerning the provision of training and tech-
nical assistance for the assessment, and provi-
sion of supports and services for, children and 
adults with autism; 
‘‘(F) convene experts from multiple inter-
disciplinary training programs, individuals with 
autism, and the families of such individuals to 
discuss and make recommendations with regard 
to training issues related to assessment, inter-
ventions, services, treatment, and supports for 
children and adults with autism; and 
‘‘(H) undertake any other functions that 
the Secretary determines to be appropriate. 
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‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there are authorized to 
be appropriated $17,000,000 for fiscal year 2011 
and such sums as may be necessary for each of fis-
cal years 2012 through 2015. 
‘‘(b) EXPANSION OF THE NUMBER OF UNIVERSITY 
CENTERS FOR EXCELLENCE IN DEVELOPMENTAL DIS-
ABILITIES EDUCATION, RESEARCH, AND SERVICE.— 
‘‘(1) GRANTS.—To provide for the establish-
ment of up to 4 new University Centers for Excel-
lence in Developmental Disabilities Education, Re-
search, and Service, the Secretary shall award up to 
4 grants to institutions of higher education. 
‘‘(2) APPLICABLE
PROVISIONS.—Except for 
subsection (a)(3), the provisions of subsection (a) 
shall apply with respect to grants under this sub-
section to the same extent and in the same manner 
as such provisions apply with respect to grants 
under subsection (a). 
‘‘(3) PRIORITY.—In awarding grants under this 
subsection, the Secretary shall give priority to appli-
cants that— 
‘‘(A) are minority institutions that have 
demonstrated capacity to meet the requirements 
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of this section and provide services to individ-
uals with autism and their families; or 
‘‘(B) are located in a State with one or 
more underserved populations. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there is authorized to 
be appropriated $2,000,000 for each of fiscal years 
2011 through 2015. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) The term ‘autism’ means an autism spec-
trum disorder or a related developmental disability. 
‘‘(2) The term ‘interventions’ means edu-
cational methods and positive behavioral support 
strategies designed to improve or ameliorate symp-
toms associated with autism. 
‘‘(3) The term ‘minority institution’ has the 
meaning given to such term in section 365 of the 
Higher Education Act of 1965. 
‘‘(4) The term ‘services’ means services to as-
sist individuals with autism to live more independ-
ently in their communities. 
‘‘(5) The term ‘treatments’ means health serv-
ices, including mental health services, designed to 
improve or ameliorate symptoms associated with au-
tism. 
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‘‘(6) The term ‘University Center for Excellence 
in Developmental Disabilities Education, Research, 
and Service’ means a University Center for Excel-
lence in Development Disabilities Education, Re-
search, and Service that has been or is funded 
through subtitle D or subsection (b).’’. 
SEC. 2528. IMPLEMENTATION OF MEDICATION MANAGE-
MENT SERVICES IN TREATMENT OF CHRONIC 
DISEASES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Director of the Agency for 
Health Care Research and Quality, shall establish a pro-
gram to provide grants to eligible entities to implement 
medication management services (referred to in this sec-
tion as ‘‘MTM services’’) provided by licensed phar-
macists, as a part of a collaborative, multidisciplinary, 
interprofessional approach to the treatment of chronic dis-
eases for targeted individuals, to improve the quality of 
care and reduce overall cost in the treatment of such dis-
eases. The Secretary shall commence the grant program 
not later than May 1, 2011. 
(b) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under subsection (a), an entity shall— 
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(1) provide a setting appropriate for MTM serv-
ices, as recommended by the experts described in 
subsection (e); 
(2) submit to the Secretary a plan for achieving 
long-term financial sustainability; 
(3) where applicable, submit a plan for coordi-
nating MTM services with other local providers and 
where applicable, through or in collaboration with 
the Medicare Medical Home Pilot program as estab-
lished by section 1866F of the Social Security Act, 
as added by section 1302(a) of this Act; 
(4) submit a plan for meeting the requirements 
under subsection (c); and 
(5) submit to the Secretary such other informa-
tion as the Secretary may require. 
(c) MTM SERVICES TO TARGETED INDIVIDUALS.— 
The MTM services provided with the assistance of a grant 
awarded under subsection (a) shall, as allowed by State 
law (including applicable collaborative pharmacy practice 
agreements), include— 
(1) performing or obtaining necessary assess-
ments of the health and functional status of each 
patient receiving such MTM services; 
(2) formulating a medication treatment plan ac-
cording to therapeutic goals agreed upon by the pre-
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scriber and the patient or caregiver or authorized 
representative of the patient; 
(3) selecting, initiating, modifying, recom-
mending changes to, or administering medication 
therapy; 
(4) monitoring, which may include access to, or-
dering, or performing laboratory assessments, and 
evaluating the response of the patient to therapy, in-
cluding safety and effectiveness; 
(5) performing an initial comprehensive medica-
tion review to identify, resolve, and prevent medica-
tion-related problems, including adverse drug events, 
quarterly targeted medication reviews for ongoing 
monitoring, and additional followup interventions on 
a schedule developed collaboratively with the pre-
scriber; 
(6) documenting the care delivered and commu-
nicating essential information about such care (in-
cluding a summary of the medication review) and 
the recommendations of the pharmacist to other ap-
propriate health care providers of the patient in a 
timely fashion; 
(7) providing education and training designed 
to enhance the understanding and appropriate use of 
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the medications by the patient, caregiver, and other 
authorized representative; 
(8) providing information, support services, and 
resources and strategies designed to enhance patient 
adherence with therapeutic regimens; 
(9) coordinating and integrating MTM services 
within the broader health care management services 
provided to the patient; and 
(10) such other patient care services as are al-
lowed under the scopes of practice for pharmacists 
for purposes of other Federal programs. 
(d) TARGETED INDIVIDUALS.—MTM services pro-
vided by licensed pharmacists under a grant awarded 
under subsection (a) shall be offered to targeted individ-
uals who— 
(1) take 4 or more prescribed medications (in-
cluding over-the-counter and dietary supplements); 
(2) take any high-risk medications; 
(3) have 2 or more chronic diseases, as identi-
fied by the Secretary; or 
(4) have undergone a transition of care, or 
other factors, as determined by the Secretary, that 
are likely to create a high risk of medication-related 
problems. 
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(e) CONSULTATION WITH EXPERTS.—In designing 
and implementing MTM services provided under grants 
awarded under subsection (a), the Secretary shall consult 
with Federal, State, private, public-private, and academic 
entities, pharmacy and pharmacist organizations, health 
care organizations, consumer advocates, chronic disease 
groups, and other stakeholders involved with the research, 
dissemination, and implementation of pharmacist-deliv-
ered MTM services, as the Secretary determines appro-
priate. The Secretary, in collaboration with this group, 
shall determine whether it is possible to incorporate rapid 
cycle process improvement concepts in use in other Fed-
eral programs that have implemented MTM services. 
(f) REPORTING TO THE SECRETARY.—An entity that 
receives a grant under subsection (a) shall submit to the 
Secretary a report that describes and evaluates, as re-
quested by the Secretary, the activities carried out under 
subsection (c), including quality measures, as determined 
by the Secretary. 
(g) EVALUATION AND REPORT.—The Secretary shall 
submit to the relevant committees of Congress a report 
which shall— 
(1) assess the clinical effectiveness of phar-
macist-provided services under the MTM services 
program, as compared to usual care, including an 
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evaluation of whether enrollees maintained better 
health with fewer hospitalizations and emergency 
room visits than similar patients not enrolled in the 
program; 
(2) assess changes in overall health care re-
source of targeted individuals; 
(3) assess patient and prescriber satisfaction 
with MTM services; 
(4) assess the impact of patient-cost-sharing re-
quirements on medication adherence and rec-
ommendations for modifications; 
(5) identify and evaluate other factors that may 
impact clinical and economic outcomes, including de-
mographic characteristics, clinical characteristics, 
and health services use of the patient, as well as 
characteristics of the regimen, pharmacy benefit, 
and MTM services provided; and 
(6) evaluate the extent to which participating 
pharmacists who maintain a dispensing role have a 
conflict of interest in the provision of MTM services, 
and if such conflict is found, provide recommenda-
tions on how such a conflict might be appropriately 
addressed. 
(h) GRANT TO FUND DEVELOPMENT OF PERFORM-
ANCE MEASURES.—The Secretary may award grants or 
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contracts to eligible entities for the purpose of funding the 
development of performance measures that assess the use 
and effectiveness of medication therapy management serv-
ices. 
SEC. 2529. POSTPARTUM DEPRESSION. 
(a) EXPANSION AND INTENSIFICATION OF ACTIVI-
TIES.— 
(1) CONTINUATION OF ACTIVITIES.—The Sec-
retary is encouraged to expand and intensify activi-
ties on postpartum conditions. 
(2) 
PROGRAMS
FOR
POSTPARTUM
CONDI-
TIONS.—In carrying out paragraph (1), the Sec-
retary is encouraged to continue research to expand 
the understanding of the causes of, and treatments 
for, postpartum conditions, including conducting and 
supporting the following: 
(A) Basic research concerning the etiology 
and causes of the conditions. 
(B) Epidemiological studies to address the 
frequency and natural history of the conditions 
and the differences among racial and ethnic 
groups with respect to the conditions. 
(C) The development of improved screen-
ing and diagnostic techniques. 
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(D) Clinical research for the development 
and evaluation of new treatments. 
(E) Information and education programs 
for health professionals and the public, which 
may include a coordinated national campaign 
that— 
(i) is designed to increase the aware-
ness and knowledge of postpartum condi-
tions; 
(ii) may include public service an-
nouncements through television, radio, and 
other means; and 
(iii) may focus on— 
(I) 
raising 
awareness 
about 
screening; 
(II) educating new mothers and 
their families about postpartum condi-
tions to promote earlier diagnosis and 
treatment; and 
(III) ensuring that such edu-
cation includes complete information 
concerning postpartum conditions, in-
cluding its symptoms, methods of cop-
ing with the illness, and treatment re-
sources. 
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(b) REPORT BY THE SECRETARY.— 
(1) STUDY.—The Secretary shall conduct a 
study on the benefits of screening for postpartum 
conditions. 
(2) REPORT.—Not later than 2 years after the 
date of the enactment of this Act, the Secretary 
shall complete the study required by paragraph (1) 
and submit a report to the Congress on the results 
of such study. 
(c) SENSE
OF CONGRESS REGARDING LONGITU-
DINAL STUDY
OF RELATIVE MENTAL HEALTH CON-
SEQUENCES
FOR
WOMEN
OF
RESOLVING
A
PREG-
NANCY.— 
(1) SENSE OF CONGRESS.—It is the sense of 
the Congress that the Director of the National Insti-
tute of Mental Health may conduct a nationally rep-
resentative longitudinal study (during the period of 
fiscal years 2011 through 2020) on the relative men-
tal health consequences for women of resolving a 
pregnancy (intended and unintended) in various 
ways, including carrying the pregnancy to term and 
parenting the child, carrying the pregnancy to term 
and placing the child for adoption, miscarriage, and 
having an abortion. This study may assess the inci-
dence, timing, magnitude, and duration of the imme-
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diate and long-term mental health consequences 
(positive or negative) of these pregnancy outcomes. 
(2) REPORT.—Beginning not later than 3 years 
after the date of the enactment of this Act, and peri-
odically thereafter for the duration of the study, 
such Director may prepare and submit to the Con-
gress reports on the findings of the study. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘postpartum condition’’ means 
postpartum depression or postpartum psychosis. 
(2) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, in addition to any 
other amounts authorized to be appropriated for such pur-
pose, there are authorized to be appropriated such sums 
as may be necessary for each of fiscal years 2011 through 
2013. 
SEC. 2530. GRANTS TO PROMOTE POSITIVE HEALTH BEHAV-
IORS AND OUTCOMES. 
Part P of title III (42 U.S.C. 280g et seq.) is amend-
ed by adding at the end the following: 
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‘‘SEC. 399V. GRANTS TO PROMOTE POSITIVE HEALTH BE-
HAVIORS AND OUTCOMES. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary, in col-
laboration with the Director of the Centers for Disease 
Control and Prevention and other Federal officials deter-
mined appropriate by the Secretary, is authorized to 
award grants to eligible entities to promote positive health 
behaviors for populations in medically underserved com-
munities through the use of community health workers. 
‘‘(b) USE OF FUNDS.—Grants awarded under sub-
section (a) shall be used to support community health 
workers— 
‘‘(1) to educate, guide, and provide outreach in 
a community setting regarding health problems prev-
alent in medically underserved communities, espe-
cially racial and ethnic minority populations; 
‘‘(2) to educate, guide, and provide experiential 
learning opportunities that target behavioral risk 
factors including— 
‘‘(A) poor nutrition; 
‘‘(B) physical inactivity; 
‘‘(C) being overweight or obese; 
‘‘(D) tobacco use; 
‘‘(E) alcohol and substance use; 
‘‘(F) injury and violence; 
‘‘(G) risky sexual behavior; 
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‘‘(H) untreated mental health problems; 
‘‘(I) untreated dental and oral health prob-
lems; and 
‘‘(J) understanding informed consent; 
‘‘(3) to educate and provide guidance regarding 
effective strategies to promote positive health behav-
iors within the family; 
‘‘(4) to educate and provide outreach regarding 
enrollment in health insurance including the State 
Children’s Health Insurance Program under title 
XXI of the Social Security Act, Medicare under title 
XVIII of such Act, and Medicaid under title XIX of 
such Act; 
‘‘(5) to educate and refer underserved popu-
lations to appropriate health care agencies and com-
munity-based programs and organizations in order 
to increase access to quality health care services, in-
cluding preventive health services, and to eliminate 
duplicative care; or 
‘‘(6) to educate, guide, and provide home visita-
tion services regarding maternal health and prenatal 
care. 
‘‘(c) APPLICATION.— 
‘‘(1) IN
GENERAL.—Each eligible entity that 
desires to receive a grant under subsection (a) shall 
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submit an application to the Secretary, at such time, 
in such manner, and accompanied by such informa-
tion as the Secretary may require. 
‘‘(2) CONTENTS.—Each application submitted 
pursuant to paragraph (1) shall— 
‘‘(A) describe the activities for which as-
sistance is sought under this section; 
‘‘(B) contain an assurance that, with re-
spect to each community health worker pro-
gram receiving funds under the grant, such pro-
gram will provide training and supervision to 
community health workers to enable such work-
ers to provide authorized program services; 
‘‘(C) contain an assurance that the appli-
cant will evaluate the effectiveness of commu-
nity health worker programs receiving funds 
under the grant; 
‘‘(D) contain an assurance that each com-
munity health worker program receiving funds 
under the grant will provide services in the cul-
tural context most appropriate for the individ-
uals served by the program; 
‘‘(E) contain a plan to document and dis-
seminate project descriptions and results to 
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other States and organizations as identified by 
the Secretary; and 
‘‘(F) describe plans to enhance the capac-
ity of individuals to utilize health services and 
health-related social services under Federal, 
State, and local programs by— 
‘‘(i) assisting individuals in estab-
lishing eligibility under the programs and 
in receiving the services or other benefits 
of the programs; and 
‘‘(ii) providing other services as the 
Secretary determines to be appropriate, 
that may include transportation and trans-
lation services. 
‘‘(d) PRIORITY.—In awarding grants under sub-
section (a), the Secretary shall give priority to applicants 
that— 
‘‘(1) propose to target geographic areas— 
‘‘(A) with a high percentage of residents 
who are eligible for health insurance but are 
uninsured or underinsured; 
‘‘(B) with a high percentage of residents 
who suffer from chronic diseases including pul-
monary conditions, hypertension, heart disease, 
mental disorders, diabetes, and asthma; and 
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‘‘(C) with a high infant mortality rate; 
‘‘(2) have experience in providing health or 
health-related social services to individuals who are 
underserved with respect to such services; and 
‘‘(3) have documented community activity and 
experience with community health workers. 
‘‘(e) COLLABORATION WITH ACADEMIC INSTITU-
TIONS.—The Secretary shall encourage community health 
worker programs receiving funds under this section to col-
laborate with academic institutions, especially those that 
graduate a disproportionate number of health and health 
care students from underrepresented racial and ethnic mi-
nority backgrounds. Nothing in this section shall be con-
strued to require such collaboration. 
‘‘(f) EVIDENCE-BASED INTERVENTIONS.—The Sec-
retary shall encourage community health worker programs 
receiving funding under this section to implement an out-
come-based payment system that rewards community 
health workers for connecting underserved populations 
with the most appropriate services at the most appropriate 
time. Nothing in this section shall be construed to require 
such payment. 
‘‘(g) QUALITY ASSURANCE AND COST EFFECTIVE-
NESS.—The Secretary shall establish guidelines for assur-
ing the quality of the training and supervision of commu-
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nity health workers under the programs funded under this 
section and for assuring the cost-effectiveness of such pro-
grams. 
‘‘(h) MONITORING.—The Secretary shall monitor 
community health worker programs identified in approved 
applications under this section and shall determine wheth-
er such programs are in compliance with the guidelines 
established under subsection (g). 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to community health worker 
programs identified in approved applications under this 
section with respect to planning, developing, and operating 
programs under the grant. 
‘‘(j) REPORT TO CONGRESS.— 
‘‘(1) IN
GENERAL.—Not later than 4 years 
after the date on which the Secretary first awards 
grants under subsection (a), the Secretary shall sub-
mit to Congress a report regarding the grant 
project. 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
‘‘(A) A description of the programs for 
which grant funds were used. 
‘‘(B) The number of individuals served 
under such programs. 
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‘‘(D) by providing culturally and linguis-
tically appropriate health or nutrition edu-
cation; 
‘‘(E) by advocating for individual and com-
munity health, including oral and mental, or 
nutrition needs; and 
‘‘(F) by providing referral and followup 
services or otherwise coordinating care. 
‘‘(2) COMMUNITY SETTING.—The term ‘commu-
nity setting’ means a home or a community organi-
zation located in the neighborhood in which a partic-
ipant resides. 
‘‘(3) MEDICALLY UNDERSERVED COMMUNITY.— 
The term ‘medically underserved community’ means 
a community identified by a State, United States 
territory or possession, or federally recognized In-
dian tribe— 
‘‘(A) that has a substantial number of in-
dividuals who are members of a medically un-
derserved population, as defined by section 
330(b)(3); and 
‘‘(B) a significant portion of which is a 
health professional shortage area as designated 
under section 332. 
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‘‘(4) SUPPORT.—The term ‘support’ means the 
provision of training, supervision, and materials 
needed to effectively deliver the services described in 
subsection (b), reimbursement for services, and 
other benefits. 
‘‘(5) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means a public or private nonprofit entity (in-
cluding a State or public subdivision of a State, a 
public health department, or a federally qualified 
health center), or a consortium of any of such enti-
ties, located in the United States or territory there-
of. 
‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$30,000,000 for each of fiscal years 2011 through 2015.’’. 
SEC. 2531. MEDICAL LIABILITY ALTERNATIVES. 
(a) INCENTIVE PAYMENTS FOR MEDICAL LIABILITY 
REFORM.— 
(1) IN GENERAL.—To the extent and in the 
amounts made available in advance in appropriations 
Acts, the Secretary shall make an incentive payment, 
in an amount determined by the Secretary, to each 
State that has an alternative medical liability law in 
compliance with this section. 
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(2) DETERMINATION
BY
SECRETARY.—The 
Secretary shall determine that a State has an alter-
native medical liability law in compliance with this 
section if the Secretary is satisfied that— 
(A) the State enacted the law after the 
date of the enactment of this Act and is imple-
menting the law; 
(B) the law is effective; and 
(C) the contents of the law are in accord-
ance with paragraph (4). 
(3) CONSIDERATIONS
FOR
DETERMINING
EF-
FECTIVENESS.—In determining whether an alter-
native medical liability law is effective under para-
graph (2)(B), the Secretary shall consider whether 
the law— 
(A) makes the medical liability system 
more reliable through prevention of, or prompt 
and fair resolution of, disputes; 
(B) encourages the disclosure of health 
care errors; and 
(C) maintains access to affordable liability 
insurance. 
(4) CONTENTS OF ALTERNATIVE MEDICAL LI-
ABILITY LAW.—The contents of an alternative liabil-
ity law are in accordance with this paragraph if— 
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(A) the litigation alternatives contained in 
the law consist of certificate of merit, early 
offer, or both; and 
(B) the law does not limit attorneys’ fees 
or impose caps on damages. 
(5) NO LIMITATION ON OTHER STATE LAWS.— 
Nothing in this section shall be construed to— 
(A) preempt or modify the application of 
any existing State law that limits attorneys’ 
fees or imposes caps on damages; 
(B) impair the authority of a State to es-
tablish or implement a law limiting attorneys’ 
fees or imposing caps on damages; or 
(C) restrict the eligibility of a State for an 
incentive payment under this section on the 
basis of a law described in subparagraph (A) or 
(B) so long as any such law is not established 
or implemented as part of the law described in 
paragraph (4), as determined by the Secretary. 
(b) USE OF INCENTIVE PAYMENTS.—Amounts re-
ceived by a State as an incentive payment under this sec-
tion shall be used to improve health care in that State. 
(c) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to the States applying for or 
receiving an incentive payment under this section. 
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(d) REPORTS.—Beginning not later than one year 
after the date of the enactment of this Act, the Secretary 
shall submit to the Congress an annual report on the 
progress States have made in enacting and implementing 
alternative medical liability laws in compliance with this 
section. Such reports shall contain sufficient documenta-
tion regarding the effectiveness of such laws to enable an 
objective comparative analysis of such laws. 
(e) DEFINITION.—In this section— 
(1) the term ‘‘Secretary’’ means the Secretary 
of Health and Human Services; and 
(2) the term ‘‘State’’ includes the several 
States, District of Columbia, the Commonwealth of 
Puerto Rico, and each other territory or possession 
of the United States. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary, to remain available until 
expended. 
SEC. 2532. INFANT MORTALITY PILOT PROGRAMS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Director, shall award grants 
to eligible entities to create, implement, and oversee infant 
mortality pilot programs. 
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(b) PERIOD OF A GRANT.—The period of a grant 
under this section shall be 5 consecutive fiscal years. 
(c) PREFERENCE.—In awarding grants under this 
section, the Secretary shall give preference to eligible enti-
ties proposing to serve any of the 15 counties or groups 
of counties with the highest rates of infant mortality in 
the United States in the past 3 years. 
(d) USE OF FUNDS.—Any infant mortality pilot pro-
gram funded under this section may— 
(1) include the development of a plan that iden-
tifies the individual needs of each community to be 
served and strategies to address those needs; 
(2) provide outreach to at-risk mothers through 
programs deemed appropriate by the Director; 
(3) develop and implement standardized sys-
tems for improved access, utilization, and quality of 
social, educational, and clinical services to promote 
healthy pregnancies, full term births, and healthy in-
fancies delivered to women and their infants, such 
as— 
(A) counseling on infant care, feeding, and 
parenting; 
(B) postpartum care; 
(C) prevention of premature delivery; and 
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(D) additional counseling for at-risk moth-
ers, including smoking cessation programs, 
drug treatment programs, alcohol treatment 
programs, nutrition and physical activity pro-
grams, postpartum depression and domestic vio-
lence programs, social and psychological serv-
ices, dental care, and parenting programs; 
(4) establish a rural outreach program to pro-
vide care to at-risk mothers in rural areas; 
(5) establish a regional public education cam-
paign, including a campaign to— 
(A) prevent preterm births; and 
(B) educate the public about infant mor-
tality; and 
(6) provide for any other activities, programs, 
or strategies as identified by the community plan. 
(e) LIMITATION.—Of the funds received through a 
grant under this section for a fiscal year, an eligible entity 
shall not use more than 10 percent for program evalua-
tion. 
(f) REPORTS ON PILOT PROGRAMS.— 
(1) IN GENERAL.—Not later than 1 year after 
receiving a grant, and annually thereafter for the 
duration of the grant period, each entity that re-
ceives a grant under subsection (a) shall submit a 
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report to the Secretary detailing its infant mortality 
pilot program. 
(2) CONTENTS OF REPORT.—The reports re-
quired under paragraph (1) shall include informa-
tion such as the methodology of, and outcomes and 
statistics from, the grantee’s infant mortality pilot 
program. 
(3) EVALUATION.—The Secretary shall use the 
reports required under paragraph (1) to evaluate, 
and conduct statistical research on, infant mortality 
pilot programs funded through this section. 
(g) DEFINITIONS.—For the purposes of this section: 
(1) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Centers for Disease Control and 
Prevention. 
(2) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a State, county, city, territorial, or tribal 
health department that has submitted a proposal to 
the Secretary that the Secretary deems likely to re-
duce infant mortality rates within the standard met-
ropolitan statistical area involved. 
(3) TRIBAL.—The term ‘‘tribal’’ refers to an 
Indian tribe, a Tribal organization, or an Urban In-
dian organization, as such terms are defined in sec-
tion 4 of the Indian Health Care Improvement Act. 
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(h) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$10,000,000 for each of fiscal years 2011 through 2015. 
SEC. 2533. SECONDARY SCHOOL HEALTH SCIENCES TRAIN-
ING PROGRAM. 
(a) PROGRAM.—The Secretary of Health and Human 
Services, acting through the Administrator of the Health 
Resources and Services Administration, and in consulta-
tion with the Secretary of Education, may establish a 
health sciences training program consisting of awarding 
grants and contracts under subsection (b) to prepare sec-
ondary school students for careers in health professions. 
(b) DEVELOPMENT
AND
IMPLEMENTATION
OF 
HEALTH SCIENCES CURRICULA.—The Secretary may 
make grants to, or enter into contracts with, eligible enti-
ties— 
(1) to plan, develop, or implement secondary 
school health sciences curricula, including curricula 
in biology, chemistry, physiology, mathematics, nu-
trition, and other courses deemed appropriate by the 
Secretary to prepare students for associate’s or 
bachelor’s degree programs in health professions or 
bachelor’s degree programs in health professions-re-
lated majors; and 
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(2) to increase the interest of secondary school 
students in applying to, and enrolling in, accredited 
associate’s or bachelor’s degree programs in health 
professions or bachelor’s degree programs in health 
professions-related majors, including through— 
(A) work-study programs; 
(B) programs to increase awareness of ca-
reers in health professions; and 
(C) other activities to increase such inter-
est. 
(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall— 
(1) be a local educational agency; and 
(2) provide assurances that activities under the 
grant or contract will be carried out in partnership 
with an accredited health professions school or pro-
gram, public or private nonprofit hospital, or public 
or private nonprofit entity. 
(d) PREFERENCE.—In awarding grants and con-
tracts under subsection (b), the Secretary shall give pref-
erence to entities that have a demonstrated record of at 
least one of the following: 
(1) Graduating a high or significantly improved 
percentage of students who have exhibited mastery 
in secondary school State science standards. 
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(2) Graduating students from disadvantaged 
backgrounds, including racial and ethnic minorities 
who are underrepresented in— 
(A) associate’s or bachelor’s degree pro-
grams in health professions or bachelor’s degree 
programs in health professions-related majors; 
or 
(B) health professions. 
(e) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘health profession’’ means the 
profession of any member of the health workforce, 
as defined in section 764(i) of the Public Health 
Service Act, as added by section 2261. 
(2) The term ‘‘local educational agency’’ has 
the meaning given to the term in section 9101 of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(3) The term ‘‘secondary school’’— 
(A) means a secondary school, as defined 
in section 9101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 
7801); and 
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(B) includes any such school that is a mid-
dle school. 
(4) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services except as otherwise 
specified. 
(g) 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. 2534. COMMUNITY-BASED COLLABORATIVE CARE NET-
WORKS. 
(a) PURPOSE.—The purpose of this subtitle is to es-
tablish and provide assistance to community-based col-
laborative care networks— 
(1) to develop or strengthen coordination of 
services to allow all individuals, including the unin-
sured and low-income, to receive efficient and higher 
quality care and to gain entry into and receive serv-
ices from a comprehensive system of care; 
(2) to develop efficient and sustainable infra-
structure for a health care delivery system charac-
terized by effective collaboration, information shar-
ing, and clinical and financial coordination among 
providers of care in the community; 
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(3) to develop or strengthen activities related to 
providing coordinated care for individuals with 
chronic conditions; and 
(4) to reduce the use of emergency depart-
ments, inpatient and other expensive resources of 
hospitals and other providers. 
(b) CREATION
OF
THE COMMUNITY-BASED COL-
LABORATIVE CARE NETWORK PROGRAM.—Part D of title 
III (42 U.S.C. 254b et seq.), as amended, is further 
amended by inserting after subpart XII the following new 
subpart: 
‘‘Subpart XIII—Community-Based Collaborative Care 
Network Program 
‘‘SEC. 340O. COMMUNITY-BASED COLLABORATIVE CARE 
NETWORK PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to eligible entities for the purpose of establishing model 
projects to accomplish the following goals: 
‘‘(1) To reduce unnecessary use of items and 
services furnished in emergency departments of hos-
pitals (especially to ensure that individuals without 
health insurance coverage or with inadequate health 
insurance coverage do not use the services of such 
department instead of the services of a primary care 
provider) through methods such as— 
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‘‘(A) screening individuals who seek emer-
gency department services for possible eligibility 
under relevant governmental health programs 
or for subsidies under such programs; and 
‘‘(B) providing such individuals referrals 
for followup care and chronic condition care. 
‘‘(2) To manage chronic conditions to reduce 
their severity, negative health outcomes, and ex-
pense. 
‘‘(3) To encourage health care providers to co-
ordinate their efforts so that the most vulnerable pa-
tient populations seek and obtain primary care. 
‘‘(4) To provide more comprehensive and co-
ordinated care to vulnerable low-income individuals 
and individuals without health insurance coverage or 
with inadequate coverage. 
‘‘(5) To provide mechanisms for improving both 
quality and efficiency of care for low-income individ-
uals and families, with an emphasis on those most 
likely to remain uninsured despite the existence of 
government programs to make health insurance 
more affordable. 
‘‘(6) To increase preventive services, including 
screening and counseling, to those who would other-
wise not receive such screening, in order to improve 
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health status and reduce long-term complications 
and costs. 
‘‘(7) To ensure the availability of community- 
wide safety net services, including emergency and 
trauma care. 
‘‘(b) ELIGIBILITY AND GRANTEE SELECTION.— 
‘‘(1) APPLICATION.—A community-based col-
laborative care network described in subsection (d) 
shall submit to the Secretary an application in such 
form and manner and containing such information 
as specified by the Secretary. Such information shall 
at least— 
‘‘(A) identify the health care providers par-
ticipating in the community-based collaborative 
care network proposed by the applicant and, if 
a provider designated in paragraph (d)(1)(B) is 
not included, the reason such provider is not so 
included; 
‘‘(B) include a description of how the pro-
viders plan to collaborate to provide comprehen-
sive and integrated care for low-income individ-
uals, including uninsured and underinsured in-
dividuals; 
‘‘(C) include a description of the organiza-
tional and joint governance structure of the 
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community-based collaborative care network in 
a manner so that it is clear how decisions will 
be made, and how the decisionmaking process 
of the network will include appropriate rep-
resentation of the participating entities; 
‘‘(D) define the geographic areas and pop-
ulations that the network intends to serve; 
‘‘(E) define the scope of services that the 
network intends to provide and identify any 
reasons why such services would not include a 
suggested core service identified by the Sec-
retary under paragraph (3); 
‘‘(F) demonstrate the network’s ability to 
meet the requirements of this section; and 
‘‘(G) provide assurances that grant funds 
received shall be used to support the entire 
community-based collaborative care network. 
‘‘(2) SELECTION OF GRANTEES.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
select community-based collaborative care net-
works to receive grants from applications sub-
mitted under paragraph (1) on the basis of 
quality of the proposal involved, geographic di-
versity (including different States and regions 
served and urban and rural diversity), and the 
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number of low-income and uninsured individ-
uals that the proposal intends to serve. 
‘‘(B) PRIORITY.—The Secretary shall give 
priority to proposals from community-based col-
laborative care networks that— 
‘‘(i) include the capability to provide 
the broadest range of services to low-in-
come individuals; and 
‘‘(ii) include providers that currently 
serve a high volume of low-income individ-
uals. 
‘‘(C) RENEWAL.—In subsequent years, 
based on the performance of grantees, the Sec-
retary may provide renewal grants to prior year 
grant recipients. 
‘‘(3) SUGGESTED
CORE
SERVICES.—For pur-
poses of paragraph (1)(E), the Secretary shall de-
velop a list of suggested core patient and core net-
work services to be provided by a community-based 
collaborative care network. The Secretary may select 
a community-based collaborative care network under 
paragraph (2), the application of which does not in-
clude all such services, if such application provides 
a reasonable explanation why such services are not 
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proposed to be included, and the Secretary deter-
mines that the application is otherwise high quality. 
‘‘(4) TERMINATION
AUTHORITY.—The Sec-
retary may terminate selection of a community- 
based collaborative care network under this section 
for good cause. Such good cause shall include a de-
termination that the network— 
‘‘(A) has failed to provide a comprehensive 
range of coordinated and integrated health care 
services as required under subsection (d)(2); 
‘‘(B) has failed to meet reasonable quality 
standards; 
‘‘(C) has misappropriated funds provided 
under this section; or 
‘‘(D) has failed to make progress toward 
accomplishing goals set out in subsection (a). 
‘‘(c) USE OF FUNDS.— 
‘‘(1) USE BY GRANTEES.—Grant funds are pro-
vided to community-based collaborative care net-
works to carry out the following activities: 
‘‘(A) Assist low-income individuals without 
adequate health care coverage to— 
‘‘(i) access and appropriately use 
health services; 
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‘‘(ii) enroll in applicable public or pri-
vate health insurance programs; 
‘‘(iii) obtain referrals to and see a pri-
mary care provider in case such an indi-
vidual does not have a primary care pro-
vider; and 
‘‘(iv) obtain appropriate care for 
chronic conditions. 
‘‘(B) Improve heath care by providing case 
management, application assistance, and appro-
priate referrals such as through methods to— 
‘‘(i) create and meaningfully use a 
health information technology network to 
track patients across collaborative pro-
viders; 
‘‘(ii) perform health outreach, such as 
by using neighborhood health workers who 
may inform individuals about the avail-
ability of safety net and primary care pro-
viders available through the community- 
based collaborative care network; 
‘‘(iii) provide for followup outreach to 
remind patients of appointments or follow- 
up care instructions; 
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‘‘(iv) provide transportation to individ-
uals to and from the site of care; 
‘‘(v) expand the capacity to provide 
care at any provider participating in the 
community-based collaborative care net-
work, including telehealth, hiring new clin-
ical or administrative staff, providing ac-
cess to services after-hours, on weekends, 
or otherwise providing an urgent care al-
ternative to an emergency department; and 
‘‘(vi) provide a primary care provider 
or medical home for each network patient. 
‘‘(C) Provide direct patient care services as 
described in their application and approved by 
the Secretary. 
‘‘(2) GRANT FUNDS TO HRSA GRANTEES.—The 
Secretary may limit the percent of grant funding 
that may be spent on direct care services provided 
by grantees of programs administered by the Health 
Resources and Services Administration (in this sec-
tion referred to as ‘HRSA’) or impose other require-
ments on HRSA grantees participating in a commu-
nity-based collaborative care network as may be nec-
essary for consistency with the requirements of such 
programs. 
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‘‘(3) RESERVATION OF FUNDS FOR NATIONAL 
PROGRAM PURPOSES.—The Secretary may use not 
more than 7 percent of funds appropriated to carry 
out this section for providing technical assistance to 
grantees, obtaining assistance of experts and con-
sultants, holding meetings, developing of tools, dis-
seminating of information, and evaluation. 
‘‘(d) COMMUNITY-BASED
COLLABORATIVE
CARE 
NETWORKS.— 
‘‘(1) IN GENERAL.— 
‘‘(A) DESCRIPTION.—A community-based 
collaborative care network described in this sub-
section is a consortium of health care providers 
with a joint governance structure that provides 
a comprehensive range of coordinated and inte-
grated health care services for low-income pa-
tient populations or medically underserved com-
munities (whether or not such individuals re-
ceive benefits under title XVIII, XIX, or XXI 
of the Social Security Act, private or other 
health insurance or are uninsured or under-
insured) and that complies with any applicable 
minimum eligibility requirements that the Sec-
retary may determine appropriate. 
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‘‘(B) REQUIRED
INCLUSION.—Each such 
network shall include the following providers 
that serve the community (unless such provider 
does not exist within the community, declines or 
refuses to participate, or places unreasonable 
conditions on their participation)— 
‘‘(i) A safety net hospital that pro-
vides services to a high volume of low-in-
come patients, as demonstrated by meeting 
the criteria in section 1923(b)(1) of the 
Social Security Act, or other similar cri-
teria determined by the Secretary; and 
‘‘(ii) All Federally qualified health 
centers (as defined in section 1861(aa) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395x(aa))) located in the geographic area 
served by the Coordinated Care Network; 
‘‘(C) 
ADDITIONAL
INCLUSIONS.—Each 
such network may include any of the following 
additional providers: 
‘‘(i) A hospital, including a critical ac-
cess 
hospital 
(as 
defined 
in 
section 
1820(c)(2) of the Social Security Act (42 
U.S.C. 1395i–4(c)(2))). 
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‘‘(ii) A county or municipal depart-
ment of health. 
‘‘(iii) A rural health clinic or a rural 
health network (as defined in sections 
1861(aa) and 1820(d) of the Social Secu-
rity 
Act, 
respectively 
(42 
U.S.C. 
1395x(aa), 1395i–4(d))). 
‘‘(iv) A community clinic, including a 
mental health clinic, substance abuse clin-
ic, or a reproductive health clinic. 
‘‘(v) A health center controlled net-
work as defined by section 330(e)(1)(C) of 
the Public Health Service Act. 
‘‘(vi) A private practice physician or 
group practice. 
‘‘(vii) A nurse or physician assistant 
or group practice. 
‘‘(viii) An adult day care center. 
‘‘(ix) A home health provider. 
‘‘(x) Any other type of provider speci-
fied by the Secretary, which has a desire to 
serve low-income and uninsured patients. 
‘‘(D) CONSTRUCTION.— 
‘‘(i) Nothing in this section shall pro-
hibit a single entity from qualifying as 
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community-based collaborative care net-
work so long as such single entity meets 
the criteria of a community-based collabo-
rative care network. If the network does 
not include the providers referenced in 
clauses (i) and (ii) of subparagraph (B) of 
this paragraph, the application must ex-
plain the reason pursuant to subsection 
(b)(1)(A). 
‘‘(ii) Participation in a community- 
based collaborative care network shall not 
affect Federally qualified health centers’ 
obligation to comply with the governance 
requirements under section 330 of the 
Public Health Service Act (42 U.S.C. 
254b). 
‘‘(iii) Federally qualified health cen-
ters participating in a community-based 
collaborative care network may not be re-
quired to provide services beyond their 
Federal Health Center scope of project ap-
proved by HRSA. 
‘‘(iv) Nothing in this section shall be 
construed to expand medical malpractice li-
ability protection under the Federal Tort 
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Claims Act for Section 330-funded Feder-
ally qualified health centers. 
‘‘(2) COMPREHENSIVE RANGE OF COORDINATED 
AND
INTEGRATED
HEALTH
CARE
SERVICES.—The 
Secretary shall define criteria for evaluating whether 
the services offered by a community-based collabo-
rative care network qualify as a comprehensive range 
of coordinated and integrated health care services. 
Such criteria may vary based on the needs of the ge-
ographic areas and populations to be served by the 
network and may include the following: 
‘‘(A) Requiring community-based collabo-
rative care networks to include at least the sug-
gested core services identified under subsection 
(b)(3), or whichever subset of the suggested 
core services is applicable to a particular net-
work. 
‘‘(B) Requiring such networks to assign 
each patient of the network to a primary care 
provider responsible for managing that patient’s 
care. 
‘‘(C) Requiring the services provided by a 
community-based collaborative care network to 
include support services appropriate to meet the 
health needs of low-income populations in the 
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network’s community, which may include chron-
ic care management, nutritional counseling, 
transportation, language services, enrollment 
counselors, social services and other services as 
proposed by the network. 
‘‘(D) Providing that the services provided 
by a community-based collaborative care net-
work may also include long-term care services 
and other services not specified in this sub-
section. 
‘‘(E) Providing for the approval by the 
Secretary of a scope of community-based col-
laborative care network services for each net-
work that addresses an appropriate minimum 
scope of work consistent with the setting of the 
network and the health professionals available 
in the community the network serves. 
‘‘(3) CLARIFICATION.—Participation in a com-
munity-based collaborative care network shall not 
disqualify a health care provider from reimburse-
ment under title XVIII, XIX, or XXI of the Social 
Security Act with respect to services otherwise reim-
bursable under such title. Nothing in this section 
shall prevent a community-based collaborative care 
network that is otherwise eligible to contract with 
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Medicare, a private health insurer, or any other ap-
propriate entity to provide care under Medicare, 
under health insurance coverage offered by the in-
surer, or otherwise. 
‘‘(e) EVALUATIONS.— 
‘‘(1) GRANTEE
REPORTS.—Beginning in the 
third year following an initial grant, each commu-
nity-based collaborative care network shall submit to 
the Secretary, with respect to each year the grantee 
has received a grant, an evaluation on the activities 
carried out by the community-based collaborative 
care network under the community-based collabo-
rative care network program and shall include— 
‘‘(A) the number of people served; 
‘‘(B) the most common health problems 
treated; 
‘‘(C) any reductions in emergency depart-
ment use; 
‘‘(D) any improvements in access to pri-
mary care; 
‘‘(E) an accounting of how amounts re-
ceived were used, including identification of 
amounts used for patient care services as may 
be required for HRSA grantees; and 
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‘‘(F) to the extent requested by the Sec-
retary, any quality measures or any other meas-
ures specified by the Secretary. 
‘‘(2) PROGRAM REPORTS.—The Secretary shall 
submit to Congress an annual evaluation (beginning 
not later than 6 months after the first reports under 
paragraph (1) are submitted) on the extent to which 
emergency department use was reduced as a result 
of the activities carried out by the community-based 
collaborative care network under the program. Each 
such evaluation shall also include information on— 
‘‘(A) the prevalence of certain chronic con-
ditions in various populations, including a com-
parison of such prevalence in the general popu-
lation versus in the population of individuals 
with inadequate health insurance coverage; 
‘‘(B) demographic characteristics of the 
population of uninsured and underinsured indi-
viduals served by the community-based collabo-
rative care network involved; and 
‘‘(C) the conditions of such individuals for 
whom services were requested at such emer-
gency departments of participating hospitals. 
‘‘(3) AUDIT AUTHORITY.—The Secretary may 
conduct periodic audits and request periodic spend-
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ing reports of community-based collaborative care 
networks under the community-based collaborative 
care network program. 
‘‘(f) CLARIFICATION.—Nothing in this section re-
quires a provider to report individually identifiable infor-
mation of an individual to government agencies, unless the 
individual consents, consistent with HIPAA privacy and 
security law, as defined in section 3009(a)(2). 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2011 through 2015.’’. 
SEC. 2535. COMMUNITY-BASED OVERWEIGHT AND OBESITY 
PREVENTION PROGRAM. 
Part Q of title III (42 U.S.C. 280h et seq.) is amend-
ed by inserting after section 399W the following: 
‘‘SEC. 399W–1. COMMUNITY-BASED OVERWEIGHT AND OBE-
SITY PREVENTION PROGRAM. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
community-based overweight and obesity prevention pro-
gram consisting of awarding grants and contracts under 
subsection (b). 
‘‘(b) GRANTS.—The Secretary shall award grants to, 
or enter into contracts with, eligible entities— 
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‘‘(1) to plan evidence-based programs for the 
prevention of overweight and obesity among children 
and their families through improved nutrition and 
increased physical activity; or 
‘‘(2) to implement such programs. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be a community 
partnership that demonstrates community support and in-
cludes— 
‘‘(1) a broad cross section of stakeholders, such 
as— 
‘‘(A) hospitals, health care systems, com-
munity health centers, or other health care pro-
viders; 
‘‘(B) universities, local educational agen-
cies, or childcare providers; 
‘‘(C) State, local, and tribal health depart-
ments; 
‘‘(D) State, local, and tribal park and 
recreation departments; 
‘‘(E) employers; and 
‘‘(F) health insurance companies; 
‘‘(2) residents of the community; and 
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‘‘(3) representatives of public and private enti-
ties that have a history of working within and serv-
ing the community. 
‘‘(d) PERIOD OF AWARDS.— 
‘‘(1) IN GENERAL.—The period of a grant or 
contract under this section shall be 5 years, subject 
to renewal under paragraph (2). 
‘‘(2) RENEWAL.—At the end of each fiscal year, 
the Secretary may renew a grant or contract award 
under this section only if the grant or contract re-
cipient demonstrates to the Secretary’s satisfaction 
that the recipient has made appropriate, measurable 
progress in preventing overweight and obesity. 
‘‘(e) REQUIREMENTS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
a grant or contract under this section to an entity 
only if the entity demonstrates to the Secretary’s 
satisfaction that— 
‘‘(A) not later than 90 days after receiving 
the grant or contract, the entity will establish 
a steering committee to provide input on the as-
sessment of, and recommendations on improve-
ments to, the entity’s program funded through 
the grant or contract; and 
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‘‘(B) the entity has conducted or will con-
duct an assessment of the overweight and obe-
sity problem in its community, including the ex-
tent of the problem and factors contributing to 
the problem. 
‘‘(2) MATCHING
REQUIREMENT.—The Sec-
retary may award a grant or contract to an eligible 
entity under this section only if the entity agrees to 
provide, from non-Federal sources, an amount equal 
to $1 (in cash or in kind) for each $9 provided 
through the grant or contract to carry out the activi-
ties supported by the grant or contract. 
‘‘(3) PAYOR OF LAST RESORT.—The Secretary 
may award a grant or contract under this section to 
an entity only if the entity demonstrates to the satis-
faction of the Secretary that funds received through 
the grant or contract will not be expended for any 
activity to the extent that payment has been made, 
or can reasonably be expected to be made— 
‘‘(A) under any insurance policy; 
‘‘(B) under any Federal or State health 
benefits program (including titles XIX and XXI 
of the Social Security Act); or 
‘‘(C) by an entity which provides health 
services on a prepaid basis. 
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‘‘(4) MAINTENANCE
OF
EFFORT.—The Sec-
retary may award a grant or contract under this sec-
tion to an entity only if the entity demonstrates to 
the satisfaction of the Secretary that— 
‘‘(A) funds received through the grant or 
contract will be expended only to supplement, 
and not supplant, non-Federal and Federal 
funds otherwise available to the entity for the 
activities to be funded through the grant or 
contract; and 
‘‘(B) with respect to such activities, the en-
tity will maintain expenditures of non-Federal 
amounts for such activities at a level not less 
than the lesser of such expenditures maintained 
by the entity for the fiscal year preceding the 
fiscal year for which the entity receives the 
grant or contract. 
‘‘(f) PREFERENCES.—In awarding grants and con-
tracts under this section, the Secretary shall give pref-
erence to eligible entities that— 
‘‘(1) will serve communities with high levels of 
overweight and obesity and related chronic diseases; 
or 
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‘‘(2) will plan or implement activities for the 
prevention of overweight and obesity in school or 
workplace settings. 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program of grants and 
contracts awarded under this section. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) The term ‘evidence-based’ means that 
methodologically sound research has demonstrated a 
beneficial health effect in the judgment of the Sec-
retary and includes the Ways to Enhance Children’s 
Activity and Nutrition (We Can) program and cur-
riculum of the National Institutes of Health. 
‘‘(2) The term ‘local educational agency’ has 
the meaning given to the term in section 9101 of the 
Elementary and Secondary Education Act of 1965. 
‘‘(i) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated $10,000,000 for fiscal year 2011 and such sums 
as may be necessary for each of fiscal years 2012 through 
2015.’’. 
SEC. 2536. REDUCING STUDENT-TO-SCHOOL NURSE RATIOS. 
(a) DEMONSTRATION GRANTS.— 
(1) IN GENERAL.—The Secretary of Education, 
in consultation with the Secretary of Health and 
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Human Services and the Director of the Centers for 
Disease Control and Prevention, may make dem-
onstration grants to eligible local educational agen-
cies for the purpose of reducing the student-to- 
school nurse ratio in public elementary and sec-
ondary schools. 
(2) SPECIAL
CONSIDERATION.—In awarding 
grants under this section, the Secretary of Edu-
cation shall give special consideration to applications 
submitted by high-need local educational agencies 
that demonstrate the greatest need for new or addi-
tional nursing services among children in the public 
elementary and secondary schools served by the 
agency, in part by providing information on current 
ratios of students to school nurses. 
(3) MATCHING FUNDS.—The Secretary of Edu-
cation may require recipients of grants under this 
subsection to provide matching funds from non-Fed-
eral sources, and shall permit the recipients to 
match funds in whole or in part with in-kind con-
tributions. 
(b) REPORT.—Not later than 24 months after the 
date on which assistance is first made available to local 
educational agencies under this section, the Secretary of 
Education shall submit to the Congress a report on the 
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results of the demonstration grant program carried out 
under this section, including an evaluation of the effective-
ness of the program in improving the student-to-school 
nurse ratios described in subsection (a) and an evaluation 
of the impact of any resulting enhanced health of students 
on learning. 
(c) DEFINITIONS.—For purposes of this section: 
(1) The terms ‘‘elementary school’’, ‘‘local edu-
cational agency’’, and ‘‘secondary school’’ have the 
meanings given to those terms in section 9101 of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(2) The term ‘‘eligible local educational agency’’ 
means a local educational agency in which the stu-
dent-to-school nurse ratio in the public elementary 
and secondary schools served by the agency is 750 
or more students to every school nurse. 
(3) The term ‘‘high-need local educational agen-
cy’’ means a local educational agency— 
(A) that serves not fewer than 10,000 chil-
dren from families with incomes below the pov-
erty line; or 
(B) for which not less than 20 percent of 
the children served by the agency are from fam-
ilies with incomes below the poverty line. 
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(4) The term ‘‘nurse’’ means a licensed nurse, 
as defined under State law. 
(d) 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. 2537. MEDICAL-LEGAL PARTNERSHIPS. 
(a) IN GENERAL.—The Secretary shall establish a 
nationwide demonstration project consisting of— 
(1) awarding grants to, and entering into con-
tracts with, medical-legal partnerships to assist pa-
tients and their families to navigate health-related 
programs and activities; and 
(2) evaluating the effectiveness of such partner-
ships. 
(b) USE OF FUNDS.—Amounts received as a grant 
or contract under this section shall be used to assist pa-
tients and their families to navigate health care-related 
programs and activities and thereby achieve one or more 
of the following goals: 
(1) Enhancing access to health care services. 
(2) Improving health outcomes for low-income 
individuals. 
(3) Reducing health disparities. 
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(4) Enhancing wellness and prevention of 
chronic conditions. 
(c) PROHIBITION.—No funds under this section may 
be used— 
(1) for any medical malpractice or other civil 
action or proceeding; or 
(2) to assist individuals who are not lawfully 
present in the United States. 
(d) REPORT.—Not later than 5 years after the date 
of the enactment of this Act, the Secretary shall submit 
a report to the Congress on the results of the demonstra-
tion project under this section. Such report shall include 
the following: 
(1) A description of the extent to which med-
ical-legal partnerships funded through this section 
achieved the goals described in subsection (b). 
(2) Recommendations on the possibility of ex-
tending or expanding the demonstration project. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘health disparities’’ has the 
meaning given to the term in section 3171 of the 
Public Health Service Act, as added by section 
2301. 
(2) The term ‘‘medical-legal partnership’’ 
means an entity— 
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(A) that is a collaboration between— 
(i) a community health center, public 
hospital, children’s hospital, or other pro-
vider of health care services to a signifi-
cant number of low-income beneficiaries; 
and 
(ii) one or more attorneys; and 
(B) whose primary mission is to assist pa-
tients and their families navigate health care-re-
lated programs and activities. 
(3) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(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. 2538. SCREENING, BRIEF INTERVENTION, REFERRAL, 
AND TREATMENT FOR MENTAL HEALTH AND 
SUBSTANCE ABUSE DISORDERS. 
Part D of title V (42 U.S.C. 290dd et seq.) is amend-
ed by adding at the end the following: 
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‘‘SEC. 544. SCREENING, BRIEF INTERVENTION, REFERRAL, 
AND TREATMENT FOR MENTAL HEALTH AND 
SUBSTANCE ABUSE DISORDERS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator, shall establish a program (consisting of 
awarding grants, contracts, and cooperative agreements 
under subsection (b)) on mental health and substance 
abuse screening, brief intervention, referral, and recovery 
services for individuals in primary health care settings. 
‘‘(b) USE OF FUNDS.—The Secretary may award 
grants to, or enter into contracts or cooperative agree-
ments with, entities— 
‘‘(1) to provide mental health and substance 
abuse screening, brief interventions, referral, and re-
covery services; 
‘‘(2) to coordinate these services with primary 
health care services in the same program and set-
ting; 
‘‘(3) to develop a network of facilities to which 
patients may be referred if needed; 
‘‘(4) to purchase needed screening and other 
tools that are— 
‘‘(A) necessary for providing these services; 
and 
‘‘(B) supported by evidence-based research; 
and 
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‘‘(5) to maintain communication with appro-
priate State mental health and substance abuse 
agencies. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant, con-
tract, or cooperative agreement under this section, an enti-
ty shall be a public or private nonprofit entity that— 
‘‘(1) provides primary health services; 
‘‘(2) seeks to integrate mental health and sub-
stance abuse services into its service system; 
‘‘(3) has developed a working relationship with 
providers of mental health and substance abuse serv-
ices; 
‘‘(4) demonstrates a need for the inclusion of 
mental health and substance abuse services in its 
service system; and 
‘‘(5) agrees— 
‘‘(A) to prepare and submit to the Sec-
retary at the end of the grant, contract, or co-
operative agreement period an evaluation of all 
activities funded through the grant, contract, or 
cooperative agreement; and 
‘‘(B) to use such performance measures as 
may be stipulated by the Secretary for purposes 
of such evaluation. 
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‘‘(d) PREFERENCE.—In awarding grants, contracts, 
and cooperative agreements under this section, the Sec-
retary shall give preference to entities that— 
‘‘(1) provide services in rural or frontier areas 
of the Nation; 
‘‘(2) provide services to special needs popu-
lations, including American Indian or Alaska Native 
populations; or 
‘‘(3) provide services in school-based health 
clinics or on university and college campuses. 
‘‘(e) DURATION.—The period of a grant, contract, or 
cooperative agreement under this section may not exceed 
5 years. 
‘‘(f) REPORT.—Not later than 4 years after the first 
appropriation of funds to carry out this section, the Sec-
retary shall submit a report to the Congress on the pro-
gram under this section— 
‘‘(1) including an evaluation of the benefits of 
integrating mental health and substance abuse care 
within primary health care; and 
‘‘(2) focusing on the performance measures 
stipulated by the Secretary under subsection (c)(5). 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there are authorized to be appropriated $30,000,000 
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for fiscal year 2011 and such sums as may be nec-
essary for each of fiscal years 2012 through 2015. 
‘‘(2) PROGRAM
MANAGEMENT.—Of the funds 
appropriated to carry out this section for a fiscal 
year, the Secretary may use not more than 5 percent 
to manage the program under this section.’’. 
SEC. 2539. GRANTS TO ASSIST IN DEVELOPING MEDICAL 
SCHOOLS 
IN 
FEDERALLY-DESIGNATED 
HEALTH PROFESSIONAL SHORTAGE AREAS. 
(a) GRANTS AUTHORIZED.—The Secretary of Health 
and Human Services may make grants to nonprofit orga-
nizations or institutions of higher education for the pur-
pose of assisting the organization or institution involved 
to develop a medical school if— 
(1) the medical school will be located in an area 
that is designated (under section 332 of the Public 
Health Service Act (42 U.S.C. 254e)) as a health 
professional shortage area; 
(2) the organization or institution provides as-
surances satisfactory to the Secretary of substantial 
private or public funding from non-Federal sources 
for the development of the medical school; and 
(3) the organization or institution provides as-
surances satisfactory to the Secretary that accredita-
tion will be achieved for the medical school. 
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(b) USE OF GRANT FUNDS.—Grants awarded under 
this section may be used for the acquisition and building 
of the medical school campus in a health professional 
shortage area and the purchase of equipment, curriculum 
and faculty development, and general operations related 
to the development and establishment of the medical 
school. 
(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated $100,000,000 for each of fiscal years 
2011 through 2015. 
PART 3—EMERGENCY CARE-RELATED 
PROGRAMS 
SEC. 2551. TRAUMA CARE CENTERS. 
(a) GRANTS FOR TRAUMA CARE CENTERS.—Section 
1241 (42 U.S.C. 300d–41) is amended to read as follows: 
‘‘SEC. 1241. GRANTS FOR CERTAIN TRAUMA CENTERS. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
trauma center program consisting of awarding grants 
under section (b). 
‘‘(b) GRANTS.—The Secretary shall award grants as 
follows: 
‘‘(1) EXISTING
CENTERS.—Grants to public, 
private nonprofit, Indian Health Service, Indian 
tribal, and urban Indian trauma centers— 
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‘‘(A) to further the core missions of such 
centers; or 
‘‘(B) to provide emergency relief to ensure 
the continued and future availability of trauma 
services by trauma centers— 
‘‘(i) at risk of closing or operating in 
an area where a closing has occurred with-
in their primary service area; or 
‘‘(ii) in need of financial assistance 
following a natural disaster or other cata-
strophic event, such as a terrorist attack. 
‘‘(2) NEW CENTERS.—Grants to local govern-
ments and public or private nonprofit entities to es-
tablish new trauma centers in urban areas with a 
substantial degree of trauma resulting from violent 
crimes. 
‘‘(c) MINIMUM QUALIFICATIONS OF TRAUMA CEN-
TERS.— 
‘‘(1) PARTICIPATION IN TRAUMA CARE SYSTEM 
OPERATING UNDER CERTAIN PROFESSIONAL GUIDE-
LINES.— 
‘‘(A) LIMITATION.—Subject to subpara-
graph (B), the Secretary may not award a 
grant to an existing trauma center under this 
section unless the center is a participant in a 
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trauma care system that substantially complies 
with section 1213. 
‘‘(B) 
EXEMPTION.—Subparagraph 
(A) 
shall not apply to trauma centers that are lo-
cated in States with no existing trauma care 
system. 
‘‘(2) DESIGNATION.—The Secretary may not 
award a grant under this section to an existing trau-
ma center unless the center is— 
‘‘(A) verified as a trauma center by the 
American College of Surgeons; or 
‘‘(B) designated as a trauma center by the 
applicable State health or emergency medical 
services authority.’’. 
(b) CONSIDERATIONS IN MAKING GRANTS.—Section 
1242 (42 U.S.C. 300d–42) is amended to read as follows: 
‘‘SEC. 1242. CONSIDERATIONS IN MAKING GRANTS. 
‘‘(a) CORE MISSION AWARDS.— 
‘‘(1) IN GENERAL.—In awarding grants under 
section 1241(b)(1)(A), the Secretary shall— 
‘‘(A) reserve a minimum of 25 percent of 
the amount allocated for such grants for level 
III and level IV trauma centers in rural or un-
derserved areas; 
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‘‘(B) reserve a minimum of 25 percent of 
the amount allocated for such grants for level 
I and level II trauma centers in urban areas; 
and 
‘‘(C) give preference to any application 
made by a trauma center— 
‘‘(i) in a geographic area where 
growth in demand for trauma services ex-
ceeds capacity; 
‘‘(ii) that demonstrates the financial 
support of the State or political subdivision 
involved; 
‘‘(iii) that has at least 1 graduate 
medical education fellowship in trauma or 
trauma-related specialties, including neuro-
logical surgery, surgical critical care, vas-
cular surgery, and spinal cord injury, for 
which demand is exceeding supply; or 
‘‘(iv) that demonstrates a substantial 
commitment to serving vulnerable popu-
lations. 
‘‘(2) FINANCIAL
SUPPORT.—For purposes of 
paragraph (1)(C)(ii), financial support may be dem-
onstrated by State or political subdivision funding 
for the trauma center’s capital or operating expenses 
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(including through State trauma regional advisory 
coordination activities, Medicaid funding designated 
for trauma services, or other governmental funding). 
State funding derived from Federal support shall 
not constitute State or local financial support for 
purposes of preferential treatment under this sub-
section. 
‘‘(3) USE OF FUNDS.—The recipient of a grant 
under section 1241(b)(1)(A) shall carry out, con-
sistent with furthering the core missions of the cen-
ter, one or more of the following activities: 
‘‘(A) Providing 24-hour-a-day, 7-day-a- 
week trauma care availability. 
‘‘(B) Reducing overcrowding related to 
throughput of trauma patients. 
‘‘(C) Enhancing trauma surge capacity. 
‘‘(D) Ensuring physician and essential per-
sonnel availability. 
‘‘(E) Trauma education and outreach. 
‘‘(F) Coordination with local and regional 
trauma care systems. 
‘‘(G) Such other activities as the Secretary 
may deem appropriate. 
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‘‘(b) EMERGENCY
AWARDS; NEW
CENTERS.—In 
awarding grants under paragraphs (1)(B) and (2) of sec-
tion 1241(b), the Secretary shall— 
‘‘(1) give preference to any application sub-
mitted by an applicant that demonstrates the finan-
cial support (in accordance with subsection (a)(2)) 
of the State or political subdivision involved for the 
activities to be funded through the grant for each 
fiscal year during which payments are made to the 
center under the grant; and 
‘‘(2) give preference to any application sub-
mitted for a trauma center that— 
‘‘(A) is providing or will provide trauma 
care in a geographic area in which the avail-
ability of trauma care has either significantly 
decreased as a result of a trauma center in the 
area permanently ceasing participation in a sys-
tem described in section 1241(c)(1) as of a date 
occurring during the 2-year period preceding 
the fiscal year for which the trauma center is 
applying to receive a grant, or in geographic 
areas where growth in demand for trauma serv-
ices exceeds capacity; 
‘‘(B) will, in providing trauma care during 
the 1-year period beginning on the date on 
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which the application for the grant is sub-
mitted, incur substantial uncompensated care 
costs in an amount that renders the center un-
able to continue participation in such system 
and results in a significant decrease in the 
availability of trauma care in the geographic 
area; 
‘‘(C) operates or will operate in rural areas 
where trauma care availability will significantly 
decrease if the center is forced to close or down-
grade service and substantial costs are contrib-
uting to a likelihood of such closure or 
downgradation; 
‘‘(D) is in a geographic location substan-
tially affected by a natural disaster or other 
catastrophic event such as a terrorist attack; or 
‘‘(E) will establish a new trauma service in 
an urban area with a substantial degree of 
trauma resulting from violent crimes. 
‘‘(c) DESIGNATIONS OF LEVELS OF TRAUMA CEN-
TERS IN CERTAIN STATES.—In the case of a State which 
has not designated 4 levels of trauma centers, any ref-
erence in this section to— 
‘‘(1) a level I or level II trauma center is 
deemed to be a reference to a trauma center within 
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the highest 2 levels of trauma centers designated 
under State guidelines; and 
‘‘(2) a level III or IV trauma center is deemed 
to be a reference to a trauma center not within such 
highest 2 levels.’’. 
(c) CERTAIN
AGREEMENTS.—Section 1243 (42 
U.S.C. 300d–43) is amended to read as follows: 
‘‘SEC. 1243. CERTAIN AGREEMENTS. 
‘‘(a) COMMITMENT REGARDING CONTINUED PAR-
TICIPATION IN TRAUMA CARE SYSTEM.—The Secretary 
may not award a grant to an applicant under section 
1241(b) unless the applicant agrees that— 
‘‘(1) the trauma center involved will continue 
participation, or in the case of a new center will par-
ticipate, 
in 
the 
system 
described 
in 
section 
1241(c)(1), 
except 
as 
provided 
in 
section 
1241(c)(1)(B), throughout the grant period begin-
ning on the date that the center first receives pay-
ments under the grant; and 
‘‘(2) if the agreement made pursuant to para-
graph (1) is violated by the center, the center will 
be liable to the United States for an amount equal 
to the sum of— 
‘‘(A) the amount of assistance provided to 
the center under section 1241; and 
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‘‘(B) an amount representing interest on 
the amount specified in subparagraph (A). 
‘‘(b) MAINTENANCE OF FINANCIAL SUPPORT.—With 
respect to activities for which funds awarded through a 
grant under section 1241 are authorized to be expended, 
the Secretary may not award such a grant unless the ap-
plicant agrees that, during the period in which the trauma 
center involved is receiving payments under the grant, the 
center will maintain access to trauma services at levels not 
less than the levels for the prior year, taking into ac-
count— 
‘‘(1) reasonable volume fluctuation that is not 
caused by intentional trauma boundary reduction; 
‘‘(2) downgrading of the level of services; and 
‘‘(3) whether such center diverts its incoming 
patients away from such center 5 percent or more 
of the time during which the center is in operation 
over the course of the year. 
‘‘(c) TRAUMA CARE REGISTRY.—The Secretary may 
not award a grant to a trauma center under section 
1241(b)(1) unless the center agrees that— 
‘‘(1) not later than 6 months after the date on 
which the center submits a grant application to the 
Secretary, the center will establish and operate a 
registry of trauma cases in accordance with guide-
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lines developed by the American College of Surgeons; 
and 
‘‘(2) in carrying out paragraph (1), the center 
will maintain information on the number of trauma 
cases treated by the center and, for each such case, 
the extent to which the center incurs uncompensated 
costs in providing trauma care.’’. 
(d) GENERAL
PROVISIONS.—Section 1244 (42 
U.S.C. 300d–44) is amended to read as follows: 
‘‘SEC. 1244. GENERAL PROVISIONS. 
‘‘(a) LIMITATION ON DURATION OF SUPPORT.—The 
period during which a trauma center receives payments 
under a grant under section 1241(b)(1) shall be for 3 fis-
cal years, except that the Secretary may waive such re-
quirement for the center and authorize the center to re-
ceive such payments for 1 additional fiscal year. 
‘‘(b) ELIGIBILITY.—The acquisition of, or eligibility 
for, a grant under section 1241(b) shall not preclude a 
trauma center’s eligibility for another grant described in 
such section. 
‘‘(c) FUNDING DISTRIBUTION.—Of the total amount 
appropriated for a fiscal year under section 1245— 
‘‘(1) 90 percent shall be used for grants under 
paragraph (1)(A) of section 1241(b); and 
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‘‘(2) 10 percent shall be used for grants under 
paragraphs (1)(B) and (2) of section 1241(b). 
‘‘(d) REPORT.—Beginning 2 years after the date of 
the enactment of the Affordable Health Care for America 
Act, and every 2 years thereafter, the Secretary shall bien-
nially— 
‘‘(1) report to Congress on the status of the 
grants made pursuant to section 1241; 
‘‘(2) evaluate and report to Congress on the 
overall financial stability of trauma centers in the 
United States; 
‘‘(3) report on the populations using trauma 
care centers and include aggregate patient data on 
income, race, ethnicity, and geography; and 
‘‘(4) evaluate the effectiveness and efficiency of 
trauma care center activities using standard public 
health measures and evaluation methodologies.’’. 
(e) AUTHORIZATION OF APPROPRIATIONS.—Section 
1245 (42 U.S.C. 300d–45) is amended to read as follows: 
‘‘SEC. 1245. AUTHORIZATION OF APPROPRIATIONS. 
‘‘(a) IN GENERAL.—For the purpose of carrying out 
this part, there are authorized to be appropriated 
$100,000,000 for fiscal year 2011, and such sums as may 
be necessary for each of fiscal years 2012 through 2015. 
Such authorization of appropriations is in addition to any 
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other authorization of appropriations or amounts that are 
available for such purpose. 
‘‘(b) REALLOCATION.—The Secretary shall reallocate 
for grants under section 1241(b)(1)(A) any funds appro-
priated for grants under paragraph (1)(B) or (2) of sec-
tion 1241(b), but not obligated due to insufficient applica-
tions eligible for funding.’’. 
SEC. 2552. EMERGENCY CARE COORDINATION. 
(a) IN GENERAL.—Subtitle B of title XXVIII (42 
U.S.C. 300hh–10 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 2816. EMERGENCY CARE COORDINATION. 
‘‘(a) EMERGENCY CARE COORDINATION CENTER.— 
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish, within the Office of the Assistant Secretary 
for Preparedness and Response, an Emergency Care 
Coordination Center (in this section referred to as 
the ‘Center’), to be headed by a director. 
‘‘(2) DUTIES.—The Secretary, acting through 
the Director of the Center, in coordination with the 
Federal Interagency Committee on Emergency Med-
ical Services, shall— 
‘‘(A) promote and fund research in emer-
gency medicine and trauma health care; 
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‘‘(B) promote regional partnerships and 
more effective emergency medical systems in 
order to enhance appropriate triage, distribu-
tion, and care of routine community patients; 
and 
‘‘(C) promote local, regional, and State 
emergency medical systems’ preparedness for 
and response to public health events. 
‘‘(b) COUNCIL OF EMERGENCY CARE.— 
‘‘(1) ESTABLISHMENT.—The Secretary, acting 
through the Director of the Center, shall establish a 
Council of Emergency Care to provide advice and 
recommendations to the Director on carrying out 
this section. 
‘‘(2) COMPOSITION.—The Council shall be com-
prised of employees of the departments and agencies 
of the Federal Government who are experts in emer-
gency care and management. 
‘‘(c) REPORT.— 
‘‘(1) SUBMISSION.—Not later than 12 months 
after the date of the enactment of the Affordable 
Health Care for America Act, the Secretary shall 
submit to the Congress an annual report on the ac-
tivities carried out under this section. 
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‘‘(2) CONSIDERATIONS.—In preparing a report 
under paragraph (1), the Secretary shall consider 
factors including— 
‘‘(A) emergency department crowding and 
boarding; and 
‘‘(B) delays in care following presentation. 
‘‘(d) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2011 through 2015.’’. 
(b) FUNCTIONS, PERSONNEL, ASSETS, LIABILITIES, 
AND
ADMINISTRATIVE
ACTIONS.—All functions, per-
sonnel, assets, and liabilities of, and administrative actions 
applicable to, the Emergency Care Coordination Center, 
as in existence on the day before the date of the enactment 
of this Act, shall be transferred to the Emergency Care 
Coordination Center established under section 2816(a) of 
the Public Health Service Act, as added by subsection (a). 
SEC. 2553. PILOT PROGRAMS TO IMPROVE EMERGENCY 
MEDICAL CARE. 
Part B of title III (42 U.S.C. 243 et seq.) is amended 
by inserting after section 314 the following: 
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‘‘SEC. 315. REGIONALIZED COMMUNICATION SYSTEMS FOR 
EMERGENCY CARE RESPONSE. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Assistant Secretary for Preparedness and Response, 
shall award not fewer than 4 multiyear contracts or com-
petitive grants to eligible entities to support demonstration 
programs that design, implement, and evaluate innovative 
models of regionalized, comprehensive, and accountable 
emergency care systems. 
‘‘(b) ELIGIBLE ENTITY; REGION.— 
‘‘(1) ELIGIBLE
ENTITY.—In this section, the 
term ‘eligible entity’ means a State or a partnership 
of 1 or more States and 1 or more local govern-
ments. 
‘‘(2) REGION.—In this section, the term ‘re-
gion’ means an area within a State, an area that lies 
within multiple States, or a similar area (such as a 
multicounty area), as determined by the Secretary. 
‘‘(c) DEMONSTRATION PROGRAM.—The Secretary 
shall award a contract or grant under subsection (a) to 
an eligible entity that proposes a demonstration program 
to design, implement, and evaluate an emergency medical 
system that— 
‘‘(1) coordinates with public safety services, 
public health services, emergency medical services, 
medical facilities, and other entities within a region; 
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‘‘(2) coordinates an approach to emergency 
medical system access throughout the region, includ-
ing 9–1–1 public safety answering points and emer-
gency medical dispatch; 
‘‘(3) includes a mechanism, such as a regional 
medical direction or transport communications sys-
tem, that operates throughout the region to ensure 
that the correct patient is taken to the medically ap-
propriate facility (whether an initial facility or a 
higher level facility) in a timely fashion; 
‘‘(4) allows for the tracking of prehospital and 
hospital resources, including inpatient bed capacity, 
emergency department capacity, on-call specialist 
coverage, ambulance diversion status, and the co-
ordination of such tracking with regional commu-
nications and hospital destination decisions; and 
‘‘(5) 
includes 
a 
consistent 
regionwide 
prehospital, hospital, and interfacility data manage-
ment system that— 
‘‘(A) complies with the National EMS In-
formation System, the National Trauma Data 
Bank, and others; 
‘‘(B) reports data to appropriate Federal 
and State databanks and registries; and 
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‘‘(C) contains information sufficient to 
evaluate key elements of prehospital care, hos-
pital destination decisions, including initial hos-
pital and interfacility decisions, and relevant 
outcomes of hospital care. 
‘‘(d) APPLICATION.— 
‘‘(1) IN
GENERAL.—An eligible entity that 
seeks a contract or grant described in subsection (a) 
shall submit to the Secretary an application at such 
time and in such manner as the Secretary may re-
quire. 
‘‘(2) APPLICATION INFORMATION.—Each appli-
cation shall include— 
‘‘(A) an assurance from the eligible entity 
that the proposed system— 
‘‘(i) has been coordinated with the ap-
plicable State office of emergency medical 
services (or equivalent State office); 
‘‘(ii) is compatible with the applicable 
State emergency medical services system; 
‘‘(iii) includes consistent indirect and 
direct medical oversight of prehospital, 
hospital, 
and 
interfacility 
transport 
throughout the region; 
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‘‘(iv) coordinates prehospital treat-
ment and triage, hospital destination, and 
interfacility transport throughout the re-
gion; 
‘‘(v) includes a categorization or des-
ignation system for special medical facili-
ties throughout the region that is— 
‘‘(I) consistent with State laws 
and regulations; and 
‘‘(II) integrated with the proto-
cols for transport and destination 
throughout the region; and 
‘‘(vi) includes a regional medical di-
rection system, a patient tracking system, 
and a resource allocation system that— 
‘‘(I) support day-to-day emer-
gency care system operation; 
‘‘(II) can manage surge capacity 
during a major event or disaster; and 
‘‘(III) are integrated with other 
components of the national and State 
emergency preparedness system; 
‘‘(B) an agreement to make available non- 
Federal contributions in accordance with sub-
section (e); and 
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SEC. 2555. DENTAL EMERGENCY RESPONDERS: PUBLIC 
HEALTH AND MEDICAL RESPONSE. 
(a) NATIONAL HEALTH SECURITY STRATEGY.—Sec-
tion 2802(b)(3) (42 U.S.C. 300hh–1(b)(3)) is amended— 
(1) in the matter preceding subparagraph (A), 
by inserting ‘‘dental and’’ before ‘‘mental health fa-
cilities’’; and 
(2) in subparagraph (D), by inserting ‘‘and 
dental’’ after ‘‘medical’’. 
(b) ALL-HAZARDS PUBLIC HEALTH AND MEDICAL 
RESPONSE
CURRICULA
AND
TRAINING.—Section 
319F(a)(5)(B) (42 U.S.C. 247d–6(a)(5)(B)) is amended 
by striking ‘‘public health or medical’’ and inserting ‘‘pub-
lic health, medical, or dental’’. 
SEC. 2556. DENTAL EMERGENCY RESPONDERS: HOMELAND 
SECURITY. 
(a) NATIONAL RESPONSE FRAMEWORK.—Paragraph 
(6) of section 2 of the Homeland Security Act of 2002 
(6 U.S.C. 101) is amended by inserting ‘‘and dental’’ after 
‘‘emergency medical’’. 
(b) NATIONAL PREPAREDNESS SYSTEM.—Subpara-
graph (B) of section 653(b)(4) of the Post-Katrina Emer-
gency Management Reform Act of 2006 (6 U.S.C. 
753(b)(4)) is amended by striking ‘‘public health and med-
ical’’ and inserting ‘‘public health, medical, and dental’’. 
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graph (7)(A) of this subsection is deemed to be 
12 years and 6 months rather than 12 years. 
‘‘(B) EXCEPTION.—The Secretary shall 
not extend the period referred to in subpara-
graph (A) of this paragraph if the determina-
tion under section 505A(d)(3) of the Federal 
Food, Drug, and Cosmetic Act is made later 
than 9 months prior to the expiration of such 
period. 
‘‘(C) APPLICATION
OF
CERTAIN
PROVI-
SIONS.—The provisions of subsections (a), (d), 
(e), (f), (h), (j), (k), and (l) of section 505A of 
the Federal Food, Drug, and Cosmetic Act 
shall apply with respect to the extension of a 
period under subparagraph (A) of this para-
graph to the same extent and in the same man-
ner as such provisions apply with respect to the 
extension of a period under subsection (b) or 
(c) of section 505A of the Federal Food, Drug, 
and Cosmetic Act. 
‘‘(9) GUIDANCE DOCUMENTS.— 
‘‘(A) IN
GENERAL.—The Secretary may, 
after opportunity for public comment, issue 
guidance in accordance, except as provided in 
subparagraph (B)(i), with section 701(h) of the 
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‘‘(iii) If the reference product sponsor 
is issued or acquires an interest in a rel-
evant patent after the date on which the 
reference product sponsor provides the list 
required by clause (ii) to the applicant, the 
reference product sponsor shall identify 
that patent to the applicant within 30 days 
of the date of issue of the patent, or the 
date of acquisition of the interest in the 
patent, as applicable. 
‘‘(B) 
EXCHANGES
WITH
INTERESTED 
THIRD PARTIES.— 
‘‘(i) At any time after the date on 
which the Secretary publishes a notice for 
an application under paragraph (3), any 
interested third party may provide notice 
to the designated agent of the applicant 
that the interested third party owns or has 
rights under 1 or more patents that may 
be relevant patents. The notice shall iden-
tify at least 1 patent and shall designate 
an individual who has executed an agree-
ment in accordance with paragraph (2) to 
receive confidential information from the 
applicant. 
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‘‘(ii) Within 30 days of the date of re-
ceiving notice pursuant to clause (i), the 
applicant shall send to the individual des-
ignated by the interested third party the 
information 
specified 
in 
subparagraph 
(A)(i), unless the applicant and interested 
third party otherwise agree. 
‘‘(iii) Within 90 days of the date of 
receiving information pursuant to clause 
(ii), the interested third party shall provide 
to the applicant a list of relevant patents 
which the interested third party owns, or 
in respect of which the interested third 
party has the right to commence or partici-
pate in an action for infringement. 
‘‘(iv) If the interested third party is 
issued or acquires an interest in a relevant 
patent after the date on which the inter-
ested third party provides the list required 
by clause (iii), the interested third party 
shall identify that patent within 30 days of 
the date of issue of the patent, or the date 
of acquisition of the interest in the patent, 
as applicable. 
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‘‘(C) IDENTIFICATION OF BASIS FOR IN-
FRINGEMENT.—For any patent identified under 
clause (ii) or (iii) of subparagraph (A) or under 
clause (iii) or (iv) of subparagraph (B), the ref-
erence product sponsor or the interested third 
party, as applicable— 
‘‘(i) shall explain in writing why the 
sponsor or the interested third party be-
lieves the relevant patent would be in-
fringed by the making, use, sale, or offer 
for sale within the United States, or im-
portation into the United States, of the 
biosimilar product or by a use of the bio-
similar product in treatment that is indi-
cated in the application; 
‘‘(ii) may specify whether the relevant 
patent is available for licensing; and 
‘‘(iii) shall specify the number and 
date of expiration of the relevant patent. 
‘‘(D) CERTIFICATION BY APPLICANT CON-
CERNING
IDENTIFIED
RELEVANT
PATENTS.— 
Not later than 45 days after the date on which 
a patent is identified under clause (ii) or (iii) of 
subparagraph (A) or under clause (iii) or (iv) of 
subparagraph (B), the applicant shall send a 
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‘‘(e) HEALTH SERVICES TO CERTAIN EMPLOYEES.— 
In the case of any Indian who— 
‘‘(1) as a result of employment in or near a 
uranium mine or mill or near any other environ-
mental hazard, suffers from a work-related illness or 
condition; 
‘‘(2) is eligible to receive diagnosis and treat-
ment services from an Indian Health Program; and 
‘‘(3) by reason of such Indian’s employment, is 
entitled to medical care at the expense of such mine 
or mill operator or entity responsible for the environ-
mental hazard, the Indian Health Program shall, at 
the request of such Indian, render appropriate med-
ical care to such Indian for such illness or condition 
and may be reimbursed for any medical care so ren-
dered to which such Indian is entitled at the expense 
of such operator or entity from such operator or en-
tity. Nothing in this subsection shall affect the 
rights of such Indian to recover damages other than 
such amounts paid to the Indian Health Program 
from the employer for providing medical care for 
such illness or condition. 
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