ditions that could adversely affect growth 
and development; and 
‘‘(ii) treatments to correct or amelio-
rate the effects of physical and mental con-
ditions, including chronic conditions, in in-
fants, young children, school-age children, 
and adolescents. 
‘‘(C) The availability of care in a range of 
ambulatory and inpatient health care settings 
in which such care is furnished. 
‘‘(D) The types of measures that, taken to-
gether, can be used to estimate the overall na-
tional quality of health care for children, includ-
ing children with special needs, and to perform 
comparative analyses of pediatric health care 
quality and racial, ethnic, and socioeconomic 
disparities in child health and health care for 
children. 
‘‘(4) ENCOURAGE VOLUNTARY AND STANDARD-
IZED REPORTING.—Not later than 2 years after the 
date of this section, the Secretary, in consultation 
with States, shall develop a standardized format for 
reporting information and procedures and ap-
proaches that encourage States to use the initial 
core measurement set to voluntarily report informa-
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tion regarding the quality of pediatric health care 
under titles XIX and XXI and for the reporting of 
such standardized reporting under title XXII. 
‘‘(5) ADOPTION OF BEST PRACTICES IN IMPLE-
MENTING QUALITY PROGRAMS.—The Secretary shall 
disseminate information to States regarding best 
practices among States with respect to measuring 
and reporting on the quality of health care for chil-
dren, and shall facilitate the adoption of such best 
practices. In developing best practices approaches, 
the Secretary shall give particular attention to State 
measurement techniques that ensure the timeliness 
and accuracy of provider reporting, encourage pro-
vider reporting compliance, encourage successful 
quality improvement strategies, and improve effi-
ciency in data collection using health information 
technology. 
‘‘(6) REPORTS TO CONGRESS.—Not later than 
January 1, 2011, and every 3 years thereafter, the 
Secretary shall report to Congress on— 
‘‘(A) the status of the Secretary’s efforts 
to improve— 
‘‘(i) quality related to the duration 
and stability of health insurance coverage 
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for children under titles XIX, XXI, and 
XXII; 
‘‘(ii) the quality of children’s health 
care under such titles, including preventive 
health services, health care for acute condi-
tions, chronic health care, and health serv-
ices to ameliorate the effects of physical 
and mental conditions and to aid in growth 
and development of infants, young chil-
dren, school-age children, and adolescents 
with special health care needs; and 
‘‘(iii) the quality of children’s health 
care under such titles across the domains 
of quality, including clinical quality, health 
care safety, family experience with health 
care, health care in the most integrated 
setting, and elimination of racial, ethnic, 
and socioeconomic disparities in health and 
health care; 
‘‘(B) the status of voluntary reporting by 
States under titles XIX and XXI, and reporting 
by the Secretary under title XXII, utilizing the 
initial core quality measurement set; and 
‘‘(C) any recommendations for legislative 
changes needed to improve the quality of care 
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provided to children under titles XIX, XXI, and 
XXII, including recommendations for quality 
reporting by States. 
‘‘(7) TECHNICAL ASSISTANCE.—The Secretary 
shall provide technical assistance to States to assist 
them in adopting and utilizing core child health 
quality measures in administering the State plans 
under titles XIX and XXI. 
‘‘(8) DEFINITION OF CORE SET.—In this sec-
tion, the term ‘core set’ means a group of valid, reli-
able, and evidence-based quality measures that, 
taken together— 
‘‘(A) provide information regarding the 
quality of health coverage and health care for 
children; 
‘‘(B) 
address 
the 
needs 
of 
children 
throughout the developmental age span; and 
‘‘(C) allow purchasers, families, and health 
care providers to understand the quality of care 
in relation to the preventive needs of children, 
treatments aimed at managing and resolving 
acute conditions, and diagnostic and treatment 
services whose purpose is to correct or amelio-
rate physical, mental, or developmental condi-
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tions that could, if untreated or poorly treated, 
become chronic. 
‘‘(b) ADVANCING AND IMPROVING PEDIATRIC QUAL-
ITY MEASURES.— 
‘‘(1) ESTABLISHMENT OF PEDIATRIC QUALITY 
MEASURES PROGRAM.—Not later than January 1, 
2011, the Secretary shall establish a pediatric qual-
ity measures program to— 
‘‘(A) improve and strengthen the initial 
core child health care quality measures estab-
lished by the Secretary under subsection (a); 
‘‘(B) expand on existing pediatric quality 
measures used by public and private health care 
purchasers and advance the development of 
such new and emerging quality measures; and 
‘‘(C) increase the portfolio of evidence- 
based, consensus pediatric quality measures 
available to public and private purchasers of 
children’s health care services, providers, and 
consumers. 
‘‘(2) EVIDENCE-BASED MEASURES.—The meas-
ures developed under the pediatric quality measures 
program shall, at a minimum, be— 
‘‘(A) evidence-based and, where appro-
priate, risk adjusted; 
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‘‘(B) designed to identify and eliminate ra-
cial and ethnic disparities in child health and 
the provision of health care; 
‘‘(C) designed to ensure that the data re-
quired for such measures is collected and re-
ported in a standard format that permits com-
parison of quality and data at a State, plan, 
and provider level; 
‘‘(D) periodically updated; and 
‘‘(E) responsive to the child health needs, 
services, and domains of health care quality de-
scribed in clauses (i), (ii), and (iii) of subsection 
(a)(6)(A). 
‘‘(3) PROCESS FOR PEDIATRIC QUALITY MEAS-
URES PROGRAM.—In identifying gaps in existing pe-
diatric quality measures and establishing priorities 
for development and advancement of such measures, 
the Secretary shall consult with— 
‘‘(A) States; 
‘‘(B) pediatricians, children’s hospitals, 
and other primary and specialized pediatric 
health care professionals (including members of 
the allied health professions) who specialize in 
the care and treatment of children, particularly 
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children with special physical, mental, and de-
velopmental health care needs; 
‘‘(C) dental professionals, including pedi-
atric dental professionals; 
‘‘(D) health care providers that furnish 
primary health care to children and families 
who live in urban and rural medically under-
served communities or who are members of dis-
tinct population sub-groups at heightened risk 
for poor health outcomes; 
‘‘(E) national organizations representing 
children, including children with disabilities and 
children with chronic conditions; 
‘‘(F) national organizations representing 
consumers and purchasers of children’s health 
care; 
‘‘(G) national organizations and individuals 
with expertise in pediatric health quality meas-
urement; and 
‘‘(H) voluntary consensus standards set-
ting organizations and other organizations in-
volved in the advancement of evidence-based 
measures of health care. 
‘‘(4) DEVELOPING, VALIDATING, AND TESTING 
A PORTFOLIO OF PEDIATRIC QUALITY MEASURES.— 
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As part of the program to advance pediatric quality 
measures, the Secretary shall— 
‘‘(A) award grants and contracts for the 
development, testing, and validation of new, 
emerging, and innovative evidence-based meas-
ures for children’s health care services across 
the domains of quality described in clauses (i), 
(ii), and (iii) of subsection (a)(6)(A); and 
‘‘(B) award grants and contracts for— 
‘‘(i) the development of consensus on 
evidence-based measures for children’s 
health care services; 
‘‘(ii) the dissemination of such meas-
ures to public and private purchasers of 
health care for children; and 
‘‘(iii) the updating of such measures 
as necessary. 
‘‘(5) REVISING, STRENGTHENING, AND IMPROV-
ING INITIAL CORE MEASURES.—Beginning no later 
than January 1, 2013, and annually thereafter, the 
Secretary shall publish recommended changes to the 
core measures described in subsection (a) that shall 
reflect the testing, validation, and consensus process 
for the development of pediatric quality measures 
described in subsection paragraphs (1) through (4). 
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‘‘(6) DEFINITION
OF
PEDIATRIC
QUALITY 
MEASURE.—In this subsection, the term ‘pediatric 
quality measure’ means a measurement of clinical 
care that is capable of being examined through the 
collection and analysis of relevant information, that 
is developed in order to assess 1 or more aspects of 
pediatric health care quality in various institutional 
and ambulatory health care settings, including the 
structure of the clinical care system, the process of 
care, the outcome of care, or patient experiences in 
care. 
‘‘(7) CONSTRUCTION.—Nothing in this section 
shall be construed as supporting the restriction of 
coverage, under title XIX, XXI, or XXII or other-
wise, to only those services that are evidence-based. 
‘‘(c) ANNUAL STATE REPORTS REGARDING STATE- 
SPECIFIC QUALITY OF CARE MEASURES APPLIED UNDER 
MEDICAID OR CHIP.— 
‘‘(1) ANNUAL
STATE
REPORTS.—Each State 
with a State plan approved under title XIX or a 
State child health plan approved under title XXI 
shall annually report to the Secretary on the— 
‘‘(A) State-specific child health quality 
measures applied by the States under such 
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plans, including measures described in subpara-
graphs (A) and (B) of subsection (a)(6); and 
‘‘(B) State-specific information on the 
quality of health care furnished to children 
under such plans, including information col-
lected through external quality reviews of man-
aged care organizations under section 1932 of 
the Social Security Act (42 U.S.C. 1396u–4) 
and benchmark plans under sections 1937 and 
2103 of such Act (42 U.S.C. 1396u–7, 1397cc). 
The Secretary shall collect such information with re-
spect to children under title XXII. 
‘‘(2) PUBLICATION.—Not later than September 
30, 2010, and annually thereafter, the Secretary 
shall collect, analyze, and make publicly available the 
information reported by States under paragraph (1) 
or collected by the Secretary under such paragraph. 
‘‘(d) DEMONSTRATION PROJECTS
FOR IMPROVING 
THE QUALITY OF CHILDREN’S HEALTH CARE AND THE 
USE OF HEALTH INFORMATION TECHNOLOGY.— 
‘‘(1) IN GENERAL.—During the period of fiscal 
years 2009 through 2013, the Secretary shall award 
not more than 10 grants to States and child health 
providers to conduct demonstration projects to 
evaluate promising ideas for improving the quality of 
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children’s health care provided under title XIX, 
XXI, or XXII, including projects to— 
‘‘(A) experiment with, and evaluate the use 
of, new measures of the quality of children’s 
health care under such titles (including testing 
the validity and suitability for reporting of such 
measures); 
‘‘(B) promote the use of health information 
technology in care delivery for children under 
such titles; 
‘‘(C) evaluate provider-based models which 
improve the delivery of children’s health care 
services under such titles, including care man-
agement for children with chronic conditions 
and the use of evidence-based approaches to im-
prove the effectiveness, safety, and efficiency of 
health care services for children; or 
‘‘(D) demonstrate the impact of the model 
electronic health record format for children de-
veloped and disseminated under subsection (f) 
on improving pediatric health, including the ef-
fects of chronic childhood health conditions, and 
pediatric health care quality as well as reducing 
health care costs. 
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‘‘(2) REQUIREMENTS.—In awarding grants 
under this subsection, the Secretary shall ensure 
that— 
‘‘(A) only 1 demonstration project funded 
under a grant awarded under this subsection 
shall be conducted in a State; and 
‘‘(B) demonstration projects funded under 
grants awarded under this subsection shall be 
conducted evenly between States with large 
urban areas and States with large rural areas. 
‘‘(3) 
AUTHORITY
FOR
MULTISTATE 
PROJECTS.—A demonstration project conducted with 
a grant awarded under this subsection may be con-
ducted on a multistate basis, as needed. 
‘‘(4) FUNDING.—$20,000,000 of the amount 
appropriated under subsection (i) for a fiscal year 
shall be used to carry out this subsection. 
‘‘(e) 
CHILDHOOD
OBESITY
DEMONSTRATION 
PROJECT.— 
‘‘(1) AUTHORITY
TO
CONDUCT
DEMONSTRA-
TION.—The Secretary, in consultation with the Ad-
ministrator of the Centers for Medicare & Medicaid 
Services, shall conduct a demonstration project to 
develop a comprehensive and systematic model for 
reducing childhood obesity by awarding grants to eli-
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gible entities to carry out such project. Such model 
shall— 
‘‘(A) identify, through self-assessment, be-
havioral risk factors for obesity among children; 
‘‘(B) identify, through self-assessment, 
needed clinical preventive and screening benefits 
among those children identified as target indi-
viduals on the basis of such risk factors; 
‘‘(C) provide ongoing support to such tar-
get individuals and their families to reduce risk 
factors and promote the appropriate use of pre-
ventive and screening benefits; and 
‘‘(D) be designed to improve health out-
comes, satisfaction, quality of life, and appro-
priate use of items and services for which med-
ical assistance is available under title XIX, 
child health assistance is available under title 
XXI, or benefits are available under title XXII 
among such target individuals. 
‘‘(2) ELIGIBILITY ENTITIES.—For purposes of 
this subsection, an eligible entity is any of the fol-
lowing: 
‘‘(A) A city, county, or Indian tribe. 
‘‘(B) A local or tribal educational agency. 
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‘‘(C) An accredited university, college, or 
community college. 
‘‘(D) A Federally-qualified health center. 
‘‘(E) A local health department. 
‘‘(F) A health care provider. 
‘‘(G) A community-based organization. 
‘‘(H) Any other entity determined appro-
priate by the Secretary, including a consortia or 
partnership of entities described in any of sub-
paragraphs (A) through (G). 
‘‘(3) USE OF FUNDS.—An eligible entity award-
ed a grant under this subsection shall use the funds 
made available under the grant to— 
‘‘(A) carry out community-based activities 
related to reducing childhood obesity, including 
by— 
‘‘(i) forming partnerships with enti-
ties, including schools and other facilities 
providing recreational services, to establish 
programs for after school and weekend 
community activities that are designed to 
reduce childhood obesity; 
‘‘(ii) 
forming 
partnerships 
with 
daycare facilities to establish programs 
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that promote healthy eating behaviors and 
physical activity; and 
‘‘(iii) developing and evaluating com-
munity educational activities targeting 
good nutrition and promoting healthy eat-
ing behaviors; 
‘‘(B) carry out age-appropriate school- 
based activities that are designed to reduce 
childhood obesity, including by— 
‘‘(i) developing and testing edu-
cational curricula and intervention pro-
grams designed to promote healthy eating 
behaviors and habits in youth, which may 
include— 
‘‘(I) after hours physical activity 
programs; and 
‘‘(II) science-based interventions 
with multiple components to prevent 
eating disorders including nutritional 
content, understanding and respond-
ing to hunger and satiety, positive 
body image development, positive self- 
esteem development, and learning life 
skills (such as stress management, 
communication skills, problemsolving 
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and decisionmaking skills), as well as 
consideration of cultural and develop-
mental issues, and the role of family, 
school, and community; 
‘‘(ii) providing education and training 
to educational professionals regarding how 
to promote a healthy lifestyle and a 
healthy school environment for children; 
‘‘(iii) planning and implementing a 
healthy lifestyle curriculum or program 
with an emphasis on healthy eating behav-
iors and physical activity; and 
‘‘(iv) 
planning 
and 
implementing 
healthy lifestyle classes or programs for 
parents or guardians, with an emphasis on 
healthy eating behaviors and physical ac-
tivity for children; 
‘‘(C) carry out educational, counseling, 
promotional, and training activities through the 
local health care delivery systems including 
by— 
‘‘(i) promoting healthy eating behav-
iors and physical activity services to treat 
or prevent eating disorders, being over-
weight, and obesity; 
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‘‘(ii) providing patient education and 
counseling to increase physical activity and 
promote healthy eating behaviors; 
‘‘(iii) training health professionals on 
how to identify and treat obese and over-
weight individuals which may include nu-
trition and physical activity counseling; 
and 
‘‘(iv) providing community education 
by a health professional on good nutrition 
and physical activity to develop a better 
understanding of the relationship between 
diet, physical activity, and eating disorders, 
obesity, or being overweight; and 
‘‘(D) provide, through qualified health pro-
fessionals, training and supervision for commu-
nity health workers to— 
‘‘(i) educate families regarding the re-
lationship between nutrition, eating habits, 
physical activity, and obesity; 
‘‘(ii) educate families about effective 
strategies to improve nutrition, establish 
healthy eating patterns, and establish ap-
propriate levels of physical activity; and 
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‘‘(iii) educate and guide parents re-
garding the ability to model and commu-
nicate positive health behaviors. 
‘‘(4) PRIORITY.—In awarding grants under 
paragraph (1), the Secretary shall give priority to 
awarding grants to eligible entities— 
‘‘(A) that demonstrate that they have pre-
viously applied successfully for funds to carry 
out activities that seek to promote individual 
and community health and to prevent the inci-
dence of chronic disease and that can cite pub-
lished 
and 
peer-reviewed 
research 
dem-
onstrating that the activities that the entities 
propose to carry out with funds made available 
under the grant are effective; 
‘‘(B) that will carry out programs or ac-
tivities that seek to accomplish a goal or goals 
set by the State in the Healthy People 2010 
plan of the State; 
‘‘(C) that provide non-Federal contribu-
tions, either in cash or in-kind, to the costs of 
funding activities under the grants; 
‘‘(D) that develop comprehensive plans 
that include a strategy for extending program 
activities developed under grants in the years 
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