956 
obligation of 2 years with an award amount 
equal to 50 percent of the amount that would 
otherwise be payable for full-time service; and’’; 
and 
(C) in paragraph (3), by striking ‘‘In eval-
uating a demonstration project described in 
paragraph (1)’’ and inserting ‘‘In evaluating 
waivers issued under paragraph (1)’’. 
(2) DEFINITIONS.—Subsection (j) of section 331 
(42 U.S.C. 254d) is amended by adding at the end 
the following: 
‘‘(5) The terms ‘full time’ and ‘full-time’ mean a 
minimum of 40 hours per week in a clinical practice, 
for a minimum of 45 weeks per year. 
‘‘(6) The terms ‘half time’ and ‘half-time’ mean 
a minimum of 20 hours per week (not to exceed 39 
hours per week) in a clinical practice, for a min-
imum of 45 weeks per year.’’. 
(b) REAPPOINTMENT TO NATIONAL ADVISORY COUN-
CIL.—Section 337(b)(1) (42 U.S.C. 254j(b)(1)) is amended 
by striking ‘‘Members may not be reappointed to the Coun-
cil.’’. 
(c) 
LOAN
REPAYMENT
AMOUNT.—Section 
338B(g)(2)(A) (42 U.S.C. 254l–1(g)(2)(A)) is amended by 
striking ‘‘$35,000’’ and inserting ‘‘$50,000, plus, beginning 
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with fiscal year 2012, an amount determined by the Sec-
retary on an annual basis to reflect inflation,’’. 
(d) TREATMENT OF TEACHING AS OBLIGATED SERV-
ICE.—Subsection (a) of section 338C (42 U.S.C. 254m) is 
amended by adding at the end the following: ‘‘The Secretary 
may treat teaching as clinical practice for up to 20 percent 
of such period of obligated service.’’. 
SEC. 2202. AUTHORIZATIONS OF APPROPRIATIONS. 
(a) NATIONAL HEALTH SERVICE CORPS PROGRAM.— 
Section 338 (42 U.S.C. 254k) is amended— 
(1) in subsection (a), by striking ‘‘2012’’ and in-
serting ‘‘2014’’; and 
(2) by adding at the end the following: 
‘‘(c) For the purpose of carrying out this subpart, in 
addition to any other amounts authorized to be appro-
priated for such purpose, there are authorized to be appro-
priated, out of any monies in the Public Health Investment 
Fund, the following: 
‘‘(1) $63,000,000 for fiscal year 2010. 
‘‘(2) $66,000,000 for fiscal year 2011. 
‘‘(3) $70,000,000 for fiscal year 2012. 
‘‘(4) $73,000,000 for fiscal year 2013. 
‘‘(5) $77,000,000 for fiscal year 2014.’’. 
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(b) SCHOLARSHIP
AND
LOAN
REPAYMENT
PRO-
GRAMS.—Subpart III of part D of title III of the Public 
Health Service Act (42 U.S.C. 254l et seq.) is amended— 
(1) in section 338H(a)— 
(A) in paragraph (4), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (5), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(6) for fiscal years 2013 and 2014, such sums 
as may be necessary.’’; and 
(2) by inserting after section 338H the following: 
‘‘SEC. 338H–1. ADDITIONAL FUNDING. 
‘‘For the purpose of carrying out this subpart, in addi-
tion to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $254,000,000 for fiscal year 2010. 
‘‘(2) $266,000,000 for fiscal year 2011. 
‘‘(3) $278,000,000 for fiscal year 2012. 
‘‘(4) $292,000,000 for fiscal year 2013. 
‘‘(5) $306,000,000 for fiscal year 2014.’’. 
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PART 2—PROMOTION OF PRIMARY CARE AND 
DENTISTRY 
SEC. 2211. FRONTLINE HEALTH PROVIDERS. 
Part D of title III (42 U.S.C. 254b et seq.) is amended 
by adding at the end the following: 
‘‘Subpart XI—Health Professional Needs Areas 
‘‘SEC. 340H. IN GENERAL. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Admin-
istration, shall establish a program, to be known as the 
Frontline Health Providers Loan Repayment Program, to 
address unmet health care needs in health professional needs 
areas through loan repayments under section 340I. 
‘‘(b) DESIGNATION OF HEALTH PROFESSIONAL NEEDS 
AREAS.— 
‘‘(1) IN GENERAL.—In this subpart, the term 
‘health professional needs area’ means an area, popu-
lation, or facility that is designated by the Secretary 
in accordance with paragraph (2). 
‘‘(2) DESIGNATION.—To be designated by the 
Secretary as a health professional needs area under 
this subpart: 
‘‘(A) In the case of an area, the area must 
be a rational area for the delivery of health serv-
ices. 
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‘‘(B) The area, population, or facility must 
have, in one or more health disciplines, special-
ties, or subspecialties for the population served, 
as determined by the Secretary— 
‘‘(i) insufficient capacity of health pro-
fessionals; or 
‘‘(ii) high needs for health services, in-
cluding services to address health dispari-
ties. 
‘‘(C) With respect to the delivery of primary 
health services, the area, population, or facility 
must not include a health professional shortage 
area (as designated under section 332), except 
that the area, population, or facility may in-
clude such a health professional shortage area in 
which there is an unmet need for such services. 
‘‘(c) ELIGIBILITY.—To be eligible to participate in the 
Program, an individual shall— 
‘‘(1) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school de-
fined in section 799B(1)(A) (other than a school of 
public health); 
‘‘(2) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school or 
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program defined in subparagraph (C), (D), or (E)(4) 
of section 799B(1), as designated by the Secretary; 
‘‘(3) be enrolled as a full-time student— 
‘‘(A) in a school or program defined in sub-
paragraph (C), (D), or (E)(4) of section 
799B(1), as designated by the Secretary, or a 
school described in paragraph (1); and 
‘‘(B) in the final year of a course of study 
or program, offered by such school or program 
and approved by the Secretary, leading to a de-
gree in a discipline referred to in subparagraph 
(A) (other than a graduate degree in public 
health), (C), (D), or (E)(4) of section 799B(1); 
‘‘(4) be a practitioner described in section 
1842(b)(18)(C) or 1848(k)(3)(B)(iii) or (iv) of the So-
cial Security Act; or 
‘‘(5) be a practitioner in the field of respiratory 
therapy, medical technology, or radiologic technology. 
‘‘(d) DEFINITIONS.—In this subpart: 
‘‘(1) The term ‘health disparities’ has the mean-
ing given to the term in section 3171. 
‘‘(2) The term ‘primary health services’ has the 
meaning given to such term in section 331(a)(3)(D). 
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‘‘SEC. 340I. LOAN REPAYMENTS. 
‘‘(a) LOAN
REPAYMENTS.—The Secretary, acting 
through the Administrator of the Health Resources and 
Services Administration, shall enter into contracts with in-
dividuals under which— 
‘‘(1) the individual agrees— 
‘‘(A) to serve as a full-time primary health 
services provider or as a full-time or part-time 
provider of other health services for a period of 
time equal to 2 years or such longer period as 
the individual may agree to; 
‘‘(B) to serve in a health professional needs 
area in a health discipline, specialty, or a sub-
specialty for which the area, population, or facil-
ity is designated as a health professional needs 
area under section 340H; and 
‘‘(C) in the case of an individual described 
in section 340H(c)(3) who is in the final year of 
study and who has accepted employment as a 
primary health services provider or provider of 
other health services in accordance with subpara-
graphs (A) and (B), to complete the education or 
training and maintain an acceptable level of 
academic standing (as determined by the edu-
cational institution offering the course of study 
or training); and 
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‘‘(2) the Secretary agrees to pay, for each year 
of such service, an amount on the principal and in-
terest of the undergraduate or graduate educational 
loans (or both) of the individual that is not more 
than 50 percent of the average award made under the 
National Health Service Corps Loan Repayment Pro-
gram under subpart III in that year. 
‘‘(b) PRACTICE SETTING.—A contract entered into 
under this section shall allow the individual receiving the 
loan repayment to satisfy the service requirement described 
in subsection (a)(1) through employment in a solo or group 
practice, a clinic, an accredited public or private nonprofit 
hospital, or any other health care entity, as deemed appro-
priate by the Secretary. 
‘‘(c) APPLICATION OF CERTAIN PROVISIONS.—The pro-
visions of subpart III of part D shall, except as inconsistent 
with this section, apply to the loan repayment program 
under this subpart in the same manner and to the same 
extent as such provisions apply to the National Health 
Service Corps Loan Repayment Program established under 
section 338B. 
‘‘(d) INSUFFICIENT
NUMBER
OF
APPLICANTS.—If 
there are an insufficient number of applicants for loan re-
payments under this section to obligate all appropriated 
funds, the Secretary shall transfer the unobligated funds to 
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the National Health Service Corps for the purpose of re-
cruiting applicants and entering into contracts with indi-
viduals so as to ensure a sufficient number of participants 
in the National Health Service Corps for the following year. 
‘‘SEC. 340J. REPORT. 
‘‘The Secretary shall submit to the Congress an annual 
report on the program carried out under this subpart. 
‘‘SEC. 340K. ALLOCATION. 
‘‘Of the amount of funds obligated under this subpart 
each fiscal year for loan repayments— 
‘‘(1) 90 percent shall be for physicians and other 
health professionals providing primary health serv-
ices; and 
‘‘(2) 10 percent shall be for health professionals 
not described in paragraph (1).’’. 
SEC. 2212. PRIMARY CARE STUDENT LOAN FUNDS. 
(a) IN GENERAL.—Section 735 (42 U.S.C. 292y) is 
amended— 
(1) by redesignating subsection (f) as subsection 
(g); and 
(2) by inserting after subsection (e) the following: 
‘‘(f) DETERMINATION OF FINANCIAL NEED.—The Sec-
retary— 
‘‘(1) may require, or authorize a school or other 
entity to require, the submission of financial informa-
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tion to determine the financial resources available to 
any individual seeking assistance under this subpart; 
and 
‘‘(2) shall take into account the extent to which 
such individual is financially independent in deter-
mining whether to require or authorize the submission 
of such information regarding such individual’s fam-
ily members.’’. 
(b) REVISED GUIDELINES.—The Secretary of Health 
and Human Services shall— 
(1) strike the second sentence of section 57.206(b) 
of title 42, Code of Federal Regulations; and 
(2) make such other revisions to guidelines and 
regulations in effect as of the date of the enactment 
of this Act as may be necessary for consistency with 
the amendments made by paragraph (1). 
SEC. 2213. TRAINING IN FAMILY MEDICINE, GENERAL IN-
TERNAL MEDICINE, GENERAL PEDIATRICS, 
GERIATRICS, AND PHYSICIAN ASSISTANTS. 
Section 747 (42 U.S.C. 293k) is amended— 
(1) by amending the section heading to read as 
follows: ‘‘PRIMARY
CARE
TRAINING
AND
EN-
HANCEMENT’’; 
(2) by redesignating subsection (e) as subsection 
(g); and 
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(3) by striking subsections (a) through (d) and 
inserting the following: 
‘‘(a) PROGRAM.—The Secretary shall establish a pri-
mary care training and capacity building program con-
sisting of awarding grants and contracts under subsections 
(b) and (c). 
‘‘(b) SUPPORT AND DEVELOPMENT OF PRIMARY CARE 
TRAINING PROGRAMS.— 
‘‘(1) IN
GENERAL.—The Secretary shall make 
grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(A) to plan, develop, operate, or partici-
pate in an accredited professional training pro-
gram, including an accredited residency or in-
ternship program, in the field of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics for medical students, interns, 
residents, or practicing physicians; 
‘‘(B) to provide financial assistance in the 
form of traineeships and fellowships to medical 
students, interns, residents, or practicing physi-
cians, who are participants in any such pro-
gram, and who plan to specialize or work in 
family medicine, general internal medicine, gen-
eral pediatrics, or geriatrics; 
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‘‘(C) to plan, develop, operate, or partici-
pate in an accredited program for the training 
of physicians who plan to teach in family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics training programs including 
in community-based settings; 
‘‘(D) to provide financial assistance in the 
form of traineeships and fellowships to prac-
ticing physicians who are participants in any 
such programs and who plan to teach in a fam-
ily medicine, general internal medicine, general 
pediatrics, or geriatrics training program; and 
‘‘(E) to plan, develop, operate, or partici-
pate in an accredited program for physician as-
sistant education, and for the training of indi-
viduals who plan to teach in programs to pro-
vide such training. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant or 
contract under paragraph (1), an entity shall be— 
‘‘(A) an accredited school of medicine or os-
teopathic medicine, public or nonprofit private 
hospital, or physician assistant training pro-
gram; 
‘‘(B) a public or private nonprofit entity; or 
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‘‘(C) a consortium of 2 or more entities de-
scribed in subparagraphs (A) and (B). 
‘‘(c) CAPACITY BUILDING IN PRIMARY CARE.— 
‘‘(1) IN
GENERAL.—The Secretary shall make 
grants to or enter into contracts with eligible entities 
to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant or 
contract under paragraph (1), an entity shall be an 
accredited school of medicine or osteopathic medicine. 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to en-
tities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or signifi-
cantly improving the percentage, of health profes-
sionals who provide primary care. 
‘‘(2) Training individuals who are from under-
represented minority groups or disadvantaged back-
grounds. 
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‘‘(3) A high rate of placing graduates in practice 
settings having the principal focus of serving in un-
derserved areas or populations experiencing health 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Secu-
rity Act or for child health assistance under title XXI 
of such Act or those with special health care needs). 
‘‘(4) Supporting teaching programs that address 
the health care needs of vulnerable populations. 
‘‘(e) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section. 
‘‘(f) DEFINITION.—In this section, the term ‘health dis-
parities’ has the meaning given the term in section 3171.’’. 
SEC. 2214. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) by redesignating section 748 as 749A; and 
(2) by inserting after section 747 the following: 
‘‘SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
‘‘(a) PROGRAM.—The Secretary shall establish a pro-
gram for the training of medical residents in community- 
based settings consisting of awarding grants and contracts 
under this section. 
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‘‘(b) DEVELOPMENT AND OPERATION OF COMMUNITY- 
BASED PROGRAMS.—The Secretary shall make grants to, 
or enter into contracts with, eligible entities— 
‘‘(1) to plan and develop a new primary care 
residency training program, which may include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruiting and training residents and 
faculty; and 
‘‘(C) other activities designated to result in 
accreditation of such a program; or 
‘‘(2) to operate or participate in an established 
primary care residency training program, which may 
include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruitment and training of residents; 
and 
‘‘(C) retention of faculty. 
‘‘(c) ELIGIBLE ENTITY.—To be eligible to receive a 
grant or contract under subsection (b), an entity shall— 
‘‘(1) be designated as a recipient of payment for 
the direct costs of medical education under section 
1886(k) of the Social Security Act; 
‘‘(2) be designated as an approved teaching 
health center under section 1502(d) of the America’s 
Affordable Health Choices Act of 2009 and continuing 
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to participate in the demonstration project under 
such section; or 
‘‘(3) be an applicant for designation described in 
paragraph (1) or (2) and have demonstrated to the 
Secretary appropriate involvement of an accredited 
teaching hospital to carry out the inpatient respon-
sibilities associated with a primary care residency 
training program. 
‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under paragraph (1) or (2) of subsection (b), the Sec-
retary shall give preference to entities that— 
‘‘(1) support teaching programs that address the 
health care needs of vulnerable populations; or 
‘‘(2) are a Federally qualified health center (as 
defined in section 1861(aa)(4) of the Social Security 
Act) or a rural health clinic (as defined in section 
1861(aa)(2) of such Act). 
‘‘(e) ADDITIONAL PREFERENCES FOR ESTABLISHED 
PROGRAMS.—In awarding grants and contracts under sub-
section (b)(2), the Secretary shall give preference to entities 
that have a demonstrated record of training— 
‘‘(1) a high or significantly improved percentage 
of health professionals who provide primary care; 
‘‘(2) individuals who are from underrepresented 
minority groups or disadvantaged backgrounds; or 
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‘‘(3) individuals who practice in settings having 
the principal focus of serving underserved areas or 
populations experiencing health disparities (including 
serving patients eligible for medical assistance under 
title XIX of the Social Security Act or for child health 
assistance under title XXI of such Act or those with 
special health care needs). 
‘‘(f) PERIOD OF AWARDS.— 
‘‘(1) IN GENERAL.—The period of a grant or 
contract under this section— 
‘‘(A) shall not exceed 3 years for awards 
under subsection (b)(1); and 
‘‘(B) shall not exceed 5 years for awards 
under subsection (b)(2). 
‘‘(2) SPECIAL RULES.— 
‘‘(A) An award of a grant or contract under 
subsection (b)(1) shall not be renewed. 
‘‘(B) The period of a grant or contract 
awarded to an entity under subsection (b)(2) 
shall not overlap with the period of any grant or 
contact awarded to the same entity under sub-
section (b)(1). 
‘‘(g) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section. 
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‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) HEALTH
DISPARITIES.—The term ‘health 
disparities’ has the meaning given the term in section 
3171. 
‘‘(2) PRIMARY CARE RESIDENT.—The term ‘pri-
mary care resident’ has the meaning given the term 
in section 1886(h)(5)(H) of the Social Security Act. 
‘‘(3) PRIMARY CARE RESIDENCY TRAINING PRO-
GRAM.—The term ‘primary care residency training 
program’ means an approved medical residency 
training program described in section 1886(h)(5)(A) 
of the Social Security Act for primary care residents 
that is— 
‘‘(A) in the case of entities seeking awards 
under subsection (b)(1), actively applying to be 
accredited by the Accreditation Council for 
Graduate Medical Education or the American 
Osteopathic Association; or 
‘‘(B) in the case of entities seeking awards 
under subsection (b)(2), so accredited.’’. 
SEC. 2215. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
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(1) in section 791(a)(1), by striking ‘‘747 and 
750’’ and inserting ‘‘747, 749, and 750’’; and 
(2) by inserting after section 748, as added, the 
following: 
‘‘SEC. 749. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
‘‘(a) PROGRAM.—The Secretary shall establish a train-
ing program for oral professionals consisting of awarding 
grants and contracts under this section. 
‘‘(b) SUPPORT AND DEVELOPMENT OF DENTAL TRAIN-
ING PROGRAMS.—The Secretary shall make grants to, or 
enter into contracts with, eligible entities— 
‘‘(1) to plan, develop, operate, or participate in 
an accredited professional training program for oral 
health professionals; 
‘‘(2) to provide financial assistance to oral 
health professionals who are in need thereof, who are 
participants in any such program, and who plan to 
work in general, pediatric, or public health dentistry, 
or dental hygiene; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry, or dental hygiene; 
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‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry or dental hygiene; 
‘‘(5) to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of general, pedi-
atric, or public health dentistry; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties; 
‘‘(6) to plan, develop, operate, or participate in 
predoctoral and postdoctoral training in general, pe-
diatric, or public health dentistry programs; 
‘‘(7) to plan, develop, operate, or participate in 
a loan repayment program for full-time faculty in a 
program of general, pediatric, or public health den-
tistry; and 
‘‘(8) to provide technical assistance to pediatric 
dental training programs in developing and imple-
menting instruction regarding the oral health status, 
dental care needs, and risk-based clinical disease 
management of all pediatric populations with an em-
phasis on underserved children. 
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‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited school of dentistry, training 
program in dental hygiene, or public or nonprofit 
private hospital; 
‘‘(2) a training program in dental hygiene at an 
accredited institution of higher education; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of— 
‘‘(A) 1 or more of the entities described in 
paragraphs (1) through (3); and 
‘‘(B) an accredited school of public health. 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to en-
tities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or signifi-
cantly improving the percentage, of oral health profes-
sionals who practice general, pediatric, or public 
health dentistry. 
‘‘(2) Training individuals who are from under-
represented minority groups or disadvantaged back-
grounds. 
‘‘(3) A high rate of placing graduates in practice 
settings having the principal focus of serving in un-
derserved areas or populations experiencing health 
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disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Secu-
rity Act or for child health assistance under title XXI 
of such Act or those with special health care needs). 
‘‘(4) Supporting teaching programs that address 
the dental needs of vulnerable populations. 
‘‘(5) Providing instruction regarding the oral 
health status, dental care needs, and risk-based clin-
ical disease management of all pediatric populations 
with an emphasis on underserved children. 
‘‘(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 disparities’ has the mean-
ing given the term in section 3171. 
‘‘(2) The term ‘oral health professional’ means 
an individual training or practicing— 
‘‘(A) in general dentistry, pediatric den-
tistry, public health dentistry, or dental hygiene; 
or 
‘‘(B) another oral health specialty, as 
deemed appropriate by the Secretary.’’. 
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SEC. 2216. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Part F of title VII (42 U.S.C. 295j 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 799C. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘(a) PROMOTION
OF
PRIMARY
CARE
AND
DEN-
TISTRY.—For the purpose of carrying out subpart XI of 
part D of title III and sections 747, 748, and 749, in addi-
tion to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $240,000,000 for fiscal year 2010. 
‘‘(2) $253,000,000 for fiscal year 2011. 
‘‘(3) $265,000,000 for fiscal year 2012. 
‘‘(4) $278,000,000 for fiscal year 2013. 
‘‘(5) $292,000,000 for fiscal year 2014.’’. 
(b) EXISTING AUTHORIZATION OF APPROPRIATIONS.— 
Subsection (g), as so redesignated, of section 747 (42 U.S.C. 
293k) is amended by striking ‘‘2002’’ and inserting ‘‘2014’’. 
SEC. 2217. STUDY ON EFFECTIVENESS OF SCHOLARSHIPS 
AND LOAN REPAYMENTS. 
Not later than 18 months after the date of the enact-
ment of this Act, the Comptroller General of the United 
States shall conduct a study to determine the effectiveness 
of scholarship and loan repayment programs under sub-
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parts III and XI of part D of title III of the Public Health 
Service Act, as amended or added by sections 2201 and 
2211, including whether scholarships or loan repayments 
are more effective in— 
(1) incentivizing physicians, and other pro-
viders, to pursue careers in primary care specialties; 
(2) retaining such primary care providers; and 
(3) encouraging such primary care providers to 
practice in underserved areas. 
Subtitle B—Nursing Workforce 
SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. 
(a) DEFINITIONS.—Section 801 (42 U.S.C. 296 et seq.) 
is amended— 
(1) in paragraph (1), by inserting ‘‘nurse-man-
aged health centers,’’ after ‘‘nursing centers,’’; and 
(2) by adding at the end the following: 
‘‘(16) NURSE-MANAGED HEALTH CENTER.—The 
term ‘nurse-managed health center’ means a nurse- 
practice arrangement, managed by advanced practice 
nurses, that provides primary care or wellness serv-
ices to underserved or vulnerable populations and is 
associated with an accredited school of nursing, Fed-
erally qualified health center, or independent non-
profit health or social services agency.’’. 
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(b) GRANTS
FOR
HEALTH
PROFESSIONS
EDU-
CATION.—Title VIII (42 U.S.C. 296 et seq.) is amended by 
striking section 807. 
(c) REPORTS.—Part A of title VIII (42 U.S.C. 296 et 
seq.) is amended by adding at the end the following: 
‘‘SEC. 809. REPORTS. 
‘‘The Secretary shall submit to the Congress a separate 
annual report on the activities carried out under each of 
sections 811, 821, 836, 846A, and 861.’’. 
(d) ADVANCED EDUCATION NURSING GRANTS.—Sec-
tion 811(f) (42 U.S.C. 296j(f)) is amended— 
(1) by striking paragraph (2); 
(2) by redesignating paragraph (3) as para-
graph (2); and 
(3) in paragraph (2), as so redesignated, by 
striking ‘‘that agrees’’ and all that follows through the 
end and inserting: ‘‘that agrees to expend the 
award— 
‘‘(A) to train advanced education nurses 
who will practice in health professional shortage 
areas designated under section 332; or 
‘‘(B) to increase diversity among advanced 
education nurses.’’. 
(e) NURSE EDUCATION, PRACTICE, AND RETENTION 
GRANTS.—Section 831 (42 U.S.C. 296p) is amended— 
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(1) in subsection (b), by amending paragraph 
(3) to read as follows: 
‘‘(3) providing coordinated care, quality care, 
and other skills needed to practice nursing; or’’; and 
(2) by striking subsection (e) and redesignating 
subsections (f) through (h) as subsections (e) through 
(g), respectively. 
(f) STUDENT LOANS.—Subsection (a) of section 836 
(42 U.S.C. 297b) is amended— 
(1) by striking ‘‘$2,500’’ and inserting ‘‘$3,300’’; 
(2) by striking ‘‘$4,000’’ and inserting ‘‘$5,200’’; 
(3) 
by 
striking 
‘‘$13,000’’ 
and 
inserting 
‘‘$17,000’’; and 
(4) by adding at the end the following: ‘‘Begin-
ning with fiscal year 2012, the dollar amounts speci-
fied in this subsection shall be adjusted by an amount 
determined by the Secretary on an annual basis to re-
flect inflation.’’. 
(g) LOAN REPAYMENT.—Section 846 (42 U.S.C. 297n) 
is amended— 
(1) in subsection (a), by amending paragraph 
(3) to read as follows: 
‘‘(3) who enters into an agreement with the Sec-
retary to serve for a period of not less than 2 years— 
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‘‘(A) as a nurse at a health care facility 
with a critical shortage of nurses; or 
‘‘(B) as a faculty member at an accredited 
school of nursing;’’; and 
(2) in subsection (g)(1), by striking ‘‘to provide 
health services’’ each place it appears and inserting 
‘‘to provide health services or serve as a faculty mem-
ber’’. 
(h) NURSE FACULTY LOAN PROGRAM.—Paragraph (2) 
of section 846A(c) (42 U.S.C. 297n–1(c)) is amended by 
striking ‘‘$30,000’’ and all that follows through the semi-
colon and inserting ‘‘$35,000, plus, beginning with fiscal 
year 2012, an amount determined by the Secretary on an 
annual basis to reflect inflation;’’. 
(i) PUBLIC SERVICE ANNOUNCEMENTS.—Title VIII 
(42 U.S.C. 296 et seq.) is amended by striking part H. 
(j) TECHNICAL
AND CONFORMING AMENDMENTS.— 
Title VIII (42 U.S.C. 296 et seq.) is amended— 
(1) by moving section 810 (relating to prohibi-
tion against discrimination by schools on the basis of 
sex) so that it follows section 809, as added by sub-
section (c); 
(2) in sections 835, 836, 838, 840, and 842, by 
striking the term ‘‘this subpart’’ each place it appears 
and inserting ‘‘this part’’; 
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(3) in section 836(h), by striking the last sen-
tence; 
(4) in section 836, by redesignating subsection 
(l) as subsection (k); 
(5) in section 839, by striking ‘‘839’’ and all 
that follows through ‘‘(a)’’ and inserting ‘‘839. (a)’’; 
(6) in section 835(b), by striking ‘‘841’’ each 
place it appears and inserting ‘‘871’’; 
(7) by redesignating section 841 as section 871, 
moving part F to the end of the title, and redesig-
nating such part as part H; 
(8) in part G— 
(A) by redesignating section 845 as section 
851; and 
(B) by redesignating part G as part F; and 
(9) in part I— 
(A) by redesignating section 855 as section 
861; and 
(B) by redesignating part I as part G. 
(k) FUNDING.— 
(1) IN GENERAL.—Part H, as redesignated, of 
title VIII is amended by adding at the end the fol-
lowing: 
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‘‘SEC. 872. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘For the purpose of carrying out this title, in addition 
to any other amounts authorized to be appropriated for 
such purpose, there are authorized to be appropriated, out 
of any monies in the Public Health Investment Fund, the 
following: 
‘‘(1) $115,000,000 for fiscal year 2010. 
‘‘(2) $122,000,000 for fiscal year 2011. 
‘‘(3) $127,000,000 for fiscal year 2012. 
‘‘(4) $134,000,000 for fiscal year 2013. 
‘‘(5) $140,000,000 for fiscal year 2014.’’. 
(2) EXISTING AUTHORIZATIONS OF APPROPRIA-
TIONS.— 
(A) SECTIONS 831, 846, 846A, AND 861.—Sec-
tions 831(g) (as so redesignated), 846(i)(1) (42 
U.S.C. 297n(i)(1)), 846A(f) (42 U.S.C. 297n– 
1(f)), and 861(e) (as so redesignated) are amend-
ed by striking ‘‘2007’’ each place it appears and 
inserting ‘‘2014’’. 
(B) SECTION 871.—Section 871, as so redes-
ignated by subsection (j), is amended to read as 
follows: 
‘‘SEC. 871. FUNDING. 
‘‘For the purpose of carrying out parts B, C, and D 
(subject to section 845(g)), there are authorized to be appro-
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priated such sums as may be necessary for each fiscal year 
through fiscal year 2014.’’. 
Subtitle C—Public Health 
Workforce 
SEC. 2231. PUBLIC HEALTH WORKFORCE CORPS. 
Part D of title III (42 U.S.C. 254b et seq.), as amended 
by section 2211, is amended by adding at the end the fol-
lowing: 
‘‘Subpart XII—Public Health Workforce 
‘‘SEC. 340L. PUBLIC HEALTH WORKFORCE CORPS. 
‘‘(a) ESTABLISHMENT.—There is established, within 
the Service, the Public Health Workforce Corps (in this sub-
part referred to as the ‘Corps’), for the purpose of ensuring 
an adequate supply of public health professionals through-
out the Nation. The Corps shall consist of— 
‘‘(1) such officers of the Regular and Reserve 
Corps of the Service as the Secretary may designate; 
‘‘(2) such civilian employees of the United States 
as the Secretary may appoint; and 
‘‘(3) such other individuals who are not employ-
ees of the United States. 
‘‘(b) ADMINISTRATION.—Except as provided in sub-
section (c), the Secretary shall carry out this subpart acting 
through the Administrator of the Health Resources and 
Services Administration. 
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‘‘(c) PLACEMENT AND ASSIGNMENT.—The Secretary, 
acting through the Director of the Centers for Disease Con-
trol and Prevention, shall develop a methodology for placing 
and assigning Corps participants as public health profes-
sionals. Such methodology may allow for placing and as-
signing such participants in State, local, and tribal health 
departments and Federally qualified health centers (as de-
fined in section 1861(aa)(4) of the Social Security Act). 
‘‘(d) APPLICATION
OF CERTAIN PROVISIONS.—The 
provisions of subpart II shall, except as inconsistent with 
this subpart, apply to the Public Health Workforce Corps 
in the same manner and to the same extent as such provi-
sions apply to the National Health Service Corps estab-
lished under section 331. 
‘‘(e) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the programs carried out under 
this subpart. 
‘‘SEC. 340M. PUBLIC HEALTH WORKFORCE SCHOLARSHIP 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish 
the Public Health Workforce Scholarship Program (referred 
to in this section as the ‘Program’) for the purpose described 
in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in the 
Program, an individual shall— 
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‘‘(1)(A) be accepted for enrollment, or be en-
rolled, as a full-time or part-time student in a course 
of study or program (approved by the Secretary) at 
an accredited graduate school or program of public 
health; or 
‘‘(B) have demonstrated expertise in public 
health and be accepted for enrollment, or be enrolled, 
as a full-time or part-time student in a course of 
study or program (approved by the Secretary) at— 
‘‘(i) an accredited graduate school or pro-
gram of nursing; health administration, manage-
ment, or policy; preventive medicine; laboratory 
science; veterinary medicine; or dental medicine; 
or 
‘‘(ii) another accredited graduate school or 
program, as deemed appropriate by Secretary; 
‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for ci-
vilian service in the Corps; and 
‘‘(3) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full-time 
as a public health professional, upon the completion 
of the course of study or program involved, for the pe-
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riod of obligated service described in subsection 
(c)(2)(E). 
‘‘(c) CONTRACT.—The written contract between the 
Secretary and an individual under subsection (b)(3) shall 
contain— 
‘‘(1) an agreement on the part of the Secretary 
that the Secretary will— 
‘‘(A) provide the individual with a scholar-
ship for a period of years (not to exceed 4 aca-
demic years) during which the individual shall 
pursue an approved course of study or program 
to prepare the individual to serve in the public 
health workforce; and 
‘‘(B) accept (subject to the availability of 
appropriated funds) the individual into the 
Corps; 
‘‘(2) an agreement on the part of the individual 
that the individual will— 
‘‘(A) accept provision of such scholarship to 
the individual; 
‘‘(B) maintain full-time or part-time enroll-
ment in the approved course of study or program 
described in subsection (b)(1) until the indi-
vidual completes that course of study or pro-
gram; 
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‘‘(C) while enrolled in the approved course 
of study or program, maintain an acceptable 
level of academic standing (as determined by the 
educational institution offering such course of 
study or program); 
‘‘(D) if applicable, complete a residency or 
internship; and 
‘‘(E) serve full-time as a public health pro-
fessional for a period of time equal to the greater 
of— 
‘‘(i) 1 year for each academic year for 
which the individual was provided a schol-
arship under the Program; or 
‘‘(ii) 2 years; and 
‘‘(3) an agreement by both parties as to the na-
ture and extent of the scholarship assistance, which 
may include— 
‘‘(A) payment of reasonable educational ex-
penses of the individual, including tuition, fees, 
books, equipment, and laboratory expenses; and 
‘‘(B) payment of a stipend of not more than 
$1,269 (plus, beginning with fiscal year 2011, 
an amount determined by the Secretary on an 
annual basis to reflect inflation) per month for 
each month of the academic year involved, with 
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the dollar amount of such a stipend determined 
by the Secretary taking into consideration 
whether the individual is enrolled full-time or 
part-time. 
‘‘(d) APPLICATION
OF CERTAIN PROVISIONS.—The 
provisions of subpart III shall, except as inconsistent with 
this subpart, apply to the scholarship program under this 
section in the same manner and to the same extent as such 
provisions apply to the National Health Service Corps 
Scholarship Program established under section 338A. 
‘‘SEC. 340N. PUBLIC HEALTH WORKFORCE LOAN REPAY-
MENT PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish 
the Public Health Workforce Loan Repayment Program (re-
ferred to in this section as the ‘Program’) for the purpose 
described in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in the 
Program, an individual shall— 
‘‘(1)(A) have a graduate degree from an accred-
ited school or program of public health; 
‘‘(B) have demonstrated expertise in public 
health and have a graduate degree in a course of 
study or program (approved by the Secretary) from— 
‘‘(i) an accredited school or program of 
nursing; health administration, management, or 
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policy; preventive medicine; laboratory science; 
veterinary medicine; or dental medicine; or 
‘‘(ii) another accredited school or program 
approved by the Secretary; or 
‘‘(C) be enrolled as a full-time or part-time stu-
dent in the final year of a course of study or program 
(approved by the Secretary) offered by a school or 
program described in subparagraph (A) or (B), lead-
ing to a graduate degree; 
‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for ci-
vilian service in the Corps; 
‘‘(3) if applicable, complete a residency or in-
ternship; and 
‘‘(4) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full-time 
as a public health professional for the period of obli-
gated service described in subsection (c)(2). 
‘‘(c) CONTRACT.—The written contract between the 
Secretary and an individual under subsection (b)(4) shall 
contain— 
‘‘(1) an agreement by the Secretary to repay on 
behalf of the individual loans incurred by the indi-
vidual in the pursuit of the relevant public health 
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workforce educational degree in accordance with the 
terms of the contract; 
‘‘(2) an agreement by the individual to serve 
full-time as a public health professional for a period 
of time equal to 2 years or such longer period as the 
individual may agree to; and 
‘‘(3) in the case of an individual described in 
subsection (b)(1)(C) who is in the final year of study 
and who has accepted employment as a public health 
professional, in accordance with section 340L(c), an 
agreement on the part of the individual to complete 
the education or training, maintain an acceptable 
level of academic standing (as determined by the edu-
cational institution offering the course of study or 
training), and serve the period of obligated service de-
scribed in paragraph (2). 
‘‘(d) PAYMENTS.— 
‘‘(1) IN GENERAL.—A loan repayment provided 
for an individual under a written contract under the 
Program shall consist of payment, in accordance with 
paragraph (2), on behalf of the individual of the prin-
cipal, interest, and related expenses on government 
and commercial loans received by the individual re-
garding the undergraduate or graduate education of 
the individual (or both), which loans were made for 
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reasonable educational expenses, including tuition, 
fees, books, equipment, and laboratory expenses, in-
curred by the individual. 
‘‘(2) PAYMENTS FOR YEARS SERVED.— 
‘‘(A) IN GENERAL.—For each year of obli-
gated service that an individual contracts to 
serve under subsection (c), the Secretary may 
pay up to $35,000 (plus, beginning with fiscal 
year 2012, an amount determined by the Sec-
retary on an annual basis to reflect inflation) on 
behalf of the individual for loans described in 
paragraph (1). 
‘‘(B) REPAYMENT
SCHEDULE.—Any ar-
rangement made by the Secretary for the making 
of loan repayments in accordance with this sub-
section shall provide that any repayments for a 
year of obligated service shall be made no later 
than the end of the fiscal year in which the indi-
vidual completes such year of service. 
‘‘(e) APPLICATION OF CERTAIN PROVISIONS.—The pro-
visions of subpart III shall, except as inconsistent with this 
subpart, apply to the loan repayment program under this 
section in the same manner and to the same extent as such 
provisions apply to the National Health Service Corps 
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Loan Repayment Program established under section 
338B.’’. 
SEC. 2232. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
Section 765 (42 U.S.C. 295) is amended to read as 
follows: 
‘‘SEC. 765. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Admin-
istration and in consultation with the Director of the Cen-
ters for Disease Control and Prevention, shall establish a 
public health workforce training and enhancement program 
consisting of awarding grants and contracts under sub-
section (b). 
‘‘(b) GRANTS AND CONTRACTS.—The Secretary shall 
award grants and contracts to eligible entities— 
‘‘(1) to plan, develop, operate, or participate in, 
an accredited professional training program in the 
field of public health (including such a program in 
nursing; health administration, management, or pol-
icy; preventive medicine; laboratory science; veteri-
nary medicine; or dental medicine) for members of 
the public health workforce including mid-career pro-
fessionals; 
‘‘(2) to provide financial assistance in the form 
of traineeships and fellowships to students who are 
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participants in any such program and who plan to 
specialize or work in the field of public health; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of public health profes-
sionals who plan to teach in any program described 
in paragraph (1); and 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to public health profes-
sionals who are participants in any program de-
scribed in paragraph (1) and who plan to teach in 
the field of public health, including nursing; health 
administration, management, or policy; preventive 
medicine; laboratory science; veterinary medicine; or 
dental medicine. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited health professions school, in-
cluding an accredited school or program of public 
health; nursing; health administration, management, 
or policy; preventive medicine; laboratory science; vet-
erinary medicine; or dental medicine; 
‘‘(2) a State, local, or tribal health department; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities described 
in paragraphs (1) through (3). 
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‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to en-
tities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or signifi-
cantly improving the percentage, of public health pro-
fessionals who serve in underserved communities. 
‘‘(2) Training individuals who are from under-
represented minority groups or disadvantaged back-
grounds. 
‘‘(3) Training individuals in public health spe-
cialties experiencing a significant shortage of public 
health professionals (as determined by the Secretary). 
‘‘(4) Training the greatest percentage, or signifi-
cantly improving the percentage, of public health pro-
fessionals serving in the Federal Government or a 
State, local, or tribal government. 
‘‘(e) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section.’’. 
SEC. 2233. PUBLIC HEALTH TRAINING CENTERS. 
Section 766 (42 U.S.C. 295a) is amended— 
(1) in subsection (b)(1), by striking ‘‘in further-
ance of the goals established by the Secretary for the 
year 2000’’ and inserting ‘‘in furtherance of the goals 
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established by the Secretary in the national preven-
tion and wellness strategy under section 3121’’; and 
(2) by adding at the end the following: 
‘‘(d) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section.’’. 
SEC. 2234. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
Section 768 (42 U.S.C. 295c) is amended to read as 
follows: 
‘‘SEC. 768. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
‘‘(a) GRANTS.—The Secretary, acting through the Ad-
ministrator of the Health Resources and Services Adminis-
tration and in consultation with the Director of the Centers 
for Disease Control and Prevention, shall award grants to, 
or enter into contracts with, eligible entities to provide 
training to graduate medical residents in preventive medi-
cine specialties. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited school of public health or 
school of medicine or osteopathic medicine; 
‘‘(2) an accredited public or private hospital; 
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‘‘(3) a State, local, or tribal health department; 
or 
‘‘(4) a consortium of 2 or more entities described 
in paragraphs (1) through (3). 
‘‘(c) USE OF FUNDS.—Amounts received under a grant 
or contract under this section shall be used to— 
‘‘(1) plan, develop (including the development of 
curricula), operate, or participate in an accredited 
residency or internship program in preventive medi-
cine or public health; 
‘‘(2) defray the costs of practicum experiences, as 
required in such a program; and 
‘‘(3) establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in preventive medicine and public 
health; or 
‘‘(B) programs that improve clinical teach-
ing in preventive medicine and public health. 
‘‘(d) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section.’’. 
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SEC. 2235. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Section 799C, as added by section 
2216 of this Act, is amended by adding at the end the fol-
lowing: 
‘‘(b) PUBLIC HEALTH WORKFORCE.—For the purpose 
of carrying out subpart XII of part D of title III and sec-
tions 765, 766, and 768, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) $51,000,000 for fiscal year 2010. 
‘‘(2) $54,000,000 for fiscal year 2011. 
‘‘(3) $57,000,000 for fiscal year 2012. 
‘‘(4) $59,000,000 for fiscal year 2013. 
‘‘(5) $62,000,000 for fiscal year 2014.’’. 
(b) EXISTING AUTHORIZATION OF APPROPRIATIONS.— 
Subsection (a) of section 770 (42 U.S.C. 295e) is amended 
by striking ‘‘2002’’ and inserting ‘‘2014’’. 
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Subtitle D—Adapting Workforce to 
Evolving Health System Needs 
PART 1—HEALTH PROFESSIONS TRAINING FOR 
DIVERSITY 
SEC. 2241. SCHOLARSHIPS FOR DISADVANTAGED STU-
DENTS, LOAN REPAYMENTS AND FELLOW-
SHIPS REGARDING FACULTY POSITIONS, AND 
EDUCATIONAL ASSISTANCE IN THE HEALTH 
PROFESSIONS 
REGARDING 
INDIVIDUALS 
FROM DISADVANTAGED BACKGROUNDS. 
Paragraph (1) of section 738(a) (42 U.S.C. 293b(a)) 
is amended by striking ‘‘not more than $20,000’’ and all 
that follows through the end of the paragraph and inserting: 
‘‘not more than $35,000 (plus, beginning with fiscal year 
2012, an amount determined by the Secretary on an annual 
basis to reflect inflation) of the principal and interest of 
the educational loans of such individuals.’’ 
SEC. 2242. NURSING WORKFORCE DIVERSITY GRANTS. 
Subsection (b) of section 821 (42 U.S.C. 296m) is 
amended— 
(1) in the heading, by striking ‘‘GUIDANCE’’ and 
inserting ‘‘CONSULTATION’’; and 
(2) by striking ‘‘shall take into consideration’’ 
and all that follows through ‘‘consult with nursing as-
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sociations’’ and inserting ‘‘shall, as appropriate, con-
sult with nursing associations’’. 
SEC. 2243. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
(a) IN GENERAL.—Title VII (42 U.S.C. 292 et seq.) 
is amended by inserting after section 739 the following: 
‘‘SEC. 739A. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
‘‘The Secretary shall, to the extent practicable, coordi-
nate the activities carried out under this part and section 
821 in order to enhance the effectiveness of such activities 
and avoid duplication of effort.’’. 
(b) REPORT.—Section 736 (42 U.S.C. 293) is amend-
ed— 
(1) by redesignating subsection (h) as subsection 
(i); and 
(2) by inserting after subsection (g) the fol-
lowing: 
‘‘(h) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the activities carried out under 
this section.’’. 
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PART 2—INTERDISCIPLINARY TRAINING 
PROGRAMS 
SEC. 
2251. 
CULTURAL 
AND 
LINGUISTIC 
COMPETENCY 
TRAINING FOR HEALTH PROFESSIONALS. 
Section 741 (42 U.S.C. 293e) is amended— 
(1) in the section heading, by striking ‘‘GRANTS 
FOR
HEALTH
PROFESSIONS
EDUCATION’’ and 
inserting ‘‘CULTURAL
AND
LINGUISTIC
COM-
PETENCY
TRAINING
FOR
HEALTH
PROFES-
SIONALS’’; 
(2) by redesignating subsection (b) as subsection 
(h); and 
(3) by striking subsection (a) and inserting the 
following: 
‘‘(a) PROGRAM.—The Secretary shall establish a cul-
tural and linguistic competency training program for 
health professionals, including nurse professionals, con-
sisting of awarding grants and contracts under subsection 
(b). 
‘‘(b) CULTURAL AND LINGUISTIC COMPETENCY TRAIN-
ING.—The Secretary shall award grants and contracts to 
eligible entities— 
‘‘(1) to test, develop, and evaluate models of cul-
tural and linguistic competency training (including 
continuing education) for health professionals; and 
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‘‘(2) to implement cultural and linguistic com-
petency training programs for health professionals de-
veloped under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities described 
in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants and con-
tracts under this section, the Secretary shall give preference 
to entities that have a demonstrated record of the following: 
‘‘(1) Addressing, or partnering with an entity 
with experience addressing, the cultural and lin-
guistic competency needs of the population to be 
served through the grant or contract. 
‘‘(2) Addressing health disparities. 
‘‘(3) Placing health professionals in regions expe-
riencing significant changes in the cultural and lin-
guistic demographics of populations, including com-
munities along the United States-Mexico border. 
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‘‘(4) Carrying out activities described in sub-
section (b) with respect to more than one health pro-
fession discipline, specialty, or subspecialty. 
‘‘(e) CONSULTATION.—The Secretary shall carry out 
this section in consultation with the heads of appropriate 
health agencies and offices in the Department of Health and 
Human Services, including the Office of Minority Health. 
‘‘(f) DEFINITION.—In this section, the term ‘health dis-
parities’ has the meaning given to the term in section 3171. 
‘‘(g) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section.’’. 
SEC. 2252. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
Part D of title VII (42 U.S.C. 294 et seq.) is amended 
by adding at the end the following: 
‘‘SEC. 759. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
‘‘(a) PROGRAM.—The Secretary shall establish an in-
novations in interdisciplinary care training program con-
sisting of awarding grants and contracts under subsection 
(b). 
‘‘(b) TRAINING
PROGRAMS.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties— 
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1005 
‘‘(1) to test, develop, and evaluate health profes-
sional training programs (including continuing edu-
cation) designed to promote— 
‘‘(A) the delivery of health services through 
interdisciplinary and team-based models, which 
may include patient-centered medical home mod-
els, medication therapy management models, and 
models integrating physical, mental, or oral 
health services; and 
‘‘(B) coordination of the delivery of health 
care within and across settings, including health 
care institutions, community-based settings, and 
the patient’s home; and 
‘‘(2) to implement such training programs devel-
oped under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
‘‘(3) a public or private nonprofit entity (includ-
ing an area health education center or a geriatric 
education center); or 
‘‘(4) a consortium of 2 or more entities described 
in paragraphs (1) through (3). 
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‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under this section, the Secretary shall give preference 
to entities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or signifi-
cantly increasing the percentage, of health profes-
sionals who serve in underserved communities. 
‘‘(2) Broad interdisciplinary team-based collabo-
rations. 
‘‘(3) Addressing health disparities. 
‘‘(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 disparities’ has the mean-
ing given the term in section 3171. 
‘‘(2) The term ‘interdisciplinary’ means collabo-
ration across health professions and specialties, which 
may include public health, nursing, allied health, and 
appropriate medical specialties.’’. 
PART 3—ADVISORY COMMITTEE ON HEALTH 
WORKFORCE EVALUATION AND ASSESSMENT 
SEC. 2261. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
Subpart 1 of part E of title VII (42 U.S.C. 294n et 
seq.) is amended by adding at the end the following: 
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1007 
‘‘SEC. 764. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
‘‘(a) ADVISORY COMMITTEE.—The Secretary, acting 
through the Assistant Secretary for Health, shall establish 
a permanent advisory committee to be known as the Advi-
sory Committee on Health Workforce Evaluation and As-
sessment (referred to in this section as the ‘Advisory Com-
mittee’). 
‘‘(b) RESPONSIBILITIES.—The Advisory Committee 
shall— 
‘‘(1) not later than 1 year after the date of the 
establishment of the Advisory Committee, submit rec-
ommendations to the Secretary on— 
‘‘(A) classifications of the health workforce 
to ensure consistency of data collection on the 
health workforce; and 
‘‘(B) based on such classifications, stand-
ardized methodologies and procedures to enu-
merate the health workforce; 
‘‘(2) not later than 2 years after the date of the 
establishment of the Advisory Committee, submit rec-
ommendations to the Secretary on— 
‘‘(A) the supply, diversity, and geographic 
distribution of the health workforce; 
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1008 
‘‘(B) the retention of the health workforce to 
ensure quality and adequacy of such workforce; 
and 
‘‘(C) policies to carry out the recommenda-
tions made pursuant to subparagraphs (A) and 
(B); and 
‘‘(3) not later than 4 years after the date of the 
establishment of the Advisory Committee, and every 2 
years thereafter, submit updated recommendations to 
the Secretary under paragraphs (1) and (2). 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support for 
the operations of the Advisory Committee, including coordi-
nating and supporting the dissemination of the rec-
ommendations of the Advisory Committee. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) NUMBER; APPOINTMENT.—The Secretary 
shall appoint 15 members to serve on the Advisory 
Committee. 
‘‘(2) TERMS.— 
‘‘(A) IN GENERAL.—The Secretary shall ap-
point members of the Advisory Committee for a 
term of 3 years and may reappoint such mem-
bers, but the Secretary may not appoint any 
member to serve more than a total of 6 years. 
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‘‘(A) include no less than one representative 
of each of— 
‘‘(i) health professionals within the 
health workforce; 
‘‘(ii) health care patients and con-
sumers; 
‘‘(iii) employers; 
‘‘(iv) labor unions; and 
‘‘(v) third-party health payors; and 
‘‘(B) ensure that— 
‘‘(i) all areas of expertise described in 
paragraph (3) are represented; 
‘‘(ii) the members of the Advisory Com-
mittee include members who, collectively, 
have significant experience working with— 
‘‘(I) populations in urban and 
federally designated rural and non-
metropolitan areas; and 
‘‘(II) populations who are under-
represented in the health professions, 
including underrepresented minority 
groups; and 
‘‘(iii) individuals who are directly in-
volved in health professions education or 
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practice do not constitute a majority of the 
members of the Advisory Committee. 
‘‘(5) DISCLOSURE
AND
CONFLICTS
OF
INTER-
EST.—Members of the Advisory Committee shall not 
be considered employees of the Federal Government by 
reason of service on the Advisory Committee, except 
members of the Advisory Committee shall be consid-
ered to be special Government employees within the 
meaning of section 107 of the Ethics in Government 
Act of 1978 (5 U.S.C. App.) and section 208 of title 
18, United States Code, for the purposes of disclosure 
and management of conflicts of interest under those 
sections. 
‘‘(6) NO PAY; RECEIPT OF TRAVEL EXPENSES.— 
Members of the Advisory Committee shall not receive 
any pay for service on the Committee, but may re-
ceive travel expenses, including a per diem, in accord-
ance with applicable provisions of subchapter I of 
chapter 57 of title 5, United States Code. 
‘‘(e) CONSULTATION.—In carrying out this section, the 
Secretary shall consult with the Secretary of Education and 
the Secretary of Labor. 
‘‘(f) COLLABORATION.—The Advisory Committee shall 
collaborate with the advisory bodies at the Health Resources 
and Services Administration, the National Advisory Coun-
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cil (as authorized in section 337), the Advisory Committee 
on Training in Primary Care Medicine and Dentistry (as 
authorized in section 749A), the Advisory Committee on 
Interdisciplinary, Community-Based Linkages (as author-
ized in section 756), the Advisory Council on Graduate 
Medical Education (as authorized in section 762), and the 
National Advisory Council on Nurse Education and Prac-
tice (as authorized in section 851). 
‘‘(g) FACA.—The Federal Advisory Committee Act (5 
U.S.C. App.) except for section 14 of such Act shall apply 
to the Advisory Committee under this section only to the 
extent that the provisions of such Act do not conflict with 
the requirements of this section. 
‘‘(h) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the activities of the Advisory 
Committee. 
‘‘(i) DEFINITION.—In this section, the term ‘health 
workforce’ includes all health care providers with direct pa-
tient care and support responsibilities, including physi-
cians, nurses, physician assistants, pharmacists, oral health 
professionals (as defined in section 749(f)), allied health 
professionals, mental and behavioral health professionals, 
and public health professionals (including veterinarians en-
gaged in public health practice).’’. 
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PART 4—HEALTH WORKFORCE ASSESSMENT 
SEC. 2271. HEALTH WORKFORCE ASSESSMENT. 
(a) IN GENERAL.—Section 761 (42 U.S.C. 294n) is 
amended— 
(1) by redesignating subsection (c) as subsection 
(e); and 
(2) by striking subsections (a) and (b) and in-
serting the following: 
‘‘(a) IN GENERAL.—The Secretary shall, based upon 
the classifications and standardized methodologies and pro-
cedures developed by the Advisory Committee on Health 
Workforce Evaluation and Assessment under section 
764(b)— 
‘‘(1) collect data on the health workforce (as de-
fined in section 764(i)), disaggregated by field, dis-
cipline, and specialty, with respect to— 
‘‘(A) the supply (including retention) of 
health professionals relative to the demand for 
such professionals; 
‘‘(B) the diversity of health professionals 
(including with respect to race, ethnic back-
ground, and gender); and 
‘‘(C) the geographic distribution of health 
professionals; and 
‘‘(2) collect such data on individuals partici-
pating in the programs authorized by subtitles A, B, 
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and C and part 1 of subtitle D of title II of division 
C of the America’s Affordable Health Choices Act of 
2009. 
‘‘(b) GRANTS AND CONTRACTS FOR HEALTH WORK-
FORCE ANALYSIS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
grants or contracts to eligible entities to carry out 
subsection (a). 
‘‘(2) ELIGIBILITY.—To be eligible for a grant or 
contract under this subsection, an entity shall be— 
‘‘(A) an accredited health professions school 
or program; 
‘‘(B) an academic health center; 
‘‘(C) a State, local, or tribal government; 
‘‘(D) a public or private entity; or 
‘‘(E) a consortium of 2 or more entities de-
scribed in subparagraphs (A) through (D). 
‘‘(c) COLLABORATION AND DATA SHARING.—The Sec-
retary shall collaborate with Federal departments and agen-
cies, health professions organizations (including health pro-
fessions education organizations), and professional medical 
societies for the purpose of carrying out subsection (a). 
‘‘(d) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the data collected under sub-
section (a).’’. 
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(b) PERIOD
BEFORE
COMPLETION
OF
NATIONAL 
STRATEGY.—Pending completion of the classifications and 
standardized methodologies and procedures developed by the 
Advisory Committee on Health Workforce Evaluation and 
Assessment under section 764(b) of the Public Health Serv-
ice Act, as added by section 2261, the Secretary of Health 
and Human Services, acting through the Administrator of 
the Health Resources and Services Administration and in 
consultation with such Advisory Committee, may make a 
judgment about the classifications, methodologies, and pro-
cedures to be used for collection of data under section 761(a) 
of the Public Health Service Act, as amended by this sec-
tion. 
PART 5—AUTHORIZATION OF APPROPRIATIONS 
SEC. 2281. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN
GENERAL.—Section 799C, as added and 
amended, is further amended by adding at the end the fol-
lowing: 
‘‘(c) HEALTH PROFESSIONS TRAINING FOR DIVER-
SITY.—For the purpose of carrying out sections 736, 737, 
738, 739, and 739A, in addition to any other amounts au-
thorized to be appropriated for such purpose, there are au-
thorized to be appropriated, out of any monies in the Public 
Health Investment Fund, the following: 
‘‘(1) $90,000,000 for fiscal year 2010. 
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‘‘(2) $97,000,000 for fiscal year 2011. 
‘‘(3) $100,000,000 for fiscal year 2012. 
‘‘(4) $104,000,000 for fiscal year 2013. 
‘‘(5) $110,000,000 for fiscal year 2014. 
‘‘(d) INTERDISCIPLINARY TRAINING PROGRAMS, ADVI-
SORY COMMITTEE ON HEALTH WORKFORCE EVALUATION 
AND ASSESSMENT, AND HEALTH WORKFORCE ASSESS-
MENT.—For the purpose of carrying out sections 741, 759, 
761, and 764, in addition to any other amounts authorized 
to be appropriated for such purpose, there are authorized 
to be appropriated, out of any monies in the Public Health 
Investment Fund, the following: 
‘‘(1) $87,000,000 for fiscal year 2010. 
‘‘(2) $97,000,000 for fiscal year 2011. 
‘‘(3) $103,000,000 for fiscal year 2012. 
‘‘(4) $105,000,000 for fiscal year 2013. 
‘‘(5) $113,000,000 for fiscal year 2014.’’. 
(b) EXISTING
AUTHORIZATIONS
OF
APPROPRIA-
TIONS.— 
(1) SECTION
736.—Paragraph (1) of section 
736(i) (42 U.S.C. 293(h)), as redesignated, is amend-
ed by striking ‘‘2002’’ and inserting ‘‘2014’’. 
(2) SECTIONS 737, 738, AND 739.—Subsections (a), 
(b), and (c) of section 740 are amended by striking 
‘‘2002’’ each place it appears and inserting ‘‘2014’’. 
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(3) SECTION 741.—Subsection (h), as so redesig-
nated, of section 741 is amended— 
(A) by striking ‘‘and’’ after ‘‘fiscal year 
2003,’’; and 
(B) by inserting ‘‘, and such sums as may 
be necessary for subsequent fiscal years through 
the end of fiscal year 2014’’ before the period at 
the end. 
(4) SECTION 761.—Subsection (e)(1), as so redes-
ignated, of section 761 is amended by striking ‘‘2002’’ 
and inserting ‘‘2014’’. 
TITLE III—PREVENTION AND 
WELLNESS 
SEC. 2301. PREVENTION AND WELLNESS. 
(a) IN GENERAL.—The Public Health Service Act (42 
U.S.C. 201 et seq.) is amended by adding at the end the 
following: 
‘‘TITLE XXXI—PREVENTION AND 
WELLNESS 
‘‘Subtitle A—Prevention and 
Wellness Trust 
‘‘SEC. 3111. PREVENTION AND WELLNESS TRUST. 
‘‘(a) DEPOSITS INTO TRUST.—There is established a 
Prevention and Wellness Trust. There are authorized to be 
appropriated to the Trust— 
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‘‘(1) 
amounts 
described 
in 
section 
2002(b)(2)(A)(ii) of the America’s Affordable Health 
Choices Act of 2009 for each fiscal year; and 
‘‘(2) in addition, out of any monies in the Public 
Health Investment Fund— 
‘‘(A) for fiscal year 2010, $2,400,000,000; 
‘‘(B) for fiscal year 2011, $2,845,000,000; 
‘‘(C) for fiscal year 2012, $3,100,000,000; 
‘‘(D) for fiscal year 2013, $3,455,000,000; 
and 
‘‘(E) for fiscal year 2014, $3,600,000,000. 
‘‘(b) AVAILABILITY OF FUNDS.—Amounts in the Pre-
vention and Wellness Trust shall be available, as provided 
in advance in appropriation Acts, for carrying out this 
title. 
‘‘(c) ALLOCATION.—Of the amounts authorized to be 
appropriated in subsection (a)(2), there are authorized to 
be appropriated— 
‘‘(1) for carrying out subtitle C (Prevention Task 
Forces), $30,000,000 for each of fiscal years 2010 
through 2014; 
‘‘(2) for carrying out subtitle D (Prevention and 
Wellness Research)— 
‘‘(A) for fiscal year 2010, $100,000,000; 
‘‘(B) for fiscal year 2011, $150,000,000; 
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‘‘(C) for fiscal year 2012, $200,000,000; 
‘‘(D) for fiscal year 2013, $250,000,000; 
and 
‘‘(E) for fiscal year 2014, $300,000,000; 
‘‘(3) for carrying out subtitle E (Delivery of 
Community Preventive and Wellness Services)— 
‘‘(A) for fiscal year 2010, $1,065,000,000; 
‘‘(B) for fiscal year 2011, $1,260,000,000; 
‘‘(C) for fiscal year 2012, $1,365,000,000; 
‘‘(D) for fiscal year 2013, $1,570,000,000; 
and 
‘‘(E) for fiscal year 2014, $1,600,000,000; 
‘‘(4) for carrying out section 3161 (Core Public 
Health Infrastructure for State, Local, and Tribal 
Health Departments)— 
‘‘(A) for fiscal year 2010, $800,000,000; 
‘‘(B) for fiscal year 2011, $1,000,000,000; 
‘‘(C) for fiscal year 2012, $1,100,000,000; 
‘‘(D) for fiscal year 2013, $1,200,000,000; 
and 
‘‘(E) for fiscal year 2014, $1,265,000,000; 
and 
‘‘(5) for carrying out section 3162 (Core Public 
Health Infrastructure and Activities for CDC), 
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$350,000,000 for each of fiscal years 2010 through 
2014. 
‘‘Subtitle B—National Prevention 
and Wellness Strategy 
‘‘SEC. 3121. NATIONAL PREVENTION AND WELLNESS STRAT-
EGY. 
‘‘(a) IN GENERAL.—The Secretary shall submit to the 
Congress within one year after the date of the enactment 
of this section, and at least every 2 years thereafter, a na-
tional strategy that is designed to improve the Nation’s 
health through evidence-based clinical and community pre-
vention and wellness activities (in this section referred to 
as ‘prevention and wellness activities’), including core pub-
lic health infrastructure improvement activities. 
‘‘(b) CONTENTS.—The strategy under subsection (a) 
shall include each of the following: 
‘‘(1) Identification of specific national goals and 
objectives in prevention and wellness activities that 
take into account appropriate public health measures 
and standards, including departmental measures and 
standards (including Healthy People and National 
Public Health Performance Standards). 
‘‘(2) Establishment of national priorities for pre-
vention and wellness, taking into account unmet pre-
vention and wellness needs. 
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‘‘(3) Establishment of national priorities for re-
search on prevention and wellness, taking into ac-
count unanswered research questions on prevention 
and wellness. 
‘‘(4) Identification of health disparities in pre-
vention and wellness. 
‘‘(5) Review of prevention payment incentives, 
the prevention workforce, and prevention delivery sys-
tem capacity. 
‘‘(6) A plan for addressing and implementing 
paragraphs (1) through (5). 
‘‘(c) CONSULTATION.—In developing or revising the 
strategy under subsection (a), the Secretary shall consult 
with the following: 
‘‘(1) The heads of appropriate health agencies 
and offices in the Department, including the Office of 
the Surgeon General of the Public Health Service, the 
Office of Minority Health, the Office on Women’s 
Health, and the Substance Abuse and Mental Health 
Services Administration. 
‘‘(2) As appropriate, the heads of other Federal 
departments and agencies whose programs have a sig-
nificant impact upon health (as determined by the 
Secretary). 
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‘‘(3) As appropriate, nonprofit and for-profit en-
tities. 
‘‘(4) The Association of State and Territorial 
Health Officials and the National Association of 
County and City Health Officials. 
‘‘(5) The Task Force on Community Preventive 
Services and the Task Force on Clinical Preventive 
Services. 
‘‘Subtitle C—Prevention Task 
Forces 
‘‘SEC. 3131. TASK FORCE ON CLINICAL PREVENTIVE SERV-
ICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Director of the Agency for Healthcare Research and Qual-
ity, shall establish a permanent task force to be known as 
the Task Force on Clinical Preventive Services (in this sec-
tion referred to as the ‘Task Force’). 
‘‘(b) RESPONSIBILITIES.—The Task Force shall— 
‘‘(1) identify clinical preventive services for re-
view; 
‘‘(2) review the scientific evidence related to the 
benefits, effectiveness, appropriateness, and costs of 
clinical preventive services identified under para-
graph (1) for the purpose of developing, updating, 
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publishing, and disseminating evidence-based rec-
ommendations on the use of such services; 
‘‘(3) as appropriate, take into account health 
disparities in developing, updating, publishing, and 
disseminating evidence-based recommendations on the 
use of such services; 
‘‘(4) identify gaps in clinical preventive services 
research and evaluation and recommend priority 
areas for such research and evaluation; 
‘‘(5) as appropriate, consult with the clinical 
prevention stakeholders board in accordance with sub-
section (f); 
‘‘(6) consult with the Task Force on Community 
Preventive Services established under section 3132; 
and 
‘‘(7) as appropriate, in carrying out this section, 
consider the national strategy under section 3121. 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support for 
the operations of the Task Force, including coordinating 
and supporting the dissemination of the recommendations 
of the Task Force. 
‘‘(d) MEMBERSHIP.— 
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‘‘(1) NUMBER; APPOINTMENT.—The Task Force 
shall be composed of 30 members, appointed by the 
Secretary. 
‘‘(2) TERMS.— 
‘‘(A) IN GENERAL.—The Secretary shall ap-
point members of the Task Force for a term of 
6 years and may reappoint such members, but 
the Secretary may not appoint any member to 
serve more than a total of 12 years. 
‘‘(B) STAGGERED TERMS.—Notwithstanding 
subparagraph (A), of the members first ap-
pointed to serve on the Task Force after the en-
actment of this title— 
‘‘(i) 10 shall be appointed for a term 
of 2 years; 
‘‘(ii) 10 shall be appointed for a term 
of 4 years; and 
‘‘(iii) 10 shall be appointed for a term 
of 6 years. 
‘‘(3) QUALIFICATIONS.—Members of the Task 
Force shall be appointed from among individuals who 
possess expertise in at least one of the following areas: 
‘‘(A) Health promotion and disease preven-
tion. 
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‘‘(B) Evaluation of research and systematic 
evidence reviews. 
‘‘(C) Application of systematic evidence re-
views to clinical decisionmaking or health policy. 
‘‘(D) Clinical primary care in child and 
adolescent health. 
‘‘(E) Clinical primary care in adult health, 
including women’s health. 
‘‘(F) Clinical primary care in geriatrics. 
‘‘(G) Clinical counseling and behavioral 
services for primary care patients. 
‘‘(4) REPRESENTATION.—In appointing members 
of the Task Force, the Secretary shall ensure that— 
‘‘(A) all areas of expertise described in 
paragraph (3) are represented; and 
‘‘(B) the members of the Task Force include 
individuals with expertise in health disparities. 
‘‘(e) SUBGROUPS.—As appropriate to maximize effi-
ciency, the Task Force may delegate authority for con-
ducting reviews and making recommendations to subgroups 
consisting of Task Force members, subject to final approval 
by the Task Force. 
‘‘(f) CLINICAL PREVENTION STAKEHOLDERS BOARD.— 
‘‘(1) IN GENERAL.—The Task Force shall con-
vene a clinical prevention stakeholders board com-
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posed of representatives of appropriate public and 
private entities with an interest in clinical preventive 
services to advise the Task Force on developing, up-
dating, publishing, and disseminating evidence-based 
recommendations on the use of clinical preventive 
services. 
‘‘(2) MEMBERSHIP.—The members of the clinical 
prevention stakeholders board shall include represent-
atives of the following: 
‘‘(A) Health care consumers and patient 
groups. 
‘‘(B) Providers of clinical preventive serv-
ices, including community-based providers. 
‘‘(C) Federal departments and agencies, in-
cluding— 
‘‘(i) appropriate health agencies and 
offices in the Department, including the Of-
fice of the Surgeon General of the Public 
Health Service, the Office of Minority 
Health, the National Center on Minority 
Health and Health Disparities, and the Of-
fice on Women’s Health; and 
‘‘(ii) as appropriate, other Federal de-
partments and agencies whose programs 
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have a significant impact upon health (as 
determined by the Secretary). 
‘‘(D) Private health care payors. 
‘‘(3) RESPONSIBILITIES.—In accordance with 
subsection (b)(5), the clinical prevention stakeholders 
board shall— 
‘‘(A) recommend clinical preventive services 
for review by the Task Force; 
‘‘(B) suggest scientific evidence for consider-
ation by the Task Force related to reviews under-
taken by the Task Force; 
‘‘(C) provide feedback regarding draft rec-
ommendations by the Task Force; and 
‘‘(D) assist with efforts regarding dissemi-
nation of recommendations by the Director of the 
Agency for Healthcare Research and Quality. 
‘‘(g) DISCLOSURE AND CONFLICTS OF INTEREST.— 
Members of the Task Force or the clinical prevention stake-
holders board shall not be considered employees of the Fed-
eral Government by reason of service on the Task Force or 
the clinical prevention stakeholders board, except members 
of the Task Force or the clinical prevention stakeholders 
board shall be considered to be special Government employ-
ees within the meaning of section 107 of the Ethics in Gov-
ernment Act of 1978 (5 U.S.C. App.) and section 208 of 
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title 18, United States Code, for the purposes of disclosure 
and management of conflicts of interest under those sec-
tions. 
‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.—Mem-
bers of the Task Force or the clinical prevention stakeholders 
board shall not receive any pay for service on the Task 
Force, but may receive travel expenses, including a per 
diem, in accordance with applicable provisions of sub-
chapter I of chapter 57 of title 5, United States Code. 
‘‘(i) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) except for section 14 of such 
Act shall apply to the Task Force to the extent that the 
provisions of such Act do not conflict with the provisions 
of this title. 
‘‘(j) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the Task Force, including with 
respect to gaps identified and recommendations made under 
subsection (b)(4). 
‘‘(k) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given the term in section 3171. 
‘‘SEC. 3132. TASK FORCE ON COMMUNITY PREVENTIVE 
SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, 
shall establish a permanent task force to be known as the 
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Task Force on Community Preventive Services (in this sec-
tion referred to as the ‘Task Force’). 
‘‘(b) RESPONSIBILITIES.—The Task Force shall— 
‘‘(1) identify community preventive services for 
review; 
‘‘(2) review the scientific evidence related to the 
benefits, effectiveness, appropriateness, and costs of 
community preventive services identified under para-
graph (1) for the purpose of developing, updating, 
publishing, and disseminating evidence-based rec-
ommendations on the use of such services; 
‘‘(3) as appropriate, take into account health 
disparities in developing, updating, publishing, and 
disseminating evidence-based recommendations on the 
use of such services; 
‘‘(4) identify gaps in community preventive serv-
ices research and evaluation and recommend priority 
areas for such research and evaluation; 
‘‘(5) as appropriate, consult with the community 
prevention stakeholders board in accordance with sub-
section (f); 
‘‘(6) consult with the Task Force on Clinical 
Preventive Services established under section 3131; 
and 
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‘‘(7) as appropriate, in carrying out this section, 
consider the national strategy under section 3121. 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support for 
the operations of the Task Force, including coordinating 
and supporting the dissemination of the recommendations 
of the Task Force. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) NUMBER; APPOINTMENT.—The Task Force 
shall be composed of 30 members, appointed by the 
Secretary. 
‘‘(2) TERMS.— 
‘‘(A) IN GENERAL.—The Secretary shall ap-
point members of the Task Force for a term of 
6 years and may reappoint such members, but 
the Secretary may not appoint any member to 
serve more than a total of 12 years. 
‘‘(B) STAGGERED TERMS.—Notwithstanding 
subparagraph (A), of the members first ap-
pointed to serve on the Task Force after the en-
actment of this section— 
‘‘(i) 10 shall be appointed for a term 
of 2 years; 
‘‘(ii) 10 shall be appointed for a term 
of 4 years; and 
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‘‘(iii) 10 shall be appointed for a term 
of 6 years. 
‘‘(3) QUALIFICATIONS.—Members of the Task 
Force shall be appointed from among individuals who 
possess expertise in at least one of the following areas: 
‘‘(A) Public health. 
‘‘(B) Evaluation of research and systematic 
evidence reviews. 
‘‘(C) Disciplines relevant to community pre-
ventive services, including health promotion; dis-
ease prevention; chronic disease; worksite health; 
qualitative and quantitative analysis; and health 
economics, policy, law, and statistics. 
‘‘(4) REPRESENTATION.—In appointing members 
of the Task Force, the Secretary— 
‘‘(A) shall ensure that all areas of expertise 
described in paragraph (3) are represented; 
‘‘(B) shall ensure that such members include 
sufficient representatives of each of— 
‘‘(i) State health officers; 
‘‘(ii) local health officers; 
‘‘(iii) health care practitioners; and 
‘‘(iv) public health practitioners; and 
‘‘(C) shall appoint individuals who have ex-
pertise in health disparities. 
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‘‘(e) SUBGROUPS.—As appropriate to maximize effi-
ciency, the Task Force may delegate authority for con-
ducting reviews and making recommendations to subgroups 
consisting of Task Force members, subject to final approval 
by the Task Force. 
‘‘(f) 
COMMUNITY
PREVENTION
STAKEHOLDERS 
BOARD.— 
‘‘(1) IN GENERAL.—The Task Force shall con-
vene a community prevention stakeholders board com-
posed of representatives of appropriate public and 
private entities with an interest in community pre-
ventive services to advise the Task Force on devel-
oping, updating, publishing, and disseminating evi-
dence-based recommendations on the use of commu-
nity preventive services. 
‘‘(2) MEMBERSHIP.—The members of the com-
munity prevention stakeholders board shall include 
representatives of the following: 
‘‘(A) Health care consumers and patient 
groups. 
‘‘(B) Providers of community preventive 
services, including community-based providers. 
‘‘(C) Federal departments and agencies, in-
cluding— 
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‘‘(i) appropriate health agencies and 
offices in the Department, including the Of-
fice of the Surgeon General of the Public 
Health Service, the Office of Minority 
Health, the National Center on Minority 
Health and Health Disparities, and the Of-
fice on Women’s Health; and 
‘‘(ii) as appropriate, other Federal de-
partments and agencies whose programs 
have a significant impact upon health (as 
determined by the Secretary). 
‘‘(D) Private health care payors. 
‘‘(3) RESPONSIBILITIES.—In accordance with 
subsection (b)(5), the community prevention stake-
holders board shall— 
‘‘(A) recommend community preventive 
services for review by the Task Force; 
‘‘(B) suggest scientific evidence for consider-
ation by the Task Force related to reviews under-
taken by the Task Force; 
‘‘(C) provide feedback regarding draft rec-
ommendations by the Task Force; and 
‘‘(D) assist with efforts regarding dissemi-
nation of recommendations by the Director of the 
Centers for Disease Control and Prevention. 
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‘‘(g) DISCLOSURE AND CONFLICTS OF INTEREST.— 
Members of the Task Force or the community prevention 
stakeholders board shall not be considered employees of the 
Federal Government by reason of service on the Task Force 
or the community prevention stakeholders board, except 
members of the Task Force or the community prevention 
stakeholders board shall be considered to be special Govern-
ment employees within the meaning of section 107 of the 
Ethics in Government Act of 1978 (5 U.S.C. App.) and sec-
tion 208 of title 18, United States Code, for the purposes 
of disclosure and management of conflicts of interest under 
those sections. 
‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.—Mem-
bers of the Task Force or the community prevention stake-
holders board shall not receive any pay for service on the 
Task Force, but may receive travel expenses, including a 
per diem, in accordance with applicable provisions of sub-
chapter I of chapter 57 of title 5, United States Code. 
‘‘(i) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) except for section 14 of such 
Act shall apply to the Task Force to the extent that the 
provisions of such Act do not conflict with the provisions 
of this title. 
‘‘(j) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the Task Force, including with 
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respect to gaps identified and recommendations made under 
subsection (b)(4). 
‘‘(k) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given the term in section 3171. 
‘‘Subtitle D—Prevention and 
Wellness Research 
‘‘SEC. 3141. PREVENTION AND WELLNESS RESEARCH ACTIV-
ITY COORDINATION. 
‘‘In conducting or supporting research on prevention 
and wellness, the Director of the Centers for Disease Control 
and Prevention, the Director of the National Institutes of 
Health, and the heads of other agencies within the Depart-
ment of Health and Human Services conducting or sup-
porting such research, shall take into consideration the na-
tional strategy under section 3121 and the recommenda-
tions of the Task Force on Clinical Preventive Services 
under section 3131 and the Task Force on Community Pre-
ventive Services under section 3132. 
‘‘SEC. 3142. COMMUNITY PREVENTION AND WELLNESS RE-
SEARCH GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, 
shall conduct, or award grants to eligible entities to con-
duct, research in priority areas identified by the Secretary 
in the national strategy under section 3121 or by the Task 
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Force on Community Preventive Services as required by 
section 3132. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall be— 
‘‘(1) a State, local, or tribal department of 
health; 
‘‘(2) a public or private nonprofit entity; or 
‘‘(3) a consortium of 2 or more entities described 
in paragraphs (1) and (2). 
‘‘(c) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program of research under 
this section. 
‘‘Subtitle E—Delivery of Community 
Prevention and Wellness Services 
‘‘SEC. 3151. COMMUNITY PREVENTION AND WELLNESS 
SERVICES GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, 
shall establish a program for the delivery of community pre-
vention and wellness services consisting of awarding grants 
to eligible entities— 
‘‘(1) to provide evidence-based, community pre-
vention and wellness services in priority areas identi-
fied by the Secretary in the national strategy under 
section 3121; or 
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‘‘(2) to plan such services. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) DEFINITION.—To be eligible for a grant 
under this section, an entity shall be— 
‘‘(A) a State, local, or tribal department of 
health; 
‘‘(B) a public or private entity; or 
‘‘(C) a consortium of— 
‘‘(i) 2 or more entities described in 
subparagraph (A) or (B); and 
‘‘(ii) a community partnership rep-
resenting a Health Empowerment Zone. 
‘‘(2) HEALTH
EMPOWERMENT
ZONE.—In this 
subsection, the term ‘Health Empowerment Zone’ 
means an area— 
‘‘(A) in which multiple community preven-
tion and wellness services are implemented in 
order to address one or more health disparities, 
including those identified by the Secretary in the 
national strategy under section 3121; and 
‘‘(B) which is represented by a community 
partnership that demonstrates community sup-
port and coordination with State, local, or tribal 
health departments and includes— 
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‘‘(i) a broad cross section of stake-
holders; 
‘‘(ii) residents of the community; and 
‘‘(iii) representatives of entities that 
have a history of working within and serv-
ing the community. 
‘‘(c) PREFERENCES.—In awarding grants under this 
section, the Secretary shall give preference to entities that— 
‘‘(1) will address one or more goals or objectives 
identified by the Secretary in the national strategy 
under section 3121; 
‘‘(2) will address significant health disparities, 
including those identified by the Secretary in the na-
tional strategy under section 3121; 
‘‘(3) will address unmet community prevention 
and wellness needs and avoids duplication of effort; 
‘‘(4) have been demonstrated to be effective in 
communities comparable to the proposed target com-
munity; 
‘‘(5) will contribute to the evidence base for com-
munity prevention and wellness services; 
‘‘(6) demonstrate that the community prevention 
and wellness services to be funded will be sustainable; 
and 
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‘‘(7) demonstrate coordination or collaboration 
across governmental and nongovernmental partners. 
‘‘(d) HEALTH DISPARITIES.—Of the funds awarded 
under this section for a fiscal year, the Secretary shall 
award not less than 50 percent for planning or imple-
menting community prevention and wellness services whose 
primary purpose is to achieve a measurable reduction in 
one or more health disparities, including those identified 
by the Secretary in the national strategy under section 
3121. 
‘‘(e) EMPHASIS ON RECOMMENDED SERVICES.—For 
fiscal year 2013 and subsequent fiscal years, the Secretary 
shall award grants under this section only for planning or 
implementing services recommended by the Task Force on 
Community Preventive Services under section 3122 or 
deemed effective based on a review of comparable rigor (as 
determined by the Director of the Centers for Disease Con-
trol and Prevention). 
‘‘(f) PROHIBITED USES OF FUNDS.—An entity that re-
ceives a grant under this section may not use funds pro-
vided through the grant— 
‘‘(1) to build or acquire real property or for con-
struction; or 
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‘‘(2) for services or planning to the extent that 
payment has been made, or can reasonably be ex-
pected to be made— 
‘‘(A) under any insurance policy; 
‘‘(B) under any Federal or State health ben-
efits program (including titles XIX and XXI of 
the Social Security Act); or 
‘‘(C) by an entity which provides health 
services on a prepaid basis. 
‘‘(g) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program of grants awarded 
under this section. 
‘‘(h) DEFINITIONS.—In this section, the term ‘evi-
dence-based’ means that methodologically sound research 
has demonstrated a beneficial health effect, in the judgment 
of the Director of the Centers for Disease Control and Pre-
vention. 
‘‘Subtitle F—Core Public Health 
Infrastructure 
‘‘SEC. 3161. CORE PUBLIC HEALTH INFRASTRUCTURE FOR 
STATE, LOCAL, AND TRIBAL HEALTH DEPART-
MENTS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention 
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shall establish a core public health infrastructure program 
consisting of awarding grants under subsection (b). 
‘‘(b) GRANTS.— 
‘‘(1) AWARD.—For the purpose of addressing 
core public health infrastructure needs, the Sec-
retary— 
‘‘(A) shall award a grant to each State 
health department; and 
‘‘(B) may award grants on a competitive 
basis to State, local, or tribal health depart-
ments. 
‘‘(2) ALLOCATION.—Of the total amount of funds 
awarded as grants under this subsection for a fiscal 
year— 
‘‘(A) not less than 50 percent shall be for 
grants to State health departments under para-
graph (1)(A); and 
‘‘(B) not less than 30 percent shall be for 
grants to State, local, or tribal health depart-
ments under paragraph (1)(B). 
‘‘(c) USE OF FUNDS.—The Secretary may award a 
grant to an entity under subsection (b)(1) only if the entity 
agrees to use the grant to address core public health infra-
structure needs, including those identified in the accredita-
tion process under subsection (g). 
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‘‘(d) FORMULA GRANTS TO STATE HEALTH DEPART-
MENTS.—In making grants under subsection (b)(1)(A), the 
Secretary shall award funds to each State health depart-
ment in accordance with— 
‘‘(1) a formula based on population size; burden 
of preventable disease and disability; and core public 
health infrastructure gaps, including those identified 
in the accreditation process under subsection (g); and 
‘‘(2) application requirements established by the 
Secretary, including a requirement that the State 
submit a plan that demonstrates to the satisfaction of 
the Secretary that the State’s health department 
will— 
‘‘(A) address its highest priority core public 
health infrastructure needs; and 
‘‘(B) as appropriate, allocate funds to local 
health departments within the State. 
‘‘(e) COMPETITIVE GRANTS TO STATE, LOCAL, AND 
TRIBAL HEALTH DEPARTMENTS.—In making grants under 
subsection (b)(1)(B), the Secretary shall give priority to ap-
plicants demonstrating core public health infrastructure 
needs identified in the accreditation process under sub-
section (g). 
‘‘(f) MAINTENANCE OF EFFORT.—The Secretary may 
award a grant to an entity under subsection (b) only if 
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the entity demonstrates to the satisfaction of the Secretary 
that— 
‘‘(1) funds received through the grant will be ex-
pended only to supplement, and not supplant, non- 
Federal and Federal funds otherwise available to the 
entity for the purpose of addressing core public health 
infrastructure needs; and 
‘‘(2) with respect to activities for which the grant 
is awarded, the entity will maintain expenditures of 
non-Federal amounts for such activities at a level not 
less than the level of such expenditures maintained by 
the entity for the fiscal year preceding the fiscal year 
for which the entity receives the grant. 
‘‘(g) ESTABLISHMENT OF A PUBLIC HEALTH ACCREDI-
TATION PROGRAM.— 
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Director of the Centers for Disease Con-
trol and Prevention, shall— 
‘‘(A) develop, and periodically review and 
update, standards for voluntary accreditation of 
State, local, or tribal health departments and 
public health laboratories for the purpose of ad-
vancing the quality and performance of such de-
partments and laboratories; and 
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‘‘(B) implement a program to accredit such 
health departments and laboratories in accord-
ance with such standards. 
‘‘(2) COOPERATIVE AGREEMENT.—The Secretary 
may enter into a cooperative agreement with a pri-
vate nonprofit entity to carry out paragraph (1). 
‘‘(h) REPORT.—The Secretary shall submit to the Con-
gress an annual report on progress being made to accredit 
entities under subsection (g), including— 
‘‘(1) a strategy, including goals and objectives, 
for accrediting entities under subsection (g) and 
achieving the purpose described in subsection (g)(1); 
and 
‘‘(2) identification of gaps in research related to 
core public health infrastructure and recommenda-
tions of priority areas for such research. 
‘‘SEC. 3162. CORE PUBLIC HEALTH INFRASTRUCTURE AND 
ACTIVITIES FOR CDC. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, 
shall expand and improve the core public health infrastruc-
ture and activities of the Centers for Disease Control and 
Prevention to address unmet and emerging public health 
needs. 
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‘‘(b) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the activities funded through this 
section. 
‘‘Subtitle G—General Provisions 
‘‘SEC. 3171. DEFINITIONS. 
‘‘In this title: 
‘‘(1) The term ‘core public health infrastructure’ 
includes workforce capacity and competency; labora-
tory systems; health information, health information 
systems, and health information analysis; commu-
nications; financing; other relevant components of or-
ganizational capacity; and other related activities. 
‘‘(2) The terms ‘Department’ and ‘departmental’ 
refer to the Department of Health and Human Serv-
ices. 
‘‘(3) The term ‘health disparities’ includes health 
and health care disparities and means population- 
specific differences in the presence of disease, health 
outcomes, or access to health care. For purposes of the 
preceding sentence, a population may be delineated 
by race, ethnicity, geographic setting, and other popu-
lations or subpopulations determined by the Secretary 
to experience significant gaps in disease, health out-
comes, or access to health care. 
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‘‘(4) The term ‘tribal’ refers to an Indian tribe, 
a Tribal organization, or an Urban Indian organiza-
tion, as such terms are defined in section 4 of the In-
dian Health Care Improvement Act.’’. 
(b) TRANSITION PROVISIONS APPLICABLE TO TASK 
FORCES.— 
(1) FUNCTIONS, PERSONNEL, ASSETS, LIABIL-
ITIES, AND ADMINISTRATIVE ACTIONS.—All functions, 
personnel, assets, and liabilities of, and administra-
tive actions applicable to, the Preventive Services 
Task Force convened under section 915(a) of the Pub-
lic Health Service Act and the Task Force on Com-
munity Preventive Services (as such section and Task 
Forces were in existence on the day before the date of 
the enactment of this Act) shall be transferred to the 
Task Force on Clinical Preventive Services and the 
Task Force on Community Preventive Services, re-
spectively, established under sections 3121 and 3122 
of the Public Health Service Act, as added by sub-
section (a). 
(2) RECOMMENDATIONS.—All recommendations 
of the Preventive Services Task Force and the Task 
Force on Community Preventive Services, as in exist-
ence on the day before the date of the enactment of 
this Act, shall be considered to be recommendations of 
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the Task Force on Clinical Preventive Services and 
the Task Force on Community Preventive Services, 
respectively, established under sections 3121 and 3122 
of the Public Health Service Act, as added by sub-
section (a). 
(3) MEMBERS ALREADY SERVING.— 
(A) INITIAL MEMBERS.—The Secretary of 
Health and Human Services may select those in-
dividuals already serving on the Preventive 
Services Task Force and the Task Force on Com-
munity Preventive Services, as in existence on 
the day before the date of the enactment of this 
Act, to be among the first members appointed to 
the Task Force on Clinical Preventive Services 
and the Task Force on Community Preventive 
Services, respectively, under sections 3121 and 
3122 of the Public Health Service Act, as added 
by subsection (a). 
(B) CALCULATION OF TOTAL SERVICE.—In 
calculating the total years of service of a member 
of 
a 
task 
force 
for 
purposes 
of 
section 
3131(d)(2)(A) or 3132(d)(2)(A) of the Public 
Health Service Act, as added by subsection (a), 
the Secretary of Health and Human Services 
shall not include any period of service by the 
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member on the Preventive Services Task Force or 
the Task Force on Community Preventive Serv-
ices, respectively, as in existence on the day be-
fore the date of the enactment of this Act. 
(c) PERIOD
BEFORE
COMPLETION
OF
NATIONAL 
STRATEGY.—Pending completion of the national strategy 
under section 3121 of the Public Health Service Act, as 
added by subsection (a), the Secretary of Health and 
Human Services, acting through the relevant agency head, 
may make a judgment about how the strategy will address 
an issue and rely on such judgment in carrying out any 
provision of subtitle C, D, E, or F of title XXXI of such 
Act, as added by subsection (a), that requires the Sec-
retary— 
(1) to take into consideration such strategy; 
(2) to conduct or support research or provide 
services in priority areas identified in such strategy; 
or 
(3) to take any other action in reliance on such 
strategy. 
(d) CONFORMING AMENDMENTS.— 
(1) Paragraph (61) of section 3(b) of the Indian 
Health Care Improvement Act (25 U.S.C. 1602) is 
amended by striking ‘‘United States Preventive Serv-
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ices Task Force’’ and inserting ‘‘Task Force on Clin-
ical Preventive Services’’. 
(2) Section 126 of the Medicare, Medicaid, and 
SCHIP Benefits Improvement and Protection Act of 
2000 (Appendix F of Public Law 106–554) is amend-
ed by striking ‘‘United States Preventive Services 
Task Force’’ each place it appears and inserting 
‘‘Task Force on Clinical Preventive Services’’. 
(3) Paragraph (7) of section 317D(a) of the Pub-
lic Health Service Act (42 U.S.C. 247b–5(a)) is 
amended by striking ‘‘United States Preventive Serv-
ices Task Force’’ and inserting ‘‘Task Force on Clin-
ical Preventive Services’’. 
(4) Section 915 of the Public Health Service Act 
(42 U.S.C. 299b–4) is amended by striking subsection 
(a). 
(5) Subsections (s)(2)(AA)(iii)(II), (xx)(1), and 
(ddd)(1)(B) of section 1861 of the Social Security Act 
(42 U.S.C. 1395x) are amended by striking ‘‘United 
States Preventive Services Task Force’’ each place it 
appears and inserting ‘‘Task Force on Clinical Pre-
ventive Services’’. 
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TITLE IV—QUALITY AND 
SURVEILLANCE 
SEC. 2401. IMPLEMENTATION OF BEST PRACTICES IN THE 
DELIVERY OF HEALTH CARE. 
(a) IN GENERAL.—Title IX of the Public Health Serv-
ice Act (42 U.S.C. 299 et seq.) is amended— 
(1) by redesignating part D as part E; 
(2) by redesignating sections 931 through 938 as 
sections 941 through 948, respectively; 
(3) in section 948(1), as redesignated, by strik-
ing ‘‘931’’ and inserting ‘‘941’’; and 
(4) by inserting after part C the following: 
‘‘PART D—IMPLEMENTATION OF BEST PRACTICES 
IN THE DELIVERY OF HEALTH CARE 
‘‘SEC. 931. CENTER FOR QUALITY IMPROVEMENT. 
‘‘(a) IN GENERAL.—There is established the Center for 
Quality Improvement (referred to in this part as the ‘Cen-
ter’), to be headed by the Director. 
‘‘(b) PRIORITIZATION.— 
‘‘(1) IN GENERAL.—The Director shall prioritize 
areas for the identification, development, evaluation, 
and implementation of best practices (including inno-
vative methodologies and strategies) for quality im-
provement activities in the delivery of health care 
services (in this section referred to as ‘best practices’). 
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‘‘(2) CONSIDERATIONS.—In prioritizing areas 
under paragraph (1), the Director shall consider— 
‘‘(A) the priorities established under section 
1191 of the Social Security Act; and 
‘‘(B) the key health indicators identified by 
the Assistant Secretary for Health Information 
under section 1709. 
‘‘(3) LIMITATIONS.—In conducting its duties 
under this subsection, the Center for Quality Improve-
ment shall not develop quality-adjusted life year 
measures or any other methodologies that can be used 
to deny benefits to a beneficiary against the bene-
ficiary’s wishes on the basis of the beneficiary’s age, 
life expectancy, present or predicted disability, or ex-
pected quality of life. 
‘‘(c) OTHER RESPONSIBILITIES.—The Director, acting 
directly or by awarding a grant or contract to an eligible 
entity, shall— 
‘‘(1) identify existing best practices under sub-
section (e); 
‘‘(2) develop new best practices under subsection 
(f); 
‘‘(3) evaluate best practices under subsection (g); 
‘‘(4) implement best practices under subsection 
(h); 
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‘‘(5) ensure that best practices are identified, de-
veloped, evaluated, and implemented under this sec-
tion consistent with standards adopted by the Sec-
retary under section 3004 for health information tech-
nology used in the collection and reporting of quality 
information (including for purposes of the demonstra-
tion of meaningful use of certified electronic health 
record (EHR) technology by physicians and hospitals 
under 
the 
Medicare 
program 
(under 
sections 
1848(o)(2) and 1886(n)(3), respectively, of the Social 
Security Act)); and 
‘‘(6) provide for dissemination of information 
and reporting under subsections (i) and (j). 
‘‘(d) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (c), an entity shall— 
‘‘(1) be a nonprofit entity; 
‘‘(2) agree to work with a variety of institutional 
health care providers, physicians, nurses, and other 
health care practitioners; and 
‘‘(3) if the entity is not the organization holding 
a contract under section 1153 of the Social Security 
Act for the area to be served, agree to cooperate with 
and avoid duplication of the activities of such organi-
zation. 
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‘‘(e) IDENTIFYING EXISTING BEST PRACTICES.—The 
Secretary shall identify best practices that are— 
‘‘(1) currently utilized by health care providers 
(including hospitals, physician and other clinician 
practices, community cooperatives, and other health 
care entities) that deliver consistently high-quality, ef-
ficient health care services; and 
‘‘(2) easily adapted for use by other health care 
providers and for use across a variety of health care 
settings. 
‘‘(f) DEVELOPING NEW BEST PRACTICES.—The Sec-
retary shall develop best practices that are— 
‘‘(1) based on a review of existing scientific evi-
dence; 
‘‘(2) sufficiently detailed for implementation and 
incorporation into the workflow of health care pro-
viders; and 
‘‘(3) designed to be easily adapted for use by 
health care providers across a variety of health care 
settings. 
‘‘(g) EVALUATION OF BEST PRACTICES.—The Director 
shall evaluate best practices identified or developed under 
this section. Such evaluation— 
‘‘(1) shall include determinations of which best 
practices— 
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‘‘(A) most reliably and effectively achieve 
significant progress in improving the quality of 
patient care; and 
‘‘(B) are easily adapted for use by health 
care providers across a variety of health care set-
tings; 
‘‘(2) shall include regular review, updating, and 
improvement of such best practices; and 
‘‘(3) may include in-depth case studies or empir-
ical assessments of health care providers (including 
hospitals, physician and other clinician practices, 
community cooperatives, and other health care enti-
ties) and simulations of such best practices for deter-
minations under paragraph (1). 
‘‘(h) IMPLEMENTATION OF BEST PRACTICES.— 
‘‘(1) IN GENERAL.—The Director shall enter into 
arrangements with entities in a State or region to 
implement best practices identified or developed under 
this section. Such implementation— 
‘‘(A) may include forming collaborative 
multi-institutional teams; and 
‘‘(B) shall include an evaluation of the best 
practices being implemented, including the meas-
urement of patient outcomes before, during, and 
after implementation of such best practices. 
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‘‘(2) PREFERENCES.—In carrying out this sub-
section, the Director shall give priority to health care 
providers implementing best practices that— 
‘‘(A) have the greatest impact on patient 
outcomes and satisfaction; 
‘‘(B) are the most easily adapted for use by 
health care providers across a variety of health 
care settings; 
‘‘(C) promote coordination of health care 
practitioners across the continuum of care; and 
‘‘(D) engage patients and their families in 
improving patient care and outcomes. 
‘‘(i) PUBLIC DISSEMINATION OF INFORMATION.—The 
Director shall provide for the public dissemination of infor-
mation with respect to best practices and activities under 
this section. Such information shall be made available in 
appropriate formats and languages to reflect the varying 
needs of consumers and diverse levels of health literacy. 
‘‘(j) REPORT.— 
‘‘(1) IN GENERAL.—The Director shall submit an 
annual report to the Congress and the Secretary on 
activities under this section. 
‘‘(2) CONTENT.—Each report under paragraph 
(1) shall include— 
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‘‘(A) information on activities conducted 
pursuant to grants and contracts awarded; 
‘‘(B) summary data on patient outcomes be-
fore, during, and after implementation of best 
practices; and 
‘‘(C) recommendations on the adaptability 
of best practices for use by health providers.’’. 
(b) INITIAL QUALITY IMPROVEMENT ACTIVITIES AND 
INITIATIVES TO BE IMPLEMENTED.—Until the Director of 
the Agency for Healthcare Research and Quality has estab-
lished initial priorities under section 931(b) of the Public 
Health Service Act, as added by subsection (a), the Director 
shall, for purposes of such section, prioritize the following: 
(1) HEALTH
CARE-ASSOCIATED
INFECTIONS.— 
Reducing health care-associated infections, including 
infections in nursing homes and outpatient settings. 
(2) SURGERY.—Increasing hospital and out-
patient perioperative patient safety, including reduc-
ing surgical-site infections and surgical errors (such 
as wrong-site surgery and retained foreign bodies). 
(3) EMERGENCY ROOM.—Improving care in hos-
pital emergency rooms, including through the use of 
principles of efficiency of design and delivery to im-
prove patient flow. 
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(4) OBSTETRICS.—Improving the provision of 
obstetrical and neonatal care, including the identi-
fication of interventions that are effective in reducing 
the risk of preterm and premature labor and the im-
plementation of best practices for labor and delivery 
care. 
(5) PEDIATRICS.—Improving the provision of 
preventive and developmental child health services, 
including interventions that can reduce child health 
disparities and reduce the risk of developing chronic 
health-threatening conditions that affect an individ-
ual’s life course development. 
(c) REPORT.—Not later than 18 months after the date 
of the enactment of this Act, the Director of the Agency for 
Healthcare Research and Quality shall submit a report to 
the Congress on the impact of the nurse-to-patient ratio on 
the quality of care and patient outcomes, including rec-
ommendations for further integration into quality measure-
ment and quality improvement activities. 
SEC. 2402. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
(a) ESTABLISHMENT.—Title XVII (42 U.S.C. 300u et 
seq.) is amended— 
(1) by redesignating sections 1709 and 1710 as 
sections 1710 and 1711, respectively; and 
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(2) by inserting after section 1708 the following: 
‘‘SEC. 1709. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
‘‘(a) IN GENERAL.—There is established within the De-
partment an Assistant Secretary for Health Information 
(in this section referred to as the ‘Assistant Secretary’), to 
be appointed by the Secretary. 
‘‘(b) RESPONSIBILITIES.—The Assistant Secretary 
shall— 
‘‘(1) ensure the collection, collation, reporting, 
and publishing of information (including full and 
complete statistics) on key health indicators regarding 
the Nation’s health and the performance of the Na-
tion’s health care; 
‘‘(2) facilitate and coordinate the collection, col-
lation, reporting, and publishing of information re-
garding the Nation’s health and the performance of 
the Nation’s health care (other than information de-
scribed in paragraph (1)); 
‘‘(3)(A) develop standards for the collection of 
data regarding the Nation’s health and the perform-
ance of the Nation’s health care; and 
‘‘(B) in carrying out subparagraph (A)— 
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‘‘(i) ensure appropriate specificity and 
standardization for data collection at the na-
tional, regional, State, and local levels; 
‘‘(ii) include standards, as appropriate, for 
the collection of accurate data on health and 
health care by race, ethnicity, primary language, 
sex, sexual orientation, gender identity, dis-
ability, socioeconomic status, rural, urban, or 
other geographic setting, and any other popu-
lation or subpopulation determined appropriate 
by the Secretary; 
‘‘(iii) ensure, with respect to data on race 
and ethnicity, consistency with the 1997 Office of 
Management and Budget Standards for Main-
taining, Collecting and Presenting Federal Data 
on Race and Ethnicity (or any successor stand-
ards); and 
‘‘(iv) in consultation with the Director of 
the Office of Minority Health, and the Director 
of the Office of Civil Rights, of the Department, 
develop standards for the collection of data on 
health and health care with respect to primary 
language; 
‘‘(4) provide support to Federal departments and 
agencies whose programs have a significant impact 
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upon health (as determined by the Secretary) for the 
collection and collation of information described in 
paragraphs (1) and (2); 
‘‘(5) ensure the sharing of information described 
in paragraphs (1) and (2) among the agencies of the 
Department; 
‘‘(6) facilitate the sharing of information de-
scribed in paragraphs (1) and (2) by Federal depart-
ments and agencies whose programs have a signifi-
cant impact upon health (as determined by the Sec-
retary); 
‘‘(7) identify gaps in information described in 
paragraphs (1) and (2) and the appropriate agency 
or entity to address such gaps; 
‘‘(8) facilitate and coordinate identification and 
monitoring by the agencies of the Department of 
health disparities to inform program and policy ef-
forts to reduce such disparities, including facilitating 
and funding analyses conducted in cooperation with 
the Social Security Administration, the Bureau of the 
Census, and other appropriate agencies and entities; 
‘‘(9) consistent with privacy, proprietary, and 
other appropriate safeguards, facilitate public accessi-
bility of datasets (such as de-identified Medicare 
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datasets or publicly available data on key health indi-
cators) by means of the Internet; and 
‘‘(10) award grants or contracts for the collection 
and collation of information described in paragraphs 
(1) and (2) (including through statewide surveys that 
provide standardized information). 
‘‘(c) KEY HEALTH INDICATORS.— 
‘‘(1) IN GENERAL.—In carrying out subsection 
(b)(1), the Assistant Secretary shall— 
‘‘(A) identify, and reassess at least once 
every 3 years, key health indicators described in 
such subsection; 
‘‘(B) publish statistics on such key health 
indicators for the public— 
‘‘(i) not less than annually; and 
‘‘(ii) on a supplemental basis whenever 
warranted by— 
‘‘(I) the rate of change for a key 
health indicator; or 
‘‘(II) the need to inform policy re-
garding the Nation’s health and the 
performance of the Nation’s health 
care; and 
‘‘(C) ensure consistency with the national 
strategy developed by the Secretary under section 
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3121 and consideration of the indicators speci-
fied in the reports under sections 308, 903(a)(6), 
and 913(b)(2). 
‘‘(2) RELEASE OF KEY HEALTH INDICATORS.— 
The regulations, rules, processes, and procedures of the 
Office of Management and Budget governing the re-
view, release, and dissemination of key health indica-
tors shall be the same as the regulations, rules, proc-
esses, and procedures of the Office of Management and 
Budget governing the review, release, and dissemina-
tion of Principal Federal Economic Indicators (or 
equivalent statistical data) by the Bureau of Labor 
Statistics. 
‘‘(d) COORDINATION.—In carrying out this section, the 
Assistant Secretary shall coordinate with— 
‘‘(1) public and private entities that collect and 
disseminate information on health and health care, 
including foundations; and 
‘‘(2) the head of the Office of the National Coor-
dinator for Health Information Technology to ensure 
optimal use of health information technology. 
‘‘(e) REQUEST FOR INFORMATION FROM OTHER DE-
PARTMENTS AND AGENCIES.—Consistent with applicable 
law, the Assistant Secretary may secure directly from any 
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Federal department or agency information necessary to en-
able the Assistant Secretary to carry out this section. 
‘‘(f) REPORT.— 
‘‘(1) 
SUBMISSION.—The 
Assistant 
Secretary 
shall submit to the Secretary and the Congress an an-
nual report containing— 
‘‘(A) a description of national, regional, or 
State changes in health or health care, as re-
flected by the key health indicators identified 
under subsection (c)(1); 
‘‘(B) a description of gaps in the collection, 
collation, reporting, and publishing of informa-
tion regarding the Nation’s health and the per-
formance of the Nation’s health care; 
‘‘(C) recommendations for addressing such 
gaps and identification of the appropriate agen-
cy within the Department or other entity to ad-
dress such gaps; 
‘‘(D) a description of analyses of health dis-
parities, including the results of completed anal-
yses, the status of ongoing longitudinal studies, 
and proposed or planned research; and 
‘‘(E) a plan for actions to be taken by the 
Assistant Secretary to address gaps described in 
subparagraph (B). 
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‘‘(2) CONSIDERATION.—In preparing a report 
under paragraph (1), the Assistant Secretary shall 
take into consideration the findings and conclusions 
in the reports under sections 308, 903(a)(6), and 
913(b)(2). 
‘‘(g) PROPRIETARY
AND PRIVACY PROTECTIONS.— 
Nothing in this section shall be construed to affect applica-
ble proprietary or privacy protections. 
‘‘(h) CONSULTATION.—In carrying out this section, the 
Assistant Secretary shall consult with— 
‘‘(1) the heads of appropriate health agencies 
and offices in the Department, including the Office of 
the Surgeon General of the Public Health Service, the 
Office of Minority Health, and the Office on Women’s 
Health; and 
‘‘(2) as appropriate, the heads of other Federal 
departments and agencies whose programs have a sig-
nificant impact upon health (as determined by the 
Secretary). 
‘‘(i) DEFINITION.—In this section: 
‘‘(1) The terms ‘agency’ and ‘agencies’ include 
an epidemiology center established under section 214 
of the Indian Health Care Improvement Act. 
‘‘(2) The term ‘Department’ means the Depart-
ment of Health and Human Services. 
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‘‘(3) The term ‘health disparities’ has the mean-
ing given to such term in section 3171.’’. 
(b) OTHER COORDINATION RESPONSIBILITIES.—Title 
III (42 U.S.C. 241 et seq.) is amended— 
(1) in paragraphs (1) and (2) of section 304(c) 
(42 U.S.C. 242b(c)), by inserting ‘‘, acting through 
the Assistant Secretary for Health Information,’’ after 
‘‘The Secretary’’ each place it appears; and 
(2) in section 306(j) (42 U.S.C. 242k(j)), by in-
serting ‘‘, acting through the Assistant Secretary for 
Health Information,’’ after ‘‘of this section, the Sec-
retary’’. 
SEC. 2403. AUTHORIZATION OF APPROPRIATIONS. 
Section 799C, as added and amended, is further 
amended by adding at the end the following: 
‘‘(e) QUALITY AND SURVEILLANCE.—For the purpose 
of carrying out part D of title IX and section 1709, in addi-
tion to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
$300,000,000 for each of fiscal years 2010 through 2014.’’. 
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TITLE V—OTHER PROVISIONS 
Subtitle A—Drug Discount for 
Rural and Other Hospitals 
SEC. 2501. EXPANDED PARTICIPATION IN 340B PROGRAM. 
(a) EXPANSION OF COVERED ENTITIES RECEIVING 
DISCOUNTED PRICES.—Section 340B(a)(4) (42 U.S.C. 
256b(a)(4)) is amended by adding at the end the following: 
‘‘(M) A children’s hospital excluded from the 
Medicare prospective payment system pursuant 
to section 1886(d)(1)(B)(iii) of the Social Secu-
rity Act which would meet the requirements of 
subparagraph (L), including the dispropor-
tionate share adjustment percentage requirement 
under subparagraph (L)(ii), if the hospital were 
a subsection (d) hospital as defined in section 
1886(d)(1)(B) of the Social Security Act. 
‘‘(N) An entity that is a critical access hos-
pital (as determined under section 1820(c)(2) of 
the Social Security Act). 
‘‘(O) An entity receiving funds under title 
V of the Social Security Act (relating to mater-
nal and child health) for the provision of health 
services. 
‘‘(P) An entity receiving funds under sub-
part I of part B of title XIX of the Public Health 
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Service Act (relating to comprehensive mental 
health services) for the provision of community 
mental health services. 
‘‘(Q) An entity receiving funds under sub-
part II of such part B (relating to the prevention 
and treatment of substance abuse) for the provi-
sion of treatment services for substance abuse. 
‘‘(R) An entity that is a Medicare-depend-
ent, small rural hospital (as defined in section 
1886(d)(5)(G)(iv) of the Social Security Act). 
‘‘(S) An entity that is a sole community 
hospital (as defined in section 1886(d)(5)(D)(iii) 
of the Social Security Act). 
‘‘(T) An entity that is classified as a rural 
referral center under section 1886(d)(5)(C) of the 
Social Security Act.’’. 
(b) PROHIBITION ON GROUP PURCHASING ARRANGE-
MENTS.—Section 340B(a) (42 U.S.C. 256b(a)) is amend-
ed— 
(1) in paragraph (4)(L)— 
(A) by adding ‘‘and’’ at the end of clause 
(i); 
(B) by striking ‘‘; and’’ at the end of clause 
(ii) and inserting a period; and 
(C) by striking clause (iii); and 
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(2) in paragraph (5), by redesignating subpara-
graphs (C) and (D) as subparagraphs (D) and (E), 
respectively, and by inserting after subparagraph (B) 
the following: 
‘‘(C) PROHIBITING
USE
OF
GROUP
PUR-
CHASING ARRANGEMENTS.— 
‘‘(i) A hospital described in subpara-
graph (L), (M), (N), (R), (S), or (T) of 
paragraph (4) shall not obtain covered out-
patient drugs through a group purchasing 
organization or other group purchasing ar-
rangement, except as permitted or provided 
pursuant to clause (ii). 
‘‘(ii) The Secretary shall establish rea-
sonable exceptions to the requirement of 
clause (i)— 
‘‘(I) with respect to a covered out-
patient drug that is unavailable to be 
purchased through the program under 
this section due to a drug shortage 
problem, manufacturer noncompliance, 
or any other reason beyond the hos-
pital’s control; 
‘‘(II) to facilitate generic substi-
tution when a generic covered out-
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patient drug is available at a lower 
price; and 
‘‘(III) to reduce in other ways the 
administrative burdens of managing 
both inventories of drugs obtained 
under this section and not under this 
section, if such exception does not cre-
ate a duplicate discount problem in 
violation of subparagraph (A) or a di-
version problem in violation of sub-
paragraph (B).’’. 
SEC. 2502. EXTENSION OF DISCOUNTS TO INPATIENT 
DRUGS. 
(a) IN GENERAL.—Section 340B (42 U.S.C. 256b) is 
amended— 
(1) in subsection (b)— 
(A) by striking ‘‘In this section, the terms’’ 
and inserting the following: ‘‘In this section: 
‘‘(1) IN GENERAL.—The terms’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(2) 
COVERED
DRUG.—The 
term 
‘covered 
drug’— 
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‘‘(A) means a covered outpatient drug (as 
defined in section 1927(k)(2) of the Social Secu-
rity Act); and 
‘‘(B) includes, notwithstanding the section 
1927(k)(3)(A) of such Act, a drug used in con-
nection with an inpatient or outpatient service 
provided by a hospital described in subpara-
graph (L), (M), (N), (R), (S), or (T) of sub-
section (a)(4) that is enrolled to participate in 
the drug discount program under this section.’’; 
and 
(2) in paragraphs (5) (other than subparagraph 
(C)), (7), and (9) of subsection (a), by striking ‘‘out-
patient’’ each place it appears. 
(b) MEDICAID CREDITS ON INPATIENT DRUGS.—Sub-
section (c) of section 340B (42 U.S.C. 256b(c)) is amended 
to read as follows: 
‘‘(c) MEDICAID CREDITS ON INPATIENT DRUGS.— 
‘‘(1) IN GENERAL.—For the cost reporting period 
covered by the most recently filed Medicare cost report 
under title XVIII of the Social Security Act, a hos-
pital described in subparagraph (L), (M), (N), (R), 
(S), or (T) of subsection (a)(4) and enrolled to par-
ticipate in the drug discount program under this sec-
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tion shall provide to each State under its plan under 
title XIX of such Act— 
‘‘(A) a credit on the estimated annual costs 
to such hospital of single source and innovator 
multiple source drugs provided to Medicaid bene-
ficiaries for inpatient use; and 
‘‘(B) a credit on the estimated annual costs 
to such hospital of noninnovator multiple source 
drugs provided to Medicaid beneficiaries for in-
patient use. 
‘‘(2) AMOUNT OF CREDITS.— 
‘‘(A) SINGLE SOURCE AND INNOVATOR MUL-
TIPLE SOURCE DRUGS.—For purposes of para-
graph (1)(A)— 
‘‘(i) the credit under such paragraph 
shall be equal to the product of— 
‘‘(I) the annual value of single 
source and innovator multiple source 
drugs purchased under this section by 
the hospital based on the drugs’ aver-
age manufacturer price; 
‘‘(II) the estimated percentage of 
the hospital’s drug purchases attrib-
utable to Medicaid beneficiaries for in-
patient use; and 
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‘‘(III) the minimum rebate per-
centage 
described 
in 
section 
1927(c)(1)(B) of the Social Security 
Act; 
‘‘(ii) the reference in clause (i)(I) to 
the annual value of single source and inno-
vator multiple source drugs purchased 
under this section by the hospital based on 
the drugs’ average manufacturer price shall 
be equal to the sum of— 
‘‘(I) the annual quantity of each 
single source and innovator multiple 
source drug purchased during the cost 
reporting period, multiplied by 
‘‘(II) the average manufacturer 
price for that drug; 
‘‘(iii) the reference in clause (i)(II) to 
the estimated percentage of the hospital’s 
drug purchases attributable to Medicaid 
beneficiaries for inpatient use shall be equal 
to— 
‘‘(I) the Medicaid inpatient drug 
charges as reported on the hospital’s 
most recently filed Medicare cost re-
port, divided by 
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‘‘(II) total drug charges reported 
on the cost report; and 
‘‘(iv) the terms ‘single source drug’ and 
‘innovator multiple source drug’ have the 
meanings given such terms in section 
1927(k)(7) of the Social Security Act. 
‘‘(B) NONINNOVATOR
MULTIPLE
SOURCE 
DRUGS.—For purposes of paragraph (1)(B)— 
‘‘(i) the credit under such paragraph 
shall be equal to the product of— 
‘‘(I) the annual value of noninno-
vator multiple source drugs purchased 
under this section by the hospital based 
on the drugs’ average manufacturer 
price; 
‘‘(II) the estimated percentage of 
the hospital’s drug purchases attrib-
utable to Medicaid beneficiaries for in-
patient use; and 
‘‘(III) the applicable percentage as 
defined in section 1927(c)(3)(B) of the 
Social Security Act; 
‘‘(ii) the reference in clause (i)(I) to 
the annual value of noninnovator multiple 
source drugs purchased under this section 
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by the hospital based on the drugs’ average 
manufacturer price shall be equal to the 
sum of— 
‘‘(I) the annual quantity of each 
noninnovator multiple source drug 
purchased during the cost reporting pe-
riod, multiplied by 
‘‘(II) the average manufacturer 
price for that drug; 
‘‘(iii) the reference in clause (i)(II) to 
the estimated percentage of the hospital’s 
drug purchases attributable to Medicaid 
beneficiaries for inpatient use shall be equal 
to— 
‘‘(I) the Medicaid inpatient drug 
charges as reported on the hospital’s 
most recently filed Medicare cost re-
port, divided by 
‘‘(II) total drug charges reported 
on the cost report; and 
‘‘(iv) the term ‘noninnovator multiple 
source drug’ has the meaning given such 
term in section 1927(k)(7) of the Social Se-
curity Act. 
‘‘(3) CALCULATION OF CREDITS.— 
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‘‘(A) IN GENERAL.—Each State calculates 
credits under paragraph (1) and informs hos-
pitals of amount under section 1927(a)(5)(D) of 
the Social Security Act. 
‘‘(B) HOSPITAL
PROVISION
OF
INFORMA-
TION.—Not later than 30 days after the date of 
the filing of the hospital’s most recently filed 
Medicare cost report, the hospital shall provide 
the State with the information described in 
paragraphs (2)(A)(ii) and (2)(B)(ii). With re-
spect to each drug purchased during the cost re-
porting period, the hospital shall provide the dos-
age form, strength, package size, date of pur-
chase, and the number of units purchased. 
‘‘(4) PAYMENT DEADLINE.—The credits provided 
by a hospital under paragraph (1) shall be paid with-
in 60 days after receiving the information specified in 
paragraph (3)(A). 
‘‘(5) OPT OUT.—A hospital shall not be required 
to provide the Medicaid credit required under para-
graph (1) if it can demonstrate to the State that it 
will lose reimbursement under the State plan result-
ing from the extension of discounts to inpatient drugs 
under subsection (b)(2) and that the loss of reimburse-
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ment will exceed the amount of the credit otherwise 
owed by the hospital. 
‘‘(6) OFFSET AGAINST MEDICAL ASSISTANCE.— 
Amounts received by a State under this subsection in 
any quarter shall be considered to be a reduction in 
the amount expended under the State plan in the 
quarter for medical assistance for purposes of section 
1903(a)(1) of the Social Security Act.’’. 
(c) CONFORMING AMENDMENTS.—Section 1927 of the 
Social Security Act (42 U.S.C. 1396r–8) is amended— 
(1) in subsection (a)(5)(A), by striking ‘‘covered 
outpatient drugs’’ and inserting ‘‘covered drugs (as 
defined in section 340B(b)(2) of the Public Health 
Service Act)’’; 
(2) in subsection (a)(5), by striking subpara-
graph (D) and inserting the following: 
‘‘(D) STATE RESPONSIBILITY FOR CALCU-
LATING
HOSPITAL
CREDITS.—The State shall 
calculate the credits owed by the hospital under 
paragraph (1) of section 340B(c) of the Public 
Health Service Act and provide the hospital with 
both the amounts and an explanation of how it 
calculated the credits. In performing the calcula-
tions specified in paragraphs (2)(A)(ii) and 
(2)(B)(ii) of such section, the State shall use the 
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average manufacturer price applicable to the cal-
endar quarter in which the drug was purchased 
by the hospital.’’; and 
(3) in subsection (k)(1)— 
(A) in subparagraph (A), by striking ‘‘sub-
paragraph (B)’’ and inserting ‘‘subparagraphs 
(B) and (D)’’; and 
(B) by adding at the end the following: 
‘‘(D) CALCULATION FOR COVERED DRUGS.— 
With respect to a covered drug (as defined in sec-
tion 340B(b)(2) of the Public Health Service 
Act), the average manufacturer price shall be de-
termined in accordance with subparagraph (A) 
except that, in the event a covered drug is not 
distributed to the retail pharmacy class of trade, 
it shall mean the average price paid to the man-
ufacturer for the drug in the United States by 
wholesalers for drugs distributed to the acute 
care class of trade, after deducting customary 
prompt pay discounts.’’. 
SEC. 2503. EFFECTIVE DATE. 
(a) IN GENERAL.—The amendments made by this sub-
title shall take effect on July 1, 2010, and shall apply to 
drugs dispensed on or after such date. 
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(b) EFFECTIVENESS.—The amendments made by this 
subtitle shall be effective, and shall be taken into account 
in determining whether a manufacturer is deemed to meet 
the requirements of section 340B(a) of the Public Health 
Service Act (42 U.S.C. 256b(a)) and of section 1927(a)(5) 
of the Social Security Act (42 U.S.C. 1396r–8(a)(5)), not-
withstanding any other provision of law. 
Subtitle B—Programs 
PART 1—GRANTS FOR CLINICS AND CENTERS 
SEC. 2511. SCHOOL-BASED HEALTH CLINICS. 
(a) IN GENERAL.—Part Q of title III (42 U.S.C. 280h 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 399Z–1. SCHOOL-BASED HEALTH CLINICS. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
school-based health clinic program consisting of awarding 
grants to eligible entities to support the operation of school- 
based health clinics (referred to in this section as ‘SBHCs’). 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall— 
‘‘(1) be an SBHC (as defined in subsection 
(l)(4)); and 
‘‘(2) submit an application at such time, in such 
manner, and containing such information as the Sec-
retary may require, including at a minimum— 
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‘‘(A) evidence that the applicant meets all 
criteria necessary to be designated as an SBHC; 
‘‘(B) evidence of local need for the services 
to be provided by the SBHC; 
‘‘(C) an assurance that— 
‘‘(i) SBHC services will be provided in 
accordance with Federal, State, and local 
laws; 
‘‘(ii) the SBHC has established and 
maintains collaborative relationships with 
other health care providers in the catchment 
area of the SBHC; 
‘‘(iii) the SBHC will provide onsite ac-
cess during the academic day when school is 
in session and has an established network of 
support and access to services with backup 
health providers when the school or SBHC 
is closed; 
‘‘(iv) the SBHC will be integrated into 
the school environment and will coordinate 
health services with appropriate school per-
sonnel and other community providers co- 
located at the school; and 
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‘‘(v) the SBHC sponsoring facility as-
sumes all responsibility for the SBHC ad-
ministration, operations, and oversight; and 
‘‘(D) such other information as the Sec-
retary may require. 
‘‘(c) USE OF FUNDS.—Funds awarded under a grant 
under this section— 
‘‘(1) may be used for— 
‘‘(A) providing training related to the pro-
vision of comprehensive primary health services 
and additional health services; 
‘‘(B) the management and operation of 
SBHC programs; 
‘‘(C) the payment of salaries for health pro-
fessionals and other appropriate SBHC per-
sonnel; and 
‘‘(2) may not be used to provide abortions. 
‘‘(d) CONSIDERATION OF NEED.—In determining the 
amount of a grant under this section, the Secretary shall 
take into consideration— 
‘‘(1) the financial need of the SBHC; 
‘‘(2) State, local, or other sources of funding pro-
vided to the SBHC; and 
‘‘(3) other factors as determined appropriate by 
the Secretary. 
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‘‘(e) PREFERENCES.—In awarding grants under this 
section, the Secretary shall give preference to SBHCs that 
have a demonstrated record of service to the following: 
‘‘(1) A high percentage of medically underserved 
children and adolescents. 
‘‘(2) Communities or populations in which chil-
dren and adolescents have difficulty accessing health 
and mental health services. 
‘‘(3) Communities with high percentages of chil-
dren and adolescents who are uninsured, under-
insured, or eligible for medical assistance under Fed-
eral or State health benefits programs (including ti-
tles XIX and XXI of the Social Security Act). 
‘‘(f) MATCHING REQUIREMENT.—The Secretary may 
award a grant to an SBHC under this section only if the 
SBHC agrees to provide, from non-Federal sources, an 
amount equal to 20 percent of the amount of the grant 
(which may be provided in cash or in kind) to carry out 
the activities supported by the grant. 
‘‘(g) SUPPLEMENT, NOT SUPPLANT.—The Secretary 
may award a grant to an SBHC under this section only 
if the SBHC demonstrates to the satisfaction of the Sec-
retary that funds received through the grant will be ex-
pended only to supplement, and not supplant, non-Federal 
and Federal funds otherwise available to the SBHC for op-
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eration of the SBHC (including each activity described in 
paragraph (1) or (2) of subsection (c)). 
‘‘(h) PAYOR OF LAST RESORT.—The Secretary may 
award a grant to an SBHC under this section only if the 
SBHC demonstrates to the satisfaction of the Secretary that 
funds received through the grant will not be expended for 
any activity to the extent that payment has been made, or 
can reasonably be expected to be made— 
‘‘(1) under any insurance policy; 
‘‘(2) under any Federal or State health benefits 
program (including titles XIX and XXI of the Social 
Security Act); or 
‘‘(3) by an entity which provides health services 
on a prepaid basis. 
‘‘(i) REGULATIONS REGARDING REIMBURSEMENT FOR 
HEALTH SERVICES.—The Secretary shall issue regulations 
regarding the reimbursement for health services provided by 
SBHCs to individuals eligible to receive such services 
through the program under this section, including reim-
bursement under any insurance policy or any Federal or 
State health benefits program (including titles XIX and 
XXI of the Social Security Act). 
‘‘(j) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly or by grant or contract) technical 
and other assistance to SBHCs to assist such SBHCs to 
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meet the requirements of this section. Such assistance may 
include fiscal and program management assistance, train-
ing in fiscal and program management, operational and 
administrative support, and the provision of information 
to the SBHCs of the variety of resources available under 
this title and how those resources can be best used to meet 
the health needs of the communities served by the SBHCs. 
‘‘(k) EVALUATION; REPORT.—The Secretary shall— 
‘‘(1) develop and implement a plan for evalu-
ating SBHCs and monitoring quality performances 
under the awards made under this section; and 
‘‘(2) submit to the Congress on an annual basis 
a report on the program under this section. 
‘‘(l) DEFINITIONS.—In this section: 
‘‘(1) COMPREHENSIVE PRIMARY HEALTH SERV-
ICES.—The term ‘comprehensive primary health serv-
ices’ means the core services offered by SBHCs, which 
shall include the following: 
‘‘(A) PHYSICAL.—Comprehensive health as-
sessments, diagnosis, and treatment of minor, 
acute, and chronic medical conditions and refer-
rals to, and followup for, specialty care. 
‘‘(B) MENTAL HEALTH.—Mental health as-
sessments, crisis intervention, counseling, treat-
ment, and referral to a continuum of services in-
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cluding emergency psychiatric care, community 
support programs, inpatient care, and out-
patient programs. 
‘‘(C) 
OPTIONAL
SERVICES.—Additional 
services, which may include oral health, social, 
and age-appropriate health education services, 
including nutritional counseling. 
‘‘(2) MEDICALLY UNDERSERVED CHILDREN AND 
ADOLESCENTS.—The term ‘medically underserved 
children and adolescents’ means a population of chil-
dren and adolescents who are residents of an area des-
ignated by the Secretary as an area with a shortage 
of personal health services and health infrastructure 
for such children and adolescents. 
‘‘(3) SCHOOL-BASED HEALTH CLINIC.—The term 
‘school-based health clinic’ means a health clinic 
that— 
‘‘(A) is located in, or is adjacent to, a school 
facility of a local educational agency; 
‘‘(B) is organized through school, commu-
nity, and health provider relationships; 
‘‘(C) is administered by a sponsoring facil-
ity; 
‘‘(D) provides, at a minimum, comprehen-
sive primary health services during school hours 
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to children and adolescents by health profes-
sionals in accordance with State and local laws 
and regulations, established standards, and com-
munity practice; and 
‘‘(E) does not perform abortion services. 
‘‘(4) SPONSORING
FACILITY.—The term ‘spon-
soring facility’ is— 
‘‘(A) a hospital; 
‘‘(B) a public health department; 
‘‘(C) a community health center; 
‘‘(D) a nonprofit health care agency; 
‘‘(E) a local educational agency; or 
‘‘(F) a program administered by the Indian 
Health Service or the Bureau of Indian Affairs 
or operated by an Indian tribe or a tribal orga-
nization under the Indian Self-Determination 
and Education Assistance Act, a Native Hawai-
ian entity, or an urban Indian program under 
title V of the Indian Health Care Improvement 
Act. 
‘‘(m) AUTHORIZATION
OF
APPROPRIATIONS.—For 
purposes of carrying out this section, there are authorized 
to be appropriated $50,000,000 for fiscal year 2010 and 
such sums as may be necessary for each of the fiscal years 
2011 through 2014.’’. 
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(b) EFFECTIVE DATE.—The Secretary of Health and 
Human Services shall begin awarding grants under section 
399Z–1 of the Public Health Service Act, as added by sub-
section (a), not later than July 1, 2010, without regard to 
whether or not final regulations have been issued under sec-
tion 399Z–1(i) of such Act. 
SEC. 2512. NURSE-MANAGED HEALTH CENTERS. 
Title III (42 U.S.C. 241 et seq.) is amended by adding 
at the end the following: 
‘‘PART S—NURSE-MANAGED HEALTH CENTERS 
‘‘SEC. 399GG. NURSE-MANAGED HEALTH CENTERS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Admin-
istration, shall establish a nurse-managed health center pro-
gram consisting of awarding grants to entities under sub-
section (b). 
‘‘(b) GRANT.—The Secretary shall award grants to en-
tities— 
‘‘(1) to plan and develop a nurse-managed health 
center; or 
‘‘(2) to operate a nurse-managed health center. 
‘‘(c) USE OF FUNDS.—Amounts received as a grant 
under subsection (b) may be used for activities including 
the following: 
‘‘(1) Purchasing or leasing equipment. 
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‘‘(2) Training and technical assistance related to 
the provision of comprehensive primary care services 
and wellness services. 
‘‘(3) Other activities for planning, developing, or 
operating, as applicable, a nurse-managed health cen-
ter. 
‘‘(d) ASSURANCES APPLICABLE TO BOTH PLANNING 
AND OPERATION GRANTS.— 
‘‘(1) IN GENERAL.—The Secretary may award a 
grant under this section to an entity only if the entity 
demonstrates to the Secretary’s satisfaction that— 
‘‘(A) nurses, in addition to managing the 
center, will be adequately represented as pro-
viders at the center; and 
‘‘(B) not later than 90 days after receiving 
the grant, the entity will establish a community 
advisory committee composed of individuals, a 
majority of whom are being served by the center, 
to provide input into the nurse-managed health 
center’s operations. 
‘‘(2) MATCHING REQUIREMENT.—The Secretary 
may award a grant under this section to an entity 
only if the entity agrees to provide, from non-Federal 
sources, an amount equal to 20 percent of the amount 
of the grant (which may be provided in cash or in 
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kind) to carry out the activities supported by the 
grant. 
‘‘(3) PAYOR OF LAST RESORT.—The Secretary 
may award a grant under this section to an entity 
only if the entity demonstrates to the satisfaction of 
the Secretary that funds received through the grant 
will not be expended for any activity to the extent 
that payment has been made, or can reasonably be ex-
pected to be made— 
‘‘(A) under any insurance policy; 
‘‘(B) under any Federal or State health ben-
efits program (including titles XIX and XXI of 
the Social Security Act); or 
‘‘(C) by an entity which provides health 
services on a prepaid basis. 
‘‘(4) MAINTENANCE OF EFFORT.—The Secretary 
may award a grant under this section to an entity 
only if the entity demonstrates to the satisfaction of 
the Secretary that— 
‘‘(A) funds received through the grant will 
be expended only to supplement, and not sup-
plant, non-Federal and Federal funds otherwise 
available to the entity for the activities to be 
funded through the grant; and 
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‘‘(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 fis-
cal year for which the entity receives the grant. 
‘‘(e) 
ADDITIONAL
ASSURANCE
FOR
PLANNING 
GRANTS.—The Secretary may award a grant under sub-
section (b)(1) to an entity only if the entity agrees— 
‘‘(1) to assess the needs of the medically under-
served populations proposed to be served by the nurse- 
managed health center; and 
‘‘(2) to design services and operations of the 
nurse-managed health center for such populations 
based on such assessment. 
‘‘(f) ADDITIONAL
ASSURANCES
FOR
OPERATION 
GRANTS.—The Secretary may award a grant under sub-
section (b)(2) to an entity only if the entity assures that 
the nurse-managed health center will provide— 
‘‘(1) 
comprehensive 
primary 
care 
services, 
wellness services, and other health care services 
deemed appropriate by the Secretary; 
‘‘(2) care without respect to insurance status or 
income of the patient; and 
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‘‘(3) direct access to client-centered services of-
fered by advanced practice nurses, other nurses, phy-
sicians, physician assistants, or other qualified health 
professionals. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly or by grant or contract) technical 
and other assistance to nurse-managed health centers to as-
sist such centers in meeting the requirements of this section. 
Such assistance may include fiscal and program manage-
ment assistance, training in fiscal and program manage-
ment, operational and administrative support, and the pro-
vision of information to nurse-managed health centers re-
garding the various resources available under this section 
and how those resources can best be used to meet the health 
needs of the communities served by nurse-managed health 
centers. 
‘‘(h) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program under this section. 
‘‘(i) DEFINITIONS.— 
‘‘(1) COMPREHENSIVE
PRIMARY
CARE
SERV-
ICES.—The term ‘comprehensive primary care serv-
ices’ has the meaning given to the term ‘required pri-
mary health services’ in section 330(b)(1). 
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‘‘(2) MEDICALLY UNDERSERVED POPULATION.— 
The term ‘medically underserved population’ has the 
meaning given to such term in section 330(b)(3). 
‘‘(3) NURSE-MANAGED
HEALTH
CENTER.—The 
term ‘nurse-managed health center’ has the meaning 
given to such term in section 801. 
‘‘(4) WELLNESS SERVICES.—The term ‘wellness 
services’ means any health-related service or interven-
tion, not including primary care, which is designed 
to reduce identifiable health risks and increase 
healthy behaviors intended to prevent the onset of dis-
ease or lessen the impact of existing chronic condi-
tions by teaching more effective management tech-
niques that focus on individual self-care and patient- 
driven decisionmaking.’’. 
SEC. 2513. FEDERALLY QUALIFIED BEHAVIORAL HEALTH 
CENTERS. 
(a) BLOCK GRANTS REGARDING MENTAL HEALTH 
AND SUBSTANCE ABUSE.—Section 1913 (42 U.S.C. 300x– 
3) is amended— 
(1) in subsection (a)(2)(A), by striking ‘‘commu-
nity mental health services’’ and inserting ‘‘behav-
ioral health services’’; 
(2) in subsection (b)— 
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(A) by striking paragraph (1) and inserting 
the following: 
‘‘(1) services under the plan will be provided 
only through appropriate, qualified community pro-
grams (which may include federally qualified behav-
ioral health centers, child mental health programs, 
psychosocial rehabilitation programs, mental health 
peer-support programs, and mental health primary 
consumer-directed programs); and’’; and 
(B) in paragraph (2), by striking ‘‘commu-
nity mental health centers’’ and inserting ‘‘feder-
ally qualified behavioral health centers’’; and 
(3) by striking subsection (c) and inserting the 
following: 
‘‘(c) CRITERIA FOR FEDERALLY QUALIFIED BEHAV-
IORAL HEALTH CENTERS.— 
‘‘(1) IN GENERAL.—The Administrator shall cer-
tify, and recertify at least every 5 years, federally 
qualified behavioral health centers as meeting the cri-
teria specified in this subsection. 
‘‘(2) REGULATIONS.—Not later than 18 months 
after the date of the enactment of the America’s Af-
fordable Health Choices Act of 2009, the Adminis-
trator shall issue final regulations for certifying cen-
ters under paragraph (1). 
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‘‘(3) CRITERIA.—The criteria referred to in sub-
section (b)(2) are that the center performs each of the 
following: 
‘‘(A) Provide services in locations that en-
sure services will be available and accessible 
promptly and in a manner which preserves 
human dignity and assures continuity of care. 
‘‘(B) Provide services in a mode of service 
delivery appropriate for the target population. 
‘‘(C) Provide individuals with a choice of 
service options where there is more than one effi-
cacious treatment. 
‘‘(D) Employ a core staff of clinical staff 
that is multidisciplinary and culturally and lin-
guistically competent. 
‘‘(E) Provide services, within the limits of 
the capacities of the center, to any individual re-
siding or employed in the service area of the cen-
ter. 
‘‘(F) Provide, directly or through contract, 
to the extent covered for adults in the State Med-
icaid plan and for children in accordance with 
section 1905(r) of the Social Security Act re-
garding early and periodic screening, diagnosis, 
and treatment, each of the following services: 
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‘‘(i) Screening, assessment, and diag-
nosis, including risk assessment. 
‘‘(ii) Person-centered treatment plan-
ning or similar processes, including risk as-
sessment and crisis planning. 
‘‘(iii) Outpatient clinic mental health 
services, including screening, assessment, di-
agnosis, psychotherapy, substance abuse 
counseling, medication management, and 
integrated treatment for mental illness and 
substance abuse which shall be evidence- 
based (including cognitive behavioral ther-
apy, dialectical behavioral therapy, motiva-
tional interviewing, and other such thera-
pies which are evidence-based). 
‘‘(iv) Outpatient clinic primary care 
services, including screening and moni-
toring of key health indicators and health 
risk (including screening for diabetes, hy-
pertension, and cardiovascular disease and 
monitoring of weight, height, body mass 
index (BMI), blood pressure, blood glucose 
or HbA1C, and lipid profile). 
‘‘(v) Crisis mental health services, in-
cluding 24-hour mobile crisis teams, emer-
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gency crisis intervention services, and crisis 
stabilization. 
‘‘(vi) Targeted case management (serv-
ices to assist individuals gaining access to 
needed medical, social, educational, and 
other services and applying for income secu-
rity and other benefits to which they may 
be entitled). 
‘‘(vii) Psychiatric rehabilitation serv-
ices including skills training, assertive com-
munity treatment, family psychoeducation, 
disability self-management, supported em-
ployment, supported housing services, thera-
peutic foster care services, multisystemic 
therapy, and such other evidence-based 
practices as the Secretary may require. 
‘‘(viii) Peer support and counselor 
services and family supports. 
‘‘(G) Maintain linkages, and where possible 
enter into formal contracts with, inpatient psy-
chiatric facilities and substance abuse detoxifica-
tion and residential programs. 
‘‘(H) Make available to individuals served 
by the center, directly, through contract, or 
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through linkages with other programs, each of 
the following: 
‘‘(i) Adult and youth peer support and 
counselor services. 
‘‘(ii) Family support services for fami-
lies of children with serious mental dis-
orders. 
‘‘(iii) Other community or regional 
services, supports, and providers, including 
schools, child welfare agencies, juvenile and 
criminal justice agencies and facilities, 
housing agencies and programs, employers, 
and other social services. 
‘‘(iv) Onsite or offsite access to pri-
mary care services. 
‘‘(v) Enabling services, including out-
reach, transportation, and translation. 
‘‘(vi) Health and wellness services, in-
cluding services for tobacco cessation.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) BLOCK GRANTS FOR BEHAVIORAL HEALTH 
SERVICES.—Subpart I of part B of title XIX (42 
U.S.C. 300x–1 et seq.) is amended— 
(A) in the subpart heading, by striking 
‘‘Community Mental Health Services’’ 
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and inserting ‘‘Behavioral Mental Health 
Services’’; 
(B) in the heading of section 1912, by strik-
ing ‘‘COMMUNITY MENTAL HEALTH SERV-
ICES’’ and inserting ‘‘BEHAVIORAL MENTAL 
HEALTH SERVICES’’; and 
(C) 
in 
sections 
1912(a)(1), 
1912(b), 
1915(b)(1), and 1918(a)(8), by striking the term 
‘‘community mental health services’’ each place 
it appears and inserting ‘‘behavioral mental 
health services’’. 
(2) CENTER FOR MENTAL HEALTH SERVICES.— 
Paragraph (13) of section 520(b) (42 U.S.C. 290bb– 
31) is amended by striking ‘‘community mental 
health centers’’ and inserting ‘‘federally qualified be-
havioral health centers’’. 
(3) GRANTS FOR EMERGENCY MENTAL HEALTH 
CENTERS.—Subsection (b) of section 520F (42 U.S.C. 
290bb–37) is amended by striking ‘‘community men-
tal health centers’’ and inserting ‘‘federally qualified 
behavioral health centers’’. 
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PART 2—OTHER GRANT PROGRAMS 
SEC. 2521. COMPREHENSIVE PROGRAMS TO PROVIDE EDU-
CATION TO NURSES AND CREATE A PIPELINE 
TO NURSING. 
(a) PURPOSES.—It is the purpose of this section to au-
thorize grants to— 
(1) address the projected shortage of nurses by 
funding comprehensive programs to create a career 
ladder to nursing (including certified nurse assist-
ants, licensed practical nurses, licensed vocational 
nurses, and registered nurses) for incumbent ancillary 
health care workers; 
(2) increase the capacity for educating nurses by 
increasing both nurse faculty and clinical opportuni-
ties through collaborative programs between staff 
nurse organizations, health care providers, and ac-
credited schools of nursing; and 
(3) provide training programs through education 
and training organizations jointly administered by 
health care providers and health care labor organiza-
tions or other organizations representing staff nurses 
and frontline health care workers, working in collabo-
ration with accredited schools of nursing and aca-
demic institutions. 
(b) GRANTS.—Not later than 6 months after the date 
of the enactment of this Act, the Secretary of Labor (referred 
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to in this section as the ‘‘Secretary’’) shall establish a part-
nership grant program to award grants to eligible entities 
to carry out comprehensive programs to provide education 
to nurses and create a pipeline to nursing for incumbent 
ancillary health care workers who wish to advance their ca-
reers, and to otherwise carry out the purposes of this sec-
tion. 
(c) ELIGIBILITY.—To be eligible for a grant under this 
section, an entity shall be— 
(1) a health care entity that is jointly adminis-
tered by a health care employer and a labor union 
representing the health care employees of the employer 
and that carries out activities using labor manage-
ment training funds as provided for under section 
302(c)(6) of the Labor Management Relations Act, 
1947 (29 U.S.C. 186(c)(6)); 
(2) an entity that operates a training program 
that is jointly administered by— 
(A) one or more health care providers or fa-
cilities, or a trade association of health care pro-
viders; and 
(B) one or more organizations which rep-
resent the interests of direct care health care 
workers or staff nurses and in which the direct 
care health care workers or staff nurses have di-
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rect input as to the leadership of the organiza-
tion; 
(3) a State training partnership program that 
consists of nonprofit organizations that include equal 
participation from industry, including public or pri-
vate employers, and labor organizations including 
joint labor-management training programs, and 
which may include representatives from local govern-
ments, worker investment agency one-stop career cen-
ters, community-based organizations, community col-
leges, and accredited schools of nursing; or 
(4) a school of nursing (as defined in section 801 
of the Public Health Service Act (42 U.S.C. 296)). 
(d) ADDITIONAL REQUIREMENTS FOR HEALTH CARE 
EMPLOYER DESCRIBED IN SUBSECTION (c).—To be eligible 
for a grant under this section, a health care employer de-
scribed in subsection (c) shall demonstrate that it— 
(1) has an established program within its facil-
ity to encourage the retention of existing nurses; 
(2) provides wages and benefits to its nurses that 
are competitive for its market or that have been col-
lectively bargained with a labor organization; and 
(3) supports programs funded under this section 
through 1 or more of the following: 
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(A) The provision of paid leave time and 
continued health coverage to incumbent health 
care workers to allow their participation in 
nursing career ladder programs, including cer-
tified nurse assistants, licensed practical nurses, 
licensed vocational nurses, and registered nurses. 
(B) Contributions to a joint labor-manage-
ment training fund which administers the pro-
gram involved. 
(C) The provision of paid release time, in-
centive compensation, or continued health cov-
erage to staff nurses who desire to work full- or 
part-time in a faculty position. 
(D) The provision of paid release time for 
staff nurses to enable them to obtain a bachelor 
of science in nursing degree, other advanced 
nursing degrees, specialty training, or certifi-
cation program. 
(E) The payment of tuition assistance 
which is managed by a joint labor-management 
training fund or other jointly administered pro-
gram. 
(e) OTHER REQUIREMENTS.— 
(1) MATCHING REQUIREMENT.— 
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(A) IN GENERAL.—The Secretary may not 
make a grant under this section unless the appli-
cant involved agrees, with respect to the costs to 
be incurred by the applicant in carrying out the 
program under the grant, to make available non- 
Federal contributions (in cash or in kind under 
subparagraph (B)) toward such costs in an 
amount equal to not less than $1 for each $1 of 
Federal funds provided in the grant. Such con-
tributions may be made directly or through do-
nations from public or private entities, or may 
be provided through the cash equivalent of paid 
release time provided to incumbent worker stu-
dents. 
(B) DETERMINATION OF AMOUNT OF NON- 
FEDERAL
CONTRIBUTION.—Non-Federal 
con-
tributions required in subparagraph (A) may be 
in cash or in kind (including paid release time), 
fairly evaluated, including equipment or services 
(and excluding indirect or overhead costs). 
Amounts provided by the Federal Government, 
or services assisted or subsidized to any signifi-
cant extent by the Federal Government, may not 
be included in determining the amount of such 
non-Federal contributions. 
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(2) REQUIRED
COLLABORATION.—Entities car-
rying out or overseeing programs carried out with as-
sistance provided under this section shall demonstrate 
collaboration with accredited schools of nursing which 
may include community colleges and other academic 
institutions providing associate, bachelor’s, or ad-
vanced nursing degree programs or specialty training 
or certification programs. 
(f) USE OF FUNDS.—Amounts awarded to an entity 
under a grant under this section shall be used for the fol-
lowing: 
(1) To carry out programs that provide edu-
cation and training to establish nursing career lad-
ders to educate incumbent health care workers to be-
come nurses (including certified nurse assistants, li-
censed practical nurses, licensed vocational nurses, 
and registered nurses). Such programs shall include 
one or more of the following: 
(A) Preparing incumbent workers to return 
to the classroom through English-as-a-second 
language education, GED education, precollege 
counseling, college preparation classes, and sup-
port with entry level college classes that are a 
prerequisite to nursing. 
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(B) Providing tuition assistance with pref-
erence for dedicated cohort classes in community 
colleges, universities, and accredited schools of 
nursing with supportive services including tutor-
ing and counseling. 
(C) Providing assistance in preparing for 
and meeting all nursing licensure tests and re-
quirements. 
(D) 
Carrying 
out 
orientation 
and 
mentorship programs that assist newly grad-
uated nurses in adjusting to working at the bed-
side to ensure their retention postgraduation, 
and ongoing programs to support nurse reten-
tion. 
(E) Providing stipends for release time and 
continued health care coverage to enable incum-
bent health care workers to participate in these 
programs. 
(2) To carry out programs that assist nurses in 
obtaining advanced degrees and completing specialty 
training or certification programs and to establish 
incentives for nurses to assume nurse faculty positions 
on a part-time or full-time basis. Such programs 
shall include one or more of the following: 
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(A) Increasing the pool of nurses with ad-
vanced degrees who are interested in teaching by 
funding programs that enable incumbent nurses 
to return to school. 
(B) Establishing incentives for advanced de-
gree bedside nurses who wish to teach in nursing 
programs so they can obtain a leave from their 
bedside position to assume a full- or part-time 
position as adjunct or full-time faculty without 
the loss of salary or benefits. 
(C) Collaboration with accredited schools of 
nursing which may include community colleges 
and other academic institutions providing asso-
ciate, bachelor’s, or advanced nursing degree pro-
grams, or specialty training or certification pro-
grams, for nurses to carry out innovative nurs-
ing programs which meet the needs of bedside 
nursing and health care providers. 
(g) PREFERENCE.—In awarding grants under this sec-
tion the Secretary shall give preference to programs that— 
(1) provide for improving nurse retention; 
(2) provide for improving the diversity of the 
new nurse graduates to reflect changes in the demo-
graphics of the patient population; 
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(3) provide for improving the quality of nursing 
education to improve patient care and safety; 
(4) have demonstrated success in upgrading in-
cumbent health care workers to become nurses or 
which have established effective programs or pilots to 
increase nurse faculty; or 
(5) are modeled after or affiliated with such pro-
grams described in paragraph (4). 
(h) EVALUATION.— 
(1) PROGRAM EVALUATIONS.—An entity that re-
ceives a grant under this section shall annually evalu-
ate, and submit to the Secretary a report on, the ac-
tivities carried out under the grant and the outcomes 
of such activities. Such outcomes may include— 
(A) an increased number of incumbent 
workers entering an accredited school of nursing 
and in the pipeline for nursing programs; 
(B) an increasing number of graduating 
nurses and improved nurse graduation and li-
censure rates; 
(C) improved nurse retention; 
(D) an increase in the number of staff 
nurses at the health care facility involved; 
(E) an increase in the number of nurses 
with advanced degrees in nursing; 
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(F) an increase in the number of nurse fac-
ulty; 
(G) improved measures of patient quality 
(which may include staffing ratios of nurses, pa-
tient satisfaction rates, and patient safety meas-
ures); and 
(H) an increase in the diversity of new 
nurse graduates relative to the patient popu-
lation. 
(2) GENERAL REPORT.—Not later than 2 years 
after the date of the enactment of this Act, and annu-
ally thereafter, the Secretary of Labor shall, using 
data and information from the reports received under 
paragraph (1), submit to the Congress a report con-
cerning the overall effectiveness of the grant program 
carried out under this section. 
(i) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section such 
sums as may be necessary. 
SEC. 2522. MENTAL AND BEHAVIORAL HEALTH TRAINING. 
Part E of title VII (42 U.S.C. 294n et seq.) is amended 
by adding at the end the following: 
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‘‘Subpart 3—Mental and Behavioral Health Training 
‘‘SEC. 775. MENTAL AND BEHAVIORAL HEALTH TRAINING 
PROGRAM. 
‘‘(a) PROGRAM.—The Secretary shall establish an 
interdisciplinary mental and behavioral health training 
program consisting of awarding grants and contracts under 
subsection (b). 
‘‘(b) SUPPORT AND DEVELOPMENT OF MENTAL AND 
BEHAVIORAL HEALTH TRAINING PROGRAMS.—The Sec-
retary shall make grants to, or enter into contracts with, 
eligible entities— 
‘‘(1) to plan, develop, operate, or participate in 
an accredited professional training program for men-
tal and behavioral health professionals to promote— 
‘‘(A) interdisciplinary training; and 
‘‘(B) coordination of the delivery of health 
care within and across settings, including health 
care institutions, community-based settings, and 
the patient’s home; 
‘‘(2) to provide financial assistance to mental 
and behavioral health professionals, who are partici-
pants in any such program, and who plan to work 
in the field of mental and behavioral health; 
‘‘(3) to plan, develop, operate, or participate in 
an accredited program for the training of mental and 
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behavioral health professionals who plan to teach in 
the field of mental and behavioral health; and 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to mental and behav-
ioral health professionals who are participants in any 
such program and who plan to teach in the field of 
mental and behavioral health. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school, in-
cluding an accredited school or program of psy-
chology, psychiatry, social work, marriage and family 
therapy, professional mental health and substance 
abuse counseling, or addiction medicine; 
‘‘(2) an accredited public or nonprofit private 
hospital; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities described 
in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to en-
tities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or signifi-
cantly improving the percentage, of health profes-
sionals who serve in underserved communities. 
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‘‘(2) Supporting teaching programs that address 
the health care needs of vulnerable populations. 
‘‘(3) Training individuals who are from under-
represented minority groups or disadvantaged back-
grounds. 
‘‘(4) Training individuals who serve geriatric 
populations with an emphasis on underserved elderly. 
‘‘(5) Training individuals who serve pediatric 
populations with an emphasis on underserved chil-
dren. 
‘‘(e) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program under this section. 
‘‘(f) DEFINITION.—In this section: 
‘‘(1) The term ‘health disparities’ has the mean-
ing given the term in section 3171. 
‘‘(2) The term ‘mental and behavioral health 
professional’ means an individual training or prac-
ticing— 
‘‘(A) in psychology; general, geriatric, child 
or adolescent psychiatry; social work; marriage 
and family therapy; professional mental health 
and substance abuse counseling; or addiction 
medicine; or 
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‘‘(B) another mental and behavioral health 
specialty, as deemed appropriate by the Sec-
retary. 
‘‘(3) The term ‘interdisciplinary’ means collabo-
ration across health professions, specialties, and sub-
specialties, which may include public health, nursing, 
allied health, and appropriate medical specialties. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$60,000,000 for each of fiscal years 2010 through 2014. Of 
the amounts appropriated to carry out this section for a 
fiscal year, not less than 15 percent shall be used for train-
ing programs in psychology.’’. 
SEC. 2523. PROGRAMS TO INCREASE AWARENESS OF AD-
VANCE CARE PLANNING ISSUES. 
Title III (42 U.S.C. 241 et seq.), as amended, is 
amended by adding at the end the following: 
‘‘PART T—PROGRAMS TO INCREASE AWARENESS 
OF ADVANCE CARE PLANNING ISSUES 
‘‘SEC. 399HH. ADVANCE CARE PLANNING EDUCATION CAM-
PAIGNS AND INFORMATION PHONE LINE AND 
CLEARINGHOUSE. 
‘‘(a) ADVANCE CARE PLANNING EDUCATION CAM-
PAIGN.—The Secretary shall, directly or through grants 
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awarded under subsection (c), conduct a national public 
education campaign— 
‘‘(1) to raise public awareness of the importance 
of planning for care near the end of life; 
‘‘(2) to improve the public’s understanding of the 
various situations in which individuals may find 
themselves if they become unable to express their 
health care wishes; 
‘‘(3) to explain the need for readily available 
legal documents that express an individual’s wishes 
through— 
‘‘(A) advance directives (including living 
wills, comfort care orders, and durable powers of 
attorney for health care); and 
‘‘(B) other planning tools, such as a physi-
cian’s 
orders 
for 
life-sustaining 
treatment 
(POLST); and 
‘‘(4) to educate the public about the availability 
of hospice care and palliative care. 
‘‘(b) INFORMATION PHONE LINE
AND CLEARING-
HOUSE.—The Secretary, directly or through grants award-
ed under subsection (c), shall provide for the establishment 
of a national, toll-free, information telephone line and a 
clearinghouse that the public and health professionals may 
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access to find out about State-specific and other informa-
tion regarding advance directive and end-of-life decisions. 
‘‘(c) GRANTS.— 
‘‘(1) IN
GENERAL.—The Secretary shall use 
funds appropriated under subsection (d) for the pur-
pose of awarding grants to public or nonprofit pri-
vate entities (including States or political subdivi-
sions of a State), or a consortium of any of such enti-
ties, for the purpose of conducting education cam-
paigns under subsection (a). 
‘‘(2) LIMITATION
ON
ELIGIBILITY.—Any grant 
awarded under this Act shall not go to any govern-
mental or nongovernmental organization that pro-
motes suicide, assisted suicide, or the active hastening 
of death. Nothing in the previous clause shall be con-
strued to prohibit palliative or hospice care. 
‘‘(3) PERIOD.—Any grant awarded under para-
graph (1) shall be for a period of 3 years. 
‘‘(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated— 
‘‘(1) for purposes of carrying out subsection (b), 
$5,000,000 for fiscal year 2010 and each subsequent 
year; and 
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‘‘(2) for purposes of making grants under sub-
section (c), $10,000,000 for fiscal year 2010, to re-
main available until expended.’’. 
SEC. 2524. REAUTHORIZATION OF TELEHEALTH AND TELE-
MEDICINE GRANT PROGRAMS. 
(a) TELEHEALTH NETWORK AND TELEHEALTH RE-
SOURCE CENTERS GRANT PROGRAMS.—Section 330I (42 
U.S.C. 254c–14) is amended— 
(1) in subsection (a)— 
(A) by striking paragraph (3) (relating to 
frontier communities); and 
(B) by inserting after paragraph (2) the fol-
lowing: 
‘‘(3) HEALTH
DISPARITIES.—The term ‘health 
disparities’ has the meaning given such term in sec-
tion 3171.’’; 
(2) in subsection (d)(1)— 
(A) in subparagraph (B), by striking ‘‘and’’ 
at the end; 
(B) in subparagraph (C), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(D) reduce health disparities.’’; 
(3) in subsection (f)(1)(B)(iii)— 
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(A) in subclause (VII), by inserting ‘‘, in-
cluding skilled nursing facilities’’ before the pe-
riod at the end; 
(B) in subclause (IX), by inserting ‘‘, in-
cluding county mental health and public mental 
health facilities’’ before the period at the end; 
and 
(C) by adding at the end the following: 
‘‘(XIII) Renal dialysis facilities.’’; 
(4) by amending subsection (i) to read as fol-
lows: 
‘‘(i) PREFERENCES.— 
‘‘(1) TELEHEALTH
NETWORKS.—In awarding 
grants under subsection (d)(1) for projects involving 
telehealth networks, the Secretary shall give preference 
to eligible entities meeting the following: 
‘‘(A) NETWORK.—The eligible entity is a 
health care provider in, or proposing to form, a 
health care network that furnishes services in a 
medically underserved area or a health profes-
sional shortage area. 
‘‘(B) BROAD GEOGRAPHIC COVERAGE.—The 
eligible entity demonstrates broad geographic 
coverage in the rural or medically underserved 
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areas of the State or States in which the entity 
is located. 
‘‘(C) HEALTH
DISPARITIES.—The eligible 
entity demonstrates how the project to be funded 
through the grant will address health disparities. 
‘‘(D) LINKAGES.—The eligible entity agrees 
to use the grant to establish or develop plans for 
telehealth systems that will link rural hospitals 
and rural health care providers to other hos-
pitals, health care providers, and patients. 
‘‘(E) 
EFFICIENCY.—The 
eligible 
entity 
agrees to use the grant to promote greater effi-
ciency in the use of health care resources. 
‘‘(F) VIABILITY.—The eligible entity dem-
onstrates the long-term viability of projects 
through— 
‘‘(i) availability of non-Federal fund-
ing sources; or 
‘‘(ii) institutional and community sup-
port for the telehealth network. 
‘‘(G) SERVICES.—The eligible entity pro-
vides a plan for coordinating system use by eli-
gible entities and prioritizes use of grant funds 
for health care services over nonclinical uses. 
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‘‘(2) TELEHEALTH
RESOURCE
CENTERS.—In 
awarding grants under subsection (d)(2) for projects 
involving telehealth resource centers, the Secretary 
shall give preference to eligible entities meeting the 
following: 
‘‘(A) PROVISION
OF
A
BROAD
RANGE
OF 
SERVICES.—The eligible entity has a record of 
success in the provision of a broad range of tele-
health services to medically underserved areas or 
populations. 
‘‘(B) PROVISION
OF
TELEHEALTH
TECH-
NICAL
ASSISTANCE.—The eligible entity has a 
record of success in the provision of technical as-
sistance to providers serving medically under-
served communities or populations in the estab-
lishment and implementation of telehealth serv-
ices. 
‘‘(C) COLLABORATION AND SHARING OF EX-
PERTISE.—The eligible entity has a dem-
onstrated record of collaborating and sharing ex-
pertise with providers of telehealth services at the 
national, regional, State, and local levels.’’; 
(5) in subsection (j)(2)(B), by striking ‘‘such 
projects for fiscal year 2001’’ and all that follows 
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through the period and inserting ‘‘such project for fis-
cal year 2009.’’; 
(6) in subsection (k)(1)— 
(A) in subparagraph (E)(i), by striking 
‘‘transmission of medical data’’ and inserting 
‘‘transmission and electronic archival of medical 
data’’; and 
(B) by amending subparagraph (F) to read 
as follows: 
‘‘(F) developing projects to use telehealth 
technology— 
‘‘(i) to facilitate collaboration between 
health care providers; 
‘‘(ii) to promote telenursing services; or 
‘‘(iii) 
to 
promote 
patient 
under-
standing and adherence to national guide-
lines for chronic disease and self-manage-
ment of such conditions;’’; 
(7) in subsection (q), by striking ‘‘Not later than 
September 30, 2005’’ and inserting ‘‘Not later than 1 
year after the date of the enactment of the America’s 
Affordable Health Choices Act of 2009, and annually 
thereafter’’; 
(8) by striking subsection (r); 
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(9) by redesignating subsection (s) as subsection 
(r); and 
(10) in subsection (r) (as so redesignated)— 
(A) in paragraph (1)— 
(i) by striking ‘‘and’’ before ‘‘such 
sums’’; and 
(ii) by inserting ‘‘, $10,000,000 for fis-
cal year 2010, and such sums as may be 
necessary for each of fiscal years 2011 
through 2014’’ before the semicolon; and 
(B) in paragraph (2)— 
(i) by striking ‘‘and’’ before ‘‘such 
sums’’; and 
(ii) by inserting ‘‘, $10,000,000 for fis-
cal year 2010, and such sums as may be 
necessary for each of fiscal years 2011 
through 2014’’ before the period. 
(b) TELEMEDICINE; INCENTIVE GRANTS REGARDING 
COORDINATION AMONG STATES.—Subsection (b) of section 
330L (42 U.S.C. 254c–18) is amended by inserting ‘‘, 
$10,000,000 for fiscal year 2010, and such sums as may 
be necessary for each of fiscal years 2011 through 2014’’ 
before the period at the end. 
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