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•AMDT. NO. 2786 
training of food service workers, variations 
in ingredients, and other factors, as the 
Secretary determines; and 
‘‘(bb) specify the format and manner 
of the nutrient content disclosure require-
ments under this subclause. 
‘‘(III) REPORTING.—The Secretary shall 
submit to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the 
Committee on Energy and Commerce of the 
House of Representatives a quarterly report 
that describes the Secretary’s progress toward 
promulgating final regulations under this sub-
paragraph. 
‘‘(xi) DEFINITION.—In this clause, the term 
‘menu’ or ‘menu board’ means the primary writing 
of the restaurant or other similar retail food estab-
lishment from which a consumer makes an order se-
lection.’’ 
(c) NATIONAL UNIFORMITY.—Section 403A(a)(4) of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
343-1(a)(4)) is amended by striking ‘‘except a require-
ment for nutrition labeling of food which is exempt under 
subclause (i) or (ii) of section 403(q)(5)(A)’’ and inserting 
‘‘except that this paragraph does not apply to food that 
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•AMDT. NO. 2786 
is offered for sale in a restaurant or similar retail food 
establishment that is not part of a chain with 20 or more 
locations doing business under the same name (regardless 
of the type of ownership of the locations) and offering for 
sale substantially the same menu items unless such res-
taurant or similar retail food establishment complies with 
the voluntary provision of nutrition information require-
ments under section 403(q)(5)(H)(ix)’’. 
(d) RULE
OF
CONSTRUCTION.—Nothing in the 
amendments made by this section shall be construed— 
(1) to preempt any provision of State or local 
law, unless such provision establishes or continues 
into effect nutrient content disclosures of the type 
required under section 403(q)(5)(H) of the Federal 
Food, Drug, and Cosmetic Act (as added by sub-
section (b)) and is expressly preempted under sub-
section (a)(4) of such section; 
(2) to apply to any State or local requirement 
respecting a statement in the labeling of food that 
provides for a warning concerning the safety of the 
food or component of the food; or 
(3) 
except 
as 
provided 
in 
section 
403(q)(5)(H)(ix) of the Federal Food, Drug, and 
Cosmetic Act (as added by subsection (b)), to apply 
to any restaurant or similar retail food establish-
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•AMDT. NO. 2786 
ment other than a restaurant or similar retail food 
establishment described in section 403(q)(5)(H)(i) of 
such Act. 
SEC. 4206. DEMONSTRATION PROJECT CONCERNING INDI-
VIDUALIZED WELLNESS PLAN. 
Section 330 of the Public Health Service Act (42 
U.S.C. 245b) is amended by adding at the end the fol-
lowing: 
‘‘(s) DEMONSTRATION PROGRAM FOR INDIVIDUAL-
IZED WELLNESS PLANS.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a pilot program to test the impact of providing 
at-risk populations who utilize community health 
centers funded under this section an individualized 
wellness plan that is designed to reduce risk factors 
for preventable conditions as identified by a com-
prehensive risk-factor assessment. 
‘‘(2) AGREEMENTS.—The Secretary shall enter 
into agreements with not more than 10 community 
health centers funded under this section to conduct 
activities under the pilot program under paragraph 
(1). 
‘‘(3) WELLNESS PLANS.— 
‘‘(A) 
IN
GENERAL.—An 
individualized 
wellness plan prepared under the pilot program 
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•AMDT. NO. 2786 
under this subsection may include one or more 
of the following as appropriate to the individ-
ual’s identified risk factors: 
‘‘(i) Nutritional counseling. 
‘‘(ii) A physical activity plan. 
‘‘(iii) Alcohol and smoking cessation 
counseling and services. 
‘‘(iv) Stress management. 
‘‘(v) Dietary supplements that have 
health claims approved by the Secretary. 
‘‘(vi) Compliance assistance provided 
by a community health center employee. 
‘‘(B) RISK FACTORS.—Wellness plan risk 
factors shall include— 
‘‘(i) weight; 
‘‘(ii) tobacco and alcohol use; 
‘‘(iii) exercise rates; 
‘‘(iv) nutritional status; and 
‘‘(v) blood pressure. 
‘‘(C) 
COMPARISONS.—Individualized 
wellness plans shall make comparisons between 
the individual involved and a control group of 
individuals with respect to the risk factors de-
scribed in subparagraph (B). 
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•AMDT. NO. 2786 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, such sums as may be necessary.’’. 
SEC. 4207. REASONABLE BREAK TIME FOR NURSING MOTH-
ERS. 
Section 7 of the Fair Labor Standards Act of 1938 
(29 U.S.C. 207) is amended by adding at the end the fol-
lowing: 
‘‘(r)(1) An employer shall provide— 
‘‘(A) a reasonable break time for an employee 
to express breast milk for her nursing child for 1 
year after the child’s birth each time such employee 
has need to express the milk; and 
‘‘(B) a place, other than a bathroom, that is 
shielded from view and free from intrusion from co-
workers and the public, which may be used by an 
employee to express breast milk. 
‘‘(2) An employer shall not be required to compensate 
an employee receiving reasonable break time under para-
graph (1) for any work time spent for such purpose. 
‘‘(3) An employer that employs less than 50 employ-
ees shall not be subject to the requirements of this sub-
section, if such requirements would impose an undue hard-
ship by causing the employer significant difficulty or ex-
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•AMDT. NO. 2786 
pense when considered in relation to the size, financial re-
sources, nature, or structure of the employer’s business. 
‘‘(4) Nothing in this subsection shall preempt a State 
law that provides greater protections to employees than 
the protections provided for under this subsection.’’. 
Subtitle D—Support for Prevention 
and Public Health Innovation 
SEC. 4301. RESEARCH ON OPTIMIZING THE DELIVERY OF 
PUBLIC HEALTH SERVICES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Director of the Centers for 
Disease Control and Prevention, shall provide funding for 
research in the area of public health services and systems. 
(b) REQUIREMENTS OF RESEARCH.—Research sup-
ported under this section shall include— 
(1) examining evidence-based practices relating 
to prevention, with a particular focus on high pri-
ority areas as identified by the Secretary in the Na-
tional Prevention Strategy or Healthy People 2020, 
and including comparing community-based public 
health interventions in terms of effectiveness and 
cost; 
(2) analyzing the translation of interventions 
from academic settings to real world settings; and 
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•AMDT. NO. 2786 
(3) identifying effective strategies for orga-
nizing, financing, or delivering public health services 
in real world community settings, including com-
paring State and local health department structures 
and systems in terms of effectiveness and cost. 
(c) EXISTING PARTNERSHIPS.—Research supported 
under this section shall be coordinated with the Commu-
nity Preventive Services Task Force and carried out by 
building on existing partnerships within the Federal Gov-
ernment while also considering initiatives at the State and 
local levels and in the private sector. 
(d) ANNUAL REPORT.—The Secretary shall, on an 
annual basis, submit to Congress a report concerning the 
activities and findings with respect to research supported 
under this section. 
SEC. 4302. UNDERSTANDING HEALTH DISPARITIES: DATA 
COLLECTION AND ANALYSIS. 
(a) UNIFORM CATEGORIES AND COLLECTION RE-
QUIREMENTS.—The Public Health Service Act (42 U.S.C. 
201 et seq.) is amended by adding at the end the fol-
lowing: 
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•AMDT. NO. 2786 
‘‘TITLE 
XXXI—DATA 
COLLEC-
TION, ANALYSIS, AND QUAL-
ITY 
‘‘SEC. 3101. DATA COLLECTION, ANALYSIS, AND QUALITY. 
‘‘(a) DATA COLLECTION.— 
‘‘(1) IN GENERAL.—The Secretary shall ensure 
that, by not later than 2 years after the date of en-
actment of this title, any federally conducted or sup-
ported health care or public health program, activity 
or survey (including Current Population Surveys and 
American Community Surveys conducted by the Bu-
reau of Labor Statistics and the Bureau of the Cen-
sus) collects and reports, to the extent practicable— 
‘‘(A) data on race, ethnicity, sex, primary 
language, and disability status for applicants, 
recipients, or participants; 
‘‘(B) data at the smallest geographic level 
such as State, local, or institutional levels if 
such data can be aggregated; 
‘‘(C) sufficient data to generate statis-
tically reliable estimates by racial, ethnic, sex, 
primary language, and disability status sub-
groups for applicants, recipients or participants 
using, if needed, statistical oversamples of these 
subpopulations; and 
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•AMDT. NO. 2786 
‘‘(D) any other demographic data as 
deemed appropriate by the Secretary regarding 
health disparities. 
‘‘(2) COLLECTION
STANDARDS.—In collecting 
data described in paragraph (1), the Secretary or 
designee shall— 
‘‘(A) use Office of Management and Budg-
et standards, at a minimum, for race and eth-
nicity measures; 
‘‘(B) develop standards for the measure-
ment of sex, primary language, and disability 
status; 
‘‘(C) develop standards for the collection of 
data described in paragraph (1) that, at a min-
imum— 
‘‘(i) collects self-reported data by the 
applicant, recipient, or participant; and 
‘‘(ii) collects data from a parent or 
legal guardian if the applicant, recipient, 
or participant is a minor or legally inca-
pacitated; 
‘‘(D) survey health care providers and es-
tablish other procedures in order to assess ac-
cess to care and treatment for individuals with 
disabilities and to identify— 
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•AMDT. NO. 2786 
‘‘(i) locations where individuals with 
disabilities access primary, acute (including 
intensive), and long-term care; 
‘‘(ii) the number of providers with ac-
cessible facilities and equipment to meet 
the needs of the individuals with disabil-
ities, including medical diagnostic equip-
ment that meets the minimum technical 
criteria set forth in section 510 of the Re-
habilitation Act of 1973; and 
‘‘(iii) the number of employees of 
health care providers trained in disability 
awareness and patient care of individuals 
with disabilities; and 
‘‘(E) require that any reporting require-
ment imposed for purposes of measuring quality 
under any ongoing or federally conducted or 
supported health care or public health program, 
activity, or survey includes requirements for the 
collection of data on individuals receiving health 
care items or services under such programs ac-
tivities by race, ethnicity, sex, primary lan-
guage, and disability status. 
‘‘(3) DATA MANAGEMENT.—In collecting data 
described in paragraph (1), the Secretary, acting 
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•AMDT. NO. 2786 
through the National Coordinator for Health Infor-
mation Technology shall— 
‘‘(A) develop national standards for the 
management of data collected; and 
‘‘(B) develop interoperability and security 
systems for data management. 
‘‘(b) DATA ANALYSIS.— 
‘‘(1) IN
GENERAL.—For each federally con-
ducted or supported health care or public health pro-
gram or activity, the Secretary shall analyze data 
collected under paragraph (a) to detect and monitor 
trends in health disparities (as defined for purposes 
of section 485E) at the Federal and State levels. 
‘‘(c) DATA REPORTING AND DISSEMINATION.— 
‘‘(1) IN GENERAL.—The Secretary shall make 
the analyses described in (b) available to— 
‘‘(A) the Office of Minority Health; 
‘‘(B) the National Center on Minority 
Health and Health Disparities; 
‘‘(C) the Agency for Healthcare Research 
and Quality; 
‘‘(D) the Centers for Disease Control and 
Prevention; 
‘‘(E) the Centers for Medicare & Medicaid 
Services; 
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•AMDT. NO. 2786 
‘‘(F) the Indian Health Service and epide-
miology centers funded under the Indian Health 
Care Improvement Act; 
‘‘(G) the Office of Rural health; 
‘‘(H) other agencies within the Department 
of Health and Human Services; and 
‘‘(I) other entities as determined appro-
priate by the Secretary. 
‘‘(2) REPORTING
OF
DATA.—The Secretary 
shall report data and analyses described in (a) and 
(b) through— 
‘‘(A) public postings on the Internet 
websites of the Department of Health and 
Human Services; and 
‘‘(B) any other reporting or dissemination 
mechanisms determined appropriate by the Sec-
retary. 
‘‘(3) AVAILABILITY OF DATA.—The Secretary 
may make data described in (a) and (b) available for 
additional research, analyses, and dissemination to 
other Federal agencies, non-governmental entities, 
and the public, in accordance with any Federal agen-
cy’s data user agreements. 
‘‘(d) LIMITATIONS ON USE OF DATA.—Nothing in 
this section shall be construed to permit the use of infor-
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•AMDT. NO. 2786 
mation collected under this section in a manner that would 
adversely affect any individual. 
‘‘(e) PROTECTION AND SHARING OF DATA.— 
‘‘(1) PRIVACY AND OTHER SAFEGUARDS.—The 
Secretary shall ensure (through the promulgation of 
regulations or otherwise) that— 
‘‘(A) all data collected pursuant to sub-
section (a) is protected— 
‘‘(i) under privacy protections that are 
at least as broad as those that the Sec-
retary applies to other health data under 
the regulations promulgated under section 
264(c) of the Health Insurance Portability 
and Accountability Act of 1996 (Public 
Law 104-191; 110 Stat. 2033); and 
‘‘(ii) from all inappropriate internal 
use by any entity that collects, stores, or 
receives the data, including use of such 
data in determinations of eligibility (or 
continued eligibility) in health plans, and 
from other inappropriate uses, as defined 
by the Secretary; and 
‘‘(B) all appropriate information security 
safeguards are used in the collection, analysis, 
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•AMDT. NO. 2786 
and sharing of data collected pursuant to sub-
section (a). 
‘‘(2) DATA SHARING.—The Secretary shall es-
tablish procedures for sharing data collected pursu-
ant to subsection (a), measures relating to such 
data, and analyses of such data, with other relevant 
Federal and State agencies including the agencies, 
centers, and entities within the Department of 
Health and Human Services specified in subsection 
(c)(1).. 
‘‘(f) DATA
ON
RURAL
UNDERSERVED
POPU-
LATIONS.—The Secretary shall ensure that any data col-
lected in accordance with this section regarding racial and 
ethnic minority groups are also collected regarding under-
served rural and frontier populations. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of fiscal years 2010 through 2014. 
‘‘(h) REQUIREMENT FOR IMPLEMENTATION.—Not-
withstanding any other provision of this section, data may 
not be collected under this section unless funds are di-
rectly appropriated for such purpose in an appropriations 
Act. 
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•AMDT. NO. 2786 
‘‘(i) CONSULTATION.—The Secretary shall consult 
with the Director of the Office of Personnel Management, 
the Secretary of Defense, the Secretary of Veterans Af-
fairs, the Director of the Bureau of the Census, the Com-
missioner of Social Security, and the head of other appro-
priate Federal agencies in carrying out this section.’’. 
(b) ADDRESSING HEALTH CARE DISPARITIES
IN 
MEDICAID AND CHIP.— 
(1) STANDARDIZED
COLLECTION
REQUIRE-
MENTS INCLUDED IN STATE PLANS.— 
(A) MEDICAID.—Section 1902(a) of the 
Social Security Act (42 U.S.C. 1396a(a)), as 
amended by section 2001(d), is amended— 
(i) in paragraph 4), by striking ‘‘and’’ 
at the end; 
(ii) in paragraph (75), by striking the 
period at the end and inserting ‘‘; and’’; 
and 
(iii) by inserting after paragraph (75) 
the following new paragraph: 
‘‘(76) provide that any data collected under the 
State plan meets the requirements of section 3101 
of the Public Health Service Act.’’. 
(B) CHIP.—Section 2108(e) of the Social 
Security Act (42 U.S.C. 1397hh(e)) is amended 
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•AMDT. NO. 2786 
by adding at the end the following new para-
graph: 
‘‘(7) Data collected and reported in accordance 
with section 3101 of the Public Health Service Act, 
with respect to individuals enrolled in the State child 
health plan (and, in the case of enrollees under 19 
years of age, their parents or legal guardians), in-
cluding data regarding the primary language of such 
individuals, parents, and legal guardians.’’. 
(2) EXTENDING MEDICARE REQUIREMENT TO 
ADDRESS HEALTH DISPARITIES DATA COLLECTION 
TO MEDICAID AND CHIP.—Title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.), as amended 
by section 2703 is amended by adding at the end the 
following new section: 
‘‘SEC. 1946. ADDRESSING HEALTH CARE DISPARITIES. 
‘‘(a) 
EVALUATING
DATA
COLLECTION
AP-
PROACHES.—The Secretary shall evaluate approaches for 
the collection of data under this title and title XXI, to 
be performed in conjunction with existing quality report-
ing requirements and programs under this title and title 
XXI, that allow for the ongoing, accurate, and timely col-
lection and evaluation of data on disparities in health care 
services and performance on the basis of race, ethnicity, 
sex, primary language, and disability status. In conducting 
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•AMDT. NO. 2786 
such evaluation, the Secretary shall consider the following 
objectives: 
‘‘(1) Protecting patient privacy. 
‘‘(2) Minimizing the administrative burdens of 
data collection and reporting on States, providers, 
and health plans participating under this title or 
title XXI. 
‘‘(3) Improving program data under this title 
and title XXI on race, ethnicity, sex, primary lan-
guage, and disability status. 
‘‘(b) REPORTS TO CONGRESS.— 
‘‘(1) REPORT ON EVALUATION.—Not later than 
18 months after the date of the enactment of this 
section, the Secretary shall submit to Congress a re-
port on the evaluation conducted under subsection 
(a). Such report shall, taking into consideration the 
results of such evaluation— 
‘‘(A) identify approaches (including defin-
ing methodologies) for identifying and collecting 
and evaluating data on health care disparities 
on the basis of race, ethnicity, sex, primary lan-
guage, and disability status for the programs 
under this title and title XXI; and 
‘‘(B) include recommendations on the most 
effective strategies and approaches to reporting 
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•AMDT. NO. 2786 
HEDIS quality measures as required under sec-
tion 1852(e)(3) and other nationally recognized 
quality performance measures, as appropriate, 
on such bases. 
‘‘(2) REPORTS ON DATA ANALYSES.—Not later 
than 4 years after the date of the enactment of this 
section, and 4 years thereafter, the Secretary shall 
submit to Congress a report that includes rec-
ommendations for improving the identification of 
health care disparities for beneficiaries under this 
title and under title XXI based on analyses of the 
data collected under subsection (c). 
‘‘(c) IMPLEMENTING EFFECTIVE APPROACHES.—Not 
later than 24 months after the date of the enactment of 
this section, the Secretary shall implement the approaches 
identified in the report submitted under subsection (b)(1) 
for the ongoing, accurate, and timely collection and eval-
uation of data on health care disparities on the basis of 
race, ethnicity, sex, primary language, and disability sta-
tus.’’. 
SEC. 4303. CDC AND EMPLOYER-BASED WELLNESS PRO-
GRAMS. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.), by section 4102, is further amended by add-
ing at the end the following: 
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•AMDT. NO. 2786 
‘‘PART U—EMPLOYER-BASED WELLNESS 
PROGRAM 
‘‘SEC. 399MM. TECHNICAL ASSISTANCE FOR EMPLOYER- 
BASED WELLNESS PROGRAMS. 
‘‘In order to expand the utilization of evidence-based 
prevention and health promotion approaches in the work-
place, the Director shall— 
‘‘(1) provide employers (including small, me-
dium, and large employers, as determined by the Di-
rector) with technical assistance, consultation, tools, 
and other resources in evaluating such employers’ 
employer-based wellness programs, including— 
‘‘(A) measuring the participation and 
methods to increase participation of employees 
in such programs; 
‘‘(B) developing standardized measures 
that assess policy, environmental and systems 
changes necessary to have a positive health im-
pact on employees’ health behaviors, health out-
comes, and health care expenditures; and 
‘‘(C) evaluating such programs as they re-
late to changes in the health status of employ-
ees, the absenteeism of employees, the produc-
tivity of employees, the rate of workplace in-
jury, and the medical costs incurred by employ-
ees; and 
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•AMDT. NO. 2786 
‘‘(2) build evaluation capacity among workplace 
staff by training employers on how to evaluate em-
ployer-based wellness programs by ensuring evalua-
tion resources, technical assistance, and consultation 
are available to workplace staff as needed through 
such mechanisms as web portals, call centers, or 
other means. 
‘‘SEC. 399MM-1. NATIONAL WORKSITE HEALTH POLICIES 
AND PROGRAMS STUDY. 
‘‘(a) IN GENERAL.—In order to assess, analyze, and 
monitor over time data about workplace policies and pro-
grams, and to develop instruments to assess and evaluate 
comprehensive workplace chronic disease prevention and 
health promotion programs, policies and practices, not 
later than 2 years after the date of enactment of this part, 
and at regular intervals (to be determined by the Director) 
thereafter, the Director shall conduct a national worksite 
health policies and programs survey to assess employer- 
based health policies and programs. 
‘‘(b) REPORT.—Upon the completion of each study 
under subsection (a), the Director shall submit to Con-
gress a report that includes the recommendations of the 
Director for the implementation of effective employer- 
based health policies and programs. 
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•AMDT. NO. 2786 
‘‘SEC. 399MM–2. PRIORITIZATION OF EVALUATION BY SEC-
RETARY. 
‘‘The Secretary shall evaluate, in accordance with this 
part, all programs funded through the Centers for Disease 
Control and Prevention before conducting such an evalua-
tion of privately funded programs unless an entity with 
a privately funded wellness program requests such an eval-
uation. 
‘‘SEC. 399MM–3. PROHIBITION OF FEDERAL WORKPLACE 
WELLNESS REQUIREMENTS. 
‘‘Notwithstanding any other provision of this part, 
any recommendations, data, or assessments carried out 
under this part shall not be used to mandate requirements 
for workplace wellness programs.’’. 
SEC. 
4304. 
EPIDEMIOLOGY-LABORATORY 
CAPACITY 
GRANTS. 
Title XXVIII of the Public Health Service Act (42 
U.S.C. 300hh et seq.) is amended by adding at the end 
the following: 
‘‘Subtitle C—Strengthening Public 
Health Surveillance Systems 
‘‘SEC. 
2821. 
EPIDEMIOLOGY-LABORATORY 
CAPACITY 
GRANTS. 
‘‘(a) IN GENERAL.—Subject to the availability of ap-
propriations, the Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, shall 
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establish an Epidemiology and Laboratory Capacity Grant 
Program to award grants to State health departments as 
well as local health departments and tribal jurisdictions 
that meet such criteria as the Director determines appro-
priate. Academic centers that assist State and eligible 
local and tribal health departments may also be eligible 
for funding under this section as the Director determines 
appropriate. Grants shall be awarded under this section 
to assist public health agencies in improving surveillance 
for, and response to, infectious diseases and other condi-
tions of public health importance by— 
‘‘(1) strengthening epidemiologic capacity to 
identify and monitor the occurrence of infectious dis-
eases and other conditions of public health impor-
tance; 
‘‘(2) enhancing laboratory practice as well as 
systems to report test orders and results electroni-
cally; 
‘‘(3) improving information systems including 
developing and maintaining an information exchange 
using national guidelines and complying with capac-
ities and functions determined by an advisory coun-
cil established and appointed by the Director; and 
‘‘(4) developing and implementing prevention 
and control strategies. 
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‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$190,000,000 for each of fiscal years 2010 through 2013, 
of which— 
‘‘(1) not less than $95,000,000 shall be made 
available each such fiscal year for activities under 
paragraphs (1) and (4) of subsection (a); 
‘‘(2) not less than $60,000,000 shall be made 
available each such fiscal year for activities under 
subsection (a)(3); and 
‘‘(3) not less than $32,000,000 shall be made 
available each such fiscal year for activities under 
subsection (a)(2).’’. 
SEC. 4305. ADVANCING RESEARCH AND TREATMENT FOR 
PAIN CARE MANAGEMENT. 
(a) INSTITUTE
OF
MEDICINE
CONFERENCE
ON 
PAIN.— 
(1) CONVENING.—Not later than 1 year after 
funds are appropriated to carry out this subsection, 
the Secretary of Health and Human Services shall 
seek to enter into an agreement with the Institute 
of Medicine of the National Academies to convene a 
Conference on Pain (in this subsection referred to as 
‘‘the Conference’’). 
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(2) PURPOSES.—The purposes of the Con-
ference shall be to— 
(A) increase the recognition of pain as a 
significant public health problem in the United 
States; 
(B) evaluate the adequacy of assessment, 
diagnosis, treatment, and management of acute 
and chronic pain in the general population, and 
in identified racial, ethnic, gender, age, and 
other demographic groups that may be dis-
proportionately affected by inadequacies in the 
assessment, diagnosis, treatment, and manage-
ment of pain; 
(C) identify barriers to appropriate pain 
care; 
(D) establish an agenda for action in both 
the public and private sectors that will reduce 
such barriers and significantly improve the 
state of pain care research, education, and clin-
ical care in the United States. 
(3) OTHER APPROPRIATE ENTITY.—If the In-
stitute of Medicine declines to enter into an agree-
ment under paragraph (1), the Secretary of Health 
and Human Services may enter into such agreement 
with another appropriate entity. 
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(4) REPORT.—A report summarizing the Con-
ference’s findings and recommendations shall be 
submitted to the Congress not later than June 30, 
2011. 
(5) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out this subsection, there is 
authorized to be appropriated such sums as may be 
necessary for each of fiscal years 2010 and 2011. 
(b) PAIN RESEARCH AT NATIONAL INSTITUTES OF 
HEALTH.—Part B of title IV of the Public Health Service 
Act (42 U.S.C. 284 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 409J. PAIN RESEARCH. 
‘‘(a) RESEARCH INITIATIVES.— 
‘‘(1) IN GENERAL.—The Director of NIH is en-
couraged to continue and expand, through the Pain 
Consortium, an aggressive program of basic and 
clinical research on the causes of and potential treat-
ments for pain. 
‘‘(2) ANNUAL
RECOMMENDATIONS.—Not less 
than annually, the Pain Consortium, in consultation 
with the Division of Program Coordination, Plan-
ning, and Strategic Initiatives, shall develop and 
submit to the Director of NIH recommendations on 
appropriate pain research initiatives that could be 
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undertaken with funds reserved under section 
402A(c)(1) for the Common Fund or otherwise 
available for such initiatives. 
‘‘(3) DEFINITION.—In this subsection, the term 
‘Pain Consortium’ means the Pain Consortium of 
the National Institutes of Health or a similar trans- 
National Institutes of Health coordinating entity 
designated by the Secretary for purposes of this sub-
section. 
‘‘(b) INTERAGENCY PAIN RESEARCH COORDINATING 
COMMITTEE.— 
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish not later than 1 year after the date of the 
enactment of this section and as necessary maintain 
a committee, to be known as the Interagency Pain 
Research Coordinating Committee (in this section 
referred to as the ‘Committee’), to coordinate all ef-
forts within the Department of Health and Human 
Services and other Federal agencies that relate to 
pain research. 
‘‘(2) MEMBERSHIP.— 
‘‘(A) IN GENERAL.—The Committee shall 
be composed of the following voting members: 
‘‘(i) Not more than 7 voting Federal 
representatives appoint by the Secretary 
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from agencies that conduct pain care re-
search and treatment. 
‘‘(ii) 12 additional voting members ap-
pointed under subparagraph (B). 
‘‘(B) ADDITIONAL MEMBERS.—The Com-
mittee shall include additional voting members 
appointed by the Secretary as follows: 
‘‘(i) 6 non-Federal members shall be 
appointed from among scientists, physi-
cians, and other health professionals. 
‘‘(ii) 6 members shall be appointed 
from members of the general public, who 
are representatives of leading research, ad-
vocacy, and service organizations for indi-
viduals with pain-related conditions. 
‘‘(C) NONVOTING
MEMBERS.—The Com-
mittee shall include such nonvoting members as 
the Secretary determines to be appropriate. 
‘‘(3) CHAIRPERSON.—The voting members of 
the Committee shall select a chairperson from 
among such members. The selection of a chairperson 
shall be subject to the approval of the Director of 
NIH. 
‘‘(4) MEETINGS.—The Committee shall meet at 
the call of the chairperson of the Committee or upon 
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the request of the Director of NIH, but in no case 
less often than once each year. 
‘‘(5) DUTIES.—The Committee shall— 
‘‘(A) develop a summary of advances in 
pain care research supported or conducted by 
the Federal agencies relevant to the diagnosis, 
prevention, and treatment of pain and diseases 
and disorders associated with pain; 
‘‘(B) identify critical gaps in basic and 
clinical research on the symptoms and causes of 
pain; 
‘‘(C) make recommendations to ensure that 
the activities of the National Institutes of 
Health and other Federal agencies are free of 
unnecessary duplication of effort; 
‘‘(D) make recommendations on how best 
to disseminate information on pain care; and 
‘‘(E) make recommendations on how to ex-
pand partnerships between public entities and 
private entities to expand collaborative, cross- 
cutting research. 
‘‘(6) REVIEW.—The Secretary shall review the 
necessity of the Committee at least once every 2 
years.’’. 
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(c) PAIN CARE EDUCATION AND TRAINING.—Part D 
of title VII of the Public Health Service Act (42 U.S.C. 
294 et seq.) is amended by adding at the end the following 
new section: 
‘‘SEC. 759. PROGRAM FOR EDUCATION AND TRAINING IN 
PAIN CARE. 
‘‘(a) IN GENERAL.—The Secretary may make awards 
of grants, cooperative agreements, and contracts to health 
professions schools, hospices, and other public and private 
entities for the development and implementation of pro-
grams to provide education and training to health care 
professionals in pain care. 
‘‘(b) CERTAIN TOPICS.—An award may be made 
under subsection (a) only if the applicant for the award 
agrees that the program carried out with the award will 
include information and education on— 
‘‘(1) recognized means for assessing, diag-
nosing, treating, and managing pain and related 
signs and symptoms, including the medically appro-
priate use of controlled substances; 
‘‘(2) applicable laws, regulations, rules, and 
policies on controlled substances, including the de-
gree to which misconceptions and concerns regarding 
such laws, regulations, rules, and policies, or the en-
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forcement thereof, may create barriers to patient ac-
cess to appropriate and effective pain care; 
‘‘(3) interdisciplinary approaches to the delivery 
of pain care, including delivery through specialized 
centers providing comprehensive pain care treatment 
expertise; 
‘‘(4) cultural, linguistic, literacy, geographic, 
and other barriers to care in underserved popu-
lations; and 
‘‘(5) recent findings, developments, and im-
provements in the provision of pain care. 
‘‘(c) EVALUATION
OF PROGRAMS.—The Secretary 
shall (directly or through grants or contracts) provide for 
the evaluation of programs implemented under subsection 
(a) in order to determine the effect of such programs on 
knowledge and practice of pain care. 
‘‘(d) PAIN CARE DEFINED.—For purposes of this 
section the term ‘pain care’ means the assessment, diag-
nosis, treatment, or management of acute or chronic pain 
regardless of causation or body location. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of the fiscal years 
2010 through 2012. Amounts appropriated under this 
subsection shall remain available until expended.’’. 
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•AMDT. NO. 2786 
SEC. 4306. FUNDING FOR CHILDHOOD OBESITY DEM-
ONSTRATION PROJECT. 
Section 1139A(e)(8) of the Social Security Act (42 
U.S.C. 1320b–9a(e)(8)) is amended to read as follows: 
‘‘(8) APPROPRIATION.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated to carry out this subsection, $25,000,000 for 
the period of fiscal years 2010 through 2014.’’. 
Subtitle E—Miscellaneous 
Provisions 
SEC. 4401. SENSE OF THE SENATE CONCERNING CBO SCOR-
ING. 
(a) FINDING.—The Senate finds that the costs of 
prevention programs are difficult to estimate due in part 
because prevention initiatives are hard to measure and re-
sults may occur outside the 5 and 10 year budget win-
dows. 
(b) SENSE OF CONGRESS.—It is the sense of the Sen-
ate that Congress should work with the Congressional 
Budget Office to develop better methodologies for scoring 
progress to be made in prevention and wellness programs. 
SEC. 4402. EFFECTIVENESS OF FEDERAL HEALTH AND 
WELLNESS INITIATIVES. 
To determine whether existing Federal health and 
wellness initiatives are effective in achieving their stated 
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goals, the Secretary of Health and Human Services 
shall— 
(1) conduct an evaluation of such programs as 
they relate to changes in health status of the Amer-
ican public and specifically on the health status of 
the Federal workforce, including absenteeism of em-
ployees, the productivity of employees, the rate of 
workplace injury, and the medical costs incurred by 
employees, and health conditions, including work-
place fitness, healthy food and beverages, and incen-
tives in the Federal Employee Health Benefits Pro-
gram; and 
(2) submit to Congress a report concerning 
such evaluation, which shall include conclusions con-
cerning the reasons that such existing programs 
have proven successful or not successful and what 
factors contributed to such conclusions. 
TITLE V—HEALTH CARE 
WORKFORCE 
Subtitle A—Purpose and 
Definitions 
SEC. 5001. PURPOSE. 
The purpose of this title is to improve access to and 
the delivery of health care services for all individuals, par-
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ticularly low income, underserved, uninsured, minority, 
health disparity, and rural populations by— 
(1) gathering and assessing comprehensive data 
in order for the health care workforce to meet the 
health care needs of individuals, including research 
on the supply, demand, distribution, diversity, and 
skills needs of the health care workforce; 
(2) increasing the supply of a qualified health 
care workforce to improve access to and the delivery 
of health care services for all individuals; 
(3) enhancing health care workforce education 
and training to improve access to and the delivery 
of health care services for all individuals; and 
(4) providing support to the existing health care 
workforce to improve access to and the delivery of 
health care services for all individuals. 
SEC. 5002. DEFINITIONS. 
(a) THIS TITLE.—In this title: 
(1) ALLIED
HEALTH
PROFESSIONAL.—The 
term ‘‘allied health professional’’ means an allied 
health professional as defined in section 799B(5) of 
the Public Heath Service Act (42 U.S.C. 295p(5)) 
who— 
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(A) has graduated and received an allied 
health professions degree or certificate from an 
institution of higher education; and 
(B) is employed with a Federal, State, 
local or tribal public health agency, or in a set-
ting where patients might require health care 
services, including acute care facilities, ambula-
tory care facilities, personal residences, and 
other settings located in health professional 
shortage areas, medically underserved areas, or 
medically underserved populations, as recog-
nized by the Secretary of Health and Human 
Services. 
(2) HEALTH
CARE
CAREER
PATHWAY.—The 
term ‘‘healthcare career pathway’’ means a rigorous, 
engaging, and high quality set of courses and serv-
ices that— 
(A) includes an articulated sequence of 
academic and career courses, including 21st 
century skills; 
(B) is aligned with the needs of healthcare 
industries in a region or State; 
(C) prepares students for entry into the 
full range of postsecondary education options, 
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including registered apprenticeships, and ca-
reers; 
(D) provides academic and career coun-
seling in student-to-counselor ratios that allow 
students to make informed decisions about aca-
demic and career options; 
(E) meets State academic standards, State 
requirements for secondary school graduation 
and is aligned with requirements for entry into 
postsecondary education, and applicable indus-
try standards; and 
(F) leads to 2 or more credentials, includ-
ing— 
(i) a secondary school diploma; and 
(ii) a postsecondary degree, an ap-
prenticeship or other occupational certifi-
cation, a certificate, or a license. 
(3) INSTITUTION OF HIGHER EDUCATION.—The 
term ‘‘institution of higher education’’ has the 
meaning given the term in sections 101 and 102 of 
the Higher Education Act of 1965 (20 U.S.C. 1001 
and 1002). 
(4) LOW
INCOME
INDIVIDUAL, STATE
WORK-
FORCE
INVESTMENT
BOARD, AND
LOCAL
WORK-
FORCE INVESTMENT BOARD.— 
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(A) LOW-INCOME INDIVIDUAL.—The term 
‘‘low-income individual’’ has the meaning given 
that term in section 101 of the Workforce in-
vestment Act of 1998 (29 U.S.C. 2801). 
(B) 
STATE
WORKFORCE
INVESTMENT 
BOARD; 
LOCAL
WORKFORCE
INVESTMENT 
BOARD.—The terms ‘‘State workforce invest-
ment board’’ and ‘‘local workforce investment 
board’’, refer to a State workforce investment 
board established under section 111 of the 
Workforce Investment Act of 1998 (29 U.S.C. 
2821) and a local workforce investment board 
established under section 117 of such Act (29 
U.S.C. 2832), respectively. 
(5) POSTSECONDARY
EDUCATION.—The term 
‘‘postsecondary education’’ means— 
(A) a 4-year program of instruction, or not 
less than a 1-year program of instruction that 
is acceptable for credit toward an associate or 
a baccalaureate degree, offered by an institution 
of higher education; or 
(B) a certificate or registered apprentice-
ship program at the postsecondary level offered 
by an institution of higher education or a non- 
profit educational institution. 
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(6) REGISTERED APPRENTICESHIP PROGRAM.— 
The term ‘‘registered apprenticeship program’’ 
means an industry skills training program at the 
postsecondary level that combines technical and the-
oretical training through structure on the job learn-
ing with related instruction (in a classroom or 
through distance learning) while an individual is em-
ployed, working under the direction of qualified per-
sonnel or a mentor, and earning incremental wage 
increases aligned to enhance job proficiency, result-
ing in the acquisition of a nationally recognized and 
portable certificate, under a plan approved by the 
Office of Apprenticeship or a State agency recog-
nized by the Department of Labor. 
(b) TITLE VII OF THE PUBLIC HEALTH SERVICE 
ACT.—Section 799B of the Public Health Service Act (42 
U.S.C. 295p) is amended— 
(1) by striking paragraph (3) and inserting the 
following: 
‘‘(3) PHYSICIAN
ASSISTANT
EDUCATION
PRO-
GRAM.—The term ‘physician assistant education 
program’ means an educational program in a public 
or private institution in a State that— 
‘‘(A) has as its objective the education of 
individuals who, upon completion of their stud-
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ies in the program, be qualified to provide pri-
mary care medical services with the supervision 
of a physician; and 
‘‘(B) is accredited by the Accreditation Re-
view Commission on Education for the Physi-
cian Assistant.’’; and 
(2) by adding at the end the following: 
‘‘(12) AREA
HEALTH
EDUCATION
CENTER.— 
The term ‘area health education center’ means a 
public or nonprofit private organization that has a 
cooperative agreement or contract in effect with an 
entity that has received an award under subsection 
(a)(1) or (a)(2) of section 751, satisfies the require-
ments in section 751(d)(1), and has as one of its 
principal functions the operation of an area health 
education center. Appropriate organizations may in-
clude hospitals, health organizations with accredited 
primary care training programs, accredited physician 
assistant educational programs associated with a col-
lege or university, and universities or colleges not 
operating a school of medicine or osteopathic medi-
cine. 
‘‘(13) AREA HEALTH EDUCATION CENTER PRO-
GRAM.—The term ‘area health education center pro-
gram’ means cooperative program consisting of an 
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entity that has received an award under subsection 
(a)(1) or (a)(2) of section 751 for the purpose of 
planning, developing, operating, and evaluating an 
area health education center program and one or 
more area health education centers, which carries 
out the required activities described in section 
751(c), satisfies the program requirements in such 
section, has as one of its principal functions identi-
fying and implementing strategies and activities that 
address health care workforce needs in its service 
area, in coordination with the local workforce invest-
ment boards. 
‘‘(14) CLINICAL
SOCIAL
WORKER.—The term 
‘clinical social worker’ has the meaning given the 
term in section 1861(hh)(1) of the Social Security 
Act (42 U.S.C. 1395x(hh)(1)). 
‘‘(15) CULTURAL
COMPETENCY.—The term 
‘cultural competency’ shall be defined by the Sec-
retary 
in 
a 
manner 
consistent 
with 
section 
1707(d)(3). 
‘‘(16) DIRECT CARE WORKER.—The term ‘di-
rect care worker’ has the meaning given that term 
in the 2010 Standard Occupational Classifications of 
the Department of Labor for Home Health Aides 
[31–1011], Psychiatric Aides [31–1013], Nursing 
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Assistants [31–1014], and Personal Care Aides [39– 
9021]. 
‘‘(17) FEDERALLY
QUALIFIED
HEALTH
CEN-
TER.—The term ‘Federally qualified health center’ 
has the meaning given that term in section 1861(aa) 
of the Social Security Act (42 U.S.C. 1395x(aa)). 
‘‘(18) 
FRONTIER
HEALTH
PROFESSIONAL 
SHORTAGE AREA.—The term ‘frontier health profes-
sional shortage area’ means an area— 
‘‘(A) with a population density less than 6 
persons per square mile within the service area; 
and 
‘‘(B) with respect to which the distance or 
time for the population to access care is exces-
sive. 
‘‘(19) GRADUATE
PSYCHOLOGY.—The term 
‘graduate psychology’ means an accredited program 
in professional psychology. 
‘‘(20) HEALTH DISPARITY POPULATION.—The 
term ‘health disparity population’ has the meaning 
given such term in section 903(d)(1). 
‘‘(21) HEALTH
LITERACY.—The term ‘health 
literacy’ means the degree to which an individual has 
the capacity to obtain, communicate, process, and 
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understand health information and services in order 
to make appropriate health decisions. 
‘‘(22) MENTAL
HEALTH
SERVICE
PROFES-
SIONAL.—The term ‘mental health service profes-
sional’ means an individual with a graduate or post-
graduate degree from an accredited institution of 
higher education in psychiatry, psychology, school 
psychology, behavioral pediatrics, psychiatric nurs-
ing, social work, school social work, substance abuse 
disorder prevention and treatment, marriage and 
family counseling, school counseling, or professional 
counseling. 
‘‘(23) ONE-STOP DELIVERY SYSTEM CENTER.— 
The term ‘one-stop delivery system’ means a one- 
stop delivery system described in section 134(c) of 
the Workforce Investment Act of 1998 (29 U.S.C. 
2864(c)). 
‘‘(24) PARAPROFESSIONAL CHILD AND ADOLES-
CENT MENTAL HEALTH WORKER.—The term ‘para-
professional child and adolescent mental health 
worker’ means an individual who is not a mental or 
behavioral health service professional, but who works 
at the first stage of contact with children and fami-
lies who are seeking mental or behavioral health 
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services, including substance abuse prevention and 
treatment services. 
‘‘(25) RACIAL AND ETHNIC MINORITY GROUP; 
RACIAL AND ETHNIC MINORITY POPULATION.—The 
terms ‘racial and ethnic minority group’ and ‘racial 
and ethnic minority population’ have the meaning 
given the term ‘racial and ethnic minority group’ in 
section 1707. 
‘‘(26) RURAL
HEALTH
CLINIC.—The term 
‘rural health clinic’ has the meaning given that term 
in section 1861(aa) of the Social Security Act (42 
U.S.C. 1395x(aa)).’’. 
(c) TITLE VIII OF THE PUBLIC HEALTH SERVICE 
ACT.—Section 801 of the Public Health Service Act (42 
U.S.C. 296) is amended— 
(1) in paragraph (2)— 
(A) by striking ‘‘means a’’ and inserting 
‘‘means an accredited (as defined in paragraph 
6)’’; and 
(B) by striking the period as inserting the 
following: ‘‘where graduates are— 
‘‘(A) authorized to sit for the National 
Council 
Licensure 
EXamination-Registered 
Nurse (NCLEX-RN); or 
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•AMDT. NO. 2786 
‘‘(B) licensed registered nurses who will re-
ceive a graduate or equivalent degree or train-
ing to become an advanced education nurse as 
defined by section 811(b).’’; and 
(2) by adding at the end the following: 
‘‘(16) ACCELERATED
NURSING
DEGREE
PRO-
GRAM.—The term ‘accelerated nursing degree pro-
gram’ means a program of education in professional 
nursing offered by an accredited school of nursing in 
which an individual holding a bachelors degree in 
another discipline receives a BSN or MSN degree in 
an accelerated time frame as determined by the ac-
credited school of nursing. 
‘‘(17) BRIDGE OR DEGREE COMPLETION PRO-
GRAM.—The term ‘bridge or degree completion pro-
gram’ means a program of education in professional 
nursing offered by an accredited school of nursing, 
as defined in paragraph (2), that leads to a bacca-
laureate degree in nursing. Such programs may in-
clude, Registered Nurse (RN) to Bachelor’s of 
Science of Nursing (BSN) programs, RN to MSN 
(Master of Science of Nursing) programs, or BSN to 
Doctoral programs.’’. 
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•AMDT. NO. 2786 
Subtitle B—Innovations in the 
Health Care Workforce 
SEC. 5101. NATIONAL HEALTH CARE WORKFORCE COMMIS-
SION. 
(a) PURPOSE.—It is the purpose of this section to 
establish a National Health Care Workforce Commission 
that— 
(1) serves as a national resource for Congress, 
the President, States, and localities; 
(2) communicates and coordinates with the De-
partments of Health and Human Services, Labor, 
Veterans Affairs, Homeland Security, and Education 
on related activities administered by one or more of 
such Departments; 
(3) develops and commissions evaluations of 
education and training activities to determine wheth-
er the demand for health care workers is being met; 
(4) identifies barriers to improved coordination 
at the Federal, State, and local levels and rec-
ommend ways to address such barriers; and 
(5) encourages innovations to address popu-
lation needs, constant changes in technology, and 
other environmental factors. 
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•AMDT. NO. 2786 
(b) ESTABLISHMENT.—There is hereby established 
the National Health Care Workforce Commission (in this 
section referred to as the ‘‘Commission’’). 
(c) MEMBERSHIP.— 
(1) NUMBER AND APPOINTMENT.—The Com-
mission shall be composed of 15 members to be ap-
pointed by the Comptroller General, without regard 
to section 5 of the Federal Advisory Committee Act 
(5 U.S.C. App.). 
(2) QUALIFICATIONS.— 
(A) IN GENERAL.—The membership of the 
Commission shall include individuals— 
(i) with national recognition for their 
expertise in health care labor market anal-
ysis, including health care workforce anal-
ysis; health care finance and economics; 
health care facility management; health 
care plans and integrated delivery systems; 
health care workforce education and train-
ing; health care philanthropy; providers of 
health care services; and other related 
fields; and 
(ii) who will provide a combination of 
professional perspectives, broad geographic 
representation, and a balance between 
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•AMDT. NO. 2786 
urban, suburban, rural, and frontier rep-
resentatives. 
(B) INCLUSION.— 
(i) IN GENERAL.—The membership of 
the Commission shall include no less than 
one representative of— 
(I) the health care workforce and 
health professionals; 
(II) employers; 
(III) third-party payers; 
(IV) individuals skilled in the 
conduct and interpretation of health 
care services and health economics re-
search; 
(V) representatives of consumers; 
(VI) labor unions; 
(VII) State or local workforce in-
vestment boards; and 
(VIII) 
educational 
institutions 
(which may include elementary and 
secondary institutions, institutions of 
higher education, including 2 and 4 
year institutions, or registered ap-
prenticeship programs). 
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•AMDT. NO. 2786 
(ii) ADDITIONAL MEMBERS.—The re-
maining membership may include addi-
tional representatives from clause (i) and 
other individuals as determined appro-
priate by the Comptroller General of the 
United States. 
(C) MAJORITY
NON-PROVIDERS.—Individ-
uals who are directly involved in health profes-
sions education or practice shall not constitute 
a majority of the membership of the Commis-
sion. 
(D) ETHICAL
DISCLOSURE.—The Comp-
troller General shall establish a system for pub-
lic disclosure by members of the Commission of 
financial and other potential conflicts of interest 
relating to such members. Members of the 
Commission shall be treated as employees of 
Congress for purposes of applying title I of the 
Ethics in Government Act of 1978. Members of 
the Commission shall not be treated as special 
government employees under title 18, United 
States Code. 
(3) TERMS.— 
(A) IN GENERAL.—The terms of members 
of the Commission shall be for 3 years except 
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•AMDT. NO. 2786 
that the Comptroller General shall designate 
staggered terms for the members first ap-
pointed. 
(B) VACANCIES.—Any member appointed 
to fill a vacancy occurring before the expiration 
of the term for which the member’s predecessor 
was appointed shall be appointed only for the 
remainder of that term. A member may serve 
after the expiration of that member’s term until 
a successor has taken office. A vacancy in the 
Commission shall be filled in the manner in 
which the original appointment was made. 
(C) INITIAL APPOINTMENTS.—The Comp-
troller General shall make initial appointments 
of members to the Commission not later than 
September 30, 2010. 
(4) COMPENSATION.—While serving on the 
business of the Commission (including travel time), 
a member of the Commission shall be entitled to 
compensation at the per diem equivalent of the rate 
provided for level IV of the Executive Schedule 
under section 5315 of tile 5, United States Code, 
and while so serving away from home and the mem-
ber’s regular place of business, a member may be al-
lowed travel expenses, as authorized by the Chair-
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•AMDT. NO. 2786 
man of the Commission. Physicians serving as per-
sonnel of the Commission may be provided a physi-
cian comparability allowance by the Commission in 
the same manner as Government physicians may be 
provided such an allowance by an agency under sec-
tion 5948 of title 5, United States Code, and for 
such purpose subsection (i) of such section shall 
apply to the Commission in the same manner as it 
applies to the Tennessee Valley Authority. For pur-
poses of pay (other than pay of members of the 
Commission) and employment benefits, rights, and 
privileges, all personnel of the Commission shall be 
treated as if they were employees of the United 
States Senate. Personnel of the Commission shall 
not be treated as employees of the Government Ac-
countability Office for any purpose. 
(5) CHAIRMAN, VICE CHAIRMAN.—The Comp-
troller General shall designate a member of the 
Commission, at the time of appointment of the mem-
ber, as Chairman and a member as Vice Chairman 
for that term of appointment, except that in the case 
of vacancy of the chairmanship or vice chairman-
ship, the Comptroller General may designate another 
member for the remainder of that member’s term. 
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•AMDT. NO. 2786 
(6) MEETINGS.—The Commission shall meet at 
the call of the chairman, but no less frequently than 
on a quarterly basis. 
(d) DUTIES.— 
(1) RECOGNITION, DISSEMINATION, AND COM-
MUNICATION.—The Commission shall— 
(A) recognize efforts of Federal, State, and 
local partnerships to develop and offer health 
care career pathways of proven effectiveness; 
(B) disseminate information on promising 
retention practices for health care professionals; 
and 
(C) communicate information on important 
policies and practices that affect the recruit-
ment, education and training, and retention of 
the health care workforce. 
(2) REVIEW
OF
HEALTH
CARE
WORKFORCE 
AND ANNUAL REPORTS.—In order to develop a fis-
cally sustainable integrated workforce that supports 
a high-quality, readily accessible health care delivery 
system that meets the needs of patients and popu-
lations, the Commission, in consultation with rel-
evant Federal, State, and local agencies, shall— 
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•AMDT. NO. 2786 
(A) review current and projected health 
care workforce supply and demand, including 
the topics described in paragraph (3); 
(B) make recommendations to Congress 
and the Administration concerning national 
health care workforce priorities, goals, and poli-
cies; 
(C) by not later than October 1 of each 
year (beginning with 2011), submit a report to 
Congress and the Administration containing the 
results of such reviews and recommendations 
concerning related policies; and 
(D) by not later than April 1 of each year 
(beginning with 2011), submit a report to Con-
gress and the Administration containing a re-
view of, and recommendations on, at a min-
imum one high priority area as described in 
paragraph (4). 
(3) SPECIFIC TOPICS TO BE REVIEWED.—The 
topics described in this paragraph include— 
(A) current health care workforce supply 
and distribution, including demographics, skill 
sets, and demands, with projected demands 
during the subsequent 10 and 25 year periods; 
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•AMDT. NO. 2786 
(B) health care workforce education and 
training capacity, including the number of stu-
dents who have completed education and train-
ing, including registered apprenticeships; the 
number of qualified faculty; the education and 
training infrastructure; and the education and 
training demands, with projected demands dur-
ing the subsequent 10 and 25 year periods; 
(C) the education loan and grant programs 
in titles VII and VIII of the Public Health 
Service Act (42 U.S.C. 292 et seq. and 296 et 
seq.), with recommendations on whether such 
programs should become part of the Higher 
Education Act of 1965 (20 U.S.C. 1001 et 
seq); 
(D) the implications of new and existing 
Federal policies which affect the health care 
workforce, including Medicare and Medicaid 
graduate medical education policies, titles VII 
and VIII of the Public Health Service Act (42 
U.S.C. 292 et seq. and 296 et seq.), the Na-
tional Health Service Corps (with recommenda-
tions for aligning such programs with national 
health workforce priorities and goals), and 
other health care workforce programs, including 
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•AMDT. NO. 2786 
from human subjects, in which a drug or device is 
administered, dispensed, or used. 
‘‘(4) COVERED DEVICE.—The term ‘covered de-
vice’ means any device for which payment is avail-
able under title XVIII or a State plan under title 
XIX or XXI (or a waiver of such a plan). 
‘‘(5) COVERED DRUG, DEVICE, BIOLOGICAL, OR 
MEDICAL SUPPLY.—The term ‘covered drug, device, 
biological, or medical supply’ means any drug, bio-
logical product, device, or medical supply for which 
payment is available under title XVIII or a State 
plan under title XIX or XXI (or a waiver of such 
a plan). 
‘‘(6) COVERED RECIPIENT.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘covered recipient’ 
means the following: 
‘‘(i) A physician. 
‘‘(ii) A teaching hospital. 
‘‘(B) EXCLUSION.—Such term does not in-
clude a physician who is an employee of the ap-
plicable manufacturer that is required to submit 
information under subsection (a). 
‘‘(7) EMPLOYEE.—The term ‘employee’ has the 
meaning given such term in section 1877(h)(2). 
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