1130 
‘‘(1) meet the definition of the term ‘evidence- 
based’ in subsection (i); 
‘‘(2) are medically and scientifically accurate; 
and 
‘‘(3) provide age-appropriate information. 
‘‘(h) MATCHING FUNDS.—The Secretary may award 
a grant to a State under this section for a fiscal year only 
if the State agrees to provide, from non-Federal sources, an 
amount equal to $1 (in cash or in kind) for each $4 pro-
vided through the grant to carry out the activities supported 
by the grant. 
‘‘(i) DEFINITION.—In this section, the term ‘evidence- 
based’ means based on a model that has been found, in 
methodologically sound research— 
‘‘(1) to delay initiation of sex; 
‘‘(2) to decrease number of partners; 
‘‘(3) to reduce teen pregnancy; 
‘‘(4) to reduce sexually transmitted infection 
rates; or 
‘‘(5) to improve rates of contraceptive use. 
‘‘(j) APPROPRIATIONS.—To carry out this section, 
there is authorized to be appropriated $50,000,000 for each 
of the fiscal years 2010 through 2014.’’. 
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SEC. 2528. NATIONAL TRAINING INITIATIVE ON AUTISM 
SUPPLEMENTAL GRANTS AND TECHNICAL AS-
SISTANCE. 
Part R of title III (42 U.S.C. 280i et seq.) is amend-
ed— 
(1) by inserting after the header for part R the 
following: 
‘‘Subpart 1—Surveillance and Research Program; 
Education, Early Detection, and Intervention; 
and Reporting’’; 
(2) in section 399AA(d), by striking ‘‘part’’ and 
inserting ‘‘subpart’’; and 
(3) by adding at the end the following: 
‘‘Subpart 2—National Training Initiative 
‘‘SEC. 399FF. NATIONAL TRAINING INITIATIVE. 
‘‘(a) NATIONAL TRAINING INITIATIVE SUPPLEMENTAL 
GRANTS AND TECHNICAL ASSISTANCE.— 
‘‘(1) SUPPLEMENTAL GRANTS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
award, in consultation with the Interagency Au-
tism Coordinating Committee, multiyear na-
tional training initiative supplemental grants to 
University Centers for Excellence in Develop-
mental Disabilities authorized by the Develop-
mental Disabilities Assistance and Bill of Rights 
Act of 2000, public or private nonprofit entities, 
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and other comparable interdisciplinary service, 
training, and academic entities to provide inter-
disciplinary training, continuing education ini-
tiatives, technical assistance, dissemination, and 
services to address the unmet needs of children 
and adults with autism spectrum disorders and 
related developmental disabilities, and their fam-
ilies. 
‘‘(B) REQUIREMENTS.—A University Cen-
ter for Excellence in Developmental Disabilities 
that desires to receive a grant under this para-
graph shall submit to the Secretary an applica-
tion containing such agreements and informa-
tion as the Secretary may require, including 
agreements that the training program shall— 
‘‘(i) provide trainees with an appro-
priate balance of interdisciplinary aca-
demic and community-based experiences; 
‘‘(ii) have a demonstrated capacity to 
provide training and technical assistance in 
evidence-based practices to evaluate, and 
provide effective interventions, treatment, 
services, and supports to children and 
adults with autism and related develop-
mental disabilities, and their families; 
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‘‘(iii) have a demonstrated capacity to 
include persons with autism spectrum dis-
orders, parents, and family members as 
part of the training program to ensure that 
a person and family-centered approach is 
used; 
‘‘(iv) provide to the Secretary, in the 
manner prescribed by the Secretary, data 
regarding the number of persons who have 
benefitted and outcomes of the provision of 
training and technical assistance; 
‘‘(v) demonstrate a capacity to share 
and disseminate materials and practices 
that are developed and evaluated to be effec-
tive in the provision of training and tech-
nical assistance; 
‘‘(vi) provide assurances that training, 
technical assistance, dissemination, and 
services performed under grants made pur-
suant to this paragraph shall be consistent 
with the goals of the Developmental Disabil-
ities Act of 1984, the Americans with Dis-
abilities Act of 1990, the Individuals with 
Disabilities Education Act, and the No 
Child Left Behind Act of 2001 and con-
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ducted in coordination with other relevant 
State agencies, other institutions of higher 
education, and service providers; and 
‘‘(vii) have a demonstrated capacity to 
provide training, technical assistance, sup-
ports, and services under this section state-
wide. 
‘‘(C) ACTIVITIES.—A University Center for 
Excellence in Developmental Disabilities, or 
other eligible entity that receives a grant under 
this paragraph shall expand and develop inter-
disciplinary training and continuing education 
initiatives for parents, health, allied health, vo-
cational, educational, and other professionals 
and develop model services and supports that 
demonstrate evidence-based practices, by engag-
ing in the following activities: 
‘‘(i) Training health, allied health, vo-
cational, and educational professionals to 
identify, evaluate the needs, and develop 
treatments, interventions, services, and sup-
ports for children and adults with, autism 
spectrum disorder and related develop-
mental disabilities. 
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‘‘(ii) Developing systems and products 
that allow for the interventions, services and 
supports to be evaluated for fidelity of im-
plementation. 
‘‘(iii) Working to expand the avail-
ability of evidence-based, lifelong interven-
tions, educational, employment, and transi-
tion services, and community supports. 
‘‘(iv) Providing statewide technical as-
sistance in collaboration with relevant State 
agencies, other institutions of higher edu-
cation, autism spectrum disorder advocacy 
groups, and community-based service pro-
viders. 
‘‘(v) Working to develop comprehensive 
systems of supports and services for individ-
uals with autism and related developmental 
disabilities and their families, including 
seamless transitions between educational 
and health systems across the lifespan. 
‘‘(vi) Promoting training, technical as-
sistance, dissemination, supports, and serv-
ices. 
‘‘(vii) Developing mechanisms to pro-
vide training and technical assistance, in-
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cluding for-credit courses, intensive summer 
institutes, continuing education programs, 
distance based programs, and Web-based in-
formation dissemination strategies. 
‘‘(viii) Promoting activities that sup-
port community-based family and indi-
vidual services and enable individuals with 
autism and related developmental disabil-
ities to fully participate in society and 
achieve good quality of life outcomes. 
‘‘(ix) Collecting data on the outcomes 
of training and technical assistance pro-
grams to meet statewide needs for the ex-
pansion of services to children and adults 
with autism spectrum disorders and related 
developmental disabilities. 
‘‘(2) TECHNICAL
ASSISTANCE.—The Secretary 
shall reserve 2 percent of the appropriated funds to 
make a grant to a national organization with dem-
onstrated capacity for proving training and technical 
assistance to University Centers for Excellence in De-
velopmental Disabilities to— 
‘‘(A) assist in national dissemination of 
specific information, including evidence-based 
best practices, from interdisciplinary training 
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programs, and when appropriate, other entities 
whose findings would inform the work performed 
by entities awarded grants; 
‘‘(B) compile and disseminate strategies 
and materials that prove to be effective in the 
provision of training and technical assistance so 
that the entire network can benefit from the mod-
els, materials, and practices developed in indi-
vidual centers; 
‘‘(C) assist in the coordination of activities 
of grantees under this section; 
‘‘(D) develop a Web portal that will provide 
linkages to each of the individual training ini-
tiatives and provide access to training modules, 
promising training, and technical assistance 
practices and other materials developed by 
grantees; 
‘‘(E) serve as a research-based resource for 
Federal and State policymakers on information 
concerning the provision of training and tech-
nical assistance for the assessment, and provision 
of supports and services for children and adults 
with autism spectrum disorders and related de-
velopmental disabilities; 
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‘‘(F) convene experts from multiple inter-
disciplinary training programs, individuals 
with autism spectrum disorders, and their fami-
lies to discuss and make recommendations with 
regard to training issues related to the assess-
ment, and treatment, interventions, supports, 
and services for children and adults with autism 
spectrum disorders and related developmental 
disorders; and 
‘‘(G) undertake any other functions that the 
Secretary determines to be appropriate. 
‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), there is authorized to be appropriated 
to carry out this subsection $17,000,000 for fiscal 
year 2011 to be equally divided among existing 
University Centers for Excellence in Develop-
mental Disabilities and such sums for fiscal 
years 2012 through 2015 in the case of Univer-
sity Centers for Excellence in Developmental 
Disabilities located in American Samoa or the 
Commonwealth of the Northern Mariana Islands, 
supplemental grants of not less than $100,000. 
‘‘(B) 
APPROPRIATIONS
LESS
THAN 
$17,000,000.—With respect to any fiscal year in 
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which the amount appropriated under subsection 
(A) to carry out this section is less than 
$17,000,000, the Secretary shall make competi-
tive grants from such amount to individual Uni-
versity Centers for Excellence in Developmental 
Disabilities but would not be less than $250,000 
per individual grant, in the case of University 
Centers for Excellence for Developmental Disabil-
ities located in American Samoa or the Com-
monwealth of the Northern Mariana Islands, 
supplemental grants of not less than $100,000. 
‘‘(C) RESERVATION.—Not more than 2 per-
cent of the amount appropriated under subpara-
graphs (A) or (B) shall be reserved to carry out 
paragraph (2). 
‘‘(b) EXPANSION OF THE NUMBER OF UNIVERSITY 
CENTERS FOR EXCELLENCE IN DEVELOPMENTAL DISABIL-
ITIES RESEARCH, EDUCATION, AND SERVICES.— 
‘‘(1) PURPOSE.—The Secretary shall award up 
to four additional grants for the University Centers 
for Excellence in Developmental Disabilities for the 
purpose of expanding the capacity of existing na-
tional network and enhance the number of training 
facilities serving minority institutions with a pri-
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mary focus on autism spectrum disorder and related 
developmental disabilities. Such centers shall— 
‘‘(A) train health, allied health, and edu-
cational professionals to identify, diagnose, treat, 
and provide services for individuals with autism 
spectrum disorders; 
‘‘(B) provide services, including early iden-
tification, diagnosis, and intervention for indi-
viduals with autism spectrum disorders; and 
‘‘(C) provide other training and technical 
assistance, as necessary. 
‘‘(2) PRIORITY.—The Secretary shall give pri-
ority to establishing such centers in— 
‘‘(A) minority-serving institutions that have 
demonstrated capacity to meet the requirements 
to qualify as a University Center for Excellence 
in Developmental Disabilities and provide serv-
ices to individuals with autism spectrum dis-
orders; or 
‘‘(B) States with underserved populations. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection $2,000,000 for each of the fiscal years 
2011 through 2015.’’. 
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SEC. 2529. IMPLEMENTATION OF MEDICATION MANAGE-
MENT SERVICES IN TREATMENT OF CHRONIC 
DISEASES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Director of the Agency for 
Health Care Research and Quality, shall establish a pro-
gram to provide grants to eligible entities to implement 
medication management services (referred to in this section 
as ‘‘MTM services’’) provided by licensed pharmacists, as 
a part of a collaborative, multidisciplinary, interprofes-
sional approach to the treatment of chronic diseases for tar-
geted individuals, to improve the quality of care and reduce 
overall cost in the treatment of such diseases. The Secretary 
shall commence the grant program not later than May 1, 
2010. 
(b) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under subsection (a), an entity shall— 
(1) provide a setting appropriate for MTM serv-
ices, as recommended by the experts described in sub-
section (e); 
(2) submit to the Secretary a plan for achieving 
long-term financial sustainability; 
(3) where applicable, submit a plan for coordi-
nating MTM services with other local providers and 
where applicable, through or in collaboration with the 
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Medicare Medical Home Pilot program as established 
by section 1866F of the Social Security Act, as added 
by section 1302(a) of this Act; 
(4) submit a plan for meeting the requirements 
under subsection (c); and 
(5) submit to the Secretary such other informa-
tion as the Secretary may require. 
(c) MTM SERVICES TO TARGETED INDIVIDUALS.—The 
MTM services provided with the assistance of a grant 
awarded under subsection (a) shall, as allowed by State law 
(including applicable collaborative pharmacy practice 
agreements), include— 
(1) performing or obtaining necessary assess-
ments of the health and functional status of each pa-
tient receiving such MTM services; 
(2) formulating a medication treatment plan ac-
cording to therapeutic goals agreed upon by the pre-
scriber and the patient or caregiver or authorized rep-
resentative of the patient; 
(3) selecting, initiating, modifying, recom-
mending changes to, or administering medication 
therapy; 
(4) monitoring, which may include access to, or-
dering, or performing laboratory assessments, and 
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evaluating the response of the patient to therapy, in-
cluding safety and effectiveness; 
(5) performing an initial comprehensive medica-
tion review to identify, resolve, and prevent medica-
tion-related problems, including adverse drug events, 
quarterly targeted medication reviews for ongoing 
monitoring, and additional follow–up interventions 
on a schedule developed collaboratively with the pre-
scriber; 
(6) documenting the care delivered and commu-
nicating essential information about such care (in-
cluding a summary of the medication review) and the 
recommendations of the pharmacist to other appro-
priate health care providers of the patient in a timely 
fashion; 
(7) providing education and training designed to 
enhance the understanding and appropriate use of the 
medications by the patient, caregiver, and other au-
thorized representative; 
(8) providing information, support services, and 
resources and strategies designed to enhance patient 
adherence with therapeutic regimens; 
(9) coordinating and integrating MTM services 
within the broader health care management services 
provided to the patient; and 
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(10) such other patient care services as are al-
lowed under the scopes of practice for pharmacists for 
purposes of other Federal programs. 
(d) TARGETED INDIVIDUALS.—MTM services provided 
by licensed pharmacists under a grant awarded under sub-
section (a) shall be offered to targeted individuals who— 
(1) take 4 or more prescribed medications (in-
cluding over-the-counter and dietary supplements); 
(2) take any high-risk medications; 
(3) have 2 or more chronic diseases, as identified 
by the Secretary; or 
(4) have undergone a transition of care, or other 
factors, as determined by the Secretary, that are like-
ly to create a high risk of medication-related prob-
lems. 
(e) CONSULTATION WITH EXPERTS.—In designing 
and implementing MTM services provided under grants 
awarded under subsection (a), the Secretary shall consult 
with Federal, State, private, public-private, and academic 
entities, pharmacy and pharmacist organizations, health 
care organizations, consumer advocates, chronic disease 
groups, and other stakeholders involved with the research, 
dissemination, and implementation of pharmacist-delivered 
MTM services, as the Secretary determines appropriate. The 
Secretary, in collaboration with this group, shall determine 
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whether it is possible to incorporate rapid cycle process im-
provement concepts in use in other Federal programs that 
have implemented MTM services. 
(f) REPORTING TO THE SECRETARY.—An entity that 
receives a grant under subsection (a) shall submit to the 
Secretary a report that describes and evaluates, as requested 
by the Secretary, the activities carried out under subsection 
(c), including quality measures, as determined by the Sec-
retary. 
(g) EVALUATION AND REPORT.—The Secretary shall 
submit to the relevant committees of Congress a report 
which shall— 
(1) assess the clinical effectiveness of pharmacist- 
provided services under the MTM services program, as 
compared to usual care, including an evaluation of 
whether enrollees maintained better health with fewer 
hospitalizations and emergency room visits than 
similar patients not enrolled in the program; 
(2) assess changes in overall health care resource 
of targeted individuals; 
(3) assess patient and prescriber satisfaction 
with MTM services; 
(4) assess the impact of patient-cost-sharing re-
quirements 
on 
medication 
adherence 
and 
rec-
ommendations for modifications; 
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(5) identify and evaluate other factors that may 
impact clinical and economic outcomes, including de-
mographic characteristics, clinical characteristics, 
and health services use of the patient, as well as char-
acteristics of the regimen, pharmacy benefit, and 
MTM services provided; and 
(6) evaluate the extent to which participating 
pharmacists who maintain a dispensing role have a 
conflict of interest in the provision of MTM services, 
and if such conflict is found, provide recommenda-
tions on how such a conflict might be appropriately 
addressed. 
(h) GRANT TO FUND DEVELOPMENT OF PERFORM-
ANCE MEASURES.—The Secretary may award grants or 
contracts to eligible entities for the purpose of funding the 
development of performance measures that assess the use 
and effectiveness of medication therapy management serv-
ices. 
SEC. 2530. POSTPARTUM DEPRESSION. 
(a) EXPANSION
AND INTENSIFICATION
OF ACTIVI-
TIES.— 
(1) CONTINUATION
OF
ACTIVITIES.—The Sec-
retary is encouraged to expand and intensify activi-
ties on postpartum conditions. 
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(2) PROGRAMS FOR POSTPARTUM CONDITIONS.— 
In carrying out paragraph (1), the Secretary is en-
couraged to continue research to expand the under-
standing of the causes of, and treatments for, 
postpartum conditions, including conducting and 
supporting the following: 
(A) Basic research concerning the etiology 
and causes of the conditions. 
(B) Epidemiological studies to address the 
frequency and natural history of the conditions 
and the differences among racial and ethnic 
groups with respect to the conditions. 
(C) The development of improved screening 
and diagnostic techniques. 
(D) Clinical research for the development 
and evaluation of new treatments. 
(E) Information and education programs 
for health professionals and the public, which 
may include a coordinated national campaign 
that— 
(i) is designed to increase the aware-
ness and knowledge of postpartum condi-
tions; 
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(ii) may include public service an-
nouncements through television, radio, and 
other means; and 
(iii) may focus on— 
(I) 
raising 
awareness 
about 
screening; 
(II) educating new mothers and 
their families about postpartum condi-
tions to promote earlier diagnosis and 
treatment; and 
(III) ensuring that such education 
includes complete information con-
cerning postpartum conditions, includ-
ing its symptoms, methods of coping 
with the illness, and treatment re-
sources. 
(b) REPORT BY THE SECRETARY.— 
(1) STUDY.—The Secretary shall conduct a study 
on the benefits of screening for postpartum conditions. 
(2) REPORT.—Not later than 2 years after the 
date of the enactment of this Act, the Secretary shall 
complete the study required by paragraph (1) and 
submit a report to the Congress on the results of such 
study. 
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(c) SENSE OF CONGRESS REGARDING LONGITUDINAL 
STUDY OF RELATIVE MENTAL HEALTH CONSEQUENCES 
FOR WOMEN OF RESOLVING A PREGNANCY.— 
(1) SENSE OF CONGRESS.—It is the sense of the 
Congress that the Director of the National Institute of 
Mental Health may conduct a nationally representa-
tive longitudinal study (during the period of fiscal 
years 2009 through 2018) on the relative mental 
health consequences for women of resolving a preg-
nancy (intended and unintended) in various ways, 
including carrying the pregnancy to term and par-
enting the child, carrying the pregnancy to term and 
placing the child for adoption, miscarriage, and hav-
ing an abortion. This study may assess the incidence, 
timing, magnitude, and duration of the immediate 
and long-term mental health consequences (positive or 
negative) of these pregnancy outcomes. 
(2) REPORT.—Beginning not later than 3 years 
after the date of the enactment of this Act, and peri-
odically thereafter for the duration of the study, such 
Director may prepare and submit to the Congress re-
ports on the findings of the study. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘postpartum condition’’ means 
postpartum depression or postpartum psychosis. 
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(2) The term ‘‘Secretary’’ means the Secretary of 
Health and Human Services. 
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, in addition to any 
other amounts authorized to be appropriated for such pur-
pose, there are authorized to be appropriated such sums as 
may be necessary for fiscal years 2010 through 2012. 
SEC. 2531. GRANTS TO PROMOTE POSITIVE HEALTH BEHAV-
IORS AND OUTCOMES. 
Part P of title III (42 U.S.C. 280g et seq.) is amended 
by adding at the end the following: 
‘‘SEC. 399V. GRANTS TO PROMOTE POSITIVE HEALTH BE-
HAVIORS AND OUTCOMES. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary, in col-
laboration with the Director of the Centers for Disease Con-
trol and Prevention and other Federal officials determined 
appropriate by the Secretary, is authorized to award grants 
to eligible entities to promote positive health behaviors for 
populations in medically underserved communities through 
the use of community health workers. 
‘‘(b) USE OF FUNDS.—Grants awarded under sub-
section (a) shall be used to support community health work-
ers— 
‘‘(1) to educate, guide, and provide outreach in 
a community setting regarding health problems prev-
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alent in medically underserved communities, espe-
cially racial and ethnic minority populations; 
‘‘(2) to educate, guide, and provide experiential 
learning opportunities that target behavioral risk fac-
tors including— 
‘‘(A) poor nutrition; 
‘‘(B) physical inactivity; 
‘‘(C) being overweight or obese; 
‘‘(D) tobacco use; 
‘‘(E) alcohol and substance use; 
‘‘(F) injury and violence; 
‘‘(G) risky sexual behavior; 
‘‘(H) untreated mental health problems; 
‘‘(I) untreated dental and oral health prob-
lems; and 
‘‘(J) understanding informed consent; 
‘‘(3) to educate and provide guidance regarding 
effective strategies to promote positive health behav-
iors within the family; 
‘‘(4) to educate and provide outreach regarding 
enrollment in health insurance including the State 
Children’s Health Insurance Program under title XXI 
of the Social Security Act, Medicare under title XVIII 
of such Act, and Medicaid under title XIX of such 
Act; 
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‘‘(5) to educate and refer underserved popu-
lations to appropriate health care agencies and com-
munity-based programs and organizations in order to 
increase access to quality health care services, includ-
ing preventive health services, and to eliminate dupli-
cative care; or 
‘‘(6) to educate, guide, and provide home visita-
tion services regarding maternal health and prenatal 
care. 
‘‘(c) APPLICATION.— 
‘‘(1) IN GENERAL.—Each eligible entity that de-
sires to receive a grant under subsection (a) shall sub-
mit an application to the Secretary, at such time, in 
such manner, and accompanied by such information 
as the Secretary may require. 
‘‘(2) CONTENTS.—Each application submitted 
pursuant to paragraph (1) shall— 
‘‘(A) describe the activities for which assist-
ance is sought under this section; 
‘‘(B) contain an assurance that, with re-
spect to each community health worker program 
receiving funds under the grant, such program 
will provide training and supervision to commu-
nity health workers to enable such workers to 
provide authorized program services; 
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‘‘(C) contain an assurance that the appli-
cant will evaluate the effectiveness of community 
health worker programs receiving funds under 
the grant; 
‘‘(D) contain an assurance that each com-
munity health worker program receiving funds 
under the grant will provide services in the cul-
tural context most appropriate for the individ-
uals served by the program; 
‘‘(E) contain a plan to document and dis-
seminate project descriptions and results to other 
States and organizations as identified by the 
Secretary; and 
‘‘(F) describe plans to enhance the capacity 
of individuals to utilize health services and 
health-related social services under Federal, 
State, and local programs by— 
‘‘(i) assisting individuals in estab-
lishing eligibility under the programs and 
in receiving the services or other benefits of 
the programs; and 
‘‘(ii) providing other services as the 
Secretary determines to be appropriate, that 
may include transportation and translation 
services. 
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‘‘(d) PRIORITY.—In awarding grants under subsection 
(a), the Secretary shall give priority to applicants that— 
‘‘(1) propose to target geographic areas— 
‘‘(A) with a high percentage of residents 
who are eligible for health insurance but are un-
insured or underinsured; 
‘‘(B) with a high percentage of residents 
who suffer from chronic diseases including pul-
monary conditions, hypertension, heart disease, 
mental disorders, diabetes, and asthma; and 
‘‘(C) with a high infant mortality rate; 
‘‘(2) have experience in providing health or 
health-related social services to individuals who are 
underserved with respect to such services; and 
‘‘(3) have documented community activity and 
experience with community health workers. 
‘‘(e) COLLABORATION
WITH
ACADEMIC
INSTITU-
TIONS.—The Secretary shall encourage community health 
worker programs receiving funds under this section to col-
laborate with academic institutions, especially those that 
graduate a disproportionate number of health and health 
care students from underrepresented racial and ethnic mi-
nority backgrounds. Nothing in this section shall be con-
strued to require such collaboration. 
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‘‘(f) EVIDENCE-BASED
INTERVENTIONS.—The Sec-
retary shall encourage community health worker programs 
receiving funding under this section to implement an out-
come-based payment system that rewards community health 
workers for connecting underserved populations with the 
most appropriate services at the most appropriate time. 
Nothing in this section shall be construed to require such 
payment. 
‘‘(g) QUALITY ASSURANCE
AND COST EFFECTIVE-
NESS.—The Secretary shall establish guidelines for assuring 
the quality of the training and supervision of community 
health workers under the programs funded under this sec-
tion and for assuring the cost-effectiveness of such programs. 
‘‘(h) MONITORING.—The Secretary shall monitor com-
munity health worker programs identified in approved ap-
plications under this section and shall determine whether 
such programs are in compliance with the guidelines estab-
lished under subsection (g). 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to community health worker 
programs identified in approved applications under this 
section with respect to planning, developing, and operating 
programs under the grant. 
‘‘(j) REPORT TO CONGRESS.— 
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‘‘(1) IN GENERAL.—Not later than 4 years after 
the date on which the Secretary first awards grants 
under subsection (a), the Secretary shall submit to 
Congress a report regarding the grant project. 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
‘‘(A) A description of the programs for 
which grant funds were used. 
‘‘(B) The number of individuals served 
under such programs. 
‘‘(C) An evaluation of— 
‘‘(i) the effectiveness of such programs; 
‘‘(ii) the cost of such programs; and 
‘‘(iii) the impact of the programs on 
the health outcomes of the community resi-
dents. 
‘‘(D) Recommendations for sustaining the 
community health worker programs developed or 
assisted under this section. 
‘‘(E) Recommendations regarding training 
to enhance career opportunities for community 
health workers. 
‘‘(k) DEFINITIONS.—In this section: 
‘‘(1) COMMUNITY HEALTH WORKER.—The term 
‘community health worker’ means an individual who 
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promotes health or nutrition within the community 
in which the individual resides— 
‘‘(A) by serving as a liaison between com-
munities and health care agencies; 
‘‘(B) by providing guidance and social as-
sistance to community residents; 
‘‘(C) by enhancing community residents’ 
ability to effectively communicate with health 
care providers; 
‘‘(D) by providing culturally and linguis-
tically appropriate health or nutrition edu-
cation; 
‘‘(E) by advocating for individual and com-
munity health, including oral and mental, or 
nutrition needs; and 
‘‘(F) by providing referral and followup 
services or otherwise coordinating care. 
‘‘(2) COMMUNITY SETTING.—The term ‘commu-
nity setting’ means a home or a community organiza-
tion located in the neighborhood in which a partici-
pant resides. 
‘‘(3) MEDICALLY UNDERSERVED COMMUNITY.— 
The term ‘medically underserved community’ means a 
community identified by a State, United States terri-
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tory or possession, or federally recognized Indian 
tribe— 
‘‘(A) that has a substantial number of indi-
viduals who are members of a medically under-
served 
population, 
as 
defined 
by 
section 
330(b)(3); and 
‘‘(B) a significant portion of which is a 
health professional shortage area as designated 
under section 332. 
‘‘(4) SUPPORT.—The term ‘support’ means the 
provision of training, supervision, and materials 
needed to effectively deliver the services described in 
subsection (b), reimbursement for services, and other 
benefits. 
‘‘(5) ELIGIBLE ENTITY.—The term ‘eligible enti-
ty’ means a public or nonprofit private entity (in-
cluding a State or public subdivision of a State, a 
public health department, or a federally qualified 
health center), or a consortium of any of such entities, 
located in the United States or territory thereof. 
‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$30,000,000 for each of fiscal years 2010, 2011, 2012, 2013, 
and 2014.’’. 
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PART 3—EMERGENCY CARE-RELATED PROGRAMS 
SEC. 2541. TRAUMA CARE CENTERS. 
(a) GRANTS FOR TRAUMA CARE CENTERS.—Section 
1241 (42 U.S.C. 300d–41) is amended to read as follows: 
‘‘SEC. 1241. GRANTS FOR CERTAIN TRAUMA CENTERS. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
trauma center program consisting of awarding grants 
under section (b). 
‘‘(b) GRANTS.—The Secretary shall award grants as 
follows: 
‘‘(1) EXISTING CENTERS.—Grants to public, pri-
vate nonprofit, Indian Health Service, Indian tribal, 
and urban Indian trauma centers— 
‘‘(A) to further the core missions of such 
centers; or 
‘‘(B) to provide emergency relief to ensure 
the continued and future availability of trauma 
services by trauma centers— 
‘‘(i) at risk of closing or operating in 
an area where a closing has occurred within 
their primary service area; or 
‘‘(ii) in need of financial assistance 
following a natural disaster or other cata-
strophic event, such as a terrorist attack. 
‘‘(2) NEW
CENTERS.—Grants to local govern-
ments and public or private nonprofit entities to es-
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tablish new trauma centers in urban areas with a 
substantial degree of trauma resulting from violent 
crimes. 
‘‘(c) MINIMUM QUALIFICATIONS
OF TRAUMA CEN-
TERS.— 
‘‘(1) PARTICIPATION IN TRAUMA CARE SYSTEM 
OPERATING UNDER CERTAIN PROFESSIONAL GUIDE-
LINES.— 
‘‘(A) LIMITATION.—Subject to subparagraph 
(B), the Secretary may not award a grant to an 
existing trauma center under this section unless 
the center is a participant in a trauma care sys-
tem that substantially complies with section 
1213. 
‘‘(B) EXEMPTION.—Subparagraph (A) shall 
not apply to trauma centers that are located in 
States with no existing trauma care system. 
‘‘(2) DESIGNATION.—The Secretary may not 
award a grant under this section to an existing trau-
ma center unless the center is— 
‘‘(A) verified as a trauma center by the 
American College of Surgeons; or 
‘‘(B) designated as a trauma center by the 
applicable State health or emergency medical 
services authority.’’. 
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(b) CONSIDERATIONS IN MAKING GRANTS.—Section 
1242 (42 U.S.C. 300d–42) is amended to read as follows: 
‘‘SEC. 1242. CONSIDERATIONS IN MAKING GRANTS. 
‘‘(a) CORE MISSION AWARDS.— 
‘‘(1) IN GENERAL.—In awarding grants under 
section 1241(b)(1)(A), the Secretary shall— 
‘‘(A) reserve a minimum of 25 percent of 
the amount allocated for such grants for level III 
and level IV trauma centers in rural or under-
served areas; 
‘‘(B) reserve a minimum of 25 percent of 
the amount allocated for such grants for level I 
and level II trauma centers in urban areas; and 
‘‘(C) give preference to any application 
made by a trauma center— 
‘‘(i) in a geographic area where growth 
in demand for trauma services exceeds ca-
pacity; 
‘‘(ii) that demonstrates the financial 
support of the State or political subdivision 
involved; 
‘‘(iii) that has at least 1 graduate med-
ical education fellowship in trauma or 
trauma-related specialties, including neuro-
logical surgery, surgical critical care, vas-
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cular surgery, and spinal cord injury, for 
which demand is exceeding supply; or 
‘‘(iv) that demonstrates a substantial 
commitment to serving vulnerable popu-
lations. 
‘‘(2) FINANCIAL
SUPPORT.—For purposes of 
paragraph (1)(C)(ii), financial support may be dem-
onstrated by State or political subdivision funding for 
the trauma center’s capital or operating expenses (in-
cluding through State trauma regional advisory co-
ordination activities, Medicaid funding designated for 
trauma services, or other governmental funding). 
State funding derived from Federal support shall not 
constitute State or local financial support for pur-
poses of preferential treatment under this subsection. 
‘‘(3) USE OF FUNDS.—The recipient of a grant 
under section 1241(b)(1)(A) shall carry out, con-
sistent with furthering the core missions of the center, 
one or more of the following activities: 
‘‘(A) Providing 24-hour-a-day, 7-day-a-week 
trauma care availability. 
‘‘(B) Reducing overcrowding related to 
throughput of trauma patients. 
‘‘(C) Enhancing trauma surge capacity. 
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‘‘(D) Ensuring physician and essential per-
sonnel availability. 
‘‘(E) Trauma education and outreach. 
‘‘(F) Coordination with local and regional 
trauma care systems. 
‘‘(G) Such other activities as the Secretary 
may deem appropriate. 
‘‘(b) EMERGENCY
AWARDS; NEW
CENTERS.—In 
awarding grants under paragraphs (1)(B) and (2) of sec-
tion 1241(b), the Secretary shall— 
‘‘(1) give preference to any application submitted 
by an applicant that demonstrates the financial sup-
port (in accordance with subsection (a)(2)) of the 
State or political subdivision involved for the activi-
ties to be funded through the grant for each fiscal year 
during which payments are made to the center under 
the grant; and 
‘‘(2) give preference to any application submitted 
for a trauma center that— 
‘‘(A) is providing or will provide trauma 
care in a geographic area in which the avail-
ability of trauma care has either significantly 
decreased as a result of a trauma center in the 
area permanently ceasing participation in a sys-
tem described in section 1241(c)(1) as of a date 
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occurring during the 2-year period preceding the 
fiscal year for which the trauma center is apply-
ing to receive a grant, or in geographic areas 
where growth in demand for trauma services ex-
ceeds capacity; 
‘‘(B) will, in providing trauma care during 
the 1-year period beginning on the date on which 
the application for the grant is submitted, incur 
substantial uncompensated care costs in an 
amount that renders the center unable to con-
tinue participation in such system and results in 
a significant decrease in the availability of trau-
ma care in the geographic area; 
‘‘(C) operates or will operate in rural areas 
where trauma care availability will significantly 
decrease if the center is forced to close or down-
grade service and substantial costs are contrib-
uting to a likelihood of such closure or 
downgradation; 
‘‘(D) is in a geographic location substan-
tially affected by a natural disaster or other cat-
astrophic event such as a terrorist attack; or 
‘‘(E) will establish a new trauma service in 
an urban area with a substantial degree of trau-
ma resulting from violent crimes. 
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‘‘(c) DESIGNATIONS OF LEVELS OF TRAUMA CENTERS 
IN CERTAIN STATES.—In the case of a State which has not 
designated 4 levels of trauma centers, any reference in this 
section to— 
‘‘(1) a level I or level II trauma center is deemed 
to be a reference to a trauma center within the highest 
2 levels of trauma centers designated under State 
guidelines; and 
‘‘(2) a level III or IV trauma center is deemed 
to be a reference to a trauma center not within such 
highest 2 levels.’’. 
(c) CERTAIN AGREEMENTS.—Section 1243 (42 U.S.C. 
300d–43) is amended to read as follows: 
‘‘SEC. 1243. CERTAIN AGREEMENTS. 
‘‘(a) COMMITMENT REGARDING CONTINUED PARTICI-
PATION IN TRAUMA CARE SYSTEM.—The Secretary may 
not award a grant to an applicant under section 1241(b) 
unless the applicant agrees that— 
‘‘(1) the trauma center involved will continue 
participation, or in the case of a new center will par-
ticipate, in the system described in section 1241(c)(1), 
except as provided in section 1241(c)(1)(B), through-
out the grant period beginning on the date that the 
center first receives payments under the grant; and 
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‘‘(ii) the waiver of a patent infringe-
ment claim for damages based on prior 
marketing of such drug. 
‘‘(C) ENFORCEMENT.— 
‘‘(i) IN GENERAL.—A violation of sub-
paragraph (A) shall be treated as an unfair 
and deceptive act or practice and an unfair 
method of competition in or affecting inter-
state commerce prohibited under section 5 of 
the Federal Trade Commission Act and 
shall be enforced by the Federal Trade Com-
mission in the same manner, by the same 
means, and with the same jurisdiction as 
though all applicable terms and provisions 
of the Federal Trade Commission Act were 
incorporated into and made a part of this 
subsection. 
‘‘(ii) INAPPLICABILITY.—Subchapter A 
of chapter VII shall not apply with respect 
to this subsection. 
‘‘(D) DEFINITIONS.—In this subsection: 
‘‘(i) AGREEMENT.—The term ‘agree-
ment’ means anything that would constitute 
an agreement under section 5 of the Federal 
Trade Commission Act. 
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‘‘(ii) AGREEMENT RESOLVING OR SET-
TLING.—The term ‘agreement resolving or 
settling’, in reference to a patent infringe-
ment claim, includes any agreement that is 
contingent upon, provides a contingent con-
dition for, or is otherwise related to the res-
olution or settlement of the claim. 
‘‘(iii) 
ANDA.—The 
term 
‘ANDA’ 
means an abbreviated new drug application 
for the approval of a new drug under sec-
tion (j). 
‘‘(iv) ANDA FILER.—The term ‘ANDA 
filer’ means a party that has filed an 
ANDA with the Food and Drug Adminis-
tration. 
‘‘(v) 
PATENT
INFRINGEMENT.—The 
term ‘patent infringement’ means infringe-
ment of any patent or of any filed patent 
application, extension, reissuance, renewal, 
division, 
continuation, 
continuation 
in 
part, reexamination, patent term restora-
tion, patent of addition, or extension there-
of. 
‘‘(vi) PATENT INFRINGEMENT CLAIM.— 
The term ‘patent infringement claim’ means 
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(1) IN GENERAL.—The purpose of this 
division is to provide affordable, quality 
health care for all Americans and reduce 
the growth in health care spending. 
(2) BUILDING
ON
CURRENT
SYSTEM.— 
This division achieves this purpose by 
building on what works in today’s health 
care system, while repairing the aspects 
that are broken. 
(3) INSURANCE
REFORMS.—This divi-
sion— 
(A) enacts strong insurance mar-
ket reforms; 
(B) creates a new Health Insur-
ance Exchange, with a public health 
insurance option alongside private 
plans; 
(C) includes sliding scale afford-
ability credits; and 
(D) initiates shared responsibility 
among workers, employers, and the 
government; 
so that all Americans have coverage of es-
sential health benefits. 
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the change in intensity of vis-
its in an episode, growth in 
cost per episode, and other 
factors 
that 
the 
Secretary 
considers to be relevant. 
‘‘(V) 
Subject 
to 
clause 
(iii)(II), for a year after 2011, 
such a amount (or amounts) 
shall be equal to the amount 
(or 
amounts) 
determined 
under this clause for the pre-
vious year, updated under 
subparagraph (B).’’; and 
(2) by adding at the end the following 
new clause: 
‘‘(iii) SPECIAL RULE IN CASE OF 
INABILITY
TO
EFFECT
TIMELY
RE-
BASING.— 
‘‘(I) APPLICATION OF PROXY 
AMOUNT FOR 2011.—If the Sec-
retary is not able to compute 
the 
amount 
(or 
amounts) 
under clause (i)(IV) so as to 
permit, on a timely basis, the 
application of such clause for 
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