125 
agency shall provide such technical assistance to the 
Community as the Community determines to be nec-
essary to carry out its duties. 
(3) OTHER RESOURCES.—The Community shall 
have reasonable access to materials, resources, sta-
tistical data, and other information from the Library 
of Congress and agencies and elected representatives 
of the executive and legislative branches of the Fed-
eral Government. The chairperson or vice chair-
person of the Community shall make requests for 
such access in writing when necessary. 
(e) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) shall apply to the Commu-
nity, except that the term provided for under section 
14(a)(2) of such Act shall be not longer than 7 years. 
(f) SUNSET.—The provisions of this section shall not 
apply after September 20, 2014. 
(g) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$2,000,000 for each of fiscal years 2009 and 2010. 
SEC. 204. RESEARCH ACCESS TO HEALTH CARE DATA AND 
REPORTING ON PERFORMANCE. 
The Secretary shall permit researchers that meet cri-
teria used to evaluate the appropriateness of the release 
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data for research purpose (as established by the Sec-
retary) to— 
(1) have access to all Federal health care data; 
and 
(2) report on the performance of health care 
providers and suppliers, including reporting in a 
provider- or supplier-identifiable format. 
Subtitle B—Facilitating the Wide-
spread Adoption of Interoper-
able Health Information Tech-
nology 
SEC. 211. FACILITATING THE WIDESPREAD ADOPTION OF 
INTEROPERABLE 
HEALTH 
INFORMATION 
TECHNOLOGY. 
(a) COMPETITIVE GRANTS FOR ADOPTION OF TECH-
NOLOGY.— 
(1) IN GENERAL.—The Secretary may award 
competitive grants to eligible entities to facilitate the 
purchase and enhance the utilization of qualified 
health information technology systems (as defined in 
section 213) to improve the quality and efficiency of 
health care. 
(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1) an entity shall— 
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(A) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require; 
(B) submit to the Secretary a strategic 
plan for the implementation of data sharing 
and interoperability measures; 
(C) adopt the standards adopted by the 
Federal Government under section 301; 
(D) implement the measures adopted 
under section 221 and report to the Secretary 
on such measures; 
(E) comply with the requirements of title 
I; 
(F) take into account the input of employ-
ees and staff who are directly involved in pa-
tient care of such health care providers in the 
design, implementation, and use of qualified 
health information technology systems; 
(G) demonstrate significant financial need; 
(H) provide matching funds in accordance 
with paragraph (4); and 
(I) be a— 
(i) public or not for profit hospital; 
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(ii) federally qualified health center 
(as defined in section 1861(aa)(4) of the 
Social Security Act); 
(iii) individual or group practice (or a 
consortium thereof); or 
(iv) another health care provider not 
described in clause (i) or (ii); 
that serves medically undeserved communities. 
(3) USE OF FUNDS.—Amounts received under a 
grant under this subsection shall be used to— 
(A) facilitate the purchase of qualified 
health information technology systems; 
(B) train personnel in the use of such sys-
tems; 
(C) enhance the utilization of qualified 
health information technology systems (which 
may include activities to increase the awareness 
among consumers of health care privacy protec-
tions); or 
(D) improve the prevention and manage-
ment of chronic disease. 
(4) MATCHING REQUIREMENT.—To be eligible 
for a grant under this subsection an entity shall con-
tribute non-Federal contributions to the costs of car-
rying out the activities for which the grant is award-
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ed in an amount equal to $1 for each $3 of Federal 
funds provided under the grant. 
(5) PREFERENCE IN AWARDING GRANTS.—In 
awarding grants under this subsection the Secretary 
shall give preference to— 
(A) eligible entities that will improve the 
degree to which such entity will link the quali-
fied health information technology system to 
local or regional health information plan or 
plans; and 
(B) with respect to awards made for the 
purpose of providing care in an outpatient med-
ical setting, entities that organize their prac-
tices as a patient-centered medical home. 
(b) COMPETITIVE GRANTS FOR THE DEVELOPMENT 
OF STATE LOAN PROGRAMS TO FACILITATE THE WIDE-
SPREAD ADOPTION
OF HEALTH INFORMATION TECH-
NOLOGY.— 
(1) IN GENERAL.—The Secretary may award 
competitive grants to States for the establishment of 
State programs for loans to health care providers to 
facilitate the purchase and enhance the utilization of 
qualified health information technology. 
(2) ESTABLISHMENT OF FUND.—To be eligible 
to receive a competitive grant under this subsection, 
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a State shall establish a qualified health information 
technology loan fund (referred to in this subsection 
as a ‘‘State loan fund’’) and comply with the other 
requirements contained in this subsection. Amounts 
received under a grant under this subsection shall be 
deposited in the State loan fund established by the 
State. No funds authorized by other provisions of 
this title to be used for other purposes specified in 
this title shall be deposited in any such State loan 
fund. 
(3) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1) a State shall— 
(A) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require; 
(B) submit to the Secretary a strategic 
plan in accordance with paragraph (4); 
(C) establish a qualified health information 
technology loan fund in accordance with para-
graph (2); 
(D) require that health care providers re-
ceiving loans under the grant— 
(i) link, to the extent practicable, the 
qualified health information system to a 
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measures adopted under section 221 and report 
to the Secretary on such measures; and 
(G) provide matching funds in accordance 
with paragraph (8). 
(4) STRATEGIC PLAN.— 
(A) IN GENERAL.—A State that receives a 
grant under this subsection shall annually pre-
pare a strategic plan that identifies the in-
tended uses of amounts available to the State 
loan fund of the State. 
(B) CONTENTS.—A strategic plan under 
subparagraph (A) shall include— 
(i) a list of the projects to be assisted 
through the State loan fund in the first 
fiscal year that begins after the date on 
which the plan is submitted; 
(ii) a description of the criteria and 
methods established for the distribution of 
funds from the State loan fund; 
(iii) a description of the financial sta-
tus of the State loan fund and the short- 
term and long-term goals of the State loan 
fund; and 
(iv) a description of the strategies the 
State will use to address challenges in the 
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adoption of health information technology 
due to limited broadband access. 
(5) USE OF FUNDS.— 
(A) IN GENERAL.—Amounts deposited in a 
State loan fund, including loan repayments and 
interest earned on such amounts, shall be used 
only for awarding loans or loan guarantees, or 
as a source of reserve and security for leveraged 
loans, the proceeds of which are deposited in 
the State loan fund established under para-
graph (1). Loans under this section may be 
used by a health care provider to— 
(i) facilitate the purchase of qualified 
health information technology systems; 
(ii) enhance the utilization of qualified 
health information technology systems 
(which may include activities to increase 
the awareness among consumers of health 
care of privacy protections and privacy 
rights); or 
(iii) train personnel in the use of such 
systems. 
(B) LIMITATION.—Amounts received by a 
State under this subsection may not be used— 
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(i) for the purchase or other acquisi-
tion of any health information technology 
system that is not a qualified health infor-
mation technology system; 
(ii) to conduct activities for which 
Federal funds are expended under this 
title, or the amendments made by this 
title; or 
(iii) for any purpose other than mak-
ing loans to eligible entities under this sec-
tion. 
(6) TYPES OF ASSISTANCE.—Except as other-
wise limited by applicable State law, amounts depos-
ited into a State loan fund under this subsection 
may only be used for the following: 
(A) To award loans that comply with the 
following: 
(i) The interest rate for each loan 
shall be less than or equal to the market 
interest rate. 
(ii) The principal and interest pay-
ments on each loan shall commence not 
later than 1 year after the date on which 
the loan was awarded, and each loan shall 
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be fully amortized not later than 10 years 
after such date. 
(iii) The State loan fund shall be 
credited with all payments of principal and 
interest on each loan awarded from the 
fund. 
(B) To guarantee, or purchase insurance 
for, a local obligation (all of the proceeds of 
which finance a project eligible for assistance 
under this subsection) if the guarantee or pur-
chase would improve credit market access or re-
duce the interest rate applicable to the obliga-
tion involved. 
(C) As a source of revenue or security for 
the payment of principal and interest on rev-
enue or general obligation bonds issued by the 
State if the proceeds of the sale of the bonds 
will be deposited into the State loan fund. 
(D) To earn interest on the amounts de-
posited into the State loan fund. 
(7) 
ADMINISTRATION
OF
STATE
LOAN 
FUNDS.— 
(A) COMBINED
FINANCIAL
ADMINISTRA-
TION.—A State may (as a convenience and to 
avoid unnecessary administrative costs) com-
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bine, in accordance with State law, the financial 
administration of a State loan fund established 
under this subsection with the financial admin-
istration of any other revolving fund established 
by the State if not otherwise prohibited by the 
law under which the State loan fund was estab-
lished. 
(B) COST
OF
ADMINISTERING
FUND.— 
Each State may annually use not to exceed 4 
percent of the funds provided to the State 
under a grant under this subsection to pay the 
reasonable costs of the administration of the 
programs under this section, including the re-
covery of reasonable costs expended to establish 
a State loan fund which are incurred after the 
date of enactment of this title. 
(C) GUIDANCE
AND
REGULATIONS.—The 
Secretary shall publish guidance and promul-
gate regulations as may be necessary to carry 
out the provisions of this subsection, includ-
ing— 
(i) provisions to ensure that each 
State commits and expends funds allotted 
to the State under this subsection as effi-
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ciently as possible in accordance with this 
title and applicable State laws; and 
(ii) guidance to prevent waste, fraud, 
and abuse. 
(D) PRIVATE SECTOR CONTRIBUTIONS.— 
(i) IN GENERAL.—A State loan fund 
established under this subsection may ac-
cept contributions from private sector enti-
ties, except that such entities may not 
specify the recipient or recipients of any 
loan issued under this subsection. 
(ii) 
AVAILABILITY
OF
INFORMA-
TION.—A State shall make publicly avail-
able the identity of, and amount contrib-
uted by, any private sector entity under 
clause (i) and may issue letters of com-
mendation or make other awards (that 
have no financial value) to any such entity. 
(8) MATCHING REQUIREMENTS.— 
(A) IN GENERAL.—The Secretary may not 
make a grant under paragraph (1) to a State 
unless the State agrees to make available (di-
rectly or through donations from public or pri-
vate entities) non-Federal contributions in cash 
toward the costs of the State program to be im-
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plemented under the grant in an amount equal 
to not less than $1 for each $1 of Federal 
funds provided under the grant. 
(B) DETERMINATION OF AMOUNT OF NON- 
FEDERAL CONTRIBUTION.—In determining the 
amount of non-Federal contributions that a 
State has provided pursuant to subparagraph 
(A), the Secretary may not include any 
amounts provided to the State by the Federal 
Government. 
(9) PREFERENCE IN AWARDING GRANTS.—The 
Secretary may give a preference in awarding grants 
under this subsection to States that adopt value- 
based purchasing programs to improve health care 
quality. 
(10) REPORTS.—The Secretary shall annually 
submit to the Committee on Health, Education, 
Labor, and Pensions and the Committee on Finance 
of the Senate, and the Committee on Energy and 
Commerce and the Committee on Ways and Means 
of the House of Representatives, a report summa-
rizing the reports received by the Secretary from 
each State that receives a grant under this sub-
section. 
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(c) COMPETITIVE GRANTS FOR THE IMPLEMENTA-
TION OF REGIONAL OR LOCAL HEALTH INFORMATION 
TECHNOLOGY PLANS.— 
(1) IN GENERAL.—The Secretary may award 
competitive grants to eligible entities to implement 
regional or local health information plans to improve 
health care quality and efficiency through the elec-
tronic exchange of personal health information pur-
suant to the standards, implementation specifica-
tions and certification criteria, and other require-
ments adopted by the Secretary under section 221. 
(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1) an entity, which may be 
a health record bank or trust, shall— 
(A) demonstrate financial need to the Sec-
retary; 
(B) demonstrate that one of its principal 
missions or purposes is to use information tech-
nology to improve health care quality and effi-
ciency; 
(C) adopt bylaws, memoranda of under-
standing, or other charter documents that dem-
onstrate that the governance structure and de-
cision making processes of such entity allow for 
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participation on an ongoing basis by multiple 
stakeholders within a community, including— 
(i) health care providers (including 
health care providers that provide services 
to low income and undeserved popu-
lations); 
(ii) pharmacists or pharmacies; 
(iii) health plans; 
(iv) health centers (as defined in sec-
tion 330(b)) and federally qualified health 
centers (as defined in section 1861(aa)(4) 
of the Social Security Act) and rural 
health clinics (as defined in section 
1861(aa) of the Social Security Act), if 
such centers or clinics are present in the 
community served by the entity; 
(v) patient or consumer organizations; 
(vi) organizations dedicated to im-
proving the health of vulnerable popu-
lations; 
(vii) employers; 
(viii) State or local health depart-
ments; and 
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141 
(ix) any other health care providers or 
other entities, as determined appropriate 
by the Secretary; 
(D) demonstrate the participation, to the 
extent practicable, of stakeholders in the elec-
tronic exchange of personal health information 
within the local or regional plan pursuant to 
subparagraph (C); 
(E) adopt nondiscrimination and conflict of 
interest policies that demonstrate a commit-
ment to open, fair, and nondiscriminatory par-
ticipation in the health information plan by all 
stakeholders; 
(F) adopt the standards adopted by the 
Secretary under section 301; 
(G) require that health care providers re-
ceiving such grants— 
(i) implement the measures adopted 
under section 221 and report to the Sec-
retary on such measures; and 
(ii) take into account the input of em-
ployees and staff who are directly involved 
in patient care of such health care pro-
viders in the design, implementation, and 
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use of health information technology sys-
tems; 
(H) agree to comply with the requirements 
of title I; 
(I) facilitate the electronic exchange of per-
sonal health information within the local or re-
gional area and among local and regional areas; 
(J) prepare and submit to the Secretary an 
application in accordance with paragraph (3); 
(K) agree to provide matching funds in ac-
cordance with paragraph (5); and 
(L) reduce barriers to the implementation 
of health information technology by providers. 
(3) APPLICATION.— 
(A) IN GENERAL.—To be eligible to receive 
a grant under paragraph (1), an entity shall 
submit to the Secretary an application at such 
time, in such manner, and containing such in-
formation as the Secretary may require. 
(B) REQUIRED INFORMATION.—At a min-
imum, an application submitted under this 
paragraph shall include— 
(i) clearly identified short-term and 
long-term objectives of the regional or local 
health information plan; 
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(ii) a technology plan that complies 
with the standards, implementation speci-
fications, and certification criteria adopted 
under section 202(c)(6) and that includes 
a descriptive and reasoned estimate of 
costs of the hardware, software, training, 
and consulting services necessary to imple-
ment the regional or local health informa-
tion plan; 
(iii) a strategy that includes initiatives 
to improve health care quality and effi-
ciency, including the use and reporting of 
health care quality measures adopted 
under section 221; 
(iv) a plan that describes provisions to 
encourage the implementation of the elec-
tronic exchange of personal health infor-
mation by all health care providers partici-
pating in the health information plan; 
(v) a plan to ensure the privacy and 
security of personal health information 
that is consistent with the requirements of 
title I; 
(vi) a governance plan that defines 
the manner in which the stakeholders shall 
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jointly make policy and operational deci-
sions on an ongoing basis; 
(vii) a financial or business plan that 
describes— 
(I) the sustain ability of the plan; 
(II) the financial costs and bene-
fits of the plan; and 
(III) the entities to which such 
costs and benefits will accrue; 
(viii) a description of whether the 
State in which the entity resides has re-
ceived a grant under section 319D of the 
Public Health Service Act, alone or as a 
part of a consortium, and if the State has 
received such a grant, how the entity will 
coordinate the activities funded under such 
section 319D with the system under this 
section; and 
(ix) in the case of an applicant entity 
that is unable to demonstrate the partici-
pation of all stakeholders pursuant to 
paragraph (2)(C), the justification from 
the entity for any such nonparticipation. 
(4) USE OF FUNDS.—Amounts received under a 
grant under paragraph (1) shall be used to establish 
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and implement a regional or local health information 
plan in accordance with this subsection. 
(5) MATCHING REQUIREMENT.— 
(A) IN GENERAL.—The Secretary may not 
make a grant under this subsection to an entity 
unless the entity agrees that, with respect to 
the costs to be incurred by the entity in car-
rying out the network program for which the 
grant was awarded, the entity will make avail-
able (directly or through donations from public 
or private entities) non-Federal contributions 
toward such costs in an amount equal to not 
less than 50 percent of such costs ($1 for each 
$2 of Federal funds provided under the grant). 
(B) DETERMINATION
OF
AMOUNT
CON-
TRIBUTED.—Non-Federal 
contributions 
re-
quired under subparagraph (A) may be in cash 
or in kind, fairly evaluated, including equip-
ment, technology, or services. Amounts provided 
by the Federal Government, or services assisted 
or subsidized to any significant extent by the 
Federal Government, may not be included in 
determining the amount of such non-Federal 
contributions. 
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146 
(6) HEALTH
RECORD
BANK
OR
TRUST
DE-
FINED.—In this section, the term ‘‘health record 
bank or trust’’ means an independent organization 
that provides a secure electronic repository for stor-
ing and maintaining an individual’s lifetime health 
and medical records from multiple sources and en-
suring that the individual always has complete con-
trol over who accesses their information. 
(d) REPORTS.—Not later than 1 year after the date 
on which the first grant is awarded under this section, 
and annually thereafter during the grant period, an entity 
that receives a grant under this section shall submit to 
the Secretary a report on the activities carried out under 
the grant involved. Each such report shall include— 
(1) a description of the financial costs and ben-
efits of the project involved and of the entities to 
which such costs and benefits accrue; 
(2) an analysis of the impact of the project on 
health care quality and safety; 
(3) a description of any reduction in duplicative 
or unnecessary care as a result of the project in-
volved; and 
(4) other information as required by the Sec-
retary. 
(e) AUTHORIZATION OF APPROPRIATIONS.— 
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(1) IN GENERAL.—For the purpose of carrying 
out this section, there is authorized to be appro-
priated $139,000,000 for fiscal year 2009 and 
$139,000,000 for fiscal year 2010. 
(2) 
AVAILABILITY.—Amounts 
appropriated 
under paragraph (1) shall remain available through 
fiscal year 2012. 
SEC. 212. DEMONSTRATION PROGRAM TO INTEGRATE IN-
FORMATION TECHNOLOGY INTO CLINICAL 
EDUCATION. 
(a) IN GENERAL.—The Secretary may award grants 
to eligible entities or consortia under this section to carry 
out demonstration projects to develop academic curricula 
integrating qualified health information technology sys-
tems in the clinical education of health professionals or 
analyze clinical data sets to discover quality measures. 
Such awards shall be made on a competitive basis and 
pursuant to peer review. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity or consortium shall— 
(1) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require; 
(2) be or include— 
(A) a health professions school; 
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(B) a school of nursing; or 
(C) an institution with a graduate medical 
education program; 
(3) provide for the collection of data regarding 
the effectiveness of the demonstration project to be 
funded under the grant in improving the safety of 
patients and the efficiency of health care delivery; 
and 
(4) provide matching funds in accordance with 
subsection (d). 
(c) USE OF FUNDS.— 
(1) IN
GENERAL.—With respect to a grant 
under subsection (a), an eligible entity or consortium 
shall use amounts received under the grant in col-
laboration with 2 or more disciplines. 
(2) LIMITATION.—An eligible entity or consor-
tium shall not award a grant under subsection (a) 
to purchase hardware, software, or services. 
(d) MATCHING FUNDS.— 
(1) IN GENERAL.—The Secretary may award a 
grant to an entity under or consortium this section 
only if the entity of consortium agrees to make avail-
able non-Federal contributions toward the costs of 
the program to be funded under the grant in an 
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