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‘network’) shall be a consortium of health care pro-
viders with a joint governance structure (including 
providers within a single entity) that provides com-
prehensive coordinated and integrated health care 
services (as defined by the Secretary) for low-income 
populations. 
‘‘(2) REQUIRED INCLUSION.—A network shall in-
clude the following providers (unless such provider 
does not exist within the community, declines or re-
fuses to participate, or places unreasonable conditions 
on their participation): 
‘‘(A) A hospital that meets the criteria in 
section 1923(b)(1) of the Social Security Act; 
and 
‘‘(B) All Federally qualified health centers 
(as defined in section 1861(aa) of the Social Se-
curity Act located in the community. 
‘‘(3) PRIORITY.—In awarding grants, the Sec-
retary shall give priority to networks that include— 
‘‘(A) the capability to provide the broadest 
range of services to low-income individuals; 
‘‘(B) the broadest range of providers that 
currently serve a high volume of low-income in-
dividuals; and
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‘‘(C) a county or municipal department of 
health. 
‘‘(c) APPLICATION.— 
‘‘(1) APPLICATION.—A network described in sub-
section (b) shall submit an application to the Sec-
retary. 
‘‘(2) RENEWAL.—In subsequent years, based on 
the performance of grantees, the Secretary may pro-
vide renewal grants to prior year grant recipients. 
‘‘(d) USE OF FUNDS.— 
‘‘(1) USE BY GRANTEES.—Grant funds may be 
used for the following activities: 
‘‘(A) Assist low-income individuals to— 
‘‘(i) access and appropriately use 
health services; 
‘‘(ii) enroll in health coverage pro-
grams; and 
‘‘(iii) obtain a regular primary care 
provider or a medical home. 
‘‘(B) Provide case management and care 
management. 
‘‘(C) Perform health outreach using neigh-
borhood health workers or through other means. 
‘‘(D) Provide transportation.
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‘‘(E) Expand capacity, including through 
telehealth, after-hours services or urgent care. 
‘‘(F) Provide direct patient care services. 
‘‘(2) GRANT FUNDS TO HRSA GRANTEES.—The 
Secretary may limit the percent of grant funding that 
may be spent on direct care services provided by 
grantees of programs administered by the Health Re-
sources and Services Administration or impose other 
requirements on such grantees deemed necessary. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section such 
sums as may be necessary for each of fiscal years 2011 
through 2015.’’. 
SEC. 10334. MINORITY HEALTH. 
(a) OFFICE OF MINORITY HEALTH.— 
(1) IN GENERAL.—Section 1707 of the Public 
Health Service Act (42 U.S.C. 300u–6) is amended— 
(A) in subsection (a), by striking ‘‘within 
the Office of Public Health and Science’’ and all 
that follows through the end and inserting ‘‘. The 
Office of Minority Health as existing on the date 
of enactment of the Patient Protection and Af-
fordable Care Act shall be transferred to the Of-
fice of the Secretary in such manner that there 
is established in the Office of the Secretary, the
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Office of Minority Health, which shall be headed 
by the Deputy Assistant Secretary for Minority 
Health who shall report directly to the Secretary, 
and shall retain and strengthen authorities (as 
in existence on such date of enactment) for the 
purpose of improving minority health and the 
quality of health care minorities receive, and 
eliminating racial and ethnic disparities. In 
carrying out this subsection, the Secretary, act-
ing through the Deputy Assistant Secretary, 
shall award grants, contracts, enter into memo-
randa of understanding, cooperative, inter-
agency, intra-agency and other agreements with 
public and nonprofit private entities, agencies, 
as well as Departmental and Cabinet agencies 
and organizations, and with organizations that 
are indigenous human resource providers in 
communities of color to assure improved health 
status of racial and ethnic minorities, and shall 
develop measures to evaluate the effectiveness of 
activities aimed at reducing health disparities 
and supporting the local community. Such meas-
ures shall evaluate community outreach activi-
ties, language services, workforce cultural com-
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petence, and other areas as determined by the 
Secretary.’’; and 
(B) by striking subsection (h) and inserting 
the following: 
‘‘(h) 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 2011 through 2016.’’. 
(2) TRANSFER OF FUNCTIONS.—There are trans-
ferred to the Office of Minority Health in the office 
of the Secretary of Health and Human Services, all 
duties, responsibilities, authorities, accountabilities, 
functions, staff, funds, award mechanisms, and other 
entities under the authority of the Office of Minority 
Health of the Public Health Service as in effect on the 
date before the date of enactment of this Act, which 
shall continue in effect according to the terms in effect 
on the date before such date of enactment, until modi-
fied, terminated, superseded, set aside, or revoked in 
accordance with law by the President, the Secretary, 
a court of competent jurisdiction, or by operation of 
law. 
(3) REPORTS.—Not later than 1 year after the 
date of enactment of this section, and biennially 
thereafter, the Secretary of Health and Human Serv-
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ices shall prepare and submit to the appropriate com-
mittees of Congress a report describing the activities 
carried out under section 1707 of the Public Health 
Service Act (as amended by this subsection) during 
the period for which the report is being prepared. Not 
later than 1 year after the date of enactment of this 
section, and biennially thereafter, the heads of each of 
the agencies of the Department of Health and Human 
Services shall submit to the Deputy Assistant Sec-
retary for Minority Health a report summarizing the 
minority health activities of each of the respective 
agencies. 
(b) ESTABLISHMENT OF INDIVIDUAL OFFICES OF MI-
NORITY HEALTH WITHIN THE DEPARTMENT OF HEALTH 
AND HUMAN SERVICES.— 
(1) IN
GENERAL.—Title XVII of the Public 
Health Service Act (42 U.S.C. 300u et seq.) is amend-
ed by inserting after section 1707 the following sec-
tion: 
‘‘SEC. 1707A. INDIVIDUAL OFFICES OF MINORITY HEALTH 
WITHIN THE DEPARTMENT. 
‘‘(a) IN GENERAL.—The head of each agency specified 
in subsection (b)(1) shall establish within the agency an of-
fice to be known as the Office of Minority Health. The head 
of each such Office shall be appointed by the head of the
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agency within which the Office is established, and shall re-
port directly to the head of the agency. The head of such 
agency shall carry out this section (as this section relates 
to the agency) acting through such Director. 
‘‘(b) SPECIFIED AGENCIES.—The agencies referred to 
in subsection (a) are the Centers for Disease Control and 
Prevention, the Health Resources and Services Administra-
tion, the Substance Abuse and Mental Health Services Ad-
ministration, the Agency for Healthcare Research and 
Quality, the Food and Drug Administration, and the Cen-
ters for Medicare & Medicaid Services. 
‘‘(c) DIRECTOR; APPOINTMENT.—Each Office of Mi-
nority Health established in an agency listed in subsection 
(a) shall be headed by a director, with documented experi-
ence and expertise in minority health services research and 
health disparities elimination. 
‘‘(d) REFERENCES.—Except as otherwise specified, 
any reference in Federal law to an Office of Minority 
Health (in the Department of Health and Human Services) 
is deemed to be a reference to the Office of Minority Health 
in the Office of the Secretary. 
‘‘(e) FUNDING.— 
‘‘(1) ALLOCATIONS.—Of the amounts appro-
priated for a specified agency for a fiscal year, the 
Secretary must designate an appropriate amount of
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funds for the purpose of carrying out activities under 
this section through the minority health office of the 
agency. In reserving an amount under the preceding 
sentence for a minority health office for a fiscal year, 
the Secretary shall reduce, by substantially the same 
percentage, the amount that otherwise would be avail-
able for each of the programs of the designated agency 
involved. 
‘‘(2) AVAILABILITY OF FUNDS FOR STAFFING.— 
The purposes for which amounts made available 
under paragraph may be expended by a minority 
health office include the costs of employing staff for 
such office.’’. 
(2) NO NEW REGULATORY AUTHORITY.—Nothing 
in this subsection and the amendments made by this 
subsection may be construed as establishing regu-
latory authority or modifying any existing regulatory 
authority. 
(3) LIMITATION
ON
TERMINATION.—Notwith-
standing any other provision of law, a Federal office 
of minority health or Federal appointive position 
with primary responsibility over minority health 
issues that is in existence in an office of agency of the 
Department of Health and Human Services on the 
date of enactment of this section shall not be termi-
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nated, reorganized, or have any of its power or duties 
transferred unless such termination, reorganization, 
or transfer is approved by an Act of Congress. 
(c) REDESIGNATION OF NATIONAL CENTER ON MINOR-
ITY HEALTH AND HEALTH DISPARITIES.— 
(1) REDESIGNATION.—Title IV of the Public 
Health Service Act (42 U.S.C. 281 et seq.) is amend-
ed— 
(A) by redesignating subpart 6 of part E as 
subpart 20; 
(B) by transferring subpart 20, as so redes-
ignated, to part C of such title IV; 
(C) by inserting subpart 20, as so redesig-
nated, after subpart 19 of such part C; and 
(D) in subpart 20, as so redesignated— 
(i) by redesignating sections 485E 
through 485H as sections 464z–3 through 
464z–6, respectively; 
(ii) by striking ‘‘National Center on 
Minority Health and Health Disparities’’ 
each place such term appears and inserting 
‘‘National Institute on Minority Health and 
Health Disparities’’; and
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(3) 
TECHNICAL
AND
CONFORMING
AMEND-
MENTS.— 
(A) Section 401(b)(24) of the Public Health 
Service Act (42 U.S.C. 281(b)(24)) is amended 
by striking ‘‘Center’’ and inserting ‘‘Institute’’. 
(B) Subsection (d)(1) of section 903 of the 
Public Health Service Act (42 U.S.C. 299a– 
1(d)(1)) is amended by striking ‘‘section 485E’’ 
and inserting ‘‘section 464z–3’’. 
SEC. 10335. TECHNICAL CORRECTION TO THE HOSPITAL 
VALUE-BASED PURCHASING PROGRAM. 
Section 1886(o)(2)A) of the Social Security Act, as 
added by section 3001, is amended, in the first sentence, 
by inserting ‘‘, other than measures of readmissions,’’ after 
‘‘shall select measures’’. 
SEC. 10336. GAO STUDY AND REPORT ON MEDICARE BENE-
FICIARY ACCESS TO HIGH-QUALITY DIALYSIS 
SERVICES. 
(a) STUDY.— 
(1) IN GENERAL.—The Comptroller General of 
the United States shall conduct a study on the impact 
on Medicare beneficiary access to high-quality dialy-
sis services of including specified oral drugs that are 
furnished to such beneficiaries for the treatment of 
end stage renal disease in the bundled prospective
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payment system under section 1881(b)(14) of the So-
cial Security Act (42 U.S.C. 1395rr(b)(14)) (pursu-
ant to the proposed rule published by the Secretary of 
Health and Human Services in the Federal Register 
on September 29, 2009 (74 Fed. Reg. 49922 et seq.)). 
Such study shall include an analysis of— 
(A) the ability of providers of services and 
renal dialysis facilities to furnish specified oral 
drugs or arrange for the provision of such drugs; 
(B) the ability of providers of services and 
renal dialysis facilities to comply, if necessary, 
with applicable State laws (such as State phar-
macy licensure requirements) in order to furnish 
specified oral drugs; 
(C) whether appropriate quality measures 
exist to safeguard care for Medicare beneficiaries 
being furnished specified oral drugs by providers 
of services and renal dialysis facilities; and 
(D) other areas determined appropriate by 
the Comptroller General. 
(2) SPECIFIED ORAL DRUG DEFINED.—For pur-
poses of paragraph (1), the term ‘‘specified oral drug’’ 
means a drug or biological for which there is no 
injectable equivalent (or other non-oral form of ad-
ministration).
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(b) REPORT.—Not later than 1 year after the date of 
the enactment of this Act, the Comptroller General of the 
United States shall submit to Congress a report containing 
the results of the study conducted under subsection (a), to-
gether with recommendations for such legislation and ad-
ministrative action as the Comptroller General determines 
appropriate. 
Subtitle D—Provisions Relating to 
Title IV 
SEC. 10401. AMENDMENTS TO SUBTITLE A. 
(a) Section 4001(h)(4) and (5) of this Act is amended 
by striking ‘‘2010’’ each place such appears and inserting 
‘‘2020’’. 
(b) Section 4002(c) of this Act is amended— 
(1) by striking ‘‘research and health screenings’’ 
and inserting ‘‘research, health screenings, and initia-
tives’’; and 
(2) by striking ‘‘for Preventive’’ and inserting 
‘‘Regarding Preventive’’. 
(c) Section 4004(a)(4) of this Act is amended by strik-
ing ‘‘a Gateway’’ and inserting ‘‘an Exchange’’. 
SEC. 10402. AMENDMENTS TO SUBTITLE B. 
(a) Section 399Z–1(a)(1(A) of the Public Health Serv-
ice Act, as added by section 4101(b) of this Act, is amended 
by inserting ‘‘and vision’’ after ‘‘oral’’.
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(b) Section 1861(hhh)(4)(G) of the Social Security Act, 
as added by section 4103(b), is amended to read as follows: 
‘‘(G) A beneficiary shall be eligible to re-
ceive only an initial preventive physical exam-
ination (as defined under subsection (ww)(1)) 
during the 12-month period after the date that 
the beneficiary’s coverage begins under part B 
and shall be eligible to receive personalized pre-
vention plan services under this subsection each 
year thereafter provided that the beneficiary has 
not received either an initial preventive physical 
examination or personalized prevention plan 
services within the preceding 12-month period.’’. 
SEC. 10403. AMENDMENTS TO SUBTITLE C. 
Section 4201 of this Act is amended— 
(1) in subsection (a), by adding before the period 
the following: ‘‘, with not less than 20 percent of such 
grants being awarded to rural and frontier areas’’; 
(2) in subsection (c)(2)(B)(vii), by striking ‘‘both 
urban and rural areas’’ and inserting ‘‘urban, rural, 
and frontier areas’’; and 
(3) in subsection (f), by striking ‘‘each fiscal 
years’’ and inserting ‘‘each of fiscal year’’.
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SEC. 10404. AMENDMENTS TO SUBTITLE D. 
Section 399MM(2) of the Public Health Service Act, 
as added by section 4303 of this Act, is amended by striking 
‘‘by ensuring’’ and inserting ‘‘and ensuring’’. 
SEC. 10405. AMENDMENTS TO SUBTITLE E. 
Subtitle E of title IV of this Act is amended by striking 
section 4401. 
SEC. 10406. AMENDMENT RELATING TO WAIVING COINSUR-
ANCE FOR PREVENTIVE SERVICES. 
Section 4104(b) of this Act is amended to read as fol-
lows: 
‘‘(b) PAYMENT AND ELIMINATION OF COINSURANCE IN 
ALL SETTINGS.—Section 1833(a)(1) of the Social Security 
Act (42 U.S.C. 1395l(a)(1)), as amended by section 
4103(c)(1), is amended— 
‘‘(1) in subparagraph (T), by inserting ‘(or 100 
percent if such services are recommended with a grade 
of A or B by the United States Preventive Services 
Task Force for any indication or population and are 
appropriate for the individual)’ after ‘80 percent’; 
‘‘(2) in subparagraph (W)— 
‘‘(A) in clause (i), by inserting ‘(if such 
subparagraph were applied, by substituting ‘‘100 
percent’’ for ‘‘80 percent’’)’ after ‘subparagraph 
(D)’; and
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‘‘(B) in clause (ii), by striking ‘80 percent’ 
and inserting ‘100 percent’; 
‘‘(3) by striking ‘and’ before ‘(X)’; and 
‘‘(4) by inserting before the semicolon at the end 
the following: ‘, and (Y) with respect to preventive 
services described in subparagraphs (A) and (B) of 
section 1861(ddd)(3) that are appropriate for the in-
dividual and, in the case of such services described in 
subparagraph (A), are recommended with a grade of 
A or B by the United States Preventive Services Task 
Force for any indication or population, the amount 
paid shall be 100 percent of (i) except as provided in 
clause (ii), the lesser of the actual charge for the serv-
ices or the amount determined under the fee schedule 
that applies to such services under this part, and (ii) 
in the case of such services that are covered OPD serv-
ices (as defined in subsection (t)(1)(B)), the amount 
determined under subsection (t)’.’’. 
SEC. 10407. BETTER DIABETES CARE. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Catalyst to Better Diabetes Care Act of 2009’’. 
(b) NATIONAL DIABETES REPORT CARD.— 
(1) IN GENERAL.—The Secretary, in collabora-
tion with the Director of the Centers for Disease Con-
trol and Prevention (referred to in this section as the
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‘‘Director’’), shall prepare on a biennial basis a na-
tional diabetes report card (referred to in this section 
as a ‘‘Report Card’’) and, to the extent possible, for 
each State. 
(2) CONTENTS.— 
(A) IN GENERAL.—Each Report Card shall 
include aggregate health outcomes related to in-
dividuals 
diagnosed 
with 
diabetes 
and 
prediabetes including— 
(i) preventative care practices and 
quality of care; 
(ii) risk factors; and 
(iii) outcomes. 
(B) UPDATED
REPORTS.—Each Report 
Card that is prepared after the initial Report 
Card shall include trend analysis for the Nation 
and, to the extent possible, for each State, for the 
purpose of— 
(i) tracking progress in meeting estab-
lished national goals and objectives for im-
proving diabetes care, costs, and prevalence 
(including Healthy People 2010); and 
(ii) informing policy and program de-
velopment.
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(3) AVAILABILITY.—The Secretary, in collabora-
tion with the Director, shall make each Report Card 
publicly available, including by posting the Report 
Card on the Internet. 
(c) IMPROVEMENT
OF VITAL STATISTICS COLLEC-
TION.— 
(1) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and 
Prevention and in collaboration with appropriate 
agencies and States, shall— 
(A) promote the education and training of 
physicians on the importance of birth and death 
certificate data and how to properly complete 
these documents, including the collection of such 
data for diabetes and other chronic diseases; 
(B) encourage State adoption of the latest 
standard revisions of birth and death certificates; 
and 
(C) work with States to re-engineer their 
vital statistics systems in order to provide cost- 
effective, timely, and accurate vital systems data. 
(2) DEATH
CERTIFICATE
ADDITIONAL
LAN-
GUAGE.—In carrying out this subsection, the Sec-
retary may promote improvements to the collection of 
diabetes mortality data, including the addition of a
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question for the individual certifying the cause of 
death regarding whether the deceased had diabetes. 
(d) STUDY ON APPROPRIATE LEVEL OF DIABETES 
MEDICAL EDUCATION.— 
(1) IN GENERAL.—The Secretary shall, in col-
laboration with the Institute of Medicine and appro-
priate associations and councils, conduct a study of 
the impact of diabetes on the practice of medicine in 
the United States and the appropriateness of the level 
of diabetes medical education that should be required 
prior to licensure, board certification, and board re-
certification. 
(2) REPORT.—Not later than 2 years after the 
date of the enactment of this Act, the Secretary shall 
submit a report on the study under paragraph (1) to 
the Committees on Ways and Means and Energy and 
Commerce of the House of Representatives and the 
Committees on Finance and Health, Education, 
Labor, and Pensions of the Senate. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section such 
sums as may be necessary.
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SEC. 10408. GRANTS FOR SMALL BUSINESSES TO PROVIDE 
COMPREHENSIVE 
WORKPLACE 
WELLNESS 
PROGRAMS. 
(a) ESTABLISHMENT.—The Secretary shall award 
grants to eligible employers to provide their employees with 
access to comprehensive workplace wellness programs (as 
described under subsection (c)). 
(b) SCOPE.— 
(1) DURATION.—The grant program established 
under this section shall be conducted for a 5-year pe-
riod. 
(2) ELIGIBLE
EMPLOYER.—The term ‘‘eligible 
employer’’ means an employer (including a non-prof-
it employer) that— 
(A) employs less than 100 employees who 
work 25 hours or greater per week; and 
(B) does not provide a workplace wellness 
program as of the date of enactment of this Act. 
(c) COMPREHENSIVE WORKPLACE WELLNESS PRO-
GRAMS.— 
(1) CRITERIA.—The Secretary shall develop pro-
gram criteria for comprehensive workplace wellness 
programs under this section that are based on and 
consistent with evidence-based research and best prac-
tices, including research and practices as provided in 
the Guide to Community Preventive Services, the
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Guide to Clinical Preventive Services, and the Na-
tional Registry for Effective Programs. 
(2) REQUIREMENTS.—A comprehensive work-
place wellness program shall be made available by an 
eligible employer to all employees and include the fol-
lowing components: 
(A) Health awareness initiatives (including 
health education, preventive screenings, and 
health risk assessments). 
(B) Efforts to maximize employee engage-
ment (including mechanisms to encourage em-
ployee participation). 
(C) Initiatives to change unhealthy behav-
iors and lifestyle choices (including counseling, 
seminars, online programs, and self-help mate-
rials). 
(D) Supportive environment efforts (includ-
ing workplace policies to encourage healthy life-
styles, healthy eating, increased physical activ-
ity, and improved mental health). 
(d) APPLICATION.—An eligible employer desiring to 
participate in the grant program under this section shall 
submit an application to the Secretary, in such manner 
and containing such information as the Secretary may re-
quire, which shall include a proposal for a comprehensive
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workplace wellness program that meet the criteria and re-
quirements described under subsection (c). 
(e) AUTHORIZATION OF APPROPRIATION.—For pur-
poses of carrying out the grant program under this section, 
there is authorized to be appropriated $200,000,000 for the 
period of fiscal years 2011 through 2015. Amounts appro-
priated pursuant to this subsection shall remain available 
until expended. 
SEC. 10409. CURES ACCELERATION NETWORK. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Cures Acceleration Network Act of 2009’’. 
(b) REQUIREMENT FOR THE DIRECTOR OF NIH TO 
ESTABLISH A CURES ACCELERATION NETWORK.—Section 
402(b) of the Public Health Service Act (42 U.S.C. 282(b)) 
is amended— 
(1) in paragraph (22), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (23), by striking the period 
and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (23), the fol-
lowing: 
‘‘(24) implement the Cures Acceleration Network 
described in section 402C.’’. 
(c) ACCEPTING GIFTS TO SUPPORT THE CURES AC-
CELERATION NETWORK.—Section 499(c)(1) of the Public
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Health Service Act (42 U.S.C. 290b(c)(1)) is amended by 
adding at the end the following: 
‘‘(E) The Cures Acceleration Network de-
scribed in section 402C.’’. 
(d) ESTABLISHMENT OF THE CURES ACCELERATION 
NETWORK.—Part A of title IV of the Public Health Service 
Act is amended by inserting after section 402B (42 U.S.C. 
282b) the following: 
‘‘SEC. 402C. CURES ACCELERATION NETWORK. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) BIOLOGICAL PRODUCT.—The term ‘biologi-
cal product’ has the meaning given such term in sec-
tion 351 of the Public Health Service Act. 
‘‘(2) DRUG; DEVICE.—The terms ‘drug’ and ‘de-
vice’ have the meanings given such terms in section 
201 of the Federal Food, Drug, and Cosmetic Act. 
‘‘(3) HIGH NEED CURE.—The term ‘high need 
cure’ means a drug (as that term is defined by section 
201(g)(1) of the Federal Food, Drug, and Cosmetic 
Act, biological product (as that term is defined by sec-
tion 262(i)), or device (as that term is defined by sec-
tion 201(h) of the Federal Food, Drug, and Cosmetic 
Act) that, in the determination of the Director of 
NIH—
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‘‘(A) is a priority to diagnose, mitigate, 
prevent, or treat harm from any disease or con-
dition; and 
‘‘(B) for which the incentives of the commer-
cial market are unlikely to result in its adequate 
or timely development. 
‘‘(4) MEDICAL
PRODUCT.—The term ‘medical 
product’ means a drug, device, biological product, or 
product that is a combination of drugs, devices, and 
biological products. 
‘‘(b) ESTABLISHMENT OF THE CURES ACCELERATION 
NETWORK.—Subject to the appropriation of funds as de-
scribed in subsection (g), there is established within the Of-
fice of the Director of NIH a program to be known as the 
Cures Acceleration Network (referred to in this section as 
‘CAN’), which shall— 
‘‘(1) be under the direction of the Director of 
NIH, taking into account the recommendations of a 
CAN Review Board (referred to in this section as the 
‘Board’), described in subsection (d); and 
‘‘(2) award grants and contracts to eligible enti-
ties, as described in subsection (e), to accelerate the 
development of high need cures, including through the 
development of medical products and behavioral 
therapies.
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‘‘(c) FUNCTIONS.—The functions of the CAN are to— 
‘‘(1) conduct and support revolutionary advances 
in basic research, translating scientific discoveries 
from bench to bedside; 
‘‘(2) award grants and contracts to eligible enti-
ties to accelerate the development of high need cures; 
‘‘(3) provide the resources necessary for govern-
ment agencies, independent investigators, research or-
ganizations, biotechnology companies, academic re-
search institutions, and other entities to develop high 
need cures; 
‘‘(4) reduce the barriers between laboratory dis-
coveries and clinical trials for new therapies; and 
‘‘(5) facilitate review in the Food and Drug Ad-
ministration for the high need cures funded by the 
CAN, through activities that may include— 
‘‘(A) the facilitation of regular and ongoing 
communication with the Food and Drug Admin-
istration regarding the status of activities con-
ducted under this section; 
‘‘(B) ensuring that such activities are co-
ordinated with the approval requirements of the 
Food and Drug Administration, with the goal of 
expediting the development and approval of 
countermeasures and products; and
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‘‘(C) connecting interested persons with ad-
ditional technical assistance made available 
under section 565 of the Federal Food, Drug, 
and Cosmetic Act. 
‘‘(d) CAN BOARD.— 
‘‘(1) ESTABLISHMENT.—There is established a 
Cures Acceleration Network Review Board (referred to 
in this section as the ‘Board’), which shall advise the 
Director of NIH on the conduct of the activities of the 
Cures Acceleration Network. 
‘‘(2) MEMBERSHIP.— 
‘‘(A) IN GENERAL.— 
‘‘(i) APPOINTMENT.—The Board shall 
be comprised of 24 members who are ap-
pointed by the Secretary and who serve at 
the pleasure of the Secretary. 
‘‘(ii) CHAIRPERSON AND VICE CHAIR-
PERSON.—The Secretary shall designate, 
from among the 24 members appointed 
under clause (i), one Chairperson of the 
Board (referred to in this section as the 
‘Chairperson’) and one Vice Chairperson. 
‘‘(B) TERMS.— 
‘‘(i) IN GENERAL.—Each member shall 
be appointed to serve a 4-year term, except
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that any member appointed to fill a va-
cancy occurring prior to the expiration of 
the term for which the member’s predecessor 
was appointed shall be appointed for the re-
mainder of such term. 
‘‘(ii) 
CONSECUTIVE
APPOINTMENTS; 
MAXIMUM TERMS.—A member may be ap-
pointed to serve not more than 3 terms on 
the Board, and may not serve more than 2 
such terms consecutively. 
‘‘(C) QUALIFICATIONS.— 
‘‘(i) IN GENERAL.—The Secretary shall 
appoint individuals to the Board based sole-
ly upon the individual’s established record 
of distinguished service in one of the areas 
of expertise described in clause (ii). Each 
individual appointed to the Board shall be 
of distinguished achievement and have a 
broad range of disciplinary interests. 
‘‘(ii) EXPERTISE.—The Secretary shall 
select individuals based upon the following 
requirements: 
‘‘(I) For each of the fields of— 
‘‘(aa) basic research; 
‘‘(bb) medicine;
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‘‘(cc) biopharmaceuticals; 
‘‘(dd) discovery and delivery 
of medical products; 
‘‘(ee) bioinformatics and gene 
therapy; 
‘‘(ff) medical instrumenta-
tion; and 
‘‘(gg) regulatory review and 
approval of medical products, 
the Secretary shall select at least 1 in-
dividual who is eminent in such fields. 
‘‘(II) At least 4 individuals shall 
be recognized leaders in professional 
venture capital or private equity orga-
nizations and have demonstrated expe-
rience in private equity investing. 
‘‘(III) At least 8 individuals shall 
represent disease advocacy organiza-
tions. 
‘‘(3) EX-OFFICIO MEMBERS.— 
‘‘(A) APPOINTMENT.—In addition to the 24 
Board members described in paragraph (2), the 
Secretary shall appoint as ex-officio members of 
the Board—
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‘‘(i) a representative of the National 
Institutes of Health, recommended by the 
Secretary of the Department of Health and 
Human Services; 
‘‘(ii) a representative of the Office of 
the Assistant Secretary of Defense for 
Health Affairs, recommended by the Sec-
retary of Defense; 
‘‘(iii) a representative of the Office of 
the Under Secretary for Health for the Vet-
erans Health Administration, recommended 
by the Secretary of Veterans Affairs; 
‘‘(iv) a representative of the National 
Science Foundation, recommended by the 
Chair of the National Science Board; and 
‘‘(v) a representative of the Food and 
Drug Administration, recommended by the 
Commissioner of Food and Drugs. 
‘‘(B) TERMS.—Each ex-officio member shall 
serve a 3-year term on the Board, except that the 
Chairperson may adjust the terms of the initial 
ex-officio members in order to provide for a stag-
gered term of appointment for all such members. 
‘‘(4) RESPONSIBILITIES OF THE BOARD AND THE 
DIRECTOR OF NIH.—
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‘‘(A) RESPONSIBILITIES OF THE BOARD.— 
‘‘(i) IN
GENERAL.—The Board shall 
advise, and provide recommendations to, the 
Director of NIH with respect to— 
‘‘(I) policies, programs, and pro-
cedures for carrying out the duties of 
the Director of NIH under this section; 
and 
‘‘(II) significant barriers to suc-
cessful translation of basic science into 
clinical application (including issues 
under the purview of other agencies 
and departments). 
‘‘(ii) REPORT.—In the case that the 
Board identifies a significant barrier, as 
described in clause (i)(II), the Board shall 
submit to the Secretary a report regarding 
such barrier. 
‘‘(B) RESPONSIBILITIES OF THE DIRECTOR 
OF NIH.—With respect to each recommendation 
provided by the Board under subparagraph 
(A)(i), the Director of NIH shall respond in 
writing to the Board, indicating whether such 
Director will implement such recommendation. 
In the case that the Director of NIH indicates a
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recommendation of the Board will not be imple-
mented, such Director shall provide an expla-
nation of the reasons for not implementing such 
recommendation. 
‘‘(5) MEETINGS.— 
‘‘(A) IN GENERAL.—The Board shall meet 4 
times per calendar year, at the call of the Chair-
person. 
‘‘(B) QUORUM; 
REQUIREMENTS; 
LIMITA-
TIONS.— 
‘‘(i) QUORUM.—A quorum shall consist 
of a total of 13 members of the Board, ex-
cluding ex-officio members, with diverse 
representation as described in clause (iii). 
‘‘(ii) CHAIRPERSON
OR
VICE
CHAIR-
PERSON.—Each meeting of the Board shall 
be attended by either the Chairperson or the 
Vice Chairperson. 
‘‘(iii) DIVERSE REPRESENTATION.—At 
each meeting of the Board, there shall be not 
less than one scientist, one representative of 
a disease advocacy organization, and one 
representative of a professional venture cap-
ital or private equity organization. 
‘‘(6) COMPENSATION AND TRAVEL EXPENSES.—
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‘‘(A) COMPENSATION.—Members shall re-
ceive compensation at a rate to be fixed by the 
Chairperson but not to exceed a rate equal to the 
daily equivalent of the annual rate of basic pay 
prescribed for level IV of the Executive Schedule 
under section 5315 of title 5, United States Code, 
for each day (including travel time) during 
which the member is engaged in the performance 
of the duties of the Board. All members of the 
Board who are officers or employees of the 
United States shall serve without compensation 
in addition to that received for their services as 
officers or employees of the United States. 
‘‘(B) TRAVEL EXPENSES.—Members of the 
Board shall be allowed travel expenses, including 
per diem in lieu of subsistence, at rates author-
ized for persons employed intermittently by the 
Federal Government under section 5703(b) of 
title 5, United States Code, while away from 
their homes or regular places of business in the 
performance of services for the Board. 
‘‘(e) GRANT PROGRAM.— 
‘‘(1) SUPPORTING
INNOVATION.—To carry out 
the purposes described in this section, the Director of 
NIH shall award contracts, grants, or cooperative
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agreements to the entities described in paragraph (2), 
to— 
‘‘(A) promote innovation in technologies 
supporting the advanced research and develop-
ment and production of high need cures, includ-
ing through the development of medical products 
and behavioral therapies. 
‘‘(B) accelerate the development of high need 
cures, including through the development of med-
ical products, behavioral therapies, and biomark-
ers that demonstrate the safety or effectiveness of 
medical products; or 
‘‘(C) help the award recipient establish pro-
tocols that comply with Food and Drug Admin-
istration standards and otherwise permit the re-
cipient to meet regulatory requirements at all 
stages of development, manufacturing, review, 
approval, and safety surveillance of a medical 
product. 
‘‘(2) ELIGIBLE ENTITIES.—To receive assistance 
under paragraph (1), an entity shall— 
‘‘(A) be a public or private entity, which 
may include a private or public research institu-
tion, an institution of higher education, a med-
ical center, a biotechnology company, a pharma-
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ceutical company, a disease advocacy organiza-
tion, a patient advocacy organization, or an 
academic research institution; 
‘‘(B) submit an application containing— 
‘‘(i) a detailed description of the 
project for which the entity seeks such grant 
or contract; 
‘‘(ii) a timetable for such project; 
‘‘(iii) an assurance that the entity will 
submit— 
‘‘(I) interim reports describing the 
entity’s— 
‘‘(aa) progress in carrying 
out the project; and 
‘‘(bb) compliance with all 
provisions of this section and con-
ditions of receipt of such grant or 
contract; and 
‘‘(II) a final report at the conclu-
sion of the grant period, describing the 
outcomes of the project; and 
‘‘(iv) a description of the protocols the 
entity will follow to comply with Food and 
Drug Administration standards and regu-
latory requirements at all stages of develop-
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ment, manufacturing, review, approval, and 
safety surveillance of a medical product; 
and 
‘‘(C) provide such additional information as 
the Director of NIH may require. 
‘‘(3) AWARDS.— 
‘‘(A) THE CURES ACCELERATION PARTNER-
SHIP AWARDS.— 
‘‘(i) INITIAL
AWARD
AMOUNT.—Each 
award under this subparagraph shall be not 
more than $15,000,000 per project for the 
first fiscal year for which the project is 
funded, which shall be payable in one pay-
ment. 
‘‘(ii) FUNDING IN SUBSEQUENT FISCAL 
YEARS.—An eligible entity receiving an 
award under clause (i) may apply for addi-
tional funding for such project by submit-
ting to the Director of NIH the information 
required under subparagraphs (B) and (C) 
of paragraph (2). The Director may fund a 
project of such eligible entity in an amount 
not to exceed $15,000,000 for a fiscal year 
subsequent to the initial award under clause 
(i).
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‘‘(iii) MATCHING FUNDS.—As a condi-
tion for receiving an award under this sub-
section, an eligible entity shall contribute to 
the project non-Federal funds in the amount 
of $1 for every $3 awarded under clauses (i) 
and (ii), except that the Director of NIH 
may waive or modify such matching re-
quirement in any case where the Director 
determines that the goals and objectives of 
this section cannot adequately be carried 
out unless such requirement is waived. 
‘‘(B) THE
CURES
ACCELERATION
GRANT 
AWARDS.— 
‘‘(i) INITIAL
AWARD
AMOUNT.—Each 
award under this subparagraph shall be not 
more than $15,000,000 per project for the 
first fiscal year for which the project is 
funded, which shall be payable in one pay-
ment. 
‘‘(ii) FUNDING IN SUBSEQUENT FISCAL 
YEARS.—An eligible entity receiving an 
award under clause (i) may apply for addi-
tional funding for such project by submit-
ting to the Board the information required 
under subparagraphs (B) and (C) of para-
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graph (2). The Director of NIH may fund 
a project of such eligible entity in an 
amount not to exceed $15,000,000 for a fis-
cal year subsequent to the initial award 
under clause (i). 
‘‘(C) THE CURES ACCELERATION FLEXIBLE 
RESEARCH AWARDS.—If the Director of NIH de-
termines that the goals and objectives of this sec-
tion cannot adequately be carried out through a 
contract, grant, or cooperative agreement, the 
Director of NIH shall have flexible research au-
thority to use other transactions to fund projects 
in accordance with the terms and conditions of 
this section. Awards made under such flexible re-
search authority for a fiscal year shall not exceed 
20 percent of the total funds appropriated under 
subsection (g)(1) for such fiscal year. 
‘‘(4) SUSPENSION OF AWARDS FOR DEFAULTS, 
NONCOMPLIANCE WITH PROVISIONS AND PLANS, AND 
DIVERSION OF FUNDS; REPAYMENT OF FUNDS.—The 
Director of NIH may suspend the award to any enti-
ty upon noncompliance by such entity with provi-
sions and plans under this section or diversion of 
funds.
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‘‘(5) AUDITS.—The Director of NIH may enter 
into agreements with other entities to conduct peri-
odic audits of the projects funded by grants or con-
tracts awarded under this subsection. 
‘‘(6) CLOSEOUT PROCEDURES.—At the end of a 
grant or contract period, a recipient shall follow the 
closeout procedures under section 74.71 of title 45, 
Code of Federal Regulations (or any successor regula-
tion). 
‘‘(7) REVIEW.—A determination by the Director 
of NIH as to whether a drug, device, or biological 
product is a high need cure (for purposes of subsection 
(a)(3)) shall not be subject to judicial review. 
‘‘(f) COMPETITIVE BASIS OF AWARDS.—Any grant, co-
operative agreement, or contract awarded under this section 
shall be awarded on a competitive basis. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—For purposes of carrying out 
this section, there are authorized to be appropriated 
$500,000,000 for fiscal year 2010, and such sums as 
may be necessary for subsequent fiscal years. Funds 
appropriated under this section shall be available 
until expended. 
‘‘(2) LIMITATION ON USE OF FUNDS OTHERWISE 
APPROPRIATED.—No funds appropriated under this
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Act, other than funds appropriated under paragraph 
(1), may be allocated to the Cures Acceleration Net-
work.’’. 
SEC. 10410. CENTERS OF EXCELLENCE FOR DEPRESSION. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Establishing a Network of Health-Advancing National 
Centers of Excellence for Depression Act of 2009’’ or the 
‘‘ENHANCED Act of 2009’’. 
(b) CENTERS OF EXCELLENCE FOR DEPRESSION.— 
Subpart 3 of part B of title V of the Public Health Service 
Act (42 U.S.C. 290bb et seq.) is amended by inserting after 
section 520A the following: 
‘‘SEC. 520B. NATIONAL CENTERS OF EXCELLENCE FOR DE-
PRESSION. 
‘‘(a) DEPRESSIVE DISORDER DEFINED.—In this sec-
tion, the term ‘depressive disorder’ means a mental or brain 
disorder relating to depression, including major depression, 
bipolar disorder, and related mood disorders. 
‘‘(b) GRANT PROGRAM.— 
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Administrator, shall award grants on a 
competitive basis to eligible entities to establish na-
tional centers of excellence for depression (referred to 
in this section as ‘Centers’), which shall engage in ac-
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tivities related to the treatment of depressive dis-
orders. 
‘‘(2) ALLOCATION OF AWARDS.—If the funds au-
thorized under subsection (f) are appropriated in the 
amounts provided for under such subsection, the Sec-
retary shall allocate such amounts so that— 
‘‘(A) not later than 1 year after the date of 
enactment of the ENHANCED Act of 2009, not 
more than 20 Centers may be established; and 
‘‘(B) not later than September 30, 2016, not 
more than 30 Centers may be established. 
‘‘(3) GRANT PERIOD.— 
‘‘(A) IN GENERAL.—A grant awarded under 
this section shall be for a period of 5 years. 
‘‘(B) RENEWAL.—A grant awarded under 
subparagraph (A) may be renewed, on a com-
petitive basis, for 1 additional 5-year period, at 
the discretion of the Secretary. In determining 
whether to renew a grant, the Secretary shall 
consider the report cards issued under subsection 
(e)(2). 
‘‘(4) USE
OF
FUNDS.—Grant funds awarded 
under this subsection shall be used for the establish-
ment and ongoing activities of the recipient of such 
funds.
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‘‘(5) ELIGIBLE ENTITIES.— 
‘‘(A) REQUIREMENTS.—To be eligible to re-
ceive a grant under this section, an entity 
shall— 
‘‘(i) be an institution of higher edu-
cation or a public or private nonprofit re-
search institution; and 
‘‘(ii) submit an application to the Sec-
retary at such time and in such manner as 
the Secretary may require, as described in 
subparagraph (B). 
‘‘(B) APPLICATION.—An application de-
scribed in subparagraph (A)(ii) shall include— 
‘‘(i) evidence that such entity— 
‘‘(I) provides, or is capable of co-
ordinating with other entities to pro-
vide, comprehensive health services 
with a focus on mental health services 
and subspecialty expertise for depres-
sive disorders; 
‘‘(II) collaborates with other men-
tal health providers, as necessary, to 
address co-occurring mental illnesses;
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‘‘(III) is capable of training 
health 
professionals 
about 
mental 
health; and 
‘‘(ii) such other information, as the 
Secretary may require. 
‘‘(C) PRIORITIES.—In awarding grants 
under this section, the Secretary shall give pri-
ority to eligible entities that meet 1 or more of 
the following criteria: 
‘‘(i) Demonstrated capacity and exper-
tise to serve the targeted population. 
‘‘(ii) Existing infrastructure or exper-
tise to provide appropriate, evidence-based 
and culturally and linguistically competent 
services. 
‘‘(iii) A location in a geographic area 
with disproportionate numbers of under-
served and at-risk populations in medically 
underserved areas and health professional 
shortage areas. 
‘‘(iv) Proposed innovative approaches 
for outreach to initiate or expand services. 
‘‘(v) Use of the most up-to-date science, 
practices, and interventions available.
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‘‘(vi) Demonstrated capacity to estab-
lish cooperative and collaborative agree-
ments with community mental health cen-
ters and other community entities to pro-
vide mental health, social, and human serv-
ices to individuals with depressive dis-
orders. 
‘‘(6) NATIONAL COORDINATING CENTER.— 
‘‘(A) IN GENERAL.—The Secretary, acting 
through the Administrator, shall designate 1 re-
cipient of a grant under this section to be the co-
ordinating center of excellence for depression (re-
ferred to in this section as the ‘coordinating cen-
ter’). The Secretary shall select such coordinating 
center on a competitive basis, based upon the 
demonstrated capacity of such center to perform 
the duties described in subparagraph (C). 
‘‘(B) APPLICATION.—A Center that has been 
awarded a grant under paragraph (1) may 
apply for designation as the coordinating center 
by submitting an application to the Secretary at 
such time, in such manner, and containing such 
information as the Secretary may require. 
‘‘(C) DUTIES.—The coordinating center 
shall—
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‘‘(i) develop, administer, and coordi-
nate the network of Centers under this sec-
tion; 
‘‘(ii) oversee and coordinate the na-
tional database described in subsection (d); 
‘‘(iii) lead a strategy to disseminate 
the findings and activities of the Centers 
through such database; and 
‘‘(iv) serve as a liaison with the Ad-
ministration, the National Registry of Evi-
dence-based Programs and Practices of the 
Administration, and any Federal inter-
agency or interagency forum on mental 
health. 
‘‘(7) MATCHING FUNDS.—The Secretary may not 
award a grant or contract under this section to an 
entity unless the entity agrees that it will make avail-
able (directly or through contributions from other 
public or private entities) non-Federal contributions 
toward the activities to be carried out under the grant 
or contract in an amount equal to $1 for each $5 of 
Federal funds provided under the grant or contract. 
Such non-Federal matching funds may be provided 
directly or through donations from public or private
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entities and may be in cash or in-kind, fairly evalu-
ated, including plant, equipment, or services. 
‘‘(c) ACTIVITIES OF THE CENTERS.—Each Center shall 
carry out the following activities: 
‘‘(1) GENERAL ACTIVITIES.—Each Center shall— 
‘‘(A) integrate basic, clinical, or health serv-
ices interdisciplinary research and practice in 
the development, implementation, and dissemi-
nation of evidence-based interventions; 
‘‘(B) involve a broad cross-section of stake-
holders, such as researchers, clinicians, con-
sumers, families of consumers, and voluntary 
health organizations, to develop a research agen-
da and disseminate findings, and to provide 
support in the implementation of evidence-based 
practices; 
‘‘(C) provide training and technical assist-
ance to mental health professionals, and engage 
in and disseminate translational research with a 
focus on meeting the needs of individuals with 
depressive disorders; and 
‘‘(D) educate policy makers, employers, 
community leaders, and the public about depres-
sive disorders to reduce stigma and raise aware-
ness of treatments.
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‘‘(2) IMPROVED TREATMENT STANDARDS, CLIN-
ICAL GUIDELINES, DIAGNOSTIC PROTOCOLS, AND CARE 
COORDINATION PRACTICE.—Each Center shall collabo-
rate with other Centers in the network to— 
‘‘(A) develop and implement treatment 
standards, clinical guidelines, and protocols that 
emphasize primary prevention, early interven-
tion, treatment for, and recovery from, depressive 
disorders; 
‘‘(B) foster communication with other pro-
viders attending to co-occurring physical health 
conditions such as cardiovascular, diabetes, can-
cer, and substance abuse disorders; 
‘‘(C) leverage available community re-
sources, develop and implement improved self- 
management programs, and, when appropriate, 
involve family and other providers of social sup-
port in the development and implementation of 
care plans; and 
‘‘(D) use electronic health records and tele-
health technology to better coordinate and man-
age, and improve access to, care, as determined 
by the coordinating center.
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‘‘(3) TRANSLATIONAL RESEARCH THROUGH COL-
LABORATION OF CENTERS AND COMMUNITY-BASED OR-
GANIZATIONS.—Each Center shall— 
‘‘(A) demonstrate effective use of a public- 
private partnership to foster collaborations 
among members of the network and community- 
based organizations such as community mental 
health centers and other social and human serv-
ices providers; 
‘‘(B) 
expand 
interdisciplinary, 
translational, and patient-oriented research and 
treatment; and 
‘‘(C) coordinate with accredited academic 
programs to provide ongoing opportunities for 
the professional and continuing education of 
mental health providers. 
‘‘(d) NATIONAL DATABASE.— 
‘‘(1) IN GENERAL.—The coordinating center shall 
establish and maintain a national, publicly available 
database to improve prevention programs, evidence- 
based interventions, and disease management pro-
grams for depressive disorders, using data collected 
from the Centers, as described in paragraph (2).