H. R. 3590—417 
‘‘SEC. 925. ACTIVITIES REGARDING WOMEN’S HEALTH. 
‘‘(a) ESTABLISHMENT.—There is established within the Office 
of the Director, an Office of Women’s Health and Gender-Based 
Research (referred to in this section as the ‘Office’). The Office 
shall be headed by a director who shall be appointed by the Director 
of Healthcare and Research Quality. 
‘‘(b) PURPOSE.—The official designated under subsection (a) 
shall— 
‘‘(1) report to the Director on the current Agency level 
of activity regarding women’s health, across, where appropriate, 
age, biological, and sociocultural contexts, in all aspects of 
Agency work, including the development of evidence reports 
and clinical practice protocols and the conduct of research into 
patient outcomes, delivery of health care services, quality of 
care, and access to health care; 
‘‘(2) establish short-range and long-range goals and objec-
tives within the Agency for research important to women’s 
health and, as relevant and appropriate, coordinate with other 
appropriate offices on activities within the Agency that relate 
to health services and medical effectiveness research, for issues 
of particular concern to women; 
‘‘(3) identify projects in women’s health that should be 
conducted or supported by the Agency; 
‘‘(4) consult with health professionals, nongovernmental 
organizations, consumer organizations, women’s health profes-
sionals, and other individuals and groups, as appropriate, on 
Agency policy with regard to women; and 
‘‘(5) serve as a member of the Department of Health and 
Human Services Coordinating Committee on Women’s Health 
(established under section 229(b)(4)).’’. 
‘‘(c) 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 the fiscal years 2010 
through 2014.’’. 
(f) HEALTH RESOURCES AND SERVICES ADMINISTRATION OFFICE 
OF WOMEN’S HEALTH.—Title VII of the Social Security Act (42 
U.S.C. 901 et seq.) is amended by adding at the end the following: 
‘‘SEC. 713. OFFICE OF WOMEN’S HEALTH. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish within the 
Office of the Administrator of the Health Resources and Services 
Administration, an office to be known as the Office of Women’s 
Health. The Office shall be headed by a director who shall be 
appointed by the Administrator. 
‘‘(b) PURPOSE.—The Director of the Office shall— 
‘‘(1) report to the Administrator on the current Administra-
tion level of activity regarding women’s health across, where 
appropriate, age, biological, and sociocultural contexts; 
‘‘(2) establish short-range and long-range goals and objec-
tives within the Health Resources and Services Administration 
for women’s health and, as relevant and appropriate, coordinate 
with other appropriate offices on activities within the Adminis-
tration that relate to health care provider training, health 
service delivery, research, and demonstration projects, for 
issues of particular concern to women; 
‘‘(3) identify projects in women’s health that should be 
conducted or supported by the bureaus of the Administration;
H. R. 3590—418 
‘‘(4) consult with health professionals, nongovernmental 
organizations, consumer organizations, women’s health profes-
sionals, and other individuals and groups, as appropriate, on 
Administration policy with regard to women; and 
‘‘(5) serve as a member of the Department of Health and 
Human Services Coordinating Committee on Women’s Health 
(established under section 229(b)(4) of the Public Health Service 
Act). 
‘‘(c) CONTINUED ADMINISTRATION OF EXISTING PROGRAMS.—The 
Director of the Office shall assume the authority for the develop-
ment, implementation, administration, and evaluation of any 
projects carried out through the Health Resources and Services 
Administration relating to women’s health on the date of enactment 
of this section. 
‘‘(d) DEFINITIONS.—For purposes of this section: 
‘‘(1) ADMINISTRATION.—The term ‘Administration’ means 
the Health Resources and Services Administration. 
‘‘(2) ADMINISTRATOR.—The term ‘Administrator’ means the 
Administrator of the Health Resources and Services Adminis-
tration. 
‘‘(3) OFFICE.—The term ‘Office’ means the Office of Women’s 
Health established under this section in the Administration. 
‘‘(e) 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 the fiscal years 2010 
through 2014.’’. 
(g) FOOD
AND DRUG ADMINISTRATION OFFICE
OF WOMEN’S 
HEALTH.—Chapter X of the Federal Food, Drug, and Cosmetic Act 
(21 U.S.C. 391 et seq.) is amended by adding at the end the 
following: 
‘‘SEC. 1011. OFFICE OF WOMEN’S HEALTH. 
‘‘(a) ESTABLISHMENT.—There is established within the Office 
of the Commissioner, an office to be known as the Office of Women’s 
Health (referred to in this section as the ‘Office’). The Office shall 
be headed by a director who shall be appointed by the Commissioner 
of Food and Drugs. 
‘‘(b) PURPOSE.—The Director of the Office shall— 
‘‘(1) report to the Commissioner of Food and Drugs on 
current Food and Drug Administration (referred to in this 
section as the ‘Administration’) levels of activity regarding 
women’s participation in clinical trials and the analysis of 
data by sex in the testing of drugs, medical devices, and 
biological products across, where appropriate, age, biological, 
and sociocultural contexts; 
‘‘(2) establish short-range and long-range goals and objec-
tives within the Administration for issues of particular concern 
to women’s health within the jurisdiction of the Administration, 
including, where relevant and appropriate, adequate inclusion 
of women and analysis of data by sex in Administration proto-
cols and policies; 
‘‘(3) provide information to women and health care pro-
viders on those areas in which differences between men and 
women exist; 
‘‘(4) consult with pharmaceutical, biologics, and device 
manufacturers, health professionals with expertise in women’s
H. R. 3590—419 
issues, consumer organizations, and women’s health profes-
sionals on Administration policy with regard to women; 
‘‘(5) make annual estimates of funds needed to monitor 
clinical trials and analysis of data by sex in accordance with 
needs that are identified; and 
‘‘(6) serve as a member of the Department of Health and 
Human Services Coordinating Committee on Women’s Health 
(established under section 229(b)(4) of the Public Health Service 
Act). 
‘‘(c) 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 the fiscal years 2010 
through 2014.’’. 
(h) NO NEW REGULATORY AUTHORITY.—Nothing in this section 
and the amendments made by this section may be construed as 
establishing regulatory authority or modifying any existing regu-
latory authority. 
(i) LIMITATION ON TERMINATION.—Notwithstanding any other 
provision of law, a Federal office of women’s health (including 
the Office of Research on Women’s Health of the National Institutes 
of Health) or Federal appointive position with primary responsibility 
over women’s health issues (including the Associate Administrator 
for Women’s Services under the Substance Abuse and Mental 
Health Services Administration) that is in existence on the date 
of enactment of this section shall not be terminated, reorganized, 
or have any of it’s powers or duties transferred unless such termi-
nation, reorganization, or transfer is approved by Congress through 
the adoption of a concurrent resolution of approval. 
(j) RULE OF CONSTRUCTION.—Nothing in this section (or the 
amendments made by this section) shall be construed to limit 
the authority of the Secretary of Health and Human Services with 
respect to women’s health, or with respect to activities carried 
out through the Department of Health and Human Services on 
the date of enactment of this section. 
SEC. 3510. PATIENT NAVIGATOR PROGRAM. 
Section 340A of the Public Health Service Act (42 U.S.C. 256a) 
is amended— 
(1) by striking subsection (d)(3) and inserting the following: 
‘‘(3) LIMITATIONS ON GRANT PERIOD.—In carrying out this 
section, the Secretary shall ensure that the total period of 
a grant does not exceed 4 years.’’; 
(2) in subsection (e), by adding at the end the following: 
‘‘(3) MINIMUM CORE PROFICIENCIES.—The Secretary shall 
not award a grant to an entity under this section unless such 
entity provides assurances that patient navigators recruited, 
assigned, trained, or employed using grant funds meet min-
imum core proficiencies, as defined by the entity that submits 
the application, that are tailored for the main focus or interven-
tion of the navigator involved.’’; and 
(3) in subsection (m)— 
(A) in paragraph (1), by striking ‘‘and $3,500,000 for 
fiscal year 2010.’’ and inserting ‘‘$3,500,000 for fiscal year 
2010, and such sums as may be necessary for each of 
fiscal years 2011 through 2015.’’; and 
(B) in paragraph (2), by striking ‘‘2010’’ and inserting 
‘‘2015’’.
H. R. 3590—420 
SEC. 3511. AUTHORIZATION OF APPROPRIATIONS. 
Except where otherwise provided in this subtitle (or an amend-
ment made by this subtitle), there is authorized to be appropriated 
such sums as may be necessary to carry out this subtitle (and 
such amendments made by this subtitle). 
Subtitle G—Protecting and Improving 
Guaranteed Medicare Benefits 
SEC. 3601. PROTECTING AND IMPROVING GUARANTEED MEDICARE 
BENEFITS. 
(a) PROTECTING GUARANTEED MEDICARE BENEFITS.—Nothing 
in the provisions of, or amendments made by, this Act shall result 
in a reduction of guaranteed benefits under title XVIII of the 
Social Security Act. 
(b) ENSURING THAT MEDICARE SAVINGS BENEFIT THE MEDICARE 
PROGRAM AND MEDICARE BENEFICIARIES.—Savings generated for 
the Medicare program under title XVIII of the Social Security 
Act under the provisions of, and amendments made by, this Act 
shall extend the solvency of the Medicare trust funds, reduce Medi-
care premiums and other cost-sharing for beneficiaries, and improve 
or expand guaranteed Medicare benefits and protect access to Medi-
care providers. 
SEC. 3602. NO CUTS IN GUARANTEED BENEFITS. 
Nothing in this Act shall result in the reduction or elimination 
of any benefits guaranteed by law to participants in Medicare 
Advantage plans. 
TITLE IV—PREVENTION OF CHRONIC 
DISEASE 
AND 
IMPROVING 
PUBLIC 
HEALTH 
Subtitle A—Modernizing Disease 
Prevention and Public Health Systems 
SEC. 4001. NATIONAL PREVENTION, HEALTH PROMOTION AND PUBLIC 
HEALTH COUNCIL. 
(a) ESTABLISHMENT.—The President shall establish, within the 
Department of Health and Human Services, a council to be known 
as the ‘‘National Prevention, Health Promotion and Public Health 
Council’’ (referred to in this section as the ‘‘Council’’). 
(b) CHAIRPERSON.—The President shall appoint the Surgeon 
General to serve as the chairperson of the Council. 
(c) COMPOSITION.—The Council shall be composed of— 
(1) the Secretary of Health and Human Services; 
(2) the Secretary of Agriculture; 
(3) the Secretary of Education; 
(4) the Chairman of the Federal Trade Commission; 
(5) the Secretary of Transportation; 
(6) the Secretary of Labor; 
(7) the Secretary of Homeland Security;
H. R. 3590—421 
(8) the Administrator of the Environmental Protection 
Agency; 
(9) the Director of the Office of National Drug Control 
Policy; 
(10) the Director of the Domestic Policy Council; 
(11) the Assistant Secretary for Indian Affairs; 
(12) the Chairman of the Corporation for National and 
Community Service; and 
(13) the head of any other Federal agency that the chair-
person determines is appropriate. 
(d) PURPOSES AND DUTIES.—The Council shall— 
(1) provide coordination and leadership at the Federal level, 
and among all Federal departments and agencies, with respect 
to prevention, wellness and health promotion practices, the 
public health system, and integrative health care in the United 
States; 
(2) after obtaining input from relevant stakeholders, 
develop a national prevention, health promotion, public health, 
and integrative health care strategy that incorporates the most 
effective and achievable means of improving the health status 
of Americans and reducing the incidence of preventable illness 
and disability in the United States; 
(3) provide recommendations to the President and Congress 
concerning the most pressing health issues confronting the 
United States and changes in Federal policy to achieve national 
wellness, health promotion, and public health goals, including 
the reduction of tobacco use, sedentary behavior, and poor 
nutrition; 
(4) consider and propose evidence-based models, policies, 
and innovative approaches for the promotion of transformative 
models of prevention, integrative health, and public health 
on individual and community levels across the United States; 
(5) establish processes for continual public input, including 
input from State, regional, and local leadership communities 
and other relevant stakeholders, including Indian tribes and 
tribal organizations; 
(6) submit the reports required under subsection (g); and 
(7) carry out other activities determined appropriate by 
the President. 
(e) MEETINGS.—The Council shall meet at the call of the Chair-
person. 
(f) ADVISORY GROUP.— 
(1) IN GENERAL.—The President shall establish an Advisory 
Group to the Council to be known as the ‘‘Advisory Group 
on Prevention, Health Promotion, and Integrative and Public 
Health’’ (hereafter referred to in this section as the ‘‘Advisory 
Group’’). The Advisory Group shall be within the Department 
of Health and Human Services and report to the Surgeon 
General. 
(2) COMPOSITION.— 
(A) IN GENERAL.—The Advisory Group shall be com-
posed of not more than 25 non-Federal members to be 
appointed by the President. 
(B) REPRESENTATION.—In appointing members under 
subparagraph (A), the President shall ensure that the 
Advisory Group includes a diverse group of licensed health
H. R. 3590—422 
professionals, including integrative health practitioners 
who have expertise in— 
(i) worksite health promotion; 
(ii) community services, including community 
health centers; 
(iii) preventive medicine; 
(iv) health coaching; 
(v) public health education; 
(vi) geriatrics; and 
(vii) rehabilitation medicine. 
(3) PURPOSES
AND
DUTIES.—The Advisory Group shall 
develop policy and program recommendations and advise the 
Council on lifestyle-based chronic disease prevention and 
management, integrative health care practices, and health pro-
motion. 
(g) 
NATIONAL
PREVENTION
AND
HEALTH
PROMOTION 
STRATEGY.—Not later than 1 year after the date of enactment 
of this Act, the Chairperson, in consultation with the Council, 
shall develop and make public a national prevention, health pro-
motion and public health strategy, and shall review and revise 
such strategy periodically. Such strategy shall— 
(1) set specific goals and objectives for improving the health 
of the United States through federally-supported prevention, 
health promotion, and public health programs, consistent with 
ongoing goal setting efforts conducted by specific agencies; 
(2) establish specific and measurable actions and timelines 
to carry out the strategy, and determine accountability for 
meeting those timelines, within and across Federal departments 
and agencies; and 
(3) make recommendations to improve Federal efforts 
relating to prevention, health promotion, public health, and 
integrative health care practices to ensure Federal efforts are 
consistent with available standards and evidence. 
(h) REPORT.—Not later than July 1, 2010, and annually there-
after through January 1, 2015, the Council shall submit to the 
President and the relevant committees of Congress, a report that— 
(1) describes the activities and efforts on prevention, health 
promotion, and public health and activities to develop a national 
strategy conducted by the Council during the period for which 
the report is prepared; 
(2) describes the national progress in meeting specific 
prevention, health promotion, and public health goals defined 
in the strategy and further describes corrective actions rec-
ommended by the Council and taken by relevant agencies and 
organizations to meet these goals; 
(3) contains a list of national priorities on health promotion 
and disease prevention to address lifestyle behavior modifica-
tion (smoking cessation, proper nutrition, appropriate exercise, 
mental health, behavioral health, substance use disorder, and 
domestic violence screenings) and the prevention measures for 
the 5 leading disease killers in the United States; 
(4) contains specific science-based initiatives to achieve the 
measurable goals of Healthy People 2010 regarding nutrition, 
exercise, and smoking cessation, and targeting the 5 leading 
disease killers in the United States; 
(5) contains specific plans for consolidating Federal health 
programs and Centers that exist to promote healthy behavior
H. R. 3590—423 
and reduce disease risk (including eliminating programs and 
offices determined to be ineffective in meeting the priority 
goals of Healthy People 2010); 
(6) contains specific plans to ensure that all Federal health 
care programs are fully coordinated with science-based preven-
tion recommendations by the Director of the Centers for Disease 
Control and Prevention; and 
(7) contains specific plans to ensure that all non-Depart-
ment of Health and Human Services prevention programs are 
based on the science-based guidelines developed by the Centers 
for Disease Control and Prevention under paragraph (4). 
(i) PERIODIC REVIEWS.—The Secretary and the Comptroller 
General of the United States shall jointly conduct periodic reviews, 
not less than every 5 years, and evaluations of every Federal 
disease prevention and health promotion initiative, program, and 
agency. Such reviews shall be evaluated based on effectiveness 
in meeting metrics-based goals with an analysis posted on such 
agencies’ public Internet websites. 
SEC. 4002. PREVENTION AND PUBLIC HEALTH FUND. 
(a) PURPOSE.—It is the purpose of this section to establish 
a Prevention and Public Health Fund (referred to in this section 
as the ‘‘Fund’’), to be administered through the Department of 
Health and Human Services, Office of the Secretary, to provide 
for expanded and sustained national investment in prevention and 
public health programs to improve health and help restrain the 
rate of growth in private and public sector health care costs. 
(b) FUNDING.—There are hereby authorized to be appropriated, 
and appropriated, to the Fund, out of any monies in the Treasury 
not otherwise appropriated— 
(1) for fiscal year 2010, $500,000,000; 
(2) for fiscal year 2011, $750,000,000; 
(3) for fiscal year 2012, $1,000,000,000; 
(4) for fiscal year 2013, $1,250,000,000; 
(5) for fiscal year 2014, $1,500,000,000; and 
(6) for fiscal year 2015, and each fiscal year thereafter, 
$2,000,000,000. 
(c) USE OF FUND.—The Secretary shall transfer amounts in 
the Fund to accounts within the Department of Health and Human 
Services to increase funding, over the fiscal year 2008 level, for 
programs authorized by the Public Health Service Act, for preven-
tion, wellness, and public health activities including prevention 
research and health screenings, such as the Community Trans-
formation grant program, the Education and Outreach Campaign 
for Preventive Benefits, and immunization programs. 
(d) TRANSFER AUTHORITY.—The Committee on Appropriations 
of the Senate and the Committee on Appropriations of the House 
of Representatives may provide for the transfer of funds in the 
Fund to eligible activities under this section, subject to subsection 
(c). 
SEC. 4003. CLINICAL AND COMMUNITY PREVENTIVE SERVICES. 
(a) PREVENTIVE SERVICES TASK FORCE.—Section 915 of the 
Public Health Service Act (42 U.S.C. 299b–4) is amended by striking 
subsection (a) and inserting the following: 
‘‘(a) PREVENTIVE SERVICES TASK FORCE.— 
‘‘(1) ESTABLISHMENT AND PURPOSE.—The Director shall con-
vene an independent Preventive Services Task Force (referred
H. R. 3590—424 
to in this subsection as the ‘Task Force’) to be composed of 
individuals with appropriate expertise. Such Task Force shall 
review the scientific evidence related to the effectiveness, appro-
priateness, and cost-effectiveness of clinical preventive services 
for the purpose of developing recommendations for the health 
care community, and updating previous clinical preventive rec-
ommendations, to be published in the Guide to Clinical Preven-
tive Services (referred to in this section as the ‘Guide’), for 
individuals and organizations delivering clinical services, 
including primary care professionals, health care systems, 
professional societies, employers, community organizations, 
non-profit organizations, Congress and other policy-makers, 
governmental public health agencies, health care quality 
organizations, and organizations developing national health 
objectives. Such recommendations shall consider clinical 
preventive best practice recommendations from the Agency for 
Healthcare Research and Quality, the National Institutes of 
Health, the Centers for Disease Control and Prevention, the 
Institute of Medicine, specialty medical associations, patient 
groups, and scientific societies. 
‘‘(2) DUTIES.—The duties of the Task Force shall include— 
‘‘(A) the development of additional topic areas for new 
recommendations and interventions related to those topic 
areas, including those related to specific sub-populations 
and age groups; 
‘‘(B) at least once during every 5-year period, review 
interventions and update recommendations related to 
existing topic areas, including new or improved techniques 
to assess the health effects of interventions; 
‘‘(C) improved integration with Federal Government 
health objectives and related target setting for health 
improvement; 
‘‘(D) the enhanced dissemination of recommendations; 
‘‘(E) the provision of technical assistance to those 
health care professionals, agencies and organizations that 
request help in implementing the Guide recommendations; 
and 
‘‘(F) the submission of yearly reports to Congress and 
related agencies identifying gaps in research, such as 
preventive services that receive an insufficient evidence 
statement, and recommending priority areas that deserve 
further examination, including areas related to populations 
and age groups not adequately addressed by current rec-
ommendations. 
‘‘(3) ROLE OF AGENCY.—The Agency shall provide ongoing 
administrative, research, and technical support for the oper-
ations of the Task Force, including coordinating and supporting 
the dissemination of the recommendations of the Task Force, 
ensuring adequate staff resources, and assistance to those 
organizations requesting it for implementation of the Guide’s 
recommendations. 
‘‘(4) COORDINATION WITH COMMUNITY PREVENTIVE SERVICES 
TASK FORCE.—The Task Force shall take appropriate steps to 
coordinate its work with the Community Preventive Services 
Task Force and the Advisory Committee on Immunization Prac-
tices, including the examination of how each task force’s rec-
ommendations interact at the nexus of clinic and community.
H. R. 3590—425 
‘‘(5) OPERATION.—Operation. In carrying out the duties 
under paragraph (2), the Task Force is not subject to the 
provisions of Appendix 2 of title 5, United States Code. 
‘‘(6) INDEPENDENCE.—All members of the Task Force con-
vened under this subsection, and any recommendations made 
by such members, shall be independent and, to the extent 
practicable, not subject to political pressure. 
‘‘(7) 
AUTHORIZATION
OF
APPROPRIATIONS.—There 
are 
authorized to be appropriated such sums as may be necessary 
for each fiscal year to carry out the activities of the Task 
Force.’’. 
(b) COMMUNITY PREVENTIVE SERVICES TASK FORCE.— 
(1) IN GENERAL.—Part P of title III of the Public Health 
Service Act, as amended by paragraph (2), is amended by 
adding at the end the following: 
‘‘SEC. 399U. COMMUNITY PREVENTIVE SERVICES TASK FORCE. 
‘‘(a) ESTABLISHMENT AND PURPOSE.—The Director of the Cen-
ters for Disease Control and Prevention shall convene an inde-
pendent Community Preventive Services Task Force (referred to 
in this subsection as the ‘Task Force’) to be composed of individuals 
with appropriate expertise. Such Task Force shall review the sci-
entific evidence related to the effectiveness, appropriateness, and 
cost-effectiveness of community preventive interventions for the 
purpose of developing recommendations, to be published in the 
Guide to Community Preventive Services (referred to in this section 
as the ‘Guide’), for individuals and organizations delivering popu-
lation-based services, including primary care professionals, health 
care 
systems, 
professional 
societies, 
employers, 
community 
organizations, non-profit organizations, schools, governmental 
public health agencies, Indian tribes, tribal organizations and urban 
Indian organizations, medical groups, Congress and other policy- 
makers. Community preventive services include any policies, pro-
grams, processes or activities designed to affect or otherwise 
affecting health at the population level. 
‘‘(b) DUTIES.—The duties of the Task Force shall include— 
‘‘(1) the development of additional topic areas for new rec-
ommendations and interventions related to those topic areas, 
including those related to specific populations and age groups, 
as well as the social, economic and physical environments that 
can have broad effects on the health and disease of populations 
and health disparities among sub-populations and age groups; 
‘‘(2) at least once during every 5-year period, review inter-
ventions and update recommendations related to existing topic 
areas, including new or improved techniques to assess the 
health effects of interventions, including health impact assess-
ment and population health modeling; 
‘‘(3) improved integration with Federal Government health 
objectives and related target setting for health improvement; 
‘‘(4) the enhanced dissemination of recommendations; 
‘‘(5) the provision of technical assistance to those health 
care professionals, agencies, and organizations that request 
help in implementing the Guide recommendations; and 
‘‘(6) providing yearly reports to Congress and related agen-
cies identifying gaps in research and recommending priority 
areas that deserve further examination, including areas related