1120 
SEC. 2525. NO CHILD LEFT UNIMMUNIZED AGAINST INFLU-
ENZA: DEMONSTRATION PROGRAM USING EL-
EMENTARY AND SECONDARY SCHOOLS AS IN-
FLUENZA VACCINATION CENTERS. 
(a) PURPOSE.—The Secretary of Health and Human 
Services, in consultation with the Secretary of Education 
and the Secretary of Labor, shall award grants to eligible 
partnerships to carry out demonstration programs designed 
to test the feasibility of using the Nation’s elementary 
schools and secondary schools as influenza vaccination cen-
ters. 
(b) IN GENERAL.—The Secretary shall coordinate with 
the Secretary of Labor, the Secretary of Education, State 
Medicaid agencies, State insurance agencies, and private 
insurers to carry out a program consisting of awarding 
grants under subsection (c) to ensure that children have cov-
erage for all reasonable and customary expenses related to 
influenza vaccinations, including the costs of purchasing 
and administering the vaccine incurred when influenza 
vaccine is administered outside of the physician’s office in 
a school or other related setting. 
(c) PROGRAM DESCRIPTION.— 
(1) GRANTS.—From amounts appropriated pur-
suant to subsection (l), the Secretary shall award 
grants to eligible partnerships to be used to provide 
influenza vaccinations to children in elementary and 
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secondary schools, in coordination with school nurses, 
school health care programs, community health care 
providers, State insurance agencies, or private insur-
ers. 
(2) ACIP RECOMMENDATIONS.—The program 
under this section shall be designed to administer vac-
cines consistent with the recommendations of the Cen-
ters for Disease Control and Prevention’s Advisory 
Committee on Immunization Practices (ACIP) for the 
annual vaccination of all children 5 through 19 years 
of age. 
(3) PARTICIPATION
VOLUNTARY.—Participation 
by a school or an individual shall be voluntary. 
(d) USE OF FUNDS.—Eligible partnerships receiving 
a grant under this section shall ensure the maximum num-
ber of children access influenza vaccinations as follows: 
(1) COVERED CHILDREN.—To the extent to which 
payment of the costs of purchasing and administering 
the influenza vaccine for children is not covered 
through other federally funded programs or through 
private insurance, eligible partnerships receiving a 
grant shall use funds to purchase and administer in-
fluenza vaccinations. 
(2) CHILDREN
COVERED
BY
OTHER
FEDERAL 
PROGRAMS.—For children who are eligible under 
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other federally funded programs for payment of the 
costs of purchasing and administering the influenza 
vaccine, eligible partnerships receiving a grant shall 
not use funds provided under this section for such 
costs. 
(3) CHILDREN COVERED BY PRIVATE HEALTH IN-
SURANCE.—For children who have private insurance, 
eligible partnerships receiving a grant shall offer as-
sistance in accessing coverage for vaccinations admin-
istered through the program under this section. 
(e) PRIVACY.—The Secretary shall ensure that the pro-
gram under this section adheres to confidentiality and pri-
vacy requirements of section 264 of the Health Insurance 
Portability and Accountability Act of 1996 (42 U.S.C. 
1320d–2 note) and section 444 of the General Education 
Provisions Act (20 U.S.C. 1232g; commonly referred to as 
the ‘‘Family Educational Rights and Privacy Act of 
1974’’). 
(f) APPLICATION.—An eligible partnership desiring a 
grant under this section shall submit an application to the 
Secretary at such time, in such manner, and containing 
such information as the Secretary may require. 
(g) DURATION.—Eligible partnerships receiving a 
grant shall administer a demonstration program funded 
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through this section over a period of 2 consecutive school 
years. 
(h) CHOICE OF VACCINE.—The program under this 
section shall not restrict the discretion of a health care pro-
vider to administer any influenza vaccine approved by the 
Food and Drug Administration for use in pediatric popu-
lations. 
(i) AWARDS.—The Secretary shall award— 
(1) a minimum of 10 grants in 10 different 
States to eligible partnerships that each include one 
or more public schools serving primarily low-income 
students; and 
(2) a minimum of 5 grants in 5 different States 
to eligible partnerships that each include one or more 
public schools located in a rural local education agen-
cy. 
(j) REPORT.—Not later than 90 days following the 
completion of the program under this section, the Secretary 
shall submit to the Committees on Education and Labor, 
Energy and Commerce, and Appropriations of the House 
of Representatives and to the Committees on Health, Edu-
cation, Labor, and Pensions and Appropriations of the Sen-
ate a report on the results of the program. The report shall 
include— 
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(1) an assessment of the influenza vaccination 
rates of school-age children in localities where the pro-
gram is implemented, compared to the national aver-
age influenza vaccination rates for school-aged chil-
dren, including whether school-based vaccination as-
sists in achieving the recommendations of the Advi-
sory Committee on Immunization Practices for an-
nual influenza vaccination of all children 6 months 
to 18 years of age; 
(2) an assessment of the utility of employing ele-
mentary schools and secondary schools as a part of a 
multistate, community-based pandemic response pro-
gram that is consistent with existing Federal and 
State pandemic response plans; 
(3) an assessment of the feasibility of using exist-
ing Federal and private insurance funding in estab-
lishing a multistate, school-based vaccination pro-
gram for seasonal influenza vaccination; 
(4) an assessment of the number of education 
days gained by students as a result of seasonal vac-
cinations based on absenteeism rates; 
(5) a determination of whether the program 
under this section— 
(A) increased vaccination rates in the par-
ticipating localities; and 
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(B) was implemented for sufficient time for 
gathering enough valid data; and 
(6) a recommendation on whether the program 
should be continued, expanded, or terminated. 
(k) DEFINITIONS.—In this section: 
(1) ELIGIBLE PARTNERSHIP.—The term ‘‘eligible 
partnership’’ means a local public health department, 
or another health organization defined by the Sec-
retary as eligible to submit an application, and one 
or more elementary and secondary schools. 
(2) ELEMENTARY SCHOOL.—The terms ‘‘elemen-
tary school’ ’’ and ‘‘secondary school’’ have the mean-
ings given such terms in section 9101 of the Elemen-
tary and Secondary Education Act of 1965 (20 
U.S.C. 7801). 
(3) 
LOW-INCOME.—The 
term 
‘‘low-income’’ 
means a student, age 5 through 19, eligible for free or 
reduced-price lunch under the National School Lunch 
Act (42 U.S.C. 1751 et seq.). 
(4) RURAL LOCAL EDUCATIONAL AGENCY.—The 
term ‘‘rural local educational agency’’ means an eligi-
ble local educational agency described in section 
6211(b)(1) of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 7345(b)(1)). 
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(5) SECRETARY.—Except as otherwise specified, 
the term ‘‘Secretary’’ means the Secretary of Health 
and Human Services. 
(l) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary. 
SEC. 2526. EXTENSION OF WISEWOMAN PROGRAM. 
Section 1509 of the Public Health Service Act (42 
U.S.C. 300n–4a) is amended— 
(1) in subsection (a)— 
(A) by striking the heading and inserting 
‘‘IN GENERAL.—’’; and 
(B) in the matter preceding paragraph (1), 
by striking ‘‘may make grants’’ and all that fol-
lows through ‘‘purpose’’ and inserting the fol-
lowing: ‘‘may make grants to such States for the 
purpose’’; and 
(2) in subsection (d)(1), by striking ‘‘there are 
authorized’’ and all that follows through the period 
and inserting ‘‘there are authorized to be appro-
priated $70,000,000 for fiscal year 2010, $73,500,000 
for fiscal year 2011, $77,000,000 for fiscal year 2012, 
$81,000,000 for fiscal year 2013, and $85,000,000 for 
fiscal year 2014.’’. 
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SEC. 2527. HEALTHY TEEN INITIATIVE TO PREVENT TEEN 
PREGNANCY. 
Part B of title III (42 U.S.C. 243 et seq.) is amended 
by inserting after section 317T the following: 
‘‘SEC. 317U. HEALTHY TEEN INITIATIVE TO PREVENT TEEN 
PREGNANCY. 
‘‘(a) PROGRAM.—To the extent and in the amount of 
appropriations made in advance in appropriations Acts, 
the Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, shall establish a pro-
gram consisting of making grants, in amounts determined 
under subsection (c), to each State that submits an applica-
tion in accordance with subsection (d) for an evidence-based 
education program described in subsection (b). 
‘‘(b) USE OF FUNDS.—Amounts received by a State 
under this section shall be used to conduct or support evi-
dence-based education programs (directly or through grants 
or contracts to public or private nonprofit entities, includ-
ing schools and community-based and faith-based organiza-
tions) to reduce teen pregnancy or sexually transmitted dis-
eases. 
‘‘(c) DISTRIBUTION OF FUNDS.—The Director shall, 
for fiscal year 2010 and each subsequent fiscal year, make 
a grant to each State described in subsection (a) in an 
amount equal to the product of— 
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‘‘(1) the amount appropriated to carry out this 
section for the fiscal year; and 
‘‘(2) the percentage determined for the State 
under section 502(c)(1)(B)(ii) of the Social Security 
Act. 
‘‘(d) APPLICATION.—To seek a grant under this sec-
tion, a State shall submit an application at such time, in 
such manner, and containing such information and assur-
ance of compliance with this section as the Secretary may 
require. At a minimum, an application shall to the satisfac-
tion of the Secretary— 
‘‘(1) describe how the State’s proposal will ad-
dress the needs of at-risk teens in the State; 
‘‘(2) identify the evidence-based education pro-
gram or programs selected from the registry developed 
under subsection (g) that will be used to address risks 
in priority populations; 
‘‘(3) describe how the program or programs will 
be implemented and any adaptations to the evidence- 
based model that will be made; 
‘‘(4) list any private and public entities with 
whom the State proposes to work, including schools 
and community-based and faith-based organizations, 
and demonstrate their capacity to implement the pro-
posed program or programs; and 
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‘‘(5) identify an independent entity that will 
evaluate the impact of the program or programs. 
‘‘(e) EVALUATION.— 
‘‘(1) REQUIREMENT.—As a condition on receipt 
of a grant under this section, a State shall agree— 
‘‘(A) to arrange for an independent evalua-
tion of the impact of the programs to be con-
ducted or supported through the grant; and 
‘‘(B) submit reports to the Secretary on 
such programs and the results of evaluation of 
such programs. 
‘‘(2) FUNDING
LIMITATION.—Of the amounts 
made available to a State through a grant under this 
section for any fiscal year, not more than 10 percent 
may be used for such evaluation. 
‘‘(f) RULE OF CONSTRUCTION.—This section shall not 
be construed to preempt or limit any State law regarding 
parental involvement and decisionmaking in children’s 
education. 
‘‘(g) REGISTRY OF ELIGIBLE PROGRAMS.—The Sec-
retary shall develop not later than 180 days after the date 
of the enactment of the America’s Affordable Health Choices 
Act of 2009, and periodically update thereafter, a publicly 
available registry of programs described in subsection (b) 
that, as determined by the Secretary— 
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SEC. 2545. DENTAL EMERGENCY RESPONDERS: PUBLIC 
HEALTH AND MEDICAL RESPONSE. 
(a) NATIONAL HEALTH SECURITY STRATEGY.—Sec-
tion 2802(b)(3) (42 U.S.C. 300hh–1(b)(3)) is amended— 
(1) in the matter preceding subparagraph (A), 
by inserting ‘‘dental and’’ before ‘‘mental health fa-
cilities’’; and 
(2) in subparagraph (D), by inserting ‘‘and den-
tal’’ after ‘‘medical’’. 
(b) ALL-HAZARDS PUBLIC HEALTH AND MEDICAL RE-
SPONSE
CURRICULA
AND
TRAINING.—Section 
319F(a)(5)(B) (42 U.S.C. 247d–6(a)(5)(B)) is amended by 
striking ‘‘public health or medical’’ and inserting ‘‘public 
health, medical, or dental’’. 
SEC. 2546. DENTAL EMERGENCY RESPONDERS: HOMELAND 
SECURITY. 
(a) NATIONAL RESPONSE FRAMEWORK.—Paragraph 
(6) of section 2 of the Homeland Security Act of 2002 (6 
U.S.C. 101) is amended by inserting ‘‘and dental’’ after 
‘‘emergency medical’’. 
(b) NATIONAL PREPAREDNESS SYSTEM.—Subpara-
graph (B) of section 653(b)(4) of the Post-Katrina Emer-
gency Management Reform Act of 2006 (6 U.S.C. 753(b)(4)) 
is amended by striking ‘‘public health and medical’’ and 
inserting ‘‘public health, medical, and dental’’. 
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the reference product if the Secretary determines that 
the information submitted in the application (or a 
supplement to such application) is sufficient to show 
that— 
‘‘(A) the biological product— 
‘‘(i) is biosimilar to the reference prod-
uct; and 
‘‘(ii) can be expected to produce the 
same clinical result as the reference product 
in any given patient; and 
‘‘(B) for a biological product that is admin-
istered more than once to an individual, the risk 
in terms of safety or diminished efficacy of alter-
nating or switching between use of the biological 
product and the reference product is not greater 
than the risk of using the reference product with-
out such alternation or switch. 
‘‘(5) GENERAL RULES.— 
‘‘(A) ONE REFERENCE PRODUCT PER APPLI-
CATION.—A biological product, in an applica-
tion submitted under this subsection, may not be 
evaluated against more than 1 reference product. 
‘‘(B) REVIEW.—An application submitted 
under this subsection shall be reviewed by the di-
vision within the Food and Drug Administra-
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evant patent after the date on which the ref-
erence product sponsor provides the list re-
quired by clause (ii) to the applicant, the 
reference product sponsor shall identify that 
patent to the applicant within 30 days of 
the date of issue of the patent, or the date 
of acquisition of the interest in the patent, 
as applicable. 
‘‘(B) EXCHANGES WITH INTERESTED THIRD 
PARTIES.— 
‘‘(i) At any time after the date on 
which the Secretary publishes a notice for 
an application under paragraph (3), any 
interested third party may provide notice to 
the designated agent of the applicant that 
the interested third party owns or has 
rights under 1 or more patents that may be 
relevant patents. The notice shall identify at 
least 1 patent and shall designate an indi-
vidual who has executed an agreement in 
accordance with paragraph (2) to receive 
confidential information from the appli-
cant. 
‘‘(ii) Within 30 days of the date of re-
ceiving notice pursuant to clause (i), the 
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applicant shall send to the individual des-
ignated by the interested third party the in-
formation specified in subparagraph (A)(i), 
unless the applicant and interested third 
party otherwise agree. 
‘‘(iii) Within 90 days of the date of re-
ceiving information pursuant to clause (ii), 
the interested third party shall provide to 
the applicant a list of relevant patents 
which the interested third party owns, or in 
respect of which the interested third party 
has the right to commence or participate in 
an action for infringement. 
‘‘(iv) If the interested third party is 
issued or acquires an interest in a relevant 
patent after the date on which the interested 
third party provides the list required by 
clause (iii), the interested third party shall 
identify that patent within 30 days of the 
date of issue of the patent, or the date of ac-
quisition of the interest in the patent, as 
applicable. 
‘‘(C) IDENTIFICATION
OF
BASIS
FOR
IN-
FRINGEMENT.—For any patent identified under 
clause (ii) or (iii) of subparagraph (A) or under 
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tions that explain in a prac-
tical manner what is required. 
‘‘(V) 
The 
organization 
must have taken reasonable 
steps to achieve compliance 
with its standards, such as by 
utilizing monitoring and au-
diting systems reasonably de-
signed 
to 
detect 
criminal, 
civil, and administrative vio-
lations under this Act by its 
employees and other agents 
and by having in place and 
publicizing a reporting sys-
tem whereby employees and 
other agents could report vio-
lations by others within the 
organization without fear of 
retribution. 
‘‘(VI) The standards must 
have been consistently en-
forced 
through 
appropriate 
disciplinary mechanisms, in-
cluding, as appropriate, dis-
cipline of individuals respon-
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‘‘(l) RESERVATIONS
OF FUNDS.—From the 
amounts appropriated for a fiscal year under 
subsection (m), the Secretary shall reserve— 
‘‘(1) an amount equal to 5 percent of 
the amounts to pay the cost of the evalua-
tion provided for in subsection (j), and 
the provision to States of training and 
technical assistance, including the dis-
semination of best practices in early 
childhood home visitation; and 
‘‘(2) after making the reservation re-
quired by paragraph (1), an amount equal 
to 3 percent of the amount so appro-
priated, to pay for grants to Indian tribes 
under this section. 
‘‘(m) APPROPRIATIONS.—Out of any money 
in the Treasury of the United States not other-
wise appropriated, there is appropriated to 
the Secretary to carry out this section— 
‘‘(1) $50,000,000 for fiscal year 2010; 
‘‘(2) $100,000,000 for fiscal year 2011; 
‘‘(3) $150,000,000 for fiscal year 2012; 
‘‘(4) $200,000,000 for fiscal year 2013; 
and 
‘‘(5) $250,000,000 for fiscal year 2014. 
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surance to employees of such employers 
through the Health Insurance Exchange. 
(2) DUTIES.—The program established 
under paragraph (1) shall include the fol-
lowing services: 
(A) Educational activities to in-
crease awareness of the Health Insur-
ance Exchange and available small 
employer health plan options. 
(B) Distribution of information to 
small employers with respect to the 
enrollment and selection process for 
health plans available under the 
Health Insurance Exchange, includ-
ing standardized comparative infor-
mation on the health plans available 
under 
the 
Health 
Insurance 
Ex-
change. 
(C) Distribution of information to 
small employers with respect to avail-
able affordability credits or other fi-
nancial assistance. 
(D) Referrals to appropriate enti-
ties of complaints and questions relat-
ing to the Health Insurance Exchange. 
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accordance with the requirements of this 
subtitle. 
(3) EFFECTIVENESS.—The ceasing or 
termination of a State-based Health In-
surance Exchange under this subsection 
shall be effective in such time and man-
ner as the Commissioner shall specify. 
(d) RETENTION OF AUTHORITY.— 
(1) 
AUTHORITY
RETAINED.—Enforce-
ment authorities of the Commissioner 
shall be retained by the Commissioner. 
(2) DISCRETION TO RETAIN ADDITIONAL 
AUTHORITY.—The Commissioner may speci-
fy functions of the Health Insurance Ex-
change that— 
(A) may not be performed by a 
State-based 
Health 
Insurance 
Ex-
change under this section; or 
(B) may be performed by the Com-
missioner and by such a State-based 
Health Insurance Exchange. 
(e) REFERENCES.—In the case of a State- 
based Health Insurance Exchange, except as 
the Commissioner may otherwise specify under 
subsection (d), any references in this subtitle 
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