1177 
‘‘Subpart 3—Support for Quality Home Visitation 
Programs 
‘‘SEC. 440. HOME VISITATION PROGRAMS FOR FAMILIES 
WITH YOUNG CHILDREN AND FAMILIES EX-
PECTING CHILDREN. 
‘‘(a) PURPOSE.—The purpose of this section is to im-
prove the well-being, health, and development of children 
by enabling the establishment and expansion of high qual-
ity programs providing voluntary home visitation for fami-
lies with young children and families expecting children. 
‘‘(b) GRANT APPLICATION.—A State that desires to 
receive a grant under this section shall submit to the Sec-
retary for approval, at such time and in such manner as 
the Secretary may require, an application for the grant 
that includes the following: 
‘‘(1) DESCRIPTION OF HOME VISITATION PRO-
GRAMS.—A description of the high quality programs 
of home visitation for families with young children 
and families expecting children that will be sup-
ported by a grant made to the State under this sec-
tion, the outcomes the programs are intended to 
achieve, and the evidence supporting the effective-
ness of the programs. 
‘‘(2) RESULTS OF NEEDS ASSESSMENT.—The 
results of a statewide needs assessment that de-
scribes— 
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‘‘(A) the number, quality, and capacity of 
home visitation programs for families with 
young children and families expecting children 
in the State; 
‘‘(B) the number and types of families who 
are receiving services under the programs; 
‘‘(C) the sources and amount of funding 
provided to the programs; 
‘‘(D) the gaps in home visitation in the 
State, including identification of communities 
that are in high need of the services; and 
‘‘(E) training and technical assistance ac-
tivities designed to achieve or support the goals 
of the programs. 
‘‘(3) ASSURANCES.—Assurances from the State 
that— 
‘‘(A) in supporting home visitation pro-
grams using funds provided under this section, 
the State shall identify and prioritize serving 
communities that are in high need of such serv-
ices, especially communities with a high propor-
tion of low-income families or a high incidence 
of child maltreatment; 
‘‘(B) the State will reserve 5 percent of the 
grant funds for training and technical assist-
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ance to the home visitation programs using 
such funds; 
‘‘(C) in supporting home visitation pro-
grams using funds provided under this section, 
the State will promote coordination and collabo-
ration with other home visitation programs (in-
cluding programs funded under title XIX) and 
with other child and family services, health 
services, income supports, and other related as-
sistance; 
‘‘(D) home visitation programs supported 
using such funds will, when appropriate, pro-
vide referrals to other programs serving chil-
dren and families; and 
‘‘(E) the State will comply with subsection 
(i), and cooperate with any evaluation con-
ducted under subsection (j). 
‘‘(4) OTHER INFORMATION.—Such other infor-
mation as the Secretary may require. 
‘‘(c) ALLOTMENTS.— 
‘‘(1) INDIAN
TRIBES.—From the amount re-
served under subsection (l)(2) for a fiscal year, the 
Secretary shall allot to each Indian tribe that meets 
the requirement of subsection (d), if applicable, for 
the fiscal year the amount that bears the same ratio 
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to the amount so reserved as the number of children 
in the Indian tribe whose families have income that 
does not exceed 200 percent of the poverty line bears 
to the total number of children in such Indian tribes 
whose families have income that does not exceed 200 
percent of the poverty line. 
‘‘(2) STATES
AND
TERRITORIES.—From the 
amount appropriated under subsection (m) for a fis-
cal year that remains after making the reservations 
required by subsection (l), the Secretary shall allot 
to each State that is not an Indian tribe and that 
meets the requirement of subsection (d), if applica-
ble, for the fiscal year the amount that bears the 
same ratio to the remainder of the amount so appro-
priated as the number of children in the State whose 
families have income that does not exceed 200 per-
cent of the poverty line bears to the total number of 
children in such States whose families have income 
that does not exceed 200 percent of the poverty line. 
‘‘(3) REALLOTMENTS.—The amount of any al-
lotment to a State under a paragraph of this sub-
section for any fiscal year that the State certifies to 
the Secretary will not be expended by the State pur-
suant to this section shall be available for reallot-
ment using the allotment methodology specified in 
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that paragraph. Any amount so reallotted to a State 
is deemed part of the allotment of the State under 
this subsection. 
‘‘(d) MAINTENANCE OF EFFORT.—Beginning with 
fiscal year 2011, a State meets the requirement of this 
subsection for a fiscal year if the Secretary finds that the 
aggregate expenditures by the State from State and local 
sources for programs of home visitation for families with 
young children and families expecting children for the then 
preceding fiscal year was not less than 100 percent of such 
aggregate expenditures for the then 2nd preceding fiscal 
year. 
‘‘(e) PAYMENT OF GRANT.— 
‘‘(1) IN GENERAL.—The Secretary shall make a 
grant to each State that meets the requirements of 
subsections (b) and (d), if applicable, for a fiscal 
year for which funds are appropriated under sub-
section (m), in an amount equal to the reimbursable 
percentage of the eligible expenditures of the State 
for the fiscal year, but not more than the amount 
allotted to the State under subsection (c) for the fis-
cal year. 
‘‘(2) REIMBURSABLE PERCENTAGE DEFINED.— 
In paragraph (1), the term ‘reimbursable percent-
age’ means, with respect to a fiscal year— 
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‘‘(A) 85 percent, in the case of fiscal year 
2010; 
‘‘(B) 80 percent, in the case of fiscal year 
2011; or 
‘‘(C) 75 percent, in the case of fiscal year 
2012 and any succeeding fiscal year. 
‘‘(f) ELIGIBLE EXPENDITURES.— 
‘‘(1) IN GENERAL.—In this section, the term 
‘eligible expenditures’— 
‘‘(A) means expenditures to provide vol-
untary home visitation for as many families 
with young children (under the age of school 
entry) and families expecting children as prac-
ticable, through the implementation or expan-
sion of high quality home visitation programs 
that— 
‘‘(i) adhere to clear evidence-based 
models of home visitation that have dem-
onstrated positive effects on important pro-
gram-determined child and parenting out-
comes, such as reducing abuse and neglect 
and improving child health and develop-
ment; 
‘‘(ii) employ well-trained and com-
petent staff, maintain high quality super-
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vision, provide for ongoing training and 
professional development, and show strong 
organizational capacity to implement such 
a program; 
‘‘(iii) establish appropriate linkages 
and referrals to other community resources 
and supports; 
‘‘(iv) monitor fidelity of program im-
plementation to ensure that services are 
delivered according to the specified model; 
and 
‘‘(v) provide parents with— 
‘‘(I) knowledge of age-appro-
priate child development in cognitive, 
language, social, emotional, and motor 
domains (including knowledge of sec-
ond language acquisition, in the case 
of English language learners); 
‘‘(II) knowledge of realistic ex-
pectations of age-appropriate child be-
haviors; 
‘‘(III) knowledge of health and 
wellness issues for children and par-
ents; 
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‘‘(IV) modeling, consulting, and 
coaching on parenting practices; 
‘‘(V) skills to interact with their 
child to enhance age-appropriate de-
velopment; 
‘‘(VI) skills to recognize and seek 
help for issues related to health, devel-
opmental delays, and social, emo-
tional, and behavioral skills; and 
‘‘(VII) activities designed to help 
parents become full partners in the 
education of their children; 
‘‘(B) includes expenditures for training, 
technical assistance, and evaluations related to 
the programs; and 
‘‘(C) does not include any expenditure with 
respect to which a State has submitted a claim 
for payment under any other provision of Fed-
eral law. 
‘‘(2) PRIORITY FUNDING FOR PROGRAMS WITH 
STRONGEST EVIDENCE.— 
‘‘(A) IN GENERAL.—The expenditures, de-
scribed in paragraph (1), of a State for a fiscal 
year that are attributable to the cost of pro-
grams that do not adhere to a model of home 
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visitation with the strongest evidence of effec-
tiveness shall not be considered eligible expendi-
tures for the fiscal year to the extent that the 
total of the expenditures exceeds the applicable 
percentage for the fiscal year of the allotment 
of the State under subsection (c) for the fiscal 
year. 
‘‘(B) 
APPLICABLE
PERCENTAGE
DE-
FINED.—In subparagraph (A), the term ‘appli-
cable percentage’ means, with respect to a fiscal 
year— 
‘‘(i) 60 percent for fiscal year 2010; 
‘‘(ii) 55 percent for fiscal year 2011; 
‘‘(iii) 50 percent for fiscal year 2012; 
‘‘(iv) 45 percent for fiscal year 2013; 
or 
‘‘(v) 40 percent for fiscal year 2014. 
‘‘(g) NO USE
OF OTHER FEDERAL FUNDS
FOR 
STATE MATCH.—A State to which a grant is made under 
this section may not expend any Federal funds to meet 
the State share of the cost of an eligible expenditure for 
which the State receives a payment under this section. 
‘‘(h) WAIVER AUTHORITY.— 
‘‘(1) IN GENERAL.—The Secretary may waive 
or modify the application of any provision of this 
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section, other than subsection (b) or (f), to an In-
dian tribe if the failure to do so would impose an 
undue burden on the Indian tribe. 
‘‘(2) SPECIAL
RULE.—An Indian tribe is 
deemed to meet the requirement of subsection (d) 
for purposes of subsections (c) and (e) if— 
‘‘(A) the Secretary waives the requirement; 
or 
‘‘(B) the Secretary modifies the require-
ment, and the Indian tribe meets the modified 
requirement. 
‘‘(i) STATE REPORTS.—Each State to which a grant 
is made under this section shall submit to the Secretary 
an annual report on the progress made by the State in 
addressing the purposes of this section. Each such report 
shall include a description of— 
‘‘(1) the services delivered by the programs that 
received funds from the grant; 
‘‘(2) the characteristics of each such program, 
including information on the service model used by 
the program and the performance of the program; 
‘‘(3) the characteristics of the providers of serv-
ices through the program, including staff qualifica-
tions, work experience, and demographic characteris-
tics; 
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‘‘(4) the characteristics of the recipients of serv-
ices provided through the program, including the 
number of the recipients, the demographic charac-
teristics of the recipients, and family retention; 
‘‘(5) the annual cost of implementing the pro-
gram, including the cost per family served under the 
program; 
‘‘(6) the outcomes experienced by recipients of 
services through the program; 
‘‘(7) the training and technical assistance pro-
vided to aid implementation of the program, and 
how the training and technical assistance contrib-
uted to the outcomes achieved through the program; 
‘‘(8) the indicators and methods used to mon-
itor whether the program is being implemented as 
designed; and 
‘‘(9) other information as determined necessary 
by the Secretary. 
‘‘(j) EVALUATION.— 
‘‘(1) IN
GENERAL.—The Secretary shall, by 
grant or contract, provide for the conduct of an 
independent evaluation of the effectiveness of home 
visitation programs receiving funds provided under 
this section, which shall examine the following: 
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‘‘(A) The effect of home visitation pro-
grams on child and parent outcomes, including 
child maltreatment, child health and develop-
ment, school readiness, and links to community 
services. 
‘‘(B) The effectiveness of home visitation 
programs on different populations, including 
the extent to which the ability of programs to 
improve outcomes varies across programs and 
populations. 
‘‘(2) REPORTS TO THE CONGRESS.— 
‘‘(A) INTERIM
REPORT.—Within 3 years 
after the date of the enactment of this section, 
the Secretary shall submit to the Congress an 
interim report on the evaluation conducted pur-
suant to paragraph (1). 
‘‘(B) FINAL
REPORT.—Within 5 years 
after the date of the enactment of this section, 
the Secretary shall submit to the Congress a 
final report on the evaluation conducted pursu-
ant to paragraph (1). 
‘‘(k) ANNUAL REPORTS TO THE CONGRESS.—The 
Secretary shall submit annually to the Congress a report 
on the activities carried out using funds made available 
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under this section, which shall include a description of the 
following: 
‘‘(1) The high need communities targeted by 
States for programs carried out under this section. 
‘‘(2) The service delivery models used in the 
programs receiving funds provided under this sec-
tion. 
‘‘(3) The characteristics of the programs, in-
cluding— 
‘‘(A) the qualifications and demographic 
characteristics of program staff; and 
‘‘(B) recipient characteristics including the 
number of families served, the demographic 
characteristics of the families served, and fam-
ily retention and duration of services. 
‘‘(4) The outcomes reported by the programs. 
‘‘(5) The research-based instruction, materials, 
and activities being used in the activities funded 
under the grant. 
‘‘(6) The training and technical activities, in-
cluding on-going professional development, provided 
to the programs. 
‘‘(7) The annual costs of implementing the pro-
grams, including the cost per family served under 
the programs. 
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‘‘(8) The indicators and methods used by States 
to monitor whether the programs are being been im-
plemented as designed. 
‘‘(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 evaluation 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 required by 
paragraph (1), an amount equal to 3 percent of the 
amount so appropriated, to pay for grants to Indian 
tribes under this section. 
‘‘(m) APPROPRIATIONS.—Out of any money in the 
Treasury of the United States not otherwise 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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‘‘(n) INDIAN TRIBES TREATED AS STATES.—In this 
section, paragraphs (4), (5), and (6) of section 431(a) 
shall apply.’’. 
SEC. 1905. IMPROVED COORDINATION AND PROTECTION 
FOR DUAL ELIGIBLES. 
Title XI of the Social Security Act is amended by 
inserting after section 1150 the following new section: 
‘‘IMPROVED COORDINATION AND PROTECTION FOR DUAL 
ELIGIBLES 
‘‘SEC. 1150A. (a) IN GENERAL.—The Secretary shall 
provide, through an identifiable office or program within 
the Centers for Medicare & Medicaid Services, for a fo-
cused effort to provide for improved coordination between 
Medicare and Medicaid and protection in the case of dual 
eligibles (as defined in subsection (g)). The office or pro-
gram shall— 
‘‘(1) review Medicare and Medicaid policies re-
lated to enrollment, benefits, service delivery, pay-
ment, and grievance and appeals processes under 
parts A and B of title XVIII, under the Medicare 
Advantage program under part C of such title, and 
under title XIX; 
‘‘(2) identify areas of such policies where better 
coordination and protection could improve care and 
costs; and 
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‘‘(3) issue guidance to States regarding improv-
ing such coordination and protection. 
‘‘(b) ELEMENTS.—The improved coordination and 
protection under this section shall include efforts— 
‘‘(1) to simplify access of dual eligibles to bene-
fits and services under Medicare and Medicaid; 
‘‘(2) to improve care continuity for dual eligi-
bles and ensure safe and effective care transitions; 
‘‘(3) to harmonize regulatory conflicts between 
Medicare and Medicaid rules with regard to dual eli-
gibles; and 
‘‘(4) to improve total cost and quality perform-
ance under Medicare and Medicaid for dual eligibles. 
‘‘(c) RESPONSIBILITIES.—In carrying out this sec-
tion, the Secretary shall provide for the following: 
‘‘(1) An examination of Medicare and Medicaid 
payment systems to develop strategies to foster more 
integrated and higher quality care. 
‘‘(2) Development of methods to facilitate ac-
cess to post-acute and community-based services and 
to identify actions that could lead to better coordina-
tion of community-based care. 
‘‘(3) A study of enrollment of dual eligibles in 
the Medicare Savings Program (as defined in section 
1144(c)(7)), under Medicaid, and in the low-income 
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subsidy program under section 1860D–14 to identify 
methods to more efficiently and effectively reach and 
enroll dual eligibles. 
‘‘(4) An assessment of communication strate-
gies for dual eligibles to determine whether addi-
tional informational materials or outreach is needed, 
including an assessment of the Medicare website, 1– 
800–MEDICARE, and the Medicare handbook. 
‘‘(5) Research and evaluation of areas where 
service utilization, quality, and access to cost sharing 
protection could be improved and an assessment of 
factors related to enrollee satisfaction with services 
and care delivery. 
‘‘(6) Collection (and making available to the 
public) of data and a database that describe the eli-
gibility, benefit and cost-sharing assistance available 
to dual eligibles by State. 
‘‘(7) Support for coordination of State and Fed-
eral contracting and oversight for dual coordination 
programs supportive of the goals described in sub-
section (b). 
‘‘(8) Support for State Medicaid agencies 
through the provision of technical assistance for 
Medicare and Medicaid coordination initiatives de-
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signed to improve acute and long-term care for dual 
eligibles. 
‘‘(9) Monitoring total combined Medicare and 
Medicaid program costs in serving dual eligibles and 
making recommendations for optimizing total quality 
and cost performance across both programs. 
‘‘(10) Coordination of activities relating to 
Medicare Advantage plans under 1859(b)(6)(B)(ii) 
and Medicaid. 
‘‘(d) REPORTING.—The Office or program shall work 
with relevant State agencies and any appropriate quality 
measurement entities to improve and coordinate reporting 
requirements for Medicare and Medicaid. In addition, the 
Office or program shall seek to minimize duplication in 
reporting requirements, where appropriate, and to identify 
opportunities to combine assessment requirements, where 
appropriate. The Office or program shall seek to identify 
quality metrics and assessment requirements that facili-
tate comparisons of the quality of care received by bene-
ficiaries enrolled in or entitled to benefits under fee-for- 
service Medicare, the Medicare Advantage program, fee- 
for-service Medicaid, and Medicaid managed care, and 
combinations thereof (including integrated Medicare-Med-
icaid programs for dual eligibles). 
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‘‘(e) ENDORSEMENT.—The Secretary shall seek en-
dorsement by the entity with a contract under section 
1890(a) of quality measures and benchmarks developed 
under this section. 
‘‘(f) CONSULTATION WITH STAKEHOLDERS.—The 
Office or program shall consult with relevant stakeholders, 
including dual eligible beneficiaries representatives for 
dual eligible beneficiaries, health plans, providers, and rel-
evant State agencies, in the development of policies related 
to integrated Medicare-Medicaid programs for dual eligi-
bles. 
‘‘(g) PERIODIC REPORTS.—Not later than 1 year 
after the date of the enactment of this section and every 
3 years thereafter the Secretary shall submit to Congress 
a report on progress in activities conducted under this sec-
tion. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) DUAL ELIGIBLE.—The term ‘dual eligible’ 
means an individual who is dually eligible for bene-
fits under title XVIII, and medical assistance under 
title XIX, including such individuals who are eligible 
for benefits under the Medicare Savings Program 
(as defined in section 1144(c)(7)). 
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‘‘(2) MEDICARE; MEDICAID.—The terms ‘Medi-
care’ and ‘Medicaid’ mean the programs under titles 
XVIII and XIX, respectively.’’. 
SEC. 1906. ASSESSMENT OF MEDICARE COST-INTENSIVE 
DISEASES AND CONDITIONS. 
(a) INITIAL ASSESSMENT.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall conduct an assessment of the 
diseases and conditions that are the most cost-inten-
sive for the Medicare program and, to the extent 
possible, assess the diseases and conditions that 
could become cost-intensive for Medicare in the fu-
ture. In conducting the assessment, the Secretary 
shall include the input of relevant research agencies, 
including the National Institutes of Health, the 
Agency for Healthcare Research and Quality, the 
Food and Drug Administration, and the Centers for 
Medicare & Medicaid Services. 
(2) REPORT.—Not later than January 1, 2011, 
the Secretary shall transmit a report to the Commit-
tees on Energy and Commerce, Ways and Means, 
and Appropriations of the House of Representatives 
and the Committees on Health, Education, Labor 
and Pensions, Finance, and Appropriations of the 
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Senate on the assessment conducted under para-
graph (1). Such report shall— 
(A) include the assessment of current and 
future trends of cost-intensive diseases and con-
ditions described in such paragraph; 
(B) address whether current research pri-
orities are appropriately addressing current and 
future cost-intensive conditions so identified; 
and 
(C) include recommendations concerning 
research in the Department of Health and 
Human Services that should be funded to im-
prove the prevention, treatment, or cure of such 
cost-intensive diseases and conditions. 
(b) UPDATES OF ASSESSMENT.—Not later than Jan-
uary 1, 2013, and biennially thereafter, the Secretary 
shall— 
(1) review and update the assessment and rec-
ommendations described in subsection (a)(1); and 
(2) submit a report described in subsection 
(a)(2) to the Committees specified in subsection 
(a)(2) on such updated assessment and rec-
ommendations. 
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SEC. 1907. ESTABLISHMENT OF CENTER FOR MEDICARE 
AND MEDICAID INNOVATION WITHIN CMS. 
(a) IN GENERAL.—Title XI of the Social Security Act 
is amended by inserting after section 1115 the following 
new section: 
‘‘CENTER FOR MEDICARE AND MEDICAID INNOVATION 
‘‘SEC. 1115A. (a) CENTER
FOR MEDICARE
AND 
MEDICAID INNOVATION ESTABLISHED.— 
‘‘(1) IN GENERAL.—There is created within the 
Centers for Medicare & Medicaid Services a Center 
for Medicare and Medicaid Innovation (in this sec-
tion referred to as the ‘CMI’) to carry out the duties 
described in this section. The purpose of the CMI is 
to test innovative payment and service delivery mod-
els to improve the coordination, quality, and effi-
ciency of health care services provided to applicable 
individuals defined in paragraph (4)(A). 
‘‘(2) DEADLINE.—The Secretary shall ensure 
that the CMI is carrying out the duties described in 
this section by not later than January 1, 2011. 
‘‘(3) CONSULTATION.—In carrying out the du-
ties under this section, the CMI shall consult rep-
resentatives of relevant Federal agencies, clinical 
and analytical experts with expertise in medicine and 
health care management, and States. The CMI shall 
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use open door forums or other mechanisms to seek 
input from interested parties. 
‘‘(4) DEFINITIONS.—In this section: 
‘‘(A) APPLICABLE INDIVIDUAL.—The term 
‘applicable individual’ means— 
‘‘(i) an individual who is enrolled 
under part B and entitled to benefits 
under part A of title XVIII; 
‘‘(ii) an individual who is eligible for 
medical assistance under title XIX; or 
‘‘(iii) an individual who meets the cri-
teria of both clauses (i) and (ii). 
‘‘(B) APPLICABLE TITLE.—The term ‘ap-
plicable title’ means title XVIII, title XIX, or 
both. 
‘‘(b) TESTING OF MODELS (PHASE I).— 
‘‘(1) IN GENERAL.—The CMI shall test pay-
ment and service delivery models in accordance with 
selection criteria under paragraph (2) to determine 
the effect of applying such models under the applica-
ble title (as defined in subsection (a)(4)(B)) on pro-
gram expenditures under such titles and the quality 
of care received by individuals receiving benefits 
under such title. 
‘‘(2) SELECTION OF MODELS TO BE TESTED.— 
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‘‘(A) IN
GENERAL.—The Secretary shall 
give preference to testing models for which, as 
determined by the Administrator of the Centers 
for Medicare & Medicaid Services and using 
such input from outside the Centers as the Ad-
ministrator determines appropriate, there is evi-
dence that the model addresses a defined popu-
lation for which there are deficits in care lead-
ing to poor clinical outcomes or potentially 
avoidable expenditures. The Administrator shall 
focus on models expected to reduce program 
costs under the applicable title while preserving 
or enhancing the quality of care received by in-
dividuals receiving benefits under such title. 
‘‘(B) 
APPLICATION
TO
OTHER
DEM-
ONSTRATIONS.—The Secretary shall operate the 
demonstration programs under sections 1222 
and 1236 of the Affordable Health Care for 
America Act through the CMI in accordance 
with the rules applicable under this section, in-
cluding those relating to evaluations, termi-
nations, and expansions. 
‘‘(3) BUDGET NEUTRALITY.— 
‘‘(A) INITIAL
PERIOD.—The Secretary 
shall not require, as a condition for testing a 
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model under paragraph (1), that the design of 
such model ensure that such model is budget 
neutral initially with respect to expenditures 
under the applicable title. 
‘‘(B) TERMINATION.—The Secretary shall 
terminate or modify the design and implemen-
tation of a model unless the Secretary deter-
mines (and the Chief Actuary of the Centers for 
Medicare & Medicaid Services, with respect to 
spending under the applicable title, certifies), 
after testing has begun, that the model is ex-
pected to— 
‘‘(i) improve the quality of care (as 
determined by the Administrator of the 
Centers for Medicare & Medicaid Services) 
without increasing spending under such 
title; 
‘‘(ii) reduce spending under such titles 
without reducing the quality of care; or 
‘‘(iii) do both. 
Such termination may occur at any time after 
such testing has begun and before completion of 
the testing. 
‘‘(4) EVALUATION.— 
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‘‘(A) IN
GENERAL.—The Secretary shall 
conduct an evaluation of each model tested 
under this subsection. Such evaluation shall in-
clude an analysis of— 
‘‘(i) the quality of care furnished 
under the model, including through the use 
of patient-level outcomes measures; and 
‘‘(ii) the changes in spending under 
the applicable titles by reason of the 
model. 
The Secretary shall make the results of each 
evaluation under this paragraph available to the 
public in a timely fashion. 
‘‘(B) MEASURE
SELECTION.—To the ex-
tent feasible, the Secretary shall select meas-
ures under this paragraph that reflect national 
priorities for quality improvement and patient- 
centered care consistent with the measures de-
veloped under section 1192(c)(1). 
‘‘(5) TESTING
PERIOD.—In no case shall a 
model be tested under this subsection for more than 
a 7-year period. 
‘‘(c) EXPANSION OF MODELS (PHASE II).—The Sec-
retary may expand the duration and the scope of a model 
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that is being tested under subsection (b) (including imple-
mentation on a nationwide basis), to the extent deter-
mined appropriate by the Secretary, if— 
‘‘(1) the Secretary determines that such expan-
sion is expected— 
‘‘(A) to improve the quality of patient care 
without increasing spending under the applica-
ble titles; 
‘‘(B) to reduce spending under applicable 
titles without reducing the quality of care; or 
‘‘(C) to do both; 
‘‘(2) the Chief Actuary of the Centers for Medi-
care & Medicaid Services certifies that such expan-
sion would reduce (or not result in any increase in) 
net program spending under applicable titles; and 
‘‘(3) the Secretary determines that such expan-
sion would not deny or limit the coverage or provi-
sion of benefits under the applicable title for applica-
ble individuals. 
‘‘(d) IMPLEMENTATION.— 
‘‘(1) WAIVER AUTHORITY.—The Secretary may 
waive such requirements of titles XI and XVIII and 
of sections 1902 and 1903(m) as may be necessary 
solely for purposes of carrying out this section with 
respect to testing models described in subsection (b). 
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‘‘(2) LIMITATIONS ON REVIEW.—There shall be 
no administrative or judicial review under section 
1869, section 1878, or otherwise of— 
‘‘(A) the selection of models for testing or 
expansion under this section; 
‘‘(B) the elements, parameters, scope, and 
duration of such models for testing or dissemi-
nation; 
‘‘(C) the termination or modification of the 
design and implementation of a model under 
subsection (b)(3)(B); and 
‘‘(D) determinations about expansion of 
the duration and scope of a model under sub-
section (c) including the determination that a 
model is not expected to meet criteria described 
in paragraphs (1) or (2) of such subsection. 
‘‘(3) ADMINISTRATION.—Chapter 35 of title 44, 
United States Code shall not apply to the testing 
and evaluation of models or expansion of such mod-
els under this section. 
‘‘(4) FUNDING FOR TESTING ITEMS AND SERV-
ICES AND ADMINISTRATIVE COSTS.— 
‘‘(A) ADDITIONAL BENEFITS.—There shall 
be available until expended, equally divided 
from the Federal Supplementary Hospital In-
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surance Trust Fund and Federal Supple-
mentary Medical Insurance Trust Fund for 
payments for additional benefits for items and 
services under models tested under subsection 
(b) not otherwise covered under this title and 
applicable to benefits under this title, and for 
researching, designing, implementing, and eval-
uating such models, $350,000,000 for fiscal 
year 2010, $440,000,000 for fiscal year 2011, 
$550,000,000 for fiscal year 2012, and, for a 
subsequent fiscal year, the amount determined 
under this subparagraph for the preceding fis-
cal year increased by the annual percentage 
rate of increase in total expenditures under this 
title for the subsequent fiscal year as estimated 
in the latest available Annual Report of the 
Board of Trustees as described in section 
1841(b)(2). 
‘‘(B) MEDICAID.—For administrative costs 
of the Centers for Medicare & Medicaid Serv-
ices for administering this section with respect 
to title XIX, from any amounts in the Treasury 
not otherwise appropriated there are appro-
priated to the Secretary for the Centers for 
Medicare & Medicaid Services Program Man-
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agement Account $25,000,000 for each fiscal 
year beginning with fiscal year 2010. Amounts 
appropriated under this subparagraph for a fis-
cal year shall be available until expended. 
‘‘(e) REPORT TO CONGRESS.—Beginning in 2012, 
and not less than once every other year thereafter, the 
Secretary shall submit to Congress a report on activities 
under this section. Each such report shall describe the 
payment models tested under subsection (b), including the 
number of individuals described in subsection (a)(4)(A)(i) 
and of individuals described in subsection (a)(4)(A)(ii) 
participating in such models and payments made under 
applicable titles for services on behalf of such individuals, 
any models chosen for expansion under subsection (c), and 
the results from evaluations under subsection (b)(4). In 
addition, each such report shall provide such recommenda-
tions as the Secretary believes are appropriate for legisla-
tive action to facilitate the development and expansion of 
successful payment models.’’. 
(b) MEDICAID CONFORMING AMENDMENT.—Section 
1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), 
as amended by sections 1631(b), 1703(a), 1729, 1753, 
1757(a), and 1759(a), is amended— 
(1) in paragraph (78), by striking ‘‘and’’ at the 
end; 
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(2) in paragraph (79), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (79) the fol-
lowing new paragraph: 
‘‘(80) provide for implementation of the pay-
ment models specified by the Secretary under section 
1115A(c) for implementation on a nationwide basis 
unless the State demonstrates to the satisfaction of 
the Secretary that implementation would not be ad-
ministratively feasible or appropriate to the health 
care delivery system of the State.’’. 
SEC. 1908. APPLICATION OF EMERGENCY SERVICES LAWS. 
Nothing in this Act shall be construed to relieve any 
health care provider from providing emergency services as 
required by State or Federal law, including section 1867 
of the Social Security Act (popularly known as 
″EMTALA″). 
SEC. 1909. DISREGARD UNDER THE SUPPLEMENTAL SECU-
RITY INCOME PROGRAM OF COMPENSATION 
FOR PARTICIPATION IN CLINICAL TRIALS 
FOR RARE DISEASES OR CONDITIONS. 
(a) INCOME DISREGARD.—Section 1612(b) of the So-
cial Security Act (42 U.S.C. 1382a(b)) is amended— 
(1) by striking ‘‘and’’ at the end of paragraph 
(24); 
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(2) by striking the period at the end of para-
graph (25) and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(26) The first $2,000 per year received by 
such individual (or such spouse) for participation in 
a clinical trial to test a treatment for a rare disease 
or condition (within the meaning of section 5(b)(2) 
of the Orphan Drug Act (Public Law 97–414)), 
that— 
‘‘(A) has been reviewed and approved by 
an institutional review board that— 
‘‘(i) is established to protect the rights 
and welfare of human subjects partici-
pating in research; and 
‘‘(ii) meet the standards for such bod-
ies set forth in part 46 of title 45, Code of 
Federal Regulations; and 
‘‘(B) meets the standards for protection of 
human subjects for clinical research (as set 
forth in such part).’’. 
(b) RESOURCE DISREGARD.—Section 1613(a) of 
such Act (42 U.S.C. 1382b(a)) is amended— 
(1) by striking ‘‘and’’ at the end of paragraph 
(15); 
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(2) by striking the period at the end of para-
graph (16) and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (16) the fol-
lowing: 
‘‘(17) the first $2,000 per year received by such 
individual (or such spouse) for participation in a 
clinical trial, as described in section 1612(b)(26).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to benefits payable for calendar 
months beginning after the earlier of— 
(1) the date the Commissioner of Social Secu-
rity promulgates regulations to carry out the amend-
ments; or 
(2) the 180-day period that begins with the 
date of the enactment of this Act. 
DIVISION 
C—PUBLIC 
HEALTH 
AND WORKFORCE DEVELOP-
MENT 
SEC. 2001. TABLE OF CONTENTS; REFERENCES. 
(a) TABLE OF CONTENTS.—The table of contents of 
this division is as follows: 
Sec. 2001. Table of contents; references. 
Sec. 2002. Public Health Investment Fund. 
Sec. 2003. Deficit neutrality. 
TITLE I—COMMUNITY HEALTH CENTERS 
Sec. 2101. Increased funding. 
TITLE II—WORKFORCE 
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Subtitle A—Primary Care Workforce 
PART 1—NATIONAL HEALTH SERVICE CORPS 
Sec. 2201. National Health Service Corps. 
Sec. 2202. Authorizations of appropriations. 
PART 2—PROMOTION OF PRIMARY CARE AND DENTISTRY 
Sec. 2211. Frontline health providers. 
‘‘SUBPART XI—HEALTH PROFESSIONAL NEEDS AREAS 
‘‘Sec. 340H. In general. 
‘‘Sec. 340I. Loan repayments. 
‘‘Sec. 340J. Report. 
‘‘Sec. 340K. Allocation. 
Sec. 2212. Primary care student loan funds. 
Sec. 2213. Training in family medicine, general internal medicine, general pedi-
atrics, geriatrics, and physician assistants. 
Sec. 2214. Training of medical residents in community-based settings. 
Sec. 2215. Training for general, pediatric, and public health dentists and dental 
hygienists. 
Sec. 2216. Authorization of appropriations. 
Sec. 2217. Study on effectiveness of scholarships and loan repayments. 
Subtitle B—Nursing Workforce 
Sec. 2221. Amendments to Public Health Service Act. 
Subtitle C—Public Health Workforce 
Sec. 2231. Public Health Workforce Corps. 
‘‘SUBPART XII—PUBLIC HEALTH WORKFORCE 
‘‘Sec. 340L. Public Health Workforce Corps. 
‘‘Sec. 340M. Public Health Workforce Scholarship Program. 
‘‘Sec. 340N. Public Health Workforce Loan Repayment Program. 
Sec. 2232. Enhancing the public health workforce. 
Sec. 2233. Public health training centers. 
Sec. 2234. Preventive medicine and public health training grant program. 
Sec. 2235. Authorization of appropriations. 
Subtitle D—Adapting Workforce to Evolving Health System Needs 
PART 1—HEALTH PROFESSIONS TRAINING FOR DIVERSITY 
Sec. 2241. Scholarships for disadvantaged students, loan repayments and fel-
lowships regarding faculty positions, and educational assistance 
in the health professions regarding individuals from disadvan-
taged backgrounds. 
Sec. 2242. Nursing workforce diversity grants. 
Sec. 2243. Coordination of diversity and cultural competency programs. 
PART 2—INTERDISCIPLINARY TRAINING PROGRAMS 
Sec. 2251. Cultural and linguistic competency training for health professionals. 
Sec. 2252. Innovations in interdisciplinary care training. 
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PART 3—ADVISORY COMMITTEE ON HEALTH WORKFORCE EVALUATION AND 
ASSESSMENT 
Sec. 2261. Health workforce evaluation and assessment. 
PART 4—HEALTH WORKFORCE ASSESSMENT 
Sec. 2271. Health workforce assessment. 
PART 5—AUTHORIZATION OF APPROPRIATIONS 
Sec. 2281. Authorization of appropriations. 
TITLE III—PREVENTION AND WELLNESS 
Sec. 2301. Prevention and wellness. 
‘‘TITLE XXXI—PREVENTION AND WELLNESS 
‘‘Subtitle A—Prevention and Wellness Trust 
‘‘Sec. 3111. Prevention and Wellness Trust. 
‘‘Subtitle B—National Prevention and Wellness Strategy 
‘‘Sec. 3121. National Prevention and Wellness Strategy. 
‘‘Subtitle C—Prevention Task Forces 
‘‘Sec. 3131. Task Force on Clinical Preventive Services. 
‘‘Sec. 3132. Task Force on Community Preventive Services. 
‘‘Subtitle D—Prevention and Wellness Research 
‘‘Sec. 3141. Prevention and wellness research activity coordination. 
‘‘Sec. 3142. Community prevention and wellness research grants. 
‘‘Sec. 3143. Research on subsidies and rewards to encourage wellness and 
healthy behaviors. 
‘‘Subtitle E—Delivery of Community Prevention and Wellness Services 
‘‘Sec. 3151. Community prevention and wellness services grants. 
‘‘Subtitle F—Core Public Health Infrastructure 
‘‘Sec. 3161. Core public health infrastructure for State, local, and tribal 
health departments. 
‘‘Sec. 3162. Core public health infrastructure and activities for CDC. 
‘‘Subtitle G—General Provisions 
‘‘Sec. 3171. Definitions. 
TITLE IV—QUALITY AND SURVEILLANCE 
Sec. 2401. Implementation of best practices in the delivery of health care. 
Sec. 2402. Assistant Secretary for Health Information. 
Sec. 2403. Authorization of appropriations. 
TITLE V—OTHER PROVISIONS 
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Subtitle A—Drug Discount for Rural and Other Hospitals; 340B Program 
Integrity 
Sec. 2501. Expanded participation in 340B program. 
Sec. 2502. Improvements to 340B program integrity. 
Sec. 2503. Effective date. 
Subtitle B—Programs 
PART 1—GRANTS FOR CLINICS AND CENTERS 
Sec. 2511. School-based health clinics. 
Sec. 2512. Nurse-Managed health centers. 
Sec. 2513. Federally qualified behavioral health centers. 
PART 2—OTHER GRANT PROGRAMS 
Sec. 2521. Comprehensive programs to provide education to nurses and create 
a pipeline to nursing. 
Sec. 2522. Mental and behavioral health training. 
Sec. 2523. Reauthorization of telehealth and telemedicine grant programs. 
Sec. 2524. No child left unimmunized against influenza: demonstration pro-
gram using elementary and secondary schools as influenza vac-
cination centers. 
Sec. 2525. Extension of Wisewoman Program. 
Sec. 2526. Healthy teen initiative to prevent teen pregnancy. 
Sec. 2527. National training initiatives on autism spectrum disorders. 
Sec. 2528. Implementation of medication management services in treatment of 
chronic diseases. 
Sec. 2529. Postpartum depression. 
Sec. 2530. Grants to promote positive health behaviors and outcomes. 
Sec. 2531. Medical liability alternatives. 
Sec. 2532. Infant mortality pilot programs. 
Sec. 2533. Secondary school health sciences training program. 
Sec. 2534. Community-based collaborative care networks. 
Sec. 2535. Community-based overweight and obesity prevention program. 
Sec. 2536. Reducing student-to-school nurse ratios. 
Sec. 2537. Medical-legal partnerships. 
PART 3—EMERGENCY CARE-RELATED PROGRAMS 
Sec. 2551. Trauma care centers. 
Sec. 2552. Emergency care coordination. 
Sec. 2553. Pilot programs to improve emergency medical care. 
Sec. 2554. Assisting veterans with military emergency medical training to be-
come State-licensed or certified emergency medical technicians 
(EMTs). 
Sec. 2555. Dental emergency responders: public health and medical response. 
Sec. 2556. Dental emergency responders: homeland security. 
PART 4—PAIN CARE AND MANAGEMENT PROGRAMS 
Sec. 2561. Institute of Medicine Conference on Pain. 
Sec. 2562. Pain research at National Institutes of Health. 
Sec. 2563. Public awareness campaign on pain management. 
Subtitle C—Food and Drug Administration 
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PART 1—IN GENERAL 
Sec. 2571. National medical device registry. 
Sec. 2572. Nutrition labeling of standard menu items at chain restaurants and 
of articles of food sold from vending machines. 
Sec. 2573. Protecting consumer access to generic drugs. 
PART 2—BIOSIMILARS 
Sec. 2575. Licensure pathway for biosimilar biological products. 
Sec. 2576. Fees relating to biosimilar biological products. 
Sec. 2577. Amendments to certain patent provisions. 
Subtitle D—Community Living Assistance Services and Supports 
Sec. 2581. Establishment of national voluntary insurance program for pur-
chasing community living assistance services and support 
(CLASS program). 
‘‘TITLE XXXII—COMMUNITY LIVING ASSISTANCE SERVICES AND 
SUPPORTS 
‘‘Sec. 3201. Purpose. 
‘‘Sec. 3202. Definitions. 
‘‘Sec. 3203. CLASS Independence Benefit Plan. 
‘‘Sec. 3204. Enrollment and disenrollment requirements. 
‘‘Sec. 3205. Benefits. 
‘‘Sec. 3206. CLASS Independence Fund. 
‘‘Sec. 3207. CLASS Independence Advisory Council. 
‘‘Sec. 3208. Regulations; annual report. 
‘‘Sec. 3209. Inspector General’s report. 
Subtitle E—Miscellaneous 
Sec. 2585. States failing to adhere to certain employment obligations. 
Sec. 2586. Health centers under Public Health Service Act; liability protections 
for volunteer practitioners. 
Sec. 2587. Report to Congress on the current state of parasitic diseases that 
have been overlooked among the poorest Americans. 
Sec. 2588. Office of Women’s Health. 
Sec. 2589. Long-Term Care and Family Caregiver Support. 
Sec. 2590. Web site on health care labor market and related educational and 
training opportunities. 
Sec. 2591. Online health workforce training programs. 
Sec. 2592. Access for individuals with disabilities. 
(b) REFERENCES.—Except as otherwise specified, 
whenever in this division an amendment is expressed in 
terms of an amendment to a section or other provision, 
the reference shall be considered to be made to a section 
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or other provision of the Public Health Service Act (42 
U.S.C. 201 et seq.). 
SEC. 2002. PUBLIC HEALTH INVESTMENT FUND. 
(a) ESTABLISHMENT OF FUNDS.— 
(1) IN
GENERAL.—Subject to section 2003, 
there is hereby established in the Treasury a sepa-
rate account to be known as the ‘‘Public Health In-
vestment Fund’’ (referred to in this section and sec-
tion 2003 as the ‘‘Fund’’). 
(2) FUNDING.— 
(A) There shall be deposited into the 
Fund— 
(i) 
for 
fiscal 
year 
2011, 
$4,600,000,000; 
(ii) 
for 
fiscal 
year 
2012, 
$5,600,000,000; 
(iii) 
for 
fiscal 
year 
2013, 
$6,900,000,000; 
(iv) 
for 
fiscal 
year 
2014, 
$7,800,000,000; and 
(v) 
for 
fiscal 
year 
2015, 
$9,000,000,000. 
(B) Amounts deposited into the Fund shall 
be derived from general revenues of the Treas-
ury only for the fiscal years set forth in this 
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section, and amounts appropriated from the 
Fund shall remain available until expended. 
(b) AUTHORIZATION OF APPROPRIATIONS FROM THE 
FUND.— 
(1) NEW FUNDING.— 
(A) IN
GENERAL.—Subject to section 
2003, amounts in the Fund are authorized to 
be appropriated for carrying out activities 
under designated public health provisions. 
(B) DESIGNATED PROVISIONS.—For pur-
poses of this paragraph, the term ‘‘designated 
public health provisions’’ means the provisions 
for which amounts are authorized to be appro-
priated under section 330(s), 338(c), 338H–1, 
799C, 872, or 3111 of the Public Health Serv-
ice Act, as added by this division. 
(2) BASELINE FUNDING.— 
(A) IN GENERAL.—Amounts in the Fund 
are authorized to be appropriated (as described 
in paragraph (1)) for a fiscal year only if (ex-
cluding any amounts in or appropriated from 
the Fund)— 
(i) the amounts specified in subpara-
graph (B) for the fiscal year involved are 
equal to or greater than the amounts spec-
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ified in subparagraph (B) for fiscal year 
2008; and 
(ii) the amounts appropriated, out of 
the general fund of the Treasury, to the 
Prevention and Wellness Trust under sec-
tion 3111(a)(1) of the Public Health Serv-
ice Act, as added by this division, for the 
fiscal year involved are equal to or greater 
than the funds— 
(I) appropriated under the head-
ing ‘‘Prevention and Wellness Fund’’ 
in title VIII of division A of the Amer-
ican Recovery and Reinvestment Act 
of 2009 (Public Law 111–5); and 
(II) allocated by the second pro-
viso under such heading for evidence- 
based clinical and community-based 
prevention and wellness strategies. 
(B) AMOUNTS SPECIFIED.—The amounts 
specified in this subparagraph, with respect to 
a fiscal year, are the amounts appropriated for 
the following: 
(i) Community health centers (includ-
ing funds appropriated under the authority 
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of section 330 of the Public Health Service 
Act (42 U.S.C. 254b)). 
(ii) The National Health Service 
Corps Program (including funds appro-
priated under the authority of section 338 
of such Act (42 U.S.C. 254k)). 
(iii) The National Health Service 
Corps Scholarship and Loan Repayment 
Programs (including funds appropriated 
under the authority of section 338H of 
such Act (42 U.S.C. 254q)). 
(iv) Primary care education programs 
(including funds appropriated under the 
authority of sections 736, 740, 741, and 
747 of such Act (42 U.S.C. 293, 293d, 
and 293k)). 
(v) Sections 761 and 770 of such Act 
(42 U.S.C. 294n and 295e). 
(vi) Nursing workforce development 
(including funds appropriated under the 
authority of title VIII of such Act (42 
U.S.C. 296 et seq.)). 
(vii) The National Center for Health 
Statistics (including funds appropriated 
under the authority of sections 304, 306, 
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307, and 308 of such Act (42 U.S.C. 
242b, 242k, 242l, and 242m)). 
(viii) The Agency for Healthcare Re-
search and Quality (including funds appro-
priated under the authority of title IX of 
such Act (42 U.S.C. 299 et seq.)). 
SEC. 2003. DEFICIT NEUTRALITY. 
(a) AVAILABILITY.—Funds appropriated or made 
available pursuant to sections 330(s), 338(c), 338H–1, 
799C, 872, or 3111 of the Public Health Service Act, as 
added by this division, are only available for the purposes 
set forth in this Act. Appropriations shall not be available 
and are precluded from obligation for any other purpose. 
(b) ESTIMATION OF BUDGETARY IMPACT.—For the 
purposes of estimating the spending effects of this Act, 
the authorization of appropriations from the Fund, to the 
extent amounts in the Fund are derived from the general 
revenues of the Treasury, shall be treated as new direct 
spending and attributed to this Act. 
(c) BUDGETARY TREATMENT.—For the purposes of 
section 257 of the Balanced Budget and Emergency Def-
icit Control Act of 1985, the Fund, to the extent amounts 
in the Fund are derived from the general revenues of the 
Treasury, and not in excess of amounts subsequently ap-
propriated from the Fund, shall be deemed to be included 
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on the list of appropriations referenced under section 
250(c)(17) of that Act. 
TITLE I—COMMUNITY HEALTH 
CENTERS 
SEC. 2101. INCREASED FUNDING. 
Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (r)(1)— 
(A) in subparagraph (D), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (E), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by inserting at the end the following: 
‘‘(F) such sums as may be necessary for 
each of fiscal years 2013 through 2015.’’; and 
(2) by inserting after subsection (r) the fol-
lowing: 
‘‘(s) ADDITIONAL FUNDING.—For the purpose of 
carrying out this section, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) For fiscal year 2011, $1,000,000,000. 
‘‘(2) For fiscal year 2012, $1,500,000,000. 
‘‘(3) For fiscal year 2013, $2,500,000,000. 
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‘‘(4) For fiscal year 2014, $3,000,000,000. 
‘‘(5) For fiscal year 2015, $4,000,000,000.’’. 
TITLE II—WORKFORCE 
Subtitle A—Primary Care 
Workforce 
PART 1—NATIONAL HEALTH SERVICE CORPS 
SEC. 2201. NATIONAL HEALTH SERVICE CORPS. 
(a) FULFILLMENT
OF OBLIGATED SERVICE RE-
QUIREMENT THROUGH HALF-TIME SERVICE.— 
(1) WAIVERS.—Subsection (i) of section 331 
(42 U.S.C. 254d) is amended— 
(A) in paragraph (1), by striking ‘‘In car-
rying out subpart III’’ and all that follows 
through the period and inserting ‘‘In carrying 
out subpart III, the Secretary may, in accord-
ance with this subsection, issue waivers to indi-
viduals who have entered into a contract for ob-
ligated service under the Scholarship Program 
or the Loan Repayment Program under which 
the individuals are authorized to satisfy the re-
quirement of obligated service through pro-
viding clinical practice that is half-time.’’; 
(B) in paragraph (2)— 
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(i) in subparagraphs (A)(ii) and (B), 
by striking ‘‘less than full time’’ each place 
it appears and inserting ‘‘half time’’; 
(ii) in subparagraphs (C) and (F), by 
striking ‘‘less than full-time service’’ each 
place it appears and inserting ‘‘half-time 
service’’; and 
(iii) by amending subparagraphs (D) 
and (E) to read as follows: 
‘‘(D) the entity and the Corps member agree in 
writing that the Corps member will perform half- 
time clinical practice; 
‘‘(E) the Corps member agrees in writing to 
fulfill all of the service obligations under section 
338C through half-time clinical practice and ei-
ther— 
‘‘(i) double the period of obligated service 
that would otherwise be required; or 
‘‘(ii) in the case of contracts entered into 
under section 338B, accept a minimum service 
obligation of 2 years with an award amount 
equal to 50 percent of the amount that would 
otherwise be payable for full-time service; and’’; 
and 
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(C) in paragraph (3), by striking ‘‘In eval-
uating a demonstration project described in 
paragraph (1)’’ and inserting ‘‘In evaluating 
waivers issued under paragraph (1)’’. 
(2) DEFINITIONS.—Subsection (j) of section 
331 (42 U.S.C. 254d) is amended by adding at the 
end the following: 
‘‘(5) The terms ‘full time’ and ‘full-time’ mean 
a minimum of 40 hours per week in a clinical prac-
tice, for a minimum of 45 weeks per year. 
‘‘(6) The terms ‘half time’ and ‘half-time’ mean 
a minimum of 20 hours per week (not to exceed 39 
hours per week) in a clinical practice, for a min-
imum of 45 weeks per year.’’. 
(b) REAPPOINTMENT TO NATIONAL ADVISORY COUN-
CIL.—Section 337(b)(1) (42 U.S.C. 254j(b)(1)) is amend-
ed by striking ‘‘Members may not be reappointed to the 
Council.’’. 
(c) 
LOAN
REPAYMENT
AMOUNT.—Section 
338B(g)(2)(A) (42 U.S.C. 254l–1(g)(2)(A)) is amended 
by striking ‘‘$35,000’’ and inserting ‘‘$50,000, plus, be-
ginning with fiscal year 2012, an amount determined by 
the Secretary on an annual basis to reflect inflation,’’. 
(d) TREATMENT OF TEACHING AS OBLIGATED SERV-
ICE.—Subsection (a) of section 338C (42 U.S.C. 254m) 
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is amended by adding at the end the following: ‘‘The Sec-
retary may treat teaching as clinical practice for up to 
20 percent of such period of obligated service.’’. 
SEC. 2202. AUTHORIZATIONS OF APPROPRIATIONS. 
(a) NATIONAL
HEALTH
SERVICE
CORPS
PRO-
GRAM.—Section 338 (42 U.S.C. 254k) is amended— 
(1) in subsection (a), by striking ‘‘2012’’ and 
inserting ‘‘2015’’; and 
(2) by adding at the end the following: 
‘‘(c) For the purpose of carrying out this subpart, 
in addition to any other amounts authorized to be appro-
priated for such purpose, there are authorized to be appro-
priated, out of any monies in the Public Health Invest-
ment Fund, the following: 
‘‘(1) $63,000,000 for fiscal year 2011. 
‘‘(2) $66,000,000 for fiscal year 2012. 
‘‘(3) $70,000,000 for fiscal year 2013. 
‘‘(4) $73,000,000 for fiscal year 2014. 
‘‘(5) $77,000,000 for fiscal year 2015.’’. 
(b) SCHOLARSHIP
AND LOAN REPAYMENT PRO-
GRAMS.—Subpart III of part D of title III of the Public 
Health Service Act (42 U.S.C. 254l et seq.) is amended— 
(1) in section 338H(a)— 
(A) in paragraph (4), by striking ‘‘and’’ at 
the end; 
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(B) in paragraph (5), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(6) for each of fiscal years 2013 through 
2015, such sums as may be necessary.’’; and 
(2) by inserting after section 338H the fol-
lowing: 
‘‘SEC. 338H–1. ADDITIONAL FUNDING. 
‘‘For the purpose of carrying out this subpart, in ad-
dition to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $254,000,000 for fiscal year 2011. 
‘‘(2) $266,000,000 for fiscal year 2012. 
‘‘(3) $278,000,000 for fiscal year 2013. 
‘‘(4) $292,000,000 for fiscal year 2014. 
‘‘(5) $306,000,000 for fiscal year 2015.’’. 
PART 2—PROMOTION OF PRIMARY CARE AND 
DENTISTRY 
SEC. 2211. FRONTLINE HEALTH PROVIDERS. 
Part D of title III (42 U.S.C. 254b et seq.) is amend-
ed by adding at the end the following: 
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‘‘Subpart XI—Health Professional Needs Areas 
‘‘SEC. 340H. IN GENERAL. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, shall establish a program, to be known as 
the Frontline Health Providers Loan Repayment Pro-
gram, to address unmet health care needs in health profes-
sional needs areas through loan repayments under section 
340I. 
‘‘(b) DESIGNATION
OF
HEALTH
PROFESSIONAL 
NEEDS AREAS.— 
‘‘(1) IN GENERAL.—In this subpart, the term 
‘health professional needs area’ means an area, pop-
ulation, or facility that is designated by the Sec-
retary in accordance with paragraph (2). 
‘‘(2) DESIGNATION.—To be designated by the 
Secretary as a health professional needs area under 
this subpart: 
‘‘(A) In the case of an area, the area must 
be a rational area for the delivery of health 
services. 
‘‘(B) The area, population, or facility must 
have, in one or more health disciplines, special-
ties, or subspecialties for the population served, 
as determined by the Secretary— 
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‘‘(i) insufficient capacity of health 
professionals; or 
‘‘(ii) high needs for health services, in-
cluding services to address health dispari-
ties. 
‘‘(C) With respect to the delivery of pri-
mary health services, the area, population, or 
facility must not include a health professional 
shortage area (as designated under section 
332), except that the area, population, or facil-
ity may include such a health professional 
shortage area in which there is an unmet need 
for such services. 
‘‘(c) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
‘‘(1) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school de-
fined in section 799B(1)(A) (other than a school of 
public health); 
‘‘(2) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school or 
program defined in subparagraph (C), (D), or 
(E)(4) of section 799B(1), as designated by the Sec-
retary; 
‘‘(3) be enrolled as a full-time student— 
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‘‘(A) in a school or program defined in 
subparagraph (C), (D), or (E)(4) of section 
799B(1), as designated by the Secretary, or a 
school described in paragraph (1); and 
‘‘(B) in the final year of a course of study 
or program, offered by such school or program 
and approved by the Secretary, leading to a de-
gree in a discipline referred to in subparagraph 
(A) (other than a graduate degree in public 
health), (C), (D), or (E)(4) of section 799B(1); 
‘‘(4) be a practitioner described in section 
1842(b)(18)(C) or 1848(k)(3)(B)(iii) or (iv) of the 
Social Security Act; or 
‘‘(5) be a practitioner in the field of respiratory 
therapy, medical technology, or radiologic tech-
nology. 
‘‘(d) DEFINITIONS.—In this subpart: 
‘‘(1) The term ‘health disparities’ has the 
meaning given to the term in section 3171. 
‘‘(2) The term ‘primary health services’ has the 
meaning given to such term in section 331(a)(3)(D). 
‘‘SEC. 340I. LOAN REPAYMENTS. 
‘‘(a) LOAN REPAYMENTS.—The Secretary, acting 
through the Administrator of the Health Resources and 
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Services Administration, shall enter into contracts with in-
dividuals under which— 
‘‘(1) the individual agrees— 
‘‘(A) to serve as a full-time primary health 
services provider or as a full-time or part-time 
provider of other health services for a period of 
time equal to 2 years or such longer period as 
the individual may agree to; 
‘‘(B) to serve in a health professional 
needs area in a health discipline, specialty, or a 
subspecialty for which the area, population, or 
facility is designated as a health professional 
needs area under section 340H; and 
‘‘(C) in the case of an individual described 
in section 340H(c)(3) who is in the final year 
of study and who has accepted employment as 
a primary health services provider or provider 
of other health services in accordance with sub-
paragraphs (A) and (B), to complete the edu-
cation or training and maintain an acceptable 
level of academic standing (as determined by 
the educational institution offering the course 
of study or training); and 
‘‘(2) the Secretary agrees to pay, for each year 
of such service, an amount on the principal and in-
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terest of the undergraduate or graduate educational 
loans (or both) of the individual that is not more 
than 50 percent of the average award made under 
the National Health Service Corps Loan Repayment 
Program under subpart III in that year. 
‘‘(b) PRACTICE SETTING.—A contract entered into 
under this section shall allow the individual receiving the 
loan repayment to satisfy the service requirement de-
scribed in subsection (a)(1) through employment in a solo 
or group practice, a clinic, an accredited public or private 
nonprofit hospital, or any other health care entity, as 
deemed appropriate by the Secretary. 
‘‘(c) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III of part D shall, except as incon-
sistent with this section, apply to the loan repayment pro-
gram under this subpart in the same manner and to the 
same extent as such provisions apply to the National 
Health Service Corps Loan Repayment Program estab-
lished under section 338B. 
‘‘(d) INSUFFICIENT NUMBER OF APPLICANTS.—If 
there are an insufficient number of applicants for loan re-
payments under this section to obligate all appropriated 
funds, the Secretary shall transfer the unobligated funds 
to the National Health Service Corps for the purpose of 
recruiting applicants and entering into contracts with indi-
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viduals so as to ensure a sufficient number of participants 
in the National Health Service Corps for the following 
year. 
‘‘SEC. 340J. REPORT. 
‘‘The Secretary shall submit to the Congress an an-
nual report on the program carried out under this subpart. 
‘‘SEC. 340K. ALLOCATION. 
‘‘Of the amount of funds obligated under this subpart 
each fiscal year for loan repayments— 
‘‘(1) 90 percent shall be for physicians and 
other health professionals providing primary health 
services; and 
‘‘(2) 10 percent shall be for health professionals 
not described in paragraph (1).’’. 
SEC. 2212. PRIMARY CARE STUDENT LOAN FUNDS. 
(a) IN GENERAL.—Section 735 (42 U.S.C. 292y) is 
amended— 
(1) by redesignating subsection (f) as sub-
section (g); and 
(2) by inserting after subsection (e) the fol-
lowing: 
‘‘(f) DETERMINATION OF FINANCIAL NEED.—The 
Secretary— 
‘‘(1) may require, or authorize a school or other 
entity to require, the submission of financial infor-
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mation to determine the financial resources available 
to any individual seeking assistance under this sub-
part; and 
‘‘(2) shall take into account the extent to which 
such individual is financially independent in deter-
mining whether to require or authorize the submis-
sion of such information regarding such individual’s 
family members.’’. 
(b) REVISED GUIDELINES.—The Secretary of Health 
and Human Services shall— 
(1) strike the second sentence of section 
57.206(b)(1) of title 42, Code of Federal Regula-
tions; and 
(2) make such other revisions to guidelines and 
regulations in effect as of the date of the enactment 
of this Act as may be necessary for consistency with 
the amendments made by paragraph (1). 
SEC. 2213. TRAINING IN FAMILY MEDICINE, GENERAL IN-
TERNAL MEDICINE, GENERAL PEDIATRICS, 
GERIATRICS, AND PHYSICIAN ASSISTANTS. 
Section 747 (42 U.S.C. 293k) is amended— 
(1) by amending the section heading to read as 
follows: ‘‘PRIMARY
CARE
TRAINING
AND
EN-
HANCEMENT’’; 
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(2) by redesignating subsection (e) as sub-
section (g); and 
(3) by striking subsections (a) through (d) and 
inserting the following: 
‘‘(a) PROGRAM.—The Secretary shall establish a pri-
mary care training and capacity building program con-
sisting of awarding grants and contracts under sub-
sections (b) and (c). 
‘‘(b) SUPPORT
AND DEVELOPMENT
OF PRIMARY 
CARE TRAINING PROGRAMS.— 
‘‘(1) IN GENERAL.—The Secretary shall make 
grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(A) to plan, develop, operate, or partici-
pate in an accredited professional training pro-
gram, including an accredited residency or in-
ternship program, in the field of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics for medical students, interns, 
residents, or practicing physicians; 
‘‘(B) to provide financial assistance in the 
form of traineeships and fellowships to medical 
students, interns, residents, or practicing physi-
cians, who are participants in any such pro-
gram, and who plan to specialize or work in 
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family medicine, general internal medicine, gen-
eral pediatrics, or geriatrics; 
‘‘(C) to plan, develop, operate, or partici-
pate in an accredited program for the training 
of physicians who plan to teach in family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics training programs including 
in community-based settings; 
‘‘(D) to provide financial assistance in the 
form of traineeships and fellowships to prac-
ticing physicians who are participants in any 
such programs and who plan to teach in a fam-
ily medicine, general internal medicine, general 
pediatrics, or geriatrics training program; and 
‘‘(E) to plan, develop, operate, or partici-
pate in an accredited program for physician as-
sistant education, and for the training of indi-
viduals who plan to teach in programs to pro-
vide such training. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall 
be— 
‘‘(A) an accredited school of medicine or 
osteopathic medicine, public or nonprofit private 
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hospital, or physician assistant training pro-
gram; 
‘‘(B) a public or private nonprofit entity; 
or 
‘‘(C) a consortium of 2 or more entities de-
scribed in subparagraphs (A) and (B). 
‘‘(c) CAPACITY BUILDING IN PRIMARY CARE.— 
‘‘(1) IN GENERAL.—The Secretary shall make 
grants to or enter into contracts with eligible entities 
to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall be 
an accredited school of medicine or osteopathic med-
icine. 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
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‘‘(1) Training a high or significantly improved 
percentage of health professionals who provide pri-
mary care. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among primary care 
professionals). 
‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the health care needs of vulnerable popu-
lations. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given the term in section 
3171.’’. 
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SEC. 2214. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) by redesignating section 748 as 749A; and 
(2) by inserting after section 747 the following: 
‘‘SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
‘‘(a) PROGRAM.—The Secretary shall establish a pro-
gram for the training of medical residents in community- 
based settings consisting of awarding grants and contracts 
under this section. 
‘‘(b) DEVELOPMENT AND OPERATION OF COMMU-
NITY-BASED
PROGRAMS.—The Secretary shall make 
grants to, or enter into contracts with, eligible entities— 
‘‘(1) to plan and develop a new primary care 
residency training program, which may include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruiting and training residents and 
faculty; and 
‘‘(C) other activities designated to result in 
accreditation of such a program; or 
‘‘(2) to operate or participate in an established 
primary care residency training program, which may 
include— 
‘‘(A) planning and developing curricula; 
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‘‘(B) recruitment and training of residents; 
and 
‘‘(C) retention of faculty. 
‘‘(c) ELIGIBLE ENTITY.—To be eligible to receive a 
grant or contract under subsection (b), an entity shall— 
‘‘(1) be designated as a recipient of payment 
for the direct costs of medical education under sec-
tion 1886(k) of the Social Security Act; 
‘‘(2) be designated as an approved teaching 
health center under section 1502(d) of the Afford-
able Health Care for America Act and continuing to 
participate in the demonstration project under such 
section; 
‘‘(3) be an applicant for designation described 
in paragraph (1) or (2) and have demonstrated to 
the Secretary appropriate involvement of an accred-
ited teaching hospital to carry out the inpatient re-
sponsibilities associated with a primary care resi-
dency training program; or 
‘‘(4) be eligible to be designated as described in 
paragraph (1) or (2), not be an applicant as de-
scribed in paragraph (3), and have demonstrated ap-
propriate involvement of an accredited teaching hos-
pital to carry out the inpatient responsibilities asso-
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ciated with a primary care residency training pro-
gram. 
‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under paragraph (1) or (2) of subsection (b), the 
Secretary shall give preference to entities that— 
‘‘(1) support teaching programs that address 
the health care needs of vulnerable populations; or 
‘‘(2) are a Federally qualified health center (as 
defined in section 1861(aa)(4) of the Social Security 
Act) or a rural health clinic (as defined in section 
1861(aa)(2) of such Act). 
‘‘(e) ADDITIONAL PREFERENCES FOR ESTABLISHED 
PROGRAMS.—In awarding grants and contracts under 
subsection (b)(2), the Secretary shall give preference to 
entities that have a demonstrated record of training— 
‘‘(1) a high or significantly improved percentage 
of health professionals who provide primary care; 
‘‘(2) individuals who are from disadvantaged 
backgrounds (including racial and ethnic minorities 
underrepresented among primary care professionals); 
or 
‘‘(3) individuals who practice in settings having 
the principal focus of serving underserved areas or 
populations experiencing health disparities (including 
serving patients eligible for medical assistance under 
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title XIX of the Social Security Act or for child 
health assistance under title XXI of such Act or 
those with special health care needs). 
‘‘(f) PERIOD OF AWARDS.— 
‘‘(1) IN GENERAL.—The period of a grant or 
contract under this section— 
‘‘(A) shall not exceed 3 years for awards 
under subsection (b)(1); and 
‘‘(B) shall not exceed 5 years for awards 
under subsection (b)(2). 
‘‘(2) SPECIAL RULES.— 
‘‘(A) An award of a grant or contract 
under subsection (b)(1) shall not be renewed. 
‘‘(B) The period of a grant or contract 
awarded to an entity under subsection (b)(2) 
shall not overlap with the period of any grant 
or contact awarded to the same entity under 
subsection (b)(1). 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) HEALTH DISPARITIES.—The term ‘health 
disparities’ has the meaning given the term in sec-
tion 3171. 
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‘‘(2) PRIMARY CARE RESIDENT.—The term ‘pri-
mary care resident’ has the meaning given the term 
in section 1886(h)(5)(H) of the Social Security Act. 
‘‘(3) PRIMARY CARE RESIDENCY TRAINING PRO-
GRAM.—The term ‘primary care residency training 
program’ means an approved medical residency 
training program described in section 1886(h)(5)(A) 
of the Social Security Act for primary care residents 
that is— 
‘‘(A) in the case of entities seeking awards 
under subsection (b)(1), actively applying to be 
accredited by the Accreditation Council for 
Graduate Medical Education or the American 
Osteopathic Association; or 
‘‘(B) in the case of entities seeking awards 
under subsection (b)(2), so accredited. 
‘‘(i) ALLOCATION OF FUNDS.—Of the amount appro-
priated pursuant to section 799C(a) for a fiscal year, not 
more than 17 percent of such amount shall be made avail-
able to carry out this section.’’. 
SEC. 2215. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
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(1) in section 791(a)(1), by striking ‘‘747 and 
750’’ and inserting ‘‘747, 749, and 750’’; and 
(2) by inserting after section 748, as added, the 
following: 
‘‘SEC. 749. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
training program for oral health professionals consisting 
of awarding grants and contracts under this section. 
‘‘(b) SUPPORT
AND
DEVELOPMENT
OF
ORAL 
HEALTH TRAINING PROGRAMS.—The Secretary shall 
make grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to plan, develop, operate, or participate in 
an accredited professional training program for oral 
health professionals; 
‘‘(2) to provide financial assistance to oral 
health professionals who are in need thereof, who 
are participants in any such program, and who plan 
to work in general, pediatric, or public health den-
tistry, or dental hygiene; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of oral health profes-
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sionals who plan to teach in general, pediatric, or 
public health dentistry, or dental hygiene; 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry or dental hygiene; 
‘‘(5) to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of general, pedi-
atric, or public health dentistry; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties; 
‘‘(6) to plan, develop, operate, or participate in 
predoctoral and postdoctoral training in general, pe-
diatric, or public health dentistry programs; 
‘‘(7) to plan, develop, operate, or participate in 
a loan repayment program for full-time faculty in a 
program of general, pediatric, or public health den-
tistry; and 
‘‘(8) to provide technical assistance to pediatric 
dental training programs in developing and imple-
menting instruction regarding the oral health status, 
dental care needs, and risk-based clinical disease 
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management of all pediatric populations with an em-
phasis on underserved children. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under this section, an entity shall be— 
‘‘(1) an accredited school of dentistry, training 
program in dental hygiene, or public or nonprofit 
private hospital; 
‘‘(2) a training program in dental hygiene at an 
accredited institution of higher education; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of— 
‘‘(A) 1 or more of the entities described in 
paragraphs (1) through (3); and 
‘‘(B) an accredited school of public health. 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of oral health professionals who practice 
general, pediatric, or public health dentistry. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among oral health pro-
fessionals). 
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‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the oral health needs of vulnerable popu-
lations. 
‘‘(5) Providing instruction regarding the oral 
health status, oral health care needs, and risk-based 
clinical disease management of all pediatric popu-
lations with an emphasis on underserved children. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘health disparities’ has the 
meaning given the term in section 3171. 
‘‘(2) The term ‘oral health professional’ means 
an individual training or practicing— 
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‘‘(A) in general dentistry, pediatric den-
tistry, public health dentistry, or dental hy-
giene; or 
‘‘(B) another oral health specialty, as 
deemed appropriate by the Secretary.’’. 
SEC. 2216. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Part F of title VII (42 U.S.C. 
295j et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 799C. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘(a) PROMOTION
OF PRIMARY CARE
AND DEN-
TISTRY.—For the purpose of carrying out subpart XI of 
part D of title III and sections 747, 748, and 749, in addi-
tion to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $240,000,000 for fiscal year 2011. 
‘‘(2) $253,000,000 for fiscal year 2012. 
‘‘(3) $265,000,000 for fiscal year 2013. 
‘‘(4) $278,000,000 for fiscal year 2014. 
‘‘(5) $292,000,000 for fiscal year 2015.’’. 
(b) EXISTING
AUTHORIZATION
OF
APPROPRIA-
TIONS.—Subsection (g)(1), as so redesignated, of section 
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747 (42 U.S.C. 293k) is amended by striking ‘‘2002’’ and 
inserting ‘‘2015’’. 
SEC. 2217. STUDY ON EFFECTIVENESS OF SCHOLARSHIPS 
AND LOAN REPAYMENTS. 
(a) STUDY.—The Comptroller General of the United 
States shall conduct a study to determine the effectiveness 
of scholarship and loan repayment programs under sub-
parts III and XI of part D of title III of the Public Health 
Service Act, as amended or added by sections 2201 and 
2211, including whether scholarships or loan repayments 
are more effective in— 
(1) incentivizing physicians, and other pro-
viders, to pursue careers in primary care specialties; 
(2) retaining such primary care providers; and 
(3) encouraging such primary care providers to 
practice in underserved areas. 
(b) REPORT.—Not later than 12 months after the 
date of the enactment of this Act, the Comptroller General 
shall submit to the Congress a report on the results of 
the study under subsection (a). 
Subtitle B—Nursing Workforce 
SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. 
(a) DEFINITIONS.—Section 801 (42 U.S.C. 296 et 
seq.) is amended— 
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(1) in paragraph (1), by inserting ‘‘nurse-man-
aged health centers,’’ after ‘‘nursing centers,’’; and 
(2) by adding at the end the following: 
‘‘(16) NURSE-MANAGED
HEALTH
CENTER.— 
The term ‘nurse-managed health center’— 
‘‘(A) means a nurse-practice arrangement, 
managed by one or more advanced practice 
nurses, that provides primary care or wellness 
services to underserved or vulnerable popu-
lations and is associated with an accredited 
school of nursing, Federally qualified health 
center, or independent nonprofit health or social 
services agency; and 
‘‘(B) shall not be construed as changing 
State law requirements applicable to an ad-
vanced practice nurse or the authorized scope of 
practice of such a nurse.’’. 
(b) GRANTS
FOR
HEALTH
PROFESSIONS
EDU-
CATION.—Title VIII (42 U.S.C. 296 et seq.) is amended 
by striking section 807. 
(c) REPORTS.—Part A of title VIII (42 U.S.C. 296 
et seq.) is amended by adding at the end the following: 
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‘‘SEC. 809. REPORTS. 
‘‘The Secretary shall submit to the Congress a sepa-
rate annual report on the activities carried out under each 
of sections 811, 821, 836, 846A, and 861.’’. 
(d) ADVANCED EDUCATION NURSING GRANTS.—Sec-
tion 811(f) (42 U.S.C. 296j(f)) is amended— 
(1) by striking paragraph (2); 
(2) by redesignating paragraph (3) as para-
graph (2); and 
(3) in paragraph (2), as so redesignated, by 
striking ‘‘that agrees’’ and all that follows through 
the end and inserting: ‘‘that agrees to expend the 
award— 
‘‘(A) to train advanced education nurses 
who will practice in health professional shortage 
areas designated under section 332; or 
‘‘(B) to increase diversity among advanced 
education nurses.’’. 
(e) NURSE EDUCATION, PRACTICE, AND RETENTION 
GRANTS.—Section 831 (42 U.S.C. 296p) is amended— 
(1) in subsection (b), by amending paragraph 
(3) to read as follows: 
‘‘(3) providing coordinated care, quality care, 
and other skills needed to practice nursing; or’’; and 
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(2) by striking subsection (e) and redesignating 
subsections (f) through (h) as subsections (e) 
through (g), respectively. 
(f) STUDENT LOANS.—Subsection (a) of section 836 
(42 U.S.C. 297b) is amended— 
(1) 
by 
striking 
‘‘$2,500’’ 
and 
inserting 
‘‘$3,300’’; 
(2) 
by 
striking 
‘‘$4,000’’ 
and 
inserting 
‘‘$5,200’’; 
(3) by striking ‘‘$13,000’’ and inserting 
‘‘$17,000’’; and 
(4) by adding at the end the following: ‘‘Begin-
ning with fiscal year 2012, the dollar amounts speci-
fied in this subsection shall be adjusted by an 
amount determined by the Secretary on an annual 
basis to reflect inflation.’’. 
(g) LOAN REPAYMENT.—Section 846 (42 U.S.C. 
297n) is amended— 
(1) in subsection (a), by amending paragraph 
(3) to read as follows: 
‘‘(3) who enters into an agreement with the 
Secretary to serve for a period of not less than 2 
years— 
‘‘(A) as a nurse at a health care facility 
with a critical shortage of nurses; or 
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‘‘(B) as a faculty member at an accredited 
school of nursing;’’; and 
(2) in subsection (g)(1), by striking ‘‘to provide 
health services’’ each place it appears and inserting 
‘‘to provide health services or serve as a faculty 
member’’. 
(h) NURSE FACULTY LOAN PROGRAM.—Paragraph 
(2) of section 846A(c) (42 U.S.C. 297n–1(c)) is amended 
by striking ‘‘$30,000’’ and all that follows through the 
semicolon and inserting ‘‘$35,000, plus, beginning with 
fiscal year 2012, an amount determined by the Secretary 
on an annual basis to reflect inflation;’’. 
(i) PUBLIC SERVICE ANNOUNCEMENTS.—Title VIII 
(42 U.S.C. 296 et seq.) is amended by striking part H. 
(j) TECHNICAL AND CONFORMING AMENDMENTS.— 
Title VIII (42 U.S.C. 296 et seq.) is amended— 
(1) by moving section 810 (relating to prohibi-
tion against discrimination by schools on the basis of 
sex) so that it follows section 809, as added by sub-
section (c); 
(2) in sections 835, 836, 838, 840, and 842, by 
striking the term ‘‘this subpart’’ each place it ap-
pears and inserting ‘‘this part’’; 
(3) in section 836(h), by striking the last sen-
tence; 
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(4) in section 836, by redesignating subsection 
(l) as subsection (k); 
(5) in section 839, by striking ‘‘839’’ and all 
that follows through ‘‘(a)’’ and inserting ‘‘839. (a)’’; 
(6) in section 835(b), by striking ‘‘841’’ each 
place it appears and inserting ‘‘871’’; 
(7) by redesignating section 841 as section 871, 
moving part F to the end of the title, and redesig-
nating such part as part H; 
(8) in part G— 
(A) by redesignating section 845 as section 
851; and 
(B) by redesignating part G as part F; and 
(9) in part I— 
(A) by redesignating section 855 as section 
861; and 
(B) by redesignating part I as part G. 
(k) FUNDING.— 
(1) IN GENERAL.—Part H, as redesignated, of 
title VIII is amended by adding at the end the fol-
lowing: 
‘‘SEC. 872. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘For the purpose of carrying out this title, in addi-
tion to any other amounts authorized to be appropriated 
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for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $115,000,000 for fiscal year 2011. 
‘‘(2) $122,000,000 for fiscal year 2012. 
‘‘(3) $127,000,000 for fiscal year 2013. 
‘‘(4) $134,000,000 for fiscal year 2014. 
‘‘(5) $140,000,000 for fiscal year 2015.’’. 
(2) EXISTING AUTHORIZATIONS OF APPROPRIA-
TIONS.— 
(A) SECTIONS 831, 846, 846A, AND 861.— 
Sections 831(g) (as so redesignated), 846(i)(1) 
(42 U.S.C. 297n(i)(1)), 846A(f) (42 U.S.C. 
297n–1(f)), and 861(e) (as so redesignated) are 
amended by striking ‘‘2007’’ each place it ap-
pears and inserting ‘‘2015’’. 
(B) SECTION 871.—Section 871, as so re-
designated by subsection (j), is amended to read 
as follows: 
‘‘SEC. 871. FUNDING. 
‘‘For the purpose of carrying out parts B, C, and D 
(subject to section 851(g)), there are authorized to be ap-
propriated such sums as may be necessary for each fiscal 
year through fiscal year 2015.’’. 
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Subtitle C—Public Health 
Workforce 
SEC. 2231. PUBLIC HEALTH WORKFORCE CORPS. 
Part D of title III (42 U.S.C. 254b et seq.), as 
amended by section 2211, is amended by adding at the 
end the following: 
‘‘Subpart XII—Public Health Workforce 
‘‘SEC. 340L. PUBLIC HEALTH WORKFORCE CORPS. 
‘‘(a) ESTABLISHMENT.—There is established, within 
the Service, the Public Health Workforce Corps (in this 
subpart referred to as the ‘Corps’), for the purpose of en-
suring an adequate supply of public health professionals 
throughout the Nation. The Corps shall consist of— 
‘‘(1) such officers of the Regular and Reserve 
Corps of the Service as the Secretary may designate; 
‘‘(2) such civilian employees of the United 
States as the Secretary may appoint; and 
‘‘(3) such other individuals who are not employ-
ees of the United States. 
‘‘(b) ADMINISTRATION.—Except as provided in sub-
section (c), the Secretary shall carry out this subpart act-
ing through the Administrator of the Health Resources 
and Services Administration. 
‘‘(c) PLACEMENT AND ASSIGNMENT.—The Secretary, 
acting through the Director of the Centers for Disease 
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Control and Prevention, shall develop a methodology for 
placing and assigning Corps participants as public health 
professionals. Such methodology may allow for placing and 
assigning such participants in State, local, and tribal 
health departments and Federally qualified health centers 
(as defined in section 1861(aa)(4) of the Social Security 
Act). 
‘‘(d) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart II shall, except as inconsistent with 
this subpart, apply to the Public Health Workforce Corps 
in the same manner and to the same extent as such provi-
sions apply to the National Health Service Corps estab-
lished under section 331. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the programs carried out 
under this subpart. 
‘‘SEC. 340M. PUBLIC HEALTH WORKFORCE SCHOLARSHIP 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish the Public Health Workforce Scholarship Program 
(referred to in this section as the ‘Program’) for the pur-
pose described in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
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‘‘(1)(A) be accepted for enrollment, or be en-
rolled, as a full-time or part-time student in a course 
of study or program (approved by the Secretary) at 
an accredited graduate school or program of public 
health; or 
‘‘(B) have demonstrated expertise in public 
health and be accepted for enrollment, or be en-
rolled, as a full-time or part-time student in a course 
of study or program (approved by the Secretary) 
at— 
‘‘(i) an accredited graduate school or pro-
gram of nursing; health administration, man-
agement, or policy; preventive medicine; labora-
tory science; veterinary medicine; or dental 
medicine; or 
‘‘(ii) another accredited graduate school or 
program, as deemed appropriate by the Sec-
retary; 
‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for 
civilian service in the Corps; and 
‘‘(3) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full- 
time as a public health professional, upon the com-
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dividual completes that course of study or pro-
gram; 
‘‘(C) while enrolled in the approved course 
of study or program, maintain an acceptable 
level of academic standing (as determined by 
the educational institution offering such course 
of study or program); 
‘‘(D) if applicable, complete a residency or 
internship; and 
‘‘(E) serve full-time as a public health pro-
fessional for a period of time equal to the great-
er of— 
‘‘(i) 1 year for each academic year for 
which the individual was provided a schol-
arship under the Program; or 
‘‘(ii) 2 years; and 
‘‘(3) an agreement by both parties as to the na-
ture and extent of the scholarship assistance, which 
may include— 
‘‘(A) payment of reasonable educational ex-
penses of the individual, including tuition, fees, 
books, equipment, and laboratory expenses; and 
‘‘(B) payment of a stipend of not more 
than $1,269 (plus, beginning with fiscal year 
2012, an amount determined by the Secretary 
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on an annual basis to reflect inflation) per 
month for each month of the academic year in-
volved, with the dollar amount of such a stipend 
determined by the Secretary taking into consid-
eration whether the individual is enrolled full- 
time or part-time. 
‘‘(d) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III shall, except as inconsistent with 
this subpart, apply to the scholarship program under this 
section in the same manner and to the same extent as 
such provisions apply to the National Health Service 
Corps Scholarship Program established under section 
338A. 
‘‘SEC. 340N. PUBLIC HEALTH WORKFORCE LOAN REPAY-
MENT PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish the Public Health Workforce Loan Repayment Pro-
gram (referred to in this section as the ‘Program’) for the 
purpose described in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
‘‘(1)(A) have a graduate degree from an accred-
ited school or program of public health; 
‘‘(B) have demonstrated expertise in public 
health and have a graduate degree in a course of 
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study or program (approved by the Secretary) 
from— 
‘‘(i) an accredited school or program of 
nursing; health administration, management, or 
policy; preventive medicine; laboratory science; 
veterinary medicine; or dental medicine; or 
‘‘(ii) another accredited school or program 
approved by the Secretary; or 
‘‘(C) be enrolled as a full-time or part-time stu-
dent in the final year of a course of study or pro-
gram (approved by the Secretary) offered by a 
school or program described in subparagraph (A) or 
(B), leading to a graduate degree; 
‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for 
civilian service in the Corps; 
‘‘(3) if applicable, complete a residency or in-
ternship; and 
‘‘(4) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full- 
time as a public health professional for the period of 
obligated service described in subsection (c)(2). 
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‘‘(c) CONTRACT.—The written contract between the 
Secretary and an individual under subsection (b)(4) shall 
contain— 
‘‘(1) an agreement by the Secretary to repay on 
behalf of the individual loans incurred by the indi-
vidual in the pursuit of the relevant public health 
workforce educational degree in accordance with the 
terms of the contract; 
‘‘(2) an agreement by the individual to serve 
full-time as a public health professional for a period 
of time equal to 2 years or such longer period as the 
individual may agree to; and 
‘‘(3) in the case of an individual described in 
subsection (b)(1)(C) who is in the final year of study 
and who has accepted employment as a public health 
professional, in accordance with section 340L(c), an 
agreement on the part of the individual to complete 
the education or training, maintain an acceptable 
level of academic standing (as determined by the 
educational institution offering the course of study 
or training), and serve the period of obligated service 
described in paragraph (2). 
‘‘(d) PAYMENTS.— 
‘‘(1) IN GENERAL.—A loan repayment provided 
for an individual under a written contract under the 
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Program shall consist of payment, in accordance 
with paragraph (2), on behalf of the individual of 
the principal, interest, and related expenses on gov-
ernment and commercial loans received by the indi-
vidual regarding the undergraduate or graduate edu-
cation of the individual (or both), which loans were 
made for reasonable educational expenses, including 
tuition, fees, books, equipment, and laboratory ex-
penses, incurred by the individual. 
‘‘(2) PAYMENTS FOR YEARS SERVED.— 
‘‘(A) IN GENERAL.—For each year of obli-
gated service that an individual contracts to 
serve under subsection (c), the Secretary may 
pay up to $35,000 (plus, beginning with fiscal 
year 2012, an amount determined by the Sec-
retary on an annual basis to reflect inflation) 
on behalf of the individual for loans described 
in paragraph (1). 
‘‘(B) REPAYMENT
SCHEDULE.—Any ar-
rangement made by the Secretary for the mak-
ing of loan repayments in accordance with this 
subsection shall provide that any repayments 
for a year of obligated service shall be made no 
later than the end of the fiscal year in which 
the individual completes such year of service. 
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‘‘(e) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III shall, except as inconsistent with 
this subpart, apply to the loan repayment program under 
this section in the same manner and to the same extent 
as such provisions apply to the National Health Service 
Corps Loan Repayment Program established under sec-
tion 338B.’’. 
SEC. 2232. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
Section 765 (42 U.S.C. 295) is amended to read as 
follows: 
‘‘SEC. 765. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Director of the 
Centers for Disease Control and Prevention, shall estab-
lish a public health workforce training and enhancement 
program consisting of awarding grants and contracts 
under subsection (b). 
‘‘(b) GRANTS AND CONTRACTS.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to plan, develop, operate, or participate in, 
an accredited professional training program in the 
field of public health (including such a program in 
nursing; health administration, management, or pol-
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icy; preventive medicine; laboratory science; veteri-
nary medicine; or dental medicine) for members of 
the public health workforce, including midcareer pro-
fessionals; 
‘‘(2) to provide financial assistance in the form 
of traineeships and fellowships to students who are 
participants in any such program and who plan to 
specialize or work in the field of public health; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of public health profes-
sionals who plan to teach in any program described 
in paragraph (1); and 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to public health pro-
fessionals who are participants in any program de-
scribed in paragraph (1) and who plan to teach in 
the field of public health, including nursing; health 
administration, management, or policy; preventive 
medicine; laboratory science; veterinary medicine; or 
dental medicine. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under this section, an entity shall be— 
‘‘(1) an accredited health professions school, in-
cluding an accredited school or program of public 
health; nursing; health administration, management, 
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or policy; preventive medicine; laboratory science; 
veterinary medicine; or dental medicine; 
‘‘(2) a State, local, or tribal health department; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of public health professionals who serve 
in underserved communities. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among public health 
professionals). 
‘‘(3) Training individuals in public health spe-
cialties experiencing a significant shortage of public 
health professionals (as determined by the Sec-
retary). 
‘‘(4) Training a high or significantly improved 
percentage of public health professionals serving in 
the Federal Government or a State, local, or tribal 
government. 
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‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2233. PUBLIC HEALTH TRAINING CENTERS. 
Section 766 (42 U.S.C. 295a) is amended— 
(1) in subsection (b)(1), by striking ‘‘in further-
ance of the goals established by the Secretary for 
the year 2000’’ and inserting ‘‘in furtherance of the 
goals established by the Secretary in the national 
prevention and wellness strategy under section 
3121’’; and 
(2) by adding at the end the following: 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2234. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
Section 768 (42 U.S.C. 295c) is amended to read as 
follows: 
‘‘SEC. 768. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Director of the 
Centers for Disease Control and Prevention, shall award 
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grants to, or enter into contracts with, eligible entities to 
provide training to graduate medical residents in preven-
tive medicine specialties. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited school of public health or 
school of medicine or osteopathic medicine; 
‘‘(2) an accredited public or private nonprofit 
hospital; 
‘‘(3) a State, local, or tribal health department; 
or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(c) USE OF FUNDS.—Amounts received under a 
grant or contract under this section shall be used to— 
‘‘(1) plan, develop (including the development of 
curricula), operate, or participate in an accredited 
residency or internship program in preventive medi-
cine or public health; 
‘‘(2) defray the costs of practicum experiences, 
as required in such a program; and 
‘‘(3) establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
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priate units) in preventive medicine and public 
health; or 
‘‘(B) programs that improve clinical teach-
ing in preventive medicine and public health. 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2235. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Section 799C, as added by section 
2216 of this Act, is amended by adding at the end the 
following: 
‘‘(b) PUBLIC HEALTH WORKFORCE.—For the pur-
pose of carrying out subpart XII of part D of title III 
and sections 765, 766, and 768, in addition to any other 
amounts authorized to be appropriated for such purpose, 
there are authorized to be appropriated, out of any monies 
in the Public Health Investment Fund, the following: 
‘‘(1) $51,000,000 for fiscal year 2011. 
‘‘(2) $54,000,000 for fiscal year 2012. 
‘‘(3) $57,000,000 for fiscal year 2013. 
‘‘(4) $59,000,000 for fiscal year 2014. 
‘‘(5) $62,000,000 for fiscal year 2015.’’. 
(b) EXISTING
AUTHORIZATION
OF
APPROPRIA-
TIONS.—Subsection (a) of section 770 (42 U.S.C. 295e) 
is amended by striking ‘‘2002’’ and inserting ‘‘2015’’. 
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Subtitle D—Adapting Workforce to 
Evolving Health System Needs 
PART 1—HEALTH PROFESSIONS TRAINING FOR 
DIVERSITY 
SEC. 2241. SCHOLARSHIPS FOR DISADVANTAGED STU-
DENTS, LOAN REPAYMENTS AND FELLOW-
SHIPS REGARDING FACULTY POSITIONS, AND 
EDUCATIONAL ASSISTANCE IN THE HEALTH 
PROFESSIONS 
REGARDING 
INDIVIDUALS 
FROM DISADVANTAGED BACKGROUNDS. 
Paragraph (1) of section 738(a) (42 U.S.C. 293b(a)) 
is amended by striking ‘‘not more than $20,000’’ and all 
that follows through the end of the paragraph and insert-
ing: ‘‘not more than $35,000 (plus, beginning with fiscal 
year 2012, an amount determined by the Secretary on an 
annual basis to reflect inflation) of the principal and inter-
est of the educational loans of such individuals.’’. 
SEC. 2242. NURSING WORKFORCE DIVERSITY GRANTS. 
Subsection (b) of section 821 (42 U.S.C. 296m) is 
amended— 
(1) in the heading, by striking ‘‘GUIDANCE’’ 
and inserting ‘‘CONSULTATION’’; and 
(2) by striking ‘‘shall take into consideration’’ 
and all that follows through ‘‘consult with nursing 
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associations’’ and inserting ‘‘shall, as appropriate, 
consult with nursing associations’’. 
SEC. 2243. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
(a) IN GENERAL.—Title VII (42 U.S.C. 292 et seq.) 
is amended by inserting after section 739 the following: 
‘‘SEC. 739A. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
‘‘The Secretary shall, to the extent practicable, co-
ordinate the activities carried out under this part and sec-
tion 821 in order to enhance the effectiveness of such ac-
tivities and avoid duplication of effort.’’. 
(b) REPORT.—Section 736 (42 U.S.C. 293) is 
amended— 
(1) by redesignating subsection (h) as sub-
section (i); and 
(2) by inserting after subsection (g) the fol-
lowing: 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on the activities carried out 
under this section.’’. 
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PART 2—INTERDISCIPLINARY TRAINING 
PROGRAMS 
SEC. 2251. CULTURAL AND LINGUISTIC COMPETENCY 
TRAINING FOR HEALTH PROFESSIONALS. 
Section 741 (42 U.S.C. 293e) is amended— 
(1) in the section heading, by striking 
‘‘GRANTS
FOR
HEALTH
PROFESSIONS
EDU-
CATION’’ and inserting ‘‘CULTURAL
AND
LIN-
GUISTIC COMPETENCY TRAINING FOR HEALTH 
PROFESSIONALS’’; 
(2) by redesignating subsection (b) as sub-
section (h); and 
(3) by striking subsection (a) and inserting the 
following: 
‘‘(a) PROGRAM.—The Secretary shall establish a cul-
tural and linguistic competency training program for 
health professionals, including nurse professionals, con-
sisting of awarding grants and contracts under subsection 
(b). 
‘‘(b) CULTURAL
AND
LINGUISTIC
COMPETENCY 
TRAINING.—The Secretary shall award grants to, or enter 
into contracts with, eligible entities— 
‘‘(1) to test, develop, and evaluate models of 
cultural and linguistic competency training (includ-
ing continuing education) for health professionals; 
and 
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‘‘(2) to implement cultural and linguistic com-
petency training programs for health professionals 
developed under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants and con-
tracts under this section, the Secretary shall give pref-
erence to entities that have a demonstrated record of at 
least one of the following: 
‘‘(1) Addressing, or partnering with an entity 
with experience addressing, the cultural and lin-
guistic competency needs of the population to be 
served through the grant or contract. 
‘‘(2) Addressing health disparities. 
‘‘(3) Placing health professionals in regions ex-
periencing significant changes in the cultural and 
linguistic demographics of populations, including 
communities along the United States-Mexico border. 
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‘‘(4) Carrying out activities described in sub-
section (b) with respect to more than one health pro-
fession discipline, specialty, or subspecialty. 
‘‘(e) CONSULTATION.—The Secretary shall carry out 
this section in consultation with the heads of appropriate 
health agencies and offices in the Department of Health 
and Human Services, including the Office of Minority 
Health and the National Center on Minority Health and 
Health Disparities. 
‘‘(f) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given to the term in section 
3171. 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2252. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
Part D of title VII (42 U.S.C. 294 et seq.) is amend-
ed by adding at the end the following: 
‘‘SEC. 759. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
‘‘(a) PROGRAM.—The Secretary shall establish an in-
novations in interdisciplinary care training program con-
sisting of awarding grants and contracts under subsection 
(b). 
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‘‘(b) TRAINING PROGRAMS.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to test, develop, and evaluate health pro-
fessional training programs (including continuing 
education) designed to promote— 
‘‘(A) the delivery of health services through 
interdisciplinary and team-based models, which 
may include patient-centered medical home 
models, medication therapy management mod-
els, and models integrating physical, mental, or 
oral health services; and 
‘‘(B) coordination of the delivery of health 
care within and across settings, including health 
care institutions, community-based settings, 
and the patient’s home; and 
‘‘(2) to implement such training programs de-
veloped under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
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‘‘(3) a public or private nonprofit entity (includ-
ing an area health education center or a geriatric 
education center); or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under this section, the Secretary shall give pref-
erence to entities that have a demonstrated record of at 
least one of the following: 
‘‘(1) Training a high or significantly improved 
percentage of health professionals who serve in un-
derserved communities. 
‘‘(2) Broad interdisciplinary team-based collabo-
rations. 
‘‘(3) Addressing health disparities. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘health disparities’ has the 
meaning given the term in section 3171. 
‘‘(2) The term ‘interdisciplinary’ means collabo-
ration across health professions and specialties, 
which may include public health, nursing, allied 
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health, dietetics or nutrition, and appropriate health 
specialties.’’. 
PART 3—ADVISORY COMMITTEE ON HEALTH 
WORKFORCE EVALUATION AND ASSESSMENT 
SEC. 2261. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
Subpart 1 of part E of title VII (42 U.S.C. 294n 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 764. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
‘‘(a) ADVISORY COMMITTEE.—The Secretary, acting 
through the Assistant Secretary for Health, shall establish 
a permanent advisory committee to be known as the Advi-
sory Committee on Health Workforce Evaluation and As-
sessment (referred to in this section as the ‘Advisory Com-
mittee’) to develop and implement an integrated, coordi-
nated, and strategic national health workforce policy re-
flective of current and evolving health workforce needs. 
‘‘(b) RESPONSIBILITIES.—The Advisory Committee 
shall— 
‘‘(1) not later than 1 year after the date of the 
establishment of the Advisory Committee, submit 
recommendations to the Secretary on— 
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‘‘(A) classifications of the health workforce 
to ensure consistency of data collection on the 
health workforce; and 
‘‘(B) based on such classifications, stand-
ardized methodologies and procedures to enu-
merate the health workforce; 
‘‘(2) not later than 2 years after the date of the 
establishment of the Advisory Committee, submit 
recommendations to the Secretary on— 
‘‘(A) the supply, diversity, and geographic 
distribution of the health workforce; 
‘‘(B) the retention and expansion of the 
health workforce (on a short- and long-term 
basis) to ensure quality and adequacy of such 
workforce; and 
‘‘(C) policies to carry out the recommenda-
tions made pursuant to subparagraphs (A) and 
(B); and 
‘‘(3) not later than 4 years after the date of the 
establishment of the Advisory Committee, and every 
2 years thereafter, submit updated recommendations 
to the Secretary under paragraphs (1) and (2). 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Advisory Committee, including 
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coordinating and supporting the dissemination of the rec-
ommendations of the Advisory Committee. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) NUMBER; APPOINTMENT.—The Secretary 
shall appoint 15 members to serve on the Advisory 
Committee. 
‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Advisory Committee for 
a term of 3 years and may reappoint such 
members, but the Secretary may not appoint 
any member to serve more than a total of 6 
years. 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to the Advisory Committee 
under paragraph (1)— 
‘‘(i) 5 shall be appointed for a term of 
1 year; 
‘‘(ii) 5 shall be appointed for a term 
of 2 years; and 
‘‘(iii) 5 shall be appointed for a term 
of 3 years. 
‘‘(3) QUALIFICATIONS.—Members of the Advi-
sory Committee shall be appointed from among indi-
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viduals who possess expertise in at least one of the 
following areas: 
‘‘(A) Conducting and interpreting health 
workforce market analysis, including health 
care labor workforce analysis. 
‘‘(B) Conducting and interpreting health 
finance and economics research. 
‘‘(C) Delivering and administering health 
care services. 
‘‘(D) Delivering and administering health 
workforce education and training. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Advisory Committee, the Secretary 
shall— 
‘‘(A) include no less than one representa-
tive of each of— 
‘‘(i) health professionals within the 
health workforce; 
‘‘(ii) health care patients and con-
sumers; 
‘‘(iii) employers; 
‘‘(iv) labor unions; and 
‘‘(v) third-party health payors; and 
‘‘(B) ensure that— 
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‘‘(i) all areas of expertise described in 
paragraph (3) are represented; 
‘‘(ii) the members of the Advisory 
Committee include members who, collec-
tively, have significant experience working 
with— 
‘‘(I) populations in urban and 
federally designated rural and non-
metropolitan areas; and 
‘‘(II) populations who are under-
represented in the health professions, 
including underrepresented minority 
groups; and 
‘‘(iii) individuals who are directly in-
volved in health professions education or 
practice do not constitute a majority of the 
members of the Advisory Committee. 
‘‘(5) DISCLOSURE AND CONFLICTS OF INTER-
EST.—Members of the Advisory Committee shall not 
be considered employees of the Federal Government 
by reason of service on the Advisory Committee, ex-
cept members of the Advisory Committee shall be 
considered to be special Government employees with-
in the meaning of section 107 of the Ethics in Gov-
ernment Act of 1978 (5 U.S.C. App.) and section 
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208 of title 18, United States Code, for the purposes 
of disclosure and management of conflicts of interest 
under those sections. 
‘‘(6) NO
PAY; 
RECEIPT
OF
TRAVEL
EX-
PENSES.—Members of the Advisory Committee shall 
not receive any pay for service on the Committee, 
but may receive travel expenses, including a per 
diem, in accordance with applicable provisions of 
subchapter I of chapter 57 of title 5, United States 
Code. 
‘‘(e) CONSULTATION.—In carrying out this section, 
the Secretary shall consult with the Secretary of Edu-
cation and the Secretary of Labor. 
‘‘(f) COLLABORATION.—The Advisory Committee 
shall collaborate with the advisory bodies at the Health 
Resources and Services Administration, the National Ad-
visory Council (as authorized in section 337), the Advisory 
Committee on Training in Primary Care Medicine and 
Dentistry (as authorized in section 749A), the Advisory 
Committee on Interdisciplinary, Community-Based Link-
ages (as authorized in section 756), the Advisory Council 
on Graduate Medical Education (as authorized in section 
762), and the National Advisory Council on Nurse Edu-
cation and Practice (as authorized in section 851). 
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1969 
‘‘(2) DUTIES.—Not later than 180 days after 
the date of enactment of this section, the Committee 
shall— 
‘‘(A) carry out such activities as are nec-
essary to incorporate the Foundation under the 
laws of the District of Columbia, including act-
ing as incorporators of the Foundation; 
‘‘(B) ensure that the Foundation qualifies 
for and maintains the status required to carry 
out this section, until the Board is established; 
‘‘(C) establish the constitution and initial 
bylaws of the Foundation; 
‘‘(D) provide for the initial operation of 
the Foundation, including providing for tem-
porary or interim quarters, equipment, and 
staff; and 
‘‘(E) appoint the initial members of the 
Board in accordance with the constitution and 
initial bylaws of the Foundation. 
‘‘(g) BOARD OF DIRECTORS.— 
‘‘(1) IN
GENERAL.—The Board of Directors 
shall be the governing body of the Foundation. 
‘‘(2) POWERS.—The Board may exercise, or 
provide for the exercise of, the powers of the Foun-
dation. 
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