1373 
‘‘(B) not later than 90 days after receiving 
the grant, the entity will establish a community 
advisory committee composed of individuals, a 
majority of whom are being served by the cen-
ter, to provide input into the nurse-managed 
health center’s operations. 
‘‘(2) MATCHING
REQUIREMENT.—The Sec-
retary may award a grant under this section to an 
entity only if the entity agrees to provide, from non- 
Federal sources, an amount equal to 20 percent of 
the amount of the grant (which may be provided in 
cash or in kind) to carry out the activities supported 
by the grant. 
‘‘(3) PAYOR OF LAST RESORT.—The Secretary 
may award a grant under this section to an entity 
only if the entity demonstrates to the satisfaction of 
the Secretary that funds received through the grant 
will not be expended for any activity to the extent 
that payment has been made, or can reasonably be 
expected to be made— 
‘‘(A) under any insurance policy; 
‘‘(B) under any Federal or State health 
benefits program (including titles XIX and XXI 
of the Social Security Act); or
1374 
‘‘(C) by an entity which provides health 
services on a prepaid basis. 
‘‘(4) MAINTENANCE
OF
EFFORT.—The Sec-
retary may award a grant under this section to an 
entity only if the entity demonstrates to the satisfac-
tion of the Secretary that— 
‘‘(A) funds received through the grant will 
be expended only to supplement, and not sup-
plant, non-Federal and Federal funds otherwise 
available to the entity for the activities to be 
funded through the grant; and 
‘‘(B) with respect to such activities, the en-
tity will maintain expenditures of non-Federal 
amounts for such activities at a level not less 
than the lesser of such expenditures maintained 
by the entity for the fiscal year preceding the 
fiscal year for which the entity receives the 
grant. 
‘‘(e) ADDITIONAL
ASSURANCE
FOR
PLANNING 
GRANTS.—The Secretary may award a grant under sub-
section (b)(1) to an entity only if the entity agrees— 
‘‘(1) to assess the needs of the medically under-
served populations proposed to be served by the 
nurse-managed health center; and
1375 
‘‘(2) to design services and operations of the 
nurse-managed health center for such populations 
based on such assessment. 
‘‘(f) ADDITIONAL
ASSURANCE
FOR
OPERATION 
GRANTS.—The Secretary may award a grant under sub-
section (b)(2) to an entity only if the entity assures that 
the nurse-managed health center will provide— 
‘‘(1) comprehensive primary care services, 
wellness services, and other health care services 
deemed appropriate by the Secretary; 
‘‘(2) care without respect to insurance status or 
income of the patient; and 
‘‘(3) direct access to client-centered services of-
fered by advanced practice nurses, other nurses, 
physicians, physician assistants, or other qualified 
health professionals. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly or by grant or contract) technical 
and other assistance to nurse-managed health centers to 
assist such centers in meeting the requirements of this 
section. Such assistance may include fiscal and program 
management assistance, training in fiscal and program 
management, operational and administrative support, and 
the provision of information to nurse-managed health cen-
ters regarding the various resources available under this
1376 
section and how those resources can best be used to meet 
the health needs of the communities served by nurse-man-
aged health centers. 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program under this sec-
tion. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) COMPREHENSIVE
PRIMARY
CARE
SERV-
ICES.—The term ‘comprehensive primary care serv-
ices’ has the meaning given to the term ‘required 
primary health services’ in section 330(b)(1). 
‘‘(2) 
MEDICALLY
UNDERSERVED
POPU-
LATION.—The term ‘medically underserved popu-
lation’ has the meaning given to such term in section 
330(b)(3). 
‘‘(3) NURSE-MANAGED HEALTH CENTER.—The 
term ‘nurse-managed health center’ has the meaning 
given to such term in section 801. 
‘‘(4) WELLNESS SERVICES.—The term ‘wellness 
services’ means any health-related service or inter-
vention, not including primary care, which is de-
signed to reduce identifiable health risks and in-
crease healthy behaviors intended to prevent the 
onset of disease or lessen the impact of existing 
chronic conditions by teaching more effective man-
1377 
agement techniques that focus on individual self-care 
and patient-driven decisionmaking. 
‘‘(j) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2011 through 2015.’’. 
SEC. 2513. FEDERALLY QUALIFIED BEHAVIORAL HEALTH 
CENTERS. 
Section 1913 (42 U.S.C. 300x–3) is amended— 
(1) in subsection (a)(2)(A), by striking ‘‘com-
munity mental health services’’ and inserting ‘‘be-
havioral health services (of the type offered by feder-
ally qualified behavioral health centers consistent 
with subsection (c)(3))’’; 
(2) in subsection (b)— 
(A) by striking paragraph (1) and insert-
ing the following: 
‘‘(1) services under the plan will be provided 
only through appropriate, qualified community pro-
grams (which may include federally qualified behav-
ioral health centers, child mental health programs, 
psychosocial rehabilitation programs, mental health 
peer-support programs, and mental health primary 
consumer-directed programs); and’’; and
1378 
(B) in paragraph (2), by striking ‘‘commu-
nity mental health centers’’ and inserting ‘‘fed-
erally qualified behavioral health centers’’; and 
(3) by striking subsection (c) and inserting the 
following: 
‘‘(c) CRITERIA FOR FEDERALLY QUALIFIED BEHAV-
IORAL HEALTH CENTERS.— 
‘‘(1) IN
GENERAL.—The Administrator shall 
certify, and recertify at least every 5 years, federally 
qualified behavioral health centers as meeting the 
criteria specified in this subsection. 
‘‘(2) REGULATIONS.—Not later than 18 months 
after the date of the enactment of the Affordable 
Health Care for America Act, the Administrator 
shall issue final regulations for certifying centers 
under paragraph (1). 
‘‘(3) CRITERIA.—The criteria referred to in 
subsection (b)(2) are that the center performs each 
of the following: 
‘‘(A) Provide services in locations that en-
sure services will be available and accessible 
promptly and in a manner which preserves 
human dignity and assures continuity of care. 
‘‘(B) Provide services in a mode of service 
delivery appropriate for the target population.
1379 
‘‘(C) Provide individuals with a choice of 
service options where there is more than one ef-
ficacious treatment. 
‘‘(D) Employ a core staff of clinical staff 
that is multidisciplinary and culturally and lin-
guistically competent. 
‘‘(E) Provide services, within the limits of 
the capacities of the center, to any individual 
residing or employed in the service area of the 
center. 
‘‘(F) Provide, directly or through contract, 
to the extent covered for adults in the State 
Medicaid plan and for children in accordance 
with section 1905(r) of the Social Security Act 
regarding early and periodic screening, diag-
nosis, and treatment, each of the following serv-
ices: 
‘‘(i) Screening, assessment, and diag-
nosis, including risk assessment. 
‘‘(ii) Person-centered treatment plan-
ning or similar processes, including risk as-
sessment and crisis planning. 
‘‘(iii) Outpatient clinic mental health 
services, including screening, assessment, 
diagnosis, psychotherapy, substance abuse
1380 
counseling, medication management, and 
integrated treatment for mental illness and 
substance abuse which shall be evidence- 
based (including cognitive behavioral ther-
apy, dialectical behavioral therapy, motiva-
tional interviewing, and other such thera-
pies which are evidence-based). 
‘‘(iv) Outpatient clinic primary care 
services, including screening and moni-
toring of key health indicators and health 
risk (including screening for diabetes, hy-
pertension, and cardiovascular disease and 
monitoring of weight, height, body mass 
index (BMI), blood pressure, blood glucose 
or HbA1C, and lipid profile). 
‘‘(v) Crisis mental health services, in-
cluding 24-hour mobile crisis teams, emer-
gency crisis intervention services, and cri-
sis stabilization. 
‘‘(vi) 
Targeted 
case 
management 
(services to assist individuals gaining ac-
cess to needed medical, social, educational, 
and other services and applying for income 
security and other benefits to which they 
may be entitled).
1381 
‘‘(vii) Psychiatric rehabilitation serv-
ices including skills training, assertive com-
munity treatment, family psychoeducation, 
disability self-management, supported em-
ployment, 
supported 
housing 
services, 
therapeutic foster care services, multisys-
temic therapy, and such other evidence- 
based practices as the Secretary may re-
quire. 
‘‘(viii) Peer support and counselor 
services and family supports. 
‘‘(G) Maintain linkages, and where possible 
enter into formal contracts with, inpatient psy-
chiatric facilities and substance abuse detoxi-
fication and residential programs. 
‘‘(H) Make available to individuals served 
by the center, directly, through contract, or 
through linkages with other programs, each of 
the following: 
‘‘(i) Adult and youth peer support and 
counselor services. 
‘‘(ii) Family support services for fami-
lies of children with serious mental dis-
orders.
1382 
‘‘(iii) Other community or regional 
services, supports, and providers, including 
schools, child welfare agencies, juvenile and 
criminal justice agencies and facilities, 
housing agencies and programs, employers, 
and other social services. 
‘‘(iv) Onsite or offsite access to pri-
mary care services. 
‘‘(v) Enabling services, including out-
reach, transportation, and translation. 
‘‘(vi) Health and wellness services, in-
cluding services for tobacco cessation.’’. 
PART 2—OTHER GRANT PROGRAMS 
SEC. 2521. COMPREHENSIVE PROGRAMS TO PROVIDE EDU-
CATION TO NURSES AND CREATE A PIPELINE 
TO NURSING. 
(a) PURPOSES.—It is the purpose of this section to 
authorize grants to— 
(1) address the projected shortage of nurses by 
funding comprehensive programs to create a career 
ladder to nursing (including certified nurse assist-
ants, licensed practical nurses, licensed vocational 
nurses, and registered nurses) for incumbent ancil-
lary health care workers;
1383 
(2) increase the capacity for educating nurses 
by increasing both nurse faculty and clinical oppor-
tunities through collaborative programs between 
staff nurse organizations, health care providers, and 
accredited schools of nursing; and 
(3) provide training programs through edu-
cation and training organizations jointly adminis-
tered by health care providers and health care labor 
organizations or other organizations representing 
staff nurses and frontline health care workers, work-
ing in collaboration with accredited schools of nurs-
ing and academic institutions. 
(b) GRANTS.—Not later than 6 months after the date 
of the enactment of this Act, the Secretary of Labor (re-
ferred to in this section as the ‘‘Secretary’’) shall establish 
a partnership grant program to award grants to eligible 
entities to carry out comprehensive programs to provide 
education to nurses and create a pipeline to nursing for 
incumbent ancillary health care workers who wish to ad-
vance their careers, and to otherwise carry out the pur-
poses of this section. 
(c) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall be— 
(1) a health care entity that is jointly adminis-
tered by a health care employer and a labor union
1384 
representing the health care employees of the em-
ployer and that carries out activities using labor- 
management training funds as provided for under 
section 302(c)(6) of the Labor Management Rela-
tions Act, 1947 (29 U.S.C. 186(c)(6)); 
(2) an entity that operates a training program 
that is jointly administered by— 
(A) one or more health care providers or 
facilities, or a trade association of health care 
providers; and 
(B) one or more organizations which rep-
resent the interests of direct care health care 
workers or staff nurses and in which the direct 
care health care workers or staff nurses have 
direct input as to the leadership of the organi-
zation; 
(3) a State training partnership program that 
consists of nonprofit organizations that include equal 
participation from industry, including public or pri-
vate employers, and labor organizations including 
joint labor-management training programs, and 
which may include representatives from local govern-
ments, worker investment agency one-stop career 
centers, community-based organizations, community 
colleges, and accredited schools of nursing; or
1385 
(4) a school of nursing (as defined in section 
801 of the Public Health Service Act (42 U.S.C. 
296)). 
(d) ADDITIONAL REQUIREMENTS FOR HEALTH CARE 
EMPLOYER DESCRIBED IN SUBSECTION (c).—To be eligi-
ble for a grant under this section, a health care employer 
described in subsection (c) shall demonstrate that it— 
(1) has an established program within its facil-
ity to encourage the retention of existing nurses; 
(2) provides wages and benefits to its nurses 
that are competitive for its market or that have been 
collectively bargained with a labor organization; and 
(3) supports programs funded under this sec-
tion through 1 or more of the following: 
(A) The provision of paid leave time and 
continued health coverage to incumbent health 
care workers to allow their participation in 
nursing career ladder programs, including cer-
tified nurse assistants, licensed practical nurses, 
licensed 
vocational 
nurses, 
and 
registered 
nurses. 
(B) Contributions to a joint labor-manage-
ment training fund which administers the pro-
gram involved.
1386 
(C) The provision of paid release time, in-
centive compensation, or continued health cov-
erage to staff nurses who desire to work full- or 
part-time in a faculty position. 
(D) The provision of paid release time for 
staff nurses to enable them to obtain a bachelor 
of science in nursing degree, other advanced 
nursing degrees, specialty training, or certifi-
cation program. 
(E) The payment of tuition assistance 
which is managed by a joint labor-management 
training fund or other jointly administered pro-
gram. 
(e) OTHER REQUIREMENTS.— 
(1) MATCHING REQUIREMENT.— 
(A) IN GENERAL.—The Secretary may not 
make a grant under this section unless the ap-
plicant involved agrees, with respect to the costs 
to be incurred by the applicant in carrying out 
the program under the grant, to make available 
non-Federal contributions (in cash or in kind 
under subparagraph (B)) toward such costs in 
an amount equal to not less than $1 for each 
$1 of Federal funds provided in the grant. Such 
contributions may be made directly or through
1387 
donations from public or private entities, or 
may be provided through the cash equivalent of 
paid release time provided to incumbent worker 
students. 
(B) DETERMINATION OF AMOUNT OF NON- 
FEDERAL
CONTRIBUTION.—Non-Federal con-
tributions required in subparagraph (A) may be 
in cash or in kind (including paid release time), 
fairly evaluated, including equipment or services 
(and excluding indirect or overhead costs). 
Amounts provided by the Federal Government, 
or services assisted or subsidized to any signifi-
cant extent by the Federal Government, may 
not be included in determining the amount of 
such non-Federal contributions. 
(2) REQUIRED COLLABORATION.—Entities car-
rying out or overseeing programs carried out with 
assistance provided under this section shall dem-
onstrate collaboration with accredited schools of 
nursing which may include community colleges and 
other academic institutions providing associate’s, 
bachelor’s, or advanced nursing degree programs or 
specialty training or certification programs.
1388 
(f) USE OF FUNDS.—Amounts awarded to an entity 
under a grant under this section shall be used for the fol-
lowing: 
(1) To carry out programs that provide edu-
cation and training to establish nursing career lad-
ders to educate incumbent health care workers to be-
come nurses (including certified nurse assistants, li-
censed practical nurses, licensed vocational nurses, 
and registered nurses). Such programs shall include 
one or more of the following: 
(A) Preparing incumbent workers to return 
to the classroom through English-as-a-second- 
language education, GED education, precollege 
counseling, college preparation classes, and sup-
port with entry level college classes that are a 
prerequisite to nursing. 
(B) Providing tuition assistance with pref-
erence for dedicated cohort classes in commu-
nity 
colleges, 
universities, 
and 
accredited 
schools of nursing with supportive services in-
cluding tutoring and counseling. 
(C) Providing assistance in preparing for 
and meeting all nursing licensure tests and re-
quirements.
1389 
(D) 
Carrying 
out 
orientation 
and 
mentorship programs that assist newly grad-
uated nurses in adjusting to working at the 
bedside 
to 
ensure 
their 
retention 
postgraduation, and ongoing programs to sup-
port nurse retention. 
(E) Providing stipends for release time and 
continued health care coverage to enable incum-
bent health care workers to participate in these 
programs. 
(2) To carry out programs that assist nurses in 
obtaining advanced degrees and completing specialty 
training or certification programs and to establish 
incentives for nurses to assume nurse faculty posi-
tions on a part-time or full-time basis. Such pro-
grams shall include one or more of the following: 
(A) Increasing the pool of nurses with ad-
vanced degrees who are interested in teaching 
by funding programs that enable incumbent 
nurses to return to school. 
(B) Establishing incentives for advanced 
degree bedside nurses who wish to teach in 
nursing programs so they can obtain a leave 
from their bedside position to assume a full- or
1390 
part-time position as adjunct or full-time fac-
ulty without the loss of salary or benefits. 
(C) Collaboration with accredited schools 
of nursing which may include community col-
leges and other academic institutions providing 
associate’s, bachelor’s, or advanced nursing de-
gree programs, or specialty training or certifi-
cation programs, for nurses to carry out innova-
tive nursing programs which meet the needs of 
bedside nursing and health care providers. 
(g) PREFERENCE.—In awarding grants under this 
section the Secretary shall give preference to programs 
that— 
(1) provide for improving nurse retention; 
(2) provide for improving the diversity of the 
new nurse graduates to reflect changes in the demo-
graphics of the patient population; 
(3) provide for improving the quality of nursing 
education to improve patient care and safety; 
(4) have demonstrated success in upgrading in-
cumbent health care workers to become nurses or 
which have established effective programs or pilots 
to increase nurse faculty; or 
(5) are modeled after or affiliated with such 
programs described in paragraph (4).
1391 
(h) EVALUATION.— 
(1) PROGRAM
EVALUATIONS.—An entity that 
receives a grant under this section shall annually 
evaluate, and submit to the Secretary a report on, 
the activities carried out under the grant and the 
outcomes of such activities. Such outcomes may in-
clude— 
(A) an increased number of incumbent 
workers entering an accredited school of nurs-
ing and in the pipeline for nursing programs; 
(B) an increasing number of graduating 
nurses and improved nurse graduation and li-
censure rates; 
(C) improved nurse retention; 
(D) an increase in the number of staff 
nurses at the health care facility involved; 
(E) an increase in the number of nurses 
with advanced degrees in nursing; 
(F) an increase in the number of nurse 
faculty; 
(G) improved measures of patient quality 
(which may include staffing ratios of nurses, 
patient satisfaction rates, and patient safety 
measures); and
1392 
(H) an increase in the diversity of new 
nurse graduates relative to the patient popu-
lation. 
(2) GENERAL REPORT.—Not later than 2 years 
after the date of the enactment of this Act, and an-
nually thereafter, the Secretary of Labor shall, using 
data and information from the reports received 
under paragraph (1), submit to the Congress a re-
port concerning the overall effectiveness of the grant 
program carried out under this section. 
(i) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2011 through 2015. 
SEC. 2522. MENTAL AND BEHAVIORAL HEALTH TRAINING. 
Part E of title VII (42 U.S.C. 294n et seq.) is amend-
ed by adding at the end the following: 
‘‘Subpart 3—Mental and Behavioral Health Training 
‘‘SEC. 775. MENTAL AND BEHAVIORAL HEALTH TRAINING 
PROGRAM. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Administrator 
of the Substance Abuse and Mental Health Services Ad-
ministration, shall establish an interdisciplinary mental
1393 
and behavioral health training program consisting of 
awarding grants and contracts under subsection (b). 
‘‘(b) SUPPORT AND DEVELOPMENT OF MENTAL AND 
BEHAVIORAL HEALTH TRAINING PROGRAMS.—The Sec-
retary shall make grants to, or enter into contracts with, 
eligible entities— 
‘‘(1) to plan, develop, operate, or participate in 
an accredited professional training program for men-
tal and behavioral health professionals to promote— 
‘‘(A) interdisciplinary training; 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; 
‘‘(2) to provide financial assistance to mental 
and behavioral health professionals, who are partici-
pants in any such program, and who plan to work 
in the field of mental and behavioral health; 
‘‘(3) to plan, develop, operate, or participate in 
an accredited program for the training of mental 
and behavioral health professionals who plan to 
teach in the field of mental and behavioral health; 
and 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to mental and behav-
1394 
ioral health professionals who are participants in any 
such program and who plan to teach in the field of 
mental and behavioral health. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school, in-
cluding an accredited school or program of psy-
chology, psychiatry, social work, marriage and family 
therapy, professional mental health or substance 
abuse counseling, or addiction medicine; 
‘‘(2) an accredited public or nonprofit private 
hospital; 
‘‘(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 health professionals who serve in un-
derserved communities. 
‘‘(2) Supporting teaching programs that ad-
dress the health care needs of vulnerable popu-
lations.
1395 
‘‘(3) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among mental and be-
havioral health professionals). 
‘‘(4) Training individuals who serve geriatric 
populations with an emphasis on underserved elder-
ly. 
‘‘(5) Training individuals who serve pediatric 
populations with an emphasis on underserved chil-
dren. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program under this sec-
tion. 
‘‘(f) DEFINITION.—In this section: 
‘‘(1) The term ‘interdisciplinary’ means collabo-
ration across health professions, specialties, and sub-
specialties, which may include public health, nursing, 
allied health, dietetics or nutrition, and appropriate 
health specialties. 
‘‘(2) The term ‘mental and behavioral health 
professional’ means an individual training or prac-
ticing— 
‘‘(A) in psychology; general, geriatric, child 
or adolescent psychiatry; social work; marriage 
and family therapy; professional mental health
1396 
or substance abuse counseling; or addiction 
medicine; or 
‘‘(B) another mental and behavioral health 
specialty, as deemed appropriate by the Sec-
retary. 
‘‘(g) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $60,000,000 for each of fiscal years 2011 through 
2015. Of the amounts appropriated to carry out this sec-
tion for a fiscal year, not less than 15 percent shall be 
used for training programs in psychology.’’. 
SEC. 2523. REAUTHORIZATION OF TELEHEALTH AND TELE-
MEDICINE GRANT PROGRAMS. 
(a) TELEHEALTH NETWORK AND TELEHEALTH RE-
SOURCE CENTERS GRANT PROGRAMS.—Section 330I (42 
U.S.C. 254c–14) is amended— 
(1) in subsection (a)— 
(A) by striking paragraph (3) (relating to 
frontier communities); and 
(B) by inserting after paragraph (2) the 
following: 
‘‘(3) HEALTH DISPARITIES.—The term ‘health 
disparities’ has the meaning given such term in sec-
tion 3171.’’; 
(2) in subsection (d)(1)—
1397 
(A) in subparagraph (B), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (C), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(D) reduce health disparities.’’; 
(3) in subsection (f)(1)(B)(iii)— 
(A) in subclause (VII), by inserting ‘‘, in-
cluding skilled nursing facilities’’ before the pe-
riod at the end; 
(B) in subclause (IX), by inserting ‘‘, in-
cluding county mental health and public mental 
health facilities’’ before the period at the end; 
and 
(C) by adding at the end the following: 
‘‘(XIII) Renal dialysis facilities.’’; 
(4) by amending subsection (i) to read as fol-
lows: 
‘‘(i) PREFERENCES.— 
‘‘(1) TELEHEALTH
NETWORKS.—In awarding 
grants under subsection (d)(1) for projects involving 
telehealth networks, the Secretary shall give pref-
erence to eligible entities meeting at least one of the 
following:
1398 
‘‘(A) NETWORK.—The eligible entity is a 
health care provider in, or proposing to form, a 
health care network that furnishes services in a 
medically underserved area or a health profes-
sional shortage area. 
‘‘(B) BROAD
GEOGRAPHIC
COVERAGE.— 
The eligible entity demonstrates broad geo-
graphic coverage in the rural or medically un-
derserved areas of the State or States in which 
the entity is located. 
‘‘(C) HEALTH DISPARITIES.—The eligible 
entity demonstrates how the project to be fund-
ed through the grant will address health dis-
parities. 
‘‘(D) 
LINKAGES.—The 
eligible 
entity 
agrees to use the grant to establish or develop 
plans for telehealth systems that will link rural 
hospitals and rural health care providers to 
other hospitals, health care providers, and pa-
tients. 
‘‘(E) EFFICIENCY.—The eligible entity 
agrees to use the grant to promote greater effi-
ciency in the use of health care resources.
1399 
‘‘(F) VIABILITY.—The eligible entity dem-
onstrates the long-term viability of projects 
through— 
‘‘(i) availability of non-Federal fund-
ing sources; or 
‘‘(ii) institutional and community sup-
port for the telehealth network. 
‘‘(G) SERVICES.—The eligible entity pro-
vides a plan for coordinating system use by eli-
gible entities and prioritizes use of grant funds 
for health care services over nonclinical uses. 
‘‘(2) TELEHEALTH
RESOURCE
CENTERS.—In 
awarding grants under subsection (d)(2) for projects 
involving telehealth resource centers, the Secretary 
shall give preference to eligible entities meeting at 
least one of the following: 
‘‘(A) PROVISION OF A BROAD RANGE OF 
SERVICES.—The eligible entity has a record of 
success in the provision of a broad range of 
telehealth services to medically underserved 
areas or populations. 
‘‘(B) PROVISION OF TELEHEALTH TECH-
NICAL ASSISTANCE.—The eligible entity has a 
record of success in the provision of technical 
assistance to providers serving medically under-
1400 
served communities or populations in the estab-
lishment and implementation of telehealth serv-
ices. 
‘‘(C) COLLABORATION
AND
SHARING
OF 
EXPERTISE.—The eligible entity has a dem-
onstrated record of collaborating and sharing 
expertise with providers of telehealth services at 
the national, regional, State, and local levels.’’; 
(5) in subsection (j)(2)(B), by striking ‘‘such 
projects for fiscal year 2001’’ and all that follows 
through the period and inserting ‘‘such projects for 
fiscal year 2010.’’; 
(6) in subsection (k)(1)— 
(A) in subparagraph (E)(i), by striking 
‘‘transmission of medical data’’ and inserting 
‘‘transmission and electronic archival of medical 
data’’; and 
(B) by amending subparagraph (F) to read 
as follows: 
‘‘(F) developing projects to use telehealth 
technology to— 
‘‘(i) facilitate collaboration between 
health care providers; 
‘‘(ii) promote telenursing services; or
1401 
‘‘(iii) promote patient understanding 
and adherence to national guidelines for 
chronic disease and self-management of 
such conditions;’’; 
(7) in subsection (q), by striking ‘‘Not later 
than September 30, 2005’’ and inserting ‘‘Not later 
than 1 year after the date of the enactment of the 
Affordable Health Care for America Act, and annu-
ally thereafter’’; 
(8) by striking subsection (r); 
(9) by redesignating subsection (s) as sub-
section (r); and 
(10) in subsection (r) (as so redesignated)— 
(A) in paragraph (1)— 
(i) by striking ‘‘and’’ before ‘‘such 
sums’’; and 
(ii) by inserting ‘‘, $10,000,000 for 
fiscal year 2011, and such sums as may be 
necessary for each of fiscal years 2012 
through 2015’’ before the semicolon; and 
(B) in paragraph (2)— 
(i) by striking ‘‘and’’ before ‘‘such 
sums’’; and 
(ii) by inserting ‘‘, $10,000,000 for 
fiscal year 2011, and such sums as may be
1402 
necessary for each of fiscal years 2012 
through 2015’’ before the period. 
(b) TELEMEDICINE; INCENTIVE GRANTS REGARDING 
COORDINATION AMONG STATES.—Subsection (b) of sec-
tion 330L (42 U.S.C. 254c–18) is amended by inserting 
‘‘, $10,000,000 for fiscal year 2011, and such sums as 
may be necessary for each of fiscal years 2012 through 
2015’’ before the period at the end. 
SEC. 2524. NO CHILD LEFT UNIMMUNIZED AGAINST INFLU-
ENZA: DEMONSTRATION PROGRAM USING EL-
EMENTARY AND SECONDARY SCHOOLS AS IN-
FLUENZA VACCINATION CENTERS. 
(a) PURPOSE.—The Secretary of Health and Human 
Services in consultation with the Secretary of Education, 
shall award grants to eligible partnerships to carry out 
demonstration programs designed to test the feasibility of 
using the Nation’s elementary schools and secondary 
schools as influenza vaccination centers. 
(b) IN GENERAL.—The Secretary shall coordinate 
with the Secretary of Labor, the Secretary of Education, 
State Medicaid agencies, State insurance agencies, and 
private insurers to carry out a program consisting of 
awarding grants under subsection (c) to ensure that chil-
dren have coverage for all reasonable and customary ex-
penses related to influenza vaccinations, including the
1403 
costs of purchasing and administering the vaccine in-
curred when influenza vaccine is administered outside of 
the physician’s office in a school or other related setting. 
(c) PROGRAM DESCRIPTION.— 
(1) GRANTS.—From amounts appropriated pur-
suant to subsection (l), the Secretary shall award 
grants to eligible partnerships to be used to provide 
influenza vaccinations to children in elementary and 
secondary schools, in coordination with school 
nurses, school health care programs, community 
health care providers, State insurance agencies, or 
private insurers. 
(2) ACIP RECOMMENDATIONS.—The program 
under this section shall be designed to administer 
vaccines consistent with the recommendations of the 
Centers for Disease Control and Prevention’s Advi-
sory Committee on Immunization Practices (ACIP) 
for the annual vaccination of all children 5 through 
19 years of age. 
(3) PARTICIPATION VOLUNTARY.—Participation 
by a school or an individual shall be voluntary. 
(d) USE OF FUNDS.—Eligible partnerships receiving 
a grant under this section shall ensure the maximum num-
ber of children access influenza vaccinations as follows:
1404 
(1) COVERED
CHILDREN.—To the extent to 
which payment of the costs of purchasing or admin-
istering the influenza vaccine for children is not cov-
ered through other federally funded programs or 
through private insurance, eligible partnerships re-
ceiving a grant shall use funds to purchase and ad-
minister influenza vaccinations. 
(2) CHILDREN COVERED BY OTHER FEDERAL 
PROGRAMS.—For children who are eligible under 
other federally funded programs for payment of the 
costs of purchasing or administering the influenza 
vaccine, eligible partnerships receiving a grant shall 
not use funds provided under this section for such 
costs. 
(3) CHILDREN COVERED BY PRIVATE HEALTH 
INSURANCE.—For children who have private insur-
ance, eligible partnerships receiving a grant shall 
offer assistance in accessing coverage for vaccina-
tions administered through the program under this 
section. 
(e) PRIVACY.—The Secretary shall ensure that the 
program under this section adheres to confidentiality and 
privacy requirements of section 264 of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note) and section 444 of the General
1405 
Education Provisions Act (20 U.S.C. 1232g; commonly re-
ferred to as the ‘‘Family Educational Rights and Privacy 
Act of 1974’’). 
(f) APPLICATION.—An eligible partnership desiring a 
grant under this section shall submit an application to the 
Secretary at such time, in such manner, and containing 
such information as the Secretary may require. 
(g) DURATION.—Eligible partnerships receiving a 
grant shall administer a demonstration program funded 
through this section over a period of 2 consecutive school 
years. 
(h) CHOICE OF VACCINE.—The program under this 
section shall not restrict the discretion of a health care 
provider to administer any influenza vaccine approved by 
the Food and Drug Administration for use in pediatric 
populations. 
(i) AWARDS.—The Secretary shall award— 
(1) a minimum of 10 grants in 10 different 
States to eligible partnerships that each include one 
or more public schools serving primarily low-income 
students; and 
(2) a minimum of 5 grants in 5 different States 
to eligible partnerships that each include one or 
more public schools located in a rural local edu-
cational agency.
1406 
(j) REPORT.—Not later than 90 days following the 
completion of the program under this section, the Sec-
retary shall submit to the Committees on Education and 
Labor, Energy and Commerce, and Appropriations of the 
House of Representatives and to the Committees on 
Health, Education, Labor, and Pensions and Appropria-
tions of the Senate a report on the results of the program. 
The report shall include— 
(1) an assessment of the influenza vaccination 
rates of school-age children in localities where the 
program is implemented, compared to the national 
average influenza vaccination rates for school-aged 
children, including whether school-based vaccination 
assists in achieving the recommendations of the Ad-
visory Committee on Immunization Practices; 
(2) an assessment of the utility of employing el-
ementary schools and secondary schools as a part of 
a multistate, community-based pandemic response 
program that is consistent with existing Federal and 
State pandemic response plans; 
(3) an assessment of the feasibility of using ex-
isting Federal and private insurance funding in es-
tablishing a multistate, school-based vaccination pro-
gram for seasonal influenza vaccination;
1407 
(4) an assessment of the number of education 
days gained by students as a result of seasonal vac-
cinations based on absenteeism rates; 
(5) a determination of whether the program 
under this section— 
(A) increased vaccination rates in the par-
ticipating localities; and 
(B) was implemented for sufficient time 
for gathering enough valid data; and 
(6) a recommendation on whether the program 
should be continued, expanded, or terminated. 
(k) DEFINITIONS.—In this section: 
(1) ELIGIBLE PARTNERSHIP.—The term ‘‘eligi-
ble partnership’’ means a local public health depart-
ment, or another health organization defined by the 
Secretary as eligible to submit an application, and 
one or more elementary and secondary schools. 
(2) ELEMENTARY
SCHOOL.—The terms ‘‘ele-
mentary school’’ and ‘‘secondary school’’ have the 
meanings given such terms in section 9101 of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(3) LOW-INCOME.—The term ‘‘low-income’’ 
means a student, age 5 through 19, eligible for free
1408 
or reduced-price lunch under the National School 
Lunch Act (42 U.S.C. 1751 et seq.). 
(4) RURAL
LOCAL
EDUCATIONAL
AGENCY.— 
The term ‘‘rural local educational agency’’ means an 
eligible local educational agency described in section 
6211(b)(1) of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 7345(b)(1)). 
(5) SECRETARY.—Except as otherwise speci-
fied, the term ‘‘Secretary’’ means the Secretary of 
Health and Human Services. 
(l) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for each of fiscal years 
2011 through 2015. 
SEC. 2525. EXTENSION OF WISEWOMAN PROGRAM. 
Section 1509 of the Public Health Service Act (42 
U.S.C. 300n–4a) is amended— 
(1) in subsection (a)— 
(A) by striking the heading and inserting 
‘‘IN GENERAL.—’’; and 
(B) in the matter preceding paragraph (1), 
by striking ‘‘may make grants’’ and all that fol-
lows through ‘‘purpose’’ and inserting the fol-
lowing: ‘‘may make grants to such States for 
the purpose’’; and
1409 
(2) in subsection (d)(1), by striking ‘‘there are 
authorized’’ and all that follows through the period 
and inserting ‘‘there are authorized to be appro-
priated 
$70,000,000 
for 
fiscal 
year 
2011, 
$73,500,000 for fiscal year 2012, $77,000,000 for 
fiscal year 2013, $81,000,000 for fiscal year 2014, 
and $85,000,000 for fiscal year 2015.’’. 
SEC. 2526. HEALTHY TEEN INITIATIVE TO PREVENT TEEN 
PREGNANCY. 
Part B of title III (42 U.S.C. 243 et seq.) is amended 
by inserting after section 317T the following: 
‘‘SEC. 317U. HEALTHY TEEN INITIATIVE TO PREVENT TEEN 
PREGNANCY. 
‘‘(a) PROGRAM.—To the extent and in the amount 
of appropriations made in advance in appropriations Acts, 
the Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, shall establish a pro-
gram consisting of making grants, in amounts determined 
under subsection (c), to each State that submits an appli-
cation in accordance with subsection (d) for an evidence- 
based education program described in subsection (b). 
‘‘(b) USE OF FUNDS.—Amounts received by a State 
under this section shall be used to conduct or support evi-
dence-based education programs (directly or through 
grants or contracts to public or private nonprofit entities,
1410 
including schools and community-based and faith-based 
organizations) to reduce teen pregnancy or sexually trans-
mitted diseases. 
‘‘(c) DISTRIBUTION OF FUNDS.—The Director shall, 
for fiscal year 2011 and each subsequent fiscal year, make 
a grant to each State described in subsection (a) in an 
amount equal to the product of— 
‘‘(1) the amount appropriated to carry out this 
section for the fiscal year; and 
‘‘(2) the percentage determined for the State 
under section 502(c)(1)(B)(ii) of the Social Security 
Act. 
‘‘(d) APPLICATION.—To seek a grant under this sec-
tion, a State shall submit an application at such time, in 
such manner, and containing such information and assur-
ance of compliance with this section as the Secretary may 
require. At a minimum, an application shall to the satis-
faction of the Secretary— 
‘‘(1) describe how the State’s proposal will ad-
dress the needs of at-risk teens in the State; 
‘‘(2) identify the evidence-based education pro-
gram or programs selected from the registry devel-
oped under subsection (g) that will be used to ad-
dress risks in priority populations;
1411 
‘‘(3) describe how the program or programs will 
be implemented and any adaptations to the evidence- 
based model that will be made; 
‘‘(4) list any private and public entities with 
whom the State proposes to work, including schools 
and community-based and faith-based organizations, 
and demonstrate their capacity to implement the 
proposed program or programs; and 
‘‘(5) identify an independent entity that will 
evaluate the impact of the program or programs. 
‘‘(e) EVALUATION.— 
‘‘(1) REQUIREMENT.—As a condition on receipt 
of a grant under this section, a State shall agree— 
‘‘(A) to arrange for an independent evalua-
tion of the impact of the programs to be con-
ducted or supported through the grant; and 
‘‘(B) submit reports to the Secretary on 
such programs and the results of evaluation of 
such programs. 
‘‘(2) FUNDING LIMITATION.—Of the amounts 
made available to a State through a grant under this 
section for any fiscal year, not more than 10 percent 
may be used for such evaluation. 
‘‘(f) RULE OF CONSTRUCTION.—This section shall 
not be construed to preempt or limit any State law regard-
1412 
ing parental involvement and decisionmaking in children’s 
education. 
‘‘(g) REGISTRY OF ELIGIBLE PROGRAMS.—The Sec-
retary shall develop not later than 180 days after the date 
of the enactment of the Affordable Health Care for Amer-
ica Act, and periodically update thereafter, a publicly 
available registry of programs described in subsection (b) 
that, as determined by the Secretary— 
‘‘(1) meet the definition of the term ‘evidence- 
based’ in subsection (i); 
‘‘(2) are medically and scientifically accurate; 
and 
‘‘(3) provide age-appropriate information. 
‘‘(h) MATCHING FUNDS.—The Secretary may award 
a grant to a State under this section for a fiscal year only 
if the State agrees to provide, from non-Federal sources, 
an amount equal to $1 (in cash or in kind) for each $4 
provided through the grant to carry out the activities sup-
ported by the grant. 
‘‘(i) DEFINITION.—In this section, the term ‘evi-
dence-based’ means based on a model that has been found, 
in methodologically sound research— 
‘‘(1) to delay initiation of sex; 
‘‘(2) to decrease number of partners; 
‘‘(3) to reduce teen pregnancy;
1413 
‘‘(4) to reduce sexually transmitted infection 
rates; or 
‘‘(5) to improve rates of contraceptive use. 
‘‘(j) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $50,000,000 for each of fiscal years 2011 through 
2015.’’. 
SEC. 2527. NATIONAL TRAINING INITIATIVES ON AUTISM 
SPECTRUM DISORDERS. 
Title I of the Developmental Disabilities Assistance 
and Bill of Rights Act of 2000 (42 U.S.C. 15001 et seq.) 
is amended by adding at the end the following: 
‘‘Subtitle F—National Training Ini-
tiative on Autism Spectrum Dis-
orders 
‘‘SEC. 171. NATIONAL TRAINING INITIATIVE. 
‘‘(a) GRANTS AND TECHNICAL ASSISTANCE.— 
‘‘(1) GRANTS.— 
‘‘(A) IN GENERAL.—The Secretary, in con-
sultation with the Interagency Autism Coordi-
nating Committee, shall award multiyear grants 
to eligible entities to provide individuals (includ-
ing parents and health, allied health, vocational, 
and educational professionals) with interdiscipli-
nary training, continuing education, technical
1414 
assistance, and information for the purpose of 
improving services rendered to children and 
adults with autism, and their families, to ad-
dress unmet needs related to autism. 
‘‘(B) ELIGIBLE ENTITY.—To be eligible to 
receive a grant under this subsection, an entity 
shall be— 
‘‘(i) a University Center for Excel-
lence in Developmental Disabilities Edu-
cation, Research, and Service; or 
‘‘(ii) a comparable interdisciplinary 
education, research, and service entity. 
‘‘(C) APPLICATION
REQUIREMENTS.—An 
entity that desires to receive a grant for a pro-
gram under this paragraph shall submit to the 
Secretary an application— 
‘‘(i) demonstrating that the entity has 
capacity to— 
‘‘(I) provide training and tech-
nical assistance in evidence-based 
practices to evaluate, and provide ef-
fective interventions, services, treat-
ments, and supports to, children and 
adults with autism and their families;
1415 
‘‘(II) include individuals with au-
tism and their families as part of the 
program to ensure that an individual- 
and family-centered approach is used; 
‘‘(III) share and disseminate ma-
terials and practices that are devel-
oped for, and evaluated to be effective 
in, the provision of training and tech-
nical assistance; and 
‘‘(IV) provide training, technical 
assistance, 
interventions, 
services, 
treatments, and supports under this 
subsection statewide. 
‘‘(ii) providing assurances that the en-
tity will— 
‘‘(I) provide trainees under this 
subsection with an appropriate bal-
ance of interdisciplinary academic and 
community-based experiences; and 
‘‘(II) provide to the Secretary, in 
the manner prescribed by the Sec-
retary, data regarding the number of 
individuals who have benefitted from, 
and outcomes of, the provision of
1416 
training 
and 
technical 
assistance 
under this subsection; 
‘‘(iii) providing assurances that train-
ing, technical assistance, dissemination of 
information, and services under this sub-
section will be— 
‘‘(I) consistent with the goals of 
this Act, the Americans with Disabil-
ities Act of 1990, the Individuals with 
Disabilities Education Act, and the 
Elementary and Secondary Education 
Act of 1965; and 
‘‘(II) conducted in coordination 
with relevant State agencies, institu-
tions of higher education, and service 
providers; and 
‘‘(iv) containing such other informa-
tion and assurances as the Secretary may 
require. 
‘‘(D) USE OF FUNDS.—A grant received 
under this subsection shall be used to provide 
individuals (including parents and health, allied 
health, vocational, and educational profes-
sionals) with interdisciplinary training, con-
tinuing education, technical assistance, and in-
1417 
formation for the purpose of improving services 
rendered to children and adults with autism, 
and their families, to address unmet needs re-
lated to autism. Such training, education, as-
sistance, and information shall include each of 
the following: 
‘‘(i) Training health, allied health, vo-
cational, and educational professionals to 
identify, evaluate the needs of, and develop 
interventions, services, treatments, and 
supports for, children and adults with au-
tism. 
‘‘(ii) Developing model services and 
supports that demonstrate evidence-based 
practices. 
‘‘(iii) Developing systems and prod-
ucts that allow for the interventions, serv-
ices, treatments, and supports to be evalu-
ated for fidelity of implementation. 
‘‘(iv) Working to expand the avail-
ability of evidence-based, lifelong interven-
tions; educational, employment, and transi-
tion services; and community supports. 
‘‘(v) Providing statewide technical as-
sistance in collaboration with relevant
1418 
State agencies, institutions of higher edu-
cation, autism advocacy groups, and com-
munity-based service providers. 
‘‘(vi) Working to develop comprehen-
sive systems of supports and services for 
individuals with autism and their families, 
including seamless transitions between 
education and health systems across the 
lifespan. 
‘‘(vii) Promoting training, technical 
assistance, dissemination of information, 
supports, and services. 
‘‘(viii) Developing mechanisms to pro-
vide training and technical assistance, in-
cluding for-credit courses, intensive sum-
mer institutes, continuing education pro-
grams, distance based programs, and Web- 
based information dissemination strategies. 
‘‘(ix) Promoting activities that sup-
port community-based family and indi-
vidual services and enable individuals with 
autism and related developmental disabil-
ities to fully participate in society and 
achieve good quality-of-life outcomes.
1419 
‘‘(x) Collecting data on the outcomes 
of training and technical assistance pro-
grams to meet statewide needs for the ex-
pansion of services to children and adults 
with autism. 
‘‘(E) AMOUNT OF GRANTS.—The amount 
of a grant to any entity for a fiscal year under 
this section shall be not less than $250,000. 
‘‘(2) TECHNICAL ASSISTANCE.—The Secretary 
shall reserve 2 percent of the amount appropriated 
to carry out this subsection for a fiscal year to make 
a grant to a national organization with dem-
onstrated capacity for providing training and tech-
nical assistance to— 
‘‘(A) assist in national dissemination of 
specific information, including evidence-based 
best practices, from interdisciplinary training 
programs, and when appropriate, other entities 
whose findings would inform the work per-
formed by entities awarded grants; 
‘‘(B) compile and disseminate strategies 
and materials that prove to be effective in the 
provision of training and technical assistance so 
that the entire network can benefit from the
1420 
models, materials, and practices developed in 
individual centers; 
‘‘(C) assist in the coordination of activities 
of grantees under this subsection; 
‘‘(D) develop a Web portal that will pro-
vide linkages to each of the individual training 
initiatives and provide access to training mod-
ules, promising training, and technical assist-
ance practices and other materials developed by 
grantees; 
‘‘(E) serve as a research-based resource for 
Federal and State policymakers on information 
concerning the provision of training and tech-
nical assistance for the assessment, and provi-
sion of supports and services for, children and 
adults with autism; 
‘‘(F) convene experts from multiple inter-
disciplinary training programs, individuals with 
autism, and the families of such individuals to 
discuss and make recommendations with regard 
to training issues related to assessment, inter-
ventions, services, treatment, and supports for 
children and adults with autism; and 
‘‘(H) undertake any other functions that 
the Secretary determines to be appropriate.
1421 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there are authorized to 
be appropriated $17,000,000 for fiscal year 2011 
and such sums as may be necessary for each of fis-
cal years 2012 through 2015. 
‘‘(b) EXPANSION OF THE NUMBER OF UNIVERSITY 
CENTERS FOR EXCELLENCE IN DEVELOPMENTAL DIS-
ABILITIES EDUCATION, RESEARCH, AND SERVICE.— 
‘‘(1) GRANTS.—To provide for the establish-
ment of up to 4 new University Centers for Excel-
lence in Developmental Disabilities Education, Re-
search, and Service, the Secretary shall award up to 
4 grants to institutions of higher education. 
‘‘(2) APPLICABLE
PROVISIONS.—Except for 
subsection (a)(3), the provisions of subsection (a) 
shall apply with respect to grants under this sub-
section to the same extent and in the same manner 
as such provisions apply with respect to grants 
under subsection (a). 
‘‘(3) PRIORITY.—In awarding grants under this 
subsection, the Secretary shall give priority to appli-
cants that— 
‘‘(A) are minority institutions that have 
demonstrated capacity to meet the requirements
1422 
of this section and provide services to individ-
uals with autism and their families; or 
‘‘(B) are located in a State with one or 
more underserved populations. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there is authorized to 
be appropriated $2,000,000 for each of fiscal years 
2011 through 2015. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) The term ‘autism’ means an autism spec-
trum disorder or a related developmental disability. 
‘‘(2) The term ‘interventions’ means edu-
cational methods and positive behavioral support 
strategies designed to improve or ameliorate symp-
toms associated with autism. 
‘‘(3) The term ‘minority institution’ has the 
meaning given to such term in section 365 of the 
Higher Education Act of 1965. 
‘‘(4) The term ‘services’ means services to as-
sist individuals with autism to live more independ-
ently in their communities. 
‘‘(5) The term ‘treatments’ means health serv-
ices, including mental health services, designed to 
improve or ameliorate symptoms associated with au-
tism.
1423 
‘‘(6) The term ‘University Center for Excellence 
in Developmental Disabilities Education, Research, 
and Service’ means a University Center for Excel-
lence in Development Disabilities Education, Re-
search, and Service that has been or is funded 
through subtitle D or subsection (b).’’. 
SEC. 2528. IMPLEMENTATION OF MEDICATION MANAGE-
MENT SERVICES IN TREATMENT OF CHRONIC 
DISEASES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Director of the Agency for 
Health Care Research and Quality, shall establish a pro-
gram to provide grants to eligible entities to implement 
medication management services (referred to in this sec-
tion as ‘‘MTM services’’) provided by licensed phar-
macists, as a part of a collaborative, multidisciplinary, 
interprofessional approach to the treatment of chronic dis-
eases for targeted individuals, to improve the quality of 
care and reduce overall cost in the treatment of such dis-
eases. The Secretary shall commence the grant program 
not later than May 1, 2011. 
(b) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under subsection (a), an entity shall—
1424 
(1) provide a setting appropriate for MTM serv-
ices, as recommended by the experts described in 
subsection (e); 
(2) submit to the Secretary a plan for achieving 
long-term financial sustainability; 
(3) where applicable, submit a plan for coordi-
nating MTM services with other local providers and 
where applicable, through or in collaboration with 
the Medicare Medical Home Pilot program as estab-
lished by section 1866F of the Social Security Act, 
as added by section 1302(a) of this Act; 
(4) submit a plan for meeting the requirements 
under subsection (c); and 
(5) submit to the Secretary such other informa-
tion as the Secretary may require. 
(c) MTM SERVICES TO TARGETED INDIVIDUALS.— 
The MTM services provided with the assistance of a grant 
awarded under subsection (a) shall, as allowed by State 
law (including applicable collaborative pharmacy practice 
agreements), include— 
(1) performing or obtaining necessary assess-
ments of the health and functional status of each 
patient receiving such MTM services; 
(2) formulating a medication treatment plan ac-
cording to therapeutic goals agreed upon by the pre-
1425 
scriber and the patient or caregiver or authorized 
representative of the patient; 
(3) selecting, initiating, modifying, recom-
mending changes to, or administering medication 
therapy; 
(4) monitoring, which may include access to, or-
dering, or performing laboratory assessments, and 
evaluating the response of the patient to therapy, in-
cluding safety and effectiveness; 
(5) performing an initial comprehensive medica-
tion review to identify, resolve, and prevent medica-
tion-related problems, including adverse drug events, 
quarterly targeted medication reviews for ongoing 
monitoring, and additional followup interventions on 
a schedule developed collaboratively with the pre-
scriber; 
(6) documenting the care delivered and commu-
nicating essential information about such care (in-
cluding a summary of the medication review) and 
the recommendations of the pharmacist to other ap-
propriate health care providers of the patient in a 
timely fashion; 
(7) providing education and training designed 
to enhance the understanding and appropriate use of
1426 
the medications by the patient, caregiver, and other 
authorized representative; 
(8) providing information, support services, and 
resources and strategies designed to enhance patient 
adherence with therapeutic regimens; 
(9) coordinating and integrating MTM services 
within the broader health care management services 
provided to the patient; and 
(10) such other patient care services as are al-
lowed under the scopes of practice for pharmacists 
for purposes of other Federal programs. 
(d) TARGETED INDIVIDUALS.—MTM services pro-
vided by licensed pharmacists under a grant awarded 
under subsection (a) shall be offered to targeted individ-
uals who— 
(1) take 4 or more prescribed medications (in-
cluding over-the-counter and dietary supplements); 
(2) take any high-risk medications; 
(3) have 2 or more chronic diseases, as identi-
fied by the Secretary; or 
(4) have undergone a transition of care, or 
other factors, as determined by the Secretary, that 
are likely to create a high risk of medication-related 
problems.
1427 
(e) CONSULTATION WITH EXPERTS.—In designing 
and implementing MTM services provided under grants 
awarded under subsection (a), the Secretary shall consult 
with Federal, State, private, public-private, and academic 
entities, pharmacy and pharmacist organizations, health 
care organizations, consumer advocates, chronic disease 
groups, and other stakeholders involved with the research, 
dissemination, and implementation of pharmacist-deliv-
ered MTM services, as the Secretary determines appro-
priate. The Secretary, in collaboration with this group, 
shall determine whether it is possible to incorporate rapid 
cycle process improvement concepts in use in other Fed-
eral programs that have implemented MTM services. 
(f) REPORTING TO THE SECRETARY.—An entity that 
receives a grant under subsection (a) shall submit to the 
Secretary a report that describes and evaluates, as re-
quested by the Secretary, the activities carried out under 
subsection (c), including quality measures, as determined 
by the Secretary. 
(g) EVALUATION AND REPORT.—The Secretary shall 
submit to the relevant committees of Congress a report 
which shall— 
(1) assess the clinical effectiveness of phar-
macist-provided services under the MTM services 
program, as compared to usual care, including an
1428 
evaluation of whether enrollees maintained better 
health with fewer hospitalizations and emergency 
room visits than similar patients not enrolled in the 
program; 
(2) assess changes in overall health care re-
source of targeted individuals; 
(3) assess patient and prescriber satisfaction 
with MTM services; 
(4) assess the impact of patient-cost-sharing re-
quirements on medication adherence and rec-
ommendations for modifications; 
(5) identify and evaluate other factors that may 
impact clinical and economic outcomes, including de-
mographic characteristics, clinical characteristics, 
and health services use of the patient, as well as 
characteristics of the regimen, pharmacy benefit, 
and MTM services provided; and 
(6) evaluate the extent to which participating 
pharmacists who maintain a dispensing role have a 
conflict of interest in the provision of MTM services, 
and if such conflict is found, provide recommenda-
tions on how such a conflict might be appropriately 
addressed. 
(h) GRANT TO FUND DEVELOPMENT OF PERFORM-
ANCE MEASURES.—The Secretary may award grants or
1429 
contracts to eligible entities for the purpose of funding the 
development of performance measures that assess the use 
and effectiveness of medication therapy management serv-
ices. 
SEC. 2529. POSTPARTUM DEPRESSION. 
(a) EXPANSION AND INTENSIFICATION OF ACTIVI-
TIES.— 
(1) CONTINUATION OF ACTIVITIES.—The Sec-
retary is encouraged to expand and intensify activi-
ties on postpartum conditions. 
(2) 
PROGRAMS
FOR
POSTPARTUM
CONDI-
TIONS.—In carrying out paragraph (1), the Sec-
retary is encouraged to continue research to expand 
the understanding of the causes of, and treatments 
for, postpartum conditions, including conducting and 
supporting the following: 
(A) Basic research concerning the etiology 
and causes of the conditions. 
(B) Epidemiological studies to address the 
frequency and natural history of the conditions 
and the differences among racial and ethnic 
groups with respect to the conditions. 
(C) The development of improved screen-
ing and diagnostic techniques.
1430 
(D) Clinical research for the development 
and evaluation of new treatments. 
(E) Information and education programs 
for health professionals and the public, which 
may include a coordinated national campaign 
that— 
(i) is designed to increase the aware-
ness and knowledge of postpartum condi-
tions; 
(ii) may include public service an-
nouncements through television, radio, and 
other means; and 
(iii) may focus on— 
(I) 
raising 
awareness 
about 
screening; 
(II) educating new mothers and 
their families about postpartum condi-
tions to promote earlier diagnosis and 
treatment; and 
(III) ensuring that such edu-
cation includes complete information 
concerning postpartum conditions, in-
cluding its symptoms, methods of cop-
ing with the illness, and treatment re-
sources.
1431 
(b) REPORT BY THE SECRETARY.— 
(1) STUDY.—The Secretary shall conduct a 
study on the benefits of screening for postpartum 
conditions. 
(2) REPORT.—Not later than 2 years after the 
date of the enactment of this Act, the Secretary 
shall complete the study required by paragraph (1) 
and submit a report to the Congress on the results 
of such study. 
(c) SENSE
OF CONGRESS REGARDING LONGITU-
DINAL STUDY
OF RELATIVE MENTAL HEALTH CON-
SEQUENCES
FOR
WOMEN
OF
RESOLVING
A
PREG-
NANCY.— 
(1) SENSE OF CONGRESS.—It is the sense of 
the Congress that the Director of the National Insti-
tute of Mental Health may conduct a nationally rep-
resentative longitudinal study (during the period of 
fiscal years 2011 through 2020) on the relative men-
tal health consequences for women of resolving a 
pregnancy (intended and unintended) in various 
ways, including carrying the pregnancy to term and 
parenting the child, carrying the pregnancy to term 
and placing the child for adoption, miscarriage, and 
having an abortion. This study may assess the inci-
dence, timing, magnitude, and duration of the imme-
1432 
diate and long-term mental health consequences 
(positive or negative) of these pregnancy outcomes. 
(2) REPORT.—Beginning not later than 3 years 
after the date of the enactment of this Act, and peri-
odically thereafter for the duration of the study, 
such Director may prepare and submit to the Con-
gress reports on the findings of the study. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘postpartum condition’’ means 
postpartum depression or postpartum psychosis. 
(2) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, in addition to any 
other amounts authorized to be appropriated for such pur-
pose, there are authorized to be appropriated such sums 
as may be necessary for each of fiscal years 2011 through 
2013. 
SEC. 2530. GRANTS TO PROMOTE POSITIVE HEALTH BEHAV-
IORS AND OUTCOMES. 
Part P of title III (42 U.S.C. 280g et seq.) is amend-
ed by adding at the end the following:
1433 
‘‘SEC. 399V. GRANTS TO PROMOTE POSITIVE HEALTH BE-
HAVIORS AND OUTCOMES. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary, in col-
laboration with the Director of the Centers for Disease 
Control and Prevention and other Federal officials deter-
mined appropriate by the Secretary, is authorized to 
award grants to eligible entities to promote positive health 
behaviors for populations in medically underserved com-
munities through the use of community health workers. 
‘‘(b) USE OF FUNDS.—Grants awarded under sub-
section (a) shall be used to support community health 
workers— 
‘‘(1) to educate, guide, and provide outreach in 
a community setting regarding health problems prev-
alent in medically underserved communities, espe-
cially racial and ethnic minority populations; 
‘‘(2) to educate, guide, and provide experiential 
learning opportunities that target behavioral risk 
factors including— 
‘‘(A) poor nutrition; 
‘‘(B) physical inactivity; 
‘‘(C) being overweight or obese; 
‘‘(D) tobacco use; 
‘‘(E) alcohol and substance use; 
‘‘(F) injury and violence; 
‘‘(G) risky sexual behavior;
1434 
‘‘(H) untreated mental health problems; 
‘‘(I) untreated dental and oral health prob-
lems; and 
‘‘(J) understanding informed consent; 
‘‘(3) to educate and provide guidance regarding 
effective strategies to promote positive health behav-
iors within the family; 
‘‘(4) to educate and provide outreach regarding 
enrollment in health insurance including the State 
Children’s Health Insurance Program under title 
XXI of the Social Security Act, Medicare under title 
XVIII of such Act, and Medicaid under title XIX of 
such Act; 
‘‘(5) to educate and refer underserved popu-
lations to appropriate health care agencies and com-
munity-based programs and organizations in order 
to increase access to quality health care services, in-
cluding preventive health services, and to eliminate 
duplicative care; or 
‘‘(6) to educate, guide, and provide home visita-
tion services regarding maternal health and prenatal 
care. 
‘‘(c) APPLICATION.— 
‘‘(1) IN
GENERAL.—Each eligible entity that 
desires to receive a grant under subsection (a) shall
1435 
submit an application to the Secretary, at such time, 
in such manner, and accompanied by such informa-
tion as the Secretary may require. 
‘‘(2) CONTENTS.—Each application submitted 
pursuant to paragraph (1) shall— 
‘‘(A) describe the activities for which as-
sistance is sought under this section; 
‘‘(B) contain an assurance that, with re-
spect to each community health worker pro-
gram receiving funds under the grant, such pro-
gram will provide training and supervision to 
community health workers to enable such work-
ers to provide authorized program services; 
‘‘(C) contain an assurance that the appli-
cant will evaluate the effectiveness of commu-
nity health worker programs receiving funds 
under the grant; 
‘‘(D) contain an assurance that each com-
munity health worker program receiving funds 
under the grant will provide services in the cul-
tural context most appropriate for the individ-
uals served by the program; 
‘‘(E) contain a plan to document and dis-
seminate project descriptions and results to
1436 
other States and organizations as identified by 
the Secretary; and 
‘‘(F) describe plans to enhance the capac-
ity of individuals to utilize health services and 
health-related social services under Federal, 
State, and local programs by— 
‘‘(i) assisting individuals in estab-
lishing eligibility under the programs and 
in receiving the services or other benefits 
of the programs; and 
‘‘(ii) providing other services as the 
Secretary determines to be appropriate, 
that may include transportation and trans-
lation services. 
‘‘(d) PRIORITY.—In awarding grants under sub-
section (a), the Secretary shall give priority to applicants 
that— 
‘‘(1) propose to target geographic areas— 
‘‘(A) with a high percentage of residents 
who are eligible for health insurance but are 
uninsured or underinsured; 
‘‘(B) with a high percentage of residents 
who suffer from chronic diseases including pul-
monary conditions, hypertension, heart disease, 
mental disorders, diabetes, and asthma; and
1437 
‘‘(C) with a high infant mortality rate; 
‘‘(2) have experience in providing health or 
health-related social services to individuals who are 
underserved with respect to such services; and 
‘‘(3) have documented community activity and 
experience with community health workers. 
‘‘(e) COLLABORATION WITH ACADEMIC INSTITU-
TIONS.—The Secretary shall encourage community health 
worker programs receiving funds under this section to col-
laborate with academic institutions, especially those that 
graduate a disproportionate number of health and health 
care students from underrepresented racial and ethnic mi-
nority backgrounds. Nothing in this section shall be con-
strued to require such collaboration. 
‘‘(f) EVIDENCE-BASED INTERVENTIONS.—The Sec-
retary shall encourage community health worker programs 
receiving funding under this section to implement an out-
come-based payment system that rewards community 
health workers for connecting underserved populations 
with the most appropriate services at the most appropriate 
time. Nothing in this section shall be construed to require 
such payment. 
‘‘(g) QUALITY ASSURANCE AND COST EFFECTIVE-
NESS.—The Secretary shall establish guidelines for assur-
ing the quality of the training and supervision of commu-
1438 
nity health workers under the programs funded under this 
section and for assuring the cost-effectiveness of such pro-
grams. 
‘‘(h) MONITORING.—The Secretary shall monitor 
community health worker programs identified in approved 
applications under this section and shall determine wheth-
er such programs are in compliance with the guidelines 
established under subsection (g). 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to community health worker 
programs identified in approved applications under this 
section with respect to planning, developing, and operating 
programs under the grant. 
‘‘(j) REPORT TO CONGRESS.— 
‘‘(1) IN
GENERAL.—Not later than 4 years 
after the date on which the Secretary first awards 
grants under subsection (a), the Secretary shall sub-
mit to Congress a report regarding the grant 
project. 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
‘‘(A) A description of the programs for 
which grant funds were used. 
‘‘(B) The number of individuals served 
under such programs.
1439 
‘‘(C) An evaluation of— 
‘‘(i) the effectiveness of such pro-
grams; 
‘‘(ii) the cost of such programs; and 
‘‘(iii) the impact of the programs on 
the health outcomes of the community resi-
dents. 
‘‘(D) Recommendations for sustaining the 
community health worker programs developed 
or assisted under this section. 
‘‘(E) Recommendations regarding training 
to enhance career opportunities for community 
health workers. 
‘‘(k) DEFINITIONS.—In this section: 
‘‘(1) COMMUNITY HEALTH WORKER.—The term 
‘community health worker’ means an individual who 
promotes health or nutrition within the community 
in which the individual resides— 
‘‘(A) by serving as a liaison between com-
munities and health care agencies; 
‘‘(B) by providing guidance and social as-
sistance to community residents; 
‘‘(C) by enhancing community residents’ 
ability to effectively communicate with health 
care providers;
1440 
‘‘(D) by providing culturally and linguis-
tically appropriate health or nutrition edu-
cation; 
‘‘(E) by advocating for individual and com-
munity health, including oral and mental, or 
nutrition needs; and 
‘‘(F) by providing referral and followup 
services or otherwise coordinating care. 
‘‘(2) COMMUNITY SETTING.—The term ‘commu-
nity setting’ means a home or a community organi-
zation located in the neighborhood in which a partic-
ipant resides. 
‘‘(3) MEDICALLY UNDERSERVED COMMUNITY.— 
The term ‘medically underserved community’ means 
a community identified by a State, United States 
territory or possession, or federally recognized In-
dian tribe— 
‘‘(A) that has a substantial number of in-
dividuals who are members of a medically un-
derserved population, as defined by section 
330(b)(3); and 
‘‘(B) a significant portion of which is a 
health professional shortage area as designated 
under section 332.
1441 
‘‘(4) SUPPORT.—The term ‘support’ means the 
provision of training, supervision, and materials 
needed to effectively deliver the services described in 
subsection (b), reimbursement for services, and 
other benefits. 
‘‘(5) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means a public or private nonprofit entity (in-
cluding a State or public subdivision of a State, a 
public health department, or a federally qualified 
health center), or a consortium of any of such enti-
ties, located in the United States or territory there-
of. 
‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$30,000,000 for each of fiscal years 2011 through 2015.’’. 
SEC. 2531. MEDICAL LIABILITY ALTERNATIVES. 
(a) INCENTIVE PAYMENTS FOR MEDICAL LIABILITY 
REFORM.— 
(1) IN GENERAL.—To the extent and in the 
amounts made available in advance in appropriations 
Acts, the Secretary shall make an incentive payment, 
in an amount determined by the Secretary, to each 
State that has an alternative medical liability law in 
compliance with this section.
1442 
(2) DETERMINATION
BY
SECRETARY.—The 
Secretary shall determine that a State has an alter-
native medical liability law in compliance with this 
section if the Secretary is satisfied that— 
(A) the State enacted the law after the 
date of the enactment of this Act and is imple-
menting the law; 
(B) the law is effective; and 
(C) the contents of the law are in accord-
ance with paragraph (4). 
(3) CONSIDERATIONS
FOR
DETERMINING
EF-
FECTIVENESS.—In determining whether an alter-
native medical liability law is effective under para-
graph (2)(B), the Secretary shall consider whether 
the law— 
(A) makes the medical liability system 
more reliable through prevention of, or prompt 
and fair resolution of, disputes; 
(B) encourages the disclosure of health 
care errors; and 
(C) maintains access to affordable liability 
insurance. 
(4) CONTENTS OF ALTERNATIVE MEDICAL LI-
ABILITY LAW.—The contents of an alternative liabil-
ity law are in accordance with this paragraph if—
1443 
(A) the litigation alternatives contained in 
the law consist of certificate of merit, early 
offer, or both; and 
(B) the law does not limit attorneys’ fees 
or impose caps on damages. 
(5) NO LIMITATION ON OTHER STATE LAWS.— 
Nothing in this section shall be construed to— 
(A) preempt or modify the application of 
any existing State law that limits attorneys’ 
fees or imposes caps on damages; 
(B) impair the authority of a State to es-
tablish or implement a law limiting attorneys’ 
fees or imposing caps on damages; or 
(C) restrict the eligibility of a State for an 
incentive payment under this section on the 
basis of a law described in subparagraph (A) or 
(B) so long as any such law is not established 
or implemented as part of the law described in 
paragraph (4), as determined by the Secretary. 
(b) USE OF INCENTIVE PAYMENTS.—Amounts re-
ceived by a State as an incentive payment under this sec-
tion shall be used to improve health care in that State. 
(c) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to the States applying for or 
receiving an incentive payment under this section.
1444 
(d) REPORTS.—Beginning not later than one year 
after the date of the enactment of this Act, the Secretary 
shall submit to the Congress an annual report on the 
progress States have made in enacting and implementing 
alternative medical liability laws in compliance with this 
section. Such reports shall contain sufficient documenta-
tion regarding the effectiveness of such laws to enable an 
objective comparative analysis of such laws. 
(e) DEFINITION.—In this section— 
(1) the term ‘‘Secretary’’ means the Secretary 
of Health and Human Services; and 
(2) the term ‘‘State’’ includes the several 
States, District of Columbia, the Commonwealth of 
Puerto Rico, and each other territory or possession 
of the United States. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary, to remain available until 
expended. 
SEC. 2532. INFANT MORTALITY PILOT PROGRAMS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Director, shall award grants 
to eligible entities to create, implement, and oversee infant 
mortality pilot programs.
1445 
(b) PERIOD OF A GRANT.—The period of a grant 
under this section shall be 5 consecutive fiscal years. 
(c) PREFERENCE.—In awarding grants under this 
section, the Secretary shall give preference to eligible enti-
ties proposing to serve any of the 15 counties or groups 
of counties with the highest rates of infant mortality in 
the United States in the past 3 years. 
(d) USE OF FUNDS.—Any infant mortality pilot pro-
gram funded under this section may— 
(1) include the development of a plan that iden-
tifies the individual needs of each community to be 
served and strategies to address those needs; 
(2) provide outreach to at-risk mothers through 
programs deemed appropriate by the Director; 
(3) develop and implement standardized sys-
tems for improved access, utilization, and quality of 
social, educational, and clinical services to promote 
healthy pregnancies, full term births, and healthy in-
fancies delivered to women and their infants, such 
as— 
(A) counseling on infant care, feeding, and 
parenting; 
(B) postpartum care; 
(C) prevention of premature delivery; and
1446 
(D) additional counseling for at-risk moth-
ers, including smoking cessation programs, 
drug treatment programs, alcohol treatment 
programs, nutrition and physical activity pro-
grams, postpartum depression and domestic vio-
lence programs, social and psychological serv-
ices, dental care, and parenting programs; 
(4) establish a rural outreach program to pro-
vide care to at-risk mothers in rural areas; 
(5) establish a regional public education cam-
paign, including a campaign to— 
(A) prevent preterm births; and 
(B) educate the public about infant mor-
tality; and 
(6) provide for any other activities, programs, 
or strategies as identified by the community plan. 
(e) LIMITATION.—Of the funds received through a 
grant under this section for a fiscal year, an eligible entity 
shall not use more than 10 percent for program evalua-
tion. 
(f) REPORTS ON PILOT PROGRAMS.— 
(1) IN GENERAL.—Not later than 1 year after 
receiving a grant, and annually thereafter for the 
duration of the grant period, each entity that re-
ceives a grant under subsection (a) shall submit a
1447 
report to the Secretary detailing its infant mortality 
pilot program. 
(2) CONTENTS OF REPORT.—The reports re-
quired under paragraph (1) shall include informa-
tion such as the methodology of, and outcomes and 
statistics from, the grantee’s infant mortality pilot 
program. 
(3) EVALUATION.—The Secretary shall use the 
reports required under paragraph (1) to evaluate, 
and conduct statistical research on, infant mortality 
pilot programs funded through this section. 
(g) DEFINITIONS.—For the purposes of this section: 
(1) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Centers for Disease Control and 
Prevention. 
(2) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a State, county, city, territorial, or tribal 
health department that has submitted a proposal to 
the Secretary that the Secretary deems likely to re-
duce infant mortality rates within the standard met-
ropolitan statistical area involved. 
(3) TRIBAL.—The term ‘‘tribal’’ refers to an 
Indian tribe, a Tribal organization, or an Urban In-
dian organization, as such terms are defined in sec-
tion 4 of the Indian Health Care Improvement Act.
1448 
(h) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$10,000,000 for each of fiscal years 2011 through 2015. 
SEC. 2533. SECONDARY SCHOOL HEALTH SCIENCES TRAIN-
ING PROGRAM. 
(a) PROGRAM.—The Secretary of Health and Human 
Services, acting through the Administrator of the Health 
Resources and Services Administration, and in consulta-
tion with the Secretary of Education, may establish a 
health sciences training program consisting of awarding 
grants and contracts under subsection (b) to prepare sec-
ondary school students for careers in health professions. 
(b) DEVELOPMENT
AND
IMPLEMENTATION
OF 
HEALTH SCIENCES CURRICULA.—The Secretary may 
make grants to, or enter into contracts with, eligible enti-
ties— 
(1) to plan, develop, or implement secondary 
school health sciences curricula, including curricula 
in biology, chemistry, physiology, mathematics, nu-
trition, and other courses deemed appropriate by the 
Secretary to prepare students for associate’s or 
bachelor’s degree programs in health professions or 
bachelor’s degree programs in health professions-re-
lated majors; and
1449 
(2) to increase the interest of secondary school 
students in applying to, and enrolling in, accredited 
associate’s or bachelor’s degree programs in health 
professions or bachelor’s degree programs in health 
professions-related majors, including through— 
(A) work-study programs; 
(B) programs to increase awareness of ca-
reers in health professions; and 
(C) other activities to increase such inter-
est. 
(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall— 
(1) be a local educational agency; and 
(2) provide assurances that activities under the 
grant or contract will be carried out in partnership 
with an accredited health professions school or pro-
gram, public or private nonprofit hospital, or public 
or private nonprofit entity. 
(d) PREFERENCE.—In awarding grants and con-
tracts under subsection (b), the Secretary shall give pref-
erence to entities that have a demonstrated record of at 
least one of the following: 
(1) Graduating a high or significantly improved 
percentage of students who have exhibited mastery 
in secondary school State science standards.
1450 
(2) Graduating students from disadvantaged 
backgrounds, including racial and ethnic minorities 
who are underrepresented in— 
(A) associate’s or bachelor’s degree pro-
grams in health professions or bachelor’s degree 
programs in health professions-related majors; 
or 
(B) health professions. 
(e) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘health profession’’ means the 
profession of any member of the health workforce, 
as defined in section 764(i) of the Public Health 
Service Act, as added by section 2261. 
(2) The term ‘‘local educational agency’’ has 
the meaning given to the term in section 9101 of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(3) The term ‘‘secondary school’’— 
(A) means a secondary school, as defined 
in section 9101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 
7801); and
1451 
(B) includes any such school that is a mid-
dle school. 
(4) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services except as otherwise 
specified. 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for each of fiscal years 
2011 through 2015. 
SEC. 2534. COMMUNITY-BASED COLLABORATIVE CARE NET-
WORKS. 
(a) PURPOSE.—The purpose of this subtitle is to es-
tablish and provide assistance to community-based col-
laborative care networks— 
(1) to develop or strengthen coordination of 
services to allow all individuals, including the unin-
sured and low-income, to receive efficient and higher 
quality care and to gain entry into and receive serv-
ices from a comprehensive system of care; 
(2) to develop efficient and sustainable infra-
structure for a health care delivery system charac-
terized by effective collaboration, information shar-
ing, and clinical and financial coordination among 
providers of care in the community;
1452 
(3) to develop or strengthen activities related to 
providing coordinated care for individuals with 
chronic conditions; and 
(4) to reduce the use of emergency depart-
ments, inpatient and other expensive resources of 
hospitals and other providers. 
(b) CREATION
OF
THE COMMUNITY-BASED COL-
LABORATIVE CARE NETWORK PROGRAM.—Part D of title 
III (42 U.S.C. 254b et seq.), as amended, is further 
amended by inserting after subpart XII the following new 
subpart: 
‘‘Subpart XIII—Community-Based Collaborative Care 
Network Program 
‘‘SEC. 340O. COMMUNITY-BASED COLLABORATIVE CARE 
NETWORK PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to eligible entities for the purpose of establishing model 
projects to accomplish the following goals: 
‘‘(1) To reduce unnecessary use of items and 
services furnished in emergency departments of hos-
pitals (especially to ensure that individuals without 
health insurance coverage or with inadequate health 
insurance coverage do not use the services of such 
department instead of the services of a primary care 
provider) through methods such as—
1453 
‘‘(A) screening individuals who seek emer-
gency department services for possible eligibility 
under relevant governmental health programs 
or for subsidies under such programs; and 
‘‘(B) providing such individuals referrals 
for followup care and chronic condition care. 
‘‘(2) To manage chronic conditions to reduce 
their severity, negative health outcomes, and ex-
pense. 
‘‘(3) To encourage health care providers to co-
ordinate their efforts so that the most vulnerable pa-
tient populations seek and obtain primary care. 
‘‘(4) To provide more comprehensive and co-
ordinated care to vulnerable low-income individuals 
and individuals without health insurance coverage or 
with inadequate coverage. 
‘‘(5) To provide mechanisms for improving both 
quality and efficiency of care for low-income individ-
uals and families, with an emphasis on those most 
likely to remain uninsured despite the existence of 
government programs to make health insurance 
more affordable. 
‘‘(6) To increase preventive services, including 
screening and counseling, to those who would other-
wise not receive such screening, in order to improve
1454 
health status and reduce long-term complications 
and costs. 
‘‘(7) To ensure the availability of community- 
wide safety net services, including emergency and 
trauma care. 
‘‘(b) ELIGIBILITY AND GRANTEE SELECTION.— 
‘‘(1) APPLICATION.—A community-based col-
laborative care network described in subsection (d) 
shall submit to the Secretary an application in such 
form and manner and containing such information 
as specified by the Secretary. Such information shall 
at least— 
‘‘(A) identify the health care providers par-
ticipating in the community-based collaborative 
care network proposed by the applicant and, if 
a provider designated in paragraph (d)(1)(B) is 
not included, the reason such provider is not so 
included; 
‘‘(B) include a description of how the pro-
viders plan to collaborate to provide comprehen-
sive and integrated care for low-income individ-
uals, including uninsured and underinsured in-
dividuals; 
‘‘(C) include a description of the organiza-
tional and joint governance structure of the
1455 
community-based collaborative care network in 
a manner so that it is clear how decisions will 
be made, and how the decisionmaking process 
of the network will include appropriate rep-
resentation of the participating entities; 
‘‘(D) define the geographic areas and pop-
ulations that the network intends to serve; 
‘‘(E) define the scope of services that the 
network intends to provide and identify any 
reasons why such services would not include a 
suggested core service identified by the Sec-
retary under paragraph (3); 
‘‘(F) demonstrate the network’s ability to 
meet the requirements of this section; and 
‘‘(G) provide assurances that grant funds 
received shall be used to support the entire 
community-based collaborative care network. 
‘‘(2) SELECTION OF GRANTEES.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
select community-based collaborative care net-
works to receive grants from applications sub-
mitted under paragraph (1) on the basis of 
quality of the proposal involved, geographic di-
versity (including different States and regions 
served and urban and rural diversity), and the
1456 
number of low-income and uninsured individ-
uals that the proposal intends to serve. 
‘‘(B) PRIORITY.—The Secretary shall give 
priority to proposals from community-based col-
laborative care networks that— 
‘‘(i) include the capability to provide 
the broadest range of services to low-in-
come individuals; and 
‘‘(ii) include providers that currently 
serve a high volume of low-income individ-
uals. 
‘‘(C) RENEWAL.—In subsequent years, 
based on the performance of grantees, the Sec-
retary may provide renewal grants to prior year 
grant recipients. 
‘‘(3) SUGGESTED
CORE
SERVICES.—For pur-
poses of paragraph (1)(E), the Secretary shall de-
velop a list of suggested core patient and core net-
work services to be provided by a community-based 
collaborative care network. The Secretary may select 
a community-based collaborative care network under 
paragraph (2), the application of which does not in-
clude all such services, if such application provides 
a reasonable explanation why such services are not
1457 
proposed to be included, and the Secretary deter-
mines that the application is otherwise high quality. 
‘‘(4) TERMINATION
AUTHORITY.—The Sec-
retary may terminate selection of a community- 
based collaborative care network under this section 
for good cause. Such good cause shall include a de-
termination that the network— 
‘‘(A) has failed to provide a comprehensive 
range of coordinated and integrated health care 
services as required under subsection (d)(2); 
‘‘(B) has failed to meet reasonable quality 
standards; 
‘‘(C) has misappropriated funds provided 
under this section; or 
‘‘(D) has failed to make progress toward 
accomplishing goals set out in subsection (a). 
‘‘(c) USE OF FUNDS.— 
‘‘(1) USE BY GRANTEES.—Grant funds are pro-
vided to community-based collaborative care net-
works to carry out the following activities: 
‘‘(A) Assist low-income individuals without 
adequate health care coverage to— 
‘‘(i) access and appropriately use 
health services;
1458 
‘‘(ii) enroll in applicable public or pri-
vate health insurance programs; 
‘‘(iii) obtain referrals to and see a pri-
mary care provider in case such an indi-
vidual does not have a primary care pro-
vider; and 
‘‘(iv) obtain appropriate care for 
chronic conditions. 
‘‘(B) Improve heath care by providing case 
management, application assistance, and appro-
priate referrals such as through methods to— 
‘‘(i) create and meaningfully use a 
health information technology network to 
track patients across collaborative pro-
viders; 
‘‘(ii) perform health outreach, such as 
by using neighborhood health workers who 
may inform individuals about the avail-
ability of safety net and primary care pro-
viders available through the community- 
based collaborative care network; 
‘‘(iii) provide for followup outreach to 
remind patients of appointments or follow- 
up care instructions;
1459 
‘‘(iv) provide transportation to individ-
uals to and from the site of care; 
‘‘(v) expand the capacity to provide 
care at any provider participating in the 
community-based collaborative care net-
work, including telehealth, hiring new clin-
ical or administrative staff, providing ac-
cess to services after-hours, on weekends, 
or otherwise providing an urgent care al-
ternative to an emergency department; and 
‘‘(vi) provide a primary care provider 
or medical home for each network patient. 
‘‘(C) Provide direct patient care services as 
described in their application and approved by 
the Secretary. 
‘‘(2) GRANT FUNDS TO HRSA GRANTEES.—The 
Secretary may limit the percent of grant funding 
that may be spent on direct care services provided 
by grantees of programs administered by the Health 
Resources and Services Administration (in this sec-
tion referred to as ‘HRSA’) or impose other require-
ments on HRSA grantees participating in a commu-
nity-based collaborative care network as may be nec-
essary for consistency with the requirements of such 
programs.
1460 
‘‘(3) RESERVATION OF FUNDS FOR NATIONAL 
PROGRAM PURPOSES.—The Secretary may use not 
more than 7 percent of funds appropriated to carry 
out this section for providing technical assistance to 
grantees, obtaining assistance of experts and con-
sultants, holding meetings, developing of tools, dis-
seminating of information, and evaluation. 
‘‘(d) COMMUNITY-BASED
COLLABORATIVE
CARE 
NETWORKS.— 
‘‘(1) IN GENERAL.— 
‘‘(A) DESCRIPTION.—A community-based 
collaborative care network described in this sub-
section is a consortium of health care providers 
with a joint governance structure that provides 
a comprehensive range of coordinated and inte-
grated health care services for low-income pa-
tient populations or medically underserved com-
munities (whether or not such individuals re-
ceive benefits under title XVIII, XIX, or XXI 
of the Social Security Act, private or other 
health insurance or are uninsured or under-
insured) and that complies with any applicable 
minimum eligibility requirements that the Sec-
retary may determine appropriate.
1461 
‘‘(B) REQUIRED
INCLUSION.—Each such 
network shall include the following providers 
that serve the community (unless such provider 
does not exist within the community, declines or 
refuses to participate, or places unreasonable 
conditions on their participation)— 
‘‘(i) A safety net hospital that pro-
vides services to a high volume of low-in-
come patients, as demonstrated by meeting 
the criteria in section 1923(b)(1) of the 
Social Security Act, or other similar cri-
teria determined by the Secretary; and 
‘‘(ii) All Federally qualified health 
centers (as defined in section 1861(aa) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395x(aa))) located in the geographic area 
served by the Coordinated Care Network; 
‘‘(C) 
ADDITIONAL
INCLUSIONS.—Each 
such network may include any of the following 
additional providers: 
‘‘(i) A hospital, including a critical ac-
cess 
hospital 
(as 
defined 
in 
section 
1820(c)(2) of the Social Security Act (42 
U.S.C. 1395i–4(c)(2))).
1462 
‘‘(ii) A county or municipal depart-
ment of health. 
‘‘(iii) A rural health clinic or a rural 
health network (as defined in sections 
1861(aa) and 1820(d) of the Social Secu-
rity 
Act, 
respectively 
(42 
U.S.C. 
1395x(aa), 1395i–4(d))). 
‘‘(iv) A community clinic, including a 
mental health clinic, substance abuse clin-
ic, or a reproductive health clinic. 
‘‘(v) A health center controlled net-
work as defined by section 330(e)(1)(C) of 
the Public Health Service Act. 
‘‘(vi) A private practice physician or 
group practice. 
‘‘(vii) A nurse or physician assistant 
or group practice. 
‘‘(viii) An adult day care center. 
‘‘(ix) A home health provider. 
‘‘(x) Any other type of provider speci-
fied by the Secretary, which has a desire to 
serve low-income and uninsured patients. 
‘‘(D) CONSTRUCTION.— 
‘‘(i) Nothing in this section shall pro-
hibit a single entity from qualifying as
1463 
community-based collaborative care net-
work so long as such single entity meets 
the criteria of a community-based collabo-
rative care network. If the network does 
not include the providers referenced in 
clauses (i) and (ii) of subparagraph (B) of 
this paragraph, the application must ex-
plain the reason pursuant to subsection 
(b)(1)(A). 
‘‘(ii) Participation in a community- 
based collaborative care network shall not 
affect Federally qualified health centers’ 
obligation to comply with the governance 
requirements under section 330 of the 
Public Health Service Act (42 U.S.C. 
254b). 
‘‘(iii) Federally qualified health cen-
ters participating in a community-based 
collaborative care network may not be re-
quired to provide services beyond their 
Federal Health Center scope of project ap-
proved by HRSA. 
‘‘(iv) Nothing in this section shall be 
construed to expand medical malpractice li-
ability protection under the Federal Tort
1464 
Claims Act for Section 330-funded Feder-
ally qualified health centers. 
‘‘(2) COMPREHENSIVE RANGE OF COORDINATED 
AND
INTEGRATED
HEALTH
CARE
SERVICES.—The 
Secretary shall define criteria for evaluating whether 
the services offered by a community-based collabo-
rative care network qualify as a comprehensive range 
of coordinated and integrated health care services. 
Such criteria may vary based on the needs of the ge-
ographic areas and populations to be served by the 
network and may include the following: 
‘‘(A) Requiring community-based collabo-
rative care networks to include at least the sug-
gested core services identified under subsection 
(b)(3), or whichever subset of the suggested 
core services is applicable to a particular net-
work. 
‘‘(B) Requiring such networks to assign 
each patient of the network to a primary care 
provider responsible for managing that patient’s 
care. 
‘‘(C) Requiring the services provided by a 
community-based collaborative care network to 
include support services appropriate to meet the 
health needs of low-income populations in the
1465 
network’s community, which may include chron-
ic care management, nutritional counseling, 
transportation, language services, enrollment 
counselors, social services and other services as 
proposed by the network. 
‘‘(D) Providing that the services provided 
by a community-based collaborative care net-
work may also include long-term care services 
and other services not specified in this sub-
section. 
‘‘(E) Providing for the approval by the 
Secretary of a scope of community-based col-
laborative care network services for each net-
work that addresses an appropriate minimum 
scope of work consistent with the setting of the 
network and the health professionals available 
in the community the network serves. 
‘‘(3) CLARIFICATION.—Participation in a com-
munity-based collaborative care network shall not 
disqualify a health care provider from reimburse-
ment under title XVIII, XIX, or XXI of the Social 
Security Act with respect to services otherwise reim-
bursable under such title. Nothing in this section 
shall prevent a community-based collaborative care 
network that is otherwise eligible to contract with
1478 
(A) that is a collaboration between— 
(i) a community health center, public 
hospital, children’s hospital, or other pro-
vider of health care services to a signifi-
cant number of low-income beneficiaries; 
and 
(ii) one or more attorneys; and 
(B) whose primary mission is to assist pa-
tients and their families navigate health care-re-
lated programs and activities. 
(3) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(f) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for each of fiscal years 
2011 through 2015. 
SEC. 2538. SCREENING, BRIEF INTERVENTION, REFERRAL, 
AND TREATMENT FOR MENTAL HEALTH AND 
SUBSTANCE ABUSE DISORDERS. 
Part D of title V (42 U.S.C. 290dd et seq.) is amend-
ed by adding at the end the following:
1516 
‘‘(7) other issues the Secretary deems appro-
priate. 
‘‘(c) CONSULTATION.—In designing and imple-
menting the public awareness campaign required by this 
section, the Secretary shall consult with organizations rep-
resenting patients in pain and other consumers, employ-
ers, physicians including physicians specializing in pain 
care, other pain management professionals, medical device 
manufacturers, and pharmaceutical companies. 
‘‘(d) COORDINATION.— 
‘‘(1) LEAD OFFICIAL.—The Secretary shall des-
ignate one official in the Department of Health and 
Human Services to oversee the campaign established 
under this section. 
‘‘(2) AGENCY
COORDINATION.—The Secretary 
shall ensure the involvement in the public awareness 
campaign under this section of the Surgeon General 
of the Public Health Service, the Director of the 
Centers for Disease Control and Prevention, and 
such other representatives of offices and agencies of 
the Department of Health and Human Services as 
the Secretary determines appropriate. 
‘‘(e) UNDERSERVED AREAS AND POPULATIONS.—In 
designing the public awareness campaign under this sec-
tion, the Secretary shall—
1637 
and groups, as appropriate, on Administration policy 
with regard to women; and 
‘‘(5) serve as a member of the Department of 
Health and Human Services Coordinating Com-
mittee on Women’s Health (established under sec-
tion 229(b)(4) of the Public Health Service Act). 
‘‘(c) CONTINUED ADMINISTRATION
OF EXISTING 
PROGRAMS.—The Director of the Office shall assume the 
authority for the development, implementation, adminis-
tration, and evaluation of any projects carried out through 
the Health Resources and Services Administration relat-
ing to women’s health on the date of enactment of this 
section. 
‘‘(d) DEFINITIONS.—For purposes of this section: 
‘‘(1) ADMINISTRATION.—The term ‘Administra-
tion’ means the Health Resources and Services Ad-
ministration. 
‘‘(2) ADMINISTRATOR.—The term ‘Adminis-
trator’ means the Administrator of the Health Re-
sources and Services Administration. 
‘‘(3) OFFICE.—The term ‘Office’ means the Of-
fice of Women’s Health established under this sec-
tion in the Administration.’’. 
(g) FOOD AND DRUG ADMINISTRATION OFFICE OF 
WOMEN’S HEALTH.—Chapter IX of the Federal Food,