1345 
use the identification system developed by 
the Secretary for purposes of facilitating 
the ordering, purchasing, and delivery of 
covered drugs under this section, including 
the processing of chargebacks for such 
drugs. 
‘‘(vii) The imposition of sanctions in 
the form of civil monetary penalties, 
which— 
‘‘(I) shall be assessed according 
to standards and procedures estab-
lished in regulations to be promul-
gated by the Secretary within one 
year of the date of the enactment of 
the Affordable Health Care for Amer-
ica Act; and 
‘‘(II) shall apply to any manufac-
turer with an agreement under this 
section and shall not exceed $100,000 
for each instance where a manufac-
turer knowingly charges a covered en-
tity a price for purchase of a drug 
that exceeds the maximum applicable 
price under subsection (a)(1) or that 
knowingly violates any other provision 
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of this section, or withholds or pro-
vides false information to the Sec-
retary or to covered entities under 
this section. 
‘‘(2) COVERED ENTITY COMPLIANCE.— 
‘‘(A) IN GENERAL.—From amounts appro-
priated under paragraph (4), the Secretary 
shall provide for improvements in compliance by 
covered entities with the requirements of this 
section in order to prevent diversion and viola-
tions of the duplicate discount provision and 
other requirements under subsection (a)(5). 
‘‘(B) IMPROVEMENTS.—The improvements 
described in subparagraph (A) shall include the 
following: 
‘‘(i) The development of procedures to 
enable and require covered entities to up-
date at least annually the information on 
the Internet Web site of the Department of 
Health and Human Services relating to 
this section. 
‘‘(ii) The development of procedures 
for the Secretary to verify the accuracy of 
information regarding covered entities that 
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is listed on the Web site described in 
clause (i). 
‘‘(iii) The development of more de-
tailed guidance describing methodologies 
and options available to covered entities for 
billing covered drugs to State Medicaid 
agencies in a manner that avoids duplicate 
discounts pursuant to subsection (a)(5)(A). 
‘‘(iv) The establishment of a single, 
universal, and standardized identification 
system by which each covered entity site 
can be identified by manufacturers, dis-
tributors, covered entities, and the Sec-
retary for purposes of facilitating the or-
dering, purchasing, and delivery of covered 
drugs under this section, including the 
processing of chargebacks for such drugs. 
‘‘(v) The imposition of sanctions in 
the form of civil monetary penalties, 
which— 
‘‘(I) shall be assessed according 
to standards and procedures estab-
lished in regulations promulgated by 
the Secretary; 
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‘‘(II) shall not exceed $5,000 for 
each violation; and 
‘‘(III) shall apply to any covered 
entity that knowingly violates sub-
paragraph (a)(5)(B) or knowingly vio-
lates any other provision of this sec-
tion. 
‘‘(vi) The exclusion of a covered entity 
from participation in the program under 
this section, for a period of time to be de-
termined by the Secretary, in cases in 
which the Secretary determines, in accord-
ance with standards and procedures estab-
lished in regulations, that— 
‘‘(I) a violation of a requirement 
of this section was repeated and 
knowing; and 
‘‘(II) imposition of a monetary 
penalty would be insufficient to rea-
sonably ensure compliance. 
‘‘(vii) The referral of matters as ap-
propriate to the Food and Drug Adminis-
tration, the Office of Inspector General of 
Department of Health and Human Serv-
ices, or other Federal agencies. 
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‘‘(3) ADMINISTRATIVE
DISPUTE
RESOLUTION 
PROCESS.—From amounts appropriated under para-
graph (4), the Secretary may establish and imple-
ment an administrative process for the resolution of 
the following: 
‘‘(A) Claims by covered entities that manu-
facturers have violated the terms of their agree-
ment with the Secretary under subsection 
(a)(1). 
‘‘(B) Claims by manufacturers that cov-
ered entities have violated subsection (a)(5)(A) 
or (a)(5)(B). 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection, such sums as may be necessary for 
fiscal year 2011 and each succeeding fiscal year.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 340B(a) (42 U.S.C. 256b(a)) is 
amended— 
(A) by adding at the end of paragraph (1) 
the following: ‘‘Such agreement shall require 
that the manufacturer offer each covered entity 
covered drugs for purchase at or below the ap-
plicable ceiling price if such drug is made avail-
able to any other purchaser at any price. Such 
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agreement shall require that, if the supply of a 
covered drug is insufficient to meet demand, 
then the manufacturer may utilize an allocation 
method that is reported in writing to the Sec-
retary and does not discriminate on the basis of 
the price paid by covered entities or on any 
other basis related to an entity’s participation 
in the program under this section. Notwith-
standing any other provision of law, if the Sec-
retary requests a manufacturer to enter into a 
new or amended agreement under this section 
that complies with current law and if the manu-
facturer opts not to sign the new or amended 
agreement, then any existing agreement be-
tween the manufacturer and the Secretary 
under this section is deemed to no longer meet 
the requirements of this section for purposes of 
this section and section 1927 of the Social Se-
curity Act.’’; and 
(B) by adding at the end the following 
paragraph: 
‘‘(11) QUARTERLY
REPORTS.—An agreement 
described in paragraph (1) shall require that the 
manufacturer furnish the Secretary with reports on 
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a quarterly basis that include the following informa-
tion: 
‘‘(A) The price for each covered drug sub-
ject to the agreement that, according to the 
manufacturer, represents the maximum price 
that covered entities may permissibly be re-
quired to pay for the drug (referred to in this 
section as the ‘ceiling price’). 
‘‘(B) The component information used to 
calculate the ceiling price as determined nec-
essary to administer the requirements of the 
program under this section. 
‘‘(C) Rebates, discounts, and other price 
concessions provided by manufacturers to other 
purchasers subsequent to the sale of covered 
drugs to covered entities.’’. 
(2) Section 1927(a)(5) of the Social Security 
Act (42 U.S.C. 1396r–8(a)(5)) is amended by strik-
ing subparagraph (D). 
SEC. 2503. EFFECTIVE DATE. 
(a) IN GENERAL.—The amendments made by this 
subtitle shall take effect on the date of the enactment of 
this Act, and sections 2501, 2502(a)(1), and 2502(b)(2) 
shall apply to drugs dispensed on or after such date. 
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(b) EFFECTIVENESS.—The amendments made by 
this subtitle shall be effective, and shall be taken into ac-
count in determining whether a manufacturer is deemed 
to meet the requirements of section 340B(a) of the Public 
Health Service Act (42 U.S.C. 256b(a)), and of section 
1927(a)(5) of the Social Security Act (42 U.S.C. 1396r– 
8(a)(5)), notwithstanding any other provision of law. 
Subtitle B—Programs 
PART 1—GRANTS FOR CLINICS AND CENTERS 
SEC. 2511. SCHOOL-BASED HEALTH CLINICS. 
(a) IN GENERAL.—Part Q of title III (42 U.S.C. 
280h et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 399Z–1. SCHOOL-BASED HEALTH CLINICS. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
school-based health clinic program consisting of awarding 
grants to eligible entities to support the operation of 
school-based health clinics (referred to in this section as 
‘SBHCs’). 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall— 
‘‘(1) be an SBHC (as defined in subsection 
(l)(3)); and 
‘‘(2) submit an application at such time, in 
such manner, and containing such information as 
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the Secretary may require, including at a min-
imum— 
‘‘(A) evidence that the applicant meets all 
criteria necessary to be designated as an 
SBHC; 
‘‘(B) evidence of local need for the services 
to be provided by the SBHC; 
‘‘(C) an assurance that— 
‘‘(i) SBHC services will be provided in 
accordance with Federal, State, and local 
laws; 
‘‘(ii) the SBHC has established and 
maintains collaborative relationships with 
other 
health 
care 
providers 
in 
the 
catchment area of the SBHC; 
‘‘(iii) the SBHC will provide onsite ac-
cess during the academic day when school 
is in session and has an established net-
work of support and access to services with 
backup health providers when the school or 
SBHC is closed; 
‘‘(iv) the SBHC will be integrated into 
the school environment and will coordinate 
health services with appropriate school per-
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sonnel and other community providers co- 
located at the school; and 
‘‘(v) the SBHC sponsoring facility as-
sumes all responsibility for the SBHC ad-
ministration, operations, and oversight; 
and 
‘‘(D) such other information as the Sec-
retary may require. 
‘‘(c) USE OF FUNDS.—Funds awarded under a grant 
under this section— 
‘‘(1) may be used for— 
‘‘(A) providing training related to the pro-
vision of comprehensive primary health services 
and additional health services; 
‘‘(B) the management and operation of 
SBHC 
programs, 
including 
through 
sub-
contracts; and 
‘‘(C) the payment of salaries for health 
professionals and other appropriate SBHC per-
sonnel; and 
‘‘(2) may not be used to provide abortions. 
‘‘(d) CONSIDERATION OF NEED.—In determining the 
amount of a grant under this section, the Secretary shall 
take into consideration— 
‘‘(1) the financial need of the SBHC; 
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‘‘(2) State, local, or other sources of funding 
provided to the SBHC; and 
‘‘(3) other factors as determined appropriate by 
the Secretary. 
‘‘(e) PREFERENCES.—In awarding grants under this 
section, the Secretary shall give preference to SBHCs that 
have a demonstrated record of service to at least one of 
the following: 
‘‘(1) A high percentage of medically under-
served children and adolescents. 
‘‘(2) Communities or populations in which chil-
dren and adolescents have difficulty accessing health 
and mental health services. 
‘‘(3) Communities with high percentages of chil-
dren and adolescents who are uninsured, under-
insured, or eligible for medical assistance under Fed-
eral or State health benefits programs (including ti-
tles XIX and XXI of the Social Security Act). 
‘‘(f) MATCHING REQUIREMENT.—The Secretary may 
award a grant to an SBHC under this section only if the 
SBHC 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. 
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‘‘(g) SUPPLEMENT, NOT SUPPLANT.—The Secretary 
may award a grant to an SBHC under this section only 
if the SBHC demonstrates to the satisfaction of the Sec-
retary that funds received through the grant will be ex-
pended only to supplement, and not supplant, non-Federal 
and Federal funds otherwise available to the SBHC for 
operation of the SBHC (including each activity described 
in paragraph (1) or (2) of subsection (c)). 
‘‘(h) PAYOR OF LAST RESORT.—The Secretary may 
award a grant to an SBHC under this section only if the 
SBHC 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— 
‘‘(1) under any insurance policy; 
‘‘(2) under any Federal or State health benefits 
program (including titles XIX and XXI of the Social 
Security Act); or 
‘‘(3) by an entity which provides health services 
on a prepaid basis. 
‘‘(i) REGULATIONS REGARDING REIMBURSEMENT 
FOR HEALTH SERVICES.—The Secretary shall issue regu-
lations regarding the reimbursement for health services 
provided by SBHCs to individuals eligible to receive such 
services through the program under this section, including 
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reimbursement under any insurance policy or any Federal 
or State health benefits program (including titles XIX and 
XXI of the Social Security Act). 
‘‘(j) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly or by grant or contract) technical 
and other assistance to SBHCs to assist such SBHCs to 
meet 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 informa-
tion to the SBHCs of the variety of resources available 
under this title and how those resources can be best used 
to meet the health needs of the communities served by 
the SBHCs. 
‘‘(k) EVALUATION; REPORT.—The Secretary shall— 
‘‘(1) develop and implement a plan for evalu-
ating SBHCs and monitoring quality performances 
under the awards made under this section; and 
‘‘(2) submit to the Congress on an annual basis 
a report on the program under this section. 
‘‘(l) DEFINITIONS.—In this section: 
‘‘(1) COMPREHENSIVE PRIMARY HEALTH SERV-
ICES.—The term ‘comprehensive primary health 
services’ means the core services offered by SBHCs, 
which— 
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‘‘(A) shall include— 
‘‘(i) 
comprehensive 
health 
assess-
ments, diagnosis, and treatment of minor, 
acute, and chronic medical conditions and 
referrals to, and followup for, specialty 
care; and 
‘‘(ii) mental health assessments, crisis 
intervention, counseling, treatment, and re-
ferral to a continuum of services including 
emergency psychiatric care, community 
support programs, inpatient care, and out-
patient programs; and 
‘‘(B) may include additional services, such 
as oral health, social, and age-appropriate 
health education services, including nutritional 
counseling. 
‘‘(2) MEDICALLY
UNDERSERVED
CHILDREN 
AND
ADOLESCENTS.—The term ‘medically under-
served children and adolescents’ means a population 
of children and adolescents who are residents of an 
area designated by the Secretary as an area with a 
shortage of personal health services and health in-
frastructure for such children and adolescents. 
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‘‘(3) SCHOOL-BASED
HEALTH
CLINIC.—The 
term ‘school-based health clinic’ means a health clin-
ic that— 
‘‘(A) is located in, or is adjacent to, a 
school facility of a local educational agency; 
‘‘(B) is organized through school, commu-
nity, and health provider relationships; 
‘‘(C) is administered by a sponsoring facil-
ity; 
‘‘(D) 
provides 
comprehensive 
primary 
health services during school hours to children 
and adolescents by health professionals in ac-
cordance with State and local laws and regula-
tions, established standards, and community 
practice; and 
‘‘(E) does not perform abortion services. 
‘‘(4) SPONSORING FACILITY.—The term ‘spon-
soring facility’ is— 
‘‘(A) a hospital; 
‘‘(B) a public health department; 
‘‘(C) a community health center; 
‘‘(D) a nonprofit health care entity whose 
mission is to provide access to comprehensive 
primary health care services; 
‘‘(E) a local educational agency; or 
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‘‘(F) a program administered by the In-
dian Health Service or the Bureau of Indian 
Affairs or operated by an Indian tribe or a trib-
al organization under the Indian Self-Deter-
mination and Education Assistance Act, a Na-
tive Hawaiian entity, or an urban Indian pro-
gram under title V of the Indian Health Care 
Improvement Act. 
‘‘(m) AUTHORIZATION
OF APPROPRIATIONS.—For 
purposes of carrying out this section, there are authorized 
to be appropriated $50,000,000 for fiscal year 2011 and 
such sums as may be necessary for each of fiscal years 
2012 through 2015.’’. 
(b) EFFECTIVE DATE.—The Secretary of Health and 
Human Services shall begin awarding grants under section 
399Z–1 of the Public Health Service Act, as added by sub-
section (a), not later than July 1, 2010, without regard 
to whether or not final regulations have been issued under 
section 399Z–1(i) of such Act. 
(c) TERMINATION OF STUDY.—Section 2(b) of the 
Health Care Safety Net Act of 2008 (42 U.S.C. 254b 
note) is amended by striking paragraph (2) (relating to 
a school-based health center study). 
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SEC. 2512. NURSE-MANAGED HEALTH CENTERS. 
Title III (42 U.S.C. 241 et seq.) is amended by add-
ing at the end the following: 
‘‘PART S—NURSE-MANAGED HEALTH CENTERS 
‘‘SEC. 399FF. NURSE-MANAGED HEALTH CENTERS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, shall establish a nurse-managed health cen-
ter program consisting of awarding grants to entities 
under subsection (b). 
‘‘(b) GRANT.—The Secretary shall award grants to 
entities— 
‘‘(1) to plan and develop a nurse-managed 
health center; or 
‘‘(2) to operate a nurse-managed health center. 
‘‘(c) USE OF FUNDS.—Amounts received as a grant 
under subsection (b) may be used for activities including 
the following: 
‘‘(1) Purchasing or leasing equipment. 
‘‘(2) Training and technical assistance related 
to the provision of comprehensive primary care serv-
ices and wellness services. 
‘‘(3) Other activities for planning, developing, 
or operating, as applicable, a nurse-managed health 
center. 
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‘‘(d) ASSURANCES APPLICABLE TO BOTH PLANNING 
AND OPERATION GRANTS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
a grant under this section to an entity only if the 
entity demonstrates to the Secretary’s satisfaction 
that— 
‘‘(A) nurses, in addition to managing the 
center, will be adequately represented as pro-
viders at the center; and 
‘‘(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 
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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 
‘‘(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 
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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 
‘‘(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. 
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‘‘(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 
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). 
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‘‘(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-
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)— 
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(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 
(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). 
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‘‘(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. 
‘‘(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-
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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 
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). 
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‘‘(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). 
‘‘(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. 
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‘‘(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. 
‘‘(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.’’. 
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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; 
(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-
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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 
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 
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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 
(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: 
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(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. 
(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.— 
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(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 
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. 
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(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. 
(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. 
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(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. 
(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: 
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(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 
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; 
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(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). 
(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; 
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(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 
(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: 
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‘‘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 
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; 
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‘‘(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-
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 
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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. 
‘‘(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, 
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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 
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)— 
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(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)— 
(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.’’; 
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(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: 
‘‘(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 
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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. 
‘‘(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 
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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-
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: 
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‘‘(F) developing projects to use telehealth 
technology to— 
‘‘(i) facilitate collaboration between 
health care providers; 
‘‘(ii) promote telenursing services; or 
‘‘(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 
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(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 
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, 
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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 
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. 
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(3) PARTICIPATION VOLUNTARY.—Participation 
by a school or an individual shall be voluntary. 
(d) USE OF FUNDS.—Eligible partnerships receiving 
a grant under this section shall ensure the maximum num-
ber of children access influenza vaccinations as follows: 
(1) COVERED
CHILDREN.—To the extent to 
which payment of the costs of purchasing 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. 
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(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 
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 
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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. 
(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 
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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; 
(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 
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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 
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 
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(B) in the matter preceding paragraph (1), 
by striking ‘‘may make grants’’ and all that fol-
lows through ‘‘purpose’’ and inserting the fol-
lowing: ‘‘may make grants to such States for 
the purpose’’; and 
(2) in subsection (d)(1), by striking ‘‘there are 
authorized’’ and all that follows through the period 
and inserting ‘‘there are authorized to be appro-
priated 
$70,000,000 
for 
fiscal 
year 
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-
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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, 
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— 
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‘‘(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; 
‘‘(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. 
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‘‘(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-
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. 
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‘‘(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; 
‘‘(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.— 
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‘‘(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 
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— 
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‘‘(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; 
‘‘(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 
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‘‘(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 
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. 
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‘‘(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-
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. 
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‘‘(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 
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. 
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‘‘(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. 
‘‘(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 
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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 
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 
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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. 
‘‘(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). 
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‘‘(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 
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. 
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‘‘(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. 
‘‘(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-
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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 
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— 
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pose of providing sanitation facilities and services 
and place these funds into contracts or compacts 
under the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 450 et seq.); 
‘‘(5) except as otherwise prohibited by this sec-
tion, the Secretary may use funds appropriated 
under the authority of section 7 of the Act of Au-
gust 5, 1954 (42 U.S.C. 2004a), to fund up to 100 
percent of the amount of an Indian Tribe’s loan ob-
tained under any Federal program for new projects 
to construct eligible sanitation facilities to serve In-
dian homes; 
‘‘(6) except as otherwise prohibited by this sec-
tion, the Secretary may use funds appropriated 
under the authority of section 7 of the Act of Au-
gust 5, 1954 (42 U.S.C. 2004a), to meet matching 
or cost participation requirements under other Fed-
eral and non-Federal programs for new projects to 
construct eligible sanitation facilities; 
‘‘(7) all Federal agencies are authorized to 
transfer to the Secretary funds identified, granted, 
loaned, or appropriated whereby the Department’s 
applicable policies, rules, and regulations shall apply 
in the implementation of such projects; 
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‘‘(1) IN GENERAL.—Subject to complying with 
the requirements of paragraph (2), a Tribal Health 
Program may elect to directly bill for, and receive 
payment for, health care items and services provided 
by such Program for which payment is made under 
title XVIII, XIX, or XXI of the Social Security Act. 
‘‘(2) DIRECT REIMBURSEMENT.— 
‘‘(A) USE OF FUNDS.—Each Tribal Health 
Program making the election described in para-
graph (1) with respect to a program under title 
XVIII, XIX, or XXI of the Social Security Act 
shall be reimbursed directly by that program 
for items and services furnished without regard 
to subsection (c)(1), but all amounts so reim-
bursed shall be used by the Tribal Health Pro-
gram for the same purposes with respect to 
such Program for which payment under sub-
paragraph (A) of subsection (c)(1) to a facility 
of the Service may be used pursuant to sub-
paragraph (B) of such subsection with respect 
to the Service. 
‘‘(B) AUDITS.—The amounts paid to a 
Tribal Health Program making the election de-
scribed in paragraph (1) with respect to a pro-
gram under title XVIII, XIX, or XXI of the So-
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