H. R. 3590—445 
(2) to the extent practicable, establish standards and health 
status targets for Medicaid beneficiaries participating in the 
program and measure the degree to which such standards 
and targets are met; 
(3) evaluate the effectiveness of the program and provide 
the Secretary with such evaluations; 
(4) report to the Secretary on processes that have been 
developed and lessons learned from the program; and 
(5) report on preventive services as part of reporting on 
quality measures for Medicaid managed care programs. 
(d) EVALUATIONS AND REPORTS.— 
(1) INDEPENDENT ASSESSMENT.—The Secretary shall enter 
into a contract with an independent entity or organization 
to conduct an evaluation and assessment of the initiatives 
carried out by States under this section, for the purpose of 
determining— 
(A) the effect of such initiatives on the use of health 
care services by Medicaid beneficiaries participating in the 
program; 
(B) the extent to which special populations (including 
adults with disabilities, adults with chronic illnesses, and 
children with special health care needs) are able to partici-
pate in the program; 
(C) the level of satisfaction of Medicaid beneficiaries 
with respect to the accessibility and quality of health care 
services provided through the program; and 
(D) the administrative costs incurred by State agencies 
that are responsible for administration of the program. 
(2) STATE REPORTING.—A State awarded a grant to carry 
out initiatives under this section shall submit reports to the 
Secretary, on a semi-annual basis, regarding the programs 
that are supported by the grant funds. Such report shall include 
information, as specified by the Secretary, regarding— 
(A) the specific uses of the grant funds; 
(B) an assessment of program implementation and les-
sons learned from the programs; 
(C) an assessment of quality improvements and clinical 
outcomes under such programs; and 
(D) estimates of cost savings resulting from such pro-
grams. 
(3) INITIAL REPORT.—Not later than January 1, 2014, the 
Secretary shall submit to Congress an initial report on such 
initiatives based on information provided by States through 
reports required under paragraph (2). The initial report shall 
include an interim evaluation of the effectiveness of the initia-
tives carried out with grants awarded under this section and 
a recommendation regarding whether funding for expanding 
or extending the initiatives should be extended beyond January 
1, 2016. 
(4) FINAL REPORT.—Not later than July 1, 2016, the Sec-
retary shall submit to Congress a final report on the program 
that includes the results of the independent assessment 
required under paragraph (1), together with recommendations 
for such legislation and administrative action as the Secretary 
determines appropriate.
H. R. 3590—446 
(e) NO EFFECT ON ELIGIBILITY FOR, OR AMOUNT OF, MEDICAID 
OR OTHER BENEFITS.—Any incentives provided to a Medicaid bene-
ficiary participating in a program described in subsection (a)(3) 
shall not be taken into account for purposes of determining the 
beneficiary’s eligibility for, or amount of, benefits under the Med-
icaid program or any program funded in whole or in part with 
Federal funds. 
(f) FUNDING.—Out of any funds in the Treasury not otherwise 
appropriated, there are appropriated for the 5-year period beginning 
on January 1, 2011, $100,000,000 to the Secretary to carry out 
this section. Amounts appropriated under this subsection shall 
remain available until expended. 
(g) DEFINITIONS.—In this section: 
(1) MEDICAID
BENEFICIARY.—The term ‘‘Medicaid bene-
ficiary’’ means an individual who is eligible for medical assist-
ance under a State plan or waiver under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.) and is enrolled 
in such plan or waiver. 
(2) STATE.—The term ‘‘State’’ has the meaning given that 
term for purposes of title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.). 
Subtitle C—Creating Healthier 
Communities 
SEC. 4201. COMMUNITY TRANSFORMATION GRANTS. 
(a) IN GENERAL.—The Secretary of Health and Human Services 
(referred to in this section as the ‘‘Secretary’’), acting through the 
Director of the Centers for Disease Control and Prevention (referred 
to in this section as the ‘‘Director’’), shall award competitive grants 
to State and local governmental agencies and community-based 
organizations for the implementation, evaluation, and dissemination 
of evidence-based community preventive health activities in order 
to reduce chronic disease rates, prevent the development of sec-
ondary conditions, address health disparities, and develop a 
stronger evidence-base of effective prevention programming. 
(b) ELIGIBILITY.—To be eligible to receive a grant under sub-
section (a), an entity shall— 
(1) be— 
(A) a State governmental agency; 
(B) a local governmental agency; 
(C) a national network of community-based organiza-
tions; 
(D) a State or local non-profit organization; or 
(E) an Indian tribe; and 
(2) submit to the Director an application at such time, 
in such a manner, and containing such information as the 
Director may require, including a description of the program 
to be carried out under the grant; and 
(3) demonstrate a history or capacity, if funded, to develop 
relationships necessary to engage key stakeholders from mul-
tiple sectors within and beyond health care and across a 
community, such as healthy futures corps and health care 
providers. 
(c) USE OF FUNDS.—
H. R. 3590—447 
(1) IN
GENERAL.—An eligible entity shall use amounts 
received under a grant under this section to carry out programs 
described in this subsection. 
(2) COMMUNITY TRANSFORMATION PLAN.— 
(A) IN GENERAL.—An eligible entity that receives a 
grant under this section shall submit to the Director (for 
approval) a detailed plan that includes the policy, environ-
mental, programmatic, and as appropriate infrastructure 
changes needed to promote healthy living and reduce 
disparities. 
(B) ACTIVITIES.—Activities within the plan may focus 
on (but not be limited to)— 
(i) 
creating 
healthier 
school 
environments, 
including increasing healthy food options, physical 
activity opportunities, promotion of healthy lifestyle, 
emotional wellness, and prevention curricula, and 
activities to prevent chronic diseases; 
(ii) creating the infrastructure to support active 
living and access to nutritious foods in a safe environ-
ment; 
(iii) developing and promoting programs targeting 
a variety of age levels to increase access to nutrition, 
physical activity and smoking cessation, improve social 
and emotional wellness, enhance safety in a commu-
nity, or address any other chronic disease priority area 
identified by the grantee; 
(iv) assessing and implementing worksite wellness 
programming and incentives; 
(v) working to highlight healthy options at res-
taurants and other food venues; 
(vi) prioritizing strategies to reduce racial and 
ethnic disparities, including social, economic, and 
geographic determinants of health; and 
(vii) 
addressing 
special 
populations 
needs, 
including all age groups and individuals with disabil-
ities, and individuals in both urban and rural areas. 
(3) COMMUNITY-BASED PREVENTION HEALTH ACTIVITIES.— 
(A) IN GENERAL.—An eligible entity shall use amounts 
received under a grant under this section to implement 
a variety of programs, policies, and infrastructure improve-
ments to promote healthier lifestyles. 
(B) ACTIVITIES.—An eligible entity shall implement 
activities detailed in the community transformation plan 
under paragraph (2). 
(C) IN-KIND SUPPORT.—An eligible entity may provide 
in-kind resources such as staff, equipment, or office space 
in carrying out activities under this section. 
(4) EVALUATION.— 
(A) IN GENERAL.—An eligible entity shall use amounts 
provided under a grant under this section to conduct activi-
ties to measure changes in the prevalence of chronic disease 
risk factors among community members participating in 
preventive health activities 
(B) TYPES
OF
MEASURES.—In carrying out subpara-
graph (A), the eligible entity shall, with respect to residents 
in the community, measure— 
(i) changes in weight;
H. R. 3590—448 
(ii) changes in proper nutrition; 
(iii) changes in physical activity; 
(iv) changes in tobacco use prevalence; 
(v) changes in emotional well-being and overall 
mental health; 
(vi) other factors using community-specific data 
from the Behavioral Risk Factor Surveillance Survey; 
and 
(vii) other factors as determined by the Secretary. 
(C) REPORTING.—An eligible entity shall annually 
submit to the Director a report containing an evaluation 
of activities carried out under the grant. 
(5) DISSEMINATION.—A grantee under this section shall— 
(A) meet at least annually in regional or national 
meetings to discuss challenges, best practices, and lessons 
learned with respect to activities carried out under the 
grant; and 
(B) develop models for the replication of successful 
programs and activities and the mentoring of other eligible 
entities. 
(d) TRAINING.— 
(1) IN GENERAL.—The Director shall develop a program 
to provide training for eligible entities on effective strategies 
for the prevention and control of chronic disease and the link 
between physical, emotional, and social well-being. 
(2) COMMUNITY TRANSFORMATION PLAN.—The Director shall 
provide appropriate feedback and technical assistance to 
grantees to establish community transformation plans 
(3) EVALUATION.—The Director shall provide a literature 
review and framework for the evaluation of programs conducted 
as part of the grant program under this section, in addition 
to working with academic institutions or other entities with 
expertise in outcome evaluation. 
(e) PROHIBITION.—A grantee shall not use funds provided under 
a grant under this section to create video games or to carry out 
any other activities that may lead to higher rates of obesity or 
inactivity. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to carry out this section, such sums as may 
be necessary for each fiscal years 2010 through 2014. 
SEC. 4202. HEALTHY AGING, LIVING WELL; EVALUATION OF COMMU-
NITY-BASED PREVENTION AND WELLNESS PROGRAMS 
FOR MEDICARE BENEFICIARIES. 
(a) HEALTHY AGING, LIVING WELL.— 
(1) IN
GENERAL.—The Secretary of Health and Human 
Services (referred to in this section as the ‘‘Secretary’’), acting 
through the Director of the Centers for Disease Control and 
Prevention, shall award grants to State or local health depart-
ments and Indian tribes to carry out 5-year pilot programs 
to provide public health community interventions, screenings, 
and where necessary, clinical referrals for individuals who are 
between 55 and 64 years of age. 
(2) ELIGIBILITY.—To be eligible to receive a grant under 
paragraph (1), an entity shall— 
(A) be— 
(i) a State health department;