856 
ond language acquisition, in the case 
of English language learners); 
‘‘(II) knowledge of realistic ex-
pectations of age-appropriate child be-
haviors; 
‘‘(III) knowledge of health and 
wellness issues for children and par-
ents; 
‘‘(IV) modeling, consulting, and 
coaching on parenting practices; 
‘‘(V) skills to interact with their 
child to enhance age-appropriate de-
velopment; 
‘‘(VI) skills to recognize and seek 
help for issues related to health, devel-
opmental delays, and social, emo-
tional, and behavioral skills; and 
‘‘(VII) activities designed to help 
parents become full partners in the 
education of their children; 
‘‘(B) includes expenditures for training, 
technical assistance, and evaluations related to 
the programs; and 
‘‘(C) does not include any expenditure with 
respect to which a State has submitted a claim 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00856
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
857 
for payment under any other provision of Fed-
eral law. 
‘‘(2) PRIORITY FUNDING FOR PROGRAMS WITH 
STRONGEST EVIDENCE.— 
‘‘(A) IN GENERAL.—The expenditures, de-
scribed in paragraph (1), of a State for a fiscal 
year that are attributable to the cost of pro-
grams that do not adhere to a model of home 
visitation with the strongest evidence of effec-
tiveness shall not be considered eligible expendi-
tures for the fiscal year to the extent that the 
total of the expenditures exceeds the applicable 
percentage for the fiscal year of the allotment 
of the State under subsection (c) for the fiscal 
year. 
‘‘(B) 
APPLICABLE
PERCENTAGE
DE-
FINED.—In subparagraph (A), the term ‘appli-
cable percentage’ means, with respect to a fiscal 
year— 
‘‘(i) 60 percent for fiscal year 2010; 
‘‘(ii) 55 percent for fiscal year 2011; 
‘‘(iii) 50 percent for fiscal year 2012; 
‘‘(iv) 45 percent for fiscal year 2013; 
or 
‘‘(v) 40 percent for fiscal year 2014. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00857
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
858 
‘‘(g) NO USE
OF OTHER FEDERAL FUNDS
FOR 
STATE MATCH.—A State to which a grant is made under 
this section may not expend any Federal funds to meet 
the State share of the cost of an eligible expenditure for 
which the State receives a payment under this section. 
‘‘(h) WAIVER AUTHORITY.— 
‘‘(1) IN GENERAL.—The Secretary may waive 
or modify the application of any provision of this 
section, other than subsection (b) or (f), to an In-
dian tribe if the failure to do so would impose an 
undue burden on the Indian tribe. 
‘‘(2) SPECIAL
RULE.—An Indian tribe is 
deemed to meet the requirement of subsection (d) 
for purposes of subsections (c) and (e) if— 
‘‘(A) the Secretary waives the requirement; 
or 
‘‘(B) the Secretary modifies the require-
ment, and the Indian tribe meets the modified 
requirement. 
‘‘(i) STATE REPORTS.—Each State to which a grant 
is made under this section shall submit to the Secretary 
an annual report on the progress made by the State in 
addressing the purposes of this section. Each such report 
shall include a description of— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00858
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
859 
‘‘(1) the services delivered by the programs that 
received funds from the grant; 
‘‘(2) the characteristics of each such program, 
including information on the service model used by 
the program and the performance of the program; 
‘‘(3) the characteristics of the providers of serv-
ices through the program, including staff qualifica-
tions, work experience, and demographic characteris-
tics; 
‘‘(4) the characteristics of the recipients of serv-
ices provided through the program, including the 
number of the recipients, the demographic charac-
teristics of the recipients, and family retention; 
‘‘(5) the annual cost of implementing the pro-
gram, including the cost per family served under the 
program; 
‘‘(6) the outcomes experienced by recipients of 
services through the program; 
‘‘(7) the training and technical assistance pro-
vided to aid implementation of the program, and 
how the training and technical assistance contrib-
uted to the outcomes achieved through the program; 
‘‘(8) the indicators and methods used to mon-
itor whether the program is being implemented as 
designed; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00859
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
860 
‘‘(9) other information as determined necessary 
by the Secretary. 
‘‘(j) EVALUATION.— 
‘‘(1) IN
GENERAL.—The Secretary shall, by 
grant or contract, provide for the conduct of an 
independent evaluation of the effectiveness of home 
visitation programs receiving funds provided under 
this section, which shall examine the following: 
‘‘(A) The effect of home visitation pro-
grams on child and parent outcomes, including 
child maltreatment, child health and develop-
ment, school readiness, and links to community 
services. 
‘‘(B) The effectiveness of home visitation 
programs on different populations, including 
the extent to which the ability of programs to 
improve outcomes varies across programs and 
populations. 
‘‘(2) REPORTS TO THE CONGRESS.— 
‘‘(A) INTERIM
REPORT.—Within 3 years 
after the date of the enactment of this section, 
the Secretary shall submit to the Congress an 
interim report on the evaluation conducted pur-
suant to paragraph (1). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00860
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
861 
‘‘(B) FINAL
REPORT.—Within 5 years 
after the date of the enactment of this section, 
the Secretary shall submit to the Congress a 
final report on the evaluation conducted pursu-
ant to paragraph (1). 
‘‘(k) ANNUAL REPORTS TO THE CONGRESS.—The 
Secretary shall submit annually to the Congress a report 
on the activities carried out using funds made available 
under this section, which shall include a description of the 
following: 
‘‘(1) The high need communities targeted by 
States for programs carried out under this section. 
‘‘(2) The service delivery models used in the 
programs receiving funds provided under this sec-
tion. 
‘‘(3) The characteristics of the programs, in-
cluding— 
‘‘(A) the qualifications and demographic 
characteristics of program staff; and 
‘‘(B) recipient characteristics including the 
number of families served, the demographic 
characteristics of the families served, and fam-
ily retention and duration of services. 
‘‘(4) The outcomes reported by the programs. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00861
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
862 
‘‘(5) The research-based instruction, materials, 
and activities being used in the activities funded 
under the grant. 
‘‘(6) The training and technical activities, in-
cluding on-going professional development, provided 
to the programs. 
‘‘(7) The annual costs of implementing the pro-
grams, including the cost per family served under 
the programs. 
‘‘(8) The indicators and methods used by States 
to monitor whether the programs are being been im-
plemented as designed. 
‘‘(l) RESERVATIONS OF FUNDS.—From the amounts 
appropriated for a fiscal year under subsection (m), the 
Secretary shall reserve— 
‘‘(1) an amount equal to 5 percent of the 
amounts to pay the cost of the evaluation provided 
for in subsection (j), and the provision to States of 
training and technical assistance, including the dis-
semination of best practices in early childhood home 
visitation; and 
‘‘(2) after making the reservation required by 
paragraph (1), an amount equal to 3 percent of the 
amount so appropriated, to pay for grants to Indian 
tribes under this section. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00862
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
863 
‘‘(m) APPROPRIATIONS.—Out of any money in the 
Treasury of the United States not otherwise appropriated, 
there is appropriated to the Secretary to carry out this 
section— 
‘‘(1) $50,000,000 for fiscal year 2010; 
‘‘(2) $100,000,000 for fiscal year 2011; 
‘‘(3) $150,000,000 for fiscal year 2012; 
‘‘(4) $200,000,000 for fiscal year 2013; and 
‘‘(5) $250,000,000 for fiscal year 2014. 
‘‘(n) INDIAN TRIBES TREATED AS STATES.—In this 
section, paragraphs (4), (5), and (6) of section 431(a) 
shall apply.’’. 
SEC. 1905. IMPROVED COORDINATION AND PROTECTION 
FOR DUAL ELIGIBLES. 
Title XI of the Social Security Act is amended by 
inserting after section 1150 the following new section: 
‘‘IMPROVED COORDINATION AND PROTECTION FOR DUAL 
ELIGIBLES 
‘‘SEC. 1150A. (a) IN GENERAL.—The Secretary shall 
provide, through an identifiable office or program within 
the Centers for Medicare & Medicaid Services, for a fo-
cused effort to provide for improved coordination between 
Medicare and Medicaid and protection in the case of dual 
eligibles (as defined in subsection (e)). The office or pro-
gram shall— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00863
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
864 
‘‘(1) review Medicare and Medicaid policies re-
lated to enrollment, benefits, service delivery, pay-
ment, and grievance and appeals processes under 
parts A and B of title XVIII, under the Medicare 
Advantage program under part C of such title, and 
under title XIX; 
‘‘(2) identify areas of such policies where better 
coordination and protection could improve care and 
costs; and 
‘‘(3) issue guidance to States regarding improv-
ing such coordination and protection. 
‘‘(b) ELEMENTS.—The improved coordination and 
protection under this section shall include efforts— 
‘‘(1) to simplify access of dual eligibles to bene-
fits and services under Medicare and Medicaid; 
‘‘(2) to improve care continuity for dual eligi-
bles and ensure safe and effective care transitions; 
‘‘(3) to harmonize regulatory conflicts between 
Medicare and Medicaid rules with regard to dual eli-
gibles; and 
‘‘(4) to improve total cost and quality perform-
ance under Medicare and Medicaid for dual eligibles. 
‘‘(c) RESPONSIBILITIES.—In carrying out this sec-
tion, the Secretary shall provide for the following: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00864
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
865 
‘‘(1) An examination of Medicare and Medicaid 
payment systems to develop strategies to foster more 
integrated and higher quality care. 
‘‘(2) Development of methods to facilitate ac-
cess to post-acute and community-based services and 
to identify actions that could lead to better coordina-
tion of community-based care. 
‘‘(3) A study of enrollment of dual eligibles in 
the Medicare Savings Program (as defined in section 
1144(c)(7)), under Medicaid, and in the low-income 
subsidy program under section 1860D–14 to identify 
methods to more efficiently and effectively reach and 
enroll dual eligibles. 
‘‘(4) An assessment of communication strate-
gies for dual eligibles to determine whether addi-
tional informational materials or outreach is needed, 
including an assessment of the Medicare website, 1– 
800–MEDICARE, and the Medicare handbook. 
‘‘(5) Research and evaluation of areas where 
service utilization, quality, and access to cost sharing 
protection could be improved and an assessment of 
factors related to enrollee satisfaction with services 
and care delivery. 
‘‘(6) Collection (and making available to the 
public) of data and a database that describe the eli-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00865
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
866 
gibility, benefit and cost-sharing assistance available 
to dual eligibles by State. 
‘‘(7) Monitoring total combined Medicare and 
Medicaid program costs in serving dual eligibles and 
making recommendations for optimizing total quality 
and cost performance across both programs. 
‘‘(8) Coordination of activities relating to Medi-
care Advantage plans under 1859(b)(6)(B)(ii) and 
Medicaid. 
‘‘(d) PERIODIC REPORTS.—Not later than 1 year 
after the date of the enactment of this section and every 
3 years thereafter the Secretary shall submit to Congress 
a report on progress in activities conducted under this sec-
tion. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) DUAL ELIGIBLE.—The term ‘dual eligible’ 
means an individual who is dually eligible for bene-
fits under title XVIII, and medical assistance under 
title XIX, including such individuals who are eligible 
for benefits under the Medicare Savings Program 
(as defined in section 1144(c)(7)). 
‘‘(2) MEDICARE; MEDICAID.—The terms ‘Medi-
care’ and ‘Medicaid’ mean the programs under titles 
XVIII and XIX, respectively.’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00866
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
867 
SEC. 1906. ASSESSMENT OF MEDICARE COST-INTENSIVE 
DISEASES AND CONDITIONS. 
(a) INITIAL ASSESSMENT.— 
(1) IN
GENERAL.—The Administrator of the 
Centers for Medicare & Medicaid Services shall con-
duct an assessment of the diseases and conditions 
that are the most cost-intensive for the Medicare 
program. The assessment shall inform research pri-
orities within the Department of Health and Human 
Services in order improve the prevention, or treat-
ment or cure, of such diseases and conditions. 
(2) REPORT.— Not later than January 1, 
2011, the Administrator shall submit to the Sec-
retary of Health and Human Services a report on 
such assessment and the Secretary shall transmit 
such report to the Congress. 
(b) UPDATES OF ASSESSMENT.—Not later than Jan-
uary 1, 2013, and biennially thereafter, the Administrator 
of the Centers for Medicare & Medicaid Services shall re-
view and update the assessment described in subsection 
(a) and make such recommendations to the Secretary on 
changes in research priorities referred to in such sub-
section as may be appropriate. The Secretary shall submit 
to the Congress a report on such recommendations. 
(c) MEDICARE COST-INTENSIVE RESEARCH FUND.— 
There is established in the Treasury of the United States 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00867
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
868 
a Fund to be known as the Medicare Cost-Intensive Re-
search Fund (in this subsection referred to as the 
‘‘Fund’’), consisting of such amounts as may be appro-
priated or credited to such Fund for research priorities 
identified as a result of the assessments conducted under 
this section. 
SUBDIVISION 
C—PUBLIC 
HEALTH 
AND 
WORKFORCE 
DEVELOPMENT 
SEC. 2001. TABLE OF CONTENTS; REFERENCES. 
(a) TABLE OF CONTENTS.—The table of contents of 
this subdivision is as follows: 
Sec. 2001. Table of contents; references. 
Sec. 2002. Public Health Investment Fund. 
TITLE I—COMMUNITY HEALTH CENTERS 
Sec. 2101. Increased funding. 
TITLE II—WORKFORCE 
Subtitle A—Primary Care Workforce 
PART 1—NATIONAL HEALTH SERVICE CORPS 
Sec. 2201. National Health Service Corps. 
Sec. 2202. Authorizations of appropriations. 
PART 2—PROMOTION OF PRIMARY CARE AND DENTISTRY 
Sec. 2211. Frontline health providers. 
‘‘SUBPART XI—HEALTH PROFESSIONAL NEEDS AREAS 
‘‘Sec. 340H. In general. 
‘‘Sec. 340I. Loan repayments. 
‘‘Sec. 340J. Report. 
‘‘Sec. 340K. Allocation. 
Sec. 2212. Primary care student loan funds. 
Sec. 2213. Training in family medicine, general internal medicine, general pedi-
atrics, geriatrics, and physician assistantship. 
Sec. 2214. Training of medical residents in community-based settings. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00868
Fmt 6652
Sfmt 6211
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
869 
Sec. 2215. Training for general, pediatric, and public health dentists and dental 
hygienists. 
Sec. 2216. Authorization of appropriations. 
Subtitle B—Nursing Workforce 
Sec. 2221. Amendments to Public Health Service Act. 
Subtitle C—Public Health Workforce 
Sec. 2231. Public Health Workforce Corps. 
‘‘SUBPART XII—PUBLIC HEALTH WORKFORCE 
‘‘Sec. 340L. Public Health Workforce Corps. 
‘‘Sec. 340M. Public Health Workforce Scholarship Program. 
‘‘Sec. 340N. Public Health Workforce Loan Repayment Program. 
Sec. 2232. Enhancing the public health workforce. 
Sec. 2233. Public health training centers. 
Sec. 2234. Preventive medicine and public health training grant program. 
Sec. 2235. Authorization of appropriations. 
Subtitle D—Adapting Workforce to Evolving Health System Needs 
PART 1—HEALTH PROFESSIONS TRAINING FOR DIVERSITY 
Sec. 2241. Scholarships for disadvantaged students, loan repayments and fel-
lowships regarding faculty positions, and educational assistance 
in the health professions regarding individuals from disadvan-
taged backgrounds. 
Sec. 2242. Nursing workforce diversity grants. 
Sec. 2243. Coordination of diversity and cultural competency programs. 
PART 2—INTERDISCIPLINARY TRAINING PROGRAMS 
Sec. 2251. Cultural and linguistic competency training for health care profes-
sionals. 
Sec. 2252. Innovations in interdisciplinary care training. 
PART 3—ADVISORY COMMITTEE ON HEALTH WORKFORCE EVALUATION AND 
ASSESSMENT 
Sec. 2261. Health workforce evaluation and assessment. 
PART 4—HEALTH WORKFORCE ASSESSMENT 
Sec. 2271. Health workforce assessment. 
PART 5—AUTHORIZATION OF APPROPRIATIONS 
Sec. 2281. Authorization of appropriations. 
TITLE III—PREVENTION AND WELLNESS 
Sec. 2301. Prevention and wellness. 
‘‘TITLE XXXI—PREVENTION AND WELLNESS 
‘‘Subtitle A—Prevention and Wellness Trust 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00869
Fmt 6652
Sfmt 6211
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
870 
‘‘Sec. 3111. Prevention and Wellness Trust. 
‘‘Subtitle B—National Prevention and Wellness Strategy 
‘‘Sec. 3121. National Prevention and Wellness Strategy. 
‘‘Subtitle C—Prevention Task Forces 
‘‘Sec. 3131. Task Force on Clinical Preventive Services. 
‘‘Sec. 3132. Task Force on Community Preventive Services. 
‘‘Subtitle D—Prevention and Wellness Research 
‘‘Sec. 3141. Prevention and wellness research activity coordination. 
‘‘Sec. 3142. Community prevention and wellness research grants. 
‘‘Subtitle E—Delivery of Community Prevention and Wellness Services 
‘‘Sec. 3151. Community prevention and wellness services grants. 
‘‘Subtitle F—Core Public Health Infrastructure 
‘‘Sec. 3161. Core public health infrastructure for State, local, and tribal 
health departments. 
‘‘Sec. 3162. Core public health infrastructure and activities for CDC. 
‘‘Subtitle G—General Provisions 
‘‘Sec. 3171. Definitions. 
TITLE IV—QUALITY AND SURVEILLANCE 
Sec. 2401. Implementation of best practices in the delivery of health care. 
Sec. 2402. Assistant Secretary for Health Information. 
Sec. 2403. Authorization of appropriations. 
TITLE V—OTHER PROVISIONS 
Subtitle A—Drug Discount for Rural and Other Hospitals 
Sec. 2501. Expanded participation in 340B program. 
Sec. 2502. Extension of discounts to inpatient drugs. 
Sec. 2503. Effective date. 
Subtitle B—School-Based Health Clinics 
Sec. 2511. School-based health clinics. 
Subtitle C—National Medical Device Registry 
Sec. 2521. National medical device registry. 
Subtitle D—Grants for Comprehensive Programs To Provide Education to 
Nurses and Create a Pipeline to Nursing 
Sec. 2531. Establishment of grant program. 
Subtitle E—States Failing To Adhere to Certain Employment Obligations 
Sec. 2541. Limitation on Federal funds. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00870
Fmt 6652
Sfmt 6211
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
871 
(b) REFERENCES.—Except as otherwise specified, 
whenever in this subdivision an amendment is expressed 
in terms of an amendment to a section or other provision, 
the reference shall be considered to be made to a section 
or other provision of the Public Health Service Act (42 
U.S.C. 201 et seq.). 
SEC. 2002. PUBLIC HEALTH INVESTMENT FUND. 
(a) ESTABLISHMENT OF FUNDS.— 
(1) IN GENERAL.—There is established a fund 
to be known as the ‘‘Public Health Investment 
Fund’’ (referred to in this section as the ‘‘Fund’’). 
(2) FUNDING.— 
(A) There shall be deposited into the 
Fund— 
(i) 
for 
fiscal 
year 
2010, 
$4,600,000,000; 
(ii) 
for 
fiscal 
year 
2011, 
$5,600,000,000; 
(iii) 
for 
fiscal 
year 
2012, 
$6,900,000,000; 
(iv) 
for 
fiscal 
year 
2013, 
$7,800,000,000; 
(v) 
for 
fiscal 
year 
2014, 
$9,000,000,000; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00871
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
872 
(vi) 
for 
fiscal 
year 
2015, 
$9,400,000,000; 
(vii) 
for 
fiscal 
year 
2016, 
$10,100,000,000; 
(viii) 
for 
fiscal 
year 
2017, 
$10,800,000,000; 
(ix) 
for 
fiscal 
year 
2018, 
$11,800,000,000; and 
(x) 
for 
fiscal 
year 
2019, 
$12,700,000,000. 
(B) Amounts deposited into the Fund shall 
be derived from general revenues of the Treas-
ury. 
(b) AUTHORIZATION OF APPROPRIATIONS FROM THE 
FUND.— 
(1) NEW FUNDING.— 
(A) IN GENERAL.—Amounts in the Fund 
are authorized to be appropriated by the Com-
mittees on Appropriations of the House of Rep-
resentatives and the Senate for carrying out ac-
tivities under designated public health provi-
sions. 
(B) DESIGNATED PROVISIONS.—For pur-
poses of this paragraph, the term ‘‘designated 
public health provisions’’ means the provisions 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00872
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
873 
for which amounts are authorized to be appro-
priated under section 330(s), 338(c), 338H–1, 
799C, 872, or 3111 of the Public Health Serv-
ice Act, as added by this subdivision. 
(2) BASELINE FUNDING.— 
(A) IN GENERAL.—Amounts in the Fund 
are authorized to be appropriated (as described 
in paragraph (1)) for a fiscal year only if (ex-
cluding any amounts in or appropriated from 
the Fund)— 
(i) the amounts specified in subpara-
graph (B) for the fiscal year involved are 
equal to or greater than the amounts spec-
ified in subparagraph (B) for fiscal year 
2008; and 
(ii) the amounts appropriated, out of 
the general fund of the Treasury, to the 
Prevention and Wellness Trust under sec-
tion 3111 of the Public Health Service 
Act, as added by this subdivision, for the 
fiscal year involved are equal to or greater 
than the funds— 
(I) appropriated under the head-
ing ‘‘Prevention and Wellness Fund’’ 
in title VIII of division A of the Amer-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00873
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
874 
ican Recovery and Reinvestment Act 
of 2009 (Public Law 111–5); and 
(II) allocated by the second pro-
viso under such heading for evidence- 
based clinical and community-based 
prevention and wellness strategies. 
(B) AMOUNTS SPECIFIED.—The amounts 
specified in this subparagraph, with respect to 
a fiscal year, are the amounts appropriated for 
the following: 
(i) Community health centers (includ-
ing funds appropriated under the authority 
of section 330 of the Public Health Service 
Act (42 U.S.C. 254b)). 
(ii) The National Health Service 
Corps Program (including funds appro-
priated under the authority of section 338 
of such Act (42 U.S.C. 254k)). 
(iii) The National Health Service 
Corps Scholarship and Loan Repayment 
Programs (including funds appropriated 
under the authority of section 338H of 
such Act (42 U.S.C. 254q)). 
(iv) Primary care loan funds (includ-
ing funds appropriated for schools of medi-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00874
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
875 
cine or osteopathic medicine under the au-
thority of section 735(f) of such Act (42 
U.S.C. 292y(f))). 
(v) Primary care education programs 
(including funds appropriated under the 
authority of sections 736, 740, 741, and 
747 of such Act (42 U.S.C. 293, 293d, 
and 293k)). 
(vi) Sections 761 and 770 of such Act 
(42 U.S.C. 294n and 295e). 
(vii) Nursing workforce development 
(including funds appropriated under the 
authority of title VIII of such Act (42 
U.S.C. 296 et seq.)). 
(viii) The National Center for Health 
Statistics (including funds appropriated 
under the authority of sections 304, 306, 
307, and 308 of such Act (42 U.S.C. 
242b, 242k, 242l, and 242m)). 
(ix) The Agency for Healthcare Re-
search and Quality (including funds appro-
priated under the authority of title IX of 
such Act (42 U.S.C. 299 et seq.)). 
(3) BUDGETARY IMPLICATIONS.—Amounts ap-
propriated under this section, and outlays flowing 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00875
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
876 
from such appropriations, shall not be taken into ac-
count for purposes of any budget enforcement proce-
dures including allocations under section 302(a) and 
(b) of the Balanced Budget and Emergency Deficit 
Control Act and budget resolutions for fiscal years 
during which appropriations are made from the 
Fund. 
TITLE I—COMMUNITY HEALTH 
CENTERS 
SEC. 2101. INCREASED FUNDING. 
Section 330 of the Public Health Service Act (42 
U.S.C. 254b) is amended— 
(1) in subsection (r)(1)— 
(A) in subparagraph (D), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (E), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by inserting at the end the following: 
‘‘(F) Such sums as may be necessary for 
each of fiscal years 2013 and 2019.’’; and 
(2) by inserting after subsection (r) the fol-
lowing: 
‘‘(s) ADDITIONAL FUNDING.—For the purpose of 
carrying out this section, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00876
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
877 
authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) For fiscal year 2010, $1,000,000,000. 
‘‘(2) For fiscal year 2011, $1,500,000,000. 
‘‘(3) For fiscal year 2012, $2,500,000,000. 
‘‘(4) For fiscal year 2013, $3,000,000,000. 
‘‘(5) For fiscal year 2014, $4,000,000,000. 
‘‘(6) For fiscal year 2015, $4,400,000,000. 
‘‘(7) For fiscal year 2016, $4,800,000,000. 
‘‘(8) For fiscal year 2017, $5,300,000,000. 
‘‘(9) For fiscal year 2018, $5,900,000,000. 
‘‘(10) For fiscal year 2019, $6,400,000,000.’’. 
TITLE II—WORKFORCE 
Subtitle A—Primary Care 
Workforce 
PART 1—NATIONAL HEALTH SERVICE CORPS 
SEC. 2201. NATIONAL HEALTH SERVICE CORPS. 
(a) FULFILLMENT
OF OBLIGATED SERVICE RE-
QUIREMENT THROUGH HALF-TIME SERVICE.— 
(1) WAIVERS.—Subsection (i) of section 331 
(42 U.S.C. 254d) is amended— 
(A) in paragraph (1), by striking ‘‘In car-
rying out subpart III’’ and all that follows 
through the period and inserting ‘‘In carrying 
out subpart III, the Secretary may, in accord-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00877
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
878 
ance with this subsection, issue waivers to indi-
viduals who have entered into a contract for ob-
ligated service under the Scholarship Program 
or the Loan Repayment Program under which 
the individuals are authorized to satisfy the re-
quirement of obligated service through pro-
viding clinical practice that is half-time.’’; 
(B) in paragraph (2)— 
(i) in subparagraphs (A)(ii) and (B), 
by striking ‘‘less than full time’’ each place 
it appears and inserting ‘‘half time’’; 
(ii) in subparagraphs (C) and (F), by 
striking ‘‘less than full-time service’’ each 
place it appears and inserting ‘‘half-time 
service’’; and 
(iii) by amending subparagraphs (D) 
and (E) to read as follows: 
‘‘(D) the entity and the Corps member agree in 
writing that the Corps member will perform half- 
time clinical practice; 
‘‘(E) the Corps member agrees in writing to 
fulfill all of the service obligations under section 
338C through half-time clinical practice and ei-
ther— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00878
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
879 
‘‘(i) double the period of obligated service; 
or 
‘‘(ii) in the case of contracts entered into 
under section 338B, accept a minimum service 
obligation of 2 years with an award amount 
equal to 50 percent of the amount that would 
otherwise be payable for full-time service; and’’; 
and 
(C) in paragraph (3), by striking ‘‘In eval-
uating a demonstration project described in 
paragraph (1)’’ and inserting ‘‘In evaluating 
waivers issued under paragraph (1)’’. 
(2) DEFINITIONS.—Subsection (j) of section 
331 (42 U.S.C. 254d) is amended by adding at the 
end the following: 
‘‘(5) The terms ‘full time’ and ‘full-time’ mean 
a minimum of 40 hours per week in a clinical prac-
tice, for a minimum of 45 weeks per year. 
‘‘(6) The terms ‘half time’ and ‘half-time’ mean 
a minimum of 20 hours per week (not to exceed 39 
hours per week) in a clinical practice, for a min-
imum of 45 weeks per year.’’. 
(b) REAPPOINTMENT TO NATIONAL ADVISORY COUN-
CIL.—Section 337(b)(1) (42 U.S.C. 254j(b)(1)) is amend-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00879
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
880 
ed by striking ‘‘Members may not be reappointed to the 
Council.’’. 
(c) 
LOAN
REPAYMENT
AMOUNT.—Section 
338B(g)(2)(A) is amended (42 U.S.C. 254l–1(g)(2)(A)) 
by striking ‘‘$35,000’’ and inserting ‘‘$50,000, plus, be-
ginning with fiscal year 2012, an amount determined by 
the Secretary on an annual basis to reflect inflation,’’. 
(d) TREATMENT OF TEACHING AS OBLIGATED SERV-
ICE.—Subsection (a) of section 338C (42 U.S.C. 254m) 
is amended by adding at the end the following: ‘‘The Sec-
retary may treat teaching as clinical practice for up to 
20 percent of such period of obligated service.’’. 
SEC. 2202. AUTHORIZATIONS OF APPROPRIATIONS. 
(a) NATIONAL
HEALTH
SERVICE
CORPS
PRO-
GRAM.—Section 338 (42 U.S.C. 254k) is amended— 
(1) in subsection (a), by striking ‘‘2012’’ and 
inserting ‘‘2019’’; and 
(2) by adding at the end the following: 
‘‘(c) For the purpose of carrying out this subpart, 
in addition to any other amounts authorized to be appro-
priated for such purpose, there are authorized to be appro-
priated, out of any monies in the Public Health Invest-
ment Fund, the following: 
‘‘(1) $63,000,000 for fiscal year 2010. 
‘‘(2) $66,000,000 for fiscal year 2011. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00880
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
881 
‘‘(3) $70,000,000 for fiscal year 2012. 
‘‘(4) $73,000,000 for fiscal year 2013. 
‘‘(5) $77,000,000 for fiscal year 2014. 
‘‘(6) $81,000,000 for fiscal year 2015. 
‘‘(7) $85,000,000 for fiscal year 2016. 
‘‘(8) $89,000,000 for fiscal year 2017. 
‘‘(9) $94,000,000 for fiscal year 2018. 
‘‘(10) $98,000,000 for fiscal year 2019.’’. 
(b) SCHOLARSHIP
AND LOAN REPAYMENT PRO-
GRAMS.—Subpart III of part D of title III of the Public 
Health Service Act (42 U.S.C. 254l et seq.) is amended— 
(1) in section 338H(a)— 
(A) in paragraph (4), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (5), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(6) for fiscal years 2013 and 2019, such sums 
as may be necessary.’’; and 
(2) by inserting after section 338H the fol-
lowing: 
‘‘SEC. 338H–1. ADDITIONAL FUNDING. 
‘‘For the purpose of carrying out this subpart, in ad-
dition to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00881
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
882 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $254,000,000 for fiscal year 2010. 
‘‘(2) $266,000,000 for fiscal year 2011. 
‘‘(3) $278,000,000 for fiscal year 2012. 
‘‘(4) $292,000,000 for fiscal year 2013. 
‘‘(5) $306,000,000 for fiscal year 2014. 
‘‘(6) $321,000,000 for fiscal year 2015. 
‘‘(7) $337,000,000 for fiscal year 2016. 
‘‘(8) $354,000,000 for fiscal year 2017. 
‘‘(9) $372,000,000 for fiscal year 2018. 
‘‘(10) $391,000,000 for fiscal year 2019.’’. 
PART 2—PROMOTION OF PRIMARY CARE AND 
DENTISTRY 
SEC. 2211. FRONTLINE HEALTH PROVIDERS. 
Part D of title III (42 U.S.C. 254b et seq.) is amend-
ed by adding at the end the following: 
‘‘Subpart XI—Health Professional Needs Areas 
‘‘SEC. 340H. IN GENERAL. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, shall establish a program, to be known as 
the Frontline Health Providers Loan Repayment Pro-
gram, to address unmet health care needs in health profes-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00882
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
883 
sional needs areas through loan repayments under section 
340I. 
‘‘(b) DESIGNATION
OF
HEALTH
PROFESSIONAL 
NEEDS AREAS.— 
‘‘(1) IN GENERAL.—In this subpart, the term 
‘health professional needs area’ means an area, pop-
ulation, or facility that is designated by the Sec-
retary in accordance with paragraph (2). 
‘‘(2) DESIGNATION.—To be designated by the 
Secretary as a health professional needs area under 
this subpart: 
‘‘(A) In the case of an area, the area must 
be a rational area for the delivery of health 
services. 
‘‘(B) The area, population, or facility must 
have, in one or more health disciplines, special-
ties, or subspecialties for the population served, 
as determined by the Secretary— 
‘‘(i) insufficient capacity of health 
professionals; or 
‘‘(ii) high needs for health services. 
‘‘(C) With respect to the delivery of pri-
mary health services, the area, population, or 
facility must not include a health professional 
shortage area (as designated under section 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00883
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
884 
332), except that the area, population, or facil-
ity may include such a health professional 
shortage area to which no member of the Na-
tional Health Service Corps is currently as-
signed. 
‘‘(c) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
‘‘(1) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school de-
fined in section 799B(1)(A) (other than a school of 
public health); 
‘‘(2) hold a degree in a course of study or pro-
gram (approved by the Secretary) from a school or 
program defined in subparagraph (C), (D), or 
(E)(4) of section 799B(1), as designated by the Sec-
retary; 
‘‘(3) be enrolled as a full-time student— 
‘‘(A) in a school or program defined in 
subparagraph (C), (D), or (E)(4) of section 
799B(1), as designated by the Secretary, or a 
school described in paragraph (1); and 
‘‘(B) in the final year of a course of study 
or program, offered by such school or program 
and approved by the Secretary, leading to a de-
gree in a discipline referred to in subparagraph 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00884
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
885 
(A) (other than a graduate degree in public 
health), (C), (D), or (E)(4) of section 799B(1); 
‘‘(4) be a practitioner described in section 
1842(b)(18)(C) or 1848(k)(3)(B)(iii) or (iv) of the 
Social Security Act; or 
‘‘(5) be a practitioner in the field of respiratory 
therapy, medical technology, or radiologic tech-
nology. 
‘‘(d) DEFINITION.—In this subpart, the term ‘pri-
mary health services’ has the meaning given to such term 
in section 331(a)(3)(D). 
‘‘SEC. 340I. LOAN REPAYMENTS. 
‘‘(a) LOAN REPAYMENTS.—The Secretary, acting 
through the Administrator of the Health Resources and 
Services Administration, shall enter into contracts with in-
dividuals under which— 
‘‘(1) the individual agrees— 
‘‘(A) to serve as a full-time primary health 
services provider or as a full-time or part-time 
provider of other health services for a period of 
time equal to 2 years or such longer period as 
the individual may agree to; 
‘‘(B) to serve in a health professional 
needs area in a health discipline, specialty, or a 
subspecialty for which the area, population, or 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00885
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
886 
facility is designated as a health professional 
needs area under section 340H; and 
‘‘(C) in the case of an individual described 
in subsection 340H(c)(3) who is in the final 
year of study and who has accepted employ-
ment as primary health services provider or 
provider of other health services in accordance 
with subparagraphs (A) and (B), to complete 
the education or training and maintain an ac-
ceptable level of academic standing (as deter-
mined by the educational institution offering 
the course of study or training); and 
‘‘(2) the Secretary agrees to pay, for each year 
of such service, an amount on the principal and in-
terest of the undergraduate or graduate educational 
loans (or both) of the individual that is not more 
than 50 percent of the average award made under 
the National Health Service Corps Loan Repayment 
Program under subpart III in that year. 
‘‘(b) PRACTICE SETTING.—A contract entered into 
under this section shall allow the individual receiving the 
loan repayment to satisfy the service requirement de-
scribed in subsection (a)(1) through employment in a solo 
or group practice, a clinic, an accredited public or private 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00886
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
887 
nonprofit hospital, or any other health care entity, as 
deemed appropriate by the Secretary. 
‘‘(c) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III of part D shall, except as incon-
sistent with this section, apply to the loan repayment pro-
gram under this subpart in the same manner and to the 
same extent as such provisions apply to the National 
Health Service Corps Loan Repayment Program estab-
lished under section 338B. 
‘‘(d) INSUFFICIENT NUMBER OF APPLICANTS.—If 
there are an insufficient number of applicants for loan re-
payments under this section to obligate all appropriated 
funds, the Secretary shall transfer the unobligated funds 
to the National Health Service Corps for the purpose of— 
‘‘(1) recruitment of sufficient applicants for the 
National Health Service Corps for the following 
year; or 
‘‘(2) making additional loan repayments under 
section 338B if there is an excess number of quali-
fied applicants for loan repayments under such sec-
tion. 
‘‘SEC. 340J. REPORT. 
‘‘The Secretary shall submit to the Congress an an-
nual report on the program carried out under this subpart. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00887
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
888 
‘‘SEC. 340K. ALLOCATION. 
‘‘Of the amount of funds obligated under this subpart 
each fiscal year for loan repayments— 
‘‘(1) 90 percent shall be for physicians and 
other health professionals providing primary health 
services; and 
‘‘(2) 10 percent shall be for health professionals 
not described in paragraph (1).’’. 
SEC. 2212. PRIMARY CARE STUDENT LOAN FUNDS. 
(a) LOAN PROVISIONS.—Section 722 (42 U.S.C. 
292r) is amended by striking subsection (e) and inserting 
the following: 
‘‘(e) RATE OF INTEREST.—Such loans shall bear in-
terest, on the unpaid balance of the loan, computed only 
for periods for which the loan is repayable, at the rate 
of 2 percentage points less than the applicable rate of in-
terest described in section 427A(l)(1) of the Higher Edu-
cation Act of 1965 per year.’’. 
(b) MEDICAL
SCHOOLS
AND
PRIMARY
HEALTH 
CARE.—Subsection (a) of section 723 (42 U.S.C. 292s) 
is amended— 
(1) in paragraph (1), by striking subparagraph 
(B) and inserting the following: 
‘‘(B) to practice in such care for 10 years 
(including residency training in primary health 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00888
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
889 
care) or through the date on which the loan is 
repaid in full, whichever occurs first.’’; and 
(2) by striking paragraph (3) and inserting the 
following: 
‘‘(3) NONCOMPLIANCE BY STUDENT.—If an in-
dividual fails to comply with an agreement entered 
into pursuant to paragraph (1), such agreement 
shall provide that the total interest to be paid on the 
loan, over the course of the loan period, shall equal 
the total amount of interest that would have been in-
curred by the individual if, from the outset of the 
loan, the loan was repayable at the rate of interest 
described in section 427A(l)(1) of the Higher Edu-
cation Act of 1965 per year instead of the rate of 
interest described in section 722(e).’’. 
(c) STUDENT LOAN GUIDELINES.— 
(1) IN
GENERAL.—Section 735 (42 U.S.C. 
292y) is amended— 
(A) by redesignating subsection (f) as sub-
section (g); and 
(B) by inserting after subsection (e) the 
following: 
‘‘(f) DETERMINATION OF FINANCIAL NEED.—The 
Secretary— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00889
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
890 
‘‘(1) may require, or authorize a school or other 
entity to require, the submission of financial infor-
mation to determine the financial resources available 
to any individual seeking assistance under this sub-
part; and 
‘‘(2) shall take into account the extent to which 
such individual is financially independent in deter-
mining whether to require or authorize the submis-
sion of such information regarding such individual’s 
family members.’’. 
(2) REVISED GUIDELINES.—The Secretary of 
Health and Human Services shall— 
(A) strike the second sentence of section 
57.206(b) of title 42, Code of Federal Regula-
tions; and 
(B) make such other revisions to guidelines 
and regulations in effect as of the date of the 
enactment of this Act as may be necessary for 
consistency with the amendments made by 
paragraph (1). 
SEC. 2213. TRAINING IN FAMILY MEDICINE, GENERAL IN-
TERNAL MEDICINE, GENERAL PEDIATRICS, 
GERIATRICS, 
AND 
PHYSICIAN 
ASSISTANTSHIP. 
Section 747 (42 U.S.C. 293k) is amended— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00890
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
891 
(1) by amending the section heading to read as 
follows: ‘‘PRIMARY
CARE
TRAINING
AND
EN-
HANCEMENT’’; 
(2) by redesignating subsection (e) as sub-
section (f); and 
(3) by striking subsections (a) through (d) and 
inserting the following: 
‘‘(a) PROGRAM.—The Secretary shall establish a pri-
mary care training and capacity building program con-
sisting of awarding grants and contracts under sub-
sections (b) and (c). 
‘‘(b) SUPPORT
AND DEVELOPMENT
OF PRIMARY 
CARE TRAINING PROGRAMS.— 
‘‘(1) IN GENERAL.—The Secretary shall make 
grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(A) to plan, develop, operate, or partici-
pate in an accredited professional training pro-
gram, including an accredited residency or in-
ternship program, in the field of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics for medical students, interns, 
residents, or practicing physicians; 
‘‘(B) to provide financial assistance in the 
form of traineeships and fellowships to medical 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00891
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
892 
students, interns, residents, or practicing physi-
cians, who are participants in any such pro-
gram, and who plan to specialize or work in 
family medicine, general internal medicine, gen-
eral pediatrics, or geriatrics; 
‘‘(C) to plan, develop, operate, or partici-
pate in an accredited program for the training 
of physicians who plan to teach in family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics training programs including 
in community-based settings; 
‘‘(D) to provide financial assistance in the 
form of traineeships and fellowships to prac-
ticing physicians who are participants in any 
such programs and who plan to teach in a fam-
ily medicine, general internal medicine, general 
pediatrics, or geriatrics training program; and 
‘‘(E) to plan, develop, operate, or partici-
pate in an accredited program for physician as-
sistant education, and for the training of indi-
viduals who plan to teach in programs to pro-
vide such training. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall 
be— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00892
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
893 
‘‘(A) an accredited school of medicine or 
osteopathic medicine, public or nonprofit private 
hospital, or physician assistant training pro-
gram; 
‘‘(B) a public or private nonprofit entity; 
or 
‘‘(C) a consortium of 2 or more entities de-
scribed in subparagraphs (A) and (B). 
‘‘(c) CAPACITY BUILDING IN PRIMARY CARE.— 
‘‘(1) IN GENERAL.—The Secretary shall make 
grants to or enter into contracts with eligible entities 
to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall be 
an accredited school of medicine or osteopathic med-
icine. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00893
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
894 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or sig-
nificantly improving the percentage, of health care 
professionals who provide primary care. 
‘‘(2) Training individuals who are from under-
represented minority groups or disadvantaged back-
grounds. 
‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the health care needs of vulnerable popu-
lations. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00894
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
895 
‘‘(f) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given the term in section 
3171.’’. 
SEC. 2214. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) by redesignating section 748 as 749A; and 
(2) by inserting after section 747 the following: 
‘‘SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
‘‘(a) PROGRAM.—The Secretary shall establish a pro-
gram for the training of medical residents in community- 
based settings consisting of awarding grants or contracts 
under this section. 
‘‘(b) DEVELOPMENT AND OPERATION OF COMMU-
NITY-BASED
PROGRAMS.—The Secretary shall make 
grants to, or enter into contracts with, eligible entities— 
‘‘(1) to plan and develop a new primary care 
residency training program, which may include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruiting and training residents and 
faculty; and 
‘‘(C) other activities designated to result in 
accreditation of such a program; or 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00895
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
896 
‘‘(2) to operate or participate in an established 
primary care residency training program, which may 
include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruitment and training of residents; 
and 
‘‘(C) retention of faculty. 
‘‘(c) ELIGIBLE ENTITY.—To be eligible to receive a 
grant or contract under subsection (b), an entity shall— 
‘‘(1) be designated as a recipient of payment 
for the direct costs of medical education under sec-
tion 1886(k) of the Social Security Act; 
‘‘(2) be designated as an approved teaching 
health center under section 1502(d) of the America’s 
Affordable Health Choices Act of 2009 and con-
tinuing to participate in the demonstration project 
under such section; or 
‘‘(3) be an applicant for designation described 
in paragraph (1) or (2) and have demonstrated to 
the Secretary appropriate involvement of an accred-
ited teaching hospital to carry out the inpatient re-
sponsibilities associated with a primary care resi-
dency training program. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00896
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
897 
‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under paragraph (1) or (2) of subsection (b), the 
Secretary shall give preference to entities that— 
‘‘(1) support teaching programs that address 
the health care needs of vulnerable populations; or 
‘‘(2) are a Federally qualified health center (as 
defined in section 1861(aa)(4) of the Social Security 
Act) or a rural health clinic (as defined in section 
1861(aa)(2) of such Act). 
‘‘(e) ADDITIONAL PREFERENCES FOR ESTABLISHED 
PROGRAMS.—In awarding grants and contracts under 
subsection (b)(2), the Secretary shall give preference to 
entities that have a demonstrated record of training— 
‘‘(1) a high or significantly improved percentage 
of health care professionals who provide primary 
care; 
‘‘(2) individuals who are from underrepresented 
minority groups or disadvantaged backgrounds; or 
‘‘(3) individuals who practice in settings having 
the principal focus of serving underserved areas or 
populations experiencing health disparities (including 
serving patients eligible for medical assistance under 
title XIX of the Social Security Act or for child 
health assistance under title XXI of such Act or 
those with special health care needs). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00897
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
898 
‘‘(f) PERIOD OF AWARDS.— 
‘‘(1) IN GENERAL.—The period of a grant or 
contract under this section— 
‘‘(A) shall not exceed 2 years for awards 
under subsection (b)(1); and 
‘‘(B) shall not exceed 5 years for awards 
under subsection (b)(2). 
‘‘(2) SPECIAL RULES.— 
‘‘(A) An award of a grant or contract 
under subsection (b)(1) shall not be renewed. 
‘‘(B) The period of a grant or contract 
awarded to an entity under subsection (b)(2) 
shall not overlap with the period of any grant 
or contact awarded to the same entity under 
subsection (b)(1). 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) PRIMARY CARE RESIDENCY TRAINING PRO-
GRAM.—The term ‘primary care residency training 
program’ means an approved medical residency 
training program described in section 1886(h)(5)(A) 
of the Social Security Act that is— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00898
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
899 
‘‘(A) in the case of entities seeking awards 
under subsection (b)(1), actively applying to be 
accredited by the Accreditation Council for 
Graduate Medical Education; or 
‘‘(B) in the case of entities seeking awards 
under subsection (b)(2), so accredited. 
‘‘(2) HEALTH DISPARITIES.—The term ‘health 
disparities’ has the meaning given the term in sec-
tion 3171.’’. 
SEC. 2215. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) in section 791(a)(1), by striking ‘‘747 and 
750’’ and inserting ‘‘747, 749, and 750’’; and 
(2) by inserting after section 748, as added, the 
following: 
‘‘SEC. 749. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
‘‘(a) PROGRAM.—The Secretary shall establish a den-
tal medicine training program consisting of awarding 
grants and contracts under this section. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00899
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
900 
‘‘(b) SUPPORT
AND DEVELOPMENT
OF DENTAL 
TRAINING PROGRAMS.—The Secretary 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 oral 
health professionals; 
‘‘(2) to provide financial assistance to oral 
health professionals who are in need thereof, who 
are participants in any such program, and who plan 
to work in general, pediatric, or public heath den-
tistry, or dental hygiene; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry, or dental hygiene; 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry or dental hygiene; 
‘‘(5) to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of general, pedi-
atric, or public health dentistry; or 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00900
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
901 
‘‘(B) programs that improve clinical teach-
ing in such specialties; 
‘‘(6) to plan, develop, operate, or participate in 
predoctoral and postdoctoral training in general, pe-
diatric, or public health dentistry programs, or train-
ing for dental hygienists; 
‘‘(7) to plan, develop, operate, or participate in 
a loan repayment program for full-time faculty in a 
program of general, pediatric, or public health den-
tistry; and 
‘‘(8) to provide technical assistance to pediatric 
dental training programs in developing and imple-
menting instruction regarding the oral health status, 
dental care needs, and risk-based clinical disease 
management of all pediatric populations with an em-
phasis on underserved children. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited school of dentistry, training 
program in dental hygiene, or public or nonprofit 
private hospital; 
‘‘(2) a training program in dental hygiene at an 
accredited institution of higher education; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00901
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
902 
‘‘(A) 2 or more of the entities described in 
paragraphs (1) through (3); and 
‘‘(B) an accredited school of public health. 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or sig-
nificantly improving the percentage, of oral health 
professionals who practice general, pediatric, or pub-
lic health dentistry. 
‘‘(2) Training individuals who are from under-
represented minority groups or disadvantaged back-
grounds. 
‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the dental needs of vulnerable populations. 
‘‘(5) Providing instruction regarding the oral 
health status, dental care needs, and risk-based clin-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00902
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
903 
ical disease management of all pediatric populations 
with an emphasis on underserved children. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITION.—In this section: 
‘‘(1) The term ‘health disparities’ has the 
meaning given the term in section 3171. 
‘‘(2) The term ‘oral health professional’ means 
an individual training or practicing— 
‘‘(A) in general dentistry, pediatric den-
tistry, public health dentistry, or dental hy-
giene; or 
‘‘(B) another dental medicine specialty, as 
deemed appropriate by the Secretary.’’. 
SEC. 2216. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Part F of title VII (42 U.S.C. 
295j et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 799C. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘(a) PROMOTION
OF PRIMARY CARE
AND DEN-
TISTRY.—For the purpose of carrying out subpart XI of 
part D of title III and sections 723, 747, 748, and 749, 
in addition to any other amounts authorized to be appro-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00903
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
904 
priated for such purpose, there is authorized to be appro-
priated, out of any monies in the Public Health Invest-
ment Fund, the following: 
‘‘(1) $240,000,000 for fiscal year 2010. 
‘‘(2) $253,000,000 for fiscal year 2011. 
‘‘(3) $265,000,000 for fiscal year 2012. 
‘‘(4) $278,000,000 for fiscal year 2013. 
‘‘(5) $292,000,000 for fiscal year 2014. 
‘‘(6) $307,000,000 for fiscal year 2015. 
‘‘(7) $322,000,000 for fiscal year 2016. 
‘‘(8) $338,000,000 for fiscal year 2017. 
‘‘(9) $355,000,000 for fiscal year 2018. 
‘‘(10) $373,000,000 for fiscal year 2019.’’. 
(b) EXISTING
AUTHORIZATIONS
OF
APPROPRIA-
TIONS.— 
(1) SECTION
735.—Paragraph (1) of section 
735(g), as so redesignated, is amended by inserting 
‘‘and such sums as may be necessary for subsequent 
years through fiscal year 2019’’ before the period at 
the end. 
(2) SECTION 747.—Subsection (f), as so redes-
ignated, of section 747 (42 U.S.C. 293k) is amended 
by striking ‘‘2002’’ and inserting ‘‘2019’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00904
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
905 
Subtitle B—Nursing Workforce 
SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. 
(a) DEFINITIONS.—Section 801 (42 U.S.C. 296 et 
seq.) is amended— 
(1) in paragraph (1), by inserting ‘‘nurse-man-
aged health centers’’ after ‘‘nursing centers,’’; and 
(2) by adding at the end the following: 
‘‘(16) NURSE-MANAGED
HEALTH
CENTER.— 
The term ‘nurse-managed health center’ means a 
nurse-practice arrangement, managed by advanced 
practice nurses, that provides primary care or 
wellness services to underserved or vulnerable popu-
lations and is associated with an accredited school of 
nursing, Federally qualified health center, or inde-
pendent nonprofit health or social services agency.’’. 
(a) GRANTS
FOR
HEALTH
PROFESSIONS
EDU-
CATION.—Title VIII (42 U.S.C. 296 et seq.) is amended 
by striking section 807. 
(b) ADVANCED EDUCATION NURSING GRANTS.—Sec-
tion 811(f) (42 U.S.C. 296j(f)) is amended— 
(1) by striking paragraph (2); 
(2) by redesignating paragraph (3) as para-
graph (2); and 
(3) in paragraph (2), as so redesignated, by 
striking ‘‘that agrees’’ and all that follows through 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00905
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
906 
the end and inserting: ‘‘that agrees to expend the 
award— 
‘‘(A) to train advanced education nurses 
who will practice in health professional shortage 
areas designated under section 332; or 
‘‘(B) to increase diversity among advanced 
education nurses.’’. 
(c) NURSE EDUCATION, PRACTICE, AND RETENTION 
GRANTS.—Section 831 (42 U.S.C. 296p) is amended— 
(1) in subsection (b), by amending paragraph 
(3) to read as follows: 
‘‘(3) providing coordinated care, quality care, 
and other skills needed to practice nursing;’’; and 
(2) by striking subsection (e) and redesignating 
subsections (f) through (h) as subsections (e) 
through (g), respectively. 
(d) STUDENT LOANS.—Subsection (a) of section 836 
(42 U.S.C. 297b) is amended— 
(1) 
by 
striking 
‘‘$2,500’’ 
and 
inserting 
‘‘$3,300’’; 
(2) 
by 
striking 
‘‘$4,000’’ 
and 
inserting 
‘‘$5,200’’; 
(3) by striking ‘‘$13,000’’ and inserting 
‘‘$17,000’’; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00906
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
907 
(4) by adding at the end the following: ‘‘Begin-
ning with fiscal year 2012, the dollar amounts speci-
fied in this subsection shall be adjusted by an 
amount determined by the Secretary on an annual 
basis to reflect inflation.’’. 
(e) LOAN REPAYMENT.—Section 846 (42 U.S.C. 
297n) is amended— 
(1) in subsection (a), by amending paragraph 
(3) to read as follows: 
‘‘(3) who enters into an agreement with the 
Secretary to serve for a period of not less than 2 
years— 
‘‘(A) as a nurse at a health care facility 
with a critical shortage of nurses; or 
‘‘(B) as a faculty member at an accredited 
school of nursing;’’; and 
(2) in subsection (g)(1), by striking ‘‘to provide 
health services’’ each place it appears and inserting 
‘‘to provide health services or serve as a faculty 
member’’. 
(f) NURSE FACULTY LOAN PROGRAM.—Paragraph 
(2) of section 846A(c) (42 U.S.C. 297n–1(c)) is amended 
by striking ‘‘$30,000’’ and all that follows through the 
semicolon and inserting ‘‘$35,000, plus, beginning with 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00907
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
908 
fiscal year 2012, an amount determined by the Secretary 
on an annual basis to reflect inflation;’’. 
(g) PUBLIC SERVICE ANNOUNCEMENTS.—Title VIII 
(42 U.S.C. 296 et seq.) is amended by striking part H. 
(h) TECHNICAL AND CONFORMING AMENDMENTS.— 
Title VIII (42 U.S.C. 296 et seq.) is amended— 
(1) by redesignating section 810 (relating to 
prohibition against discrimination by schools on the 
basis of sex) as section 809 and moving such section 
so that it follows section 808; 
(2) in sections 835, 836, 838, 840, and 842, by 
striking the term ‘‘this subpart’’ each place it ap-
pears and inserting ‘‘this part’’; 
(3) in section 836(h), by striking the last sen-
tence; 
(4) in section 836, by redesignating subsection 
(l) as subsection (k); 
(5) in section 839, by striking ‘‘839’’ and all 
that follows through ‘‘(a)’’ and inserting ‘‘839. (a)’’; 
(6) in section 835(b), by striking ‘‘841’’ each 
place it appears and inserting ‘‘871’’; 
(7) by redesignating section 841 as section 871, 
moving part F to the end of the title, and redesig-
nating such part as part H; 
(8) in part G— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00908
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
909 
(A) by redesignating section 845 as section 
851; and 
(B) by redesignating part G as part F; and 
(9) in part I— 
(A) by redesignating section 855 as section 
861; and 
(B) by redesignating part I as part G. 
(i) FUNDING.— 
(1) IN GENERAL.—Part H, as redesignated, of 
title VIII is amended by adding at the end the fol-
lowing: 
‘‘SEC. 872. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘For the purpose of carrying out this title, in addi-
tion to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $115,000,000 for fiscal year 2010. 
‘‘(2) $122,000,000 for fiscal year 2011. 
‘‘(3) $127,000,000 for fiscal year 2012. 
‘‘(4) $134,000,000 for fiscal year 2013. 
‘‘(5) $140,000,000 for fiscal year 2014. 
‘‘(6) $147,000,000 for fiscal year 2015. 
‘‘(7) $154,000,000 for fiscal year 2016. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00909
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
910 
‘‘(8) $162,000,000 for fiscal year 2017. 
‘‘(9) $170,000,000 for fiscal year 2018. 
‘‘(10) $179,000,000 for fiscal year 2019.’’. 
(2) EXISTING AUTHORIZATIONS OF APPROPRIA-
TIONS.— 
(A) SECTIONS 831, 846, 846A, AND 861.— 
Sections 831(g) (as so redesignated), 846(i)(1) 
(42 U.S.C. 297n(i)(1)), 846A(f) (42 U.S.C. 
297n–1(f)), and 861(e) (as so redesignated) are 
amended by striking ‘‘2007’’ each place it ap-
pears and inserting ‘‘2019’’. 
(B) SECTION 871.—Section 871, as so re-
designated, is amended to read as follows: 
‘‘SEC. 871. FUNDING. 
‘‘For the purpose of carrying out parts B, C, and D 
(subject to section 845(g)), there are authorized to be ap-
propriated such sums as may be necessary for each fiscal 
year through fiscal year 2019.’’. 
Subtitle C—Public Health 
Workforce 
SEC. 2231. PUBLIC HEALTH WORKFORCE CORPS. 
Part D of title III (42 U.S.C. 254b et seq.), as 
amended by section 2211, is amended by adding at the 
end the following: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00910
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
911 
‘‘Subpart XII—Public Health Workforce 
‘‘SEC. 340L. PUBLIC HEALTH WORKFORCE CORPS. 
‘‘(a) ESTABLISHMENT.—There is established, within 
the Service, the Public Health Workforce Corps (in this 
subpart referred to as the ‘Corps’), for the purpose of en-
suring an adequate supply of public health professionals 
throughout the Nation. The Corps shall consist of— 
‘‘(1) such officers of the Regular and Reserve 
Corps of the Service as the Secretary may designate; 
and 
‘‘(2) such civilian employees of the United 
States as the Secretary may appoint. 
‘‘(b) ADMINISTRATION.—Except as provided in sub-
section (c), the Secretary shall carry out this subpart act-
ing through the Administrator of the Health Resources 
and Services Administration. 
‘‘(c) PLACEMENT AND ASSIGNMENT.—The Secretary, 
acting through the Director of the Centers for Disease 
Control and Prevention, shall develop a methodology for 
placing and assigning Corps participants as public health 
professionals. Such methodology may allow for placing and 
assigning such participants in State, local, and tribal 
health departments and Federally qualified health centers 
(as defined in section 1861(aa)(4) of the Social Security 
Act). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00911
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
912 
‘‘(d) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart II shall, except as inconsistent with 
this subpart, apply to the Public Health Workforce Corps 
in the same manner and to the same extent as such provi-
sions apply to the National Health Service Corps estab-
lished under section 331. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the programs carried out 
under this subpart. 
‘‘SEC. 340M. PUBLIC HEALTH WORKFORCE SCHOLARSHIP 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish the Public Health Workforce Scholarship Program 
(referred to in this section as the ‘Program’) for the pur-
pose described in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
‘‘(1)(A) be accepted for enrollment, or be en-
rolled, as a full-time or part-time student in a course 
of study or program (approved by the Secretary) at 
an accredited graduate school or program of public 
health; or 
‘‘(B) have demonstrated expertise in public 
health and be accepted for enrollment, or be en-
rolled, as a full-time or part-time student in a course 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00912
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
913 
of study or program (approved by the Secretary) 
at— 
‘‘(i) an accredited graduate school or pro-
gram of nursing; health administration, man-
agement, or policy; preventive medicine; labora-
tory science; veterinary medicine; or dental 
medicine; or 
‘‘(ii) another accredited graduate school or 
program, as deemed appropriate by Secretary; 
‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for 
civilian service in the Corps; and 
‘‘(3) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full- 
time as a public health professional, upon the com-
pletion of the course of study or program involved, 
for the period of obligated service described in sub-
section (c)(2)(E). 
‘‘(c) CONTRACT.—The written contract between the 
Secretary and an individual under subsection (b)(3) shall 
contain— 
‘‘(1) an agreement on the part of the Secretary 
that the Secretary will— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00913
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
914 
‘‘(A) provide the individual with a scholar-
ship for a period of years (not to exceed 4 aca-
demic years) during which the individual shall 
pursue an approved course of study or program 
to prepare the individual to serve in the public 
health workforce; and 
‘‘(B) accept (subject to the availability of 
appropriated funds) the individual into the 
Corps; 
‘‘(2) an agreement on the part of the individual 
that the individual will— 
‘‘(A) accept provision of such scholarship 
to the individual; 
‘‘(B) maintain full-time or part-time enroll-
ment in the approved course of study or pro-
gram described in subsection (b)(1) until the in-
dividual completes that course of study or pro-
gram; 
‘‘(C) while enrolled in the approved course 
of study or program, maintain an acceptable 
level of academic standing (as determined by 
the educational institution offering such course 
of study or program); 
‘‘(D) if applicable, complete a residency or 
internship; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00914
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
915 
‘‘(E) serve full-time as a public health pro-
fessional for a period of time equal to the great-
er of— 
‘‘(i) 1 year for each academic year for 
which the individual was provided a schol-
arship under the Program; or 
‘‘(ii) 2 years; and 
‘‘(3) an agreement by both parties as to the na-
ture and extent of the scholarship assistance, which 
may include— 
‘‘(A) payment of reasonable educational ex-
penses of the individual, including tuition, fees, 
books, equipment, and laboratory expenses; and 
‘‘(B) payment of a stipend of not more 
than $1,269 (plus, beginning with fiscal year 
2011, an amount determined by the Secretary 
on an annual basis to reflect inflation) per 
month for each month of the academic year in-
volved, with the dollar amount of such a stipend 
determined by the Secretary taking into consid-
eration whether the individual is enrolled full- 
time or part-time. 
‘‘(d) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III shall, except as inconsistent with 
this subpart, apply to the scholarship program under this 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00915
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
916 
section in the same manner and to the same extent as 
such provisions apply to the National Health Service 
Corps Scholarship Program established under section 
338A. 
‘‘SEC. 340N. PUBLIC HEALTH WORKFORCE LOAN REPAY-
MENT PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish the Public Health Workforce Loan Repayment Pro-
gram (referred to in this section as the ‘Program’) for the 
purpose described in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
‘‘(1)(A) have a graduate degree from an accred-
ited school or program of public health; 
‘‘(B) have demonstrated expertise in public 
health and have a graduate degree in a course of 
study or program (approved by the Secretary) 
from— 
‘‘(i) an accredited school or program of 
nursing; health administration, management, or 
policy; preventive medicine; laboratory science; 
veterinary medicine; or dental medicine; or 
‘‘(ii) another accredited school or program 
approved by the Secretary; or 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00916
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
917 
‘‘(C) be enrolled as a full-time or part-time stu-
dent in the final year of a course of study or pro-
gram (approved by the Secretary) offered by a 
school or program described in subparagraph (A) or 
(B), leading to a graduate degree; 
‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for 
civilian service in the Corps; 
‘‘(3) if applicable, complete a residency or in-
ternship; and 
‘‘(4) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full- 
time as a public health professional for the period of 
obligated service described in subsection (c)(2). 
‘‘(c) CONTRACT.—The written contract between the 
Secretary and an individual under subsection (b)(4) shall 
contain— 
‘‘(1) an agreement by the Secretary to repay on 
behalf of the individual loans incurred by the indi-
vidual in the pursuit of the relevant public health 
workforce educational degree in accordance with the 
terms of the contract; 
‘‘(2) an agreement by the individual to serve 
full-time as a public health professional for a period 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00917
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
918 
of time equal to 2 years or such longer period as the 
individual may agree to; and 
‘‘(3) in the case of an individual described in 
subsection (b)(1)(C) who is in the final year of study 
and who has accepted employment as a public health 
professional, in accordance with subsection 340L(c), 
an agreement on the part of the individual to com-
plete the education or training, maintain an accept-
able level of academic standing (as determined by 
the educational institution offering the course of 
study or training), and serve the period of obligated 
service described in paragraph (2). 
‘‘(d) PAYMENTS.— 
‘‘(1) IN GENERAL.—A loan repayment provided 
for an individual under a written contract under the 
Program shall consist of payment, in accordance 
with paragraph (2), on behalf of the individual of 
the principal, interest, and related expenses on gov-
ernment and commercial loans received by the indi-
vidual regarding the undergraduate or graduate edu-
cation of the individual (or both), which loans were 
made for reasonable educational expenses, including 
tuition, fees, books, equipment, and laboratory ex-
penses, incurred by the individual. 
‘‘(2) PAYMENTS FOR YEARS SERVED.— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00918
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
919 
‘‘(A) IN GENERAL.—For each year of obli-
gated service that an individual contracts to 
serve under subsection (c), the Secretary may 
pay up to $35,000 (plus, beginning with fiscal 
year 2012, an amount determined by the Sec-
retary on an annual basis to reflect inflation) 
on behalf of the individual for loans described 
in paragraph (1). 
‘‘(B) REPAYMENT
SCHEDULE.—Any ar-
rangement made by the Secretary for the mak-
ing of loan repayments in accordance with this 
subsection shall provide that any repayments 
for a year of obligated service shall be made no 
later than the end of the fiscal year in which 
the individual completes such year of service. 
‘‘(e) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III shall, except as inconsistent with 
this subpart, apply to the loan repayment program under 
this section in the same manner and to the same extent 
as such provisions apply to the National Health Service 
Corps Loan Repayment Program established under sec-
tion 338B.’’. 
SEC. 2232. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
Section 765 (42 U.S.C. 295) is amended to read as 
follows: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00919
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
920 
‘‘SEC. 765. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Director of the 
Centers for Disease Control and Prevention, shall estab-
lish a public health workforce training and enhancement 
program consisting of awarding grants and contracts 
under subsection (b). 
‘‘(b) GRANTS AND CONTRACTS.—The Secretary shall 
award grants and contracts to eligible entities— 
‘‘(1) to plan, develop, operate, or participate in, 
an accredited professional training program in the 
field of public health (including such a program in 
nursing; health administration, management, or pol-
icy; preventive medicine; laboratory science; veteri-
nary medicine; or dental medicine) for members of 
the public health workforce including mid-career 
professionals; 
‘‘(2) to provide financial assistance in the form 
of traineeships and fellowships to students who are 
participants in any such program and who plan to 
specialize or work in the field of public health; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of public health profes-
sionals who plan to teach in any program described 
in paragraph (1); and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00920
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
921 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to public health pro-
fessionals who are participants in any program de-
scribed in paragraph (1) and who plan to teach in 
the field of public health, including nursing; health 
administration, management, or policy; preventive 
medicine; laboratory science; veterinary medicine; or 
dental medicine. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited health professions school, in-
cluding an accredited graduate school or program of 
public health; nursing; health administration, man-
agement, or policy; preventive medicine; laboratory 
science; veterinary medicine; or dental medicine; 
‘‘(2) a State, local, or tribal health department; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of the following: 
‘‘(1) Training the greatest percentage, or sig-
nificantly improving the percentage, of public health 
professionals who serve in underserved communities. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00921
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
922 
‘‘(2) Training individuals who are from under-
represented minority groups or disadvantaged back-
grounds. 
‘‘(3) Training individuals in public health spe-
cialties experiencing a significant shortage of public 
health professionals (as determined by the Sec-
retary). 
‘‘(4) Training the greatest percentage, or sig-
nificantly improving the percentage, of public health 
professionals serving in the Federal Government or 
a State, local, or tribal government. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2233. PUBLIC HEALTH TRAINING CENTERS. 
Section 766 (42 U.S.C. 295a) is amended— 
(1) in subsection (b)(1), by striking ‘‘in further-
ance of the goals established by the Secretary for 
the year 2000’’ and inserting ‘‘in furtherance of the 
goals established by the Secretary in the national 
prevention and wellness strategy under section 
3121’’; and 
(2) by adding at the end the following: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00922
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
923 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2234. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
Section 768 (42 U.S.C. 295c) is amended to read as 
follows: 
‘‘SEC. 768. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Director of the 
Centers for Disease Control and Prevention, shall award 
grants to, or enter into contracts with, eligible entities to 
provide training to graduate medical residents in preven-
tive medicine specialties. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited school of public health or 
school of medicine or osteopathic medicine; 
‘‘(2) an accredited public or private hospital; 
‘‘(3) a State, local, or tribal health department; 
or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00923
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
924 
‘‘(c) USE OF FUNDS.—Amounts received under a 
grant or contract under this section shall be used to— 
‘‘(1) plan, develop (including the development of 
curricula), operate, or participate in an accredited 
residency or internship program in preventive medi-
cine or public health; 
‘‘(2) defray the costs of practicum experiences, 
as required in such a program; and 
‘‘(3) establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in preventive medicine and public 
health; or 
‘‘(B) programs that improve clinical teach-
ing in preventive medicine and public health. 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2235. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Section 799C, as added by section 
2216 of this division, is amended by adding at the end 
the following: 
‘‘(b) PUBLIC HEALTH WORKFORCE.—For the pur-
pose of carrying out subpart XII of part D of title III 
and sections 765, 766, and 768, in addition to any other 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00924
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
925 
amounts authorized to be appropriated for such purpose, 
there are authorized to be appropriated, out of any monies 
in the Public Health Investment Fund, the following: 
‘‘(1) $51,000,000 for fiscal year 2010. 
‘‘(2) $54,000,000 for fiscal year 2011. 
‘‘(3) $57,000,000 for fiscal year 2012. 
‘‘(4) $59,000,000 for fiscal year 2013. 
‘‘(5) $62,000,000 for fiscal year 2014. 
‘‘(6) $65,000,000 for fiscal year 2015. 
‘‘(7) $68,000,000 for fiscal year 2016. 
‘‘(8) $72,000,000 for fiscal year 2017. 
‘‘(9) $75,000,000 for fiscal year 2018. 
‘‘(10) $79,000,000 for fiscal year 2019.’’. 
(b) EXISTING
AUTHORIZATION
OF
APPROPRIA-
TIONS.—Subpart (a) of section 770 (42 U.S.C. 295e) is 
amended by striking ‘‘2002’’ and inserting ‘‘2019’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00925
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
926 
Subtitle D—Adapting Workforce to 
Evolving Health System Needs 
PART 1—HEALTH PROFESSIONS TRAINING FOR 
DIVERSITY 
SEC. 2241. SCHOLARSHIPS FOR DISADVANTAGED STU-
DENTS, LOAN REPAYMENTS AND FELLOW-
SHIPS REGARDING FACULTY POSITIONS, AND 
EDUCATIONAL ASSISTANCE IN THE HEALTH 
PROFESSIONS 
REGARDING 
INDIVIDUALS 
FROM DISADVANTAGED BACKGROUNDS. 
Paragraph (1) of section 738(a) (42 U.S.C. 293b(a)) 
is amended by striking ‘‘not more than $20,000’’ and all 
that follows through the end of the paragraph and insert-
ing: ‘‘not more than $35,000 (plus, beginning with fiscal 
year 2012, an amount determined by the Secretary on an 
annual basis to reflect inflation) of the principal and inter-
est of the educational loans of such individuals.’’ 
SEC. 2242. NURSING WORKFORCE DIVERSITY GRANTS. 
Subsection (b) of section 821 (42 U.S.C. 296m) is 
amended— 
(1) in the heading, by striking ‘‘GUIDANCE’’ 
and inserting ‘‘CONSULTATION’’; and 
(2) by striking ‘‘shall take into consideration’’ 
and all that follows through ‘‘consult with nursing 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00926
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
927 
associations’’ and inserting ‘‘shall, as appropriate, 
consult with nursing associations’’. 
SEC. 2243. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
Title VII (42 U.S.C. 292 et seq.) is amended by in-
serting after section 739 the following: 
‘‘SEC. 739A. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
‘‘The Secretary shall, to the extent practicable, co-
ordinate the activities carried out under this part and sec-
tion 821 in order to enhance the effectiveness of such ac-
tivities and avoid duplication of effort.’’. 
PART 2—INTERDISCIPLINARY TRAINING 
PROGRAMS 
SEC. 2251. CULTURAL AND LINGUISTIC COMPETENCY 
TRAINING 
FOR 
HEALTH 
CARE 
PROFES-
SIONALS. 
Section 741 (42 U.S.C. 293e) is amended— 
(1) in the section heading, by striking ‘‘GRANTS 
FOR HEALTH PROFESSIONS EDUCATION’’ and in-
serting ‘‘CULTURAL AND LINGUISTIC COMPETENCY 
TRAINING FOR HEALTH CARE PROFESSIONALS’’; 
(2) by redesignating subsection (b) as sub-
section (h); and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00927
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
928 
(3) by striking subsection (a) and inserting the 
following: 
‘‘(a) PROGRAM.—The Secretary shall establish a cul-
tural and linguistic competency training program for 
health care professionals, including nurse professionals, 
consisting of awarding grants and contracts under sub-
section (b). 
‘‘(b) CULTURAL
AND
LINGUISTIC
COMPETENCY 
TRAINING.—The Secretary shall award grants and con-
tracts to eligible entities— 
‘‘(1) to test, develop, and evaluate models of 
cultural and linguistic competency training (includ-
ing continuing education) for health professionals; 
and 
‘‘(2) to implement cultural and linguistic com-
petency training programs for health professionals 
developed under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00928
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
929 
‘‘(d) PREFERENCE.—In awarding grants and con-
tracts under this section, the Secretary shall give pref-
erence to entities that have a demonstrated record of the 
following: 
‘‘(1) Addressing, or partnering with an entity 
with experience addressing, the cultural and lin-
guistic competency needs of the population to be 
served through the grant or contract. 
‘‘(2) Addressing health disparities. 
‘‘(3) Placing health professionals in regions ex-
periencing significant changes in the cultural and 
linguistic demographics of populations, including 
communities along the United States-Mexico border. 
‘‘(4) Carrying out activities described in sub-
section (b) with respect to more than one health pro-
fession discipline, specialty, or subspecialty. 
‘‘(e) CONSULTATION.—The Secretary shall carry out 
this section in consultation with the heads of appropriate 
health agencies and offices in the Department of Health 
and Human Services, including the Office of Minority 
Health. 
‘‘(f) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given to the term in section 
3171. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00929
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
930 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2252. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
Part D of title VII (42 U.S.C. 294 et seq.) is amend-
ed by adding at the end the following: 
‘‘SEC. 759. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
‘‘(a) PROGRAM.—The Secretary shall establish an in-
novations in interdisciplinary care training program con-
sisting of awarding grants and contracts under subsection 
(b). 
‘‘(b) TRAINING PROGRAMS.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to test, develop, and evaluate health pro-
fessional training programs (including continuing 
education) designed to promote— 
‘‘(A) the delivery of health services through 
interdisciplinary and team-based models, which 
may include patient-centered medical home 
models, medication therapy management mod-
els, and models integrating physical, mental, or 
oral health services; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00930
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
931 
‘‘(B) coordination of the delivery of health 
care within and across settings, including health 
care institutions, community-based settings, 
and the patient’s home; and 
‘‘(2) to implement such training programs de-
veloped under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
‘‘(3) a public or private nonprofit entity (includ-
ing an area health education center or a geriatric 
education center); or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under this section, the Secretary shall give pref-
erence to entities that have a demonstrated record of the 
following: 
‘‘(1) Training the greatest percentage, or sig-
nificantly increasing the percentage, of health pro-
fessionals who serve in underserved communities. 
‘‘(2) Broad interdisciplinary team-based collabo-
rations. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00931
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
932 
‘‘(3) Addressing health disparities. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘health disparities’ has the 
meaning given the term in section 3171. 
‘‘(2) The term ‘interdisciplinary’ means collabo-
ration across health professions and specialties, 
which may include public health, nursing, allied 
health, and appropriate medical specialties.’’. 
PART 3—ADVISORY COMMITTEE ON HEALTH 
WORKFORCE EVALUATION AND ASSESSMENT 
SEC. 2261. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
Subpart 1 of part E of title VII (42 U.S.C. 294n 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 764. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
‘‘(a) ADVISORY COMMITTEE.—The Secretary, acting 
through the Assistant Secretary for Health, shall establish 
a permanent advisory committee to be known as the Advi-
sory Committee on Health Workforce Evaluation and As-
sessment (referred to in this section as the ‘Advisory Com-
mittee’). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00932
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
933 
‘‘(b) RESPONSIBILITIES.—The Advisory Committee 
shall— 
‘‘(1) not later than 1 year after the date of the 
establishment of the Advisory Committee, submit 
recommendations to the Secretary on— 
‘‘(A) classifications of the health workforce 
to ensure consistency of data collection on the 
health workforce; and 
‘‘(B) based on such classifications, stand-
ardized methodologies and procedures to enu-
merate the health workforce; 
‘‘(2) not later than 2 years after the date of the 
establishment of the Advisory Committee, submit 
recommendations to the Secretary on— 
‘‘(A) the supply, diversity, and geographic 
distribution of the health workforce; 
‘‘(B) the retention of the health workforce 
to ensure quality and adequacy of such work-
force; and 
‘‘(C) policies to carry out the recommenda-
tions made pursuant to subparagraphs (A) and 
(B); and 
‘‘(3) not later than 4 years after the date of the 
establishment of the Advisory Committee, and every 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00933
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
934 
2 years thereafter, submit updated recommendations 
to the Secretary under paragraphs (1) and (2). 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Advisory Committee, including 
coordinating and supporting the dissemination of the rec-
ommendations of the Advisory Committee. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) NUMBER; APPOINTMENT.—The Secretary 
shall appoint 15 members to serve on the Advisory 
Committee. 
‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Advisory Committee for 
a term of 3 years and may reappoint such 
members, but the Secretary may not appoint 
any member to serve more than a total of 6 
years. 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to the Advisory Committee 
under paragraph (1)— 
‘‘(i) 5 shall be appointed for a term of 
1 year; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00934
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
935 
‘‘(ii) 5 shall be appointed for a term 
of 2 years; and 
‘‘(iii) 5 shall be appointed for a term 
of 3 years. 
‘‘(3) QUALIFICATIONS.—Members of the Advi-
sory Committee shall be appointed from among indi-
viduals who possess expertise in at least one of the 
following areas: 
‘‘(A) Conducting and interpreting health 
workforce market analysis, including health 
care labor workforce analysis. 
‘‘(B) Conducting and interpreting health 
finance and economics research. 
‘‘(C) Delivering and administering health 
care services. 
‘‘(D) Delivering and administering health 
workforce education and training. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Advisory Committee, the Secretary 
shall— 
‘‘(A) include no less than one representa-
tive of each of— 
‘‘(i) health professionals within the 
health workforce; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00935
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
936 
‘‘(ii) health care patients and con-
sumers; 
‘‘(iii) employers; 
‘‘(iv) labor unions; and 
‘‘(v) third-party health payors; and 
‘‘(B) ensure that— 
‘‘(i) all areas of expertise described in 
paragraph (3) are represented; 
‘‘(ii) the members of the Advisory 
Committee include members who, collec-
tively, have significant experience working 
with— 
‘‘(I) populations in urban and 
federally designated rural and non-
metropolitan areas; and 
‘‘(II) populations who are under-
represented in the health professions, 
including underrepresented minority 
groups; and 
‘‘(iii) individuals who are directly in-
volved in health professions education or 
practice do not constitute a majority of the 
members of the Advisory Committee. 
‘‘(5) DISCLOSURE AND CONFLICTS OF INTER-
EST.—Members of the Advisory Committee shall not 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00936
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
937 
be considered employees of the Federal Government 
by reason of service on the Advisory Committee, ex-
cept members of the Advisory Committee shall be 
considered to be special Government employees with-
in the meaning of section 107 of the Ethics in Gov-
ernment Act of 1978 (5 U.S.C. App.) and section 
208 of title 18, United States Code, for the purposes 
of disclosure and management of conflicts of interest 
under those sections. 
‘‘(6) NO
PAY; 
RECEIPT
OF
TRAVEL
EX-
PENSES.—Members of the Advisory Committee shall 
not receive any pay for service on the Committee, 
but may receive travel expenses, including a per 
diem, in accordance with applicable provisions of 
subchapter I of chapter 57 of title 5, United States 
Code. 
‘‘(e) CONSULTATION.—In carrying out this section, 
the Secretary shall consult with the Secretary of Edu-
cation and the Secretary of Labor. 
‘‘(f) COLLABORATION.—The Advisory Committee 
shall collaborate with the advisory bodies at the Health 
Resources and Services Administration, the National Ad-
visory Council (as authorized in section 337), the Advisory 
Committee on Training in Primary Care Medicine and 
Dentistry (as authorized in section 749A), the Advisory 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00937
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
938 
Committee on Interdisciplinary, Community-Based Link-
ages (as authorized in section 756), the Advisory Council 
on Graduate Medical Education (as authorized in section 
762), and the National Advisory Council on Nurse Edu-
cation and Practice (as authorized in section 851). 
‘‘(g) FACA.—The Federal Advisory Committee Act 
(5 U.S.C. App.) except for section 14 of such Act shall 
apply to the Advisory Committee under this section only 
to the extent that the provisions of such Act do not conflict 
with the requirements of this section. 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on the activities of the Advisory 
Committee. 
‘‘(i) DEFINITION.—In this section, the term ‘health 
workforce’ includes all health care providers with direct 
patient care and support responsibilities, including physi-
cians, nurses, physician assistants, pharmacists, oral 
health professionals (as defined in section 749(f)), allied 
health professionals, mental and behavioral professionals, 
and public health professionals (including veterinarians 
engaged in public health practice).’’. 
PART 4—HEALTH WORKFORCE ASSESSMENT 
SEC. 2271. HEALTH WORKFORCE ASSESSMENT. 
(a) IN GENERAL.—Section 761 (42 U.S.C. 294n) is 
amended— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00938
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
939 
(1) by redesignating subsection (c) as sub-
section (e); and 
(2) by striking subsections (a) and (b) and in-
serting the following: 
‘‘(a) IN GENERAL.—The Secretary shall, based upon 
the classifications and standardized methodologies and 
procedures developed by the Advisory Committee on 
Health Workforce Evaluation and Assessment under sec-
tion 764(b)— 
‘‘(1) collect data on the health workforce (as 
defined in section 764(i)), disaggregated by field, 
discipline, and specialty, with respect to— 
‘‘(A) the supply (including retention) of 
health professionals relative to the demand for 
such professionals; 
‘‘(B) the diversity of health professionals 
(including with respect to race, ethnic back-
ground, and gender); and 
‘‘(C) the geographic distribution of health 
professionals; and 
‘‘(2) collect such data on individuals partici-
pating in the programs authorized by subtitles A, B, 
and C and part 1 of subtitle D of title II of subdivi-
sion C of the America’s Affordable Health Choices 
Act of 2009. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00939
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
940 
‘‘(b) GRANTS AND CONTRACTS FOR HEALTH WORK-
FORCE ANALYSIS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
grants or contracts to eligible entities to carry out 
subsection (a). 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under this subsection, an entity shall 
be— 
‘‘(A) an accredited health professions 
school or program; 
‘‘(B) an academic health center; 
‘‘(C) a State, local, or tribal government; 
‘‘(D) a public or private entity; or 
‘‘(E) a consortium of 2 or more entities de-
scribed in subparagraphs (A) through (D). 
‘‘(c) COLLABORATION
AND DATA SHARING.—The 
Secretary shall collaborate with Federal departments and 
agencies, health professions organizations (including 
health professions education organizations), and profes-
sional medical societies for the purpose of carrying out 
subsection (a). 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the data collected under 
subsection (a).’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00940
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
941 
(b) PERIOD BEFORE COMPLETION
OF NATIONAL 
STRATEGY.—Pending completion of the classifications and 
standardized methodologies and procedures developed by 
the Advisory Committee on Health Workforce Evaluation 
and Assessment under section 764(b) of the Public Health 
Service Act, as added by section 2261, the Secretary of 
Health and Human Services, acting through the Adminis-
trator of the Health Resources and Services Administra-
tion and in consultation with such Advisory Committee, 
may make a judgment about the classifications, meth-
odologies, and procedures to be used for collection of data 
under section 761(a) of the Public Health Service Act, as 
amended by this section. 
PART 5—AUTHORIZATION OF APPROPRIATIONS 
SEC. 2281. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Section 799C, as added by section 
2216 of this division, is amended by adding at the end 
the following: 
‘‘(c) HEALTH PROFESSIONS TRAINING FOR DIVER-
SITY.—For the purpose of carrying out sections 736, 737, 
738, 739, and 739A, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) $90,000,000 for fiscal year 2010. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00941
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
942 
‘‘(2) $97,000,000 for fiscal year 2011. 
‘‘(3) $100,000,000 for fiscal year 2012. 
‘‘(4) $104,000,000 for fiscal year 2013. 
‘‘(5) $110,000,000 for fiscal year 2014. 
‘‘(6) $116,000,000 for fiscal year 2015. 
‘‘(7) $121,000,000 for fiscal year 2016. 
‘‘(8) $127,000,000 for fiscal year 2017. 
‘‘(9) $133,000,000 for fiscal year 2018. 
‘‘(10) $140,000,000 for fiscal year 2019. 
‘‘(d) INTERDISCIPLINARY TRAINING PROGRAMS, AD-
VISORY COMMITTEE ON HEALTH WORKFORCE EVALUA-
TION AND ASSESSMENT, AND HEALTH WORKFORCE AS-
SESSMENT.—For the purpose of carrying out sections 
741, 759, 761, and 764, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) $91,000,000 for fiscal year 2010. 
‘‘(2) $97,000,000 for fiscal year 2011. 
‘‘(3) $101,000,000 for fiscal year 2012. 
‘‘(4) $105,000,000 for fiscal year 2013. 
‘‘(5) $111,000,000 for fiscal year 2014. 
‘‘(6) $117,000,000 for fiscal year 2015. 
‘‘(7) $122,000,000 for fiscal year 2016. 
‘‘(8) $129,000,000 for fiscal year 2017. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00942
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
943 
‘‘(9) $135,000,000 for fiscal year 2018. 
‘‘(10) $141,000,000 for fiscal year 2019.’’. 
(b) EXISTING
AUTHORIZATIONS
OF
APPROPRIA-
TIONS.— 
(1) SECTION
736.—Paragraph (1) of section 
736(h) (42 U.S.C. 293(h)) is amended by striking 
‘‘2002’’ and inserting ‘‘2019’’. 
(2) SECTIONS 737, 738, AND 739.—Subsections 
(a), (b), and (c) of section 740 are amended by 
striking ‘‘2002’’ each place it appears and inserting 
‘‘2019’’. 
(3) SECTION 741.—Subsection (h), as so redes-
ignated, of section 741 is amended— 
(A) by striking ‘‘and’’ after ‘‘fiscal year 
2003,’’; and 
(B) by inserting ‘‘, and such sums as may 
be necessary for subsequent fiscal years 
through the end of fiscal year 2019’’ before the 
period at the end. 
(4) SECTION 761.—Subsection (e)(1), as so re-
designated, of section 761 is amended by striking 
‘‘2002’’ and inserting ‘‘2019’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00943
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
944 
TITLE III—PREVENTION AND 
WELLNESS 
SEC. 2301. PREVENTION AND WELLNESS. 
(a) IN GENERAL.—The Public Health Service Act 
(42 U.S.C. 201 et seq.) is amended by adding at the end 
the following: 
‘‘TITLE XXXI—PREVENTION AND 
WELLNESS 
‘‘Subtitle A—Prevention and 
Wellness Trust 
‘‘SEC. 3111. PREVENTION AND WELLNESS TRUST. 
‘‘(a) DEPOSITS INTO TRUST.—There is established 
a Prevention and Wellness Trust. There are authorized 
to be appropriated to the Trust— 
‘‘(1) 
amounts 
described 
in 
section 
2002(b)(2)(ii) of the America’s Affordable Health 
Choices Act of 2009 for each fiscal year; and 
‘‘(2) in addition, out of any monies in the Pub-
lic Health Investment Fund— 
‘‘(A) for fiscal year 2010, $2,400,000,000; 
‘‘(B) for fiscal year 2011, $2,800,000,000; 
‘‘(C) for fiscal year 2012, $3,100,000,000; 
‘‘(D) for fiscal year 2013, $3,400,000,000; 
‘‘(E) for fiscal year 2014, $3,500,000,000; 
‘‘(F) for fiscal year 2015, $3,600,000,000; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00944
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
945 
‘‘(G) for fiscal year 2016, $3,700,000,000; 
‘‘(H) for fiscal year 2017, $3,900,000,000; 
‘‘(I) for fiscal year 2018, $4,300,000,000; 
and 
‘‘(J) for fiscal year 2019, $4,600,000,000. 
‘‘(b) AVAILABILITY OF FUNDS.—Amounts in the Pre-
vention and Wellness Trust shall be available, as provided 
in advance in appropriation Acts, for carrying out this 
title. 
‘‘(c) ALLOCATION.—Of the amounts authorized to be 
appropriated in subsection (a)(2), there are authorized to 
be appropriated— 
‘‘(1) for carrying out subtitle C (Prevention 
Task Forces), $35,000,000 for each of fiscal years 
2010 through 2019; 
‘‘(2) for carrying out subtitle D (Prevention 
and Wellness Research)— 
‘‘(A) for fiscal year 2010, $100,000,000; 
‘‘(B) for fiscal year 2011, $150,000,000; 
‘‘(C) for fiscal year 2012, $200,000,000; 
‘‘(D) for fiscal year 2013, $250,000,000; 
‘‘(E) for fiscal year 2014, $300,000,000; 
‘‘(F) for fiscal year 2015, $315,000,000; 
‘‘(G) for fiscal year 2016, $331,000,000; 
‘‘(H) for fiscal year 2017, $347,000,000; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00945
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
946 
‘‘(I) for fiscal year 2018, $364,000,000; 
and 
‘‘(J) for fiscal year 2019, $383,000,000. 
‘‘(3) for carrying out subtitle E (Delivery of 
Community Preventive and Wellness Services)— 
‘‘(A) for fiscal year 2010, $1,100,000,000; 
‘‘(B) for fiscal year 2011, $1,300,000,000; 
‘‘(C) for fiscal year 2012, $1,400,000,000; 
‘‘(D) for fiscal year 2013, $1,600,000,000; 
‘‘(E) for fiscal year 2014, $1,700,000,000; 
‘‘(F) for fiscal year 2015, $1,800,000,000; 
‘‘(G) for fiscal year 2016, $1,900,000,000; 
‘‘(H) for fiscal year 2017, $2,000,000,000; 
‘‘(I) for fiscal year 2018, $2,100,000,000; 
and 
‘‘(J) for fiscal year 2019, $2,300,000,000. 
‘‘(4) for carrying out section 3161 (Core Public 
Health Infrastructure and Activities for State and 
Local Health Departments)— 
‘‘(A) for fiscal year 2010, $800,000,000; 
‘‘(B) for fiscal year 2011, $1,000,000,000; 
‘‘(C) for fiscal year 2012, $1,100,000,000; 
‘‘(D) for fiscal year 2013, $1,200,000,000; 
‘‘(E) for fiscal year 2014, $1,300,000,000; 
‘‘(F) for fiscal year 2015, $1,400,000,000; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00946
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
947 
‘‘(G) for fiscal year 2016, $1,500,000,000; 
‘‘(H) for fiscal year 2017, $1,600,000,000; 
‘‘(I) for fiscal year 2018, $1,800,000,000; 
and 
‘‘(J) for fiscal year 2019, $1,900,000,000; 
and 
‘‘(5) for carrying out section 3162 (Core Public 
Health Infrastructure and Activities for CDC), 
$400,000,000 for each of fiscal years 2010 through 
2019. 
‘‘Subtitle B—National Prevention 
and Wellness Strategy 
‘‘SEC. 3121. NATIONAL PREVENTION AND WELLNESS STRAT-
EGY. 
‘‘(a) IN GENERAL.—The Secretary shall submit to 
the Congress within one year after the date of the enact-
ment of this section, and at least every 2 years thereafter, 
a national strategy that is designed to improve the Na-
tion’s health through evidence-based clinical and commu-
nity prevention and wellness activities (in this section re-
ferred to as ‘prevention and wellness activities’), including 
core public health infrastructure improvement activities. 
‘‘(b) CONTENTS.—The strategy under subsection (a) 
shall include each of the following: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00947
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
948 
‘‘(1) Identification of specific national goals and 
objectives in prevention and wellness activities that 
take into account appropriate public health measures 
and standards, including departmental measures and 
standards (including Healthy People and National 
Public Health Performance Standards). 
‘‘(2) Establishment of national priorities for 
prevention and wellness, taking into account unmet 
prevention and wellness needs. 
‘‘(3) Establishment of national priorities for re-
search on prevention and wellness, taking into ac-
count unanswered research questions on prevention 
and wellness. 
‘‘(4) Identification of health disparities in pre-
vention and wellness. 
‘‘(5) A plan for addressing and implementing 
paragraphs (1) through (4). 
‘‘(c) CONSULTATION.—In developing or revising the 
strategy under subsection (a), the Secretary shall consult 
with the following: 
‘‘(1) The heads of appropriate health agencies 
and offices in the Department, including the Office 
of the Surgeon General of the Public Health Service, 
the Office of Minority Health, and the Office on 
Women’s Health. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00948
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
949 
‘‘(2) As appropriate, the heads of other Federal 
departments and agencies whose programs have a 
significant impact upon health (as determined by the 
Secretary). 
‘‘(3) As appropriate, nonprofit and for-profit 
entities. 
‘‘(4) The Association of State and Territorial 
Health Officials and the National Association of 
County and City Health Officials. 
‘‘Subtitle C—Prevention Task 
Forces 
‘‘SEC. 3131. TASK FORCE ON CLINICAL PREVENTIVE SERV-
ICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Agency for Healthcare Research and 
Quality, shall establish a permanent task force to be 
known as the Task Force on Clinical Preventive Services 
(in this section referred to as the ‘Task Force’). 
‘‘(b) RESPONSIBILITIES.—The Task Force shall— 
‘‘(1) identify clinical preventive services for re-
view; 
‘‘(2) review the scientific evidence related to the 
benefits, effectiveness, appropriateness, and costs of 
clinical preventive services identified under para-
graph (1) for the purpose of developing, updating, 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00949
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
950 
publishing, and disseminating evidence-based rec-
ommendations on the use of such services; 
‘‘(3) as appropriate, take into account health 
disparities in developing, updating, publishing, and 
disseminating evidence-based recommendations on 
the use of such services; 
‘‘(4) identify gaps in clinical preventive services 
research and evaluation and recommend priority 
areas for such research and evaluation; 
‘‘(5) as appropriate, consult with the clinical 
prevention stakeholders board in accordance with 
subsection (f); 
‘‘(6) as appropriate, consult with the Task 
Force on Community Preventive Services established 
under section 3132; and 
‘‘(7) as appropriate, in carrying out this sec-
tion, consider the national strategy under section 
3121. 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Task Force, including coordi-
nating and supporting the dissemination of the rec-
ommendations of the Task Force. 
‘‘(d) MEMBERSHIP.— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00950
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
951 
‘‘(1) 
NUMBER; 
APPOINTMENT.—The 
Task 
Force shall be composed of 30 members, appointed 
by the Secretary. 
‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Task Force for a term 
of 6 years and may reappoint such members, 
but the Secretary may not appoint any member 
to serve more than a total of 12 years. 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to serve on the Task Force after 
the enactment of this title— 
‘‘(i) 10 shall be appointed for a term 
of 2 years; 
‘‘(ii) 10 shall be appointed for a term 
of 4 years; and 
‘‘(iii) 10 shall be appointed for a term 
of 6 years. 
‘‘(3) QUALIFICATIONS.—Members of the Task 
Force shall be appointed from among individuals 
who possess expertise in at least one of the following 
areas: 
‘‘(A) Health promotion and disease preven-
tion. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00951
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
952 
‘‘(B) Evaluation of research and system-
atic evidence reviews. 
‘‘(C) Application of systematic evidence re-
views to clinical decisionmaking or health pol-
icy. 
‘‘(D) Clinical primary care in child and ad-
olescent health. 
‘‘(E) Clinical primary care in adult health, 
including women’s health. 
‘‘(F) Clinical primary care in geriatrics. 
‘‘(G) Clinical counseling and behavioral 
services for primary care patients. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Task Force, the Secretary shall ensure 
that— 
‘‘(A) all areas of expertise described in 
paragraph (3) are represented; and 
‘‘(B) the members of the Task Force in-
clude practitioners who, collectively, have sig-
nificant experience treating racially and eth-
nically diverse populations. 
‘‘(e) SUBGROUPS.—As appropriate to maximize effi-
ciency, the Task Force may delegate authority for con-
ducting reviews and making recommendations to sub-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00952
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
953 
groups consisting of Task Force members, subject to final 
approval by the Task Force. 
‘‘(f) 
CLINICAL
PREVENTION
STAKEHOLDERS 
BOARD.— 
‘‘(1) IN GENERAL.—The Task Force shall con-
vene a clinical prevention stakeholders board com-
posed of representatives of appropriate public and 
private entities with an interest in clinical preventive 
services to advise the Task Force on developing, up-
dating, publishing, and disseminating evidence-based 
recommendations on the use of clinical preventive 
services. 
‘‘(2) MEMBERSHIP.—The members of the clin-
ical prevention stakeholders board shall include rep-
resentatives of the following: 
‘‘(A) Health care consumers and patient 
groups. 
‘‘(B) Providers of clinical preventive serv-
ices, including community-based providers. 
‘‘(C) Federal departments and agencies, 
including— 
‘‘(i) appropriate health agencies and 
offices in the Department, including the 
Office of the Surgeon General of the Pub-
lic Health Service, the Office of Minority 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00953
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
954 
Health, and the Office on Women’s 
Health; and 
‘‘(ii) as appropriate, other Federal de-
partments and agencies whose programs 
have a significant impact upon health (as 
determined by the Secretary). 
‘‘(D) Private health care payors. 
‘‘(3) RESPONSIBILITIES.—In accordance with 
subsection (b)(5), the clinical prevention stake-
holders board shall— 
‘‘(A) recommend clinical preventive serv-
ices for review by the Task Force; 
‘‘(B) suggest scientific evidence for consid-
eration by the Task Force related to reviews 
undertaken by the Task Force; 
‘‘(C) provide feedback regarding draft rec-
ommendations by the Task Force; and 
‘‘(D) assist with efforts regarding dissemi-
nation of recommendations by the Director of 
the Agency for Healthcare Research and Qual-
ity. 
‘‘(g) DISCLOSURE AND CONFLICTS OF INTEREST.— 
Members of the Task Force or the clinical prevention 
stakeholders board shall not be considered employees of 
the Federal Government by reason of service on the Task 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00954
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
955 
Force, except members of the Task Force shall be consid-
ered to be special Government employees within the mean-
ing of section 107 of the Ethics in Government Act of 
1978 (5 U.S.C. App.) and section 208 of title 18, United 
States Code, for the purposes of disclosure and manage-
ment of conflicts of interest under those sections. 
‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.— 
Members of the Task Force or the clinical prevention 
stakeholders board shall not receive any pay for service 
on the Task Force, but may receive travel expenses, in-
cluding a per diem, in accordance with applicable provi-
sions of subchapter I of chapter 57 of title 5, United 
States Code. 
‘‘(i) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) except for section 14 of 
such Act shall apply to the Task Force to the extent that 
the provisions of such Act do not conflict with the provi-
sions of this title. 
‘‘(j) REPORT.—The Secretary shall submit to the 
Congress an annual report on the Task Force, including 
with respect to gaps identified and recommendations made 
under subsection (b)(4). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00955
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
956 
‘‘SEC. 3132. TASK FORCE ON COMMUNITY PREVENTIVE 
SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall establish a permanent task force to be 
known as the Task Force on Community Preventive Serv-
ices (in this section referred to as the ‘Task Force’). 
‘‘(b) RESPONSIBILITIES.—The Task Force shall— 
‘‘(1) identify community preventive services for 
review; 
‘‘(2) review the scientific evidence related to the 
benefits, effectiveness, appropriateness, and costs of 
community preventive services identified under para-
graph (1) for the purpose of developing, updating, 
publishing, and disseminating evidence-based rec-
ommendations on the use of such services; 
‘‘(3) as appropriate, take into account health 
disparities in developing, updating, publishing, and 
disseminating evidence-based recommendations on 
the use of such services; 
‘‘(4) identify gaps in community preventive 
services research and evaluation and recommend pri-
ority areas for such research and evaluation; 
‘‘(5) as appropriate, consult with the commu-
nity prevention stakeholders board in accordance 
with subsection (f); 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00956
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
957 
‘‘(6) as appropriate, consult with the Task 
Force on Clinical Preventive Services established 
under section 3131; and 
‘‘(7) as appropriate, in carrying out this sec-
tion, consider the national strategy under section 
3121. 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Task Force, including coordi-
nating and supporting the dissemination of the rec-
ommendations of the Task Force. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) 
NUMBER; 
APPOINTMENT.—The 
Task 
Force shall be composed of 30 members, appointed 
by the Secretary. 
‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Task Force for a term 
of 6 years and may reappoint such members, 
but the Secretary may not appoint any member 
to serve more than a total of 12 years. 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to serve on the Task Force after 
the enactment of this section— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00957
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
958 
‘‘(i) 10 shall be appointed for a term 
of 2 years; 
‘‘(ii) 10 shall be appointed for a term 
of 4 years; and 
‘‘(iii) 10 shall be appointed for a term 
of 6 years. 
‘‘(3) QUALIFICATIONS.—Members of the Task 
Force shall be appointed from among individuals 
who possess expertise in at least one of the following 
areas: 
‘‘(A) Public health. 
‘‘(B) Evaluation of research and system-
atic evidence reviews. 
‘‘(C) Disciplines relevant to community 
preventive services, including health promotion; 
disease prevention; chronic disease; worksite 
health; qualitative and quantitative analysis; 
and health economics, policy, law, and statis-
tics. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Task Force, the Secretary— 
‘‘(A) shall ensure that all areas of exper-
tise described in paragraph (3) are represented; 
‘‘(B) shall ensure that such members in-
clude sufficient representatives of each of— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00958
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
959 
‘‘(i) State health officers; 
‘‘(ii) local health officers; 
‘‘(iii) health care practitioners; and 
‘‘(iv) public health practitioners; and 
‘‘(C) shall appoint individuals who, collec-
tively, have significant experience working with 
racially and ethnically diverse populations. 
‘‘(e) SUBGROUPS.—As appropriate to maximize effi-
ciency, the Task Force may delegate authority for con-
ducting reviews and making recommendations to sub-
groups consisting of Task Force members, subject to final 
approval by the Task Force. 
‘‘(f) 
COMMUNITY
PREVENTION
STAKEHOLDERS 
BOARD.— 
‘‘(1) IN GENERAL.—The Task Force shall con-
vene a community prevention stakeholders board 
composed of representatives of appropriate public 
and private entities with an interest in community 
preventive services to advise the Task Force on de-
veloping, updating, publishing, and disseminating 
evidence-based recommendations on the use of com-
munity preventive services. 
‘‘(2) MEMBERSHIP.—The members of the com-
munity prevention stakeholders board shall include 
representatives of the following: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00959
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
960 
‘‘(A) Health care consumers and patient 
groups. 
‘‘(B) Providers of community preventive 
services, including community-based providers. 
‘‘(C) Federal departments and agencies, 
including— 
‘‘(i) appropriate health agencies and 
offices in the Department, including the 
Office of the Surgeon General of the Pub-
lic Health Service, the Office of Minority 
Health, and the Office on Women’s 
Health; and 
‘‘(ii) as appropriate, other Federal de-
partments and agencies whose programs 
have a significant impact upon health (as 
determined by the Secretary). 
‘‘(D) Private health care payors. 
‘‘(3) RESPONSIBILITIES.—In accordance with 
subsection (b)(5), the community prevention stake-
holders board shall— 
‘‘(A) recommend community preventive 
services for review by the Task Force; 
‘‘(B) suggest scientific evidence for consid-
eration by the Task Force related to reviews 
undertaken by the Task Force; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00960
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
961 
‘‘(C) provide feedback regarding draft rec-
ommendations by the Task Force; and 
‘‘(D) assist with efforts regarding dissemi-
nation of recommendations by the Director of 
the Centers for Disease Control and Prevention. 
‘‘(g) DISCLOSURE AND CONFLICTS OF INTEREST.— 
Members of the Task Force or the community prevention 
stakeholders board shall not be considered employees of 
the Federal Government by reason of service on the Task 
Force, except members of the Task Force shall be consid-
ered to be special Government employees within the mean-
ing of section 107 of the Ethics in Government Act of 
1978 (5 U.S.C. App.) and section 208 of title 18, United 
States Code, for the purposes of disclosure and manage-
ment of conflicts of interest under those sections. 
‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.— 
Members of the Task Force or the community prevention 
stakeholders board shall not receive any pay for service 
on the Task Force, but may receive travel expenses, in-
cluding a per diem, in accordance with applicable provi-
sions of subchapter I of chapter 57 of title 5, United 
States Code. 
‘‘(i) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) except for section 14 of 
such Act shall apply to the Task Force to the extent that 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00961
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
962 
the provisions of such Act do not conflict with the provi-
sions of this title. 
‘‘(j) REPORT.—The Secretary shall submit to the 
Congress an annual report on the Task Force, including 
with respect to gaps identified and recommendations made 
under subsection (b)(4). 
‘‘Subtitle D—Prevention and 
Wellness Research 
‘‘SEC. 3141. PREVENTION AND WELLNESS RESEARCH ACTIV-
ITY COORDINATION. 
‘‘In conducting or supporting research on prevention 
and wellness, the Director of the Centers for Disease Con-
trol and Prevention, the Director of the National Insti-
tutes of Health, and the heads of other agencies within 
the Department of Health and Human Services con-
ducting or supporting such research, shall take into con-
sideration the national strategy under section 3121 and 
the recommendations of the Task Force on Clinical Pre-
ventive Services under section 3131 and the Task Force 
on Community Preventive Services under section 3132. 
‘‘SEC. 3142. COMMUNITY PREVENTION AND WELLNESS RE-
SEARCH GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall conduct, or award grants to eligible entities 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00962
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
963 
to conduct, research in priority areas identified by the Sec-
retary in the national strategy under section 3121 or by 
the Task Force on Community Preventive Services as re-
quired by section 3132. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall be— 
‘‘(1) a State, local, or tribal department of 
health; 
‘‘(2) a public or private nonprofit entity; or 
‘‘(3) a consortium of 2 or more entities de-
scribed in paragraphs (1) and (2). 
‘‘(c) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program of research 
under this section. 
‘‘Subtitle E—Delivery of Commu-
nity Prevention and Wellness 
Services 
‘‘SEC. 3151. COMMUNITY PREVENTION AND WELLNESS 
SERVICES GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall establish a program for the delivery of com-
munity preventive and wellness services consisting of 
awarding grants to eligible entities— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00963
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
964 
‘‘(1) to provide evidence-based, community pre-
ventive and wellness services in priority areas identi-
fied by the Secretary in the national strategy under 
section 3121; or 
‘‘(2) to plan such services. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) DEFINITION.—To be eligible for a grant 
under this section, an entity shall be— 
‘‘(A) a State, local, or tribal department of 
health; 
‘‘(B) a public or private entity; or 
‘‘(C) a consortium of— 
‘‘(i) 2 or more entities described in 
subparagraph (A) or (B); and 
‘‘(ii) a community partnership rep-
resenting a Health Empowerment Zone. 
‘‘(2) HEALTH EMPOWERMENT ZONE.—In this 
subsection, the term ‘Health Empowerment Zone’ 
means an area— 
‘‘(A) in which multiple community preven-
tive and wellness services are implemented in 
order to address one or more health disparities, 
including those identified by the Secretary in 
the national strategy under section 3121; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00964
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
965 
‘‘(B) which is represented by a community 
partnership that demonstrates community sup-
port and coordination with State, local, or tribal 
health departments and includes— 
‘‘(i) a broad cross section of stake-
holders; 
‘‘(ii) residents of the community; and 
‘‘(iii) representatives of entities that 
have a history of working within and serv-
ing the community. 
‘‘(c) PREFERENCES.—In awarding grants under this 
section, the Secretary shall give preference to entities 
that— 
‘‘(1) will address one or more goals or objec-
tives identified by the Secretary in the national 
strategy under section 3121; 
‘‘(2) will address significant health disparities, 
including those identified by the Secretary in the na-
tional strategy under section 3121; 
‘‘(3) will address unmet community prevention 
needs and avoids duplication of effort; 
‘‘(4) have been demonstrated to be effective in 
communities comparable to the proposed target com-
munity; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00965
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
966 
‘‘(5) will contribute to the evidence base for 
community preventive and wellness services; 
‘‘(6) demonstrate that the community preven-
tive services to be funded will be sustainable; and 
‘‘(7) demonstrate coordination or collaboration 
across governmental and nongovernmental partners. 
‘‘(d) HEALTH DISPARITIES.—Of the funds awarded 
under this section for a fiscal year, the Secretary shall 
award not less than 50 percent for planning or imple-
menting community preventive and wellness services 
whose primary purpose is to achieve a measurable reduc-
tion in one or more health disparities, including those 
identified by the Secretary in the national strategy under 
section 3121. 
‘‘(e) EMPHASIS ON RECOMMENDED SERVICES.—For 
fiscal year 2013 and subsequent fiscal years, the Secretary 
shall award grants under this section only for planning 
or implementing services recommended by the Task Force 
on Community Preventive Services under section 3122 or 
deemed effective based on a review of comparable rigor 
(as determined by the Director of the Centers for Disease 
Control and Prevention). 
‘‘(f) PROHIBITED USES OF FUNDS.—An entity that 
receives a grant under this section may not use funds pro-
vided through the grant— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00966
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
967 
‘‘(1) to build or acquire real property or for 
construction; or 
‘‘(2) for services or planning to the extent that 
payment has been made, or can reasonably be ex-
pected 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. 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program of grants 
awarded under this section. 
‘‘(h) DEFINITIONS.—In this section, the term ‘evi-
dence-based’ means that methodologically sound research 
has demonstrated a beneficial health effect, in the judg-
ment of the Director of the Centers for Disease Control 
and Prevention. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00967
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
968 
‘‘Subtitle F—Core Public Health 
Infrastructure 
‘‘SEC. 3161. CORE PUBLIC HEALTH INFRASTRUCTURE FOR 
STATE, LOCAL, AND TRIBAL HEALTH DEPART-
MENTS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion shall establish a core public health infrastructure pro-
gram consisting of awarding grants under subsection (b). 
‘‘(b) GRANTS.— 
‘‘(1) AWARD.—For the purpose of addressing 
core public health infrastructure needs, the Sec-
retary— 
‘‘(A) shall award a grant to each State 
health department; and 
‘‘(B) may award grants on a competitive 
basis to State, local, or tribal health depart-
ments. 
‘‘(2) ALLOCATION.—Of the total amount of 
funds awarded as grants under this subsection for a 
fiscal year— 
‘‘(A) not less than 50 percent shall be for 
grants to State health departments under para-
graph (1)(A); and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00968
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
969 
‘‘(B) not less than 30 percent shall be for 
grants to State, local, or tribal health depart-
ments under paragraph (1)(B). 
‘‘(c) USE OF FUNDS.—The Secretary may award a 
grant to an entity under subsection (b)(1) only if the enti-
ty agrees to use the grant to address core public health 
infrastructure needs, including those identified in the ac-
creditation process under subsection (g). 
‘‘(d) FORMULA GRANTS TO STATE HEALTH DEPART-
MENTS.—In making grants under subsection (b)(1)(A), 
the Secretary shall award funds to each State health de-
partment in accordance with— 
‘‘(1) a formula based on population size; burden 
of preventable disease and disability; and core public 
health infrastructure gaps, including those identified 
in the accreditation process under subsection (g); 
and 
‘‘(2) application requirements established by the 
Secretary, including a requirement that the State 
submit a plan that demonstrates to the satisfaction 
of the Secretary that the State’s health department 
will— 
‘‘(A) address its highest priority core pub-
lic health infrastructure needs; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00969
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
970 
‘‘(B) as appropriate, allocate funds to local 
health departments within the State. 
‘‘(e) COMPETITIVE GRANTS TO STATE, LOCAL, AND 
TRIBAL
HEALTH
DEPARTMENTS.—In making grants 
under subsection (b)(1)(B), the Secretary shall give pri-
ority to applicants demonstrating core public health infra-
structure needs identified in the accreditation process 
under subsection (g). 
‘‘(f) MAINTENANCE
OF EFFORT.—The Secretary 
may award a grant to an entity under subsection (b) only 
if the entity demonstrates to the satisfaction of the Sec-
retary that— 
‘‘(1) funds received through the grant will be 
expended only to supplement, and not supplant, non- 
Federal and Federal funds otherwise available to the 
entity for the purpose of addressing core public 
health infrastructure needs; and 
‘‘(2) with respect to activities for which the 
grant is awarded, the entity will maintain expendi-
tures of non-Federal amounts for such activities at 
a level not less than the level of such expenditures 
maintained by the entity for the fiscal year pre-
ceding the fiscal year for which the entity receives 
the grant. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00970
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
971 
‘‘(g) ESTABLISHMENT OF A PUBLIC HEALTH AC-
CREDITATION PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall— 
‘‘(A) develop, and periodically review and 
update, standards for voluntary accreditation of 
State, local, or tribal health departments and 
public health laboratories for the purpose of ad-
vancing the quality and performance of such de-
partments and laboratories; and 
‘‘(B) implement a program to accredit 
such health departments and laboratories in ac-
cordance with such standards. 
‘‘(2) COOPERATIVE
AGREEMENT.—The Sec-
retary may enter into a cooperative agreement with 
a private nonprofit entity to carry out paragraph 
(1). 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on progress being made to ac-
credit entities under subsection (g), including— 
‘‘(1) a strategy, including goals and objectives, 
for accrediting entities under subsection (g) and 
achieving the purpose described in subsection (g)(1); 
and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00971
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
972 
‘‘(2) identification of gaps in research related to 
core public health infrastructure and recommenda-
tions of priority areas for such research. 
‘‘SEC. 3162. CORE PUBLIC HEALTH INFRASTRUCTURE AND 
ACTIVITIES FOR CDC. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall expand and improve the core public health 
infrastructure and activities of the Centers for Disease 
Control and Prevention to address unmet and emerging 
public health needs. 
‘‘(b) REPORT.—The Secretary shall submit to the 
Congress an annual report on the activities funded 
through this section. 
‘‘Subtitle G—General Provisions 
‘‘SEC. 3171. DEFINITIONS. 
‘‘In this title: 
‘‘(1) The term ‘core public health infrastruc-
ture’ includes workforce capacity and competency; 
laboratory systems; health information, health infor-
mation systems, and health information analysis; 
communications; financing; other relevant compo-
nents of organizational capacity; and other related 
activities. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00972
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
973 
‘‘(2) The terms ‘Department’ and ‘depart-
mental’ refer to the Department of Health and 
Human Services. 
‘‘(3) The term ‘health disparities’ includes 
health and health care disparities and means popu-
lation-specific differences in the presence of disease, 
health outcomes, or access to health care. For pur-
poses of the preceding sentence, a population may be 
delineated by race, ethnicity, geographic setting, or 
other population or subpopulation determined appro-
priate by the Secretary. 
‘‘(4) The term ‘tribal’ refers to an Indian tribe, 
a Tribal organization, or an Urban Indian organiza-
tion, as such terms are defined in section 4 of the 
Indian Health Care Improvement Act.’’. 
(b) TRANSITION PROVISIONS APPLICABLE TO TASK 
FORCES.— 
(1) FUNCTIONS, PERSONNEL, ASSETS, LIABIL-
ITIES, AND
ADMINISTRATIVE
ACTIONS.—All func-
tions, personnel, assets, and liabilities of, and ad-
ministrative actions applicable to, the Preventive 
Services Task Force convened under section 915(a) 
of the Public Health Service Act and the Task Force 
on Community Preventive Services (as such section 
and Task Forces were in existence on the day before 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00973
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
974 
the date of the enactment of this Act) shall be trans-
ferred to the Task Force on Clinical Preventive 
Services and the Task Force on Community Preven-
tive Services, respectively, established under sections 
3121 and 3122 of the Public Health Service Act, as 
added by subsection (a). 
(2) RECOMMENDATIONS.—All recommendations 
of the Preventive Services Task Force and the Task 
Force on Community Preventive Services, as in ex-
istence on the day before the date of the enactment 
of this Act, shall be considered to be recommenda-
tions of the Task Force on Clinical Preventive Serv-
ices and the Task Force on Community Preventive 
Services, respectively, established under sections 
3121 and 3122 of the Public Health Service Act, as 
added by subsection (a). 
(3) MEMBERS ALREADY SERVING.— 
(A) INITIAL MEMBERS.—The Secretary of 
Health and Human Services may select those 
individuals already serving on the Preventive 
Services Task Force and the Task Force on 
Community Preventive Services, as in existence 
on the day before the date of the enactment of 
this Act, to be among the first members ap-
pointed to the Task Force on Clinical Preven-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00974
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
975 
tive Services and the Task Force on Commu-
nity Preventive Services, respectively, under sec-
tions 3121 and 3122 of the Public Health Serv-
ice Act, as added by subsection (a). 
(B) CALCULATION OF TOTAL SERVICE.—In 
calculating the total years of service of a mem-
ber of a task force for purposes of section 
3131(d)(2)(A) or 3132(d)(2)(A) of the Public 
Health Service Act, as added by subsection (a), 
the Secretary of Health and Human Services 
shall not include any period of service by the 
member on the Preventive Services Task Force 
or the Task Force on Community Preventive 
Services, respectively, as in existence on the day 
before the date of the enactment of this Act. 
(c) PERIOD BEFORE COMPLETION
OF NATIONAL 
STRATEGY.—Pending completion of the national strategy 
under section 3121 of the Public Health Service Act, as 
added by subsection (a), the Secretary of Health and 
Human Services, acting through the relevant agency head, 
may make a judgment about how the strategy will address 
an issue and rely on such judgment in carrying out any 
provision of subtitle C, D, E, or F of title XXXI of such 
Act, as added by subsection (a), that requires the Sec-
retary— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00975
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
976 
(1) to take into consideration such strategy; 
(2) to conduct or support research or provide 
services in priority areas identified in such strategy; 
or 
(3) to take any other action in reliance on such 
strategy. 
(d) CONFORMING AMENDMENTS.— 
(1) Paragraph (61) of section 3(b) of the In-
dian Health Care Improvement Act (25 U.S.C. 
1602) is amended by striking ‘‘United States Pre-
ventive Services Task Force’’ and inserting ‘‘Task 
Force on Clinical Preventive Services’’. 
(2) Section 126 of the Medicare, Medicaid, and 
SCHIP Benefits Improvement and Protection Act of 
2000 (Appendix F of Public Law 106–554) is 
amended by striking ‘‘United States Preventive 
Services Task Force’’ each place it appears and in-
serting ‘‘Task Force on Clinical Preventive Serv-
ices’’. 
(3) Paragraph (7) of section 317D of the Pub-
lic Health Service Act (42 U.S.C. 247b–5) is amend-
ed by striking ‘‘United States Preventive Services 
Task Force’’ each place it appears and inserting 
‘‘Task Force on Clinical Preventive Services’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00976
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
977 
(4) Section 915 of the Public Health Service 
Act (42 U.S.C. 299b–4) is amended by striking sub-
section (a). 
(5) Subsections (s)(2)(AA)(iii)(II), (xx)(1), and 
(ddd)(1)(B) of section 1861 of the Social Security 
Act (42 U.S.C. 1395x) are amended by striking 
‘‘United States Preventive Services Task Force’’ 
each place it appears and inserting ‘‘Task Force on 
Clinical Preventive Services’’. 
TITLE IV—QUALITY AND 
SURVEILLANCE 
SEC. 2401. IMPLEMENTATION OF BEST PRACTICES IN THE 
DELIVERY OF HEALTH CARE. 
(a) IN GENERAL.—Title IX of the Public Health 
Service Act (42 U.S.C. 299 et seq.) is amended— 
(1) by redesignating part D as part E; 
(2) by redesignating sections 931 through 938 
as sections 941 through 948, respectively; 
(3) in section 938(1), by striking ‘‘931’’ and in-
serting ‘‘941’’; and 
(4) by inserting after part C the following: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00977
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
978 
‘‘PART D—IMPLEMENTATION OF BEST 
PRACTICES IN THE DELIVERY OF HEALTH CARE 
‘‘SEC. 931. CENTER FOR QUALITY IMPROVEMENT. 
‘‘(a) IN GENERAL.—There is established the Center 
for Quality Improvement (referred to in this part as the 
‘Center’), to be headed by the Director. 
‘‘(b) PRIORITIZATION.— 
‘‘(1) 
IN
GENERAL.—The 
Director 
shall 
prioritize areas for the identification, development, 
evaluation, and implementation of best practices (in-
cluding innovative methodologies and strategies) for 
quality improvement activities in the delivery of 
health care services (in this section referred to as 
‘best practices’). 
‘‘(2) CONSIDERATIONS.—In prioritizing areas 
under paragraph (1), the Director shall consider— 
‘‘(A) the priorities established under sec-
tion 1191 of the Social Security Act; and 
‘‘(B) the key health indicators identified by 
the Assistant Secretary for Health Information 
under section 1709. 
‘‘(c) OTHER RESPONSIBILITIES.—The Director, act-
ing directly or by awarding a grant or contract to an eligi-
ble entity, shall— 
‘‘(1) identify existing best practices under sub-
section (e); 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00978
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
979 
‘‘(2) develop new best practices under sub-
section (f); 
‘‘(3) evaluate best practices under subsection 
(g); 
‘‘(4) implement best practices under subsection 
(h); 
‘‘(5) ensure that best practices are identified, 
developed, evaluated, and implemented under this 
section consistent with standards adopted by the 
Secretary under section 3004 for health information 
technology used in the collection and reporting of 
quality information (including for purposes of the 
demonstration of meaningful use of certified elec-
tronic health record (EHR) technology by physicians 
and hospitals under the Medicare program (under 
sections 1848(o)(2) and 1886(n)(3), respectively, of 
the Social Security Act)); and 
‘‘(6) provide for dissemination of information 
and reporting under subsections (i) and (j). 
‘‘(d) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (c), an entity shall— 
‘‘(1) be a nonprofit entity; 
‘‘(2) agree to work with a variety of institu-
tional health care providers, physicians, nurses, and 
other health care practitioners; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00979
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
980 
‘‘(3) if the entity is not the organization holding 
a contract under section 1153 of the Social Security 
Act for the area to be served, agree to cooperate 
with and avoid duplication of the activities of such 
organization. 
‘‘(e) IDENTIFYING EXISTING BEST PRACTICES.—The 
Secretary shall identify best practices that are— 
‘‘(1) currently utilized by health care providers 
(including hospitals, physician and other clinician 
practices, community cooperatives, and other health 
care entities) that deliver consistently high-quality, 
efficient health care services; and 
‘‘(2) easily adapted for use by other health care 
providers and for use across a variety of health care 
settings. 
‘‘(f) DEVELOPING NEW BEST PRACTICES.—The Sec-
retary shall develop best practices that are— 
‘‘(1) based on a review of existing scientific evi-
dence; 
‘‘(2) sufficiently detailed for implementation 
and incorporation into the workflow of health care 
providers; and 
‘‘(3) designed to be easily adapted for use by 
health care providers across a variety of health care 
settings. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00980
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
981 
‘‘(g) EVALUATION OF BEST PRACTICES.—The Direc-
tor shall evaluate best practices identified or developed 
under this section. Such evaluation— 
‘‘(1) shall include determinations of which best 
practices— 
‘‘(A) most reliably and effectively achieve 
significant progress in improving the quality of 
patient care; and 
‘‘(B) are easily adapted for use by health 
care providers across a variety of health care 
settings; 
‘‘(2) shall include regular review, updating, and 
improvement of such best practices; and 
‘‘(3) may include in-depth case studies or em-
pirical assessments of health care providers (includ-
ing hospitals, physician and other clinician practices, 
community cooperatives, and other health care enti-
ties) and simulations of such best practices for de-
terminations under paragraph (1). 
‘‘(h) IMPLEMENTATION OF BEST PRACTICES.— 
‘‘(1) IN
GENERAL.—The Director shall enter 
into voluntary arrangements with health care pro-
viders (including hospitals and other health facilities 
and health practitioners) in a State or region to im-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00981
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
982 
plement best practices identified or developed under 
this section. Such implementation— 
‘‘(A) may include forming collaborative 
multi-institutional teams; and 
‘‘(B) shall include an evaluation of the best 
practices being implemented, including the 
measurement of patient outcomes before, dur-
ing, and after implementation of such best 
practices. 
‘‘(2) PREFERENCES.—In carrying out this sub-
section, the Director shall give priority to health 
care providers implementing best practices that— 
‘‘(A) have the greatest impact on patient 
outcomes and satisfaction; 
‘‘(B) are the most easily adapted for use 
by health care providers across a variety of 
health care settings; 
‘‘(C) promote coordination of health care 
practitioners across the continuum of care; and 
‘‘(D) engage patients and their families in 
improving patient care and outcomes. 
‘‘(i) PUBLIC DISSEMINATION
OF INFORMATION.— 
The Director shall provide for the public dissemination of 
information with respect to best practices and activities 
under this section. Such information shall be made avail-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00982
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
983 
able in appropriate formats and languages to reflect the 
varying needs of consumers and diverse levels of health 
literacy. 
‘‘(j) REPORT.— 
‘‘(1) IN GENERAL.—The Director shall submit 
an annual report to the Congress and the Secretary 
on activities under this section. 
‘‘(2) CONTENT.—Each report under paragraph 
(1) shall include— 
‘‘(A) information on activities conducted 
pursuant to grants and contracts awarded; 
‘‘(B) summary data on patient outcomes 
before, during, and after implementation of best 
practices; and 
‘‘(C) recommendations on the adaptability 
of best practices for use by health providers.’’. 
(b) INITIAL QUALITY IMPROVEMENT ACTIVITIES AND 
INITIATIVES TO BE IMPLEMENTED.—Until the Director 
of the Agency for Healthcare Research and Quality has 
established initial priorities under section 931(b) of the 
Public Health Service Act, as added by subsection (a), the 
Director shall, for purposes of such section, prioritize the 
following: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00983
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
984 
(1) HEALTH CARE-ASSOCIATED INFECTIONS.— 
Reducing health care-associated infections, including 
infections in nursing homes and outpatient settings. 
(2) SURGERY.—Increasing hospital and out-
patient perioperative patient safety, including reduc-
ing surgical-site infections and surgical errors (such 
as wrong-site surgery and retained foreign bodies). 
(3) EMERGENCY
ROOM.—Improving care in 
hospital emergency rooms, including through the use 
of principles of efficiency of design and delivery to 
improve patient flow. 
(4) OBSTETRICS.—Improving the provision of 
obstetrical and neonatal care, including the identi-
fication of interventions that are effective in reduc-
ing the risk of preterm and premature labor and the 
implementation of best practices for labor and deliv-
ery care. 
SEC. 2402. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
(a) ESTABLISHMENT.—Title XVII (42 U.S.C. 300u 
et seq.) is amended— 
(1) by redesignating sections 1709 and 1710 as 
sections 1710 and 1711, respectively; and 
(2) by inserting after section 1708 the fol-
lowing: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00984
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
985 
‘‘SEC. 1709. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
‘‘(a) IN GENERAL.—There is established within the 
Department an Assistant Secretary for Health Informa-
tion (in this section referred to as the ‘Assistant Sec-
retary’), to be appointed by the Secretary. 
‘‘(b) RESPONSIBILITIES.—The Assistant Secretary 
shall— 
‘‘(1) ensure the collection, collation, reporting, 
and publishing of information (including full and 
complete statistics) on key health indicators regard-
ing the Nation’s health and the performance of the 
Nation’s health care; 
‘‘(2) facilitate and coordinate the collection, col-
lation, reporting, and publishing of information re-
garding the Nation’s health and the performance of 
the Nation’s health care (other than information de-
scribed in paragraph (1)); 
‘‘(3)(A) develop standards for the collection of 
data regarding the Nation’s health and the perform-
ance of the Nation’s health care; and 
‘‘(B) in carrying out subparagraph (A)— 
‘‘(i) ensure appropriate specificity and 
standardization for data collection at the na-
tional, regional, State, and local levels; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00985
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
986 
‘‘(ii) include standards, as appropriate, for 
the collection of accurate data on health and 
health care by race, ethnicity, primary lan-
guage, sex, sexual orientation, gender identity, 
disability, socioeconomic status, rural, urban, or 
other geographic setting, and any other popu-
lation or subpopulation determined appropriate 
by the Secretary; 
‘‘(iii) ensure, with respect to data on race 
and ethnicity, consistency with the 1997 Office 
of Management and Budget Standards for 
Maintaining, Collecting and Presenting Federal 
Data on Race and Ethnicity (or any successor 
standards); and 
‘‘(iv) in consultation with the Director of 
the Office of Minority Health, and the Director 
of the Office of Civil Rights, of the Department, 
develop standards for the collection of data on 
health and health care with respect to data on 
primary language; 
‘‘(4) provide support to Federal departments 
and agencies whose programs have a significant im-
pact upon health (as determined by the Secretary) 
for the collection and collation of information de-
scribed in paragraphs (1) and (2); 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00986
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
987 
‘‘(5) ensure the sharing of information de-
scribed in paragraphs (1) and (2) among the agen-
cies of the Department; 
‘‘(6) facilitate the sharing of information de-
scribed in paragraphs (1) and (2) by Federal depart-
ments and agencies whose programs have a signifi-
cant impact upon health (as determined by the Sec-
retary); 
‘‘(7) identify gaps in information described in 
paragraphs (1) and (2) and the appropriate agency 
or entity to address such gaps; 
‘‘(8) facilitate and coordinate identification and 
monitoring by the agencies of the Department of 
health disparities to inform program and policy ef-
forts to reduce such disparities, including facilitating 
and funding analyses conducted in cooperation with 
the Social Security Administration, the Bureau of 
the Census, and other appropriate agencies and enti-
ties; 
‘‘(9) consistent with privacy, proprietary, and 
other appropriate safeguards, facilitate public acces-
sibility of datasets (such as de-identified Medicare 
datasets or publicly available data on key health in-
dicators) by means of the Internet; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00987
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
988 
‘‘(10) award grants or contracts for the collec-
tion and collation of information described in para-
graphs (1) and (2) (including through statewide sur-
veys that provide standardized information). 
‘‘(c) KEY HEALTH INDICATORS.— 
‘‘(1) IN GENERAL.—In carrying out subsection 
(b)(1), the Assistant Secretary shall— 
‘‘(A) identify, and reassess at least once 
every 3 years, key health indicators described in 
such subsection; 
‘‘(B) publish statistics on such key health 
indicators for the public— 
‘‘(i) not less than annually; and 
‘‘(ii) on a supplemental basis when-
ever warranted by— 
‘‘(I) the rate of change for a key 
health indicator; or 
‘‘(II) the need to inform policy 
regarding the Nation’s health and the 
performance of the Nation’s health 
care; and 
‘‘(C) ensure consistency with the national 
strategy developed by the Secretary under sec-
tion 3121 and consideration of the indicators 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00988
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
989 
specified in the reports under sections 308, 
903(a)(6), and 913(b)(2). 
‘‘(2) RELEASE OF KEY HEALTH INDICATORS.— 
The regulations, rules, processes, and procedures of 
the Office of Management and Budget governing the 
review, release, and dissemination of key health indi-
cators shall be the same as the regulations, rules, 
processes, and procedures of the Office of Manage-
ment and Budget governing the review, release, and 
dissemination of Principal Federal Economic Indica-
tors (or equivalent statistical data) by the Bureau of 
Labor Statistics. 
‘‘(d) COORDINATION.—In carrying out this section, 
the Assistant Secretary shall coordinate with— 
‘‘(1) public and private entities that collect and 
disseminate information on health and health care, 
including foundations; and 
‘‘(2) the head of the Office of the National Co-
ordinator for Health Information Technology to en-
sure optimal use of health information technology. 
‘‘(e) REQUEST FOR INFORMATION FROM OTHER DE-
PARTMENTS AND AGENCIES.—Consistent with applicable 
law, the Assistant Secretary may secure directly from any 
Federal department or agency information necessary to 
enable the Assistant Secretary to carry out this section. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00989
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
990 
‘‘(f) REPORT.— 
‘‘(1) SUBMISSION.—The Assistant Secretary 
shall submit to the Secretary and the Congress an 
annual report containing— 
‘‘(A) a description of national, regional, or 
State changes in health or health care, as re-
flected by the key health indicators identified 
under subsection (c)(1); 
‘‘(B) a description of gaps in the collection, 
collation, reporting, and publishing of informa-
tion regarding the Nation’s health and the per-
formance of the Nation’s health care; 
‘‘(C) recommendations for addressing such 
gaps and identification of the appropriate agen-
cy within the Department or other entity to ad-
dress such gaps; 
‘‘(D) a description of analyses of health 
disparities, including the results of completed 
analyses, the status of ongoing longitudinal 
studies, and proposed or planned research; and 
‘‘(E) a plan for actions to be taken by the 
Assistant Secretary to address gaps described 
in subparagraph (B). 
‘‘(2) CONSIDERATION.—In preparing a report 
under paragraph (1), the Assistant Secretary shall 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00990
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
991 
take into consideration the findings and conclusions 
in the reports under sections 308, 903(a)(6), and 
913(b)(2). 
‘‘(g) PROPRIETARY AND PRIVACY PROTECTIONS.— 
Nothing in this section shall be construed to affect appli-
cable proprietary or privacy protections. 
‘‘(h) CONSULTATION.—In carrying out this section, 
the Assistant Secretary shall consult with— 
‘‘(1) the heads of appropriate health agencies 
and offices in the Department, including the Office 
of the Surgeon General of the Public Health Service, 
the Office of Minority Health, and the Office on 
Women’s Health; and 
‘‘(2) as appropriate, the heads of other Federal 
departments and agencies whose programs have a 
significant impact upon health (as determined by the 
Secretary). 
‘‘(i) DEFINITION.—In this section: 
‘‘(1) The terms ‘agency’ and ‘agencies’ include 
an epidemiology center established under section 214 
of the Indian Health Care Improvement Act. 
‘‘(2) The term ‘Department’ means the Depart-
ment of Health and Human Services. 
‘‘(3) The term ‘health disparities’ has the 
meaning given to such term in section 3171.’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00991
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
992 
(b) OTHER
COORDINATION
RESPONSIBILITIES.— 
Title III (42 U.S.C. 241 et seq.) is amended— 
(1) in paragraphs (1) and (2) of section 304(c) 
(42 U.S.C. 242b(c)), by inserting ‘‘, acting through 
the Assistant Secretary for Health Information,’’ 
after ‘‘The Secretary’’ each place it appears; and 
(2) in section 306(j) (42 U.S.C. 242k(j)), by in-
serting ‘‘, acting through the Assistant Secretary for 
Health Information,’’ after ‘‘of this section, the Sec-
retary’’. 
SEC. 2403. AUTHORIZATION OF APPROPRIATIONS. 
Section 799C, as added and amended, is further 
amended by adding at the end the following: 
‘‘(e) QUALITY AND SURVEILLANCE.—For the pur-
pose of carrying out part D of title IX and section 1709, 
in addition to any other amounts authorized to be appro-
priated for such purpose, there is authorized to be appro-
priated, out of any monies in the Public Health Invest-
ment Fund, $300,000,000 for each of fiscal years 2010 
through 2014 and $330,000,000 for each of fiscal years 
2015 through 2019.’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00992
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
993 
TITLE V—OTHER PROVISIONS 
Subtitle A—Drug Discount for 
Rural and Other Hospitals 
SEC. 2501. EXPANDED PARTICIPATION IN 340B PROGRAM. 
(a) EXPANSION OF COVERED ENTITIES RECEIVING 
DISCOUNTED PRICES.—Section 340B(a)(4) (42 U.S.C. 
256b(a)(4)) is amended by adding at the end the fol-
lowing: 
‘‘(M) A children’s hospital excluded from 
the Medicare prospective payment system pur-
suant to section 1886(d)(1)(B)(iii) of the Social 
Security Act which would meet the require-
ments of subparagraph (L), including the dis-
proportionate share adjustment percentage re-
quirement under subparagraph (L)(ii), if the 
hospital were a subsection (d) hospital as de-
fined in section 1886(d)(1)(B) of the Social Se-
curity Act. 
‘‘(N) An entity that is a critical access hos-
pital (as determined under section 1820(c)(2) 
of the Social Security Act). 
‘‘(O) An entity receiving funds under title 
V of the Social Security Act (relating to mater-
nal and child health) for the provision of health 
services. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00993
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
994 
‘‘(P) An entity receiving funds under sub-
part I of part B of title XIX of the Public 
Health Service Act (relating to comprehensive 
mental health services) for the provision of com-
munity mental health services. 
‘‘(Q) An entity receiving funds under sub-
part II of such part B (relating to the preven-
tion and treatment of substance abuse) for the 
provision of treatment services for substance 
abuse. 
‘‘(R) An entity that is a Medicare-depend-
ent, small rural hospital (as defined in section 
1886(d)(5)(G)(iv) of the Social Security Act). 
‘‘(S) An entity that is a sole community 
hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii) of the Social Security Act). 
‘‘(T) An entity that is classified as a rural 
referral center under section 1886(d)(5)(C) of 
the Social Security Act.’’. 
(b) PROHIBITION ON GROUP PURCHASING ARRANGE-
MENTS.—Section 340B(a) (42 U.S.C. 256b(a)) is amend-
ed— 
(1) in paragraph (4)(L)— 
(A) by adding ‘‘and’’ at the end of clause 
(i); 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00994
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
995 
(B) by striking ‘‘; and’’ at the end of 
clause (ii) and inserting a period; and 
(C) by striking clause (iii); 
(2) in paragraph (5), by redesignating subpara-
graphs (C) and (D) as subparagraphs (D) and (E), 
respectively, and by inserting after subparagraph 
(B) the following: 
‘‘(C) PROHIBITING
USE
OF
GROUP
PUR-
CHASING ARRANGEMENTS.— 
‘‘(i) A hospital described in subpara-
graph (L), (M), (N), (R), (S), or (T) of 
paragraph (4) shall not obtain covered out-
patient drugs through a group purchasing 
organization or other group purchasing ar-
rangement, except as permitted or pro-
vided pursuant to clause (ii). 
‘‘(ii) The Secretary shall establish rea-
sonable exceptions to the requirement of 
clause (i)— 
‘‘(I) with respect to a covered 
outpatient drug that is unavailable to 
be purchased through the program 
under this section due to a drug 
shortage problem, manufacturer non-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00995
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
996 
compliance, or any other reason be-
yond the hospital’s control; 
‘‘(II) to facilitate generic substi-
tution when a generic covered out-
patient drug is available at a lower 
price; and 
‘‘(III) to reduce in other ways 
the administrative burdens of man-
aging both inventories of drugs ob-
tained under this section and not 
under this section, if such exception 
does not create a duplicate discount 
problem in violation of subparagraph 
(A) or a diversion problem in violation 
of subparagraph (B).’’. 
SEC. 2502. EXTENSION OF DISCOUNTS TO INPATIENT 
DRUGS. 
(a) IN GENERAL.—Section 340B (42 U.S.C. 256b) 
is amended— 
(1) in subsection (b)— 
(A) by striking ‘‘In this section, the terms’’ 
and inserting the following: ‘‘In this section: 
‘‘(1) IN GENERAL.—The terms’’; and 
(B) by adding at the end the following new 
paragraph: 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00996
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
997 
‘‘(2) COVERED
DRUG.—The term ‘covered 
drug’— 
‘‘(A) means a covered outpatient drug (as 
defined in section 1927(k)(2) of the Social Se-
curity Act); and 
‘‘(B) includes, notwithstanding the section 
1927(k)(3)(A) of such Act, a drug used in con-
nection with an inpatient or outpatient service 
provided by a hospital described in subpara-
graph (L), (M), (N), (R), (S), or (T) of sub-
section (a)(4) that is enrolled to participate in 
the drug discount program under this section.’’; 
and 
(2) in paragraphs (5), (7), and (9) of sub-
section (a), by striking ‘‘outpatient’’ each place it 
appears. 
(b) MEDICAID CREDITS ON INPATIENT DRUGS.— 
Subsection (c) of section 340B (42 U.S.C. 256b(c)) is 
amended to read as follows: 
‘‘(c) MEDICAID CREDITS ON INPATIENT DRUGS.— 
‘‘(1) IN GENERAL.—For the cost reporting pe-
riod covered by the most recently filed Medicare cost 
report under title XVIII of the Social Security Act, 
a hospital described in subparagraph (L), (M), (N), 
(R), (S), or (T) of subsection (a)(4) and enrolled to 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00997
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
998 
participate in the drug discount program under this 
section shall provide to each State under its plan 
under title XIX of such Act— 
‘‘(A) a credit on the estimated annual 
costs to such hospital of single source and inno-
vator multiple source drugs provided to Med-
icaid beneficiaries for inpatient use; and 
‘‘(B) a credit on the estimated annual 
costs to such hospital of noninnovator multiple 
source drugs provided to Medicaid beneficiaries 
for inpatient use. 
‘‘(2) AMOUNT OF CREDITS.— 
‘‘(A) SINGLE
SOURCE
AND
INNOVATOR 
MULTIPLE
SOURCE
DRUGS.—For purposes of 
paragraph (1)(A)— 
‘‘(i) the credit under such paragraph 
shall be equal to the product of— 
‘‘(I) the annual value of single 
source and innovator multiple source 
drugs purchased under this section by 
the hospital based on the drugs’ aver-
age manufacturer price; 
‘‘(II) the estimated percentage of 
the hospital’s drug purchases attrib-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00998
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
999 
utable to Medicaid beneficiaries for in-
patient use; and 
‘‘(III) the minimum rebate per-
centage 
described 
in 
section 
1927(c)(1)(B) of the Social Security 
Act; 
‘‘(ii) the reference in clause (i)(I) to 
the annual value of single source and inno-
vator multiple source drugs purchased 
under this section by the hospital based on 
the drugs’ average manufacturer price 
shall be equal to the sum of— 
‘‘(I) the annual quantity of each 
single source and innovator multiple 
source drug purchased during the cost 
reporting period, multiplied by 
‘‘(II) the average manufacturer 
price for that drug; 
‘‘(iii) the reference in clause (i)(II) to 
the estimated percentage of the hospital’s 
drug purchases attributable to Medicaid 
beneficiaries for inpatient use; shall be 
equal to— 
‘‘(I) the Medicaid inpatient drug 
charges as reported on the hospital’s 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 00999
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1000 
most recently filed Medicare cost re-
port, divided by 
‘‘(II) total drug charges reported 
on the cost report; and 
‘‘(iv) the terms ‘single source drug’ 
and ‘innovator multiple source drug’ have 
the meanings given such terms in section 
1927(k)(7) of the Social Security Act. 
‘‘(B) NONINNOVATOR
MULTIPLE
SOURCE 
DRUGS.—For purposes of paragraph (1)(B)— 
‘‘(i) the credit under such paragraph 
shall be equal to the product of— 
‘‘(I) the annual value of noninno-
vator multiple source drugs purchased 
under this section by the hospital 
based on the drugs’ average manufac-
turer price; 
‘‘(II) the estimated percentage of 
the hospital’s drug purchases attrib-
utable to Medicaid beneficiaries for in-
patient use; and 
‘‘(III) the applicable percentage 
as defined in section 1927(c)(3)(B) of 
the Social Security Act; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01000
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1001 
‘‘(ii) the reference in clause (i)(I) to 
the annual value of noninnovator multiple 
source drugs purchased under this section 
by the hospital based on the drugs’ average 
manufacturer price shall be equal to the 
sum of— 
‘‘(I) the annual quantity of each 
noninnovator multiple source drug 
purchased during the cost reporting 
period, multiplied by 
‘‘(II) the average manufacturer 
price for that drug; 
‘‘(iii) the reference in clause (i)(II) to 
the estimated percentage of the hospital’s 
drug purchases attributable to Medicaid 
beneficiaries for inpatient use shall be 
equal to— 
‘‘(I) the Medicaid inpatient drug 
charges as reported on the hospital’s 
most recently filed Medicare cost re-
port, divided by 
‘‘(II) total drug charges reported 
on the cost report; and 
‘‘(iv) the term ‘noninnovator multiple 
source drug’ has the meaning given such 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01001
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1002 
term in section 1927(k)(7) of the Social 
Security Act. 
‘‘(3) CALCULATION OF CREDITS.— 
‘‘(A) IN GENERAL.—Each State calculates 
credits under paragraph (1) and informs hos-
pitals of amount under section 1927(a)(5)(D) 
of the Social Security Act. 
‘‘(B) HOSPITAL PROVISION OF INFORMA-
TION.—Not later than 30 days after the date of 
the filing of the hospital’s most recently filed 
Medicare cost report, the hospital shall provide 
the State with the information described in 
paragraphs (2)(A)(ii) and (2)(B)(ii). With re-
spect to each drug purchased during the cost 
reporting period, the hospital shall provide the 
dosage form, strength, package size, date of 
purchase and the number of units purchased. 
‘‘(4) PAYMENT
DEADLINE.—The credits pro-
vided by a hospital under paragraph (1) shall be 
paid within 60 days after receiving the information 
specified in paragraph (3)(A). 
‘‘(5) OPT
OUT.—A hospital shall not be re-
quired to provide the Medicaid credit required under 
paragraph (1) if it can demonstrate to the State 
that it will lose reimbursement under the State plan 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01002
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1003 
resulting from the extension of discounts to inpa-
tient drugs under subsection (b)(2) and that the loss 
of reimbursement will exceed the amount of the 
credit otherwise owed by the hospital. 
‘‘(6) OFFSET AGAINST MEDICAL ASSISTANCE.— 
Amounts received by a State under this subsection 
in any quarter shall be considered to be a reduction 
in the amount expended under the State plan in the 
quarter for medical assistance for purposes of sec-
tion 1903(a)(1) of the Social Security Act.’’. 
(c) CONFORMING AMENDMENTS.—Section 1927 of 
the Social Security Act (42 U.S.C. 1396r–8) is amended— 
(1) in subsection (a)(5)(A), by striking ‘‘covered 
outpatient drugs’’ and inserting ‘‘covered drugs (as 
defined in section 340B(b)(2) of the Public Health 
Service Act)’’; 
(2) in subsection (a)(5), by striking subpara-
graph (D) and inserting the following: 
‘‘(D) STATE RESPONSIBILITY FOR CALCU-
LATING HOSPITAL CREDITS.—The State shall 
calculate the credits owed by the hospital under 
paragraph (1) of section 340B(c) of the Public 
Health Service Act and provide the hospital 
with both the amounts and an explanation of 
how it calculated the credits. In performing the 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01003
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1004 
calculations specified in paragraphs (2)(A)(ii) 
and (2)(B)(ii) of such section, the State shall 
use the average manufacturer price applicable 
to the calendar quarter in which the drug was 
purchased by the hospital.’’; and 
(3) in subsection (k)(1)— 
(A) in subparagraph (A), by striking ‘‘sub-
paragraph (B)’’ and inserting ‘‘subparagraphs 
(B) and (D)’’; and 
(B) by adding at the end the following: 
‘‘(D) 
CALCULATION
FOR
COVERED 
DRUGS.—With respect to a covered drug (as de-
fined in section 340B(b)(2) of the Public 
Health Service Act), the average manufacturer 
price shall be determined in accordance with 
subparagraph (A) except that, in the event a 
covered drug is not distributed to the retail 
pharmacy class of trade, it shall mean the aver-
age price paid to the manufacturer for the drug 
in the United States by wholesalers for drugs 
distributed to the acute care class of trade, 
after deducting customary prompt pay dis-
counts.’’. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01004
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1005 
SEC. 2503. EFFECTIVE DATE. 
(a) IN GENERAL.—The amendments made by this 
subtitle shall take effect on July 1, 2010, and shall apply 
to drugs dispensed on or after such date. 
(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—School-Based Health 
Clinics 
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— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01005
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1006 
‘‘(1) be an SBHC (as defined in subsection 
(l)(4)); and 
‘‘(2) submit an application at such time, in 
such manner, and containing such information as 
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 governing— 
‘‘(I) obtaining parental or guard-
ian consent; and 
‘‘(II) patient privacy and student 
records, including section 264 of the 
Health Insurance Portability and Ac-
countability Act of 1996 and section 
444 of the General Education Provi-
sions Act; 
‘‘(ii) the SBHC has established and 
maintains collaborative relationships with 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01006
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1007 
other 
health 
care 
providers 
in 
the 
catchment area of the SBHC; 
‘‘(iii) the SBHC will provide on-site 
access during the academic day when 
school is in session and has an established 
network 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-
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 may be used for— 
‘‘(1) providing training related to the provision 
of comprehensive primary health services and addi-
tional health services; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01007
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1008 
‘‘(2) the management and operation of SBHC 
programs; and 
‘‘(3) the payment of salaries for health profes-
sionals and other appropriate SBHC personnel. 
‘‘(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; 
‘‘(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 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). 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01008
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1009 
‘‘(f) MATCHING REQUIREMENT.—The Secretary may 
award a grant to an SBHC 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 pro-
vided in cash or in kind) to carry out the activities sup-
ported by the grant. 
‘‘(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 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01009
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1010 
‘‘(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 
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 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01010
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1011 
‘‘(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 shall include the following: 
‘‘(A) PHYSICAL.—Comprehensive health 
assessments, diagnosis, and treatment of minor, 
acute, and chronic medical conditions and refer-
rals to, and follow-up for, specialty care. 
‘‘(B) MENTAL
HEALTH.—Mental health 
assessments, crisis intervention, counseling, 
treatment, and referral to a continuum of serv-
ices including emergency psychiatric care, com-
munity support programs, inpatient care, and 
outpatient programs. 
‘‘(C) 
OPTIONAL
SERVICES.—Additional 
services, which may include 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 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01011
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1012 
area designated by the Secretary as an area with a 
shortage of personal health services and health in-
frastructure for such children and adolescents. 
‘‘(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; and 
‘‘(D) provides, at a minimum, comprehen-
sive primary health services during school hours 
to children and adolescents by health profes-
sionals in accordance with State and local laws 
and regulations, established standards, and 
community practice. 
‘‘(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 agency; 
‘‘(E) a local educational agency; or 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01012
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1013 
‘‘(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 2010 and 
such sums as may be necessary for each of the fiscal years 
2011 through 2014.’’. 
(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 (b), not later than July 1, 2010, without regard 
to whether or not final regulations have been issued under 
section 399Z–1(h) of such Act. 
Subtitle C—National Medical 
Device Registry 
SEC. 2521. NATIONAL MEDICAL DEVICE REGISTRY. 
(a) REGISTRY.— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01013
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1014 
(1) IN GENERAL.—Section 519 of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 360i) is 
amended— 
(A) by redesignating subsection (g) as sub-
section (h); and 
(B) by inserting after subsection (f) the 
following: 
‘‘National Medical Device Registry 
‘‘(g)(1) The Secretary shall establish a national med-
ical device registry (in this subsection referred to as the 
‘registry’) to facilitate analysis of postmarket safety and 
outcomes data on each device that— 
‘‘(A) is or has been used in or on a patient; and 
‘‘(B) is— 
‘‘(i) a class III device; or 
‘‘(ii) a class II device that is implantable, 
life-supporting, or life-sustaining. 
‘‘(2) In developing the registry, the Secretary shall, 
in consultation with the Commissioner of Food and Drugs, 
the Administrator of the Centers for Medicare & Medicaid 
Services, the head of the Office of the National Coordi-
nator for Health Information Technology, and the Sec-
retary of Veterans Affairs, determine the best methods 
for— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01014
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1015 
‘‘(A) including in the registry, in a manner con-
sistent with subsection (f), appropriate information 
to identify each device described in paragraph (1) by 
type, model, and serial number or other unique iden-
tifier; 
‘‘(B) validating methods for analyzing patient 
safety and outcomes data from multiple sources and 
for linking such data with the information included 
in the registry as described in subparagraph (A), in-
cluding, to the extent feasible, use of— 
‘‘(i) data provided to the Secretary under 
other provisions of this chapter; and 
‘‘(ii) information from public and private 
sources identified under paragraph (3); 
‘‘(C) integrating the activities described in this 
subsection with— 
‘‘(i) activities under paragraph (3) of sec-
tion 505(k) (relating to active postmarket risk 
identification); 
‘‘(ii) activities under paragraph (4) of sec-
tion 505(k) (relating to advanced analysis of 
drug safety data); and 
‘‘(iii) other postmarket device surveillance 
activities of the Secretary authorized by this 
chapter; and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01015
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1016 
‘‘(D) providing public access to the data and 
analysis collected or developed through the registry 
in a manner and form that protects patient privacy 
and proprietary information and is comprehensive, 
useful, and not misleading to patients, physicians, 
and scientists. 
‘‘(3)(A) To facilitate analyses of postmarket safety 
and patient outcomes for devices described in paragraph 
(1), the Secretary shall, in collaboration with public, aca-
demic, and private entities, develop methods to— 
‘‘(i) obtain access to disparate sources of 
patient safety and outcomes data, including— 
‘‘(I) Federal health-related electronic 
data (such as data from the Medicare pro-
gram under title XVIII of the Social Secu-
rity Act or from the health systems of the 
Department of Veterans Affairs); 
‘‘(II) private sector health-related 
electronic data (such as pharmaceutical 
purchase data and health insurance claims 
data); and 
‘‘(III) other data as the Secretary 
deems necessary to permit postmarket as-
sessment of device safety and effectiveness; 
and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01016
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1017 
‘‘(ii) link data obtained under clause (i) 
with information in the registry. 
‘‘(B) In this paragraph, the term ‘data’ refers to in-
formation respecting a device described in paragraph (1), 
including claims data, patient survey data, standardized 
analytic files that allow for the pooling and analysis of 
data from disparate data environments, electronic health 
records, and any other data deemed appropriate by the 
Secretary. 
‘‘(4) Not later than 36 months after the date of the 
enactment of this subsection, the Secretary shall promul-
gate regulations for establishment and operation of the 
registry under paragraph (1). Such regulations— 
‘‘(A)(i) in the case of devices that are described 
in paragraph (1) and sold on or after the date of the 
enactment of this subsection, shall require manufac-
turers of such devices to submit information to the 
registry, including, for each such device, the type, 
model, and serial number or, if required under sub-
section (f), other unique device identifier; and 
‘‘(ii) in the case of devices that are described in 
paragraph (1) and sold before such date, may re-
quire manufacturers of such devices to submit such 
information to the registry, if deemed necessary by 
the Secretary to protect the public health; 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01017
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1018 
‘‘(B) shall establish procedures— 
‘‘(i) to permit linkage of information sub-
mitted pursuant to subparagraph (A) with pa-
tient safety and outcomes data obtained under 
paragraph (3); and 
‘‘(ii) to permit analyses of linked data; 
‘‘(C) may require device manufacturers to sub-
mit such other information as is necessary to facili-
tate postmarket assessments of device safety and ef-
fectiveness and notification of device risks; 
‘‘(D) shall establish requirements for regular 
and timely reports to the Secretary, which shall be 
included in the registry, concerning adverse event 
trends, adverse event patterns, incidence and preva-
lence of adverse events, and other information the 
Secretary determines appropriate, which may include 
data on comparative safety and outcomes trends; 
and 
‘‘(E) shall establish procedures to permit public 
access to the information in the registry in a manner 
and form that protects patient privacy and propri-
etary information and is comprehensive, useful, and 
not misleading to patients, physicians, and sci-
entists. 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01018
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1019 
‘‘(5) To carry out this subsection, there are author-
ized to be appropriated such sums as may be necessary 
for fiscal years 2010 and 2011.’’. 
(2) 
EFFECTIVE
DATE.—The 
Secretary 
of 
Health and Human Services shall establish and 
begin implementation of the registry under section 
519(g) of the Federal Food, Drug, and Cosmetic 
Act, as added by paragraph (1), by not later than 
the date that is 36 months after the date of the en-
actment of this Act, without regard to whether or 
not final regulations to establish and operate the 
registry have been promulgated by such date. 
(3) 
CONFORMING
AMENDMENT.—Section 
303(f)(1)(B)(ii) of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 333(f)(1)(B)(ii)) is amend-
ed by striking ‘‘519(g)’’ and inserting ‘‘519(h)’’. 
(b) ELECTRONIC EXCHANGE AND USE IN CERTIFIED 
ELECTRONIC HEALTH RECORDS
OF UNIQUE DEVICE 
IDENTIFIERS.— 
(1) 
RECOMMENDATIONS.—The 
HIT 
Policy 
Committee established under section 3002 of the 
Public Health Service Act (42 U.S.C. 300jj–12) 
shall recommend to the head of the Office of the Na-
tional Coordinator for Health Information Tech-
nology standards, implementation specifications, and 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01019
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1020 
certification criteria for the electronic exchange and 
use in certified electronic health records of a unique 
device identifier for each device described in section 
519(g)(1) of the Federal Food, Drug, and Cosmetic 
Act, as added by subsection (a). 
(2) STANDARDS, IMPLEMENTATION
CRITERIA, 
AND
CERTIFICATION
CRITERIA.—The Secretary of 
the Health Human Services, acting through the 
head of the Office of the National Coordinator for 
Health Information Technology, shall adopt stand-
ards, implementation specifications, and certification 
criteria for the electronic exchange and use in cer-
tified electronic health records of a unique device 
identifier for each device described in paragraph (1), 
if such an identifier is required by section 519(f) of 
the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 360i(f)) for the device. 
Subtitle D—Grants for Comprehen-
sive Programs To Provide Edu-
cation to Nurses and Create a 
Pipeline to Nursing 
SEC. 2531. ESTABLISHMENT OF GRANT PROGRAM. 
(a) PURPOSES.—It is the purpose of this section to 
authorize grants to— 
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01020
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS
1021 
(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-
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-
VerDate Nov 24 2008 
23:53 Mar 17, 2010
Jkt 089200
PO 00000
Frm 01021
Fmt 6652
Sfmt 6201
E:\BILLS\H4872.RH
H4872
dcolon on DSK2BSOYB1PROD with BILLS