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(2) DURATION.— 
(A) 
INITIATION
OF
PROGRAM; 
RE-
SOURCES.—The Secretary shall awards grants to 
States beginning on January 1, 2011, or begin-
ning on the date on which the Secretary develops 
program criteria, whichever is earlier. The Sec-
retary shall develop program criteria for initia-
tives under this section using relevant evidence- 
based research and resources, including the 
Guide to Community Preventive Services, the 
Guide to Clinical Preventive Services, and the 
National Registry of Evidence-Based Programs 
and Practices. 
(B) DURATION
OF
PROGRAM.—A State 
awarded a grant to carry out initiatives under 
this section shall carry out such initiatives with-
in the 5-year period beginning on January 1, 
2011, or beginning on the date on which the Sec-
retary develops program criteria, whichever is 
earlier. Initiatives under this section shall be 
carried out by a State for a period of not less 
than 3 years. 
(3) PROGRAM DESCRIBED.— 
(A) IN GENERAL.—A program described in 
this paragraph is a comprehensive, evidence-
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based, widely available, and easily accessible 
program, proposed by the State and approved by 
the Secretary, that is designed and uniquely 
suited to address the needs of Medicaid bene-
ficiaries and has demonstrated success in helping 
individuals achieve one or more of the following: 
(i) Ceasing use of tobacco products. 
(ii) Controlling or reducing their 
weight. 
(iii) Lowering their cholesterol. 
(iv) Lowering their blood pressure. 
(v) Avoiding the onset of diabetes or, 
in the case of a diabetic, improving the 
management of that condition. 
(B) CO-MORBIDITIES.—A program under 
this section may also address co-morbidities (in-
cluding depression) that are related to any of the 
conditions described in subparagraph (A). 
(C) WAIVER
AUTHORITY.—The Secretary 
may 
waive 
the 
requirements 
of 
section 
1902(a)(1) (relating to statewideness) of the So-
cial Security Act for a State awarded a grant to 
conduct an initiative under this section and 
shall ensure that a State makes any program de-
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scribed in subparagraph (A) available and acces-
sible to Medicaid beneficiaries. 
(D) FLEXIBILITY IN IMPLEMENTATION.—A 
State may enter into arrangements with pro-
viders participating in Medicaid, community- 
based organizations, faith-based organizations, 
public-private partnerships, Indian tribes, or 
similar entities or organizations to carry out 
programs described in subparagraph (A). 
(4) APPLICATION.—Following the development of 
program criteria by the Secretary, a State may sub-
mit an application, in such manner and containing 
such information as the Secretary may require, that 
shall include a proposal for programs described in 
paragraph (3)(A) and a plan to make Medicaid bene-
ficiaries and providers participating in Medicaid who 
reside in the State aware and informed about such 
programs. 
(b) EDUCATION AND OUTREACH CAMPAIGN.— 
(1) STATE
AWARENESS.—The Secretary shall 
conduct an outreach and education campaign to make 
States aware of the grants under this section. 
(2) PROVIDER AND BENEFICIARY EDUCATION.—A 
State awarded a grant to conduct an initiative under 
this section shall conduct an outreach and education
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campaign to make Medicaid beneficiaries and pro-
viders participating in Medicaid who reside in the 
State aware of the programs described in subsection 
(a)(3) that are to be carried out by the State under 
the grant. 
(c) IMPACT.—A State awarded a grant to conduct an 
initiative under this section shall develop and implement 
a system to— 
(1) track Medicaid beneficiary participation in 
the program and validate changes in health risk and 
outcomes with clinical data, including the adoption 
and maintenance of health behaviors by such bene-
ficiaries; 
(2) to the extent practicable, establish standards 
and health status targets for Medicaid beneficiaries 
participating in the program and measure the degree 
to which such standards and targets are met; 
(3) evaluate the effectiveness of the program and 
provide the Secretary with such evaluations; 
(4) report to the Secretary on processes that have 
been developed and lessons learned from the program; 
and 
(5) report on preventive services as part of re-
porting on quality measures for Medicaid managed 
care programs.
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(d) EVALUATIONS AND REPORTS.— 
(1) INDEPENDENT ASSESSMENT.—The Secretary 
shall enter into a contract with an independent entity 
or organization to conduct an evaluation and assess-
ment of the initiatives carried out by States under 
this section, for the purpose of determining— 
(A) the effect of such initiatives on the use 
of health care services by Medicaid beneficiaries 
participating in the program; 
(B) the extent to which special populations 
(including adults with disabilities, adults with 
chronic illnesses, and children with special 
health care needs) are able to participate in the 
program; 
(C) the level of satisfaction of Medicaid 
beneficiaries with respect to the accessibility and 
quality of health care services provided through 
the program; and 
(D) the administrative costs incurred by 
State agencies that are responsible for adminis-
tration of the program. 
(2) STATE
REPORTING.—A State awarded a 
grant to carry out initiatives under this section shall 
submit reports to the Secretary, on a semi-annual 
basis, regarding the programs that are supported by
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the grant funds. Such report shall include informa-
tion, as specified by the Secretary, regarding— 
(A) the specific uses of the grant funds; 
(B) an assessment of program implementa-
tion and lessons learned from the programs; 
(C) an assessment of quality improvements 
and clinical outcomes under such programs; and 
(D) estimates of cost savings resulting from 
such programs. 
(3) INITIAL REPORT.—Not later than January 1, 
2014, the Secretary shall submit to Congress an ini-
tial report on such initiatives based on information 
provided by States through reports required under 
paragraph (2). The initial report shall include an in-
terim evaluation of the effectiveness of the initiatives 
carried out with grants awarded under this section 
and a recommendation regarding whether funding for 
expanding or extending the initiatives should be ex-
tended beyond January 1, 2016. 
(4) FINAL
REPORT.—Not later than July 1, 
2016, the Secretary shall submit to Congress a final 
report on the program that includes the results of the 
independent assessment required under paragraph 
(1), together with recommendations for such legisla-
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tion and administrative action as the Secretary deter-
mines appropriate. 
(e) NO EFFECT ON ELIGIBILITY FOR, OR AMOUNT OF, 
MEDICAID OR OTHER BENEFITS.—Any incentives provided 
to a Medicaid beneficiary participating in a program de-
scribed in subsection (a)(3) shall not be taken into account 
for purposes of determining the beneficiary’s eligibility for, 
or amount of, benefits under the Medicaid program or any 
program funded in whole or in part with Federal funds. 
(f) FUNDING.—Out of any funds in the Treasury not 
otherwise appropriated, there are appropriated for the 5- 
year period beginning on January 1, 2011, $100,000,000 
to the Secretary to carry out this section. Amounts appro-
priated under this subsection shall remain available until 
expended. 
(g) DEFINITIONS.—In this section: 
(1) MEDICAID BENEFICIARY.—The term ‘‘Med-
icaid beneficiary’’ means an individual who is eligi-
ble for medical assistance under a State plan or 
waiver under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) and is enrolled in such plan or 
waiver. 
(2) STATE.—The term ‘‘State’’ has the meaning 
given that term for purposes of title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.).
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Subtitle C—Creating Healthier 
Communities 
SEC. 4201. COMMUNITY TRANSFORMATION GRANTS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Director of the Centers for Dis-
ease Control and Prevention (referred to in this section as 
the ‘‘Director’’), shall award competitive grants to State 
and local governmental agencies and community-based or-
ganizations for the implementation, evaluation, and dis-
semination of evidence-based community preventive health 
activities in order to reduce chronic disease rates, prevent 
the development of secondary conditions, address health dis-
parities, and develop a stronger evidence-base of effective 
prevention programming. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall— 
(1) be— 
(A) a State governmental agency; 
(B) a local governmental agency; 
(C) a national network of community-based 
organizations; 
(D) a State or local non-profit organiza-
tion; or 
(E) an Indian tribe; and
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(2) submit to the Director an application at such 
time, in such a manner, and containing such infor-
mation as the Director may require, including a de-
scription of the program to be carried out under the 
grant; and 
(3) demonstrate a history or capacity, if funded, 
to develop relationships necessary to engage key stake-
holders from multiple sectors within and beyond 
health care and across a community, such as healthy 
futures corps and health care providers. 
(c) USE OF FUNDS.— 
(1) IN GENERAL.—An eligible entity shall use 
amounts received under a grant under this section to 
carry out programs described in this subsection. 
(2) COMMUNITY TRANSFORMATION PLAN.— 
(A) IN GENERAL.—An eligible entity that 
receives a grant under this section shall submit 
to the Director (for approval) a detailed plan 
that includes the policy, environmental, pro-
grammatic, and as appropriate infrastructure 
changes needed to promote healthy living and re-
duce disparities. 
(B) ACTIVITIES.—Activities within the plan 
may focus on (but not be limited to)—
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(i) creating healthier school environ-
ments, including increasing healthy food 
options, physical activity opportunities, 
promotion of healthy lifestyle, emotional 
wellness, and prevention curricula, and ac-
tivities to prevent chronic diseases; 
(ii) creating the infrastructure to sup-
port active living and access to nutritious 
foods in a safe environment; 
(iii) developing and promoting pro-
grams targeting a variety of age levels to 
increase access to nutrition, physical activ-
ity and smoking cessation, improve social 
and emotional wellness, enhance safety in a 
community, or address any other chronic 
disease priority area identified by the 
grantee; 
(iv) assessing and implementing work-
site wellness programming and incentives; 
(v) working to highlight healthy op-
tions at restaurants and other food venues; 
(vi) prioritizing strategies to reduce 
racial and ethnic disparities, including so-
cial, economic, and geographic determinants 
of health; and
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(vii) addressing special populations 
needs, including all age groups and individ-
uals with disabilities, and individuals in 
both urban and rural areas. 
(3) COMMUNITY-BASED PREVENTION HEALTH AC-
TIVITIES.— 
(A) IN GENERAL.—An eligible entity shall 
use amounts received under a grant under this 
section to implement a variety of programs, poli-
cies, and infrastructure improvements to pro-
mote healthier lifestyles. 
(B) ACTIVITIES.—An eligible entity shall 
implement activities detailed in the community 
transformation plan under paragraph (2). 
(C) IN-KIND SUPPORT.—An eligible entity 
may provide in-kind resources such as staff, 
equipment, or office space in carrying out activi-
ties under this section. 
(4) EVALUATION.— 
(A) IN GENERAL.—An eligible entity shall 
use amounts provided under a grant under this 
section to conduct activities to measure changes 
in the prevalence of chronic disease risk factors 
among community members participating in 
preventive health activities
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(B) TYPES OF MEASURES.—In carrying out 
subparagraph (A), the eligible entity shall, with 
respect to residents in the community, meas-
ure— 
(i) changes in weight; 
(ii) changes in proper nutrition; 
(iii) changes in physical activity; 
(iv) changes in tobacco use prevalence; 
(v) changes in emotional well-being 
and overall mental health; 
(vi) other factors using community- 
specific data from the Behavioral Risk Fac-
tor Surveillance Survey; and 
(vii) other factors as determined by the 
Secretary. 
(C) REPORTING.—An eligible entity shall 
annually submit to the Director a report con-
taining an evaluation of activities carried out 
under the grant. 
(5) DISSEMINATION.—A grantee under this sec-
tion shall— 
(A) meet at least annually in regional or 
national meetings to discuss challenges, best 
practices, and lessons learned with respect to ac-
tivities carried out under the grant; and
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(B) develop models for the replication of 
successful programs and activities and the men-
toring of other eligible entities. 
(d) TRAINING.— 
(1) IN GENERAL.—The Director shall develop a 
program to provide training for eligible entities on ef-
fective strategies for the prevention and control of 
chronic disease and the link between physical, emo-
tional, and social well-being. 
(2) COMMUNITY
TRANSFORMATION
PLAN.—The 
Director shall provide appropriate feedback and tech-
nical assistance to grantees to establish community 
transformation plans 
(3) EVALUATION.—The Director shall provide a 
literature review and framework for the evaluation of 
programs conducted as part of the grant program 
under this section, in addition to working with aca-
demic institutions or other entities with expertise in 
outcome evaluation. 
(e) PROHIBITION.—A grantee shall not use funds pro-
vided under a grant under this section to create video games 
or to carry out any other activities that may lead to higher 
rates of obesity or inactivity. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section, such
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sums as may be necessary for each fiscal years 2010 through 
2014. 
SEC. 4202. HEALTHY AGING, LIVING WELL; EVALUATION OF 
COMMUNITY-BASED 
PREVENTION 
AND 
WELLNESS PROGRAMS FOR MEDICARE BENE-
FICIARIES. 
(a) HEALTHY AGING, LIVING WELL.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the 
‘‘Secretary’’), acting through the Director of the Cen-
ters for Disease Control and Prevention, shall award 
grants to State or local health departments and In-
dian tribes to carry out 5-year pilot programs to pro-
vide 
public 
health 
community 
interventions, 
screenings, and where necessary, clinical referrals for 
individuals who are between 55 and 64 years of age. 
(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1), an entity shall— 
(A) be— 
(i) a State health department; 
(ii) a local health department; or 
(iii) an Indian tribe; 
(B) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require
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including a description of the program to be car-
ried out under the grant; 
(C) design a strategy for improving the 
health of the 55-to-64 year-old population 
through community-based public health interven-
tions; and 
(D) demonstrate the capacity, if funded, to 
develop the relationships necessary with relevant 
health agencies, health care providers, commu-
nity-based organizations, and insurers to carry 
out the activities described in paragraph (3), 
such relationships to include the identification of 
a community-based clinical partner, such as a 
community health center or rural health clinic. 
(3) USE OF FUNDS.— 
(A) IN GENERAL.—A State or local health 
department shall use amounts received under a 
grant under this subsection to carry out a pro-
gram to provide the services described in this 
paragraph to individuals who are between 55 
and 64 years of age. 
(B) PUBLIC HEALTH INTERVENTIONS.— 
(i) IN GENERAL.—In developing and 
implementing such activities, a grantee 
shall collaborate with the Centers for Dis-
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ease Control and Prevention and the Ad-
ministration on Aging, and relevant local 
agencies and organizations. 
(ii) TYPES OF INTERVENTION ACTIVI-
TIES.—Intervention 
activities 
conducted 
under this subparagraph may include ef-
forts to improve nutrition, increase physical 
activity, reduce tobacco use and substance 
abuse, improve mental health, and promote 
healthy lifestyles among the target popu-
lation. 
(C) 
COMMUNITY
PREVENTIVE 
SCREENINGS.— 
(i) IN GENERAL.—In addition to com-
munity-wide public health interventions, a 
State or local health department shall use 
amounts received under a grant under this 
subsection to conduct ongoing health screen-
ing to identify risk factors for cardio-
vascular disease, cancer, stroke, and diabe-
tes among individuals in both urban and 
rural areas who are between 55 and 64 
years of age.
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(ii) TYPES
OF
SCREENING
ACTIVI-
TIES.—Screening activities conducted under 
this subparagraph may include— 
(I) 
mental 
health/behavioral 
health and substance use disorders; 
(II) physical activity, smoking, 
and nutrition; and 
(III) any other measures deemed 
appropriate by the Secretary. 
(iii) 
MONITORING.—Grantees 
under 
this section shall maintain records of 
screening results under this subparagraph 
to establish the baseline data for monitoring 
the targeted population 
(D) CLINICAL
REFERRAL/TREATMENT
FOR 
CHRONIC DISEASES.— 
(i) IN
GENERAL.—A State or local 
health department shall use amounts re-
ceived under a grant under this subsection 
to ensure that individuals between 55 and 
64 years of age who are found to have 
chronic disease risk factors through the 
screening activities described in subpara-
graph (C)(ii), receive clinical referral/treat-
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ment for follow-up services to reduce such 
risk. 
(ii) MECHANISM.— 
(I) IDENTIFICATION AND DETER-
MINATION OF STATUS.—With respect to 
each individual with risk factors for or 
having heart disease, stroke, diabetes, 
or any other condition for which such 
individual was screened under sub-
paragraph (C), a grantee under this 
section shall determine whether or not 
such individual is covered under any 
public or private health insurance pro-
gram. 
(II) INSURED
INDIVIDUALS.—An 
individual determined to be covered 
under a health insurance program 
under subclause (I) shall be referred by 
the grantee to the existing providers 
under such program or, if such indi-
vidual does not have a current pro-
vider, to a provider who is in-network 
with respect to the program involved. 
(III) UNINSURED INDIVIDUALS.— 
With respect to an individual deter-
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mined to be uninsured under subclause 
(I), the grantee’s community-based 
clinical partner described in para-
graph (4)(D) shall assist the indi-
vidual in determining eligibility for 
available public coverage options and 
identify other appropriate community 
health care resources and assistance 
programs. 
(iii) PUBLIC
HEALTH
INTERVENTION 
PROGRAM.—A State or local health depart-
ment shall use amounts received under a 
grant under this subsection to enter into 
contracts with community health centers or 
rural health clinics and mental health and 
substance use disorder service providers to 
assist in the referral/treatment of at risk 
patients to community resources for clinical 
follow-up and help determine eligibility for 
other public programs. 
(E) GRANTEE EVALUATION.—An eligible en-
tity shall use amounts provided under a grant 
under this subsection to conduct activities to 
measure changes in the prevalence of chronic dis-
ease risk factors among participants.
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(4) PILOT
PROGRAM
EVALUATION.—The Sec-
retary shall conduct an annual evaluation of the effec-
tiveness of the pilot program under this subsection. In 
determining such effectiveness, the Secretary shall 
consider changes in the prevalence of uncontrolled 
chronic disease risk factors among new Medicare en-
rollees (or individuals nearing enrollment, including 
those who are 63 and 64 years of age) who reside in 
States or localities receiving grants under this section 
as compared with national and historical data for 
those States and localities for the same population. 
(5) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection, such sums as may be necessary for 
each of fiscal years 2010 through 2014. 
(b) EVALUATION AND PLAN FOR COMMUNITY-BASED 
PREVENTION AND WELLNESS PROGRAMS FOR MEDICARE 
BENEFICIARIES.— 
(1) IN GENERAL.—The Secretary shall conduct 
an evaluation of community-based prevention and 
wellness programs and develop a plan for promoting 
healthy lifestyles and chronic disease self-management 
for Medicare beneficiaries. 
(2) MEDICARE EVALUATION OF PREVENTION AND 
WELLNESS PROGRAMS.—
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(A) IN
GENERAL.—The Secretary shall 
evaluate community prevention and wellness 
programs including those that are sponsored by 
the Administration on Aging, are evidence-based, 
and have demonstrated potential to help Medi-
care beneficiaries (particularly beneficiaries that 
have attained 65 years of age) reduce their risk 
of disease, disability, and injury by making 
healthy lifestyle choices, including exercise, diet, 
and self-management of chronic diseases. 
(B) EVALUATION.—The evaluation under 
subparagraph (A) shall consist of the following: 
(i) EVIDENCE REVIEW.—The Secretary 
shall review available evidence, literature, 
best practices, and resources that are rel-
evant to programs that promote healthy life-
styles and reduce risk factors for the Medi-
care population. The Secretary may deter-
mine the scope of the evidence review and 
such issues to be considered, which shall in-
clude, at a minimum— 
(I) physical activity, nutrition, 
and obesity; 
(II) falls;
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(III) chronic disease self-manage-
ment; and 
(IV) mental health. 
(ii) INDEPENDENT
EVALUATION
OF 
EVIDENCE-BASED
COMMUNITY
PREVENTION 
AND WELLNESS PROGRAMS.—The Adminis-
trator of the Centers for Medicare & Med-
icaid Services, in consultation with the As-
sistant Secretary for Aging, shall, to the ex-
tent feasible and practicable, conduct an 
evaluation of existing community preven-
tion and wellness programs that are spon-
sored by the Administration on Aging to as-
sess the extent to which Medicare bene-
ficiaries who participate in such pro-
grams— 
(I) reduce their health risks, im-
prove their health outcomes, and adopt 
and maintain healthy behaviors; 
(II) improve their ability to man-
age their chronic conditions; and 
(III) reduce their utilization of 
health services and associated costs 
under the Medicare program for condi-
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tions that are amenable to improve-
ment under such programs. 
(3) REPORT.—Not later than September 30, 
2013, the Secretary shall submit to Congress a report 
that includes— 
(A) recommendations for such legislation 
and administrative action as the Secretary de-
termines appropriate to promote healthy life-
styles and chronic disease self-management for 
Medicare beneficiaries; 
(B) any relevant findings relating to the 
evidence review under paragraph (2)(B)(i); and 
(C) the results of the evaluation under para-
graph (2)(B)(ii). 
(4) FUNDING.—For purposes of carrying out this 
subsection, the Secretary shall provide for the trans-
fer, from the Federal Hospital Insurance Trust Fund 
under section 1817 of the Social Security Act (42 
U.S.C. 1395i) and the Federal Supplemental Medical 
Insurance Trust Fund under section 1841 of such Act 
(42 U.S.C. 1395t), in such proportion as the Sec-
retary determines appropriate, of $50,000,000 to the 
Centers for Medicare & Medicaid Services Program 
Management Account. Amounts transferred under the
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preceding sentence shall remain available until ex-
pended. 
(5) ADMINISTRATION.—Chapter 35 of title 44, 
United States Code shall not apply to the this sub-
section. 
(6) MEDICARE BENEFICIARY.—In this subsection, 
the term ‘‘Medicare beneficiary’’ means an individual 
who is entitled to benefits under part A of title XVIII 
of the Social Security Act and enrolled under part B 
of such title. 
SEC. 4203. REMOVING BARRIERS AND IMPROVING ACCESS 
TO WELLNESS FOR INDIVIDUALS WITH DIS-
ABILITIES. 
Title V of the Rehabilitation Act of 1973 (29 U.S.C. 
791 et seq.) is amended by adding at the end of the fol-
lowing: 
‘‘SEC. 510. ESTABLISHMENT OF STANDARDS FOR ACCES-
SIBLE MEDICAL DIAGNOSTIC EQUIPMENT. 
‘‘(a) STANDARDS.—Not later than 24 months after the 
date of enactment of the Affordable Health Choices Act, the 
Architectural and Transportation Barriers Compliance 
Board shall, in consultation with the Commissioner of the 
Food and Drug Administration, promulgate regulatory 
standards in accordance with the Administrative Procedure 
Act (2 U.S.C. 551 et seq.) setting forth the minimum tech-
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nical criteria for medical diagnostic equipment used in (or 
in conjunction with) physician’s offices, clinics, emergency 
rooms, hospitals, and other medical settings. The standards 
shall ensure that such equipment is accessible to, and usable 
by, individuals with accessibility needs, and shall allow 
independent entry to, use of, and exit from the equipment 
by such individuals to the maximum extent possible. 
‘‘(b) MEDICAL DIAGNOSTIC EQUIPMENT COVERED.— 
The standards issued under subsection (a) for medical diag-
nostic equipment shall apply to equipment that includes ex-
amination tables, examination chairs (including chairs 
used for eye examinations or procedures, and dental exami-
nations or procedures), weight scales, mammography equip-
ment, x-ray machines, and other radiological equipment 
commonly used for diagnostic purposes by health profes-
sionals. 
‘‘(c) REVIEW AND AMENDMENT.—The Architectural 
and Transportation Barriers Compliance Board, in con-
sultation with the Commissioner of the Food and Drug Ad-
ministration, shall periodically review and, as appropriate, 
amend the standards in accordance with the Administrative 
Procedure Act (2 U.S.C. 551 et seq.).’’. 
SEC. 4204. IMMUNIZATIONS. 
(a) STATE AUTHORITY TO PURCHASE RECOMMENDED 
VACCINES FOR ADULTS.—Section 317 of the Public Health
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dren, adolescents, and adults through the use of evi-
dence-based, population-based interventions for high- 
risk populations. 
‘‘(2) STATE PLAN.—To be eligible for a grant 
under paragraph (1), a State shall submit to the Sec-
retary an application at such time, in such manner, 
and containing such information as the Secretary 
may require, including a State plan that describes the 
interventions to be implemented under the grant and 
how such interventions match with local needs and 
capabilities, as determined through consultation with 
local authorities. 
‘‘(3) USE OF FUNDS.—Funds received under a 
grant under this subsection shall be used to imple-
ment interventions that are recommended by the Task 
Force on Community Preventive Services (as estab-
lished by the Secretary, acting through the Director of 
the Centers for Disease Control and Prevention) or 
other evidence-based interventions, including— 
‘‘(A) providing immunization reminders or 
recalls for target populations of clients, patients, 
and consumers; 
‘‘(B) educating targeted populations and 
health care providers concerning immunizations
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in combination with one or more other interven-
tions; 
‘‘(C) reducing out-of-pocket costs for fami-
lies for vaccines and their administration; 
‘‘(D) carrying out immunization-promoting 
strategies for participants or clients of public 
programs, including assessments of immuniza-
tion status, referrals to health care providers, 
education, provision of on-site immunizations, or 
incentives for immunization; 
‘‘(E) providing for home visits that promote 
immunization through education, assessments of 
need, referrals, provision of immunizations, or 
other services; 
‘‘(F) providing reminders or recalls for im-
munization providers; 
‘‘(G) conducting assessments of, and pro-
viding feedback to, immunization providers; 
‘‘(H) any combination of one or more inter-
ventions described in this paragraph; or 
‘‘(I) immunization information systems to 
allow all States to have electronic databases for 
immunization records. 
‘‘(4) 
CONSIDERATION.—In 
awarding 
grants 
under this subsection, the Secretary shall consider
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any reviews or recommendations of the Task Force on 
Community Preventive Services. 
‘‘(5) EVALUATION.—Not later than 3 years after 
the date on which a State receives a grant under this 
subsection, the State shall submit to the Secretary an 
evaluation of progress made toward improving immu-
nization coverage rates among high-risk populations 
within the State. 
‘‘(6) REPORT TO CONGRESS.—Not later than 4 
years after the date of enactment of the Affordable 
Health Choices Act, the Secretary shall submit to 
Congress a report concerning the effectiveness of the 
demonstration program established under this sub-
section together with recommendations on whether to 
continue and expand such program. 
‘‘(7) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, such sums as may be necessary for 
each of fiscal years 2010 through 2014.’’. 
(c) REAUTHORIZATION
OF
IMMUNIZATION
PRO-
GRAM.—Section 317(j) of the Public Health Service Act (42 
U.S.C. 247b(j)) is amended— 
(1) in paragraph (1), by striking ‘‘for each of the 
fiscal years 1998 through 2005’’; and
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(2) in paragraph (2), by striking ‘‘after October 
1, 1997,’’. 
(d) RULE OF CONSTRUCTION REGARDING ACCESS TO 
IMMUNIZATIONS.—Nothing in this section (including the 
amendments made by this section), or any other provision 
of this Act (including any amendments made by this Act) 
shall be construed to decrease children’s access to immuniza-
tions. 
(e) GAO STUDY AND REPORT ON MEDICARE BENE-
FICIARY ACCESS TO VACCINES.— 
(1) STUDY.—The Comptroller General of the 
United States (in this section referred to as the 
‘‘Comptroller General’’) shall conduct a study on the 
ability of Medicare beneficiaries who were 65 years of 
age or older to access routinely recommended vaccines 
covered under the prescription drug program under 
part D of title XVIII of the Social Security Act over 
the period since the establishment of such program. 
Such study shall include the following: 
(A) An analysis and determination of— 
(i) the number of Medicare bene-
ficiaries who were 65 years of age or older 
and were eligible for a routinely rec-
ommended vaccination that was covered 
under part D;
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(ii) the number of such beneficiaries 
who actually received a routinely rec-
ommended vaccination that was covered 
under part D; and 
(iii) any barriers to access by such 
beneficiaries to routinely recommended vac-
cinations that were covered under part D. 
(B) A summary of the findings and rec-
ommendations by government agencies, depart-
ments, and advisory bodies (as well as relevant 
professional organizations) on the impact of cov-
erage under part D of routinely recommended 
adult immunizations for access to such immuni-
zations by Medicare beneficiaries. 
(2) REPORT.—Not later than June 1, 2011, the 
Comptroller General shall submit to the appropriate 
committees of jurisdiction of the House of Representa-
tives and the Senate a report containing the results 
of the study conducted under paragraph (1), together 
with recommendations for such legislation and ad-
ministrative action as the Comptroller General deter-
mines appropriate. 
(3) FUNDING.—Out of any funds in the Treas-
ury not otherwise appropriated, there are appro-
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priated $1,000,000 for fiscal year 2010 to carry out 
this subsection. 
SEC. 4205. NUTRITION LABELING OF STANDARD MENU 
ITEMS AT CHAIN RESTAURANTS. 
(a) TECHNICAL AMENDMENTS.—Section 403(q)(5)(A) 
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
343(q)(5)(A)) is amended— 
(1) in subitem (i), by inserting at the beginning 
‘‘except as provided in clause (H)(ii)(III),’’; and 
(2) in subitem (ii), by inserting at the beginning 
‘‘except as provided in clause (H)(ii)(III),’’. 
(b) LABELING REQUIREMENTS.—Section 403(q)(5) of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
343(q)(5)) is amended by adding at the end the following: 
‘‘(H) RESTAURANTS, RETAIL FOOD ESTABLISHMENTS, 
AND VENDING MACHINES.— 
‘‘(i) 
GENERAL
REQUIREMENTS
FOR
RES-
TAURANTS
AND
SIMILAR
RETAIL
FOOD
ESTABLISH-
MENTS.—Except for food described in subclause (vii), 
in the case of food that is a standard menu item that 
is offered for sale in a restaurant or similar retail 
food establishment that is part of a chain with 20 or 
more locations doing business under the same name 
(regardless of the type of ownership of the locations) 
and offering for sale substantially the same menu
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standard menu item, on the menu board, includ-
ing a drive-through menu board, the number of 
calories contained in the standard menu item, as 
usually prepared and offered for sale; and 
‘‘(bb) a succinct statement concerning sug-
gested daily caloric intake, as specified by the 
Secretary by regulation and posted prominently 
on the menu board, designed to enable the public 
to understand, in the context of a total daily 
diet, the significance of the nutrition informa-
tion that is provided on the menu board; 
‘‘(III) in a written form, available on the prem-
ises of the restaurant or similar retail establishment 
and to the consumer upon request, the nutrition infor-
mation required under clauses (C) and (D) of sub-
paragraph (1); and 
‘‘(IV) on the menu or menu board, a prominent, 
clear, and conspicuous statement regarding the avail-
ability of the information described in item (III). 
‘‘(iii) SELF-SERVICE FOOD AND FOOD ON DIS-
PLAY.—Except as provided in subclause (vii), in the 
case of food sold at a salad bar, buffet line, cafeteria 
line, or similar self-service facility, and for self-service 
beverages or food that is on display and that is visible 
to customers, a restaurant or similar retail food es-
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tablishment shall place adjacent to each food offered 
a sign that lists calories per displayed food item or 
per serving. 
‘‘(iv) REASONABLE BASIS.—For the purposes of 
this clause, a restaurant or similar retail food estab-
lishment shall have a reasonable basis for its nutrient 
content disclosures, including nutrient databases, 
cookbooks, laboratory analyses, and other reasonable 
means, as described in section 101.10 of title 21, Code 
of Federal Regulations (or any successor regulation) 
or in a related guidance of the Food and Drug Ad-
ministration. 
‘‘(v) MENU
VARIABILITY
AND
COMBINATION 
MEALS.—The Secretary shall establish by regulation 
standards for determining and disclosing the nutrient 
content for standard menu items that come in dif-
ferent flavors, varieties, or combinations, but which 
are listed as a single menu item, such as soft drinks, 
ice cream, pizza, doughnuts, or children’s combina-
tion meals, through means determined by the Sec-
retary, including ranges, averages, or other methods. 
‘‘(vi) ADDITIONAL
INFORMATION.—If the Sec-
retary determines that a nutrient, other than a nutri-
ent required under subclause (ii)(III), should be dis-
closed for the purpose of providing information to as-
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sist consumers in maintaining healthy dietary prac-
tices, the Secretary may require, by regulation, disclo-
sure of such nutrient in the written form required 
under subclause (ii)(III). 
‘‘(vii) NONAPPLICABILITY TO CERTAIN FOOD.— 
‘‘(I) IN GENERAL.—Subclauses (i) through 
(vi) do not apply to— 
‘‘(aa) items that are not listed on a 
menu or menu board (such as condiments 
and other items placed on the table or 
counter for general use); 
‘‘(bb) daily specials, temporary menu 
items appearing on the menu for less than 
60 days per calendar year, or custom or-
ders; or 
‘‘(cc) such other food that is part of a 
customary market test appearing on the 
menu for less than 90 days, under terms 
and conditions established by the Secretary. 
‘‘(II) 
WRITTEN
FORMS.—Subparagraph 
(5)(C) shall apply to any regulations promul-
gated under subclauses (ii)(III) and (vi). 
‘‘(viii) VENDING MACHINES.— 
‘‘(I) IN GENERAL.—In the case of an article 
of food sold from a vending machine that—
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‘‘(aa) does not permit a prospective 
purchaser to examine the Nutrition Facts 
Panel before purchasing the article or does 
not otherwise provide visible nutrition in-
formation at the point of purchase; and 
‘‘(bb) is operated by a person who is 
engaged in the business of owning or oper-
ating 20 or more vending machines, 
the vending machine operator shall provide a 
sign in close proximity to each article of food or 
the selection button that includes a clear and 
conspicuous statement disclosing the number of 
calories contained in the article. 
‘‘(ix) VOLUNTARY PROVISION OF NUTRITION IN-
FORMATION.— 
‘‘(I) IN GENERAL.—An authorized official of 
any restaurant or similar retail food establish-
ment or vending machine operator not subject to 
the requirements of this clause may elect to be 
subject to the requirements of such clause, by reg-
istering biannually the name and address of 
such restaurant or similar retail food establish-
ment or vending machine operator with the Sec-
retary, as specified by the Secretary by regula-
tion.
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‘‘(II) REGISTRATION.—Within 120 days of 
enactment of this clause, the Secretary shall pub-
lish a notice in the Federal Register specifying 
the terms and conditions for implementation of 
item (I), pending promulgation of regulations. 
‘‘(III) RULE OF CONSTRUCTION.—Nothing 
in this subclause shall be construed to authorize 
the Secretary to require an application, review, 
or licensing process for any entity to register 
with the Secretary, as described in such item. 
‘‘(x) REGULATIONS.— 
‘‘(I) PROPOSED
REGULATION.—Not later 
than 1 year after the date of enactment of this 
clause, the Secretary shall promulgate proposed 
regulations to carry out this clause. 
‘‘(II) CONTENTS.—In promulgating regula-
tions, the Secretary shall— 
‘‘(aa) consider standardization of rec-
ipes and methods of preparation, reasonable 
variation in serving size and formulation of 
menu items, space on menus and menu 
boards, inadvertent human error, training 
of food service workers, variations in ingre-
dients, and other factors, as the Secretary 
determines; and
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‘‘(bb) specify the format and manner of 
the nutrient content disclosure requirements 
under this subclause. 
‘‘(III) REPORTING.—The Secretary shall 
submit to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Com-
mittee on Energy and Commerce of the House of 
Representatives a quarterly report that describes 
the Secretary’s progress toward promulgating 
final regulations under this subparagraph. 
‘‘(xi) DEFINITION.—In this clause, the term 
‘menu’ or ‘menu board’ means the primary writing of 
the restaurant or other similar retail food establish-
ment from which a consumer makes an order selec-
tion.’’ 
(c) NATIONAL UNIFORMITY.—Section 403A(a)(4) of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 343– 
1(a)(4)) is amended by striking ‘‘except a requirement for 
nutrition labeling of food which is exempt under subclause 
(i) or (ii) of section 403(q)(5)(A)’’ and inserting ‘‘except 
that this paragraph does not apply to food that is offered 
for sale in a restaurant or similar retail food establishment 
that is not part of a chain with 20 or more locations doing 
business under the same name (regardless of the type of 
ownership of the locations) and offering for sale substan-
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SEC. 4206. DEMONSTRATION PROJECT CONCERNING INDI-
VIDUALIZED WELLNESS PLAN. 
Section 330 of the Public Health Service Act (42 
U.S.C. 245b) is amended by adding at the end the following: 
‘‘(s) DEMONSTRATION PROGRAM FOR INDIVIDUALIZED 
WELLNESS PLANS.— 
‘‘(1) IN GENERAL.—The Secretary shall establish 
a pilot program to test the impact of providing at- 
risk populations who utilize community health centers 
funded under this section an individualized wellness 
plan that is designed to reduce risk factors for pre-
ventable conditions as identified by a comprehensive 
risk-factor assessment. 
‘‘(2) AGREEMENTS.—The Secretary shall enter 
into agreements with not more than 10 community 
health centers funded under this section to conduct ac-
tivities under the pilot program under paragraph (1). 
‘‘(3) WELLNESS PLANS.— 
‘‘(A) 
IN
GENERAL.—An 
individualized 
wellness plan prepared under the pilot program 
under this subsection may include one or more 
of the following as appropriate to the individ-
ual’s identified risk factors: 
‘‘(i) Nutritional counseling. 
‘‘(ii) A physical activity plan.
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‘‘(iii) Alcohol and smoking cessation 
counseling and services. 
‘‘(iv) Stress management. 
‘‘(v) Dietary supplements that have 
health claims approved by the Secretary. 
‘‘(vi) Compliance assistance provided 
by a community health center employee. 
‘‘(B) RISK
FACTORS.—Wellness plan risk 
factors shall include— 
‘‘(i) weight; 
‘‘(ii) tobacco and alcohol use; 
‘‘(iii) exercise rates; 
‘‘(iv) nutritional status; and 
‘‘(v) blood pressure. 
‘‘(C) 
COMPARISONS.—Individualized 
wellness plans shall make comparisons between 
the individual involved and a control group of 
individuals with respect to the risk factors de-
scribed in subparagraph (B). 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, such sums as may be necessary.’’.
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SEC. 4207. REASONABLE BREAK TIME FOR NURSING MOTH-
ERS. 
Section 7 of the Fair Labor Standards Act of 1938 
(29 U.S.C. 207) is amended by adding at the end the fol-
lowing: 
‘‘(r)(1) An employer shall provide— 
‘‘(A) a reasonable break time for an employee to 
express breast milk for her nursing child for 1 year 
after the child’s birth each time such employee has 
need to express the milk; and 
‘‘(B) a place, other than a bathroom, that is 
shielded from view and free from intrusion from co-
workers and the public, which may be used by an em-
ployee to express breast milk. 
‘‘(2) An employer shall not be required to compensate 
an employee receiving reasonable break time under para-
graph (1) for any work time spent for such purpose. 
‘‘(3) An employer that employs less than 50 employees 
shall not be subject to the requirements of this subsection, 
if such requirements would impose an undue hardship by 
causing the employer significant difficulty or expense when 
considered in relation to the size, financial resources, na-
ture, or structure of the employer’s business. 
‘‘(4) Nothing in this subsection shall preempt a State 
law that provides greater protections to employees than the 
protections provided for under this subsection.’’.
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Subtitle D—Support for Prevention 
and Public Health Innovation 
SEC. 4301. RESEARCH ON OPTIMIZING THE DELIVERY OF 
PUBLIC HEALTH SERVICES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Director of the Centers for Dis-
ease Control and Prevention, shall provide funding for re-
search in the area of public health services and systems. 
(b) REQUIREMENTS
OF RESEARCH.—Research sup-
ported under this section shall include— 
(1) examining evidence-based practices relating 
to prevention, with a particular focus on high pri-
ority areas as identified by the Secretary in the Na-
tional Prevention Strategy or Healthy People 2020, 
and including comparing community-based public 
health interventions in terms of effectiveness and cost; 
(2) analyzing the translation of interventions 
from academic settings to real world settings; and 
(3) identifying effective strategies for organizing, 
financing, or delivering public health services in real 
world community settings, including comparing State 
and local health department structures and systems 
in terms of effectiveness and cost.
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(c) EXISTING PARTNERSHIPS.—Research supported 
under this section shall be coordinated with the Community 
Preventive Services Task Force and carried out by building 
on existing partnerships within the Federal Government 
while also considering initiatives at the State and local lev-
els and in the private sector. 
(d) ANNUAL REPORT.—The Secretary shall, on an an-
nual basis, submit to Congress a report concerning the ac-
tivities and findings with respect to research supported 
under this section. 
SEC. 4302. UNDERSTANDING HEALTH DISPARITIES: DATA 
COLLECTION AND ANALYSIS. 
(a) UNIFORM CATEGORIES
AND COLLECTION RE-
QUIREMENTS.—The Public Health Service Act (42 U.S.C. 
201 et seq.) is amended by adding at the end the following: 
‘‘TITLE 
XXXI—DATA 
COLLEC-
TION, ANALYSIS, AND QUAL-
ITY 
‘‘SEC. 3101. DATA COLLECTION, ANALYSIS, AND QUALITY. 
‘‘(a) DATA COLLECTION.— 
‘‘(1) IN GENERAL.—The Secretary shall ensure 
that, by not later than 2 years after the date of enact-
ment of this title, any federally conducted or sup-
ported health care or public health program, activity 
or survey (including Current Population Surveys and
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American Community Surveys conducted by the Bu-
reau of Labor Statistics and the Bureau of the Cen-
sus) collects and reports, to the extent practicable— 
‘‘(A) data on race, ethnicity, sex, primary 
language, and disability status for applicants, 
recipients, or participants; 
‘‘(B) data at the smallest geographic level 
such as State, local, or institutional levels if such 
data can be aggregated; 
‘‘(C) sufficient data to generate statistically 
reliable estimates by racial, ethnic, sex, primary 
language, and disability status subgroups for ap-
plicants, recipients or participants using, if 
needed, statistical oversamples of these sub-
populations; and 
‘‘(D) any other demographic data as deemed 
appropriate by the Secretary regarding health 
disparities. 
‘‘(2) COLLECTION
STANDARDS.—In collecting 
data described in paragraph (1), the Secretary or des-
ignee shall— 
‘‘(A) use Office of Management and Budget 
standards, at a minimum, for race and ethnicity 
measures;
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‘‘(B) develop standards for the measurement 
of sex, primary language, and disability status; 
‘‘(C) develop standards for the collection of 
data described in paragraph (1) that, at a min-
imum— 
‘‘(i) collects self-reported data by the 
applicant, recipient, or participant; and 
‘‘(ii) collects data from a parent or 
legal guardian if the applicant, recipient, 
or participant is a minor or legally inca-
pacitated; 
‘‘(D) survey health care providers and es-
tablish other procedures in order to assess access 
to care and treatment for individuals with dis-
abilities and to identify— 
‘‘(i) locations where individuals with 
disabilities access primary, acute (including 
intensive), and long-term care; 
‘‘(ii) the number of providers with ac-
cessible facilities and equipment to meet the 
needs of the individuals with disabilities, 
including medical diagnostic equipment 
that meets the minimum technical criteria 
set forth in section 510 of the Rehabilitation 
Act of 1973; and
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‘‘(iii) the number of employees of 
health care providers trained in disability 
awareness and patient care of individuals 
with disabilities; and 
‘‘(E) require that any reporting require-
ment imposed for purposes of measuring quality 
under any ongoing or federally conducted or 
supported health care or public health program, 
activity, or survey includes requirements for the 
collection of data on individuals receiving health 
care items or services under such programs ac-
tivities by race, ethnicity, sex, primary language, 
and disability status. 
‘‘(3) DATA MANAGEMENT.—In collecting data de-
scribed in paragraph (1), the Secretary, acting 
through the National Coordinator for Health Infor-
mation Technology shall— 
‘‘(A) develop national standards for the 
management of data collected; and 
‘‘(B) develop interoperability and security 
systems for data management. 
‘‘(b) DATA ANALYSIS.— 
‘‘(1) IN GENERAL.—For each federally conducted 
or supported health care or public health program or 
activity, the Secretary shall analyze data collected
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under paragraph (a) to detect and monitor trends in 
health disparities (as defined for purposes of section 
485E) at the Federal and State levels. 
‘‘(c) DATA REPORTING AND DISSEMINATION.— 
‘‘(1) IN GENERAL.—The Secretary shall make the 
analyses described in (b) available to— 
‘‘(A) the Office of Minority Health; 
‘‘(B) the National Center on Minority 
Health and Health Disparities; 
‘‘(C) the Agency for Healthcare Research 
and Quality; 
‘‘(D) the Centers for Disease Control and 
Prevention; 
‘‘(E) the Centers for Medicare & Medicaid 
Services; 
‘‘(F) the Indian Health Service and epide-
miology centers funded under the Indian Health 
Care Improvement Act; 
‘‘(G) the Office of Rural health; 
‘‘(H) other agencies within the Department 
of Health and Human Services; and 
‘‘(I) other entities as determined appro-
priate by the Secretary.
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‘‘(2) REPORTING OF DATA.—The Secretary shall 
report data and analyses described in (a) and (b) 
through— 
‘‘(A) public postings on the Internet 
websites of the Department of Health and 
Human Services; and 
‘‘(B) any other reporting or dissemination 
mechanisms determined appropriate by the Sec-
retary. 
‘‘(3) AVAILABILITY
OF
DATA.—The Secretary 
may make data described in (a) and (b) available for 
additional research, analyses, and dissemination to 
other Federal agencies, non-governmental entities, 
and the public, in accordance with any Federal agen-
cy’s data user agreements. 
‘‘(d) LIMITATIONS ON USE OF DATA.—Nothing in this 
section shall be construed to permit the use of information 
collected under this section in a manner that would ad-
versely affect any individual. 
‘‘(e) PROTECTION AND SHARING OF DATA.— 
‘‘(1) PRIVACY
AND
OTHER
SAFEGUARDS.—The 
Secretary shall ensure (through the promulgation of 
regulations or otherwise) that— 
‘‘(A) all data collected pursuant to sub-
section (a) is protected—
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‘‘(i) under privacy protections that are 
at least as broad as those that the Secretary 
applies to other health data under the regu-
lations promulgated under section 264(c) of 
the Health Insurance Portability and Ac-
countability Act of 1996 (Public Law 104– 
191; 110 Stat. 2033); and 
‘‘(ii) from all inappropriate internal 
use by any entity that collects, stores, or re-
ceives the data, including use of such data 
in determinations of eligibility (or contin-
ued eligibility) in health plans, and from 
other inappropriate uses, as defined by the 
Secretary; and 
‘‘(B) all appropriate information security 
safeguards are used in the collection, analysis, 
and sharing of data collected pursuant to sub-
section (a). 
‘‘(2) DATA SHARING.—The Secretary shall estab-
lish procedures for sharing data collected pursuant to 
subsection (a), measures relating to such data, and 
analyses of such data, with other relevant Federal 
and State agencies including the agencies, centers, 
and entities within the Department of Health and 
Human Services specified in subsection (c)(1)..
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‘‘(f) DATA ON RURAL UNDERSERVED POPULATIONS.— 
The Secretary shall ensure that any data collected in ac-
cordance with this section regarding racial and ethnic mi-
nority groups are also collected regarding underserved rural 
and frontier populations. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for each 
of fiscal years 2010 through 2014. 
‘‘(h) REQUIREMENT FOR IMPLEMENTATION.—Notwith-
standing any other provision of this section, data may not 
be collected under this section unless funds are directly ap-
propriated for such purpose in an appropriations Act. 
‘‘(i) CONSULTATION.—The Secretary shall consult with 
the Director of the Office of Personnel Management, the Sec-
retary of Defense, the Secretary of Veterans Affairs, the Di-
rector of the Bureau of the Census, the Commissioner of So-
cial Security, and the head of other appropriate Federal 
agencies in carrying out this section.’’. 
(b) ADDRESSING HEALTH CARE DISPARITIES IN MED-
ICAID AND CHIP.— 
(1) STANDARDIZED COLLECTION REQUIREMENTS 
INCLUDED IN STATE PLANS.—
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(A) MEDICAID.—Section 1902(a) of the So-
cial Security Act (42 U.S.C. 1396a(a)), as 
amended by section 2001(d), is amended— 
(i) in paragraph 4), by striking ‘‘and’’ 
at the end; 
(ii) in paragraph (75), by striking the 
period at the end and inserting ‘‘; and’’; 
and 
(iii) by inserting after paragraph (75) 
the following new paragraph: 
‘‘(76) provide that any data collected under the 
State plan meets the requirements of section 3101 of 
the Public Health Service Act.’’. 
(B) CHIP.—Section 2108(e) of the Social 
Security Act (42 U.S.C. 1397hh(e)) is amended 
by adding at the end the following new para-
graph: 
‘‘(7) Data collected and reported in accordance 
with section 3101 of the Public Health Service Act, 
with respect to individuals enrolled in the State child 
health plan (and, in the case of enrollees under 19 
years of age, their parents or legal guardians), in-
cluding data regarding the primary language of such 
individuals, parents, and legal guardians.’’.
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(2) EXTENDING MEDICARE REQUIREMENT TO AD-
DRESS HEALTH DISPARITIES DATA COLLECTION TO 
MEDICAID AND CHIP.—Title XIX of the Social Secu-
rity Act (42 U.S.C. 1396 et seq.), as amended by sec-
tion 2703 is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 1946. ADDRESSING HEALTH CARE DISPARITIES. 
‘‘(a) EVALUATING DATA COLLECTION APPROACHES.— 
The Secretary shall evaluate approaches for the collection 
of data under this title and title XXI, to be performed in 
conjunction with existing quality reporting requirements 
and programs under this title and title XXI, that allow for 
the ongoing, accurate, and timely collection and evaluation 
of data on disparities in health care services and perform-
ance on the basis of race, ethnicity, sex, primary language, 
and disability status. In conducting such evaluation, the 
Secretary shall consider the following objectives: 
‘‘(1) Protecting patient privacy. 
‘‘(2) Minimizing the administrative burdens of 
data collection and reporting on States, providers, 
and health plans participating under this title or title 
XXI. 
‘‘(3) Improving program data under this title 
and title XXI on race, ethnicity, sex, primary lan-
guage, and disability status.
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‘‘(b) REPORTS TO CONGRESS.— 
‘‘(1) REPORT ON EVALUATION.—Not later than 
18 months after the date of the enactment of this sec-
tion, the Secretary shall submit to Congress a report 
on the evaluation conducted under subsection (a). 
Such report shall, taking into consideration the re-
sults of such evaluation— 
‘‘(A) identify approaches (including defin-
ing methodologies) for identifying and collecting 
and evaluating data on health care disparities 
on the basis of race, ethnicity, sex, primary lan-
guage, and disability status for the programs 
under this title and title XXI; and 
‘‘(B) include recommendations on the most 
effective strategies and approaches to reporting 
HEDIS quality measures as required under sec-
tion 1852(e)(3) and other nationally recognized 
quality performance measures, as appropriate, 
on such bases. 
‘‘(2) REPORTS ON DATA ANALYSES.—Not later 
than 4 years after the date of the enactment of this 
section, and 4 years thereafter, the Secretary shall 
submit to Congress a report that includes rec-
ommendations for improving the identification of 
health care disparities for beneficiaries under this
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title and under title XXI based on analyses of the 
data collected under subsection (c). 
‘‘(c) IMPLEMENTING EFFECTIVE APPROACHES.—Not 
later than 24 months after the date of the enactment of this 
section, the Secretary shall implement the approaches iden-
tified in the report submitted under subsection (b)(1) for 
the ongoing, accurate, and timely collection and evaluation 
of data on health care disparities on the basis of race, eth-
nicity, sex, primary language, and disability status.’’. 
SEC. 4303. CDC AND EMPLOYER-BASED WELLNESS PRO-
GRAMS. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.), by section 4102, is further amended by adding 
at the end the following: 
‘‘PART U—EMPLOYER-BASED WELLNESS 
PROGRAM 
‘‘SEC. 399MM. TECHNICAL ASSISTANCE FOR EMPLOYER- 
BASED WELLNESS PROGRAMS. 
‘‘In order to expand the utilization of evidence-based 
prevention and health promotion approaches in the work-
place, the Director shall— 
‘‘(1) provide employers (including small, me-
dium, and large employers, as determined by the Di-
rector) with technical assistance, consultation, tools,
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and other resources in evaluating such employers’ em-
ployer-based wellness programs, including— 
‘‘(A) measuring the participation and meth-
ods to increase participation of employees in 
such programs; 
‘‘(B) developing standardized measures that 
assess policy, environmental and systems changes 
necessary to have a positive health impact on 
employees’ health behaviors, health outcomes, and 
health care expenditures; and 
‘‘(C) evaluating such programs as they re-
late to changes in the health status of employees, 
the absenteeism of employees, the productivity of 
employees, the rate of workplace injury, and the 
medical costs incurred by employees; and 
‘‘(2) build evaluation capacity among workplace 
staff by training employers on how to evaluate em-
ployer-based wellness programs by ensuring evalua-
tion resources, technical assistance, and consultation 
are available to workplace staff as needed through 
such mechanisms as web portals, call centers, or other 
means.
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‘‘SEC. 399MM–1. NATIONAL WORKSITE HEALTH POLICIES 
AND PROGRAMS STUDY. 
‘‘(a) IN GENERAL.—In order to assess, analyze, and 
monitor over time data about workplace policies and pro-
grams, and to develop instruments to assess and evaluate 
comprehensive workplace chronic disease prevention and 
health promotion programs, policies and practices, not later 
than 2 years after the date of enactment of this part, and 
at regular intervals (to be determined by the Director) 
thereafter, the Director shall conduct a national worksite 
health policies and programs survey to assess employer- 
based health policies and programs. 
‘‘(b) REPORT.—Upon the completion of each study 
under subsection (a), the Director shall submit to Congress 
a report that includes the recommendations of the Director 
for the implementation of effective employer-based health 
policies and programs. 
‘‘SEC. 399MM–2. PRIORITIZATION OF EVALUATION BY SEC-
RETARY. 
‘‘The Secretary shall evaluate, in accordance with this 
part, all programs funded through the Centers for Disease 
Control and Prevention before conducting such an evalua-
tion of privately funded programs unless an entity with a 
privately funded wellness program requests such an evalua-
tion.
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‘‘SEC. 399MM–3. PROHIBITION OF FEDERAL WORKPLACE 
WELLNESS REQUIREMENTS. 
‘‘Notwithstanding any other provision of this part, 
any recommendations, data, or assessments carried out 
under this part shall not be used to mandate requirements 
for workplace wellness programs.’’. 
SEC. 
4304. 
EPIDEMIOLOGY-LABORATORY 
CAPACITY 
GRANTS. 
Title XXVIII of the Public Health Service Act (42 
U.S.C. 300hh et seq.) is amended by adding at the end the 
following: 
‘‘Subtitle C—Strengthening Public 
Health Surveillance Systems 
‘‘SEC. 
2821. 
EPIDEMIOLOGY-LABORATORY 
CAPACITY 
GRANTS. 
‘‘(a) IN GENERAL.—Subject to the availability of ap-
propriations, the Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, shall estab-
lish an Epidemiology and Laboratory Capacity Grant Pro-
gram to award grants to State health departments as well 
as local health departments and tribal jurisdictions that 
meet such criteria as the Director determines appropriate. 
Academic centers that assist State and eligible local and 
tribal health departments may also be eligible for funding 
under this section as the Director determines appropriate. 
Grants shall be awarded under this section to assist public
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health agencies in improving surveillance for, and response 
to, infectious diseases and other conditions of public health 
importance by— 
‘‘(1) strengthening epidemiologic capacity to 
identify and monitor the occurrence of infectious dis-
eases and other conditions of public health impor-
tance; 
‘‘(2) enhancing laboratory practice as well as 
systems to report test orders and results electronically; 
‘‘(3) improving information systems including 
developing and maintaining an information exchange 
using national guidelines and complying with capac-
ities and functions determined by an advisory council 
established and appointed by the Director; and 
‘‘(4) developing and implementing prevention 
and control strategies. 
‘‘(b) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$190,000,000 for each of fiscal years 2010 through 2013, 
of which— 
‘‘(1) not less than $95,000,000 shall be made 
available each such fiscal year for activities under 
paragraphs (1) and (4) of subsection (a);
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‘‘(2) not less than $60,000,000 shall be made 
available each such fiscal year for activities under 
subsection (a)(3); and 
‘‘(3) not less than $32,000,000 shall be made 
available each such fiscal year for activities under 
subsection (a)(2).’’. 
SEC. 4305. ADVANCING RESEARCH AND TREATMENT FOR 
PAIN CARE MANAGEMENT. 
(a) INSTITUTE OF MEDICINE CONFERENCE ON PAIN.— 
(1) CONVENING.—Not later than 1 year after 
funds are appropriated to carry out this subsection, 
the Secretary of Health and Human Services shall 
seek to enter into an agreement with the Institute of 
Medicine of the National Academies to convene a Con-
ference on Pain (in this subsection referred to as ‘‘the 
Conference’’). 
(2) PURPOSES.—The purposes of the Conference 
shall be to— 
(A) increase the recognition of pain as a 
significant public health problem in the United 
States; 
(B) evaluate the adequacy of assessment, di-
agnosis, treatment, and management of acute 
and chronic pain in the general population, and 
in identified racial, ethnic, gender, age, and
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other demographic groups that may be dis-
proportionately affected by inadequacies in the 
assessment, diagnosis, treatment, and manage-
ment of pain; 
(C) identify barriers to appropriate pain 
care; 
(D) establish an agenda for action in both 
the public and private sectors that will reduce 
such barriers and significantly improve the state 
of pain care research, education, and clinical 
care in the United States. 
(3) OTHER APPROPRIATE ENTITY.—If the Insti-
tute of Medicine declines to enter into an agreement 
under paragraph (1), the Secretary of Health and 
Human Services may enter into such agreement with 
another appropriate entity. 
(4) REPORT.—A report summarizing the Con-
ference’s findings and recommendations shall be sub-
mitted to the Congress not later than June 30, 2011. 
(5) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out this subsection, there is 
authorized to be appropriated such sums as may be 
necessary for each of fiscal years 2010 and 2011. 
(b) PAIN RESEARCH AT NATIONAL INSTITUTES OF 
HEALTH.—Part B of title IV of the Public Health Service
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Act (42 U.S.C. 284 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 409J. PAIN RESEARCH. 
‘‘(a) RESEARCH INITIATIVES.— 
‘‘(1) IN GENERAL.—The Director of NIH is en-
couraged to continue and expand, through the Pain 
Consortium, an aggressive program of basic and clin-
ical research on the causes of and potential treatments 
for pain. 
‘‘(2) ANNUAL RECOMMENDATIONS.—Not less than 
annually, the Pain Consortium, in consultation with 
the Division of Program Coordination, Planning, and 
Strategic Initiatives, shall develop and submit to the 
Director of NIH recommendations on appropriate 
pain research initiatives that could be undertaken 
with funds reserved under section 402A(c)(1) for the 
Common Fund or otherwise available for such initia-
tives. 
‘‘(3) DEFINITION.—In this subsection, the term 
‘Pain Consortium’ means the Pain Consortium of the 
National Institutes of Health or a similar trans-Na-
tional Institutes of Health coordinating entity des-
ignated by the Secretary for purposes of this sub-
section.
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‘‘(b) INTERAGENCY PAIN RESEARCH COORDINATING 
COMMITTEE.— 
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish not later than 1 year after the date of the en-
actment of this section and as necessary maintain a 
committee, to be known as the Interagency Pain Re-
search Coordinating Committee (in this section re-
ferred to as the ‘Committee’), to coordinate all efforts 
within the Department of Health and Human Serv-
ices and other Federal agencies that relate to pain re-
search. 
‘‘(2) MEMBERSHIP.— 
‘‘(A) IN GENERAL.—The Committee shall be 
composed of the following voting members: 
‘‘(i) Not more than 7 voting Federal 
representatives appoint by the Secretary 
from agencies that conduct pain care re-
search and treatment. 
‘‘(ii) 12 additional voting members ap-
pointed under subparagraph (B). 
‘‘(B) ADDITIONAL
MEMBERS.—The Com-
mittee shall include additional voting members 
appointed by the Secretary as follows:
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‘‘(i) 6 non-Federal members shall be 
appointed from among scientists, physi-
cians, and other health professionals. 
‘‘(ii) 6 members shall be appointed 
from members of the general public, who are 
representatives of leading research, advo-
cacy, and service organizations for individ-
uals with pain-related conditions. 
‘‘(C) NONVOTING
MEMBERS.—The Com-
mittee shall include such nonvoting members as 
the Secretary determines to be appropriate. 
‘‘(3) CHAIRPERSON.—The voting members of the 
Committee shall select a chairperson from among such 
members. The selection of a chairperson shall be sub-
ject to the approval of the Director of NIH. 
‘‘(4) MEETINGS.—The Committee shall meet at 
the call of the chairperson of the Committee or upon 
the request of the Director of NIH, but in no case less 
often than once each year. 
‘‘(5) DUTIES.—The Committee shall— 
‘‘(A) develop a summary of advances in 
pain care research supported or conducted by the 
Federal agencies relevant to the diagnosis, pre-
vention, and treatment of pain and diseases and 
disorders associated with pain;
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‘‘(B) identify critical gaps in basic and 
clinical research on the symptoms and causes of 
pain; 
‘‘(C) make recommendations to ensure that 
the activities of the National Institutes of Health 
and other Federal agencies are free of unneces-
sary duplication of effort; 
‘‘(D) make recommendations on how best to 
disseminate information on pain care; and 
‘‘(E) make recommendations on how to ex-
pand partnerships between public entities and 
private entities to expand collaborative, cross- 
cutting research. 
‘‘(6) REVIEW.—The Secretary shall review the 
necessity of the Committee at least once every 2 
years.’’. 
(c) PAIN CARE EDUCATION AND TRAINING.—Part D 
of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended by adding at the end the following new 
section: 
‘‘SEC. 759. PROGRAM FOR EDUCATION AND TRAINING IN 
PAIN CARE. 
‘‘(a) IN GENERAL.—The Secretary may make awards 
of grants, cooperative agreements, and contracts to health 
professions schools, hospices, and other public and private
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entities for the development and implementation of pro-
grams to provide education and training to health care pro-
fessionals in pain care. 
‘‘(b) CERTAIN TOPICS.—An award may be made under 
subsection (a) only if the applicant for the award agrees 
that the program carried out with the award will include 
information and education on— 
‘‘(1) recognized means for assessing, diagnosing, 
treating, and managing pain and related signs and 
symptoms, including the medically appropriate use of 
controlled substances; 
‘‘(2) applicable laws, regulations, rules, and poli-
cies on controlled substances, including the degree to 
which misconceptions and concerns regarding such 
laws, regulations, rules, and policies, or the enforce-
ment thereof, may create barriers to patient access to 
appropriate and effective pain care; 
‘‘(3) interdisciplinary approaches to the delivery 
of pain care, including delivery through specialized 
centers providing comprehensive pain care treatment 
expertise; 
‘‘(4) cultural, linguistic, literacy, geographic, 
and other barriers to care in underserved populations; 
and
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‘‘(5) recent findings, developments, and improve-
ments in the provision of pain care. 
‘‘(c) EVALUATION OF PROGRAMS.—The Secretary shall 
(directly or through grants or contracts) provide for the 
evaluation of programs implemented under subsection (a) 
in order to determine the effect of such programs on knowl-
edge and practice of pain care. 
‘‘(d) PAIN CARE DEFINED.—For purposes of this sec-
tion the term ‘pain care’ means the assessment, diagnosis, 
treatment, or management of acute or chronic pain regard-
less of causation or body location. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, such 
sums as may be necessary for each of the fiscal years 2010 
through 2012. Amounts appropriated under this subsection 
shall remain available until expended.’’. 
SEC. 4306. FUNDING FOR CHILDHOOD OBESITY DEM-
ONSTRATION PROJECT. 
Section 1139A(e)(8) of the Social Security Act (42 
U.S.C. 1320b–9a(e)(8)) is amended to read as follows: 
‘‘(8) APPROPRIATION.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated to carry out this subsection, $25,000,000 for 
the period of fiscal years 2010 through 2014.’’.
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Subtitle E—Miscellaneous 
Provisions 
SEC. 4401. SENSE OF THE SENATE CONCERNING CBO SCOR-
ING. 
(a) FINDING.—The Senate finds that the costs of pre-
vention programs are difficult to estimate due in part be-
cause prevention initiatives are hard to measure and results 
may occur outside the 5 and 10 year budget windows. 
(b) SENSE OF CONGRESS.—It is the sense of the Senate 
that Congress should work with the Congressional Budget 
Office to develop better methodologies for scoring progress 
to be made in prevention and wellness programs. 
SEC. 4402. EFFECTIVENESS OF FEDERAL HEALTH AND 
WELLNESS INITIATIVES. 
To determine whether existing Federal health and 
wellness initiatives are effective in achieving their stated 
goals, the Secretary of Health and Human Services shall— 
(1) conduct an evaluation of such programs as 
they relate to changes in health status of the Amer-
ican public and specifically on the health status of the 
Federal workforce, including absenteeism of employ-
ees, the productivity of employees, the rate of work-
place injury, and the medical costs incurred by em-
ployees, and health conditions, including workplace
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fitness, healthy food and beverages, and incentives in 
the Federal Employee Health Benefits Program; and 
(2) submit to Congress a report concerning such 
evaluation, which shall include conclusions con-
cerning the reasons that such existing programs have 
proven successful or not successful and what factors 
contributed to such conclusions. 
TITLE V—HEALTH CARE 
WORKFORCE 
Subtitle A—Purpose and 
Definitions 
SEC. 5001. PURPOSE. 
The purpose of this title is to improve access to and 
the delivery of health care services for all individuals, par-
ticularly low income, underserved, uninsured, minority, 
health disparity, and rural populations by— 
(1) gathering and assessing comprehensive data 
in order for the health care workforce to meet the 
health care needs of individuals, including research 
on the supply, demand, distribution, diversity, and 
skills needs of the health care workforce; 
(2) increasing the supply of a qualified health 
care workforce to improve access to and the delivery 
of health care services for all individuals;
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(3) enhancing health care workforce education 
and training to improve access to and the delivery of 
health care services for all individuals; and 
(4) providing support to the existing health care 
workforce to improve access to and the delivery of 
health care services for all individuals. 
SEC. 5002. DEFINITIONS. 
(a) THIS TITLE.—In this title: 
(1) ALLIED HEALTH PROFESSIONAL.—The term 
‘‘allied health professional’’ means an allied health 
professional as defined in section 799B(5) of the Pub-
lic Heath Service Act (42 U.S.C. 295p(5)) who— 
(A) has graduated and received an allied 
health professions degree or certificate from an 
institution of higher education; and 
(B) is employed with a Federal, State, local 
or tribal public health agency, or in a setting 
where patients might require health care services, 
including acute care facilities, ambulatory care 
facilities, personal residences, and other settings 
located in health professional shortage areas, 
medically underserved areas, or medically under-
served populations, as recognized by the Sec-
retary of Health and Human Services.
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(2) HEALTH CARE CAREER PATHWAY.—The term 
‘‘healthcare career pathway’’ means a rigorous, en-
gaging, and high quality set of courses and services 
that— 
(A) includes an articulated sequence of aca-
demic and career courses, including 21st century 
skills; 
(B) is aligned with the needs of healthcare 
industries in a region or State; 
(C) prepares students for entry into the full 
range of postsecondary education options, in-
cluding registered apprenticeships, and careers; 
(D) provides academic and career coun-
seling in student-to-counselor ratios that allow 
students to make informed decisions about aca-
demic and career options; 
(E) meets State academic standards, State 
requirements for secondary school graduation 
and is aligned with requirements for entry into 
postsecondary education, and applicable indus-
try standards; and 
(F) leads to 2 or more credentials, includ-
ing— 
(i) a secondary school diploma; and
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(ii) a postsecondary degree, an appren-
ticeship or other occupational certification, 
a certificate, or a license. 
(3) INSTITUTION OF HIGHER EDUCATION.—The 
term ‘‘institution of higher education’’ has the mean-
ing given the term in sections 101 and 102 of the 
Higher Education Act of 1965 (20 U.S.C. 1001 and 
1002). 
(4) LOW
INCOME
INDIVIDUAL, STATE
WORK-
FORCE INVESTMENT BOARD, AND LOCAL WORKFORCE 
INVESTMENT BOARD.— 
(A) LOW-INCOME
INDIVIDUAL.—The term 
‘‘low-income individual’’ has the meaning given 
that term in section 101 of the Workforce invest-
ment Act of 1998 (29 U.S.C. 2801). 
(B) 
STATE
WORKFORCE
INVESTMENT 
BOARD; 
LOCAL
WORKFORCE
INVESTMENT 
BOARD.—The terms ‘‘State workforce investment 
board’’ and ‘‘local workforce investment board’’, 
refer to a State workforce investment board es-
tablished under section 111 of the Workforce In-
vestment Act of 1998 (29 U.S.C. 2821) and a 
local workforce investment board established 
under section 117 of such Act (29 U.S.C. 2832), 
respectively.
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(5) POSTSECONDARY
EDUCATION.—The term 
‘‘postsecondary education’’ means— 
(A) a 4-year program of instruction, or not 
less than a 1-year program of instruction that is 
acceptable for credit toward an associate or a 
baccalaureate degree, offered by an institution of 
higher education; or 
(B) a certificate or registered apprentice-
ship program at the postsecondary level offered 
by an institution of higher education or a non- 
profit educational institution. 
(6) REGISTERED APPRENTICESHIP PROGRAM.— 
The term ‘‘registered apprenticeship program’’ means 
an industry skills training program at the postsec-
ondary level that combines technical and theoretical 
training through structure on the job learning with 
related instruction (in a classroom or through dis-
tance learning) while an individual is employed, 
working under the direction of qualified personnel or 
a mentor, and earning incremental wage increases 
aligned to enhance job proficiency, resulting in the 
acquisition of a nationally recognized and portable 
certificate, under a plan approved by the Office of 
Apprenticeship or a State agency recognized by the 
Department of Labor.
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(b) TITLE VII OF THE PUBLIC HEALTH SERVICE 
ACT.—Section 799B of the Public Health Service Act (42 
U.S.C. 295p) is amended— 
(1) by striking paragraph (3) and inserting the 
following: 
‘‘(3) PHYSICIAN
ASSISTANT
EDUCATION
PRO-
GRAM.—The term ‘physician assistant education pro-
gram’ means an educational program in a public or 
private institution in a State that— 
‘‘(A) has as its objective the education of in-
dividuals who, upon completion of their studies 
in the program, be qualified to provide primary 
care medical services with the supervision of a 
physician; and 
‘‘(B) is accredited by the Accreditation Re-
view Commission on Education for the Physi-
cian Assistant.’’; and 
(2) by adding at the end the following: 
‘‘(12) AREA HEALTH EDUCATION CENTER.—The 
term ‘area health education center’ means a public or 
nonprofit private organization that has a cooperative 
agreement or contract in effect with an entity that 
has received an award under subsection (a)(1) or 
(a)(2) of section 751, satisfies the requirements in sec-
tion 751(d)(1), and has as one of its principal func-
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tions the operation of an area health education center. 
Appropriate organizations may include hospitals, 
health organizations with accredited primary care 
training programs, accredited physician assistant 
educational programs associated with a college or 
university, and universities or colleges not operating 
a school of medicine or osteopathic medicine. 
‘‘(13) AREA HEALTH EDUCATION CENTER PRO-
GRAM.—The term ‘area health education center pro-
gram’ means cooperative program consisting of an 
entity that has received an award under subsection 
(a)(1) or (a)(2) of section 751 for the purpose of plan-
ning, developing, operating, and evaluating an area 
health education center program and one or more 
area health education centers, which carries out the 
required activities described in section 751(c), satis-
fies the program requirements in such section, has as 
one of its principal functions identifying and imple-
menting strategies and activities that address health 
care workforce needs in its service area, in coordina-
tion with the local workforce investment boards. 
‘‘(14) CLINICAL
SOCIAL
WORKER.—The term 
‘clinical social worker’ has the meaning given the 
term in section 1861(hh)(1) of the Social Security Act 
(42 U.S.C. 1395x(hh)(1)).
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‘‘(15) CULTURAL COMPETENCY.—The term ‘cul-
tural competency’ shall be defined by the Secretary in 
a manner consistent with section 1707(d)(3). 
‘‘(16) DIRECT CARE WORKER.—The term ‘direct 
care worker’ has the meaning given that term in the 
2010 Standard Occupational Classifications of the 
Department of Labor for Home Health Aides [31– 
1011], Psychiatric Aides [31–1013], Nursing Assist-
ants [31–1014], and Personal Care Aides [39–9021]. 
‘‘(17) FEDERALLY
QUALIFIED
HEALTH
CEN-
TER.—The term ‘Federally qualified health center’ 
has the meaning given that term in section 1861(aa) 
of the Social Security Act (42 U.S.C. 1395x(aa)). 
‘‘(18) FRONTIER HEALTH PROFESSIONAL SHORT-
AGE
AREA.—The term ‘frontier health professional 
shortage area’ means an area— 
‘‘(A) with a population density less than 6 
persons per square mile within the service area; 
and 
‘‘(B) with respect to which the distance or 
time for the population to access care is exces-
sive. 
‘‘(19) GRADUATE PSYCHOLOGY.—The term ‘grad-
uate psychology’ means an accredited program in 
professional psychology.
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‘‘(20) HEALTH
DISPARITY
POPULATION.—The 
term ‘health disparity population’ has the meaning 
given such term in section 903(d)(1). 
‘‘(21) HEALTH LITERACY.—The term ‘health lit-
eracy’ means the degree to which an individual has 
the capacity to obtain, communicate, process, and un-
derstand health information and services in order to 
make appropriate health decisions. 
‘‘(22) 
MENTAL
HEALTH
SERVICE
PROFES-
SIONAL.—The term ‘mental health service profes-
sional’ means an individual with a graduate or post-
graduate degree from an accredited institution of 
higher education in psychiatry, psychology, school 
psychology, behavioral pediatrics, psychiatric nurs-
ing, social work, school social work, substance abuse 
disorder prevention and treatment, marriage and 
family counseling, school counseling, or professional 
counseling. 
‘‘(23) ONE-STOP DELIVERY SYSTEM CENTER.— 
The term ‘one-stop delivery system’ means a one-stop 
delivery system described in section 134(c) of the 
Workforce Investment Act of 1998 (29 U.S.C. 
2864(c)). 
‘‘(24) PARAPROFESSIONAL CHILD AND ADOLES-
CENT MENTAL HEALTH WORKER.—The term ‘para-
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professional child and adolescent mental health work-
er’ means an individual who is not a mental or be-
havioral health service professional, but who works at 
the first stage of contact with children and families 
who are seeking mental or behavioral health services, 
including substance abuse prevention and treatment 
services. 
‘‘(25) RACIAL AND ETHNIC MINORITY GROUP; RA-
CIAL AND ETHNIC MINORITY POPULATION.—The terms 
‘racial and ethnic minority group’ and ‘racial and 
ethnic minority population’ have the meaning given 
the term ‘racial and ethnic minority group’ in section 
1707. 
‘‘(26) RURAL HEALTH CLINIC.—The term ‘rural 
health clinic’ has the meaning given that term in sec-
tion 1861(aa) of the Social Security Act (42 U.S.C. 
1395x(aa)).’’. 
(c) TITLE VIII OF THE PUBLIC HEALTH SERVICE 
ACT.—Section 801 of the Public Health Service Act (42 
U.S.C. 296) is amended— 
(1) in paragraph (2)— 
(A) by striking ‘‘means a’’ and inserting 
‘‘means an accredited (as defined in paragraph 
6)’’; and
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(B) by striking the period as inserting the 
following: ‘‘where graduates are— 
‘‘(A) authorized to sit for the National 
Council 
Licensure 
EXamination-Registered 
Nurse (NCLEX–RN); or 
‘‘(B) licensed registered nurses who will re-
ceive a graduate or equivalent degree or training 
to become an advanced education nurse as de-
fined by section 811(b).’’; and 
(2) by adding at the end the following: 
‘‘(16) ACCELERATED
NURSING
DEGREE
PRO-
GRAM.—The term ‘accelerated nursing degree pro-
gram’ means a program of education in professional 
nursing offered by an accredited school of nursing in 
which an individual holding a bachelors degree in an-
other discipline receives a BSN or MSN degree in an 
accelerated time frame as determined by the accred-
ited school of nursing. 
‘‘(17) BRIDGE
OR
DEGREE
COMPLETION
PRO-
GRAM.—The term ‘bridge or degree completion pro-
gram’ means a program of education in professional 
nursing offered by an accredited school of nursing, as 
defined in paragraph (2), that leads to a bacca-
laureate degree in nursing. Such programs may in-
clude, Registered Nurse (RN) to Bachelor’s of Science
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of Nursing (BSN) programs, RN to MSN (Master of 
Science of Nursing) programs, or BSN to Doctoral 
programs.’’. 
Subtitle B—Innovations in the 
Health Care Workforce 
SEC. 5101. NATIONAL HEALTH CARE WORKFORCE COMMIS-
SION. 
(a) PURPOSE.—It is the purpose of this section to es-
tablish a National Health Care Workforce Commission 
that— 
(1) serves as a national resource for Congress, 
the President, States, and localities; 
(2) communicates and coordinates with the De-
partments of Health and Human Services, Labor, 
Veterans Affairs, Homeland Security, and Education 
on related activities administered by one or more of 
such Departments; 
(3) develops and commissions evaluations of edu-
cation and training activities to determine whether 
the demand for health care workers is being met; 
(4) identifies barriers to improved coordination 
at the Federal, State, and local levels and recommend 
ways to address such barriers; and
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(5) encourages innovations to address population 
needs, constant changes in technology, and other envi-
ronmental factors. 
(b) ESTABLISHMENT.—There is hereby established the 
National Health Care Workforce Commission (in this sec-
tion referred to as the ‘‘Commission’’). 
(c) MEMBERSHIP.— 
(1) NUMBER AND APPOINTMENT.—The Commis-
sion shall be composed of 15 members to be appointed 
by the Comptroller General, without regard to section 
5 of the Federal Advisory Committee Act (5 U.S.C. 
App.). 
(2) QUALIFICATIONS.— 
(A) IN GENERAL.—The membership of the 
Commission shall include individuals— 
(i) with national recognition for their 
expertise in health care labor market anal-
ysis, including health care workforce anal-
ysis; health care finance and economics; 
health care facility management; health care 
plans and integrated delivery systems; 
health care workforce education and train-
ing; health care philanthropy; providers of 
health care services; and other related fields; 
and
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(ii) who will provide a combination of 
professional perspectives, broad geographic 
representation, and a balance between 
urban, suburban, rural, and frontier rep-
resentatives. 
(B) INCLUSION.— 
(i) IN GENERAL.—The membership of 
the Commission shall include no less than 
one representative of— 
(I) the health care workforce and 
health professionals; 
(II) employers; 
(III) third-party payers; 
(IV) individuals skilled in the 
conduct and interpretation of health 
care services and health economics re-
search; 
(V) representatives of consumers; 
(VI) labor unions; 
(VII) State or local workforce in-
vestment boards; and 
(VIII) 
educational 
institutions 
(which may include elementary and 
secondary institutions, institutions of 
higher education, including 2 and 4
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year institutions, or registered appren-
ticeship programs). 
(ii) ADDITIONAL
MEMBERS.—The re-
maining membership may include addi-
tional representatives from clause (i) and 
other individuals as determined appropriate 
by the Comptroller General of the United 
States. 
(C) MAJORITY
NON-PROVIDERS.—Individ-
uals who are directly involved in health profes-
sions education or practice shall not constitute a 
majority of the membership of the Commission. 
(D) ETHICAL
DISCLOSURE.—The Comp-
troller General shall establish a system for public 
disclosure by members of the Commission of fi-
nancial and other potential conflicts of interest 
relating to such members. Members of the Com-
mission shall be treated as employees of Congress 
for purposes of applying title I of the Ethics in 
Government Act of 1978. Members of the Com-
mission shall not be treated as special govern-
ment employees under title 18, United States 
Code. 
(3) TERMS.—
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(A) IN GENERAL.—The terms of members of 
the Commission shall be for 3 years except that 
the Comptroller General shall designate staggered 
terms for the members first appointed. 
(B) VACANCIES.—Any member appointed to 
fill a vacancy occurring before the expiration of 
the term for which the member’s predecessor was 
appointed shall be appointed only for the re-
mainder of that term. A member may serve after 
the expiration of that member’s term until a suc-
cessor has taken office. A vacancy in the Com-
mission shall be filled in the manner in which 
the original appointment was made. 
(C) INITIAL
APPOINTMENTS.—The Comp-
troller General shall make initial appointments 
of members to the Commission not later than 
September 30, 2010. 
(4) COMPENSATION.—While serving on the busi-
ness of the Commission (including travel time), a 
member of the Commission shall be entitled to com-
pensation at the per diem equivalent of the rate pro-
vided for level IV of the Executive Schedule under sec-
tion 5315 of tile 5, United States Code, and while so 
serving away from home and the member’s regular 
place of business, a member may be allowed travel ex-
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penses, as authorized by the Chairman of the Com-
mission. Physicians serving as personnel of the Com-
mission may be provided a physician comparability 
allowance by the Commission in the same manner as 
Government physicians may be provided such an al-
lowance by an agency under section 5948 of title 5, 
United States Code, and for such purpose subsection 
(i) of such section shall apply to the Commission in 
the same manner as it applies to the Tennessee Valley 
Authority. For purposes of pay (other than pay of 
members of the Commission) and employment bene-
fits, rights, and privileges, all personnel of the Com-
mission shall be treated as if they were employees of 
the United States Senate. Personnel of the Commis-
sion shall not be treated as employees of the Govern-
ment Accountability Office for any purpose. 
(5) CHAIRMAN, VICE
CHAIRMAN.—The Comp-
troller General shall designate a member of the Com-
mission, at the time of appointment of the member, 
as Chairman and a member as Vice Chairman for 
that term of appointment, except that in the case of 
vacancy of the chairmanship or vice chairmanship, 
the Comptroller General may designate another mem-
ber for the remainder of that member’s term.
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(6) MEETINGS.—The Commission shall meet at 
the call of the chairman, but no less frequently than 
on a quarterly basis. 
(d) DUTIES.— 
(1) RECOGNITION, DISSEMINATION, AND COMMU-
NICATION.—The Commission shall— 
(A) recognize efforts of Federal, State, and 
local partnerships to develop and offer health 
care career pathways of proven effectiveness; 
(B) disseminate information on promising 
retention practices for health care professionals; 
and 
(C) communicate information on important 
policies and practices that affect the recruitment, 
education and training, and retention of the 
health care workforce. 
(2) REVIEW OF HEALTH CARE WORKFORCE AND 
ANNUAL REPORTS.—In order to develop a fiscally sus-
tainable integrated workforce that supports a high- 
quality, readily accessible health care delivery system 
that meets the needs of patients and populations, the 
Commission, in consultation with relevant Federal, 
State, and local agencies, shall—
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(A) review current and projected health care 
workforce supply and demand, including the top-
ics described in paragraph (3); 
(B) make recommendations to Congress and 
the Administration concerning national health 
care workforce priorities, goals, and policies; 
(C) by not later than October 1 of each year 
(beginning with 2011), submit a report to Con-
gress and the Administration containing the re-
sults of such reviews and recommendations con-
cerning related policies; and 
(D) by not later than April 1 of each year 
(beginning with 2011), submit a report to Con-
gress and the Administration containing a re-
view of, and recommendations on, at a min-
imum one high priority area as described in 
paragraph (4). 
(3) SPECIFIC
TOPICS
TO
BE
REVIEWED.—The 
topics described in this paragraph include— 
(A) current health care workforce supply 
and distribution, including demographics, skill 
sets, and demands, with projected demands dur-
ing the subsequent 10 and 25 year periods; 
(B) health care workforce education and 
training capacity, including the number of stu-
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2006 (20 U.S.C. 2301 et seq.), the Higher Edu-
cation Act of 1965 (20 U.S.C. 1001 et seq.), and 
any other Federal health care workforce pro-
grams; 
(E) the health care workforce needs of spe-
cial populations, such as minorities, rural popu-
lations, medically underserved populations, gen-
der specific needs, individuals with disabilities, 
and geriatric and pediatric populations with 
recommendations for new and existing Federal 
policies to meet the needs of these special popu-
lations; and 
(F) recommendations creating or revising 
national loan repayment programs and scholar-
ship programs to require low-income, minority 
medical students to serve in their home commu-
nities, if designated as medical underserved com-
munity. 
(4) HIGH PRIORITY AREAS.— 
(A) IN GENERAL.—The initial high priority 
topics described in this paragraph include each 
of the following: 
(i) Integrated health care workforce 
planning that identifies health care profes-
sional skills needed and maximizes the skill
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sets of health care professionals across dis-
ciplines. 
(ii) An analysis of the nature, scopes of 
practice, and demands for health care work-
ers in the enhanced information technology 
and management workplace. 
(iii) An analysis of how to align Medi-
care and Medicaid graduate medical edu-
cation policies with national workforce 
goals. 
(iv) The education and training capac-
ity, projected demands, and integration 
with the health care delivery system of each 
of the following: 
(I) Nursing workforce capacity at 
all levels. 
(II) Oral health care workforce ca-
pacity at all levels. 
(III) 
Mental 
and 
behavioral 
health care workforce capacity at all 
levels. 
(IV) Allied health and public 
health care workforce capacity at all 
levels.
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(V) Emergency medical service 
workforce capacity, including the re-
tention and recruitment of the volun-
teer workforce, at all levels. 
(VI) The geographic distribution 
of health care providers as compared to 
the identified health care workforce 
needs of States and regions. 
(B) FUTURE DETERMINATIONS.—The Com-
mission may require that additional topics be 
included under subparagraph (A). The appro-
priate committees of Congress may recommend to 
the Commission the inclusion of other topics for 
health care workforce development areas that re-
quire special attention. 
(5) GRANT PROGRAM.—The Commission shall— 
(A) review implementation progress reports 
on, and report to Congress about, the State 
Health Care Workforce Development Grant pro-
gram established in section 5102; 
(B) in collaboration with the Department of 
Labor and in coordination with the Department 
of Education and other relevant Federal agen-
cies, make recommendations to the fiscal and ad-
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ministrative agent under section 5102(b) for 
grant recipients under section 5102; 
(C) assess the implementation of the grants 
under such section; and 
(D) collect performance and report informa-
tion, including identified models and best prac-
tices, on grants from the fiscal and administra-
tive agent under such section and distribute this 
information to Congress, relevant Federal agen-
cies, and to the public. 
(6) STUDY.—The Commission shall study effec-
tive mechanisms for financing education and training 
for careers in health care, including public health and 
allied health. 
(7) RECOMMENDATIONS.—The Commission shall 
submit recommendations to Congress, the Department 
of Labor, and the Department of Health and Human 
Services about improving safety, health, and worker 
protections in the workplace for the health care work-
force. 
(8) ASSESSMENT.—The Commission shall assess 
and receive reports from the National Center for 
Health Care Workforce Analysis established under sec-
tion 761(b) of the Public Service Health Act (as 
amended by section 5103).
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(e) CONSULTATION
WITH
FEDERAL, STATE, AND 
LOCAL AGENCIES, CONGRESS, AND OTHER ORGANIZA-
TIONS.— 
(1) IN GENERAL.—The Commission shall consult 
with Federal agencies (including the Departments of 
Health and Human Services, Labor, Education, Com-
merce, Agriculture, Defense, and Veterans Affairs and 
the Environmental Protection Agency), Congress, the 
Medicare Payment Advisory Commission, the Med-
icaid and CHIP Payment and Access Commission, 
and, to the extent practicable, with State and local 
agencies, Indian tribes, voluntary health care organi-
zations, professional societies, and other relevant pub-
lic-private health care partnerships. 
(2) OBTAINING OFFICIAL DATA.—The Commis-
sion, consistent with established privacy rules, may 
secure directly from any department or agency of the 
Executive Branch information necessary to enable the 
Commission to carry out this section. 
(3) DETAIL OF FEDERAL GOVERNMENT EMPLOY-
EES.—An employee of the Federal Government may 
be detailed to the Commission without reimbursement. 
The detail of such an employee shall be without inter-
ruption or loss of civil service status.
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(f) DIRECTOR AND STAFF; EXPERTS AND CONSULT-
ANTS.—Subject to such review as the Comptroller General 
of the United States determines to be necessary to ensure 
the efficient administration of the Commission, the Com-
mission may— 
(1) employ and fix the compensation of an exec-
utive director that shall not exceed the rate of basic 
pay payable for level V of the Executive Schedule and 
such other personnel as may be necessary to carry out 
its duties (without regard to the provisions of title 5, 
United States Code, governing appointments in the 
competitive service); 
(2) seek such assistance and support as may be 
required in the performance of its duties from appro-
priate Federal departments and agencies; 
(3) enter into contracts or make other arrange-
ments, as may be necessary for the conduct of the 
work of the Commission (without regard to section 
3709 of the Revised Statutes (41 U.S.C. 5)); 
(4) make advance, progress, and other payments 
which relate to the work of the Commission; 
(5) provide transportation and subsistence for 
persons serving without compensation; and 
(6) prescribe such rules and regulations as the 
Commission determines to be necessary with respect
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to the internal organization and operation of the 
Commission. 
(g) POWERS.— 
(1) DATA COLLECTION.—In order to carry out 
its functions under this section, the Commission 
shall— 
(A) utilize existing information, both pub-
lished and unpublished, where possible, collected 
and assessed either by its own staff or under 
other arrangements made in accordance with 
this section, including coordination with the Bu-
reau of Labor Statistics; 
(B) carry out, or award grants or contracts 
for the carrying out of, original research and de-
velopment, where existing information is inad-
equate, and 
(C) adopt procedures allowing interested 
parties to submit information for the Commis-
sion’s use in making reports and recommenda-
tions. 
(2) ACCESS
OF
THE
GOVERNMENT
ACCOUNT-
ABILITY OFFICE TO INFORMATION.—The Comptroller 
General of the United States shall have unrestricted 
access to all deliberations, records, and data of the 
Commission, immediately upon request.
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(3) PERIODIC AUDIT.—The Commission shall be 
subject to periodic audit by an independent public ac-
countant under contract to the Commission. 
(h) AUTHORIZATION OF APPROPRIATIONS.— 
(1) REQUEST FOR APPROPRIATIONS.—The Com-
mission shall submit requests for appropriations in 
the same manner as the Comptroller General of the 
United States submits requests for appropriations. 
Amounts so appropriated for the Commission shall be 
separate from amounts appropriated for the Comp-
troller General. 
(2) AUTHORIZATION.—There are authorized to be 
appropriated such sums as may be necessary to carry 
out this section. 
(3) GIFTS
AND
SERVICES.—The Commission 
may not accept gifts, bequeaths, or donations of prop-
erty, but may accept and use donations of services for 
purposes of carrying out this section. 
(i) DEFINITIONS.—In this section: 
(1) HEALTH
CARE
WORKFORCE.—The term 
‘‘health care workforce’’ includes all health care pro-
viders with direct patient care and support respon-
sibilities, such as physicians, nurses, nurse practi-
tioners, primary care providers, preventive medicine 
physicians, optometrists, ophthalmologists, physician
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assistants, pharmacists, dentists, dental hygienists, 
and other oral healthcare professionals, allied health 
professionals, doctors of chiropractic, community 
health workers, health care paraprofessionals, direct 
care workers, psychologists and other behavioral and 
mental health professionals (including substance 
abuse prevention and treatment providers), social 
workers, physical and occupational therapists, cer-
tified nurse midwives, podiatrists, the EMS workforce 
(including professional and volunteer ambulance per-
sonnel and firefighters who perform emergency med-
ical services), licensed complementary and alternative 
medicine providers, integrative health practitioners, 
public health professionals, and any other health pro-
fessional that the Comptroller General of the United 
States determines appropriate. 
(2) HEALTH PROFESSIONALS.—The term ‘‘health 
professionals’’ includes— 
(A) dentists, dental hygienists, primary 
care providers, specialty physicians, nurses, 
nurse practitioners, physician assistants, psy-
chologists and other behavioral and mental 
health professionals (including substance abuse 
prevention and treatment providers), social 
workers, physical and occupational therapists,
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public health professionals, clinical pharmacists, 
allied health professionals, doctors of chiro-
practic, 
community 
health 
workers, 
school 
nurses, certified nurse midwives, podiatrists, li-
censed complementary and alternative medicine 
providers, the EMS workforce (including profes-
sional and volunteer ambulance personnel and 
firefighters who perform emergency medical serv-
ices), and integrative health practitioners; 
(B) national representatives of health pro-
fessionals; 
(C) representatives of schools of medicine, 
osteopathy, nursing, dentistry, optometry, phar-
macy, chiropractic, allied health, educational 
programs for public health professionals, behav-
ioral and mental health professionals (as so de-
fined), social workers, pharmacists, physical and 
occupational therapists, oral health care indus-
try dentistry and dental hygiene, and physician 
assistants; 
(D) representatives of public and private 
teaching hospitals, and ambulatory health facili-
ties, including Federal medical facilities; and
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(E) any other health professional the Comp-
troller General of the United States determines 
appropriate. 
SEC. 5102. STATE HEALTH CARE WORKFORCE DEVELOP-
MENT GRANTS. 
(a) ESTABLISHMENT.—There is established a competi-
tive health care workforce development grant program (re-
ferred to in this section as the ‘‘program’’) for the purpose 
of enabling State partnerships to complete comprehensive 
planning and to carry out activities leading to coherent and 
comprehensive health care workforce development strategies 
at the State and local levels. 
(b) FISCAL
AND
ADMINISTRATIVE
AGENT.—The 
Health Resources and Services Administration of the De-
partment of Health and Human Services (referred to in this 
section as the ‘‘Administration’’) shall be the fiscal and ad-
ministrative agent for the grants awarded under this sec-
tion. The Administration is authorized to carry out the pro-
gram, in consultation with the National Health Care Work-
force Commission (referred to in this section as the ‘‘Com-
mission’’), which shall review reports on the development, 
implementation, and evaluation activities of the grant pro-
gram, including— 
(1) administering the grants;
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(2) providing technical assistance to grantees; 
and 
(3) reporting performance information to the 
Commission. 
(c) PLANNING GRANTS.— 
(1) AMOUNT AND DURATION.—A planning grant 
shall be awarded under this subsection for a period of 
not more than one year and the maximum award 
may not be more than $150,000. 
(2) ELIGIBILITY.—To be eligible to receive a 
planning grant, an entity shall be an eligible partner-
ship. An eligible partnership shall be a State work-
force investment board, if it includes or modifies the 
members to include at least one representative from 
each of the following: health care employer, labor or-
ganization, a public 2-year institution of higher edu-
cation, a public 4-year institution of higher edu-
cation, the recognized State federation of labor, the 
State public secondary education agency, the State 
P–16 or P–20 Council if such a council exists, and 
a philanthropic organization that is actively engaged 
in providing learning, mentoring, and work opportu-
nities to recruit, educate, and train individuals for, 
and retain individuals in, careers in health care and 
related industries.
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(3) FISCAL AND ADMINISTRATIVE AGENT.—The 
Governor of the State receiving a planning grant has 
the authority to appoint a fiscal and an administra-
tive agency for the partnership. 
(4) APPLICATION.—Each State partnership de-
siring a planning grant shall submit an application 
to the Administrator of the Administration at such 
time and in such manner, and accompanied by such 
information as the Administrator may reasonable re-
quire. Each application submitted for a planning 
grant shall describe the members of the State partner-
ship, the activities for which assistance is sought, the 
proposed performance benchmarks to be used to meas-
ure progress under the planning grant, a budget for 
use of the funds to complete the required activities de-
scribed in paragraph (5), and such additional assur-
ance and information as the Administrator deter-
mines to be essential to ensure compliance with the 
grant program requirements. 
(5) REQUIRED ACTIVITIES.—A State partnership 
receiving a planning grant shall carry out the fol-
lowing: 
(A) Analyze State labor market information 
in order to create health care career pathways
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for students and adults, including dislocated 
workers. 
(B) Identify current and projected high de-
mand State or regional health care sectors for 
purposes of planning career pathways. 
(C) Identify existing Federal, State, and 
private resources to recruit, educate or train, 
and retain a skilled health care workforce and 
strengthen partnerships. 
(D) Describe the academic and health care 
industry skill standards for high school gradua-
tion, for entry into postsecondary education, and 
for various credentials and licensure. 
(E) Describe State secondary and postsec-
ondary education and training policies, models, 
or practices for the health care sector, including 
career information and guidance counseling. 
(F) Identify Federal or State policies or 
rules to developing a coherent and comprehensive 
health care workforce development strategy and 
barriers and a plan to resolve these barriers. 
(G) Participate in the Administration’s 
evaluation and reporting activities. 
(6) PERFORMANCE AND EVALUATION.—Before the 
State partnership receives a planning grant, such
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partnership and the Administrator of the Administra-
tion shall jointly determine the performance bench-
marks that will be established for the purposes of the 
planning grant. 
(7) MATCH.—Each State partnership receiving a 
planning grant shall provide an amount, in cash or 
in kind, that is not less that 15 percent of the amount 
of the grant, to carry out the activities supported by 
the grant. The matching requirement may be provided 
from funds available under other Federal, State, local 
or private sources to carry out the activities. 
(8) REPORT.— 
(A) REPORT
TO
ADMINISTRATION.—Not 
later than 1 year after a State partnership re-
ceives a planning grant, the partnership shall 
submit a report to the Administration on the 
State’s performance of the activities under the 
grant, including the use of funds, including 
matching funds, to carry out required activities, 
and a description of the progress of the State 
workforce investment board in meeting the per-
formance benchmarks. 
(B) REPORT TO CONGRESS.—The Adminis-
tration shall submit a report to Congress ana-
lyzing the planning activities, performance, and
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fund utilization of each State grant recipient, 
including an identification of promising prac-
tices and a profile of the activities of each State 
grant recipient. 
(d) IMPLEMENTATION GRANTS.— 
(1) IN GENERAL.—The Administration shall— 
(A) competitively award implementation 
grants to State partnerships to enable such part-
nerships to implement activities that will result 
in a coherent and comprehensive plan for health 
workforce development that will address current 
and projected workforce demands within the 
State; and 
(B) inform the Commission and Congress 
about the awards made. 
(2) DURATION.—An implementation grant shall 
be awarded for a period of no more than 2 years, ex-
cept in those cases where the Administration deter-
mines that the grantee is high performing and the ac-
tivities supported by the grant warrant up to 1 addi-
tional year of funding. 
(3) ELIGIBILITY.—To be eligible for an imple-
mentation grant, a State partnership shall have—
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(A) received a planning grant under sub-
section (c) and completed all requirements of 
such grant; or 
(B) completed a satisfactory application, 
including a plan to coordinate with required 
partners and complete the required activities 
during the 2 year period of the implementation 
grant. 
(4) FISCAL
AND
ADMINISTRATIVE
AGENT.—A 
State partnership receiving an implementation grant 
shall appoint a fiscal and an administration agent 
for the implementation of such grant. 
(5) APPLICATION.—Each eligible State partner-
ship desiring an implementation grant shall submit 
an application to the Administration at such time, in 
such manner, and accompanied by such information 
as the Administration may reasonably require. Each 
application submitted shall include— 
(A) a description of the members of the 
State partnership; 
(B) a description of how the State partner-
ship completed the required activities under the 
planning grant, if applicable; 
(C) a description of the activities for which 
implementation grant funds are sought, includ-
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ing grants to regions by the State partnership to 
advance coherent and comprehensive regional 
health care workforce planning activities; 
(D) a description of how the State partner-
ship will coordinate with required partners and 
complete the required partnership activities dur-
ing the duration of an implementation grant; 
(E) a budget proposal of the cost of the ac-
tivities supported by the implementation grant 
and a timeline for the provision of matching 
funds required; 
(F) proposed performance benchmarks to be 
used to assess and evaluate the progress of the 
partnership activities; 
(G) a description of how the State partner-
ship will collect data to report progress in grant 
activities; and 
(H) such additional assurances as the Ad-
ministration determines to be essential to ensure 
compliance with grant requirements. 
(6) REQUIRED ACTIVITIES.— 
(A) IN GENERAL.—A State partnership that 
receives an implementation grant may reserve 
not less than 60 percent of the grant funds to 
make grants to be competitively awarded by the
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State partnership, consistent with State procure-
ment rules, to encourage regional partnerships to 
address health care workforce development needs 
and to promote innovative health care workforce 
career pathway activities, including career coun-
seling, learning, and employment. 
(B) ELIGIBLE PARTNERSHIP DUTIES.—An 
eligible State partnership receiving an imple-
mentation grant shall— 
(i) identify and convene regional lead-
ership to discuss opportunities to engage in 
statewide health care workforce development 
planning, including the potential use of 
competitive grants to improve the develop-
ment, distribution, and diversity of the re-
gional health care workforce; the alignment 
of curricula for health care careers; and the 
access to quality career information and 
guidance and education and training op-
portunities; 
(ii) in consultation with key stake-
holders and regional leaders, take appro-
priate steps to reduce Federal, State, or 
local barriers to a comprehensive and coher-
ent strategy, including changes in State or
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local policies to foster coherent and com-
prehensive health care workforce develop-
ment activities, including health care career 
pathways at the regional and State levels, 
career planning information, retraining for 
dislocated workers, and as appropriate, re-
quests for Federal program or administra-
tive waivers; 
(iii) develop, disseminate, and review 
with key stakeholders a preliminary state-
wide strategy that addresses short- and 
long-term health care workforce development 
supply versus demand; 
(iv) convene State partnership mem-
bers on a regular basis, and at least on a 
semiannual basis; 
(v) assist leaders at the regional level 
to form partnerships, including technical 
assistance and capacity building activities; 
(vi) collect and assess data on and re-
port on the performance benchmarks selected 
by the State partnership and the Adminis-
tration for implementation activities car-
ried out by regional and State partnerships; 
and
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(vii) participate in the Administra-
tion’s evaluation and reporting activities. 
(7) PERFORMANCE AND EVALUATION.—Before the 
State partnership receives an implementation grant, 
it and the Administrator shall jointly determine the 
performance benchmarks that shall be established for 
the purposes of the implementation grant. 
(8) MATCH.—Each State partnership receiving 
an implementation grant shall provide an amount, in 
cash or in kind that is not less than 25 percent of the 
amount of the grant, to carry out the activities sup-
ported by the grant. The matching funds may be pro-
vided from funds available from other Federal, State, 
local, or private sources to carry out such activities. 
(9) REPORTS.— 
(A) REPORT
TO
ADMINISTRATION.—For 
each year of the implementation grant, the State 
partnership receiving the implementation grant 
shall submit a report to the Administration on 
the performance of the State of the grant activi-
ties, including a description of the use of the 
funds, including matched funds, to complete ac-
tivities, and a description of the performance of 
the State partnership in meeting the perform-
ance benchmarks.
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(B) REPORT TO CONGRESS.—The Adminis-
tration shall submit a report to Congress ana-
lyzing implementation activities, performance, 
and fund utilization of the State grantees, in-
cluding an identification of promising practices 
and a profile of the activities of each State 
grantee. 
(e) AUTHORIZATION FOR APPROPRIATIONS.— 
(1) PLANNING GRANTS.—There are authorized to 
be appropriated to award planning grants under sub-
section (c) $8,000,000 for fiscal year 2010, and such 
sums as may be necessary for each subsequent fiscal 
year. 
(2) IMPLEMENTATION
GRANTS.—There are au-
thorized to be appropriated to award implementation 
grants under subsection (d), $150,000,000 for fiscal 
year 2010, and such sums as may be necessary for 
each subsequent fiscal year. 
SEC. 5103. HEALTH CARE WORKFORCE ASSESSMENT. 
(a) IN GENERAL.—Section 761 of the Public Health 
Service Act (42 U.S.C. 294m) is amended— 
(1) by redesignating subsection (c) as subsection 
(e); 
(2) by striking subsection (b) and inserting the 
following:
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‘‘(b) NATIONAL CENTER FOR HEALTH CARE WORK-
FORCE ANALYSIS.— 
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish the National Center for Health Workforce 
Analysis (referred to in this section as the ‘National 
Center’). 
‘‘(2) PURPOSES.—The National Center, in co-
ordination to the extent practicable with the National 
Health Care Workforce Commission (established in 
section 5101 of the Patient Protection and Affordable 
Care Act), and relevant regional and State centers 
and agencies, shall— 
‘‘(A) provide for the development of infor-
mation describing and analyzing the health care 
workforce and workforce related issues; 
‘‘(B) carry out the activities under section 
792(a); 
‘‘(C) annually evaluate programs under this 
title; 
‘‘(D) develop and publish performance 
measures and benchmarks for programs under 
this title; and 
‘‘(E) establish, maintain, and publicize a 
national Internet registry of each grant awarded 
under this title and a database to collect data
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from longitudinal evaluations (as described in 
subsection (d)(2)) on performance measures (as 
developed under sections 749(d)(3), 757(d)(3), 
and 762(a)(3)). 
‘‘(3) COLLABORATION AND DATA SHARING.— 
‘‘(A) IN
GENERAL.—The National Center 
shall collaborate with Federal agencies and rel-
evant professional and educational organizations 
or societies for the purpose of linking data re-
garding grants awarded under this title. 
‘‘(B) CONTRACTS FOR HEALTH WORKFORCE 
ANALYSIS.—For the purpose of carrying out the 
activities described in subparagraph (A), the Na-
tional Center may enter into contracts with rel-
evant professional and educational organizations 
or societies. 
‘‘(c) STATE AND REGIONAL CENTERS FOR HEALTH 
WORKFORCE ANALYSIS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants to, or enter into contracts with, eligible entities 
for purposes of— 
‘‘(A) collecting, analyzing, and reporting 
data regarding programs under this title to the 
National Center and to the public; and
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‘‘(B) providing technical assistance to local 
and regional entities on the collection, analysis, 
and reporting of data. 
‘‘(2) ELIGIBLE ENTITIES.—To be eligible for a 
grant or contract under this subsection, an entity 
shall— 
‘‘(A) be a State, a State workforce invest-
ment board, a public health or health professions 
school, an academic health center, or an appro-
priate public or private nonprofit entity; and 
‘‘(B) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(d) INCREASE IN GRANTS FOR LONGITUDINAL EVAL-
UATIONS.— 
‘‘(1) IN GENERAL.—The Secretary shall increase 
the amount awarded to an eligible entity under this 
title for a longitudinal evaluation of individuals who 
have received education, training, or financial assist-
ance from programs under this title. 
‘‘(2) CAPABILITY.—A longitudinal evaluation 
shall be capable of— 
‘‘(A) studying practice patterns; and
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‘‘(B) collecting and reporting data on per-
formance measures developed under sections 
749(d)(3), 757(d)(3), and 762(a)(3). 
‘‘(3) GUIDELINES.—A longitudinal evaluation 
shall comply with guidelines issued under sections 
749(d)(4), 757(d)(4), and 762(a)(4). 
‘‘(4) ELIGIBLE ENTITIES.—To be eligible to ob-
tain an increase under this section, an entity shall be 
a recipient of a grant or contract under this title.’’; 
and 
(3) in subsection (e), as so redesignated— 
(A) by striking paragraph (1) and inserting 
the following: 
‘‘(1) IN GENERAL.— 
‘‘(A) NATIONAL
CENTER.—To carry out 
subsection (b), there are authorized to be appro-
priated $7,500,000 for each of fiscal years 2010 
through 2014. 
‘‘(B) STATE AND REGIONAL CENTERS.—To 
carry out subsection (c), there are authorized to 
be appropriated $4,500,000 for each of fiscal 
years 2010 through 2014. 
‘‘(C) GRANTS FOR LONGITUDINAL EVALUA-
TIONS.—To carry out subsection (d), there are 
authorized to be appropriated such sums as may
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‘‘(3) develop, publish, and implement perform-
ance measures for programs under this part; 
‘‘(4) develop and publish guidelines for longitu-
dinal evaluations (as described in section 761(d)(2)) 
for programs under this part; and 
‘‘(5) recommend appropriation levels for pro-
grams under this part.’’. 
(3) ADVISORY COUNCIL ON GRADUATE MEDICAL 
EDUCATION.—Section 762(a) of the Public Health 
Service Act (42 U.S.C. 294o(a)) is amended— 
(A) in paragraph (1), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (2), by striking the period 
and inserting a semicolon; and 
(C) by adding at the end the following: 
‘‘(3) develop, publish, and implement perform-
ance measures for programs under this title, except 
for programs under part C or D; 
‘‘(4) develop and publish guidelines for longitu-
dinal evaluations (as described in section 761(d)(2)) 
for programs under this title, except for programs 
under part C or D; and 
‘‘(5) recommend appropriation levels for pro-
grams under this title, except for programs under 
part C or D.’’.
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Subtitle C—Increasing the Supply 
of the Health Care Workforce 
SEC. 5201. FEDERALLY SUPPORTED STUDENT LOAN FUNDS. 
(a) MEDICAL
SCHOOLS
AND
PRIMARY
HEALTH 
CARE.—Section 723 of the Public Health Service Act (42 
U.S.C. 292s) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by striking subpara-
graph (B) and inserting the following: 
‘‘(B) to practice in such care for 10 years 
(including residency training in primary health 
care) or through the date on which the loan is 
repaid in full, whichever occurs first.’’; and 
(B) by striking paragraph (3) and inserting 
the following: 
‘‘(3) 
NONCOMPLIANCE
BY
STUDENT.—Each 
agreement entered into with a student pursuant to 
paragraph (1) shall provide that, if the student fails 
to comply with such agreement, the loan involved will 
begin to accrue interest at a rate of 2 percent per 
year greater than the rate at which the student would 
pay if compliant in such year.’’; and 
(2) by adding at the end the following: 
‘‘(d) SENSE OF CONGRESS.—It is the sense of Congress 
that funds repaid under the loan program under this sec-
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tion should not be transferred to the Treasury of the United 
States or otherwise used for any other purpose other than 
to carry out this section.’’. 
(b) STUDENT LOAN GUIDELINES.—The Secretary of 
Health and Human Services shall not require parental fi-
nancial information for an independent student to deter-
mine financial need under section 723 of the Public Health 
Service Act (42 U.S.C. 292s) and the determination of need 
for such information shall be at the discretion of applicable 
school loan officer. The Secretary shall amend guidelines 
issued by the Health Resources and Services Administra-
tion in accordance with the preceding sentence. 
SEC. 5202. NURSING STUDENT LOAN PROGRAM. 
(a) LOAN AGREEMENTS.—Section 836(a) of the Public 
Health Service Act (42 U.S.C. 297b(a)) is amended— 
(1) by striking ‘‘$2,500’’ and inserting ‘‘$3,300’’; 
(2) by striking ‘‘$4,000’’ and inserting ‘‘$5,200’’; 
and 
(3) by striking ‘‘$13,000’’ and all that follows 
through the period and inserting ‘‘$17,000 in the case 
of any student during fiscal years 2010 and 2011. 
After fiscal year 2011, such amounts shall be adjusted 
to provide for a cost-of-attendance increase for the 
yearly loan rate and the aggregate of the loans.’’.
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(b) LOAN PROVISIONS.—Section 836(b) of the Public 
Health Service Act (42 U.S.C. 297b(b)) is amended— 
(1) in paragraph (1)(C), by striking ‘‘1986’’ and 
inserting ‘‘2000’’; and 
(2) in paragraph (3), by striking ‘‘the date of en-
actment of the Nurse Training Amendments of 1979’’ 
and inserting ‘‘September 29, 1995’’. 
SEC. 5203. HEALTH CARE WORKFORCE LOAN REPAYMENT 
PROGRAMS. 
Part E of title VII of the Public Health Service Act 
(42 U.S.C. 294n et seq.) is amended by adding at the end 
the following: 
‘‘Subpart 3—Recruitment and Retention Programs 
‘‘SEC. 
775. 
INVESTMENT 
IN 
TOMORROW’S 
PEDIATRIC 
HEALTH CARE WORKFORCE. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish 
and carry out a pediatric specialty loan repayment pro-
gram under which the eligible individual agrees to be em-
ployed full-time for a specified period (which shall not be 
less than 2 years) in providing pediatric medical sub-
specialty, pediatric surgical specialty, or child and adoles-
cent mental and behavioral health care, including substance 
abuse prevention and treatment services. 
‘‘(b) PROGRAM ADMINISTRATION.—Through the pro-
gram established under this section, the Secretary shall
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enter into contracts with qualified health professionals 
under which— 
‘‘(1) such qualified health professionals will 
agree to provide pediatric medical subspecialty, pedi-
atric surgical specialty, or child and adolescent men-
tal and behavioral health care in an area with a 
shortage of the specified pediatric subspecialty that 
has a sufficient pediatric population to support such 
pediatric subspecialty, as determined by the Sec-
retary; and 
‘‘(2) the Secretary agrees to make payments on 
the principal and interest of undergraduate, grad-
uate, or graduate medical education loans of profes-
sionals described in paragraph (1) of not more than 
$35,000 a year for each year of agreed upon service 
under such paragraph for a period of not more than 
3 years during the qualified health professional’s— 
‘‘(A) participation in an accredited pedi-
atric medical subspecialty, pediatric surgical 
specialty, or child and adolescent mental health 
subspecialty residency or fellowship; or 
‘‘(B) employment as a pediatric medical 
subspecialist, pediatric surgical specialist, or 
child and adolescent mental health professional
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serving an area or population described in such 
paragraph. 
‘‘(c) IN GENERAL.— 
‘‘(1) ELIGIBLE INDIVIDUALS.— 
‘‘(A) PEDIATRIC MEDICAL SPECIALISTS AND 
PEDIATRIC
SURGICAL
SPECIALISTS.—For pur-
poses of contracts with respect to pediatric med-
ical specialists and pediatric surgical specialists, 
the term ‘qualified health professional’ means a 
licensed physician who— 
‘‘(i) is entering or receiving training 
in an accredited pediatric medical sub-
specialty or pediatric surgical specialty 
residency or fellowship; or 
‘‘(ii) has completed (but not prior to 
the end of the calendar year in which this 
section is enacted) the training described in 
subparagraph (B). 
‘‘(B) CHILD AND ADOLESCENT MENTAL AND 
BEHAVIORAL
HEALTH.—For purposes of con-
tracts with respect to child and adolescent men-
tal and behavioral health care, the term ‘quali-
fied health professional’ means a health care pro-
fessional who—
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‘‘(A) the individual agrees to work in, or for 
a provider serving, a health professional shortage 
area or medically underserved area, or to serve 
a medically underserved population; 
‘‘(B) the individual is a United States cit-
izen or a permanent legal United States resident; 
and 
‘‘(C) if the individual is enrolled in a grad-
uate program, the program is accredited, and the 
individual has an acceptable level of academic 
standing (as determined by the Secretary). 
‘‘(d) PRIORITY.—In entering into contracts under this 
subsection, the Secretary shall give priority to applicants 
who— 
‘‘(1) are or will be working in a school or other 
pre-kindergarten, elementary, or secondary education 
setting; 
‘‘(2) have familiarity with evidence-based meth-
ods and cultural and linguistic competence health 
care services; and 
‘‘(3) demonstrate financial need. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $30,000,000 for each of fiscal 
years 2010 through 2014 to carry out subsection (c)(1)(A)
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and $20,000,000 for each of fiscal years 2010 through 2013 
to carry out subsection (c)(1)(B).’’. 
SEC. 5204. PUBLIC HEALTH WORKFORCE RECRUITMENT 
AND RETENTION PROGRAMS. 
Part E of title VII of the Public Health Service Act 
(42 U.S.C. 294n et seq.), as amended by section 5203, is 
further amended by adding at the end the following: 
‘‘SEC. 776. PUBLIC HEALTH WORKFORCE LOAN REPAYMENT 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish 
the Public Health Workforce Loan Repayment Program (re-
ferred to in this section as the ‘Program’) to assure an ade-
quate supply of public health professionals to eliminate crit-
ical public health workforce shortages in Federal, State, 
local, and tribal public health agencies. 
‘‘(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 student in an accredited academic edu-
cational institution in a State or territory in the 
final year of a course of study or program leading to 
a public health or health professions degree or certifi-
cate; and have accepted employment with a Federal, 
State, local, or tribal public health agency, or a re-
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lated training fellowship, as recognized by the Sec-
retary, to commence upon graduation; 
‘‘(B)(i) have graduated, during the preceding 10- 
year period, from an accredited educational institu-
tion in a State or territory and received a public 
health or health professions degree or certificate; and 
‘‘(ii) be employed by, or have accepted employ-
ment with, a Federal, State, local, or tribal public 
health agency or a related training fellowship, as rec-
ognized by the Secretary; 
‘‘(2) be a United States citizen; and 
‘‘(3)(A) submit an application to the Secretary 
to participate in the Program; 
‘‘(B) execute a written contract as required in 
subsection (c); and 
‘‘(4) not have received, for the same service, a re-
duction of loan obligations under section 455(m), 
428J, 428K, 428L, or 460 of the Higher Education 
Act of 1965. 
‘‘(c) CONTRACT.—The written contract (referred to in 
this section as the ‘written contract’) between the Secretary 
and an individual shall contain— 
‘‘(1) an agreement on the part of the Secretary 
that the Secretary will repay on behalf of the indi-
vidual loans incurred by the individual in the pur-
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suit of the relevant degree or certificate in accordance 
with the terms of the contract; 
‘‘(2) an agreement on the part of the individual 
that the individual will serve in the full-time employ-
ment of a Federal, State, local, or tribal public health 
agency or a related fellowship program in a position 
related to the course of study or program for which 
the contract was awarded for a period of time (re-
ferred to in this section as the ‘period of obligated 
service’) equal to the greater of— 
‘‘(A) 3 years; or 
‘‘(B) such longer period of time as deter-
mined appropriate by the Secretary and the in-
dividual; 
‘‘(3) an agreement, as appropriate, on the part 
of the individual to relocate to a priority service area 
(as determined by the Secretary) in exchange for an 
additional loan repayment incentive amount to be de-
termined by the Secretary; 
‘‘(4) a provision that any financial obligation of 
the United States arising out of a contract entered 
into under this section and any obligation of the indi-
vidual that is conditioned thereon, is contingent on 
funds being appropriated for loan repayments under 
this section;
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‘‘(5) a statement of the damages to which the 
United States is entitled, under this section for the 
individual’s breach of the contract; and 
‘‘(6) such other statements of the rights and li-
abilities of the Secretary and of the individual, not 
inconsistent with this section. 
‘‘(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 prin-
cipal, interest, and related expenses on government 
and commercial loans received by the individual re-
garding the undergraduate or graduate education of 
the individual (or both), which loans were made for 
tuition expenses incurred by the individual. 
‘‘(2) PAYMENTS FOR YEARS SERVED.—For each 
year of obligated service that an individual contracts 
to serve under subsection (c) the Secretary may pay 
up to $35,000 on behalf of the individual for loans de-
scribed in paragraph (1). With respect to participants 
under the Program whose total eligible loans are less 
than $105,000, the Secretary shall pay an amount 
that does not exceed 1⁄3 of the eligible loan balance for 
each year of obligated service of the individual.
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‘‘(3) TAX LIABILITY.—For the purpose of pro-
viding reimbursements for tax liability resulting from 
payments under paragraph (2) on behalf of an indi-
vidual, the Secretary shall, in addition to such pay-
ments, make payments to the individual in an 
amount not to exceed 39 percent of the total amount 
of loan repayments made for the taxable year in-
volved. 
‘‘(e) POSTPONING OBLIGATED SERVICE.—With respect 
to an individual receiving a degree or certificate from a 
health professions or other related school, the date of the ini-
tiation of the period of obligated service may be postponed 
as approved by the Secretary. 
‘‘(f) BREACH OF CONTRACT.—An individual who fails 
to comply with the contract entered into under subsection 
(c) shall be subject to the same financial penalties as pro-
vided for under section 338E for breaches of loan repayment 
contracts under section 338B. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$195,000,000 for fiscal year 2010, and such sums as may 
be necessary for each of fiscal years 2011 through 2015.’’.
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SEC. 5205. ALLIED HEALTH WORKFORCE RECRUITMENT 
AND RETENTION PROGRAMS. 
(a) PURPOSE.—The purpose of this section is to assure 
an adequate supply of allied health professionals to elimi-
nate critical allied health workforce shortages in Federal, 
State, local, and tribal public health agencies or in settings 
where patients might require health care services, including 
acute care facilities, ambulatory care facilities, personal 
residences and other settings, as recognized by the Secretary 
of Health and Human Services by authorizing an Allied 
Health Loan Forgiveness Program. 
(b) ALLIED HEALTH WORKFORCE RECRUITMENT AND 
RETENTION PROGRAM.—Section 428K of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1078–11) is amended— 
(1) in subsection (b), by adding at the end the 
following: 
‘‘(18) ALLIED
HEALTH
PROFESSIONALS.—The 
individual is employed full-time as an allied health 
professional— 
‘‘(A) in a Federal, State, local, or tribal 
public health agency; or 
‘‘(B) in a setting where patients might re-
quire health care services, including acute care 
facilities, ambulatory care facilities, personal 
residences and other settings located in health 
professional shortage areas, medically under-
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served areas, or medically underserved popu-
lations, as recognized by the Secretary of Health 
and Human Services.’’; and 
(2) in subsection (g)— 
(A) 
by 
redesignating 
paragraphs 
(1) 
through (9) as paragraphs (2) through (10), re-
spectively; and 
(B) by inserting before paragraph (2) (as 
redesignated by subparagraph (A)) the following: 
‘‘(1) ALLIED HEALTH PROFESSIONAL.—The term 
‘allied health professional’ means an allied health 
professional as defined in section 799B(5) of the Pub-
lic Heath Service Act (42 U.S.C. 295p(5)) who— 
‘‘(A) has graduated and received an allied 
health professions degree or certificate from an 
institution of higher education; and 
‘‘(B) is employed with a Federal, State, 
local or tribal public health agency, or in a set-
ting where patients might require health care 
services, including acute care facilities, ambula-
tory care facilities, personal residences and other 
settings located in health professional shortage 
areas, medically underserved areas, or medically 
underserved populations, as recognized by the 
Secretary of Health and Human Services.’’.
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SEC. 5206. GRANTS FOR STATE AND LOCAL PROGRAMS. 
(a) IN GENERAL.—Section 765(d) of the Public Health 
Service Act (42 U.S.C. 295(d)) is amended— 
(1) in paragraph (7), by striking ‘‘; or’’ and in-
serting a semicolon; 
(2) by redesignating paragraph (8) as para-
graph (9); and 
(3) by inserting after paragraph (7) the fol-
lowing: 
‘‘(8) public health workforce loan repayment pro-
grams; or’’. 
(b) TRAINING FOR MID-CAREER PUBLIC HEALTH PRO-
FESSIONALS.—Part E of title VII of the Public Health Serv-
ice Act (42 U.S.C. 294n et seq.), as amended by section 
5204, is further amended by adding at the end the fol-
lowing: 
‘‘SEC. 777. TRAINING FOR MID-CAREER PUBLIC AND ALLIED 
HEALTH PROFESSIONALS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to, or enter into contracts with, any eligible entity to award 
scholarships to eligible individuals to enroll in degree or 
professional training programs for the purpose of enabling 
mid-career professionals in the public health and allied 
health workforce to receive additional training in the field 
of public health and allied health. 
‘‘(b) ELIGIBILITY.—
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‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible enti-
ty’ indicates an accredited educational institution 
that offers a course of study, certificate program, or 
professional training program in public or allied 
health or a related discipline, as determined by the 
Secretary 
‘‘(2) ELIGIBLE INDIVIDUALS.—The term ‘eligible 
individuals’ includes those individuals employed in 
public and allied health positions at the Federal, 
State, tribal, or local level who are interested in re-
taining or upgrading their education. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$60,000,000 for fiscal year 2010 and such sums as may be 
necessary for each of fiscal years 2011 through 2015. Fifty 
percent of appropriated funds shall be allotted to public 
health mid-career professionals and 50 percent shall be al-
lotted to allied health mid-career professionals.’’. 
SEC. 5207. FUNDING FOR NATIONAL HEALTH SERVICE 
CORPS. 
Section 338H(a) of the Public Health Service Act (42 
U.S.C. 254q(a)) is amended to read as follows: 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized to
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be appropriated, out of any funds in the Treasury not oth-
erwise appropriated, the following: 
‘‘(1) For fiscal year 2010, $320,461,632. 
‘‘(2) For fiscal year 2011, $414,095,394. 
‘‘(3) For fiscal year 2012, $535,087,442. 
‘‘(4) For fiscal year 2013, $691,431,432. 
‘‘(5) For fiscal year 2014, $893,456,433. 
‘‘(6) For fiscal year 2015, $1,154,510,336. 
‘‘(7) For fiscal year 2016, and each subsequent 
fiscal year, the amount appropriated for the pre-
ceding fiscal year adjusted by the product of— 
‘‘(A) one plus the average percentage in-
crease in the costs of health professions education 
during the prior fiscal year; and 
‘‘(B) one plus the average percentage change 
in the number of individuals residing in health 
professions shortage areas designated under sec-
tion 333 during the prior fiscal year, relative to 
the number of individuals residing in such areas 
during the previous fiscal year.’’. 
SEC. 5208. NURSE-MANAGED HEALTH CLINICS. 
(a) PURPOSE.—The purpose of this section is to fund 
the development and operation of nurse-managed health 
clinics.
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(b) GRANTS.—Subpart 1 of part D of title III of the 
Public Health Service Act (42 U.S.C. 254b et seq.) is 
amended by inserting after section 330A the following: 
‘‘SEC. 330A–1. GRANTS TO NURSE–MANAGED HEALTH CLIN-
ICS. 
‘‘(a) DEFINITIONS.— 
‘‘(1) COMPREHENSIVE
PRIMARY
HEALTH
CARE 
SERVICES.—In this section, the term ‘comprehensive 
primary health care services’ means the primary 
health services described in section 330(b)(1). 
‘‘(2) NURSE-MANAGED
HEALTH
CLINIC.—The 
term ‘nurse-managed health clinic’ means a nurse- 
practice arrangement, managed by advanced practice 
nurses, that provides primary care or wellness serv-
ices to underserved or vulnerable populations and 
that is associated with a school, college, university or 
department of nursing, federally qualified health cen-
ter, or independent nonprofit health or social services 
agency. 
‘‘(b) AUTHORITY TO AWARD GRANTS.—The Secretary 
shall award grants for the cost of the operation of nurse- 
managed health clinics that meet the requirements of this 
section. 
‘‘(c) APPLICATIONS.—To be eligible to receive a grant 
under this section, an entity shall—
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‘‘(1) be an NMHC; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing— 
‘‘(A) assurances that nurses are the major 
providers of services at the NMHC and that at 
least 1 advanced practice nurse holds an execu-
tive management position within the organiza-
tional structure of the NMHC; 
‘‘(B) an assurance that the NMHC will con-
tinue providing comprehensive primary health 
care services or wellness services without regard 
to income or insurance status of the patient for 
the duration of the grant period; and 
‘‘(C) an assurance that, not later than 90 
days of receiving a grant under this section, the 
NMHC will establish a community advisory 
committee, for which a majority of the members 
shall be individuals who are served by the 
NMHC. 
‘‘(d) GRANT AMOUNT.—The amount of any grant 
made under this section for any fiscal year shall be deter-
mined by the Secretary, taking into account— 
‘‘(1) the financial need of the NMHC, consid-
ering State, local, and other operational funding pro-
vided to the NMHC; and
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‘‘(2) other factors, as the Secretary determines 
appropriate. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purposes of carrying out this section, there are authorized 
to be appropriated $50,000,000 for the fiscal year 2010 and 
such sums as may be necessary for each of the fiscal years 
2011 through 2014.’’. 
SEC. 5209. ELIMINATION OF CAP ON COMMISSIONED 
CORPS. 
Section 202 of the Department of Health and Human 
Services Appropriations Act, 1993 (Public Law 102–394) 
is amended by striking ‘‘not to exceed 2,800’’. 
SEC. 5210. ESTABLISHING A READY RESERVE CORPS. 
Section 203 of the Public Health Service Act (42 
U.S.C. 204) is amended to read as follows: 
‘‘SEC. 203. COMMISSIONED CORPS AND READY RESERVE 
CORPS. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—There shall be in the Service 
a commissioned Regular Corps and a Ready Reserve 
Corps for service in time of national emergency. 
‘‘(2) REQUIREMENT.—All commissioned officers 
shall be citizens of the United States and shall be ap-
pointed without regard to the civil-service laws and
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compensated without regard to the Classification Act 
of 1923, as amended. 
‘‘(3) APPOINTMENT.—Commissioned officers of 
the Ready Reserve Corps shall be appointed by the 
President and commissioned officers of the Regular 
Corps shall be appointed by the President with the 
advice and consent of the Senate. 
‘‘(4) ACTIVE DUTY.—Commissioned officers of the 
Ready Reserve Corps shall at all times be subject to 
call to active duty by the Surgeon General, including 
active duty for the purpose of training. 
‘‘(5) WARRANT
OFFICERS.—Warrant officers 
may be appointed to the Service for the purpose of 
providing support to the health and delivery systems 
maintained by the Service and any warrant officer 
appointed to the Service shall be considered for pur-
poses of this Act and title 37, United States Code, to 
be a commissioned officer within the Commissioned 
Corps of the Service. 
‘‘(b) ASSIMILATING RESERVE CORP OFFICERS INTO 
THE REGULAR CORPS.—Effective on the date of enactment 
of the Patient Protection and Affordable Care Act, all indi-
viduals classified as officers in the Reserve Corps under this 
section (as such section existed on the day before the date
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of enactment of such Act) and serving on active duty shall 
be deemed to be commissioned officers of the Regular Corps. 
‘‘(c) PURPOSE AND USE OF READY RESEARCH.— 
‘‘(1) PURPOSE.—The purpose of the Ready Re-
serve Corps is to fulfill the need to have additional 
Commissioned Corps personnel available on short no-
tice (similar to the uniformed service’s reserve pro-
gram) to assist regular Commissioned Corps per-
sonnel to meet both routine public health and emer-
gency response missions. 
‘‘(2) USES.—The Ready Reserve Corps shall— 
‘‘(A) participate in routine training to meet 
the general and specific needs of the Commis-
sioned Corps; 
‘‘(B) be available and ready for involuntary 
calls to active duty during national emergencies 
and public health crises, similar to the uni-
formed service reserve personnel; 
‘‘(C) be available for backfilling critical po-
sitions left vacant during deployment of active 
duty Commissioned Corps members, as well as 
for deployment to respond to public health emer-
gencies, both foreign and domestic; and 
‘‘(D) be available for service assignment in 
isolated, hardship, and medically underserved
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communities (as defined in section 799B) to im-
prove access to health services. 
‘‘(d) FUNDING.—For the purpose of carrying out the 
duties and responsibilities of the Commissioned Corps 
under this section, there are authorized to be appropriated 
$5,000,000 for each of fiscal years 2010 through 2014 for 
recruitment and training and $12,500,000 for each of fiscal 
years 2010 through 2014 for the Ready Reserve Corps.’’. 
Subtitle D—Enhancing Health Care 
Workforce Education and Training 
SEC. 5301. TRAINING IN FAMILY MEDICINE, GENERAL IN-
TERNAL MEDICINE, GENERAL PEDIATRICS, 
AND PHYSICIAN ASSISTANTSHIP. 
Part C of title VII (42 U.S.C. 293k et seq.) is amended 
by striking section 747 and inserting the following: 
‘‘SEC. 747. PRIMARY CARE TRAINING AND ENHANCEMENT. 
‘‘(a) SUPPORT AND DEVELOPMENT OF PRIMARY CARE 
TRAINING PROGRAMS.— 
‘‘(1) IN
GENERAL.—The Secretary may make 
grants to, or enter into contracts with, an accredited 
public or nonprofit private hospital, school of medi-
cine or osteopathic medicine, academically affiliated 
physician assistant training program, or a public or 
private nonprofit entity which the Secretary has de-
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termined is capable of carrying out such grant or 
contract— 
‘‘(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 medicine, 
general internal medicine, or general pediatrics 
for medical students, interns, residents, or prac-
ticing physicians as defined by the Secretary; 
‘‘(B) to provide need-based financial assist-
ance in the form of traineeships and fellowships 
to medical students, interns, residents, practicing 
physicians, or other medical personnel, who are 
participants in any such program, and who 
plan to specialize or work in the practice of the 
fields defined in subparagraph (A); 
‘‘(C) to plan, develop, and operate a pro-
gram for the training of physicians who plan to 
teach in family medicine, general internal medi-
cine, or general pediatrics training programs; 
‘‘(D) to plan, develop, and operate a pro-
gram for the training of physicians teaching in 
community-based settings; 
‘‘(E) to provide financial assistance in the 
form of traineeships and fellowships to physi-
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cians who are participants in any such pro-
grams and who plan to teach or conduct research 
in a family medicine, general internal medicine, 
or general pediatrics training program; 
‘‘(F) to plan, develop, and operate a physi-
cian assistant education program, and for the 
training of individuals who will teach in pro-
grams to provide such training; 
‘‘(G) to plan, develop, and operate a dem-
onstration program that provides training in 
new competencies, as recommended by the Advi-
sory Committee on Training in Primary Care 
Medicine and Dentistry and the National Health 
Care Workforce Commission established in sec-
tion 5101 of the Patient Protection and Afford-
able Care Act, which may include— 
‘‘(i) providing training to primary 
care physicians relevant to providing care 
through patient-centered medical homes (as 
defined by the Secretary for purposes of this 
section); 
‘‘(ii) developing tools and curricula 
relevant to patient-centered medical homes; 
and
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‘‘(iii) providing continuing education 
to primary care physicians relevant to pa-
tient-centered medical homes; and 
‘‘(H) to plan, develop, and operate joint de-
gree programs to provide interdisciplinary and 
interprofessional graduate training in public 
health and other health professions to provide 
training in environmental health, infectious dis-
ease control, disease prevention and health pro-
motion, epidemiological studies and injury con-
trol. 
‘‘(2) DURATION OF AWARDS.—The period during 
which payments are made to an entity from an 
award of a grant or contract under this subsection 
shall be 5 years. 
‘‘(b) CAPACITY BUILDING IN PRIMARY CARE.— 
‘‘(1) IN
GENERAL.—The Secretary may make 
grants to or enter into contracts with accredited 
schools of medicine or osteopathic medicine to estab-
lish, maintain, or improve— 
‘‘(A) academic units or programs that im-
prove clinical teaching and research in fields de-
fined in subsection (a)(1)(A); or 
‘‘(B) programs that integrate academic ad-
ministrative units in fields defined in subsection
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(a)(1)(A) to enhance interdisciplinary recruit-
ment, training, and faculty development. 
‘‘(2) PREFERENCE IN MAKING AWARDS UNDER 
THIS SUBSECTION.—In making awards of grants and 
contracts under paragraph (1), the Secretary shall 
give preference to any qualified applicant for such an 
award that agrees to expend the award for the pur-
pose of— 
‘‘(A) establishing academic units or pro-
grams in fields defined in subsection (a)(1)(A); 
or 
‘‘(B) substantially expanding such units or 
programs. 
‘‘(3) 
PRIORITIES
IN
MAKING
AWARDS.—In 
awarding grants or contracts under paragraph (1), 
the Secretary shall give priority to qualified appli-
cants that— 
‘‘(A) proposes a collaborative project be-
tween academic administrative units of primary 
care; 
‘‘(B) proposes innovative approaches to 
clinical teaching using models of primary care, 
such as the patient centered medical home, team 
management of chronic disease, and interprofes-
sional integrated models of health care that in-
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corporate transitions in health care settings and 
integration physical and mental health provi-
sion; 
‘‘(C) have a record of training the greatest 
percentage of providers, or that have dem-
onstrated significant improvements in the per-
centage of providers trained, who enter and re-
main in primary care practice; 
‘‘(D) have a record of training individuals 
who are from underrepresented minority groups 
or from a rural or disadvantaged background; 
‘‘(E) provide training in the care of vulner-
able populations such as children, older adults, 
homeless individuals, victims of abuse or trau-
ma, individuals with mental health or substance- 
related disorders, individuals with HIV/AIDS, 
and individuals with disabilities; 
‘‘(F) establish formal relationships and sub-
mit joint applications with federally qualified 
health centers, rural health clinics, area health 
education centers, or clinics located in under-
served areas or that serve underserved popu-
lations;
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‘‘(G) teach trainees the skills to provide 
interprofessional, integrated care through col-
laboration among health professionals; 
‘‘(H) provide training in enhanced commu-
nication with patients, evidence-based practice, 
chronic disease management, preventive care, 
health information technology, or other com-
petencies as recommended by the Advisory Com-
mittee on Training in Primary Care Medicine 
and Dentistry and the National Health Care 
Workforce Commission established in section 
5101 of the Patient Protection and Affordable 
Care Act; or 
‘‘(I) provide training in cultural com-
petency and health literacy. 
‘‘(4) DURATION OF AWARDS.—The period during 
which payments are made to an entity from an 
award of a grant or contract under this subsection 
shall be 5 years. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—For purposes of carrying out 
this section (other than subsection (b)(1)(B)), there 
are authorized to be appropriated $125,000,000 for 
fiscal year 2010, and such sums as may be necessary 
for each of fiscal years 2011 through 2014.
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‘‘(2) TRAINING
PROGRAMS.—Fifteen percent of 
the amount appropriated pursuant to paragraph (1) 
in each such fiscal year shall be allocated to the phy-
sician assistant training programs described in sub-
section (a)(1)(F), which prepare students for practice 
in primary care. 
‘‘(3) INTEGRATING
ACADEMIC
ADMINISTRATIVE 
UNITS.—For purposes of carrying out subsection 
(b)(1)(B), there are authorized to be appropriated 
$750,000 for each of fiscal years 2010 through 2014.’’. 
SEC. 5302. TRAINING OPPORTUNITIES FOR DIRECT CARE 
WORKERS. 
Part C of title VII of the Public Health Service Act 
(42 U.S.C. 293k et seq.) is amended by inserting after sec-
tion 747, as amended by section 5301, the following: 
‘‘SEC. 747A. TRAINING OPPORTUNITIES FOR DIRECT CARE 
WORKERS. 
‘‘(a) IN GENERAL.—The Secretary shall award grants 
to eligible entities to enable such entities to provide new 
training opportunities for direct care workers who are em-
ployed in long-term care settings such as nursing homes (as 
defined in section 1908(e)(1) of the Social Security Act (42 
U.S.C. 1396g(e)(1)), assisted living facilities and skilled 
nursing facilities, intermediate care facilities for individ-
uals with mental retardation, home and community based
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settings, and any other setting the Secretary determines to 
be appropriate. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section, an entity shall— 
‘‘(1) be an institution of higher education (as de-
fined in section 102 of the Higher Education Act of 
1965 (20 U.S.C. 1002)) that— 
‘‘(A) is accredited by a nationally recog-
nized accrediting agency or association listed 
under section 101(c) of the Higher Education 
Act of 1965 (20 U.S.C. 1001(c)); and 
‘‘(B) has established a public-private edu-
cational partnership with a nursing home or 
skilled nursing facility, agency or entity pro-
viding home and community based services to 
individuals with disabilities, or other long-term 
care provider; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
‘‘(c) USE OF FUNDS.—An eligible entity shall use 
amounts awarded under a grant under this section to pro-
vide assistance to eligible individuals to offset the cost of 
tuition and required fees for enrollment in academic pro-
grams provided by such entity.
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‘‘(d) ELIGIBLE INDIVIDUAL.— 
‘‘(1) ELIGIBILITY.—To be eligible for assistance 
under this section, an individual shall be enrolled in 
courses provided by a grantee under this subsection 
and maintain satisfactory academic progress in such 
courses. 
‘‘(2) CONDITION OF ASSISTANCE.—As a condi-
tion of receiving assistance under this section, an in-
dividual shall agree that, following completion of the 
assistance period, the individual will work in the 
field of geriatrics, disability services, long term serv-
ices and supports, or chronic care management for a 
minimum of 2 years under guidelines set by the Sec-
retary. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$10,000,000 for the period of fiscal years 2011 through 
2013.’’. 
SEC. 5303. TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC 
HEALTH DENTISTRY. 
Part C of Title VII of the Public Health Service Act 
(42 U.S.C. 293k et seq.) is amended by— 
(1) redesignating section 748, as amended by sec-
tion 5103 of this Act, as section 749; and
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(2) inserting after section 747A, as added by sec-
tion 5302, the following: 
‘‘SEC. 748. TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC 
HEALTH DENTISTRY. 
‘‘(a) SUPPORT AND DEVELOPMENT OF DENTAL TRAIN-
ING PROGRAMS.— 
‘‘(1) IN
GENERAL.—The Secretary may make 
grants to, or enter into contracts with, a school of 
dentistry, public or nonprofit private hospital, or a 
public or private nonprofit entity which the Secretary 
has determined is capable of carrying out such grant 
or contract— 
‘‘(A) to plan, develop, and operate, or par-
ticipate in, an approved professional training 
program in the field of general dentistry, pedi-
atric dentistry, or public health dentistry for 
dental students, residents, practicing dentists, 
dental hygienists, or other approved primary 
care dental trainees, that emphasizes training for 
general, pediatric, or public health dentistry; 
‘‘(B) to provide financial assistance to den-
tal students, residents, practicing dentists, and 
dental hygiene students who are in need thereof, 
who are participants in any such program, and
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who plan to work in the practice of general, pe-
diatric, public heath dentistry, or dental hygiene; 
‘‘(C) to plan, develop, and operate a pro-
gram for the training of oral health care pro-
viders who plan to teach in general, pediatric, 
public health dentistry, or dental hygiene; 
‘‘(D) to provide financial assistance in the 
form of traineeships and fellowships to dentists 
who plan to teach or are teaching in general, pe-
diatric, or public health dentistry; 
‘‘(E) to meet the costs of projects to estab-
lish, maintain, or improve dental faculty devel-
opment programs in primary care (which may 
be departments, divisions or other units); 
‘‘(F) to meet the costs of projects to estab-
lish, maintain, or improve predoctoral and 
postdoctoral training in primary care programs; 
‘‘(G) to create a loan repayment program 
for faculty in dental programs; and 
‘‘(H) to provide technical assistance to pedi-
atric training programs in developing and im-
plementing instruction regarding the oral health 
status, dental care needs, and risk-based clinical 
disease management of all pediatric populations 
with an emphasis on underserved children.
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‘‘(2) FACULTY LOAN REPAYMENT.— 
‘‘(A) IN
GENERAL.—A grant or contract 
under subsection (a)(1)(G) may be awarded to a 
program of general, pediatric, or public health 
dentistry described in such subsection to plan, 
develop, and operate a loan repayment program 
under which— 
‘‘(i) individuals agree to serve full-time 
as faculty members; and 
‘‘(ii) the program of general, pediatric 
or public health dentistry agrees to pay the 
principal and interest on the outstanding 
student loans of the individuals. 
‘‘(B) MANNER OF PAYMENTS.—With respect 
to the payments described in subparagraph 
(A)(ii), upon completion by an individual of 
each of the first, second, third, fourth, and fifth 
years of service, the program shall pay an 
amount equal to 10, 15, 20, 25, and 30 percent, 
respectively, of the individual’s student loan bal-
ance as calculated based on principal and inter-
est owed at the initiation of the agreement. 
‘‘(b) ELIGIBLE ENTITY.—For purposes of this sub-
section, entities eligible for such grants or contracts in gen-
eral, pediatric, or public health dentistry shall include enti-
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ties that have programs in dental or dental hygiene schools, 
or approved residency or advanced education programs in 
the practice of general, pediatric, or public health dentistry. 
Eligible entities may partner with schools of public health 
to permit the education of dental students, residents, and 
dental hygiene students for a master’s year in public health 
at a school of public health. 
‘‘(c) PRIORITIES IN MAKING AWARDS.—With respect 
to training provided for under this section, the Secretary 
shall give priority in awarding grants or contracts to the 
following: 
‘‘(1) Qualified applicants that propose collabo-
rative projects between departments of primary care 
medicine and departments of general, pediatric, or 
public health dentistry. 
‘‘(2) Qualified applicants that have a record of 
training the greatest percentage of providers, or that 
have demonstrated significant improvements in the 
percentage of providers, who enter and remain in gen-
eral, pediatric, or public health dentistry. 
‘‘(3) Qualified applicants that have a record of 
training individuals who are from a rural or dis-
advantaged background, or from underrepresented mi-
norities.
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‘‘(4) Qualified applicants that establish formal 
relationships with Federally qualified health centers, 
rural health centers, or accredited teaching facilities 
and that conduct training of students, residents, fel-
lows, or faculty at the center or facility. 
‘‘(5) Qualified applicants that conduct teaching 
programs targeting vulnerable populations such as 
older adults, homeless individuals, victims of abuse or 
trauma, individuals with mental health or substance- 
related disorders, individuals with disabilities, and 
individuals with HIV/AIDS, and in the risk-based 
clinical disease management of all populations. 
‘‘(6) Qualified applicants that include edu-
cational activities in cultural competency and health 
literacy. 
‘‘(7) Qualified applicants that have a high rate 
for placing graduates in practice settings that serve 
underserved areas or health disparity populations, or 
who achieve a significant increase in the rate of plac-
ing graduates in such settings. 
‘‘(8) Qualified applicants that intend to establish 
a special populations oral health care education cen-
ter or training program for the didactic and clinical 
education of dentists, dental health professionals, and 
dental hygienists who plan to teach oral health care
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for people with developmental disabilities, cognitive 
impairment, complex medical problems, significant 
physical limitations, and vulnerable elderly. 
‘‘(d) APPLICATION.—An eligible entity desiring a 
grant under this section shall submit to the Secretary an 
application at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(e) DURATION OF AWARD.—The period during which 
payments are made to an entity from an award of a grant 
or contract under subsection (a) shall be 5 years. The provi-
sion of such payments shall be subject to annual approval 
by the Secretary and subject to the availability of appro-
priations for the fiscal year involved to make the payments. 
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the 
purpose of carrying out subsections (a) and (b), there is 
authorized to be appropriated $30,000,000 for fiscal year 
2010 and such sums as may be necessary for each of fiscal 
years 2011 through 2015. 
‘‘(g) CARRYOVER FUNDS.—An entity that receives an 
award under this section may carry over funds from 1 fiscal 
year to another without obtaining approval from the Sec-
retary. In no case may any funds be carried over pursuant 
to the preceding sentence for more than 3 years.’’.
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SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PRO-
VIDERS DEMONSTRATION PROJECT. 
Subpart X of part D of title III of the Public Health 
Service Act (42 U.S.C. 256f et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 340G–1. DEMONSTRATION PROGRAM. 
‘‘(a) IN GENERAL.— 
‘‘(1) AUTHORIZATION.—The Secretary is author-
ized to award grants to 15 eligible entities to enable 
such entities to establish a demonstration program to 
establish training programs to train, or to employ, al-
ternative dental health care providers in order to in-
crease access to dental health care services in rural 
and other underserved communities. 
‘‘(2) DEFINITION.—The term ‘alternative dental 
health care providers’ includes community dental 
health coordinators, advance practice dental hygien-
ists, independent dental hygienists, supervised dental 
hygienists, primary care physicians, dental thera-
pists, dental health aides, and any other health pro-
fessional that the Secretary determines appropriate. 
‘‘(b) TIMEFRAME.—The demonstration projects funded 
under this section shall begin not later than 2 years after 
the date of enactment of this section, and shall conclude not 
later than 7 years after such date of enactment.
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‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under subsection (a), an entity shall— 
‘‘(1) be— 
‘‘(A) an institution of higher education, in-
cluding a community college; 
‘‘(B) a public-private partnership; 
‘‘(C) a federally qualified health center; 
‘‘(D) an Indian Health Service facility or a 
tribe or tribal organization (as such terms are 
defined in section 4 of the Indian Self-Deter-
mination and Education Assistance Act); 
‘‘(E) a State or county public health clinic, 
a health facility operated by an Indian tribe or 
tribal organization, or urban Indian organiza-
tion providing dental services; or 
‘‘(F) a public hospital or health system; 
‘‘(2) be within a program accredited by the Com-
mission on Dental Accreditation or within a dental 
education program in an accredited institution; and 
‘‘(3) shall submit an application to the Secretary 
at such time, in such manner, and containing such 
information as the Secretary may require. 
‘‘(d) ADMINISTRATIVE PROVISIONS.— 
‘‘(1) AMOUNT OF GRANT.—Each grant under this 
section shall be in an amount that is not less than
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$4,000,000 for the 5-year period during which the 
demonstration project being conducted. 
‘‘(2) DISBURSEMENT OF FUNDS.— 
‘‘(A) PRELIMINARY
DISBURSEMENTS.—Be-
ginning 1 year after the enactment of this sec-
tion, the Secretary may disperse to any entity 
receiving a grant under this section not more 
than 20 percent of the total funding awarded to 
such entity under such grant, for the purpose of 
enabling the entity to plan the demonstration 
project to be conducted under such grant. 
‘‘(B) SUBSEQUENT
DISBURSEMENTS.—The 
remaining amount of grant funds not dispersed 
under subparagraph (A) shall be dispersed such 
that not less than 15 percent of such remaining 
amount is dispersed each subsequent year. 
‘‘(e) COMPLIANCE WITH STATE REQUIREMENTS.— 
Each entity receiving a grant under this section shall cer-
tify that it is in compliance with all applicable State licens-
ing requirements. 
‘‘(f) EVALUATION.—The Secretary shall contract with 
the Director of the Institute of Medicine to conduct a study 
of the demonstration programs conducted under this section 
that shall provide analysis, based upon quantitative and
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qualitative data, regarding access to dental health care in 
the United States. 
‘‘(g) CLARIFICATION REGARDING DENTAL HEALTH 
AIDE PROGRAM.—Nothing in this section shall prohibit a 
dental health aide training program approved by the In-
dian Health Service from being eligible for a grant under 
this section. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary to carry out this section.’’. 
SEC. 5305. GERIATRIC EDUCATION AND TRAINING; CAREER 
AWARDS; COMPREHENSIVE GERIATRIC EDU-
CATION. 
(a) WORKFORCE DEVELOPMENT; CAREER AWARDS.— 
Section 753 of the Public Health Service Act (42 U.S.C. 
294c) is amended by adding at the end the following: 
‘‘(d) GERIATRIC WORKFORCE DEVELOPMENT.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this subsection to entities 
that operate a geriatric education center pursuant to 
subsection (a)(1). 
‘‘(2) APPLICATION.—To be eligible for an award 
under paragraph (1), an entity described in such 
paragraph shall submit to the Secretary an applica-
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tion at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(3) USE OF FUNDS.—Amounts awarded under 
a grant or contract under paragraph (1) shall be used 
to— 
‘‘(A) carry out the fellowship program de-
scribed in paragraph (4); and 
‘‘(B) carry out 1 of the 2 activities de-
scribed in paragraph (5). 
‘‘(4) FELLOWSHIP PROGRAM.— 
‘‘(A) IN GENERAL.—Pursuant to paragraph 
(3), a geriatric education center that receives an 
award under this subsection shall use such funds 
to offer short-term intensive courses (referred to 
in this subsection as a ‘fellowship’) that focus on 
geriatrics, chronic care management, and long- 
term care that provide supplemental training for 
faculty members in medical schools and other 
health professions schools with programs in psy-
chology, pharmacy, nursing, social work, den-
tistry, public health, allied health, or other health 
disciplines, as approved by the Secretary. Such 
a fellowship shall be open to current faculty, and 
appropriately credentialed volunteer faculty and 
practitioners, who do not have formal training
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in geriatrics, to upgrade their knowledge and 
clinical skills for the care of older adults and 
adults with functional limitations and to en-
hance their interdisciplinary teaching skills. 
‘‘(B) LOCATION.—A fellowship shall be of-
fered either at the geriatric education center that 
is sponsoring the course, in collaboration with 
other geriatric education centers, or at medical 
schools, schools of dentistry, schools of nursing, 
schools of pharmacy, schools of social work, grad-
uate programs in psychology, or allied health 
and other health professions schools approved by 
the Secretary with which the geriatric education 
centers are affiliated. 
‘‘(C) CME CREDIT.—Participation in a fel-
lowship under this paragraph shall be accepted 
with respect to complying with continuing health 
profession education requirements. As a condi-
tion of such acceptance, the recipient shall agree 
to subsequently provide a minimum of 18 hours 
of voluntary instructional support through a 
geriatric education center that is providing clin-
ical training to students or trainees in long-term 
care settings.
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‘‘(5) ADDITIONAL
REQUIRED
ACTIVITIES
DE-
SCRIBED.—Pursuant to paragraph (3), a geriatric 
education center that receives an award under this 
subsection shall use such funds to carry out 1 of the 
following 2 activities. 
‘‘(A) FAMILY CAREGIVER AND DIRECT CARE 
PROVIDER TRAINING.—A geriatric education cen-
ter that receives an award under this subsection 
shall offer at least 2 courses each year, at no 
charge or nominal cost, to family caregivers and 
direct care providers that are designed to provide 
practical training for supporting frail elders and 
individuals with disabilities. The Secretary shall 
require such Centers to work with appropriate 
community partners to develop training pro-
gram content and to publicize the availability of 
training courses in their service areas. All fam-
ily caregiver and direct care provider training 
programs shall include instruction on the man-
agement of psychological and behavioral aspects 
of dementia, communication techniques for work-
ing with individuals who have dementia, and the 
appropriate, safe, and effective use of medica-
tions for older adults.
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‘‘(B) 
INCORPORATION
OF
BEST
PRAC-
TICES.—A geriatric education center that re-
ceives an award under this subsection shall de-
velop and include material on depression and 
other mental disorders common among older 
adults, medication safety issues for older adults, 
and management of the psychological and behav-
ioral aspects of dementia and communication 
techniques with individuals who have dementia 
in all training courses, where appropriate. 
‘‘(6) TARGETS.—A geriatric education center 
that receives an award under this subsection shall 
meet targets approved by the Secretary for providing 
geriatric training to a certain number of faculty or 
practitioners during the term of the award, as well as 
other parameters established by the Secretary. 
‘‘(7) AMOUNT OF AWARD.—An award under this 
subsection shall be in an amount of $150,000. Not 
more than 24 geriatric education centers may receive 
an award under this subsection. 
‘‘(8) MAINTENANCE
OF
EFFORT.—A geriatric 
education center that receives an award under this 
subsection shall provide assurances to the Secretary 
that funds provided to the geriatric education center 
under this subsection will be used only to supplement,
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not to supplant, the amount of Federal, State, and 
local funds otherwise expended by the geriatric edu-
cation center. 
‘‘(9) AUTHORIZATION OF APPROPRIATIONS.—In 
addition to any other funding available to carry out 
this section, there is authorized to be appropriated to 
carry out this subsection, $10,800,000 for the period 
of fiscal year 2011 through 2014. 
‘‘(e) GERIATRIC CAREER INCENTIVE AWARDS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this section to individuals 
described in paragraph (2) to foster greater interest 
among a variety of health professionals in entering 
the field of geriatrics, long-term care, and chronic 
care management. 
‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 
received an award under paragraph (1), an indi-
vidual shall— 
‘‘(A) be an advanced practice nurse, a clin-
ical social worker, a pharmacist, or student of 
psychology who is pursuing a doctorate or other 
advanced degree in geriatrics or related fields in 
an accredited health professions school; and
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‘‘(B) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require. 
‘‘(3) CONDITION OF AWARD.—As a condition of 
receiving an award under this subsection, an indi-
vidual shall agree that, following completion of the 
award period, the individual will teach or practice in 
the field of geriatrics, long-term care, or chronic care 
management for a minimum of 5 years under guide-
lines set by the Secretary. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, $10,000,000 for the period of fiscal 
years 2011 through 2013.’’. 
(b) EXPANSION OF ELIGIBILITY FOR GERIATRIC ACA-
DEMIC CAREER AWARDS; PAYMENT TO INSTITUTION.—Sec-
tion 753(c) of the Public Health Service Act 294(c)) is 
amended— 
(1) by redesignating paragraphs (4) and (5) as 
paragraphs (5) and (6), respectively; 
(2) by striking paragraph (2) through paragraph 
(3) and inserting the following: 
‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 
receive an Award under paragraph (1), an individual 
shall—
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‘‘(A) be board certified or board eligible in 
internal medicine, family practice, psychiatry, 
or licensed dentistry, or have completed any re-
quired training in a discipline and employed in 
an accredited health professions school that is 
approved by the Secretary; 
‘‘(B) have completed an approved fellowship 
program in geriatrics or have completed spe-
cialty training in geriatrics as required by the 
discipline and any addition geriatrics training 
as required by the Secretary; and 
‘‘(C) have a junior (non-tenured) faculty 
appointment at an accredited (as determined by 
the Secretary) school of medicine, osteopathic 
medicine, nursing, social work, psychology, den-
tistry, pharmacy, or other allied health dis-
ciplines in an accredited health professions 
school that is approved by the Secretary. 
‘‘(3) LIMITATIONS.—No Award under paragraph 
(1) may be made to an eligible individual unless the 
individual— 
‘‘(A) has submitted to the Secretary an ap-
plication, at such time, in such manner, and 
containing such information as the Secretary
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may require, and the Secretary has approved 
such application; 
‘‘(B) provides, in such form and manner as 
the Secretary may require, assurances that the 
individual will meet the service requirement de-
scribed in paragraph (6); and 
‘‘(C) provides, in such form and manner as 
the Secretary may require, assurances that the 
individual has a full-time faculty appointment 
in a health professions institution and docu-
mented commitment from such institution to 
spend 75 percent of the total time of such indi-
vidual on teaching and developing skills in 
interdisciplinary education in geriatrics. 
‘‘(4) MAINTENANCE OF EFFORT.—An eligible in-
dividual that receives an Award under paragraph (1) 
shall provide assurances to the Secretary that funds 
provided to the eligible individual under this sub-
section will be used only to supplement, not to sup-
plant, the amount of Federal, State, and local funds 
otherwise expended by the eligible individual.’’; and 
(3) in paragraph (5), as so designated— 
(A) in subparagraph (A)— 
(i) by inserting ‘‘for individuals who 
are physicians’’ after ‘‘this section’’; and
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(ii) by inserting after the period at the 
end the following: ‘‘The Secretary shall de-
termine the amount of an Award under this 
section for individuals who are not physi-
cians.’’; and 
(B) by adding at the end the following: 
‘‘(C) PAYMENT TO INSTITUTION.—The Sec-
retary shall make payments to institutions which 
include schools of medicine, osteopathic medicine, 
nursing, social work, psychology, dentistry, and 
pharmacy, or other allied health discipline in an 
accredited health professions school that is ap-
proved by the Secretary.’’. 
(c) COMPREHENSIVE GERIATRIC EDUCATION.—Sec-
tion 855 of the Public Health Service Act (42 U.S.C. 298) 
is amended— 
(1) in subsection (b)— 
(A) in paragraph (3), by striking ‘‘or’’ at 
the end; 
(B) in paragraph (4), by striking the period 
and inserting ‘‘; or’’; and 
(C) by adding at the end the following: 
‘‘(5) establish traineeships for individuals who 
are preparing for advanced education nursing degrees 
in geriatric nursing, long-term care, gero-psychiatric
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nursing or other nursing areas that specialize in the 
care of the elderly population.’’; and 
(2) in subsection (e), by striking ‘‘2003 through 
2007’’ and inserting ‘‘2010 through 2014’’. 
SEC. 5306. MENTAL AND BEHAVIORAL HEALTH EDUCATION 
AND TRAINING GRANTS. 
(a) IN GENERAL.—Part D of title VII (42 U.S.C. 294 
et seq.) is amended by— 
(1) striking section 757; 
(2) redesignating section 756 (as amended by 
section 5103) as section 757; and 
(3) inserting after section 755 the following: 
‘‘SEC. 756. MENTAL AND BEHAVIORAL HEALTH EDUCATION 
AND TRAINING GRANTS. 
‘‘(a) GRANTS
AUTHORIZED.—The Secretary may 
award grants to eligible institutions of higher education to 
support the recruitment of students for, and education and 
clinical experience of the students in— 
‘‘(1) baccalaureate, master’s, and doctoral degree 
programs of social work, as well as the development 
of faculty in social work; 
‘‘(2) accredited master’s, doctoral, internship, 
and post-doctoral residency programs of psychology 
for the development and implementation of inter-
disciplinary training of psychology graduate students
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for providing behavioral and mental health services, 
including substance abuse prevention and treatment 
services; 
‘‘(3) accredited institutions of higher education 
or accredited professional training programs that are 
establishing or expanding internships or other field 
placement programs in child and adolescent mental 
health in psychiatry, psychology, school psychology, 
behavioral pediatrics, psychiatric nursing, social 
work, school social work, substance abuse prevention 
and treatment, marriage and family therapy, school 
counseling, or professional counseling; and 
‘‘(4) State-licensed mental health nonprofit and 
for-profit organizations to enable such organizations 
to pay for programs for preservice or in-service train-
ing of paraprofessional child and adolescent mental 
health workers. 
‘‘(b) ELIGIBILITY REQUIREMENTS.—To be eligible for 
a grant under this section, an institution shall dem-
onstrate— 
‘‘(1) participation in the institutions’ programs 
of individuals and groups from different racial, eth-
nic, cultural, geographic, religious, linguistic, and 
class backgrounds, and different genders and sexual 
orientations;
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‘‘(2) knowledge and understanding of the con-
cerns of the individuals and groups described in sub-
section (a); 
‘‘(3) any internship or other field placement pro-
gram assisted under the grant will prioritize cultural 
and linguistic competency; 
‘‘(4) the institution will provide to the Secretary 
such data, assurances, and information as the Sec-
retary may require; and 
‘‘(5) with respect to any violation of the agree-
ment between the Secretary and the institution, the 
institution will pay such liquidated damages as pre-
scribed by the Secretary by regulation. 
‘‘(c) INSTITUTIONAL REQUIREMENT.—For grants au-
thorized under subsection (a)(1), at least 4 of the grant re-
cipients shall be historically black colleges or universities 
or other minority-serving institutions. 
‘‘(d) PRIORITY.— 
‘‘(1) In selecting the grant recipients in social 
work under subsection (a)(1), the Secretary shall give 
priority to applicants that— 
‘‘(A) are accredited by the Council on So-
cial Work Education; 
‘‘(B) have a graduation rate of not less than 
80 percent for social work students; and
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‘‘(C) exhibit an ability to recruit social 
workers from and place social workers in areas 
with a high need and high demand population. 
‘‘(2) In selecting the grant recipients in graduate 
psychology under subsection (a)(2), the Secretary 
shall give priority to institutions in which training 
focuses on the needs of vulnerable groups such as older 
adults and children, individuals with mental health 
or substance-related disorders, victims of abuse or 
trauma and of combat stress disorders such as 
posttraumatic stress disorder and traumatic brain in-
juries, homeless individuals, chronically ill persons, 
and their families. 
‘‘(3) In selecting the grant recipients in training 
programs in child and adolescent mental health under 
subsections (a)(3) and (a)(4), the Secretary shall give 
priority to applicants that— 
‘‘(A) have demonstrated the ability to collect 
data on the number of students trained in child 
and adolescent mental health and the popu-
lations served by such students after graduation 
or completion of preservice or in-service train-
ing; 
‘‘(B) have demonstrated familiarity with 
evidence-based methods in child and adolescent
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mental health services, including substance abuse 
prevention and treatment services; 
‘‘(C) have programs designed to increase the 
number of professionals and paraprofessionals 
serving high-priority populations and to appli-
cants who come from high-priority communities 
and plan to serve medically underserved popu-
lations, in health professional shortage areas, or 
in medically underserved areas; 
‘‘(D) offer curriculum taught collaboratively 
with a family on the consumer and family lived 
experience or the importance of family-profes-
sional or family-paraprofessional partnerships; 
and 
‘‘(E) provide services through a community 
mental health program described in section 
1913(b)(1). 
‘‘(e) AUTHORIZATION OF APPROPRIATION.—For the 
fiscal years 2010 through 2013, there is authorized to be 
appropriated to carry out this section— 
‘‘(1) $8,000,000 for training in social work in 
subsection (a)(1); 
‘‘(2) $12,000,000 for training in graduate psy-
chology in subsection (a)(2), of which not less than
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$10,000,000 
shall 
be 
allocated 
for 
doctoral, 
postdoctoral, and internship level training; 
‘‘(3) $10,000,000 for training in professional 
child and adolescent mental health in subsection 
(a)(3); and 
‘‘(4) $5,000,000 for training in paraprofessional 
child and adolescent work in subsection (a)(4).’’. 
(b) CONFORMING AMENDMENTS.—Section 757(b)(2) of 
the Public Health Service Act, as redesignated by subsection 
(a), is amended by striking ‘‘sections 751(a)(1)(A), 
751(a)(1)(B), 753(b), 754(3)(A), and 755(b)’’ and inserting 
‘‘sections 751(b)(1)(A), 753(b), and 755(b)’’. 
SEC. 5307. CULTURAL COMPETENCY, PREVENTION, AND 
PUBLIC HEALTH AND INDIVIDUALS WITH DIS-
ABILITIES TRAINING. 
(a) TITLE VII.—Section 741 of the Public Health 
Service Act (42 U.S.C. 293e) is amended— 
(1) in subsection (a)— 
(A) by striking the subsection heading and 
inserting ‘‘CULTURAL
COMPETENCY, PREVEN-
TION, AND PUBLIC HEALTH AND INDIVIDUALS 
WITH DISABILITY GRANTS’’; and 
(B) in paragraph (1), by striking ‘‘for the 
purpose of’’ and all that follows through the pe-
riod at the end and inserting ‘‘for the develop-
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ment, evaluation, and dissemination of research, 
demonstration projects, and model curricula for 
cultural competency, prevention, public health 
proficiency, reducing health disparities, and ap-
titude for working with individuals with disabil-
ities training for use in health professions schools 
and continuing education programs, and for 
other purposes determined as appropriate by the 
Secretary.’’; and 
(2) by striking subsection (b) and inserting the 
following: 
‘‘(b) COLLABORATION.—In carrying out subsection (a), 
the Secretary shall collaborate with health professional soci-
eties, licensing and accreditation entities, health professions 
schools, and experts in minority health and cultural com-
petency, prevention, and public health and disability 
groups, community-based organizations, and other organi-
zations as determined appropriate by the Secretary. The 
Secretary shall coordinate with curricula and research and 
demonstration projects developed under section 807. 
‘‘(c) DISSEMINATION.— 
‘‘(1) IN
GENERAL.—Model curricula developed 
under this section shall be disseminated through the 
Internet Clearinghouse under section 270 and such
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other means as determined appropriate by the Sec-
retary. 
‘‘(2) EVALUATION.—The Secretary shall evaluate 
the adoption and the implementation of cultural com-
petency, prevention, and public health, and working 
with individuals with a disability training curricula, 
and the facilitate inclusion of these competency meas-
ures in quality measurement systems as appropriate. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section such 
sums as may be necessary for each of fiscal years 2010 
through 2015.’’. 
(b) TITLE VIII.—Section 807 of the Public Health 
Service Act (42 U.S.C. 296e–1) is amended— 
(1) in subsection (a)— 
(A) by striking the subsection heading and 
inserting ‘‘CULTURAL
COMPETENCY, PREVEN-
TION, AND PUBLIC HEALTH AND INDIVIDUALS 
WITH DISABILITY GRANTS’’; and 
(B) by striking ‘‘for the purpose of’’ and all 
that follows through ‘‘health care.’’ and inserting 
‘‘for the development, evaluation, and dissemina-
tion of research, demonstration projects, and 
model curricula for cultural competency, preven-
tion, public health proficiency, reducing health
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disparities, and aptitude for working with indi-
viduals with disabilities training for use in 
health professions schools and continuing edu-
cation programs, and for other purposes deter-
mined as appropriate by the Secretary.’’; and 
(2) by redesignating subsection (b) as subsection 
(d); 
(3) by inserting after subsection (a) the fol-
lowing: 
‘‘(b) COLLABORATION.—In carrying out subsection (a), 
the Secretary shall collaborate with the entities described 
in section 741(b). The Secretary shall coordinate with cur-
ricula and research and demonstration projects developed 
under such section 741. 
‘‘(c) DISSEMINATION.—Model curricula developed 
under this section shall be disseminated and evaluated in 
the same manner as model curricula developed under sec-
tion 741, as described in subsection (c) of such section.’’; 
and 
(4) in subsection (d), as so redesignated— 
(A) by striking ‘‘subsection (a)’’ and insert-
ing ‘‘this section’’; and 
(B) by striking ‘‘2001 through 2004’’ and 
inserting ‘‘2010 through 2015’’.
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SEC. 5308. ADVANCED NURSING EDUCATION GRANTS. 
Section 811 of the Public Health Service Act (42 
U.S.C. 296j) is amended— 
(1) in subsection (c)— 
(A) in the subsection heading, by striking 
‘‘AND NURSE MIDWIFERY PROGRAMS’’; and 
(B) by striking ‘‘and nurse midwifery’’; 
(2) in subsection (f)— 
(A) by striking paragraph (2); and 
(B) by redesignating paragraph (3) as 
paragraph (2); and 
(3) by redesignating subsections (d), (e), and (f) 
as subsections (e), (f), and (g), respectively; and 
(4) by inserting after subsection (c), the fol-
lowing: 
‘‘(d) AUTHORIZED NURSE-MIDWIFERY PROGRAMS.— 
Midwifery programs that are eligible for support under this 
section are educational programs that— 
‘‘(1) have as their objective the education of mid-
wives; and 
‘‘(2) are accredited by the American College of 
Nurse-Midwives Accreditation Commission for Mid-
wifery Education.’’.
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SEC. 5309. NURSE EDUCATION, PRACTICE, AND RETENTION 
GRANTS. 
(a) IN GENERAL.—Section 831 of the Public Health 
Service Act (42 U.S.C. 296p) is amended— 
(1) in the section heading, by striking ‘‘RETEN-
TION’’ and inserting ‘‘QUALITY’’; 
(2) in subsection (a)— 
(A) in paragraph (1), by adding ‘‘or’’ after 
the semicolon; 
(B) by striking paragraph (2); and 
(C) by redesignating paragraph (3) as 
paragraph (2); 
(3) in subsection (b)(3), by striking ‘‘managed 
care, quality improvement’’ and inserting ‘‘coordi-
nated care’’; 
(4) in subsection (g), by inserting ‘‘, as defined 
in section 801(2),’’ after ‘‘school of nursing’’; and 
(5) in subsection (h), by striking ‘‘2003 through 
2007’’ and inserting ‘‘2010 through 2014’’. 
(b) NURSE RETENTION GRANTS.—Title VIII of the 
Public Health Service Act is amended by inserting after 
section 831 (42 U.S.C. 296b) the following: 
‘‘SEC. 831A. NURSE RETENTION GRANTS. 
‘‘(a) RETENTION PRIORITY AREAS.—The Secretary 
may award grants to, and enter into contracts with, eligible 
entities to enhance the nursing workforce by initiating and
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maintaining nurse retention programs pursuant to sub-
section (b) or (c). 
‘‘(b) GRANTS FOR CAREER LADDER PROGRAM.—The 
Secretary may award grants to, and enter into contracts 
with, eligible entities for programs— 
‘‘(1) to promote career advancement for individ-
uals including licensed practical nurses, licensed vo-
cational nurses, certified nurse assistants, home 
health aides, diploma degree or associate degree 
nurses, to become baccalaureate prepared registered 
nurses or advanced education nurses in order to meet 
the needs of the registered nurse workforce; 
‘‘(2) developing and implementing internships 
and residency programs in collaboration with an ac-
credited school of nursing, as defined by section 
801(2), to encourage mentoring and the development 
of specialties; or 
‘‘(3) to assist individuals in obtaining education 
and training required to enter the nursing profession 
and advance within such profession. 
‘‘(c) ENHANCING
PATIENT
CARE
DELIVERY
SYS-
TEMS.— 
‘‘(1) GRANTS.—The Secretary may award grants 
to eligible entities to improve the retention of nurses 
and enhance patient care that is directly related to
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nursing activities by enhancing collaboration and 
communication among nurses and other health care 
professionals, and by promoting nurse involvement in 
the organizational and clinical decision-making proc-
esses of a health care facility. 
‘‘(2) PRIORITY.—In making awards of grants 
under this subsection, the Secretary shall give pref-
erence to applicants that have not previously received 
an award under this subsection (or section 831(c) as 
such section existed on the day before the date of en-
actment of this section). 
‘‘(3) CONTINUATION
OF
AN
AWARD.—The Sec-
retary shall make continuation of any award under 
this subsection beyond the second year of such award 
contingent on the recipient of such award having 
demonstrated to the Secretary measurable and sub-
stantive improvement in nurse retention or patient 
care. 
‘‘(d) OTHER PRIORITY AREAS.—The Secretary may 
award grants to, or enter into contracts with, eligible enti-
ties to address other areas that are of high priority to nurse 
retention, as determined by the Secretary. 
‘‘(e) REPORT.—The Secretary shall submit to the Con-
gress before the end of each fiscal year a report on the grants 
awarded and the contracts entered into under this section.
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Each such report shall identify the overall number of such 
grants and contracts and provide an explanation of why 
each such grant or contract will meet the priority need of 
the nursing workforce. 
‘‘(f) ELIGIBLE ENTITY.—For purposes of this section, 
the term ‘eligible entity’ includes an accredited school of 
nursing, as defined by section 801(2), a health care facility, 
or a partnership of such a school and facility. 
‘‘(g) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 2010 
through 2012.’’. 
SEC. 5310. LOAN REPAYMENT AND SCHOLARSHIP PRO-
GRAM. 
(a) LOAN REPAYMENTS AND SCHOLARSHIPS.—Section 
846(a)(3) of the Public Health Service Act (42 U.S.C. 
297n(a)(3)) is amended by inserting before the semicolon 
the following: ‘‘, or in a accredited school of nursing, as 
defined by section 801(2), as nurse faculty’’. 
(b) TECHNICAL
AND CONFORMING AMENDMENTS.— 
Title VIII (42 U.S.C. 296 et seq.) is amended— 
(1) by redesignating section 810 (relating to pro-
hibition against discrimination by schools on the 
basis of sex) as section 809 and moving such section 
so that it follows section 808;
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(2) in sections 835, 836, 838, 840, and 842, by 
striking the term ‘‘this subpart’’ each place it appears 
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 I; 
(8) in part G— 
(A) by redesignating section 845 as section 
851; and 
(B) by redesignating part G as part F; 
(9) in part H— 
(A) by redesignating sections 851 and 852 
as sections 861 and 862, respectively; and 
(B) by redesignating part H as part G; and 
(10) in part I— 
(A) by redesignating section 855, as amend-
ed by section 5305, as section 865; and
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(B) by redesignating part I as part H. 
SEC. 5311. NURSE FACULTY LOAN PROGRAM. 
(a) IN GENERAL.—Section 846A of the Public Health 
Service Act (42 U.S.C. 297n–1) is amended— 
(1) in subsection (a)— 
(A) in the subsection heading, by striking 
‘‘ESTABLISHMENT’’ and inserting ‘‘SCHOOL OF 
NURSING STUDENT LOAN FUND’’; and 
(B) by inserting ‘‘accredited’’ after ‘‘agree-
ment with any’’; 
(2) in subsection (c)— 
(A) in paragraph (2), by striking ‘‘$30,000’’ 
and all that follows through the semicolon and 
inserting ‘‘$35,500, during fiscal years 2010 and 
2011 fiscal years (after fiscal year 2011, such 
amounts shall be adjusted to provide for a cost- 
of-attendance increase for the yearly loan rate 
and the aggregate loan;’’; and 
(B) in paragraph (3)(A), by inserting ‘‘an 
accredited’’ after ‘‘faculty member in’’; 
(3) in subsection (e), by striking ‘‘a school’’ and 
inserting ‘‘an accredited school’’; and 
(4) in subsection (f), by striking ‘‘2003 through 
2007’’ and inserting ‘‘2010 through 2014’’.
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(b) ELIGIBLE INDIVIDUAL STUDENT LOAN REPAY-
MENT.—Title VIII of the Public Health Service Act is 
amended by inserting after section 846A (42 U.S.C. 297n– 
1) the following: 
‘‘SEC. 847. ELIGIBLE INDIVIDUAL STUDENT LOAN REPAY-
MENT. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Administrator of the Health Resources and Services Admin-
istration, may enter into an agreement with eligible indi-
viduals for the repayment of education loans, in accordance 
with this section, to increase the number of qualified nurs-
ing faculty. 
‘‘(b) AGREEMENTS.—Each agreement entered into 
under this subsection shall require that the eligible indi-
vidual shall serve as a full-time member of the faculty of 
an accredited school of nursing, for a total period, in the 
aggregate, of at least 4 years during the 6-year period be-
ginning on the later of— 
‘‘(1) the date on which the individual receives a 
master’s or doctorate nursing degree from an accred-
ited school of nursing; or 
‘‘(2) the date on which the individual enters into 
an agreement under this subsection. 
‘‘(c) AGREEMENT PROVISIONS.—Agreements entered 
into pursuant to subsection (b) shall be entered into on such
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terms and conditions as the Secretary may determine, ex-
cept that— 
‘‘(1) not more than 10 months after the date on 
which the 6-year period described under subsection (b) 
begins, but in no case before the individual starts as 
a full-time member of the faculty of an accredited 
school of nursing the Secretary shall begin making 
payments, for and on behalf of that individual, on the 
outstanding principal of, and interest on, any loan of 
that individual obtained to pay for such degree; 
‘‘(2) for an individual who has completed a mas-
ter’s in nursing or equivalent degree in nursing— 
‘‘(A) payments may not exceed $10,000 per 
calendar year; and 
‘‘(B) total payments may not exceed 
$40,000 during the 2010 and 2011 fiscal years 
(after fiscal year 2011, such amounts shall be ad-
justed to provide for a cost-of-attendance increase 
for the yearly loan rate and the aggregate loan); 
and 
‘‘(3) for an individual who has completed a doc-
torate or equivalent degree in nursing— 
‘‘(A) payments may not exceed $20,000 per 
calendar year; and