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eases for targeted individuals, to improve the quality of 
care and reduce overall cost in the treatment of such dis-
eases. The Secretary shall commence the grant program 
not later than May 1, 2011. 
(b) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under subsection (a), an entity shall— 
(1) provide a setting appropriate for MTM serv-
ices, as recommended by the experts described in 
subsection (e); 
(2) submit to the Secretary a plan for achieving 
long-term financial sustainability; 
(3) where applicable, submit a plan for coordi-
nating MTM services with other local providers and 
where applicable, through or in collaboration with 
the Medicare Medical Home Pilot program as estab-
lished by section 1866F of the Social Security Act, 
as added by section 1302(a) of this Act; 
(4) submit a plan for meeting the requirements 
under subsection (c); and 
(5) submit to the Secretary such other informa-
tion as the Secretary may require. 
(c) MTM SERVICES TO TARGETED INDIVIDUALS.— 
The MTM services provided with the assistance of a grant 
awarded under subsection (a) shall, as allowed by State 
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law (including applicable collaborative pharmacy practice 
agreements), include— 
(1) performing or obtaining necessary assess-
ments of the health and functional status of each 
patient receiving such MTM services; 
(2) formulating a medication treatment plan ac-
cording to therapeutic goals agreed upon by the pre-
scriber and the patient or caregiver or authorized 
representative of the patient; 
(3) selecting, initiating, modifying, recom-
mending changes to, or administering medication 
therapy; 
(4) monitoring, which may include access to, or-
dering, or performing laboratory assessments, and 
evaluating the response of the patient to therapy, in-
cluding safety and effectiveness; 
(5) performing an initial comprehensive medica-
tion review to identify, resolve, and prevent medica-
tion-related problems, including adverse drug events, 
quarterly targeted medication reviews for ongoing 
monitoring, and additional followup interventions on 
a schedule developed collaboratively with the pre-
scriber; 
(6) documenting the care delivered and commu-
nicating essential information about such care (in-
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cluding a summary of the medication review) and 
the recommendations of the pharmacist to other ap-
propriate health care providers of the patient in a 
timely fashion; 
(7) providing education and training designed 
to enhance the understanding and appropriate use of 
the medications by the patient, caregiver, and other 
authorized representative; 
(8) providing information, support services, and 
resources and strategies designed to enhance patient 
adherence with therapeutic regimens; 
(9) coordinating and integrating MTM services 
within the broader health care management services 
provided to the patient; and 
(10) such other patient care services as are al-
lowed under the scopes of practice for pharmacists 
for purposes of other Federal programs. 
(d) TARGETED INDIVIDUALS.—MTM services pro-
vided by licensed pharmacists under a grant awarded 
under subsection (a) shall be offered to targeted individ-
uals who— 
(1) take 4 or more prescribed medications (in-
cluding over-the-counter and dietary supplements); 
(2) take any high-risk medications; 
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(3) have 2 or more chronic diseases, as identi-
fied by the Secretary; or 
(4) have undergone a transition of care, or 
other factors, as determined by the Secretary, that 
are likely to create a high risk of medication-related 
problems. 
(e) CONSULTATION WITH EXPERTS.—In designing 
and implementing MTM services provided under grants 
awarded under subsection (a), the Secretary shall consult 
with Federal, State, private, public-private, and academic 
entities, pharmacy and pharmacist organizations, health 
care organizations, consumer advocates, chronic disease 
groups, and other stakeholders involved with the research, 
dissemination, and implementation of pharmacist-deliv-
ered MTM services, as the Secretary determines appro-
priate. The Secretary, in collaboration with this group, 
shall determine whether it is possible to incorporate rapid 
cycle process improvement concepts in use in other Fed-
eral programs that have implemented MTM services. 
(f) REPORTING TO THE SECRETARY.—An entity that 
receives a grant under subsection (a) shall submit to the 
Secretary a report that describes and evaluates, as re-
quested by the Secretary, the activities carried out under 
subsection (c), including quality measures, as determined 
by the Secretary. 
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(g) EVALUATION AND REPORT.—The Secretary shall 
submit to the relevant committees of Congress a report 
which shall— 
(1) assess the clinical effectiveness of phar-
macist-provided services under the MTM services 
program, as compared to usual care, including an 
evaluation of whether enrollees maintained better 
health with fewer hospitalizations and emergency 
room visits than similar patients not enrolled in the 
program; 
(2) assess changes in overall health care re-
source of targeted individuals; 
(3) assess patient and prescriber satisfaction 
with MTM services; 
(4) assess the impact of patient-cost-sharing re-
quirements on medication adherence and rec-
ommendations for modifications; 
(5) identify and evaluate other factors that may 
impact clinical and economic outcomes, including de-
mographic characteristics, clinical characteristics, 
and health services use of the patient, as well as 
characteristics of the regimen, pharmacy benefit, 
and MTM services provided; and 
(6) evaluate the extent to which participating 
pharmacists who maintain a dispensing role have a 
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conflict of interest in the provision of MTM services, 
and if such conflict is found, provide recommenda-
tions on how such a conflict might be appropriately 
addressed. 
(h) GRANT TO FUND DEVELOPMENT OF PERFORM-
ANCE MEASURES.—The Secretary may award grants or 
contracts to eligible entities for the purpose of funding the 
development of performance measures that assess the use 
and effectiveness of medication therapy management serv-
ices. 
SEC. 2529. POSTPARTUM DEPRESSION. 
(a) EXPANSION AND INTENSIFICATION OF ACTIVI-
TIES.— 
(1) CONTINUATION OF ACTIVITIES.—The Sec-
retary is encouraged to expand and intensify activi-
ties on postpartum conditions. 
(2) 
PROGRAMS
FOR
POSTPARTUM
CONDI-
TIONS.—In carrying out paragraph (1), the Sec-
retary is encouraged to continue research to expand 
the understanding of the causes of, and treatments 
for, postpartum conditions, including conducting and 
supporting the following: 
(A) Basic research concerning the etiology 
and causes of the conditions. 
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(B) Epidemiological studies to address the 
frequency and natural history of the conditions 
and the differences among racial and ethnic 
groups with respect to the conditions. 
(C) The development of improved screen-
ing and diagnostic techniques. 
(D) Clinical research for the development 
and evaluation of new treatments. 
(E) Information and education programs 
for health professionals and the public, which 
may include a coordinated national campaign 
that— 
(i) is designed to increase the aware-
ness and knowledge of postpartum condi-
tions; 
(ii) may include public service an-
nouncements through television, radio, and 
other means; and 
(iii) may focus on— 
(I) 
raising 
awareness 
about 
screening; 
(II) educating new mothers and 
their families about postpartum condi-
tions to promote earlier diagnosis and 
treatment; and 
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(III) ensuring that such edu-
cation includes complete information 
concerning postpartum conditions, in-
cluding its symptoms, methods of cop-
ing with the illness, and treatment re-
sources. 
(b) REPORT BY THE SECRETARY.— 
(1) STUDY.—The Secretary shall conduct a 
study on the benefits of screening for postpartum 
conditions. 
(2) REPORT.—Not later than 2 years after the 
date of the enactment of this Act, the Secretary 
shall complete the study required by paragraph (1) 
and submit a report to the Congress on the results 
of such study. 
(c) SENSE
OF CONGRESS REGARDING LONGITU-
DINAL STUDY
OF RELATIVE MENTAL HEALTH CON-
SEQUENCES
FOR
WOMEN
OF
RESOLVING
A
PREG-
NANCY.— 
(1) SENSE OF CONGRESS.—It is the sense of 
the Congress that the Director of the National Insti-
tute of Mental Health may conduct a nationally rep-
resentative longitudinal study (during the period of 
fiscal years 2011 through 2020) on the relative men-
tal health consequences for women of resolving a 
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pregnancy (intended and unintended) in various 
ways, including carrying the pregnancy to term and 
parenting the child, carrying the pregnancy to term 
and placing the child for adoption, miscarriage, and 
having an abortion. This study may assess the inci-
dence, timing, magnitude, and duration of the imme-
diate and long-term mental health consequences 
(positive or negative) of these pregnancy outcomes. 
(2) REPORT.—Beginning not later than 3 years 
after the date of the enactment of this Act, and peri-
odically thereafter for the duration of the study, 
such Director may prepare and submit to the Con-
gress reports on the findings of the study. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘postpartum condition’’ means 
postpartum depression or postpartum psychosis. 
(2) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, in addition to any 
other amounts authorized to be appropriated for such pur-
pose, there are authorized to be appropriated such sums 
as may be necessary for each of fiscal years 2011 through 
2013. 
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SEC. 2530. GRANTS TO PROMOTE POSITIVE HEALTH BEHAV-
IORS AND OUTCOMES. 
Part P of title III (42 U.S.C. 280g et seq.) is amend-
ed by adding at the end the following: 
‘‘SEC. 399V. GRANTS TO PROMOTE POSITIVE HEALTH BE-
HAVIORS AND OUTCOMES. 
‘‘(a) GRANTS AUTHORIZED.—The Secretary, in col-
laboration with the Director of the Centers for Disease 
Control and Prevention and other Federal officials deter-
mined appropriate by the Secretary, is authorized to 
award grants to eligible entities to promote positive health 
behaviors for populations in medically underserved com-
munities through the use of community health workers. 
‘‘(b) USE OF FUNDS.—Grants awarded under sub-
section (a) shall be used to support community health 
workers— 
‘‘(1) to educate, guide, and provide outreach in 
a community setting regarding health problems prev-
alent in medically underserved communities, espe-
cially racial and ethnic minority populations; 
‘‘(2) to educate, guide, and provide experiential 
learning opportunities that target behavioral risk 
factors including— 
‘‘(A) poor nutrition; 
‘‘(B) physical inactivity; 
‘‘(C) being overweight or obese; 
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‘‘(D) tobacco use; 
‘‘(E) alcohol and substance use; 
‘‘(F) injury and violence; 
‘‘(G) risky sexual behavior; 
‘‘(H) untreated mental health problems; 
‘‘(I) untreated dental and oral health prob-
lems; and 
‘‘(J) understanding informed consent; 
‘‘(3) to educate and provide guidance regarding 
effective strategies to promote positive health behav-
iors within the family; 
‘‘(4) to educate and provide outreach regarding 
enrollment in health insurance including the State 
Children’s Health Insurance Program under title 
XXI of the Social Security Act, Medicare under title 
XVIII of such Act, and Medicaid under title XIX of 
such Act; 
‘‘(5) to educate and refer underserved popu-
lations to appropriate health care agencies and com-
munity-based programs and organizations in order 
to increase access to quality health care services, in-
cluding preventive health services, and to eliminate 
duplicative care; or 
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‘‘(A) with a high percentage of residents 
who are eligible for health insurance but are 
uninsured or underinsured; 
‘‘(B) with a high percentage of residents 
who suffer from chronic diseases including pul-
monary conditions, hypertension, heart disease, 
mental disorders, diabetes, and asthma; and 
‘‘(C) with a high infant mortality rate; 
‘‘(2) have experience in providing health or 
health-related social services to individuals who are 
underserved with respect to such services; and 
‘‘(3) have documented community activity and 
experience with community health workers. 
‘‘(e) COLLABORATION WITH ACADEMIC INSTITU-
TIONS.—The Secretary shall encourage community health 
worker programs receiving funds under this section to col-
laborate with academic institutions, especially those that 
graduate a disproportionate number of health and health 
care students from underrepresented racial and ethnic mi-
nority backgrounds. Nothing in this section shall be con-
strued to require such collaboration. 
‘‘(f) EVIDENCE-BASED INTERVENTIONS.—The Sec-
retary shall encourage community health worker programs 
receiving funding under this section to implement an out-
come-based payment system that rewards community 
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health workers for connecting underserved populations 
with the most appropriate services at the most appropriate 
time. Nothing in this section shall be construed to require 
such payment. 
‘‘(g) QUALITY ASSURANCE AND COST EFFECTIVE-
NESS.—The Secretary shall establish guidelines for assur-
ing the quality of the training and supervision of commu-
nity health workers under the programs funded under this 
section and for assuring the cost-effectiveness of such pro-
grams. 
‘‘(h) MONITORING.—The Secretary shall monitor 
community health worker programs identified in approved 
applications under this section and shall determine wheth-
er such programs are in compliance with the guidelines 
established under subsection (g). 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to community health worker 
programs identified in approved applications under this 
section with respect to planning, developing, and operating 
programs under the grant. 
‘‘(j) REPORT TO CONGRESS.— 
‘‘(1) IN
GENERAL.—Not later than 4 years 
after the date on which the Secretary first awards 
grants under subsection (a), the Secretary shall sub-
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mit to Congress a report regarding the grant 
project. 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
‘‘(A) A description of the programs for 
which grant funds were used. 
‘‘(B) The number of individuals served 
under such programs. 
‘‘(C) An evaluation of— 
‘‘(i) the effectiveness of such pro-
grams; 
‘‘(ii) the cost of such programs; and 
‘‘(iii) the impact of the programs on 
the health outcomes of the community resi-
dents. 
‘‘(D) Recommendations for sustaining the 
community health worker programs developed 
or assisted under this section. 
‘‘(E) Recommendations regarding training 
to enhance career opportunities for community 
health workers. 
‘‘(k) DEFINITIONS.—In this section: 
‘‘(1) COMMUNITY HEALTH WORKER.—The term 
‘community health worker’ means an individual who 
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promotes health or nutrition within the community 
in which the individual resides— 
‘‘(A) by serving as a liaison between com-
munities and health care agencies; 
‘‘(B) by providing guidance and social as-
sistance to community residents; 
‘‘(C) by enhancing community residents’ 
ability to effectively communicate with health 
care providers; 
‘‘(D) by providing culturally and linguis-
tically appropriate health or nutrition edu-
cation; 
‘‘(E) by advocating for individual and com-
munity health, including oral and mental, or 
nutrition needs; and 
‘‘(F) by providing referral and followup 
services or otherwise coordinating care. 
‘‘(2) COMMUNITY SETTING.—The term ‘commu-
nity setting’ means a home or a community organi-
zation located in the neighborhood in which a partic-
ipant resides. 
‘‘(3) MEDICALLY UNDERSERVED COMMUNITY.— 
The term ‘medically underserved community’ means 
a community identified by a State, United States 
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territory or possession, or federally recognized In-
dian tribe— 
‘‘(A) that has a substantial number of in-
dividuals who are members of a medically un-
derserved population, as defined by section 
330(b)(3); and 
‘‘(B) a significant portion of which is a 
health professional shortage area as designated 
under section 332. 
‘‘(4) SUPPORT.—The term ‘support’ means the 
provision of training, supervision, and materials 
needed to effectively deliver the services described in 
subsection (b), reimbursement for services, and 
other benefits. 
‘‘(5) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means a public or private nonprofit entity (in-
cluding a State or public subdivision of a State, a 
public health department, or a federally qualified 
health center), or a consortium of any of such enti-
ties, located in the United States or territory there-
of. 
‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$30,000,000 for each of fiscal years 2011 through 2015.’’. 
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SEC. 2531. MEDICAL LIABILITY ALTERNATIVES. 
(a) INCENTIVE PAYMENTS FOR MEDICAL LIABILITY 
REFORM.— 
(1) IN GENERAL.—To the extent and in the 
amounts made available in advance in appropriations 
Acts, the Secretary shall make an incentive payment, 
in an amount determined by the Secretary, to each 
State that has an alternative medical liability law in 
compliance with this section. 
(2) DETERMINATION
BY
SECRETARY.—The 
Secretary shall determine that a State has an alter-
native medical liability law in compliance with this 
section if the Secretary is satisfied that— 
(A) the State enacted the law after the 
date of the enactment of this Act and is imple-
menting the law; 
(B) the law is effective; and 
(C) the contents of the law are in accord-
ance with paragraph (4). 
(3) CONSIDERATIONS
FOR
DETERMINING
EF-
FECTIVENESS.—In determining whether an alter-
native medical liability law is effective under para-
graph (2)(B), the Secretary shall consider whether 
the law— 
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(A) makes the medical liability system 
more reliable through prevention of, or prompt 
and fair resolution of, disputes; 
(B) encourages the disclosure of health 
care errors; and 
(C) maintains access to affordable liability 
insurance. 
(4) CONTENTS OF ALTERNATIVE MEDICAL LI-
ABILITY LAW.—The contents of an alternative liabil-
ity law are in accordance with this paragraph if— 
(A) the litigation alternatives contained in 
the law consist of certificate of merit, early 
offer, or both; and 
(B) the law does not limit attorneys’ fees 
or impose caps on damages. 
(b) USE OF INCENTIVE PAYMENTS.—Amounts re-
ceived by a State as an incentive payment under this sec-
tion shall be used to improve health care in that State. 
(c) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to the States applying for or 
receiving an incentive payment under this section. 
(d) REPORTS.—Beginning not later than one year 
after the date of the enactment of this Act, the Secretary 
shall submit to the Congress an annual report on the 
progress States have made in enacting and implementing 
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alternative medical liability laws in compliance with this 
section. Such reports shall contain sufficient documenta-
tion regarding the effectiveness of such laws to enable an 
objective comparative analysis of such laws. 
(e) DEFINITION.—In this section— 
(1) the term ‘‘Secretary’’ means the Secretary 
of Health and Human Services; and 
(2) the term ‘‘State’’ includes the several 
States, District of Columbia, the Commonwealth of 
Puerto Rico, and each other territory or possession 
of the United States. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary, to remain available until 
expended. 
SEC. 2532. INFANT MORTALITY PILOT PROGRAMS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Director, shall award grants 
to eligible entities to create, implement, and oversee infant 
mortality pilot programs. 
(b) PERIOD OF A GRANT.—The period of a grant 
under this section shall be 5 consecutive fiscal years. 
(c) PREFERENCE.—In awarding grants under this 
section, the Secretary shall give preference to eligible enti-
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ties proposing to serve any of the 15 counties or groups 
of counties with the highest rates of infant mortality in 
the United States in the past 3 years. 
(d) USE OF FUNDS.—Any infant mortality pilot pro-
gram funded under this section may— 
(1) include the development of a plan that iden-
tifies the individual needs of each community to be 
served and strategies to address those needs; 
(2) provide outreach to at-risk mothers through 
programs deemed appropriate by the Director; 
(3) develop and implement standardized sys-
tems for improved access, utilization, and quality of 
social, educational, and clinical services to promote 
healthy pregnancies, full term births, and healthy in-
fancies delivered to women and their infants, such 
as— 
(A) counseling on infant care, feeding, and 
parenting; 
(B) postpartum care; 
(C) prevention of premature delivery; and 
(D) additional counseling for at-risk moth-
ers, including smoking cessation programs, 
drug treatment programs, alcohol treatment 
programs, nutrition and physical activity pro-
grams, postpartum depression and domestic vio-
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lence programs, social and psychological serv-
ices, dental care, and parenting programs; 
(4) establish a rural outreach program to pro-
vide care to at-risk mothers in rural areas; 
(5) establish a regional public education cam-
paign, including a campaign to— 
(A) prevent preterm births; and 
(B) educate the public about infant mor-
tality; and 
(6) provide for any other activities, programs, 
or strategies as identified by the community plan. 
(e) LIMITATION.—Of the funds received through a 
grant under this section for a fiscal year, an eligible entity 
shall not use more than 10 percent for program evalua-
tion. 
(f) REPORTS ON PILOT PROGRAMS.— 
(1) IN GENERAL.—Not later than 1 year after 
receiving a grant, and annually thereafter for the 
duration of the grant period, each entity that re-
ceives a grant under subsection (a) shall submit a 
report to the Secretary detailing its infant mortality 
pilot program. 
(2) CONTENTS OF REPORT.—The reports re-
quired under paragraph (1) shall include informa-
tion such as the methodology of, and outcomes and 
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statistics from, the grantee’s infant mortality pilot 
program. 
(3) EVALUATION.—The Secretary shall use the 
reports required under paragraph (1) to evaluate, 
and conduct statistical research on, infant mortality 
pilot programs funded through this section. 
(g) DEFINITIONS.—For the purposes of this section: 
(1) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Centers for Disease Control and 
Prevention. 
(2) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a State, county, city, territorial, or tribal 
health department that has submitted a proposal to 
the Secretary that the Secretary deems likely to re-
duce infant mortality rates within the standard met-
ropolitan statistical area involved. 
(3) TRIBAL.—The term ‘‘tribal’’ refers to an 
Indian tribe, a Tribal organization, or an Urban In-
dian organization, as such terms are defined in sec-
tion 4 of the Indian Health Care Improvement Act. 
(h) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$10,000,000 for each of fiscal years 2011 through 2015. 
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SEC. 2533. SECONDARY SCHOOL HEALTH SCIENCES TRAIN-
ING PROGRAM. 
(a) PROGRAM.—The Secretary of Health and Human 
Services, acting through the Administrator of the Health 
Resources and Services Administration, and in consulta-
tion with the Secretary of Education, may establish a 
health sciences training program consisting of awarding 
grants and contracts under subsection (b) to prepare sec-
ondary school students for careers in health professions. 
(b) DEVELOPMENT
AND
IMPLEMENTATION
OF 
HEALTH SCIENCES CURRICULA.—The Secretary may 
make grants to, or enter into contracts with, eligible enti-
ties— 
(1) to plan, develop, or implement secondary 
school health sciences curricula, including curricula 
in biology, chemistry, physiology, mathematics, nu-
trition, and other courses deemed appropriate by the 
Secretary to prepare students for associate’s or 
bachelor’s degree programs in health professions or 
bachelor’s degree programs in health professions-re-
lated majors; and 
(2) to increase the interest of secondary school 
students in applying to, and enrolling in, accredited 
associate’s or bachelor’s degree programs in health 
professions or bachelor’s degree programs in health 
professions-related majors, including through— 
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(A) work-study programs; 
(B) programs to increase awareness of ca-
reers in health professions; and 
(C) other activities to increase such inter-
est. 
(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall— 
(1) be a local educational agency; and 
(2) provide assurances that activities under the 
grant or contract will be carried out in partnership 
with an accredited health professions school or pro-
gram, public or private nonprofit hospital, or public 
or private nonprofit entity. 
(d) PREFERENCE.—In awarding grants and con-
tracts under subsection (b), the Secretary shall give pref-
erence to entities that have a demonstrated record of at 
least one of the following: 
(1) Graduating a high or significantly improved 
percentage of students who have exhibited mastery 
in secondary school State science standards. 
(2) Graduating students from disadvantaged 
backgrounds, including racial and ethnic minorities 
who are underrepresented in— 
(A) associate’s or bachelor’s degree pro-
grams in health professions or bachelor’s degree 
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programs in health professions-related majors; 
or 
(B) health professions. 
(e) REPORT.—The Secretary shall submit to the Con-
gress an annual report on the program carried out under 
this section. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘health profession’’ means the 
profession of any member of the health workforce, 
as defined in section 764(i) of the Public Health 
Service Act, as added by section 2261. 
(2) The term ‘‘local educational agency’’ has 
the meaning given to the term in section 9101 of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(3) The term ‘‘secondary school’’— 
(A) means a secondary school, as defined 
in section 9101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 
7801); and 
(B) includes any such school that is a mid-
dle school. 
(4) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services except as otherwise 
specified. 
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(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for each of fiscal years 
2011 through 2015. 
SEC. 2534. COMMUNITY-BASED COLLABORATIVE CARE NET-
WORKS. 
(a) PURPOSE.—The purpose of this subtitle is to es-
tablish and provide assistance to community-based col-
laborative care networks— 
(1) to develop or strengthen coordination of 
services to allow all individuals, including the unin-
sured and low-income, to receive efficient and higher 
quality care and to gain entry into and receive serv-
ices from a comprehensive system of care; 
(2) to develop efficient and sustainable infra-
structure for a health care delivery system charac-
terized by effective collaboration, information shar-
ing, and clinical and financial coordination among 
providers of care in the community; 
(3) to develop or strengthen activities related to 
providing coordinated care for individuals with 
chronic conditions; and 
(4) to reduce the use of emergency depart-
ments, inpatient and other expensive resources of 
hospitals and other providers. 
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(b) CREATION
OF
THE COMMUNITY-BASED COL-
LABORATIVE CARE NETWORK PROGRAM.—Part D of title 
III (42 U.S.C. 254b et seq.), as amended, is further 
amended by inserting after subpart XII the following new 
subpart: 
‘‘Subpart XIII—Community-Based Collaborative Care 
Network Program 
‘‘SEC. 340O. COMMUNITY-BASED COLLABORATIVE CARE 
NETWORK PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to eligible entities for the purpose of establishing model 
projects to accomplish the following goals: 
‘‘(1) To reduce unnecessary use of items and 
services furnished in emergency departments of hos-
pitals (especially to ensure that individuals without 
health insurance coverage or with inadequate health 
insurance coverage do not use the services of such 
department instead of the services of a primary care 
provider) through methods such as— 
‘‘(A) screening individuals who seek emer-
gency department services for possible eligibility 
under relevant governmental health programs 
or for subsidies under such programs; and 
‘‘(B) providing such individuals referrals 
for followup care and chronic condition care. 
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‘‘(2) To manage chronic conditions to reduce 
their severity, negative health outcomes, and ex-
pense. 
‘‘(3) To encourage health care providers to co-
ordinate their efforts so that the most vulnerable pa-
tient populations seek and obtain primary care. 
‘‘(4) To provide more comprehensive and co-
ordinated care to vulnerable low-income individuals 
and individuals without health insurance coverage or 
with inadequate coverage. 
‘‘(5) To provide mechanisms for improving both 
quality and efficiency of care for low-income individ-
uals and families, with an emphasis on those most 
likely to remain uninsured despite the existence of 
government programs to make health insurance 
more affordable. 
‘‘(6) To increase preventive services, including 
screening and counseling, to those who would other-
wise not receive such screening, in order to improve 
health status and reduce long-term complications 
and costs. 
‘‘(7) To ensure the availability of community- 
wide safety net services, including emergency and 
trauma care. 
‘‘(b) ELIGIBILITY AND GRANTEE SELECTION.— 
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‘‘(1) APPLICATION.—A community-based col-
laborative care network described in subsection (d) 
shall submit to the Secretary an application in such 
form and manner and containing such information 
as specified by the Secretary. Such information shall 
at least— 
‘‘(A) identify the health care providers par-
ticipating in the community-based collaborative 
care network proposed by the applicant and, if 
a provider designated in paragraph (d)(1)(B) is 
not included, the reason such provider is not so 
included; 
‘‘(B) include a description of how the pro-
viders plan to collaborate to provide comprehen-
sive and integrated care for low-income individ-
uals, including uninsured and underinsured in-
dividuals; 
‘‘(C) include a description of the organiza-
tional and joint governance structure of the 
community-based collaborative care network in 
a manner so that it is clear how decisions will 
be made, and how the decisionmaking process 
of the network will include appropriate rep-
resentation of the participating entities; 
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‘‘(D) define the geographic areas and pop-
ulations that the network intends to serve; 
‘‘(E) define the scope of services that the 
network intends to provide and identify any 
reasons why such services would not include a 
suggested core service identified by the Sec-
retary under paragraph (3); 
‘‘(F) demonstrate the network’s ability to 
meet the requirements of this section; and 
‘‘(G) provide assurances that grant funds 
received shall be used to support the entire 
community-based collaborative care network. 
‘‘(2) SELECTION OF GRANTEES.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
select community-based collaborative care net-
works to receive grants from applications sub-
mitted under paragraph (1) on the basis of 
quality of the proposal involved, geographic di-
versity (including different States and regions 
served and urban and rural diversity), and the 
number of low-income and uninsured individ-
uals that the proposal intends to serve. 
‘‘(B) PRIORITY.—The Secretary shall give 
priority to proposals from community-based col-
laborative care networks that— 
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‘‘(i) include the capability to provide 
the broadest range of services to low-in-
come individuals; and 
‘‘(ii) include providers that currently 
serve a high volume of low-income individ-
uals. 
‘‘(C) RENEWAL.—In subsequent years, 
based on the performance of grantees, the Sec-
retary may provide renewal grants to prior year 
grant recipients. 
‘‘(3) SUGGESTED
CORE
SERVICES.—For pur-
poses of paragraph (1)(E), the Secretary shall de-
velop a list of suggested core patient and core net-
work services to be provided by a community-based 
collaborative care network. The Secretary may select 
a community-based collaborative care network under 
paragraph (2), the application of which does not in-
clude all such services, if such application provides 
a reasonable explanation why such services are not 
proposed to be included, and the Secretary deter-
mines that the application is otherwise high quality. 
‘‘(4) TERMINATION
AUTHORITY.—The Sec-
retary may terminate selection of a community- 
based collaborative care network under this section 
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for good cause. Such good cause shall include a de-
termination that the network— 
‘‘(A) has failed to provide a comprehensive 
range of coordinated and integrated health care 
services as required under subsection (d)(2); 
‘‘(B) has failed to meet reasonable quality 
standards; 
‘‘(C) has misappropriated funds provided 
under this section; or 
‘‘(D) has failed to make progress toward 
accomplishing goals set out in subsection (a). 
‘‘(c) USE OF FUNDS.— 
‘‘(1) USE BY GRANTEES.—Grant funds are pro-
vided to community-based collaborative care net-
works to carry out the following activities: 
‘‘(A) Assist low-income individuals without 
adequate health care coverage to— 
‘‘(i) access and appropriately use 
health services; 
‘‘(ii) enroll in applicable public or pri-
vate health insurance programs; 
‘‘(iii) obtain referrals to and see a pri-
mary care provider in case such an indi-
vidual does not have a primary care pro-
vider; and 
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‘‘(iv) obtain appropriate care for 
chronic conditions. 
‘‘(B) Improve heath care by providing case 
management, application assistance, and appro-
priate referrals such as through methods to— 
‘‘(i) create and meaningfully use a 
health information technology network to 
track patients across collaborative pro-
viders; 
‘‘(ii) perform health outreach, such as 
by using neighborhood health workers who 
may inform individuals about the avail-
ability of safety net and primary care pro-
viders available through the community- 
based collaborative care network; 
‘‘(iii) provide for followup outreach to 
remind patients of appointments or follow- 
up care instructions; 
‘‘(iv) provide transportation to individ-
uals to and from the site of care; 
‘‘(v) expand the capacity to provide 
care at any provider participating in the 
community-based collaborative care net-
work, including telehealth, hiring new clin-
ical or administrative staff, providing ac-
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cess to services after-hours, on weekends, 
or otherwise providing an urgent care al-
ternative to an emergency department; and 
‘‘(vi) provide a primary care provider 
or medical home for each network patient. 
‘‘(C) Provide direct patient care services as 
described in their application and approved by 
the Secretary. 
‘‘(2) GRANT FUNDS TO HRSA GRANTEES.—The 
Secretary may limit the percent of grant funding 
that may be spent on direct care services provided 
by grantees of programs administered by the Health 
Resources and Services Administration (in this sec-
tion referred to as ‘HRSA’) or impose other require-
ments on HRSA grantees participating in a commu-
nity-based collaborative care network as may be nec-
essary for consistency with the requirements of such 
programs. 
‘‘(3) RESERVATION OF FUNDS FOR NATIONAL 
PROGRAM PURPOSES.—The Secretary may use not 
more than 7 percent of funds appropriated to carry 
out this section for providing technical assistance to 
grantees, obtaining assistance of experts and con-
sultants, holding meetings, developing of tools, dis-
seminating of information, and evaluation. 
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‘‘(d) COMMUNITY-BASED
COLLABORATIVE
CARE 
NETWORKS.— 
‘‘(1) IN GENERAL.— 
‘‘(A) DESCRIPTION.—A community-based 
collaborative care network described in this sub-
section is a consortium of health care providers 
with a joint governance structure that provides 
a comprehensive range of coordinated and inte-
grated health care services for low-income pa-
tient populations or medically underserved com-
munities (whether or not such individuals re-
ceive benefits under title XVIII, XIX, or XXI 
of the Social Security Act, private or other 
health insurance or are uninsured or under-
insured) and that complies with any applicable 
minimum eligibility requirements that the Sec-
retary may determine appropriate. 
‘‘(B) REQUIRED
INCLUSION.—Each such 
network shall include the following providers 
that serve the community (unless such provider 
does not exist within the community, declines or 
refuses to participate, or places unreasonable 
conditions on their participation)— 
‘‘(i) A safety net hospital that pro-
vides services to a high volume of low-in-
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come patients, as demonstrated by meeting 
the criteria in section 1923(b)(1) of the 
Social Security Act, or other similar cri-
teria determined by the Secretary; and 
‘‘(ii) All Federally qualified health 
centers (as defined in section 1861(aa) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395x(aa))) located in the geographic area 
served by the Coordinated Care Network; 
‘‘(C) 
ADDITIONAL
INCLUSIONS.—Each 
such network may include any of the following 
additional providers: 
‘‘(i) A hospital, including a critical ac-
cess 
hospital 
(as 
defined 
in 
section 
1820(c)(2) of the Social Security Act (42 
U.S.C. 1395i–4(c)(2))). 
‘‘(ii) A county or municipal depart-
ment of health. 
‘‘(iii) A rural health clinic or a rural 
health network (as defined in sections 
1861(aa) and 1820(d) of the Social Secu-
rity 
Act, 
respectively 
(42 
U.S.C. 
1395x(aa), 1395i–4(d))). 
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‘‘(iv) A community clinic, including a 
mental health clinic, substance abuse clin-
ic, or a reproductive health clinic. 
‘‘(v) A health center controlled net-
work as defined by section 330(e)(1)(C) of 
the Public Health Service Act 
‘‘(vi) A private practice physician or 
group practice. 
‘‘(vii) A nurse or physician assistant 
or group practice. 
‘‘(viii) An adult day care center. 
‘‘(ix) A home health provider. 
‘‘(x) Any other type of provider speci-
fied by the Secretary, which has a desire to 
serve low-income and uninsured patients. 
‘‘(D) CONSTRUCTION.— 
‘‘(i) Nothing in this section shall pro-
hibit a single entity from qualifying as 
community-based collaborative care net-
work so long as such single entity meets 
the criteria of a community-based collabo-
rative care network. If the network does 
not include the providers referenced in 
clauses (i) and (ii) of subparagraph (B) of 
this paragraph, the application must ex-
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plain the reason pursuant to subsection 
(b)(1)(A). 
‘‘(ii) Participation in a community- 
based collaborative care network shall not 
affect Federally qualified health centers’ 
obligation to comply with the governance 
requirements under section 330 of the 
Public Health Service Act (42 U.S.C. 
254b). 
‘‘(iii) Federally qualified health cen-
ters participating in a community-based 
collaborative care network may not be re-
quired to provide services beyond their 
Federal Health Center scope of project ap-
proved by HRSA. 
‘‘(iv) Nothing in this section shall be 
construed to expand medical malpractice li-
ability protection under the Federal Tort 
Claims Act for Section 330-funded Feder-
ally qualified health centers. 
‘‘(2) COMPREHENSIVE RANGE OF COORDINATED 
AND
INTEGRATED
HEALTH
CARE
SERVICES.—The 
Secretary shall define criteria for evaluating whether 
the services offered by a community-based collabo-
rative care network qualify as a comprehensive range 
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of coordinated and integrated health care services. 
Such criteria may vary based on the needs of the ge-
ographic areas and populations to be served by the 
network and may include the following: 
‘‘(A) Requiring community-based collabo-
rative care networks to include at least the sug-
gested core services identified under subsection 
(b)(3), or whichever subset of the suggested 
core services is applicable to a particular net-
work. 
‘‘(B) Requiring such networks to assign 
each patient of the network to a primary care 
provider responsible for managing that patient’s 
care. 
‘‘(C) Requiring the services provided by a 
community-based collaborative care network to 
include support services appropriate to meet the 
health needs of low-income populations in the 
network’s community, which may include chron-
ic care management, nutritional counseling, 
transportation, language services, enrollment 
counselors, social services and other services as 
proposed by the network. 
‘‘(D) Providing that the services provided 
by a community-based collaborative care net-
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work may also include long-term care services 
and other services not specified in this sub-
section. 
‘‘(E) Providing for the approval by the 
Secretary of a scope of community-based col-
laborative care network services for each net-
work that addresses an appropriate minimum 
scope of work consistent with the setting of the 
network and the health professionals available 
in the community the network serves. 
‘‘(3) CLARIFICATION.—Participation in a com-
munity-based collaborative care network shall not 
disqualify a health care provider from reimburse-
ment under title XVIII, XIX, or XXI of the Social 
Security Act with respect to services otherwise reim-
bursable under such title. Nothing in this section 
shall prevent a community-based collaborative care 
network that is otherwise eligible to contract with 
Medicare, a private health insurer, or any other ap-
propriate entity to provide care under Medicare, 
under health insurance coverage offered by the in-
surer, or otherwise. 
‘‘(e) EVALUATIONS.— 
‘‘(1) GRANTEE
REPORTS.—Beginning in the 
third year following an initial grant, each commu-
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nity-based collaborative care network shall submit to 
the Secretary, with respect to each year the grantee 
has received a grant, an evaluation on the activities 
carried out by the community-based collaborative 
care network under the community-based collabo-
rative care network program and shall include— 
‘‘(A) the number of people served; 
‘‘(B) the most common health problems 
treated; 
‘‘(C) any reductions in emergency depart-
ment use; 
‘‘(D) any improvements in access to pri-
mary care; 
‘‘(E) an accounting of how amounts re-
ceived were used, including identification of 
amounts used for patient care services as may 
be required for HRSA grantees; and 
‘‘(F) to the extent requested by the Sec-
retary, any quality measures or any other meas-
ures specified by the Secretary. 
‘‘(2) PROGRAM REPORTS.—The Secretary shall 
submit to Congress an annual evaluation (beginning 
not later than 6 months after the first reports under 
paragraph (1) are submitted) on the extent to which 
emergency department use was reduced as a result 
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of the activities carried out by the community-based 
collaborative care network under the program. Each 
such evaluation shall also include information on— 
‘‘(A) the prevalence of certain chronic con-
ditions in various populations, including a com-
parison of such prevalence in the general popu-
lation versus in the population of individuals 
with inadequate health insurance coverage; 
‘‘(B) demographic characteristics of the 
population of uninsured and underinsured indi-
viduals served by the community-based collabo-
rative care network involved; and 
‘‘(C) the conditions of such individuals for 
whom services were requested at such emer-
gency departments of participating hospitals. 
‘‘(3) AUDIT AUTHORITY.—The Secretary may 
conduct periodic audits and request periodic spend-
ing reports of community-based collaborative care 
networks under the community-based collaborative 
care network program. 
‘‘(f) CLARIFICATION.—Nothing in this section re-
quires a provider to report individually identifiable infor-
mation of an individual to government agencies, unless the 
individual consents, consistent with HIPAA privacy and 
security law, as defined in section 3009(a)(2). 
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‘‘(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 
2011 through 2015.’’. 
SEC. 2535. COMMUNITY-BASED OVERWEIGHT AND OBESITY 
PREVENTION PROGRAM. 
Part Q of title III (42 U.S.C. 280h et seq.) is amend-
ed by inserting after section 399W the following: 
‘‘SEC. 399W–1. COMMUNITY-BASED OVERWEIGHT AND OBE-
SITY PREVENTION PROGRAM. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
community-based overweight and obesity prevention pro-
gram consisting of awarding grants and contracts under 
subsection (b). 
‘‘(b) GRANTS.—The Secretary shall award grants to, 
or enter into contracts with, eligible entities— 
‘‘(1) to plan evidence-based programs for the 
prevention of overweight and obesity among children 
and their families through improved nutrition and 
increased physical activity; or 
‘‘(2) to implement such programs. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be a community 
partnership that demonstrates community support and in-
cludes— 
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‘‘(1) a broad cross section of stakeholders, such 
as— 
‘‘(A) hospitals, health care systems, com-
munity health centers, or other health care pro-
viders; 
‘‘(B) universities, local educational agen-
cies, or childcare providers; 
‘‘(C) State, local, and tribal health depart-
ments; 
‘‘(D) State, local, and tribal park and 
recreation departments; 
‘‘(E) employers; and 
‘‘(F) health insurance companies; 
‘‘(2) residents of the community; and 
‘‘(3) representatives of public and private enti-
ties that have a history of working within and serv-
ing the community. 
‘‘(d) PERIOD OF AWARDS.— 
‘‘(1) IN GENERAL.—The period of a grant or 
contract under this section shall be 5 years, subject 
to renewal under paragraph (2). 
‘‘(2) RENEWAL.—At the end of each fiscal year, 
the Secretary may renew a grant or contract award 
under this section only if the grant or contract re-
cipient demonstrates to the Secretary’s satisfaction 
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the Secretary may not award such a grant unless the ap-
plicant agrees that, during the period in which the trauma 
center involved is receiving payments under the grant, the 
center will maintain access to trauma services at levels not 
less than the levels for the prior year, taking into ac-
count— 
‘‘(1) reasonable volume fluctuation that is not 
caused by intentional trauma boundary reduction; 
‘‘(2) downgrading of the level of services; and 
‘‘(3) whether such center diverts its incoming 
patients away from such center 5 percent or more 
of the time during which the center is in operation 
over the course of the year. 
‘‘(c) TRAUMA CARE REGISTRY.—The Secretary may 
not award a grant to a trauma center under section 
1241(b)(1) unless the center agrees that— 
‘‘(1) not later than 6 months after the date on 
which the center submits a grant application to the 
Secretary, the center will establish and operate a 
registry of trauma cases in accordance with guide-
lines developed by the American College of Surgeons; 
and 
‘‘(2) in carrying out paragraph (1), the center 
will maintain information on the number of trauma 
cases treated by the center and, for each such case, 
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