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(1) strike the second sentence of section 
57.206(b)(1) of title 42, Code of Federal Regula-
tions; and 
(2) make such other revisions to guidelines and 
regulations in effect as of the date of the enactment 
of this Act as may be necessary for consistency with 
the amendments made by paragraph (1). 
SEC. 2213. TRAINING IN FAMILY MEDICINE, GENERAL IN-
TERNAL MEDICINE, GENERAL PEDIATRICS, 
GERIATRICS, AND PHYSICIAN ASSISTANTS. 
Section 747 (42 U.S.C. 293k) is amended— 
(1) by amending the section heading to read as 
follows: ‘‘PRIMARY
CARE
TRAINING
AND
EN-
HANCEMENT’’; 
(2) by redesignating subsection (e) as sub-
section (g); and 
(3) by striking subsections (a) through (d) and 
inserting the following: 
‘‘(a) PROGRAM.—The Secretary shall establish a pri-
mary care training and capacity building program con-
sisting of awarding grants and contracts under sub-
sections (b) and (c). 
‘‘(b) SUPPORT
AND DEVELOPMENT
OF PRIMARY 
CARE TRAINING PROGRAMS.— 
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‘‘(1) IN GENERAL.—The Secretary shall make 
grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(A) to plan, develop, operate, or partici-
pate in an accredited professional training pro-
gram, including an accredited residency or in-
ternship program, in the field of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics for medical students, interns, 
residents, or practicing physicians; 
‘‘(B) to provide financial assistance in the 
form of traineeships and fellowships to medical 
students, interns, residents, or practicing physi-
cians, who are participants in any such pro-
gram, and who plan to specialize or work in 
family medicine, general internal medicine, gen-
eral pediatrics, or geriatrics; 
‘‘(C) to plan, develop, operate, or partici-
pate in an accredited program for the training 
of physicians who plan to teach in family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics training programs including 
in community-based settings; 
‘‘(D) to provide financial assistance in the 
form of traineeships and fellowships to prac-
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ticing physicians who are participants in any 
such programs and who plan to teach in a fam-
ily medicine, general internal medicine, general 
pediatrics, or geriatrics training program; and 
‘‘(E) to plan, develop, operate, or partici-
pate in an accredited program for physician as-
sistant education, and for the training of indi-
viduals who plan to teach in programs to pro-
vide such training. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall 
be— 
‘‘(A) an accredited school of medicine or 
osteopathic medicine, public or nonprofit private 
hospital, or physician assistant training pro-
gram; 
‘‘(B) a public or private nonprofit entity; 
or 
‘‘(C) a consortium of 2 or more entities de-
scribed in subparagraphs (A) and (B). 
‘‘(c) CAPACITY BUILDING IN PRIMARY CARE.— 
‘‘(1) IN GENERAL.—The Secretary shall make 
grants to or enter into contracts with eligible entities 
to establish, maintain, or improve— 
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‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of family medi-
cine, general internal medicine, general pediat-
rics, or geriatrics; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties. 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under paragraph (1), an entity shall be 
an accredited school of medicine or osteopathic med-
icine. 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of health professionals who provide pri-
mary care. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among primary care 
professionals). 
‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health 
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disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the health care needs of vulnerable popu-
lations. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given the term in section 
3171.’’. 
SEC. 2214. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) by redesignating section 748 as 749A; and 
(2) by inserting after section 747 the following: 
‘‘SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMU-
NITY-BASED SETTINGS. 
‘‘(a) PROGRAM.—The Secretary shall establish a pro-
gram for the training of medical residents in community- 
based settings consisting of awarding grants and contracts 
under this section. 
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‘‘(b) DEVELOPMENT AND OPERATION OF COMMU-
NITY-BASED
PROGRAMS.—The Secretary shall make 
grants to, or enter into contracts with, eligible entities— 
‘‘(1) to plan and develop a new primary care 
residency training program, which may include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruiting and training residents and 
faculty; and 
‘‘(C) other activities designated to result in 
accreditation of such a program; or 
‘‘(2) to operate or participate in an established 
primary care residency training program, which may 
include— 
‘‘(A) planning and developing curricula; 
‘‘(B) recruitment and training of residents; 
and 
‘‘(C) retention of faculty. 
‘‘(c) ELIGIBLE ENTITY.—To be eligible to receive a 
grant or contract under subsection (b), an entity shall— 
‘‘(1) be designated as a recipient of payment 
for the direct costs of medical education under sec-
tion 1886(k) of the Social Security Act; 
‘‘(2) be designated as an approved teaching 
health center under section 1502(d) of the Afford-
able Health Care for America Act and continuing to 
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‘‘(e) ADDITIONAL PREFERENCES FOR ESTABLISHED 
PROGRAMS.—In awarding grants and contracts under 
subsection (b)(2), the Secretary shall give preference to 
entities that have a demonstrated record of training— 
‘‘(1) a high or significantly improved percentage 
of health professionals who provide primary care; 
‘‘(2) individuals who are from disadvantaged 
backgrounds (including racial and ethnic minorities 
underrepresented among primary care professionals); 
or 
‘‘(3) individuals who practice in settings having 
the principal focus of serving underserved areas or 
populations experiencing health disparities (including 
serving patients eligible for medical assistance under 
title XIX of the Social Security Act or for child 
health assistance under title XXI of such Act or 
those with special health care needs). 
‘‘(f) PERIOD OF AWARDS.— 
‘‘(1) IN GENERAL.—The period of a grant or 
contract under this section— 
‘‘(A) shall not exceed 3 years for awards 
under subsection (b)(1); and 
‘‘(B) shall not exceed 5 years for awards 
under subsection (b)(2). 
‘‘(2) SPECIAL RULES.— 
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‘‘(A) An award of a grant or contract 
under subsection (b)(1) shall not be renewed. 
‘‘(B) The period of a grant or contract 
awarded to an entity under subsection (b)(2) 
shall not overlap with the period of any grant 
or contact awarded to the same entity under 
subsection (b)(1). 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) HEALTH DISPARITIES.—The term ‘health 
disparities’ has the meaning given the term in sec-
tion 3171. 
‘‘(2) PRIMARY CARE RESIDENT.—The term ‘pri-
mary care resident’ has the meaning given the term 
in section 1886(h)(5)(H) of the Social Security Act. 
‘‘(3) PRIMARY CARE RESIDENCY TRAINING PRO-
GRAM.—The term ‘primary care residency training 
program’ means an approved medical residency 
training program described in section 1886(h)(5)(A) 
of the Social Security Act for primary care residents 
that is— 
‘‘(A) in the case of entities seeking awards 
under subsection (b)(1), actively applying to be 
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accredited by the Accreditation Council for 
Graduate Medical Education or the American 
Osteopathic Association; or 
‘‘(B) in the case of entities seeking awards 
under subsection (b)(2), so accredited. 
‘‘(i) ALLOCATION OF FUNDS.—Of the amount appro-
priated pursuant to section 799C(a) for a fiscal year, not 
more than 17 percent of such amount shall be made avail-
able to carry out this section.’’. 
SEC. 2215. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
Title VII (42 U.S.C. 292 et seq.) is amended— 
(1) in section 791(a)(1), by striking ‘‘747 and 
750’’ and inserting ‘‘747, 749, and 750’’; and 
(2) by inserting after section 748, as added, the 
following: 
‘‘SEC. 749. TRAINING FOR GENERAL, PEDIATRIC, AND PUB-
LIC HEALTH DENTISTS AND DENTAL HYGIEN-
ISTS. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
training program for oral health professionals consisting 
of awarding grants and contracts under this section. 
‘‘(b) SUPPORT
AND
DEVELOPMENT
OF
ORAL 
HEALTH TRAINING PROGRAMS.—The Secretary shall 
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make grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to plan, develop, operate, or participate in 
an accredited professional training program for oral 
health professionals; 
‘‘(2) to provide financial assistance to oral 
health professionals who are in need thereof, who 
are participants in any such program, and who plan 
to work in general, pediatric, or public health den-
tistry, or dental hygiene; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry, or dental hygiene; 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to oral health profes-
sionals who plan to teach in general, pediatric, or 
public health dentistry or dental hygiene; 
‘‘(5) to establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in the specialties of general, pedi-
atric, or public health dentistry; or 
‘‘(B) programs that improve clinical teach-
ing in such specialties; 
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‘‘(6) to plan, develop, operate, or participate in 
predoctoral and postdoctoral training in general, pe-
diatric, or public health dentistry programs; 
‘‘(7) to plan, develop, operate, or participate in 
a loan repayment program for full-time faculty in a 
program of general, pediatric, or public health den-
tistry; and 
‘‘(8) to provide technical assistance to pediatric 
dental training programs in developing and imple-
menting instruction regarding the oral health status, 
dental care needs, and risk-based clinical disease 
management of all pediatric populations with an em-
phasis on underserved children. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under this section, an entity shall be— 
‘‘(1) an accredited school of dentistry, training 
program in dental hygiene, or public or nonprofit 
private hospital; 
‘‘(2) a training program in dental hygiene at an 
accredited institution of higher education; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of— 
‘‘(A) 1 or more of the entities described in 
paragraphs (1) through (3); and 
‘‘(B) an accredited school of public health. 
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‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of oral health professionals who practice 
general, pediatric, or public health dentistry. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among oral health pro-
fessionals). 
‘‘(3) A high rate of placing graduates in prac-
tice settings having the principal focus of serving in 
underserved areas or populations experiencing health 
disparities (including serving patients eligible for 
medical assistance under title XIX of the Social Se-
curity Act or for child health assistance under title 
XXI of such Act or those with special health care 
needs). 
‘‘(4) Supporting teaching programs that ad-
dress the oral health needs of vulnerable popu-
lations. 
‘‘(5) Providing instruction regarding the oral 
health status, oral health care needs, and risk-based 
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clinical disease management of all pediatric popu-
lations with an emphasis on underserved children. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘health disparities’ has the 
meaning given the term in section 3171. 
‘‘(2) The term ‘oral health professional’ means 
an individual training or practicing— 
‘‘(A) in general dentistry, pediatric den-
tistry, public health dentistry, or dental hy-
giene; or 
‘‘(B) another oral health specialty, as 
deemed appropriate by the Secretary.’’. 
SEC. 2216. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Part F of title VII (42 U.S.C. 
295j et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 799C. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘(a) PROMOTION
OF PRIMARY CARE
AND DEN-
TISTRY.—For the purpose of carrying out subpart XI of 
part D of title III and sections 747, 748, and 749, in addi-
tion to any other amounts authorized to be appropriated 
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for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $240,000,000 for fiscal year 2011. 
‘‘(2) $253,000,000 for fiscal year 2012. 
‘‘(3) $265,000,000 for fiscal year 2013. 
‘‘(4) $278,000,000 for fiscal year 2014. 
‘‘(5) $292,000,000 for fiscal year 2015.’’. 
(b) EXISTING
AUTHORIZATION
OF
APPROPRIA-
TIONS.—Subsection (g)(1), as so redesignated, of section 
747 (42 U.S.C. 293k) is amended by striking ‘‘2002’’ and 
inserting ‘‘2015’’. 
SEC. 2217. STUDY ON EFFECTIVENESS OF SCHOLARSHIPS 
AND LOAN REPAYMENTS. 
(a) STUDY.—The Comptroller General of the United 
States shall conduct a study to determine the effectiveness 
of scholarship and loan repayment programs under sub-
parts III and XI of part D of title III of the Public Health 
Service Act, as amended or added by sections 2201 and 
2211, including whether scholarships or loan repayments 
are more effective in— 
(1) incentivizing physicians, and other pro-
viders, to pursue careers in primary care specialties; 
(2) retaining such primary care providers; and 
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(3) encouraging such primary care providers to 
practice in underserved areas. 
(b) REPORT.—Not later than 12 months after the 
date of the enactment of this Act, the Comptroller General 
shall submit to the Congress a report on the results of 
the study under subsection (a). 
Subtitle B—Nursing Workforce 
SEC. 2221. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. 
(a) DEFINITIONS.—Section 801 (42 U.S.C. 296 et 
seq.) is amended— 
(1) in paragraph (1), by inserting ‘‘nurse-man-
aged health centers,’’ after ‘‘nursing centers,’’; and 
(2) by adding at the end the following: 
‘‘(16) NURSE-MANAGED
HEALTH
CENTER.— 
The term ‘nurse-managed health center’— 
‘‘(A) means a nurse-practice arrangement, 
managed by one or more advanced practice 
nurses, that provides primary care or wellness 
services to underserved or vulnerable popu-
lations and is associated with an accredited 
school of nursing, Federally qualified health 
center, or independent nonprofit health or social 
services agency; and 
‘‘(B) shall not be construed as changing 
State law requirements applicable to an ad-
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vanced practice nurse or the authorized scope of 
practice of such a nurse.’’. 
(b) GRANTS
FOR
HEALTH
PROFESSIONS
EDU-
CATION.—Title VIII (42 U.S.C. 296 et seq.) is amended 
by striking section 807. 
(c) REPORTS.—Part A of title VIII (42 U.S.C. 296 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 809. REPORTS. 
‘‘The Secretary shall submit to the Congress a sepa-
rate annual report on the activities carried out under each 
of sections 811, 821, 836, 846A, and 861.’’. 
(d) ADVANCED EDUCATION NURSING GRANTS.—Sec-
tion 811(f) (42 U.S.C. 296j(f)) is amended— 
(1) by striking paragraph (2); 
(2) by redesignating paragraph (3) as para-
graph (2); and 
(3) in paragraph (2), as so redesignated, by 
striking ‘‘that agrees’’ and all that follows through 
the end and inserting: ‘‘that agrees to expend the 
award— 
‘‘(A) to train advanced education nurses 
who will practice in health professional shortage 
areas designated under section 332; or 
‘‘(B) to increase diversity among advanced 
education nurses.’’. 
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(e) NURSE EDUCATION, PRACTICE, AND RETENTION 
GRANTS.—Section 831 (42 U.S.C. 296p) is amended— 
(1) in subsection (b), by amending paragraph 
(3) to read as follows: 
‘‘(3) providing coordinated care, quality care, 
and other skills needed to practice nursing; or’’; and 
(2) by striking subsection (e) and redesignating 
subsections (f) through (h) as subsections (e) 
through (g), respectively. 
(f) STUDENT LOANS.—Subsection (a) of section 836 
(42 U.S.C. 297b) is amended— 
(1) 
by 
striking 
‘‘$2,500’’ 
and 
inserting 
‘‘$3,300’’; 
(2) 
by 
striking 
‘‘$4,000’’ 
and 
inserting 
‘‘$5,200’’; 
(3) by striking ‘‘$13,000’’ and inserting 
‘‘$17,000’’; and 
(4) by adding at the end the following: ‘‘Begin-
ning with fiscal year 2012, the dollar amounts speci-
fied in this subsection shall be adjusted by an 
amount determined by the Secretary on an annual 
basis to reflect inflation.’’. 
(g) LOAN REPAYMENT.—Section 846 (42 U.S.C. 
297n) is amended— 
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(1) in subsection (a), by amending paragraph 
(3) to read as follows: 
‘‘(3) who enters into an agreement with the 
Secretary to serve for a period of not less than 2 
years— 
‘‘(A) as a nurse at a health care facility 
with a critical shortage of nurses; or 
‘‘(B) as a faculty member at an accredited 
school of nursing;’’; and 
(2) in subsection (g)(1), by striking ‘‘to provide 
health services’’ each place it appears and inserting 
‘‘to provide health services or serve as a faculty 
member’’. 
(h) NURSE FACULTY LOAN PROGRAM.—Paragraph 
(2) of section 846A(c) (42 U.S.C. 297n–1(c)) is amended 
by striking ‘‘$30,000’’ and all that follows through the 
semicolon and inserting ‘‘$35,000, plus, beginning with 
fiscal year 2012, an amount determined by the Secretary 
on an annual basis to reflect inflation;’’. 
(i) PUBLIC SERVICE ANNOUNCEMENTS.—Title VIII 
(42 U.S.C. 296 et seq.) is amended by striking part H. 
(j) TECHNICAL AND CONFORMING AMENDMENTS.— 
Title VIII (42 U.S.C. 296 et seq.) is amended— 
(1) by moving section 810 (relating to prohibi-
tion against discrimination by schools on the basis of 
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sex) so that it follows section 809, as added by sub-
section (c); 
(2) in sections 835, 836, 838, 840, and 842, by 
striking the term ‘‘this subpart’’ each place it ap-
pears and inserting ‘‘this part’’; 
(3) in section 836(h), by striking the last sen-
tence; 
(4) in section 836, by redesignating subsection 
(l) as subsection (k); 
(5) in section 839, by striking ‘‘839’’ and all 
that follows through ‘‘(a)’’ and inserting ‘‘839. (a)’’; 
(6) in section 835(b), by striking ‘‘841’’ each 
place it appears and inserting ‘‘871’’; 
(7) by redesignating section 841 as section 871, 
moving part F to the end of the title, and redesig-
nating such part as part H; 
(8) in part G— 
(A) by redesignating section 845 as section 
851; and 
(B) by redesignating part G as part F; and 
(9) in part I— 
(A) by redesignating section 855 as section 
861; and 
(B) by redesignating part I as part G. 
(k) FUNDING.— 
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(1) IN GENERAL.—Part H, as redesignated, of 
title VIII is amended by adding at the end the fol-
lowing: 
‘‘SEC. 872. FUNDING THROUGH PUBLIC HEALTH INVEST-
MENT FUND. 
‘‘For the purpose of carrying out this title, in addi-
tion to any other amounts authorized to be appropriated 
for such purpose, there are authorized to be appropriated, 
out of any monies in the Public Health Investment Fund, 
the following: 
‘‘(1) $115,000,000 for fiscal year 2011. 
‘‘(2) $122,000,000 for fiscal year 2012. 
‘‘(3) $127,000,000 for fiscal year 2013. 
‘‘(4) $134,000,000 for fiscal year 2014. 
‘‘(5) $140,000,000 for fiscal year 2015.’’. 
(2) EXISTING AUTHORIZATIONS OF APPROPRIA-
TIONS.— 
(A) SECTIONS 831, 846, 846A, AND 861.— 
Sections 831(g) (as so redesignated), 846(i)(1) 
(42 U.S.C. 297n(i)(1)), 846A(f) (42 U.S.C. 
297n–1(f)), and 861(e) (as so redesignated) are 
amended by striking ‘‘2007’’ each place it ap-
pears and inserting ‘‘2015’’. 
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(B) SECTION 871.—Section 871, as so re-
designated by subsection (j), is amended to read 
as follows: 
‘‘SEC. 871. FUNDING. 
‘‘For the purpose of carrying out parts B, C, and D 
(subject to section 851(g)), there are authorized to be ap-
propriated such sums as may be necessary for each fiscal 
year through fiscal year 2015.’’. 
Subtitle C—Public Health 
Workforce 
SEC. 2231. PUBLIC HEALTH WORKFORCE CORPS. 
Part D of title III (42 U.S.C. 254b et seq.), as 
amended by section 2211, is amended by adding at the 
end the following: 
‘‘Subpart XII—Public Health Workforce 
‘‘SEC. 340L. PUBLIC HEALTH WORKFORCE CORPS. 
‘‘(a) ESTABLISHMENT.—There is established, within 
the Service, the Public Health Workforce Corps (in this 
subpart referred to as the ‘Corps’), for the purpose of en-
suring an adequate supply of public health professionals 
throughout the Nation. The Corps shall consist of— 
‘‘(1) such officers of the Regular and Reserve 
Corps of the Service as the Secretary may designate; 
‘‘(2) such civilian employees of the United 
States as the Secretary may appoint; and 
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‘‘(3) such other individuals who are not employ-
ees of the United States. 
‘‘(b) ADMINISTRATION.—Except as provided in sub-
section (c), the Secretary shall carry out this subpart act-
ing through the Administrator of the Health Resources 
and Services Administration. 
‘‘(c) PLACEMENT AND ASSIGNMENT.—The Secretary, 
acting through the Director of the Centers for Disease 
Control and Prevention, shall develop a methodology for 
placing and assigning Corps participants as public health 
professionals. Such methodology may allow for placing and 
assigning such participants in State, local, and tribal 
health departments and Federally qualified health centers 
(as defined in section 1861(aa)(4) of the Social Security 
Act). 
‘‘(d) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart II shall, except as inconsistent with 
this subpart, apply to the Public Health Workforce Corps 
in the same manner and to the same extent as such provi-
sions apply to the National Health Service Corps estab-
lished under section 331. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the programs carried out 
under this subpart. 
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‘‘SEC. 340M. PUBLIC HEALTH WORKFORCE SCHOLARSHIP 
PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish the Public Health Workforce Scholarship Program 
(referred to in this section as the ‘Program’) for the pur-
pose described in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
‘‘(1)(A) be accepted for enrollment, or be en-
rolled, as a full-time or part-time student in a course 
of study or program (approved by the Secretary) at 
an accredited graduate school or program of public 
health; or 
‘‘(B) have demonstrated expertise in public 
health and be accepted for enrollment, or be en-
rolled, as a full-time or part-time student in a course 
of study or program (approved by the Secretary) 
at— 
‘‘(i) an accredited graduate school or pro-
gram of nursing; health administration, man-
agement, or policy; preventive medicine; labora-
tory science; veterinary medicine; or dental 
medicine; or 
‘‘(ii) another accredited graduate school or 
program, as deemed appropriate by the Sec-
retary; 
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‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for 
civilian service in the Corps; and 
‘‘(3) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full- 
time as a public health professional, upon the com-
pletion of the course of study or program involved, 
for the period of obligated service described in sub-
section (c)(2)(E). 
‘‘(c) CONTRACT.—The written contract between the 
Secretary and an individual under subsection (b)(3) shall 
contain— 
‘‘(1) an agreement on the part of the Secretary 
that the Secretary will— 
‘‘(A) provide the individual with a scholar-
ship for a period of years (not to exceed 4 aca-
demic years) during which the individual shall 
pursue an approved course of study or program 
to prepare the individual to serve in the public 
health workforce; and 
‘‘(B) accept (subject to the availability of 
appropriated funds) the individual into the 
Corps; 
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‘‘(2) an agreement on the part of the individual 
that the individual will— 
‘‘(A) accept provision of such scholarship 
to the individual; 
‘‘(B) maintain full-time or part-time enroll-
ment in the approved course of study or pro-
gram described in subsection (b)(1) until the in-
dividual completes that course of study or pro-
gram; 
‘‘(C) while enrolled in the approved course 
of study or program, maintain an acceptable 
level of academic standing (as determined by 
the educational institution offering such course 
of study or program); 
‘‘(D) if applicable, complete a residency or 
internship; and 
‘‘(E) serve full-time as a public health pro-
fessional for a period of time equal to the great-
er of— 
‘‘(i) 1 year for each academic year for 
which the individual was provided a schol-
arship under the Program; or 
‘‘(ii) 2 years; and 
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‘‘(3) an agreement by both parties as to the na-
ture and extent of the scholarship assistance, which 
may include— 
‘‘(A) payment of reasonable educational ex-
penses of the individual, including tuition, fees, 
books, equipment, and laboratory expenses; and 
‘‘(B) payment of a stipend of not more 
than $1,269 (plus, beginning with fiscal year 
2012, an amount determined by the Secretary 
on an annual basis to reflect inflation) per 
month for each month of the academic year in-
volved, with the dollar amount of such a stipend 
determined by the Secretary taking into consid-
eration whether the individual is enrolled full- 
time or part-time. 
‘‘(d) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III shall, except as inconsistent with 
this subpart, apply to the scholarship program under this 
section in the same manner and to the same extent as 
such provisions apply to the National Health Service 
Corps Scholarship Program established under section 
338A. 
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‘‘SEC. 340N. PUBLIC HEALTH WORKFORCE LOAN REPAY-
MENT PROGRAM. 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish the Public Health Workforce Loan Repayment Pro-
gram (referred to in this section as the ‘Program’) for the 
purpose described in section 340L(a). 
‘‘(b) ELIGIBILITY.—To be eligible to participate in 
the Program, an individual shall— 
‘‘(1)(A) have a graduate degree from an accred-
ited school or program of public health; 
‘‘(B) have demonstrated expertise in public 
health and have a graduate degree in a course of 
study or program (approved by the Secretary) 
from— 
‘‘(i) an accredited school or program of 
nursing; health administration, management, or 
policy; preventive medicine; laboratory science; 
veterinary medicine; or dental medicine; or 
‘‘(ii) another accredited school or program 
approved by the Secretary; or 
‘‘(C) be enrolled as a full-time or part-time stu-
dent in the final year of a course of study or pro-
gram (approved by the Secretary) offered by a 
school or program described in subparagraph (A) or 
(B), leading to a graduate degree; 
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‘‘(2) be eligible for, or hold, an appointment as 
a commissioned officer in the Regular or Reserve 
Corps of the Service or be eligible for selection for 
civilian service in the Corps; 
‘‘(3) if applicable, complete a residency or in-
ternship; and 
‘‘(4) sign and submit to the Secretary a written 
contract (described in subsection (c)) to serve full- 
time as a public health professional for the period of 
obligated service described in subsection (c)(2). 
‘‘(c) CONTRACT.—The written contract between the 
Secretary and an individual under subsection (b)(4) shall 
contain— 
‘‘(1) an agreement by the Secretary to repay on 
behalf of the individual loans incurred by the indi-
vidual in the pursuit of the relevant public health 
workforce educational degree in accordance with the 
terms of the contract; 
‘‘(2) an agreement by the individual to serve 
full-time as a public health professional for a period 
of time equal to 2 years or such longer period as the 
individual may agree to; and 
‘‘(3) in the case of an individual described in 
subsection (b)(1)(C) who is in the final year of study 
and who has accepted employment as a public health 
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professional, in accordance with section 340L(c), an 
agreement on the part of the individual to complete 
the education or training, maintain an acceptable 
level of academic standing (as determined by the 
educational institution offering the course of study 
or training), and serve the period of obligated service 
described in paragraph (2). 
‘‘(d) PAYMENTS.— 
‘‘(1) IN GENERAL.—A loan repayment provided 
for an individual under a written contract under the 
Program shall consist of payment, in accordance 
with paragraph (2), on behalf of the individual of 
the principal, interest, and related expenses on gov-
ernment and commercial loans received by the indi-
vidual regarding the undergraduate or graduate edu-
cation of the individual (or both), which loans were 
made for reasonable educational expenses, including 
tuition, fees, books, equipment, and laboratory ex-
penses, incurred by the individual. 
‘‘(2) PAYMENTS FOR YEARS SERVED.— 
‘‘(A) IN GENERAL.—For each year of obli-
gated service that an individual contracts to 
serve under subsection (c), the Secretary may 
pay up to $35,000 (plus, beginning with fiscal 
year 2012, an amount determined by the Sec-
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retary on an annual basis to reflect inflation) 
on behalf of the individual for loans described 
in paragraph (1). 
‘‘(B) REPAYMENT
SCHEDULE.—Any ar-
rangement made by the Secretary for the mak-
ing of loan repayments in accordance with this 
subsection shall provide that any repayments 
for a year of obligated service shall be made no 
later than the end of the fiscal year in which 
the individual completes such year of service. 
‘‘(e) APPLICATION OF CERTAIN PROVISIONS.—The 
provisions of subpart III shall, except as inconsistent with 
this subpart, apply to the loan repayment program under 
this section in the same manner and to the same extent 
as such provisions apply to the National Health Service 
Corps Loan Repayment Program established under sec-
tion 338B.’’. 
SEC. 2232. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
Section 765 (42 U.S.C. 295) is amended to read as 
follows: 
‘‘SEC. 765. ENHANCING THE PUBLIC HEALTH WORKFORCE. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Director of the 
Centers for Disease Control and Prevention, shall estab-
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lish a public health workforce training and enhancement 
program consisting of awarding grants and contracts 
under subsection (b). 
‘‘(b) GRANTS AND CONTRACTS.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to plan, develop, operate, or participate in, 
an accredited professional training program in the 
field of public health (including such a program in 
nursing; health administration, management, or pol-
icy; preventive medicine; laboratory science; veteri-
nary medicine; or dental medicine) for members of 
the public health workforce, including midcareer pro-
fessionals; 
‘‘(2) to provide financial assistance in the form 
of traineeships and fellowships to students who are 
participants in any such program and who plan to 
specialize or work in the field of public health; 
‘‘(3) to plan, develop, operate, or participate in 
a program for the training of public health profes-
sionals who plan to teach in any program described 
in paragraph (1); and 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to public health pro-
fessionals who are participants in any program de-
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scribed in paragraph (1) and who plan to teach in 
the field of public health, including nursing; health 
administration, management, or policy; preventive 
medicine; laboratory science; veterinary medicine; or 
dental medicine. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under this section, an entity shall be— 
‘‘(1) an accredited health professions school, in-
cluding an accredited school or program of public 
health; nursing; health administration, management, 
or policy; preventive medicine; laboratory science; 
veterinary medicine; or dental medicine; 
‘‘(2) a State, local, or tribal health department; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of public health professionals who serve 
in underserved communities. 
‘‘(2) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
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minorities underrepresented among public health 
professionals). 
‘‘(3) Training individuals in public health spe-
cialties experiencing a significant shortage of public 
health professionals (as determined by the Sec-
retary). 
‘‘(4) Training a high or significantly improved 
percentage of public health professionals serving in 
the Federal Government or a State, local, or tribal 
government. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2233. PUBLIC HEALTH TRAINING CENTERS. 
Section 766 (42 U.S.C. 295a) is amended— 
(1) in subsection (b)(1), by striking ‘‘in further-
ance of the goals established by the Secretary for 
the year 2000’’ and inserting ‘‘in furtherance of the 
goals established by the Secretary in the national 
prevention and wellness strategy under section 
3121’’; and 
(2) by adding at the end the following: 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
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SEC. 2234. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
Section 768 (42 U.S.C. 295c) is amended to read as 
follows: 
‘‘SEC. 768. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Director of the 
Centers for Disease Control and Prevention, shall award 
grants to, or enter into contracts with, eligible entities to 
provide training to graduate medical residents in preven-
tive medicine specialties. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (a), an entity shall be— 
‘‘(1) an accredited school of public health or 
school of medicine or osteopathic medicine; 
‘‘(2) an accredited public or private nonprofit 
hospital; 
‘‘(3) a State, local, or tribal health department; 
or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(c) USE OF FUNDS.—Amounts received under a 
grant or contract under this section shall be used to— 
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‘‘(1) plan, develop (including the development of 
curricula), operate, or participate in an accredited 
residency or internship program in preventive medi-
cine or public health; 
‘‘(2) defray the costs of practicum experiences, 
as required in such a program; and 
‘‘(3) establish, maintain, or improve— 
‘‘(A) academic administrative units (in-
cluding departments, divisions, or other appro-
priate units) in preventive medicine and public 
health; or 
‘‘(B) programs that improve clinical teach-
ing in preventive medicine and public health. 
‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
SEC. 2235. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Section 799C, as added by section 
2216 of this Act, is amended by adding at the end the 
following: 
‘‘(b) PUBLIC HEALTH WORKFORCE.—For the pur-
pose of carrying out subpart XII of part D of title III 
and sections 765, 766, and 768, in addition to any other 
amounts authorized to be appropriated for such purpose, 
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there are authorized to be appropriated, out of any monies 
in the Public Health Investment Fund, the following: 
‘‘(1) $51,000,000 for fiscal year 2011. 
‘‘(2) $54,000,000 for fiscal year 2012. 
‘‘(3) $57,000,000 for fiscal year 2013. 
‘‘(4) $59,000,000 for fiscal year 2014. 
‘‘(5) $62,000,000 for fiscal year 2015.’’. 
(b) EXISTING
AUTHORIZATION
OF
APPROPRIA-
TIONS.—Subsection (a) of section 770 (42 U.S.C. 295e) 
is amended by striking ‘‘2002’’ and inserting ‘‘2015’’. 
Subtitle D—Adapting Workforce to 
Evolving Health System Needs 
PART 1—HEALTH PROFESSIONS TRAINING FOR 
DIVERSITY 
SEC. 2241. SCHOLARSHIPS FOR DISADVANTAGED STU-
DENTS, LOAN REPAYMENTS AND FELLOW-
SHIPS REGARDING FACULTY POSITIONS, AND 
EDUCATIONAL ASSISTANCE IN THE HEALTH 
PROFESSIONS 
REGARDING 
INDIVIDUALS 
FROM DISADVANTAGED BACKGROUNDS. 
Paragraph (1) of section 738(a) (42 U.S.C. 293b(a)) 
is amended by striking ‘‘not more than $20,000’’ and all 
that follows through the end of the paragraph and insert-
ing: ‘‘not more than $35,000 (plus, beginning with fiscal 
year 2012, an amount determined by the Secretary on an 
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annual basis to reflect inflation) of the principal and inter-
est of the educational loans of such individuals.’’. 
SEC. 2242. NURSING WORKFORCE DIVERSITY GRANTS. 
Subsection (b) of section 821 (42 U.S.C. 296m) is 
amended— 
(1) in the heading, by striking ‘‘GUIDANCE’’ 
and inserting ‘‘CONSULTATION’’; and 
(2) by striking ‘‘shall take into consideration’’ 
and all that follows through ‘‘consult with nursing 
associations’’ and inserting ‘‘shall, as appropriate, 
consult with nursing associations’’. 
SEC. 2243. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
(a) IN GENERAL.—Title VII (42 U.S.C. 292 et seq.) 
is amended by inserting after section 739 the following: 
‘‘SEC. 739A. COORDINATION OF DIVERSITY AND CULTURAL 
COMPETENCY PROGRAMS. 
‘‘The Secretary shall, to the extent practicable, co-
ordinate the activities carried out under this part and sec-
tion 821 in order to enhance the effectiveness of such ac-
tivities and avoid duplication of effort.’’. 
(b) REPORT.—Section 736 (42 U.S.C. 293) is 
amended— 
(1) by redesignating subsection (h) as sub-
section (i); and 
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(2) by inserting after subsection (g) the fol-
lowing: 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on the activities carried out 
under this section.’’. 
PART 2—INTERDISCIPLINARY TRAINING 
PROGRAMS 
SEC. 2251. CULTURAL AND LINGUISTIC COMPETENCY 
TRAINING FOR HEALTH PROFESSIONALS. 
Section 741 (42 U.S.C. 293e) is amended— 
(1) in the section heading, by striking 
‘‘GRANTS
FOR
HEALTH
PROFESSIONS
EDU-
CATION’’ and inserting ‘‘CULTURAL
AND
LIN-
GUISTIC COMPETENCY TRAINING FOR HEALTH 
PROFESSIONALS’’; 
(2) by redesignating subsection (b) as sub-
section (h); and 
(3) by striking subsection (a) and inserting the 
following: 
‘‘(a) PROGRAM.—The Secretary shall establish a cul-
tural and linguistic competency training program for 
health professionals, including nurse professionals, con-
sisting of awarding grants and contracts under subsection 
(b). 
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‘‘(b) CULTURAL
AND
LINGUISTIC
COMPETENCY 
TRAINING.—The Secretary shall award grants to, or enter 
into contracts with, eligible entities— 
‘‘(1) to test, develop, and evaluate models of 
cultural and linguistic competency training (includ-
ing continuing education) for health professionals; 
and 
‘‘(2) to implement cultural and linguistic com-
petency training programs for health professionals 
developed under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants and con-
tracts under this section, the Secretary shall give pref-
erence to entities that have a demonstrated record of at 
least one of the following: 
‘‘(1) Addressing, or partnering with an entity 
with experience addressing, the cultural and lin-
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guistic competency needs of the population to be 
served through the grant or contract. 
‘‘(2) Addressing health disparities. 
‘‘(3) Placing health professionals in regions ex-
periencing significant changes in the cultural and 
linguistic demographics of populations, including 
communities along the United States-Mexico border. 
‘‘(4) Carrying out activities described in sub-
section (b) with respect to more than one health pro-
fession discipline, specialty, or subspecialty. 
‘‘(e) CONSULTATION.—The Secretary shall carry out 
this section in consultation with the heads of appropriate 
health agencies and offices in the Department of Health 
and Human Services, including the Office of Minority 
Health and the National Center on Minority Health and 
Health Disparities. 
‘‘(f) DEFINITION.—In this section, the term ‘health 
disparities’ has the meaning given to the term in section 
3171. 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section.’’. 
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SEC. 2252. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
Part D of title VII (42 U.S.C. 294 et seq.) is amend-
ed by adding at the end the following: 
‘‘SEC. 759. INNOVATIONS IN INTERDISCIPLINARY CARE 
TRAINING. 
‘‘(a) PROGRAM.—The Secretary shall establish an in-
novations in interdisciplinary care training program con-
sisting of awarding grants and contracts under subsection 
(b). 
‘‘(b) TRAINING PROGRAMS.—The Secretary shall 
award grants to, or enter into contracts with, eligible enti-
ties— 
‘‘(1) to test, develop, and evaluate health pro-
fessional training programs (including continuing 
education) designed to promote— 
‘‘(A) the delivery of health services through 
interdisciplinary and team-based models, which 
may include patient-centered medical home 
models, medication therapy management mod-
els, and models integrating physical, mental, or 
oral health services; and 
‘‘(B) coordination of the delivery of health 
care within and across settings, including health 
care institutions, community-based settings, 
and the patient’s home; and 
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‘‘(2) to implement such training programs de-
veloped under paragraph (1) or otherwise. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school or 
program; 
‘‘(2) an academic health center; 
‘‘(3) a public or private nonprofit entity (includ-
ing an area health education center or a geriatric 
education center); or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCES.—In awarding grants and con-
tracts under this section, the Secretary shall give pref-
erence to entities that have a demonstrated record of at 
least one of the following: 
‘‘(1) Training a high or significantly improved 
percentage of health professionals who serve in un-
derserved communities. 
‘‘(2) Broad interdisciplinary team-based collabo-
rations. 
‘‘(3) Addressing health disparities. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program carried out 
under this section. 
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‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘health disparities’ has the 
meaning given the term in section 3171. 
‘‘(2) The term ‘interdisciplinary’ means collabo-
ration across health professions and specialties, 
which may include public health, nursing, allied 
health, dietetics or nutrition, and appropriate health 
specialties.’’. 
PART 3—ADVISORY COMMITTEE ON HEALTH 
WORKFORCE EVALUATION AND ASSESSMENT 
SEC. 2261. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
Subpart 1 of part E of title VII (42 U.S.C. 294n 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 764. HEALTH WORKFORCE EVALUATION AND ASSESS-
MENT. 
‘‘(a) ADVISORY COMMITTEE.—The Secretary, acting 
through the Assistant Secretary for Health, shall establish 
a permanent advisory committee to be known as the Advi-
sory Committee on Health Workforce Evaluation and As-
sessment (referred to in this section as the ‘Advisory Com-
mittee’) to develop and implement an integrated, coordi-
nated, and strategic national health workforce policy re-
flective of current and evolving health workforce needs. 
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‘‘(b) RESPONSIBILITIES.—The Advisory Committee 
shall— 
‘‘(1) not later than 1 year after the date of the 
establishment of the Advisory Committee, submit 
recommendations to the Secretary on— 
‘‘(A) classifications of the health workforce 
to ensure consistency of data collection on the 
health workforce; and 
‘‘(B) based on such classifications, stand-
ardized methodologies and procedures to enu-
merate the health workforce; 
‘‘(2) not later than 2 years after the date of the 
establishment of the Advisory Committee, submit 
recommendations to the Secretary on— 
‘‘(A) the supply, diversity, and geographic 
distribution of the health workforce; 
‘‘(B) the retention and expansion of the 
health workforce (on a short- and long-term 
basis) to ensure quality and adequacy of such 
workforce; and 
‘‘(C) policies to carry out the recommenda-
tions made pursuant to subparagraphs (A) and 
(B); and 
‘‘(3) not later than 4 years after the date of the 
establishment of the Advisory Committee, and every 
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2 years thereafter, submit updated recommendations 
to the Secretary under paragraphs (1) and (2). 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Advisory Committee, including 
coordinating and supporting the dissemination of the rec-
ommendations of the Advisory Committee. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) NUMBER; APPOINTMENT.—The Secretary 
shall appoint 15 members to serve on the Advisory 
Committee. 
‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Advisory Committee for 
a term of 3 years and may reappoint such 
members, but the Secretary may not appoint 
any member to serve more than a total of 6 
years. 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to the Advisory Committee 
under paragraph (1)— 
‘‘(i) 5 shall be appointed for a term of 
1 year; 
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‘‘(ii) 5 shall be appointed for a term 
of 2 years; and 
‘‘(iii) 5 shall be appointed for a term 
of 3 years. 
‘‘(3) QUALIFICATIONS.—Members of the Advi-
sory Committee shall be appointed from among indi-
viduals who possess expertise in at least one of the 
following areas: 
‘‘(A) Conducting and interpreting health 
workforce market analysis, including health 
care labor workforce analysis. 
‘‘(B) Conducting and interpreting health 
finance and economics research. 
‘‘(C) Delivering and administering health 
care services. 
‘‘(D) Delivering and administering health 
workforce education and training. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Advisory Committee, the Secretary 
shall— 
‘‘(A) include no less than one representa-
tive of each of— 
‘‘(i) health professionals within the 
health workforce; 
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‘‘(ii) health care patients and con-
sumers; 
‘‘(iii) employers; 
‘‘(iv) labor unions; and 
‘‘(v) third-party health payors; and 
‘‘(B) ensure that— 
‘‘(i) all areas of expertise described in 
paragraph (3) are represented; 
‘‘(ii) the members of the Advisory 
Committee include members who, collec-
tively, have significant experience working 
with— 
‘‘(I) populations in urban and 
federally designated rural and non-
metropolitan areas; and 
‘‘(II) populations who are under-
represented in the health professions, 
including underrepresented minority 
groups; and 
‘‘(iii) individuals who are directly in-
volved in health professions education or 
practice do not constitute a majority of the 
members of the Advisory Committee. 
‘‘(5) DISCLOSURE AND CONFLICTS OF INTER-
EST.—Members of the Advisory Committee shall not 
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be considered employees of the Federal Government 
by reason of service on the Advisory Committee, ex-
cept members of the Advisory Committee shall be 
considered to be special Government employees with-
in the meaning of section 107 of the Ethics in Gov-
ernment Act of 1978 (5 U.S.C. App.) and section 
208 of title 18, United States Code, for the purposes 
of disclosure and management of conflicts of interest 
under those sections. 
‘‘(6) NO
PAY; 
RECEIPT
OF
TRAVEL
EX-
PENSES.—Members of the Advisory Committee shall 
not receive any pay for service on the Committee, 
but may receive travel expenses, including a per 
diem, in accordance with applicable provisions of 
subchapter I of chapter 57 of title 5, United States 
Code. 
‘‘(e) CONSULTATION.—In carrying out this section, 
the Secretary shall consult with the Secretary of Edu-
cation and the Secretary of Labor. 
‘‘(f) COLLABORATION.—The Advisory Committee 
shall collaborate with the advisory bodies at the Health 
Resources and Services Administration, the National Ad-
visory Council (as authorized in section 337), the Advisory 
Committee on Training in Primary Care Medicine and 
Dentistry (as authorized in section 749A), the Advisory 
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Committee on Interdisciplinary, Community-Based Link-
ages (as authorized in section 756), the Advisory Council 
on Graduate Medical Education (as authorized in section 
762), and the National Advisory Council on Nurse Edu-
cation and Practice (as authorized in section 851). 
‘‘(g) FACA.—The Federal Advisory Committee Act 
(5 U.S.C. App.) except for section 14 of such Act shall 
apply to the Advisory Committee under this section only 
to the extent that the provisions of such Act do not conflict 
with the requirements of this section. 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on the activities of the Advisory 
Committee. 
‘‘(i) DEFINITION.—In this section, the term ‘health 
workforce’ includes all health care providers with direct 
patient care and support responsibilities, including physi-
cians, nurses, physician assistants, pharmacists, oral 
health professionals (as defined in section 749(f)(2)), al-
lied health professionals, mental and behavioral health 
professionals (as defined in section 775(f)(2)), and public 
health professionals (including veterinarians engaged in 
public health practice).’’. 
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PART 4—HEALTH WORKFORCE ASSESSMENT 
SEC. 2271. HEALTH WORKFORCE ASSESSMENT. 
(a) IN GENERAL.—Section 761 (42 U.S.C. 294n) is 
amended— 
(1) by redesignating subsection (c) as sub-
section (e); and 
(2) by striking subsections (a) and (b) and in-
serting the following: 
‘‘(a) IN GENERAL.—The Secretary shall, based upon 
the classifications and standardized methodologies and 
procedures developed by the Advisory Committee on 
Health Workforce Evaluation and Assessment under sec-
tion 764(b)— 
‘‘(1) collect data on the health workforce (as 
defined in section 764(i)), disaggregated by field, 
discipline, and specialty, with respect to— 
‘‘(A) the supply (including retention) of 
health professionals relative to the demand for 
such professionals; 
‘‘(B) the diversity of health professionals 
(including with respect to race, ethnic back-
ground, and sex); and 
‘‘(C) the geographic distribution of health 
professionals; and 
‘‘(2) collect such data on individuals partici-
pating in the programs authorized by subtitles A, B, 
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and C and part 1 of subtitle D of title II of division 
C of the Affordable Health Care for America Act. 
‘‘(b) GRANTS AND CONTRACTS FOR HEALTH WORK-
FORCE ANALYSIS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
grants to, or enter into contracts with, eligible enti-
ties to carry out subsection (a). 
‘‘(2) ELIGIBILITY.—To be eligible for a grant 
or contract under this subsection, an entity shall 
be— 
‘‘(A) an accredited health professions 
school or program; 
‘‘(B) an academic health center; 
‘‘(C) a State, local, or tribal government; 
‘‘(D) a public or private entity; or 
‘‘(E) a consortium of 2 or more entities de-
scribed in subparagraphs (A) through (D). 
‘‘(c) COLLABORATION
AND DATA SHARING.—The 
Secretary shall collaborate with Federal departments and 
agencies, health professions organizations (including 
health professions education organizations), and profes-
sional medical societies for the purpose of carrying out 
subsection (a). 
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‘‘(d) REPORT.—The Secretary shall submit to the 
Congress an annual report on the data collected under 
subsection (a).’’. 
(b) PERIOD BEFORE COMPLETION
OF NATIONAL 
STRATEGY.—Pending completion of the classifications and 
standardized methodologies and procedures developed by 
the Advisory Committee on Health Workforce Evaluation 
and Assessment under section 764(b) of the Public Health 
Service Act, as added by section 2261, the Secretary of 
Health and Human Services, acting through the Adminis-
trator of the Health Resources and Services Administra-
tion and in consultation with such Advisory Committee, 
may make a judgment about the classifications, meth-
odologies, and procedures to be used for collection of data 
under section 761(a) of the Public Health Service Act, as 
amended by this section. 
PART 5—AUTHORIZATION OF APPROPRIATIONS 
SEC. 2281. AUTHORIZATION OF APPROPRIATIONS. 
(a) IN GENERAL.—Section 799C, as added and 
amended, is further amended by adding at the end the 
following: 
‘‘(c) HEALTH PROFESSIONS TRAINING FOR DIVER-
SITY.—For the purpose of carrying out sections 736, 737, 
738, 739, and 739A, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
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authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) $90,000,000 for fiscal year 2011. 
‘‘(2) $97,000,000 for fiscal year 2012. 
‘‘(3) $100,000,000 for fiscal year 2013. 
‘‘(4) $104,000,000 for fiscal year 2014. 
‘‘(5) $110,000,000 for fiscal year 2015. 
‘‘(d) INTERDISCIPLINARY TRAINING PROGRAMS, AD-
VISORY COMMITTEE ON HEALTH WORKFORCE EVALUA-
TION AND ASSESSMENT, AND HEALTH WORKFORCE AS-
SESSMENT.—For the purpose of carrying out sections 
741, 759, 761, and 764, in addition to any other amounts 
authorized to be appropriated for such purpose, there are 
authorized to be appropriated, out of any monies in the 
Public Health Investment Fund, the following: 
‘‘(1) $87,000,000 for fiscal year 2011. 
‘‘(2) $97,000,000 for fiscal year 2012. 
‘‘(3) $103,000,000 for fiscal year 2013. 
‘‘(4) $105,000,000 for fiscal year 2014. 
‘‘(5) $113,000,000 for fiscal year 2015.’’. 
(b) EXISTING
AUTHORIZATIONS
OF
APPROPRIA-
TIONS.— 
(1) SECTION
736.—Paragraph (1) of section 
736(i) (42 U.S.C. 293(h)), as redesignated, is 
amended by striking ‘‘2002’’ and inserting ‘‘2015’’. 
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(2) SECTIONS 737, 738, AND 739.—Subsections 
(a), (b), and (c) of section 740 are amended by 
striking ‘‘2002’’ each place it appears and inserting 
‘‘2015’’. 
(3) SECTION 741.—Subsection (h), as so redes-
ignated, of section 741 is amended— 
(A) by striking ‘‘and’’ after ‘‘fiscal year 
2003,’’; and 
(B) by inserting ‘‘, and such sums as may 
be necessary for each subsequent fiscal year 
through the end of fiscal year 2015’’ before the 
period at the end. 
(4) SECTION 761.—Subsection (e)(1), as so re-
designated, of section 761 is amended by striking 
‘‘2002’’ and inserting ‘‘2015’’. 
TITLE III—PREVENTION AND 
WELLNESS 
SEC. 2301. PREVENTION AND WELLNESS. 
(a) IN GENERAL.—The Public Health Service Act 
(42 U.S.C. 201 et seq.) is amended by inserting after title 
XXX the following: 
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‘‘TITLE XXXI—PREVENTION AND 
WELLNESS 
‘‘Subtitle A—Prevention and 
Wellness Trust 
‘‘SEC. 3111. PREVENTION AND WELLNESS TRUST. 
‘‘(a) DEPOSITS INTO TRUST.—There is established 
a Prevention and Wellness Trust. There are authorized 
to be appropriated to the Trust, out of any monies in the 
Public Health Investment Fund— 
‘‘(1) for fiscal year 2011, $2,400,000,000; 
‘‘(2) for fiscal year 2012, $2,845,000,000; 
‘‘(3) for fiscal year 2013, $3,100,000,000; 
‘‘(4) for fiscal year 2014, $3,455,000,000; and 
‘‘(5) for fiscal year 2015, $3,600,000,000. 
‘‘(b) AVAILABILITY OF FUNDS.—Amounts in the Pre-
vention and Wellness Trust shall be available, as provided 
in advance in appropriation Acts, for carrying out this 
title. 
‘‘(c) ALLOCATION.—Of the amounts authorized to be 
appropriated in subsection (a), there are authorized to be 
appropriated— 
‘‘(1) for carrying out subtitle C (Prevention 
Task Forces), $30,000,000 for each of fiscal years 
2011 through 2015; 
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‘‘(2) for carrying out subtitle D (Prevention 
and Wellness Research)— 
‘‘(A) for fiscal year 2011, $155,000,000; 
‘‘(B) for fiscal year 2012, $205,000,000; 
‘‘(C) for fiscal year 2013, $255,000,000; 
‘‘(D) for fiscal year 2014, $305,000,000; 
and 
‘‘(E) for fiscal year 2015, $355,000,000; 
‘‘(3) for carrying out subtitle E (Delivery of 
Community Preventive and Wellness Services)— 
‘‘(A) for fiscal year 2011, $1,065,000,000; 
‘‘(B) for fiscal year 2012, $1,260,000,000; 
‘‘(C) for fiscal year 2013, $1,365,000,000; 
‘‘(D) for fiscal year 2014, $1,570,000,000; 
and 
‘‘(E) for fiscal year 2015, $1,600,000,000; 
‘‘(4) for carrying out section 3161 (Core Public 
Health Infrastructure for State, Local, and Tribal 
Health Departments)— 
‘‘(A) for fiscal year 2011, $800,000,000; 
‘‘(B) for fiscal year 2012, $1,000,000,000; 
‘‘(C) for fiscal year 2013, $1,100,000,000; 
‘‘(D) for fiscal year 2014, $1,200,000,000; 
and 
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‘‘(E) for fiscal year 2015, $1,265,000,000; 
and 
‘‘(5) for carrying out section 3162 (Core Public 
Health Infrastructure and Activities for CDC), 
$350,000,000 for each of fiscal years 2011 through 
2015. 
‘‘Subtitle B—National Prevention 
and Wellness Strategy 
‘‘SEC. 3121. NATIONAL PREVENTION AND WELLNESS STRAT-
EGY. 
‘‘(a) IN GENERAL.—The Secretary shall submit to 
the Congress within one year after the date of the enact-
ment of this section, and at least every 2 years thereafter, 
a national strategy that is designed to improve the Na-
tion’s health through evidence-based clinical and commu-
nity prevention and wellness activities (in this section re-
ferred to as ‘prevention and wellness activities’), including 
core public health infrastructure improvement activities. 
‘‘(b) CONTENTS.—The strategy under subsection (a) 
shall include each of the following: 
‘‘(1) Identification of specific national goals and 
objectives in prevention and wellness activities that 
take into account appropriate public health measures 
and standards, including departmental measures and 
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standards (including Healthy People and National 
Public Health Performance Standards). 
‘‘(2) Establishment of national priorities for 
prevention and wellness, taking into account unmet 
prevention and wellness needs. 
‘‘(3) Establishment of national priorities for re-
search on prevention and wellness, taking into ac-
count unanswered research questions on prevention 
and wellness. 
‘‘(4) Identification of health disparities in pre-
vention and wellness. 
‘‘(5) Review of prevention payment incentives, 
the prevention workforce, and prevention delivery 
system capacity. 
‘‘(6) A plan for addressing and implementing 
paragraphs (1) through (5). 
‘‘(c) CONSULTATION.—In developing or revising the 
strategy under subsection (a), the Secretary shall consult 
with the following: 
‘‘(1) The heads of appropriate health agencies 
and offices in the Department, including the Office 
of the Surgeon General of the Public Health Service, 
the Office of Minority Health, the Office on Wom-
en’s Health, and the Substance Abuse and Mental 
Health Services Administration. 
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‘‘(2) As appropriate, the heads of other Federal 
departments and agencies whose programs have a 
significant impact upon health (as determined by the 
Secretary). 
‘‘(3) As appropriate, nonprofit and for-profit 
entities. 
‘‘(4) The Association of State and Territorial 
Health Officials and the National Association of 
County and City Health Officials. 
‘‘(5) The Task Force on Community Preventive 
Services and the Task Force on Clinical Preventive 
Services. 
‘‘Subtitle C—Prevention Task 
Forces 
‘‘SEC. 3131. TASK FORCE ON CLINICAL PREVENTIVE SERV-
ICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Agency for Healthcare Research and 
Quality, shall establish a permanent task force to be 
known as the Task Force on Clinical Preventive Services 
(in this section referred to as the ‘Task Force’). 
‘‘(b) RESPONSIBILITIES.—The Task Force shall— 
‘‘(1) identify clinical preventive services for re-
view; 
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‘‘(2) review the scientific evidence related to the 
benefits, effectiveness, appropriateness, and costs of 
clinical preventive services identified under para-
graph (1) for the purpose of developing, updating, 
publishing, and disseminating evidence-based rec-
ommendations on the use of such services; 
‘‘(3) as appropriate, take into account health 
disparities in developing, updating, publishing, and 
disseminating evidence-based recommendations on 
the use of such services; 
‘‘(4) identify gaps in clinical preventive services 
research and evaluation and recommend priority 
areas for such research and evaluation; 
‘‘(5) pursuant to section 3143(c), determine 
whether subsidies and rewards meet the Task 
Force’s standards for a grade of A or B; 
‘‘(6) as appropriate, consult with the clinical 
prevention stakeholders board in accordance with 
subsection (f); 
‘‘(7) consult with the Task Force on Commu-
nity Preventive Services established under section 
3132; and 
‘‘(8) as appropriate, in carrying out this sec-
tion, consider the national strategy under section 
3121. 
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‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Task Force, including coordi-
nating and supporting the dissemination of the rec-
ommendations of the Task Force. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) 
NUMBER; 
APPOINTMENT.—The 
Task 
Force shall be composed of 30 members, appointed 
by the Secretary. 
‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Task Force for a term 
of 6 years and may reappoint such members, 
but the Secretary may not appoint any member 
to serve more than a total of 12 years. 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to serve on the Task Force after 
the enactment of this title— 
‘‘(i) 10 shall be appointed for a term 
of 2 years; 
‘‘(ii) 10 shall be appointed for a term 
of 4 years; and 
‘‘(iii) 10 shall be appointed for a term 
of 6 years. 
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‘‘(3) QUALIFICATIONS.—Members of the Task 
Force shall be appointed from among individuals 
who possess expertise in at least one of the following 
areas: 
‘‘(A) Health promotion and disease preven-
tion. 
‘‘(B) Evaluation of research and system-
atic evidence reviews. 
‘‘(C) Application of systematic evidence re-
views to clinical decisionmaking or health pol-
icy. 
‘‘(D) Clinical primary care in child and ad-
olescent health. 
‘‘(E) Clinical primary care in adult health, 
including women’s health. 
‘‘(F) Clinical primary care in geriatrics. 
‘‘(G) Clinical counseling and behavioral 
services for primary care patients. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Task Force, the Secretary shall ensure 
that— 
‘‘(A) all areas of expertise described in 
paragraph (3) are represented; and 
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‘‘(B) the members of the Task Force in-
clude individuals with expertise in health dis-
parities. 
‘‘(e) SUBGROUPS.—As appropriate to maximize effi-
ciency, the Task Force may delegate authority for con-
ducting reviews and making recommendations to sub-
groups consisting of Task Force members, subject to final 
approval by the Task Force. 
‘‘(f) 
CLINICAL
PREVENTION
STAKEHOLDERS 
BOARD.— 
‘‘(1) IN GENERAL.—The Task Force shall con-
vene a clinical prevention stakeholders board com-
posed of representatives of appropriate public and 
private entities with an interest in clinical preventive 
services to advise the Task Force on developing, up-
dating, publishing, and disseminating evidence-based 
recommendations on the use of clinical preventive 
services. 
‘‘(2) MEMBERSHIP.—The members of the clin-
ical prevention stakeholders board shall include rep-
resentatives of the following: 
‘‘(A) Health care consumers and patient 
groups. 
‘‘(B) Providers of clinical preventive serv-
ices, including community-based providers. 
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‘‘(C) Federal departments and agencies, 
including— 
‘‘(i) appropriate health agencies and 
offices in the Department, including the 
Office of the Surgeon General of the Pub-
lic Health Service, the Office of Minority 
Health, the National Center on Minority 
Health and Health Disparities, and the Of-
fice on Women’s Health; and 
‘‘(ii) as appropriate, other Federal de-
partments and agencies whose programs 
have a significant impact upon health (as 
determined by the Secretary). 
‘‘(D) Private health care payors. 
‘‘(3) RESPONSIBILITIES.—In accordance with 
subsection (b)(6), the clinical prevention stake-
holders board shall— 
‘‘(A) recommend clinical preventive serv-
ices for review by the Task Force; 
‘‘(B) suggest scientific evidence for consid-
eration by the Task Force related to reviews 
undertaken by the Task Force; 
‘‘(C) provide feedback regarding draft rec-
ommendations by the Task Force; and 
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‘‘(D) assist with efforts regarding dissemi-
nation of recommendations by the Director of 
the Agency for Healthcare Research and Qual-
ity. 
‘‘(g) DISCLOSURE AND CONFLICTS OF INTEREST.— 
Members of the Task Force or the clinical prevention 
stakeholders board shall not be considered employees of 
the Federal Government by reason of service on the Task 
Force or the clinical prevention stakeholders board, except 
members of the Task Force or the clinical prevention 
stakeholders board shall be considered to be special Gov-
ernment employees within the meaning of section 107 of 
the Ethics in Government Act of 1978 (5 U.S.C. App.) 
and section 208 of title 18, United States Code, for the 
purposes of disclosure and management of conflicts of in-
terest under those sections. 
‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.— 
Members of the Task Force or the clinical prevention 
stakeholders board shall not receive any pay for service 
on the Task Force, but may receive travel expenses, in-
cluding a per diem, in accordance with applicable provi-
sions of subchapter I of chapter 57 of title 5, United 
States Code. 
‘‘(i) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) except for section 14 of 
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such Act shall apply to the Task Force to the extent that 
the provisions of such Act do not conflict with the provi-
sions of this title. 
‘‘(j) REPORT.—The Secretary shall submit to the 
Congress an annual report on the Task Force, including 
with respect to gaps identified and recommendations made 
under subsection (b)(4). 
‘‘SEC. 3132. TASK FORCE ON COMMUNITY PREVENTIVE 
SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall establish a permanent task force to be 
known as the Task Force on Community Preventive Serv-
ices (in this section referred to as the ‘Task Force’). 
‘‘(b) RESPONSIBILITIES.—The Task Force shall— 
‘‘(1) identify community preventive services for 
review; 
‘‘(2) review the scientific evidence related to the 
benefits, effectiveness, appropriateness, and costs of 
community preventive services identified under para-
graph (1) for the purpose of developing, updating, 
publishing, and disseminating evidence-based rec-
ommendations on the use of such services; 
‘‘(3) as appropriate, take into account health 
disparities in developing, updating, publishing, and 
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disseminating evidence-based recommendations on 
the use of such services; 
‘‘(4) identify gaps in community preventive 
services research and evaluation and recommend pri-
ority areas for such research and evaluation; 
‘‘(5) pursuant to section 3143(d), determine 
whether subsidies and rewards are effective; 
‘‘(6) as appropriate, consult with the commu-
nity prevention stakeholders board in accordance 
with subsection (f); 
‘‘(7) consult with the Task Force on Clinical 
Preventive Services established under section 3131; 
and 
‘‘(8) as appropriate, in carrying out this sec-
tion, consider the national strategy under section 
3121. 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Task Force, including coordi-
nating and supporting the dissemination of the rec-
ommendations of the Task Force. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) 
NUMBER; 
APPOINTMENT.—The 
Task 
Force shall be composed of 30 members, appointed 
by the Secretary. 
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‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Task Force for a term 
of 6 years and may reappoint such members, 
but the Secretary may not appoint any member 
to serve more than a total of 12 years. 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to serve on the Task Force after 
the enactment of this section— 
‘‘(i) 10 shall be appointed for a term 
of 2 years; 
‘‘(ii) 10 shall be appointed for a term 
of 4 years; and 
‘‘(iii) 10 shall be appointed for a term 
of 6 years. 
‘‘(3) QUALIFICATIONS.—Members of the Task 
Force shall be appointed from among individuals 
who possess expertise in at least one of the following 
areas: 
‘‘(A) Public health. 
‘‘(B) Evaluation of research and system-
atic evidence reviews. 
‘‘(C) Disciplines relevant to community 
preventive services, including health promotion; 
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disease prevention; chronic disease; worksite 
health; school-site health; qualitative and quan-
titative analysis; and health economics, policy, 
law, and statistics. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Task Force, the Secretary— 
‘‘(A) shall ensure that all areas of exper-
tise described in paragraph (3) are represented; 
‘‘(B) shall ensure that such members in-
clude sufficient representatives of each of— 
‘‘(i) State health officers; 
‘‘(ii) local health officers; 
‘‘(iii) health care practitioners; and 
‘‘(iv) public health practitioners; and 
‘‘(C) shall appoint individuals who have ex-
pertise in health disparities. 
‘‘(e) SUBGROUPS.—As appropriate to maximize effi-
ciency, the Task Force may delegate authority for con-
ducting reviews and making recommendations to sub-
groups consisting of Task Force members, subject to final 
approval by the Task Force. 
‘‘(f) 
COMMUNITY
PREVENTION
STAKEHOLDERS 
BOARD.— 
‘‘(1) IN GENERAL.—The Task Force shall con-
vene a community prevention stakeholders board 
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composed of representatives of appropriate public 
and private entities with an interest in community 
preventive services to advise the Task Force on de-
veloping, updating, publishing, and disseminating 
evidence-based recommendations on the use of com-
munity preventive services. 
‘‘(2) MEMBERSHIP.—The members of the com-
munity prevention stakeholders board shall include 
representatives of the following: 
‘‘(A) Health care consumers and patient 
groups. 
‘‘(B) Providers of community preventive 
services, including community-based providers. 
‘‘(C) Federal departments and agencies, 
including— 
‘‘(i) appropriate health agencies and 
offices in the Department, including the 
Office of the Surgeon General of the Pub-
lic Health Service, the Office of Minority 
Health, the National Center on Minority 
Health and Health Disparities, and the Of-
fice on Women’s Health; and 
‘‘(ii) as appropriate, other Federal de-
partments and agencies whose programs 
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have a significant impact upon health (as 
determined by the Secretary). 
‘‘(D) Private health care payors. 
‘‘(3) RESPONSIBILITIES.—In accordance with 
subsection (b)(6), the community prevention stake-
holders board shall— 
‘‘(A) recommend community preventive 
services for review by the Task Force; 
‘‘(B) suggest scientific evidence for consid-
eration by the Task Force related to reviews 
undertaken by the Task Force; 
‘‘(C) provide feedback regarding draft rec-
ommendations by the Task Force; and 
‘‘(D) assist with efforts regarding dissemi-
nation of recommendations by the Director of 
the Centers for Disease Control and Prevention. 
‘‘(g) DISCLOSURE AND CONFLICTS OF INTEREST.— 
Members of the Task Force or the community prevention 
stakeholders board shall not be considered employees of 
the Federal Government by reason of service on the Task 
Force or the community prevention stakeholders board, 
except members of the Task Force or the community pre-
vention stakeholders board shall be considered to be spe-
cial Government employees within the meaning of section 
107 of the Ethics in Government Act of 1978 (5 U.S.C. 
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App.) and section 208 of title 18, United States Code, for 
the purposes of disclosure and management of conflicts 
of interest under those sections. 
‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.— 
Members of the Task Force or the community prevention 
stakeholders board shall not receive any pay for service 
on the Task Force, but may receive travel expenses, in-
cluding a per diem, in accordance with applicable provi-
sions of subchapter I of chapter 57 of title 5, United 
States Code. 
‘‘(i) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) except for section 14 of 
such Act shall apply to the Task Force to the extent that 
the provisions of such Act do not conflict with the provi-
sions of this title. 
‘‘(j) REPORT.—The Secretary shall submit to the 
Congress an annual report on the Task Force, including 
with respect to gaps identified and recommendations made 
under subsection (b)(4). 
‘‘Subtitle D—Prevention and 
Wellness Research 
‘‘SEC. 3141. PREVENTION AND WELLNESS RESEARCH ACTIV-
ITY COORDINATION. 
‘‘In conducting or supporting research on prevention 
and wellness, the Director of the Centers for Disease Con-
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trol and Prevention, the Director of the National Insti-
tutes of Health, and the heads of other agencies within 
the Department of Health and Human Services con-
ducting or supporting such research, shall take into con-
sideration the national strategy under section 3121 and 
the recommendations of the Task Force on Clinical Pre-
ventive Services under section 3131 and the Task Force 
on Community Preventive Services under section 3132. 
‘‘SEC. 3142. COMMUNITY PREVENTION AND WELLNESS RE-
SEARCH GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall conduct, or award grants to eligible entities 
to conduct, research in priority areas identified by the Sec-
retary in the national strategy under section 3121 or by 
the Task Force on Community Preventive Services as re-
quired by section 3132. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall be— 
‘‘(1) a State, local, or tribal department of 
health; 
‘‘(2) a public or private nonprofit entity; or 
‘‘(3) a consortium of 2 or more entities de-
scribed in paragraphs (1) and (2). 
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‘‘(c) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program of research 
under this section. 
‘‘SEC. 3143. RESEARCH ON SUBSIDIES AND REWARDS TO 
ENCOURAGE WELLNESS AND HEALTHY BE-
HAVIORS. 
‘‘(a) RESEARCH AND DEMONSTRATION PROJECTS.— 
‘‘(1) IN GENERAL.—The Secretary shall con-
duct, or award grants to public or nonprofit private 
entities to conduct, research and demonstration 
projects on the use of financial and in-kind subsidies 
and rewards to encourage individuals and commu-
nities to promote wellness, adopt healthy behaviors, 
and use evidence-based preventive health services. 
‘‘(2) FOCUS.—Research and demonstration 
projects under paragraph (1) shall focus on— 
‘‘(A) tobacco use, obesity, and other pre-
vention and wellness priorities identified by the 
Secretary in the national strategy under section 
3121; 
‘‘(B) the initiation, maintenance, and long- 
term sustainability of wellness promotion; adop-
tion of healthy behaviors; and use of evidence- 
based preventive health services; and 
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‘‘(C) populations at high risk of prevent-
able diseases and conditions. 
‘‘(b) FINDINGS; REPORT.— 
‘‘(1) SUBMISSION OF FINDINGS.—The Secretary 
shall submit the findings of research and demonstra-
tion projects under subsection (a) to— 
‘‘(A) the Task Force on Clinical Preventive 
Services established under section 3131 or the 
Task Force on Community Preventive Services 
established under section 3132, as appropriate; 
and 
‘‘(B) the Health Benefits Advisory Com-
mittee established by section 223 of the Afford-
able Health Care for America Act. 
‘‘(2) REPORT TO CONGRESS.—Not later than 
18 months after the initiation of research and dem-
onstration projects under subsection (a), the Sec-
retary shall submit a report to the Congress on the 
progress of such research and projects, including 
any preliminary findings. 
‘‘(c) INCLUSION
IN ESSENTIAL BENEFITS PACK-
AGE.—If, on the basis of the findings of research and dem-
onstration projects under subsection (a) or other sources 
consistent with section 3131, the Task Force on Clinical 
Preventive Services determines that a subsidy or reward 
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meets the Task Force’s standards for a grade A or B, 
the Secretary shall ensure that the subsidy or reward is 
included in the essential benefits package under section 
222. 
‘‘(d) INCLUSION AS ALLOWABLE USE OF COMMUNITY 
PREVENTION AND WELLNESS SERVICES GRANTS.—If, on 
the basis of the findings of research and demonstration 
projects under subsection (a) or other sources consistent 
with section 3132, the Task Force on Community Preven-
tive Services determines that a subsidy or reward is effec-
tive, the Secretary shall ensure that the subsidy or reward 
becomes an allowable use of grant funds under section 
3151. 
‘‘(e) NONDISCRIMINATION; NO TIE TO PREMIUM OR 
COST SHARING.—In carrying out this section, the Sec-
retary shall ensure that any subsidy or reward— 
‘‘(1) does not have a discriminatory effect on 
the basis of any personal characteristic extraneous 
to the provision of high-quality health care or related 
services; and 
‘‘(2) is not tied to the premium or cost sharing 
of an individual under any qualified health benefits 
plan (as defined in section 100(c)). 
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‘‘Subtitle E—Delivery of Commu-
nity Prevention and Wellness 
Services 
‘‘SEC. 3151. COMMUNITY PREVENTION AND WELLNESS 
SERVICES GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall establish a program for the delivery of com-
munity prevention and wellness services consisting of 
awarding grants to eligible entities— 
‘‘(1) to provide evidence-based, community pre-
vention and wellness services in priority areas identi-
fied by the Secretary in the national strategy under 
section 3121; or 
‘‘(2) to plan such services. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) DEFINITION.—To be eligible for a grant 
under this section, an entity shall be— 
‘‘(A) a State, local, or tribal department of 
health; 
‘‘(B) a public or private entity; or 
‘‘(C) a consortium that— 
‘‘(i) consists of 2 or more entities de-
scribed in subparagraph (A) or (B); and 
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‘‘(ii) may be a community partnership 
representing a Health Empowerment Zone. 
‘‘(2) HEALTH EMPOWERMENT ZONE.—In this 
subsection, the term ‘Health Empowerment Zone’ 
means an area— 
‘‘(A) in which multiple community preven-
tion and wellness services are implemented in 
order to address one or more health disparities, 
including those identified by the Secretary in 
the national strategy under section 3121; and 
‘‘(B) which is represented by a community 
partnership that demonstrates community sup-
port and coordination with State, local, or tribal 
health departments and includes— 
‘‘(i) a broad cross section of stake-
holders; 
‘‘(ii) residents of the community; and 
‘‘(iii) representatives of entities that 
have a history of working within and serv-
ing the community. 
‘‘(c) PREFERENCES.—In awarding grants under this 
section, the Secretary shall give preference to entities 
that— 
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‘‘(1) will address one or more goals or objec-
tives identified by the Secretary in the national 
strategy under section 3121; 
‘‘(2) will address significant health disparities, 
including those identified by the Secretary in the na-
tional strategy under section 3121; 
‘‘(3) will address unmet community prevention 
and wellness needs and avoid duplication of effort; 
‘‘(4) have been demonstrated to be effective in 
communities comparable to the proposed target com-
munity; 
‘‘(5) will contribute to the evidence base for 
community prevention and wellness services; 
‘‘(6) demonstrate that the community preven-
tion and wellness services to be funded will be sus-
tainable; and 
‘‘(7) demonstrate coordination or collaboration 
across governmental and nongovernmental partners. 
‘‘(d) HEALTH DISPARITIES.—Of the funds awarded 
under this section for a fiscal year, the Secretary shall 
award not less than 50 percent for planning or imple-
menting community prevention and wellness services 
whose primary purpose is to achieve a measurable reduc-
tion in one or more health disparities, including those 
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identified by the Secretary in the national strategy under 
section 3121. 
‘‘(e) EMPHASIS ON RECOMMENDED SERVICES.—For 
fiscal year 2014 and subsequent fiscal years, the Secretary 
shall award grants under this section only for planning 
or implementing services recommended by the Task Force 
on Community Preventive Services under section 3132 or 
deemed effective based on a review of comparable rigor 
(as determined by the Director of the Centers for Disease 
Control and Prevention). 
‘‘(f) PROHIBITED USES OF FUNDS.—An entity that 
receives a grant under this section may not use funds pro-
vided through the grant— 
‘‘(1) to build or acquire real property or for 
construction; or 
‘‘(2) for services or planning to the extent that 
payment has been made, or can reasonably be ex-
pected to be made— 
‘‘(A) under any insurance policy; 
‘‘(B) under any Federal or State health 
benefits program (including titles XIX and XXI 
of the Social Security Act); or 
‘‘(C) by an entity which provides health 
services on a prepaid basis. 
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‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program of grants 
awarded under this section. 
‘‘(h) DEFINITIONS.—In this section, the term ‘evi-
dence-based’ means that methodologically sound research 
has demonstrated a beneficial health effect, in the judg-
ment of the Director of the Centers for Disease Control 
and Prevention. 
‘‘Subtitle F—Core Public Health 
Infrastructure 
‘‘SEC. 3161. CORE PUBLIC HEALTH INFRASTRUCTURE FOR 
STATE, LOCAL, AND TRIBAL HEALTH DEPART-
MENTS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion, shall establish a core public health infrastructure 
program consisting of awarding grants under subsection 
(b). 
‘‘(b) GRANTS.— 
‘‘(1) AWARD.—For the purpose of addressing 
core public health infrastructure needs, the Sec-
retary— 
‘‘(A) shall award a grant to each State 
health department; and 
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‘‘(B) may award grants on a competitive 
basis to State, local, or tribal health depart-
ments. 
‘‘(2) ALLOCATION.—Of the total amount of 
funds awarded as grants under this subsection for a 
fiscal year— 
‘‘(A) not less than 50 percent shall be for 
grants to State health departments under para-
graph (1)(A); and 
‘‘(B) not less than 30 percent shall be for 
grants to State, local, or tribal health depart-
ments under paragraph (1)(B). 
‘‘(c) USE OF FUNDS.—The Secretary may award a 
grant to an entity under subsection (b)(1) only if the enti-
ty agrees to use the grant to address core public health 
infrastructure needs, including those identified in the ac-
creditation process under subsection (g). 
‘‘(d) FORMULA GRANTS TO STATE HEALTH DEPART-
MENTS.—In making grants under subsection (b)(1)(A), 
the Secretary shall award funds to each State health de-
partment in accordance with— 
‘‘(1) a formula based on population size; burden 
of preventable disease and disability; and core public 
health infrastructure gaps, including those identified 
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in the accreditation process under subsection (g); 
and 
‘‘(2) application requirements established by the 
Secretary, including a requirement that the State 
submit a plan that demonstrates to the satisfaction 
of the Secretary that the State’s health department 
will— 
‘‘(A) address its highest priority core pub-
lic health infrastructure needs; and 
‘‘(B) as appropriate, allocate funds to local 
health departments within the State. 
‘‘(e) COMPETITIVE GRANTS TO STATE, LOCAL, AND 
TRIBAL
HEALTH
DEPARTMENTS.—In making grants 
under subsection (b)(1)(B), the Secretary shall give pri-
ority to applicants demonstrating core public health infra-
structure needs identified in the accreditation process 
under subsection (g). 
‘‘(f) MAINTENANCE
OF EFFORT.—The Secretary 
may award a grant to an entity under subsection (b) only 
if the entity demonstrates to the satisfaction of the Sec-
retary that— 
‘‘(1) funds received through the grant will be 
expended only to supplement, and not supplant, non- 
Federal and Federal funds otherwise available to the 
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entity for the purpose of addressing core public 
health infrastructure needs; and 
‘‘(2) with respect to activities for which the 
grant is awarded, the entity will maintain expendi-
tures of non-Federal amounts for such activities at 
a level not less than the level of such expenditures 
maintained by the entity for the fiscal year pre-
ceding the fiscal year for which the entity receives 
the grant. 
‘‘(g) ESTABLISHMENT OF A PUBLIC HEALTH AC-
CREDITATION PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall— 
‘‘(A) develop, and periodically review and 
update, standards for voluntary accreditation of 
State, local, or tribal health departments and 
public health laboratories for the purpose of ad-
vancing the quality and performance of such de-
partments and laboratories; and 
‘‘(B) implement a program to accredit 
such health departments and laboratories in ac-
cordance with such standards. 
‘‘(2) COOPERATIVE
AGREEMENT.—The Sec-
retary may enter into a cooperative agreement with 
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a private nonprofit entity to carry out paragraph 
(1). 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on progress being made to ac-
credit entities under subsection (g), including— 
‘‘(1) a strategy, including goals and objectives, 
for accrediting entities under subsection (g) and 
achieving the purpose described in subsection (g)(1); 
and 
‘‘(2) identification of gaps in research related to 
core public health infrastructure and recommenda-
tions of priority areas for such research. 
‘‘SEC. 3162. CORE PUBLIC HEALTH INFRASTRUCTURE AND 
ACTIVITIES FOR CDC. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall expand and improve the core public health 
infrastructure and activities of the Centers for Disease 
Control and Prevention to address unmet and emerging 
public health needs. 
‘‘(b) REPORT.—The Secretary shall submit to the 
Congress an annual report on the activities funded 
through this section. 
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‘‘Subtitle G—General Provisions 
‘‘SEC. 3171. DEFINITIONS. 
‘‘In this title: 
‘‘(1) The term ‘core public health infrastruc-
ture’ includes workforce capacity and competency; 
laboratory systems; health information, health infor-
mation systems, and health information analysis; 
communications; financing; other relevant compo-
nents of organizational capacity; and other related 
activities. 
‘‘(2) The terms ‘Department’ and ‘depart-
mental’ refer to the Department of Health and 
Human Services. 
‘‘(3) The term ‘health disparities’ includes 
health and health care disparities and means popu-
lation-specific differences in the presence of disease, 
health outcomes, or access to health care. For pur-
poses of the preceding sentence, a population may be 
delineated by race, ethnicity, primary language, sex, 
sexual orientation, gender identity, disability, socio-
economic status, or rural, urban, or other geographic 
setting, and any other population or subpopulation 
determined by the Secretary to experience significant 
gaps in disease, health outcomes, or access to health 
care. 
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‘‘(4) The term ‘tribal’ refers to an Indian tribe, 
a Tribal organization, or an Urban Indian organiza-
tion, as such terms are defined in section 4 of the 
Indian Health Care Improvement Act.’’. 
(b) TRANSITION PROVISIONS APPLICABLE TO TASK 
FORCES.— 
(1) FUNCTIONS, PERSONNEL, ASSETS, LIABIL-
ITIES, AND
ADMINISTRATIVE
ACTIONS.—All func-
tions, personnel, assets, and liabilities of, and ad-
ministrative actions applicable to, the Preventive 
Services Task Force convened under section 915(a) 
of the Public Health Service Act and the Task Force 
on Community Preventive Services (as such section 
and Task Forces were in existence on the day before 
the date of the enactment of this Act) shall be trans-
ferred to the Task Force on Clinical Preventive 
Services and the Task Force on Community Preven-
tive Services, respectively, established under sections 
3131 and 3132 of the Public Health Service Act, as 
added by subsection (a). 
(2) RECOMMENDATIONS.—All recommendations 
of the Preventive Services Task Force and the Task 
Force on Community Preventive Services, as in ex-
istence on the day before the date of the enactment 
of this Act, shall be considered to be recommenda-
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tions of the Task Force on Clinical Preventive Serv-
ices and the Task Force on Community Preventive 
Services, respectively, established under sections 
3131 and 3132 of the Public Health Service Act, as 
added by subsection (a). 
(3) MEMBERS ALREADY SERVING.— 
(A) INITIAL MEMBERS.—The Secretary of 
Health and Human Services may select those 
individuals already serving on the Preventive 
Services Task Force and the Task Force on 
Community Preventive Services, as in existence 
on the day before the date of the enactment of 
this Act, to be among the first members ap-
pointed to the Task Force on Clinical Preven-
tive Services and the Task Force on Commu-
nity Preventive Services, respectively, under sec-
tions 3131 and 3132 of the Public Health Serv-
ice Act, as added by subsection (a). 
(B) CALCULATION OF TOTAL SERVICE.—In 
calculating the total years of service of a mem-
ber of a task force for purposes of section 
3131(d)(2)(A) or 3132(d)(2)(A) of the Public 
Health Service Act, as added by subsection (a), 
the Secretary of Health and Human Services 
shall not include any period of service by the 
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member on the Preventive Services Task Force 
or the Task Force on Community Preventive 
Services, respectively, as in existence on the day 
before the date of the enactment of this Act. 
(c) PERIOD BEFORE COMPLETION
OF NATIONAL 
STRATEGY.—Pending completion of the national strategy 
under section 3121 of the Public Health Service Act, as 
added by subsection (a), the Secretary of Health and 
Human Services, acting through the relevant agency head, 
may make a judgment about how the strategy will address 
an issue and rely on such judgment in carrying out any 
provision of subtitle C, D, E, or F of title XXXI of such 
Act, as added by subsection (a), that requires the Sec-
retary— 
(1) to take into consideration such strategy; 
(2) to conduct or support research or provide 
services in priority areas identified in such strategy; 
or 
(3) to take any other action in reliance on such 
strategy. 
(d) CONFORMING AMENDMENTS.— 
(1) Paragraph (61) of section 3(b) of the In-
dian Health Care Improvement Act (25 U.S.C. 
1602) is amended by striking ‘‘United States Pre-
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ventive Services Task Force’’ and inserting ‘‘Task 
Force on Clinical Preventive Services’’. 
(2) Section 126 of the Medicare, Medicaid, and 
SCHIP Benefits Improvement and Protection Act of 
2000 (Appendix F of Public Law 106–554) is 
amended by striking ‘‘United States Preventive 
Services Task Force’’ each place it appears and in-
serting ‘‘Task Force on Clinical Preventive Serv-
ices’’. 
(3) Paragraph (7) of section 317D(a) of the 
Public Health Service Act (42 U.S.C. 247b–5(a)) is 
amended by striking ‘‘United States Preventive 
Services Task Force’’ and inserting ‘‘Task Force on 
Clinical Preventive Services’’. 
(4) Section 915 of the Public Health Service 
Act (42 U.S.C. 299b–4) is amended by striking sub-
section (a). 
(5) Subsections (s)(2)(AA)(iii)(II), (xx)(1), and 
(ddd)(1)(B) of section 1861 of the Social Security 
Act (42 U.S.C. 1395x) are amended by striking 
‘‘United States Preventive Services Task Force’’ 
each place it appears and inserting ‘‘Task Force on 
Clinical Preventive Services’’. 
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TITLE IV—QUALITY AND 
SURVEILLANCE 
SEC. 2401. IMPLEMENTATION OF BEST PRACTICES IN THE 
DELIVERY OF HEALTH CARE. 
(a) IN GENERAL.—Title IX of the Public Health 
Service Act (42 U.S.C. 299 et seq.) is amended— 
(1) by redesignating part D as part E; 
(2) by redesignating sections 931 through 938 
as sections 941 through 948, respectively; 
(3) in section 948(1), as redesignated, by strik-
ing ‘‘931’’ and inserting ‘‘941’’; and 
(4) by inserting after part C the following: 
‘‘PART D—IMPLEMENTATION OF BEST 
PRACTICES IN THE DELIVERY OF HEALTH CARE 
‘‘SEC. 931. CENTER FOR QUALITY IMPROVEMENT. 
‘‘(a) IN GENERAL.—There is established the Center 
for Quality Improvement (referred to in this part as the 
‘Center’), to be headed by the Director. 
‘‘(b) PRIORITIZATION.— 
‘‘(1) 
IN
GENERAL.—The 
Director 
shall 
prioritize areas for the identification, development, 
evaluation, and implementation of best practices (in-
cluding innovative methodologies and strategies) for 
quality improvement activities in the delivery of 
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health care services (in this section referred to as 
‘best practices’). 
‘‘(2) CONSIDERATIONS.—In prioritizing areas 
under paragraph (1), the Director shall consider— 
‘‘(A) the priorities established under sec-
tion 1191 of the Social Security Act; and 
‘‘(B) the key health indicators identified by 
the Assistant Secretary for Health Information 
under section 1709. 
‘‘(3) LIMITATIONS.—In conducting its duties 
under this subsection, the Center for Quality Im-
provement shall not develop quality-adjusted life 
year measures or any other methodologies that can 
be used to deny benefits to a beneficiary against the 
beneficiary’s wishes on the basis of the beneficiary’s 
age, life expectancy, present or predicted disability, 
or expected quality of life. 
‘‘(c) OTHER RESPONSIBILITIES.—The Director, act-
ing directly or by awarding a grant or contract to an eligi-
ble entity, shall— 
‘‘(1) identify existing best practices under sub-
section (e); 
‘‘(2) develop new best practices under sub-
section (f); 
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‘‘(3) evaluate best practices under subsection 
(g); 
‘‘(4) implement best practices under subsection 
(h); 
‘‘(5) ensure that best practices are identified, 
developed, evaluated, and implemented under this 
section consistent with standards adopted by the 
Secretary under section 3004 for health information 
technology used in the collection and reporting of 
quality information (including for purposes of the 
demonstration of meaningful use of certified elec-
tronic health record (EHR) technology by physicians 
and hospitals under the Medicare program (under 
sections 1848(o)(2) and 1886(n)(3), respectively, of 
the Social Security Act)); and 
‘‘(6) provide for dissemination of information 
and reporting under subsections (i) and (j). 
‘‘(d) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (c), an entity shall— 
‘‘(1) be a nonprofit entity; 
‘‘(2) agree to work with a variety of institu-
tional health care providers, physicians, nurses, and 
other health care practitioners; and 
‘‘(3) if the entity is not the organization holding 
a contract under section 1153 of the Social Security 
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Act for the area to be served, agree to cooperate 
with and avoid duplication of the activities of such 
organization. 
‘‘(e) IDENTIFYING EXISTING BEST PRACTICES.—The 
Director shall identify best practices that are— 
‘‘(1) currently utilized by health care providers 
(including hospitals, physician and other clinician 
practices, community cooperatives, and other health 
care entities) that deliver consistently high-quality, 
efficient health care services; and 
‘‘(2) easily adapted for use by other health care 
providers and for use across a variety of health care 
settings. 
‘‘(f) DEVELOPING NEW BEST PRACTICES.—The Di-
rector shall develop best practices that are— 
‘‘(1) based on a review of existing scientific evi-
dence; 
‘‘(2) sufficiently detailed for implementation 
and incorporation into the workflow of health care 
providers; and 
‘‘(3) designed to be easily adapted for use by 
health care providers across a variety of health care 
settings. 
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‘‘(g) EVALUATION OF BEST PRACTICES.—The Direc-
tor shall evaluate best practices identified or developed 
under this section. Such evaluation— 
‘‘(1) shall include determinations of which best 
practices— 
‘‘(A) most reliably and effectively achieve 
significant progress in improving the quality of 
patient care; and 
‘‘(B) are easily adapted for use by health 
care providers across a variety of health care 
settings; 
‘‘(2) shall include regular review, updating, and 
improvement of such best practices; and 
‘‘(3) may include in-depth case studies or em-
pirical assessments of health care providers (includ-
ing hospitals, physician and other clinician practices, 
community cooperatives, and other health care enti-
ties) and simulations of such best practices for de-
terminations under paragraph (1). 
‘‘(h) IMPLEMENTATION OF BEST PRACTICES.— 
‘‘(1) IN
GENERAL.—The Director shall enter 
into arrangements with entities in a State or region 
to implement best practices identified or developed 
under this section. Such implementation— 
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‘‘(A) may include forming collaborative 
multi-institutional teams; and 
‘‘(B) shall include an evaluation of the best 
practices being implemented, including the 
measurement of patient outcomes before, dur-
ing, and after implementation of such best 
practices. 
‘‘(2) PREFERENCES.—In carrying out this sub-
section, the Director shall give priority to health 
care providers implementing best practices that— 
‘‘(A) have the greatest impact on patient 
outcomes and satisfaction; 
‘‘(B) are the most easily adapted for use 
by health care providers across a variety of 
health care settings; 
‘‘(C) promote coordination of health care 
practitioners across the continuum of care; and 
‘‘(D) engage patients and their families in 
improving patient care and outcomes. 
‘‘(i) PUBLIC DISSEMINATION
OF INFORMATION.— 
The Director shall provide for the public dissemination of 
information with respect to best practices and activities 
under this section. Such information shall be made avail-
able in appropriate formats and languages to reflect the 
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varying needs of consumers and diverse levels of health 
literacy. 
‘‘(j) REPORT.— 
‘‘(1) IN GENERAL.—The Director shall submit 
an annual report to the Congress and the Secretary 
on activities under this section. 
‘‘(2) CONTENT.—Each report under paragraph 
(1) shall include— 
‘‘(A) information on activities conducted 
pursuant to grants and contracts awarded; 
‘‘(B) summary data on patient outcomes 
before, during, and after implementation of best 
practices; and 
‘‘(C) recommendations on the adaptability 
of best practices for use by health providers.’’. 
(b) INITIAL QUALITY IMPROVEMENT ACTIVITIES AND 
INITIATIVES TO BE IMPLEMENTED.—Until the Director 
of the Agency for Healthcare Research and Quality has 
established initial priorities under section 931(b) of the 
Public Health Service Act, as added by subsection (a), the 
Director shall, for purposes of such section, prioritize the 
following: 
(1) HEALTH CARE-ASSOCIATED INFECTIONS.— 
Reducing health care-associated infections, including 
infections in nursing homes and outpatient settings. 
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(2) SURGERY.—Increasing hospital and out-
patient perioperative patient safety, including reduc-
ing surgical-site infections and surgical errors (such 
as wrong-site surgery and retained foreign bodies). 
(3) EMERGENCY
ROOM.—Improving care in 
hospital emergency rooms, including through the use 
of principles of efficiency of design and delivery to 
improve patient flow. 
(4) OBSTETRICS.—Improving the provision of 
obstetrical and neonatal care, including the identi-
fication of interventions that are effective in reduc-
ing the risk of preterm and premature labor and the 
implementation of best practices for labor and deliv-
ery care. 
(5) PEDIATRICS.—Improving the provision of 
preventive and developmental child health services, 
including interventions that can reduce child health 
disparities (as defined in section 3171 of the Public 
Health Service Act, as added by section 2301) and 
reduce the risk of developing chronic health-threat-
ening conditions that affect an individual’s life 
course development. 
(c) REPORT.—Not later than 18 months after the 
date of the enactment of this Act, the Director of the 
Agency for Healthcare Research and Quality shall submit 
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a report to the Congress on the impact of the nurse-to- 
patient ratio on the quality of care and patient outcomes, 
including recommendations for further integration into 
quality measurement and quality improvement activities. 
SEC. 2402. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
(a) ESTABLISHMENT.—Title XVII (42 U.S.C. 300u 
et seq.) is amended— 
(1) by redesignating sections 1709 and 1710 as 
sections 1710 and 1711, respectively; and 
(2) by inserting after section 1708 the fol-
lowing: 
‘‘SEC. 1709. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
‘‘(a) IN GENERAL.—There is established within the 
Department an Assistant Secretary for Health Informa-
tion (in this section referred to as the ‘Assistant Sec-
retary’), to be appointed by the Secretary. 
‘‘(b) RESPONSIBILITIES.—The Assistant Secretary 
shall— 
‘‘(1) ensure the collection, collation, reporting, 
and publishing of information (including full and 
complete statistics) on key health indicators regard-
ing the Nation’s health and the performance of the 
Nation’s health care; 
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‘‘(2) facilitate and coordinate the collection, col-
lation, reporting, and publishing of information re-
garding the Nation’s health and the performance of 
the Nation’s health care (other than information de-
scribed in paragraph (1)); 
‘‘(3)(A) develop standards for the collection of 
data regarding the Nation’s health and the perform-
ance of the Nation’s health care; and 
‘‘(B) in carrying out subparagraph (A)— 
‘‘(i) ensure appropriate specificity and 
standardization for data collection at the na-
tional, regional, State, and local levels; 
‘‘(ii) include standards, as appropriate, for 
the collection of accurate data on health dis-
parities; 
‘‘(iii) ensure, with respect to data on race 
and ethnicity, consistency with the 1997 Office 
of Management and Budget Standards for 
Maintaining, Collecting and Presenting Federal 
Data on Race and Ethnicity (or any successor 
standards); and 
‘‘(iv) in consultation with the Director of 
the Office of Minority Health, and the Director 
of the Office of Civil Rights of the Department, 
develop standards for the collection of data on 
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health and health care with respect to primary 
language; 
‘‘(4) provide support to Federal departments 
and agencies whose programs have a significant im-
pact upon health (as determined by the Secretary) 
for the collection and collation of information de-
scribed in paragraphs (1) and (2); 
‘‘(5) ensure the sharing of information de-
scribed in paragraphs (1) and (2) among the agen-
cies of the Department; 
‘‘(6) facilitate the sharing of information de-
scribed in paragraphs (1) and (2) by Federal depart-
ments and agencies whose programs have a signifi-
cant impact upon health (as determined by the Sec-
retary); 
‘‘(7) identify gaps in information described in 
paragraphs (1) and (2) and the appropriate agency 
or entity to address such gaps; 
‘‘(8) facilitate and coordinate identification and 
monitoring of health disparities by the agencies of 
the Department to inform program and policy ef-
forts to reduce such disparities, including facilitating 
and funding analyses conducted in cooperation with 
the Social Security Administration, the Bureau of 
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the Census, and other appropriate agencies and enti-
ties; 
‘‘(9) consistent with privacy, proprietary, and 
other appropriate safeguards, facilitate public acces-
sibility of datasets (such as de-identified Medicare 
datasets or publicly available data on key health in-
dicators) by means of the Internet; and 
‘‘(10) award grants or contracts for the collec-
tion and collation of information described in para-
graphs (1) and (2) (including through statewide sur-
veys that provide standardized information). 
‘‘(c) KEY HEALTH INDICATORS.— 
‘‘(1) IN GENERAL.—In carrying out subsection 
(b)(1), the Assistant Secretary shall— 
‘‘(A) identify, and reassess at least once 
every 3 years, key health indicators described in 
such subsection; 
‘‘(B) publish statistics on such key health 
indicators for the public— 
‘‘(i) not less than annually; and 
‘‘(ii) on a supplemental basis when-
ever warranted by— 
‘‘(I) the rate of change for a key 
health indicator; or 
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‘‘(II) the need to inform policy 
regarding the Nation’s health and the 
performance of the Nation’s health 
care; and 
‘‘(C) ensure consistency with the national 
strategy developed by the Secretary under sec-
tion 3121 and consideration of the indicators 
specified in the reports under sections 308, 
903(a)(6), and 913(b)(2). 
‘‘(2) RELEASE OF KEY HEALTH INDICATORS.— 
The regulations, rules, processes, and procedures of 
the Office of Management and Budget governing the 
review, release, and dissemination of key health indi-
cators shall be the same as the regulations, rules, 
processes, and procedures of the Office of Manage-
ment and Budget governing the review, release, and 
dissemination of Principal Federal Economic Indica-
tors (or equivalent statistical data) by the Bureau of 
Labor Statistics. 
‘‘(d) COORDINATION.—In carrying out this section, 
the Assistant Secretary shall coordinate with— 
‘‘(1) public and private entities that collect and 
disseminate information on health and health care, 
including foundations; and 
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‘‘(2) the head of the Office of the National Co-
ordinator for Health Information Technology to en-
sure optimal use of health information technology. 
‘‘(e) REQUEST FOR INFORMATION FROM DEPART-
MENTS AND AGENCIES.—Consistent with applicable law, 
the Assistant Secretary may secure directly from any Fed-
eral department or agency information necessary to enable 
the Assistant Secretary to carry out this section. 
‘‘(f) REPORT.— 
‘‘(1) SUBMISSION.—The Assistant Secretary 
shall submit to the Secretary and the Congress an 
annual report containing— 
‘‘(A) a description of national, regional, or 
State changes in health or health care, as re-
flected by the key health indicators identified 
under subsection (c)(1); 
‘‘(B) a description of gaps in the collection, 
collation, reporting, and publishing of informa-
tion regarding the Nation’s health and the per-
formance of the Nation’s health care; 
‘‘(C) recommendations for addressing such 
gaps and identification of the appropriate agen-
cy within the Department or other entity to ad-
dress such gaps; 
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‘‘(D) a description of analyses of health 
disparities, including the results of completed 
analyses, the status of ongoing longitudinal 
studies, and proposed or planned research; and 
‘‘(E) a plan for actions to be taken by the 
Assistant Secretary to address gaps described 
in subparagraph (B). 
‘‘(2) CONSIDERATION.—In preparing a report 
under paragraph (1), the Assistant Secretary shall 
take into consideration the findings and conclusions 
in the reports under sections 308, 903(a)(6), and 
913(b)(2). 
‘‘(g) PROPRIETARY AND PRIVACY PROTECTIONS.— 
Nothing in this section shall be construed to affect appli-
cable proprietary or privacy protections. 
‘‘(h) CONSULTATION.—In carrying out this section, 
the Assistant Secretary shall consult with— 
‘‘(1) the heads of appropriate health agencies 
and offices in the Department, including the Office 
of the Surgeon General of the Public Health Service, 
the Office of Minority Health, and the Office on 
Women’s Health; and 
‘‘(2) as appropriate, the heads of other Federal 
departments and agencies whose programs have a 
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significant impact upon health (as determined by the 
Secretary). 
‘‘(i) DEFINITION.—In this section: 
‘‘(1) The terms ‘agency’ and ‘agencies’ include 
an epidemiology center established under section 214 
of the Indian Health Care Improvement Act. 
‘‘(2) The term ‘Department’ means the Depart-
ment of Health and Human Services. 
‘‘(3) The term ‘health disparities’ has the 
meaning given to such term in section 3171.’’. 
(b) OTHER
COORDINATION
RESPONSIBILITIES.— 
Title III (42 U.S.C. 241 et seq.) is amended— 
(1) in paragraphs (1) and (2) of section 304(c) 
(42 U.S.C. 242b(c)), by inserting ‘‘, acting through 
the Assistant Secretary for Health Information,’’ 
after ‘‘The Secretary’’ each place it appears; and 
(2) in section 306(j) (42 U.S.C. 242k(j)), by in-
serting ‘‘, acting through the Assistant Secretary for 
Health Information,’’ after ‘‘of this section, the Sec-
retary’’. 
SEC. 2403. AUTHORIZATION OF APPROPRIATIONS. 
Section 799C, as added and amended, is further 
amended by adding at the end the following: 
‘‘(e) QUALITY AND SURVEILLANCE.—For the pur-
pose of carrying out part D of title IX and section 1709, 
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in addition to any other amounts authorized to be appro-
priated for such purpose, there are authorized to be appro-
priated, out of any monies in the Public Health Invest-
ment Fund, $300,000,000 for each of fiscal years 2011 
through 2015.’’. 
TITLE V—OTHER PROVISIONS 
Subtitle 
A—Drug 
Discount 
for 
Rural and Other Hospitals; 340B 
Program Integrity 
SEC. 2501. EXPANDED PARTICIPATION IN 340B PROGRAM. 
(a) EXPANSION OF COVERED ENTITIES RECEIVING 
DISCOUNTED PRICES.—Section 340B(a)(4) (42 U.S.C. 
256b(a)(4)) is amended by adding at the end the fol-
lowing: 
‘‘(M) A children’s hospital excluded from 
the Medicare prospective payment system pur-
suant to section 1886(d)(1)(B)(iii) of the Social 
Security Act, or a free-standing cancer hospital 
excluded from the Medicare prospective pay-
ment 
system 
pursuant 
to 
section 
1886(d)(1)(B)(v) of the Social Security Act 
that would meet the requirements of subpara-
graph (L), including the disproportionate share 
adjustment 
percentage 
requirement 
under 
clause (ii) of such subparagraph, if the hospital 
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were a subsection (d) hospital as defined by sec-
tion 1886(d)(1)(B) of the Social Security Act. 
‘‘(N) An entity that is a critical access hos-
pital (as determined under section 1820(c)(2) 
of the Social Security Act). 
‘‘(O) An entity receiving funds under title 
V of the Social Security Act (relating to mater-
nal and child health) for the provision of health 
services. 
‘‘(P) An entity receiving funds under sub-
part I of part B of title XIX of the Public 
Health Service Act (relating to comprehensive 
mental health services) for the provision of com-
munity mental health services. 
‘‘(Q) An entity receiving funds under sub-
part II of such part B (relating to the preven-
tion and treatment of substance abuse) for the 
provision of treatment services for substance 
abuse. 
‘‘(R) An entity that is a Medicare-depend-
ent, small rural hospital (as defined in section 
1886(d)(5)(G)(iv) of the Social Security Act). 
‘‘(S) An entity that is a sole community 
hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii) of the Social Security Act). 
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‘‘(T) An entity that is classified as a rural 
referral center under section 1886(d)(5)(C) of 
the Social Security Act.’’. 
(b) PROHIBITION ON GROUP PURCHASING ARRANGE-
MENTS.—Section 340B(a) (42 U.S.C. 256b(a)) is amend-
ed— 
(1) in paragraph (4)(L)— 
(A) by adding ‘‘and’’ at the end of clause 
(i); 
(B) by striking ‘‘; and’’ at the end of 
clause (ii) and inserting a period; and 
(C) by striking clause (iii); and 
(2) in paragraph (5), by redesignating subpara-
graphs (C) and (D) as subparagraphs (D) and (E), 
respectively, and by inserting after subparagraph 
(B) the following: 
‘‘(C) PROHIBITING
USE
OF
GROUP
PUR-
CHASING
ARRANGEMENTS.—A 
hospital 
de-
scribed in subparagraph (L), (M), (N), (R), 
(S), or (T) of paragraph (4) shall not obtain 
covered outpatient drugs through a group pur-
chasing organization or other group purchasing 
arrangement.’’. 
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SEC. 2502. IMPROVEMENTS TO 340B PROGRAM INTEGRITY. 
(a) INTEGRITY IMPROVEMENTS.—Section 340B (42 
U.S.C. 256b) is amended— 
(1) by striking subsections (c) and (d); and 
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) IMPROVEMENTS IN PROGRAM INTEGRITY.— 
‘‘(1) MANUFACTURER COMPLIANCE.— 
‘‘(A) IN GENERAL.—From amounts appro-
priated under paragraph (4), the Secretary 
shall provide for improvements in compliance by 
manufacturers with the requirements of this 
section in order to prevent overcharges and 
other violations of the discounted pricing re-
quirements specified in this section. 
‘‘(B) IMPROVEMENTS.—The improvements 
described in subparagraph (A) shall include the 
following: 
‘‘(i) The establishment of a process to 
enable the Secretary to verify the accuracy 
of ceiling prices calculated by manufactur-
ers under subsection (a)(1) and charged to 
covered entities, which shall include the 
following: 
‘‘(I) Developing and publishing, 
through an appropriate policy or regu-
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latory issuance, standards and meth-
odology for the calculation of ceiling 
prices under such subsection. 
‘‘(II) Comparing regularly the 
ceiling prices calculated by the Sec-
retary with the quarterly pricing data 
that is reported by manufacturers to 
the Secretary. 
‘‘(III) Conducting periodic moni-
toring of sales transactions to covered 
entities. 
‘‘(IV) Inquiring into any discrep-
ancies between ceiling prices and 
manufacturer pricing data that may 
be identified and taking, or requiring 
manufacturers to take, corrective ac-
tion in response to such discrepancies, 
including the issuance of refunds pur-
suant to the procedures set forth in 
clause (ii). 
‘‘(ii) The establishment of procedures 
for the issuance of refunds to covered enti-
ties by manufacturers in the event that the 
Secretary finds there has been an over-
charge, including the following: 
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‘‘(I) Submission to the Secretary 
by manufacturers of an explanation of 
why and how the overcharge occurred, 
how the refunds will be calculated, 
and to whom the refunds will be 
issued. 
‘‘(II) Oversight by the Secretary 
to ensure that the refunds are issued 
accurately and within a reasonable pe-
riod of time. 
‘‘(iii) Notwithstanding any other pro-
vision of law prohibiting the disclosure of 
ceiling prices or data used to calculate the 
ceiling price, the provision of access to cov-
ered entities and State Medicaid agencies 
through an Internet website of the Depart-
ment of Health and Human Services or 
contractor to the applicable ceiling prices 
for covered drugs as calculated and verified 
by the Secretary in a manner that ensures 
protection of privileged pricing data from 
unauthorized disclosure. 
‘‘(iv) The development of a mecha-
nism by which— 
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‘‘(I) rebates, discounts, or other 
price concessions provided by manu-
facturers to other purchasers subse-
quent to the sale of covered drugs to 
covered entities are reported to the 
Secretary; and 
‘‘(II) appropriate credits and re-
funds are issued to covered entities if 
such rebates, discounts, or other price 
concessions have the effect of lowering 
the applicable ceiling price for the rel-
evant quarter for the drugs involved. 
‘‘(v) In addition to authorities under 
section 1927(b)(3) of the Social Security 
Act, the Secretary may conduct audits of 
manufacturers and wholesalers to ensure 
the integrity of the program under this 
section, including audits on the market 
price of covered drugs. 
‘‘(vi) The establishment of a require-
ment that manufacturers and wholesalers 
use the identification system developed by 
the Secretary for purposes of facilitating 
the ordering, purchasing, and delivery of 
covered drugs under this section, including 
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the processing of chargebacks for such 
drugs. 
‘‘(vii) The imposition of sanctions in 
the form of civil monetary penalties, 
which— 
‘‘(I) shall be assessed according 
to standards and procedures estab-
lished in regulations to be promul-
gated by the Secretary within one 
year of the date of the enactment of 
the Affordable Health Care for Amer-
ica Act; and 
‘‘(II) shall apply to any manufac-
turer with an agreement under this 
section and shall not exceed $100,000 
for each instance where a manufac-
turer knowingly charges a covered en-
tity a price for purchase of a drug 
that exceeds the maximum applicable 
price under subsection (a)(1) or that 
knowingly violates any other provision 
of this section, or withholds or pro-
vides false information to the Sec-
retary or to covered entities under 
this section. 
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‘‘(2) COVERED ENTITY COMPLIANCE.— 
‘‘(A) IN GENERAL.—From amounts appro-
priated under paragraph (4), the Secretary 
shall provide for improvements in compliance by 
covered entities with the requirements of this 
section in order to prevent diversion and viola-
tions of the duplicate discount provision and 
other requirements under subsection (a)(5). 
‘‘(B) IMPROVEMENTS.—The improvements 
described in subparagraph (A) shall include the 
following: 
‘‘(i) The development of procedures to 
enable and require covered entities to up-
date at least annually the information on 
the Internet Web site of the Department of 
Health and Human Services relating to 
this section. 
‘‘(ii) The development of procedures 
for the Secretary to verify the accuracy of 
information regarding covered entities that 
is listed on the Web site described in 
clause (i). 
‘‘(iii) The development of more de-
tailed guidance describing methodologies 
and options available to covered entities for 
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billing covered drugs to State Medicaid 
agencies in a manner that avoids duplicate 
discounts pursuant to subsection (a)(5)(A). 
‘‘(iv) The establishment of a single, 
universal, and standardized identification 
system by which each covered entity site 
can be identified by manufacturers, dis-
tributors, covered entities, and the Sec-
retary for purposes of facilitating the or-
dering, purchasing, and delivery of covered 
drugs under this section, including the 
processing of chargebacks for such drugs. 
‘‘(v) The imposition of sanctions in 
the form of civil monetary penalties, 
which— 
‘‘(I) shall be assessed according 
to standards and procedures estab-
lished in regulations promulgated by 
the Secretary; 
‘‘(II) shall not exceed $5,000 for 
each violation; and 
‘‘(III) shall apply to any covered 
entity that knowingly violates sub-
paragraph (a)(5)(B) or knowingly vio-
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lates any other provision of this sec-
tion. 
‘‘(vi) The exclusion of a covered entity 
from participation in the program under 
this section, for a period of time to be de-
termined by the Secretary, in cases in 
which the Secretary determines, in accord-
ance with standards and procedures estab-
lished in regulations, that— 
‘‘(I) a violation of a requirement 
of this section was repeated and 
knowing; and 
‘‘(II) imposition of a monetary 
penalty would be insufficient to rea-
sonably ensure compliance. 
‘‘(vii) The referral of matters as ap-
propriate to the Food and Drug Adminis-
tration, the Office of Inspector General of 
Department of Health and Human Serv-
ices, or other Federal agencies. 
‘‘(3) ADMINISTRATIVE
DISPUTE
RESOLUTION 
PROCESS.—From amounts appropriated under para-
graph (4), the Secretary may establish and imple-
ment an administrative process for the resolution of 
the following: 
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‘‘(A) Claims by covered entities that manu-
facturers have violated the terms of their agree-
ment with the Secretary under subsection 
(a)(1). 
‘‘(B) Claims by manufacturers that cov-
ered entities have violated subsection (a)(5)(A) 
or (a)(5)(B). 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection, such sums as may be necessary for 
fiscal year 2011 and each succeeding fiscal year.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 340B(a) (42 U.S.C. 256b(a)) is 
amended— 
(A) by adding at the end of paragraph (1) 
the following: ‘‘Such agreement shall require 
that the manufacturer offer each covered entity 
covered drugs for purchase at or below the ap-
plicable ceiling price if such drug is made avail-
able to any other purchaser at any price. Such 
agreement shall require that, if the supply of a 
covered drug is insufficient to meet demand, 
then the manufacturer may utilize an allocation 
method that is reported in writing to the Sec-
retary and does not discriminate on the basis of 
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the price paid by covered entities or on any 
other basis related to an entity’s participation 
in the program under this section. Notwith-
standing any other provision of law, if the Sec-
retary requests a manufacturer to enter into a 
new or amended agreement under this section 
that complies with current law and if the manu-
facturer opts not to sign the new or amended 
agreement, then any existing agreement be-
tween the manufacturer and the Secretary 
under this section is deemed to no longer meet 
the requirements of this section for purposes of 
this section and section 1927 of the Social Se-
curity Act.’’; and 
(B) by adding at the end the following 
paragraph: 
‘‘(11) QUARTERLY
REPORTS.—An agreement 
described in paragraph (1) shall require that the 
manufacturer furnish the Secretary with reports on 
a quarterly basis that include the following informa-
tion: 
‘‘(A) The price for each covered drug sub-
ject to the agreement that, according to the 
manufacturer, represents the maximum price 
that covered entities may permissibly be re-
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quired to pay for the drug (referred to in this 
section as the ‘ceiling price’). 
‘‘(B) The component information used to 
calculate the ceiling price as determined nec-
essary to administer the requirements of the 
program under this section. 
‘‘(C) Rebates, discounts, and other price 
concessions provided by manufacturers to other 
purchasers subsequent to the sale of covered 
drugs to covered entities.’’. 
(2) Section 1927(a)(5) of the Social Security 
Act (42 U.S.C. 1396r–8(a)(5)) is amended by strik-
ing subparagraph (D). 
SEC. 2503. EFFECTIVE DATE. 
(a) IN GENERAL.—The amendments made by this 
subtitle shall take effect on the date of the enactment of 
this Act, and sections 2501, 2502(a)(1), and 2502(b)(2) 
shall apply to drugs dispensed on or after such date. 
(b) EFFECTIVENESS.—The amendments made by 
this subtitle shall be effective, and shall be taken into ac-
count in determining whether a manufacturer is deemed 
to meet the requirements of section 340B(a) of the Public 
Health Service Act (42 U.S.C. 256b(a)), and of section 
1927(a)(5) of the Social Security Act (42 U.S.C. 1396r– 
8(a)(5)), notwithstanding any other provision of law. 
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Subtitle B—Programs 
PART 1—GRANTS FOR CLINICS AND CENTERS 
SEC. 2511. SCHOOL-BASED HEALTH CLINICS. 
(a) IN GENERAL.—Part Q of title III (42 U.S.C. 
280h et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 399Z–1. SCHOOL-BASED HEALTH CLINICS. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
school-based health clinic program consisting of awarding 
grants to eligible entities to support the operation of 
school-based health clinics (referred to in this section as 
‘SBHCs’). 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall— 
‘‘(1) be an SBHC (as defined in subsection 
(l)(3)); and 
‘‘(2) submit an application at such time, in 
such manner, and containing such information as 
the Secretary may require, including at a min-
imum— 
‘‘(A) evidence that the applicant meets all 
criteria necessary to be designated as an 
SBHC; 
‘‘(B) evidence of local need for the services 
to be provided by the SBHC; 
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‘‘(C) an assurance that— 
‘‘(i) SBHC services will be provided in 
accordance with Federal, State, and local 
laws; 
‘‘(ii) the SBHC has established and 
maintains collaborative relationships with 
other 
health 
care 
providers 
in 
the 
catchment area of the SBHC; 
‘‘(iii) the SBHC will provide onsite ac-
cess during the academic day when school 
is in session and has an established net-
work of support and access to services with 
backup health providers when the school or 
SBHC is closed; 
‘‘(iv) the SBHC will be integrated into 
the school environment and will coordinate 
health services with appropriate school per-
sonnel and other community providers co- 
located at the school; and 
‘‘(v) the SBHC sponsoring facility as-
sumes all responsibility for the SBHC ad-
ministration, operations, and oversight; 
and 
‘‘(D) such other information as the Sec-
retary may require. 
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‘‘(c) USE OF FUNDS.—Funds awarded under a grant 
under this section— 
‘‘(1) may be used for— 
‘‘(A) providing training related to the pro-
vision of comprehensive primary health services 
and additional health services; 
‘‘(B) the management and operation of 
SBHC 
programs, 
including 
through 
sub-
contracts; and 
‘‘(C) the payment of salaries for health 
professionals and other appropriate SBHC per-
sonnel; and 
‘‘(2) may not be used to provide abortions. 
‘‘(d) CONSIDERATION OF NEED.—In determining the 
amount of a grant under this section, the Secretary shall 
take into consideration— 
‘‘(1) the financial need of the SBHC; 
‘‘(2) State, local, or other sources of funding 
provided to the SBHC; and 
‘‘(3) other factors as determined appropriate by 
the Secretary. 
‘‘(e) PREFERENCES.—In awarding grants under this 
section, the Secretary shall give preference to SBHCs that 
have a demonstrated record of service to at least one of 
the following: 
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‘‘(1) A high percentage of medically under-
served children and adolescents. 
‘‘(2) Communities or populations in which chil-
dren and adolescents have difficulty accessing health 
and mental health services. 
‘‘(3) Communities with high percentages of chil-
dren and adolescents who are uninsured, under-
insured, or eligible for medical assistance under Fed-
eral or State health benefits programs (including ti-
tles XIX and XXI of the Social Security Act). 
‘‘(f) MATCHING REQUIREMENT.—The Secretary may 
award a grant to an SBHC under this section only if the 
SBHC agrees to provide, from non-Federal sources, an 
amount equal to 20 percent of the amount of the grant 
(which may be provided in cash or in kind) to carry out 
the activities supported by the grant. 
‘‘(g) SUPPLEMENT, NOT SUPPLANT.—The Secretary 
may award a grant to an SBHC under this section only 
if the SBHC demonstrates to the satisfaction of the Sec-
retary that funds received through the grant will be ex-
pended only to supplement, and not supplant, non-Federal 
and Federal funds otherwise available to the SBHC for 
operation of the SBHC (including each activity described 
in paragraph (1) or (2) of subsection (c)). 
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‘‘(h) PAYOR OF LAST RESORT.—The Secretary may 
award a grant to an SBHC under this section only if the 
SBHC demonstrates to the satisfaction of the Secretary 
that funds received through the grant will not be expended 
for any activity to the extent that payment has been made, 
or can reasonably be expected to be made— 
‘‘(1) under any insurance policy; 
‘‘(2) under any Federal or State health benefits 
program (including titles XIX and XXI of the Social 
Security Act); or 
‘‘(3) by an entity which provides health services 
on a prepaid basis. 
‘‘(i) REGULATIONS REGARDING REIMBURSEMENT 
FOR HEALTH SERVICES.—The Secretary shall issue regu-
lations regarding the reimbursement for health services 
provided by SBHCs to individuals eligible to receive such 
services through the program under this section, including 
reimbursement under any insurance policy or any Federal 
or State health benefits program (including titles XIX and 
XXI of the Social Security Act). 
‘‘(j) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly or by grant or contract) technical 
and other assistance to SBHCs to assist such SBHCs to 
meet the requirements of this section. Such assistance 
may include fiscal and program management assistance, 
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training in fiscal and program management, operational 
and administrative support, and the provision of informa-
tion to the SBHCs of the variety of resources available 
under this title and how those resources can be best used 
to meet the health needs of the communities served by 
the SBHCs. 
‘‘(k) EVALUATION; REPORT.—The Secretary shall— 
‘‘(1) develop and implement a plan for evalu-
ating SBHCs and monitoring quality performances 
under the awards made under this section; and 
‘‘(2) submit to the Congress on an annual basis 
a report on the program under this section. 
‘‘(l) DEFINITIONS.—In this section: 
‘‘(1) COMPREHENSIVE PRIMARY HEALTH SERV-
ICES.—The term ‘comprehensive primary health 
services’ means the core services offered by SBHCs, 
which— 
‘‘(A) shall include— 
‘‘(i) 
comprehensive 
health 
assess-
ments, diagnosis, and treatment of minor, 
acute, and chronic medical conditions and 
referrals to, and followup for, specialty 
care; and 
‘‘(ii) mental health assessments, crisis 
intervention, counseling, treatment, and re-
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ferral to a continuum of services including 
emergency psychiatric care, community 
support programs, inpatient care, and out-
patient programs; and 
‘‘(B) may include additional services, such 
as oral health, social, and age-appropriate 
health education services, including nutritional 
counseling. 
‘‘(2) MEDICALLY
UNDERSERVED
CHILDREN 
AND
ADOLESCENTS.—The term ‘medically under-
served children and adolescents’ means a population 
of children and adolescents who are residents of an 
area designated by the Secretary as an area with a 
shortage of personal health services and health in-
frastructure for such children and adolescents. 
‘‘(3) SCHOOL-BASED
HEALTH
CLINIC.—The 
term ‘school-based health clinic’ means a health clin-
ic that— 
‘‘(A) is located in, or is adjacent to, a 
school facility of a local educational agency; 
‘‘(B) is organized through school, commu-
nity, and health provider relationships; 
‘‘(C) is administered by a sponsoring facil-
ity; 
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‘‘(D) 
provides 
comprehensive 
primary 
health services during school hours to children 
and adolescents by health professionals in ac-
cordance with State and local laws and regula-
tions, established standards, and community 
practice; and 
‘‘(E) does not perform abortion services. 
‘‘(4) SPONSORING FACILITY.—The term ‘spon-
soring facility’ is— 
‘‘(A) a hospital; 
‘‘(B) a public health department; 
‘‘(C) a community health center; 
‘‘(D) a nonprofit health care entity whose 
mission is to provide access to comprehensive 
primary health care services; 
‘‘(E) a local educational agency; or 
‘‘(F) a program administered by the In-
dian Health Service or the Bureau of Indian 
Affairs or operated by an Indian tribe or a trib-
al organization under the Indian Self-Deter-
mination and Education Assistance Act, a Na-
tive Hawaiian entity, or an urban Indian pro-
gram under title V of the Indian Health Care 
Improvement Act. 
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‘‘(m) AUTHORIZATION
OF APPROPRIATIONS.—For 
purposes of carrying out this section, there are authorized 
to be appropriated $50,000,000 for fiscal year 2011 and 
such sums as may be necessary for each of fiscal years 
2012 through 2015.’’. 
(b) EFFECTIVE DATE.—The Secretary of Health and 
Human Services shall begin awarding grants under section 
399Z–1 of the Public Health Service Act, as added by sub-
section (a), not later than July 1, 2010, without regard 
to whether or not final regulations have been issued under 
section 399Z–1(i) of such Act. 
(c) TERMINATION OF STUDY.—Section 2(b) of the 
Health Care Safety Net Act of 2008 (42 U.S.C. 254b 
note) is amended by striking paragraph (2) (relating to 
a school-based health center study). 
SEC. 2512. NURSE-MANAGED HEALTH CENTERS. 
Title III (42 U.S.C. 241 et seq.) is amended by add-
ing at the end the following: 
‘‘PART S—NURSE-MANAGED HEALTH CENTERS 
‘‘SEC. 399FF. NURSE-MANAGED HEALTH CENTERS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, shall establish a nurse-managed health cen-
ter program consisting of awarding grants to entities 
under subsection (b). 
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‘‘(b) GRANT.—The Secretary shall award grants to 
entities— 
‘‘(1) to plan and develop a nurse-managed 
health center; or 
‘‘(2) to operate a nurse-managed health center. 
‘‘(c) USE OF FUNDS.—Amounts received as a grant 
under subsection (b) may be used for activities including 
the following: 
‘‘(1) Purchasing or leasing equipment. 
‘‘(2) Training and technical assistance related 
to the provision of comprehensive primary care serv-
ices and wellness services. 
‘‘(3) Other activities for planning, developing, 
or operating, as applicable, a nurse-managed health 
center. 
‘‘(d) ASSURANCES APPLICABLE TO BOTH PLANNING 
AND OPERATION GRANTS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
a grant under this section to an entity only if the 
entity demonstrates to the Secretary’s satisfaction 
that— 
‘‘(A) nurses, in addition to managing the 
center, will be adequately represented as pro-
viders at the center; and 
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‘‘(B) not later than 90 days after receiving 
the grant, the entity will establish a community 
advisory committee composed of individuals, a 
majority of whom are being served by the cen-
ter, to provide input into the nurse-managed 
health center’s operations. 
‘‘(2) MATCHING
REQUIREMENT.—The Sec-
retary may award a grant under this section to an 
entity only if the entity agrees to provide, from non- 
Federal sources, an amount equal to 20 percent of 
the amount of the grant (which may be provided in 
cash or in kind) to carry out the activities supported 
by the grant. 
‘‘(3) PAYOR OF LAST RESORT.—The Secretary 
may award a grant under this section to an entity 
only if the entity demonstrates to the satisfaction of 
the Secretary that funds received through the grant 
will not be expended for any activity to the extent 
that payment has been made, or can reasonably be 
expected to be made— 
‘‘(A) under any insurance policy; 
‘‘(B) under any Federal or State health 
benefits program (including titles XIX and XXI 
of the Social Security Act); or 
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‘‘(C) by an entity which provides health 
services on a prepaid basis. 
‘‘(4) MAINTENANCE
OF
EFFORT.—The Sec-
retary may award a grant under this section to an 
entity only if the entity demonstrates to the satisfac-
tion of the Secretary that— 
‘‘(A) funds received through the grant will 
be expended only to supplement, and not sup-
plant, non-Federal and Federal funds otherwise 
available to the entity for the activities to be 
funded through the grant; and 
‘‘(B) with respect to such activities, the en-
tity will maintain expenditures of non-Federal 
amounts for such activities at a level not less 
than the lesser of such expenditures maintained 
by the entity for the fiscal year preceding the 
fiscal year for which the entity receives the 
grant. 
‘‘(e) ADDITIONAL
ASSURANCE
FOR
PLANNING 
GRANTS.—The Secretary may award a grant under sub-
section (b)(1) to an entity only if the entity agrees— 
‘‘(1) to assess the needs of the medically under-
served populations proposed to be served by the 
nurse-managed health center; and 
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‘‘(2) to design services and operations of the 
nurse-managed health center for such populations 
based on such assessment. 
‘‘(f) ADDITIONAL
ASSURANCE
FOR
OPERATION 
GRANTS.—The Secretary may award a grant under sub-
section (b)(2) to an entity only if the entity assures that 
the nurse-managed health center will provide— 
‘‘(1) comprehensive primary care services, 
wellness services, and other health care services 
deemed appropriate by the Secretary; 
‘‘(2) care without respect to insurance status or 
income of the patient; and 
‘‘(3) direct access to client-centered services of-
fered by advanced practice nurses, other nurses, 
physicians, physician assistants, or other qualified 
health professionals. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly or by grant or contract) technical 
and other assistance to nurse-managed health centers to 
assist such centers in meeting the requirements of this 
section. Such assistance may include fiscal and program 
management assistance, training in fiscal and program 
management, operational and administrative support, and 
the provision of information to nurse-managed health cen-
ters regarding the various resources available under this 
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section and how those resources can best be used to meet 
the health needs of the communities served by nurse-man-
aged health centers. 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program under this sec-
tion. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) COMPREHENSIVE
PRIMARY
CARE
SERV-
ICES.—The term ‘comprehensive primary care serv-
ices’ has the meaning given to the term ‘required 
primary health services’ in section 330(b)(1). 
‘‘(2) 
MEDICALLY
UNDERSERVED
POPU-
LATION.—The term ‘medically underserved popu-
lation’ has the meaning given to such term in section 
330(b)(3). 
‘‘(3) NURSE-MANAGED HEALTH CENTER.—The 
term ‘nurse-managed health center’ has the meaning 
given to such term in section 801. 
‘‘(4) WELLNESS SERVICES.—The term ‘wellness 
services’ means any health-related service or inter-
vention, not including primary care, which is de-
signed to reduce identifiable health risks and in-
crease healthy behaviors intended to prevent the 
onset of disease or lessen the impact of existing 
chronic conditions by teaching more effective man-
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agement techniques that focus on individual self-care 
and patient-driven decisionmaking. 
‘‘(j) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2011 through 2015.’’. 
SEC. 2513. FEDERALLY QUALIFIED BEHAVIORAL HEALTH 
CENTERS. 
Section 1913 (42 U.S.C. 300x–3) is amended— 
(1) in subsection (a)(2)(A), by striking ‘‘com-
munity mental health services’’ and inserting ‘‘be-
havioral health services (of the type offered by feder-
ally qualified behavioral health centers consistent 
with subsection (c)(3))’’; 
(2) in subsection (b)— 
(A) by striking paragraph (1) and insert-
ing the following: 
‘‘(1) services under the plan will be provided 
only through appropriate, qualified community pro-
grams (which may include federally qualified behav-
ioral health centers, child mental health programs, 
psychosocial rehabilitation programs, mental health 
peer-support programs, and mental health primary 
consumer-directed programs); and’’; and 
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(B) in paragraph (2), by striking ‘‘commu-
nity mental health centers’’ and inserting ‘‘fed-
erally qualified behavioral health centers’’; and 
(3) by striking subsection (c) and inserting the 
following: 
‘‘(c) CRITERIA FOR FEDERALLY QUALIFIED BEHAV-
IORAL HEALTH CENTERS.— 
‘‘(1) IN
GENERAL.—The Administrator shall 
certify, and recertify at least every 5 years, federally 
qualified behavioral health centers as meeting the 
criteria specified in this subsection. 
‘‘(2) REGULATIONS.—Not later than 18 months 
after the date of the enactment of the Affordable 
Health Care for America Act, the Administrator 
shall issue final regulations for certifying centers 
under paragraph (1). 
‘‘(3) CRITERIA.—The criteria referred to in 
subsection (b)(2) are that the center performs each 
of the following: 
‘‘(A) Provide services in locations that en-
sure services will be available and accessible 
promptly and in a manner which preserves 
human dignity and assures continuity of care. 
‘‘(B) Provide services in a mode of service 
delivery appropriate for the target population. 
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‘‘(C) Provide individuals with a choice of 
service options where there is more than one ef-
ficacious treatment. 
‘‘(D) Employ a core staff of clinical staff 
that is multidisciplinary and culturally and lin-
guistically competent. 
‘‘(E) Provide services, within the limits of 
the capacities of the center, to any individual 
residing or employed in the service area of the 
center. 
‘‘(F) Provide, directly or through contract, 
to the extent covered for adults in the State 
Medicaid plan and for children in accordance 
with section 1905(r) of the Social Security Act 
regarding early and periodic screening, diag-
nosis, and treatment, each of the following serv-
ices: 
‘‘(i) Screening, assessment, and diag-
nosis, including risk assessment. 
‘‘(ii) Person-centered treatment plan-
ning or similar processes, including risk as-
sessment and crisis planning. 
‘‘(iii) Outpatient clinic mental health 
services, including screening, assessment, 
diagnosis, psychotherapy, substance abuse 
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counseling, medication management, and 
integrated treatment for mental illness and 
substance abuse which shall be evidence- 
based (including cognitive behavioral ther-
apy, dialectical behavioral therapy, motiva-
tional interviewing, and other such thera-
pies which are evidence-based). 
‘‘(iv) Outpatient clinic primary care 
services, including screening and moni-
toring of key health indicators and health 
risk (including screening for diabetes, hy-
pertension, and cardiovascular disease and 
monitoring of weight, height, body mass 
index (BMI), blood pressure, blood glucose 
or HbA1C, and lipid profile). 
‘‘(v) Crisis mental health services, in-
cluding 24-hour mobile crisis teams, emer-
gency crisis intervention services, and cri-
sis stabilization. 
‘‘(vi) 
Targeted 
case 
management 
(services to assist individuals gaining ac-
cess to needed medical, social, educational, 
and other services and applying for income 
security and other benefits to which they 
may be entitled). 
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‘‘(vii) Psychiatric rehabilitation serv-
ices including skills training, assertive com-
munity treatment, family psychoeducation, 
disability self-management, supported em-
ployment, 
supported 
housing 
services, 
therapeutic foster care services, multisys-
temic therapy, and such other evidence- 
based practices as the Secretary may re-
quire. 
‘‘(viii) Peer support and counselor 
services and family supports. 
‘‘(G) Maintain linkages, and where possible 
enter into formal contracts with, inpatient psy-
chiatric facilities and substance abuse detoxi-
fication and residential programs. 
‘‘(H) Make available to individuals served 
by the center, directly, through contract, or 
through linkages with other programs, each of 
the following: 
‘‘(i) Adult and youth peer support and 
counselor services. 
‘‘(ii) Family support services for fami-
lies of children with serious mental dis-
orders. 
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‘‘(iii) Other community or regional 
services, supports, and providers, including 
schools, child welfare agencies, juvenile and 
criminal justice agencies and facilities, 
housing agencies and programs, employers, 
and other social services. 
‘‘(iv) Onsite or offsite access to pri-
mary care services. 
‘‘(v) Enabling services, including out-
reach, transportation, and translation. 
‘‘(vi) Health and wellness services, in-
cluding services for tobacco cessation.’’. 
PART 2—OTHER GRANT PROGRAMS 
SEC. 2521. COMPREHENSIVE PROGRAMS TO PROVIDE EDU-
CATION TO NURSES AND CREATE A PIPELINE 
TO NURSING. 
(a) PURPOSES.—It is the purpose of this section to 
authorize grants to— 
(1) address the projected shortage of nurses by 
funding comprehensive programs to create a career 
ladder to nursing (including certified nurse assist-
ants, licensed practical nurses, licensed vocational 
nurses, and registered nurses) for incumbent ancil-
lary health care workers; 
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(2) increase the capacity for educating nurses 
by increasing both nurse faculty and clinical oppor-
tunities through collaborative programs between 
staff nurse organizations, health care providers, and 
accredited schools of nursing; and 
(3) provide training programs through edu-
cation and training organizations jointly adminis-
tered by health care providers and health care labor 
organizations or other organizations representing 
staff nurses and frontline health care workers, work-
ing in collaboration with accredited schools of nurs-
ing and academic institutions. 
(b) GRANTS.—Not later than 6 months after the date 
of the enactment of this Act, the Secretary of Labor (re-
ferred to in this section as the ‘‘Secretary’’) shall establish 
a partnership grant program to award grants to eligible 
entities to carry out comprehensive programs to provide 
education to nurses and create a pipeline to nursing for 
incumbent ancillary health care workers who wish to ad-
vance their careers, and to otherwise carry out the pur-
poses of this section. 
(c) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall be— 
(1) a health care entity that is jointly adminis-
tered by a health care employer and a labor union 
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representing the health care employees of the em-
ployer and that carries out activities using labor- 
management training funds as provided for under 
section 302(c)(6) of the Labor Management Rela-
tions Act, 1947 (29 U.S.C. 186(c)(6)); 
(2) an entity that operates a training program 
that is jointly administered by— 
(A) one or more health care providers or 
facilities, or a trade association of health care 
providers; and 
(B) one or more organizations which rep-
resent the interests of direct care health care 
workers or staff nurses and in which the direct 
care health care workers or staff nurses have 
direct input as to the leadership of the organi-
zation; 
(3) a State training partnership program that 
consists of nonprofit organizations that include equal 
participation from industry, including public or pri-
vate employers, and labor organizations including 
joint labor-management training programs, and 
which may include representatives from local govern-
ments, worker investment agency one-stop career 
centers, community-based organizations, community 
colleges, and accredited schools of nursing; or 
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(4) a school of nursing (as defined in section 
801 of the Public Health Service Act (42 U.S.C. 
296)). 
(d) ADDITIONAL REQUIREMENTS FOR HEALTH CARE 
EMPLOYER DESCRIBED IN SUBSECTION (c).—To be eligi-
ble for a grant under this section, a health care employer 
described in subsection (c) shall demonstrate that it— 
(1) has an established program within its facil-
ity to encourage the retention of existing nurses; 
(2) provides wages and benefits to its nurses 
that are competitive for its market or that have been 
collectively bargained with a labor organization; and 
(3) supports programs funded under this sec-
tion through 1 or more of the following: 
(A) The provision of paid leave time and 
continued health coverage to incumbent health 
care workers to allow their participation in 
nursing career ladder programs, including cer-
tified nurse assistants, licensed practical nurses, 
licensed 
vocational 
nurses, 
and 
registered 
nurses. 
(B) Contributions to a joint labor-manage-
ment training fund which administers the pro-
gram involved. 
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(C) The provision of paid release time, in-
centive compensation, or continued health cov-
erage to staff nurses who desire to work full- or 
part-time in a faculty position. 
(D) The provision of paid release time for 
staff nurses to enable them to obtain a bachelor 
of science in nursing degree, other advanced 
nursing degrees, specialty training, or certifi-
cation program. 
(E) The payment of tuition assistance 
which is managed by a joint labor-management 
training fund or other jointly administered pro-
gram. 
(e) OTHER REQUIREMENTS.— 
(1) MATCHING REQUIREMENT.— 
(A) IN GENERAL.—The Secretary may not 
make a grant under this section unless the ap-
plicant involved agrees, with respect to the costs 
to be incurred by the applicant in carrying out 
the program under the grant, to make available 
non-Federal contributions (in cash or in kind 
under subparagraph (B)) toward such costs in 
an amount equal to not less than $1 for each 
$1 of Federal funds provided in the grant. Such 
contributions may be made directly or through 
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donations from public or private entities, or 
may be provided through the cash equivalent of 
paid release time provided to incumbent worker 
students. 
(B) DETERMINATION OF AMOUNT OF NON- 
FEDERAL
CONTRIBUTION.—Non-Federal con-
tributions required in subparagraph (A) may be 
in cash or in kind (including paid release time), 
fairly evaluated, including equipment or services 
(and excluding indirect or overhead costs). 
Amounts provided by the Federal Government, 
or services assisted or subsidized to any signifi-
cant extent by the Federal Government, may 
not be included in determining the amount of 
such non-Federal contributions. 
(2) REQUIRED COLLABORATION.—Entities car-
rying out or overseeing programs carried out with 
assistance provided under this section shall dem-
onstrate collaboration with accredited schools of 
nursing which may include community colleges and 
other academic institutions providing associate’s, 
bachelor’s, or advanced nursing degree programs or 
specialty training or certification programs. 
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(f) USE OF FUNDS.—Amounts awarded to an entity 
under a grant under this section shall be used for the fol-
lowing: 
(1) To carry out programs that provide edu-
cation and training to establish nursing career lad-
ders to educate incumbent health care workers to be-
come nurses (including certified nurse assistants, li-
censed practical nurses, licensed vocational nurses, 
and registered nurses). Such programs shall include 
one or more of the following: 
(A) Preparing incumbent workers to return 
to the classroom through English-as-a-second- 
language education, GED education, precollege 
counseling, college preparation classes, and sup-
port with entry level college classes that are a 
prerequisite to nursing. 
(B) Providing tuition assistance with pref-
erence for dedicated cohort classes in commu-
nity 
colleges, 
universities, 
and 
accredited 
schools of nursing with supportive services in-
cluding tutoring and counseling. 
(C) Providing assistance in preparing for 
and meeting all nursing licensure tests and re-
quirements. 
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(D) 
Carrying 
out 
orientation 
and 
mentorship programs that assist newly grad-
uated nurses in adjusting to working at the 
bedside 
to 
ensure 
their 
retention 
postgraduation, and ongoing programs to sup-
port nurse retention. 
(E) Providing stipends for release time and 
continued health care coverage to enable incum-
bent health care workers to participate in these 
programs. 
(2) To carry out programs that assist nurses in 
obtaining advanced degrees and completing specialty 
training or certification programs and to establish 
incentives for nurses to assume nurse faculty posi-
tions on a part-time or full-time basis. Such pro-
grams shall include one or more of the following: 
(A) Increasing the pool of nurses with ad-
vanced degrees who are interested in teaching 
by funding programs that enable incumbent 
nurses to return to school. 
(B) Establishing incentives for advanced 
degree bedside nurses who wish to teach in 
nursing programs so they can obtain a leave 
from their bedside position to assume a full- or 
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part-time position as adjunct or full-time fac-
ulty without the loss of salary or benefits. 
(C) Collaboration with accredited schools 
of nursing which may include community col-
leges and other academic institutions providing 
associate’s, bachelor’s, or advanced nursing de-
gree programs, or specialty training or certifi-
cation programs, for nurses to carry out innova-
tive nursing programs which meet the needs of 
bedside nursing and health care providers. 
(g) PREFERENCE.—In awarding grants under this 
section the Secretary shall give preference to programs 
that— 
(1) provide for improving nurse retention; 
(2) provide for improving the diversity of the 
new nurse graduates to reflect changes in the demo-
graphics of the patient population; 
(3) provide for improving the quality of nursing 
education to improve patient care and safety; 
(4) have demonstrated success in upgrading in-
cumbent health care workers to become nurses or 
which have established effective programs or pilots 
to increase nurse faculty; or 
(5) are modeled after or affiliated with such 
programs described in paragraph (4). 
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(h) EVALUATION.— 
(1) PROGRAM
EVALUATIONS.—An entity that 
receives a grant under this section shall annually 
evaluate, and submit to the Secretary a report on, 
the activities carried out under the grant and the 
outcomes of such activities. Such outcomes may in-
clude— 
(A) an increased number of incumbent 
workers entering an accredited school of nurs-
ing and in the pipeline for nursing programs; 
(B) an increasing number of graduating 
nurses and improved nurse graduation and li-
censure rates; 
(C) improved nurse retention; 
(D) an increase in the number of staff 
nurses at the health care facility involved; 
(E) an increase in the number of nurses 
with advanced degrees in nursing; 
(F) an increase in the number of nurse 
faculty; 
(G) improved measures of patient quality 
(which may include staffing ratios of nurses, 
patient satisfaction rates, and patient safety 
measures); and 
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(H) an increase in the diversity of new 
nurse graduates relative to the patient popu-
lation. 
(2) GENERAL REPORT.—Not later than 2 years 
after the date of the enactment of this Act, and an-
nually thereafter, the Secretary of Labor shall, using 
data and information from the reports received 
under paragraph (1), submit to the Congress a re-
port concerning the overall effectiveness of the grant 
program carried out under this section. 
(i) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2011 through 2015. 
SEC. 2522. MENTAL AND BEHAVIORAL HEALTH TRAINING. 
Part E of title VII (42 U.S.C. 294n et seq.) is amend-
ed by adding at the end the following: 
‘‘Subpart 3—Mental and Behavioral Health Training 
‘‘SEC. 775. MENTAL AND BEHAVIORAL HEALTH TRAINING 
PROGRAM. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration and in consultation with the Administrator 
of the Substance Abuse and Mental Health Services Ad-
ministration, shall establish an interdisciplinary mental 
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and behavioral health training program consisting of 
awarding grants and contracts under subsection (b). 
‘‘(b) SUPPORT AND DEVELOPMENT OF MENTAL AND 
BEHAVIORAL HEALTH TRAINING PROGRAMS.—The Sec-
retary shall make grants to, or enter into contracts with, 
eligible entities— 
‘‘(1) to plan, develop, operate, or participate in 
an accredited professional training program for men-
tal and behavioral health professionals to promote— 
‘‘(A) interdisciplinary training; and 
‘‘(B) coordination of the delivery of health 
care within and across settings, including health 
care institutions, community-based settings, 
and the patient’s home; 
‘‘(2) to provide financial assistance to mental 
and behavioral health professionals, who are partici-
pants in any such program, and who plan to work 
in the field of mental and behavioral health; 
‘‘(3) to plan, develop, operate, or participate in 
an accredited program for the training of mental 
and behavioral health professionals who plan to 
teach in the field of mental and behavioral health; 
and 
‘‘(4) to provide financial assistance in the form 
of traineeships and fellowships to mental and behav-
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ioral health professionals who are participants in any 
such program and who plan to teach in the field of 
mental and behavioral health. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (b), an entity shall be— 
‘‘(1) an accredited health professions school, in-
cluding an accredited school or program of psy-
chology, psychiatry, social work, marriage and family 
therapy, professional mental health or substance 
abuse counseling, or addiction medicine; 
‘‘(2) an accredited public or nonprofit private 
hospital; 
‘‘(3) a public or private nonprofit entity; or 
‘‘(4) a consortium of 2 or more entities de-
scribed in paragraphs (1) through (3). 
‘‘(d) PREFERENCE.—In awarding grants or contracts 
under this section, the Secretary shall give preference to 
entities that have a demonstrated record of at least one 
of the following: 
‘‘(1) Training a high or significantly improved 
percentage of health professionals who serve in un-
derserved communities. 
‘‘(2) Supporting teaching programs that ad-
dress the health care needs of vulnerable popu-
lations. 
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‘‘(3) Training individuals who are from dis-
advantaged backgrounds (including racial and ethnic 
minorities underrepresented among mental and be-
havioral health professionals). 
‘‘(4) Training individuals who serve geriatric 
populations with an emphasis on underserved elder-
ly. 
‘‘(5) Training individuals who serve pediatric 
populations with an emphasis on underserved chil-
dren. 
‘‘(e) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program under this sec-
tion. 
‘‘(f) DEFINITION.—In this section: 
‘‘(1) The term ‘interdisciplinary’ means collabo-
ration across health professions, specialties, and sub-
specialties, which may include public health, nursing, 
allied health, dietetics or nutrition, and appropriate 
health specialties. 
‘‘(2) The term ‘mental and behavioral health 
professional’ means an individual training or prac-
ticing— 
‘‘(A) in psychology; general, geriatric, child 
or adolescent psychiatry; social work; marriage 
and family therapy; professional mental health 
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or substance abuse counseling; or addiction 
medicine; or 
‘‘(B) another mental and behavioral health 
specialty, as deemed appropriate by the Sec-
retary. 
‘‘(g) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $60,000,000 for each of fiscal years 2011 through 
2015. Of the amounts appropriated to carry out this sec-
tion for a fiscal year, not less than 15 percent shall be 
used for training programs in psychology.’’. 
SEC. 2523. REAUTHORIZATION OF TELEHEALTH AND TELE-
MEDICINE GRANT PROGRAMS. 
(a) TELEHEALTH NETWORK AND TELEHEALTH RE-
SOURCE CENTERS GRANT PROGRAMS.—Section 330I (42 
U.S.C. 254c–14) is amended— 
(1) in subsection (a)— 
(A) by striking paragraph (3) (relating to 
frontier communities); and 
(B) by inserting after paragraph (2) the 
following: 
‘‘(3) HEALTH DISPARITIES.—The term ‘health 
disparities’ has the meaning given such term in sec-
tion 3171.’’; 
(2) in subsection (d)(1)— 
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(A) in subparagraph (B), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (C), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(D) reduce health disparities.’’; 
(3) in subsection (f)(1)(B)(iii)— 
(A) in subclause (VII), by inserting ‘‘, in-
cluding skilled nursing facilities’’ before the pe-
riod at the end; 
(B) in subclause (IX), by inserting ‘‘, in-
cluding county mental health and public mental 
health facilities’’ before the period at the end; 
and 
(C) by adding at the end the following: 
‘‘(XIII) Renal dialysis facilities.’’; 
(4) by amending subsection (i) to read as fol-
lows: 
‘‘(i) PREFERENCES.— 
‘‘(1) TELEHEALTH
NETWORKS.—In awarding 
grants under subsection (d)(1) for projects involving 
telehealth networks, the Secretary shall give pref-
erence to eligible entities meeting at least one of the 
following: 
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‘‘(A) NETWORK.—The eligible entity is a 
health care provider in, or proposing to form, a 
health care network that furnishes services in a 
medically underserved area or a health profes-
sional shortage area. 
‘‘(B) BROAD
GEOGRAPHIC
COVERAGE.— 
The eligible entity demonstrates broad geo-
graphic coverage in the rural or medically un-
derserved areas of the State or States in which 
the entity is located. 
‘‘(C) HEALTH DISPARITIES.—The eligible 
entity demonstrates how the project to be fund-
ed through the grant will address health dis-
parities. 
‘‘(D) 
LINKAGES.—The 
eligible 
entity 
agrees to use the grant to establish or develop 
plans for telehealth systems that will link rural 
hospitals and rural health care providers to 
other hospitals, health care providers, and pa-
tients. 
‘‘(E) EFFICIENCY.—The eligible entity 
agrees to use the grant to promote greater effi-
ciency in the use of health care resources. 
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‘‘(F) VIABILITY.—The eligible entity dem-
onstrates the long-term viability of projects 
through— 
‘‘(i) availability of non-Federal fund-
ing sources; or 
‘‘(ii) institutional and community sup-
port for the telehealth network. 
‘‘(G) SERVICES.—The eligible entity pro-
vides a plan for coordinating system use by eli-
gible entities and prioritizes use of grant funds 
for health care services over nonclinical uses. 
‘‘(2) TELEHEALTH
RESOURCE
CENTERS.—In 
awarding grants under subsection (d)(2) for projects 
involving telehealth resource centers, the Secretary 
shall give preference to eligible entities meeting at 
least one of the following: 
‘‘(A) PROVISION OF A BROAD RANGE OF 
SERVICES.—The eligible entity has a record of 
success in the provision of a broad range of 
telehealth services to medically underserved 
areas or populations. 
‘‘(B) PROVISION OF TELEHEALTH TECH-
NICAL ASSISTANCE.—The eligible entity has a 
record of success in the provision of technical 
assistance to providers serving medically under-
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served communities or populations in the estab-
lishment and implementation of telehealth serv-
ices. 
‘‘(C) COLLABORATION
AND
SHARING
OF 
EXPERTISE.—The eligible entity has a dem-
onstrated record of collaborating and sharing 
expertise with providers of telehealth services at 
the national, regional, State, and local levels.’’; 
(5) in subsection (j)(2)(B), by striking ‘‘such 
projects for fiscal year 2001’’ and all that follows 
through the period and inserting ‘‘such projects for 
fiscal year 2010.’’; 
(6) in subsection (k)(1)— 
(A) in subparagraph (E)(i), by striking 
‘‘transmission of medical data’’ and inserting 
‘‘transmission and electronic archival of medical 
data’’; and 
(B) by amending subparagraph (F) to read 
as follows: 
‘‘(F) developing projects to use telehealth 
technology to— 
‘‘(i) facilitate collaboration between 
health care providers; 
‘‘(ii) promote telenursing services; or 
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‘‘(iii) promote patient understanding 
and adherence to national guidelines for 
chronic disease and self-management of 
such conditions;’’; 
(7) in subsection (q), by striking ‘‘Not later 
than September 30, 2005’’ and inserting ‘‘Not later 
than 1 year after the date of the enactment of the 
Affordable Health Care for America Act, and annu-
ally thereafter’’; 
(8) by striking subsection (r); 
(9) by redesignating subsection (s) as sub-
section (r); and 
(10) in subsection (r) (as so redesignated)— 
(A) in paragraph (1)— 
(i) by striking ‘‘and’’ before ‘‘such 
sums’’; and 
(ii) by inserting ‘‘, $10,000,000 for 
fiscal year 2011, and such sums as may be 
necessary for each of fiscal years 2012 
through 2015’’ before the semicolon; and 
(B) in paragraph (2)— 
(i) by striking ‘‘and’’ before ‘‘such 
sums’’; and 
(ii) by inserting ‘‘, $10,000,000 for 
fiscal year 2011, and such sums as may be 
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necessary for each of fiscal years 2012 
through 2015’’ before the period. 
(b) TELEMEDICINE; INCENTIVE GRANTS REGARDING 
COORDINATION AMONG STATES.—Subsection (b) of sec-
tion 330L (42 U.S.C. 254c–18) is amended by inserting 
‘‘, $10,000,000 for fiscal year 2011, and such sums as 
may be necessary for each of fiscal years 2012 through 
2015’’ before the period at the end. 
SEC. 2524. NO CHILD LEFT UNIMMUNIZED AGAINST INFLU-
ENZA: DEMONSTRATION PROGRAM USING EL-
EMENTARY AND SECONDARY SCHOOLS AS IN-
FLUENZA VACCINATION CENTERS. 
(a) PURPOSE.—The Secretary of Health and Human 
Services in consultation with the Secretary of Education, 
shall award grants to eligible partnerships to carry out 
demonstration programs designed to test the feasibility of 
using the Nation’s elementary schools and secondary 
schools as influenza vaccination centers. 
(b) IN GENERAL.—The Secretary shall coordinate 
with the Secretary of Labor, the Secretary of Education, 
State Medicaid agencies, State insurance agencies, and 
private insurers to carry out a program consisting of 
awarding grants under subsection (c) to ensure that chil-
dren have coverage for all reasonable and customary ex-
penses related to influenza vaccinations, including the 
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costs of purchasing and administering the vaccine in-
curred when influenza vaccine is administered outside of 
the physician’s office in a school or other related setting. 
(c) PROGRAM DESCRIPTION.— 
(1) GRANTS.—From amounts appropriated pur-
suant to subsection (l), the Secretary shall award 
grants to eligible partnerships to be used to provide 
influenza vaccinations to children in elementary and 
secondary schools, in coordination with school 
nurses, school health care programs, community 
health care providers, State insurance agencies, or 
private insurers. 
(2) ACIP RECOMMENDATIONS.—The program 
under this section shall be designed to administer 
vaccines consistent with the recommendations of the 
Centers for Disease Control and Prevention’s Advi-
sory Committee on Immunization Practices (ACIP) 
for the annual vaccination of all children 5 through 
19 years of age. 
(3) PARTICIPATION VOLUNTARY.—Participation 
by a school or an individual shall be voluntary. 
(d) USE OF FUNDS.—Eligible partnerships receiving 
a grant under this section shall ensure the maximum num-
ber of children access influenza vaccinations as follows: 
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(1) COVERED
CHILDREN.—To the extent to 
which payment of the costs of purchasing or admin-
istering the influenza vaccine for children is not cov-
ered through other federally funded programs or 
through private insurance, eligible partnerships re-
ceiving a grant shall use funds to purchase and ad-
minister influenza vaccinations. 
(2) CHILDREN COVERED BY OTHER FEDERAL 
PROGRAMS.—For children who are eligible under 
other federally funded programs for payment of the 
costs of purchasing or administering the influenza 
vaccine, eligible partnerships receiving a grant shall 
not use funds provided under this section for such 
costs. 
(3) CHILDREN COVERED BY PRIVATE HEALTH 
INSURANCE.—For children who have private insur-
ance, eligible partnerships receiving a grant shall 
offer assistance in accessing coverage for vaccina-
tions administered through the program under this 
section. 
(e) PRIVACY.—The Secretary shall ensure that the 
program under this section adheres to confidentiality and 
privacy requirements of section 264 of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note) and section 444 of the General 
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Education Provisions Act (20 U.S.C. 1232g; commonly re-
ferred to as the ‘‘Family Educational Rights and Privacy 
Act of 1974’’). 
(f) APPLICATION.—An eligible partnership desiring a 
grant under this section shall submit an application to the 
Secretary at such time, in such manner, and containing 
such information as the Secretary may require. 
(g) DURATION.—Eligible partnerships receiving a 
grant shall administer a demonstration program funded 
through this section over a period of 2 consecutive school 
years. 
(h) CHOICE OF VACCINE.—The program under this 
section shall not restrict the discretion of a health care 
provider to administer any influenza vaccine approved by 
the Food and Drug Administration for use in pediatric 
populations. 
(i) AWARDS.—The Secretary shall award— 
(1) a minimum of 10 grants in 10 different 
States to eligible partnerships that each include one 
or more public schools serving primarily low-income 
students; and 
(2) a minimum of 5 grants in 5 different States 
to eligible partnerships that each include one or 
more public schools located in a rural local edu-
cational agency. 
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(j) REPORT.—Not later than 90 days following the 
completion of the program under this section, the Sec-
retary shall submit to the Committees on Education and 
Labor, Energy and Commerce, and Appropriations of the 
House of Representatives and to the Committees on 
Health, Education, Labor, and Pensions and Appropria-
tions of the Senate a report on the results of the program. 
The report shall include— 
(1) an assessment of the influenza vaccination 
rates of school-age children in localities where the 
program is implemented, compared to the national 
average influenza vaccination rates for school-aged 
children, including whether school-based vaccination 
assists in achieving the recommendations of the Ad-
visory Committee on Immunization Practices; 
(2) an assessment of the utility of employing el-
ementary schools and secondary schools as a part of 
a multistate, community-based pandemic response 
program that is consistent with existing Federal and 
State pandemic response plans; 
(3) an assessment of the feasibility of using ex-
isting Federal and private insurance funding in es-
tablishing a multistate, school-based vaccination pro-
gram for seasonal influenza vaccination; 
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