H. R. 3590—469 
‘‘(b) CERTAIN TOPICS.—An award may be made under subsection 
(a) only if the applicant for the award agrees that the program 
carried out with the award will include information and education 
on— 
‘‘(1) recognized means for assessing, diagnosing, treating, 
and managing pain and related signs and symptoms, including 
the medically appropriate use of controlled substances; 
‘‘(2) applicable laws, regulations, rules, and policies on con-
trolled substances, including the degree to which misconcep-
tions and concerns regarding such laws, regulations, rules, 
and policies, or the enforcement thereof, may create barriers 
to patient access to appropriate and effective pain care; 
‘‘(3) interdisciplinary approaches to the delivery of pain 
care, including delivery through specialized centers providing 
comprehensive pain care treatment expertise; 
‘‘(4) cultural, linguistic, literacy, geographic, and other bar-
riers to care in underserved populations; and 
‘‘(5) recent findings, developments, and improvements in 
the provision of pain care. 
‘‘(c) EVALUATION OF PROGRAMS.—The Secretary shall (directly 
or through grants or contracts) provide for the evaluation of pro-
grams implemented under subsection (a) in order to determine 
the effect of such programs on knowledge and practice of pain 
care. 
‘‘(d) PAIN CARE DEFINED.—For purposes of this section the 
term ‘pain care’ means the assessment, diagnosis, treatment, or 
management of acute or chronic pain regardless of causation or 
body location. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is authorized 
to be appropriated to carry out this section, such sums as may 
be necessary for each of the fiscal years 2010 through 2012. 
Amounts appropriated under this subsection shall remain available 
until expended.’’. 
SEC. 4306. FUNDING FOR CHILDHOOD OBESITY DEMONSTRATION 
PROJECT. 
Section 1139A(e)(8) of the Social Security Act (42 U.S.C. 1320b– 
9a(e)(8)) is amended to read as follows: 
‘‘(8) APPROPRIATION.—Out of any funds in the Treasury 
not otherwise appropriated, there is appropriated to carry out 
this subsection, $25,000,000 for the period of fiscal years 2010 
through 2014.’’. 
Subtitle E—Miscellaneous Provisions 
SEC. 4401. SENSE OF THE SENATE CONCERNING CBO SCORING. 
(a) FINDING.—The Senate finds that the costs of prevention 
programs are difficult to estimate due in part because prevention 
initiatives are hard to measure and results may occur outside 
the 5 and 10 year budget windows. 
(b) SENSE OF CONGRESS.—It is the sense of the Senate that 
Congress should work with the Congressional Budget Office to 
develop better methodologies for scoring progress to be made in 
prevention and wellness programs.
H. R. 3590—470 
SEC. 4402. EFFECTIVENESS OF FEDERAL HEALTH AND WELLNESS INI-
TIATIVES. 
To determine whether existing Federal health and wellness 
initiatives are effective in achieving their stated goals, the Secretary 
of Health and Human Services shall— 
(1) conduct an evaluation of such programs as they relate 
to changes in health status of the American public and specifi-
cally on the health status of the Federal workforce, including 
absenteeism of employees, the productivity of employees, the 
rate of workplace injury, and the medical costs incurred by 
employees, and health conditions, including workplace fitness, 
healthy food and beverages, and incentives in the Federal 
Employee Health Benefits Program; and 
(2) submit to Congress a report concerning such evaluation, 
which shall include conclusions concerning the reasons that 
such existing programs have proven successful or not successful 
and what factors contributed to such conclusions. 
TITLE V—HEALTH CARE WORKFORCE 
Subtitle A—Purpose and Definitions 
SEC. 5001. PURPOSE. 
The purpose of this title is to improve access to and the delivery 
of health care services for all individuals, particularly low income, 
underserved, uninsured, minority, health disparity, and rural popu-
lations by— 
(1) gathering and assessing comprehensive data in order 
for the health care workforce to meet the health care needs 
of individuals, including research on the supply, demand, dis-
tribution, diversity, and skills needs of the health care 
workforce; 
(2) increasing the supply of a qualified health care 
workforce to improve access to and the delivery of health care 
services for all individuals; 
(3) enhancing health care workforce education and training 
to improve access to and the delivery of health care services 
for all individuals; and 
(4) providing support to the existing health care workforce 
to improve access to and the delivery of health care services 
for all individuals. 
SEC. 5002. DEFINITIONS. 
(a) THIS TITLE.—In this title: 
(1) ALLIED HEALTH PROFESSIONAL.—The term ‘‘allied health 
professional’’ means an allied health professional as defined 
in section 799B(5) of the Public Heath Service Act (42 U.S.C. 
295p(5)) who— 
(A) has graduated and received an allied health profes-
sions degree or certificate from an institution of higher 
education; and 
(B) is employed with a Federal, State, local or tribal 
public health agency, or in a setting where patients might 
require health care services, including acute care facilities, 
ambulatory care facilities, personal residences, and other
H. R. 3590—471 
settings located in health professional shortage areas, medi-
cally underserved areas, or medically underserved popu-
lations, as recognized by the Secretary of Health and 
Human Services. 
(2) HEALTH CARE CAREER PATHWAY.—The term ‘‘healthcare 
career pathway’’ means a rigorous, engaging, and high quality 
set of courses and services that— 
(A) includes an articulated sequence of academic and 
career courses, including 21st century skills; 
(B) is aligned with the needs of healthcare industries 
in a region or State; 
(C) prepares students for entry into the full range 
of postsecondary education options, including registered 
apprenticeships, and careers; 
(D) provides academic and career counseling in stu-
dent-to-counselor ratios that allow students to make 
informed decisions about academic and career options; 
(E) meets State academic standards, State require-
ments for secondary school graduation and is aligned with 
requirements for entry into postsecondary education, and 
applicable industry standards; and 
(F) leads to 2 or more credentials, including— 
(i) a secondary school diploma; and 
(ii) a postsecondary degree, an apprenticeship or 
other occupational certification, a certificate, or a 
license. 
(3) INSTITUTION OF HIGHER EDUCATION.—The term ‘‘institu-
tion of higher education’’ has the meaning given the term 
in sections 101 and 102 of the Higher Education Act of 1965 
(20 U.S.C. 1001 and 1002). 
(4) LOW
INCOME
INDIVIDUAL, STATE
WORKFORCE
INVEST-
MENT
BOARD, AND
LOCAL
WORKFORCE
INVESTMENT
BOARD.— 
(A) LOW-INCOME INDIVIDUAL.—The term ‘‘low-income 
individual’’ has the meaning given that term in section 
101 of the Workforce investment Act of 1998 (29 U.S.C. 
2801). 
(B) STATE
WORKFORCE
INVESTMENT
BOARD; LOCAL 
WORKFORCE
INVESTMENT
BOARD.—The 
terms 
‘‘State 
workforce investment board’’ and ‘‘local workforce invest-
ment board’’, refer to a State workforce investment board 
established under section 111 of the Workforce Investment 
Act of 1998 (29 U.S.C. 2821) and a local workforce invest-
ment board established under section 117 of such Act (29 
U.S.C. 2832), respectively. 
(5) POSTSECONDARY EDUCATION.—The term ‘‘postsecondary 
education’’ means— 
(A) a 4-year program of instruction, or not less than 
a 1-year program of instruction that is acceptable for credit 
toward an associate or a baccalaureate degree, offered by 
an institution of higher education; or 
(B) a certificate or registered apprenticeship program 
at the postsecondary level offered by an institution of 
higher education or a non-profit educational institution. 
(6) REGISTERED APPRENTICESHIP PROGRAM.—The term ‘‘reg-
istered apprenticeship program’’ means an industry skills 
training program at the postsecondary level that combines tech-
nical and theoretical training through structure on the job
H. R. 3590—472 
learning with related instruction (in a classroom or through 
distance learning) while an individual is employed, working 
under the direction of qualified personnel or a mentor, and 
earning incremental wage increases aligned to enhance job 
proficiency, resulting in the acquisition of a nationally recog-
nized and portable certificate, under a plan approved by the 
Office of Apprenticeship or a State agency recognized by the 
Department of Labor. 
(b) TITLE VII OF THE PUBLIC HEALTH SERVICE ACT.—Section 
799B of the Public Health Service Act (42 U.S.C. 295p) is amended— 
(1) by striking paragraph (3) and inserting the following: 
‘‘(3) PHYSICIAN ASSISTANT EDUCATION PROGRAM.—The term 
‘physician assistant education program’ means an educational 
program in a public or private institution in a State that— 
‘‘(A) has as its objective the education of individuals 
who, upon completion of their studies in the program, 
be qualified to provide primary care medical services with 
the supervision of a physician; and 
‘‘(B) is accredited by the Accreditation Review Commis-
sion on Education for the Physician Assistant.’’; and 
(2) by adding at the end the following: 
‘‘(12) AREA HEALTH EDUCATION CENTER.—The term ‘area 
health education center’ means a public or nonprofit private 
organization that has a cooperative agreement or contract in 
effect with an entity that has received an award under sub-
section (a)(1) or (a)(2) of section 751, satisfies the requirements 
in section 751(d)(1), and has as one of its principal functions 
the operation of an area health education center. Appropriate 
organizations may include hospitals, health organizations with 
accredited primary care training programs, accredited physician 
assistant educational programs associated with a college or 
university, and universities or colleges not operating a school 
of medicine or osteopathic medicine. 
‘‘(13) AREA
HEALTH
EDUCATION
CENTER
PROGRAM.—The 
term ‘area health education center program’ means cooperative 
program consisting of an entity that has received an award 
under subsection (a)(1) or (a)(2) of section 751 for the purpose 
of planning, developing, operating, and evaluating an area 
health education center program and one or more area health 
education centers, which carries out the required activities 
described in section 751(c), satisfies the program requirements 
in such section, has as one of its principal functions identifying 
and implementing strategies and activities that address health 
care workforce needs in its service area, in coordination with 
the local workforce investment boards. 
‘‘(14) CLINICAL SOCIAL WORKER.—The term ‘clinical social 
worker’ has the meaning given the term in section 1861(hh)(1) 
of the Social Security Act (42 U.S.C. 1395x(hh)(1)). 
‘‘(15) CULTURAL
COMPETENCY.—The term ‘cultural com-
petency’ shall be defined by the Secretary in a manner con-
sistent with section 1707(d)(3). 
‘‘(16) DIRECT CARE WORKER.—The term ‘direct care worker’ 
has the meaning given that term in the 2010 Standard Occupa-
tional Classifications of the Department of Labor for Home 
Health Aides [31–1011], Psychiatric Aides [31–1013], Nursing 
Assistants [31–1014], and Personal Care Aides [39–9021].