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tional and State emergency preparedness 
system; and 
‘‘(vi) addresses pediatric concerns re-
lated to integration, planning, prepared-
ness, and coordination of emergency med-
ical services for infants, children and ado-
lescents; and 
‘‘(B) such other information as the Sec-
retary may require. 
‘‘(e) REQUIREMENT OF MATCHING FUNDS.— 
‘‘(1) IN GENERAL.—The Secretary may not make 
a grant under this section unless the State (or con-
sortia of States) involved agrees, with respect to the 
costs to be incurred by the State (or consortia) in car-
rying out the purpose for which such grant was made, 
to make available non-Federal contributions (in cash 
or in kind under paragraph (2)) toward such costs in 
an amount equal to not less than $1 for each $3 of 
Federal funds provided in the grant. Such contribu-
tions may be made directly or through donations from 
public or private entities. 
‘‘(2) NON-FEDERAL CONTRIBUTIONS.—Non-Fed-
eral contributions required in paragraph (1) may be 
in cash or in kind, fairly evaluated, including equip-
ment or services (and excluding indirect or overhead 
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costs). Amounts provided by the Federal Government, 
or services assisted or subsidized to any significant 
extent by the Federal Government, may not be in-
cluded in determining the amount of such non-Fed-
eral contributions. 
‘‘(f) PRIORITY.—The Secretary shall give priority for 
the award of the contracts or grants described in subsection 
(a) to any eligible entity that serves a population in a 
medically underserved area (as defined in section 
330(b)(3)). 
‘‘(g) REPORT.—Not later than 90 days after the com-
pletion of a pilot project under subsection (a), the recipient 
of such contract or grant described in shall submit to the 
Secretary a report containing the results of an evaluation 
of the program, including an identification of— 
‘‘(1) the impact of the regional, accountable 
emergency care and trauma system on patient health 
outcomes for various critical care categories, such as 
trauma, stroke, cardiac emergencies, neurological 
emergencies, and pediatric emergencies; 
‘‘(2) the system characteristics that contribute to 
the effectiveness and efficiency of the program (or lack 
thereof); 
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‘‘(3) methods of assuring the long-term financial 
sustainability of the emergency care and trauma sys-
tem; 
‘‘(4) the State and local legislation necessary to 
implement and to maintain the system; 
‘‘(5) the barriers to developing regionalized, ac-
countable emergency care and trauma systems, as 
well as the methods to overcome such barriers; and 
‘‘(6) recommendations on the utilization of avail-
able funding for future regionalization efforts. 
‘‘(h) DISSEMINATION
OF FINDINGS.—The Secretary 
shall, as appropriate, disseminate to the public and to the 
appropriate Committees of the Congress, the information 
contained in a report made under subsection (g).’’; and 
(3) in section 1232— 
(A) in subsection (a), by striking ‘‘appro-
priated’’ and all that follows through the period 
at 
the 
end 
and 
inserting 
‘‘appropriated 
$24,000,000 for each of fiscal years 2010 through 
2014.’’; and 
(B) by inserting after subsection (c) the fol-
lowing: 
‘‘(d) AUTHORITY.—For the purpose of carrying out 
parts A through C, beginning on the date of enactment of 
the Patient Protection and Affordable Care Act, the Sec-
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retary shall transfer authority in administering grants and 
related authorities under such parts from the Administrator 
of the Health Resources and Services Administration to the 
Assistant Secretary for Preparedness and Response.’’. 
(b) SUPPORT
FOR
EMERGENCY
MEDICINE
RE-
SEARCH.—Part H of title IV of the Public Health Service 
Act (42 U.S.C. 289 et seq.) is amended by inserting after 
the section 498C the following: 
‘‘SEC. 498D. SUPPORT FOR EMERGENCY MEDICINE RE-
SEARCH. 
‘‘(a) EMERGENCY MEDICAL RESEARCH.—The Sec-
retary shall support Federal programs administered by the 
National Institutes of Health, the Agency for Healthcare 
Research and Quality, the Health Resources and Services 
Administration, the Centers for Disease Control and Pre-
vention, and other agencies involved in improving the emer-
gency care system to expand and accelerate research in 
emergency medical care systems and emergency medicine, 
including— 
‘‘(1) the basic science of emergency medicine; 
‘‘(2) the model of service delivery and the compo-
nents of such models that contribute to enhanced pa-
tient health outcomes; 
‘‘(3) the translation of basic scientific research 
into improved practice; and 
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‘‘(4) the development of timely and efficient de-
livery of health services. 
‘‘(b) PEDIATRIC EMERGENCY MEDICAL RESEARCH.— 
The Secretary shall support Federal programs administered 
by the National Institutes of Health, the Agency for 
Healthcare Research and Quality, the Health Resources and 
Services Administration, the Centers for Disease Control 
and Prevention, and other agencies to coordinate and ex-
pand research in pediatric emergency medical care systems 
and pediatric emergency medicine, including— 
‘‘(1) an examination of the gaps and opportuni-
ties in pediatric emergency care research and a strat-
egy for the optimal organization and funding of such 
research; 
‘‘(2) the role of pediatric emergency services as 
an integrated component of the overall health system; 
‘‘(3) system-wide pediatric emergency care plan-
ning, preparedness, coordination, and funding; 
‘‘(4) pediatric training in professional edu-
cation; and 
‘‘(5) research in pediatric emergency care, spe-
cifically on the efficacy, safety, and health outcomes 
of medications used for infants, children, and adoles-
cents in emergency care settings in order to improve 
patient safety. 
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‘‘(c) IMPACT RESEARCH.—The Secretary shall support 
research to determine the estimated economic impact of, and 
savings that result from, the implementation of coordinated 
emergency care systems. 
‘‘(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 2010 
through 2014.’’. 
SEC. 3505. TRAUMA CARE CENTERS AND SERVICE AVAIL-
ABILITY. 
(a) TRAUMA CARE CENTERS.— 
(1) GRANTS FOR TRAUMA CARE CENTERS.—Sec-
tion 1241 of the Public Health Service Act (42 U.S.C. 
300d–41) is amended by striking subsections (a) and 
(b) and inserting the following: 
‘‘(a) IN GENERAL.—The Secretary shall establish 3 
programs to award grants to qualified public, nonprofit In-
dian Health Service, Indian tribal, and urban Indian trau-
ma centers— 
‘‘(1) to assist in defraying substantial uncom-
pensated care costs; 
‘‘(2) to further the core missions of such trauma 
centers, including by addressing costs associated with 
patient stabilization and transfer, trauma education 
and outreach, coordination with local and regional 
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trauma systems, essential personnel and other fixed 
costs, and expenses associated with employee and non- 
employee physician services; and 
‘‘(3) to provide emergency relief to ensure the 
continued and future availability of trauma services. 
‘‘(b) MINIMUM QUALIFICATIONS
OF TRAUMA CEN-
TERS.— 
‘‘(1) PARTICIPATION IN TRAUMA CARE SYSTEM 
OPERATING UNDER CERTAIN PROFESSIONAL GUIDE-
LINES.—Except as provided in paragraph (2), the 
Secretary may not award a grant to a trauma center 
under subsection (a) unless the trauma center is a 
participant in a trauma system that substantially 
complies with section 1213. 
‘‘(2) EXEMPTION.—Paragraph (1) shall not 
apply to trauma centers that are located in States 
with no existing trauma care system. 
‘‘(3) QUALIFICATION FOR SUBSTANTIAL UNCOM-
PENSATED CARE COSTS.—The Secretary shall award 
substantial uncompensated care grants under sub-
section (a)(1) only to trauma centers meeting at least 
1 of the criteria in 1 of the following 3 categories: 
‘‘(A) CATEGORY A.—The criteria for cat-
egory A are as follows: 
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‘‘(i) At least 40 percent of the visits in 
the emergency department of the hospital in 
which the trauma center is located were 
charity or self-pay patients. 
‘‘(ii) At least 50 percent of the visits in 
such emergency department were Medicaid 
(under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.)) and charity and 
self-pay patients combined. 
‘‘(B) CATEGORY B.—The criteria for cat-
egory B are as follows: 
‘‘(i) At least 35 percent of the visits in 
the emergency department were charity or 
self-pay patients. 
‘‘(ii) At least 50 percent of the visits in 
the emergency department were Medicaid 
and charity and self-pay patients combined. 
‘‘(C) CATEGORY
C.—The criteria for cat-
egory C are as follows: 
‘‘(i) At least 20 percent of the visits in 
the emergency department were charity or 
self-pay patients. 
‘‘(ii) At least 30 percent of the visits in 
the emergency department were Medicaid 
and charity and self-pay patients combined. 
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‘‘(4) 
TRAUMA
CENTERS
IN
1115
WAIVER 
STATES.—Notwithstanding paragraph (3), the Sec-
retary may award a substantial uncompensated care 
grant to a trauma center under subsection (a)(1) if 
the trauma center qualifies for funds under a Low In-
come Pool or Safety Net Care Pool established through 
a waiver approved under section 1115 of the Social 
Security Act (42 U.S.C. 1315). 
‘‘(5) DESIGNATION.—The Secretary may not 
award a grant to a trauma center unless such trauma 
center is verified by the American College of Surgeons 
or designated by an equivalent State or local agency. 
‘‘(c) ADDITIONAL
REQUIREMENTS.—The Secretary 
may not award a grant to a trauma center under subsection 
(a)(1) unless such trauma center— 
‘‘(1) submits to the Secretary a plan satisfactory 
to the Secretary that demonstrates a continued com-
mitment to serving trauma patients regardless of 
their ability to pay; and 
‘‘(2) has policies in place to assist patients who 
cannot pay for part or all of the care they receive, in-
cluding a sliding fee scale, and to ensure fair billing 
and collection practices.’’. 
(2) CONSIDERATIONS IN MAKING GRANTS.—Sec-
tion 1242 of the Public Health Service Act (42 U.S.C. 
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300d–42) is amended by striking subsections (a) and 
(b) and inserting the following: 
‘‘(a) 
SUBSTANTIAL
UNCOMPENSATED
CARE 
AWARDS.— 
‘‘(1) IN GENERAL.—The Secretary shall establish 
an award basis for each eligible trauma center for 
grants under section 1241(a)(1) according to the per-
centage described in paragraph (2), subject to the re-
quirements of section 1241(b)(3). 
‘‘(2) PERCENTAGES.—The applicable percentages 
are as follows: 
‘‘(A) With respect to a category A trauma 
center, 100 percent of the uncompensated care 
costs. 
‘‘(B) With respect to a category B trauma 
center, not more than 75 percent of the uncom-
pensated care costs. 
‘‘(C) With respect to a category C trauma 
center, not more than 50 percent of the uncom-
pensated care costs. 
‘‘(b) CORE MISSION AWARDS.— 
‘‘(1) IN GENERAL.—In awarding grants under 
section 1241(a)(2), the Secretary shall— 
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‘‘(A) reserve 25 percent of the amount allo-
cated for core mission awards for Level III and 
Level IV trauma centers; and 
‘‘(B) reserve 25 percent of the amount allo-
cated for core mission awards for large urban 
Level I and II trauma centers— 
‘‘(i) that have at least 1 graduate med-
ical education fellowship in trauma or 
trauma related specialties for which de-
mand is exceeding supply; 
‘‘(ii) for which— 
‘‘(I) annual uncompensated care 
costs exceed $10,000,000; or 
‘‘(II) at least 20 percent of emer-
gency department visits are charity or 
self-pay or Medicaid patients; and 
‘‘(iii) that are not eligible for substan-
tial uncompensated care awards under sec-
tion 1241(a)(1). 
‘‘(c) EMERGENCY
AWARDS.—In awarding grants 
under section 1241(a)(3), the Secretary shall— 
‘‘(1) give preference to any application submitted 
by a trauma center that provides trauma care in a 
geographic area in which the availability of trauma 
care has significantly decreased or will significantly 
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decrease if the center is forced to close or downgrade 
service or growth in demand for trauma services ex-
ceeds capacity; and 
‘‘(2) reallocate any emergency awards funds not 
obligated due to insufficient, or a lack of qualified, 
applications to the significant uncompensated care 
award program.’’. 
(3) CERTAIN AGREEMENTS.—Section 1243 of the 
Public Health Service Act (42 U.S.C. 300d–43) is 
amended by striking subsections (a), (b), and (c) and 
inserting the following: 
‘‘(a) MAINTENANCE
OF FINANCIAL SUPPORT.—The 
Secretary may require a trauma center receiving a grant 
under section 1241(a) to maintain access to trauma services 
at comparable levels to the prior year during the grant pe-
riod. 
‘‘(b) TRAUMA CARE REGISTRY.—The Secretary may 
require the trauma center receiving a grant under section 
1241(a) to provide data to a national and centralized reg-
istry of trauma cases, in accordance with guidelines devel-
oped by the American College of Surgeons, and as the Sec-
retary may otherwise require.’’. 
(4) GENERAL PROVISIONS.—Section 1244 of the 
Public Health Service Act (42 U.S.C. 300d–44) is 
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amended by striking subsections (a), (b), and (c) and 
inserting the following: 
‘‘(a) APPLICATION.—The Secretary may not award a 
grant to a trauma center under section 1241(a) unless such 
center submits an application for the grant to the Secretary 
and the application is in such form, is made in such man-
ner, and contains such agreements, assurances, and infor-
mation as the Secretary determines to be necessary to carry 
out this part. 
‘‘(b) LIMITATION ON DURATION OF SUPPORT.—The pe-
riod during which a trauma center receives payments under 
a grant under section 1241(a)(3) shall be for 3 fiscal years, 
except that the Secretary may waive such requirement for 
a center and authorize such center to receive such payments 
for 1 additional fiscal year. 
‘‘(c) LIMITATION ON AMOUNT OF GRANT.—Notwith-
standing section 1242(a), a grant under section 1241 may 
not be made in an amount exceeding $2,000,000 for each 
fiscal year. 
‘‘(d) ELIGIBILITY.—Except as provided in section 
1242(b)(1)(B)(iii), acquisition of, or eligibility for, a grant 
under section 1241(a) shall not preclude a trauma center 
from being eligible for other grants described in such sec-
tion. 
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‘‘(e) FUNDING DISTRIBUTION.—Of the total amount 
appropriated for a fiscal year under section 1245, 70 per-
cent shall be used for substantial uncompensated care 
awards under section 1241(a)(1), 20 percent shall be used 
for core mission awards under section 1241(a)(2), and 10 
percent shall be used for emergency awards under section 
1241(a)(3). 
‘‘(f) MINIMUM ALLOWANCE.—Notwithstanding sub-
section (e), if the amount appropriated for a fiscal year 
under section 1245 is less than $25,000,000, all available 
funding for such fiscal year shall be used for substantial 
uncompensated care awards under section 1241(a)(1). 
‘‘(g) SUBSTANTIAL UNCOMPENSATED CARE AWARD 
DISTRIBUTION
AND
PROPORTIONAL
SHARE.—Notwith-
standing section 1242(a), of the amount appropriated for 
substantial uncompensated care grants for a fiscal year, the 
Secretary shall— 
‘‘(1) make available— 
‘‘(A) 50 percent of such funds for category 
A trauma center grantees; 
‘‘(B) 35 percent of such funds for category 
B trauma center grantees; and 
‘‘(C) 15 percent of such funds for category 
C trauma center grantees; and 
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‘‘(2) provide available funds within each cat-
egory in a manner proportional to the award basis 
specified in section 1242(a)(2) to each eligible trauma 
center. 
‘‘(h) REPORT.—Beginning 2 years after the date of en-
actment of the Patient Protection and Affordable Care Act, 
and every 2 years thereafter, the Secretary shall biennially 
report to Congress regarding the status of the grants made 
under section 1241 and on the overall financial stability 
of trauma centers.’’. 
(5) AUTHORIZATION OF APPROPRIATIONS.—Sec-
tion 1245 of the Public Health Service Act (42 U.S.C. 
300d–45) is amended to read as follows: 
‘‘SEC. 1245. AUTHORIZATION OF APPROPRIATIONS. 
‘‘For the purpose of carrying out this part, there are 
authorized to be appropriated $100,000,000 for fiscal year 
2009, and such sums as may be necessary for each of fiscal 
years 2010 through 2015. Such authorization of appropria-
tions is in addition to any other authorization of appro-
priations or amounts that are available for such purpose.’’. 
(6) DEFINITION.—Part D of title XII of the Pub-
lic Health Service Act (42 U.S.C. 300d–41 et seq.) is 
amended by adding at the end the following: 
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‘‘SEC. 1246. DEFINITION. 
‘‘In this part, the term ‘uncompensated care costs’ 
means unreimbursed costs from serving self-pay, charity, 
or Medicaid patients, without regard to payment under sec-
tion 1923 of the Social Security Act, all of which are attrib-
utable to emergency care and trauma care, including costs 
related to subsequent inpatient admissions to the hospital.’’. 
(b) TRAUMA SERVICE AVAILABILITY.—Title XII of the 
Public Health Service Act (42 U.S.C. 300d et seq.) is 
amended by adding at the end the following: 
‘‘PART H—TRAUMA SERVICE AVAILABILITY 
‘‘SEC. 1281. GRANTS TO STATES. 
‘‘(a) ESTABLISHMENT.—To promote universal access 
to trauma care services provided by trauma centers and 
trauma-related physician specialties, the Secretary shall 
provide funding to States to enable such States to award 
grants to eligible entities for the purposes described in this 
section. 
‘‘(b) AWARDING OF GRANTS BY STATES.—Each State 
may award grants to eligible entities within the State for 
the purposes described in subparagraph (d). 
‘‘(c) ELIGIBILITY.— 
‘‘(1) IN GENERAL.—To be eligible to receive a 
grant under subsection (b) an entity shall— 
‘‘(A) be— 
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‘‘(i) a public or nonprofit trauma cen-
ter or consortium thereof that meets that re-
quirements of paragraphs (1), (2), and (5) 
of section 1241(b); 
‘‘(ii) a safety net public or nonprofit 
trauma center that meets the requirements 
of paragraphs (1) through (5) of section 
1241(b); or 
‘‘(iii) a hospital in an underserved 
area (as defined by the State) that seeks to 
establish new trauma services; and 
‘‘(B) submit to the State an application at 
such time, in such manner, and containing such 
information as the State may require. 
‘‘(2) LIMITATION.—A State shall use at least 40 
percent of the amount available to the State under 
this part for a fiscal year to award grants to safety 
net trauma centers described in paragraph (1)(A)(ii). 
‘‘(d) USE OF FUNDS.—The recipient of a grant under 
subsection (b) shall carry out 1 or more of the following 
activities consistent with subsection (b): 
‘‘(1) Providing trauma centers with funding to 
support physician compensation in trauma-related 
physician specialties where shortages exist in the re-
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gion involved, with priority provided to safety net 
trauma centers described in subsection (c)(1)(A)(ii). 
‘‘(2) Providing for individual safety net trauma 
center fiscal stability and costs related to having serv-
ice that is available 24 hours a day, 7 days a week, 
with priority provided to safety net trauma centers 
described in subsection (c)(1)(A)(ii) located in urban, 
border, and rural areas. 
‘‘(3) Reducing trauma center overcrowding at 
specific trauma centers related to throughput of trau-
ma patients. 
‘‘(4) Establishing new trauma services in under-
served areas as defined by the State. 
‘‘(5) Enhancing collaboration between trauma 
centers and other hospitals and emergency medical 
services personnel related to trauma service avail-
ability. 
‘‘(6) Making capital improvements to enhance 
access and expedite trauma care, including providing 
helipads and associated safety infrastructure. 
‘‘(7) Enhancing trauma surge capacity at spe-
cific trauma centers. 
‘‘(8) Ensuring expedient receipt of trauma pa-
tients transported by ground or air to the appropriate 
trauma center. 
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‘‘(9) Enhancing interstate trauma center collabo-
ration. 
‘‘(e) LIMITATION.— 
‘‘(1) IN GENERAL.—A State may use not more 
than 20 percent of the amount available to the State 
under this part for a fiscal year for administrative 
costs associated with awarding grants and related 
costs. 
‘‘(2) MAINTENANCE OF EFFORT.—The Secretary 
may not provide funding to a State under this part 
unless the State agrees that such funds will be used 
to supplement and not supplant State funding other-
wise available for the activities and costs described in 
this part. 
‘‘(f) DISTRIBUTION OF FUNDS.—The following shall 
apply with respect to grants provided in this part: 
‘‘(1) LESS THAN $10,000,000.—If the amount of 
appropriations for this part in a fiscal year is less 
than $10,000,000, the Secretary shall divide such 
funding evenly among only those States that have 1 
or more trauma centers eligible for funding under sec-
tion 1241(b)(3)(A). 
‘‘(2) LESS THAN $20,000,000.—If the amount of 
appropriations in a fiscal year is less than 
$20,000,000, the Secretary shall divide such funding 
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evenly among only those States that have 1 or more 
trauma centers eligible for funding under subpara-
graphs (A) and (B) of section 1241(b)(3). 
‘‘(3) LESS THAN $30,000,000.—If the amount of 
appropriations for this part in a fiscal year is less 
than $30,000,000, the Secretary shall divide such 
funding evenly among only those States that have 1 
or more trauma centers eligible for funding under sec-
tion 1241(b)(3). 
‘‘(4) $30,000,000 OR MORE.—If the amount of 
appropriations for this part in a fiscal year is 
$30,000,000 or more, the Secretary shall divide such 
funding evenly among all States. 
‘‘SEC. 1282. AUTHORIZATION OF APPROPRIATIONS. 
‘‘For the purpose of carrying out this part, there is 
authorized to be appropriated $100,000,000 for each of fis-
cal years 2010 through 2015.’’. 
SEC. 3506. PROGRAM TO FACILITATE SHARED DECISION-
MAKING. 
Part D of title IX of the Public Health Service Act, 
as amended by section 3503, is further amended by adding 
at the end the following: 
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‘‘SEC. 936. PROGRAM TO FACILITATE SHARED DECISION-
MAKING. 
‘‘(a) PURPOSE.—The purpose of this section is to fa-
cilitate collaborative processes between patients, caregivers 
or authorized representatives, and clinicians that engages 
the patient, caregiver or authorized representative in deci-
sionmaking, provides patients, caregivers or authorized rep-
resentatives with information about trade-offs among treat-
ment options, and facilitates the incorporation of patient 
preferences and values into the medical plan. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) PATIENT DECISION AID.—The term ‘patient 
decision aid’ means an educational tool that helps pa-
tients, caregivers or authorized representatives under-
stand and communicate their beliefs and preferences 
related to their treatment options, and to decide with 
their health care provider what treatments are best for 
them based on their treatment options, scientific evi-
dence, circumstances, beliefs, and preferences. 
‘‘(2) PREFERENCE SENSITIVE CARE.—The term 
‘preference sensitive care’ means medical care for 
which the clinical evidence does not clearly support 
one treatment option such that the appropriate course 
of treatment depends on the values of the patient or 
the preferences of the patient, caregivers or authorized 
representatives regarding the benefits, harms and sci-
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entific evidence for each treatment option, the use of 
such care should depend on the informed patient 
choice among clinically appropriate treatment op-
tions. 
‘‘(c) ESTABLISHMENT OF INDEPENDENT STANDARDS 
FOR PATIENT DECISION AIDS FOR PREFERENCE SENSITIVE 
CARE.— 
‘‘(1) CONTRACT
WITH
ENTITY
TO
ESTABLISH 
STANDARDS AND CERTIFY PATIENT DECISION AIDS.— 
‘‘(A) IN GENERAL.—For purposes of sup-
porting consensus-based standards for patient de-
cision aids for preference sensitive care and a 
certification process for patient decision aids for 
use in the Federal health programs and by other 
interested parties, the Secretary shall have in ef-
fect a contract with the entity with a contract 
under section 1890 of the Social Security Act. 
Such contract shall provide that the entity per-
form the duties described in paragraph (2). 
‘‘(B) TIMING
FOR
FIRST
CONTRACT.—As 
soon as practicable after the date of the enact-
ment of this section, the Secretary shall enter 
into the first contract under subparagraph (A). 
‘‘(C) PERIOD
OF
CONTRACT.—A contract 
under subparagraph (A) shall be for a period of 
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18 months (except such contract may be renewed 
after a subsequent bidding process). 
‘‘(2) DUTIES.—The following duties are de-
scribed in this paragraph: 
‘‘(A) DEVELOP AND IDENTIFY STANDARDS 
FOR PATIENT DECISION AIDS.—The entity shall 
synthesize evidence and convene a broad range of 
experts and key stakeholders to develop and iden-
tify consensus-based standards to evaluate pa-
tient decision aids for preference sensitive care. 
‘‘(B) ENDORSE PATIENT DECISION AIDS.— 
The entity shall review patient decision aids and 
develop a certification process whether patient 
decision aids meet the standards developed and 
identified under subparagraph (A). The entity 
shall give priority to the review and certification 
of patient decision aids for preference sensitive 
care. 
‘‘(d) PROGRAM TO DEVELOP, UPDATE AND PATIENT 
DECISION AIDS TO ASSIST HEALTH CARE PROVIDERS AND 
PATIENTS.— 
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Director, and in coordination with heads 
of other relevant agencies, such as the Director of the 
Centers for Disease Control and Prevention and the 
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Director of the National Institutes of Health, shall es-
tablish a program to award grants or contracts— 
‘‘(A) to develop, update, and produce pa-
tient decision aids for preference sensitive care to 
assist health care providers in educating pa-
tients, caregivers, and authorized representatives 
concerning the relative safety, relative effective-
ness (including possible health outcomes and im-
pact on functional status), and relative cost of 
treatment or, where appropriate, palliative care 
options; 
‘‘(B) to test such materials to ensure such 
materials are balanced and evidence based in 
aiding health care providers and patients, care-
givers, and authorized representatives to make 
informed decisions about patient care and can be 
easily incorporated into a broad array of prac-
tice settings; and 
‘‘(C) to educate providers on the use of such 
materials, including through academic curricula. 
‘‘(2) REQUIREMENTS
FOR
PATIENT
DECISION 
AIDS.—Patient decision aids developed and produced 
pursuant to a grant or contract under paragraph 
(1)— 
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‘‘(A) shall be designed to engage patients, 
caregivers, and authorized representatives in in-
formed decisionmaking with health care pro-
viders; 
‘‘(B) shall present up-to-date clinical evi-
dence about the risks and benefits of treatment 
options in a form and manner that is age-appro-
priate and can be adapted for patients, care-
givers, and authorized representatives from a va-
riety of cultural and educational backgrounds to 
reflect the varying needs of consumers and di-
verse levels of health literacy; 
‘‘(C) shall, where appropriate, explain why 
there is a lack of evidence to support one treat-
ment option over another; and 
‘‘(D) shall address health care decisions 
across the age span, including those affecting 
vulnerable populations including children. 
‘‘(3) DISTRIBUTION.—The Director shall ensure 
that patient decision aids produced with grants or 
contracts under this section are available to the pub-
lic. 
‘‘(4) NONDUPLICATION OF EFFORTS.—The Direc-
tor shall ensure that the activities under this section 
of the Agency and other agencies, including the Cen-
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ters for Disease Control and Prevention and the Na-
tional Institutes of Health, are free of unnecessary du-
plication of effort. 
‘‘(e) GRANTS TO SUPPORT SHARED DECISIONMAKING 
IMPLEMENTATION.— 
‘‘(1) IN GENERAL.—The Secretary shall establish 
a program to provide for the phased-in development, 
implementation, and evaluation of shared decision-
making using patient decision aids to meet the objec-
tive of improving the understanding of patients of 
their medical treatment options. 
‘‘(2) SHARED DECISIONMAKING RESOURCE CEN-
TERS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
provide grants for the establishment and support 
of Shared Decisionmaking Resource Centers (re-
ferred to in this subsection as ‘Centers’) to pro-
vide technical assistance to providers and to de-
velop and disseminate best practices and other 
information to support and accelerate adoption, 
implementation, and effective use of patient deci-
sion aids and shared decisionmaking by pro-
viders. 
‘‘(B) OBJECTIVES.—The objective of a Cen-
ter is to enhance and promote the adoption of 
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patient decision aids and shared decisionmaking 
through— 
‘‘(i) providing assistance to eligible 
providers with the implementation and ef-
fective use of, and training on, patient deci-
sion aids; and 
‘‘(ii) the dissemination of best practices 
and research on the implementation and ef-
fective use of patient decision aids. 
‘‘(3) SHARED
DECISIONMAKING
PARTICIPATION 
GRANTS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
provide grants to health care providers for the 
development and implementation of shared deci-
sionmaking techniques and to assess the use of 
such techniques. 
‘‘(B) PREFERENCE.—In order to facilitate 
the use of best practices, the Secretary shall pro-
vide a preference in making grants under this 
subsection to health care providers who partici-
pate in training by Shared Decisionmaking Re-
source Centers or comparable training. 
‘‘(C) LIMITATION.—Funds under this para-
graph shall not be used to purchase or imple-
ment use of patient decision aids other than 
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those certified under the process identified in 
subsection (c). 
‘‘(4) GUIDANCE.—The Secretary may issue guid-
ance to eligible grantees under this subsection on the 
use of patient decision aids. 
‘‘(f) FUNDING.—For purposes of carrying out this sec-
tion there are authorized to be appropriated such sums as 
may be necessary for fiscal year 2010 and each subsequent 
fiscal year.’’. 
SEC. 3507. PRESENTATION OF PRESCRIPTION DRUG BEN-
EFIT AND RISK INFORMATION. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Commissioner of Food and 
Drugs, shall determine whether the addition of quantitative 
summaries of the benefits and risks of prescription drugs 
in a standardized format (such as a table or drug facts box) 
to the promotional labeling or print advertising of such 
drugs would improve health care decisionmaking by clini-
cians and patients and consumers. 
(b) REVIEW AND CONSULTATION.—In making the de-
termination under subsection (a), the Secretary shall review 
all available scientific evidence and research on decision-
making and social and cognitive psychology and consult 
with drug manufacturers, clinicians, patients and con-
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sumers, experts in health literacy, representatives of racial 
and ethnic minorities, and experts in women’s and pedi-
atric health. 
(c) REPORT.—Not later than 1 year after the date of 
enactment of this Act, the Secretary shall submit to Con-
gress a report that provides— 
(1) the determination by the Secretary under 
subsection (a); and 
(2) the reasoning and analysis underlying that 
determination. 
(d) AUTHORITY.—If the Secretary determines under 
subsection (a) that the addition of quantitative summaries 
of the benefits and risks of prescription drugs in a stand-
ardized format (such as a table or drug facts box) to the 
promotional labeling or print advertising of such drugs 
would improve health care decisionmaking by clinicians 
and patients and consumers, then the Secretary, not later 
than 3 years after the date of submission of the report under 
subsection (c), shall promulgate proposed regulations as 
necessary to implement such format. 
(e) CLARIFICATION.—Nothing in this section shall be 
construed to restrict the existing authorities of the Secretary 
with respect to benefit and risk information. 
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SEC. 3508. DEMONSTRATION PROGRAM TO INTEGRATE 
QUALITY IMPROVEMENT AND PATIENT SAFE-
TY TRAINING INTO CLINICAL EDUCATION OF 
HEALTH PROFESSIONALS. 
(a) IN GENERAL.—The Secretary may award grants 
to eligible entities or consortia under this section to carry 
out demonstration projects to develop and implement aca-
demic curricula that integrates quality improvement and 
patient safety in the clinical education of health profes-
sionals. Such awards shall be made on a competitive basis 
and pursuant to peer review. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity or consortium shall— 
(1) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require; 
(2) be or include— 
(A) a health professions school; 
(B) a school of public health; 
(C) a school of social work; 
(D) a school of nursing; 
(E) a school of pharmacy; 
(F) an institution with a graduate medical 
education program; or 
(G) a school of health care administration; 
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(3) collaborate in the development of curricula 
described in subsection (a) with an organization that 
accredits such school or institution; 
(4) provide for the collection of data regarding 
the effectiveness of the demonstration project; and 
(5) provide matching funds in accordance with 
subsection (c). 
(c) MATCHING FUNDS.— 
(1) IN GENERAL.—The Secretary may award a 
grant to an entity or consortium under this section 
only if the entity or consortium agrees to make avail-
able non-Federal contributions toward the costs of the 
program to be funded under the grant in an amount 
that is not less than $1 for each $5 of Federal funds 
provided under the grant. 
(2) DETERMINATION
OF
AMOUNT
CONTRIB-
UTED.—Non-Federal contributions under paragraph 
(1) may be in cash or in-kind, fairly evaluated, in-
cluding equipment or services. Amounts provided by 
the Federal Government, or services assisted or sub-
sidized to any significant extent by the Federal Gov-
ernment, may not be included in determining the 
amount of such contributions. 
(d) EVALUATION.—The Secretary shall take such ac-
tion as may be necessary to evaluate the projects funded 
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under this section and publish, make publicly available, 
and disseminate the results of such evaluations on as wide 
a basis as is practicable. 
(e) REPORTS.—Not later than 2 years after the date 
of enactment of this section, and annually thereafter, the 
Secretary shall submit to the Committee on Health, Edu-
cation, Labor, and Pensions and the Committee on Finance 
of the Senate and the Committee on Energy and Commerce 
and the Committee on Ways and Means of the House of 
Representatives a report that— 
(1) describes the specific projects supported 
under this section; and 
(2) contains recommendations for Congress based 
on the evaluation conducted under subsection (d). 
SEC. 3509. IMPROVING WOMEN’S HEALTH. 
(a) HEALTH
AND HUMAN SERVICES OFFICE
ON 
WOMEN’S HEALTH.— 
(1) ESTABLISHMENT.—Part A of title II of the 
Public Health Service Act (42 U.S.C. 202 et seq.) is 
amended by adding at the end the following: 
‘‘SEC. 229. HEALTH AND HUMAN SERVICES OFFICE ON WOM-
EN’S HEALTH. 
‘‘(a) ESTABLISHMENT OF OFFICE.—There is estab-
lished within the Office of the Secretary, an Office on Wom-
en’s Health (referred to in this section as the ‘Office’). The 
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sistant Secretary for Women’s Health and composed 
of senior level representatives from each of the agen-
cies and offices of the Department of Health and 
Human Services; 
‘‘(5) establish a National Women’s Health Infor-
mation Center to— 
‘‘(A) facilitate the exchange of information 
regarding matters relating to health information, 
health promotion, preventive health services, re-
search advances, and education in the appro-
priate use of health care; 
‘‘(B) facilitate access to such information; 
‘‘(C) assist in the analysis of issues and 
problems relating to the matters described in this 
paragraph; and 
‘‘(D) provide technical assistance with re-
spect to the exchange of information (including 
facilitating the development of materials for such 
technical assistance); 
‘‘(6) coordinate efforts to promote women’s health 
programs and policies with the private sector; and 
‘‘(7) through publications and any other means 
appropriate, provide for the exchange of information 
between the Office and recipients of grants, contracts, 
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and agreements under subsection (c), and between the 
Office and health professionals and the general public. 
‘‘(c) GRANTS AND CONTRACTS REGARDING DUTIES.— 
‘‘(1) AUTHORITY.—In carrying out subsection 
(b), the Secretary may make grants to, and enter into 
cooperative agreements, contracts, and interagency 
agreements with, public and private entities, agencies, 
and organizations. 
‘‘(2) EVALUATION
AND
DISSEMINATION.—The 
Secretary shall directly or through contracts with 
public and private entities, agencies, and organiza-
tions, provide for evaluations of projects carried out 
with financial assistance provided under paragraph 
(1) and for the dissemination of information devel-
oped as a result of such projects. 
‘‘(d) REPORTS.—Not later than 1 year after the date 
of enactment of this section, and every second year there-
after, the Secretary shall prepare and submit to the appro-
priate committees of Congress a report describing the activi-
ties carried out under this section during the period for 
which the report is being prepared. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for each 
of the fiscal years 2010 through 2014.’’. 
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(2) TRANSFER OF FUNCTIONS.—There are trans-
ferred to the Office on Women’s Health (established 
under section 229 of the Public Health Service Act, 
as added by this section), all functions exercised by 
the Office on Women’s Health of the Public Health 
Service prior to the date of enactment of this section, 
including all personnel and compensation authority, 
all delegation and assignment authority, and all re-
maining appropriations. All orders, determinations, 
rules, regulations, permits, agreements, grants, con-
tracts, certificates, licenses, registrations, privileges, 
and other administrative actions that— 
(A) have been issued, made, granted, or al-
lowed to become effective by the President, any 
Federal agency or official thereof, or by a court 
of competent jurisdiction, in the performance of 
functions transferred under this paragraph; and 
(B) are in effect at the time this section 
takes effect, or were final before the date of enact-
ment of this section and are to become effective 
on or after such date, 
shall continue in effect according to their terms until 
modified, terminated, superseded, set aside, or revoked 
in accordance with law by the President, the Sec-
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retary, or other authorized official, a court of com-
petent jurisdiction, or by operation of law. 
(b) CENTERS FOR DISEASE CONTROL AND PREVEN-
TION OFFICE OF WOMEN’S HEALTH.—Part A of title III 
of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following: 
‘‘SEC. 310A. CENTERS FOR DISEASE CONTROL AND PREVEN-
TION OFFICE OF WOMEN’S HEALTH. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Office of the Director of the Centers for Disease Control 
and Prevention, an office to be known as the Office of Wom-
en’s Health (referred to in this section as the ‘Office’). The 
Office shall be headed by a director who shall be appointed 
by the Director of such Centers. 
‘‘(b) PURPOSE.—The Director of the Office shall— 
‘‘(1) report to the Director of the Centers for Dis-
ease Control and Prevention on the current level of 
the Centers’ activity regarding women’s health condi-
tions across, where appropriate, age, biological, and 
sociocultural contexts, in all aspects of the Centers’ 
work, including prevention programs, public and pro-
fessional education, services, and treatment; 
‘‘(2) establish short-range and long-range goals 
and objectives within the Centers for women’s health 
and, as relevant and appropriate, coordinate with 
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other appropriate offices on activities within the Cen-
ters that relate to prevention, research, education and 
training, service delivery, and policy development, for 
issues of particular concern to women; 
‘‘(3) identify projects in women’s health that 
should be conducted or supported by the Centers; 
‘‘(4) consult with health professionals, non-
governmental organizations, consumer organizations, 
women’s health professionals, and other individuals 
and groups, as appropriate, on the policy of the Cen-
ters with regard to women; and 
‘‘(5) serve as a member of the Department of 
Health and Human Services Coordinating Committee 
on Women’s Health (established under section 
229(b)(4)). 
‘‘(c) DEFINITION.—As used in this section, the term 
‘women’s health conditions’, with respect to women of all 
age, ethnic, and racial groups, means diseases, disorders, 
and conditions— 
‘‘(1) unique to, significantly more serious for, or 
significantly more prevalent in women; and 
‘‘(2) for which the factors of medical risk or type 
of medical intervention are different for women, or for 
which there is reasonable evidence that indicates that 
such factors or types may be different for women. 
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‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for each 
of the fiscal years 2010 through 2014.’’. 
(c) OFFICE OF WOMEN’S HEALTH RESEARCH.—Sec-
tion 486(a) of the Public Health Service Act (42 U.S.C. 
287d(a)) is amended by inserting ‘‘and who shall report 
directly to the Director’’ before the period at the end thereof. 
(d) SUBSTANCE ABUSE AND MENTAL HEALTH SERV-
ICES
ADMINISTRATION.—Section 501(f) of the Public 
Health Service Act (42 U.S.C. 290aa(f)) is amended— 
(1) in paragraph (1), by inserting ‘‘who shall re-
port directly to the Administrator’’ before the period; 
(2) by redesignating paragraph (4) as para-
graph (5); and 
(3) by inserting after paragraph (3), the fol-
lowing: 
‘‘(4) OFFICE.—Nothing in this subsection shall 
be construed to preclude the Secretary from estab-
lishing within the Substance Abuse and Mental 
Health 
Administration 
an 
Office 
of 
Women’s 
Health.’’. 
(e) AGENCY FOR HEALTHCARE RESEARCH AND QUAL-
ITY ACTIVITIES REGARDING WOMEN’S HEALTH.—Part C 
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of title IX of the Public Health Service Act (42 U.S.C. 299c 
et seq.) is amended— 
(1) by redesignating sections 925 and 926 as sec-
tions 926 and 927, respectively; and 
(2) by inserting after section 924 the following: 
‘‘SEC. 925. ACTIVITIES REGARDING WOMEN’S HEALTH. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Office of the Director, an Office of Women’s Health and 
Gender-Based Research (referred to in this section as the 
‘Office’). The Office shall be headed by a director who shall 
be appointed by the Director of Healthcare and Research 
Quality. 
‘‘(b) PURPOSE.—The official designated under sub-
section (a) shall— 
‘‘(1) report to the Director on the current Agency 
level of activity regarding women’s health, across, 
where appropriate, age, biological, and sociocultural 
contexts, in all aspects of Agency work, including the 
development of evidence reports and clinical practice 
protocols and the conduct of research into patient out-
comes, delivery of health care services, quality of care, 
and access to health care; 
‘‘(2) establish short-range and long-range goals 
and objectives within the Agency for research impor-
tant to women’s health and, as relevant and appro-
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priate, coordinate with other appropriate offices on 
activities within the Agency that relate to health serv-
ices and medical effectiveness research, for issues of 
particular concern to women; 
‘‘(3) identify projects in women’s health that 
should be conducted or supported by the Agency; 
‘‘(4) consult with health professionals, non-
governmental organizations, consumer organizations, 
women’s health professionals, and other individuals 
and groups, as appropriate, on Agency policy with 
regard to women; and 
‘‘(5) serve as a member of the Department of 
Health and Human Services Coordinating Committee 
on Women’s Health (established under section 
229(b)(4)).’’. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for each 
of the fiscal years 2010 through 2014.’’. 
(f) HEALTH RESOURCES AND SERVICES ADMINISTRA-
TION OFFICE OF WOMEN’S HEALTH.—Title VII of the So-
cial Security Act (42 U.S.C. 901 et seq.) is amended by 
adding at the end the following: 
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‘‘SEC. 713. OFFICE OF WOMEN’S HEALTH. 
‘‘(a) ESTABLISHMENT.—The Secretary shall establish 
within the Office of the Administrator of the Health Re-
sources and Services Administration, an office to be known 
as the Office of Women’s Health. The Office shall be headed 
by a director who shall be appointed by the Administrator. 
‘‘(b) PURPOSE.—The Director of the Office shall— 
‘‘(1) report to the Administrator on the current 
Administration level of activity regarding women’s 
health across, where appropriate, age, biological, and 
sociocultural contexts; 
‘‘(2) establish short-range and long-range goals 
and objectives within the Health Resources and Serv-
ices Administration for women’s health and, as rel-
evant and appropriate, coordinate with other appro-
priate offices on activities within the Administration 
that relate to health care provider training, health 
service delivery, research, and demonstration projects, 
for issues of particular concern to women; 
‘‘(3) identify projects in women’s health that 
should be conducted or supported by the bureaus of 
the Administration; 
‘‘(4) consult with health professionals, non-
governmental organizations, consumer organizations, 
women’s health professionals, and other individuals 
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and groups, as appropriate, on Administration policy 
with regard to women; and 
‘‘(5) serve as a member of the Department of 
Health and Human Services Coordinating Committee 
on Women’s Health (established under section 
229(b)(4) of the Public Health Service Act). 
‘‘(c) CONTINUED ADMINISTRATION OF EXISTING PRO-
GRAMS.—The Director of the Office shall assume the author-
ity for the development, implementation, administration, 
and evaluation of any projects carried out through the 
Health Resources and Services Administration relating to 
women’s health on the date of enactment of this section. 
‘‘(d) DEFINITIONS.—For purposes of this section: 
‘‘(1) ADMINISTRATION.—The term ‘Administra-
tion’ means the Health Resources and Services Ad-
ministration. 
‘‘(2) 
ADMINISTRATOR.—The 
term 
‘Adminis-
trator’ means the Administrator of the Health Re-
sources and Services Administration. 
‘‘(3) OFFICE.—The term ‘Office’ means the Office 
of Women’s Health established under this section in 
the Administration. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
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to be appropriated such sums as may be necessary for each 
of the fiscal years 2010 through 2014.’’. 
(g) FOOD AND DRUG ADMINISTRATION OFFICE OF 
WOMEN’S HEALTH.—Chapter X of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 391 et seq.) is amended by 
adding at the end the following: 
‘‘SEC. 1011. OFFICE OF WOMEN’S HEALTH. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Office of the Commissioner, an office to be known as 
the Office of Women’s Health (referred to in this section 
as the ‘Office’). The Office shall be headed by a director who 
shall be appointed by the Commissioner of Food and Drugs. 
‘‘(b) PURPOSE.—The Director of the Office shall— 
‘‘(1) report to the Commissioner of Food and 
Drugs on current Food and Drug Administration (re-
ferred to in this section as the ‘Administration’) levels 
of activity regarding women’s participation in clin-
ical trials and the analysis of data by sex in the test-
ing of drugs, medical devices, and biological products 
across, where appropriate, age, biological, and 
sociocultural contexts; 
‘‘(2) establish short-range and long-range goals 
and objectives within the Administration for issues of 
particular concern to women’s health within the juris-
diction of the Administration, including, where rel-
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evant and appropriate, adequate inclusion of women 
and analysis of data by sex in Administration proto-
cols and policies; 
‘‘(3) provide information to women and health 
care providers on those areas in which differences be-
tween men and women exist; 
‘‘(4) consult with pharmaceutical, biologics, and 
device manufacturers, health professionals with exper-
tise in women’s issues, consumer organizations, and 
women’s health professionals on Administration pol-
icy with regard to women; 
‘‘(5) make annual estimates of funds needed to 
monitor clinical trials and analysis of data by sex in 
accordance with needs that are identified; and 
‘‘(6) serve as a member of the Department of 
Health and Human Services Coordinating Committee 
on Women’s Health (established under section 
229(b)(4) of the Public Health Service Act). 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for each 
of the fiscal years 2010 through 2014.’’. 
(h) NO NEW REGULATORY AUTHORITY.—Nothing in 
this section and the amendments made by this section may 
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be construed as establishing regulatory authority or modi-
fying any existing regulatory authority. 
(i) LIMITATION ON TERMINATION.—Notwithstanding 
any other provision of law, a Federal office of women’s 
health (including the Office of Research on Women’s Health 
of the National Institutes of Health) or Federal appointive 
position with primary responsibility over women’s health 
issues (including the Associate Administrator for Women’s 
Services under the Substance Abuse and Mental Health 
Services Administration) that is in existence on the date 
of enactment of this section shall not be terminated, reorga-
nized, or have any of it’s powers or duties transferred unless 
such termination, reorganization, or transfer is approved 
by Congress through the adoption of a concurrent resolution 
of approval. 
(j) RULE OF CONSTRUCTION.—Nothing in this section 
(or the amendments made by this section) shall be construed 
to limit the authority of the Secretary of Health and 
Human Services with respect to women’s health, or with 
respect to activities carried out through the Department of 
Health and Human Services on the date of enactment of 
this section. 
SEC. 3510. PATIENT NAVIGATOR PROGRAM. 
Section 340A of the Public Health Service Act (42 
U.S.C. 256a) is amended— 
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(1) by striking subsection (d)(3) and inserting 
the following: 
‘‘(3) LIMITATIONS ON GRANT PERIOD.—In car-
rying out this section, the Secretary shall ensure that 
the total period of a grant does not exceed 4 years.’’; 
(2) in subsection (e), by adding at the end the 
following: 
‘‘(3) MINIMUM CORE PROFICIENCIES.—The Sec-
retary shall not award a grant to an entity under 
this section unless such entity provides assurances 
that patient navigators recruited, assigned, trained, 
or employed using grant funds meet minimum core 
proficiencies, as defined by the entity that submits the 
application, that are tailored for the main focus or 
intervention of the navigator involved.’’; and 
(3) in subsection (m)— 
(A) in paragraph (1), by striking ‘‘and 
$3,500,000 for fiscal year 2010.’’ and inserting 
‘‘$3,500,000 for fiscal year 2010, and such sums 
as may be necessary for each of fiscal years 2011 
through 2015.’’; and 
(B) in paragraph (2), by striking ‘‘2010’’ 
and inserting ‘‘2015’’. 
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SEC. 3511. AUTHORIZATION OF APPROPRIATIONS. 
Except where otherwise provided in this subtitle (or 
an amendment made by this subtitle), there is authorized 
to be appropriated such sums as may be necessary to carry 
out this subtitle (and such amendments made by this sub-
title). 
Subtitle G—Protecting and Improv-
ing Guaranteed Medicare Bene-
fits 
SEC. 3601. PROTECTING AND IMPROVING GUARANTEED 
MEDICARE BENEFITS. 
(a) PROTECTING
GUARANTEED
MEDICARE
BENE-
FITS.—Nothing in the provisions of, or amendments made 
by, this Act shall result in a reduction of guaranteed bene-
fits under title XVIII of the Social Security Act. 
(b) ENSURING THAT MEDICARE SAVINGS BENEFIT 
THE
MEDICARE
PROGRAM
AND
MEDICARE
BENE-
FICIARIES.—Savings generated for the Medicare program 
under title XVIII of the Social Security Act under the pro-
visions of, and amendments made by, this Act shall extend 
the solvency of the Medicare trust funds, reduce Medicare 
premiums and other cost-sharing for beneficiaries, and im-
prove or expand guaranteed Medicare benefits and protect 
access to Medicare providers. 
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SEC. 3602. NO CUTS IN GUARANTEED BENEFITS. 
Nothing in this Act shall result in the reduction or 
elimination of any benefits guaranteed by law to partici-
pants in Medicare Advantage plans. 
TITLE 
IV—PREVENTION 
OF 
CHRONIC DISEASE AND IM-
PROVING PUBLIC HEALTH 
Subtitle 
A—Modernizing 
Disease 
Prevention and Public Health 
Systems 
SEC. 4001. NATIONAL PREVENTION, HEALTH PROMOTION 
AND PUBLIC HEALTH COUNCIL. 
(a) ESTABLISHMENT.—The President shall establish, 
within the Department of Health and Human Services, a 
council to be known as the ‘‘National Prevention, Health 
Promotion and Public Health Council’’ (referred to in this 
section as the ‘‘Council’’). 
(b) CHAIRPERSON.—The President shall appoint the 
Surgeon General to serve as the chairperson of the Council. 
(c) COMPOSITION.—The Council shall be composed 
of— 
(1) the Secretary of Health and Human Serv-
ices; 
(2) the Secretary of Agriculture; 
(3) the Secretary of Education; 
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(A) and may be used to meet the requirement under para-
graph (1)(A). 
‘‘(ii) Any health risk assessment that meets the guide-
lines under subparagraph (A) and is approved by the Sec-
retary may be used to meet the requirement under para-
graph (1)(A). 
‘‘(D) The Secretary may coordinate with community- 
based entities (including State Health Insurance Programs, 
Area Agencies on Aging, Aging and Disability Resource 
Centers, and the Administration on Aging) to— 
‘‘(i) ensure that health risk assessments are ac-
cessible to beneficiaries; and 
‘‘(ii) provide appropriate support for the comple-
tion of health risk assessments by beneficiaries. 
‘‘(E) The Secretary shall establish procedures to make 
beneficiaries and providers aware of the requirement that 
a beneficiary complete a health risk assessment prior to or 
at the same time as receiving personalized prevention plan 
services. 
‘‘(F) To the extent practicable, the Secretary shall en-
courage the use of, integration with, and coordination of 
health information technology (including use of technology 
that is compatible with electronic medical records and per-
sonal health records) and may experiment with the use of 
personalized technology to aid in the development of self- 
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