H. R. 3590—558 
demonstration. Such settings include Federally qualified health 
centers, rural health clinics, and other non-hospital settings 
as determined appropriate by the Secretary. 
(3) APPLICABLE SCHOOL OF NURSING.—The term ‘‘applicable 
school of nursing’’ means an accredited school of nursing (as 
defined in section 801 of the Public Health Service Act) which 
has entered into a written agreement (as described in sub-
section (b)) with the eligible hospital participating in the dem-
onstration. 
(4) DEMONSTRATION.—The term ‘‘demonstration’’ means the 
graduate nurse education demonstration established under sub-
section (a). 
(5) ELIGIBLE HOSPITAL.—The term ‘‘eligible hospital’’ means 
a hospital (as defined in subsection (e) of section 1861 of the 
Social Security Act (42 U.S.C. 1395x)) or a critical access hos-
pital (as defined in subsection (mm)(1) of such section) that 
has a written agreement in place with— 
(A) 1 or more applicable schools of nursing; and 
(B) 2 or more applicable non-hospital community-based 
care settings. 
(6) ELIGIBLE
PARTNERS.—The term ‘‘eligible partners’’ 
includes the following: 
(A) An applicable non-hospital community-based care 
setting. 
(B) An applicable school of nursing. 
(7) QUALIFIED TRAINING.— 
(A) IN GENERAL.—The term ‘‘qualified training’’ means 
training— 
(i) that provides an advanced practice registered 
nurse with the clinical skills necessary to provide pri-
mary care, preventive care, transitional care, chronic 
care management, and other services appropriate for 
individuals entitled to, or enrolled for, benefits under 
part A of title XVIII of the Social Security Act, or 
enrolled under part B of such title; and 
(ii) subject to subparagraph (B), at least half of 
which is provided in a non-hospital community-based 
care setting. 
(B) WAIVER OF REQUIREMENT HALF OF TRAINING BE 
PROVIDED IN NON-HOSPITAL COMMUNITY-BASED CARE SET-
TING IN CERTAIN AREAS.—The Secretary may waive the 
requirement under subparagraph (A)(ii) with respect to 
eligible hospitals located in rural or medically underserved 
areas. 
(8) SECRETARY.—The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
Subtitle G—Improving Access to Health 
Care Services 
SEC. 5601. SPENDING FOR FEDERALLY QUALIFIED HEALTH CENTERS 
(FQHCS). 
(a) IN GENERAL.—Section 330(r) of the Public Health Service 
Act (42 U.S.C. 254b(r)) is amended by striking paragraph (1) and 
inserting the following:
H. R. 3590—559 
‘‘(1) GENERAL AMOUNTS FOR GRANTS.—For the purpose of 
carrying out this section, in addition to the amounts authorized 
to be appropriated under subsection (d), there is authorized 
to be appropriated the following: 
‘‘(A) For fiscal year 2010, $2,988,821,592. 
‘‘(B) For fiscal year 2011, $3,862,107,440. 
‘‘(C) For fiscal year 2012, $4,990,553,440. 
‘‘(D) For fiscal year 2013, $6,448,713,307. 
‘‘(E) For fiscal year 2014, $7,332,924,155. 
‘‘(F) For fiscal year 2015, $8,332,924,155. 
‘‘(G) For fiscal year 2016, and each subsequent fiscal 
year, the amount appropriated for the preceding fiscal year 
adjusted by the product of— 
‘‘(i) one plus the average percentage increase in 
costs incurred per patient served; and 
‘‘(ii) one plus the average percentage increase in 
the total number of patients served.’’. 
(b) RULE
OF CONSTRUCTION.—Section 330(r) of the Public 
Health Service Act (42 U.S.C. 254b(r)) is amended by adding at 
the end the following: 
‘‘(4) RULE
OF
CONSTRUCTION
WITH
RESPECT
TO
RURAL 
HEALTH CLINICS.— 
‘‘(A) IN
GENERAL.—Nothing in this section shall be 
construed to prevent a community health center from con-
tracting with a Federally certified rural health clinic (as 
defined in section 1861(aa)(2) of the Social Security Act), 
a low-volume hospital (as defined for purposes of section 
1886 of such Act), a critical access hospital, a sole commu-
nity 
hospital 
(as 
defined 
for 
purposes 
of 
section 
1886(d)(5)(D)(iii) of such Act), or a medicare-dependent 
share hospital (as defined for purposes of section 
1886(d)(5)(G)(iv) of such Act) for the delivery of primary 
health care services that are available at the clinic or 
hospital to individuals who would otherwise be eligible 
for free or reduced cost care if that individual were able 
to obtain that care at the community health center. Such 
services may be limited in scope to those primary health 
care services available in that clinic or hospitals. 
‘‘(B) ASSURANCES.—In order for a clinic or hospital 
to receive funds under this section through a contract with 
a community health center under subparagraph (A), such 
clinic or hospital shall establish policies to ensure— 
‘‘(i) nondiscrimination based on the ability of a 
patient to pay; and 
‘‘(ii) the establishment of a sliding fee scale for 
low-income patients.’’. 
SEC. 5602. NEGOTIATED RULEMAKING FOR DEVELOPMENT OF METH-
ODOLOGY AND CRITERIA FOR DESIGNATING MEDICALLY 
UNDERSERVED POPULATIONS AND HEALTH PROFES-
SIONS SHORTAGE AREAS. 
(a) ESTABLISHMENT.— 
(1) IN
GENERAL.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) shall 
establish, through a negotiated rulemaking process under sub-
chapter 3 of chapter 5 of title 5, United States Code, a com-
prehensive methodology and criteria for designation of—
H. R. 3590—560 
(A) medically underserved populations in accordance 
with section 330(b)(3) of the Public Health Service Act 
(42 U.S.C. 254b(b)(3)); 
(B) health professions shortage areas under section 
332 of the Public Health Service Act (42 U.S.C. 254e). 
(2) FACTORS TO CONSIDER.—In establishing the method-
ology and criteria under paragraph (1), the Secretary— 
(A) shall consult with relevant stakeholders who will 
be significantly affected by a rule (such as national, State 
and regional organizations representing affected entities), 
State health offices, community organizations, health cen-
ters and other affected entities, and other interested par-
ties; and 
(B) shall take into account— 
(i) the timely availability and appropriateness of 
data used to determine a designation to potential 
applicants for such designations; 
(ii) the impact of the methodology and criteria 
on communities of various types and on health centers 
and other safety net providers; 
(iii) the degree of ease or difficulty that will face 
potential applicants for such designations in securing 
the necessary data; and 
(iv) the extent to which the methodology accurately 
measures various barriers that confront individuals 
and population groups in seeking health care services. 
(b) PUBLICATION OF NOTICE.—In carrying out the rulemaking 
process under this subsection, the Secretary shall publish the notice 
provided for under section 564(a) of title 5, United States Code, 
by not later than 45 days after the date of the enactment of 
this Act. 
(c) TARGET DATE FOR PUBLICATION OF RULE.—As part of the 
notice under subsection (b), and for purposes of this subsection, 
the ‘‘target date for publication’’, as referred to in section 564(a)(5) 
of title 5, United Sates Code, shall be July 1, 2010. 
(d) APPOINTMENT OF NEGOTIATED RULEMAKING COMMITTEE AND 
FACILITATOR.—The Secretary shall provide for— 
(1) the appointment of a negotiated rulemaking committee 
under section 565(a) of title 5, United States Code, by not 
later than 30 days after the end of the comment period provided 
for under section 564(c) of such title; and 
(2) the nomination of a facilitator under section 566(c) 
of such title 5 by not later than 10 days after the date of 
appointment of the committee. 
(e) PRELIMINARY COMMITTEE REPORT.—The negotiated rule-
making committee appointed under subsection (d) shall report to 
the Secretary, by not later than April 1, 2010, regarding the commit-
tee’s progress on achieving a consensus with regard to the rule-
making proceeding and whether such consensus is likely to occur 
before one month before the target date for publication of the 
rule. If the committee reports that the committee has failed to 
make significant progress toward such consensus or is unlikely 
to reach such consensus by the target date, the Secretary may 
terminate such process and provide for the publication of a rule 
under this section through such other methods as the Secretary 
may provide.
H. R. 3590—561 
(f) FINAL COMMITTEE REPORT.—If the committee is not termi-
nated under subsection (e), the rulemaking committee shall submit 
a report containing a proposed rule by not later than one month 
before the target publication date. 
(g) INTERIM FINAL EFFECT.—The Secretary shall publish a rule 
under this section in the Federal Register by not later than the 
target publication date. Such rule shall be effective and final imme-
diately on an interim basis, but is subject to change and revision 
after public notice and opportunity for a period (of not less than 
90 days) for public comment. In connection with such rule, the 
Secretary shall specify the process for the timely review and 
approval of applications for such designations pursuant to such 
rules and consistent with this section. 
(h) PUBLICATION OF RULE AFTER PUBLIC COMMENT.—The Sec-
retary shall provide for consideration of such comments and 
republication of such rule by not later than 1 year after the target 
publication date. 
SEC. 5603. REAUTHORIZATION OF THE WAKEFIELD EMERGENCY MED-
ICAL SERVICES FOR CHILDREN PROGRAM. 
Section 1910 of the Public Health Service Act (42 U.S.C. 300w– 
9) is amended— 
(1) in subsection (a), by striking ‘‘3-year period (with an 
optional 4th year’’ and inserting ‘‘4-year period (with an optional 
5th year’’; and 
(2) in subsection (d)— 
(A) by striking ‘‘and such sums’’ and inserting ‘‘such 
sums’’; and 
(B) by inserting before the period the following: ‘‘, 
$25,000,000 for fiscal year 2010, $26,250,000 for fiscal year 
2011, $27,562,500 for fiscal year 2012, $28,940,625 for fiscal 
year 2013, and $30,387,656 for fiscal year 2014’’. 
SEC. 5604. CO-LOCATING PRIMARY AND SPECIALTY CARE IN COMMU-
NITY-BASED MENTAL HEALTH SETTINGS. 
Subpart 3 of part B of title V of the Public Health Service 
Act (42 U.S.C. 290bb–31 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 520K. AWARDS FOR CO-LOCATING PRIMARY AND SPECIALTY 
CARE IN COMMUNITY-BASED MENTAL HEALTH SET-
TINGS. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible entity’ means a 
qualified community mental health program defined under sec-
tion 1913(b)(1). 
‘‘(2) SPECIAL POPULATIONS.—The term ‘special populations’ 
means adults with mental illnesses who have co-occurring pri-
mary care conditions and chronic diseases. 
‘‘(b) PROGRAM AUTHORIZED.—The Secretary, acting through the 
Administrator shall award grants and cooperative agreements to 
eligible entities to establish demonstration projects for the provision 
of coordinated and integrated services to special populations 
through the co-location of primary and specialty care services in 
community-based mental and behavioral health settings. 
‘‘(c) APPLICATION.—To be eligible to receive a grant or coopera-
tive agreement under this section, an eligible entity shall submit 
an application to the Administrator at such time, in such manner,