‘‘(ii) evidence concerning the relation-
ship between consumption of certain nutri-
ents, ingredients, and foods to both pre-
venting and promoting the development of 
overweight, obesity, and other chronic ill-
nesses; 
‘‘(iii) recommendations made by au-
thoritative scientific organizations con-
cerning appropriate nutritional standards 
for foods sold outside of the reimbursable 
meal programs in schools; and 
‘‘(iv) special exemptions for school- 
sponsored fundraisers (other than fund-
raising through vending machines, school 
stores, snack bars, a la carte sales, and 
any other exclusions determined by the 
Secretary), if the fundraisers are approved 
by the school and are infrequent within the 
school. 
‘‘(2) IMPLEMENTATION.— 
‘‘(A) EFFECTIVE DATE.— 
‘‘(i) IN
GENERAL.—Except as pro-
vided in clause (ii), the proposed regula-
tions shall take effect at the beginning of 
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the school year following the date on which 
the regulations are finalized. 
‘‘(ii) EXCEPTION.—If the regulations 
are finalized on a date that is not more 
than 60 days before the beginning of the 
school year, the proposed regulations shall 
take effect at the beginning of the fol-
lowing school year. 
‘‘(B) FAILURE TO PROMULGATE.—If, on 
the date that is 1 year after the date of enact-
ment of this paragraph, the Secretary has not 
promulgated final regulations, the proposed reg-
ulations shall be considered to be final regula-
tions.’’. 
SEC. 103. SCHOOL NUTRITION ENVIRONMENT ENHANCE-
MENT GRANTS. 
Section 18 of the Richard B. Russell National School 
Lunch Act (42 U.S.C. 1769) is amended by adding at the 
end the following: 
‘‘(l) HEALTHY SCHOOL NUTRITION ENVIRONMENT 
INCENTIVE GRANTS.— 
‘‘(1) IN GENERAL.—Following the publication 
of the recommendations of the Institute of Medicine 
study carried out using funds made available for 
public health improvement and leadership under the 
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heading ‘Centers for Disease Control and Preven-
tion’ in the Department of Labor Appropriations 
Act, 2005 (title I of division F of Public Law 108– 
447; 118 Stat. 3124) regarding appropriate nutri-
tional standards for the availability, sale, content, 
and consumption of food at school, with particular 
attention given to foods offered in competition with 
federally reimbursed meals and snacks, the Sec-
retary may carry out a grant program to— 
‘‘(A) provide schools with technical assist-
ance in implementing the recommendations of 
the Institute of Medicine regarding appropriate 
school nutrition standards; and 
‘‘(B) assess the impact of implementing 
the recommendations on the health and well- 
being of children enrolled in the schools. 
‘‘(2) SELECTION
OF
SCHOOLS.—In selecting 
schools to receive incentive grants under this sub-
section, the Secretary shall— 
‘‘(A) ensure that not less than 75 percent 
of schools selected to participate in the program 
established under this subsection are schools in 
which not less than 50 percent of the students 
enrolled in each school are eligible for free or 
reduced price meals under this Act; 
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‘‘(B) ensure that, of the schools selected to 
participate in the program, there is appropriate 
representation of rural, urban, and suburban 
schools, as determined by the Secretary; 
‘‘(C) ensure that, of the schools selected to 
participate in the program, there is appropriate 
representation of elementary, middle, and sec-
ondary schools, as determined by the Secretary; 
‘‘(D) ensure that schools selected to receive 
a grant under this subsection meet the require-
ments of paragraph (3); 
‘‘(E) give priority to schools that develop 
comprehensive plans that include the involve-
ment of a broad range of community stake-
holders in achieving healthy school nutrition en-
vironments; and 
‘‘(F) give priority to schools that develop 
comprehensive plans that include a strategy for 
maintaining healthy school nutrition environ-
ments in the years following the fiscal years for 
which the schools receive grants under this sub-
section. 
‘‘(3) REQUIREMENTS.— 
‘‘(A) CRITERIA FOR HEALTHY SCHOOL EN-
VIRONMENTS.—The Secretary shall establish 
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criteria, based upon the recommendations of the 
Institute of Medicine described in paragraph 
(1), under which schools may receive grants 
under this section. 
‘‘(B) PLAN.—To be eligible to receive a 
grant under this subsection, a school shall— 
‘‘(i) submit to the Secretary a healthy 
school nutrition environment plan that de-
scribes the actions the school will take to 
meet the criteria established under sub-
paragraph (A); and 
‘‘(ii) take the actions described in the 
plan. 
‘‘(4) GRANTS.—For each of fiscal years 2007 
through 2011, the Secretary shall make a grant to 
each school selected under paragraph (2). 
‘‘(5) EVALUATIONS.— 
‘‘(A) IN GENERAL.—The Secretary, acting 
through the Administrator of the Food and Nu-
trition Service, shall conduct an evaluation of a 
representative sample of schools that receive 
grants under this subsection. 
‘‘(B) CONTENT.—The evaluation shall 
measure, at a minimum, the effects of a healthy 
school nutrition environment on— 
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‘‘(i) overweight children and obesity; 
‘‘(ii) dietary intake; 
‘‘(iii) nutrition education and behav-
ior; 
‘‘(iv) parental and student attitudes 
and participation; and 
‘‘(v) related funding issues, including 
the cost of maintaining a healthy school 
nutrition environment. 
‘‘(C) REPORTS.—The Secretary shall sub-
mit to the Committee on Education and the 
Workforce of the House of Representatives and 
the Committee on Agriculture, Nutrition, and 
Forestry of the Senate— 
‘‘(i) an interim report on the activities 
of schools evaluated under this subsection; 
and 
‘‘(ii) a final report on the activities of 
schools evaluated under this subsection. 
‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(A) IN GENERAL.—There are authorized 
to be appropriated such sums as are necessary 
to carry out this subsection for fiscal year 2007 
and each subsequent fiscal year, to remain 
available until expended. 
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‘‘(B) EVALUATIONS.—The Secretary may 
use not more than 10 percent of the total funds 
made available for a fiscal year under subpara-
graph (A) to carry out paragraph (5).’’. 
TITLE II—HEALTHIER COMMU-
NITIES AND WORKPLACES 
Subtitle A—Incentives for a 
Healthy Workforce 
SEC. 201. SHORT TITLE. 
This subtitle may be cited as the ‘‘Healthy Workforce 
Act of 2006’’. 
SEC. 202. TAX CREDIT TO EMPLOYERS FOR COSTS OF IM-
PLEMENTING WELLNESS PROGRAMS. 
(a) IN GENERAL.—Subpart D of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 (relating to business related credits) is amended by 
adding at the end the following: 
‘‘SEC. 45N. WELLNESS PROGRAM CREDIT. 
‘‘(a) ALLOWANCE OF CREDIT.— 
‘‘(1) IN GENERAL.—For purposes of section 38, 
the wellness program credit determined under this 
section for any taxable year is— 
‘‘(A) in the case of a small business em-
ployer, an amount equal to 50 percent of the 
costs paid or incurred by the small business em-
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ployer in connection with a qualified small busi-
ness wellness program during the taxable year, 
and 
‘‘(B) in the case of any other employer, an 
amount equal to 50 percent of the costs paid or 
incurred by the employer in connection with a 
qualified wellness program during the taxable 
year. 
‘‘(2) LIMITATION.—The amount of credit al-
lowed under paragraph (1) for any taxable year shall 
not exceed the product of $200 and the number of 
employees of the employer or small business em-
ployer, as the case may be. 
‘‘(b) QUALIFIED WELLNESS PROGRAM; QUALIFIED 
SMALL BUSINESS WELLNESS PROGRAM.—For purposes 
of this section— 
‘‘(1) QUALIFIED
WELLNESS
PROGRAM.—The 
term ‘qualified wellness program’ means a program 
which consists of all of the wellness program compo-
nents described in subsection (c) and which is cer-
tified by the Secretary of Health and Human Serv-
ices, in consultation with persons who have expertise 
in employer health promotion and wellness pro-
grams, as a qualified wellness program under this 
section. 
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‘‘(2) QUALIFIED SMALL BUSINESS WELLNESS 
PROGRAM.—The term ‘qualified small business 
wellness program’ means a program which consists 
of any 2 of the components described in subsection 
(c) and which is certified by the Secretary of Health 
and Human Services, in consultation with persons 
who have expertise in employer health promotion 
and wellness programs, as a qualified small business 
wellness program under this section. 
‘‘(c) WELLNESS PROGRAM COMPONENTS.—For pur-
poses of this section, the wellness program components de-
scribed in this subsection are the following: 
‘‘(1) HEALTH
AWARENESS
COMPONENT.—A 
health awareness component which provides for the 
following: 
‘‘(A) HEALTH EDUCATION.—The dissemi-
nation of health information which addresses 
the specific needs and health risks of employees. 
‘‘(B) HEALTH SCREENINGS.—The oppor-
tunity for periodic screenings for health prob-
lems and referrals for appropriate follow up 
measures. 
‘‘(2) BEHAVIORAL
CHANGE
COMPONENT.—A 
behavioral change component which provides for al-
tering employee lifestyles to encourage healthy living 
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through counseling, seminars, on-line programs, or 
self-help materials. Such component shall include 
programs relating to— 
‘‘(A) smoking, 
‘‘(B) obesity, 
‘‘(C) stress management, 
‘‘(D) physical fitness, 
‘‘(E) nutrition, 
‘‘(F) substance abuse, 
‘‘(G) depression, 
‘‘(H) mental health promotion (including 
anxiety), and 
‘‘(I) sleep (including sleep disorders and 
the consequences of sleep deprivation). 
‘‘(3) 
SUPPORTIVE
ENVIRONMENT
COMPO-
NENT.—A supportive environment component which 
includes the following: 
‘‘(A) ON-SITE
POLICIES.—Policies and 
services at the worksite which promote a 
healthy lifestyle, including policies relating to— 
‘‘(i) smoking at the worksite, 
‘‘(ii) the nutrition of food available at 
the worksite through cafeterias and vend-
ing options, 
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‘‘(iii) minimizing stress in the work-
place, 
‘‘(iv) where applicable, accessible and 
attractive stairs, 
‘‘(v) the encouragement of physical 
activity during work hours, and 
‘‘(vi) the promotion of fatigue coun-
termeasures. 
‘‘(B) PARTICIPATION INCENTIVES.— 
‘‘(i) IN GENERAL.—Qualified incentive 
benefits for each employee who participates 
in the health screenings described in para-
graph (1)(B) or the behavioral change pro-
grams described in paragraph (2). 
‘‘(ii) QUALIFIED
INCENTIVE
BEN-
EFIT.—For purposes of clause (i), the 
term ‘qualified incentive benefit’ means 
any benefit which is approved by the Sec-
retary of Health and Human Services. 
Such benefit may include an adjustment in 
health insurance premiums or co-pays. 
‘‘(C) EMPLOYEE INPUT.—The opportunity 
for employees to participate in the management 
of any qualified wellness program or qualified 
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small business wellness program to which this 
section applies. 
‘‘(d) PARTICIPATION REQUIREMENT.— 
‘‘(1) IN GENERAL.—No credit shall be allowed 
under subsection (a) unless the Secretary of Health 
and Human Services certifies, as a part of any cer-
tification described in subsection (b), that each 
wellness program component of the qualified 
wellness program or qualified small business 
wellness program applies to all qualified employees 
of the employer. 
‘‘(2) QUALIFIED EMPLOYEE.—For purposes of 
paragraph (1), the term ‘qualified employee’ means 
an employee who works an average of not less than 
25 hours per week during the taxable year. 
‘‘(e) OTHER DEFINITIONS AND SPECIAL RULES.— 
For purposes of this section— 
‘‘(1) EMPLOYEE AND EMPLOYER.— 
‘‘(A) PARTNERS
AND
PARTNERSHIPS.— 
The term ‘employee’ includes a partner and the 
term ‘employer’ includes a partnership. 
‘‘(B) CERTAIN RULES TO APPLY.—Rules 
similar to the rules of section 52 shall apply. 
‘‘(2) SMALL BUSINESS EMPLOYER.— 
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‘‘(A) IN GENERAL.—The term ‘small busi-
ness employer’ means, with respect to any tax-
able year, an employer who employed an aver-
age of 200 or fewer employees on business days 
during such taxable year. 
‘‘(B) CONTROLLED
GROUPS.—For pur-
poses of subparagraph (A), all persons treated 
as a single employer under subsection (b), (c), 
(m), or (o) of section 414 shall be treated as a 
single employer. 
‘‘(3) CERTAIN
COSTS
NOT
INCLUDED.—Costs 
paid or incurred by an employer or small business 
employer for food or health insurance shall not be 
taken into account under subsection (a). 
‘‘(f) PORTION OF CREDIT MADE REFUNDABLE.— 
‘‘(1) IN GENERAL.—In the case of an eligible 
employer of an employee, the aggregate credits al-
lowed to a taxpayer under subpart C shall be in-
creased by the lesser of— 
‘‘(A) the credit which would be allowed 
under this section without regard to this sub-
section and the limitation under section 38(c), 
or 
‘‘(B) the amount by which the aggregate 
amount of credits allowed by this subpart (de-
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termined without regard to this subsection) 
would increase if the limitation imposed by sec-
tion 38(c) for any taxable year were increased 
by the amount of employer payroll taxes im-
posed on the taxpayer during the calendar year 
in which the taxable year begins. 
The amount of the credit allowed under this sub-
section shall not be treated as a credit allowed under 
this subpart and shall reduce the amount of the 
credit otherwise allowable under subsection (a) with-
out regard to section 38(c). 
‘‘(2) ELIGIBLE
EMPLOYER.—For purposes of 
this subsection, the term ‘eligible employer’ means 
an employer or small business employer which is— 
‘‘(A) a State or political subdivision there-
of, the District of Columbia, a possession of the 
United States, or an agency or instrumentality 
of any of the foregoing, or 
‘‘(B) any organization described in section 
501(c) of the Internal Revenue Code of 1986 
which is exempt from taxation under section 
501(a) of such Code. 
‘‘(3) EMPLOYER
PAYROLL
TAXES.—For pur-
poses of this subsection— 
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‘‘(A) IN
GENERAL.—The term ‘employer 
payroll taxes’ means the taxes imposed by— 
‘‘(i) section 3111(b), and 
‘‘(ii) sections 3211(a) and 3221(a) 
(determined at a rate equal to the rate 
under section 3111(b)). 
‘‘(B) SPECIAL
RULE.—A rule similar to 
the rule of section 24(d)(2)(C) shall apply for 
purposes of subparagraph (A). 
‘‘(g) TERMINATION.—This section shall not apply to 
any amount paid or incurred after December 31, 2016.’’. 
(b) TREATMENT AS GENERAL BUSINESS CREDIT.— 
Subsection (b) of section 38 of the Internal Revenue Code 
of 1986 (relating to general business credit) is amended 
by striking ‘‘and’’ at the end of paragraph (29), by strik-
ing the period at the end of paragraph (30) and inserting 
‘‘, and’’, and by adding at the end the following: 
‘‘(31) the wellness program credit determined 
under section 45N.’’. 
(c) DENIAL OF DOUBLE BENEFIT.—Section 280C of 
the Internal Revenue Code of 1986 (relating to certain 
expenses for which credits are allowable) is amended by 
adding at the end the following new subsection: 
‘‘(e) WELLNESS PROGRAM CREDIT.— 
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‘‘(1) IN GENERAL.—No deduction shall be al-
lowed for that portion of the costs paid or incurred 
for a qualified wellness program (within the meaning 
of section 45N) or a qualified small business 
wellness program (within the meaning of such sec-
tion) allowable as a deduction for the taxable year 
which is equal to the amount of the credit allowable 
for the taxable year under section 45N. 
‘‘(2) SIMILAR
RULE
WHERE
TAXPAYER
CAP-
ITALIZES RATHER THAN DEDUCTS EXPENSES.—If— 
‘‘(A) the amount of the credit determined 
for the taxable year under section 45N, exceeds 
‘‘(B) the amount allowable as a deduction 
for such taxable year for a qualified wellness 
program or a qualified small business wellness 
program, the amount chargeable to capital ac-
count for the taxable year for such expenses 
shall be reduced by the amount of such excess. 
‘‘(3) CONTROLLED GROUPS.—In the case of a 
corporation which is a member of a controlled group 
of corporations (within the meaning of section 
41(f)(5)) or a trade or business which is treated as 
being under common control with other trades or 
business 
(within 
the 
meaning 
of 
section 
41(f)(1)(B)), this subsection shall be applied under 
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rules prescribed by the Secretary similar to the rules 
applicable under subparagraphs (A) and (B) of sec-
tion 41(f)(1).’’. 
(d) CLERICAL AMENDMENT.—The table of sections 
for subpart D of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 is amended by add-
ing at the end the following: 
‘‘Sec. 45N. Wellness program credit.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2006. 
(f) OUTREACH.— 
(1) IN GENERAL.—The Secretary of the Treas-
ury, in conjunction with the Director of the Centers 
for Disease Control and members of the business 
community, shall institute an outreach program to 
inform businesses about the availability of the 
wellness program credit under section 45N of the 
Internal Revenue Code of 1986. 
(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated such sums 
as are necessary to carry out the outreach program 
described in paragraph (1). 
(g) RESTORATION OF HIGHEST INCOME TAX RATE 
TO PRE-2001 LEVEL.—Section 1(i)(2) of the Internal 
Revenue Code of 1986 (relating to reductions in rates 
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after June 30, 2001) is amended by adding at the end 
the following new flush sentence: 
‘‘In the case of taxable years beginning after 2006, 
the last item in the fourth column in the preceding 
table shall be applied by substituting ‘39.6%’ for 
‘35.0%’ ’’. 
(h) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2006. 
SEC. 203. INCOME EXCLUSION FOR EMPLOYER-PROVIDED 
OFF-PREMISES HEALTH CLUB SERVICES. 
(a) TREATMENT
AS FRINGE BENEFIT.—Subpara-
graph (A) of section 132(j)(4) of the Internal Revenue 
Code of 1986 (relating to on-premises gyms and other ath-
letic facilities) is amended to read as follows: 
‘‘(A) IN
GENERAL.—Gross income shall 
not include— 
‘‘(i) the value of any on-premises ath-
letic facility provided by an employer to its 
employees, and 
‘‘(ii) fees or membership expenses 
paid by an employer to an athletic or fit-
ness facility described in subparagraph (C) 
on behalf of its employees, but only to the 
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extent that such fees or expenses do not 
exceed $900. 
The preceding sentence shall apply with respect 
to any highly compensated employee only if ac-
cess to the facility is available on substantially 
the same terms to each member of a group of 
employees which is defined under a reasonable 
classification set up by the employer which does 
not discriminate in favor of highly compensated 
employees.’’. 
(b) ATHLETIC FACILITIES DESCRIBED.—Paragraph 
(4) of section 132(j) of such Code is amended by adding 
at the end the following new subparagraph: 
‘‘(C) CERTAIN ATHLETIC OR FITNESS FA-
CILITIES
DESCRIBED.—For purposes of sub-
paragraph (A)(ii), an athletic or fitness facility 
described in this subparagraph is a facility— 
‘‘(i) providing instruction in a pro-
gram of physical exercise or offering facili-
ties for the preservation, maintenance, en-
couragement, or development of physical 
fitness, 
‘‘(ii) which is not a private club owned 
and operated by its members, 
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‘‘(iii) which does not offer golf, hunt-
ing, sailing, or riding facilities, 
‘‘(iv) whose health or fitness facility is 
not incidental to its overall function and 
purpose, and 
‘‘(v) which is fully compliant with the 
State of jurisdiction and Federal anti-dis-
criminations laws.’’. 
(c) EMPLOYER DEDUCTION FOR DUES TO CERTAIN 
ATHLETIC FACILITIES.— 
(1) IN
GENERAL.—Paragraph (3) of section 
274(a) of such Code (relating to denial of deduction 
for club dues) is amended— 
(A) by striking ‘‘Notwithstanding’’ and in-
serting the following: 
‘‘(A) 
IN
GENERAL.—Notwithstanding’’, 
and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(B) EXCEPTION FOR ATHLETIC FACILI-
TIES.—This paragraph shall not apply to fees 
or dues paid to athletic or fitness facilities 
(within the meaning of section 132(j)(4)(C)) to 
the extent that such fees or dues do not exceed 
$900 for any membership.’’. 
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(2) 
CONFORMING
AMENDMENT.—Section 
274(e)(4) of such Code is amended by striking ‘‘sub-
section 
(a)(3)’’ 
and 
by 
inserting 
‘‘subsection 
(a)(3)(A)’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 204. CDC AND EMPLOYER-BASED WELLNESS PRO-
GRAMS. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by adding at the end the fol-
lowing: 
‘‘PART R—CDC AND EMPLOYER-BASED 
WELLNESS PROGRAMS 
‘‘SEC. 399Z–1. EMPLOYER-BASED WELLNESS BEST PRAC-
TICES. 
‘‘(a) IN GENERAL.—The Director of the Centers for 
Disease Control and Prevention shall conduct a study that 
analyzes employer-based wellness programs and deter-
mines— 
‘‘(1) best practices of such programs that im-
pact and sustain behavior change in employees; 
‘‘(2) the impact that such programs have on re-
ducing health risk prevalence and improving absen-
teeism of employees; and 
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‘‘(3) the return to employers on the investment 
made by such employers in such programs. 
‘‘(b) REPORT.—After completing the study under 
subsection (a), the Director of the Centers for Disease 
Control and Prevention shall submit to Congress not later 
than 1 year after the date of enactment of this part— 
‘‘(1) a report that includes recommendations of 
effective employer-based wellness programs; and 
‘‘(2) an Employer Wellness Model that is sup-
ported by the Centers for Disease Control and Pre-
vention. 
‘‘SEC. 399Z–2. WORKPLACE WELLNESS EDUCATION CAM-
PAIGN FOR EMPLOYERS. 
‘‘The Director of the Centers for Disease Control and 
Prevention, in coordination with relevant worksite health 
promotion organizations, shall conduct an educational 
campaign to make employers, employer groups, and other 
interested parties aware of the benefits of employer-based 
wellness programs. Such campaign shall include informa-
tion about the Employer Wellness Model described in sec-
tion 399Z–1(b)(2) and information on developing, imple-
menting, and maintaining a program based on such model. 
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‘‘SEC. 
399Z–3. 
EVALUATION 
OF 
EMPLOYER-BASED 
WELLNESS PROGRAMS. 
‘‘The Director of the Centers for Disease Control and 
Prevention shall enter into contracts with entities to— 
‘‘(1) provide employers with technical assistance 
in 
evaluating 
such 
employers’ 
employer-based 
wellness programs; and 
‘‘(2) train employers on how to evaluate such 
employers’ employer-based wellness programs. 
‘‘SEC. 399Z–4. REQUIREMENTS BASED ON APPROPRIATED 
FUNDS. 
‘‘The Director of the Centers for Disease Control and 
Prevention shall be required to carry out the activities in 
sections 399Z–1, 399Z–2, and 399Z–3 only if funds are 
appropriated to carry out such sections.’’. 
Subtitle B—Healthy Communities 
SEC. 211. HEALTHY COMMUNITY GRANTS. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 399P. HEALTHY COMMUNITY GRANTS. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Director of the Centers for Disease Control 
and Prevention and in coordination with the Directors of 
other appropriate Federal agencies, shall award competi-
tive grants to eligible entities for the purpose of planning 
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and implementing programs that seek to promote indi-
vidual and community health and to prevent the incidence 
of chronic disease. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) IN GENERAL.—To be eligible to receive a 
grant under this section an entity shall— 
‘‘(A) be— 
‘‘(i) a city, county, or Indian tribe; 
‘‘(ii) a local or tribal educational 
agency; 
‘‘(iii) an accredited university, college, 
or community college; 
‘‘(iv) a federally qualified health cen-
ter; 
‘‘(v) a local health department; 
‘‘(vi) a health care provider; 
‘‘(vii) a community-based organiza-
tion; or 
‘‘(viii) any other entity determined ap-
propriate by the Secretary, including a 
consortia or partnership of entities de-
scribed in any of clauses (i) through (vii); 
‘‘(B) prepare and submit an application in 
accordance with paragraph (2); and 
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‘‘(C) provide assurances that the entity will 
contribute the non-Federal share as required 
under paragraph (3) to the cost of the activities 
carried out under the grant. 
‘‘(2) APPLICATION.— 
‘‘(A) IN GENERAL.—An entity desiring a 
grant under this section shall submit an appli-
cation to the Secretary at such time, in such 
manner, and containing such information as the 
Secretary may require, including a plan that 
meets the requirements of subparagraph (B). 
‘‘(B) PLAN.—A plan meets the require-
ments of this subparagraph if such plan, at a 
minimum, includes information regarding— 
‘‘(i)(I) programs or community-based 
activities that the applicant proposes to 
carry out with funds received under this 
section and which seek to prevent and re-
duce the incidence of— 
‘‘(aa) overweight and obesity, or 
chronic diseases associated with over-
weight and obesity; 
‘‘(bb) tobacco use; or 
‘‘(cc) mental illness; or 
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‘‘(II) other such activities, as deter-
mined appropriate by the Secretary, that 
are consistent with the goals of promoting 
individual and community health and pre-
venting chronic disease; and 
‘‘(ii) the manner in which the appli-
cant will evaluate the effectiveness of the 
program or activities carried out under this 
section. 
‘‘(3) NON-FEDERAL SHARE.—To be eligible to 
receive a grant under this section, an entity shall 
provide a non-Federal contribution, in cash or in 
kind, to the costs of activities under the grant in an 
amount that is equal to not less than 25 percent of 
the costs of such activities. 
‘‘(c) USE OF FUNDS.—An entity that receives a grant 
under this section shall use the amount made available 
under the grant to carry out community-based activities, 
including— 
‘‘(1) activities that seek to promote individual 
health and community wellness and to prevent and 
reduce the incidence of health problems and chronic 
diseases associated with— 
‘‘(A) being overweight or obese; 
‘‘(B) tobacco use; or 
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‘‘(C) mental illness; or 
‘‘(2) other activities undertaken with the goals 
of health promotion and chronic disease prevention, 
as determined appropriate by the Secretary. 
‘‘(d) PRIORITY.—In awarding grants under sub-
section (a), the Secretary shall give priority to— 
‘‘(1) entities that demonstrate that they have 
previously applied successfully for funds to carry out 
activities that seek to promote individual and com-
munity health and to prevent the incidence of chron-
ic disease and that can cite published and peer-re-
viewed research demonstrating that the activities 
that the entity proposes to carry out under this sub-
section are effective; 
‘‘(2) entities that will carry out programs or ac-
tivities that seek to accomplish a goal or goals set 
by the State in the Healthy People 2010 plan of the 
State; 
‘‘(3) entities that provide non-Federal contribu-
tions, either in cash or in kind, to the costs of fund-
ing activities under the grant; 
‘‘(4) entities that develop comprehensive plans 
that include a strategy for extending program activi-
ties developed under this section in the years fol-
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lowing the fiscal years for which they receive grants 
under this section; 
‘‘(5) entities located in communities that are 
medically underserved, as determined by the Sec-
retary; 
‘‘(6) entities located in areas where the average 
poverty rate is 150 or higher than the average pov-
erty rate in the State involved, as determined by the 
Secretary; and 
‘‘(7) entities that submit plans that exhibit 
multisectoral, cooperative conduct that includes the 
involvement of a broad range of stakeholders, includ-
ing— 
‘‘(A) community-based organizations; 
‘‘(B) local governments; 
‘‘(C) local educational agencies; 
‘‘(D) the private sector; 
‘‘(E) State or local departments of health; 
‘‘(F) accredited colleges, universities, and 
community colleges; 
‘‘(G) health care providers; 
‘‘(H) State and local departments of trans-
portation and city planning; and 
‘‘(I) other entities determined appropriate 
by the Secretary. 
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‘‘(e) TECHNICAL ASSISTANCE.—From amounts ap-
propriated to carry out this section, the Secretary may re-
serve not more than 10 percent for each fiscal year to pro-
vide entities receiving grants under this section with tech-
nical assistance in the implementation of the plans re-
quired under subsection (b)(2)(B). 
‘‘(f) EVALUATION.—From amounts appropriated to 
carry out this section, the Secretary may reserve not to 
exceed 5 percent for each fiscal year for the purpose of 
carrying out evaluations of the activities carried out under 
this section. Not later than 90 days after the completion 
of any such evaluation, the results of such evaluation shall 
be submitted to the relevant authorizing committees of 
Congress and to the Committee on Appropriations of the 
Senate and the Committee on Appropriations of the House 
of Representatives. 
‘‘(g) LIMITATION ON ADMINISTRATIVE COSTS.—An 
entity may not use more than 10 percent of amounts re-
ceived under a grant under this section for administrative 
expenses. 
‘‘(h) SUPPLEMENT NOT SUPPLANT.—Amounts pro-
vided under a grant under this section shall be used to 
supplement, and not supplant, other amounts provided for 
activities of the type to be carried out under this section. 
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‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary to carry out this section.’’. 
SEC. 212. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
Part C of title VII of the Public Health Service Act 
is amended by inserting after section 747 (42 U.S.C. 
293k) the following: 
‘‘SEC. 747A. PREVENTIVE MEDICINE AND PUBLIC HEALTH 
TRAINING GRANT PROGRAM. 
‘‘(a) GRANTS.—The Secretary may award grants to, 
or enter into contracts with, eligible entities to provide 
training to graduate medical residents in preventive medi-
cine and public health. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
or contract under subsection (a), an entity shall— 
‘‘(1) be a school of public health, public health 
department, school of medicine or osteopathic medi-
cine, public or private hospital, or public or private 
non-profit entity; and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
‘‘(c) PREFERENCE AND SPECIAL CONSIDERATION.— 
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‘‘(1) PREFERENCE.—In awarding grants or 
contracts under this section, the Secretary shall give 
preference to one or more eligible entities that have 
a record of training providers who practice preven-
tive medicine or public health as compared to other 
eligible entities. 
‘‘(2) SPECIAL
CONSIDERATION.—In awarding 
grants or contracts under this section, the Secretary 
shall give special consideration to eligible entities 
that will carry out projects under the grant or con-
tract that train physicians in community-based ap-
proaches to combating the incidence rates of obesity, 
diabetes, heart disease, cancer, and other chronic 
diseases, and institutions that have a record of 
training qualified individuals from disadvantaged 
backgrounds. 
‘‘(d) USE OF FUNDS.—Amounts received under a 
grant or contract under this section shall be used to— 
‘‘(1) plan, develop, and operate residency pro-
grams for preventive medicine or public health; 
‘‘(2) provide financial assistance, including tui-
tion and stipends, to resident physicians (MD or 
DO) who plan to specialize in preventive medicine or 
public health; 
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‘‘(3) defray the costs associated with the plan-
ning, development, and operation of preventive medi-
cine or public health programs, including the devel-
opment of curriculum to be used in such program; 
and 
‘‘(4) provide for the improvement of academic 
administrative units. 
‘‘(e) DURATION OF AWARD.—A grant or contract 
under this section shall be for a term not to exceed 5 
years. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$43,000,000 for fiscal year 2007, and such sums as may 
be necessary for each succeeding fiscal year.’’. 
Subtitle C—Family Smoking 
Prevention and Control 
SEC. 221. SHORT TITLE. 
This subtitle may be cited as the ‘‘Family Smoking 
Prevention and Tobacco Control Act’’. 
SEC. 222. FINDINGS. 
The Congress finds the following: 
(1) The use of tobacco products by the Nation’s 
children is a pediatric disease of considerable pro-
portions that results in new generations of tobacco- 
dependent children and adults. 
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(2) A consensus exists within the scientific and 
medical communities that tobacco products are in-
herently dangerous and cause cancer, heart disease, 
and other serious adverse health effects. 
(3) Nicotine is an addictive drug. 
(4) Virtually all new users of tobacco products 
are under the minimum legal age to purchase such 
products. 
(5) Tobacco advertising and marketing con-
tribute significantly to the use of nicotine-containing 
tobacco products by adolescents. 
(6) Because past efforts to restrict advertising 
and marketing of tobacco products have failed ade-
quately to curb tobacco use by adolescents, com-
prehensive restrictions on the sale, promotion, and 
distribution of such products are needed. 
(7) Federal and State governments have lacked 
the legal and regulatory authority and resources 
they need to address comprehensively the public 
health and societal problems caused by the use of to-
bacco products. 
(8) Federal and State public health officials, 
the public health community, and the public at large 
recognize that the tobacco industry should be subject 
to ongoing oversight. 
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(9) Under article I, section 8 of the Constitu-
tion, the Congress is vested with the responsibility 
for regulating interstate commerce and commerce 
with Indian tribes. 
(10) The sale, distribution, marketing, adver-
tising, and use of tobacco products are activities in 
and substantially affecting interstate commerce be-
cause they are sold, marketed, advertised, and dis-
tributed in interstate commerce on a nationwide 
basis, and have a substantial effect on the Nation’s 
economy. 
(11) The sale, distribution, marketing, adver-
tising, and use of such products substantially affect 
interstate commerce through the health care and 
other costs attributable to the use of tobacco prod-
ucts. 
(12) It is in the public interest for Congress to 
enact legislation that provides the Food and Drug 
Administration with the authority to regulate to-
bacco products and the advertising and promotion of 
such products. The benefits to the American people 
from enacting such legislation would be significant 
in human and economic terms. 
(13) Tobacco use is the foremost preventable 
cause of premature death in America. It causes over 
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400,000 deaths in the United States each year and 
approximately 8,600,000 Americans have chronic ill-
nesses related to smoking. 
(14) Reducing the use of tobacco by minors by 
50 percent would prevent well over 10,000,000 of to-
day’s children from becoming regular, daily smokers, 
saving over 3,000,000 of them from premature 
death due to tobacco induced disease. Such a reduc-
tion in youth smoking would also result in approxi-
mately $75,000,000,000 in savings attributable to 
reduced health care costs. 
(15) Advertising, marketing, and promotion of 
tobacco products have been especially directed to at-
tract young persons to use tobacco products and 
these efforts have resulted in increased use of such 
products by youth. Past efforts to oversee these ac-
tivities have not been successful in adequately pre-
venting such increased use. 
(16) In 2002, the tobacco industry spent more 
than $12,466,000,000 to attract new users, retain 
current users, increase current consumption, and 
generate favorable long-term attitudes toward smok-
ing and tobacco use. 
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(17) 
Tobacco 
product 
advertising 
often 
misleadingly portrays the use of tobacco as socially 
acceptable and healthful to minors. 
(18) Tobacco product advertising is regularly 
seen by persons under the age of 18, and persons 
under the age of 18 are regularly exposed to tobacco 
product promotional efforts. 
(19) Through advertisements during and spon-
sorship of sporting events, tobacco has become 
strongly associated with sports and has become por-
trayed as an integral part of sports and the healthy 
lifestyle associated with rigorous sporting activity. 
(20) Children are exposed to substantial and 
unavoidable tobacco advertising that leads to favor-
able beliefs about tobacco use, plays a role in leading 
young people to overestimate the prevalence of to-
bacco use, and increases the number of young people 
who begin to use tobacco. 
(21) The use of tobacco products in motion pic-
tures and other mass media glamorizes its use for 
young people and encourages them to use tobacco 
products. 
(22) Tobacco advertising expands the size of 
the tobacco market by increasing consumption of to-
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bacco products including tobacco use by young peo-
ple. 
(23) Children are more influenced by tobacco 
advertising than adults, they smoke the most adver-
tised brands. 
(24) Tobacco company documents indicate that 
young people are an important and often crucial seg-
ment of the tobacco market. Children, who tend to 
be more price-sensitive than adults, are influenced 
by advertising and promotion practices that result in 
drastically reduced cigarette prices. 
(25) Comprehensive advertising restrictions will 
have a positive effect on the smoking rates of young 
people. 
(26) Restrictions on advertising are necessary 
to prevent unrestricted tobacco advertising from un-
dermining legislation prohibiting access to young 
people and providing for education about tobacco 
use. 
(27) International experience shows that adver-
tising regulations that are stringent and comprehen-
sive have a greater impact on overall tobacco use 
and young people’s use than weaker or less com-
prehensive ones. 
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(28) Text only requirements, although not as 
stringent as a ban, will help reduce underage use of 
tobacco products while preserving the informational 
function of advertising. 
(29) It is in the public interest for Congress to 
adopt legislation to address the public health crisis 
created by actions of the tobacco industry. 
(30) The final regulations promulgated by the 
Secretary of Health and Human Services in the Au-
gust 28, 1996, issue of the Federal Register (61 
Fed. Reg. 44615–44618) for inclusion as part 897 
of title 21, Code of Federal Regulations, are con-
sistent with the First Amendment to the United 
States Constitution and with the standards set forth 
in the amendments made by this subtitle for the reg-
ulation of tobacco products by the Food and Drug 
Administration and the restriction on the sale and 
distribution, including access to and the advertising 
and promotion of, tobacco products contained in 
such regulations are substantially related to accom-
plishing the public health goals of this Act. 
(31) The regulations described in paragraph 
(30) will directly and materially advance the Federal 
Government’s substantial interest in reducing the 
number of children and adolescents who use ciga-
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rettes and smokeless tobacco and in preventing the 
life-threatening health consequences associated with 
tobacco use. An overwhelming majority of Americans 
who use tobacco products begin using such products 
while they are minors and become addicted to the 
nicotine in those products before reaching the age of 
18. Tobacco advertising and promotion plays a cru-
cial role in the decision of these minors to begin 
using tobacco products. Less restrictive and less 
comprehensive approaches have not and will not be 
effective in reducing the problems addressed by such 
regulations. The reasonable restrictions on the ad-
vertising and promotion of tobacco products con-
tained in such regulations will lead to a significant 
decrease in the number of minors using and becom-
ing addicted to those products. 
(32) The regulations described in paragraph 
(30) impose no more extensive restrictions on com-
munication by tobacco manufacturers and sellers 
than are necessary to reduce the number of children 
and adolescents who use cigarettes and smokeless to-
bacco and to prevent the life-threatening health con-
sequences associated with tobacco use. Such regula-
tions are narrowly tailored to restrict those adver-
tising and promotional practices which are most like-
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ly to be seen or heard by youth and most likely to 
entice them into tobacco use, while affording tobacco 
manufacturers and sellers ample opportunity to con-
vey information about their products to adult con-
sumers. 
(33) Tobacco dependence is a chronic disease, 
one that typically requires repeated interventions to 
achieve long-term or permanent abstinence. 
(34) Because the only known safe alternative to 
smoking is cessation, interventions should target all 
smokers to help them quit completely. 
(35) Tobacco products have been used to facili-
tate and finance criminal activities both domestically 
and internationally. Illicit trade of tobacco products 
has been linked to organized crime and terrorist 
groups. 
(36) It is essential that the Food and Drug Ad-
ministration review products sold or distributed for 
use to reduce risks or exposures associated with to-
bacco products and that it be empowered to review 
any advertising and labeling for such products. It is 
also essential that manufacturers, prior to marketing 
such products, be required to demonstrate that such 
products will meet a series of rigorous criteria, and 
will benefit the health of the population as a whole, 
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taking into account both users of tobacco products 
and persons who do not currently use tobacco prod-
ucts. 
(37) Unless tobacco products that purport to 
reduce the risks to the public of tobacco use actually 
reduce such risks, those products can cause substan-
tial harm to the public health to the extent that the 
individuals, who would otherwise not consume to-
bacco products or would consume such products less, 
use tobacco products purporting to reduce risk. 
Those who use products sold or distributed as modi-
fied risk products that do not in fact reduce risk, 
rather than quitting or reducing their use of tobacco 
products, have a substantially increased likelihood of 
suffering disability and premature death. The costs 
to society of the widespread use of products sold or 
distributed as modified risk products that do not in 
fact reduce risk or that increase risk include thou-
sands of unnecessary deaths and injuries and huge 
costs to our health care system. 
(38) As the National Cancer Institute has 
found, many smokers mistakenly believe that ‘‘low 
tar’’ and ‘‘light’’ cigarettes cause fewer health prob-
lems than other cigarettes. As the National Cancer 
Institute has also found, mistaken beliefs about the 
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health consequences of smoking ‘‘low tar’’ and 
‘‘light’’ cigarettes can reduce the motivation to quit 
smoking entirely and thereby lead to disease and 
death. 
(39) Recent studies have demonstrated that 
there has been no reduction in risk on a population- 
wide basis from ‘‘low tar’’ and ‘‘light’’ cigarettes and 
such products may actually increase the risk of to-
bacco use. 
(40) The dangers of products sold or distrib-
uted as modified risk tobacco products that do not 
in fact reduce risk are so high that there is a com-
pelling governmental interest in insuring that state-
ments about modified risk tobacco products are com-
plete, accurate, and relate to the overall disease risk 
of the product. 
(41) As the Federal Trade Commission has 
found, consumers have misinterpreted advertise-
ments in which one product is claimed to be less 
harmful than a comparable product, even in the 
presence of disclosures and advisories intended to 
provide clarification. 
(42) Permitting manufacturers to make unsub-
stantiated statements concerning modified risk to-
bacco products, whether express or implied, even if 
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accompanied by disclaimers would be detrimental to 
the public health. 
(43) The only way to effectively protect the 
public health from the dangers of unsubstantiated 
modified risk tobacco products is to empower the 
Food and Drug Administration to require that prod-
ucts that tobacco manufacturers sold or distributed 
for risk reduction be approved in advance of mar-
keting, and to require that the evidence relied on to 
support approval of these products is rigorous. 
SEC. 223. PURPOSE. 
The purposes of this Act are— 
(1) to provide authority to the Food and Drug 
Administration to regulate tobacco products under 
the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 301 et seq.), by recognizing it as the primary 
Federal regulatory authority with respect to the 
manufacture, marketing, and distribution of tobacco 
products; 
(2) to ensure that the Food and Drug Adminis-
tration has the authority to address issues of par-
ticular concern to public health officials, especially 
the use of tobacco by young people and dependence 
on tobacco; 
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(3) to authorize the Food and Drug Adminis-
tration to set national standards controlling the 
manufacture of tobacco products and the identity, 
public disclosure, and amount of ingredients used in 
such products; 
(4) to provide new and flexible enforcement au-
thority to ensure that there is effective oversight of 
the tobacco industry’s efforts to develop, introduce, 
and promote less harmful tobacco products; 
(5) to vest the Food and Drug Administration 
with the authority to regulate the levels of tar, nico-
tine, and other harmful components of tobacco prod-
ucts; 
(6) in order to ensure that consumers are better 
informed, to require tobacco product manufacturers 
to disclose research which has not previously been 
made available, as well as research generated in the 
future, relating to the health and dependency effects 
or safety of tobacco products; 
(7) to continue to permit the sale of tobacco 
products to adults in conjunction with measures to 
ensure that they are not sold or accessible to under-
age purchasers; 
(8) to impose appropriate regulatory controls on 
the tobacco industry; 
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(9) to promote cessation to reduce disease risk 
and the social costs associated with tobacco related 
diseases; and 
(10) to strengthen legislation against illicit 
trade in tobacco products. 
SEC. 224. SCOPE AND EFFECT. 
(a) INTENDED EFFECT.—Nothing in this Act (or an 
amendment made by this Act) shall be construed to— 
(1) establish a precedent with regard to any 
other industry, situation, circumstance, or legal ac-
tion; or 
(2) affect any action pending in Federal, State, 
or Tribal court, or any agreement, consent decree, or 
contract of any kind. 
(b) AGRICULTURAL ACTIVITIES.—The provisions of 
this Act (or an amendment made by this Act) which au-
thorize the Secretary to take certain actions with regard 
to tobacco and tobacco products shall not be construed to 
affect any authority of the Secretary of Agriculture under 
existing law regarding the growing, cultivation, or curing 
of raw tobacco. 
SEC. 225. SEVERABILITY. 
If any provision of this Act, the amendments made 
by this Act, or the application of any provision of this Act 
to any person or circumstance is held to be invalid, the 
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remainder of this Act, the amendments made by this Act, 
and the application of the provisions of this Act to any 
other person or circumstance shall not be affected and 
shall continue to be enforced to the fullest extent possible. 
PART I—AUTHORITY OF THE FOOD AND DRUG 
ADMINISTRATION 
SEC. 231. AMENDMENT OF FEDERAL FOOD, DRUG, AND 
COSMETIC ACT. 
(a) DEFINITION OF TOBACCO PRODUCTS.—Section 
201 of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 321) is amended by adding at the end the fol-
lowing: 
‘‘(nn)(1) The term ‘tobacco product’ means any prod-
uct made or derived from tobacco that is intended for 
human consumption, including any component, part, or 
accessory of a tobacco product (except for raw materials 
other than tobacco used in manufacturing a component, 
part, or accessory of a tobacco product). 
‘‘(2) The term ‘tobacco product’ does not mean— 
‘‘(A) a product in the form of conventional food 
(including water and chewing gum), a product rep-
resented for use as or for use in a conventional food, 
or a product that is intended for ingestion in cap-
sule, tablet, softgel, or liquid form; or 
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